Originality: This presentation focuses on past and current trends in deinstitutionalisation in mental health / psychiatric care in Europe, with a particular focus on EU Member States. The presentation will use a human rights lens to contextualise deinstitutionalisation that is an obligation on both the European Union and its Member States. Although the analysis will appraise major trends in deinsitutionalisation in the international level, it will build strongly on data from the country-level.

The problem: there are still over 100.000 people who live in psychiatric institutions, long-term hospitals or social care homes for people with mental health problems in Europe. Despite decades of efforts to close down these facilities, many European countries are struggling to implement deinstitutionalisation policies. Current EU and domestic policies are believed to both support and hinder progressive reforms. 

Methods: this presentation will build on policy analysis and statistical data about deinstitutionalisation in the mental health field, since 2010. Two ‘Mapping Exclusion' reports (2012 and 2017) by Mental Health Europe will provide the bulk of data covering 36 countries, other sources will include recent academic publications, WHO and EU Commission data, and EU and Member States reports submitted to the United Nations.

Results: Current reforms are influenced by both international and national factors. The UN CRPD is a common reference point in deinstitutionalisation policies but its implementation remains a question. EU Structural Funds provide financial source to implement reforms. Current programmes lack transparency and close monitoring in many countries. Parallel to deinstitutionalisation, the strengthening of community-based mental health services seems to be lacking in many countries, putting human rights principles and needs of service users at risk. Linkages with other policies, e.g. with legal capacity legislation need to be considered to achieve the full implementation of the CRPD.