Moreover, general medicine specialist training also includes tasks that require a deeper knowledge of common public health issues, mental health included (OECD Mental health questionnaire, 2013). As there is no gatekeeping in primary care to limit the access to specialist (mental) health services, many patients in need of treatment (for severe mental disorders in particular) may seek specialist level care directly. Psychiatric specialist services are mainly provided in psychiatric outpatient wards located in general hospitals.