Mental health reforms in Eastern Europe.
OBJECTIVE
To describe the background in general culture, public and professional discourse against which mental health care reform initiatives in Eastern Europe need to be seen.


METHODS
An account of some key aspects of sociopolitical and cultural transition in Eastern European countries is given, and core results of a research project on attitudes and needs assessment in psychiatry in six Eastern European countries are reported.


RESULTS
In post-totalitarian cultures mental health reforms impinge on imagination in ways which are not easy to predict. Some of the reasons for this are traced to the psychiatric practices under the system of total control, e.g. dispensary care, political abuse, reification of classificatory terms. Data on a study of attitudes suggest that institutions had replaced community life in those parts of Europe.


CONCLUSIONS
It is predicted that with time trust in the capacity of community to contain mental illness will be regained.
Tomov
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Department of Psychiatry, University Hospital Alexandrovska, Sofia, Bulgaria. ttomov@sun.medun.acad.bg
D003469:Culture; D005061:Europe, Eastern; D018166:Health Care Reform; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D011057:Politics; D012959:Socioeconomic Factors