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Child and Adolescent Mental Health in Europe

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Child and Adolescent Mental Health in Europe CHILD AND ADOLESCENT MENTAL HEALTH IN EUROPE: INFRASTRUCTURES, POLICY AND PROGRAMMES Neither the European Commission nor any person acting on its behalf is responsible for any use that might be made of the following information. The information contained in this publication does not necessary reflect the opinion or the position of the European Commission. The project has received funding from the European Commission Public Health Programme. More information on the CAMHEE project at: www.camhee.eu This document should be quoted: Braddick, F., Carral, V., Jenkins, R., & Jané-Llopis, E. (2009). Child and Adolescent Mental Health in Europe: Infrastructures, Policy and Programmes. Luxembourg: European Communities. Design by Rita Mickute. Formatting and design by Jurgita Sajeviciene. Printed by the services of the European Commission Contents An Introductory Word ............................................................................................................5 A Snapshot of Child and Adolescent Mental Health in Europe: Infrastructures, Policy and Programmes ..........................................................................7 A Collection of Country Profiles Belgium .....................................................................................................................................27 Bulgaria .....................................................................................................................................47 Estonia .......................................................................................................................................57 Finland .......................................................................................................................................65 Germany, Heidelberg ...........................................................................................................75 Greece .......................................................................................................................................89 Hungary ....................................................................................................................................97 Latvia .......................................................................................................................................103 Lithuania ................................................................................................................................113 Norway ...................................................................................................................................125 Poland .....................................................................................................................................139 Romania .................................................................................................................................159 Slovenia .................................................................................................................................. 167 Spain, Catalonia .................................................................................................................. 181 United Kingdom, England ................................................................................................195 Acknowledgements .......................................................................................................... 209 Annex I. CAMHEE Work Package 4 Partners ...............................................................210 3 An introduction to the country profiles This report presents an overview of the situation of child mental health policies and practices across 15 European countries/regions: Belgium, Bulgaria, Estonia, Finland, Germany (Heidelberg), Greece, Hungary, Latvia, Lithuania, Norway, Poland, Romania, Slovenia, Spain (Catalonia), and the United Kingdom (England). The country stories presented in this report have been prepared by the partners of the CAMHEE project who are key experts on child mental health in their respective countries. For the preparation of this report, the partners of each of 15 countries. have involved stakeholders in their countries to collect information about available policies, programmes, workforce and infrastructures for mental health promotion, mental disorder prevention and care in childhood and adolescence. This document is not an official and exhaustive account, but rather a snapshot of the current situation and a first attempt to collect comparable baseline information on the general situation in the field of child mental health policies and practices across countries and regions within the enlarged European Union. This process, initiated by the CAMHEE project, and supported by the European Commission, will hopefully act as an impetus and have a positive impact on development of effective child and adolescent mental health policies and practices across Europe. One of main goals of CAMHEE project was to provide new opportunities for the newer EU Member states to move towards evidence-based CAMH policies and a modern culture of management and evaluation of activities within the CAMH field. The design of the project brought together state agencies, academic centres and NGOs from both “old” and “new” EU Member States, so that creative networking and “cross-fertilization” between different partners could facilitate mutual learning, addressing challenges and identifying new opportunities. The significance of this process of networking within the CAMHEE project and its results was increased through synergy with new developments in EU Mental health agenda, especially with the launch of the European Pact on Mental Health and Well-being. The results of this exercise, as well as the process of dialogue, raising awareness and networking between partners in 15 countries, revealed many gaps in different levels which need to be filled with evidence- based practices for the promotion of mental health and prevention of mental disorders in childhood and adolescence. These gaps – such as lack of evidence-based CAMH policies, lack of political will to implement existing policies and programmes, low level of investment in modern culture of evaluation and monitoring of policies and services and lack of sustainable preventive programmes – need to be addressed in all EU countries. New EU Member states need to demonstrate a clear political will and to invest in child mental health in ways based on evidence and European values. On behalf of CAMHEE project leadership, I would like to thank all partners who contributed to this report. Dainius Puras Scientific leader of CAMHEE project 5 SLOVENIA A Snapshot of Child and Adolescent Mental Health in Europe: Infrastructures, Policy and Programmes Prepared by Vanesa Carral, Fleur Braddick, Eva Jané-Llopis and Rachel Jenkins 1.INTRODUCTION The foundation for good mental health is laid in the early Child mental health policies are stimulated by the years and society as a whole benefits from investing in interaction of knowledge, public awareness, social children and families. mobilisation and advocacy. They are also influenced Fortunately, the majority of young people in the EU enjoy by other contextual issues such as historic and existing good mental health. However, on average, one in every health, social and educational policy and services. The 5 children and adolescents suffers from developmental, need to develop policy on child mental health has, sadly, emotional or behavioural problems and approximately 1/8 been widely neglected, but is now recognised as a crucial have a clinically diagnosed mental disorder. Unfortunately, first step in the development of accessible and effective new and applicant countries are facing larger problems services for children2. As well as policy, detailed strategic in the field of children and adolescent mental health action plans, identification of entry points and levers for (CAMH), revealed by strikingly high rates of ill-mental change are all crucial. A strong supporting infrastructure health among children and young people. Therefore, and facilitators for change, as well as regular audit and there is a clear and urgent need for development of review will be needed at the ground level to enable effective CAMH policies and practices in enlarged Europe practice to effectively represent the policy behind it. and for a creative process of interaction and a proactive exchange of information between European countries. The overall objectives in developing these CAMHEE Country Profiles are 1) to monitor and map, as far as The CAMHEE Country Profiles have been developed with possible within the scope of this exercise, available the intention of beginning the process of analysing the infrastructures, policies and programmes for CAMH situation regarding CAMH in participating countries across the 15 partner countries involved in the CAMHEE and identifying obstacles and opportunities to develop network; 2) to analyse these aspects of CAMH at the evidence-based and multi-sectoral national CAMH European level in order to begin to identify gaps and policies within the enlarged EU. While it is understood support recommendations for policy and infrastructure that the situation analyses complied in the country stories development for CAMH; 3) to develop and produce can never be exhaustive and will represent mainly the detailed Country Profiles, focusing on CAMH, for 15 perspectives of the multiple stakeholders consulted by European countries. the authors for each country, this work aims
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