The role of national policies and mental health care systems in the development of community care and community support: an international analysis

BACKGROUND: The development of adequate community support of persons with severe mental health problems is an ongoing effort. National policies and national health and social care systems play an important role in the effectiveness of these efforts.

AIMS: To get a better understanding of the ways in which national policies and (mental) health care systems can enhance the development of community support and social inclusion for people with severe mental illness.

METHOD: A comparison was made between the experiences of 75 key persons on regional community support development regarding national policies and systems in Denmark, England and the Netherlands respectively.

RESULTS: Four themes stood out as being particularly instrumental in the development of community support: - implementation of a national policy on social inclusion, - development of a national framework of responsibilities, entitlements and services, - solid funding and social inclusion incentivizing reimbursement systems, - integrated care.

CONCLUSION: National governments do have opportunities to take or retake the lead to ensure that community support and social inclusion of persons with severe mental illness health problems are not just ideological slogans but solid policy.