Despite much effort in community treatment, patients still experience stigma and discrimination. Community mental health care professionals should not only be aware of structural problems in mental health care, but should also pay considerable attention towards the relational and behavioural aspects in their clients' life concerning stigma. Furthermore, they have the crucial role in the community to raise awareness about stigma in order to increase their clients' acceptance in society.

Background: In line with international developments, the Flemish government is concerned about the quality of care in Flemish nursing homes. In 2003, new legislation shifted the attention from structural quality aspects to introducing quality processes. From from 2010 on, this evolved further with growing interest in the outcomes of quality management. This presentation will describe the subsequent steps taken towards the development and implementation of an integral framework of quality for the Flemish nursing homes using quality indicators. Objective: The aim was to develop an integral framework which supports nursing homes in quality management and improvement. This framework also needs to be informative for policy makers and be useful for inspection services and public communication. Process description: As a research partner, we started with formulating six process agreements, for instance, defining the objectives of the project, the roles of partners or clarifying the distinction between monitoring and evaluation. In 2011 and inspired by the Progress-study (Hoffman e.a. 2010), an integral framework of quality was developed through focus group discussions with all relevant stakeholders, including representatives of residents and family, nursing home workers, representative organisations,