[A global reform of mental health care based on a community approach: the Belgian experience]

The developments in mental health care in Belgium over the last few years show that some major steps are already taken towards implementing community oriented care. In Belgium, we are going through a historic moment, as the proposed reform is ambitious but also complex. Indeed we talk here about a comprehensive mental health care reform which brings together federal, regional and community competencies.It aims to transform part of hospital care into community oriented care by e.g. creating mobile teams in the existing community care mechanisms.In the same time we are developing an operational approach to networking focusing on the needs of care users and of their families.In this paper, we will describe the content of the reform, its mechanisms and all care professionals involved. We will also present the progress of the exploratory phase by stressing not only positive aspects that highlight the evolving nature of our approach, but also the difficulties we are facing in implementing it.