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Prior research has shown that user-generated content (UGC) on social media is an important source for consumers seeking information about mental health treatment. The purpose of this study is to explore UGC about prescription drugs for depression as a type of digital 'pharma' folklore. Using qualitative inquiry, the authors analyse 73 user-generated product reviews on YouTube. Findings yield a compelling portrait of people's struggle with mental illness and their treatment journey. Applying folklore as a framework provides a novel strategy for analysing and theorising the cultural worldview of a consumer group. It allows marketers to decipher the knowledge being passed on to others from product review videos and gain a deeper understanding of stories that resonate with consumers seeking treatment with depression drugs. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

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

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

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

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

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

Objective: To assess differences in internalized stigma of mental illness based on demographic characteristics and mental healthcare utilization among college students. Participants: Students with self-reported mental illness (n = 128) were recruited via random sampling. Methods: Participants completed an online survey, including questions related to demographic characteristics and mental healthcare utilization. The survey also included the Internalized Stigma of Mental Illness (ISMI) scale. Data were analyzed using descriptive and inferential statistics. Results: Students accessing mental healthcare (pharmacological and/or psychotherapeutic) reported higher ISMI scores than students who did not access services during past year. Students with sexual minority statuses also reported higher ISMI scores than their heterosexual counterparts. Conclusions: Results highlight differences in internalized stigma based on demographics characteristics and mental healthcare utilization among college students. More research is needed to better understand intersectional stigma. Further, universities need tailored and specific interventions to address internalized stigma among students with diverse backgrounds and needs. [ABSTRACT FROM AUTHOR]

The demand for mental health treatment on university campuses continues to increase. This report will outline sources of increased demand and how traditional campus-based models have managed it. It will then describe the University of Southern California's work mobilizing resources to develop a unique model for insurance based long-term care emphasizing the importance of collaboration between long-term and short-term resources. Finally, this report will suggest interventions that may help to ease the burden of increased demand for mental health treatment on campuses. [ABSTRACT FROM AUTHOR]

Objectives: Common mental disorders affect high proportions of university students. This systematic review aims to summarize the barriers and facilitators to help-seeking for depression and anxiety among university students and provide evidence to improve mental health services. Methods: EMBASE, MEDLINE, and PsycINFO were searched for eligible papers. Inclusion criteria: (1) published between 1990 and 2021, (2) written in English, (3) had qualitative or quantitative methodology, (4) involved university students, (5) students had depression or anxiety, (6) students were explicitly asked about barriers and facilitators, (7) >60% of study population had mental illness. Results: Ten studies were included into this review. The most common barriers were self-reliance, stigma, and poor mental health literacy. Good mental health literacy and social encouragement were significant facilitators. Conclusions: Universities could encourage help-seeking by targeting stigma and increasing mental health literacy. Future research could explore the role of self-reliance in help-seeking and identify more facilitators. [ABSTRACT FROM AUTHOR]

Background: Access to university mental health services is poorly characterized. Our objectives were to (1) assess patterns of access and (2) explore predictability of contact with student mental health services. Participants: Data derived from the U-Flourish study, which includes a survey of successive cohorts of incoming undergraduate students attending Queen's University, located in Ontario, Canada (Cohort 1: 2018, Cohort 2: 2019). Methods: Survey data sets were deterministically linked to administrative data provided by Student Wellness Services. Analyses included cross-tabulation, logistic and negative binomial regression. Predictive modeling used LASSO regression. Results: Baseline symptoms were robust determinants of access. For example, a PHQ-9 rating in the severe range (≥ 20) was associated with an OR of 9.71 (95% CI: 4.46–21.1). A predictive algorithm did not outperform cut point-based interpretation of PHQ-9 or GAD-7 ratings. Conclusions: Self-reported symptoms are consistently associated with service use, supporting the widespread use of symptom screens. [ABSTRACT FROM AUTHOR]

Objective: This study was designed to assess the relationship between mental health service utilization and heavy episodic drinking (HED) after controlling for demographic and student-level variables. Participants: A national sample of college undergraduate respondents to the 2017–2018 Healthy Minds Study survey (n = 67,427). Methods: Hierarchical logistic regression entering all variables on a single step. Subsequent logistic regression was used to assess interactions between mental health service variables and select demographic and student level variables. Results: Twenty-two demographic and student-level variables were associated with current HED (9 protective and 11 risk factors). Current mental health therapy was associated with a lower risk of current HED while mental health medication use in the past 12 months (but not currently) was associated with a higher risk of HED. Conclusions: Findings provide guidance to college/university community professionals given the responsibility of designing and implementing programs for mitigation of alcohol misuse on their campus. [ABSTRACT FROM AUTHOR]

Jihan, a former Kurdish guerilla fighter, struggles to gain medical treatment for the health problems she suffers as a result of war and trauma. The provision of care in Turkey has been motivated by ethno-political security concerns. Therefore, medical encounters are characterized by silences, not-knowing and of averting danger. Based on theories of ignorance, I explore how experiences of war and torture constitute dangerous knowledge that are difficult to share in a context, without a guaranteed therapeutic safe space. Patient and doctor navigate mistrust, silences and proxy-reasons in an attempt to deal with the traumata and violent experiences left unsaid. [ABSTRACT FROM AUTHOR]

Objectives: Mental health remains an unmet need among Chinese Americans. This study aims to identify specific needs and strategies that may address the needs. Design: A total of 55 Chinese Americans consented and participated in online focus groups conducted in either Chinese or English using nominal group technique. Participants discussed the following questions, achieved themes, and provided ranking of themes in importance for each: (1) In general, what do people in the Chinese American community think about mental health or emotional well-being? (2) What have you found to be helpful for accessing mental health or emotional well-being services or care in the Chinese American population? And (3) What actions would you suggest to improve mental health and emotional well-being in the Chinese American population? Results: Across the focus groups, we observed high consistency of top ranked themes including lack of knowledge and awareness, negative impression, lack of Chinese-speaking providers, and that the most helpful factor toward access to care was education and increased awareness. Seminars and trainings was the top actionable suggestion. Conclusion: The findings are consistent with previous findings and continue to show that Chinese Americans need more education and training and that providers who can speak the language and understand the culture would be very helpful to increase access to care. This study emphasizes addressing mental health disparities in the Chinese American community through awareness, tailored interventions, and barrier removal. Promoting equal access also underscores the need for ongoing assessment and responsive strategies. [ABSTRACT FROM AUTHOR]

In North America, LGBTQ+ youth have high rates of cannabis use and face mental health issues. We conducted a photovoice study to describe the perspectives, needs, and motivations of forty-six LGBTQ+ youth who use cannabis as they access mental healthcare services. Participants' photographs were discussed in individual semi-structured interviews conducted by peer researchers. Following a thematic analysis of the interview transcripts, we first found that, beyond medication, LGBTQ+ youth sought mental health services facilitating introspection to better understand their sexual and gender identities and mental health. Second, participants sought affirming health professionals but often felt judged by providers. Third, access to desired services was often described as uncertain and taxing, which impacted their mental health. Fourth, participants' agency was determined by their experience with mental health services, which translated into resilience to tackle access challenges and cannabis use to mitigate their mental health struggles. Our findings point to the need for mental healthcare delivery that goes beyond medication provision but which in addition foster therapeutic processes based on a holistic understanding of mental health. A trusting dynamic between health professionals and LGBTQ+ youth is imperative to counteract the feelings of stigma experienced by LGBTQ+ youth using cannabis in Canada. [ABSTRACT FROM AUTHOR]

Objective: The management of HIV has shifted from a focus solely on the disease to a broader perspective encompassing co-occurring medical conditions and quality of life. Mental health concerns such as depression and sleep disturbances, particularly insomnia, are often overlooked in HIV care. The aim of the study was to investigate the longitudinal impact of insomnia on depression and medication adherence among (PLWH). Methods: This study, conducted in an urban HIV clinic, involved active patients and assessed depression, insomnia, and medication adherence at baseline, 3-month, and 6-month intervals. Hierarchical linear models were employed to analyze the fixed and random effects of time, within-person and between-person insomnia on depression, as well as the effects of time, within-person and between-person depression on ART adherence. Results: Within-person effects revealed that each one unit increase in the Insomnia Severity Index (ISI) was associated with a b = 0.267-point rise in Patient Health Questionnaire-9 (PHQ-9) scores (p <.001). Between-person effects revealed that each one-point increase in an individual's average ISI score was associated with a 0.476-point elevation in their PHQ-9 scores (p <.001). The between-person effects of depression on medication adherence indicated significance, with each point increase in an individual's average PHQ-9 score being linked to a 0.36% decrease in adherence (p =.012). Conclusion: The study underscores the potential impact of insomnia on mental health and treatment adherence in people living with HIV (PLWH). This study emphasizes the necessity of comprehensive care models considering the interplay between sleep quality, mental health, and medication adherence for PLWH. [ABSTRACT FROM AUTHOR]

The article discusses the use of clinical research in decision-making for therapy provision, focusing on the debate between qualitative and quantitative research methods. It explores the differences, strengths, and weaknesses of each approach, particularly in the context of psychodynamic psychotherapy. The article emphasizes the importance of understanding the philosophical foundations of each method and how they shape our understanding of people and reality. It also delves into the practical application of research in clinical settings, using therapy endings as a case study to illustrate how research can inform psychodynamic practice. [Extracted from the article]

Objective: This study examines how therapist emotional response/countertransference (CT) develops during treatment for patients with personality disorders (PDs) and how pre-treatment patient factors (severity of personality pathology, PD category, level of symptom distress) predict CT responses. Secondly, we explored associations between patient clinical outcome and CT. Method: A longitudinal, observational study including 1956 patients with personality pathology treated at psychotherapy units within specialist mental health services. Therapists' emotional response was repeatedly assessed by the Feeling Word Checklist—Brief Version (FWC-BV) with three subscales—Inadequate, Confident, and Idealized. Results: Levels of Inadequate CT were lowest and stable over time while Confident and Idealized increased over time. Greater severity of personality pathology and borderline PD predicted higher initial Inadequate, lower initial Confident and decreasing Inadequate over time. Antisocial PD predicted decreasing Confident. Number of PD criteria had higher impact on therapist CT than level of symptom distress. Clinical improvement was associated with decreasing Inadequate. Conclusion: Therapists reported predominantly Confident CT when working with PD patients. More severe personality pathology, and borderline PD, specifically, predicted more negative CT initially, but the negative CT decreased over time. Patients who did not improve were associated with increasing Inadequate. [ABSTRACT FROM AUTHOR]

The federal Ending the HIV Epidemic (EHE) initiative was created to reduce new US HIV infections, largely through pre-exposure prophylaxis and HIV treatments that reduce HIV transmissibility to zero. Behavioral health disorders (mental health and substance use) remain significant barriers to achieving EHE goals. Addressing behavioral health (BH) disorders within HIV primary care settings has been promoted as a critical EHE strategy. Implementation of efficacious HIV-BH care integration and its impact on HIV-related health outcomes is not well documented. In a federally-funded, exploratory phase implementation science study, we used the Collective Impact Framework to engage partners in seven EHE jurisdictions about the feasibility, acceptability, and sustainability of implementing HIV-BH integration interventions within local HIV settings. Partners concluded that full integration will remain the exception unless health systems invest in collaborative practice, professional training, appropriate health technology, and inter-system communication. Partners supported smaller incremental improvements including transdiagnostic approaches to reinforce each team member's sense of value in the shared endeavor. This early phase implementation science study identified research and implementation gaps that are critical to fill to end the HIV epidemic. Both the Collective Impact Framework and implementation science show promise for guiding future implementation of evidence-based HIV-BH intervention integration. [ABSTRACT FROM AUTHOR]

Over the past few decades, the level of police involvement at a community level in matters of mental health has increased significantly. Police are often the only agency immediately available day or night to respond to such emergencies and are often left to deal with mental illness and associated social crises with very limited support. Whilst recent years have witnessed an upsurge in governmental policy intended to safeguard vulnerable groups, such as young people and people with mental illness, there is a dearth of research regarding the proficiency and operability of these directives in practice. Even less is known about how these policies are practically applied to young people in crisis. The study examines the police-led care pathways of Irish youth experiencing a crisis mental health event from the commencement of police involvement through to the initiation of psychiatric care. Qualitative interviews were conducted with police and a group of stakeholders comprised of medical professionals and a social worker. Results indicate a complex care pathway beset with ambiguous policy and legislation, deficits in specialist training, and chronic under-resourcing of services. In the face of these shortcomings, police innovate informal practices that sometimes help and at other times pose a risk to young people in crisis. Furthermore, uncertainties surrounding formal procedure was a source of significant psychological burden for police and potential disciplinary action. These findings are discussed in the context of existing theory and research, and recommendations for policy and practice are offered. [ABSTRACT FROM AUTHOR]

Background: The linkage between substance use and youth suicidality is less developed due to the predominant focus on certain types of substances (e.g., alcohol consumption, prescription opioid misuse). This study examines polysubstance use and its mutual impact on suicidal thoughts and behaviors among US adolescents. Methods: Data from 2019 Youth Risk Behavior Survey were utilized. Associations between the concurrent use of five substances (cigarette, e-cigarette, alcohol, marijuana, and prescription opioid) and suicidality (suicidal thoughts, suicide plans, and suicide attempts) were measured by logistic regression models. The combined effect of polysubstance use on suicidality was further assessed by structural equation modeling. Results: About two in five (42.1%) adolescents used at least one type of substances in the past month and one in seven (13.5%) used three or more types concurrently (polysubstance use). Adolescents with polysubstance use behaviors were three to five times more likely to experience suicidal thoughts (OR=3.8, p < 0.05), make a suicide plan (OR=3.5, p < 0.05), or attempt suicide (OR=4.6, p < 0.05) than non-users. In the final structural model, polysubstance use and suicidality were significantly correlated with each other (β=0.37, p < 0.05). Collectively, polysubstance use explained about 14% of variance in youth suicidality. Conclusions: Polysubstance use shows a significant impact on youth suicidality. School-based health centers and educational programs are recommended to reduce substance use and suicidal behaviors among adolescents. Accessible mental health services and targeted treatments are needed for polysubstance users to mitigate their risk of suicide. [ABSTRACT FROM AUTHOR]

While mental health frameworks are increasingly accepted in Countering Violent Extremism (CVE) policies, little is known about practitioners' experiences when individuals are mentally ill. This paper discusses how mental health clinicians review interactions between psychopathology and violent extremism, and which challenges Dutch practitioners face in decision-making processes around including severely mentally ill people in CVE individual case management approaches. Inclusion means that people are identified as (potential) violent extremists, which justifies CVE interventions on top of regular mental health care. Semi-structured interviews were conducted with 12 international mental health clinicians and 13 Dutch CVE practitioners. Data was analysed with qualitative thematic analysis. Results show that professionals usually view the risk of extremist violence, and not psychopathology, as the decisive factor for inclusion, unless (forensic) mental health clinicians advise otherwise. Nevertheless, some practitioners can experience challenges around making dichotomous choices about including mentally ill persons. Some expressed concerns about illegitimately labelling certain people as 'radicalised' when they suffer from severe mental illnesses (e.g. psychosis). CVE cases with mental illnesses are, however, characterised by heterogeneity, non-dichotomy and missing information. False negatives and false positives concerning uptake in pre-emptive CVE policies can have detrimental individual and societal effects. Future research suggestions are provided. [ABSTRACT FROM AUTHOR]

The willingness of friends or family to share concerns about an 'intimate' preparing to perpetrate public, mass violence, such as violent extremism or targeted violence, is considered a possible part of preventative strategies. To understand what is needed to help intimate bystanders share information on potential acts of violent extremism or targeted violence, we conducted 25 semi-structured qualitative interviews with experts in intimate bystander reporting, including law enforcement, social service and mental health providers, faith-based leaders, staff in school threat assessment programs, and community practitioners in California and Illinois. Results showed reporting was impeded by multiple factors, including lack of knowledge about violent extremism and reporting processes, fear of being incorrect, difficulty distinguishing between violent extremism and mental illness, low trust in law enforcement, and lack of standardized reporting processes. Practitioners said reporting could be improved by several interventions, including increasing awareness about reporting processes, improving reporting methods and policies, training community members who can take reports, and increasing trust between community members and law enforcement. Improving bystander reporting for targeted violence and violent extremism in the U.S. requires collaboratively strengthening law enforcement and community capacities based on sound theory, best practices, and monitoring and evaluation. [ABSTRACT FROM AUTHOR]

The editorial discusses how disrupted interoception can lead to disturbances in perceptual reality monitoring. It explores the overlap in neural activation patterns between imagination and perception, highlighting errors in perceptual reality monitoring in both clinical and non-clinical populations. The editorial speculates that differences in interoception may play a role in distinguishing between reality and imagination, particularly in cases of psychiatric conditions. The role of interoception in emotional processing is also discussed, with a focus on how disruptions in interoceptive processing may contribute to perceptual reality monitoring failures in various disorders, including schizophrenia. [Extracted from the article]

This study investigates the challenges faced by LGBT Myanmar migrants in Thailand, including discrimination and abuse due to their gender identity or sexual orientation, and their coping strategies. Through qualitative interviews with 20 self-identified LGBT Myanmar migrants aged over 18 years who experienced discrimination or abuse in Thailand, the findings underscore the presence of a segment within the Myanmar LGBT migrant community in Thailand subject to discrimination and violence across diverse settings, including workplaces, public areas, and even within their homes. Additionally, the research identified healthy coping strategies like self-soothing thoughts, relaxation activities, and seeking support, contrasted with unhealthy coping strategies such as negative self-talk, rumination, and suppressing one’s identity, leading to harmful behaviors and even suicidality. The experiences of severe discrimination and violence among LGBT migrants help this study advocate for policy interventions, such as extending the coverage of the Gender Equality Act to encompass LGBT migrants and implementing mental health support services as a form of secondary prevention. Given the significant contribution of LGBT migrants to various sectors of Thailand’s workforce, these measures are essential. However, the existing legislation concerning gender equality in Thailand inadequately addresses the specific concerns of this demographic group. [ABSTRACT FROM AUTHOR]

The high prevalence of trauma among people with HIV (PWH) and its negative impact on HIV outcomes underscore the need for Ryan White-funded HIV clinics (RWCs) to implement trauma-informed care (TIC) inclusive of crisis prevention and response. As part of a mixed-methods study of TIC practices employed by RWCs, we conducted qualitative interviews with 36 administrators, providers, and staff from Southeastern RWCs exploring crisis prevention and response strategies. Interviews were guided by the Substance Abuse and Mental Health Services Administration TIC framework and analyzed using a framework-driven, qualitative thematic approach. Crisis prevention strategies included: using electronic medical records to identify patients at risk for experiencing crisis, peer navigators to help patients bypass clinic public spaces, protocols to ensure perpetrator-victim pairs were not concurrently scheduled, and social workers to help patients identify crisis triggers and develop safety plans, plus dedicating safe spaces for patients with extensive trauma histories. Crisis response included patient referral to onsite and community crisis intake, trauma support, and mental health services and having onsite security personnel and alarm systems. Several participants requested additional training in response protocols. Study findings highlight the need for RW network-wide TIC training and sharing of best practices in crisis prevention and response. [ABSTRACT FROM AUTHOR]

AbstractIn Ethiopia, as in many other low-and middle-income countries, health professionals, particularly mental health workers, are scarce. The purpose of this case study is to describe the process of establishing training child psychiatry and capacity building to implement clinical care for child and adolescent mental health. We present a case study on training of child and adolescent psychiatry embedded within the master’s degree program in integrated clinical and community mental health at the department of psychiatry in Jimma University, Ethiopia. This program is jointly developed in collaboration between Jimma University and Ludwig-Maximilian-University, Germany. The core elements of the training were to train mental state description, making decisions on possible disorders, perform occupational activities, and design psychosocial interventions. The WHOmhGAP guide is considered as appropriate knowledgebase for our teaching program. Each course was evaluated bidirectional with multiple methods. From 2010 to 2024, twelve trainings were organized. We structured the program in three phases. The initial phase (2010–2014) was to establish collaboration with guest lecturers and to develop, implement, and evaluate the training. The second phase (2015–2019) changed to mentorship and transition from guest lecturers to local trainers and included a refresher course. Phase three (2020–2024) was independent work. An outpatient clinical service for children was implemented by the lead author and now is running at Jimma University. The implementation of the training took place in small steps. A long-term commitment of local and guest lecturers enabled to develop culturally appropriate solutions for the local context. A similar approach can be applied to effectively start and expand child and adolescent mental health care in other resource limited settings. [ABSTRACT FROM AUTHOR]

AbstractBackgroundAimsMethodsResultsLimitationsConclusionsP-factor and mentalizing theory and research set perspectives for transdiagnostic psychiatric treatments.To test the effects of a low-cost mentalization-based health education program (the Thoughtful program) in an unselected waiting list population, from a psychiatric outpatient clinic in North Norway.Waiting list patients were randomized (1:1 allocation): 79 patients in the control group were offered standard individual assessment and treatment. Seventy-nine patients in the intervention group were offered a one-day (six-hour) group-based Thoughtful course, plus individual assessment, and treatment.During a 6-month follow-up period, the number of patients in active assessment and treatment was 66% higher in the control group than in the intervention group. Self-reported patient questionnaire scores on mentalizing, well-being and suicidal ideation scores showed no significant changes in the control group. In the intervention group, significant changes were reported: Mentalizing scores improved by 72% and well-being scores improved by 55%. Suicidal ideation scores were not significantly changed. No adverse effects were registered.The results from this study should be interpreted with caution because of a small population size and low questionnaire response rate. The follow up period was limited to 6 months. Transfer of program information from intervention group patients to control group patients could not be guaranteed. It may be considered a limitation that diagnostic pattern analysis was not included in the study.A low-cost transdiagnostic mentalization-based educational program in an outpatient psychiatry clinic may improve patient mentalizing and wellbeing without adverse effects and reduce the use of hospital services. [ABSTRACT FROM AUTHOR]

\nPractice implicationsDuring four days of observation at a therapeutic residential care (TRC) facility for adolescents with complex behavioral issues, we encountered a growing trend in the Norwegian child welfare system. High demand for institutional beds, along with reduced capacity in psychiatric services and the legal system, has led to increased reliance on the Duty to Assist obligation of the TRCs, administered by the Office for Children, Youth and Family Affairs (Bufetat) in Norway. This obligation is legally binding, ensuring the provision of justifiable treatment. Our observations of staff interactions and documentation analysis of an adolescent, Peter, revealed that staff’s ability to deliver appropriate care and manage high-risk situations is constrained by governmental standards set through law and regulation. Through the theoretical lens of power and discretion, we found that the combination of forced treatment at open institutions, with a strong emphasis on user involvement, creates a power struggle. Without clear practice standards, staff are left to rely on their own competencies in managing conflicts, resulting in inconsistent and unpredictable interactions. This inconsistency increases the likelihood that Peter will resist the care and treatment being offered. Providing staff education and training, establishing clear and predictable standards, is essential to avoid inconsistent frameworks and practices within TRC.Staff training should place greater emphasis on teaching how to wield power and authority effectively, paralleling focus on preventing violence.There is pressing need for deeper comprehension of the government-set standards implications for adolescents and staff members within TRC settings.Providing staff education and training, establishing clear and predictable standards, is essential to avoid inconsistent frameworks and practices within TRC.Staff training should place greater emphasis on teaching how to wield power and authority effectively, paralleling focus on preventing violence.There is pressing need for deeper comprehension of the government-set standards implications for adolescents and staff members within TRC settings. [ABSTRACT FROM AUTHOR]

The aims of this quality improvement programme were to enable providers of mental health in-patient services for children and young people in England to review their prescribing practice alongside the views and experiences of children, young people and their parent carers. Three online tools were developed. First was a medication census tool to be completed by provider clinicians to capture prescribing practices around psychotropic medication. The two other online tools were questionnaires that provided an opportunity for inpatient children and young people and their parent carers to express their views of the medication. 193 children and young people had a primary diagnosis of eating disorders. Antidepressants were the most widely prescribed (56%), followed by antipsychotics (41%), benzodiazepines, and antihistamines as sedatives (18%) and hypnotics (11%). Of those receiving regular psychotropic medications, 67% were prescribed two or more. Both the children and young people and their parent carers expressed concerns about the high level of psychotropic medication, the number of prn administrations, the number of psychotropic medications prescribed and the extent of side effects. Psychotropic medications are widely prescribed both on a regular and on a prn basis for children and young people with eating disorders in mental health in-patient services. [ABSTRACT FROM AUTHOR]

The global rise in adolescent self-harm and suicidal behaviours has intensified the demand for mental health services in the UK. This has further strained already underfunded and understaffed resources, resulting in longer waiting times and increased emergency department visits among teenagers. To address the overwhelming need for effective community-based emergency support, a brief psychodynamic crisis therapeutic intervention was developed within a CAMHS adolescent crisis team, inspired by child psychotherapist Ruth Schmidt Neven’s work on time-limited psychotherapy with adolescents and their families. This 12-session intervention offers both individual therapy for the adolescent and sessions for their parents, along with regular family reviews. Two psychotherapists work closely together on each case – one with the young person, the other with the parents. The brief model views crises as opportunities for deeper understanding, moving beyond diagnostic and symptom-centred approaches, as well as standard risk management and safety-planning strategies, and underlines the centrality of parent involvement in adolescent crisis work. This paper outlines the intervention’s theoretical foundation, guiding principles, and practical design, and presents preliminary findings from a pilot study of 22 cases, run over two and a half years. Early results suggest broad potential for this psychodynamic crisis approach in various adolescent crises, and merit further investigation. [ABSTRACT FROM AUTHOR]

This study explores the effectiveness of Religious Savior-Centered Psychotherapy (RSCP) in treating depression in religious women. RSCP is a therapeutic approach that integrates Islamic teachings, particularly the concept of a Savior, with cognitive and behavioral strategies to address mental health challenges. Unlike traditional therapy models, RSCP emphasizes spiritual healing by fostering a strong connection to faith and a hopeful outlook for the future. The study aims to assess RSCP’s impact on depression in women by aligning with Islamic teachings and emphasizing positive future expectations. A pretest-posttest design with a two-month follow-up was employed to evaluate the effects of RSCP. The study included 70 women aged 18–60 from five counseling clinics in Tehran, all diagnosed with mild to moderate depression, and having expressed a belief in a Savior. MANCOVA was used to analyze the data, ensuring assumptions of normality and homogeneity of variances were met. MANCOVA results indicated a significant linear correlation between the treatment and depression levels (p < .05), with a large effect size (partial η2 = .61 for posttest and .54 for follow-up). Initial findings suggest RSCP’s potential benefit on mental well-being. RSCP has the potential to be integrated into existing mental health frameworks as a culturally sensitive option, particularly for Muslim women seeking faith-based approaches to mental health care. Future research with larger samples, randomized controlled trials, and longitudinal studies is needed to explore the effectiveness of this new positive psychotherapy approach. [ABSTRACT FROM AUTHOR]

The book "Decolonising and Reframing Critical Social Work" by Goldingay, Ryan, and Daddow challenges dominant social work paradigms by emphasizing intersectionality, decolonization, and indigenous knowledge systems. It critiques the historical complicity of social work in perpetuating colonial ideologies and advocates for a more equitable and just practice through collaboration with Indigenous communities. The book offers theoretical insights and practical narratives, urging professionals to rethink their approach to social work within indigenous frameworks, particularly in Australia and Aotearoa New Zealand. It explores the limitations of critical social work practice and proposes a more inclusive approach that integrates Indigenous perspectives and intersectionality, emphasizing decolonization and storytelling. [Extracted from the article]

This study explores the mental health perceptions, expectations for mental healthcare, and use of existing mental health services among international engineering students at a Western Canadian university. Employing a phenomenological qualitative approach, semi-structured interviews were conducted with 18 international undergraduate engineering students to understand their mental health challenges and service usage. The thematic analysis revealed three significant themes: students’ understanding of mental health; their experiences within the engineering programme, and recommendations to enhance and facilitate a positive mental health experience at the university. Findings suggest that mental healthcare for international engineering students should be responsive to the students’ unique needs, providing support and accessible services during their transition from their home countries and recognising the impact of the environmental and cultural factors on their experiences as members of the Faculty of Engineering and the broader university community. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsDiscussionPsychotic Like Experiences (PLEs), suicidal ideation, and depressive symptoms are related and common symptoms in adolescents treated in psychiatric services. However, more granular analysis of the associations between the two types of symptoms is sparse. This study aims to investigate the associations between self-reported PLEs and depressive symptoms on a sub-scale and item level, among adolescents attending secondary level psychiatric care.The sample included 328 adolescents (aged 13–18 years) attending adolescent psychiatry outpatient units of the Helsinki University Hospital. Depressive symptoms were assessed using the BDI-1A (total score and separate Suicidal Ideation item score). PLEs were assessed with the PQ-B and analysed as sum scores for the sub-scales Sensory Distortion, Grandiosity, Disorganised Speech, Paranoia, and Unusual Thoughts.High scores on PQ-B subscales Paranoia and Unusual Thoughts were both independently associated with more depression and suicidality. Item analysis showed that the associations between PLEs and depression were driven by two PQ-B Paranoia subscale items, and one Unusual Thoughts subscale item.The findings suggest that the association between PLEs and depressive symptoms is driven by paranoid experiences and unusual thought content. Professionals in psychiatric care should expect this type of co-occurrence. [ABSTRACT FROM AUTHOR]

IntroductionMethodsConclusionIncreasingly more self-report measures of psychological distress are used as screening tools in mental health care for treatment planning and routing outcome monitoring. Research on the psychometric properties and utility of these measures in individuals with mild intellectual disability or borderline intellectual functioning (MID-BIF) are limited, even though this target group accounts for a large proportion of individuals treated in mental health care services. The aim of the present study was to explore the psychometric properties of the SQ-48, a self-report on psychological distress, when used in adults with MID-BIF.The SQ-48 was administered to 213 patients of two specialist mental health services for MID-BIF in the Netherlands. A second administration took place after three weeks in a test–retest design (N = 24). Results: The SQ-48 has adequate internal consistency, discriminant validity, test–retest reliability, and factor structure when used in adults with MID-BIF.This study provides preliminary evidence that the limitations in intellectual and adaptive functioning in people with MID-BIF do not influence the reliability and validity of the SQ-48 and can be used reliably in this population. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusions\nKEYPOINTSTransitioning to university brings challenges and stress that could be mitigated through self-care practices and knowledge and use of mental health services. This study examined these variables in first-year students at an Australian university, exploring any differences between international and domestic students and whether demographic variables and psychological distress influence knowledge and use of mental health services and self-care practices.Participants were 821 first-year students (77.6% female, 25.2% international, Mage = 20.7, SDage = 5.54 years). Measures included the Mental Health Literacy Scale, purpose-written questions about awareness, confidence, and engagement with mental health services, self-care knowledge and use, and PsyCheck. T-tests examined differences between domestic and international students. Hierarchical regression analysis assessed relationships between demographic factors, psychological distress, and mental health-related variables.Compared with international students, domestic students had greater awareness, confidence, and engagement in mental health services, and better self-care knowledge. Demographic variables were associated with mental health outcomes, with limited model strength. Psychological distress was associated with less knowledge and confidence in accessing mental health services yet higher engagement with services, and lower self-care knowledge and use.The findings underscore the need for targeted mental health resources, particularly for international students and those experiencing higher psychological distress.What is already known about this topic:(1) Mental health issues are widespread among university students, but students often display limited knowledge of where to seek help, low engagement in help-seeking, and self-care.(2) Demographic factors such as age and gender, and barriers such as stigma and embarrassment, are associated with general mental health literacy and help-seeking behaviours among university students.(3) International students often show lower levels of awareness and engagement in seeking mental health support than domestic students.What this topic adds:(1) This topic provides up-to-date insights on the state of knowledge and use of mental health services, as well as self-care practices among first-year university students.(2) The study found that domestic students exhibited greater awareness, confidence, and engagement in mental health services, and better self-care knowledge than international students.(3) The study found that first-year students with higher levels of psychological distress had lower knowledge and confidence in accessing mental health services, more engagement with these services, and poorer self-care practices. [ABSTRACT FROM AUTHOR]

Encompassing human rights-based approaches within mental health service delivery is essential to supporting the recovery of service users, their family members/carers/supporters. This is being increasingly led by social workers due to their role in responding to psychosocial challenges. This is seen in today’s mental health services through their work in safeguarding service users and addressing familial concerns regarding all aspects of life. It is also evidenced in their openness to the concept of personal recovery—a movement aimed at defending and improving human rights for service users and their family members/carers/supporters through the recognition of international legislation. Recent debates within social work education have explored whether our critical and radical roots are declining or absent in practice. One argument for this has been the increasing pressures coming from neoliberal policies. This paper describes how both authors approached several co-produced sessions with social work students at an Irish university regarding mental health recovery and social work. The authors provide insight into this approach, including a description and exploration of a model of reflexivity used during this process which can be used by other educators, students, and practitioners [CS is an Assistant Professor of Social Work,MJN is a Consumer Academic]. [ABSTRACT FROM AUTHOR]

Holistic approaches, such as the Biopsychosocial model, have become mainstream frameworks for organizing mental health services in recent decades. However, little research has explored how frontline social workers embrace and synthesize the different dimensions within this holistic approach. This paper uses semi-structured interviews to investigate diverse conceptualizations of mental health issues among frontline social workers. Fourteen social workers from Hong Kong and twelve from Sydney were interviewed. Three prevalent positions were identified: prioritizing chemical imbalance, questioning the concept of illness, and refusing a fixed understanding of mental health issues. The analysis also reveals how these understandings influence frontline social work practice, uncovers broader socio-cultural influences through s cross-cultural lens, and highlights implications for social work education for navigating the inclusivity of holistic approaches. [ABSTRACT FROM AUTHOR]

Lived experience education occupies an increasingly important space in mental health education for social workers. Despite being plagued by practices that continue to be discriminating and exclusionary, the mental health policy and practice context demand robust attention to the meaningful inclusion of service users and their families to achieve genuine partnership, reciprocity, and equality in mental health service provision. For social work educators, lived experience education is now an indispensable component of a critically informed mental health curriculum and pedagogy. Framed within an appeal for epistemic justice, this article reports on qualitative survey data from social work students who experienced teaching from people with lived experience. Findings show that students greatly valued lived experience education, as it created opportunities for authentic and more diverse understandings of mental health that fostered critical reflection. A curriculum that supports epistemic equality and a social justice agenda would help scaffold lived experience expertise for student learning.IMPLICATIONS Mental health lived experience education positively impacts social work students’ values and attitudes towards mental health service users.Lived experience education supports social work students to expand their understandings of mental health and recovery beyond dominant biomedical perspectives.Genuine valuing of lived experience knowledge and expertise in social work education helps address epistemic injustice.Mental health lived experience education positively impacts social work students’ values and attitudes towards mental health service users.Lived experience education supports social work students to expand their understandings of mental health and recovery beyond dominant biomedical perspectives.Genuine valuing of lived experience knowledge and expertise in social work education helps address epistemic injustice. [ABSTRACT FROM AUTHOR]

This study assessed the roles of COVID-19 lockdown on access to mental health services in Nigeria. 172 patients who visited the hospital before and during the lockdown were recruited. The methods of data analyses were descriptive, correlations and binary logistic regression. The logistic regression confirmed that socioeconomics of participants predicted their likelihood to access mental health services in hospital during the COVID-19 lockdown. Participants accessed treatments in traditional healing homes, home treatment centers, and place of religious worship. Policymakers need to expand the existing programs for accessible and affordable mental health services and standardized alternatives during health emergencies. [ABSTRACT FROM AUTHOR]

This paper provides a comprehensive perspective on recovery, highlighting the significance of cultural awareness and the use of intersectionality theory to further the understanding of the influence of diverse identities on the recovery journey. A conceptual model is being introduced for culturally safe recovery-oriented practices, encompassing key domains: ways of knowing, presence, doing, and operating. Social workers are urged to lead the adoption of these practices, addressing service delivery gaps and promoting cultural safety for mental health service users. The model encourages mental health practitioners to engage in self-reflexivity, challenge power structures, and dismantle social inequities that hinder mental health recovery. The holistic embrace of all four practice domains can enhance service delivery and foster cultural safety for service users in recovery. [ABSTRACT FROM AUTHOR]

The article explores the impact of a mental health community symposium on nursing students' knowledge and attitudes towards mental illness. It discusses the challenges faced by nursing students in mental health courses, such as societal stigma and personal mental health issues. The study used innovative pedagogical methods to enhance students' understanding of mental health nursing care, resulting in improved attitudes towards mental illness and increased knowledge. The findings suggest that innovation positively influences nursing students' attitudes and learning outcomes in mental health nursing courses. [Extracted from the article]

AbstractAcute psychiatric services are crucial for immigrants who face barriers in accessing outpatient mental healthcare due to socio-economic, cultural, and linguistic challenges. This study compared psychiatric hospitalization characteristics between immigrants and native Italians at the University of Foggia from 2004 to 2019. A total of 536 inpatients, equally divided between immigrants and natives, were analysed for sociodemographic and clinical variables. Findings revealed that immigrants were hospitalized through emergency departments for severe psychiatric disorders such as psychosis, while natives were more often admitted for mood disorders. Immigrants showed a higher incidence of substance abuse and suicidal attempts and a lower number of prior hospitalizations compared to natives, with higher incidence of first episodes of mental illness. Despite presenting with severe psychopathology, natives exhibited better clinical outcomes, longer hospitalizations and higher functioning improvements. We also found that natives received more psychotropic medications but experienced fewer adverse effects compared to immigrants. Differences in pharmacological treatments and hospital outcomes suggested that culturally tailored interventions could improve the effectiveness of psychiatric care for migrants. These findings emphasized the necessity for systemic changes in mental health services to address disparities and improve care for migrant populations. [ABSTRACT FROM AUTHOR]

Different forms of eco-therapeutic interventions have positively impacted the physical, psychological and social wellbeing status of service users across a range of age groups. However, there has been little evidence exploring the experience and perceived impact of an ecotherapy program for adolescents in the UK. This study explored perceptions of adolescents and their parents of an ecotherapy program targeting improved mental health and wellbeing. This study involved semi-structured interviews with adolescents and their parents. Interviews took place shortly after the program ended (adolescents and parents) and six weeks after (adolescents only). Interviews from the two groups were initially analyzed separately before being triangulated. Eight adolescents and seven parents were interviewed in total. Three themes were generated: building connections, learning and exposure, and comparing and constructing with prior services accessed. Perceived improvements across adolescents included reduced negative emotions and anxiety, and greater self-esteem, confidence, and social skills. For the latter theme, there were reported distinctive experiences of attending this ecotherapy program compared with professional mental health support services. Exploring nature brought adolescents together with benefits of engaging in support services that varied from the norm. Future research should examine the feasibility of using ecotherapy as an alternative treatment to traditional therapy in supporting mental health, and evaluate the economic viability of such a program for non-clinical support provision. [ABSTRACT FROM AUTHOR]