The Mental Health Act (MHA) 2007 made some significant changes from the Mental Health Act 1983, including the fact that detention is now only allowed if an appropriate medical treatment is available to the patient at the time [1]. There was considerable concern at the time that the 2007 Act would lead to an increase in detentions.

The primary objective is to assess how the change in the English law with the MHA 2007 has affected the number of detentions under the MHA.

A retrospective, observational and noninterventional study used anonymised and routinely collected data regarding 11,509 people who were formally assessed under the Mental Health Act during the period of 2001–2011 in the county of Norfolk. This included 7885 assessments before the 2007 MHA and 3620 done after implementation.

The proportion of people detained following assessment decreased from 53.2% before the 2007 MHA to 42.9% after implementation (P = .000). The total proportion of patients admitted (whether informally or detained) also decreased from 63.3% before the 2007 MHA to 52.8% thereafter (P = .000).

These results show a significant decrease in the rate of detentions under the MHA since the 2007 Act became law.

The authors have not supplied their declaration of competing interest.

In Italy, considerable variations exist in the organisation of out- and in-patient mental health care. One main issue is whether to prioritise specialisation (distinct clinicians for inpatient and outpatient care) or personal continuity of care (same primary clinician for a given patient within the two settings).

To study the use of psychiatric in-patient units in the Veneto region (Italy) and to evaluate differences between personal continuity of care and specialization systems.

Study conducted in the context of the COFI, multisite naturalistic EU-funded research aiming to compare the two care approaches in 5 European countries. In Italy, baseline data collection was carried out in 14 in-patient units. Data on hospitalisation, diagnosis, severity of the illness (Clinical Global Impression Scale- CGI) and patients’ appraisal of inpatient care (Client Assessment of Treatment Scale- CAT) were collected.

Overall, 1118 patients were assessed. Most frequent diagnostic categories were mood (41.6%) and psychotic (38.3%) disorders, while anxiety disorders were less represented (11.9%). The majority of patients were at least at their second admission (69.4%) and had been voluntary admitted (91.5%). Length of stay and CGI scores were significantly higher for patients with mood and psychotic disorders. No difference in CGI score between the two systems was found. Patients in the continuity of care systems reported higher level of satisfaction with initial treatment and longer hospital stay (P < .001).

These preliminary findings suggest higher service satisfaction for personal continuity system, possibly reflecting a more individualised and comprehensive focus on the patient's needs, rather than on symptoms reduction only.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

We present the case report of a 21-year-old Chinese female, who was brought to the emergency department. We open the debate between the operative criteria stablished by DSM-5 of the clinical entity dissociative amnesia and Shenjing Shuairuo - the Chinese “culture-bound syndrome”.

To expose the relevance of the cultural formulation in the clinical evaluation of patients with a different non-Western culture in Psychiatry.

The Shenjing Shuairuo syndrome (“nervous system weakness”) was originally descripted in China, it has a gradual onset, usually after a stressful event. It involves a minimum 3 of 5 symptoms group: weakness, emotions, excitement, neurological pain and sleep. This complex group of symptoms overlap with dissociative syndrome such as dissociative amnesia.

The cultural formulation interview (CFI) was used for the diagnostic and subsequent treatment of dissociative amnesia with fugue in a different culture patient who met the clinical criteria of this two divergent clinic entities.

In our clinical practice, we will deal with different culture patients, who could present common clinical entities or with the so-called “culture-bound syndromes”. The cultural formulation of the clinical cases will help the clinicians to diagnose and have better treatment's options in clinical manifestations do not correspond to the conventional entities included in mostly Western-based nomenclatures.

The authors have not supplied their declaration of competing interest.

(1) Understand the predicament of refugees including risks to mental health, coping strategies and mental health consequences, (2) know the evidence for the emergence of mental illness in refugees and the effectiveness of multi-level interventions, (3) become familiar with published guidelines and gain a working knowledge of assessment and management of psychiatric conditions in refugee populations and cultural idioms of distress.

How will the participants receive feedback about their learning? Participants will have direct feedback through answers to questions. The authors welcome subsequent communication by email. Presenters can give attendants handouts on pertinent and concise information linked to the workshop.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

The burden of mental health impairment in medical students is an important research subjects. Evidence shows that medical students have a higher prevalence of symptoms of depression and anxiety than the general population. A number of studies regarding suicidal ideation among medical students have been carried out, but this topic has largely been ignored in regard to international medical students coming from Western European countries studying medicine in Eastern European countries. Suicidal ideation is the early symptom of suicidal actions. The students are the most vulnerable and easily influenced by cases of suicide, especially in a closed group with little connections with the general population like the international students.

Following 2 suicides in our university, we aim to measure the prevalence of suicidal ideations in international students.

Overall, 150 medical students from the French section studying at the University of Medicine and Pharmacy “Iuliu Hatieganu”, Romania, were evaluated for symptoms of depression using BDI and for suicide ideation using Beck HS.

Suicidal ideation was present in 28.57% of the French international medical students. Depression and the lack of social support had a significant relationship with suicidal ideation.

Suicide is a serious issue that has to be dealt with immediately. It is important to assist medical students who are considering the possibility of committing suicide, so that they overcome their difficulties. There is a need to identify the prevalence of suicidal ideation among medical students and for student counselling.

The authors have not supplied their declaration of competing interest.

In 2006, prior to the worldwide economic crisis which especially affected Western countries, Southern Spain was one of the illegal immigrant gateways from Africa into Europe. The aim of this study is to establish the rate of homeless immigrants in a cohort of 2006 and carry out a follow up until 2015 in order to explore the chronicity associated to the territory.

Sample: 949 persons experiencing homelessness in Girona, according to official records. Procedure: prospective longitudinal study of the total population of homeless people in Girona. In 2006, a list was made of all the homeless people detected by both specialised and nonspecialised teams, which have been followed until the present day. Instruments: data bases of different official teams. Statistical analysis: measures of central tendency and dispersion and contingency tables were used for the comparison of qualitative variables.

Overall, 64.8% of the population of Girona are immigrants (n = 614), principally from the Maghreb, (χ2 = 36.9, df = 4, P < .001) and 333 (36.3%) are autochthonous. The percentage of homeless immigrants in relation to the total immigrant population was 4.4%. Comparing the homeless autochthonous population with the total of the autochthonous population, homelessness among autochthonous population was 0.4%.

The results suggest that homelessness was more incidental in the immigrant group than in the autochthonous group. The percentage of immigrants who still live in homeless conditions suggests that immigration is a risk factor in the chronicity of the problem.

The authors have not supplied their declaration of competing interest.

In recent years, there has been an increase in migration in Europe. Particularly, Italy has been one of the most important landing place. Currently, migrants in the province of Avellino, South Italy city, amount to about 1400, housed in 40 facilities in 23 municipalities. Psychological interest on migration and its impact on lifestyle patterns has increased in recent years.

There are few studies that evaluated the frequent psychosomatic symptoms in these populations. Despite the trauma experienced, they are not able to give a name to the suffered and somatized pain.

Assessment of somatic symptoms reported by the immigrant cohort after a three-month observation period.

We included 50 migrants (21.3 mean years) hosted in emergency centre in Avellino, Italy. All guests have conducted psychological clinical interviews. At baseline, were administered following scales: the patient health questionnaire (PHQ-9); Illness Behaviour Inventory (IBI); Symptoms checklist-90-Revised (SCL-90-R) scale. Same data was collected after three months.

The migrant group was a heterogeneous group. Overall data on IBI and PHQ-9 scale indicate a statistically significant variation baseline vs deadline Data of IBI scale is statistically significant [T-Score: 3,921; P: 003]; also with PHQ-9 [T0 vs. T1: T-Score: 3,986; P: .003]. Similar results have been found with SCL-90-R.

In their vocabulary, terms such as anxiety, sadness, fear exist hardly. They tend to minimize the psychological pain, not because I do not feel, but because move it on the body. They have difficulty to talk about emotions, not just a matter of culture and language, but also because they are ashamed.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Over one percent of the world's population are currently uprooted. Over half of the world's displaced population are children.

There is considerable evidence that refugee children are at significant risk of developing psychological disturbance as they are subject to a number of risk factors.

Consistent research findings show that as the number of risk factors accumulates for children, the likelihood that they will develop psychological disturbance dramatically increases.

Traumatic events can have an effect on a child's emotional, cognitive and moral development because they influence the child's self-perceptions and expectations of others. The multidimensional effects of trauma on children and their families are compounded by forced uprooting, multiple losses and the myriad changes brought about by migration. Mental health services can be key to restoring basic psychological functioning and to supporting resilience and positive coping strategies for children, adolescents and adults.

Refugee children are a silent group that are easily overlooked. Our attitude toward young refugees and their families will determine the burden of trauma, not only on their adult future but also on our community.

An empathic and mentalizing attitude, secure sheltering, addressing health and educational needs will create a sense of stability and confidence. This is the very first step to favour, for these future adults.

The author has not supplied his/her declaration of competing interest.

Children's abuse and neglect is widely studied as a major risk factor for emotional and behavioural disorders, various somatic and psychiatric problems during adulthood.

Mental health is fundamental to health. Mental illnesses are real, disabling conditions affecting all populations regardless of race or ethnicity but disparities in mental health services exist for racial and ethnic minorities, and thus, mental illnesses exact a greater toll on their overall health and productivity.

The most important aim when working with ethnic minorities is to better understand the roles of culture, race and ethnicity, and overcome obstacles that would keep anyone with mental health problems from seeking or receiving effective treatment.

The Day Centre “The House of the Child” is a community unit which provides customized clinical mental health services for therapeutic treatment and psychosocial rehabilitation of children victims of abuse, neglect or domestic violence. The Day Centre was founded by the non-profit voluntary organization “THE SMILE OF THE CHILD”. The services are based on the bio-psycho-social model approach and treatment, which aim at early detection, and treatment of possible mental disorders and the overall psychosocial rehabilitation of victims of abuse/neglect and the support of their carers.

By identifying the many barriers to quality care faced by racial and ethnic minorities, the Day Center provides mental health services also to children who come from minority populations.

Different case studies highlight challenges and various levels of difficulties in this specific scheme of cooperation aiming to open an interesting dialogue on the topic.

The authors have not supplied their declaration of competing interest.

The needs of refugees are of pivotal concern internationally. Relational trauma, in particular, is an area that is under-emphasised and under-researched. The strength to strength program (STS) was a rare, innovative relationship and family counselling service for recently-arrived refugees in Sydney, Australia during 2006–2014. The service model built on post-Milan systemic family therapy principles to include innovative cultural and trauma-informed aspects of care.

We were interested in the experiences of staff who delivered the program, and the ways in which more traditional, Western-informed modes of family therapy were transformed by the needs of refugee clients.

To identify and describe transformations to the delivery of relationship and family counselling with refugees that enabled care, from the perspective of staff.

A thematic analysis, guided by interpretive description, of individual interviews and focus groups with STS service staff (n = 20), including family therapists, bicultural workers and managers.

Key themes pertaining to innovative aspects of the relationship and family counselling service provided by STS staff will be outlined and lessons for future service provision in this space considered.

STS is an example of staff-driven innovation to the therapeutic care of refugee families resettling in Western countries, taking into account the unique and complex set of cultural, practical and psychological needs. Important and timely lessons for future service delivery can be drawn from qualitative inquiry into the experiences of staff who deliver such programs, with refugee numbers continuing to increase internationally.

The authors have not supplied their declaration of competing interest.

Over 1,5 million of them are Ukrainians who were forced to leave their home after Crimea annexation and military conflict in the East of Ukraine.

By 2015, the University Clinic asked 156 people displaced from Lugansk and Donetsk regions. Reasons treatment: all patients were somatic complaints. In screening: using the scale hospital, all patients were found higher rates of anxiety and depression. Overall, 48% of patients abandoned psychiatric examination, even 24% of psychological counseling.

Screening of IDPs’ mental health who sought medical help in somatic clinic (University clinic KhNMU) and estimation of efficiency of interdisciplinary treatment and complex rehabilitation.

Psychodiagnostical, clinical-psychological, clinical-psychopathological.

Clinical examination during the period of acute stress reactions was observed, dominated by anxiety disorders, prolonged depressive reaction. Anxiety disorders were found in 56.5%, prolonged depressive reaction in 32.0%, post-traumatic stress disorder in 10.5% of patients. The treatment of the underlying disease, complex psychological and physical rehabilitation. Psychological rehabilitation included CBT, relaxation, art therapy. Physical rehabilitation includes kinesiotherapy and TRE. A set of measures of physical rehabilitation led to reduction of anxiety to physiological levels in all mentally healthy patients, reduce the severity of psychosomatic symptoms in the structure of the underlying disease, increased satisfaction with the results of treatment by 28.5%.

Analysis of mental health study of IDPs and evaluation of comprehensive rehabilitation in terms of the University Clinic show the need for screening mental state when applying for medical assistance and the desirability of psychological and physical rehabilitation of patients during hospital stay somatic profile.

The authors have not supplied their declaration of competing interest.

Differences between the most frequently reported diagnoses of Greek people and immigrants in Greece are expected due to the different underlying factors which are associated with mental health issues.

Examine differences in diagnoses between Greek people and immigrants.

To investigate whether Greek people and immigrants had significant differences with regard to reported diagnoses in a Greek hospital.

The patients who participated in this study are 5551, among them 2760 (49.7%) were males and 2791 (50.3%) were females. The mean age of the sample was 45.54. The sample consisted of 455 (8.3%) immigrants and 5,042 (91.7%) Greek people. Convenience sampling method was used and the sample was collected at the General Hospital of Nikaia, “Ag. Panteleimon” in Athens, Greece, between 01/01/2012 and 31/12/2015.

There were significant differences between Greek people and immigrant with regard to diagnosis as χ2 (20): 136.875, P < 0.001. More specifically, among Greek people, the most frequently reported diagnosis was psychotic disorder (26.2%), followed by depression (24.7%), general anxiety disorder (9.9%) and substance abuse (8.4%). Among immigrants, the most frequently reported diagnosis was psychotic disorder (22.9%), followed by substance abuse (21.3%), depression (17.4%) and general anxiety disorder (12.1%).

The differences between Greek people and immigrants with regard to diagnoses showcase the different needs between the two populations with regard to mental health. Especially, the higher prevalence of anxiety disorders and substance abuse problems among immigrants highlight the need for protective measures to improve their well-being and reduce their risk of mental health issues.

The authors have not supplied their declaration of competing interest.

This study aims to investigate the perceptions of health, disease and pain issues among Greek immigrant, living in Germany, as they were formed through their previous experiences, their immigration routes and their experiences in a new sociocultural environment, while taking under consideration their varying cultural backgrounds.

This research was based on the personal interpretations of ten Greek immigrant (6 women and 4 men). As to methodology, qualitative research was employed. The methodological tools used for the collection of the material were semi-structured interviews (face to face), participant observation and a field diary. Finally, the method of analysis used for the empirical material was content thematic analysis.

All participants experienced immigration as an especially stressful period of their lives that changed their state of health (these changes extend from physical complaints to manifestation of depression). Most person describe life in Germany as difficult due to various problems (loss of relatives and friends’ social networks, poor language knowledge, isolation, etc.). However, the public health system's organization (regardless any flaws), which ensures their access to health services, positively contributed in changing their attitudes regarding the issues under question. Lastly, the reference to psycho-traumatic situations, transitional life phases, as well as to stimuli in the difficult everyday life feed person's meaning-makings about pain.

The research's results showed that health and disease are not only biologically determined phenomena. They also are socially determined situations, given that they are not only related to changes in the individual's psychology but are influenced by the broader sociocultural environment in which the individual lives and works.

The authors have not supplied their declaration of competing interest.

The purpose of this research was to investigate the problems of first-generation immigrant students and the linkage of these problems with the psychopathology of students.

The sample of this study included men and women students, that were second-generation immigrants aged from 18 to > 25 years.

The research tools used were: (a) Psychopathology Scale (Symptom Checklist 90-R - SCL-90) and (b) State - Trait Anxiety Inventory (STAI), (c) the orientation test life (LOT-R) d) Other As Shamer Scale (OAS), (e) Experience of Shame Scale (ESS). The statistical processing of data showedQ (a) the students immigrants have higher levels of student migrants stairways: inferior (OAS), empty (OAS), (Mistakes (OAS), Total internal shame (ESS), characterological shame (ESS), behavioral shame (ESS), bodily shame (ESS), Trait Anxiety (STAI), Somatization (SCL-90), Inter. Sensitivity (SCL-90) and Depression (SCL-90).

The results of our study found high levels of psychopathology students immigrants and students migrant and interpretative this finding is explained by the lifestyle of their parents immigrants and different cultures which have to cope and adapt and their marginalization from society and official institutions, a situation that results in their exposure to a variety of risks to their mental health.

In addition to increased levels of psychopathology, second generation immigrants such as students and the students in our sample suffer from violence the authorities and their fellow citizens.

The authors have not supplied their declaration of competing interest.

It is a well known fact that qualified health professionals generally migrate to high-income, developed regions. Nevertheless, the perceptions of this immigrant skilled health workforce on access to opportunities or feeling discriminated in their host countries, have not yet been explored or adequately addressed.

This work has focused on the perceptions of immigrant psychiatry trainees in several European countries about their views on having equal access to opportunities as natives or feeling discriminated.

A semi-structured 61-item questionnaire was circulated by National Coordinators in each country and was completed by 2281 psychiatric trainees from 33 European countries between year 2013 and 2014. Data has been analysed using the Software Package for Social Sciences for Windows v. 22.0 (SPSS Inc. Chicago, IL).

In these findings, more than one in ten psychiatry trainees across Europe were immigrants, with top host countries being Switzerland, Sweden and UK. Satisfaction with migration and the perception of having equal opportunities as the native trainees varied depending on the host country they migrated to. More than one-third of the trainees felt discriminated, not having the same opportunities as the local colleagues, especially concerning the work opportunities and the academic conditions. Still, nearly two-thirds considered having the same opportunities than natives.

A high number of immigrant psychiatry trainees subjectively feels they do not have the same opportunities as local trainees. Further research about factual and perceived discrimination by immigrant workforce should be done.

The authors have not supplied their declaration of competing interest.

Recent historical perspective suggests that suicide is a neglected issue among immigrants and ethnic minorities.

Given the need to delivering proper care to such populations, government is now requested to address suicide risk and involve proper interventions.

To provide comprehensive overview of suicide risk among immigrants and ethnic minorities and possible targeted preventive measures.

Given the relatively early and underdeveloped state of this area of inquiry, the author viewed his task as gathering and critically appraising the available research relevant to the topic, with the aim of formulating a hypothesis to be tested with further research.

Evidence support the notion that certain communalities across ethnic groups are influenced in a considerable way by the suicide risk in the country of origin. Furthermore, some well-known risk factors for suicide may not play a central role in the case immigrants and ethnic minorities; on the contrary, adjustment problems point to the explanation that emotional distress may be caused by social problems, racism and discrimination. Suicide risk among these individuals may also be referred to the risk in the country of origin pointing to grater complexity when individuals immigrate into a country with different suicide rates as well as different contributing factors. Help-seeking barriers are still a major obstacle for delivering proper preventive intervention. The author aims at providing a comprehensive picture of suicide risk among this population and highlight possible preventive strategies.

Social interventions, culture-sensitive community projects or interventions targeting specific subgroups might be possible solutions.

The author has not supplied his/her declaration of competing interest.