Provision of holisitc, accessible and high quality mental health care to the patients requires sharing of responsibilities & resources, enhanced communication & collaboration at the interface (primary care systems and secondary care mental health services). An innovative model of single point of care for people with severe and enduring mental health problems hosted at a primary care (GP) setting has been developed and evaluated in Walsall, UK.

To develop and evaluate an integrated (multidisciplinary) approach of managing health & social care needs of people with severe mental health disorders.

People with severe & enduring mental health problems were reviewed in primary care (N=65). A comprehensive physical, mental and psychosocial assessments were undertaken by the clinicians that included GP, Psychiatrist and Care-Coordinator.The reviews included: 1) A review of physical health indicators based on the Lester toolkit by practice pharmacist/nurse, including lifestyle, body weight, BMI and blood pressure. 2) Individualised interventions included physical / psychiatric prescribing, social prescribing and advise on lifestyle changes. Stable patients were recommended for stepping down from the secondary care. Outcomes included Patient Satisfaction Questionnaire (PSQ).

Satisfaction on the PSQ was rated from very good to excellent. Results highlighted multiple benefits including trust generation, improved communication among professionals, physical health screening and prompt clinical decision making (e.g. referral / prescribing). Other benefits included patient access & satisfaction, time and cost efficiency by reducing the number of reviews.

The integtrated CPA reviews offers efficient, holisitc & cost effective model of care with high satisfaction levels for patients and is replicable.

No significant relationships.

Psychiatric services in LEDCs face a tripartite challenge: (i) limited financial capital; (ii) scarcity of professionals; (iii) restrictive health beliefs. Inevitably, services developed for the first-world are ill-suited here. Psychiatric services must be designed from the ground up: inspired by but not a replica of best practices in the developed world. The SOUL project in Larkana, Pakistan provides home based assessment by a psychiatrist and fortnightly treatment by a mobile nursing team for schizophrenic patients. Psychoeducation of carers and the community as well as facilitation of work for patients are core aims. This mixed-methods study evaluates the experiences of primary stakeholders - patients and their carers.

1.Are patients and carers satisfied with the care received? 2.Has SOUL been successful in changing health beliefs? 3.How could the programme be improved?

The principal investigator accompanied the team for 4-weeks. Purposive sampling was employed. Satisfaction was assessed quantitatively using the likert based PSQ-18 questionnaire. Thereafter, qualitative data was gathered using semi-structured interviews and analysed using a grounded theory approach. A total of 27 interviews were conducted before data saturation.

100% of interviewees answered ’Satisfied’ or ’Very’ Satisfied to all elements of the PSQ-18. Above all, stakeholders valued that treatment was free and highly accessible (home visits), promoting treatment adherence. They felt psychoeducation events significantly reduced community stigma and made families more likely to seek psychiatrists over faith healers. Provision of respite care was suggested as a future improvement.

SOUL is highly valued by stakeholders and offers an excellent example of LEDC psychiatric care.

No significant relationships.

Despite the limited evidence about the efficacy and safety of dietary supplement use for mental health, people tend to use them quite often. Generally the use of supplements among Saudi population shown to be prevalent, although limited studies that assessed their use for the improvement of mental health.

Identify the prevalence of dietary supplements use for mental health among the population in Saudi Arabia and also determine the factors that affect the use of dietary health supplements for mental health.

A cross-sectional study of a convenience sample of 443 participants from various regions in Saudi Arabia. Questionnaire includes demographics, dietary use supplement assessment, and mental health assessment via the patient health questionnaire (PHQ-9), generalized anxiety disorder questionnaire (GAD-7), and insomnia severity index (ISI).

The prevalence of DS among the Saudi population reached 44%. Vitamin D and Melatonin were the most commonly reported DS used for mental health among the study population. The use of DS was associated with three times higher odds in patients who had previous mental health disorder diagnoses (OR 2.972; 95%CI; 1.602-5.515). The chance of using DS almost doubled in patients with subthreshold and moderate-severe insomnia (OR 1.930;95% CI 1.191-3.126) and (OR 2.485; 95% CI 1.247- 4.954) respectively.

Despite the limited evidence about the efficacy and safety of dietary supplement use for mental health, people tend to use them quite often. Although the use of supplements among Saudi population shown to be prevalent, limited studies assessed their use for the improvement of mental health.

No significant relationships.

Although integrated community care programs specifically tailored to patients with severe mental illness (SMI) are available, recent studies show that these programs are not always provided to the population which would benefit the most from it.

Aims of this study were the selection of clinical and psychosocial characteristics and the development of a screening algorithm indicating the need for integrated community care services in people with mental disorders.

Data of an observational longitudinal study including N=511 participants has been used to examine the hypothesized determinants. At baseline, self-reported empowerment has been assessed via the EPAS and psychosocial impairment and perceived needs have been rated by research workers via the HoNOS and the CAN, respectively. Use of integrated community care services was defined as at least four appointments with service providers over six months and has been recorded via the CSSRI twelve to 18 months after baseline. Mixed-effects regression analyses have been performed to test the predictive value of the hypothesized determinants and marginal predictions were used to define cut-offs for the assessment tool.

EPAS, HoNOS and CAN scores each proved to be significant predictors for using integrated community care services. Cut-off scores for each predictor are presented, forming practical assessment guidelines for future studies.

A screening tool and an algorithm for the identification of mentally ill patients who can be expected to benefit from integrated community mental health care programs is available for the German health care system.

No significant relationships.

Previous studies have found long lasting cognitive delays among children with early childcare experience, especially institutionalised experience. However, little is known about institutions’ effect in late childhood.

Our goal is to identify the characteristics of cognitive functions in connection to attachment related anxiety among adopted children and children living in institutional care.

The participants’ (N=68, Mage=14.20, 29 boys and 39 girls) cognitive functions were measured with the following tests: Rey15 Memory Task, Knock And Tap Task, Simon Says Test, Verbal Fluency Task, D-KEFS 20 Questions Test. Participants completed two questionnaires: the Family Affluence Scale and the Experiences In Close Relationships Revised Scale. The results from the adopted children (N=19) and children living in institutional care (N=18) were compared to the matched control group: children living with their biological parents (N=31).

Children living in institutional care did not differ significantly from their (SES-based) matched controls. Children adopted after the age of 2 years (N=7, M =56,57month) and the low SES control group (N=14) differed from the high SES control group on tests of attention (Verbal Fluency Task, Mhigh.c.=212.50, Mad.aft.2=193.50, U=59.50, z=-2.62, p=0.009) and verbal memory (Rey15, Mhigh.c.=17.94, Mad.aft.2=9.18, U=35.00, z=-2.79, p=0.005). Children adopted before the age of 2 years differed from the high SES control as well, in inhibition (Simon Says Test, Mhigh.c.=12.26, Mad.bef.2=18.88, U=55.55, z=-2.23, p=0.026).

Our findings suggest that only in the early years is child protection experience associated with long-lasting cognitive delays and attachment related anxiety.

No significant relationships.

Measurement-Based Care (MBC) is an emerging healthcare model with a number of potential advantages over traditional approaches for the treatment of substance use disorder (SUD). Despite SUD treatment programs being theoretically well suited for the implementation of MBC, its uptake has been minimal, which in turn limits further research, knowledge synthesis, and translation into clinical practice.

The goal of this knowledge synthesis project is to stimulate greater consideration of MBC models in addictions programs, with three interrelated objectives: 1. To summarize the existing evidence from research literature 2. To complement the literature findings with the data from our clinical research and quality improvement projects 3. To explore potential risks and difficulties of MBC implementation in the SUD treatment programs

Narrative review. Knowledge synthesis.

To date, only two published randomized controlled trials, which along with the data from our pragmatic clinical research, support the wider implementation of MBC in the substance abuse treatment settings, but also indicate the high need for larger-scale clinical trials and quality improvement programs. Potential barriers to the implementation of MBC for SUD are outlined at the patient, provider, organization, and system levels, as well as challenges associated with the use of MBC programs for clinical research. Critical thinking considerations and risk mitigation strategies are offered toward advancing MBC for SUD beyond the current nascent state.

The state-of-the-art of MBC in SUD care settings reviewed and the strategies for further development from adminsitrative, clinical, and research prospectives outlined.

No significant relationships.

Non-suicidal Self-Injury (NSSI) refers to causing damage on body tissue without attending to death. It is mostly presented among the youths and not approved by the society. Studies nowadays have explored the perspectives, feelings or experience of the youths or healthcare professionals. However, negative feelings and misunderstandings toward each other remain from both sides.

The aim was to explore the encountering experience of the youths with NSSI and the healthcare professionals during the same hospitalization in a psychiatric acute ward.

Qualitative study was employed by using narrative approach. In-depth interview was conducted for the youths with NSSI and their primary nurse and resident from a medical center in southern Taiwan.

Narratives from the patients and healthcare professionals showed that the youths seemed to be comfortable as encountering with the healthcare professionals’ caring. In contrast, the healthcare professionals’ struggles had been hidden inside and remained uneasy and unsolved. Two extreme experiences have been reported by the youths with NSSI: felt satisfied and understood about being cared vs. felt numbness and not been understood. Four kinds of experience were identified as: struggling on caring them, feeling confused and helpless, keeping a safe distance, and having contradicted values.

This study found that the healthcare professionals suffer from varied aspects when encountering the youths with NSSI, which they often hid inside without expressing. Future improvement such as care guideline or staff’s support system should be built to decrease the negative effects inside the healthcare professionals’ mind.

No significant relationships.

People with mental illness (MI) have a reduced life expectancy compared to the general population, mostly attributable to somatic diseases caused by poor physical health. Lifestyle factors (exercise, sleep, diet, substance use) are associated with poor physical and mental health. Although lifestyle factors, and physical and mental health are believed to be interconnected, research has mainly focused on one-sided relationships. Currently, we are implementing a lifestyle focussed approach in treatment, in which we assess lifestyle factors as well as physical and mental health of people with MI on a large scale (˜850 places of residence).

To investigate the association between lifestyle factors, and physical and mental health in people with MI.

Baseline data from an open cohort cluster randomized stepped wedge study. Lifestyle factors (exercise, sleep, diet, substance use), physical health, medication use and psychological health (symptoms, quality of life) were assessed using data from patient files and questionnaires. Associations will be analysed with network analyses.

First results (N≈1600) show that 54% of patients have high blood pressure, 51% have excessive waist circumference, 46% are experiencing sleep problems, 71% smoke and 88% do not meet exercise guidelines. Patients experience a lower quality of life compared to the general population.

Initial results show that patients have poor physical health, low quality of life and an unhealthy lifestyle. Further analyses are currently being conducted to gain insight in the complex pattern between lifestyle factors, and physical and mental health. This can contribute to the improvement of routine clinical care.

No significant relationships.

Despite the increasing evidence for the efficacy of lifestyle interventions for people with mental illness (MI), there has been little change in routine clinical care. There are several factors that can complicate or facilitate the implementation of a lifestyle intervention. Gaining insight into such factors can contribute to effective integration into clinical practice.

To assess the perceived barriers and facilitating factors of healthcare professionals (HCPs) and inpatients of psychiatric wards for the use of a lifestyle focused approach, prior to its implementation.

Baseline data from an open cohort cluster randomized stepped wedge study. Barriers and facilitators with regards to the intervention, HCPs and inpatients, and the organization were assessed with the measurement instrument for determinants of innovations, online, or through a semi-structured interview.

Initial results show that inpatients (N=167) experience both barriers and facilitating factors with regards to themselves and the innovation. They perceive the innovation as complex and see few personal benefits, but indicate that they consider it part of their treatment. Healthcare workers (N=77) perceive facilitating factors related to themselves and the organization, such as expected support, but were not sufficiently aware of the content of the innovation. More detailed exploration of relationships with demographic and disease-related factors are currently being conducted.

These findings provide insight into the perceived barriers and facilitators of inpatients and HCPs regarding a lifestyle focused approach, prior to its implementation. More insight into relationships with demographic and disease-related factors can benefit application into routine clinical care.

No significant relationships.

knowledge and atittudes of psychiatric nurses should be continuously evaluated and updated to ensure a quality care in electroconvulsive therapy (ECT) unit.

Assessment of the psychiatric nurses knowledge and attitudes towards ECT.

A cross sectional descriptive study was conducted in multiples psychiatric departments in Razi Hospital Tunisia between January and April 2021.We asked 30 psychiatric nurses using a questionnaire evaluating their knowledge and attitudes towards ECT technique and its impact on the medical care.

Our study revealed a lack of knowledge on ECT among psychiatric nurses.In fact, 93% of nurses reported that schizophrenia represents the most frequent indication. Pregnancy was considered as a contraindication by all participants. ECT was not recognized as a first line treatment and Only few knew the complet medical checkup before ECT.As for their opinion about this technique, 73 % of the nurses have a positive attitude towards ECT and think that it is very effective .

Nurses have a major role in the progress of every ECT-session .For that, specific training can only improve their knowledge and promote more positive attitude toward ECT.

No significant relationships.

Women receiving a prenatal diagnosis of fetal anomalies are a high-risk population for psychological distress leading to mood disorders. Even so, to date we have no evidence of studies who investigated the levels of maternal anxiety and depression in pregnant women receiving a prenatal diagnosis of fetal CNS anomalies.

The aim of this study was to assess the prevalence of anxiety and depression levels in a pilot sample of pregnant women at the Prenatal Diagnostic Unit of the Bambino Gesù Children Hospital.

We collected data among 43 women who receipt fetal brain anomaly diagnosis (mean age: 35 yrs, SD ± 6.3, range 19-48 yrs; mean week at first access 26w, SD ± 3.9, range 18-33w). Prenatal diagnosis including: ventriculomegaly (37.2%), posterior cranial fossa (23.3%), choroid plexus cysts (11.6%), anomalies of CC (7%) and other (20.9%). Pregnancies with assisted reproductive technology were 14%. We use the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorders (GAD-7) questionnaires to assess anxious-depressive symptoms.

showed a rate of mild-to-severe anxious depressive symptoms by 60.5% and 48.8% respectively. In detail: 41.9% mild, 14% moderate and 4.7% of severe anxiety. Meanwhile, 41.9% mild and 7% moderate depression. The prevalence of comorbid depressive and anxiety symptoms was 39.5% among the entire sample.

Preliminary data showed a high prevalence of anxious depressive symptoms and comorbidity among pregnant with CNS fetal anomalies. Women receiving a fetal CNS anomaly diagnosis may need additional psychological support or counselling.

No significant relationships.

The consequences of schizophrenia stigma are numerous and highly damaging to individuals, their families, the health care system and society. Mental health professionals (MHP) are considered to be one of the main sources of stigmatization.

To identify the characteristics of MHP stigma in schizophrenia in comparison with other psychiatric disorders, the specificities of MHP compared with other social groups, and associated factors.

Following PRISMA guidelines, we systematically searched multiple electronic databases for articles: (i) reporting original data published in English in peer-reviewed journals, (ii) reporting quantitative data with statistical analysis, (iii) assessing stigma in a broad sense, and (iv) including samples composed only of MHP.

A total of 38 articles published from 1999 to 2019 and involving 10926 MHP fulfilled our inclusion criteria. Studies showed that schizophrenia is the most stigmatized mental illnesses in MHP, despite recent results suggesting that borderline personality disorder and substance abuse may be more stigmatized. In comparison with other social groups, MHP reported less dangerousness beliefs and more positive beliefs regarding pharmacological treatment. Nevertheless, results were less consistent regarding prognosis and desire for social distance. Age, education level, type of mental health profession, or length of practice were associated factors that showed inconsistent relations with stigma. Work setting and biological causal beliefs were more clearly associated with MHP stigma.

These findings provide strong support for the need to conduct specific research on schizophrenia stigma in MHP and the importance of controlling for several variables to identify predictors of stigma.

No significant relationships.

There is increasing number of head and neck tumors. Modern medical technologies allow to save lives, but lead to cosmetic and functional defects. DSM-V clarifies that “life threatening illness or debilitating medical condition is not necessarily considered a traumatic event”. However, cancer diagnosis and treatment influence on mental health. Patients after surgery of head and neck tumors need special rehabilitation, because of loss or impairment of speech function. This significantly reduces communicative potential, changes social status, reduces rehabilitation potential.

During 6 years we have conducted studies to improve methods of psychological and pedagogical diagnostics, optimize speech therapy and psychological support for increasing effectiveness of speech rehabilitation.

Speech rehabilitation was carried out with correctional-pedagogical technologies and psychological support. We used Achieving Tendency Scale, Questionnaire measures of Affiliative Tendency and Sensitivity to Rejection, narrative interview, Scale of speech utterance implementation, rehabilitation potential evaluation, general condition assessment by ECOG and Karnovsky, auditory assessment. Speech therapy included methods for eliminating dysphagia, normalizing speech breathing, improving utterance realization. Psychological support kept meaning-narrative approach.

Number of patients without difficulties or with slight difficulties in speech utterance implementation increased by 57.1%. Number of patients with high rehabilitation potential increased by 48.8%.

Psychological and pedagogical rehabilitation and resocialization after surgery of head and neck tumors has positive effect on mental health of patients, forms special rehabilitation motivation, helps to avoid disability and to transform life in new conditions.

No significant relationships.

Spain went into lockdown in March of 2020 due to the COVID-19 outbreak. We had to stop the third randomization of our ongoing clinical trial (Mediavilla et al., 2019), pausing weekly group psychotherapy for 12 people with a first episode of psychosis. Only 5 weekly sessions had been delivered, thus many were just starting to form a therapeutic link with the group. In a public health emergency context, psychotherapeutic groups are considered avoidable gatherings. However, stopping psychological therapy abruptly can make participants more vulnerable. The intervention groups were launched in an online format because we could not let anyone go without psychological support in such a difficult time.

Communicate how we adapted an ongoing clinical trial to an online format during the lockdown in Spain.

In light of our participants’ needs and their acute deterioration the first two weeks of lockdown, we adapted our intervention. First, both arms (mindfulness-based v. psychoeducational multicomponent intervention) began online adaptations of the interventions. Second, a research assistant made weekly phone calls to provide basic psychosocial support, assure participants groups would continue, and later remind them of each online session. Third and last, the phoneline was accessible 24/7 (WhatsApp).

The third randomization concluded in December. Six participants were lost in the transition to online groups. However, adherence was comparable to the previous two randomizations (4/12 completed the intervention).

Online psychotherapy may be used in emergencies such as a lockdown. However, the psychological mid- and long-term effects of a lockdown and online group therapy remain unknown.

No significant relationships.

BPD are often characterized by dependence, affectability, unpredictability, impulsivity and self-destructiveness. Paradoxically, the symptoms associated with BPD are the same behaviors that makes them difficult to accommodate by health professionals. They constitute the most excluded and stigmatized patient group.

To gain knowledge on how BPD patients felt acknowledged when they experienced the need for professional help.

We conducted semi-structured interviews with six BPD-women, aged between 18 to 46, all inpatient at different psychiatric units in the Capital Region of Denmark. The data were analyzed and interpreted through meaning condensation. We entered the philosophical hermeneutic framework of Hans-Georg Gadamer.

We found that the women experienced that; the diagnosis was a filter, in which they were always viewed and judged through as “just another BPD-patient” and not a unique individual. their cry for help was expected to be verbalized in a certain manner and therefore was often not understood nor heard, but instead they experienced to be scolded by health professionels. the emergency plan became a legitimate way for the health care professionals to avoid spending to many resources, rather than a helpful tool. the psychiatry as a unit was largely characterized by stigmatization and a distrustful attitude towards them. Therefore they felt deeply dependent on meeting that one special health professional who were experienced to have a genuine interest and desire to help them.

Findings correspond with the findings of existing research. Hence, there also seems to be significant barriers nationally for patients with BPD to experience being acknowledged and helped, when in need of professional help.

No significant relationships.

Referral is not a necessity for a patient who wants to get psychiatrist consultation in Latvia. The good thing about it is the availability and the possibility to consult with highest educated mental health specialist for any person in society without barriers. On the other hand, there is an overwhelming work load for psychiatrists.

To explore the prevalence of self-referred patients in out-patient care and the adherence to psychiatrist recommendations.

The medical documentation of all consecutive first-time out-patient center “Pardaugava” psychiatrist patients over the period of 01.01.2020. to 30.04.2020. with one year follow-up was analyzed.

236 patients were included in the study, 31.2% of them were men. The average age was 49 (SD ± 22.65) years. Patients with Affective (F3X) and Neurotic (F4X) disorders were self-referred more often compared to Organic mental (F0X) disorder or other spectrum patients (83.3% and 77.5% vs 33.3% or 56.0%, p<0.001). Median appointment count was 4, higher in F4X (6) and lower in F3X patients (2). Majority of F4X patients (61,6%) did not follow the recommendations or stopped seeing psychiatrist, while only 13,7% were persistent. Сonversely, 48,4% of F3X patients followed the recommendations and only 43,5% stopped. In comparison, other spectrum patients followed recommendations in 32.0% of cases and ignored - in 56.6%.

Patients were actively self-referring themselves to psychiatrist. Highest adherence to psychiatrist recommendations was found in patients with affective disorders compared to other spectrum patients. In contrast, adherence was the lowest in patients with neurotic disorders.

No significant relationships.

The relevance of studying of self-regulation styles of young people who face various difficulties at a stage of vocational training has increased in the situation of a pandemic.

The purpose of our work is to describe the functional states of students at different stages of education, characterized by different degrees of satisfaction with educational and professional activities and different levels of self-regulation, to substantiate programs of psychological support for students during the formation of their professional identity.

The sample consisted of 153 students enrolled in 1 and 3 courses in Moscow higher educational institutions. They were asked to fill out a package of methods aimed at diagnosing self-regulation styles (Morosanova, 2020), the severity of states of reduced performance (Leonova, Velichkovskaya, 2002).

Indicators of reduced working capacity among third-year students are statistically significantly higher (p≤0.05) and are in a critical range of severity than among freshmen. Despite a similar level of satisfaction, third-year students demonstrate a whole palette of states of reduced performance, characterized by the experience of monotony of activity with high tension associated with the requirements of the educational situation. The absence of significant differences in the diagnostic indicators of self-regulation obtained in these two groups does not give grounds to assert that the general self-regulation of senior students is higher than that of first-year students.

The data obtained confirm the “painfulness” of the crisis of the “middle” of education and necessarily raise the question of developing a targeted program for mastering the means of conscious self-regulation by students.

No significant relationships.

The Inventory of Academic Sources of Stress in Medical Education (IASSME) evaluates the presence and intensity of the main sources of academic stress for Portuguese Medicine students in five dimensions: Course demands/CD, Human demands/HD, Lifestyle/LS, Academic competition/AC, and Academic adjustment/AA.

To further validate the ISSME using Confirmatory Factor Analysis and to analyze[ATP1] the psychometric properties of a new version including additional sources of stress.

Participants were 666 Portuguese medicine (82.6%) and dentistry (17.4%) students (81.8% girls); they answered an online survey including the ISSME and other validated questionnaires: Maslach Burnout Inventory – Students Survey (MBI-SS) and Depression Anxiety and Stress Scales (DASS).

Confirmatory Factor Analysis showed that the second order model composed of five factors (the original structure by Loureiro et al. 2008), but excluding item 11 (loading=.371), presented good fit indexes (χ2/df=3.274; RMSEA=.0581, p<.001; CFI=.917; TLI=.904, GFI=.919). The Cronbach’s alfas were α=.897 for the total and from α=.669 (F2-HD) to α=.859 (F1-CD) for the dimensions. The expanded version, including two additional items related to lack of interest in medicine/dentistry (F6, α=.543) and two additional COVID-19 stress-related-items (F7, α=.744) also showed acceptable fit indexes (χ2/df=3.513; RMSEA=.061, p<.001; CFI=.88.; TLI=.866, GFI=.892). This new version’s α was of .896. Pearson correlations between ISSME and the other measures were significant (p<.01) and high: >.55 with DASS and >.50 with MBI-SS. Girls presented significantly higher ISSME scores. F6 score was significantly higher in dentistry students.

This further validation study underlines that IASSME presents good validity (construct and convergent) and reliability.

No significant relationships.

Major depressive disorder (MDD) is a leading cause of disability worldwide, in part due to its high prevalence and high rates of comorbidities, recurrence, chronicity and treatment-resistance. These indicate that MDD is treated suboptimally despite a multitude of effective interventions and well-regarded best-practice treatment guidelines. To improve the management of MDD, the nature and extent of ‘gaps’ in care pathways need to be understood.

We aimed to: 1. Identify ‘treatment gaps’ and patient needs along the care pathway, and determine the extent of these gaps (i.e. discrepancy between best- and current-practice). 2. Propose policy recommendation on how minimise treatment gaps for MDD.

Care pathway analysis: A set of relevant treatment gaps were agreed upon, a priori, based on gold-standard stepped-care guidelines. Data was gathered from a variety of sources in six countries (UK, Sweden, Germany, Italy, Portugal, Hungary). Policy recommendations: To attain expert consensus on proposed recommendations, a modified-Delphi approach was undertaken with a multidisciplinary panel of experts across Europe.

Taken together, data indicated that: ˜50% of episodes are undiagnosed, lifetime delay to treatment averages ˜4 years, ˜25-50% of patients are treated at any one time, ˜30-65% are followed up within 3 months of treatment, ˜5-25% can access psychiatric services. 28 specific recommendations to optimise pathways were made to enhance MDD detection (pathway entry), increase multimodal treatment, facilitate continuity of follow-up after treatment and increase access to specialist care.

There are concerning treatment gaps in depression care across Europe, from the proportion of people not being diagnosed to those stagnating in primary care with impairing, persistent illness.

No significant relationships.

Mental health professionals are one of the major sources of stigma for persons with schizophrenia and their families. The stereotype of incompetence is central in this stigmatization, whereas valuing skills is a fundamental aspect of mental health care and recovery.

The aim of this study is to identify the domains of competence stigmatized in schizophrenia by mental health professionals and the factors associated with this stigmatization.

An online survey was conducted with a specific measure of the stereotype of incompetence and these associated factors. Participants were to be mental health professionals who work or have worked with persons with schizophrenia. These participants were recruited through professional social networks.

Responses of 164 participants were analyzed. The results reported four highly stigmatized skill domains: ability to relate well socially, ability to be effective in their work, ability to make decisions about their health, and ability to control their emotions. Intelligence was found to be less stigmatized than the other dimensions. Recovery beliefs, categorical beliefs, and perceived similarities were factors associated with the stereotype of incompetence.

Responses of 164 participants were analyzed. The results reported four highly stigmatized skill domains: ability to relate well socially, ability to be effective in their work, ability to make decisions about their health, and ability to control their emotions. Intelligence was found to be less stigmatized than the other dimensions. Recovery beliefs, categorical beliefs, and perceived similarities were factors associated with the stereotype of incompetence.

No significant relationships.