Findings highlight areas that require attention if aspirations for community-oriented mental health care are to be realised, particularly integration of mental health into primary care.

Older generation antipsychotics and antidepressants were used more frequently than in the countries of Western Europe. Psychotropic polypharmacy is a common practice. There is a need for adopting more evidence-based practice in psychiatric care in these countries.

Background Numbers of psychiatric beds (general, forensic, and residential) and prison populations have been considered to be indicators of institutionalisation of people with mental illnesses. The present study aimed to assess changes of those indicators across Central Eastern Europe and Central Asia (CEECA) over the last three decades to capture how care has developed during that historical period. Methods We retrospectively obtained data on numbers of psychiatric beds and prison populations from 30 countries in CEECA between 1990 and 2019. We calculated the median of the percent changes between the first and last available data points for all CEECA and for groups of countries based on former political alliances and income levels. Findings Primary national data were retrieved from 25 out of 30 countries. Data from international registries were used for the remaining five countries. For all of CEECA, the median decrease of the general psychiatric bed rates was 33•8% between 1990 and 2019. Median increases were observed for forensic psychiatric beds (24•7%), residential facility beds (12•0%), and for prison populations (36•0%). Greater reductions of rates of psychiatric beds were observed in countries with lower per capita income as well as in countries that were formerly part of the Soviet Union. Seventeen out of 30 countries showed inverse trends for general psychiatric beds and prison populations over time, indicating a possible shift of institutionalisation towards correctional settings. Interpretation Most countries had decreased rates of general psychiatric beds, while there was an increase of forensic capacities. There was an increase in incarceration rates in a majority of countries. The large variation of changes underlines the need for policies that are informed by data and by comparisons across countries. Funding Agencia Nacional de Investigación y Desarrollo in Chile, grant scheme FONDECYT Regular, grant number 1190613.

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IntroductionEmigration is a complex process of social changing through which an individual moves from a certain cultural environment/context to another, aiming to achieve persistent or long-term residency, causing distress. There is sustainable evidence that incidence of all forms of psychosis is higher in migrants.ObjectivesThis study aims to gather data of other research conducted in the field according to emigration as a risk factor for development of different psychosis.MethodsScientific articles searched in MEDLINE, regarding the incidence of mental disorders in different emigrant populations, for the period 1995 - 2015.ResultsThe average relative risk of schizophrenia and of other psychosis occurrence among first generation emigrants was 2.7 (95% confidence interval [CI]=2.3-3.2). Statistical analysis performed among studies of first and second generation of emigrants, and among studies which don’t make difference between generations, results in a relative risk of 2.9 (95% CI=2.5-3.4) of mental illness.ConclusionsThe data presented in this study emphasize the impact of migration on central symptoms of schizophrenia. Emigration process, cultural and social adaptation, play an important role on the individual mental health.DisclosureNo significant relationships.