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Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, and clinician). Fifty-seven papers were included, with most investigating cognitive behavioral therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, and adaptations regarding organization of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesized narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however.

Indigenous people worldwide are at increased risk of mental health problems compared with non-Indigenous people. Longstanding impacts of colonisation, systematic exclusion from rights and subsequent discrimination, and lack of access to quality education and healthcare, including mental healthcare, have been identified as contributory factors to these disproportionate mental health problems. With limited access, Indigenous people are less likely to seek healthcare, owing to the insufficient number of healthcare professionals representing Indigenous communities. In the face of growing numbers of mental health problems in Indigenous people in Bangladesh, this paper sheds light on the inadequate number of mental health professionals, particularly from Indigenous communities, and the potential impacts of this on the well-being of Indigenous people, and considers ways to increase representation of Indigenous mental health professionals. The aim is to ensure that the mental health system in Bangladesh is inclusive and embraces the country's diversity. [ABSTRACT FROM AUTHOR]

Although significant progress has been made in Irish mental health law in recent decades, the Mental Health Act, 2001 still falls short of properly protecting human rights. A consideration of human rights developments, both domestically and internationally, highlights the urgent need for reform. In this paper we consider Sections 4 ('Best interests'), 3 ('Mental disorder') and 57 ('Treatment not requiring consent') of the 2001 Act and related recommendations in the 2015 Report of the Expert Group on the Review of the Mental Health Act, 2001, and suggest specific areas for reform. Just as medicine evolves over time, so too does our understanding of human rights and law. While embracing a human rights-based approach to the extent suggested here might be seen as aspirational, it is important to balance achievable goals with higher ideals if progress is to be made and rights are to be respected.

Objective: The Health Service Executive National Clinical Programme for Eating Disorders (NCPED) launched a Model of Care for Eating Disorder Services in Ireland in 2018. Currently, one adult and two child and adolescent eating disorder services are operational out of a total of sixteen recommended. The three objectives of this paper are to describe the early (1) referral pattern, (2) level of service activity and (3) the level of service user satisfaction., Method: Monthly submitted service activity data from each service to the NCPED between March 2018 and October 2020 were retrospectively analysed. One hundred and fifty-nine carers and service users completed an experience of service questionnaire (ESQ). A descriptive analysis of referral pattern, level of service activity and ESQ was performed. A thematic analysis was performed on three qualitative questions on the ESQ., Results: There was substantial referral numbers to eating disorder services by 18 months ( n = 258). The main referral source was community mental health teams. The majority ( n = 222, 86%) of referrals were offered an assessment. The most common age profile was 10-17 years of age ( n = 120, 54.1%), and anorexia nervosa was the most common disorder ( n = 96, 43.2%). ESQ results demonstrate that most service users were satisfied with their service, and the main themes were carer involvement, staff expertise, therapeutic alliance and service access., Conclusions: This preliminary service activity and service user satisfaction data highlight several issues, including trends when setting up a regional eating disorder service, potential pitfalls of pragmatic data collection and the need for adequate information-technology infrastructure.

After several decades of Market Faith in Western societies and the most severe financial crash several generations has known, there has not really been a serious re-examination of the role of markets and money in our society. A market economy may be a valuable and effective tool for organizing productive activity. The problem is whether we have become a “market society”. That is, if the economic values have been transplanted to the whole of society – not only economic life – and we have become a monetized society: a society where just about everything is up for sale. That's to say, a way of life where market relations and market incentives and market values come to dominate all aspects of life. Paradoxically, it is possible that the economic crisis has only increased this trend. Administrations at different levels – European, States, Local… – have demanded tremendous sacrifices from the population intended to save the financial system, but on the way sacrificing a Welfare state that took decades to build. In this presentation, we will review the mental health consequences of the current economic crisis. Also it examines how the change in social values and sweeping assertion of economic values can affect the way we think about Mental Health and Psychiatric Care. [ABSTRACT FROM AUTHOR]

The development of Specialist Perinatal Mental Health Services in Ireland in recent years (2018-2021) is described. The paper highlights the role of unexpected opportunity in advancing this much needed service for women, infants and their families. It also emphasises the need for funding combined with an implementation mechanism to ensure that the service emerging is true to the Model of Care designed and is available in a uniform manner to women nationally.

The Philippine Mental Health Act upholds the rights and inclusivity of all people, regardless of gender and sexual orientation, within mental health services and programmes. Nevertheless, a noteworthy challenge lies in the inadequate attention given to the needs of LGBT+ individuals within the medical and health professions education in the country. Therefore, it is imperative to integrate LGBT+ mental health into psychiatric residency training. To address this gap, this paper proposes the inclusion of concepts relevant to LGBT+ mental health, including minority stress, intersectionality, identity concealment and LGBT+-affirming practices, to enhance the understanding and response to the needs of LGBT+ Filipinos. [ABSTRACT FROM AUTHOR]

Despite the worldwide burden of mental illness and recent interest in global approaches to address this, progress on increasing awareness, lessening stigma, reducing the treatment gap, and improving research and training in mental health has been slow. In 2018, the North East England South Asia Mental health Alliance (NEESAMA) was developed as a collaboration between high-income (global north) and low- to middle-income (global south) countries to address this slow progress. This paper outlines how the joint priority areas for research, training and service delivery were identified across the life course (child and adolescent, adults and older people) between partner organisations spanning Afghanistan, Bangladesh, India, Nepal, Pakistan, Sri Lanka and the UK. It describes the progress to date and proposes a way forward for similar alliances to be forged. [ABSTRACT FROM AUTHOR]

People with psychosis in Malawi have very limited access to timely assessment and evidence-based care, leading to a long duration of untreated psychosis and persistent disability. Most people with psychosis in the country consult traditional or religious healers. Stigmatising attitudes are common and services have limited capacity, particularly in rural areas. This paper, focusing on pathways to care for psychosis in Malawi, is based on the Wellcome Trust Psychosis Flagship Report on the Landscape of Mental Health Services for Psychosis in Malawi. Its purpose is to inform Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE), a longitudinal study that aims to build on existing services to develop sustainable psychosis detection systems and management pathways to promote recovery. [ABSTRACT FROM AUTHOR]

While debts are widely used financial tools, few longitudinal studies investigating potential causal links between debts and mental wellbeing exist among older adults. Older adults, particularly those not employed, are less likely to have increasing incomes to help them pay off their debts. This study investigates whether older adults with non-mortgage debts in three different labour market states have lower mental wellbeing and, separately, whether it is likely that reducing their debts helps to improve mental wellbeing. Using the English Longitudinal Study of Ageing, the study focuses on the English context, which is particularly interesting due to the high levels of, and a unique policy approach to, private indebtedness. The results indicate that people with debts have lower mental wellbeing (more depressive symptoms and lower quality of life) in all categories, but the mental pain linked to debts is stronger for people who are jobless (not working, not retired). The analysis from a causal perspective suggests that getting rid of debts may reduce depressive symptoms among people who are jobless but may also improve quality of life among the retired and employed. Both these findings suggest that mental health services should work closely with debt advice when needed. [ABSTRACT FROM AUTHOR]

Introduction: Firstly, we will speak on the violence against women from a Russian perspective. The selected reports from regional psychiatric services and police department reports of domestic violence cases will be presented. Objectives: Secondly, we will draw upon our work developing and providing a new educational program, «Women victims of domestic violence: Detection, clinic, help,» mainly based on teaching several modules, WPA International Curriculum for Mental Healthcare Providers on Violence Against Women. Methods: In this present paper, we examine evidence-based practice from the starting points of research as illumination and psychiatry as a discipline with hermeneutic potential, to consider relationships between research and practice and the opportunities available within the current research agenda for psychiatrists and clinical psychologists working in clinical settings. Results: We contend that the quality of women's mental health services will only improve when they can acknowledge the considerable impact that intimate partner violence and sexual violence, as well as social inequalities, especially those based on gender, have on women's mental health. We do not underestimate the difficulty of providing practical help to women whose mental health has been profoundly affected by the violence, damage that is often further compounded by years of mistreatment and revictimization in services. Conclusions: The paper provides commentaries and reflections on the steps that must be taken to create opportunities to foster dialogue, discussing and exchanging ideas on a diverse range of topics relevant to the advancement of the program in the broader context. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: The incorporation of artificial intelligence (AI) in healthcare, especially in mental health services, offers potential advancements in efficiency and personalization. As AI technologies like machine learning and natural language processing (NLP) continue to evolve, it's vital to evaluate their applications in psychiatry comprehensively. Objectives: This review aims to summarize and characterize studies that used AI, particularly machine learning and NLP, in mental health. Additionally, it endeavors to understand how these technologies may enhance diagnostic tools, symptom monitoring, and delivery of personalized treatment in psychiatry. Methods: Adhering to PRISMA guidelines, a systematic search was executed across multiple medical databases, including PubMed, Scopus, ScienceDirect, and PsycINFO. Keywords encompassed machine learning, data mining, psychiatry, and mental health. Exclusion criteria included non-English papers, anonymization process descriptions, case studies, conference papers, and other reviews. Data from various segments in the provided information were synthesized to capture the broader picture of AI's application in psychiatry. Results: From the 327 articles initially identified, 58 were chosen for detailed review. Studies predominantly revolved around three main populations: patients in medical databases, emergency room visitors, and social media users. The primary applications of AI entailed symptom extraction, illness severity classification, therapy effectiveness comparison, and psychopathological insights derivation. Data sources mainly included medical records and social media, with Python emerging as the preferred platform for most studies. Conclusions: While AI shows immense promise in revolutionizing mental health care, its current applications largely confirm existing clinical hypotheses. Ethical concerns, such as patient privacy and data biases, remain paramount. Future work should delve deeper into these challenges while further exploring AI's potential in clinical psychiatry practice. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Recovery in Schizophrenia: The Role of Psychosocial interventions Recovery is individual and so needs individual responses from the mental health services. Different interventions are useful at different stages and of course they only "work" for some people. The paper will describe some psychosocial interventions and the role they might pay in the patient's journey to their expected recovery. Three main strategies are often referred to – reducing symptoms, reducing barriers to recovery, and extending and maintaining recovery to achieve some stable and acceptable (to the patient) optimal level of functioning. Psychosocial intervention strategies are beneficial for each of these often thought of as independent, but they are inter-related with one type of therapy leading to reductions in the need for other therapies. The process of considering which one to start with is a choice and this paper will describe some decision making to ensure that patients have the best options. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

This paper explores the potential for occupational therapists (OTs) to manage medicines and support patients in an in-patient psychiatric ward to effectively and safely self-administer their medication. Connelly House is an occupational therapy-led six-bed, open psychiatric rehabilitation in-patient ward supporting people transitioning from being in-patients to living in the community. Policy, process, governance and training needs are identified and discussed. Positive feedback was received from patients and staff involved with the service development, opening the door for OTs to manage medicines and support the self-administration of medication on other psychiatric rehabilitation in-patient wards using focused occupational interventions. [ABSTRACT FROM AUTHOR]

Eating disorders are one of the most common chronic illnesses among adolescents. Yet, our current framework for mental health care provides limited education, access to care, and support for adolescents suffering from this disease. The enactment of key legislation and federal guidance such as the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is evidence that there are steps being taken to ensure the removal of barriers to care. However, eating disorders are often overlooked as a category of behavioral disorders. This paper analyzes the current legal and social framework for providing care and support to adolescents suffering from eating disorders. In doing so, it offers recommendations to develop stronger protective and responsive measures to ensure access, support, and care to these individuals.

Recently, there has been growing interest in artificial intelligence (AI) to improve efficiency and personalisation of mental health services. So far, the progress has been slow, however, advancements in deep learning may change this. This paper discusses the role for AI in psychiatry, in particular (a) diagnosis tools, (b) monitoring of symptoms, and (c) delivering personalised treatment recommendations. Finally, I discuss ethical concerns and technological limitations.

Background: In the 1990s criteria were developed to detect individuals at high and imminent risk of developing a psychotic disorder. These are known as the at risk mental state, ultra high risk or clinical high risk criteria. Individuals meeting these criteria are symptomatic and help-seeking. Services for such individuals are now found worldwide. Recently Psychological Medicine published two articles that criticise these services and suggest that they should be dismantled or restructured. One paper also provides recommendations on how ARMS services should be operate. Methods: In this paper we draw on the existing literature in the field and present the perspective of some ARMS clinicians and researchers. Results: Many of the critics' arguments are refuted. Most of the recommendations included in the Moritz et al. paper are already occurring. Conclusions: ARMS services provide management of current problems, treatment to reduce risk of onset of psychotic disorder and monitoring of mental state, including attenuated psychotic symptoms. These symptoms are associated with a range of poor outcomes. It is important to assess them and track their trajectory over time. A new approach to detection of ARMS individuals can be considered that harnesses broad youth mental health services, such as headspace in Australia, Jigsaw in Ireland and ACCESS Open Minds in Canada. Attention should also be paid to the physical health of ARMS individuals. Far from needing to be dismantled we feel that the ARMS approach has much to offer to improve the health of young people. [ABSTRACT FROM AUTHOR]

This paper gives a narrative account of how the Oxford Healthcare Improvement Centre has embedded continuous quality improvement (CQI) across both mental health and community services in Oxford, UK. The aim of the centre is to develop capability across healthcare services, with frontline staff leading CQI independently. The paper discusses the various methods employed to achieve this aim, including the provision of training, mentoring and support to those undertaking improvement work, alongside developing the required governance for CQI. [ABSTRACT FROM AUTHOR]

In this paper, we examine a number of approaches that propose new models for psychiatric theory and practices: in the way that they incorporate 'social' dimensions, in the way they involve 'communities' in treatment, in the ways that they engage mental health service users, and in the ways that they try to shift the power relations within the psychiatric encounter. We examine the extent to which 'alternatives' - including 'Postpsychiatry', 'Open Dialogue', the 'Power, Threat and Meaning Framework' and Service User Involvement in Research - really do depart from mainstream models in terms of theory, practice and empirical research and identify some shortcomings in each. We propose an approach which seeks more firmly to ground mental distress within the lifeworld of those who experience it, with a particular focus on the biopsychosocial niches within which we make our lives, and the impact of systematic disadvantage, structural violence and other toxic exposures within the spaces and places that constitute and constrain many everyday lives. Further, we argue that a truly alternative psychiatry requires psychiatric professionals to go beyond simply listening to the voices of service users: to overcome epistemic injustice requires professionals to recognise that those who have experience of mental health services have their own expertise in accounting for their distress and in evaluating alternative forms of treatment. Finally we suggest that, if 'another psychiatry' is possible, this requires a radical reimagination of the role and responsibilities of the medically trained psychiatrist within and outside the clinical encounter.

Evidence-informed planning and interpretation of research results both require standardised description of local care delivery context. Such context analysis descriptions should be comparable across regions and countries to allow benchmarking and organizational learning, and for research findings to be interpreted in context. The European Service Mapping Schedule (ESMS) is a classification of adult mental health services that was later adapted for the assessment of health and social systems research (Description and Evaluation of Services and DirectoriEs - DESDE). The aim of the study was to review the diffusion and use of the ESMS/DESDE system in health and social care and its impact in health policy and decision-making. We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (1997–2018). Out of 155 papers mentioning ESMS/DESDE, 71 have used it for service research and planning. The classification has been translated into eight languages and has been used by seven international research networks. Since 2000, it has originated 11 instruments for health system research with extensive analysis of their metric properties. The ESMS/DESDE coding system has been used in 585 catchment areas in 34 countries for description of services delivery at local, regional and national levels. The ESMS/DESDE system provides a common terminology, a classification of care services, and a set of tools allowing a variety of aims to be addressed in healthcare and health systems research. It facilitates comparisons across and within countries for evidence-informed planning. [ABSTRACT FROM AUTHOR]

BJPsych International is a journal that focuses on mental health practice and policy worldwide. The journal has undergone significant transformations under the leadership of David Skuse, expanding its reach and online presence. Mental health is recognized as a global public health priority, but there are still major gaps in service quality and coverage, particularly in low- and middle-income countries. BJPsych International aims to bridge this knowledge gap by providing an overview of current policy and practice in psychiatry and mental health around the world. The journal offers a range of content, including articles on mental health policy, services, training, research, and mental health law. It also plans to expand into publishing original research and systematic reviews to contribute to building an evidence base for good practice and policy worldwide. The journal is open access and does not charge publication fees, making it accessible to readers and authors from all cultures and continents. [Extracted from the article]

This paper challenges the exclusion of patients from epistemic practices in psychiatry by examining the creation and revision processes of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a document produced by the American Psychiatric Association that identifies the properties of mental disorders and thereby guides research, diagnosis, treatment, and various administrative tasks. It argues there are epistemic—rather than exclusively social/political—reasons for including patients in the DSM revision process. Individuals with mental disorders are indispensable resources to enhance psychiatric epistemology, especially in the context of the crisis, controversy, and uncertainty surrounding mental health research and treatment. [ABSTRACT FROM AUTHOR]

Wales is a small country, with an ageing population, high levels of population health need and an economy with a significant reliance on public services. Its health system attracts little attention, with analyses tending to underplay the differences between the four countries of the UK. This paper helps redress this via a case study of Welsh mental health policy, services and nursing practice. Distinctively, successive devolved governments in Wales have emphasised public planning and provision. Wales also has primary legislation addressing sustainability and future generations, safe nurse staffing and rights of access to mental health services. However, in a context in which gaps always exist between national policy, local services and face-to-face care, evidence points to the existence of tension between Welsh policy aspirations and realities. Mental health nurses in Wales have produced a framework for action, which describes practice exemplars and looks forward to a secure future for the profession. With policy, however enlightened, lacking the singular potency to bring about intended change, nurses as the largest of the professional groups involved in mental health care have opportunities to make a difference in Wales through leadership, influence and collective action.

In Ireland, traditionally, most public Adult Mental Health Services (AMHSs) had a small cohort of service users with eating disorders (EDs) in their service. However, over the last 5 years, the National Clinical Programmes have been encouraging Mental Health Services to develop ED programmes in each catchment area. This has culminated in a model of care for EDs for children and adults. It appears that in relation to AMHSs, meaningful inclusion of families/significant other(s) in ED programmes is somewhat inconsistent. This paper will discuss the possible impact of excluding or minimising family/significant other(s)' inclusion. It will also outline a suggested approach of including families/significant other(s) in a meaningful way in an out-patient ED programme.

Background: Despite the critical role families play in the care and recovery journeys of people who experience enduring mental distress, they are often excluded by the mental health services in the care and decision-making process. International trends in mental health services emphasise promoting a partnership approach between service users, families and practitioners within an ethos of recovery., Objective: This paper evaluated the acceptability of and initial outcomes from a clinician and peer co-led family information programme., Methods: A sequential design was used involving a pre-post survey to assess changes in knowledge, confidence, advocacy, recovery and hope following programme participation and interviews with programme participants. Participants were recruited from mental health services running the information programme. In all, 86 participants completed both pre- and post-surveys, and 15 individuals consented to interviews., Results: Survey findings indicated a statistically significant change in family members' knowledge about mental health issues, recovery attitudes, sense of hope and confidence. In addition, the interviews suggested that the programme had a number of other positive outcomes for family members, including increased communication with members of the mental health team and increased awareness of communication patterns within the family unit. Family members valued the opportunity to share their experiences in a 'safe' place, learn from each other and provide mutual support., Conclusion: The evaluation highlights the importance of developing information programmes in collaboration with family members as well as the strength of a programme that is jointly facilitated by a family member and clinician.

Introduction: Transitioning from mental health inpatient care to community care is often a vulnerable time in the treatment process where additional risks and anxiety may arise. Objectives: The objective of this paper was to evaluate the progression of mental health symptoms in patients six weeks after their discharge from the hospital as the first phase of an ongoing innovative supportive program. In this study, factors that may contribute to the presence or absence of anxiety and depression symptoms, and the quality of life following a return to the community were examined. The results of this study provide evidence and baseline data for future phases of the project. Methods: An observational design was used in this study. We collected sociodemographic and clinical data using REDCap at discharge and six weeks later. Anxiety, depression, and well-being symptoms were assessed using the Generalized Anxiety Disorder (GAD-7) questionnaire, the Patient Health Questionnaire-9 (PHQ-9), and the World Health Organization-Five Well-Being Index (WHO-5) respectively. Descriptive, Chi-square, independent T-test, and multivariate regression analyses were conducted. Results: The survey was completed by 88 participants out of 144 (61.1% response rate). A statistically non-significant reduction in anxiety and depression symptoms was found six weeks after returning to the community based on the Chi-squared/Fisher exact test and independent t-test. As well, the mean anxiety and depression scores showed a non-significant marginal reduction after discharge compared to baseline. In the period following discharge, a non-significant increase in participants experiencing low well-being symptoms was observed, as well as a decline in the mean well-being scores. Based on logistic regression models, only baseline symptoms were significant predictors of symptoms six weeks after inpatient discharge. Image: Image 2: Image 3: Conclusions: In the short term following hospital discharge, no significant changes were observed in mental health conditions. A collaboration between researchers and policymakers is essential for the implementation and maintenance of effective interventions to support and maintain the mental health of patients following discharge. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: The transition from hospital to community settings for most mental health service users is often hindered by challenges that affect community adjustment and continuity of care. The first few weeks and days after discharge from mental health inpatient units represent a critical phase for many service users. Objectives: This paper aims to evaluate the changes in quality of Life status, resilience, and personal recovery of individuals with mental health challenges recently discharged from acute mental health care into the community. Methods: Data for this study were collected as part of a pragmatic stepped-wedge cluster-randomized, longitudinal approach in Alberta. A paired sample t-test and Chi-squared/Fisher test were deployed to assess changes from baseline to six weeks in the recovery assessment scale (RAS), brief resilience scale (BRS), and EuroQol-5d (EQ-5D), using an online questionnaire. Results: A total of 306 service users were recruited, and 88 completed both baseline and six weeks, giving a response rate of 28.8%. There was no statistically significant change in the level of resilience, recovery and quality of life as measured with the brief resilience scale, recovery assessment scale and EQ-5D from baseline to six weeks (p > 0.05). Conclusions: The study showed that there was neither an improvement nor deterioration in resilience, recovery, or quality of life status of service users six weeks post-discharge from inpatient mental health care. The lack of further progress calls into question whether the support available in the community when patients leave inpatient care is adequate to promote full recovery. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: A person diagnosed with a psychiatric illness, must face labels and discriminiation most of the time. Fear of these undermines the motivation of people in need to seek help. A special example of this phenomenon is the case of people experiencing homelessness and mental disorder, avoiding the additional stigma of homelessness and therefore do not seek any help for their mental ill-health. Availability of the specific services complicates their problem. Fear of stigma, trauma, and previous bad experiences of using services also keep people experiencing homelessness away from services. In Hungary, the February Third Working Group (F3) Report on the 2020 Homelessness Survey After the Penal Code - Before the Pandemic Homelessness - Services Perspectives by Péter Győri shows in his summary paper that only 29% had received psychiatric treatment. Objectives: Methodology Center of Social and Its Institutions (BMSZKI), in collaboration with the Awakenings Foundation, developed a complex rehabilitation service for people experiencing homelessness and mental disorder. This presentation aims to present this good practice. Methods: Complex rehabilitation based on the methodology of community psychiatric care with the involvement of peer support. Results: - provision of community psychiatric care for people experiencing homelessness and mental disorder, - introduction of screening for effective care of undiagnosed persons with mental disorders, - provision of outpatient and day hospital care - focus of care in accommodation services on persons with mental disorders, - the involvement of peer-support work in the service, - building a network of contact points, organizing case conferences, - developing and organizing training on recovery-based rehabilitation for people with mental disorders in cooperation between the two organizations, - telemedicine, making digital mental health available - presence of resources represented by self-help groups - running a working group to promote improvements based on practical experience homelessness and mental disorder. Conclusions: extra-institutional teamwork multiplies the resources for people experiencing homelessness and mental disorder. Keywords: mental disorder, homelessness, community psychiatric care, peer support, collaboration Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Persons with intellectual disability (PwID) and/or and autism spectrum disorder with high support needs (ASD-HSN) have resulted to be among the most vulnerable populations to COVID-19 and distress factors associated to the measures for containing its spread. Many health, rehabilitation, and assistance needs were managed through the use of telemedicine, specifically teleassistance (TA) and telerehabilitation (TR), with regard to the prevention and treatment of the epidemic illness as well as the continuity of care required for the condition of developmental disability and co-occurring physical or mental disorders. TA and TR can function either directly or indirectly with the PwID/ASD; in the latter case, a family member, a regular caregiver, or a technician provides local mediation. This paper examines the most common TA and TR activities, along with their requirements, applications, and goals. All of these activities should be in line with the overarching goal of each customized therapy and rehabilitation plan, which is to enhance and support the quality of life for people with intellectual and developmental disabilities. Studies on TA and TR efficacy for PwID/ASD are limited, especially concerning adulthood. The scant research that is currently available demonstrates efficacy in maintaining or marginally enhancing cognitive, adaptive, and vocational skills. In addition to managing both routine and unusual activities as well as critical episodes, family members and other caregivers reported feeling more empowered about their educational and interpersonal abilities with the PwID/ASD. The primary benefits over traditional in-person services have been found to be greater accessibility and availability as well as a reduction in both physical and psychological distance. The primary limits include the absence of all elements of the therapeutic alliance pertaining to face-to-face communication, possible poor ability to use technology, accessibility of the technology itself, concerns regarding privacy, and variables that divert attention connected to the household setting. Even while telemedicine has proven to be feasible and beneficial thus far, it is doubtful that traditional techniques will be able to be replaced, at least not anytime soon. Telemedicine could, nonetheless, serve as a useful addition, integration, or short-term substitute. Future studies should provide light on the indications, contextual deployment, efficacy evaluation, and operational stability over time of certain TA and TR activities in addition to the use of artificial intelligence, machine learning, and interactive avatars. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is a leading cause of morbidity and mortality. Shortfalls in treatment quantity and quality are well-established, but the specific gaps in pharmacotherapy and psychotherapy are poorly understood. This paper analyzes the gap in treatment coverage for MDD and identifies critical bottlenecks. Methods: Seventeen surveys were conducted across 15 countries by the World Health Organization-World Mental Health Surveys Initiative. Of 35 012 respondents, 3341 met DSM-IV criteria for 12-month MDD. The following components of effective treatment coverage were analyzed: (a) any mental health service utilization; (b) adequate pharmacotherapy; (c) adequate psychotherapy; and (d) adequate severity-specific combination of both. Results: MDD prevalence was 4.8% (s.e., 0.2). A total of 41.8% (s.e., 1.1) received any mental health services, 23.2% (s.e., 1.5) of which was deemed effective. This 90% gap in effective treatment is due to lack of utilization (58%) and inadequate quality or adherence (32%). Critical bottlenecks are underutilization of psychotherapy (26 percentage-points reduction in coverage), underutilization of psychopharmacology (13-point reduction), inadequate physician monitoring (13-point reduction), and inadequate drug-type (10-point reduction). High-income countries double low-income countries in any mental health service utilization, adequate pharmacotherapy, adequate psychotherapy, and adequate combination of both. Severe cases are more likely than mild-moderate cases to receive either adequate pharmacotherapy or psychotherapy, but less likely to receive an adequate combination. Conclusions: Decision-makers need to increase the utilization and quality of pharmacotherapy and psychotherapy. Innovations such as telehealth for training and supervision plus non-specialist or community resources to deliver pharmacotherapy and psychotherapy could address these bottlenecks. [ABSTRACT FROM AUTHOR]

This paper concerns mental health services in The Gambia. It describes local concepts, experiences and knowledge about mental illness and the implications of such beliefs and attitudes for access to mental health services. A pretested questionnaire and interview guide were administered to a sample of patients/family members. Barriers to accessing mental health services were identified. These included beliefs about the causes of mental illness; family decision-making; the scarcity and high cost of services. Obtaining access to mental health services in The Gambia is currently challenging. Importantly, increased community and family education about the causes and treatment of mental illnesses will be required to address these issues. [ABSTRACT FROM AUTHOR]

This paper reflects on the development of a capacity-building programme to support a mental health service modernisation pilot project based in the Lviv region of Western Ukraine. National programmes that aim to modernise mental health services now have the experience of other countries on which to draw. The challenges faced by such modernisers have much in common. Nevertheless, although there are lessons to be learned from what has worked well elsewhere, we caution that the local context can have a profound effect on the successful implementation of plans based on best practice. [ABSTRACT FROM AUTHOR]

This paper explores the key features of the emerging welfare mix for Syrian refugees in Turkey and identifies the modes of interaction between humanitarian assistance programmes, domestic policy responses and the Turkish welfare system. The welfare mix for Syrian refugees is a joint product of humanitarian assistance programmes implemented by international and domestic non-governmental organisations (NGOs) and domestic social policy programmes. Three policy domains are considered: social assistance schemes, employment and health care services. The paper suggests that granting of temporary protection status to Syrian migrants in Turkey and the agreement between Turkey and the EU shaped the welfare mix by empowering the public sector mandate vis-à-vis the humanitarian actors. As a result, the role of the public sector increases at the expense of NGOs, especially in social assistance and health care, while NGOs are increasingly specialised in protection work (especially in mental health support), where the Turkish welfare system has been weak. Employment has been essentially disregarded, in both humanitarian and social policy programmes, which casts doubt on the prospect of successful economic integration. Finally, this paper argues that the convergence of the rights of immigrants and citizens may well occur in mature components of less comprehensive welfare systems. [ABSTRACT FROM AUTHOR]

Background: This paper aims to synthesise the literature on machine learning (ML) and big data applications for mental health, highlighting current research and applications in practice. Methods: We employed a scoping review methodology to rapidly map the field of ML in mental health. Eight health and information technology research databases were searched for papers covering this domain. Articles were assessed by two reviewers, and data were extracted on the article's mental health application, ML technique, data type, and study results. Articles were then synthesised via narrative review. Results: Three hundred papers focusing on the application of ML to mental health were identified. Four main application domains emerged in the literature, including: (i) detection and diagnosis; (ii) prognosis, treatment and support; (iii) public health, and; (iv) research and clinical administration. The most common mental health conditions addressed included depression, schizophrenia, and Alzheimer's disease. ML techniques used included support vector machines, decision trees, neural networks, latent Dirichlet allocation, and clustering. Conclusions: Overall, the application of ML to mental health has demonstrated a range of benefits across the areas of diagnosis, treatment and support, research, and clinical administration. With the majority of studies identified focusing on the detection and diagnosis of mental health conditions, it is evident that there is significant room for the application of ML to other areas of psychology and mental health. The challenges of using ML techniques are discussed, as well as opportunities to improve and advance the field. [ABSTRACT FROM AUTHOR]

We thank Professor Ford and Ms McManus for raising some important questions and welcome extending the debate in this important area. In our paper we focus on raised levels of child-reported mental health difficulties in this school-based sample as likely indicators of level of difficulties that might be distressing for the child and potentially disruptive for the class and thus may be important in relation to potential early intervention.[5],[6] 10 Wolpert M, Zamperoni V, Napoleone E, Patalay P, Jacob J, Fokkema M, Predicting mental health improvement and deterioration in a large community sample of 11-to 13-year-olds. [Extracted from the article]