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Introduction:Negative attitudes towards mental illness or the psychiatrist's role have repeatedly been reported in the literature among pregraduate medical students. Although a clerkship may improve the student's attitudes, negative perceptions regarding mental illness remained unchanged in about one-third of the students. When recovery is being assumed as a central concept of care, the presence of stigma among students represents an ethical challenge that the medical schools cannot avoid.Objectives:to implement a programme aiming i. to assess the stigma towards mental illness among pregraduate medical students, and ii. to tackle negative attitudes regarding mental illness and psychiatry.Methods:The authors, targeting the 6th year medical students, have developed a one half-day program to be held before the 4-weeks psychiatric clerkship. The program offers sequentially an initial overview about the concept of stigma, several examples from experiences reported by patients, videos and role-playing exercises. Attitudes towards mental illness were assessed by the Kassam‘s et al Mental Illness: Clinicians’ Attitudes Scale MICA-2’ self-reported questionnaire.Results:106 students were evaluated. The acceptance was very good, with no refusals to participate in the program. After the clerkship, perceptions about patients’ dangerousness, the need for social protection, the assets and the role of psychiatry were significantly improved.Conclusions:The good acceptance from the students and the preliminary results were very encouraging, suggesting that this program could change attitudes towards mental illness favorably. Given we’ve just evaluated a time span of one month, further studies are needed to assess the temporal stability of the changes.

IntroductionThere is emerging evidence that organizational culture and leadership profiles influence the way health services implement their systems of care. Studies regarding organizational culture of services are widespread in economical and managerial areas but very few evaluate mental health care contexts. Most of these studies aim to help in the management of human resources.ObjectivesTo assess the organizational culture and leadership profiles in the Portuguese mental health services.MethodsCross-sectional study, made in public and private mental health services. Evaluation was made by means of the competing values framework tool (Quinn, 1990) (Portuguese version - MJ Felício, 2007), which includes dimensions such as organizational culture and leadership profiles in the framework of more open or close systems and with more control or flexibility strategies.ResultsThere is no organizational or leadership profile clearly outstanding in the Portuguese mental health services. However Director and Coordinator leadership profiles scored higher in the results. These higher scores profiles were linked with assignment of duties, delegation of tasks and planning activities. Innovation profiles had the lowest scores, linked with the ability to cope with change and to manage change.ConclusionsFurther studies are critical to develop a clearer view regarding the influence of organizational culture and leadership profiles in the organization of mental health services. Low scores on innovation components may influence the way evidence based practices are welcomed and implemented in services.

Title:'A nation-wide staff training program for family psychoeducation in severe mental illness'Background:Despite all the evidence regarding its cost-effectiveness, psychoeducational family interventions for non-organic psychotic disorders are still not steadily applied in everyday routine practice. In Portugal, these interventions are seldom used, even in well-staffed psychiatric departments. Following the recommendations of the Portuguese National Mental Health Plan, a psychoeducational training program has been prepared by the Ministry of Health.Objectives:a) to conduct a psychoeducational training program on a national basis and b) to evaluate obstacles to implementation in routine practice.Methods:Professionals from public mental health services across the Country attended a 3 days full-time program in which they were trained in the psychoeducational intervention through presentation of guidelines, demonstrative audios and role-playing.Results:The trainees' acquisition of skills was found very satisfactory. The most prevlent barriers in the implementation of the intervention included work overload, the difficulty to integrate family work with other duties, and the poor allowance of time from the service to run the intervention on a regular basis.Conclusions:Measures should be taken in order to cope with obstacles limiting the use of family interventions in practice, including changes in the services governance and increased autonomy for professionals involved in the process.