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Coaches' knowledge, attitudes, and beliefs about mental health—or mental health literacy (MHL)—affect teams' mental health climates and the detection, referral, and treatment of athletes' mental health concerns. Thus, assessing collegiate coaches' MHL, and factors related to its presence, is critical. Using the Mental Health Literacy Scale, 1,571 NCAA (National Collegiate Athletic Association) coaches were surveyed regarding their MHL and demographic and mental health experience factors. Overall, 99.9% of the coaches surveyed believe that athletes' mental health affected their sport performances. Through hierarchical regression analyses, coaches' exposure to mental health treatment, perceived helpfulness of mental health treatment, gender (i.e., woman), years coaching (i.e., fewer years), and current NCAA division (i.e., Division III) were significantly related to their MHL, explaining 15.5% of variance. However, coaches' race/ethnicity did not reach significance. Recommendations regarding increasing coaches' MHL and hiring appropriately trained and licensed mental health and sport psychology professionals are offered. [ABSTRACT FROM AUTHOR]

Assistant coaches play an important role in National Collegiate Athletic Association (NCAA) athletic departments and spend substantial amounts of time working with student-athletes, yet no research to date has examined their knowledge of mental performance and mental health services. Therefore, the purpose of this study was to learn about NCAA Division I assistant coaches' understanding and use of mental performance and mental health services. Thirteen assistant coaches employed at universities with at least one mental performance consultant and one licensed mental health provider were interviewed. Thematic analysis procedures were used, and five themes were constructed: (a) day-to-day responsibilities of the assistant coach, (b) needing both mental performance and mental health services, (c) factors influencing understanding of mental performance and mental health services, (d) factors impacting student-athlete utilization of mental performance and mental health services, and (e) confusion between mental performance and mental health services. [ABSTRACT FROM AUTHOR]

Background: Women Veterans with co-morbid medical and mental health conditions face persistent barriers accessing high-quality health care. Evidence-based quality improvement (EBQI) offers a systematic approach to implementing new care models that can address care gaps for women Veterans. Objective: This study examines factors associated with the successful deployment of EBQI within integrated health systems to improve primary care for women Veterans with complex mental health needs. Design: Following a 12-site (8 EBQI, 4 control) cluster randomized study to evaluate EBQI effectiveness, we conducted an in-depth case study analysis of one women's health clinic that used EBQI to improve integrated primary care–mental health services for women Veterans. Participants: Our study sample included providers, program managers, and clinic staff at a women Veteran's health clinic that, at the time of the study, had one Primary Care and Mental Health Integration team and one women's health primary care provider serving 800 women. We analyzed interviews conducted 12 months, 24 months, and 4 years post-implementation and call summaries between the clinic and support team. Main Measures: We conducted qualitative thematic analysis of interview and call summary data to identify EBQI elements, clinic characteristics, and reported challenges and successes within project development and execution. Key Results: The clinic harnessed core EBQI elements (multi-level stakeholder engagement, data-driven progress-monitoring, PDSA cycles, sharing results) to accomplish pre-defined project goals, strengthen inter-disciplinary partnerships, and bolster team confidence. Clinic characteristics that facilitated implementation success included prior QI experience and an organizational culture responsive to innovation, while lack of pre-existing guidelines and limited access to centralized databases posed implementation challenges. Conclusions: Successful practice transformation emerges through the interaction of evidence-based methods and site-specific characteristics. Examining how clinic characteristics support or impede EBQI adaptation can facilitate efforts to improve care within integrated health systems. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to identify and describe common views of people with lived experience of mental health challenges – consumers and carers, families and supporters – of what they consider the most important measures to include in health economic evaluations which assess the incremental value of competing options in mental health care. Methods: Participants (n = 111) were people living in the state of Victoria, Australia, who identified as consumers of mental healthcare (n = 38); carers, family members and/or supporters (n = 43); or both (n = 30). Factor analysis based on Q-Methodology was used to identify clusters of people who hold similar viewpoints. Common viewpoints were described in terms of the characteristics of the group, and a qualitative interpretation was conducted on the basis of distinguishing statements and quotes provided in participants' own words. Results: We identified four common views: (1) safety before all else, prioritizing physical, sexual and psychological safety; (2) hope and partnership in processes of care; (3) physical and emotional health and wellbeing; and (4) care access, continuity and partnership with families. Although different priorities were identified for each viewpoint, key priority areas that were common to all views were having an environment in the health service that fosters respect and dignity, and that consumers feel heard and listened to. In sub-group and qualitative analyses, differences were observed regarding the likelihood of consumers and carers holding each of the views, as well as by age group. Conclusions: While some differences were noted between the views of consumers and carers and different age groups, there was also common ground regarding what outcomes are of most importance to measure. Including these measures in evaluation frameworks would provide a way of focussing mental healthcare decisions on the aspects of mental healthcare that are of most value to consumers and carers, thereby addressing an important shortcoming of current approaches to decision-making in mental healthcare. Highlights: We identified four common viewpoints of consumers and carers in terms of what they consider the most important measures to include in health economic evaluations which asses the incremental value of competing options in mental health care: (1) safety before all else, prioritizing physical, sexual and psychological safety; (2) hope and partnership in processes of care; (3) physical and emotional health and wellbeing; and (4) care access, continuity and partnership with families. Key priority areas that were common to all views were having an environment in the health service that fosters respect and dignity, and that consumers feel heard and listened to. After these, each view was characterized by a different level of priority on additional areas of health and wellbeing, as well as processes and characteristics of care. Including the priority measures from each view within evaluation frameworks would start to incorporate the values and priorities of consumers and carers into mental healthcare decision-making, thereby addressing an important gap in current decision-making processes. [ABSTRACT FROM AUTHOR]

Introduction Method Consumer and community involvement Findings Conclusion Driving a motor vehicle is an important activity for people living with a mental health condition, as it can support engagement in the community as part of recovery. There is little research exploring mental health consumers' experiences with driving and no found research on the role of mental health lived experience staff in assisting consumers with safe driving. It is essential to learn about consumers' experiences of driving to know the supports they find useful in understanding their driver responsibilities and self‐regulating their driving through periods of changing health and wellness. This study explored the personal and professional experiences of lived experience consumer staff related to driving a motor vehicle while also living with a mental health condition.The research was guided by the interpretive paradigm and codesign principles. Qualitative data were derived from semi‐structured interviews with (n = 9) lived experience consumers working in a public mental health service. Data were thematically analysed.Our research team involved consumer and occupational therapy coresearchers.Five main themes were identified: (1) Driving means freedom and independence, (2) A nuanced understanding about the impact of mental health on driving, (3) I/we can manage: A range of strategies, (4) Driving is not something mental health staff tend to discuss, and (5) Do not beat around the bush, just talk about it.Consumers want support and direct conversations about driving and their mental health, medication side effects, and strategies to gain their licence, maintain, or return to driving. Alongside mental health clinicians, consumer lived experience staff could play a vital role in supporting safe driving. [ABSTRACT FROM AUTHOR]

ABSTRACT Mental illness stigma is still a widespread phenomenon with damaging psychological and social consequences. This study is of relevance to the design of appropriate psychiatric services which reinforce the social integration of individuals living with mental illness. It investigates the relationship between contact, emotional intelligence (EI) and attitudes of the general population towards people with mental illness. This study utilized a random sampling method to collect data from 183 participants. Measures included the EI Scale for assessing EI, the level of contact (LOC) Report to examine the LOC with mental illness, and the Attitudes towards Mental Illness Scale to evaluate attitudes towards mental illness. Each of these instruments has been validated in previous research. Data analysis involved Pearson's correlation analysis, multiple linear regression, and mediation analysis to explore the relationships between variables. EI and particularly the abilities of use of emotion and other's emotional appraisal were associated with more positive attitudes towards mental illness. conversely, lower levels of contact were associated with higher levels of social care, indicating a complicated relationship between contact and attitudes. The findings highlight that a deeper understanding of the association between contact with individuals living with mental illness and attitudes towards them is needed, focusing on potential mechanisms that might modify this association. Additionally, a focal point that is underlined in this research is the important role of EI in affecting attitudes as it seems to offer promising directions in planning educational programs and stigma reduction interventions. [ABSTRACT FROM AUTHOR]

This study analyzed caregiver feedback regarding referrals, service use, and wanting additional services using a standardized survey completed by 1,585 caregivers at 260 Children’s Advocacy Centers. Most caregivers were referred to counseling or support services for their child (84%). Caregivers who completed the survey in Spanish were significantly more likely to receive referral information for themselves, have children use the services, use the services themselves, report being on waiting lists, want additional services for their child, and believe staff could have done something additional compared to caregivers who completed it in English. African American children were significantly less likely to receive referrals, use services and have caregivers want additional services. Spanish-speaking caregivers and African American children warrant more attention to ensure all families’ needs are being addressed. [ABSTRACT FROM AUTHOR]

AbstractThis paper examines the evolution and current challenges of the Brazilian Psychosocial Care Centers for Alcohol and other Drugs (CAPS-ADs), central to Brazil’s mental health reform. Established within the broader Psychosocial Care Network (RAPS) in 2002, CAPS-AD represents a shift from hospital-centric to community-based care for mental health and substance dependency. Synthesizing 39 peer-reviewed articles, the study explores CAPS-AD’s operational characteristics, effectiveness and limitations. The model is distinguished by its interdisciplinary approach, open-door policy, and focus on social reintegration, providing continuous access to specialized care. Key features include singular therapeutic plans, harm reduction strategies and integration with primary care. The CAPS-AD III modality, offering 24-hour care, highlights the model’s adaptability. Despite its strengths, the CAPS-ADs face challenges such as user dissatisfaction with rigid therapeutic activities, limited autonomy and inadequate participation in care planning. Structural deficiencies, particularly in resource-limited regions and the persistence of traditional biomedical approaches further hinder quality care. Additional barriers include insufficient attention to gender-specific needs, age-appropriate care and the stigmatization of substance users and professionals. Addressing these challenges through structural reforms, enhanced training, and a more integrated, personalized, and stigma-free approach is essential to fully realize the potential of CAPS-AD and advance equitable mental health care in Brazil. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Aim Methods Results Discussion Implications Trial Registration Given that recovery‐oriented care focuses on empowering individuals with mental health challenges, collaborative care can be an effective tool for nurses in mental health day hospitals.To deepen knowledge about the impact of collaborative nursing care for improving health outcomes of mental health day hospital users.A sequential and transformative mixed methods study was designed. In the first phase of this mixed methods study, quantitative data were collected from 144 users of mental health day hospitals. In phase two, a group of users underwent an intervention based on collaborative nursing care, through participatory action research, and qualitative data were collected. Finally, quantitative data were again collected from all users.The users who participated in the intervention group improved quantitatively in terms of the quality of the therapeutic relationship. They also improved at different stages of the recovery process, thus the qualitative results confirmed that collaborative nursing care was an essential component in their recovery process.The findings highlight the critical role of collaborative nursing care in health outcomes. The therapeutic relationship was identified as a key factor in facilitating patient empowerment.The study supports implementing collaborative nursing care models in mental health settings to enhance patient outcomes.ClinicalTrials.gov identifier: NCT04814576 [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aim of the Study Methods Tools Results Conclusion and Implications Patient or Public Contribution Climate change significantly impacts public health, increasing the prevalence of respiratory, cardiovascular and mental health issues. Nurses, as frontline healthcare providers, need strong environmental literacy to manage these health challenges. This study explores how environmental literacy among nursing students relates to climate anxiety, aiming to improve educational strategies and mental health support for future nurses.Is to investigate how environmental literacy among nursing students affects their levels of climate anxiety.A cross‐sectional survey was utilised on a representative sample of 620 nursing students from each academic year.Climate anxiety scale and the environmental literacy scale for adults were used to collect data.Environmental literacy and its components were positively linked to cognitive‐emotional and functional impairments and climate anxiety. Gender differences were observed, with females experiencing higher climate anxiety. Increased environmental literacy generally reduced climate anxiety, particularly in females, emphasising gender differences in environmental literacy's impact on climate anxiety. Despite the model's low explanatory power (R2 = 0.026), the findings highlight the importance of gender differences in the relationship between environmental literacy and climate anxiety.Nursing students show promise in their environmental knowledge but face significant climate anxiety. Gender differences in anxiety levels warrant attention. Addressing these concerns is crucial for preparing nurses to effectively address climate change's health effects and ensuring a resilient healthcare system. The study underscores the importance of integrating environmental literacy into nursing education and promoting pro‐environmental behaviours among nursing students and professionals. It highlights the crucial role of mental health support services, policy advocacy and ongoing research in addressing climate anxiety and preparing nurses to tackle the health impacts of climate change.No patient or public involvement. [ABSTRACT FROM AUTHOR]

Dyadic interventions targeting maternal mental health and the mother‐infant relationship in the perinatal period are critical due to the potential consequences of perinatal mental illness and relational disturbance for the mother, the infant, and their family. This paper describes the Pregnancy to Parenthood (P2P) model of care, a dyadic mother‐infant community‐based program designed to support vulnerable families in Western Australia in the context of an identified need to build workforce capacity. A pragmatic service evaluation study was conducted by analyzing routine clinical data collected from 105 dyads who completed pre‐ and post‐intervention measures, including the Edinburgh Postnatal Depression Scale (EPDS), Perinatal Anxiety Screening Scale (PASS), and the Mother Object Relations Scale‐Short Form (MORS‐SF). Reliable change index and cut‐off analyses indicated a clinically reliable pre‐post reduction in perinatal depressive and anxiety symptoms for 71% and 68% of the sample, respectively. Significant pre‐post improvements with medium effect sizes (r = −.46, r = −.32) were found for caregiving representations on the MORS‐SF, suggesting representations became more balanced. These results provide provisional evidence that the P2P model of care may be effective in improving maternal mental health and caregiving representations. Further research is required to evaluate the efficacy of P2P in relation to enhancing family well‐being, and to inform policy and mental health service development. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence that spending time with or in nature can be beneficial for health and wellbeing. Emerging evidence suggests potential benefits for staff and service users in healthcare settings, yet little is known about how to put Nature-based approaches (NBAs) into practice within the Child and Adolescent Mental Health Services (CAMHS) setting. The CAMHS Goes Wild project in Southwest England aimed to explore the implementation of NBAs within CAMHS, examining staff attitudes and understanding to identify potential benefits and challenges through a mixed methods study. Methods: The study involved three phases of data collection: an online survey with two waves, the first wave prior to the training, and the second four months post-training, and semi-structured interviews. Data collection was designed to fit around NatureWell training, attended by sixty-four CAMHS staff, which took place alongside the study. All participants were sampled from one NHS Trust and the study was open to both those who had attended the NatureWell training and those who had not. Data were synthesised to produce an understanding of staff attitudes towards NBAs and perceived barriers and facilitators to the implementation of this approach. Results: Ninety-seven staff responded to the wave 1 survey and 57 responded to the wave 2 survey. Fourteen staff members were interviewed. Data synthesis generated three themes: Tension between the culture of CAMHS and NBAs (Theme 1) and the need for buy-in and governance support (Theme 2). Theme three described the potential benefits of NBAs for staff and service users in CAMHS and is presented in a separate paper. The first two themes are presented in this paper. Conclusions: The implementation of NBAs in mental health service settings for CYP presents both significant challenges and opportunities. Our findings suggest multiple barriers to implementation, often in the form of organisational or cultural factors, such as the risk averse nature of the service. Our work also elucidates several potential facilitators which may address or mitigate some of these barriers. These potential enablers, such as harnessing the role of firsthand experience, warrant further exploration in the implementation of NBAs in CAMHS. [ABSTRACT FROM AUTHOR]

Background: The Latinx community faces an increasing amount of mental health challenges and disparities in care. While the contributing factors are complex, there are likely potential barriers related to connecting with mental health support and accessing care that can be addressed. Methods: To investigate barriers in connecting to mental health care, we conducted a cross-sectional survey of mental health service use and barriers in an urban community with a primarily Hispanic/Latinx ethnicity using a modified random walk approach for door-to-door data collection with a two-cluster sampling frame. Survey included questions on socio-demographic, mental health status, desire and attempt to seek care, and the Barriers to Access to Care Evaluation. Shapley additive explanation (SHAP) identified impactful barriers and demographic characteristics. Our primary outcome was the number of respondents who saw a professional in the past 12 months and the key determinants that enabled their successful connection. Secondary outcomes were people with poor mental health who had wanted or tried to seek any source of mental health support. Results: Of the 1004 respondents enrolled, 70.5% were foreign born; 63.4% were women. In the past 12 months, 23.8% of respondents wanted to connect with mental health care; 15.5% tried to connect, and only 11.7% successfully connected to mental health services. The two most cited barriers had the highest SHAP values: concerns about treatments available (65%) and financial costs (62.7%). Additional barriers with high SHAP values: being seen as weak and having no one to help them find care. Of demographic characteristics, age had the highest SHAP values. Conclusion: In a community with a high density of Latinx immigrants, just under half of respondents wanting mental health care successfully connected. Perceived informational, financial, and stigma-related barriers impacted the likelihood to connect with mental health care. These factors should be considered when designing programs and interventions to improve mental health care access and services in the Latinx community. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionsPrevious research has demonstrated that individuals with intellectual and developmental disabilities (IDD) experience a variety of barriers in accessing mental health care and that family caregivers often play an integral role in helping individuals with IDD navigate these systems. However, little research has focused on family caregivers’ perceptions of accessing mental health services.To better understand their perspectives, we analyzed responses to an open-ended question about challenges to accessing mental health resources for adults with IDD from 208 family caregivers. Responses were analyzed using a team-based approach to qualitative data analysis.We identified five themes that capture both systematic issues and personal or interpersonal challenges that reduce access to high quality mental health care among adults with IDD. In addition to the barriers, we also identified some accounts of families succeeding in accessing adequate mental health care.We offer practical implications for research, policy, and practice that can help reduce barriers to mental health care for adults with IDD. [ABSTRACT FROM AUTHOR]

Background: Integrating behavioral health services in primary care is challenging; a toolkit approach to practice implementation can help. A recent comparative effectiveness randomized clinical trial examined the impact of a toolkit for improving integration on outcomes for patients with multiple chronic conditions. Some aspects of behavioral health integration improved; patient-reported outcomes did not. This report evaluates the implementation strategy (Toolkit) using Proctor's (2011) implementation outcomes model. Methods: Using data from the 20 practices randomized to the active (toolkit strategy) arm (education, redesign workbooks, online learning community, remote coaching), we identified 23 measures from practice member surveys, coach interviews, reports, and field logs to assess Toolkit acceptability, appropriateness, feasibility, and fidelity. A practice survey score was high (met expectations) if its average was ≥ 4 on a scale 1-5; all other data were coded dichotomously, with high = 1. Results: Regarding acceptability, 74% (14) of practices had high scores for willingness of providers and staff to use the Toolkit and 68% (13) for quality improvement teams liking the Toolkit. For appropriateness, 95% (19) of practices had high scores for the structured process being a good match and 63% (12) for the Toolkit being a good match. Feasibility, measured by Toolkit prerequisites, was scored lower by site members at project end (e.g., provider leader available as champion: 53% of practices) compared to remote coaches observing practice teams (74%). For "do-ability," coaches rated feasibility lower for practices (e.g., completion of workbook activities: 32%) than the practice teams (68%). Fidelity was low as assessed across seven measures, with 50% to 78% of practices having high scores across the seven measures. Conclusions: Existing data from large trials can be used to describe implementation outcomes. The Toolkit was not implemented with fidelity in at least one quarter of the sites, despite being acceptable and appropriate, possibly due to low feasibility in the form of unmet prerequisites and Toolkit complexity. Variability in fidelity reflects the importance of implementation strategies that fit each organization, suggesting that further study on contextual factors and use of the Toolkit, as well as the relationship of Toolkit use and study outcomes, is needed. Trial registration: ClinicalTrials.gov NCT02868983; date of registration: 08/15/2016. [ABSTRACT FROM AUTHOR]

The increasing global demand for mental health services, compounded by the COVID‐19 pandemic, has spurred innovative approaches. Among these, the utilisation of paraprofessionals for delivering brief psychological interventions (BPIs) is gaining significant traction across diverse settings and populations. Paraprofessionals (individuals equipped with specialised mental health training but lacking formal qualifications) have emerged as a valuable resource. They have the potential to offer cost‐effective, culturally sensitive and readily accessible support. The integration of paraprofessionals into various healthcare settings, such as inpatient psychiatric units and primary care clinics, underscores their potential to enhance holistic well‐being and early intervention. This integration not only lightens the load on licensed therapists but also broadens access to services while reducing treatment costs. At a global scale, paraprofessionals, armed with local knowledge and community connections, play a pivotal role in improving mental health outcomes among underserved populations. Furthermore, the rise of telemental health, an increasingly crucial aspect of mental healthcare, presents new avenues for paraprofessionals to deliver psychological care. Despite their potential, paraprofessionals encounter challenges related to work‐life balance, boundary‐setting and the stigma attached to their roles. Their integration into healthcare systems requires clear roles and responsibilities, along with continuous support to ensure effective intervention and the well‐being of both providers and recipients. Further research and development are necessary to harness their full potential and meet the increasing demand for accessible mental health services. [ABSTRACT FROM AUTHOR]

AbstractAddressing staff retention in the UK National Health Service is crucial. This study used interviews to investigate the factors influencing mental health occupational therapists’ (MHOTs) decisions to leave or remain in their positions in the UK National Health Service. Framework analysis was employed to analyze the data, focusing on how roles and organizational conditions affect job satisfaction and MHOT retention. The findings highlight that effective strategies should focus on empowering MHOTs with greater autonomy, improving communication with management, and providing high-quality training and supervision. These measures can enhance job satisfaction and retention, thereby improving mental health service delivery. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To explore the individual and interpersonal association between mental health knowledge (MHK) and depression in adolescents and one of their parents, and to explore whether gender differences exist between fathers and mothers in these associations.Participants were 3456 father–adolescent dyads and 4478 mother–adolescent dyads, recruited from eight middle schools in Wuhan, who completed self‐report assessments of MHK and depression from September to October 2021.With the application of the actor–partner interdependence model, A positive actor effect between MHK and depression in adolescents was found. Adverse partner effects from fathers' MHK and mothers' MHK to adolescent depression were noted and showed no significant difference. Adolescents' depression was significantly associated with parental depression in both fathers and mothers.It is implied that milder adolescent depression was associated with lower levels of adolescent MHK, along with higher levels of MHK in both fathers and mothers. For parents, it is important to emphasise the improvement of their own MHK and increase their attention to adolescent mental health problems, as this may contribute to enhancing the mental health of adolescents.This study is instructive and related to family‐based nursing interventions for mental health, emphasising the potential influence of parents in the family on adolescent depressive symptoms. The findings suggest that parental involvement should be encouraged and that the family's role in supporting the child's mental health should be recognised, contributing to the development of relevant policies.This study highlights that higher parental MHK is associated with lower levels of adolescent depression, with no gender differences between fathers and mothers. Family‐based nursing interventions that emphasise mental health education for parents may have an impact on improving depression in adolescents.Guidelines were followed using the STROBE reporting method.None. [ABSTRACT FROM AUTHOR]

Objective Data Sources and Study Setting Study Design Data Collection/Extraction Methods Principal Findings Conclusions To investigate provider and administrators' perspectives about the impact of the Department of Veterans Affairs' (VA) Community Care program on acute and residential mental health treatment of rural Veterans.Primary data were collected from participants via interviews. Participants were employees of VA Healthcare Systems located in Northern New England, or employees of non‐VA mental health treatment settings affiliated with VA in Northern New England.This study was informed by the Consolidated Framework for Implementation Research (CFIR), with Community Care as the implemented program. Individual, semi‐structured interviews were conducted.Individual interviews were transcribed, coded deductively using the CFIR, and inductively coded by locating themes.Twenty‐one people completed interviews. Commonly reported challenges included community programs not focused on Veterans' needs, poor coordination of care, communication challenges, and problems tracking Veteran care. Facilitators included increased access to care and strengthening coordination of care.The VA's Community Care program can address the acute or residential mental health needs of Veterans in rural settings in some circumstances, however there are challenges to successful implementation. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionsDisclosure of self-injurious thoughts and behaviors (SITBs) can serve as a catalyst to receiving mental health and lifesaving care; yet, many young people do not disclose these experiences to their therapists. In this study we aimed to identify barriers to adolescents disclosing their SITBs to their therapists and to compare these barriers across non-disclosure of suicidal ideation, suicidal behavior, and non-suicidal self-injury.Participants (n = 292) all had lived experience of at least one SITB and were an average age of 15.55 years, with the majority identifying as cisgender girls (68.15%). Using inductive content analysis of open-ended responses, six main categories of disclosure barriers were identified.These overarching barriers were: Agency Theft, Irrelevance, Therapeutic (Mis)Alliance, Internalized Stigma, Anticipated Stigma, and Lacking Disclosure Self-Efficacy. The majority (85.29%) of subordinate barriers were common across the three SITBs.Adolescents may hesitate to disclose their SITBs to their therapists for many reasons; prioritizing the therapeutic relationship and working collaboratively with adolescents could be instrumental in not only fostering disclosure but also an overall more positive therapeutic experience. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsDiscussionFamily/carer Lived Experience (LE) workers are increasingly being hired in Victorian mental health services, bringing their personal experience of supporting someone using these services and the ability to apply that experience in their roles. This project asked family/carer LE workers in Victoria, Australia to detail their experiences of working in these roles, how their personal lived experience of caring intersected with their work, and what they thought was needed to make family/carer LE work sustainable.A co-produced mixed-method design was used, including a survey of 62 Victorian family/carer LE workers and photovoice workshops attended by ten workers. The survey captured broad workforce trends, while the workshops provided narratives illustrating work experiences. Data from both sources were analysed separately and then combined into categories reflecting key dimensions of the family/carer LE worker experience.The findings were grouped into the following categories: Passion for the Work, Working Relationally in an Individualistic System, Undervalued and Poorly Understood, Workplace Conditions, Training and Development, Isolation, Beautiful but Fragile, Impact of the Work, and What is Sustaining the Work.This project emphasised the unique emotional labour family/carer LE workers perform and the specific supports they need. A clear model of practice for the profession is necessary, alongside cultural changes within mental health organisations to better integrate the strengths of this workforce. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Discussion This study describes the current management of patients with eating disorders (EDs) served by publicly–funded Medicaid behavioral health systems.Behavioral health leaders across nine counties in California met on a quarterly basis to share experiences, challenges, and lessons in the management of EDs within publicly–funded service systems. Detailed notes were taken, and a qualitative content analysis was undertaken to identify key themes.County leadership noted insufficient outpatient capacity and difficulty building capacity for ED treatment, in addition to extraordinary challenges when facilitating admission to out‐of‐network higher level of care programs, at significant expense. Several challenges were identified in building an internal ED workforce, including the fact that many providers weren't eager to treat EDs due to training burden, patient complexity, and high levels of clinician burnout. When a higher level of care was required due to lack of outpatient resources or patient symptom severity or complexity, leaders dedicated significant resources to identify and contract with an appropriate program and secure the necessary funds.Our study supports the need for specialized ED treatment and case management, as well as standardized processes and centralized resources, in Medicaid‐managed care. Findings also indicate the importance of protecting against clinician burnout, possibly through reduced caseload expectations, financial incentives, or increased support. Future policy change could reduce administrative burden and clinician burnout by facilitating admission to and reimbursement for higher levels of care. [ABSTRACT FROM AUTHOR]

Background: Advance Choice Documents (ACDs) have been recommended for use in England and Wales based on evidence from trials that show that they can reduce involuntary hospitalisation, which disproportionately affects Black African and Caribbean people. Our aim was therefore to develop and test ACD implementation resources and processes for Black people who have previously been involuntarily hospitalised and the people that support them. Methods: Resource co-production workshops were held to inform the development of the ACD template and two types of training for all stakeholders, comprising a Recovery College course and simulation training. An ACD facilitator then used the ACD template developed through the workshops to create personalised ACDs with service users and mental health staff over a series of meetings. Interviews were then conducted with service user and staff participants and analysed to document their experience of the process and opinions on ACDs. Other implementation strategies were also employed alongside to support and optimise the creation of ACDs. Results: Nine ACDs were completed and were largely reported as appropriate, acceptable, and feasible to service users and staff. Both reported it being an empowering process that encouraged hope for better future treatment and therefore better wellbeing. Uncertainty was also expressed about the confidence people had that ACDs would be adhered to/honoured, primarily due to staff workload. The information provision training and the skills training were generally considered to be informative by trainees. Conclusions: The project has developed an ACD creation resource that was reported as agreeable to all stakeholders; however, the generalisability of the findings is limited due to the small sample size. The project also highlights the importance of staff and ACD facilitator capacity and good therapeutic relationships in ACD completion. Further research is needed to determine the adjustments needed for large scale use, including for those under age 18 and those under the care of forensic mental health services; and how to include carers/supporters more in the process. [ABSTRACT FROM AUTHOR]

Background: To identify risk factors for mental distress and investigate whether the factors were different between men and women during the coronavirus disease 2019 (COVID-19), using KOKOROBO data, which is an online platform that aims to facilitate access to mental health services. Methods: We used baseline data on KOKOROBO users 13 years of age or older in Japan who accessed it from October 11, 2021, to April 6, 2023, excluding those receiving treatment for mental health problems. Global severity, based on the most severe measure on Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI), was analyzed using multivariable logistic regression with baseline characteristics for each gender, and for under 30 and 30 years of age or older in women. We conducted the same analysis of suicidal ideation for each gender. Results: In the 686 men and 1274 women, 117 (17.1%) and 100 (7.8%) had minimal global severity respectively, and the rest suffered from mental distress to some extent. For women, ages under 30 years (adjusted OR (aOR): 0.352, 95%CI: 0.231–0.539, P < 0.001), marriage (aOR: 0.453, 95%CI: 0.274–0.746, P = 0.002), and concerns about COVID-19 infection were associated with global severity, while having children (aOR: 0.509, 95% CI: 0.284–0.909, P = 0.023) and decrease of going out during the COVID-19 pandemic had a protective effect on global severity and suicidal ideation for men, respectively. Living with family was a risk factor for mental distress in unmarried women over 30 years of age. Less communication with family or others and responding to the questionnaire late at night (00:00–05:59) were associated with severe global severity in both genders. Conclusions: Age, living arrangement, marriage, having children, concerns about COVID-19 infection, and lifestyle changes during the COVID-19 pandemic had gender-specific effects on mental distress, while frequent communication and regular life rhythm maintained mental health in both genders. Young women and, unmarried middle-aged women living with their families tended to experience mental distress during the COVID-19 pandemic. Trial registration: The Ethics Committee of the National Center of Neurology and Psychiatry approved this study (approval number B2020141) on April 15, 2021. [ABSTRACT FROM AUTHOR]

Background: Access to traditional mental health services in Canada remains limited, prompting exploration into digital alternatives. The Government of Ontario initiated access to two internet-based cognitive behavioral therapy (iCBT) programs, LifeWorks AbilitiCBT and MindBeacon TAiCBT, for adults with mental health issues. Methods: An uncontrolled observational study utilizing secondary retrospective program data was conducted to evaluate the reach, uptake, and psychological symptom changes among participants engaging with either iCBT program. Results: Between May 2020 and September 2021, 56,769 individuals enrolled in LifeWorks AbilitiCBT, and 73,356 in MindBeacon TAiCBT. However, substantial exclusions were made: 56% of LifeWorks participants and 68% of MindBeacon participants were ineligible or failed to initiate treatment. Consequently, 25,154 LifeWorks participants and 23,795 MindBeacon participants were included in the analysis. Of these, 22% of LifeWorks and 26% of MindBeacon participants completed over 75% of iCBT treatment. On average, LifeWorks participants received 13 ± SD 7.1 therapist messages and sent 5 ± SD 10.3 messages, while MindBeacon participants received 25 ± SD 20.7 therapist messages and sent 13 ± SD 16.4 messages. LifeWorks included synchronous therapist contact averaging 1.4 ± SD 1.9 h per participant, while MindBeacon was purely asynchronous. Baseline severity of anxiety (37%) and depression symptoms (22%) was higher for LifeWorks participants compared to MindBeacon participants (24% and 10%, respectively). Clinically significant changes in anxiety and depression scores were observed: 22% of LifeWorks and 31% of MindBeacon participants exhibited reliable recovery in PHQ-9 scores, while 26% of LifeWorks and 25% of MindBeacon participants demonstrated reliable recovery in GAD-7 scores. Conclusion: In conclusion, iCBT programs show promise for engaged participants with varying levels of severity in anxiety and depression symptoms. Future iterations of iCBT should consider adopting a broad entry criterion to iCBT programming to increase accessibility, especially for those with severe symptoms, alongside integrated intake care pathways, and potential payment structure adjustments for iCBT service providers. Taken all together, these factors could temper high dropout rates post-intake assessment. This evaluation underscores the potential and value of digital mental health interventions for individuals with mild to severe anxiety or depression symptoms, emphasizing the importance of addressing participant dropout. [ABSTRACT FROM AUTHOR]

Background: Poverty is a key social determinant of mental health among forcibly displaced persons. This study aimed to design and pilot test a strategy to integrate existing mental health and economic inclusion interventions for displaced families in Ecuador. Methods: We conducted a series of qualitative interviews (n = 30), focus groups (n = 6), and workshops (n = 3) to develop a set of strategies for integrating cross-cutting and focused mental health and psychosocial support (MHPSS) strategies into an existing economic inclusion program for displaced families in Quito. We non-randomly assigned two field offices in Quito to (1) integrate cross-cutting strategies focused on improving economic outcomes or (2) integrate both those cross-cutting strategies plus focused MHPSS strategies into an economic inclusion program. We measured site-level implementation outcomes (adoption, appropriateness, acceptability, feasibility, fidelity, reach, retention, usability) and participant-level psychosocial (wellbeing, depressive symptoms, anxiety symptoms, functioning) and economic inclusion outcomes (financial resources, diet diversity, social capital/networks, self-reliance) over six months. We conducted a mixed-methods analysis to explore the acceptability and feasibility of the integration strategies and the ability to evaluate their effects in a future cluster randomized trial. Results: We developed a toolkit that included 10 strategies for integrating MHPSS into economic inclusion interventions. Fifty displaced persons participating in an existing economic inclusion program (25 per study condition) were enrolled and 88% remained in the study through the six-month follow-up. Participants and implementers reported that the integration strategy was appropriate, acceptable, feasible, and usable. Implementers, including people without prior experience in delivering mental health services, were able to deliver the intervention with high fidelity. Integration of focused MHPSS intervention components into an economic inclusion program appeared to improve MHPSS outcomes, the strength of social capital and networks, and engagement in economic and other programs. Conclusions: This study provides preliminary evidence of the acceptability and feasibility of integrating MHPSS into economic inclusion programs for displaced people. We found evidence supporting evaluation methods that can be employed in a future study to definitively test the added value of integrated approaches to mental health and economic wellbeing for displaced persons. [ABSTRACT FROM AUTHOR]

Background: The purpose of the study was to assess the prevalence and associated factors of major depressive disorder (MDD), generalized anxiety disorder (GAD), and past 12-month suicidal behaviour (PSB) among adolescents in Mozambique. Methods: Data from 3,109 females (aged 15–19 years) and 1,439 males (aged 15–19 years) that participated in the 2022-23 Mozambique Demographic and health Survey were analysed. MDD was assessed with the PHQ-9 and GAD with the GAD-7. Results: Results indicate that among girls the prevalence of PSB was 4.3% (attempt 1.0%, plan 1.9% and/or ideation 3.6%) and among boys 2.5% (attempt 0.3%, plan 0.7% and/or ideation 2.4%). Among girls and boys, the prevalence of MDD (≥ 8 scores) was 15.5% and 3.7%, respectively, and the prevalence of GAD (≥ 5 scores) was 25.0% and 10.3%, respectively. In adjusted logistic regression analysis, among girls, GAD was positively and solid fuel use was negatively associated with PSB, while among boys MDD and urban residence were positively associated with PSB. Among female adolescents, currently being pregnant and "big problem to get money for medical treatment" increased the odds of MDD. While among male adolescents, urban residence, having a genital sore or ulcer, has living children, and early sexual debut were positively associated with MDD. Urban residence, current alcohol use, and early sexual debut were positively associated with GAD in male adolescents, while poorer wealth status, being pregnant, and having a "big problem to get money for medical treatment" were positively associated with GAD in female adolescents. Conclusion: About 3% of participants had PSB, among girls one in five had MDD or GAD and among boys more than 5% had MDD or GAD. Public health interventions can be guided by several associated factors that have been identified. [ABSTRACT FROM AUTHOR]

Objective: This study assesses the impact of the age at which individuals first begin working on the odds of developing mental health disorders among older adults in Ecuador. Methods: Data from the 2009 Survey of Health, Well-being, and Aging (SABE) encompassing 3093 elderly participants from mainland Ecuador were analyzed. We employed binary logistic regression to explore the association between the age at which individuals started working and their subsequent mental health status. Results: Participants who started working between ages 5–12 and 26–35 had lower odds of mental health disorders compared to those who began at ages 18–25, while those who started working between ages 13–17 and 36–80 exhibited higher odds compared to the same baseline group. These associations are net of various demographic and health-related factors. Conclusion: The results indicate mixed associations between the age at which individuals started working and their mental health outcomes in older age. While some age groups demonstrate lower odds of mental health disorders, others do not, suggesting a complex relationship that warrants further investigation. Implications: This research supports the development of healthcare policies aimed at providing mental health education and services tailored to populations affected by early labor, to mitigate the enduring impacts of child labor on mental health in older age. [ABSTRACT FROM AUTHOR]

Several studies have shown high rates of mental health problems amongst doctors in training worldwide. Self-care has been shown to be protective against burnout and increases subjective wellbeing. This study aims to investigate the self-care practices of foundation year doctors (FYs) in Malta. All doctors enrolled in Foundation Programme Malta in 2022 were invited to participate in an online questionnaire containing the Mindful Self-Care Scale (MSCS). Confirmatory factor analysis confirmed the 6-factor model described in literature. The independent sample t-test and Mann–Whitney U-test were used to check for relationships between total scores and variables of interest and means and medians for each group were compared. A total of 122 doctors answered the questionnaire out of 264 (46%). The median score for our FY cohort was 68, indicating moderate levels of self-care. Almost 40% of participants rarely or never experienced a sense of meaning at work. Working for long hours under stressful conditions means that self-care must be one of the top priorities for new doctors. However, very few FYs working in Malta regularly care for their physical and mental health. Strategies to improve trainee wellbeing must first focus on systemic factors to allow the individual factors to be addressed. [ABSTRACT FROM AUTHOR]

Aim: Our aim was to assess the burden of children and adolescents' mental health problems on the Slovenian outpatient healthcare system before, during and after the pandemic. Methods: In a retrospective analysis of healthcare indicators from 2008 to 2023, we analysed data from the National Institute of Public Health. Key domains included initial visits for mental and behavioural disorders (MBDs) to primary care for the population aged 0–19; the number of referrals to an initial assessment with a child and adolescent psychiatrist (CAP) at the secondary level for the population aged 0–17 along with the corresponding waiting times; and the number of urgent referrals for the population aged 0–17 to emergency mental health centres at the tertiary level. The calculations included rates per 1000 people. Descriptive statistics and diagrams were used to compare the data. Segmented linear regression analysis (SLR) was conducted on the primary healthcare data to identify the distinct temporal point indicating an increase. Results: Comparing the average rates of the 2020–2022 period to those of the 2018–2019 period, there was a 20% increase in initial visits to primary care, a 23% increase in the referral rate to a CAP at the secondary level, and a 41% increase to the tertiary level of care. In secondary care, a four- to sevenfold increase in waiting times for the initial CAP assessment was observed between 2019 and 2023. The incidence of initial visits to primary healthcare services for MBD increased from 2008 to 2019 (average annual growth rate of 4.5%). The average annual growth rate for the 2020–2022 period tripled to 13.9%. The SLR showed that the trend of accelerating growth could have begun in 2017 for the 0–5 age group and possibly for the 15–19 age group as well. Conclusions: After the initial decline in 2020, all levels of the Slovenian healthcare system faced an increased burden of MBD in children and adolescents from 2021 to 2022 compared to pre-pandemic levels. Nevertheless, a portion of this increase aligns with longitudinal growing trends from 2008 onwards. Tackling the crisis requires urgent national action, significant improvement in organization, and investments in mental health. [ABSTRACT FROM AUTHOR]

Objectives: Telemedicine has emerged as a crucial tool in addressing public health requirements, particularly during a pandemic. This aligns with the third Sustainable Development Goals (SDGs) objective of ensuring healthy lives and promoting well‐being for all ages. The current generation demonstrates a greater proficiency in modern technology, prompting researchers to investigate their views and behavior trends in telemedicine. Methods: This research is aimed at examining the telemedicine adoption patterns of Generation Y and Generation Z by dividing them into two groups. Study Group 1 is comprised of those who have known modern technology but have yet to gain experience in using telemedicine. Meanwhile, Study Group 2 is comprised of those who had used telemedicine services. Utilizing structural equation model (SEM) analysis, this research investigates the magnitude of influence exerted by various determinants on an individual's tendency to utilize telemedicine. Results: Findings from both study groups indicate that younger generations have positive attitudes towards telemedicine, significantly influencing their willingness to use telemedicine. Furthermore, the level of readiness for change emerges as a crucial factor in determining the degree of affective commitment to change, continuance commitment to change, and normative commitment to change. In addition, the participants' affective experience state significantly influences all three dimensions of commitment to change. Conclusion: The results suggest the importance of fostering a positive and pragmatic understanding of telemedicine among young people. This can be achieved by encouraging the use of telemedicine services and fully adopting the shift to telemedicine. Therefore, it is crucial to prioritize the development of a positive view towards telemedicine, provide excellent service experiences, and promote social flexibility to attract a large user base, especially among the younger population. [ABSTRACT FROM AUTHOR]

The Senedd Children, Young People and Education Committee in Wales published an inquiry report on disabled children's access to education and childcare, highlighting significant barriers and shortcomings in mainstream settings. The report includes 32 recommendations to address these issues. The Welsh Government responded to the report, acknowledging the concerns raised and committing to work towards inclusive childcare and education. Additionally, the committee published an interim report on the implementation of education reforms in Wales, focusing on the Additional Learning Needs system and the Curriculum for Wales rollout. The report highlights concerns about a decrease in children identified with ALN and the need for a knowledge- and skills-rich approach to education. [Extracted from the article]

Background Aim Findings Conclusion This research study explores how therapists in the United Kingdom (UK) navigate the issue of loneliness when working with destitute asylum seekers (DAS). Loneliness and social isolation have adverse effects on the mental and physical health of individuals, and migrants, including asylum seekers and refugees, are particularly vulnerable to these challenges.The study aimed to provide valuable insights into the strategies employed by therapists to address loneliness in this specific population and may contribute to the development of effective interventions and programmes in mental health services for asylum seekers.Braun and Clarke's reflexive thematic analysis of focus group data revealed two main themes: (1) perceived factors that impact loneliness and (2) therapeutic strategies for alleviating loneliness.This paper concludes with a discussion of the findings of this study and provides recommendations for future research directions, aiming to further enhance our understanding and support for DAS in addressing loneliness and to continue improving mental health services for this vulnerable population. [ABSTRACT FROM AUTHOR]

ABSTRACT Rationale Aims and Objectives Method Results Conclusion This service evaluation details the process of introducing Single Session Therapy (SST) with families to a Child and Adolescent Mental Health Service in the United Kingdom. SST is a model of short‐term psychotherapy intervention which can be applied to family contexts to provide timely mental health support.This service evaluation had two objectives: (1) Review the existing evidence base and literature for SST. (2) Evaluate the implementation of a new SST treatment pathway in CAMHS, including patient experiences and satisfaction with the service.SQUIRE Guidelines are used to report on this new knowledge of healthcare. This evaluation used qualitative methods to evaluate the impact of the new service. The team also used existing frameworks within the Trust, namely discharge data, which is collected routinely as part of service evaluation.This evaluation suggests positive support for this model, and that many families appreciate and value the opportunity to build on strengths and work toward their goals as families. This project outcome appears to support some of Talmon's (1990) findings that the most commonly attended number of sessions is one, and that of those who attended only one session, many perceived the session as useful. Waiting times for our service are extremely long. The pace and structure around goals and solutions could feel both galvanising, as some reported, but others felt it was an insufficient response to the severity of their difficulties.More high‐quality research is needed before judgments can be made around the cost‐effectiveness or efficacy of SST over existing approaches in the United Kingdom. While implementing SST should not be used to justify reduction in existing interventions, it offers a positive additional service for young people experiencing mental health difficulties and their families. [ABSTRACT FROM AUTHOR]

The article discusses the evolution of substance use services, focusing on the establishment of overdose prevention centers. It highlights the challenges faced by individuals struggling with substance use and the need for more compassionate and effective support services. The text emphasizes the importance of harm reduction approaches, such as supervised consumption sites, in addressing the rising number of overdose deaths in the United States. The authors advocate for a shift towards client-centered care and collaborative efforts to improve outcomes for people who use drugs. [Extracted from the article]

In recent times, the world has witnessed unprecedented challenges, with the COVID-19 pandemic being a major disruptor to various aspects of daily life. This article delves into the profound impact of pandemics on primary care, specifically focussing on changes in antidepressant prescriptions and mental health referrals before, during, and after lockdowns in England, UK. In this retrospective study, we used anonymised individual-level electronic health record data from general practitioner (GP) practices in the North of England, UK. We applied a negative binomial-logit hurdle model and a multinominal logit regression model to assess the impact on antidepressant prescriptions and GP referral types, respectively. The initiation of antidepressant prescriptions showed a notable decrease during and post lockdowns, with a minor uptick in ongoing antidepressant prescriptions during the lockdown periods. Over the course of lockdowns and beyond, there was a growing trend of patients being referred to social prescribing interventions. Notably, individuals from ethnic minorities were more inclined to receive fewer medical treatments and more social prescribing interventions. The increase in antidepressant prescriptions during the pandemic-related lockdowns was expected due to these challenging circumstances. Reduced referrals to secondary mental health services occurred as online counselling services were deemed inappropriate by some doctors, and patients were hesitant to seek face-to-face help. Notably, there was a rise in social prescribing referrals, emerging as a valuable resource for psychological support amid heightened mental health strain. Additionally, ethnic minority patients were less likely to receive medical treatments but more likely to be referred to social prescribing services. Despite the inevitable negative impacts of the COVID-19 pandemic, these findings highlight the active role of non-clinical support in a social model of health, addressing unmet needs and reducing barriers to mental health care for certain groups. [ABSTRACT FROM AUTHOR]

Objective: Few individuals with eating disorders (EDs) receive treatment. Innovations are needed to identify individuals with EDs and address care barriers. We developed a chatbot for promoting services uptake that could be paired with online screening. However, it is not yet known which components drive effects. This study estimated individual and combined contributions of four chatbot components on mental health services use (primary), chatbot helpfulness, and attitudes toward changing eating/shape/weight concerns ("change attitudes," with higher scores indicating greater importance/readiness). Method s : Two hundred five individuals screening with an ED but not in treatment were randomized in an optimization randomized controlled trial to receive up to four chatbot components: psychoeducation, motivational interviewing, personalized service recommendations, and repeated administration (follow‐up check‐ins/reminders). Assessments were at baseline and 2, 6, and 14 weeks. Results: Participants who received repeated administration were more likely to report mental health services use, with no significant effects of other components on services use. Repeated administration slowed the decline in change attitudes participants experienced over time. Participants who received motivational interviewing found the chatbot more helpful, but this component was also associated with larger declines in change attitudes. Participants who received personalized recommendations found the chatbot more helpful, and receiving this component on its own was associated with the most favorable change attitude time trend. Psychoeducation showed no effects. Discussion: Results indicated important effects of components on outcomes; findings will be used to finalize decision making about the optimized intervention package. The chatbot shows high potential for addressing the treatment gap for EDs. [ABSTRACT FROM AUTHOR]

Objective: While understanding racial/ethnic disparities in mental health services use is a growing priority in colleges and universities, little is known the attitudes that may contribute to these disparities. Methods: This study investigates the relationship between clinic diversity, ethnic-racial identity, discrimination, and treatment attitudes. College students n = 250 (Asian 21%, Black 11%, Latinx 23%, and White 45%) participated in an online experimental task rating hypothetical clinic websites that varied by clinician diversity and completed a series of self-report questionnaires. Results: Clinician diversity did not influence treatment attitudes, but discrimination and ethnic-racial identity were significantly related to treatment attitudes. Additionally, the relationship between public regard and treatment attitudes was moderated by race/ethnicity. Conclusions: By focusing on treatment attitudes rather than behaviors, this study addresses potential areas of intervention to address racial/ethnic disparities in college mental health. [ABSTRACT FROM AUTHOR]

Objective: The current study explored differences in mental health problems, services utilization, and support of graduate students by gender, race/ethnicity, and year in school. Participants: Participants consisted of 734 graduate students from a large, Midwestern university. Methods: Graduate students answered a series of questionnaires in fall 2021 assessing their mental health, services utilization, and perception of services. Results: Women (vs men) and participants in their second year and beyond (vs first year) reported greater mental health problems, negative impact of the pandemic, and more services utilization. White (vs non-White) participants reported greater negative impact of the pandemic, greater services utilization, and less financial strain. Finances, lack of knowledge about resources, and inadequate communication from the university about services were reported as treatment barriers. Conclusion: Graduate students struggle with mental health, and universities may need to improve communication with and tailor their services to graduate students specifically to better support them. [ABSTRACT FROM AUTHOR]

Objective: To explore barriers and facilitators to mental health care among the student service member and veteran (SSM/V) population, develop an integrative model of mental health service use, and identify health communication opportunities. Participants: Participants were 21 current and former SSM/Vs recruited online and via snowball sampling. Methods: We conducted an emergent thematic analysis of in-depth interviews that took place in February 2021. Results: We identified eight major themes. Two were contextual (military culture, SSM/V identities), three were navigational (career repercussions, recognizing need, service availability/quality), and three were paths forward (high-quality accessible services, veteran peers/spaces, relevant outreach). Conclusions: We recommend higher education institutions promote SSM/V spaces, position mental health care as utilitarian, improve everyday mental health literacy, highlight service accessibility and quality, and deliver communications that reflect the diversity of SSM/V identities beyond the "warrior" archetype. [ABSTRACT FROM AUTHOR]