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To examine the association between psychologist and nurse practitioner scope-of-practice (SoP) regulations and pediatric mental health service access. A nationally representative sample of children with mental health needs was identified using 5 years of National Survey of Children's Health (2016-2020). Utilization was measured in two ways: (1) unmet mental health care needs and (2) receipt of mental health medication. Expanded SoP for psychologists and nurse practitioners was measured based on the child's state of residence and the year of the survey. The associations between both SoP expansion and both outcomes were assessed using logistic regression models adjusted for multiple covariates. The probability of having unmet mental health needs was 5.4 percentage points lower (95% CI - 0.102, - 0.006) for children living in a state with psychologist SoP expansion; however, there was no significant difference in unmet mental health needs between states with and without NP SoP expansion. The probability of receiving a mental health medication was 2.0 percentage points higher (95% CI 0.007, 0.034) for children living in a state with psychologist SoP expansion. Conversely, the probability of receiving a mental health medication was 1.5 percentage points lower (95% CI - 0.023, - 0.007) for children living in a state with NP SoP expansion. Expanded SoP for psychologists is associated with improved access to pediatric mental health care in terms of both unmet need and receiving medication. Expanded SoP for NPs, however, was not associated with unmet need and lower receipt of medication., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Suicide is the tenth leading cause of death in the U.S. Six states have granted psychologists prescriptive authority to address shortages in the provision of behavioral and mental health care services to increase provider access to pharmacological interventions using psychotropic medications., Methods: This study estimates the impact of expanding scope of practice for specifically trained psychologists to include pharmacological interventions on mortality by self-inflicted injury in the U.S. by using the implementation of prescriptive authority for psychologists in New Mexico and Louisiana as a natural experiment using a staggered different-in-difference estimation. Additional robustness tests are conducted to identify heterogenous treatment effects, observe sensitivity of our results for Medicaid expansion, and to compare other forms of mortality that should not have been affected by psychologist prescriptive authority., Results: Mortality resulting from self-inflicted injury decreased by 5 to 7 percentage points in New Mexico and Louisiana following prescriptive authority expansions for psychologists. The effect is statistically significant for males, white populations, individuals who are married or single, and for people between the ages of 35 and 55., Conclusions: In the U.S., expanding scope of practice for specifically trained psychologists to include prescriptive authority may help address poor mental health care outcomes, such as suicides. Similar policy expansions may be useful for other countries where referral from a psychologist and prescription assignment from a psychiatrist are separated., Competing Interests: Declaration of Competing Interest An honorarium of $1000 was given to support the authors during the writing and editing process by the Center for Growth and Opportunity at Utah State University. The Center for Growth and Opportunity had no role in the study design, collection, analysis, and interpretation of data, or in the writing of the report outside of grammatical editing of a working draft of the report., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Purpose: To examine trends in the psychologist workforce and training opportunities, including factors that may influence the decision of clinical psychologists to practice in rural settings., Methods: We use a mixed-methods approach to examine the psychologist workforce nationally and in North Carolina (NC), including (1) an analysis of the location of programs awarding doctoral degrees; (2) an analysis of the practice, demographic, and educational characteristics of the psychologist workforce; and (3) interviews with directors of doctoral programs in clinical psychology to understand where current graduates are getting jobs and why they may or may not be choosing to practice in rural communities., Findings: Fewer than 1% of programs and institutions awarding doctoral degrees in psychology in the United States are located in rural areas. In NC, approximately 80% of practicing psychologists have out-of-state degrees and about 80% of recent NC graduates are not currently licensed in the state. This juxtaposition undermines the utility of adding more in-state degree programs. While expansion of training programs within rural areas could help alleviate the shortages of mental health providers, adding new degree-granting programs alone will not necessarily increase supply. We discuss complementary recruitment and retention strategies, including greater incentives for rural training and practice as well as training in emerging technologies that don't require providers to be physically located in underserved areas, such as telemedicine., Conclusions: Increasing the supply of psychologists practicing in rural areas will require a thoughtful, multipronged approach to training this critical part of the behavioral health workforce., (© 2018 National Rural Health Association.)

Research supports the use of psychological therapies among people with mild to moderate intellectual disability (ID). One barrier to people with ID accessing psychological treatments is the confidence of mental health practitioners. This article explores the confidence of Australian clinicians in providing therapy to people with ID. One hundred and fifty-two psychologists and counselors in Australia completed a survey exploring self-reported confidence when working with clients who have ID and mental health difficulties. Clinicians were most confident with generic counseling skills, but less confident with elements of assessments and interventions. The use of treatment protocols was endorsed as helpful particularly among those with low confidence. This highlights the need for dissemination of treatment guides and training to help increase clinician confidence.

Background: Patient-targeted Googling (PTG) is an unavoidable aspect of the internet era, offering both opportunities and risks. However, no PTG studies have been conducted in Asian contexts to date. Additionally, existing research has provided limited exploration of factors influencing PTG practices, particularly regarding the professional differences between psychiatrists and psychologists. This study seeks to address these research gaps. Method: A total of 943 licensed psychiatrists and psychologists working in China completed an online survey. The survey included their attitudes towards PTG (including general attitude, application situations, reasons for/against PTG) and their actual practice of PTG. Results: 250(26.5%) respondents reported using PTG. Among them, 151(60.4%) respondents sought consent from clients before use, and 142(56.8%) respondents discussed search results with clients after use. Chinese psychiatrists and psychologists have contradictory attitudes, with concerns but also recognition of its possible positive effects, and expressing a need for more guidance. Compared to psychiatrists or those working in public institutions, psychologists and those working in private institutions report greater concerns about PTG but engage in it more frequently. Conclusions: Although the sample is limited, the study reveals notable differences in attitudes and practice of PTG among Chinese psychiatrists and psychologists, which may be related to their distinct professional roles and workplace environments. These findings suggest the need for further research to better understand the underlying factors contributing to these differences. Moreover, the results highlight the importance of developing tailored ethical guidelines and targeted training programs to address PTG practices for psychiatrists and psychologists in China. [ABSTRACT FROM AUTHOR]

Within the therapeutic setting there have been few ethical considerations deliberated when examining the language barrier between therapists and Non-Native English-Speaking Immigrant (NNESI) clients. The literature reports NNESIs encounter several challenges such as the migration process, experiencing acculturative stress, discrimination, and racism, which in turn impacts their mental health outcomes. These accrued barriers lead NNESI to seek out mental health services. This paper explores the ethical considerations Native-English Speaking and Bilingual Psychologists must consider when providing counseling services to Non-Native English Speakers. These considerations include Third-Party Services, Informed Consent, Cultural Competency, Boundaries of Competency, and Multiple Relationships. For the purpose of this paper, the terms “bilingual” and “multilingual” will be used interchangeably to refer to a person who speaks another language in conjunction with English. [ABSTRACT FROM AUTHOR]

The pandemic forced virtually all mental health professionals to use some form of digital technology, yet few receive any training in digital mental health tools (DMHT). Therapists and students in all mental health treatment settings should be trained to routinely include DMHT in their practice. In this article, we describe why DMHT will play an increasingly important part in clinical mental health practice and discuss how we train psychologists and counselors in our eClinic to learn the basics of incorporating digital technologies into the care they provide. More specifically, we describe the three basic components of the training: (a) an asynchronous onboarding program; (b) a didactic curriculum, implemented via monthly core skill development seminars led by experts in digital mental health practice; and (c) ongoing weekly supervision by licensed supervisors. The eClinic training approach described is a work in progress, and we expect to adjust it to follow the evolution of digital tools for mental health assessment and treatment. Public Significance Statement: The present article suggests that, despite the fact that digital mental health interventions are playing an increasingly important part in clinical mental health practice, few mental health providers have received any kind of formal training related to digital therapeutics. It argues that the training of psychologists and other mental health professionals should routinely include the development of knowledge and skills related to the delivery of digital interventions and gives an example of the design of a training program. [ABSTRACT FROM AUTHOR]

Objective: The causal effect of successive population-wide lockdowns in response to increased COVID-19 cases on mental health has yet to be examined using robust methods. A natural experiment design underpinned by objective data can improve our understanding surrounding the definitive impact of social distancing restrictions. Methods: The study employed a natural experiment design underpinned by objective data. Health service cost for visits to general practitioners and psychologists and medication dispensing costs served as objective measures of mental health. Difference-in-difference (DID) estimators, which in this study quantify differences in spending changes between groups over time, were produced based on three comparisons: Victoria 2020 lockdown comparison, Victoria 2021 lockdown comparison, and New South Wales (NSW) 2021 lockdown comparison. Specifically, differences in public health service spending during lockdown periods and the same timeframe in 2019 for Victoria and NSW, and control groups (remaining states and territories), were compared. Results: Positive estimator values indicate that public health service spending for Victoria and NSW increased more during lockdown periods compared to control states and territories. The Victorian lockdowns of 2020 and 2021, but not the NSW lockdown of 2021, resulted in increased public spending for general practitioner mental health consults (2020 DID estimator: $8498.96 [95% CI $4012.84, $12,373.57], 2021 DID estimator: $6630.06 [95% CI $41.27, $13,267.20], all monetary values in AUD$) and short visits to psychologists (2020 DID estimator: $628.82 [95% CI $466.25, $796.00], 2021 DID estimator: $230.11 [95% CI $47.52, $373.98]). The first Victorian lockdown in 2020 and the NSW lockdown in 2021 resulted in greater spending on short visits to clinical psychologists. Spending on long visits to psychologists and clinical psychologists and medication spending did not change. Conclusions: Strict lockdowns can have an adverse impact on population mental health. The impact is particularly evident in those who have a history of previous mental health concerns but does not necessitate extra use of medications, suggesting that psychological care can address the adverse impact of the lockdowns. What is known about the topic? Previous research varied in methodology, using self-reports and healthcare data to understand COVID-19 social distancing public health measures' effects on mental health. What does this paper add? This study introduces robust, objective data via a natural experiment design, examining the impact of successive lockdowns on mental health service usage and medication expenditures in specific Australian regions. What are the implications for practitioners? Findings highlight the need for flexible mental health services that can swiftly respond to increased demands during prolonged restrictions, without necessarily increasing medication use, guiding future policy and resource allocation. [ABSTRACT FROM AUTHOR]

This interpretive phenomenological analysis explored psychologists' experiences delivering mental health treatment requirements which seek to address offenders' mental health and criminal needs. Three superordinate themes were constructed. "Client placed at the centre of the individualized intervention approach" explored how an individual, non-prescriptive approach was taken. "Embedded therapeutic working relationship" relates to how therapeutic relationships and skills were central to delivery. "Barriers that impede or threaten engagement" included feeling forced to attend, situational/behavioral factors and previous negative experiences with intervention providers. Findings highlight that using formulation, taking an individualized approach, and a strong therapeutic/working relationship promotes engagement, enabling positive behavior change. [ABSTRACT FROM AUTHOR]

A recent American Psychological Association Summit provided an urgent call to transform psychological science and practice away from a solely individual-level focus to become accountable for population-level impact on health and mental health. A population focus ensures the mental health of all children, adolescents, and adults and the elimination of inequities across groups. Science must guide three components of this transformation. First, effective individual-level interventions must be scaled up to the population level using principles from implementation science, investing in novel intervention delivery systems (e.g., online, mobile application, text, interactive voice response, and machine learning-based), harnessing the strength of diverse providers, and forging culturally informed adaptations. Second, policy-driven community-level interventions must be innovated and tested, such as public efforts to promote physical activity, public policies to support families in early life, and regulation of corporal punishment in schools. Third, transformation is needed to create a new system of universal primary care for mental health, based on models such as Family Connects, Triple P, PROmoting School-community-university Partnerships to Enhance Resilience, Communities That Care, and the Early Childhood Collaborative of the Pittsburgh Study. This new system must incorporate valid measurement, universal screening, and a community-based infrastructure for service delivery. Addressing tasks ahead, including scientific creativity and discovery, rigorous evaluation, and community accountability, will lead to a comprehensive strategic plan to shape the emergent field of public mental health. Public Significance Statement: On February 25, 2022, the American Psychological Association's Council of Representatives adopted a resolution to support population health, which led to the Population Health Science Summit held on September 12–13, 2023. This article summarizes key points from the Summit. [ABSTRACT FROM AUTHOR]

Adventure therapy (AT) settings are diverse and range from school and community settings to outdoor wilderness and bush settings. However, due to the complex and diverse nature of AT, the specific practices associated with the facilitation of AT can be unclear and have been referred to as the black box. To shine light into at least one corner of the black box and understand the practices of AT facilitators, the current study explored the intentional facilitative practices of AT facilitators (i.e., social workers, psychologists, counselors, educators). These processes include: (1) Assess Point A (e.g., client history and current individual/group functioning), environmental conditions, and Point B (i.e., therapeutic goals); (2) Match interventions with the assessment of client and group needs; (3) Shape environmental conditions; (4) Facilitate the experience; and (5) Evaluate the process. Findings provide guidance for human service providers, such as social workers, as they seek to service the diverse needs of youth clients. [ABSTRACT FROM AUTHOR]

This study aimed to explore healthcare professionals' attribution of meaning to the concept of addiction, treatment and recovery. The study was conducted through semi‐structured interviews with 18 healthcare professionals in the field of addiction: nine nurses, six psychologists, a psychiatrist, a social worker and a psychosocial technician. Based on a qualitative methodology, a thematic analysis was performed using the NVivo software. Regarding professional stress, the results revealed several stress factors related to the intervention (e.g. strategic powerlessness and uncertainty of intervention's effectiveness), the addicted individuals (e.g. motivation, difficulties in adhering to treatment, patient behaviour, negative patient emotionality and lack of socio‐economic resources) as well as the healthcare services (e.g. team stress). Adaptive coping strategies were reported, both used in the work context (e.g. cognitive coping strategies and acceptance) and in personal life (e.g. work‐family boundaries and family support and closeness). Despite the professional stress experienced, the participants' narratives indicated positive transformations of the self, which suggests resilient professional trajectories. [ABSTRACT FROM AUTHOR]

Community-based participatory action research can facilitate counseling psychologists' engagement in social justice to benefit Black people's mental health. One way to improve Black mental health is to equip credible and trustworthy community members with mental health knowledge and skills to support other community members experiencing mental health challenges. This study presents the Neighborhood Healers Project—a community-based participatory action research project that trains Black adults (Neighborhood Healers Fellows) in Mental Health First Aid (MHFA). During the inaugural 12-month fellowship year, we collected longitudinal qualitative data from N = 20 Fellows on the relevance of MHFA to Black people. In this paper, we examined their responses using reflexive thematic analysis. Findings included two themes with affiliated subthemes: (a) Liberatory Paradigm Shift and (b) For Us By Us: Culturally Relevant Curriculum. We conclude with implications for counseling psychologists. [ABSTRACT FROM AUTHOR]

Introduction. Mental health has historically been overlooked in public policies in Mexico, with up to 80% of people with mental health and substance-related disorders in Mexico lacking adequate care. Objective. To characterize the mental health provider (psychiatrists and psychologists) shortage in the Mexican public sector. Method. Descriptive study. Data from SINERHIAS (Ministry of Health of Mexico) up to the first half of 2023 were analyzed. Results. A total of 1,504 psychiatrists worked in the public sector (1.1 per 100,000 population). The Health Ministry (Secretaría de Salud; Spanish acronym SS) employed 55.9%, IMSS 25.9%, ISSSTE 7.2%, while 1.0% were affiliated to other public institutions. There were 8,668 psychologists in the public sector (6.9 per 100,000 population), of which the SS employed 78.9%, IMSS 6.3%, ISSSTE 2.4%, while 12.3% worked at other public institutions. Thirty-four per cent of psychiatrists were in Mexico City, while 21 states, accounting for 70% of the population, had one psychiatrist or fewer per 100,000 population. Hospital units employed 83.3% of psychiatrists. Discussion. Mexico has an insufficient number of mental health providers at public institutions, with disparities between states and most providers affiliated to hospital units. Conclusion. There is an acute mental health provider shortage in the Mexican public sector, together with limited resources for community mental health care, affecting the treatment of mental health and substance use disorders. [ABSTRACT FROM AUTHOR]

The rapid advancement of technology has changed how mental health treatment is provided and has quickly become an important approach for treating clients. Despite extensive literature demonstrating the benefits of telemental health, Brazil has been a country that has been slow to adopt this modality, with very little research or work having been done in that arena prior to COVID-19. In fact, Brazil was one of the few countries that had legislation controlling the use of telemental health for psychological treatment. With the global pandemic, Brazilian psychologists were forced to adopt this modality, with little if any training, and little if anything is known about their experiences in effectively utilizing this modality to meet the needs of their clients. The purpose of this qualitative study was to explore more in-depth psychologists' experience of providing telemental health services during the COVID-19 pandemic. Five main themes were identified, including 1) Developing Therapeutic Relationships, 2) Setting, 3) Provider Online Bias, 4) Provider's Positive Experiences and 5) Skills Providers Need to Develop, Finally, clinical implications and future research is discussed. [ABSTRACT FROM AUTHOR]

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A designated psychologist in the Neonatal Intensive Care Unit (NICU) may seem like an obvious choice, given psychologists' expertise in trauma, attachment, neurodevelopment, mental health, and grief; however, few NICUs have a psychologist on staff. As National Network of NICU Psychologists members, we hope to increase access to psychology services as a routine part of care in NICUs. US News and World Reports (USNWR) ranks NICUs annually on multiple criteria, including having a "designated psychologist or psychiatrist" for consultations with families. We evaluated the psychology services provided by several NICUs of hospitals ranked in the top 50 by USNWR between 2015 and 2019. Many of these respondents had a designated NICU psychologist at varying capacities across the division of Neonatology. This indication should motivate other NICUs to hire a NICU psychologist as the standard of care for families and increase their overall USNWR score. [ABSTRACT FROM AUTHOR]

Objective: Post-stroke mental health impairments are common, but under-assessed and under-treated. We aim to describe trends in the provision of mood management to patients with stroke, and describe factors associated with adoption of national mood management recommendations for stroke within Australian hospitals. Design: Secondary analysis of cross-sectional data from the biennial Stroke Foundation Audit Program. Setting: Participating acute (2011–2021) and rehabilitation hospitals (2012–2020) in Australia. Participants: In the acute audit, 22,937 stroke cases were included from 133 hospitals. In the rehabilitation audit, 15,891 stroke cases were included from 127 hospitals. Main measures: Hospital- and patient-level mood management processes. Results: Among 133 acute hospitals (22,937 stroke episodes), improvements were made between 2011 and 2021 in utilization of mood screening (17% [2011], 33% [2021]; p < 0.001) and access to psychologists during hospital stay (18% [2011], 45% [2021]; p < 0.001). There was no change in access to a psychologist among those with a mood impairment (p = 0.34). Among 127 rehabilitation hospitals (15,891 stroke episodes) improvements were observed for mood screening (35% [2012], 61% [2020]; p < 0.001), and access to a psychologist during hospital stay (38% [2012], 68% [2020]; p < 0.001) and among those with a mood-impairment (30% [2012], 50% [2020]; p < 0.001). Factors associated with receiving mood management processes included: younger age, not requiring an interpreter and longer length of stay. Conclusions: Adherence to mood management recommendations has improved over 10 years within Australian hospitals. Those aged over 65, requiring an interpreter, or with shorter hospital stays are at risk of missing out on appropriate mood management. [ABSTRACT FROM AUTHOR]

Background: Psychologists are at known risk of work-related stress, secondary trauma, and burnout. The COVID-19 pandemic increased stress and anxiety for communities worldwide and corresponded with an increased demand for mental health services. Our study investigated the impact of COVID-19 on psychologists' professional quality of life, psychological symptoms, and workrelated stress in Aotearoa, New Zealand (NZ). Method: Ninety-nine registered psychologists were recruited via NZ professional psychology organizations, representing 3% of the total workforce. Survey data collected included symptoms of compassion fatigue and satisfaction, psychological symptoms, COVID-19-related stress and resilience, and professional and personal circumstances during the third year of the pandemic, 2022. Results: Seventy percent reported that their work stress had increased, and 60% reported that their caseload intensity had increased during the COVID-19 pandemic. Psychologists reported receiving little to no additional personal or professional support, while 55% reported increased personal responsibilities during the pandemic (for example, closed childcare and schools during lockdowns). High rates of compassion fatigue (burnout and secondary traumatic stress) and low resilience were reported. We observed that psychological distress was higher than the community averages before the pandemic and comparable with frontline healthcare professionals. Compassion fatigue was associated with COVID-related stress, psychological distress, years in practice, and more frequent supervision, but not with working with at-risk clients, levels of personal support, or having children at home. Despite these difficulties, high Compassion Satisfaction scores were also reported, with over 90% indicating they had no intention of leaving the profession in the foreseeable future. Conclusion: Psychologists' compassion fatigue appears to have worsened during the COVID-19 pandemic, as have their symptoms of psychological distress. Increased workplace and clinical demands, telehealth difficulties, stress relating to the pandemic, inadequate support, and increased personal responsibilities were reported by psychologists. Mental health workforces are not immune to the personal and professional impacts of crises and are at risk of burnout and secondary traumatic stress. We hope that increased awareness and understanding of psychologists' own difficulties during COVID-19 can be used to better tackle future crises and support mental health professionals. [ABSTRACT FROM AUTHOR]

Background and objective: Even though children with complex problems frequently need psychosocial care, two thirds does not receive treatment. Various barriers, particularly expectations of barriers, can hinder effective access of care. Our aim was to assess the practical barriers expected by parents, and the child, family and need factors associated with these expected barriers. Methods: We sent web‐based questionnaires to parents of a random sample of children known to have or be at risk of having complex problems (response = 77%). We used backward regression analyses to examine which factors were associated with expected barriers for children using psychosocial care, or no care at all. Results: Seventy‐three percent of all parents expected practical barriers. Parents of children using psychosocial care expected more barriers than when using no care at all. For children who used no care, parents of girls expected more barriers (regression coefficient 0.54; 95%—confidence interval 0.16, 0.92) as did families having less social support (−0.30; −0.50, −0.11). When children used psychosocial care, parents expected more barriers when their child was of school‐age (0.38; 0.01, 0.75), of non‐western origin (vs. native) (0.52; 0.17, 0.88), when parents were older (i.e., 36+ years) (−0.77; −1.12, −0.42), experienced more adverse life events (0.29; 0.13, 0.45) or had less social support (−0.17; −0.34, 0.00). Conclusion: Even when their child is already receiving treatment, parents continue to expect practical barriers to psychosocial care. Psychosocial care services and their gatekeepers should address these concerns. Access to psychosocial care can be improved by removing practical barriers, especially if children already receive psychosocial care, or when parents have a limited network or belong to an ethnic minority. [ABSTRACT FROM AUTHOR]

Research has shown that barriers and facilitators in psychotherapy exhibit similarities. The authors of this study are of the view that to effectively address the difficulties encountered in psychotherapy for children and adolescents, it is crucial to consider the points of view of professionals who have firsthand encounters with children. The purpose of this study was to effectively explore barriers and facilitators in the treatment of children exposed to trauma and violence. Exploratory and descriptive methods, as components of a qualitative research design, were employed to investigate and articulate the barriers and facilitators involved in managing childhood trauma. An advertisement was used to recruit participants. It was developed and distributed to psychologists and social workers recommended by the Thohoyandou Victim Empowerment Programme. Seventeen professionals were individually interviewed using semi-structured interview schedules. The interviews were recorded, transcribed verbatim, and analysed using interpretative phenomenological analysis (IPA). The findings of the study indicated a lack of commitment from parents in honouring appointments, financial challenges, a fear of perpetrators associated with the poor reporting of incidences, professional boundaries, and referral route challenges. Familiar facilitators in the management of childhood trauma included continuous training and workshops for all people working with childhood trauma and violence, the employment of more victim advocates, and awareness campaigns. Additionally, the referral pathway for traumatised children presents logistical, psychological, and educational hurdles, underscoring the complex nature of meeting the needs of these vulnerable populations within the healthcare system. In conclusion, even while the currently available research supports the barriers and facilitators for this population, more investigation is required to examine how these factors affect treatment outcomes, particularly in community-based settings. [ABSTRACT FROM AUTHOR]

Purpose: Child and adolescent mental health services (CAMHS) has been described as "in crisis" and "not fit for purpose". CAMHS services have undergone a multitude of changes, including policy initiatives, recent growth in demand, decreases in resources and increased pressure. This study aims to explore the experiences of clinical psychologists (CPs) working in CAMHS, leaving CAMHS and working independently with children and families. Design/methodology/approach: A qualitative design with semi-structured interviews of ten participants was used. Interviews were analysed using interpretative phenomenological analysis. Findings: Results are represented within 5 themes and 14 sub-themes. Participants felt that over time there had been undesirable changes in CAMHS, which left them reminiscing about the past. Participants felt unable to do their job in CAMHS, meet the needs of children and young people and use their psychology skills. Participants emphasised the importance of colleagues and being part of an multidisciplinary team, which had been missed since working independently, but they also highlighted difficult relationships with managers. Participants felt that working at CAMHS had negatively impacted their emotional and physical well-being and their family life. In contrast, participants felt that working independently meant they could do the job they had wanted to be doing as a CP and had a better work–life balance. Originality/value: This study had implications for services, where it would be beneficial for the experiences of CPs to be considered in relation to current practice with the view of improving the experiences of staff. Future research would benefit from exploring the experiences of CAMHS staff further. [ABSTRACT FROM AUTHOR]

Measurement-based care (MBC) is a procedure in which systematic and routine assessments are performed. Through this practice, clinicians can verify the progress of the symptomatology of the patient and adapt the appointments and the intervention to the current symptoms. Studies have reflected on the importance and the benefits of this type of procedure in the adult population, and have shown positive results. However, there is a lack of evidence concerning the remaining populations. Regarding youth, for instance, few articles have evaluated the benefits of using this procedure in clinical practice. However, research focused on this topic has revealed positive results, especially when clinicians were loyal to the MBC procedures. Still, further research is needed. This letter aims to share the methodology used by our multidisciplinary team, composed of psychologists and psychiatrists, in a clinical context at the Hospital Cruz Vermelha, Lisboa, applied to the adult population; the objective is to share and discuss some alterations that could be made to our evaluation protocol to enable the same to be used with the youth population. We believe that implementing MBC for youth is crucial for several reasons, including enhanced treatment efficacy, more personalized treatment, a reduced reliance on subjectivity, and empowerment not only of patients but also families. [ABSTRACT FROM AUTHOR]

The Community Mental Health Transformation in England has introduced a range of opportunities for clinical psychologists. Whilst the focus to increase delivery of evidence based psychological therapies requires associated expertise to deliver, train and supervise these therapies, the opportunities go beyond therapy. Genuine transformation relies on local systems moving away from a bio-medically dominated approach to mental health service delivery, to provision underpinned by a more nuanced bio-psychosocial understanding of wellbeing and personal recovery. Clinical psychologists are ideally placed to support teams and services to offer true personalised care: offering expert advice to ensure care and support is formulation based and acknowledges the individual, systemic and structural elements that contribute to mental distress. Ultimately, the cultural change required to achieve the transformation described within national policy is dependent on leadership from those with appropriate expert knowledge and understanding of mental distress. Clinical psychologists should have these competences and can offer this leadership. [ABSTRACT FROM AUTHOR]

With an ever-diversifying population and society, intercultural dynamics has been a topic of interest for many years. This is especially true within the mental health profession, as the effects of clinician bias and behaviors on client outcomes have been studied and documented many times over. However, often times these studies focus on the White clinician and client of color dynamic, with focus on the White clinician's way of being or competency and the resulting perceptions of the client of color. The opposite dynamic, that of a clinician of color with a White client, has often been overlooked and ignored. Yet, with more clinicians of color (COCs) entering the field, and with demand of mental health services increasing, this unique dynamic needs to be understood. The experiences of COCs when they are the "other" within the room is unique and not well-documented. A scoping review of the literature is conducted to examine what research has been conducted on COCs working with White clients. A total of four articles were included in the final review, and the types of research being conducted, risks of micro- and macroaggressions, the different strategies utilized, and the unique needs of COCs are analyzed and summarized. This study adds to this budding conversation by examining the extant literature on COC's experiences. Results of the limited literature and hopeful future directions are discussed, including a discussion on cultural humility as a critical factor in individual and systemic change. Public Significance Statement: This scoping review on the experiences of clinicians of color (COCs) working with White clients suggests that COCs not only have a different professional experience than their White colleagues but also lack the proper training and support to address client-led microaggressions and negative experiences. More nuanced understanding of the unique experiences of COCs is imperative to guide systemic change for the field. [ABSTRACT FROM AUTHOR]

The goal of this study was to explore preferences regarding the Mobile Application to Prevent Suicide (MAPS), an ecological momentary intervention smartphone app. We conducted individual interviews with 10 adults hospitalized for suicidal ideation or behavior. In these interviews, we asked about participants' preferences associated with smartphone apps for suicide prevention in general and requested feedback on the specific features of the MAPS intervention. We used line-by-line inductive coding to create a codebook and identify where codes were most prominently displayed. Participants expressed interest in personalized, targeted approaches to suicide prevention, psychoeducation, access to coping strategies, and direct access to crisis services. Involving individuals with lived experience in the early stages is an essential step in the development of a smartphone app for suicide prevention. [ABSTRACT FROM AUTHOR]

This study aimed to identify barriers and facilitators to engaging with online interventions among 24 ethnoracially diverse college students self-identifying as being at risk for suicide. Thematic analysis was used to identify codes from focus groups. Participants shared mixed perceptions about online intervention use and effectiveness. Regarding barriers, they mentioned lack of motivation/self-discipline, artificiality, and lack of perceived need. Participants reported promotional information, incentives, and normalizing peer usage to facilitate uptake. Lastly, they mentioned program design, human coaching, and reminders to increase retention. These insights inform future research aimed at developing online intervention engagement models to increase uptake and retention. [ABSTRACT FROM AUTHOR]

Underutilization of mental health services is common and associated with substantial suffering, mental disorders and death. The present study aimed to explore factors significantly affecting the professional psychological help-seeking behavior based on the Theory of Planned Behavior (TPB). A sample of 597 Chinese college students recruited online completed the questionnaires, which measured four constructs of TPB including help-seeking intention, attitude, subjective norm and perceived behavioral control in December 2020. Help-seeking behaviors were evaluated three months later in March 2021. A two-step structural equation modeling procedure was used to test the TPB model. Findings show that partially consistent with TPB, more positive attitudes about seeking professional help (Β =.258, p =.001) and higher perceived behavioral control (Β =.504, p <.001) directly predicted higher intention to seek mental health services, and perceived behavioral control (Β =.230, p =.006) directly predicted help-seeking behavior. However, behavioral intention (Β = −.017, p =.830) did not statistically significantly predict help-seeking behavior, while subjective norm (Β =.047, p =.356) did not predict help-seeking intention as well. The model accounted for 49.9% of the variance modeling help-seeking intention and 12.4% of the variance modeling help-seeking behavior. The results revealed the importance of attitude and perceived behavioral control in predicting help-seeking intention and behavior among Chinese college students and indicated that there existed a gap between intention and actual help-seeking behavior. [ABSTRACT FROM AUTHOR]

Quel est le sujet de la psychiatrie ? Professionnelles du service de psychiatrie de l'hôpital d'instruction des armées Sainte-Anne à Toulon, nous avons eu l'idée de formuler une première réflexion à trois, entre psychomotricienne, psychologue et psychiatre, autour du soin en psychiatrie, en supportant les nuances voire les divergences de nos pratiques. Notre présent travail ne prétend pas mener à une pensée univoque ; il s'impose d'une volonté de soutenir la nécessité d'une continuité des soins, du travail en commun, du décloisonnement des différents espaces où est entendu le sujet, devant la discontinuité qui touche aujourd'hui la psychiatrie en France. Notre fil rouge sera le transfert comme instrument nécessaire pour que puisse se produire dans la rencontre une parole inédite. What is psychiatry about? As professionals in the Department of Psychiatry of the Sainte-Anne Army Hospital in Toulon, we decided to formulate an initial three-way discussion between psycho-motor specialists, psychologists and psychiatrists on the subject of psychiatric care, bearing in mind the nuances and even the divergences in our practices. Our current work does not claim to lead to unequivocal thinking; it is based on a desire to support the need for continuity of care, for working together, and for decompartmentalizing the different areas where the subject of psychiatry is relevant, especially in light of the discontinuity that is present in the practice of psychiatry in France today. Our common thread will be transference as a necessary element so that this encounter can develop an unprecedented form of expression. [ABSTRACT FROM AUTHOR]

Background: Team case formulation is recommended clinical practice for managing patients' challenging behaviour in acute psychiatric settings. There are limited standardised protocols for case formulation and research lacks insights from facilitators. This predominantly qualitative study aimed to explore facilitators' experience of team case formulation in acute psychiatric settings to understand this practice and inform future approaches. Methodology: Clinicians with experience of facilitating team case formulation were recruited. Quantitative data was collected using visual analogue scales. Qualitative data was collected through in-depth semi-structured interviews and analysed using thematic analysis. Results: Participants were ten clinical psychologists. Findings highlighted benefits of team case formulation, including increasing staff understanding of patients' challenging behaviour and support for staff. Participants reported that a variety of models and approaches are used, which provide different ways of understanding complex presentations and challenging behaviour. Challenges to delivering case formulation included disruptions to sessions, unclear roles and expectations, and limited attendance, preparation time, and patient involvement. Challenges with dissemination and follow-ups to case formulation included lack of communication and agreement amongst staff and difficulties putting intervention plans into practice due to lack of resources. Conclusion: Team case formulation has benefits for staff and patients. While case formulation appears to enhance psychological-mindedness of staff, promote a person-centred approach, improve ward-culture, and reduce patients' challenging behaviours, there is a need to increase resources, consistency in approaches, collaboration between staff, and evaluation of outcomes. Findings from this study have the potential to inform frameworks for team case formulation. [ABSTRACT FROM AUTHOR]

Background: Since its emergence, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused severe health, social and economic challenges. Mental healthcare has been significantly affected globally, and even worse in developing countries. An emerging economy like Ghana in West Africa was not spared its disruptive effects. This study aimed to elucidate the impact of the coronavirus disease 2019, the COVID-19 pandemic (caused by SARS-CoV-2), on Ghana's mental healthcare system. Methods: This is a mixed-method study using an emergent sequential exploratory design. A total of 15 front-line healthcare professionals were recruited from the three psychiatric hospitals, including the mental health department of a new teaching hospital in Ghana. Purposive sampling techniques and a semi-structured interview approach were used for recruitment and data collection. Quantitative data from hospital registries were collected and analysed to triangulate qualitative findings. Results: Fifteen mental health workers were enrolled in the study. The mean age of participants was (34.47 ± 4.07) years, average work experience of (6.23 ± 3.64) years and the majority as males (60%). This study found an average decline of 23% in hospital attendance and a 35% decline in admissions in all four facilities compared to the previous year, 2019. The lived experiences shared by mental healthcare providers were grouped under 3 main themes: Adjustments to workplace regulations, accessibility to mental healthcare, and psychological wellbeing of mental healthcare workers. The fear of contracting SARS-CoV-2 among healthcare workers, medication shortages, and logistical challenges were also reported to affect Mental Health services during the pandemic. Conclusion: This study highlights the challenges in mental healthcare during the COVID-19 pandemic in Ghana. The experiences encountered present an opportunity to gain insights into future pandemic preparedness and establish a framework for optimal mental healthcare delivery in Ghana. [ABSTRACT FROM AUTHOR]

Background: An estimated 200 million Indians have mental health conditions -- a sizeable proportion of them requiring psychiatric rehabilitation services. The numbers of mental health professionals are abysmally low. Early psycho-social rehabilitation interventions can improve functional outcomes, reducing disability. Psycho-social interventions have been made possible with the shift away from medical and charity models of disability to the establishment of social protections for vulnerable groups. Materials and Methods: The authors have undertaken a narrative review of all the social protection measures that can be explained to persons affected by mental health conditions and their family members. A larger tabulation is provided as an appendix to this article that has details of all the social protection measures across the states and union territories of India. This tabulation can be useful as a one-stop reference for every mental health practitioner in India toward informing persons affected by mental health conditions and their family members about how recovery journeys can be advanced. The data have been compiled after extensive searches of official government websites, information brochures, and even relevant legal provisions. Conclusion: For almost all the social protection measures provided by the central or state government, a disability certificate is a prerequisite. Rehabilitation today is a collaborative process aimed at community re-integration. In the absence of specialized services like those of clinical psychologists, vocational trainers, and psychiatric social workers, the psychiatrist becomes the sole point of contact. Motivated community members, recovered services users, and family members can aid mental health professionals by disseminating this knowledge further. [ABSTRACT FROM AUTHOR]

Background: Mental health service providers are increasingly interested in patient perspectives. We examined rates and predictors of patient-reported satisfaction and perceived helpfulness in a cross-national general population survey of adults with 12-month DSM-IV disorders who saw a provider for help with their mental health. Methods: Data were obtained from epidemiological surveys in the World Mental Health Survey Initiative. Respondents were asked about satisfaction with treatments received from up to 11 different types of providers (very satisfied, satisfied, neither satisfied nor dissatisfied, somewhat dissatisfied, very dissatisfied) and helpfulness of the provider (a lot, some, a little, not at all). We modelled predictors of satisfaction and helpfulness using a dataset of patient-provider observations (n = 5,248). Results: Most treatment was provided by general medical providers (37.4%), psychiatrists (18.4%) and psychologists (12.7%). Most patients were satisfied or very satisfied (65.9-87.5%, across provider) and helped a lot or some (64.4-90.3%). Spiritual advisors and healers were most often rated satisfactory and helpful. Social workers in human services settings were rated lowest on both dimensions. Patients also reported comparatively low satisfaction with general medical doctors and psychiatrists/psychologists and found general medical doctors less helpful than other providers. Men and students reported lower levels of satisfaction than women and nonstudents. Respondents with high education reported higher satisfaction and helpfulness than those with lower education. Type of mental disorder was unrelated to satisfaction but in some cases (depression, bipolar spectrum disorder, social phobia) was associated with low perceived helpfulness. Insurance was unrelated to either satisfaction or perceived helpfulness but in some cases was associated with elevated perceived helpfulness for a given level of satisfaction. Conclusions: Satisfaction with and perceived helpfulness of treatment varied as a function of type of provider, service setting, mental status, and socio-demographic variables. Invariably, caution is needed in combining data from multiple countries where there are cultural and service delivery variations. Even so, our findings underscore the utility of patient perspectives in treatment evaluation and may also be relevant in efforts to match patients to treatments. [ABSTRACT FROM AUTHOR]

Aim: School attendance problems (SAPs) are a concern across education systems worldwide. SAPs are disproportionally experienced by certain groups of children, in particular those with mental health difficulties. Existing literature has identified myriad factors, including those proximal and distal, that influence attendance for these children. Most studies to date have focused on linear relationships between a small number of variables and fail to differentiate between types of SAPs (Heyne et al., 2019). A broader understanding of the complex context of school attendance problems remains understudied and is the focus of the current study. Method: Using a qualitative design, we explored a) the SAP typologies and b) the individual characteristics and education-related needs associated with the school attendance problems of 15 children receiving mental health services at a community clinic. Findings: Analyses of client files indicated that a) emotionally based school avoidance was the most common typology, b) approximately half the sample experienced one type of attendance problem while half experienced multiple types, c) anxiety was experienced by all children, and d) emotional, behavioural, social, and academic needs were noted in relation to SAPs over time. Our findings reflect the complex and varied profiles of students who share the experience of having significant school attendance problems. Limitations: Limitations of our study include potential bias introduced through the multi-step data extraction process, a reliance on the judgement of clinicians, and a lack of full access to data caused by Covid-19 restrictions. Conclusions: Future research and practice would benefit from a differentiated approach to understanding, preventing, and intervening to improve attendance and broad success for students with mental health difficulties. [ABSTRACT FROM AUTHOR]

Aims: School distress or school refusal is the most common reason autistic children miss school. Qualitative investigation of school distress and school refusal in autistic children is limited in the literature. This study aimed to identify school refusal behaviours in autistic children and explore parent experiences supporting their children. Method: Fifteen parents of school-aged autistic children completed semi-structured interviews. Directed content analysis was used to identify school refusal behaviours and inductive content analysis to explore impact on family systems. Findings: Parents reported a range of school refusal behaviours, many of which occurred before school or outside of school settings on days when their child attends school. This may mean many indicators of school refusal are missed by school attendance or behaviour data. Limitations: All participants were Australian and responded to an advertisement about autism and school refusal so had previously identified school refusal behaviours in their child. Conclusion: School refusal impacts upon the child, their attendance and their outcomes, but also upon family systems and supports. Implications of these findings for supporting autistic children, schools, and families are discussed. [ABSTRACT FROM AUTHOR]

The article focuses on psychologists' crucial role in promoting children's participation rights in decision-making, emphasizing the need for competence, critical awareness, and a rights-based approach. Topics include legal frameworks, key principles from the United Nations Conventions on the Rights of Persons with Disabilities and the Rights of the Child, and participation principles for psychologists, culminating in the Lundy Model as a rights-based approach to child participation.

The article focuses on the challenges encountered by early career psychologists in Ireland, as revealed by a survey conducted by CARE (CARE for Psychologists Ireland). Topics include financial struggles, exploitative practices, and systemic barriers, prompting responses from various PSI (Psychological Society of Ireland) groups that emphasize the need for changes to create a more supportive environment for these professionals.

University and college counseling centers (UCCCs) are a front-line support for the mental health needs of autistic students, though little is known about clinician attitudes, comfort level, and training in autism. 89 UCCC clinicians were recruited via email listservs. The authors developed a survey which assessed attitudes, comfort level, and training in autism. The majority of clinicians (82.0%, n = 73) had interacted with autistic students in the past year, and reported high levels of comfort with treating anxiety and depression. However, a smaller number reported confidence in their ability to diagnose autism. Training on autism emerged as an important deficit, as 31.5% of the clinicians denied receiving training either in their educational program or the UCCC. In this pilot study, clinicians reported a discrepancy between self-reported levels of comfort with autistic college students and past training, highlighting continuing education as an important area for future intervention. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented practice and related professional practice issues. Design/methodology/approach: A qualitative hermeneutic phenomenological study was conducted from a social constructivist perspective. Semi-structured interviews with 17 psychologists were analysed using reflexive thematic analysis. Findings: Twenty-four themes were identified, which were clustered into four overarching themes. Participants viewed themselves and psychology in Ireland more broadly as peripheral to seclusion. They believed that seclusion possessed no inherent therapeutic value but viewed it as an uncomfortable and multi-faceted reality. Participants regarded seclusion and recovery as largely inconsistent and difficult to reconcile, and they perceived systemic factors, which had a pervasive negative impact on seclusion and recovery in practice. Practical implications: The findings highlight the perceived complexity of seclusion and its interface with recovery, and the need to conscientiously balance conflicting priorities that cannot be easily reconciled to ensure ethical practice. The findings suggest psychologists are well-suited to participate in local and national discussions on using seclusion in recovery-oriented practice. Originality/value: This study offers a unique insight into psychologists' perceptions of seclusion and considers the implications of these views. Participants' nuanced views suggest that psychologists can make valuable contributions to local and national discussions on these topics. [ABSTRACT FROM AUTHOR]

Il est régulièrement constaté qu'en France l'« expertise psychiatrique » et l'« expertise psychologique » des commettants en vue de leurs procès pénaux peuvent présenter deux écueils dans leur réalisation : le manque d'experts (experts psychiatres notamment) et de possibles contenus parfois erronés. Compte tenu des effectifs de psychiatres et de psychologues, ces deux appellations d'expertise pourraient être abandonnées au profit d'un concept unique d'« expertise mentale » réalisé indifféremment par des psychiatres ou par des psychologues sélectionnés comme étant bien formés, professionnellement expérimentés et compétents pour mener à bien ces missions. Ce décloisonnement avec la mise en place de quelques autres grands principes (création d'un consensus clinique et juridique de l'expertise mentale, obligation de formation harmonisée et actualisée des experts, prise en compte de l'expérience professionnelle des experts, temps passé et périodes opportunes pour réaliser les expertises, revalorisation des actes d'expertise, développement de la recherche sur l'expertise, création d'instance(s) de contrôle et de régulation des pratiques expertales) pourrait permettre de mettre à la disposition de la justice et des justiciables des effectifs augmentéss d'experts de qualité sur l'ensemble du territoire national. It is regularly observed that in France "psychiatric expertise" and "psychological expertise" for criminal trials can present two pitfalls in their implementation: the lack of experts (psychiatrists experts in particular) and possible content that is sometimes erroneous. Given the number of psychiatrists and psychologists, these two terms of expertise could be abandoned in favor of a single concept of "mental expertise" carried out indifferently by psychiatrists or by psychologists selected as being well trained, professionally experienced and competent to carry out these missions. This decompartmentalization with the establishment of some other major principles (creation of a clinical and legal consensus of mental expertise, obligation of harmonized and updated training of experts, taking into account the professional experience of experts, time spent and appropriate periods for carrying out expert assessments, revaluation of expert acts, development of research on expertise, creation of body(ies) for the control and regulation of expert practices) could make it possible to make available to justice and litigants with sufficient numbers of quality experts throughout the national territory. [ABSTRACT FROM AUTHOR]

Objective: The National Mental Health Services (N-MHSs) in Iran was integrated with Primary Health Care (PHC) in 1988. This study aimeds to analyze the policy of integrating N-MHSs in PHC, focusing on the analysis of the current situation, pathology, and the existing challenge. Method: This qualitative research was conducted in 2020 using a case study approach. This study used the policy triangle model to analyze the policy. The required data were collected via interviews, literature review, and document analysis. The interviews were conducted with 23 experts, stakeholders across the country who were selected through purposive sampling, and the data were analyzed using the content-analysis method. Results: The main goals of this policy were to raise mental health literacy among the people and eliminate its stigma in the society, while implementing the referral system for N-MHSs. Twenty weaknesses were extracted in eight areas, including negative views of mental health, weaknesses in human resource training, compensation for the service of psychologists, unfavorable working conditions of the workforce, inappropriate service delivery facilities, lack of meaningful communication between different levels of service delivery, poor inter-sectorial communication, and the challenging nature of mental health care. De-stigmatizing psychological disorders in the society and identifying hidden patients are some of the most significant achievements of this policy. Conclusion: Despite the successful implementation and significant achievements in integrating N-MHSs in PHC, the results of the present study indicate that there are many challenges in this field that require serious planning and attention from relevant authorities. [ABSTRACT FROM AUTHOR]

Background: In many countries, health care professionals are legally obliged to share information from electronic health records with patients. However, concerns have been raised regarding the sharing of notes with adolescents in mental health care, and health care professionals have called for recommendations to guide this practice. Objective: The aim was to reach a consensus among authors of scientific papers on recommendations for health care professionals' digital sharing of notes with adolescents in mental health care and to investigate whether staff at child and adolescent specialist mental health care clinics agreed with the recommendations. Methods: A Delphi study was conducted with authors of scientific papers to reach a consensus on recommendations. The process of making the recommendations involved three steps. First, scientific papers meeting the eligibility criteria were identified through a PubMed search where the references were screened. Second, the results from the included papers were coded and transformed into recommendations in an iterative process. Third, the authors of the included papers were asked to provide feedback and consider their agreement with each of the suggested recommendations in two rounds. After the Delphi process, a cross-sectional study was conducted among staff at specialist child and adolescent mental health care clinics to assess whether they agreed with the recommendations that reached a consensus. Results: Of the 84 invited authors, 27 responded. A consensus was reached on 17 recommendations on areas related to digital sharing of notes with adolescents in mental health care. The recommendations considered how to introduce digital access to notes, write notes, and support health care professionals, and when to withhold notes. Of the 41 staff members at child and adolescent specialist mental health care clinics, 60% or more agreed with the 17 recommendations. No consensus was reached regarding the age at which adolescents should receive digital access to their notes and the timing of digitally sharing notes with parents. Conclusions: A total of 17 recommendations related to key aspects of health care professionals' digital sharing of notes with adolescents in mental health care achieved consensus. Health care professionals can use these recommendations to guide their practice of sharing notes with adolescents in mental health care. However, the effects and experiences of following these recommendations should be tested in clinical practice. [ABSTRACT FROM AUTHOR]

The concept of schizophrenia has been contested since its inception. Over the last decades, criticism of the concept has become increasingly mainstream and calls for its abandonment have intensified. Nevertheless, the concept remains widely used and retains taken-for-granted status within much mental health research and practice. The combination of its contested status and continued use raises questions about how it is used and with what implications for people who receive the diagnosis. This study explores how 'schizophrenia' is spoken about by mental health professionals who use the diagnosis in day-to-day practice. Eight interviews with professionals across professions were analysed using Foucauldian Discourse Analysis. Two striking and consistent themes were identified. The first is a discrepancy between the way participants talked about 'schizophrenia' to the interviewer, and the way they described talking about it in clinical encounters. The second is the potentially entrapping impact of the wider discourses participants drew on in talk about clinical encounters. The study concludes with reflections on how those working in the mental health field can break out of this discursive entrapment, and help the people they work with do the same. [ABSTRACT FROM AUTHOR]

Health inequities have persisted in scientific examination and subsequent efforts related to prevention, detection, and, particularly, treatment of mental health disorders and symptoms over most of the history of our field. In the past decade, the tide has been slowly turning to make the promotion of mental health care equity across all segments of the population more mainstream, and the momentum to do so has further accelerated in the past 5 years. This review provides a brief summary of what we currently know about mental health care inequities (across a range of identity markers), and a brief discussion about what the role of social justice and advocacy has been and can continue to be in the field of clinical science. Following this, several specific areas of scholarship are reviewed in terms of their contributions to promoting mental health care equity, namely: community-based research and community-driven mental health treatment adaptations, task-shifting efforts in domestic and global settings, utilization of technology innovations to promote such work and increase access, and policy efforts stemming from such work. The review ends off with a commentary on lessons learned and potential future directions for the field. Taken together, it is hoped that it will be clearer for clinical science scholars and trainees to grasp what role we can and should have as clinical psychologists in promoting mental health care equity in the communities we serve and in society at large. [ABSTRACT FROM AUTHOR]

Background: Providers who work within addiction and mental health (A&MH) services in New Brunswick (NB), Canada completed training in Stepped Care 2.0 and One-at-a-Time (OAAT) therapy as part of a provincial practice change initiative to implement a provincial stepped care model. The present study aimed to identify: (1) the perceived acceptability and feasibility of the SC2.0 model; (2) the perceived benefits, barriers, and facilitators to implement SC2.0 in practice; and (3) perceived impacts on clinical practice. Methods: This is a mixed-methods observational implementation study. Quantitative surveys were completed after training courses. Open-ended responses were collected after completion of SC2.0 training. A subset of providers who completed surveys were asked to participate in semi-structured interviews. Descriptive statistics were used to describe results from surveys. Open-ended responses and semi-structured interviews were compiled and thematically synthesized in an iterative process using a grounded theory framework. Quantitative and qualitative data were triangulated to build an in-depth understanding of provider perceptions. Results: 316 providers completed surveys and responded to open-ended prompts. Interviews were completed with 28 of those providers. SC2.0 was deemed to be acceptable, a suitable fit, and feasible to implement. Perceived benefits included: (1) timely access to services; (2) increased practice efficiency; and (3) increased availability of services. Perceived barriers included: (1) insufficient availability of resources to populate a SC2.0 continuum of care; (2) provider complacency with their current practice; and (3) difficulty for clients to accept and adjust to change. Conclusions: Identifying the perceived benefits, facilitators, and barriers to adopting stepped care in practice can lead to targeted implementation strategies and the collection of data that can inform continuous improvement cycles. [ABSTRACT FROM AUTHOR]

Up to one third of adults who receive mental health services in Australia are parents. Psychologists in private practice are one of the largest groups within the Australian mental health workforce who support parents experiencing mental ill-health. Parents have specific support needs relating to their parenting role and "treatment as usual" may not address their integrated parenting and mental health concerns. The service experiences of parents in this setting have not been studied. This qualitative study addresses this knowledge gap through investigation of the experiences of Australian mothers who received support from a psychologist in private practice. Semi-structured interviews were conducted with 14 mothers and interviews were analysed using Interpretive Phenomenological Analysis. Three overarching themes were identified in relation to (i) participants' need to feel understood and heard as a parent, (ii) their need for a nonjudgmental therapeutic space and (iii) their desire for practical parental support from psychologists. These findings corroborate the value of family-focused practices when supporting parents with a mental health condition. The results include ways in which family-focused practices have been incorporated by clinicians in private practice settings which may have application in other mental health service contexts. What is already known about this topic: Psychologists in private practice make up a substantial group within the Australian mental health workforce who support parents with a mental health condition. Parents who receive mental health care in tertiary mental health settings report a lack of dedicated parenting support and resources. Family-focused practices are effective in supporting parenting and recovery for parents with a mental health condition who receive mental health care in tertiary mental health settings. What this paper adds: Psychologists who support parents in private practice should collaborate with their clients to identify which aspects of their parenting may be relevant to the therapeutic work and provide targeted support for parenting difficulties. Most participants expected that their psychologist would provide targeted support for parenting difficulties, and they felt disappointed when this did not occur. The lived experiences of parents with mental ill-health in private practice psychology services are highlighted, addressing a key knowledge gap in the literature. [ABSTRACT FROM AUTHOR]

Islamic dream epistemology and the Ullman's Experiential Dreamwork Group Approach: the dream... We employed autoethnography as a form of qualitative methodology to show the possible interrelationship between the UEDGA and an Islamic interpretation of dreams. Additionally, it is noteworthy to share that it is commonly believed that in the Islamic tradition, nightmares, or bad dreams, should not be shared with anyone, as dreams are believed to have a spiritual power, and sharing a bad dream may increase the likelihood of it turning into reality. The purpose of this article is to draw attention to, and exemplify, how a dialogue between the Islamic vision of dreams could be compared with those premises proposed by Montague Ullman. Final thoughts on Ysha's dream aftermath personal findings on both methods of dream analysis:... Islamic dream interpretations may seem foreign, unapproachable, and even irrelevant to the major concerns of Western-trained psychologists who study dreams. [Extracted from the article]

The aim of this study was to provide evidence of the acceptability of the primary care psychology services that have been enhanced by the employment of assistant psychologists in Ireland to the parents of children with psychological difficulties. Data were collected from a sample of 74 parents who responded to quantitative and qualitative questions on the experience of service questionnaire. Reflexive thematic analysis was used to analyse the questionnaire responses. On average 88% of participants selected 'certainly true' in response to the statements in the experience of service questionnaire statement they were 'Totally satisfied'. Three major themes were developed; 'communication is more than talking', 'structure can facilitate or impede', and 'emotional reactions'. 'Communication is more than talking' is organised around communication The 'structure can facilitate or impede' acknowledges that systems influence psychological supports. 'Emotional reactions' captured parents' experiences, such as joy, frustration, and solidarity. The results demonstrate that the newly enhanced mental health service is acceptable to parents. Their voices provide ideas about what helps and hinders their experience of care. [ABSTRACT FROM AUTHOR]