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This paper explores the subjective experiences of mental health practitioners, people with psychosis and carers, on social isolation and community integration of people with psychosis. Focus groups and one-to-one interviews with 80 adult participants across three sites in the UK were conducted. Audio recordings were transcribed and analysed using thematic analysis. Participants commented on various aspects that may cause social isolation or enable community integration, including institutional factors (lack of resources, hospitalisation impact), illness symptoms (e.g., paranoia; over-pathologising vs individual choice), stigma (particularly the psychosis label), and the importance of communities that foster agency and embrace change. Hospitalisation maybe be a cause for isolation and psychiatric wards should consider allowing for socialisation as a therapeutic tool. Initiatives should consider the social fabric of our communities, socioeconomic inequalities and stigmatisation. Building communities that are accepting, kind and flexible can create opportunities that could lead to independence from mental health services., (© 2022. The Author(s).)

Personal recovery has become a guiding paradigm in mental health services. Most research on recovery is based on the exploration of personal stories of service users through verbal methods. As not everyone with psychiatric problems is able to verbally formulate a recovery narrative, the current study assesses personal recovery through PhotoVoice, with emphasis on visualisation, small stories and participation. Two ten-week groups were conducted with 18 participants living with severe mental illnesses. They participated in both the collection and analysis of visual narratives. Across the images produced by participants, four main recovery themes were found : People, Places, Activities and Finding Meaning. Compared to other frameworks, the emphasis participants put on the theme Places adds value to the understanding of recovery processes. Furthermore, participants showed that recovery is about dealing with vulnerabilities as well as aspiring a meaningful life. This study demonstrates that exploring visual narratives is powerful within recovery oriented mental health.

Co-occurring mental health (MH) problems are common among those with opioid use disorders (OUDs). However, most opioid treatment programs (OTPs) do not provide MH services. We measured the association between state level characteristics (Medicaid expansion status and rurality) and MH/OUD services integration. We used a generalized linear model to estimate how the association between integration and Medicaid expansions varied across levels of rurality (National Survey on Substance Abuse Treatment Services; 2018; n = 1507 OTPs). The predicted probability of OTPs offering MH services decreased as rurality increased, and the strength of the negative association was greater in non-expansion states ([Formula: see text]=-0.038, SE = 0.005, p < 0.0001) than in expansion states ([Formula: see text]=-0.020, SE = 0.003, p < 0.0001). Access to integrated MH services was lowest in rural non-Medicaid expansion states, despite the high risk of opioid misuse and a high need for MAT and MH services in this population.

This study aimed to characterize mental health service access in metropolitan Lima, Peru. Between May and December 2012, we interviewed 4,445 Peruvian adults, applying the Mini-International Neuropsychiatric Interview (MINI); a modified version of the WHO Disability Assessment Schedule (WHODAS-S); and, a health services access questionnaire. In the prior year, 3.6% (95% CI 3.0-4.4) of respondents accessed mental health services. Care access was associated with female sex; being unemployed; and having a diagnosed psychiatric morbidity. Of those with psychiatric morbidity, 16.9% (95% CI 13.3-21.3) received clinical care. Care access was 25.8% (95% CI 19.9-32.8) for people with a depressive episode; 12.1% (95% CI 7.4-19.2) for any anxiety disorder; and, 5.9% (95% CI 1.7-18.6) for harmful alcohol consumption or dependence. Respondents with moderate to severe levels of disability were more likely to recognize the need for care, but this was not necessarily associated with higher care access. Reducing the mental, neurological and substance use disorders treatment gap in Peru are discussed in light of the findings.

Mental health service disengagement can have devastating consequences for people in need of mental health services. This study explored parental factors in mental health service engagement among Chinese young adult mental health service users. Seventy-two Chinese young adults, aged from 18 to 26 years, were recruited from a Hong Kong community mental health service center. Nearly three-fifths (58.3%) of participants were female and over two-fifths (44.2%) attended college. Results of logistic regression analysis showed that Chinese young adult mental health service users with high levels of perceived need for services and low levels of perceived parental involvement in mental health services were more likely to engage in mental health services. However, concerns about the parent-child relationship, perceived parental encouragement and perceived parental demand for mental health service use were not associated with mental health service engagement. The practice implications of these results are discussed in light of the Chinese context.

Research shows that, in mental healthcare, empathy and active listening skills play a fundamental role in the therapeutic relationship. Despite this, clinicians receive little training in cultivating these qualities, and there is a dearth of training in therapeutic relationships and relational care in this field more generally. In response to this paucity of training, a new intensive three-day training programme has been developed called Compassionate and Relational Enquiry (CARE). The CARE training programme has recently been delivered to a number of mental health teams in different boroughs of an NHS Trust and has undergone several rounds of redevelopment. This paper outlines the CARE training programme's objectives and mode of delivery, and subsequently presents questionnaire results from recent CARE trainees regarding their experience of the nature and utility of the training. Four main themes emerged from responses to the question of the utility of the training, these were 'A shift towards more person-centred care', 'Strengthens the therapeutic relationship', 'Facilitates more collaborative care with patients and their families' and 'Development of new skills and therapeutic techniques'. The paper concludes by discussing the potential of this training to help forge a substantial shift in the culture of mental health services in a systemic way., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The present systematic review and meta-analysis study aimed to determine sociodemographic characteristics, risky behaviors, mental health disorders, and substance use disorders associated with suicide behaviors including suicidal ideation and suicide attempts among homeless individuals. PubMed, Scopus, Web of Science, and Cochrane Library databases were searched to identify the relevant studies published between January 1, 1995 and November 1, 2022. After initial evaluation of 9,094 papers, a total of 23 studies met the eligibility criteria. Results of the present study showed that chronic physical illnesses, violent behaviors, mood and psychotic disorders, and substance use disorders were significantly associated with both suicidal ideation and suicide attempts, while being older, having a history of physical abuse, and having mood and post-traumatic stress disorders were associated with suicide attempts only. The present study's findings suggest a crucial need for facilitating access to mental healthcare plans and promoting mental healthcare seeking among homeless individuals. [ABSTRACT FROM AUTHOR]

Socioeconomic situations in young people's families and communities make them more vulnerable to suicidal ideations. The Youth Helpline has made a significant difference in youth's lives and livelihoods by addressing their social and economic needs with positive mental health support. The quantitative and qualitative data validate the micro- and macro-level impact of the Youth Helpline in Puducherry. However, the multi-stakeholder model faces challenges in ensuring accountability, particularly from government partners. This paper highlights how direct intervention on the socio-economic determinants of youth suicidal ideation has positively affected youth mental health and reduced suicidal ideation in Puducherry. Social identity-based inequalities and access and affordability to mental health services are the major contributors to youth mental health problems. This paper critically discusses the Youth Helpline's multi-stakeholder process and youth-led approach to addressing socio-economic determinants, as well as the Helpline's impact on youth mental health., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Public-academic partnership-based program evaluations can generate actionable evidence for policymaking, program design and implementation in improving school-based mental health service delivery. The University of Pennsylvania Center for Mental Health and public behavioral health care agencies in Philadelphia in the United States have evaluated Philadelphia's school mental health programs reimbursable through Medicaid billing since 2008. The variety of evaluations include (1) examining acute mental health service use of children receiving school-based mental health care and Medicaid expenditure, (2) examining children's externalizing and internalizing behaviors to measure school mental health providers' performance, and (3) examining effects of different types of school mental health programs on children's behavioral health functioning, school outcomes, and other out-of-school service use. This paper reports key findings of these evaluations, discusses how programs have been refined based on evaluation results, and shares lessons learned for successful public-academic partnership-based evaluations to promote use of actionable evidence., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Substance misuse and mental health disorders are commonly occurring co-morbidities in young people. This paper reports on a pilot project to embed three specialist Alcohol and Other Drug (AoD) workers to be embedded in a youth early psychosis service to upskill mental health clinicians in managing substance misuse. Evaluation of the project used a mixed methods approach. Quantitative results showed that clinical staff members' knowledge of substance misuse, knowledge of AoD treatments and services, and overall confidence in working with young people with a substance misuse issue improved following implementation of the project. Qualitative results indicated four themes which emerged: defining the role of the AoD workers; support and upskilling of the mental health staff; openness and effective communication between the embedded workers and mental health teams; and barriers to collaboration. The results provide support for the embedding of specialist alcohol and drug workers in youth mental health services., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This report describes a domestic violence program in an urban Indian health center. The failure of office-based interventions and the importance of developing interventions that are sensitive to the needs of this population are discussed. Successful interventions including home visits and a domestic violence group that incorporated American Indian traditions and values are presented.

The outburst of the COVID-19 pandemic challenged vulnerable populations such as individuals with significant mental illness. In this fresh focus, we describe the innovative development of the UPSIDES mental health peer support intervention, in face of the COVID-19 pandemic in Israel. While the research program is still ongoing, in this paper we focus on the processes and lessons learned from dealing with the rapidly changing circumstances of the pandemic. We portray additional activities conducted above and beyond the UPSIDES protocol in order to maintain continuation and prevent dropout. We learned that an essential combination of keeping a close adherence with the core peer principles and UPSIDES' systematic program and the use of flexible telecommunication means, helped to maintain social connection and service users' participation throughout these times. The sudden pandemic challenges appeared to level out power imbalances and accelerated the formation of reciprocal and supportive relational interactions within the intervention. These processes highlight experiential knowledge as a unique asset, and peer support services as useful in supporting individuals with significant mental illness throughout COVID-19. [ABSTRACT FROM AUTHOR]

Black communities face multiple stressors including racism, discrimination, and navigating systems of oppression, all of which affect their mental health and wellbeing. In recent years, the practice of self-care has gained popularity as a strategy to cope with stress and to improve overall health. However, the current discourse often focuses on individual self-care behaviors and excludes systemic and community level factors that encourage, sustain, or inhibit self-care practices. This paper contextualizes a conceptual model of self-care with intersectionality theory and the psychology of liberation framework, in relation to the lived experiences of Black communities. The paper aims to underscore the necessity of self and community care as a tool for social justice, preservation, and resistance against oppressive systems that threaten the mental health and wellness of this community. [ABSTRACT FROM AUTHOR]

Hope is essential to mental health recovery, yet little is known about how mental health services can foster hope. This paper addresses the question: How can mental health services influence the sense of hope experienced by people who access their services? Sixty-one people who accessed a new mental health service were interviewed about their experiences, including about how the service had influenced their sense of hope. Interviews were analysed using constant comparative analysis. The data revealed that hope increased when people perceived positive changes in themselves and their circumstances: developing new understandings and perspectives; having effective strategies to manage challenges; seeing progress or having plans; and having support. Changes were attributed to three major features of the service: accessibility; staff competence and wisdom; and caring interactions. The findings highlight that, while individual clinicians are important, other interactions with services and the wider service context are also critical for facilitating hope., (© 2023. The Author(s).)

Inpatient psychiatric settings are now known settings in which sexual assault can occur. When a trauma survivor with psychosis makes an accusation of sexual assault within an inpatient setting, staff and the institution are frequently not well equipped in how to respond. While there is scant literature on how to proceed in such dilemmas there is even more of a dearth on how to effectively provide mental health services, trauma- and culturally informed care, and how to best engage with the individual so that safety can be maintained, and treatment continue. This article seeks to convey some basic supports for institutional response, theoretical frameworks to enhance understanding and clinical skill, and shifts in care so that trauma-informed and culturally informed care can take place within these complex dynamics. The goal of this paper is to support mental health services and interdisciplinary teams in becoming more effective in navigating these complex situations so that they can honor and respect the trauma survivor and continue to be effective at providing a healing environment.Public Significance Statement: This article offers enhanced understanding of managing risk and balancing trauma-informed care at an institutional and multi-systemic level when inpatients make allegations of sexual assault. Included in this is enhancing understanding from a theoretical framework of the traumatic experiences of clients, assessing needs and offering safety, treatment, and care, while also managing the complex dynamics and services of the organization., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The Weill Cornell Medicine Wellness Qlinic (Wellness Qlinic) is a student-run mental health clinic serving the lesbian, gay, bisexual, transgender, and queer (LGBTQ +) community in New York City. Student-run clinics have successfully provided primary care to underserved communities experiencing barriers to accessing health care. Psychiatric evaluation and medication management have also been implemented in several student-run clinics, but providing sustainable psychotherapy services has been a challenge. In this paper, we present a student-run mental health program incorporating interdisciplinary trainees to provide robust short-term psychiatric treatment, including individual psychotherapy, medication management, and group therapy. Results of a chart-review study to evaluate patient engagement and treatment outcomes are presented. The Wellness Qlinic's treatment model resulted in 90% patient retention and positive clinical outcomes for patients while addressing an education and training gap in LGBTQ + mental health for multidisciplinary mental health care providers., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The US South is disproportionately impacted by HIV. Social, cultural, economic, and political characteristics of the South shape access to mental health services leaving adverse impacts on health and wellness outcomes among People Living with HIV. The aim of this paper was to: (a) identify meso factors (at individual, organizational and community-level manifestations) which impact mental health services among People living with HIV in the South of those factors and (b) pose community-articulated recommendation and strategies. Through qualitative interviews with People Living with HIV and service providers, this study found that the meso factors of restricted funding and compounding stigma shaped mental health services in the South. Given the disproportionate rate of HIV, lack of mental health care, and landscape of socio-political factors unique to the region, attention to intervenable meso factors and community-based strategies are needed to enhance mental health services and respond to the HIV epidemic in the US South., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This paper explores the potential of collaborative group facilitation between therapists and peer workers in mental health. A case study of co-practice between a music therapist and a peer worker is used to illustrate how lived experience expertise can enrich and complement therapeutic groups. The paper aims to begin a discussion around collaborative group facilitation within mental health practice and to advocate for continued development of collaborative practice between peer workers and therapists. Experiences of collaboration are explored through the case study provided using a synthesis of the authors' reflections and dialogue. The importance of role negotiation, role definition, and open communication around changing roles and boundaries are discussed as key considerations for beginning collaborations, as well as the establishment and maintenance of a foundation of trust and support within the working relationship., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The impact of employment for individuals with mental health problems is complex. However, research suggests that when support is provided for accessing employment and gaining roles and skills that are valued by others, a positive effect can be seen on recovery. Employment-related support can take many forms and there is a need for further research into the experience of accessing different kinds of services. The current paper examines the lived experience of 11 people participating in a UK social enterprise providing work experience, training, and skills development for those with mental health problems. Although 'sheltered', the organisational ethos strongly emphasised service-user empowerment, co-production, equality with staff, provision of valued social roles and person-centred support. Phenomenological analysis revealed that participants valued a sense of belonging and authentic relationships within the service, whilst being given the opportunity to rediscover an identity that may have been lost because of their mental health problem. However, participants also discussed how, although the service improved their self-value, some feared the 'real world' outside of the service and were unsure whether they would be met with the same support. Tensions between field dominant approaches in supported employment and the experiences and values of the participants are explored. We argue that the findings highlight the importance of a nurturing working environment and the value for recovery of a range of meaningful roles, beyond competitive employment., (© 2021. The Author(s).)

Since 2016, Promotion of Human Rights of Persons with Disabilities in Bangladesh (PHRPB) has been working to include people with psychosocial disabilities in their community-based inclusive development work, and to increase access to formal mental health care. Field visits were carried out to PHRPBD catchment areas in Dhaka and Chittagong for a case study on the integration of mental health into community-based rehabilitation (CBR). This paper synthesizes the results of twenty-five semi-structured interviews carried out as part of the case study. Participants included people with psychosocial disabilities, intellectual disabilities, epilepsy or other cognitive impairments and their carers as needed. Interviews were audio-recorded, transcribed and translated from Bangla to English, then hand-coded for content analysis. Results were organized into five overarching categories: (1) explanatory models, (2) help-seeking behaviors, (3) impact of services, (4) challenges and barriers to improving mental health, (5) recommendations of users and carers. Respondents either had no explanation for why service users had become unwell or attributed it to physically and/or emotionally traumatic events or supernatural causes. Before attending PHRPBD's mental health services, most had visited formal or informal health care providers, often with disappointing results. Despite positive feedback on PHRPBD's services, participants identified ongoing challenges. Stigma, discrimination and human rights abuses persist and are compounded by issues of gender inequality. Participants also identified barriers and made recommendations specific to the program itself, mainly regarding accessibility (e.g., cost, distance, frequency). This study adds to the limited body of qualitative research on mental health in Bangladesh, reinforcing previous findings on explanatory models and health-seeking behaviors while providing new insights into the impact of a CBR program in this context. Feedback of service users and carers suggests that CBR may indeed be a useful approach to increase access to services in Bangladesh for people with psychosocial or intellectual disabilities, epilepsy or other cognitive impairments. However, this program is not without its limitations, some of which are the product of broader issues within the mental health system and others of the social and cultural context. More research is needed to formally evaluate this and other CBR programs in the Global South., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.)

The article reports that The original version of this article unfortunately contained an error in describing one of the programs discussed in the article. This paper inaccurately conflated the two Recovery After an Initial Schizophrenia Episode (RAISE) studies: Early Treatment Program (ETP) and Implementation and Evaluation Study (IES).

Indigenous groups throughout the world have experienced social exclusion and have been subjected to marginalization. Globalization has resulted in significant changes in traditional lifestyles and developmental programs have not been successful in integrating Indigenous people into communities with non-Indigenous people. Although there is substantial research on acculturation and adaptation within the field of cross-cultural psychology, there are few narrative reviews of this literature. The present paper provides such a review and examines the mental health concerns of Indigenous groups undergoing acculturation. We address the consequences of involuntary cultural change and review studies that have been conducted on mental health issues, psychosomatic symptoms, substance use, and suicidality in Indigenous groups. We conclude by offering suggestions to mitigate mental health problems. Directions for future research on the acculturation of Indigenous groups are also provided. [ABSTRACT FROM AUTHOR]

Care at Doorstep (CAD) is a home care service that includes medical and social care by skilled professionals. The purpose of this paper is to explore the need for CAD among users of the district mental health programme (DMHP) in Ramanagaram, Karnataka, India who have severe mental illness. The design of this study was descriptive where a qualitative inductive methodology was adopted. Data was collected from interviews of 20 caregivers and 7 mental health service providers linked to the DMHP. Socio demographic information was collected from participants and a semi-structured interview guides were used to explore needs and challenges in delivering care at home by the professionals. The themes that emerged from the manually transcribed and coded data were categorized as needs and challenges and used for developing a CAD model. [ABSTRACT FROM AUTHOR]

The movement for global mental health (MGMH) has raised awareness about the paucity of mental health services, particularly in low- and middle-income countries. In response, policies and programs have been developed by the World Health Organization and by the Lancet Commission on global mental health, among other organizations. These policy initiatives and programs, while recognizing the importance of being responsive to local needs and culture, are based on Western biomedical conceptualizations of emotional distress. In the paper, we discuss how a rights-based approach can promote the voice and participation of people with lived experience into the MGMH. We argue that a human rights framework can be enhanced by incorporating the conceptual approaches of critical inquiry and community mental health. We also discuss how rights-based approaches and service-user activism can productively reconfigure Western psychiatric conceptualizations of distress and provide both a moral and empirical justification for a paradigm shift within the MGMH.

This paper presents a qualitative content analysis of survey data collected from behavioral health care providers from throughout New York regarding the challenges faced as a result of COVID-19. Survey responses from 295 agency and program administrators and staff, representing 238 organizations, were analyzed. Ten themes were identified: business operations, service provision, telehealth, safety, client concerns, staff concerns, supplies, technology, illness/grief/loss, and communication. These themes represent concerns that arose from the rapid transition to widespread use of telehealth, limited technology accessibility for both staff and clients, reduced revenue and billing changes, impact of COVID-19 infection itself and subsequent deaths of clients and staff, and necessary modifications for organizational communication both internally and externally. The implications of these challenges and the need for further research to identify how to best address them are discussed.

This paper uses secondary analysis to understand how COVID-19 shaped people's experiences with psychosocial support services in Australia. Data are drawn from questionnaires (n = 66) and semi-structured interviews (n = 62), conducted for a national service evaluation, with 121 people living with enduring mental health conditions and using psychosocial support services. Data relating to COVID-19 were inductively coded and analysed using constant comparative analysis. Most people's experiences included tele-support. While some people described minimal disruption to their support, many reported reduced engagement. People's wellbeing and engagement were influenced by: their location, living situation and pre-COVID lifestyles; physical health conditions; access to, comfort with, and support worker facilitation of technology; pre-COVID relationships with support workers; and communication from the organisation. The findings can help services prepare for future pandemics, adjust their services for a 'COVID-normal' world, and consider how learnings from COVID-19 could be incorporated into a flexible suite of service delivery options. [ABSTRACT FROM AUTHOR]