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Concepts like person-centred or personalized care on the one hand and the newer term precision medicine have something in common, do partly overlap, but still elaborate different approaches to the patient. In some sense, they are borrowing from the bio-psycho-social model (Engel, 1980) in that they favor a multi-perspective approach to the ill person. But whereas the personalized approach has a more ‘holistic’ approach of the whole ‘person’ in mind, taking the ill person as an integrate unity of body, mind and brain with related needs, precision psychiatry as the newest concept aims at ‘tailoring of medical treatment to the individual characteristics of each patient … (by) classifying individuals into subpopulations that differ in their susceptibility to a particular disease or in their response to a specific treatment’ (NRC, 2011). However, although the genetic, neurobiological and technical state of the art is growing rapidly, their clinical applicability is still in its early adolescence (Perna et al., 2017). Persons with schizophrenia are the ones who profit most from a person-centred approach in early recognition, treatment, rehabilitation and care (Gaebel & Zielasek, 2016; Schizophrenia Guideline, DGPPN 2019). The broad spectrum of available effective interventions needs to be applied across an increasingly interconnected, integrated network of settings, in which the hospital is one component of a complex system of care. Hospital-based care like other components needs to follow the guidelines of person-centred care. The presentation will focus on the current state and future perspectives of hospital-based personalized treatment and care of schizophrenia.

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People with mental illness experience different types of stigma and discrimination (Gaebel, Rössler, & Sartorius, 2017). These experiences present a severe burden for those affected and lead to reduced self-esteem, social participation, and overall quality of life. Additionally, stigma and discrimination are barriers to the utilization of mental healthcare and lower help-seeking behavior of those affected by mental illness. Thus, various stakeholders have proposed recommendations to reduce the stigma of mental illness. Some of these recommendations focus on structural aspects and the quality of healthcare systems. Quality is defined as a complex construct with structure-, process-, and/or outcome-oriented features on different levels of observation (macro-, meso-, micro-level) and with different perspectives (physicians, patient, providers, etc.). It describes the degree to which health services increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Promising approaches in the context of quality medicine that may jointly contribute to reducing stigma and discrimination in mental illness include evidence-based quality management, value based care (i.e., a focus on relevant health outcomes relative to the costs of delivering the outcomes), and “choosing wisely” (i.e., an initiative to improve shared decision-making based on evidence). In this presentation, contributions of concepts, methods, practical approaches of quality medicine and available evidence to overcoming stigma and discrimination of people with mental illness will be elaborated.

Gaebel, W., Rössler, W., & Sartorius, N. (Eds.). (2017). The Stigma of Mental Illness-End of the Story? Heidelberg, Germany: Springer.

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Many patients, clinicians, and researchers consider the label schizophrenia to be stigmatizing. Thus, over the last years, a name change has increasingly been discussed to relieve patients from the negative beliefs, prejudice, and discrimination associated with the label schizophrenia (Gaebel & Kerst, 2019). In different world regions, stakeholders have developed alternative labels for schizophrenia. For example, some Asian countries have implemented alternative names in their respective healthcare systems. Also in Europe, different alternative labels have been proposed (e.g., salience dysregulation syndrome), but none have, thus far, been systematically implemented in mental healthcare. In sum, to date, there is no commonly agreed upon alternative label or conceptualization to replace schizophrenia internationally. Meeting relevant criteria for a new name, finding agreement among all involved stakeholders and replacing the established term is a complex process. This effort would be worthwhile if it contributes to a reduction of stigmatization and an improvement in mental healthcare for patients with schizophrenia. Thus far, however, there is only limited empirical evidence that a name change alone will achieve the desired effects. Hence, it may be premature to abandon the concept of schizophrenia, which has proven its reliability, clinical utility, and validity over the last century. In this lecture, the challenges, potential risks, and potential advantages of developing an internationally consistent alternative label for schizophrenia will be discussed.

Gaebel, W., & Kerst, A. (2019). The debate about renaming schizophrenia: a new name would not resolve the stigma. Epidemiology and Psychiatric Sciences, 28(3), 258-261.