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BACKGROUND: Mental health problems are of serious concern across Europe. A major barrier to the realisation of good mental health and well-being is stigma and discrimination. To date there is limited knowledge or understanding of mental health nurses' attitudes towards mental illness and individuals experiencing mental health problems. OBJECTIVES: To describe and compare attitudes towards mental illness and those experiencing mental health problems across a sample of registered nurses working in mental health settings from five European countries and the factors associated with these attitudes. DESIGN: A questionnaire survey. SETTINGS: A total of 72 inpatient wards and units and five community facilities in Finland, Lithuania, Ireland, Italy and Portugal. PARTICIPANTS: 810 registered nurses working in mental health settings. METHODS: The data were collected using The Community Attitudes towards the Mentally Ill (CAMI) scale, which is a 40-item self-report questionnaire. The data were analysed using quantitative methods. RESULTS: Nurses' attitudes were mainly positive. Attitudes differed across countries, with Portuguese nurses' attitudes being significantly more positive and Lithuanian nurses' attitudes being significantly more negative than others'. Positive attitudes were associated with being female and having a senior position. CONCLUSIONS: Though European mental health nurses' attitudes to mental illness and people with mental health problems differ significantly across some countries, they are largely similar. The differences observed could be related to wider social, cultural and organisational circumstances of nursing practice. Copyright 2009 Elsevier Ltd. All rights reserved. [ABSTRACT FROM AUTHOR]