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EPA Guidance on Building Trust in Mental Health Services

Published online by Cambridge University Press:  04 February 2014

W. Gaebel
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich, Heine University, Düsseldorf, Germany
M. Muijen
WHO Regional Office for Europe, Copenhagen, Denmark
A.E. Baumann
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich, Heine University, Düsseldorf, Germany
D. Bhugra
Institute of Psychiatry, King’ College, London, United Kingdom
D. Wasserman
NASP, National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institute, Stockholm, Sweden
R.J. van der Gaag
UMCN Nijmegen, Utrecht, The Netherlands
R. Heun
Derbyshire Mental Health Services, Derby, United Kingdom
J. Zielasek
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich, Heine University, Düsseldorf, Germany
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To advance mental health care use by developing recommendations to increase trust from the general public and patients, those who have been in contact with services, those who have never been in contact and those who care for their families in the mental health care system.


We performed a systematic literature search and the retrieved documents were evaluated by two independent reviewers. Evidence tables were generated and recommendations were developed in an expert and stakeholder consensus process.


We developed five recommendations which may increase trust in mental health care services and advance mental health care service utilization.


Trust is a mutual, complex, multidimensional and dynamic interrelationship of a multitude of factors. Its components may vary between individuals and over time. They may include, among others, age, place of residence, ethnicity, culture, experiences as a service user, and type of disorder. For mental health care services, issues of knowledge about mental health services, confidentiality, continuity of treatment, dignity, safety and avoidance of stigma and coercion are central elements to increase trust.


Evidence-based recommendations to increase mutual trust of service users and psychiatrists have been developed and may help to increase mental health care service utilization.

Original article
Copyright © European Psychiatric Association 2014

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