Just over 25 years have passed since the major sociopolitical changes in central and eastern Europe; our aim was to map and analyse the development of mental health-care practice for people with severe mental illnesses in this region since then. A scoping review was complemented by an expert survey in 24 countries. Mental health-care practice in the region differs greatly across as well as within individual countries. National policies often exist but reforms remain mostly in the realm of aspiration. Services are predominantly based in psychiatric hospitals. Decision making on resource allocation is not transparent, and full economic evaluations of complex interventions and rigorous epidemiological studies are lacking. Stigma seems to be higher than in other European countries, but consideration of human rights and user involvement are increasing. The region has seen respectable development, which happened because of grassroots initiatives supported by international organisations, rather than by systematic implementation of government policies.

3rd Department of Psychiatry Institute of Psychiatry and Neurology Warszawa Poland

Association for the Improvement of Mental Health Programmes Geneva Switzerland

Clinic of Psychiatry Faculty of Medicine Vilnius University Vilnius Lithuania

Croatian Medical Association Zagreb Croatia; Croatian Society for Clinical Psychiatry Zagreb Croatia

Department of Clinical Psychology and Psychotherapy Babes Bolyai University Cluj Napoca Romania; Department of Forensic and Neurodevelopmental Science King's College London London UK

Department of Population Health London School of Hygiene and Tropical Medicine London UK

Department of Psychiatry and Narcology Belarusian Medical Academy of Postgraduate Education Minsk Belarus

Department of Psychiatry and Narcology Riga Stradins University Riga Latvia

Department of Psychiatry and Psychotherapy Semmelweis University Budapest Hungary

Department of Psychiatry Azerbaijan Medical University Baku Azerbaijan; National Mental Health Centre Baku Azerbaijan

Department of Psychiatry Narcology Psychotherapy and Clinical Psychology Samara State Medical University Samara Russia

Department of Psychiatry Psychology and Sexology Danylo Halytsky Lviv National Medical University Lviv Ukraine

Department of Psychiatry Yerevan State Medical University Yerevan Armenia

Department of Psychological Medicine Institute of Psychiatry Psychology and Neuroscience King's College London London UK

Department of Social Psychiatry National Institute of Mental Health Klecany Czech Republic

Department of Social Psychiatry National Institute of Mental Health Klecany Czech Republic; Health Service and Population Research Department Institute of Psychiatry Psychology and Neuroscience King's College London London UK

Department of Social Psychiatry National Institute of Mental Health Klecany Czech Republic; Health Service and Population Research Department Institute of Psychiatry Psychology and Neuroscience King's College London London UK; Institute of Global Health University of Geneva Geneva Switzerland

Health Service and Population Research Department Institute of Psychiatry Psychology and Neuroscience King's College London London UK

Ilia State University Tbilisi Georgia; Vytautas Magnus University Kaunas Lithuania; Human Rights in Mental Health FGIP Hilversum Netherlands

Mental Health Center Health Care Center Pljevlja Pljevlja Montenegro

Mental Health Center Prizren Kosovo

Mental Health Project in Bosnia and Herzegovina Sarajevo Bosnia and Herzegovina

Mental Health Resource Centre Ilia State University Tbilisi Georgia; Foundation Global Initiative on Psychiatry Tbilisi Tbilisi Georgia

National Center for Public Health and Analyses Sofia Bulgaria

University Psychiatric Clinic Ljubljana Ljubljana Slovenia; Department of Psychiatry Faculty of Medicine University of Ljubljana Ljubljana Slovenia

Erratum In

Lancet Psychiatry. 2017 Sep;4(9):e19. doi: 10.1016/S2215-0366(17)30214-6. PubMed

Comment In

Lancet Psychiatry. 2017 Oct;4(10):743-744. doi: 10.1016/S2215-0366(17)30359-0. PubMed

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