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 mental distress and its contributing factors among young Belgian people.Methods: An online survey was widely distributed in Belgium during the first wave of COVID-19 in March, and 16–25-year-olds were selected as a subsample. Mental distress was assessed using the 12-item General Health Questionnaire (GHQ-12), and a threshold of ≥4 was used to discriminate mental distress cases from non-cases. Bivariate and multivariable logistic regression analyses were performed to evaluate possible predictors of mental distress, including demographics, chronic condition, history of mental health problems, social support, exposure to COVID-19, and several changes in everyday activities.Results: A total of 2,008 respondents were included, of which the majority was female (78.09%) and student (66.82%). The results indicate that about two thirds (65.49%) experienced mental distress. In the multivariable regression model, significant (p < 0.01) predictors of mental distress were female gender (OR = 1.78), low social support (OR = 2.17), loneliness (OR = 5.17), a small (OR = 1.63), or large (OR = 3.08) increase in social media use, a small (OR = 1.63) or large (OR = 2.17) decrease in going out for drinks or food, and a decrease in doing home activities (OR = 2.72).Conclusion: Young people experience high levels of mental distress during the COVID-19 pandemic. Our findings indicate that mental distress was highest among women, those experiencing loneliness or low social support and those whose usual everyday life is most affected. The psychological needs of young people, such as the need for peer interaction, should be more recognized and supported.

Background: Many people with mental health problems do not receive appropriate mental health care, resulting in a considerable level of unmet mental health needs. Epidemiological research has shown that some people are at increased risk for unmet mental health needs and has identified both structural and attitudinal barriers to mental health care. However, epidemiological studies may not provide the complete picture and qualitative research about unmet mental health needs is scarce. This study aimed to explore unmet mental health needs in the general population from the perspectives of professionals working with vulnerable groups.Methods: Four focus group discussions and two interviews were held with a total of 34 social work, mental health and primary care professionals in one rural and one urban primary care zone in the province of Antwerp, Belgium. All transcripts were thematically analyzed.Results: Five themes emerged: (1) socio-demographic determinants and mental disorder characteristics associated with unmet mental health needs; (2) attitudinal barriers; (3) structural barriers; (4) consequences of unmet mental health needs; and (5) recommendations for meeting unmet mental health needs.Conclusions: Finding suggest that unmet mental needs are associated with socio-demographic and mental disorder characteristics, and attitudinal and structural barriers. For example, professionals mentioned care-avoiders and difficult access for complex cases due to strict criteria. The high level of unmet need results in feelings of burden and powerlessness among professionals. Professionals discussed good practices and recommendations for optimal and more equitable mental health care provision, which should ideally be targeted at those in the greatest need.

Background Mental health problems often remain undetected and untreated. Prior research suggests that this is mainly due to a lack of need-perception and attitudinal barriers. The aim of this study is to examine unmet mental health needs using both a clinically assessed and a self-perceived approach in a Belgian province. Methods A cross-sectional survey study with a weighted representative sample of 1208 individuals aged 15 – 80 years old was carried out in 2021 in the province of Antwerp (Belgium). Mental health needs were defined as a positive symptom screening for depression (PHQ-9), anxiety (GAD-7) or alcohol abuse (AUDIT-C and CAGE), combined with experiencing significant dysfunction in daily life. Also 12-month health care use for mental health problems, self-perceived unmet mental health needs and reasons for not seeking (extra) help were assessed. Logistic regression analyses were used to explore the predictors of mental health problems, health care use, and objective and subjective unmet mental health needs. Results One in five participants had a positive screening on one of the scales, of whom half experienced dysfunction, leading to a prevalence of 10.4% mental health needs. Among those, only half used health care for their mental health, resulting in a population prevalence of 5.5% clinically assessed unmet mental health needs. Fourteen percent of the total sample perceived an unmet mental health need. However, more women and younger people perceived unmet needs, while clinically assessed unmet needs were higher among men and older people. One in six of the total sample used health care for their mental health, most of whom did not have a clinically assessed mental health need. Motivational reasons were most often endorsed for not seeking any help, while a financial barrier was the most important reason for not seeking extra help. Conclusions The prevalence of unmet mental health needs is high. Assessed and perceived (unmet) mental health needs are both relevant and complementary, but are predicted by different factors. More research is needed on this discrepancy.

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5Recently it was shown ' that sulfines reaot readily with diazoalkanes to A3-1,3,4-thiadiazoline-1-oxides in a regiospecific cyclo-addition process. In one case an aliphatic sulfine gave with diazomethane an episulfoxide instead of a five-membered ring product. Although we were inclined to believe that the cyclization to thiadiazoline-oxides would be a stereospecific process, recent results with the 1,3-dipolar cyclo-addition reaction of sulfines with diphenylnitrilimi-6 ne Ca regiospecific, but non-stereospecific process) threw doubt on this anticipation. Therefore, the stereochemistry of the diazoalkane-sulfine cyclization