BACKGROUND:The awareness of climate change as a global environmental threat through media consumption and/or social interaction can have a psychological impact on people's mental health. However, little is known about the association between climate change awareness-related psychological distress (CCARPD) and mental health in people with psychiatric diagnoses or subclinical symptoms. METHODS:A comprehensive and systematic literature search of the PubMed, Embase, Web of Science Core Collection, Scopus, and CENTRAL electronic databases (from inception to February 2025) was conducted, without language restriction, for articles assessing the association between CCARPD and the mental well-being of people in the general and psychiatric populations. RESULTS:Twenty-eight thousand forty-seven reports were retrieved. Of these, 67 met the inclusion criteria (64 general and 3 psychiatric population studies). The overall correlation between CCARPD and mental health measurements (ranging from subclinical symptoms to clinical diagnoses of depression, anxiety, or stress) was positive and of weak-to-moderate strength. Nevertheless, higher psychological distress due to the awareness of climate change was found in those having more severe mental health problems. CONCLUSIONS:Although most studies have found small-to-moderate correlations between CCARPD and mental health measurements, it can be distressing and damaging for those with more severe mental health problems. As CCARPD will increase globally as the climate crisis unfolds in the coming decades while the understanding of the connections between CCARPD and mental well-being is still at an early stage of development, more research will be of utmost relevance, particularly in psychiatric populations.

Background: Depression remains a major global health burden, yet fragmented care often leads to waiting times and unmet needs. Therefore, the Belgian collaborative Integrated Depression Care (IDECA) project strengthened primary care depression management by introducing a Reference Person Mental Wellbeing (RPMW) who functions as a case manager, supported by shared-care tools, structured psychoeducation modules, and targeted training for general practitioners (GPs). This study examines normalization in primary care practice. Methods: A single-arm, mixed-method study was implemented over 18 months in two Flemish Primary Care Zones (PCZ). Implementation outcomes were assessed every four months using the NoMAD questionnaire and analyzed using Wilcoxon signed-rank tests. Peer review sessions with professionals and interviews with patients were analyzed thematically. Caseload and service delivery were assessed using process evaluation logs. Results: Twenty-two professionals (17 GPs, two RPMWs, and three PCZ staff members) completed the NoMAD questionnaire. Intervention familiarity increased during the first eight months (T0-T1: p < 0.001; T1-T2: p = 0.022) and continued to rise thereafter (T3-T4: p = 0.008). Integration into daily practice and perceived impact on professional work improved progressively, reaching near-ceiling scores. Peer review sessions highlighted the RPMW's central role in trust-building and care coordination. Over 12 months, one full-time equivalent RPMW supported 175 patients (mean age 40.7 years; 75% female), with an average of five consultations per patient. Patients reported high satisfaction, emphasizing accessibility, empathy, and practical support. Conclusions: Sustained results suggest successful normalization and support the potential of collaborative, low-threshold depression care. Future work will assess clinical and economic outcomes.

Background As in other European countries, mental healthcare in Belgium has to deal with the increasing cultural diversity that exists within society. However, commitment of the Belgian healthcare system toward cultural diversity remains weak, and clear guidelines on culturally competent psychiatric practice are still lacking.Methods Three focus groups with professional caregivers, three with adult patients, and one with young adults in the transition age were organized. The seven focus groups each consisted of 5-10 participants. Two brainstorming sessions with a total of 15 experts were organized a priori to delineate focus group topics. Data analysis software MAXQDA 24 was used for thematic analysis.Results The thematic tree consists of the central theme "culturally sensitive mental healthcare" with five main themes (i.e., vulnerable population, language barrier, mental healthcare stigma, spirituality/religion, Western vs non-Western frame of reference). These themes are further stratified into a number of subthemes and one overarching theme (i.e., diversity policy). The themes have resulted in six recommendations to improve cultural psychiatric care. These recommendations underscore the vulnerability of the target patient population, specific training needs, the need for professional interpreters and intercultural mediators, the place of religion and spirituality in therapy, reflexivity as core competence, and the need to establish reference centers.Conclusions The six recommendations provide a scientifically sound base to develop focused and effective mental health policies at the governmental, organizational, and patient level. Continued attention to the importance of cultural sensitivity in mental healthcare provision remains important, particularly in countries that are lagging behind.

BACKGROUND:As healthcare systems transition toward person-centred integrated care (PC-IC), goal-oriented care (GOC) has gained prominence as a conceptual approach to aligning care with what matters most to patients. However, there is limited empirical insight of how GOC is enacted in daily practice and what competencies this requires from providers. This study explores how primary care providers enact GOC in daily practice to inform future training and competency development. METHODS:A focused, team-based ethnographic approach was used, combining non-participant observations with short reflective interviews. Primary care providers were purposively sampled from a cohort who completed interprofessional GOC training, ensuring disciplinary diversity. Data were analysed using thematic analysis to identify behaviours and competencies underpinning GOC in practice. RESULTS:Providing GOC requires competencies beyond knowledge or task-specific skills, and is enacted through contextual, relational, and reflective competencies. Providers showed contextual awareness by linking care actions to patients' lived experiences and personal goals. They built relational trust through open, authentic, and non-hierarchical communication to co-create care decisions with patients. Reflective competence was shown when providers reassessed care decisions in light of patient goals, assumptions, and team input. CONCLUSIONS:These findings highlight the importance of strengthening reflective competencies in training of primary care providers. In practice, this entails supporting providers to reflect on their professional responsibilities, alongside those of the other disciplines they work with in health and social care; and critically engage with assumptions. This reflective capacity is key to embedding GOC in daily practice and aligning care with what truly matters to patients.

BackgroundGoal-oriented care (GOC) has been proposed as a strategy for advancing person-centred integrated care by organising care around patients’ personal goals. Although patients may experience empathic and trusting relationships with their providers, they often report that their personal goals are insufficiently integrated into care planning and follow-up. Providers likewise report a need for further training to implement GOC. However, evidence linking patient and provider perspectives within the same care relationship remains scarce, limiting insight into which competencies enable patients to experience care as organised around their goals.ObjectivesTo identify competencies of primary care providers that enable patients to experience goal-oriented care.MethodsA qualitative dyadic study was conducted in Flemish primary care using multi-perspective interpretative phenomenological analysis. Twelve participants formed nine patient-provider dyads, comprising nine patients and three providers. Separate semi-structured interviews were analysed idiographically, within dyads, and across dyads to identify provider competencies enabling patients’ experiences of GOC.ResultsPatients experienced GOC when providers listened attentively over time, developed contextual understanding of the person beyond their diagnosis, and approached them without judgment. Care was experienced as aligned with what mattered when plans were flexibly shaped in dialogue, information was clear, and uncertainty and professional boundaries were communicated transparently. Patients also valued human openness and getting to know the person behind the provider, although providers described personal self-disclosure as a difficult balance.ConclusionPatients’ experiences of GOC depended on interdependent competencies beyond communication skills. Training initiatives should therefore address how providers integrate listening, contextual reasoning, shared planning, and information-giving in practice. An additional key insight was the importance of providers’ ability to coordinate and pace care by being transparent about professional boundaries and tolerating uncertainty, particularly in complex situations.

The transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) is often associated with disrupted continuity of care, where young people may experience a loss of support during transfer. This scoping review identifies the needs and challenges experienced by health and social care professionals navigating this boundary, a perspective often overlooked in transition research. A systematic search of major databases identified literature published between 2014 and 2025. Following Joanna Briggs Institute (JBI) methodology, 25 peer-reviewed publications were included after screening 4,040 records. Data were charted using a standardised extraction form and synthesised thematically within a socio-ecological framework across individual, interpersonal, service, and societal levels. Findings indicate multilevel barriers affecting transitions from CAMHS to AMHS. At the individual level, professionals often lack developmentally informed knowledge and disorder-specific expertise, alongside training to support autonomy as an ongoing process. Interpersonally, differences in care cultures -family-oriented in CAMHS versus more individualised in AMHS- complicate continuity, compounded by the absence of bridging roles and insufficient family involvement. At the service level, fragmentation is reinforced by inconsistent implementation of protocols, unclear responsibilities, and restrictive eligibility criteria, often resulting in a loss of continuity of care. At the societal level, rigid age boundaries and structural underfunding of coordination further perpetuate discontinuity. Despite well-documented challenges, progress in implementing sustainable solutions remains limited. Advancing transition care requires a shift towards action-oriented, multilevel implementation research. Integrated models, such as multidisciplinary youth mental health teams, are essential to ensure developmentally appropriate continuity of care.

Background: Healthcare systems globally are shifting towards person-centred integrated care (PC-IC) to better support individuals with complex, long-term needs. Goal-oriented care (GOC), which aligns care with patients' personal goals and preferences, is one approach to care delivery which can support person-centred integrated care. However, applying GOC in practice requires interprofessional primary care teams to adopt new routines and skills. There is limited understanding of the specific skills and behaviours needed for integrating GOC into daily practice. Therefore, this study aims to explore how primary care providers (PCPs) apply GOC in their everyday work with patients. Approach: An ethnography was conducted with PCPs who had completed a GOC pilot training between March 2022 and January 2023. Data were collected one year post-training through non-participatory observations combined with interviews that focused on PCP behaviours during patient interactions. Thematic analysis was conducted to show how GOC was delivered in primary care settings. Through member checks, participants contributed to the final description of the GOC behaviours. Results: Sixteen PCPs were observed for 166 hours over 34 days (February-May 2024), involving 156 patient interactions and 29 interviews with providers. Participants included physical therapists, social workers, nurses, dietitian, general practitioner, speech therapist, and mental health professionals. Core behaviours that emerged as central to GOC included asking about expectations and goals, defining and recalibrating goals, and evaluating care actions. Additional actions supported the demonstration of this behaviour, such as PCPs engaging in discussions about emotions and the person’s context, which guided care decisions and empowered patients in care planning. PCPs promoted autonomy of the patient by sharing clinical information in an accessible way, enabling informed decision-making. Beyond directly observable actions, interviews revealed behaviours that PCPs viewed as essential to GOC but invisible to the observer. PCPs described being mindful of how they positioned themselves to encourage patient engagement. They also used their knowledge of patients’ lives to avoid burdening them with irrelevant details. Participants highlighted actions before or after patient interactions, such as discussing goals with colleagues, as impactful behaviours that support GOC in patient-provider contact. Implications: This study shows that GOC involves both visible ("frontstage") and invisible ("backstage") behaviours. While the focus was on observable behaviours, interviews revealed that “backstage” processes also shape GOC delivery. Understanding these “backstage” elements can further add to the development of a skillset needed for applying GOC in practice. Future research should focus on the connection between patient and provider perspectives to refine GOC training for professionals. Identifying barriers and facilitators will also help policymakers and educators support GOC implementation in primary care.

Introduction:The demand for person-centred integrated care (PC-IC) requires health services focused on patients' individual needs. Strengthening primary care is crucial in promoting PC-IC. Goal-oriented care (GOC) prioritizes patient goals and fosters interprofessional team-based care, optimizing PC-IC. GOC requires healthcare providers to shift from problem- to goal-oriented practices. However, how providers change their daily practice to align care with what matters most to patients remains unclear. Aim:This qualitative study explores how primary care providers (PCPs) experience behaviour change when implementing GOC in daily work after an interprofessional GOC-training. Method:Six months post-training, focus groups with PCPs were organized. A theoretical thematic analysis was conducted using the Capability, Opportunity, Motivation, and Behaviour (COM-B) model. Results:Twenty-two PCPs participated in five focus groups. Motivational factors catalysed behaviour change towards GOC, including developing awareness on care actions through reflective practice. PCPs identified capabilities such as asking person-centred questions, maintaining a broad knowledge and enhancing their advocacy for patients. Opportunities stressed team support, care continuity, and reflexivity-promoting workplaces as vital for enabling behavioural change in GOC. Conclusion:Reflective practice is vital for aligning PCPs' behaviour with GOC. Involvement of all colleagues and dedicated time for reflection promote team alignment and consistency in achieving patients' personal goals.

Background: This study investigates the impact of Type 2 diabetes mellitus (T2DM) and depressive symptoms on the health-related quality of life (HRQoL) among patients at the Agricultural General Hospital in Hanoi, Vietnam. The research explores the interconnections between chronic physical conditions and mental health within a resource-constrained healthcare environment. Methods: A cross-sectional survey was conducted with 516 T2DM patients using the SF-36 to assess HRQoL and the PHQ-9 to measure depressive symptoms. The study examined the prevalence of depressive symptoms and their correlation with various HRQoL components. Results: Among the participants, 45.2% exhibited depressive symptoms from mild to severe levels. Significant disparities in HRQoL scores were observed, particularly in physical composite and overall quality of life scores between T2DM with and without depressive symptoms. Statistical analysis highlighted that depressive symptoms significantly diminish HRQoL, with the PHQ-9 scores serving as a robust predictor. Conclusion: The findings underscore the critical need for integrated care approaches that include mental health support for T2DM patients. Routine screening for depressive symptoms should be a component of diabetes management protocols to improve overall patient outcomes. Further longitudinal research is needed to confirm these findings and develop effective interventions.

The high prevalence of burnout in medical education indicates an urgent need to develop and implement effective interventions at both the individual and organisational levels. Currently, there is a shortage of studies that include perspectives from multiple stakeholders, such as medical students, trainees and university staff. Our objective is to identify and discuss interventions from various stakeholders using a bottom-up approach to guide future implementation. A co-creation methodology was adopted, including workshops and a Delphi session, engaging 96 participants. The study included 12 workshops with medical students and trainees in Flanders (Belgium): first-year bachelor students (n = 12), first-year master students (n = 13), first-year General Practice (GP) trainees (n = 14) and first-year specialist trainees (n = 39). Additionally, one Delphi session was held with 18 other relevant stakeholders, including university staff. All workshops were transcribed verbatim and thematically analysed using NVivo. Our results identified interventions to prevent and mitigate burnout among medical students and trainees. On the individual level, participants discussed personalized coaching, annual health assessments and training sessions. On the organisational level, a distinction was made between interventions intended for universities, and those for hospitals and GPs involved in medical training. Six interventions focused on preventing burnout in all contexts (i.e., onboarding programs); three were meant for universities only (i.e., pass-fail system), and six were tailored for hospitals and GPs (i.e., flexibility in scheduling). Through an iterative multistakeholder co-creation process, this study identified interventions to prevent and mitigate burnout within medical education. These interventions span individual and organisational levels, targeting universities, hospitals and GPs. While organisational interventions are increasingly recognized as crucial to address burnout, individual-focused interventions remain predominant in current research. There is a pressing need to further investigate organisational interventions and their combination with individual-focused strategies.

Introduction: Since 2021, project #CAVAsa strengthens the collaboration between community pharmacists and psychosocial care in Flanders (Belgium) as pharmacists are trained to identify and assist citizens with unmet psychosocial needs. This project highlights the role of pharmacists outside medication-related practice. Who’s it for? Pharmacists are accessible primary care providers who regularly engage with vulnerable individuals: people experiencing mental health problems, poverty, loneliness, family problems... However, psychosocial needs are often not or insufficiently met. The objective is therefore to train pharmacists to actively identify potential unmet needs during routine care and, if needed, signpost them to appropriate care. This early detection and intervention prevents the exacerbation of psychosocial problems. Collaborators: This initiative is a collaboration between the Flemish pharmacists’ network (VAN) and the centers for general wellbeing (CAW), supported by the universities of Leuven and Antwerp. Throughout every stage of the project, the collaboration was shaped by the collective efforts of pharmacists, welfare organizations and public mental health experts. Notably, the funding for this initiative was provided by the Flemish Government to promote the public wellbeing after the COVID-19 pandemic. Project Activities: Up to date, over 300 trained pharmacists are participating and have followed a newly developed e-learning about psychosocial needs, conversation skills, and psychosocial care. Posters and patient leaflets were developed for use in pharmacy. An online study form was used to register patient contacts concerning psychosocial care. A final evaluative survey, collecting quantitative and qualitative data, was carried out in October 2023. Results: A total of 131 pharmacists participated in the final evaluation survey. The majority of pharmacists report that they have increased awareness of psychosocial problems and they see the help and referral of patients with psychosocial problems as an important role that every pharmacist should be able to do. The e-learning and patient leaflets are seen as major added values. However, the lack of time presents an important challenge. Through the registration of patient contacts, it was found that three thirds of patients reached in the project are women, and mental health problems and family problems are most often reported. International implications: Also internationally, the traditional medication-oriented role of pharmacists continues to shift to a holistic patient-centered one. The practical approach taken in this project offers valuable insights and can be inspiring for collaborations between pharmacists and psychosocial workers. Effective training and hands-on assistance are essential, encompassing tools that facilitate pharmacists’ self-care and enable pharmacists to promptly identify psychosocial needs. The next steps: There is a need for transformative change, emphasizing the necessity of reforming pharmacists' remuneration structures in Belgium. Recognizing the pivotal role of pharmacists in the well-being of the population beyond medication management is crucial for active community involvement. This topic will be further discussed in a stakeholder meeting in January 2024.

BACKGROUND:People with severe mental illness frequently experience difficulties in other life domains, such as physical health conditions, comorbid substance abuse, unstable housing or structural poverty. The interaction between these difficulties creates a complex care need that often goes unmet. In addition, they regularly come into contact with the legal system and police, through penal as well as protective measures. AIM:To gain insight into the vision of actors from the judiciary and police into complex mental health care needs and judicial protective measures. METHOD:Qualitative semi-structured interviews were conducted with 15 actors from the judiciary system and police. RESULTS:Participants see the interaction of difficulties in different life domains as complex. They are critical of the provision of care for this population. Participants are very open towards intersectoral collaboration, but confidentiality and a lack of structural partnerships hinders this. Involuntary admission and legal guardianship are generally considered meaningful protective measures. CONCLUSION:In line with the vision of the mental health services, actors from the police and justice system consider the interaction between difficulties in different life domains as complex. They see a need for intensive, long-term and assertive care and a wide range of assisted living forms where integrated care is offered to people with complex mental health care needs. Judicial actors and police are willing to play a role in this. Further research into and development of accessible and, where necessary assertive, intersectoral care is necessary.

The role of pharmacists is increasingly expanding to encompass holistic patient-oriented services, including prevention, health advice, and counseling. Despite this, the pharmacist's role in public psychosocial wellbeing remains understudied. Project #CAVAsa, a collaboration between Flemish Pharmacists' Network and Centers for General Wellbeing (CAW), aimed to strengthen the pharmacist's role in psychosocial care. Through training and supportive materials, pharmacists were equipped to detect, inform, and refer patients to appropriate psychosocial services. Between 2021 and 2024, 387 pharmacies participated, registering 415 patient contacts about psychosocial wellbeing. Key enabling conditions for sustainable integration of pharmacists in psychosocial care include delineating their role, strengthening knowledge and competencies, and facilitating integrated care and collaboration. Further support for pharmacists and other primary care providers in psychosocial care is needed to bridge the gap between the health and social services.

Homelessness in psychiatric patients in Flanders, Belgium, has never been investigated. Advocacy groups from patients with lived experience of psychiatric disorders have sounded the alarm on the scarcity of suitable housing options, the strain on psychiatric institutions, and the challenges faced by social service workers. To investigate the extent of the problem a survey on the topic was initiated. A “homelessness-in-mental-health-questionnaire” was designed by experts in the field. The social services of all Flemish psychiatric hospitals and all psychiatric wards in general hospitals were contacted and invited to complete this survey. 24 of 70 contacted services responded. The total number of homeless patients in the inpatient setting on an annual basis are estimated to an average 19.5%. 18% of homeless patients remain longer in admission due to the lack of housing options. 13.7% of homeless psychiatric patients are referred to a community care facility such as an assisted living facility. Social service respondents reported spending an average of 27.4% of their work time on housing issues. The main focus points according to the respondents are the lack of priority measures for homeless psychiatric patients, psychiatric problems as a barrier to housing options and the shortage of adapted housing capacity. The conclusion of this study is the need for comprehensive policy interventions to ensure an adequate supply of suitable social housing for psychiatric patients, accessible mental health care, alternative housing options and crisis accommodation facilities. We propose a 10-point action plan on housing for psychiatric patients for policymakers and politicians.

Background The integration of mental health into primary care-i.e., the process by which a range of essential mental health care and services are made available in existing multipurpose health care settings that did not previously provide them-can be facilitated or hindered by several health system factors that are still poorly understood. This study aimed to identify health system facilitators and barriers to the integration of mental health services into primary care in the Democratic Republic of the Congo (DRC) to improve the success rate of integration programs. Methods We conducted a multimethod, cross-sectional exploratory study. Stakeholders (managers, health service providers, service users, etc.) from sixteen of the twenty-six provinces of the DRC participated. We collected qualitative data through 31 individual, semistructured, face-to-face key informant interviews. We then collected quantitative data through a population-based survey of 413 respondents. We analyzed the interviews via thematic analysis, assigning verbatims to predefined themes and subthemes. For the survey responses, we performed descriptive analysis followed by binomial logistic regression to explore the associations between the variables of interest. Results Strong leadership commitment, positive attitudes toward mental health care, the availability of care protocols, mental health task sharing (p < 0.001), and sufficient numbers of primary care providers (PCPs) (p < 0.001) were identified as key health system facilitators of successful integration. However, barriers to integration are mainly related to a poor understanding of what integration is and what it is not, as well as to the poor functionality and performance of health facilities. In addition, stigma, low prioritization of mental health, lack of mental health referents, low retention rate of trained health professionals, lack of reporting tools, lack of standardized national guidelines for integration (p < 0.001), lack of funding (p < 0.001), shortage of mental health specialists to coach PCPs (p < 0.001), and lack of psychotropic medications (p < 0.001) were identified as health system barriers to integration. Conclusion Improving the functionality of primary care settings before integrating mental health care would be beneficial for greater success. In addition, addressing identified barriers, such as lack of funding and mental health-related stigma, requires multistakeholder action across all building blocks of the health system.

IntroductionIntegrated nature-based interventions in healthcare facilities are gaining importance as promising health and biodiversity promotion strategies. This type of interventions combines the restoration of biodiversity in the vicinity of the healthcare facility with guiding patients in that natural environment for health outcomes. However, quality appraisal of these interventions is still poorly developed. Based on a recent scoping review, the authors developed a preliminary quality framework in support of healthcare facilities designing, implementing and evaluating integrated nature-based interventions. This present study aims to fine-tune the practical relevance of the quality framework within the emerging practice.MethodsA qualitative interview study was conducted in seven healthcare facilities in Belgium. Using a combination of snowball and purposive sampling, 22 professionals, involved in the integrated nature-based intervention in their facility, participated in the study. The semi-structured interviews were transcribed and imported into NVivo. A deductive and inductive thematic analysis was used to explore the practical relevance of the quality framework. A stakeholders’ assembly review and a member checking of the findings were also part of the study.FindingsTwenty-two interviews with nature management coordinators, healthcare professionals, and healthcare managers were conducted by three principal investigators in seven healthcare facilities implementing integrated nature-based interventions. The contextualization and complexity of integrated nature-based interventions in the participating healthcare facilities demonstrated the need for an evidence-based quality framework describing nature-based interventions. The study led to nine quality criteria, confirming the eight quality criteria derived from a previous scoping review, and the identification of a new quality criterion ‘Capacity building, leverage and continuity’. These quality criteria have been refined. Finally, a proposal for a quality framework was developed and operationalized in a checklist. Deployment of the quality framework should be embedded in a continuous cyclical, adaptive process of monitoring and adjusting based on evaluations at each phase of an integrated nature-based intervention.DiscussionBridging the domains of healthcare and nature management in the context of an integrated nature-based intervention in a healthcare facility requires a transdisciplinary approach. Scientific frameworks such as “complex interventions,” Planetary Health and One Health can support the co-design, implementation and evaluation of integrated nature-based interventions within a cyclical, adaptive process. In addition, the importance of the quality of the interactions with nature could gain from more sophisticated attention. Finally, the implications for healthcare facilities, policymakers and education are discussed, as well as the strengths and limitations of the study.

Community pharmacists are highly accessible care providers who are well-embedded in the community and usually have a close relationship with their patients. This places them in a good position to detect unmet psychosocial needs and refer patients to the psychosocial care services in their neighborhood. Therefore, a collaboration between community pharmacists and a psychosocial care organization was set up in Flanders (BE) to explore the potential role of pharmacists in the detection and referral of patients with psychosocial needs. The aim is to reach a patient population with (unmet) psychosocial needs, such as mental health problems, financial issues, family problems, substance abuse, domestic violence,... There is special attention to vulnerable groups. These needs are captured during patient visits to a community pharmacy for standard care. Pharmacists were trained by an e-learning in the topic of psychosocial wellbeing to detect unmet needs, talk about personal problems and how to help and refer these patients. This project is named #CAVAsa and is a collaboration between the Flemish network of pharmacists (VAN), the Flemish centers for general wellbeing (CAW) and the universities of Antwerp and Leuven. All parties worked together through all stages of the project. Sponsoring is provided by the Flemish Government. The project is currently running, and a total of 200 pharmacists are participating. Quantitative data are collected through an online registration form filled in by pharmacists. Collection started in July 2022 and is still running untill January 2023. Physical meetings were held as well to share experiences between pharmacists and the social workers and to provide extra support if needed. Since the start of the registration in July 2022 until today, a total of 160 patient contacts were registered in which psychosocial wellbeing was discussed. More details about the nature of these contacts will be available at the moment of the conference. During focus group discussions prior to this data collection, pharmacists indicated that they are willing to take up this role because patient wellbeing and personal assistance are key values of community pharmacy. It can be concluded that structural collaborations between community pharmacy and psychosocial care are very valuable and should be further supported. #CAVAsa is a good example of integrated care in which a whole person approach is supported, as it targets not only mental health care needs, but also broader social needs such as poverty and loneliness. Evaluation of the quantitative data is planned for January 2023. Results will be discussed during a multidisciplinary closing conference in which all stakeholders will be involved. After this evaluation, it is our goal to further expand this initiative to all of Flanders and make the collaboration between pharmacists and social workers more sustainable.

Background Suicidal ideation, or thinking about death and suicide, is common across all layers of society. The aim of this paper is to add to the understanding of suicidal ideation in the general population, as well as help-seeking behaviors and perceived unmet mental health needs among those who report suicidal thoughts. Methods The research is part of a representative population-based survey study of mental wellbeing in Antwerp (Flanders, Belgium) carried out in 2021. A total of 1202 participants between 15 and 80 years old answered the Ask Suicide-Screening Questions (ASQ), and an additional question about suicide plans. Participation was by invitation only and possible online or via a postal paper questionnaire. Univariate and multivariate logistic regression analyses were used to explore the association between both current suicidal ideation and self-reported lifetime suicide attempt with the sociodemographic factors age, gender, educational level, origin and financial distress. Moreover, formal care use for mental health was examined among those experiencing suicidal ideation, and logistic regression analyses were used to assess associated sociodemographic factors. Finally, perceived unmet mental health needs were assessed among suicide ideators. Results The point-prevalence of suicidal ideation was 8.6% and was higher among younger age groups and individuals reporting financial distress. The lifetime-prevalence of suicide attempts is 6.5% and was higher in younger people and individuals with a primary educational level and with financial distress. About half (45.6%) of those with suicidal ideation consulted a professional for mental health problems in the past twelve months. Men and those with a primary educational level were less likely to seek help. Half of suicide ideators without care use perceived some need for mental health care, and a third of suicide ideators who used care perceived the obtained help as insufficient, resulting in a population prevalence of 3.6% suicide ideators with a fully or partially perceived unmet need. Conclusions The prevalence of suicide attempts, suicidal ideation and unmet needs among suicide-ideators is high in this Belgian sample. Mental health care need perception in suicide ideators needs further investigation.