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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO256

Mental illness stigma and service engagement in a health system in transition: observations from Georgia

MENTAL HEALTH STIGMA AND SERVICE ENGAGEMENT IN A TRANSITIONING HEALTH SYSTEM: OBSERVATIONS FROM GEORGIA

Stigma delays help-seeking, shifts presentations to periods of crisis, and disrupts continuity of treatment; expanding services alone does not remove this barrier.

The aim was to examine how stigma shapes engagement with mental health services in Georgia and to consider the implications for community-based care in health systems in transition. The method was a qualitative service-level analysis based on observations in community mental health services in Tbilisi, a review of program documents, and discussions with the clinical team, focusing on help-seeking patterns, treatment engagement, and barriers to access. Preliminary observations suggest that families may delay seeking psychiatric help because of concerns about reputation and discrimination, that patients often present only during an acute crisis after prolonged periods without treatment, and that some discontinue treatment for fear of social labeling. The poster proposes a conceptual stigma pathway extending from public stigma through family concerns about reputation, delayed help-seeking, crisis presentation, and self-stigma to reduced service engagement. It notes that stigma also operates beyond the individual patient: repeated concealment or shame within the home may be where internalization begins. Stigma may also extend to psychiatry and community mental health as professional fields, making it harder for community-based care to become an accepted part of routine practice. Nevertheless, the expansion of community services is observed to improve accessibility and reduce reliance on institutional care. The authors suggest that public education initiatives, the integration of mental health services into primary care, and community-based outreach may improve early engagement and continuity of treatment, and that structural reform should be pursued alongside stigma-reduction strategies. The poster identifies several limitations: the study is observational and preliminary, the mechanisms are proposed rather than demonstrated, and no patient-level data were collected.

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