Promoting appropriate health care in Europe - the case of psychiatry

Abstract

Nowadays different professions are involved in mental heath care in Europe, e.g. general practitioners, psychiatrists, psychologists, psychotherapists, social-workers, case-managers, prevention specialists, health ministry bureaucrats etc. As mental health represents a weak concept with vague and ambiguous definitions and delimitations it remains quite unclear who should be responsible for mental health today and in the future. In the last decades psychiatrists gained high expertise in treating mental disorders (e.g. psychopharmacological, psychotherapeutic and social measures) but lost terrain in mental health matters because of a lack of interest in such questions leading to the hardly acceptable contemporary situation that professionals without any psychopathological knowledge and without clinical experiences in mental illnesses as well as in the various transitional states between mental health and disordered health have taken the leading positions in the field of mental health care. Of course, the main tasks of psychiatry are to diagnose and to treat mental disorders, but as the prognosis of mental disorders and the treatment efficacy highly depend on the time of recognizing the disorder (the earlier the recognition of a mental disorders and the earlier the start of therapy the better the treatment out-come and prognosis) early recognition of mental disorders and prevention measures (esp. secondary and tertiary prevention) have to become core fields of psychiatry. Therefore psychiatry cannot any longer restrict itself to the treatment of severe mental disorders but has to take again a crucial role in future mental health care system in cooperation with other mental health stake-holders. This implies that future training programs for psychiatrists have to take into account such considerations and have to include beside usual fields of interests (e.g. psychopathology, neurosciences, psychopharmacology, psychotherapy, medical humanities, etc.) also topics like early recognition, transitional states and prevention of mental disorders as regular parts.