Mental health reform: Europe at the cross-roads.

In June 2008, the European Commission (EC) will host a High Level Conference, under the auspices of Commission President José Manuel Barroso, to discuss the establishment of a new European Pact for Mental Health. This is the latest of several high profile initiatives on mental health to have taken place in Europe. Most notably, in 2005, the World Health Organization was instrumental in bringing together all of Europe’s health ministries to endorse an ambitious plan for the Region (World Health Organization, 2005). The EC added its weight to this trend with publication of a widely discussed Green Paper on a potential strategy for mental health later that same year (Commission of the European Communities, 2005). The subsequent failure of the EC to implement a strategy for mental health following consultation on the Green Paper and instead to focus its efforts on building consensus for action alongside Member States and other stakeholders through a non-binding Pact, has been viewed in some quarters as a major setback. Yet, for all its limitations, this Pact potentially is a very significant development. The new approach recognizes that the primary responsibility for action still rests with Member States and other stakeholders, but envisages an active role for the Commission to inform, complement, and encourage actions by these players. In this respect, it may be seen as being akin to the Open Method of Co-ordination (OMC), an approach that is used at EC level to help facilitate Member States to come together voluntarily to co-operate on health issues that are outside the competence of the European Union. However, what makes this initiative stand out from both the OMC process and past mental health initiatives, is the recognition that much of the action to both promote general population mental well-being and to address the needs of those living with mental health problems needs to be funded and implemented outside the health care system. Hence, the High Level conference is being organized jointly by DG Health and Consumer Protection and DG Employment, Social Affairs and Equal Opportunities. Moreover, there is a strong emphasis in the Pact process on