Early in the SARS–CoV-2 pandemic, most jurisdictions implemented mandatory face covering policies across healthcare settings. This intervention, which lasted multiple years, was unprecedented in psychiatry. Masks may affect the delivery of mental healthcare, given its reliance on nuanced communication and establishing a therapeutic alliance.

This scoping review aimed to provide an overview of the current literature concerning the impact of face masks in mental health settings beyond infection control and identify research gaps to guide future research and policy.

Systematic searches were completed in the MEDLINE, Embase, PsycINFO, Scopus and CINAHL databases on 14 August 2024. Articles were eligible if they described peer-reviewed empirical studies involving people with mental disorders or mental health clinicians that reported on impacts of face coverings.

Twenty-eight studies were selected for inclusion, involving 5385 participants. There was considerable heterogeneity among studies. Negative effects of face masks were reported in 26 studies in at least one domain. Themes from the survey-based literature included face masks negatively affecting communication, the therapeutic relationship and overall assessment quality. Experimental studies using emotion recognition tasks showed that people with mental disorders were disadvantaged by masks when interpreting emotions from facial expressions. The most commonly studied population was people with autism spectrum disorder. Children and people with severe or acute mental illness were underrepresented. Only two studies expressly recruited psychiatrists.

Policy makers should be aware of adverse impacts of mask-wearing in mental health settings and consider these in evolving risk–benefit analyses. Further research is needed to establish the extent of impacts on population subgroups.

We aimed to investigate the effects of the COVID-19 pandemic on the education and professional development, working conditions, and wellbeing of early career psychiatrists (ECPs) in Europe, as well as their attitudes to telepsychiatry.

A questionnaire comprising 24 items was designed by the Early Career Psychiatrists Committee of the European Psychiatric Association. Data were collected online from June 2020 to September 2021. A series of multiple regression analyses were conducted to determine variables that could predict the dependent variables.

Data were obtained from 517 early career psychiatrists from 39 different countries. Men were more confident than women in their knowledge of COVID-19 symptoms and management, including in managing patients with a comorbidity of COVID-19 and a mental disorder. Providing specific recommendations during the COVID-19 pandemic, access to additional educational activities for ECPs, following COVID-19-related recommendations and access to protective equipment were the significant predictors of a higher confidence in managing patients with comorbidity of COVID-19 and mental disorders. The obligation to change the place of work predicted a decreased satisfaction with telepsychiatry as well as a decreased willingness to use telepsychiatry after the COVID-19 pandemic, while a diagnosis of COVID-19, having recommendations for telepsychiatry and access to dedicated platform for telemedicine were predictors of an increased satisfaction with telepsychiatry.

The COVID-19 pandemic has affected ECPs in Europe to varying degrees. The results point to areas where decision-makers can improve the working conditions for ECPs.

Motor functional neurological disorder (FND) is a common illness associated with significant functional impairment. There are no effective pharmacotherapies, and despite the early promise of physiotherapy studies, many suffer disabling symptoms in the long term. There is a theoretical rationale for combining psychedelics with physiotherapy; however, the potential benefit of this approach and optimal treatment model remains unexplored. Here, we present the protocol for the first study investigating the tolerability, feasibility, and potential efficacy of two distinct treatment regimens of psilocybin-assisted physiotherapy for refractory motor FND: a moderate dose that incorporates movement tasks during the acute drug effects versus a standard dose alone.

Twenty-four participants with refractory motor FND will be randomised in a 1:1 ratio to either (1) psilocybin 15mg, with movement tasks conducted during the acute drug effects; or (2) psilocybin 25mg alone. All participants will receive two sessions of FND-specific physiotherapy pre-dosing, six sessions of physiotherapy post-dosing, and undergo follow-up visits one week and four weeks following their final physiotherapy session. A battery of outcome measures will be completed as scheduled, assessing tolerability, feasibility, motor FND symptom severity, psychiatric and physical symptoms, quality of life, treatment expectations, intensity of the acute drug effects, personality, motor function, force-matching performance, resting-state and task-based brain imaging, and subjective experiences of the study treatment.

These findings will assist the design of an adequately powered randomised controlled trial in this cohort. The findings may also inform the feasibility of psychedelic treatment in related functional and neuropsychiatric disorders.

To examine awareness of metabolic syndrome, lifestyle habits and attitudes towards physical health monitoring in a cohort of service users prescribed clozapine.

A cross-sectional study, utilising chart reviews and surveys, of service users attending a clozapine clinic in Ireland, to examine awareness of metabolic syndrome, current dietary and exercise habits and attitudes towards physical health checks for metabolic syndrome was conducted.

Sixty-nine service users attending the clozapine clinic (53.1% of attendees) participated in the study of which 23 (33.3%) participants met criteria for metabolic syndrome within the previous 12 months. Nine (13.0%) participants were aware of the term “metabolic syndrome”, with six aware of what metabolic syndrome entailed. Forty-seven (68.1%) participants described their diet as “healthy”, with 17 (24.6%) participants reporting the consumption of five portions of fruit and vegetables per day on a regular basis. Thirty-eight (55.1%) participants reported engaging in ≥ 2.5 hours of exercise per week. Most participants (> 70% for all physical indices) agreed that physical health monitoring was important with 46 participants (66.7%) stating physical health monitoring should occur monthly.

Although there was a limited awareness and understanding of “metabolic syndrome” in this cohort of service users prescribed clozapine, monitoring of physical health indices was acknowledged as important. Early dietary and exercise interventions in an attempt to combat high morbidity and premature mortality rates are advised for this service user cohort.

Off-licence psychotropic use in people with intellectual disability and/or autism, in the absence of psychiatric illness, is a major public health concern in England.

To ascertain and compare views of psychiatrists and non-psychiatrists working with people with intellectual disability and/or autism on psychotropic medication optimisation for this population.

A cross-sectional survey of 13 questions was disseminated online among psychiatrists and other health professionals working with people with intellectual disability and/or autism across England, using a non-discriminatory exponential snowballing technique leading to non-probability sampling. The questionnaire covered demographic characteristics, perceived barriers/benefits of psychotropic optimisation (including ethnicity) and views on implementation of a national medicine optimisation programme. Quantitative analysis used chi-squared, Mann–Whitney and unpaired t-tests, with significance taken as P < 0.05. Thematic analysis of free-text responses was undertaken with Braun and Clarke’s methodology.

Of 219 respondents, significant differences in attitudes to most issues emerged between psychiatrists (n = 66) and non-psychiatrists (n = 149). Psychiatrists had less optimism of a successful national medication optimisation programme if commissioned, or achieving 50% reduction in psychotropic overprescribing and inappropriate psychotropic prescribing generally. Perceived barriers to reducing overmedication differed significantly between the psychiatrists and non-psychiatrists, Thematic analysis identified five themes (system issues, resources, medication challenges, family and carers, and training and alternatives/structure).

This is the first study to highlight important differences between psychiatrists and non-psychiatrists’ attitudes to psychotropic optimisation despite respondents overall being broadly supportive of its need. A major finding is the hitherto unquantified concerns of patient ethnicity and its impact on psychotropic optimisation principles.

To triangulate the perspectives of mental health clinicians, older people with mental illness and their carers on Advance Care Planning (ACP) to develop evidence-informed educational resources.

The study setting was public mental health services. Results of previously reported reflexive thematic analyses of interviews discussing ACP with three stakeholder groups (12 older people with mental illness, 5 carers, and 15 mental health clinicians) were triangulated. The emergent overarching themes were considered within an interpretive description framework to develop educational resources to support each of the three stakeholder groups to engage in ACP.

Four overarching themes emerged: (i) importance of ACP recognized but ACP often not initiated; (ii) knowledge gaps; (iii) skill gaps – how to do it; and (iv) practical and process issues. Taking into account the research team’s knowledge of the local health contexts, two formats of educational resources were developed; written information sheets bespoke to identified knowledge gaps and needs for each group, and brief training films for clinicians addressing need for practical skills in ACP. The consumer and carer sheets were translated into three languages. Two brief clinician training films demonstrated introducing ACP within mental health reviews and how to address aspects of complexity in ACP with older adults with a mental illness and carers.

The current absence of specific educational resources for ACP with older people with mental illness contrasts with the recognized importance of ACP. Written resources were created to address empirically identified knowledge gaps and misconceptions and provide practical information and training films developed to demonstrate key skills for clinicians. The resources were made freely available, with dissemination planned to promote and evaluate use as part of a more comprehensive educational intervention. Resources supporting clinician, consumer and carer education are an important first step towards empowerment and participation in ACP.

Mental health disorders, including depression and anxiety, pose significant public health challenges globally, and in Saudi Arabia. Despite this, psychiatry suffers from a critical shortage of specialists. This study investigates factors influencing medical students’ career decisions in regard to psychiatry, aiming to enhance understanding of, and address workforce deficiencies in, mental healthcare.

This study aims to investigate the factors influencing medical students’ decision to choose psychiatry as a future career.

This cross-sectional study conducted an online survey among Saudi Arabian medical students from 28 December 2023 to 28 April 2024, employing validated questions refined through pilot testing. Participant selection included male and female students across preclinical and clinical stages, excluding non-medical students and those outside Saudi Arabia.

This study explores the perceptions and interest of 430 medical students in Saudi Arabia regarding psychiatry as a career. The majority were female (69.3%), with most in their preclinical years (60.2%). Key findings include limited personal connections to psychiatry (9.5% with a family psychiatrist), and primarily influenced by medical school (55.3%) and social media (42.1%). While 65.1% perceive psychiatry as mentally demanding, uncertainties exist about career prospects and stigma persists (39.1%). Gender differences were observed, with more females (34.6%) than males (22.7%) interested in psychiatry (P = 0.014). Early inspiration in medical education significantly increased interest (P = 0.001).

Early exposure, personal connections and gender-specific factors significantly influence medical students’ interest in psychiatry as a career. Integrating psychiatry education early in medical curricula and addressing stigma are critical for fostering positive perceptions and attracting diverse students to the field.