European Psychiatry - Volume 41 - April 2017

39 / 916

25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52 S35
on clinical staging and profiling of addictive behaviors combining
neurobiological findings and clinical practice
Disclosure of interest The author has not supplied his declaration
of competing interest.
Reference
[1] Lancet 2015;386(9995):743–800.
[2] Lancet 2013;382(9904):1575–86.
[3] European Psychiatry 2015;30(1).
[4] Addiction 2015;110(6):920–30.
[5] Tijdschr Psychiatr 2014;56(3):206–10.
[6] Tijdschr Psychiatr 2012;54(11):941–8.
S090
Clinical staging of psychotic disorders:
From dimensions to neurobiology
A. Batalla
Radboudumc, Psychiatry, Nijmegen, The Netherlands
The clinical staging model is an approach used in medicine to
define the extent of disease. In psychiatry, this model has recently
been applied to psychotic disorders to distinguish the earlier, non-
specific features of illness (e.g. ultra-high risk [UHR]; at-riskmental
state [ARMS]), from later, more severe features associated with
chronic illness. A key element of the staging model is to identify
and classify the neurobiological processes underlying the disor-
der and to define potential interventions in the different stages.
With the premise that dysfunctional neural mechanisms underlie
symptomatology, the integration of categorical phenotypic classi-
fications (class of disorder) with dimensional criteria (domains of
dysfunction) becomes crucial. This approach aims to better classify
trans-diagnostic dimensions of disease and discrete symptom-
specific subgroup populationswithin biological frameworks, which
may lead to the detection of new biomarkers and the development
of more effective treatment and prevention strategies.
Disclosure of interest The author has not supplied his declaration
of competing interest.
Symposium: Mental health care in refugees and
asylum seekers
S091
Providing care for migrants and
refugees
M. Schouler-Ocak
Psychiatric University Clinic of Charité at St. Hedwig Hospital,
Psychiatry and Psychotherapy, Berlin, Germany
With growing globalisation and an increasing number of people
on the move across boundaries, it has become vital that service
providers, policymakers andmental health professionals are aware
of the different needs of the patients they are responsible. One of
the most fundamental barriers for migrants, refugees and asylum
seekers in accessing health services are inadequate legal entitle-
ment and, mechanisms for ensuring that they are well known
and respected in practice. Access to the healthcare system is
impeded by language and cultural communication problems. Qual-
ified language and cultural mediators are not widely available, and
moreover, are not regularly asked to attend. This can lead tomisun-
derstandings, misdiagnosis and incorrect treatment, with serious
consequences for the afflicted. The language barrier represents
one of the main barriers to access to the healthcare system for
people who do not speak the local language; indeed, language is
the main working tool of psychiatry and psychotherapy, without
which successful communication is impossible. Additionally, the
lack of health literacy among the staff of institutions, which provide
care for refugees and asylum seekers means that there is a lack of
knowledge about the main symptoms of common mental health
problems among these groups. The healthcare services, which are
currently available, are not well prepared for these increasing spe-
cific groups. In dealing with ethnic minorities, including asylum
seekers and refugees, mental healthcare professionals need to be
culturally competent.
In this talk, main models for providing mental health care for
migrants and refugees will be presented and discussed.
Disclosure of interest The author has not supplied his declaration
of competing interest.
S092
Cultural competence training and
mental health care in refugees and
asylum seekers
D. Bhugra
Institute of Psychiatry, Psychology & Ne, London, United Kingdom
Recent mass movement of human beings in various parts of the
world has brought several challenges. Not only refugees from Syria
and Libya to Europe but also refugees, migrants and asylum seek-
ers in Latin America bring specific set of issues with them. It is
critical that clinicians are aware of both the vulnerability of indi-
viduals to mental ill health as a result of migratory experiences
but equally importantly their resilience. The impact on the mental
health of those who may be involved directly or indirectly in deliv-
ering care along with those new communities who receive these
groups need to be taken into account when planning and delivering
psychiatric services. It is essential to recognise that experiences of
being a refugee or asylum seeker are heterogeneous. Being an asy-
lum seeker carries with it legal definitions and legal imperatives
agreed at international levels.
Policymakers and clinicians need to be aware of differential rates
of psychiatric disorders in these vulnerable individuals and spe-
cific needs related to language, religious values and other cultural
factors. Mental health problemsmay be related to experiencing cul-
tural bereavement where individuals feel that they have lost their
cultures, relationships and cultural values. Judicious and careful
use of trained culture brokers and mediators should be encouraged
as these individuals can inform the team about community needs
and inform the community about the team functioning and its
principles so that community expectations can be managed appro-
priately. Such approaches may also help reduce stigma against
mental illness.
Disclosure of interest The author has not supplied his declaration
of competing interest.
S093
Suicide risk in refugees and asylum
seekers
D. Wasserman
Karolinska Institute, National Centre for Suicide Research and
Prevention of Mental-Ill Health NASP, Stockholm, Sweden
Increasing numbers of individuals forced to leave their home
countries in areas of war, conflict, human rights violations and
persecution pose a challenge for host countries to meet the
mental-health care needs of these individuals. Refugees and
asylum-seekers may face unique risk factors for mental disorder
before, during, and after their migration leading to suicidality.