Psychiatric services in Europe are experiencing a period of change, driven by political commitment at national and intergovernmental levels in response to the public health challenges posed by mental health problems. However, diversity among European countries makes any generalization speculative. Resources such as funding, workforce, and infrastructure vary dramatically, and new investment is limited. Some European countries can take pride in sophisticated service systems, whereas others continue to rely almost exclusively on asylums. Reforms are hampered by a lack of comparable information and a lack of research, particularly in less developed countries. However, many exciting local initiatives are emerging, even in the poorest countries. The challenge will be to translate good local practice into national policies and practice, supported by adequate resources.