Mental health problems account for approximately 20% of the total burden of ill health in Europe (WHO, 2004a). This estimate of burden is just the tip of the iceberg; what makes mental health almost unique is the broad impact it can have on all aspects of life, including physical health, family relationships and social networks, employment status and contact with the criminal-justice system. A high level of stigma associated with mental health problems can also lead to discrimination and reduced self-esteem. The economic costs of poor mental health are very high because of these multiple adverse consequences. Promoting good mental well-being and intervening to tackle the consequences of poor mental health should logically be a major priority for health policymakers across Europe. However, both the development of national policies and the level of funding for mental health are limited. Mental health promotion continues to be a low priority in most countries; instead, the emphasis is placed on treating the clinical aspects of mental health problems with much less attention paid to the broader environmental and social consequences. The development of community care-led systems of mental health care is patchy, and fundamental abuses of human rights continue to occur, most visibly, but not exclusively, within institutions in central and eastern Europe. The concept of empowering service users to be involved in making informed decisions about which services best meet their needs is still not widely implemente