Context of the conference

The modern transformation of the mental health field began in 1989 with the Velvet Revolution that fundamentally changed the way of life in the former Czechoslovakia. The formal end of communism opened space for civil society, including nongovernmental organizations (NGOs) for mental health and social care. Among these were associations of patients and service users as well as their relatives. At that time in mental health, the third sector was particularly focused on individuals who were most in need but were receiving the least care and resources.

In 1990 Dr. Jozef Hašto, former national chief psychiatrist, created the “Documents for the Reform of Psychiatric Care in the Slovak Republic” on behalf of the Slovak Minister of Health, Dr. Alojz Rakús. More than 160 psychiatrists, clinical psychologists, and nurses contributed to this groundbreaking plan for reform, accepted by the Minister of Health in 1991. This programme has driven the work of decreasing stigmatization, and eliminating the separation and even segregation of individuals with mental illness, while promoting integration and supporting other advancements in the field of mental health.

At this time, the World Health Organization’s (WHO) emphasis on mental health promotion and primary, secondary, and tertiary prevention broadened practitioners’ focus to averting the onset of mental illness among healthy populations. In addition, attention expanded to not only treatment but also rehabilitation of individuals with mental illness. The field of neuroscience confirmed that there is no health without mental health. With these advances, gradually more nations began prioritizing mental health as a critical component of a healthy society.

Against this backdrop, Slovakia undertook a three-year international project entitled “Transformation to an Integrated System of Mental Health Care” from 2002–05. This project was built on the model of tetralogue that had been developed in the preceding decade. A tetralogue is a dialogue of four parties: patients, their relatives, health/social care professionals, and representatives of general society, including collaborating institutions at the local, regional and national levels. The project’s goal was to create the preconditions for transforming the field of mental health according to the needs of the population. In 2005, the project was presented at the conference of European Ministers of Health in Helsinki.

At the same time, Slovakia created the National Programme for Mental Health (NPMH) ratified by the Government of Slovak Republic in October 2004. This document was consistent with the Declaration and Action Plan of Mental Health for Europe, that all European Ministers of Health signed at the Helsinki conference in 2005. In November 2005, the Government of Slovakia endorsed the Action Plan of the NPMH. Shortly after, the United Nations passed the Convention on the Rights of Persons with Disabilities in 2006.

In June 2005, WHO, the Slovak Ministry of Health, and the Slovak NGO, Integra, held an international conference on mental health in Bratislava, where the NPMH was presented. At this conference a delegation from California not only presented their own model of Mental Health Care, but also offered to cooperate with Slovakia in this endeavor.

Slovakia has implemented changes in many areas that are integral to the development of improved mental health care. These include facilitating a transition from institutional to community care, including the development of integrated outpatient and community-based services. Health care practitioners have also been trained in specialized psychiatric care, deinstitutionalization of the system of social care, and long-term care.

During this same period, the European Union included mental health among its priorities and signed a pilot project for psychiatric reform in the Czech Republic.
With this context and history, now is a good time for a conference to bring together stakeholders and interested individuals from many points of view to collaborate and network on such a complex topic. This can facilitate cooperation at the local, regional and national levels of Slovakia. Bratislava’s excellent geographic location will serve as an ideal gathering point to strengthen cooperation at the international level in this innovative field of mental health.