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Road traffic accidents (RTAs) are among the most frequent negative life-events. About one in five RTA survivors is susceptible to posttraumatic stress disorder (PTSD). Knowledge about needs for, and usage of, mental health services (MHSs) may improve options for care for RTA victims. The current study aimed to assess rates of victims using different MHSs, including psychotherapy, pharmacotherapy and support groups, and to explore correlates of needs for and use of these MHSs. Further, we aimed to estimate the treatment gap in post-RTA care, defined as including people with probable PTSD who did not use MHSs and people wanting but not getting help from MHSs. Dutch victims of nonlethal RTAs (N = 259) completed self-report measures on needs for and use of MHSs and PTSD. Results showed that 26% of participants had utilized care from psychotherapy, pharmacotherapy or support groups. Among people with probable PTSD, this was 56%. Increased posttraumatic stress was the strongest correlate of MHS use. Forty-eight participants (17.8%) had an unmet care need and represented the treatment gap. Commonly reported reasons and barriers preventing MHS use were perceptions that problems were limited or would disappear without care and financial worries. Regarding possible future care, participants reported a preference for face-to-face (over online) help from a psychologist (over other professionals). The treatment gap for Dutch RTA victims may be limited. However, a significant number of RTA victims need care but do not obtain this care. Care options may be improved by reducing practical barriers to MHSs and increasing mental health literacy and acceptability of different forms of care (besides face-to-face care).

Introduction: The COVID-19 pandemic significantly affected health services, including mental health services. However, there is little information on Bolivia.Objective: To describe the impact of the COVID-19 pandemic on the provision of Mental Health Services (MHS) in Bolivia.Material and Methods: A qualitative exploratory approach of phenomenological type was conducted through semi-structured, in-depth interviews with six key officials of the main MHS. The interviews were recorded, transcribed, and analyzed in Atlas.ti for its analysis by codes and categories.Results: The demand for care in the MHS was modified and the care had little inter-institutional coordination. Adaptations in the infrastructure, biosecurity measures, and health personnel were indicated. Opportunities for strengthening teamwork, equipment and infrastructure improvements, and mental health valorization were identified.Conclusions: The pandemic significantly affected the provision of MHS. It is important to delve into the potential long-term impact of the pandemic on health and the organization of services that make it possible to strengthen mental health programs., Introducción: La pandemia de Covid-19 afectó de manera significativa el funcionamiento de los servicios de salud, incluidos los de salud mental. Sin embargo existen poca información en Bolivia.Objetivo: Describir el impacto de la pandemia Covid-19 en la prestación de Servicios de Salud Mental (SSM) en Bolivia.Material y Métodos: Se utilizó un enfoque cualitativo, exploratorio de tipo fenomenológico, mediante entrevistas en profundidad semi-estructuradas realizadas a seis funcionarios clave de los principales SSM. Las entrevistas fueron grabadas, transcritas y analizadas en Atlas.ti para su análisis por códigos y categorías.Resultados: La demanda y el proceso en la atención en los SSM tuvieron modificaciones, con poca coordinación interinstitucional. Se señalaron adaptaciones en la infraestructura, medidas de bio-seguridad y personal de salud. Se identificaron oportunidades para el fortalecimiento del trabajo en equipo, mejoras en equipamiento e infraestructura, y valorización de la salud mental.Conclusiones: La pandemia afectó de forma importante la prestación de servicios de SSM. Es importante que se profundice en el potencial impacto de la pandemia a largo plazo, en la salud y organización de los servicios que permitan fortalecer los programas de salud mental.

Young people are a vulnerable population, who do not receive mental assistance until they show severe danger. The majority of adult psychopathology begins in childhood, adolescence and youth. Hence, it is recommended to focus attention on these years and promote a better transition to adult mental health teams. Youth is also a critical period, an optimal fissure for psychotherapy. This work reflects on operational group psychotherapy for youth and also evaluates group therapeutic factors in youth (compared to adults). Our conclusion is that in young people and adults, group psychotherapy operative from 12 sessions is perceived by the majority of patients as helpful and group effective. Furthermore, group therapeutic factors obtain different ratings depending on age, justifying a specific therapeutic device for young population., Los jóvenes son una población vulnerable, que no recibe asistencia mental hasta que manifiestan un peligro severo. La mayoría de la psicopatología del adulto se inicia en la infancia, la adolescencia y la juventud. Por consiguiente, se recomienda focalizar la atención en estos años y promover una mejor transición a los equipos de salud mental de adultos. La juventud es también un periodo crítico, una fisura, una grieta óptima para la psicoterapia. Este trabajo reflexiona sobre la psicoterapia de grupo operativa para jóvenes y además evalúa los factores terapéuticos grupales en jóvenes (en comparación con adultos). Acabamos concluyendo que en jóvenes y adultos la psicoterapia grupal operativa desde las 12 sesiones es percibida por la mayoría de los pacientes como de ayuda y eficacia grupal. Además, los factores terapéuticos grupales obtienen diferente calificación en función de la edad, justificándose un dispositivo terapéutico específico para población joven.

BACKGROUND: Inadequate and inequitable access to quality behavioral health services and high costs within the mental health systems are long-standing problems. System-level (e.g., fee-for-service payment model, lack of a universal payor) and individual factors (e.g., lack of knowledge of existing resources) contribute to difficulties in accessing resources and services. Patients are underserved in County behavioral health systems in the United States. Orange Countys (California) Behavioral Health System Transformation project sought to improve access by addressing two parts of their system: developing a template for value-based contracts that promote payor-agnostic care (Part 1); developing a digital platform to support resource navigation (Part 2). Our aim was to evaluate facilitators of and barriers to each of these system changes. METHODS: We collected interview data from County or health care agency leaders, contracted partners, and community stakeholders. Themes were informed by the Consolidated Framework for Implementation Research. RESULTS: Five themes were identified related to behavioral health system transformation, including 1) aligning goals and values, 2) addressing fit, 3) fostering engagement and partnership, 4) being aware of implementation contexts, and 5) promoting communication. A lack of fit into incentive structures and changing state guidelines and priorities were barriers to contract development. Involving diverse communities to inform design and content facilitated the process of developing digital tools. CONCLUSIONS: The study highlights the multifaceted factors that help facilitate or hinder behavioral health system transformation, such as the need for addressing systematic and process behaviors, leveraging the knowledge of leadership and community stakeholders, fostering collaboration, and adapting to implementation contexts.

BackgroundThere has been a longstanding effort to integrate behavioral health and HIV care for people with comorbid HIV and behavioral health needs, including those with severe mental illness (SMI). As this population frequents both behavioral health and HIV care settings, they were likely to experience new obstacles to the quality and availability of care during the COVID-19 pandemic. This study aims to describe how clinics for HIV services or behavioral healthcare-as well as co-located sites providing both-sought to rapidly shift protocols to maintain a standard of patient care for people with comorbid HIV and SMI while adapting to the unprecedented circumstances of the pandemic.MethodsWe interviewed HIV and behavioral healthcare providers, clinic leaders, and support service agencies that served clients impacted by both HIV and SMI. Seventeen key informants across three settings (HIV care settings, behavioral health care settings, and integrated or co-located care settings) were interviewed in 2022. Interviews focused on changes in clinical services, protocols, and care provision strategies during and at the onset of the COVID-19 pandemic. Interviews were transcribed and coded using thematic analysis.ResultsCommonly endorsed themes included both positive and negative changes in care and care provision during the pandemic. Negative impacts of the pandemic included the loss of physical space, exacerbated mental health needs and disengagement in HIV care, patient barriers to telehealth and the digital divide, and increased healthcare workforce burnout. Positive changes included improved healthcare delivery and care engagement through telehealth, new opportunities to provide a wide range of social services, paradoxical increases in engagement in HIV care for certain patients, and broad institution of workforce wellness practices.ConclusionsThough COVID-19 presented several complex barriers to care for providers serving patients with comorbid HIV and SMI, the increase

OBJECTIVE: Extending collaborative care, a model integrating mental health services into primary care, to include community-based organisations (CBOs) may improve older patient health outcomes by increasing access to care and addressing patients social needs; however, little is known about how CBOs contribute to such partnered depression care. We explored how six primary care clinic and CBO partnerships came together to provide late-life depression care through the Care Partners funded in 2014. DESIGN: 43 key informant interviews and 15 focus groups were conducted with care managers, administrators and primary care providers partnering to provide late-life depression care. Data were coded and analysed iteratively using qualitative thematic analysis. SETTING: Six primary care clinic-CBO sites across California. PARTICIPANTS: Care managers, administrators and primary care providers participated in this study. RESULTS: Three unique contributions of CBOs to depression care in these clinic-CBO partnerships were identified: (1) CBOs added new services that focus on social needs and enhanced depression care; (2) CBOs strengthened core aspects of collaborative care for depression; (3) CBOs provided new avenues for building connections and trust with underserved patients. CONCLUSIONS: CBOs, when partnered with clinics, enhanced both medical and social aspects of depression treatment for older adults. CBOs are well positioned to assist primary care clinics in treating the complex health needs of older adults by providing new and strengthening existing aspects of partnered depression care while building patient trust among culturally diverse populations.

BACKGROUND: The fast-growing migrant population in Japan and globally poses challenges in mental healthcare, yet research addressing migrants mental health treatment engagement remains limited. OBJECTIVE: This study examined language proficiency, demographic and clinical characteristics as predictors of early treatment discontinuation among migrants. METHODS: Electronic health record data from 196 adult migrants, identified from 14 511 patients who received mental health outpatient treatment during 2016 and 2019 at three central hospitals in the Tokyo-Yokohama metropolitan region of Japan, were used. We conducted multivariable regression models to identify predictors of early discontinuation within 3 months. FINDINGS: The study cohort (65% women, age range: 18-90 years, from 29 countries or regions) included 23% non-Japanese speakers. Japanese and non-Japanese speakers had similar discontinuation rates (26% vs 22%). Multivariable models revealed younger age (OR=0.97; 95% CI: 0.95, 0.99; p=0.016) and those with a primary diagnosis other than a schizophrenia spectrum disorder (OR=3.99; 95% CI: 1.36, 11.77; p=0.012) or a neurotic, stress-related and somatoform disorder (OR=2.79; 95% CI: 1.14, 6.84; p=0.025) had higher odds of early discontinuation. These effects were more pronounced among the Japanese speakers with significant language-by-age and language-by-diagnoses interactions. CONCLUSION: Younger age and having a primary diagnosis other than a schizophrenia spectrum disorder or a neurotic, stress-related and somatoform disorder increased vulnerability for discontinuing mental health treatment early in Japanese-speaking migrants but not for migrants with limited Japanese proficiency. CLINICAL IMPLICATIONS: Understanding language needs within a context of mental health treatment should go beyond assumed or observed fluency. Unmet language needs might increase vulnerability for treatment disengagement among migrants. Targeted clinical efforts are crucial for enhancin

Background Residents report high levels of distress but low utilization of mental health services. Prior research has shown several barriers that prevent residents from opting into available mental health services. Objective To determine the impact of a mental health initiative centered around an opt-out versus an opt-in approach to help-seeking, on the use of psychotherapy. Methods Resident use of psychotherapy was compared between 2 time frames. During the first time frame (July 1, 2020 to January 31, 2021), residents were offered access to therapy that they could self-initiate by calling to schedule an appointment (opt-in). The second time frame (February 1, 2021 to April 30, 2021) involved the switch to an opt-out structure, during which the same residents were scheduled for a session but could choose to cancel. Additional changes were implemented to reduce stigma and minimize barriers. The outcome was psychotherapy use by residents. Results Of the 114 residents, 7 (6%) self-initiated therapy during the opt-in period. When these same residents were placed in an opt-out context, 59 of the remaining 107 residents (55%) kept their initial appointment, and 23 (39%) self-initiated additional sessions. Altogether, across both phases, a total of 30 of the 114 residents initiated therapy (ie, 7 during the opt-in and 23 during the opt-out). The differences in therapy use between the 2 phases are statistically significant (P<.001 by McNemar's test). Conclusions There was a substantial increase in residents' use of psychotherapy after the opt-out initiative that included efforts to reduce stigma and encourage mental health services.

BACKGROUND: A longer duration of untreated psychosis (DUP) is associated with poorer treatment outcomes. Screening for psychosis spectrum disorders in the primary care setting could help support the earlier detection and treatment of individuals in need. However, the acceptability of screening for psychosis in this setting as part of routine care is currently unknown. METHODS: We conducted a qualitative interview study with providers and service users who participated in an early psychosis screening program conducted in an integrated behavioral health primary care (IBH-PC) setting. Interviews were recruited from one of eight WellSpace Federally Qualified Health Center IBH-PC clinics in the Sacramento, CA area. Transcripts of the recorded interviews were analyzed using thematic analysis. RESULTS: In total, 12 providers and eight service users participated in the interviews. Most service user and provider participants were supportive of psychosis screening in an IBH-PC setting, but not as part of the general practitioner consultation due to the brief, non-behavioral health nature of many of the appointments, and the expected low prevalence of psychosis in this population. The support of leadership, adequate training and support, staff turnover, and organizational changes were all seen to impact the successful implementation of the program. Different barriers and facilitators were considered important at each stage of the process from introducing the screening procedures to service users; to determining when, where, and how to screen; and how to effectively manage the referral and post-referral stages. CONCLUSIONS: Despite the additional challenges of screening in an IBH-PC setting relative to secondary mental health services, the process was considered acceptable and feasible to providers and service users. Services that plan to conduct psychosis screening in their clinics need to consider the challenges and their potential solutions to implementation at each stage of

Background The integration of mental health into primary care—i.e. the process by which a range of essential mental health care and services are made available in existing multipurpose health care settings that did not previously provide them—can be facilitated or hindered by several health system factors that are still poorly understood. This study aimed to identify health system facilitators and barriers to the integration of mental health services into primary care in the Democratic Republic of the Congo (DRC) to improve the success rate of integration programs. Methods We conducted a multimethod, cross-sectional exploratory study. Stakeholders (managers, health service providers, service users, etc.) from sixteen of the twenty-six provinces of the DRC participated. We collected qualitative data through 31 individual, semistructured, face-to-face key informant interviews. We then collected quantitative data through a population-based survey of 413 respondents. We analyzed the interviews via thematic analysis, assigning verbatims to predefined themes and subthemes. For the survey responses, we performed descriptive analysis followed by binomial logistic regression to explore the associations between the variables of interest. Results Strong leadership commitment, positive attitudes toward mental health care, the availability of care protocols, mental health task sharing ( p < 0.001), and sufficient numbers of primary care providers (PCPs) ( p < 0.001) were identified as key health system facilitators of successful integration. However, barriers to integration are mainly related to a poor understanding of what integration is and what it is not, as well as to the poor functionality and performance of health facilities. In addition, stigma, low prioritization of mental health, lack of mental health referents, low retention rate of trained health professionals, lack of reporting tools, lack of standardized national guidelines for integration ( p < 0.001), SCOPUS: ar.j, info:eu-repo/semantics/published

Background: Patients’ online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users’ overall experiences with national PAEHR services. Methods: The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users’ experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data. Results: 6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about o

The purpose of this phenomenological study was to understand college students' perspectives on college-provided mental healthcare services. The framework guiding this study is the theory of planned behavior (TPB), developed by Fishbein and Ajzen. The TPB theory is based on attitude, social norms, perceived behavioral control (PBC), and intention. The central research question: What are college students' perspectives on college-provided mental healthcare services? The design of this qualitative study is hermeneutic phenomenology, a rigorous and well-established approach. A sample of twelve participants, carefully selected based on pre-determined criteria, was included in the study. The participants, a diverse mix of current and former men and women full-time and part-time residential and commuter university students aged 18 and above, were fluent in English and either utilized, currently seeking, or have sought to use college-provided mental healthcare services. The study, conducted without a specific setting but with a particular population in mind, included three data collection methods to achieve triangulation: individual interviews, focus group interviews, and letter writing. Van Manen’s thematic analysis approach, known for its robustness, was used to analyze all collected data. Three themes emerged from the data: limiting factors and deterrents, encouraging factors, and the meaning of mental health. Ten subthemes were developed through the three themes. The study found that availability, accessibility, capacity, awareness, staff, school culture, stigma, and diversity determine whether or not a student decides to seek and utilize college-provided mental healthcare services.

Oficinas terapêuticas são recursos comumente utilizados em diversos estabelecimentos de assistência em saúde mental, entre estes os Centros de Atenção Psicossocial. Não há um consenso absoluto sobre sua definição, mas, no geral, são desenvolvidas com os usuários em grupo e oferta de alguma atividade que contribua para a redução do sofrimento mental e vivência do cotidiano com mais autonomia. O objetivo deste estudo é conhecer o modo como o usuário do serviço participa das oficinas terapêuticas e se isto vai ao encontro do que preconizam as políticas públicas que regulamentam esta estratégia. A pesquisa ocorreu em duas etapas, a primeira foi teórica em documentos governamentais disponíveis em meio virtual; e a segunda no mesmo ambiente, com preenchimento de questionário de 08 colaboradores, no dispositivo Google forms, com perguntas sociodemográficas e de percepção pessoal sobre as oficinas terapêuticas em seu tratamento. Percebeu-se que o recurso em discussão é um componente importante para que a assistência à saúde mental ocorra de acordo com o determinado em documentos governamentais e isto pode ser percebido no relato dos colaboradores de como tiveram seu humor, suas habilidades sociais, experiências e capacidade expressiva modificadas positivamente a partir do engajamento nas oficinas terapêuticas., Therapeutic workshops are commonly used resourse in a large mental health establishments, including in Psychosocial Care Centers. There is no absolute consensus about its definition, but, in general, are developed in groups and offer of some activity that contributes to the reduction of mental suffering and more autonomous daily life. The objective of this study is to understand how service’s users participates in therapeutic workshops and whether this is in line with what the public policies that regulate this strategy recommend. The research was developed in two stages. The first stage was theoretical in virtual place with government documents; the second stage was virtual too, with 8 collaborators who answered to a form in Google forms with questions about sociodemographic data and their own preferences about terapeutic workshops in your treatments. It was noticed that the resource under discussion is important for assistance in mental health to occur in accordance with the determined in government documents and this can be seen in the employees’s reports of their mood, social skills, experiences and expressive capacity were positively modified from engagement in terapeutic workshops., Los talleres terapéuticos son recursos comúnmente utilizados en diversos establecimientos del atención del salud mental, incluídos los Centros de Atención Psicosocial. No existe un consenso absoluto sobre su definición, pero, em generale, se desarrollan en grupo y ofreciendo alguna actvidad que contribuya a la reducción del sufrimiento mentale y una mayor autonomia en la vida diaria. El objetivo de este estudio es comprender cómo participan los usuarios del servicio en los talleres terapéuticos y si esto está en línea con lo que recomiendan las políticas públicas que regulan esta estrategia. La investigación ocorrió en dos etapas, la primera etapa fue teórica en ambiente virtual con documentos del gobierno; la segunda etapa también fue virtual, com 8 empleados que responderon un formulário en Google Forms com preguntas sobre datos sóciodemográficos y percepción personal sobre los talleres terapéuticos en su tratamiento. Se observó que el recurso en discusión es importante para que la atención del salud mentale se suceda de acuerdo con lo determinado en los documentos del gobierno y esto se puede notar en el informe de los empleados sobre su estado de ánimo, habilidades sociales, experiencias y capacidad expressiva modificados para mejor depués de la participación en los talleres terapêuticos.

O Recovery coloca-se como uma prática despatologizante, pois não foca na doença e seus sintomas. Propicia o protagonismo das pessoas em sofrimento psíquico nos processos de cuidado, na medida em estas passam a ter um papel ativo, através de grupos de ajuda mútua e do apoio entre pares. Foram desenvolvidas ferramentas de apoio aos usuários, a fim de sustentar processos de autocuidado e suporte de pares. Uma das mais disseminadas é o programa WRAP (Wellness Recovery Action Plan), que está em processo de adaptação cultural ao Brasil. Configura-se na elaboração de planos que auxiliam a desenvolver respostas para desafios do cotidiano, de maneira a promover o bem-estar. O Recovery e o WRAP, ao serem aplicados às pessoas que fazem uso problemático de álcool e outras drogas (AD), colocam-se como clínica ampliada, pois focam no sujeito e não no uso de drogas, trazem como meta a (re)descoberta da autonomia, da autogestão e da melhoria da qualidade de vida, sem que se imponha, necessariamente, uma meta de “cura”, de abstinência ou de “recuperação”, no seu sentido tradicional. Objetiva-se discutir possibilidades para aplicação dos princípios do Recovery e do Programa WRAP como ações despatologizadoras para auxiliar as transformações necessárias no campo do cuidado em saúde mental e, em especial, no campo AD. O Recovery e o WRAP, por proporem intervenções que dialogam diretamente com os princípios da Atenção Psicossocial e do Sistema Único de Saúde, assim como com a Redução de Danos, promovem saúde mental entre usuários, fortalecendo seus processos de cidadania., Recovery is presented as a de-pathologizing practice because it does not focus on the illness and its symptoms. It promotes the protagonism of individuals experiencing psychological distress in the care processes, as they become actively involved through mutual support groups and peer support. Support tools have been developed for users to sustain self-care processes and peer support. One of the most widely disseminated tools is the WRAP (Wellness Recovery Action Plan), which is undergoing cultural adaptation in Brazil. It involves the creation of plans that help the person develop responses to everyday challenges, in order to promote well-being. Recovery and WRAP, when applied to individuals with problematic alcohol and other drug use (AD), represent an expanded clinical approach, as they focus on the individual rather than drug use. Their goal is the (re)discovery of autonomy, self-management, and improvement in quality of life without necessarily imposing a goal of "cure," abstinence, or "recovery" in its traditional meaning. The aim is to discuss possibilities for applying the principles of Recovery and the WRAP Program as de-pathologizing actions to assist the necessary transformations in the field of mental health care, particularly in the AD field. Recovery and WRAP, being tools that directly align with the principles of Psychosocial Care and the Unified Health System, as well as with Harm Reduction, promote mental health among users, strengthening their processes of citizenship., Recovery se presenta como una práctica despatologizante, ya que no se enfoca en la enfermedad y sus síntomas. Facilita el protagonismo de las personas que sufren psicológicamente en los procesos de atención, permitiéndoles un rol activo a través de grupos de apoyo mutuo y el respaldo entre pares. Se han desarrollado herramientas para los usuarios con el fin de mantener procesos de autocuidado y apoyo entre iguales. Uno de los programas difundidos es el WRAP (Plan de Acción para el Bienestar y la Recuperación), en proceso de adaptación cultural en Brasil. Implica la creación de planes que ayudan a desarrollar respuestas para los desafíos cotidianos, con el propósito de promover el bienestar. El enfoque de lo Recovery y el WRAP, al ser aplicado en personas con problemas de consumo de alcohol y otras drogas, representa un enfoque ampliado, ya que se centra en el individuo, no en la sustancia en sí. El objetivo es (re)descubrir la autonomía, la autogestión y mejorar la calidad de vida, sin imponer necesariamente la meta tradicional de "cura", abstinencia o "recuperación". Se busca explorar cómo los principios de lo Recovery y el Programa WRAP pueden ser utilizados como acciones despatologizantes para impulsar cambios en el campo de la atención en salud mental, especialmente en el ámbito de AD. Al alinearse con los principios de la Atención Psicosocial, el Sistema Único de Salud y la Reducción de Daños, lo Recovery y el WRAP promueven la salud mental entre los usuarios, fortaleciendo sus procesos de ciudadanía.

Purpose This Multicenter Youth Flexible ACT Study examined the effect of Youth Flexible Assertive Community Treatment on symptomatic, social, and personal recovery outcomes of adolescents dealing with multifaceted psychiatric and social care needs who do not readily engage in regular office-based mental health services. Methods Newly admitted clients (n = 199) aged 12–24 years from 16 Youth Flexible ACT teams participated in this observational prospective cohort study. Client and practitioner questionnaires were administered every 6 months, up to 18 months. Latent growth curve analyses were conducted to examine changes in symptomatic, social, and personal recovery outcomes throughout Flexible ACT. Results Our analyses of client-reported outcomes showed a decrease in overall psychosocial difficulties, depressive symptoms, and subclinical psychosis symptoms. Moreover, outcomes showed improved social interaction with peers, quality of life, and feelings of empowerment and fewer contacts with the police/legal system. In addition, analyses of clinician-reported outcomes showed a decrease in problems related to family life, peer relationships, school/work attendance, emotional symptoms, and attentional problems. Problems related to personal finance, school and work status, substance misuse, disruptive and aggressive behavior, self-injury, and self-care and independence remained unchanged. Conclusion Our results showed that clients participating in Youth Flexible ACT improved in symptomatic, social, and personal recovery outcomes over 18 months. With its integrated approach and personalized care, this service delivery model is promising for adolescents unable to engage successfully in regular (office based) mental health support services.

INTRODUCTION: Major Depressive Disorder (MDD) is one of the most prevalent mental disorders worldwide with significant personal and public health consequences. After an episode of MDD, the likelihood of relapse is high. Therefore, there is a need for interventions that prevent relapse of depression when outpatient mental health care treatment has ended. This scoping review aimed to systematically map the evidence and identify knowledge gaps in interventions that aimed to promote recovery from MDD for patients transitioning from outpatient mental health services to primary care.MATERIALS AND METHODS: We followed the guidance by Joanna Briggs Institute in tandem with the PRISMA extension for Scoping Reviews checklist. Four electronic databases were systematically searched using controlled index-or thesaurus terms and free text terms, as well as backward and forward citation tracking of included studies. The search strategy was based on the identification of any type of intervention, whether simple, multicomponent, or complex. Three authors independently screened for eligibility and extracted data.RESULTS: 18 studies were included for review. The studies had high heterogeneity in design, methods, sample size, recovery rating scales, and type of interventions. All studies used several elements in their interventions; however, the majority used cognitive behavioural therapy conducted in outpatient mental health services. No studies addressed the transitioning phase from outpatient mental health services to primary care. Most studies included patients during their outpatient mental health care treatment of MDD.CONCLUSIONS: We identified several knowledge gaps. Recovery interventions for patients with MDD transitioning from outpatient mental health services to primary care are understudied. No studies addressed interventions in this transitioning phase or the patient's experience of the transitioning process. Research is needed to bridge this gap, b

Objetivou-se analisar as concepções dos profissionais das equipes da Atenção Básica de um município do sudeste do Brasil, sobre o matriciamento em saúde mental. Trata-se de uma pesquisa de abordagem qualitativa. Os dados foram coletados por meio de entrevistas semiestruturadas e submetidos à técnica de análise de conteúdo. Ao total, participaram da pesquisa seis profissionais de diferentes categorias. Os resultados demonstraram que o matriciamento é apresentado por algumas equipes de referência como uma estratégia favorável à melhoria da atenção em saúde mental e por outras como uma proposta com baixa resolutividade, que acabou por se reverter em aparato de fiscalização e de ampliação do poder dos especialistas. Destaca-se a necessidade de promover a regularidade dos encontros produtivos de matriciamento, fomentando essa estratégia na direção da promoção à saúde e da desinstitucionalização, por sua capacidade em abranger a Atenção Básica nas discussões e ações em torno da Reforma Psiquiátrica., The objective was to analyze the conceptions of professionals from Primary Care teams in a municipality in southeastern Brazil, regarding matrix support in mental health. This is a qualitative research study. Data were collected through semi-structured interviews and subjected to the content analysis technique. In total, six professionals from different categories participated in the research. The results demonstrated that matrix support is presented by some reference teams as a favorable strategy for improving mental health care and by others as a proposal with low resolution, which ended up being converted into an inspection apparatus and expansion of the power of experts. The need to promote the regularity of productive matrix support meetings is highlighted, encouraging this strategy towards health promotion and deinstitutionalization, due to its ability to cover Primary Care in discussions and actions around Psychiatric Reform., La psilocibina es una sustancia natural, con propiedades alucinógenas, que se ha utilizado recientemente en el sector sanitario. Es un alcaloide que, asociado a la psicoterapia, se ha demostrado que aporta beneficios en el tratamiento de la depresión y la ansiedad. Este estudio tiene como objetivo analizar el estado actual del conocimiento sobre los efectos psicológicos de la psilocibina en pacientes con cáncer terminal. El método utilizado fue una revisión del alcance guiada por las directrices del Instituto Joanna Briggs, siguiendo la iniciativa PRISMA Extension for Scoping Reviews. La recolección se realizó entre agosto y diciembre de 2022, en las bases de datos: Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing Allied Health Literature, Latin American and Caribbean Literature in Health Sciences, Scopus y Web of Science. Se encontraron 340 artículos, nueve fueron seleccionados y analizados, dilucidando los efectos psicológicos beneficiosos de la psilocibina en pacientes con cáncer terminal. Se descubrió que todos apuntan a la eficacia de la psilocibina para reducir los niveles sintomáticos de depresión y ansiedad. La psilocibina es bien tolerada por personas con cáncer terminal y no presenta efectos adversos significativos cuando se administra en ambientes controlados. Sin embargo, se necesitan más estudios científicos con muestras más grandes y diversas.

Objetivo: La salud mental es una de las prioridades de la Comisión Europea. Se necesitan estudios sobre el uso y el costo de los establecimientos de salud mental para mejorar la planificación y la eficiencia de los recursos de salud mental. Analizamos los patrones de uso de los servicios de salud mental en múltiples entornos clínicos para identificar factores asociados con el alto costo. Sujetos y métodos: 22.859 pacientes recibieron atención psiquiátrica en el área de influencia de un hospital español (2000-2004). Tuvieron 365.262 consultas psiquiátricas en múltiples entornos. Se seleccionaron dos grupos que generaban el 80% de los costos totales: el grupo de costo medio (N = 4,212; 50% de los costos) y el grupo de costo alto (N = 236; 30% de los costos). Los análisis estadísticos se realizaron mediante técnicas univariadas y multivariadas. Las variables significativas en los análisis univariados se introdujeron como variables independientes en un análisis de regresión logística utilizando "alto costo" (>7263$) como variable dependiente. Resultados: Los costos no se distribuyeron uniformemente en toda la muestra. El 19,4% de los pacientes generó el 80% de los costos. Las variables asociadas con alto costo fueron: grupo de edad 1 (0-14 años) en la primera evaluación, incapacidad permanente y diagnósticos CIE-10: Trastornos mentales orgánicos, incluidos sintomáticos; Trastornos mentales y del comportamiento por consumo de sustancias psicoactivas; Esquizofrenia, trastornos esquizotípicos y delirantes; Síndromes de comportamiento asociados con alteraciones fisiológicas y factores físicos; Causas externas de morbilidad y mortalidad; y Factores que influyen en el estado de salud y el contacto con los servicios de salud. Discusión: Los costos de atención de salud mental no se distribuyeron uniformemente entre la población de pacientes. Los costos más elevados están asociados a la aparición temprana del trastorno mental, incapacidad permanente, trastornos mentales orgánico, Purpose: Mental health is one of the priorities of the European Commission. Studies of the use and cost of mental health facilities are needed in order to improve the planning and efficiey of mental health resources. We analyze the patterns of mental health service use in multiple clinical settings to identify factors associated with high cost. Subjects and methods: 22,859 patients received psychiatric care in the catchment area of a Spanish hospital (2000-2004). They had 365,262 psychiatric consultations in multiple settings. Two groups were selected that generated 80% of total costs: the medium cost group (N = 4,212; 50% of costs), and the high cost group (N = 236; 30% of costs). Statistical analyses were performed using univariate and multivariate techniques. Significant variables in univariate analyses were introduced as independent variables in a logistic regression analysis using "high cost" (>7,263$) as dependent variable. Results: Costs were not evenly distributed throughout the sample. 19.4% of patients generated 80% of costs. The variables associated with high cost were: age group 1 (0-14 years) at the first evaluation, permanent disability, and ICD-10 diagnoses: Organic, including symptomatic, mental disorders; Mental and behavioural disorders due to psychoactive substance use; Schizophrenia, schizotypal and delusional disorders; Behavioural syndromes associated with physiological disturbances and physical factors; External causes of morbidity and mortality; and Factors influencing health status and contact with health services. Discussion: Mental healthcare costs were not evenly distributed throughout the patient population. The highest costs are associated with early onset of the mental disorder, permanent disability, organic mental disorders, substance-related disorders, psychotic disorders, and external factors that influence the health status and contact with health services or cause morbidity and mortality. Conclusion: Variables related to psychiatr, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

UNLABELLED: Policy Points Local governments are increasingly adopting policies that earmark taxes for mental health services, and approximately 30% of the US population lives in a jurisdiction with such a policy. Policies earmarking taxes for mental health services are heterogenous in their design, spending requirements, and oversight. In many jurisdictions, the annual per capita revenue generated by these taxes exceeds that of some major federal funding sources for mental health. CONTEXT: State and local governments have been adopting taxes that earmark (i.e., dedicate) revenue for mental health. However, this emergent financing model has not been systematically assessed. We sought to identify all jurisdictions in the United States with policies earmarking taxes for mental health services and characterize attributes of these taxes. METHODS: A legal mapping study was conducted. Literature reviews and 11 key informant interviews informed search strings. We then searched legal databases (HeinOnline, Cheetah tax repository) and municipal data sources. We collected information on the year the tax went into effect, passage by ballot initiative (yes/no), tax base, tax rate, and revenue generated annually (gross and per capita). FINDINGS: We identified 207 policies earmarking taxes for mental health services (95.7% local, 4.3% state, 95.7% passed via ballot initiative). Property taxes (73.9%) and sales taxes/fees (25.1%) were most common. There was substantial heterogeneity in tax design, spending requirements, and oversight. Approximately 30% of the US population lives in a jurisdiction with a tax earmarked for mental health, and these taxes generate over $3.57 billion annually. The median per capita annual revenue generated by these taxes was $18.59 (range = $0.04-$197.09). Per capita annual revenue exceeded $25.00 in 63 jurisdictions (about five times annual per capita spending for mental health provided by the US Substance Abuse and Mental Health Services Administratio

IntroductionSubstantial unmet need for mental health services (MHS) exists in the United States, with pronounced disparities among people of color. Research highlights the need to identify facilitators and barriers to MHS utilization among Black and Latinx individuals to better promote overall health. We tested an expanded model of MHS use based on Andersen's (1995) conceptual framework of health care utilization. Associations were examined between sociodemographic variables, trauma and adversity burden, living with HIV, and unmet need for MHS in a community sample of underresourced Black and Latinx individuals. Barriers to MHS utilization are described.MethodsFive-hundred participants completed the UCLA Life Adversities Screener (LADS), sociodemographic measures, and items assessing need for and barriers to MHS.Results228 (46%) participants reported a need for MHS; of these, 115 (51%) reported receiving MHS. A binomial logistic regression model estimated the relative contribution of the LADS on need for MHS. Severity of LADS, younger age, and living with HIV predicted unmet need for MHS. Barriers to MHS included financial and time constraints and health system-related issues. One-way analysis of variance (ANOVA) tests revealed differences in mental health symptoms by MHS need.DiscussionThe unmet need for MHS in this sample of Black and Latinx individuals highlights the importance of addressing the systemic roots of trauma and adversity burden, and eliminating structural barriers to treatment to reduce existing health and mental health inequities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

This study examined mental health service utilization and disparities during the first year of COVID. We analyzed data from all adult respondents with any mental illness in the past year (n = 6967) in the 2020 National Survey on Drug Use and Health to evaluate if mental health service utilization differed by geographic areas, race/ethnicity, and age groups. Only 46% of individuals with any mental illness had received mental health treatment. Compared to non-Hispanic Whites, Asian and Hispanics were less likely to receive outpatient services and prescription medicine. Rural residents received less outpatient treatment compared to large metropolitan residents. No difference was found in telemedicine utilization across area types and race/ethnicity groups. Older individuals were less likely to utilize telemedicine services. Our findings highlighted continued mental health treatment disparities among race/ethnic minorities and other sub-populations during COVID. Targeted strategies are warranted to allow older populations to benefit from telemedicine.

Our society is facing an unprecedented mental health crisis, with nearly one in two people being affected by mental health issues over their lifespan. This trend is especially noticeable among college students, who undergo significant shifts in social, familial, and academic responsibilities. Exacerbating the mental health crisis is the fact that students are facing other societal crises (e.g., climate change). And, in a reciprocal fashion, students experiencing poor mental health are less likely to feel resilient enough to tackle these other crises. In response to these colliding societal crises, we need a comprehensive solution that goes beyond the current models of college mental health services. We propose an alternative preventative mental health approach, which aims to prevent the onset of mental health concerns and build resilience in the face of colliding crises. Specifically, we argue that colleges can aid in building mental health resilience by creating for-credit courses that teach students the skills they need to be conscious, responsible, and resilient human beings. Toward this end, we created an experiential, workshop-style, 1 unit, P/NP course, entitled Learning Sustainable well-being (LSW), which guides students to explore, improve, and sustain their mental health. The principles taught in this course combine the wisdoms of several disciplines, including mindfulness, psychology, neuroscience, philosophy, religion, poetry, and cinema. The following community case study reflects on the journey of our LSW initiative, starting from the creation of the course in 2014 to the current mission of scaling up the offering as part of an institution-wide LSW program. To this end, we describe the LSW course modules/content, our pedagogical approach, potential limitations, and then provide data demonstrating its efficacy in improving student well-being. As a final note, we present the challenges we have faced, and the lessons learned, while on this journey. We hope

ObjectivesSmall area analysis is a health services research technique that facilitates geographical comparison of services supply and utilization rates between health service areas (HSAs). HSAs are functionally relevant regions around medical facilities within which most residents undergo treatment. We aimed to identify HSAs for psychiatric outpatient care (HSA-PSY) in Switzerland.MethodsWe used HSAr, a new and automated methodological approach, and comprehensive psychiatric service use data from insurances to identify HSA-PSY based on travel patterns between patients' residences and service sites. Resulting HSA-PSY were compared geographically, demographically and regarding the use of inpatient and outpatient psychiatric services.ResultsWe identified 68 HSA-PSY, which were reviewed and validated by local mental health services experts. The population-based rate of inpatient and outpatient service utilization varied considerably between HSA-PSY. Utilization of inpatient and outpatient services tended to be positively associated across HSA-PSY.ConclusionsWide variation of service use between HSA-PSY can hardly be fully explained by underlying differences in the prevalence or incidence of disorders. Whether other factors such as the amount of services supply did add to the high variation should be addressed in further studies, for which our functional mapping on a small-scale regional level provides a good analytical framework.

Adolescence is a vulnerable age for emerging mental health problems. As schools are everyday environments for children and adolescents, mental health promotion interventions may be especially effective when delivered within them. The aim of this study was to generate knowledge on mental health promotion interventions in comprehensive schools in northern Finland. First, a mental health promotion model for comprehensive schools was developed by psychiatric nurses in collaboration with school professionals in workshops in Oulu, Finland. A review of the literature, which revealed that mental health promotion in schools includes indicated, selective and universal interventions, was used as a basis for the study, together with written reports from the workshops. Secondly, school professionals from comprehensive schools with or without interventions developed in the mental health promotion model in Oulu were included in the study, and their perceptions of student well-being and mental health promotion in school were queried. The study samples consisted of school professionals from 9 intervention schools and from 49 non-intervention schools. School professionals considered that student well-being has declined and that students show a general disregard for their own well-being. Mental health promotion was regarded as a ‘core business’ of schools. Thirdly, a universal psychoeducation intervention, including lectures and group work on mental health issues, was delivered to 14-years old students in eighth grade. Students from two comprehensive schools were included, 85 pupils in 8th grade forming an intervention group and 77 a non-intervention group. The psychoeducation intervention delivered in classroom settings increased boys’ recognition of conduct disorders and altered girls’ attitudes to regard mental health disorders more as real medical conditions than as personal traits. Students reported feeling more comfortable seeking help from family members and friends th, Tiivistelmä Erilaiset mielenterveyteen liittyvät ongelmat ovat lapsilla ja nuorilla yleisiä ja suuri osa aikuisiän mielenterveyden häiriöistä alkaa lapsuudessa tai nuoruudessa. Koulut ovat lapsille ja nuorille yhteinen ja luonnollinen ympäristö edistää lasten ja nuorten mielenterveyttä, jonka vuoksi mielenterveyden edistämisen interventiot kouluympäristöissä voivat olla erityisen vaikuttavia. Tämän tutkimuksen tavoitteena oli tuottaa tietoa mielenterveyden edistämisestä peruskouluissa. Mielenterveyden edistämisen malli peruskouluihin kehitettiin Oulussa työpajoissa yhdessä psykiatristen sairaanhoitajien sekä eri yhteistyötahojen, koulun toimijoiden sekä vanhempien ja oppilaiden kanssa. Tutkimuksen pohjana toimi kirjallisuuskatsaus, jonka mukaan mielenterveyttä edistetään kouluissa yksilö-, ryhmä- ja yleistasolla sekä työpajojen raportit. Tutkimuksessa tarkasteltiin koulujen henkilökunnan kokemuksia oppilaiden hyvinvoinnista sekä mielenterveyden edistämisen toiminnasta kouluympäristössä. Tutkimukseen osallistui henkilökuntaa 9 koulusta, joissa toteutettiin työpajoissa kehitettyjä interventioita sekä 49 koulusta, joissa ei toteutettu työpajoissa kehitettyjä interventioita. Koulun henkilökunta koki, että oppilaiden hyvinvointi on heikentynyt ja oppilaat osoittavat välinpitämättömyyttä omaa hyvinvointia kohtaan. Koulujen henkilökunnan mielestä mielenterveyden edistäminen on osa koulun perustoimintaa. Yleistason psykoedukatiivinen interventio, johon kuului opetusta sekä ryhmätöitä mielenterveyden teemoista toteutettiin 8-luokan noin 14-vuotiaille oppilaille. Tutkimukseen osallistui oppilaita kahdesta peruskoulusta, 85 oppilasta interventiokoulusta sekä 77 ei-interventiokoulusta. Luokkaympäristössä toteutettu interventio lisäsi poikien osalta käytöshäiriöiden tunnistamista ja tyttöjen asenne muuttui mieltämään mielenterveyden häiriöitä enemmän lääketieteellisenä häiriönä eikä henkilökohtaisena ominaisuutena. Oppilaat raportoivat hakevansa mieluummin apua perheen jäseniltä

Even though it has been demonstrated that peer support contributes to positive outcomes for service users, organizational implementation issues remain. The aim of the current study was to examine an implementation of peer support from the perspective of managers in order to develop knowledge of factors influencing sustainability of this initiative. Eighteen managers were interviewed in connection with the introduction of peer support in sixteen mental health settings. Interviews were analyzed utilizing inductive and deductive approaches. The results suggested that managers were predominantly positive in their evaluation of peer support as a recovery-oriented addition to their services, but noted developmental issues regarding role, professional identity, supervision and financing in relation to other traditional personnel. The involvement of the user movement, especially with regard to training and supervision helped prepare staff and support peer workers, yet there was some apprehension attached to the critical scrutiny that this `outsider’ perspective might imply. The results confirm previously noted uncertainties regarding peer support as an integrated component of mental health systems and illuminate a number of culturally conditioned challenges that may hamper peer support from being implemented with the same approach as other interventions. In response, the present study suggests a number of focus areas that should be attended to in future implementation efforts, including issues related to staff roles, power dynamics, connection to the user movement and reconsideration of the value of experience-based knowledge. In the Swedish context, a government level commitment was identified as critical to ensure stable funding.

Bakgrund: Psykisk ohälsa ökar snabbt i världen. Stödjande samtal är en viktig arbetsuppgift för sjuksköterskan inom psykiatrisk vård. Sjuksköterskans förhållningssätt och vårdrelationen är viktiga komponenter för att möta patienternas behov och främja återhämtningsprocessen. Sjuksköterskan spelar en central roll i psykiatrisk vård. Syfte: Syftet var att sammanställa kunskap om stödjande samtal som omvårdnadsåtgärd i psykiatrisk vård. Design: Integrativ litteraturöversikt Metod: En systematisk sökning genomfördes i databaserna CINAHL, PubMed och PsycInfo. Detta för att hitta relevanta studier avseende sjuksköterskors och patienters erfarenheter av samtal samt vilka faktorer som påverkar och vad samtal får för betydelse för patienterna. Analysen av studierna genomfördes med hjälp av Whittemore & Knafl:s (2005) analysmetod. Resultat: Tio artiklar inkluderades i studien varav sex kvalitativa, två kvantitativa och två av mixad metod. Analysen resulterade i sex faktorer och sju teman. Resultatet visade att både sjuksköterskor och patienter har övervägande positiva erfarenheter av stödjande samtal. Sjuksköterskor behöver vara genuina och intresserade för att patienterna ska känna sig trygga vilket främjar vårdrelationen och därmed det stödjande samtalet. Det finns både främjande och försvårande faktorer för samtal. Stödjande samtal kan bidra till bättre psykiskt välmående, förebygga återinsjuknanden och ge stöd under akuta perioder. Stödjande samtal som omvårdnadsåtgärd kan främja patienters återhämtning. Slutsats: Stödjande samtal kan ha positiva effekter på patienternas psykiska hälsa och återhämtning. Stödjande samtal kan vara en meningsfull och holistisk omvårdnadsåtgärd för patienter i psykiatrisk vård. Resultatet från litteraturöversikten visar både på främjande och försvårande faktorer för stödjande samtal. Samtal som omvårdnadsåtgärd har en potential, som till fullo inte nyttjas.

In the Open Dialogue (OD) based psychiatric services adolescent patients receive less medication and are more often treated within an outpatient setting as compared to standard services. An evaluation of the possible risks of implementing OD are required. The aim of this longitudinal register-based study was to evaluate how treatment under OD is associated with the probability of suicide as compared standard psychiatric care. Study included all 13- to 20-year-old adolescents who enrolled to a psychiatric service in Finland in 2003–2013. The OD-group included adolescents whose treatment commenced in the Western Lapland area (n = 2107), this being the only region where OD covered all psychiatric services. The comparison group (CG) included rest of Finland (n = 121,658). Information was gathered from onset of treatment to the end of the 5-year follow-up or death. In a multivariate Cox regression there were no statistically significant differences in 5-year suicide hazard ratios between OD and CG.

OBJECTIVE: Emergency medical services (EMS) transport for mental and behavioral health (MBH) emergencies occurs frequently in children, yet little is understood regarding prehospital physical restraint use despite the potential for serious adverse events. We aim to describe restraint use prevalence and primary impressions among children with MBH emergencies. METHODS: This is a retrospective cross-sectional study of children with MBH emergencies evaluated by Alameda County (ALCO), California EMS from January 1, 2012 to December 31, 2018. Patient demographics and clinical variables were collected from the EMS records including sex, age at time of encounter, year of encounter, transport destination, medication use, and primary impression(s). The primary outcome was the use of physical restraints. Descriptive statistics were used to characterize the primary outcome and associated demographic and diagnostic features, as well as temporal use patterns. Sex and age were compared between restrained and non-restrained youth using chi-square analysis. RESULTS: Over the 7-year study period, ALCO EMS transported 9775 children with MBH emergencies. Of these transports, 1205 (12.3%) were physically restrained. Most children restrained had the primary impression of behavioral/psychiatric crisis (51.1%), psychiatric crisis (27.4%), and behavioral-other (12.4%) and the remaining children (9.1%) had a non-psychiatric/behavioral health primary impression. Over time, there was no statistically significant change in either number of children with MBH emergencies transported or physical restraint rate. CONCLUSIONS: More than 1 in 8 children with MBH emergencies are being physically restrained during EMS transport. Restraint rate did not substantially change over time. Further studies to understand existing restraint rates and EMS resources available to address acute agitation in children are needed to inform quality and care enhancing initiatives.

Bring Change 2 Mind (BC2M) high school clubs may destigmatize mental illness among club members, but clubs (1) reach and impact on non-club members at the same school, (2) connection to student help-seeking attitudes, and (3) mechanisms by which they destigmatize mental illness, are unknown. This community-partnered evaluation involved pre/post surveys of predominantly Latino (72%) students at three urban public schools and focus groups and interviews with a sample of club members (n = 26/65, 40%) and all club staff (n = 7, 100%). Multivariate regressions tested relationships between variables. In 84% of the student body responded in the Fall (n = 1,040) and Spring (n = 1,031). Non-club member engagement in BC2M (reach) increased from 25% (Fall) to 44% (Spring) (p < .01). Engagement with BC2M clubs was associated with decreased stigma among members (p < .05) but not non-members (p = .19). Decreased stigma was associated with help-seeking attitudes (p < .01). Possible BC2M mechanisms identified by students and staff include the following: (1) fostering a positive campus climate, (2) normalizing mental health discussions, (3) increasing peer support and help-seeking, and (4) increasing awareness of positive coping behaviors. While BC2M clubs likely reduce stigma for members, effects did not reach non-members, challenging the potential of BC2M clubs as a schoolwide strategy to destigmatize mental health services. Future projects could investigate how to reach non-BC2M members, complement BC2M with other school climate interventions to increase impact, and measure BC2M impact alongside other outcomes relevant to schools, such as academic achievement.