State of Psychiatry in Europe

The definition of Europe raises some interesting questions both in geographical and political terms (see Muijen in this issue). The World Health Organization (WHO) European Region, for example, consists of 53 member states with a total population of around 900 million, with a large number of languages, religions, cultures and dialects, with significant variations in social, economic and political structures and systems. Not only is there a massive variation in the gross domestic product across countries, but within counties as well. These variations cause an increase in mental illness across countries and even within the same country. Needless to say, social variations affect longevity and physical illnesses as well. It is well known that the burden of disease is highest due to non-communicable diseases such as cancer, cardiovascular disease and mental illness. Changing social structures as a result of migration and globalization, along with changing demographic factors as more people living longer, will all affect the prevalence of mental illness and increase the burden on services. Mental illnesses are well known to have a public mental health facet, which is crucial in developing and delivering services. Between a quarter and a third of the population will experience a mental disorder and will require intervention. Even within the same country, the treatment gap is notable. Stigma and fear of prejudice stop people from seeking help. Countries within the WHO European Region have often developed local strategies and examples of good practice, but often these are not available to others. In the past, the International Review of Psychiatry has looked at the state of psychiatry in Asia and in Latin America. Hence, we decided to commission this volume to share knowledge and examples of good clinical practice in Europe. We would like to thank all the contributors who, in spite of their busy schedules, have delivered their papers on time. There are many lessons here to be shared across the WHO European Region.