People centred mental health care. The interplay between the individual perspective and the broader health care context.

The three Editorials published in this issue of EPS examine the implications of recent mental health care developments emerging from the World Health Organization Policy Framework 'People-Centered Health Care' (WHO, 2007), five years after its promul-gation. The framework stated that health must be viewed in a broader context, with all stakeholders involved, as it is influenced by a complex interplay of physical, social, economic, cultural and environmental factors. The policy framework therefore re-established the core value of all people's health and well-being as the central goal of healthcare services. It also acknowledged the global challenges of: translating principles and goals, such as equity and fairness, into policies; developing health care programmes that are firmly grounded in ethical principles; ensuring quality of health care, patient safety and human dignity ; safeguarding patients' rights and needs, recognis-ing the key role of families, culture and society as broader psychosocial and cultural determinants of health; and upholding ethics related to medical prac-Although the importance of these criteria might now seem obvious, the overall history of health care systems shows that this is a rather recent view. In fact, before this last development, three eras of health-care provision styles can be identified: the age of patern-alism, the age of technological autonomy and the age of The age of paternalism characterized the early phases of medicine development and lasted until the 1960s. During this period, physicians had almost complete control over patient care, and patients placed all trust in their physicians. Patients did not question their physicians' skill levels, ethics or morals. Moreover, during this era, medicine focused mainly on alleviating symptoms, as opposed to taking care of meeting patients needs. Subsequently, economic and scientific advances radically changed health care over the decades. This age of technological autonomy of medicine was characterized by great progress, including many advances in various specialised fields, in the understanding and treatment of disease. During that era, patients, moreover, started to increase their power and their demands for autonomy. The patient–doctor relationship was therefore based on considerations of patient rights and informed consent. In the 1990s, services available and care levels provided began to be based on equations factoring in efficiency and cost containment needs. This age of bureaucracy led to the risk that the good of society overall , low staff morale and burnout could prevail over individual patient needs (Lasalvia et al. 2009; Priebe & Reininghaus, 2011). It also, …