Implementation of mental health policies and plans across the WHO European region: Barriers and facilitators.

Mental health policies and plans (MHPPs) are powerful tools developed to facilitate real-world changes in mental-health-related prevention, promotion and treatment. This study examined barriers and facilitators to MHPP implementation across the WHO European region. Key informants from 53 countries were contacted and 25 provided in-depth qualitative interviews on MHPP existence, implementation, and evaluation related barriers and facilitators of implementation. We analyzed data via qualitative framework analysis approach aligned with the WHO Comprehensive Mental Health Action Plan 2013-2030. Reported facilitators included active involvement of key stakeholders, ongoing mental healthcare reform, bottom-up approach to implementation, sufficient funding, favorable political receptivity and strong monitoring. Barriers encompassed insufficient funding, workforce shortages, adequate training in psychiatry, missing or insufficient infrastructure in terms of both physical structures and technology for data collection, low political receptivity, stigma and bureaucratic obstables. While notable progress has been made in the development of mental health plans in the European region, substantial gaps remain in information systems, research capacity, and systematic evaluation frameworks on mental health and development of appropriate evaluation plans. Strengthening these components is essential to ensure the effective and sustainable implementation of MHPPs throughout the region.