Vincent Lorant

Université Catholique de Louvain - UCLouvain | UCLouvain · Institute of Health and Society

Background Social inclusion is poor among people with mental illness (MI). In recent decades, many countries have developed policies to address this issue. It remains unclear, however, whether their social inclusion has improved over time. This study aimed to assess the evolution of the social inclusion of adults with moderate and severe MI compare...

Background Poor mental health is heavily stigmatized, even more when it comes to migrant and ethnic minority groups (MEM). Belgium, with its long history of immigration, is a good case study for analysing mental illness (MI) prevalence and how it has evolved over time across ethnic groups. This paper aims to shed light on the prevalence of MI among...

Background Although people with a migration background (MB) have more unmet mental health needs than the general population, patients with a MB are still underrepresented in mental health care services. Provider bias towards these patients has been evidenced repeatedly but its driving factors remain elusive. We assessed the moderating effect of ind...

Background The COVID-19 pandemic and subsequent restrictions increased the psychological distress of the population while the use of on-site mental health care decreased. The provision of online mental health care was therefore scaled up in many European countries. The extent to which online care can deliver services to all people (horizontal equit...

Background Patients with a migration background (MB) have more mental health disorders than those without migration background. Yet, those patients are still underrepresented in mental healthcare services and have more unmet medical needs. Although providers’ bias has been well studied, up to date, little is still known about the factors explaining...

Background General Practitioners (GPs) are the first point of contact for people from ethnic and migrant groups who have health problems. Discrimination can occur in this health care sector. Few studies, however, have investigated implicit and explicit biases in general practice against ethnic and migrant groups. This study, therefore, investigated...

Background: The COVID-19 pandemic might affect mental health. Data from population-representative panel surveys with multiple waves including pre-COVID data investigating risk and protective factors are still rare.Methods: In a stratified random sample of the German household population (n=6,684), we conducted survey-weighted multiple linear regres...

Mentally Disordered Offenders (MDOs) who have been declared not criminally responsible for their offense due to their mental condition should be admitted to settings with lowest possible level of security to support their social reintegration. In the context of the reorganization of care for MDOs in Belgium, we assessed the predictors and retrospec...

Background Social support is a key dimension of personal recovery for patients with severe mental disorders. Although clinicians and health professionals should monitor the social support resources of patients in order to provide effective treatment, no specific tool or intervention exist for that purpose. Egonet is a computer-assisted intervention...

Purpose Providing effective treatment for immigrants is an increasing challenge for mental health services across Europe. Yet, little is known as to whether current practice is associated with different outcomes in migrant and non-migrant patients. We compared outcomes of inpatient psychiatric treatment for migrants and non-migrants in a sample fro...

Background In Europe, migrants have a higher prevalence of depression compared to the native population and, more often, they face unmet medical needs, including less frequent referral to mental health services. According to social psychology, general practitioners (GPs) may undertreat migrants due to unconscious stereotypical bias that could lead...

Background Managing older people in the emergency department remains a challenge. We aimed to identify the factors influencing the care quality of older patients in the emergency department, to fine-tune future interventions for older people, considering the naturalistic context of the ED. Methods This is a qualitative study of some 450 h of obser...

Background Reducing ethnic inequalities in health care is a worldwide priority. General practice is no exception to this, as studies pointed to ethnic discrimination in diagnosis, referral and treatment of racial minorities patients by General Practitioners (GPs). However, it is unclear whether these discriminations are due to implicit bias or by t...

Background. For psychiatric service users suffering from severe mental disorders, the social support provided by personal social networks is essential for living a meaningful life within the community. However, the importance of the support received depend on the relations between the providers of social support. Yet this hasn’t been addressed in t...

Introduction European estimates of adolescent smoking cessation are lacking and studies on the role of schools in quit behaviour are scarce. We aimed to describe smoking cessation attempts and success among adolescents in Europe and explored the association with school policy and programmes. Methods We used cross-sectional data from the 2013 and 2...

Suicidality, which includes suicidal thoughts, planning, and suicide attempts, results mainly from a combination of psychological, sociological, and environmental factors. Despite a high prevalence of suicidality among adolescents in Africa, only a few studies have considered these factors simultaneously. The objective of the study was to identify...

Background Patients with severe mental illnesses (SMI) have low levels of social integration, which could be improved if they used social services. To our knowledge, however, the extent to which they use generic social services remains unknown. Aims We assessed the extent to which patients with SMI use generic social services and the factors that...

Background The relationship between socioeconomic position (SEP) and adolescent physical activity is uncertain, as most evidence is limited to specific settings and a restricted number of SEP indicators. This study aimed to assess the magnitude of socioeconomic differences in adolescent vigorous physical activity (VPA) across various European count...

De mentale impact van de coronacrisis op jongeren werd onderschat door velen. Onderzoeksgroepen van de Universiteit van Antwerpen stellen een sterke associa-tie vast tussen depressieve symptomen en lockdowngerelateerde factoren bij Belgische studenten. Het aantal jongeren met stressgerelateerde klachten was ook beduidend hoger in vergelijking met d...

Background The COVID-19 pandemic and subsequent suppression measures have had health and social implications for billions of individuals. The aim of this paper is to investigate the risk of psychological distress associated with the COVID-19 pandemic and suppression measures during the early days of the lockdown. We compared the level of psychologi...

Background Managing older people in the emergency department remains a challenge. We aimed to identify the factors influencing the care quality of older patients in the emergency department, in order to fine-tune future interventions for older people, taking into account the naturalistic context of the ED. Methods. This is a qualitative study of so...

Background Most research on mental illness stigma has involved people with psychosis; less information is available for people with affective and anxiety disorders. We aimed to compare experienced and anticipated discrimination among people with schizophrenia, and affective and anxiety disorders. Methods People with schizophrenia (n=773), affectiv...

Background Studies on adolescent secondhand smoke exposure within the family often dichotomously operationalize migration background without paying attention to social and cultural diversity within migrant populations. As a result, little is known about variation within migrant groups in smoke-free family environments (SFFEs). This study analyses...

Background: The outbreak of the COVID-19 pandemic in 2020 and its associated measures led to high levels of mental distress in the general population. Previous research indicated that young people are especially vulnerable for a wide range of mental health problems during the pandemic, but little is known about the mechanisms. This study examined m...

Background Despite an overall reduction in suicide, educational disparities in suicide have not decreased over the last decade. The mechanisms behind educational disparities in suicide, however, remain unclear: low educational status may increase the risk of suicide (“causation”) or low educational status and suicide may share confounders. This pap...

Appropriate care delivery for patients with severe mental illness (SMI) requires a high level of collaboration quality between primary, mental health, and social care services. Few studies have addressed the interpersonal and inter-organizational components of collaboration within one unique study setting and it is unclear how these components cont...

The difficulty of implementing mental healthcare reforms owes much to the influence of stakeholders. So far, the endorsement of mental health policy reforms by stakeholder coalitions has received little attention. This study describes stakeholder coalitions formed around common mental health policy goals and highlights their central goals and oppos...

PurposeLong lengths of stay (LoS) in psychiatric hospitals or repeated admission may affect the social integration of patients with psychiatric disorders. So far, however, studies have been inconclusive. This study aimed to analyse whether long LoS or repeated admissions in psychiatric wards were associated in different ways with changes in the soc...

Background Most research on mental illness stigma has involved people with psychosis; less information is available for people with affective and anxiety disorders. We aimed to compare experienced and anticipated discrimination among people with schizophrenia, and affective and anxiety disorders. Methods People with schizophrenia (n=773), affectiv...

Background: Studies comparing adolescent e-cigarette use in different countries are scarce. We study students' e-cigarette and conventional cigarette ever-use, their social correlates and e-liquid use in seven EU countries. Methods: SILNE-R data (N=12 167, response rate 79.4%) of 14-17-year-olds from Amersfoort (NL), Coimbra (PT), Dublin (IR), H...

The increasing denormalization of smoking by tobacco control policies and a normative smoke-free climate may shift power towards adolescent non-smokers. It is unclear, however, how common stigmatization of smokers is among adolescents or how stigmatization relates to the denormalization of smoking in their school and social environment. This paper...

Background For psychiatric service users, the personal social network offers resources such as behavioural guidance, social support, and coherence of care delivery. So far, most research on the subject has assessed the availability of these resources using size and composition measures. However, the availability of network resources also depends on...

La mise en place du confinement de la population a été efficace pour réduire le nombre de décès et le risque de dépassement des capacités des services de soins. Cependant les mesures restrictives de confinement et de distance ont impacté la société au-delà du plan sanitaire. Dans cet article, nous présentons brièvement quatre travaux de recherche e...

Assessment of the effectiveness of school tobacco policies (STPs) in reducing adolescent smoking remains inconclusive. Previous studies took insufficient account of different dimensions of STPs, the different views of students and staff, and policy changes over time. This study assessed how a multidimensional STP, as perceived by students and staff...

Peer networks at school and students’ position in these networks can influence their academic well-being. We study here individual students’ network position (isolation, popularity, social activity) and peer network structures at the school level (centralization, density, clustering, school connectedness) and their relations to students’ academic w...

Background The current debate on organisation of the mental health care raises a question whether to prioritise specialisation of clinical teams or personal continuity of care. The article explores the experiences of patients and clinicians regarding specialisation (SC) and personal continuity (PCC) of care in five European countries. Methods Data...

Background Advocacy, resources and intersubjective reasonable arguments are known as factors that contribute to smoke-free (SF) adoption and implementation in Chinese and Anglo-Saxon places. Less is known about how the implementation of smoking bans differs across European places. The aim of this qualitative comparative study is to identify and cl...

Background: The Netherlands increased the tobacco age-of-sale from 16 to 18 in 2014, paired with mass-media campaigns. We evaluated changes in perceived accessibility of cigarettes between 2013 and 2016 among adolescent never-smokers in the Netherlands compared with Belgium, where the age-of-sale remained 16 and no campaigns were conducted. Metho...

Most healthcare systems struggle to provide continuity of care for people with chronic conditions, such as patients with severe mental illness. In this study, we reviewed how system features in two national health systems (NHS) – England and Veneto (Italy) – and three regulated-market systems (RMS) – Germany,Belgium, and Poland –, were likely to af...

Background: Many European schools implement smoke-free school policies (SFSPs). SFSPs may decrease adolescent smoking by causing adolescents to perceive stronger anti-smoking norms, yet there exists no quantitative evidence that indicates for which norms and for whom such effects may occur. This study therefore assessed to what extent adolescents'...

Background Secondhand smoke exposure is responsible for over half a million premature deaths. With regulation now reducing smoking in most public enclosed spaces, one major source of indoor exposure remains the home environment. Home smoking bans (HSBs) are household rules that restrict smoking from certain (partial HSB) or all areas (complete HSB)...

Ch. 06 in: Mistiaen P, Cornelis J, Detollenaere J, Devriese S, Farfan-Portet MI, Ricour C (Editors) Organisation of mental health care for adults in Belgium. Health Services Research (HSR) Brussels: Belgian Health Care Knowledge Centre (KCE). 2019.

Chapter 07 in: Mistiaen P, Cornelis J, Detollenaere J, Devriese S, Farfan-Portet MI, Ricour C (Editors) Organisation of mental health care for adults in Belgium. Health Services Research (HSR) Brussels: Belgian Health Care Knowledge Centre (KCE). 2019.

Background: Most European countries have seen a decrease in the prevalence of adolescent smoking. This decrease has, however, been patterned by gender. Girls' smoking rates have now overtaken boys' in many European countries. The two genders may not, however, share the same smoking beliefs and this could explain differences between the genders in...

Adolescents often display similar health behaviour to their peers. Peer effects on health behaviour may be influenced by the school context, and by the country of residence. According to the complex contagion theory, these effects for risky health behaviour may be different from protective health behaviour. This paper combines social network analys...

Background: Despite widespread age-of-sale restrictions on tobacco, adolescents continue to obtain cigarettes and experiment with smoking. This mixed-methods study aimed to understand how European adolescents access cigarettes and how the policy context may influence this process, using a realist evaluation approach. This is the first study to ass...

Background: Tobacco-control policies have been suggested to reduce smoking among adolescents. However, there is limited evidence on the real-world costs of implementation in different settings. In this study, we aimed at estimating the costs of school smoking bans, school prevention programmes and non-school bans (smoking bans in non-educational p...

Background: In this paper we focus on adolescents in transition towards young adulthood (ATYA). We know from international studies that the transition process makes adolescents vulnerable to mental illness. However, little is known about Belgian ATYA mental-health status. Nor are risk factors associated with their mental illness understood, in par...

Background People with mental illness (MI) face issues of social integration such as finding a job and maintaining social relationships. In the past decades, many countries have developed specific social integration interventions and policies towards people with MI. Despite heterogeneous assessments of those specific interventions and policies, the...

Background Patients with severe mental illness (SMI) require continuity of care. Continuity of care refers to the uninterrupted contact of patients with the service delivery system, and includes three main dimensions: cross-sectional, longitudinal, and relational continuity. Cross-sectional care continuity refers to the provision of comprehensive c...

Background Socio-economic inequalities in suicide remain substantial and persistent in most European countries. The mechanism driving these inequalities, however, remains obscure. Two causal mechanisms have been attributed varying degrees of importance: low socio-economic status may directly increase the risk of suicide (hereafter ‘causation’) or l...

Background Smoke-free school policies (SFSPs) may influence adolescents’ smoking through the development of anti-smoking beliefs. We assessed which types of anti-smoking beliefs (health, social and societal) are associated with SFSPs and whether these associations were different for adolescents in smoking permissive versus prohibitive families. M...

Introduction Economic evaluations of tobacco control policies targeting adolescents are scarce. Few take into account real-world, large-scale implementation costs; few compare cost-effectiveness of different policies across different countries. We assessed the cost-effectiveness of five tobacco control policies (non-school bans, including bans on s...

Background Although there is evidence for socioeconomic inequalities in health and health behaviour in adolescents, different indicators of socioeconomic status (SES) have rarely been compared within one data sample. We examined associations of five SES indicators with self-rated health (SRH) and smoking (ie, a leading cause of health inequalities)...

Purpose For severely mentally ill (SMI) users, continuity of care requires consistency between the supports provided by the members of their social support network. However, we know little about their network cohesion and its association with continuity of care. We set out to investigate this association and hypothesised that it would depend on the...

Mental health and social care services networks aim to provide patients with continuity of care and support their recovery. There is, however, no conclusive evidence of their effectiveness. Since 2011, Belgium has been implementing a nation-wide reform of mental health care by commissioning service networks. Using a case–control design, we assessed...

The same or different psychiatrists for in- and out-patient treatment? A multi-country natural experiment - ADDENDUM - Volume 29 - D. Giacco, V.J. Bird, T. Ahmad, M. Bauer, A. Lasalvia, V. Lorant, E. Miglietta, J. Moskalewicz, P. Nicaise, A. Pfennig, M. Welbel, S. Priebe

Background Patient satisfaction is a key indicator of inpatient care quality and is associated with clinical outcomes following admission. Different patient characteristics have been inconsistently linked with satisfaction. This study aims to overcome previous limitations by assessing which patient characteristics are associated with satisfaction w...

Background In Europe, at discharge from a psychiatric hospital, patients with severe mental illness may be exposed to one of two main care approaches: personal continuity, where one clinician is responsible for in- and outpatient care, and specialisation, where various clinicians are. Such exposure is decided through patient-clinician agreement or...

Aims. A core question in the debate about how to organise mental healthcare is whether in- and out-patient treatment should be provided by the same (personal continuity) or different psychiatrists (specialisation). The controversial debate drives costly organisational changes in several European countries, which have gone in opposing directions. Th...

Background: During the last three decades, a decrease in psychiatric hospital admissions and a reduction in the length of stay (LoS) occurred in high-income countries, with a view to promote community care and the social integration of patients with severe mental illness (SMI). However, the impact of hospitalisations on patients’ social integration...

La Politique Scientifique Fédérale a récemment financé (2004-2006) un projet de recherche nommé ATLAS qui a pour but principal l’exploitation des données issues du dernier «recensement» de 2001. A l’heure de la sortie des monographies et atlas, il nous semble important d’insister sur le fait qu’il s’agit des dernières images géo-statistiques complè...

La Politique Scientifique Fédérale a récemment financé (2004-2006) un projet de recherche nommé ATLAS qui a pour but principal l’exploitation des données issues du dernier «recensement» de 2001. A l’heure de la sortie des monographies et atlas, il nous semble important d’insister sur le fait qu’il s’agit des dernières images géo-statistiques complè...

Background During the last three decades, in high-income countries, a transition from institutional psychiatric care to community care and a reduction in the hospital length of stay has taken place to provide community care and promote patients’ social integration. However, the impact of length of stay in psychiatric inpatient unit on the different...

Rationale Access to mental health care for Mentally Disordered Offenders (MDOs) is a common issue across Western countries. MDOs are people with mental disorders who have committed a criminal offence. Their legal condition adds complexity to the multiple fields already involved in regular mental health care: psychiatry, social, and behavioural care...

Background Stigma exists when components of labeling, stereotyping, separation, and discrimination occur together in a power situation. This may apply to smoking, a behavior being increasingly denormalized. However, it is unknown whether School Tobacco Policies (STP) may lead to the stigmatizationof adolescent smokers. Our aims are (1) to measure t...

Background: Binge drinking (BD) is frequently observed in youth, with psychological and cognitive consequences, but its specific negative impact on quality of life has been scarcely explored. Methods: This study measured the relationship between BD and self-perceived quality of life among European students. Sociodemographic and alcohol consumption...

Introduction Adolescents smoking has decreased steadily in the last decades. Yet, this decrease has been uneven across areas and across socio-economic groups. It is unclear which groups have been the least responsive to changes in smoking outcomes. We identify the levels and the groups associated with changes in smoking outcomes and in unequal chan...

Introduction Despite the evidence of the adverse health effects of smoking, more than one in five adolescents in Europe still smokes in 2015. In order to reduce this high smoking rate, tobacco control policies have been put in place, including school tobacco policies (STPs). The few studies that assessed the equity impact of tobacco control policie...

Background Suicide has been decreasing over the past decade. However, we do not know whether socioeconomic inequality in suicide has been decreasing as well. Aims We assessed recent trends in socioeconomic inequalities in suicide in 15 European populations. Method The DEMETRIQ study collected and harmonised register-based data on suicide mortalit...

Poor academic performance is a known risk factor for adolescent smoking, yet the association remains unclear, as the role of social ties has been rarely examined. Our study aims to investigate the role of friendship ties in this association. In a sample of 11,015 adolescents, aged 14 to17, in 50 schools within six European cities (SILNE-survey, 201...

Background: Previous studies in individual countries have identified inconsistent predictors of length of stay (LoS) in psychiatric inpatient units. This may reflect methodological inconsistencies across studies or true differences of predictors. In this study we assessed predictors of LoS in five European countries and explored whether their effe...

Background: Other-sex friendship (girls with boy friends, boys with girl friends) has been associated with substance use, but how the gender composition of schools influences substance use has not been known. Objectives: We analyzed the influence of other-sex friendship on substance use and took into account the proportion of each gender group a...

It is still unclear what the optimal structure of mental health care networks should be. We examine whether certain types of network structure have been associated with improved continuity of care and greater social integration. A social network survey was carried out, covering 954 patients across 19 mental health networks in Belgium in 2014. We fo...

Aim: In several countries, there is a debate to decide whether, after discharge from psychiatric stay, continuity of care is best when organised by one clinician (personal continuity of care) or by different clinicians (specialised continuity of care). These two options coexist in several countries, but they may not be accessible to all socio-econo...

Background Many risk behaviours in adolescence are socially patterned. However, it is unclear to what extent socioeconomic position (SEP) influences adolescent drinking in various parts of Europe. We examined how alcohol consumption is associated with parental SEP and adolescents’ own SEP among students aged 14–17 years. Methods Cross-sectional da...

Aims: This study investigates the link between personal income and smoking among adolescents, and aims to answer the following questions: (i) to what extent is personal income related to smoking, independent of family socioeconomic status (SES)? (ii) does the association between personal income and smoking apply to different sub-populations? Desi...