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A WHO research analyses the situation of mental health services in Europe

Published on 10.10.2023
Tampere University of Applied Sciences
TAMKin mielenterveys- ja päihdetyön yliopettaja Nina Kilkku.
Nina Kilkku believes that the information obtained from the research will benefit the development of mental health services in Finland as well.
The aim of the WHO (World Health Organization) Mental Health Workforce Research project is to conduct a situational analysis of the mental health services in European countries, the education and scope of practice of the mental health professionals, as well as the legislation guiding the mental health service provision. Results of the research will support the community- and right -based approach in transformation of mental health services towards the low threshold services and care provided already in primary health care level.

Principal Lecturer of Mental Health and Substance Abuse Care Nina Kilkku from Tampere University of Applied Sciences is leading the research which is funded by the Royal College of Surgeons in Ireland (RCSI).  

“In addition to services and professionals, we are also interested in the roles of the people with lived experience and the family members in different European countries. Their participation is important, but unfortunately its importance is not always recognized,” Kilkku adds. 

The research started in November 2022, and it is planned to end in September 2025. 

Human rights as the background 

The research is based on the WHO European Framework for Action on Mental Health 2021–2025 (EFAMH), which is supported by the Pan-European Mental Health Coalition. The coalition's activities are divided into six different work packages, one of which focuses on the transformation of mental health services, and the research led by Kilkku is part of this work package. 

“There are still many countries in Europe where the institutionalized care is primary on mental health problems. The institution based service system has been dismantled in many countries, but in some countries the number of bed sites in psychiatric hospitals has been somewhat increased. Of course, this may be due to changes in reporting, so the results are preliminary at the moment. It is important to develop community-based services and shift the emphasis of services to primary health care. This requires the right kind of know-how and competent professionals,” Kilkku says. 

The background of the research is on the human rights. Everyone has the right to receive help and support at the lowest possible threshold, even when there is no diagnosis. Fighting against the stigma of the mental health problems is also still very important. 

Multi-stage research 

The research has started by analyzing the information of the different databases about mental health services and personnel from 53 European countries. The information obtained from the databases is supplemented by interviewing, for example, organizations in the mental health field that are representing the various professional groups, people with lived experience and families. 

“Many knowledge gaps have been identified with the databases, so several extensive interviews will be conducted. There will be around 20 interviews,” Kilkku estimates. 

After the interviews, the pilot countries to be visited will be agreed upon with the WHO. During the country visits, interviews will be continued and various pre-constructed case descriptions will also be used to describe the availability of services, cooperation between the services and the scope of practice of professionals in the country in question. 

“Case descriptions can be used to find out, for example, what kind of service an 8-year-old boy or a middle-aged woman would receive, for example, in the Netherlands or Albania,” Kilkku elaborates. 

The research results will also be useful in Finland 

According to Kilkku, the findings so far are showing notable differences between European countries in the mental health service provision, in the number of personnel and in the length of educations. 

“The idea is not that all countries should have exactly the same services and features. Both the mental health service systems as well as the education systems in different countries have a very different historical, economic and political background, and we hope to be able to find out more about these during country visits.” 

Kilkku believes that the information obtained from the research will benefit the development of mental health services in Finland as well. In Finland, the national mental health strategy and suicide prevention program for the years 2020–2030 guide development activities in parallel with the European reference framework, but yet there still are many things to do also in Finland. 

“The information obtained from the research can also be used in the Finnish context in the development of mental health services, education and scope of practice of the professionals.”  

Read more about the WHO European Framework for Action on Mental Health 

Read more about The Pan-European Mental Health Coalition 

Read more about the National Mental Health Srategy and Programme for Suicide Prevention 2020–2030 

More information:
Nina Kilkku, Principal Lecturer, Tampere University of Applied Sciences
tel. +358 50 5118 754, nina.kilkku [at] (nina[dot]kilkku[at]tuni[dot]fi)


Text and photo: Emmi Suominen