Background Mental disorder is extremely common globally and integration of mental health in primary health services represents a critical gap especially in Low- and Middle-Income Countries like Egypt. The World Health Organization has repeatedly called for effective training and support of primary care providers in the identification and treatment of mental health problems over the last decades. Methods This paper aimed to evaluate attitudes and knowledge of health care providers toward mentally ill patients and measure knowledge and retention of training messages over time. A three-day mental health training workshop for nurses of public health facilities in the Governorate of Port Said was organized. Pre-training and post-training questionnaires (immediately after the workshop and three months later) were used. Significance of gain in scores was examined between baseline and following cross sectional rounds. Results The 73 participants at the study revealed a statistically significant improvement in knowledge and attitude toward mental health from the baseline (pre-training), from a general mean score for desirable answers of 10.5 (+/- 1.2) to 21.2 (+/- 0.6). However, results slightly declined after the months from the workshop (18.5 (+/- 0.6)). Conclusions Intensive short-term training on mental illness could be instrumental in improving knowledge and attitudes in a country like Egypt with extensive needs in terms of quality of comprehensive healthcare at primary and secondary level. However, additional evidence is needed to improve retention of information over time and to translate knowledge in clinical practice.

Background. Healthcare workers have a 16 times greater risk of suffering workplace violence than workers in other sectors and around 50% experience workplace violence in the course of their career. The objective of this study is to explore the characteristics and circumstances of work-related killings of doctors. Methods. Work-related homicides of doctors over the period 1988-2019 were identified retrospectively through the Italian national statistical agencies. Variables such as perpetrator, motive and location of the crime were obtained through forensic psychiatric work. After classification, the absolute and percent values of the main characteristics of the homicides were calculated. Results. Over the period considered, 21 doctors were killed in Italy in connection with their professional activity. In 52% (n=11) of cases, the killer was one of the doctor’s patients, in 29% (n=6) of cases it was a patient’s relative, in 19% (n=4) an occasional patient (first consultation). The location of the homicide was a community clinic in 48% (n=10) of cases, the street in 19% (n=4) of cases, the doctor’s home in 14% (n=3), the hospital in 14% (n=3) and the patient’s home in 5% (n=1). In 57% (n=12) of cases the perpetrator was not affected by any mental disorders. The motive for the homicide was revenge without previous threats in 52.4% (n=11) of cases; in 28.6% (n=6) the revenge was preceded by stalking. Conclusions. Doctors should be aware that the risk of being killed is not limited to hospital settings and that their patients’ family members might also pose a threat to them.