The Mental Health Europe Bucharest Manifesto calls for alternatives to the dominant biomedical model of psychiatry. It established a task force to investigate DSM-5 and develop the manifesto, which calls on organizations to take 8 actions, including ensuring users are involved in revisions to diagnostic systems and prioritizing research on positive mental health approaches. The task force is currently focused on monitoring DSM-5 and ICD-11, advocating for "sunshine laws" on pharmaceutical payments, and disseminating alternative practices.

1. The Mental Health Europe Bucharest Manifesto
“Beyond the bio-medical paradigm of DSM and ICD
diagnostic systems”
Pino Pini
Mental Health Europe
International Network Toward Alternatives and Recovery (INTAR)
Power to Communities:
Healing through social justice
University of Liverpool, United Kingdom
25th, 26th & 27° June 2014

2. Mental Health Europe (MHE)
A European non-governmental organisation committed to:
- the promotion of positive mental health and well-being
- the prevention of mental distress
- the improvement of care
- advocacy for social inclusion
- protection of human rights for people with mental health problems,
their families and carers

3. • Established in 1985 as the European branch of the World
Federation for Mental Health (WFMH) and is an
organisation in its own right since 1994
• Representing mental health in its broader sense:
No Health Without Mental Health!
• Official relations with WHO Regional Office for Europe
• Participatory status with the Council of Europe
• Liaison function for mental health promotion with the
European Commission
About Mental Health Europe

4. More than 85 member organisations
in 34 European countries
• Mental health promotion NGOs
• NGOs representing users of mental health services
• NGOs representing users’ families
• Other European NGOs in the mental health field
• Research and educational institutions
+ 60 individual members
MHE’s members

5.  Mental Health and Social Policy
 Mental Health and Human Rights
 MHE Thematic Committees
 European Projects
MHE’s areas of work

6. • Mental Health Europe (MHE), the leading independent, pan-European
mental health NGO, has for two years been calling for wider recognition
of the crisis of confidence in the increasingly biological/neurological
approach taken by Western psychiatry and for action to change the
culture and practice of mental health services to take better into account
the views, rights and lived experience of users of these services.
• MHE set up an expert Task Force to investigate, debate and report on the
development of DSM-5, its likely impact and on alternatives to the
wholly medical/biological approach to psychiatry which are effective and
which improve the lives and life chances of people with poor mental
health. Now after our first 18 months of work, we have set out a
manifesto for change.
The MHE Beyond the biomedical
paradigm Task Force

7. • At the conference “From stigma to inclusion- drivers of progress in the mental health field”
Bucharest, Romania, October 2013, the Task Force first presented the manifesto, which was
unanimously adopted by the meeting. It calls on organizations with power and influence in
the mental health field to take action which will move psychiatry and mental health
services towards more effective treatments and a greater respect for the human rights of
users.
• The manifesto (now translated into six languages) is composed of eight simple, achievable
points involving statutory bodies, such as the World Health Organization and the European
Union, political bodies, practitioners, medical insurance companies, service providers and
researchers, pharmaceutical companies and psychiatrists.
• None of the demands are new and our research tells us that they are supported by many
others in the field, but by bringing them all together for the first time, MHE hopes to spur a
debate which will change the way in which policy, research and practice in the mental
health field are conducted.
The MHE Beyond the biomedical
paradigm Task Force

8. -Task Force establishment, MHE board meeting, November 2012(1)
-MHE Position statement on DSM-5, February 2013 (2)
-Survey on the MHE position statement. March-April 2013 (3)
-Press release “More harm than good” concomitant with the DSM-5 publication, May 2013 (4)
-Task Force strategy, MHE board meeting, June 2013 (5)
-Monthly articles in the MHE newsletter (6)
-Support to initiatives of other European organizations (7)
-Press release “ Let the sunshine in”, WMHD 10 October 2013 (8)
-Bucharest Manifesto approval, MHE board meeting, November 2013 (9)
The MHE Beyond the biomedical
paradigm Task Force,
work accomplished so far

9. • Full Members:
Bob Grove -UK-; Stijn Jannes -B-; Vicente Ibáñez-Rojo -E-; Colette Versporten
-B-; Pino Pini -I-
• Correspondent members:
Josée Van Remoortel -B-; Elisabeth Muschik -A-; Nigel Henderson -UK-; Mary
Nettle -UK-; Stephanie Wooley -F-; kristijan Grdan -HR-, Birgitte Gorres -DE-;
Christa Widmaier-Berthold -DE-
• Staff:
Maria Nyman -B-
Members of the MHE Beyond the
biomedical paradigm Task Force

10. Mental Health Europe calls on:
1)The World Health Organisation (WHO) to ensure that the forthcoming revision of
International Classification of Diseases (ICD 10) takes fully into account the worldwide critique
of DSM-5 and involves people with lived experience of mental distress as equal partners in its
construction.
2) Medical insurance companies, service providers and planners to abandon DSM-5 as the only
source of criteria for access to treatment.
3) The American Psychiatric Association to respond to its critics and in particular to abandon
those new diagnostic categories which have no scientific basis and pathologise normal aspects
of human existence.
4) Pharmaceutical companies and research groups to register all trials on open access
databases and make all their trial data freely available for re-analysis.
The MHE Bucharest Manifesto’s
eight points

11. 5) The European Union, national and local governments to pass “sunshine” legislation which
makes public all payments made by pharmaceutical companies to practising clinicians, other
providers of medical treatments and services and to consumer and family organisations.
6) Research bodies to prioritise research into positive mental health and psychosocial
approaches to alleviating mental distress and to ensure that people with lived experience
participate in research as researchers and experts as well as subjects.
7) Mental health practitioners to abandon psycho-surgery altogether.
8) In view of the latest concerns about the over-diagnosis of ADHD and risks to the developing
brain from medication, MHE calls on psychiatrists to stop prescribing stimulants or other
psychotropic medication as a first response to distress or as long term therapy for children and
adolescents.
The MHE Bucharest Manifesto’s
eight points

12. • DSM 5 and ICD 11
• Sunshine laws
• Collecting and disseminating new methodologies
and practices both for comprehension of mental
health problems and for evaluation of alternative
approaches to the bio-medical model
The Task force currently is concentrating
mainly on the following points

13. • Permanent monitoring of the bio-medical approach in terms
of reliability and scientific validity
• Ensure that the forthcoming revision of International
Classification of Diseases (ICD 10) takes fully into account the
worldwide critique of DSM-5 and involves people with lived
experience of mental distress as equal partners in its
construction
• Develop an independent voice by making links with other
independent people and organizations and establish
contacts also with WHO
DSM 5 and ICD 11

14. • The European Union, national and local governments to pass
“sunshine” legislation which makes public all payments
made by pharmaceutical companies to practising clinicians,
other providers of medical treatments and services and to
consumer and relative organisations.
• Pharmaceutical companies and research groups to register
all trials on open access databases and make all their trial
data freely available for re-analysis.
• Contacts with MEPs in order to stimulate them to work on
the development of Sunshine laws.
Sunshine laws

15. • August 2013 letter of support to the EMA’s position in
relation to The Guardian’s website article “Big pharma
mobilizing patients in battle over drugs trials data” released
on Sunday 21 July 2013
• September 2013 withdrawal of the Mario Negri Institut from
an European research project with GSK for lack of
transparency
• October 2013 letter from European Federation of
Pharmaceutical Industries and Associations (EFPIA)
• November 2013 letter from European Association of Hospital
Pharmacists (EAHP)
Communications related to transparency
where the Task Force has been involved
to a certain extent

16. • February 2014 Johnson & Johnson announced that it would give all the
pharmaceutical clinical trial data it holds to researchers J&J is following the
work of GSK who in 2013 launched an online data sharing portal that has since
been joined by some other pharmaceutical companies
• April 2014 Public Petition PE01493 at Scottish Parliament: A Sunshine Act for
Scotland. "Calling on the Scottish Parliament to urge the Scottish Government to
introduce a Sunshine Act for Scotland, creating a searchable record of all
payments (including payments in kind) to NHS Scotland healthcare workers from
Industry and Commerce":
http://www.scottish.parliament.uk/GettingInvolved/Petitions/sunshineact
• June 2014 petition of Alltrials Campaign group trying to influence governments
to pass legislation that would compel all pharmaceutical companies and
academics who undertake drug trials to place all their data and results in the
public domain. http://www.alltrials.net/news/open-letter-to-the-ema-new-
proposals-will-make-scrutiny-of-data-almost-impossible/
More recent events related to
transparency

17. • Supporting the growth of non-medical approaches and users' knowledge
(Peer support , Recovery models, Hearing voices groups, Personal
ombudsman, Joint Experiences and Local mental health Systems, Individual
Placement Support, Open dialog, Soteria project, Harm Reduction
Approach, Trialog models, etc.)
• Safeguarding the autonomy of the different approaches and their reciprocal
interactions, avoiding the medical approach making non-medical
approaches subsidiary and dependent on the medical model
• Balance between biomedical approaches and other approaches
Collect and disseminate new methodologies and
practices both for comprehension of mental health
problems and for evaluation of alternative approaches
to the bio-medical model

18. • Library to collect books, articles videos, etc.
• MHE website, links with other websites
• MHE newsletter
• Events (conferences, seminars, meetings, etc.)
Instruments

19. • Advocacy France
• AISMe. Italy
• British Psychological Society
• Critical Psychiatric Network
• European Network of Users and Survivors of Psychiatry
• Finnish Association for Mental Health
• GGZ Netherlands
• International DSM 5 Response Committee
• INTERVOICE
• Lille WHO Collaborating Center
• Mind UK
• Society of Social Psychiatry and Mental Health (Greece)
Contacts with organizations

20. • Invite other people outside Mental Health
Europe to also join the task force
• Organize different kind of initiatives
• Organize a meeting with the new MEPs at the
EU parliament in order to stimulate the
development of sunshine laws both in
Europe and in the member states
What MHE intends to do

21. Thanks for attention
The MHE Beyond the biomedical
paradigm Task Force
MENTAL HEALTH EUROPE – SANTE MENTALE EUROPE aisbl
Boulevard Clovis 7, B-1000 Brussels
Tel +32 2 280 04 68 - Fax +32 2 280 16 04
E-Mail: info@mhe-sme.org
www.mhe-sme.org