Central to improving quality of mental health services is an optimization of the structures and processes provided to people with mental disorders in Europe.

To improve the quality of mental health services in Europe by developing a European guidance focusing on the quality of mental health service structures in Europe.

The main aim of this guidance is to provide recommendations based on the best available evidence for optimal structures of mental health services by identifying and evaluating the available evidence including a comparison between the efficacy of different service structures wherever possible.

Systematic literature review and expert consensus survey about questions of the structural and process quality in European mental health services.

Sixteen recommendations were developed for mental health service structures, five for mental health service processes, and four for both mental health services and structures. The recommendations span a large number of mental health services factors including - among others - structural aspects of mental health services, psychiatric workforce numbers, kinds of inpatient and outpatient services and their integration, mental health monitoring and mental health education, admission procedures and safety aspects.

Evidence regarding the quality of mental health services is mainly limited due to the small number of studies and the national or regional peculiarities of mental health service structures which make generalizations difficult. Nevertheless, twenty-five recommendations could be arrived at and future research should aim at investigating whether the implementation of these guidelines is effective in improving European mental health service structures.