The European Region had 15% of its population 65 years old or older and nearly 7% 75 or over in 2000, the world’s highest percentages. By 2030 these figures will increase to 24% and 12% respectively. The effect on health care will be amplified by a disproportionate increase in dementia, and depression, anxiety, schizophrenia, substance abuse disorders and delirium are also of major concern. Therefore effective services to treat mental illness in older people will become an ever-increasing imperative.