Introduction

Between 12 and 15 January 2005, a World Health Organization (WHO) Ministerial Conference on Mental Health in Europe took place in Helsinki, attended by over 450 delegates and observers. Approximately half of the 52 member states of WHO Europe were represented by their respective health ministers; the others by ministerial delegates. Most country delegations also included psychiatrists and departmental heads with responsibility for mental health services. Additionally, the participant list included representatives from the Council of Europe, the European Commission and selected local and international nongovernmental organisations (NGOs), as well as service user and carer groups. In the course of the conference, the delegates joined in signing the Mental health declaration and Action plan for Europe (WHO Europe, 2005a, 2005b).

After Helsinki, the Declaration and Action plan were disseminated widely, and quickly became a touchstone for subsequent developments in mental health policy in Europe. Their implications were discussed at other meetings, such as that of the Leaders of European Psychiatry that took place a few months later, and a number of follow-up conferences were held on specific issues, led by WHO-designated collaborating centres such as those in Lille and Edinburgh. Bilateral initiatives were undertaken with specific member countries in Eastern Europe. Meanwhile, in October 2005, the European Commission issued a Green Paper on mental health (European Commission, 2005) that was a direct outcome of WHO's inter-ministerial conference, and which led to further rounds of consultation and new projects across the European Union (EU). WHO, for its part, invested in a survey intended to show how member states were enacting the priorities outlined in the Declaration and Action plan. The resulting report on Policies and practices for mental health in Europe (WHO Europe, 2008) was meant to establish a ‘baseline’ against which continued progress might be measured, thereby providing a renewed impetus for the policies laid out in the Declaration and Action plan.

In acting in this way, WHO was behaving as a typical international policy organisation. As Michael Barnett and Martha Finnemore put it, international organisations: