520 - Benefits of Assertive Community Treatment for Persons with Severe Mental Illness and Cancer

Breast cancer, the most commonly diagnosed cancer in women worldwide, is responsible for one in six cancer deaths (Sung, H. et al., 2021). Women with schizophrenia have an associated increased incidence of breast cancer compared to the general population (Grassi & Riba, 2020). Patients with severe mental illness are noted to have disparities in accessing and initiating cancer treatment especially among those who are older (Iglay et al., 2017). A case vignette will be presented to illustrate the care and interventions provided by an American Assertive Community Treatment team which fostered supportive treatment engagement and improved the quality of life for a patient that chose to forgo recommended cancer treatment. This presentation will highlight the essential nature of the Assertive Community Treatment team in supporting decisional capacity, facilitation of a patient’s grief and acknowledgement of one’s own mortality as well as incorporation of medical and palliative care. The attendee will appreciate the importance of the multidisciplinary approach for persons with chronic mental illness and co-morbid cancer diagnoses.

Stigma and discrimination in individuals with severe and persistent mental illness in an assertive community treatment team: Perceptions of families and healthcare professionals

Aim: To explore family member and staff perceptions of clients’ experiences of stigma and discrimination, in those living with severe and persistent mental illness in an Assertive Community Treatment Team. Method: This qualitative study used the Discrimination and Stigma Scale to conduct structured face-to-face and telephone interviews of family members and healthcare professionals, working with the Assertive Outreach Team (AOT) (an Assertive Community Treatment Team) of a northern inner suburban catchment of Sydney, New South Wales, Australia. Results: Forty-one people participated in the study (23 AOT clinical staff members and 18 family members). Family and clinical staff commonly reported stigma and discrimination amongst their relatives and clients, respectively. Four overarching themes emerged from the data: (1) appearance and behaviour, (2) avoidance and being shunned, (3) key areas of life affected by discrimination and (4) impacts of discrimination and skills to cope with discrimination. Conclusion: Reports of stigma and discrimination were common, yet varied between groups with clinical staff commonly witnessing experiences and impacts of discrimination in everyday life, with families’ reports being substantially less. Due to the strong advocacy and support provided by the AOT model, clinical staff often buffered experiences of stigma and discrimination. Further research is needed to explore effective interventions to reduce experiences of discrimination in this population group.

Kriminalitetsprofiler i en dansk retspsykiatrisk population – udfordringer for psykiatriens kriminalitetsforebyggende opgave?

English title: Typologies of crime committed by mentally disordered offenders: A challenge to the statutory task in hospital psychiatry of preventing recidivism to criminal actsThe aim of the study is to identify and describe a number of characteristics among a selected sample of mentally disordered offenders referred to a specialized forensic assertive community treatment team in Copenhagen (n=181). Looking at a number of variables, the study identifies a heavily burdened patient population in terms of social marginalization, serious mental illness, and criminal acts. Having identified a huge variety and number of typologies of criminal acts, we argue that the task of preventing recidivism to new crime not clear among mental health professionals. Furthermore, it proves difficult to prevent crime when the typologies of crime are diverse and widespread. It is one thing is to prevent violent crimes closely related to an actual psychotic mental state and quite another to prevent drug crimes or property crimes not so obviously related to a mental disorder. The article concludes that we need to increase our knowledge and awareness of risk and protective factors specifically related to criminal recidivism and improve cooperation between hospital psychiatry, social services and probation services.