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Objectives: The aims of this study were to investigate the social and economic factors that contribute to global variability in electroconvulsive therapy (ECT) utilization and to contrast these to the factors associated with antidepressant medication rates., Methods: Rates of ECT and antidepressant utilization across nations and data on health, social, and economic indices were obtained from multiple international organizations including the World Health Organization and the Organization for Economic Co-operation and Development, as well as from the published literature. To assess whether relationships exist between selected indices and each of the outcome measures, a correlational analysis was conducted using Pearson correlation coefficients. Those that were significant at a level of P < 0.05 in the correlation analysis were selected for entry into the multivariate analyses. Selected predictor variables were entered into a stepwise multiple regression models for ECT and antidepressant utilization rates separately., Results: A stepwise multiple regression analysis indicated that government expenditure on mental health was the only significant contributor to the model, explaining 34.2% of global variation in ECT use worldwide. Human Development Index was the only variable found to be significantly correlated with global antidepressant utilization, accounting for 71% of the variation in global antidepressant utilization., Conclusions: These findings suggest that across the globe ECT but not antidepressant medication utilization is associated with the degree to which a nation financially invests in mental health care for its citizens.

The demographic characteristics of people living with HIV/AIDS (PHAs) in Canada are increasingly diverse. Despite literature suggesting a potentially heightened mental health burden borne by racialized immigrant, refugee, and non-status PHAs (IRN-PHAs), researchers have hitherto paid insufficient attention to whether existing services adequately address this need and how services might be improved. Employing community-based research methodology involving PHAs from five ethnoracial groups in Toronto, Ontario, this study explored IRN-PHAs' mental health service-seeking behaviors, service utilization experiences, and suggestions for service improvements. Results showed that while most IRN-PHAs were proactive in improving their mental health, their attempts to obtain support were commonly undermined by service provider mistreatment, unavailability of appropriate services, and multiple access barriers. A three-pronged approach involving IRN-PHA empowerment, anti-stigma and cultural competence promotion, and greater service integration is proposed for improving IRN-PHAs' mental health service experience.

Cultural competence is increasingly recognized as an essential component of effective mental health care delivery to address diversity and equity issues. Drawing from the literature and our experience in providing cultural competence consultation and training, the paper will discuss our perspective on the foundational concepts of cultural competence and how it applies to a health care organization, including its programs and services. Based on a recent consultation project, we present a methodology for assessing cultural competence in health care organizations, involving mixed quantitative and qualitative methods. Key findings and recommendations from the resulting cultural competence plan are discussed, including core principles, change strategies, and an Organizational Cultural Competence Framework, which may be applicable to other health care institutions seeking such changes. This framework, consisting of eight domains, can be used for organizational assessment and cultural competence planning, ultimately aiming at enhancing mental health care service to the diverse patients, families, and communities.

Background: Evidence shows that there is a high prevalence of mental health challenges including depression and anxiety, among Chinese university students. Providing mental health care providers with professional training is crucial to implementing effective mental health promotion initiatives in university settings. Globally, the focus of the mental health system is shifting to recovery and the importance of empowerment is increasingly being emphasized. There is a call to integrate empowerment education into professional training programs for health service providers with the goal of mobilizing them to become mental health champions capable of advancing mental health care. Method: The ACE-LYNX (Acceptance and Commitment to Empowerment-Linking Youth and Xin i.e., "heart(s)" in Chinese) intervention took place at six universities in Jinan, Shandong Province, China. It aimed to promote mental health literacy and build capacity among mental health service providers (MHSPs) to enable them to become mental health champions at their universities and beyond. A total of 139 university MHSPs participated. We collected pre-, immediate post- and three-month-post-surveys. In addition, we recruited forty-five participants to take part in three-month-post-intervention focus group interviews to explore their experiences taking part in ACE-LYNX and applying the knowledge, skills, and insights they gained from the intervention. Result: This paper reports on the effects of empowerment education, which is a key component of ACE-LYNX, on the MHSPs. Four themes were identified: 1) conscious awareness and behavioral change through psychological empowerment users; 2) professional insights and motivation for organizational empowerment; 3) non-self in the continuum of collective empowerment; and 4) interdisciplinary challenges and divergences in empowerment action. Discussion: We found that it is critical to integrate empowerment education into professional training. The process of MHSPs developing their empowerment practice is characterized by their moving from individual to collective empowerment along a continuum, with organizational and collective empowerment taking place in a longer time frame. Experiential learning, empathy education, and critical reflection accelerated the continuous iterative transformative process of empowerment practices. To advance the integration of empowerment into mental health care, the engagement of organizational decision-makers and policy makers in empowerment training is critical to ensure alignment of empowerment values and competence at all levels of service provision. [ABSTRACT FROM AUTHOR]

The knowledge and experience of diverse psychiatrists is crucial to improving care for racialized patients and working toward broader change in health-care institutions and systems.[106],[163],[183] In the meantime, health-care institutions and professional organizations must stop current "colourblind" approaches that are common and continue to perpetuate discrimination against people of colour.[184] One important step would be for each academic department of psychiatry in Canada to identify an equity, diversity and inclusion (EDI) leader. In Canada, where Indigenous Peoples[116] and many other groups are under-represented in the health professions, funding and hiring strategies that lead to recruitment of minority medical students and residents can contribute to a long range shift within psychiatry toward greater diversity and inclusiveness in the mental health workforce and equitable representation of racialized groups.[181],[182] More than mere numerical representation, racialized psychiatrists and trainees need the mental health system to change to become actively anti-racist and welcoming of diversity. Bridging cultural psychiatry and global mental health: a resident-led initiative. Bridging cultural psychiatry and global mental health: a resident-led initiative. [Extracted from the article]

This article provides a commentary on a study conducted in Wuhan City, China, which examined the factors influencing professional help-seeking intention for depression among community-dwelling populations. The study found that positive attitudes towards seeking professional help and knowledge about depression were associated with a higher likelihood of seeking help, while stigma was associated with a lower likelihood. The study emphasized the importance of considering cultural factors, such as the impact of stigma on different cultural beliefs and values, including Confucianism. The commentary also discussed the significance of internalized stigma, the impact of stigma on families, and the influence of social identities on help-seeking behaviors. The article highlights the ongoing issue of stigma surrounding mental illness and the need to address cultural factors to reduce stigma and promote mental health. It emphasizes the importance of a knowledge-based approach that incorporates cultural perspectives and appropriate research methodologies. The text also suggests the importance of conducting research on treatments that combine Western approaches with traditional practices, particularly for the Asian population, in order to expand our understanding of mental health and illness. The overall goal is to foster greater compassion, acceptance, and cultural competence in the field of mental health. [Extracted from the article]

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This article presents a demonstration project that used inclusive health promotion to address the mental health needs of East and Southeast Asian immigrant and refugee women in Toronto. The project demonstrated that effective mental health promotion must consider the social determinants of health, and integrate the principles of social inclusion, access and equity into practice. [ABSTRACT FROM AUTHOR]

Background and aims: It has been recognized that Asian immigrants in North America have lower rates of mental health service utilization. From the perspective of cross-cultural psychiatry, one of the most important cultural factors may be differences in the explanatory model of illness. This article examines the relationship of causal beliefs, perceived service accessibility and attitudes towards seeking mental health care. Method: The sample consisted of 1000 immigrant and refugee women from five ethnic minority communities in Toronto, including three Chinese Canadian communities (Hong Kong, mainland China and Taiwan), Korean Canadians and Vietnamese Canadians. Data were acquired by a self-administered structured questionnaire. Quantitative data were analysed using MANOVA, ANOVA and stepwise multiple regression. Results: The five ethnic minority groups of women differed in their explanatory models about mental illness and distress. In the full model where other variables were controlled for, the most significant factor predicting attitudes towards seeking professional help was perceived access for all groups except the Hong Kong Chinese. In the last group, those subscribing more to a Western stress model of illness had a more positive attitude towards seeking professional help, while those subscribing more to supernatural beliefs had a more negative attitude. Age and education were not significant predictors. Conclusion: Perceived access is one of the main factors that influence attitudes toward seeking professional help. Explanatory models may predict help-seeking behaviours if perceived access to such services is available. [ABSTRACT FROM AUTHOR]

Mental health literacy (MHL) is essential to mental health. Symptoms of depression and anxiety are significant antecedents and closely related to suicide among college students. Few studies have explored the mediating role of depressive and anxiety symptoms between MHL and suicidal ideation. 5578 college students were included in the analysis. The online Wenjuanxing platform was used to collect data from November 2020 to March 2021. The bootstrapping method was used to test the mediating role of depressive and anxiety symptoms in the links between MHL and suicidal ideation. Approximately 18.8 % of Chinese college students in our study reported having suicidal ideation. MHL exhibited a significant and negative correlation with depressive symptoms, anxiety symptoms, and suicidal ideation, whereas depressive and anxiety symptoms correlated significantly and positively with suicidal ideation. Compared with the lowest MHL quartile, the 3rd and 4th quartiles of MHL were associated with a significantly lower risk of suicidal ideation after adjusting for various confounding factors. Depressive and anxiety symptoms partially mediated the relationship between MHL and suicidal ideation, and the mediating effect of depressive symptoms was significantly greater than that of anxiety symptoms. This study was a cross-sectional survey. Future longitudinal studies on this relation are needed. Depressive and anxiety symptoms mediate the relationship between MHL and suicidal ideation. Comprehensive school-based specific psychological education programs are needed to improve college students' MHL and change their attitudes toward mental health services. • About 18.8% of college students have considered suicide in the past 12 months. • Mental health literacy exhibited a significant and negative correlation with depressive symptoms, anxiety symptoms, and suicidal ideation. • Depressive symptoms and anxiety symptoms partially mediated the relationship between MHL and suicidal ideation, and the mediating effect of depressive symptoms was significantly greater than that of anxiety symptoms. • Females may be more susceptible than males to the anxiety-induced suicide pathway. [ABSTRACT FROM AUTHOR]