BACKGROUND: Mental health-related stigma occurs among the public and professionals alike. The lived experience of mental illness has been linked to less stigmatising attitudes. However, data on psychiatrists and the relationship between stigmatising attitudes and psychotherapeutic activity or case discussion groups remains scarce. METHODS: A cross-sectional multicentre study was performed in 32 European countries to investigate the lived experiences and attitudes of psychiatrists toward patients with mental illness as well as the relationship between stigma, psychosocial and professional factors. The self-reported, anonymous, internet-based Opening Minds Stigma Scale for Health Care Providers was used to measure the stigmatising attitudes. The survey was translated into the local language of each participating country. All participants were practising specialists and trainees in general adult or child and adolescent psychiatry. The study took place between 2nd October, 2019 and 9th July, 2021 and was preregistered at ClinicalTrial.gov (NCT04644978). FINDINGS: A total of 4245 psychiatrists completed the survey. The majority, 2797 (66%), had completed training in psychiatry, and 3320 (78%) worked in adult psychiatry. The final regression model showed that across European countries more favourable attitudes toward people with mental illness were statistically significantly associated with the lived experience of participants (including seeking help for their own mental health conditions (d = -0.92, 95% confidence interval (CI) = -1.68 to -0.15, p = 0.019), receiving medical treatment for a mental illness (d = -0.88, 95% CI = -1.71 to -0.04, p = 0.040), as well as having a friend or a family member similarly affected (d = -0.68, 95% CI = -1.14 to -0.22, p = 0.004)), being surrounded by colleagues who are less stigmatising (d = -0.98, 95% CI = -1.26 to -0.70, p < 0.001), providing psychotherapy to patients (d = -1.14, 95% CI = -1.63 to -0.65 p < 0.001), and being open to (d = -1.69, 95% CI = -2.53 to -0.85, p < 0.001) and actively participating in (d = -0.94, 95% CI = -1.45 to -0.42, p < 0.001) case discussion, supervision, or Balint groups. INTERPRETATION: Our study highlights the importance of psychotherapy training, supervision, case discussions and Balint groups in reducing the stigmatising attitudes of psychiatrists toward patients. As the findings represent cross-national predictors, Europe-wide policy interventions, national psychiatric education systems and the management of psychiatric institutions should take these findings into consideration. FUNDING: National Youth Talent Award (Ministry of Human Resources, Hungary, (NTP-NFTÖ-20-B-0134). All authors received no funding for their contribution.

Acute Detoxification Ward State Psychiatric Hospital for Treatment of Drug Addiction and Alcoholism Sofia Bulgaria

Acute Psychiatric Department 1 Psychiatric Hospital Michalovce Michalovce Slovak Republic

Admission Ward State Psychiatric Hospital Gintermuiza Jelgava Latvia

Centre for Clinical Psychiatry University Psychiatric Clinic Ljubljana Ljubljana Slovenia

Centro de Investigacion Biomedica en Red de Salud Mental Instituto de Salud Carlos 3 Barcelona Spain

Child Psychiatry Unit University Children's Hospital University Medical Centre Ljubljana Ljubljana Slovenia

Coimbra Institute for Biomedical Imaging and Translational Research Coimbra Portugal

Department for Child Psychiatry Institute for Children's Diseases Clinical Centre of Montenegro Podgorica Montenegro

Department of Child and Adolescent Psychiatry Capital Region of Denmark Copenhagen Denmark

Department of Child and Adolescent Psychiatry EPSM du Finistère Sud Quimper France

Department of Clinical Psychology Ukrainian Catholic University Lviv Ukraine

Department of General Adult Psychiatry South Meath Mental Health Service Co Meath Ireland

Department of Medical and Surgical Sciences University Magna Græcia of Catanzaro Catanzaro Italy

Department of Mental Health Belgrade Serbia

Department of Mental Health Heim Pál National Pediatric Institute Budapest Hungary

Department of Neuroscience University Hospital Center Mother Theresa Tirane Albania

Department of Personality and Health Psychology Károli Gáspár University of the Reformed Church Budapest Hungary

Department of Psychiatry Aladar Petz County Teaching Hospital Győr Hungary

Department of Psychiatry and Psychotherapy Semmelweis University Budapest Hungary

Department of Psychiatry Erasmus University Medical Center Rotterdam the Netherlands

Department of Psychiatry United City Hospital N15 Baku Azerbaijan

Department of Psychiatry University of Ioannina Ioannina Greece

Department of Psychiatry Vrije Universiteit Brussel Brussels Belgium

Department of Psychology Fevziye School Fundatitions Işık University Istanbul Turkey

Department of Urgent and Post Urgent Psychiatry CHU Montpellier Montpellier France

Division of Child and Adolescent Psychiatry and Psychotherapy Department of Psychiatry and Psychological Medicine University Hospital Centre Zagreb Zagreb Croatia

Division of Medical Psychology 3rd Faculty of Medicine Charles University Prague The Czech Republic

Division of Medical Psychology Psychosomatics and Psychotherapeutic Medicine Medical University of Graz Graz Austria

FIDMAG Germanes Hospitalàries Research Foundation Barcelona Spain

Freelancer Larnaca Cyprus

Hospital Benito Menni Complex Assistencial Salut Mental Sant Boi de Llobregat Spain

Inpatient Psychiatric Department 2 Psychiatric Clinic of Minsk City Minsk Belarus

Institute of Behavioural Sciences Semmelweis University Budapest Hungary

Institute of Functional Genomics University of Montpellier CNRS INSERM Montpellier France

Institute of Psychological Medicine Faculty of Medicine Coimbra University Coimbra Portugal

Klinikum Rechts der Isar der Technischen Universität München Klinik und Poliklinik für Psychiatrie und Psychotherapie Technische Universität München Munich Germany

Mental Health Services Mount Carmel Hospital Attard Malta

Pennine Care NHS Foundation Trust Oldham United Kingdom

Psychiatric Clinic Faculty of Medicine Institute of Clinical Medicine Vilnius University Vilnius Lithuania

Psychiatry Department Centro Hospitalar e Universitário de Coimbra Coimbra Portugal

The Serbsky State Scientific Center for Social and Forensic Psychiatry Moscow Russian Federation

Therapie auf Augenhoehe Buelach Switzerland

University of Tartu Tartu Estonia

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ClinicalTrials.gov
NCT04644978