title: EPA guidance on building trust in mental health services.
abstract: OBJECTIVE
  To advance mental health care use by developing recommendations to increase trust from the general public and patients, those who have been in contact with services, those who have never been in contact and those who care for their families in the mental health care system.
  
  
  METHODS
  We performed a systematic literature search and the retrieved documents were evaluated by two independent reviewers. Evidence tables were generated and recommendations were developed in an expert and stakeholder consensus process.
  
  
  RESULTS
  We developed five recommendations which may increase trust in mental health care services and advance mental health care service utilization.
  
  
  CONCLUSIONS
  Trust is a mutual, complex, multidimensional and dynamic interrelationship of a multitude of factors. Its components may vary between individuals and over time. They may include, among others, age, place of residence, ethnicity, culture, experiences as a service user, and type of disorder. For mental health care services, issues of knowledge about mental health services, confidentiality, continuity of treatment, dignity, safety and avoidance of stigma and coercion are central elements to increase trust.
  
  
  CONCLUSIONS
  Evidence-based recommendations to increase mutual trust of service users and psychiatrists have been developed and may help to increase mental health care service utilization.
authors: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich, Heine University, Düsseldorf, Germany. Electronic address: wolfgang.gaebel@uni-duesseldorf.de.
authors: W
authors: W
authors: Gaebel
authors: WHO Regional Office for Europe, Copenhagen, Denmark.
authors: M
authors: M
authors: Muijen
authors: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich, Heine University, Düsseldorf, Germany.
authors: A E
authors: AE
authors: Baumann
authors: Institute of Psychiatry, King' College, London, United Kingdom.
authors: D
authors: D
authors: Bhugra
authors: NASP, National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institute, Stockholm, Sweden.
authors: D
authors: D
authors: Wasserman
authors: UMCN Nijmegen, Utrecht, The Netherlands.
authors: R J
authors: RJ
authors: van der Gaag
authors: Derbyshire Mental Health Services, Derby, United Kingdom.
authors: R
authors: R
authors: Heun
authors: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich, Heine University, Düsseldorf, Germany.
authors: J
authors: J
authors: Zielasek
mesh_terms: D003469:Culture; D006801:Humans; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards*; D011369:Professional-Patient Relations; D035502:Trust
keywords: Psychiatric services; Psychiatry in Europe; Quality of care; Stigma; Trust in mental health services; Trust in psychiatrists