Slow and inadequate implementation causes greater inequity and reduced quality in emergency psychiatric services. This symposium is based on five recommendations to improve health intervention research and implementation, presented by Professor Emma Mcginty (PhD), the leader of the Lancet Psychiatry Commission to transform implementation in mental health. This presentation will introduce each of these recommendations: I) integrate research into clinical practice to ease implementation II) embed equity in mental health intervention research III) use complexity science and bottom-up approaches to improve relevance of science and implementation IV) base implementation less additional methods beyond traditional RCT-based research V) use a transdisciplinary approach in development and implementation of research on new interventions.

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Humanitarian crises result from various events threatening many individuals’ health, safety, and well-being. The frequency of public health crises has increased within the last decades, posing significant risks to health, particularly for people in low- and middle-income countries. Social determinants such as discrimination, poverty, and violence are risk factors for mental health conditions. People living through humanitarian crises might experience mental distress, with challenging circumstances that lead to vulnerability to developing mental disorders, including depression, anxiety disorders, and post-traumatic stress disorder.

Psychotherapy in humanitarian settings mainly refers to providing psychological support and treatment to individuals affected by wars and armed conflicts, famine, and natural disasters such as earthquakes, hurricanes, or floods. Humanitarian settings pose unique challenges to the delivery of mental health services due to disrupted infrastructure, cultural differences, and the complex needs of affected individuals. Therefore, psychotherapeutic interventions in humanitarian settings should recognize the psychological and social aspects of mental well-being for prevention and treatment. The psychological components of such interventions are related to the mental and emotional state of the person. Social components include efforts to strengthen social support and interpersonal skills, promoting positive aspects of mental health.

In humanitarian settings, mental health care is often integrated with other services, such as education and social services. This holistic approach ensures that mental health is addressed with basic needs like food, shelter, and safety. Another critical aspect is ensuring the safety and mental well-being of therapists at risk in conflict zones. Although limited evidence shows their effects on better mental health outcomes, several therapeutic modalities are frequently used in humanitarian settings, adapted to unique circumstances. Those include cognitive-behavioral therapy, group therapy, trauma-focused psychotherapy, mindfulness and stress reduction, narrative therapy, and interpersonal psychotherapy.

In conclusion, psychotherapy in humanitarian settings plays a crucial role in addressing the mental health needs of individuals affected by crises. It requires flexibility, cultural sensitivity, and a multidisciplinary approach to overcome the challenges posed by these environments. Digital platforms and web-based services might offer accessible and resourceful therapy options. However, further research is needed to evaluate the effectiveness of psychosocial interventions in such settings. Efforts to expand real-world solutions in mental health services, build local capacities, and integrate psychosocial support into broader humanitarian assistance in low-resourced settings are essential to fostering recovery and resilience in affected populations.

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Worldwide, suicidal ideation in youth varies between 14% and 23 %. Between 5% and 16% have made a suicidal attempt. The prevalence has increased recently. However, we measure a decrease in suicide deaths (Van Meter et al., 2021). Suicide is the second cause of death after accidents. Most psychiatric disorders appear during or before adolescence (Solmi et al., 2022), which makes it a critical period to begin treatment. Development induces peculiarities like more dependence on the environment, insight difficulties, and impulsivity.

Risk factors should be assessed like previous suicidal attempt history, active suicidal ideation, trauma, alcohol misuse, and drug misuse (Pernau et al., 2024).

The management of these situations stresses several challenges. Several interventions were designed but did not show specificities on subsequent suicide prevention. However, they decreased immediate psychiatric hospitalisations, increased mental health service use, and showed mild improvement in subsequent depressive symptoms (Pitt et al., 2024).

Studies in non-specific factors and therapeutic alliance operationalized in motivational interviewing open perspectives like the importance of reflective listening, open questions, semi-directivity and shared objectives (Miller & Moyers, 2021).

Understanding of depression enlightens specific simple approaches like behavioral activation (Richard et al., 2016; Kanter et al., 2010) and problem-solving therapy (Bell & D’Zurilla, 2009).

Specific tools like joint crisis plans (Jong et al., 2016) are useful and ethical on paper or in apps (Stanley et al., 2018)

Organization of care is of paramount importance like phone and letters contact like the program Vigilans (Plancke et al., 2020).

Bibliotherapy and internet CBT tools (Linardon et al, 2024 ; Hedman-Lagerlöf, et al., 2023 ; Lewis et al., 2012) could be useful to improve mental health care accessibility with a small cost.

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Digital studies based on the continuous monitoring of patients in their natural environment help to refine the suicidal phenotypes. Studies using ecological momentary assessment revealed the existence of different patterns of suicidal ideation (SI) based on both their severity and variability. Specifically, variable SI may be a frequent pattern of suicidal ideation that appears to be related to some clinical features (social withdrawal, impulsive aggression, suicide attempts), rooted in childhood trauma and serotonergic dysfunction and associated with the reactivity to stressful life events. Some individuals, in response to stress could experience both psychological pain and decision-making impairment in social contexts, leading to suicide risk. Then, the description of the suicidal pattern may help to define clinically and biologically homogeneous groups of at-risk patients.

In this sense, experimental studies where patients are submitted to a social stress task reported that patients who were more sensitive to a social stress, as measured with a higher salivary cortisol response, were less depressed, more impulsive, and made suicide attempts with a higher intent. Investigating the regulation of the immune inflammatory response to the social stress task, we recently reported that suicide attempters and ideators showed less dynamic inflammatory stress responses in comparison to psychiatric controls, and that platelet activation responses to stress were blunted in individuals with suicidal ideation. Last, we will present new data of cardiovascular and emotional responses to the virtual Trier Social Stress Test in women with a history of depression and with or without a history of suicide attempt. Combining digital and experimental studies could help to refine the suicidal phenotypes and reduce the heterogeneity of suicidal behaviors that are led by different processes, in order to develop specific therapeutic approaches for a better suicide prevention.

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Decedents without known mental disorders constitute 5%-40% of suicides and epidemiologic studies show that 20% of those with a history of suicidal behavior (SB) may be free of psychiatric disorders. This implies that suicide ideation (SI) may occur in the psychiatrically healthy volunteers (HVs), providing an opportunity for preventing suicide and SB. Yet, studies of HVs have not focused on the occurrence of SI, nor has SI in HVs been characterized, especially in relation to the occurrence of stress. If SI is not rare in HVs, current approaches to managing suicide risk in medical settings may be too limited to identify psychiatrically healthy individuals at risk for suicide.

We recruited HVs and major depressive disorder (MDD) patients to test two hypotheses: (1) some HVs, screened to exclude those meeting lifetime criteria for Axis I or II disorders and with no personal or family history of SB, would endorse SI on Ecological Momentary Assessment (EMA); and (2) HVs’ SI scores would be lower than those of MDD patients. In addition, we investigated whether HV and MDD groups had different responses to stressors in terms of SI.

HVs and MDD patients were recruited through advertisements: some patients were recruited in the emergency department. Participants provided 7 days of ecological momentary assessment (EMA) data about SI and stressors. EMA data was collected in six 2-hour epochs during a 12-hour period selected to match participant wake hours. Longitudinal mixed effects logistic regression models compared HV and patient SI scores and frequency of stressors. Mixed effects linear regression models compared HVs’ and patients’ SI score change from the previous epoch’s SI score when each stressor occurred.

HVs (n=42) reported less frequent (p<0.001) and less intense SI (p<0.003) than patients (n=80). HVs did endorse SI and/or SI-related items in 44% of EMA epochs, endorsing actual SI items, as opposed to SI related items (lack of wish to live) in 25% of epochs with non-zero SI scores. For 7 of 8 stressors, patients reported stressors more often than HVs (all p<0.001) and responded to them with greater SI (0.0001<p<0.0472). HVs reported statistically significant SI increases only in response to neglect (p<0.0147), indicating HVs were relatively resilient to other stressors.

The occurrence of SI and SB among psychiatrically healthy individuals has been relatively neglected. However, SI does occur in this population. Although HVs demonstrated more modest SI increases than patients in response to stressors, the reports of SI in 44% of epochs by HVs suggest that focusing solely on individuals with mental disorders when screening for suicide risk may be too narrow an approach.

M. Oquendo, MD, PhD earned royalties from: Research Foundation for Mental Hygiene, Inc. - Columbia Suicide Scale, Conflict with: Honoraria - Alkermes - Grant Reviews, Honorarium.

Individuals with autism and intellectual disability encounter numerous challenges as they transition into adulthood. By analyzing case studies of students in both specialized and mainstream educational settings, I aim to highlight their perspectives and experiences.

These individuals grapple with a myriad of hurdles, from difficulties in communication and social interaction to challenges in academic and vocational pursuits. Through case studies, we witness the personal and societal barriers they encounter, highlighting the need for tailored interventions and support systems.

Early intervention and specialized education play crucial roles in empowering these individuals to thrive. By providing nurturing environments and equipping them with essential skills, we can foster independence and enhance their overall well-being. Additionally, community resources offer ongoing support beyond the school setting, further facilitating their transition into adulthood.

Central to our discussion is the importance of fostering an inclusive society that embraces neurodiversity. When individuals with autism and intellectual disability are valued for their unique perspectives and talents, they can contribute meaningfully to society. Through acceptance and understanding, we can pave the way for a more equitable future for all.

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According to the American Academy of Child and Adolescent Psychiatry (AACAP), 50% of all lifetime cases of mental illness begin by age 14, and 75% by age 24 (1). Development is a life-long process, but adult development is generally more gradual and less critical than that of children and adolescents. That is why the role of development in child psychiatry is particularly important, contrary to the adult psychiatry, more focused on the categorical definition of the observed clinical situation.

Autism Spectrum Disorders (ASD) in particular, characterized by heterogeneity, may evolve to adulthood with an atypical presentation. Approximately a quarter of autistic adults reported being misdiagnosed with at least one psychiatric condition before receiving an autism diagnosis. Personality disorders, mood disorders, and anxiety disorders were most frequently perceived as misdiagnoses, according to Fusar-Poli et al (2).

The contact between adult psychiatry and child and adolescent psychiatry, may be organized in transition care settings (outpatient care, clinical discussions, …). These practices may have a major impact in adult psychiatry practice, emphasizing the importance of a developmental approach, at any given time and with each patient, going beyond the classical inquiry about clinical and personal backgrounds. It also helps adult’s psychiatrists to keep in mind diagnostic hypotheses of neurodevelopmental disorders, which are usually more focused on child and adolescent psychiatry.

A clinical case will be presented to illustrate our thesis.

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Transitional care refers to the coordination and continuity of care between different healthcare locations or levels of care within the same facility, regardless of the patient’s age. Transition planning and management is therefore a key element in the organization and delivery of health services. Unfortunately, for many young people with mental health problems, transition is poorly planned, lacks coordination, and results in discontinuity of care. This is particularly true for intellectual disability, Autism Spectrum Disorder, and ADHD: as neurodevelopmental conditions, care typically begins at a young age with attendance at Child and Adolescent Mental Health Services (CAMHS), and the transition to Community Mental Health Services (CMHS) encounters numerous challenges.

A narrative review of the literature was conducted on the topic of transition from inception to January 26th, 2025. The following search string was used through PubMed, Web of Science, Scopus, and PsychInfo: (“Transitional Care” OR “Transition to Adult Care”) AND (“Neurodevelopmental Disorders” OR “Intellectual Disability” OR “Autistic Disorder” OR “Autism Spectrum Disorder”) AND (“Child and Adolescent Mental Health Services” OR “CAMHS” OR “Community Mental Health Centers”).

A total of 202 references were identified and screened considering titles and abstracts. After excluding papers not relevant to the topic and those that were unretrievable, 31 papers were included in the review. A significant majority of the included papers were qualitative studies based on focus groups and interviews conducted with family members and caregivers.

Findings reveal a lack of clarity and consistency regarding service availability for the conditions studied, possibly due to different eligibility criteria between child and adult mental health services, with variable service provision for young people with neurodevelopmental conditions (specifically, ASD, ADHD and ID). While high workloads and staff shortages were perceived to influence service thresholds and eligibility criteria, the lack of perceived severity by the CMHS often led to loss of follow-up.

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We report the case of an 18-year-old male patient diagnosed with autism spectrum disorder at age of 12. Between the age of 12 and 18 he developed anxiety and substance use disorders.

He was acutely admitted to the Department of Psychiatry and Psychotherapy at Semmelweis University due to a severe manic episode with psychotic symptoms at the age of 18. He provided a multidisciplinary treatment, including medication, support group, individual addiction consultation and rehabilitation. He became stable, currently abstinent for six months and planning to graduate.

Our case report has practical implications for physicians by raising their awareness of comorbid mental disorders in the autism spectrum and also the difficulties in the transition between adolescence to adulthood.

autism spectrum, comorbidity, transient psychiatry

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Schizophrenia (SCZ), bipolar (BD) and major depression disorder (MDD) are severe psychiatric disorders that are challenging to treat, often leading to treatment resistance (TR). It is crucial to develop effective methods to identify and treat patients at risk of TR at an early stage in a personalized manner, considering their biological basis, their clinical and psychosocial characteristics. Effective translation of theoretical knowledge into clinical practice is essential for achieving this goal. We describe the methodology of the PROMPT project that aims at the development of a precision medicine algorithm that would help early detection of non-responder patients, who might be more prone to later develop TRD. In addition, we demonstrate other ongoing comprehensive protocols in Precision Psychiatry, such as the Horizon Europe funded PsychSTRATA consortium. To address these objectives, the PROMPT project which is organized in 2 phases will involve 300 patients with MDD already recruited in phase 1, comprising 150 TRD and 150 responders. In phase 2, a new naturalistic cohort of 300 MDD patients will be recruited to assess, under real-world conditions, the capability of the algorithm to correctly predict the treatment outcomes. Moreover, in this phase a shared decision making (SDM) process in the context of pharmacogenetic testing is explored and various needs and perspectives of different stakeholders toward the use of predictive tools for MDD treatment to foster active participation and patients’ empowerment are evaluated. In addition to this effort, the Psych-STRATA consortium addresses a major research gap in Precision Psychiatry through a seven-step approach. First, transdiagnostic biosignatures of SCZ, BD and MDD are identified by GWAS and multi-modal omics signatures associated with treatment outcome and TR (steps 1 and 2). In a next step (step 3), a randomized controlled intervention study is conducted to test the efficacy and safety of an early intensified pharmacological treatment. Following this RCT, a combined clinical and omics-based algorithm will be developed to estimate the risk for TR. This algorithm-based tool will be designed for early detection and management of TR (step 4). This algorithm will then be implemented into a framework of shared treatment decision-making with a novel mental health board (step 5). The final focus of the project is based on patient empowerment, dissemination and education (step 6) as well as the development of a software for fast, effective and individualized treatment decisions (step 7). Both the PROMPT study and the PsychSTRATA project have the potential to change the current trial and error treatment approach towards an evidence-based individualized treatment setting that takes TR risk into account at an early stage.

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Schizophrenia is a chronic disorder with a massive impact on quality of life. The prevalence of treatment resistance has been estimated around 30%. Treatment resistance is typically defined as non-response to 2 antipsychotics of adequate dose and duration. However, clinical reality often shows that the definition at an individual level is more complex and a personalised approach is needed.

We present a literature review discussing clinical, neurobiological and pharmacogenetic aspects relevant to treatment resistance.

Our overview highlights the need for indiviudalised assessement of patient needs. We discuss pharmacogenetic aspects related to treatment respons and tolerability, including Clozapine. We focus on indicators for stratification and treatment optimization in the context of personalised medicine. In addition, we present evidence for other augmenting treatment modalities in the context of treatment resistance for schizophrenia, such as neuromodulation (e.g., rTMS for acoustic hallucinations).

This talk focuses on the challenges of treatment resistance in schizophrenia and discuesses new insights in the existing treatments and pharmacogenetics, as well as opportunities for treatment augmentation that arise from emerging technologies.

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The pharmacological treatment strategies for bipolar disorders include both acute and maintenance treatments. However, a substantial number of patients do not respond sufficiently to pharmacotherapy. Thus far, there has been no standardized definition for treatment resistance in bipolar disorder. Studies have been using different definitions, possibly due to the clinical complexity including the episodic nature of bipolar disorder and various subtypes. The talk will discuss the definitions, neurobiological, and genetic aspects as well as ongoing initiatives to identify markers for treatment resistance in bipolar disorder.

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Major depressive disorder (MDD) is the most heterogeneous psychiatric disorder, as over 1400 combinations of symptoms can satisfy DSM diagnostic criteria, and understanding the underlying biological heterogeneity is fundamental in the perspective of precision psychiatry. Genetic variants are responsible for part of this heterogeneity and contribute to inter-individual differences in treatment effects. Therefore, pharmacogenetic studies can identify predictors of poor treatment response and treatment-resistant depression (TRD), aid the prescription and development of targeted treatments or the prescription of early intensive treatments in patients at risk of TRD. Previous genome-wide association studies (GWASs) had limited power to identify specific variants/genes involved in TRD, but polygenic overlap between poor antidepressant response/TRD and several other traits was demonstrated, e.g., schizophrenia, attention deficit hyperactivity disorder (ADHD), and cognitive traits. As suggested by the high clinical heterogeneity of MDD, considering specific symptom profiles can improve the power to identify genetic signals associated with TRD. Other promising strategies to identify the biological mechanisms involved in TRD include the study of large population cohorts, using proxies of TRD defined from electronic health records (EHRs), and the integration of biomarkers reflecting also environmental factors, such as proteomics. These strategies and ongoing studies will be discussed during this talk, with reference to Psych-STRATA, a project within the Horizon Europe research and innovation programme (101057454; https://psych-strata.eu).

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Alterations in cognition and social cognition in bipolar disorder and schizophrenia have been largely documented. However, to which extent these alterations overlap between the disorders and how they are relevant to early stages as well as to risk conditions remains unclear. To shed light on this topic, 59 patients with Bipolar Disorder (BD), 118 patients with schizophrenia (SCZ), two independent cohorts of Healthy Controls (HC1=95, HC2=195), as well as individuals at Clinical High Risk (CHR=35) and at First Episode of Psychosis (FEP=29) were characterized for a series of cognitive and socio-cognitive features, which were entered in a machine learning analysis as a cognitive, a socio-cognitive, and a combined cognitive and socio-cognitive (stacking) classifier. Such classifiers were probed to discriminate at the single subject level BD vs. HC1 and SCZ vs. HC2. Then, those with the greatest diagnostic power in categorizing BD vs. HC1 were challenged to predict discrimination between SCZ vs. HC2, and vice-versa. Thus, decision scores for such models were compared with those obtained when they were applied to FEP and CHR. Results indicated that stacking classifiers were the best in discriminating HC1 vs. BD (Balanced Accuracy - BAC = 80%) and HC2-SCZ (BAC = 84%). Furthermore, the HC1-BD staking classifier successfully discriminated HC2 from SCZ (BAC=77.4%), and vice-versa (BAC=83.1%). Decision scores for SCZ and BD overlapped with those obtained when stacking models were applied to FEP, identifying a “patient-like” pattern. Differently, when such combined signatures were applied to CHR individuals, they were classified neither as patients nor as HC. Findings suggest an overall overlap of cognitive and socio-cognitive anomalies classifying schizophrenia and bipolar disorder, which is also relevant to early stages of disease. In this general context, disease-specific core abnormalities characterize SCZ and BD. Personalized rehabilitative programs may be oriented to primarily manage disease-related cognitive and socio-cognitive “hub” alterations, but always within a broader assessment.

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Abnormal cerebellar functional connectivity (FC) has been independently implicated in the pathophysiology of schizophrenia (SCZ) and bipolar disorder (BD). However, the relationship between cerebellar dysconnectivity patterns in these two disorders and their association with cognitive functioning and clinical symptoms have not been fully clarified. In this study, we used the state-of-the-art functional atlas of the cerebellum to examine cerebellar FC changes in the SCZ–BD spectrum and their association with cognitive and clinical variables.

Resting-state functional magnetic resonance imaging (fMRI) data of 39 individuals with SCZ, 43 BD type I and 61 healthy controls were examined. The cerebellum was parcellated into ten functional systems and we calculated seed-based FC for each cerebellar system. Cognitive abilities were investigated with the Wechsler memory scale, the California Verbal Learning test, the Stroop test, the Attentional network task, the Continuous performance test, the Task Switch task and the Stop Signal task. Psychopathological evaluation was carried out using the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms. We used principal component analyses to reduce the dimensionality of the diagnosis-related FC and cognitive variables, respectively. Multiple regression analyses were conducted to assess the relationship between FC and cognitive and clinical data.

We observed lower cerebellar FC with the frontal, temporal, occipital and thalamic areas in SCZ, and a more widespread decrease in cerebellar FC in BD, involving the frontal, cingulate, parietal, temporal, occipital and thalamic regions. SCZ presented increased within-cerebellum and cerebellar-frontal FC compared to BD. Higher cortico-cerebellar FC was positively associated with memory (p-FWE=0.036) and verbal learning (p-FWE=0.043). Exploratory analyses showed a negative correlation between cortico-cerebellar FC and positive symptoms (p-FWE=0.051).

These findings suggest a role for shared and distinct patterns of corticocerebellar dysconnectivity in the SCZ–BD spectrum that can result in cognitive impairment and psychotic symptoms. In addition, they highlight the potential role of cerebellar stimulation as a promising intervention for individuals with SCZ and BD-I that present cognitive impairment.

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Cognitive dysfunction is well documented in patients with schizophrenia and bipolar disorder, including impairments in attention, memory, executive function and social cognition. These impairments are associated with poor social functioning and reduced activities of daily living.

Various therapeutic interventions have targeted cognitive impairment in both schizophrenic and bipolar patients. Several trials and meta-analyses are currently available. In addition to psychopharmacology, cognitive remediation programmes are available and have been shown to be applicable in clinical practice.

In conclusion, as we move towards more integrative and personalised treatment strategies for schizophrenic and bipolar patients, new assessments and therapies are available to target cognitive dysfunction. Not least because there are currently no cognitive enhancers on the market, it is hoped that new pharmacological adjunctive strategies can improve cognition in schizophrenia and bipolar disorder.

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Although Autism Spectrum Disorder (ASD) is frequently reported as a comorbidity in adults with Attention Deficit Hyperactivity Disorder (ADHD), diagnosing this additional condition in clinical practice remains challenging. Missing this diagnosis can significantly impact treatment and reduce the quality of life for these adults. In child and adolescent psychiatry, attention is also given to the source(s) that influence the symptoms and complaints of ASD and ADHD, both in diagnosis and treatment.

This lecture highlights the importance of identifying the source(s) of symptoms and complaints in adult patients, with or without ADHD, in an outpatient urban setting. Better mapping of these source(s) helps distinguish the symptoms of ASD from those of ADHD, refining both diagnosis and treatment. Unsurprisingly, ASD is often not even considered a potential comorbid condition in adults. In this lecture, we share practical experiences with adult outpatients and discuss the source(s) that frequently emerge, which aid in differentiating ASD symptoms from those of ADHD.

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Attention-deficit/hyperactivity disorder (ADHD) in adults often presents with nonspecific symptoms that can be obscured by years of compensatory mechanisms and comorbid conditions. Traditional diagnostic approaches may fall short in capturing the nuanced presentation of ADHD in previously undiagnosed adults, leading to potential misdiagnosis or delayed treatment. This talk presents a comprehensive clinical framework for evaluating adult ADHD that integrates structured assessment protocols with thorough clinical investigation.

Our diagnostic model employs a multi-stage evaluation process that includes: (1) comprehensive pre-interview rating scales, (2) in-depth clinical interviews focusing on lifetime symptom presentation and functional impact, (3) systematic gathering of collateral information, and (4) administration of validated assessment instruments with embedded validity scales. The evaluation protocol emphasizes the assessment of executive function, emotional regulation, and adaptive behaviors developed throughout adulthood.

This approach represents a significant advancement in adult ADHD diagnosis by incorporating validated assessment tools with thorough clinical investigation. The model’s emphasis on lifetime symptom patterns, adaptive behaviors, and compensatory mechanisms provides crucial insights into how ADHD manifests in adults who have developed various coping strategies throughout their lives. Furthermore, the integration of multiple data sources with patient insights facilitates better treatment engagement and outcomes.

The proposed comprehensive evaluation framework offers a more sophisticated and nuanced approach to diagnosing ADHD in previously undiagnosed adults. By combining validated assessment instruments with thorough clinical investigation and collateral information, this model enhances diagnostic accuracy and treatment planning. Our findings suggest that this approach not only improves diagnostic precision but also provides valuable insights into the developmental trajectory of ADHD, leading to more personalized and effective treatment strategies.

Adult ADHD, clinical evaluation, executive function, compensatory mechanisms, diagnostic precision

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The EPA Action Plan 2025-2027 aims to optimize mental health care in Europe, by focusing on several unmet needs still experienced by patients. New ways for treatment delivery and new settings of care, tailored diagnostic approaches, research on brain and on mental health, reduction of multimorbidity and mortality gap, promotion of prevention strategies in mental health and more attention on minorities’ mental health represent some of the milestones on which a roadmap for mental health in Europe may be based.

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This study evaluated European countries’ responsiveness to mental health (MH) needs by analyzing key performance indicators (KPIs) across healthcare, workplaces, schools, and society. Data from the 2023 Headway Initiative included 15 KPIs related to healthcare responsiveness—such as workforce availability, facilities, quality of care, and MH expenditure—and 14 KPIs assessing responsiveness in workplaces, schools, and society. KPI scores were standardized on a 1-10 Likert scale, with higher scores indicating better performance. Bivariate correlations examined associations between responsiveness and overall MH status. Sweden (10.0), Denmark (8.8), and Finland (8.3) demonstrated the highest responsiveness in healthcare, whereas Romania (1.0), Slovakia (1.1), and Latvia (1.2) ranked lowest. In non-healthcare domains, Germany (10.0), France (9.1), and Denmark (9.1) were the most responsive, while Greece and Slovakia (1.0) exhibited the poorest performance. These findings highlight significant disparities in MH support across Europe and emphasize the need for policies that address inequalities and bridge treatment gaps. Future efforts should focus on balancing MH status improvements with sustained investment in MH responsiveness.

C. Arango Speakers bureau of: Dr. Arango has been a consultant to or has received honoraria or grants from Abbot, Acadia, Ambrosetti, Angelini, Biogen, BMS, Boehringer, Carnot, Gedeon Richter, Janssen Cilag, Lundbeck, Medscape, Menarini, Minerva, Otsuka, Pfizer, Roche, Sage, Servier, Shire, Schering Plough, Sumitomo Dainippon Pharma, Sunovion, Takeda and Teva.