Search

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]

ABSTRACT Objective Method Results Discussion This study describes the current management of patients with eating disorders (EDs) served by publicly–funded Medicaid behavioral health systems.Behavioral health leaders across nine counties in California met on a quarterly basis to share experiences, challenges, and lessons in the management of EDs within publicly–funded service systems. Detailed notes were taken, and a qualitative content analysis was undertaken to identify key themes.County leadership noted insufficient outpatient capacity and difficulty building capacity for ED treatment, in addition to extraordinary challenges when facilitating admission to out‐of‐network higher level of care programs, at significant expense. Several challenges were identified in building an internal ED workforce, including the fact that many providers weren't eager to treat EDs due to training burden, patient complexity, and high levels of clinician burnout. When a higher level of care was required due to lack of outpatient resources or patient symptom severity or complexity, leaders dedicated significant resources to identify and contract with an appropriate program and secure the necessary funds.Our study supports the need for specialized ED treatment and case management, as well as standardized processes and centralized resources, in Medicaid‐managed care. Findings also indicate the importance of protecting against clinician burnout, possibly through reduced caseload expectations, financial incentives, or increased support. Future policy change could reduce administrative burden and clinician burnout by facilitating admission to and reimbursement for higher levels of care. [ABSTRACT FROM AUTHOR]

Background: Advance Choice Documents (ACDs) have been recommended for use in England and Wales based on evidence from trials that show that they can reduce involuntary hospitalisation, which disproportionately affects Black African and Caribbean people. Our aim was therefore to develop and test ACD implementation resources and processes for Black people who have previously been involuntarily hospitalised and the people that support them. Methods: Resource co-production workshops were held to inform the development of the ACD template and two types of training for all stakeholders, comprising a Recovery College course and simulation training. An ACD facilitator then used the ACD template developed through the workshops to create personalised ACDs with service users and mental health staff over a series of meetings. Interviews were then conducted with service user and staff participants and analysed to document their experience of the process and opinions on ACDs. Other implementation strategies were also employed alongside to support and optimise the creation of ACDs. Results: Nine ACDs were completed and were largely reported as appropriate, acceptable, and feasible to service users and staff. Both reported it being an empowering process that encouraged hope for better future treatment and therefore better wellbeing. Uncertainty was also expressed about the confidence people had that ACDs would be adhered to/honoured, primarily due to staff workload. The information provision training and the skills training were generally considered to be informative by trainees. Conclusions: The project has developed an ACD creation resource that was reported as agreeable to all stakeholders; however, the generalisability of the findings is limited due to the small sample size. The project also highlights the importance of staff and ACD facilitator capacity and good therapeutic relationships in ACD completion. Further research is needed to determine the adjustments needed for large scale use, including for those under age 18 and those under the care of forensic mental health services; and how to include carers/supporters more in the process. [ABSTRACT FROM AUTHOR]

Background: To identify risk factors for mental distress and investigate whether the factors were different between men and women during the coronavirus disease 2019 (COVID-19), using KOKOROBO data, which is an online platform that aims to facilitate access to mental health services. Methods: We used baseline data on KOKOROBO users 13 years of age or older in Japan who accessed it from October 11, 2021, to April 6, 2023, excluding those receiving treatment for mental health problems. Global severity, based on the most severe measure on Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI), was analyzed using multivariable logistic regression with baseline characteristics for each gender, and for under 30 and 30 years of age or older in women. We conducted the same analysis of suicidal ideation for each gender. Results: In the 686 men and 1274 women, 117 (17.1%) and 100 (7.8%) had minimal global severity respectively, and the rest suffered from mental distress to some extent. For women, ages under 30 years (adjusted OR (aOR): 0.352, 95%CI: 0.231–0.539, P < 0.001), marriage (aOR: 0.453, 95%CI: 0.274–0.746, P = 0.002), and concerns about COVID-19 infection were associated with global severity, while having children (aOR: 0.509, 95% CI: 0.284–0.909, P = 0.023) and decrease of going out during the COVID-19 pandemic had a protective effect on global severity and suicidal ideation for men, respectively. Living with family was a risk factor for mental distress in unmarried women over 30 years of age. Less communication with family or others and responding to the questionnaire late at night (00:00–05:59) were associated with severe global severity in both genders. Conclusions: Age, living arrangement, marriage, having children, concerns about COVID-19 infection, and lifestyle changes during the COVID-19 pandemic had gender-specific effects on mental distress, while frequent communication and regular life rhythm maintained mental health in both genders. Young women and, unmarried middle-aged women living with their families tended to experience mental distress during the COVID-19 pandemic. Trial registration: The Ethics Committee of the National Center of Neurology and Psychiatry approved this study (approval number B2020141) on April 15, 2021. [ABSTRACT FROM AUTHOR]

Background: Access to traditional mental health services in Canada remains limited, prompting exploration into digital alternatives. The Government of Ontario initiated access to two internet-based cognitive behavioral therapy (iCBT) programs, LifeWorks AbilitiCBT and MindBeacon TAiCBT, for adults with mental health issues. Methods: An uncontrolled observational study utilizing secondary retrospective program data was conducted to evaluate the reach, uptake, and psychological symptom changes among participants engaging with either iCBT program. Results: Between May 2020 and September 2021, 56,769 individuals enrolled in LifeWorks AbilitiCBT, and 73,356 in MindBeacon TAiCBT. However, substantial exclusions were made: 56% of LifeWorks participants and 68% of MindBeacon participants were ineligible or failed to initiate treatment. Consequently, 25,154 LifeWorks participants and 23,795 MindBeacon participants were included in the analysis. Of these, 22% of LifeWorks and 26% of MindBeacon participants completed over 75% of iCBT treatment. On average, LifeWorks participants received 13 ± SD 7.1 therapist messages and sent 5 ± SD 10.3 messages, while MindBeacon participants received 25 ± SD 20.7 therapist messages and sent 13 ± SD 16.4 messages. LifeWorks included synchronous therapist contact averaging 1.4 ± SD 1.9 h per participant, while MindBeacon was purely asynchronous. Baseline severity of anxiety (37%) and depression symptoms (22%) was higher for LifeWorks participants compared to MindBeacon participants (24% and 10%, respectively). Clinically significant changes in anxiety and depression scores were observed: 22% of LifeWorks and 31% of MindBeacon participants exhibited reliable recovery in PHQ-9 scores, while 26% of LifeWorks and 25% of MindBeacon participants demonstrated reliable recovery in GAD-7 scores. Conclusion: In conclusion, iCBT programs show promise for engaged participants with varying levels of severity in anxiety and depression symptoms. Future iterations of iCBT should consider adopting a broad entry criterion to iCBT programming to increase accessibility, especially for those with severe symptoms, alongside integrated intake care pathways, and potential payment structure adjustments for iCBT service providers. Taken all together, these factors could temper high dropout rates post-intake assessment. This evaluation underscores the potential and value of digital mental health interventions for individuals with mild to severe anxiety or depression symptoms, emphasizing the importance of addressing participant dropout. [ABSTRACT FROM AUTHOR]

Background: Poverty is a key social determinant of mental health among forcibly displaced persons. This study aimed to design and pilot test a strategy to integrate existing mental health and economic inclusion interventions for displaced families in Ecuador. Methods: We conducted a series of qualitative interviews (n = 30), focus groups (n = 6), and workshops (n = 3) to develop a set of strategies for integrating cross-cutting and focused mental health and psychosocial support (MHPSS) strategies into an existing economic inclusion program for displaced families in Quito. We non-randomly assigned two field offices in Quito to (1) integrate cross-cutting strategies focused on improving economic outcomes or (2) integrate both those cross-cutting strategies plus focused MHPSS strategies into an economic inclusion program. We measured site-level implementation outcomes (adoption, appropriateness, acceptability, feasibility, fidelity, reach, retention, usability) and participant-level psychosocial (wellbeing, depressive symptoms, anxiety symptoms, functioning) and economic inclusion outcomes (financial resources, diet diversity, social capital/networks, self-reliance) over six months. We conducted a mixed-methods analysis to explore the acceptability and feasibility of the integration strategies and the ability to evaluate their effects in a future cluster randomized trial. Results: We developed a toolkit that included 10 strategies for integrating MHPSS into economic inclusion interventions. Fifty displaced persons participating in an existing economic inclusion program (25 per study condition) were enrolled and 88% remained in the study through the six-month follow-up. Participants and implementers reported that the integration strategy was appropriate, acceptable, feasible, and usable. Implementers, including people without prior experience in delivering mental health services, were able to deliver the intervention with high fidelity. Integration of focused MHPSS intervention components into an economic inclusion program appeared to improve MHPSS outcomes, the strength of social capital and networks, and engagement in economic and other programs. Conclusions: This study provides preliminary evidence of the acceptability and feasibility of integrating MHPSS into economic inclusion programs for displaced people. We found evidence supporting evaluation methods that can be employed in a future study to definitively test the added value of integrated approaches to mental health and economic wellbeing for displaced persons. [ABSTRACT FROM AUTHOR]

Background: The purpose of the study was to assess the prevalence and associated factors of major depressive disorder (MDD), generalized anxiety disorder (GAD), and past 12-month suicidal behaviour (PSB) among adolescents in Mozambique. Methods: Data from 3,109 females (aged 15–19 years) and 1,439 males (aged 15–19 years) that participated in the 2022-23 Mozambique Demographic and health Survey were analysed. MDD was assessed with the PHQ-9 and GAD with the GAD-7. Results: Results indicate that among girls the prevalence of PSB was 4.3% (attempt 1.0%, plan 1.9% and/or ideation 3.6%) and among boys 2.5% (attempt 0.3%, plan 0.7% and/or ideation 2.4%). Among girls and boys, the prevalence of MDD (≥ 8 scores) was 15.5% and 3.7%, respectively, and the prevalence of GAD (≥ 5 scores) was 25.0% and 10.3%, respectively. In adjusted logistic regression analysis, among girls, GAD was positively and solid fuel use was negatively associated with PSB, while among boys MDD and urban residence were positively associated with PSB. Among female adolescents, currently being pregnant and "big problem to get money for medical treatment" increased the odds of MDD. While among male adolescents, urban residence, having a genital sore or ulcer, has living children, and early sexual debut were positively associated with MDD. Urban residence, current alcohol use, and early sexual debut were positively associated with GAD in male adolescents, while poorer wealth status, being pregnant, and having a "big problem to get money for medical treatment" were positively associated with GAD in female adolescents. Conclusion: About 3% of participants had PSB, among girls one in five had MDD or GAD and among boys more than 5% had MDD or GAD. Public health interventions can be guided by several associated factors that have been identified. [ABSTRACT FROM AUTHOR]

Objective: This study assesses the impact of the age at which individuals first begin working on the odds of developing mental health disorders among older adults in Ecuador. Methods: Data from the 2009 Survey of Health, Well-being, and Aging (SABE) encompassing 3093 elderly participants from mainland Ecuador were analyzed. We employed binary logistic regression to explore the association between the age at which individuals started working and their subsequent mental health status. Results: Participants who started working between ages 5–12 and 26–35 had lower odds of mental health disorders compared to those who began at ages 18–25, while those who started working between ages 13–17 and 36–80 exhibited higher odds compared to the same baseline group. These associations are net of various demographic and health-related factors. Conclusion: The results indicate mixed associations between the age at which individuals started working and their mental health outcomes in older age. While some age groups demonstrate lower odds of mental health disorders, others do not, suggesting a complex relationship that warrants further investigation. Implications: This research supports the development of healthcare policies aimed at providing mental health education and services tailored to populations affected by early labor, to mitigate the enduring impacts of child labor on mental health in older age. [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]

Introduction: The application of ketogenic dietary interventions to mental health treatments is increasingly acknowledged within medical and psychiatric fields, yet its exploration in clinical psychology remains limited. This article discusses the potential implications of ketogenic diets, traditionally utilized for neurological disorders, within broader mental health practices. Methods: This article presents a perspective based on existing ketogenic diet research on historical use, biological mechanisms, and therapeutic benefits. It examines the potential application of these diets in mental health treatment and their relevance to clinical psychology research and practice. Results: The review informs psychologists of the therapeutic benefits of ketogenic diets and introduces to the psychology literature the underlying biological mechanisms involved, such as modulation of neurotransmitters, reduction of inflammation, and stabilization of brain energy metabolism, demonstrating their potential relevance to biopsychosocial practice in clinical psychology. Conclusion: By considering metabolic therapies, clinical psychologists can broaden their scope of biopsychosocial clinical psychology practice. This integration provides a care model that incorporates knowledge of the ketogenic diet as a treatment option in psychiatric care. The article emphasizes the need for further research and training for clinical psychologists to support the effective implementation of this metabolic psychiatry intervention. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the relationship between athletes' training satisfaction and competitive state anxiety, by examining the mediating roles of psychological resilience and coping strategies. The findings provide a theoretical foundation and practical recommendations for enhancing athletes' training and mental health services. Methods: A questionnaire was utilized to assess training satisfaction, psychological resilience, coping strategies, and Competitive State Anxiety among a sample of 447 athletes. The data was examined through descriptive statistics, correlation analysis, and structural equation modeling, employing SPSS and the Process 3.5 plug-in. Results: Training satisfaction had a significant positive effect on psychological resilience (β = 0.726, p <0.001), while training satisfaction (β = 0.178, p <0.001) and psychological resilience (β = 1.138, p <0.001) were found to have a significant positive effect on strategy. Additionally, training satisfaction, psychological resilience, and coping strategies all demonstrated a significant negative effect on competitive state anxiety (p <0.001). Training satisfaction indirectly influenced competitive state anxiety through psychological resilience (indirect effect 1), coping strategies (indirect effect 2), and the combined mediating effect of psychological resilience and coping strategies (indirect effect 3), resulting in a total indirect effect of −0.385 [95% CI = (−0.433, −0.337)]. Discussion: In conclusion, enhancing athletes' training satisfaction can help reduce competitive state anxiety by improving psychological resilience and fostering positive coping mechanisms. [ABSTRACT FROM AUTHOR]

This paper addresses operational stress injuries (OSIs) among military service members (SM) and public safety personnel (PSP) resulting from prolonged exposure to potentially psychologically traumatic events (PPTEs). While psychotherapeutic interventions for post-traumatic stress injuries (PTSIs) are well established, there is a significant gap in evidence-based mental health training programs addressing proactive mitigation of negative outcomes from PPTEs. Building on the Functional Disconnection/Functional Reconnection (FD/FR) model, we introduce FD/FR 2, emphasizing early identification and management of psychological risks. FD/FR 2 discusses the practice of emotional suppression, or "pseudo-stoicism," and its potential negative impact on mental health. By integrating authentic Stoic principles, FD/FR 2 offers practical exercises to enhance resilience and well-being, addressing a critical need in current training approaches for military SM and PSP. [ABSTRACT FROM AUTHOR]

Background: Health systems need tools to assess patient's experience of service, but existing tools lack reliability and validity assessment. Our aim is to investigate the factor structure, reliability, validity, item parameters and interpretability of the parent version of the Experience of Service Questionnaire (ESQ) for practical use in Greece. Methods: A total of 265 caregivers that were using mental health services in Greece participated in this study as part of the Nationwide cross-sectional survey from the Child and Adolescent Mental Health Initiative (CAMHI). Confirmatory Factor Analysis was used to test factor structure. Reliability of all models were measured with omega coefficients. Tobit regression analysis was used to test for convergent and discriminant validity with specifically designed questions. Item parameters were assessed via Item Response Theory. Interpretability was assessed by means of IRT-based scores. Results: We found that ESQ is best represented and scored as a unidimensional construct, given potential subscales would not have enough reliability apart from a general factor. Convergent and discriminant validity was demonstrated, as caregivers who perceived that their child benefited from the received mental health care had 6.50 higher summed scores (SMD = 1.14, p < 0.001); while those who believed that their child needed additional help had 5.08 lower summed scores on the ESQ (SMD = −0.89, p < 0.001). Average z-scores provided five meaningful categories of services, in terms of user satisfaction, compared to the national average. Conclusions: Our study presents evidence for the reliability and validity of the ESQ and provides recommendations for its practical use in Greece. ESQ can be used to measure experience of service and might help drive improvements in service delivery in the Greek mental health sector. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effects of a mindfulness-based family psychoeducation (MBFPE) intervention on caregivers and the young adults with first-episode psychosis in mental health care. Methods: Sixty-five caregivers were randomly assigned to the MBFPE program (n = 33) or an ordinary family psychoeducation (FPE) program (n = 32). Eighteen young adults in recovery (YAIR) also participated in the study. All of the participants completed the assessments before participating in the intervention (T1), after the intervention (T2), and at 9-month follow-up (T3). Results: Intention-to-treat analyses were conducted. The caregivers reported a significant and large effect size on positive caregiving experiences based on a Time × Group analysis (g = 0.862, p = 0.006). Among the YAIR participants, between-group differences were significant in their perceptions of caregivers' expressed emotions, including large effect sizes of perceived criticism (g = 1.396, p = 0.049) and hostility (g = 1.444, p = 0.043). Caregiver demographics, including age, education level, socioeconomic status, and number of family members, were found to moderate the effect sizes of the variables studied. Conclusion: This study provides evidence of the effects of MBFPE programs on the outcomes of caregivers and the young adults with first-episode psychosis in their care. Specifically, the MBFPE program in this study played a greater role in promoting positive caregiving experiences and changing caregivers' expressed emotions, especially their expressed criticism of YAIR, compared with the regular FPE program. Therefore, the application of mindfulness training to promote family care and YAIR recovery should be encouraged. Clinical trial registration: ClinicalTrials.gov , identifier NCT03688009. [ABSTRACT FROM AUTHOR]

While there is extensive literature examining the effectiveness of antipsychotic prescribing to patients with schizophrenia spectrum or other psychotic disorders in general psychiatric services, there is a dearth of studies examining antipsychotic prescribing practices and their effectiveness in forensic psychiatric services. Forensic psychiatric patients have unique challenges often due to their high-profile offences, public scrutiny, and legal requirements. This longitudinal, retrospective study aimed to examine antipsychotic prescribing and rehospitalization rates in a forensic psychiatric sample, along with relevant socio-demographic, clinical, and forensic characteristics. All patients had a psychotic illness and were prescribed antipsychotic medication. The sample included 153 patients, of which the majority were male (85.6%), Caucasian (71.2%), middle aged (30s to 50s), had schizophrenia or schizoaffective disorder (76.5%), had a substance use disorder (62.1%), and had a most serious index offence against the person (80.4%). Atypical antipsychotics accounted for the majority of antipsychotic prescriptions (75.9%) and the sample had an antipsychotic polypharmacy rate of 39.9%. The sample was divided into four primary antipsychotic formulation types, which were oral (34.0%), injection (39.2%), clozapine (19.0%), and subtherapeutic (7.8%). Regarding rehospitalization, 52.9% of the sample was rehospitalized, with the average number of rehospitalizations being 1.2 (SD = 1.7) and proportion of the follow up period rehospitalized being 16.4% (SD = 27.7%). Patients prescribed clozapine had numerically lower rates of rehospitalization than those prescribed oral and injection formulation types, but it was not statistically significant. With a 19.0% prescription rate, clozapine may be underutilized in this sample. Further research is needed to demonstrate the potential benefits of clozapine regarding rehospitalization in forensic psychiatric patients, as has already been done in general psychiatry. Advancing treatment of the high-profile forensic population can reduce stigma toward people with mental illness and criminal justice involvement. [ABSTRACT FROM AUTHOR]

A considerable proportion of patients with schizophrenia perform below population norms on standardized neuropsychological tests, and the performance of those performing within normal range is lower than predicted based on parental education. Cognitive impairment predates the onset of psychosis, is observed during symptom remission and in non-affected first-degree relatives of patients. At the present time, cognitive deficits are regarded as key features of schizophrenia, important determinants of poor psychosocial outcome and targets for both pharmacological and non-pharmacological treatment strategies. A group of eight key opinion leaders reviewed and discussed latest advances in scientific research and current good clinical practices on assessment, management, and treatment of CIAS. In the present paper they summarize the current evidence, identify main gaps between current knowledge and mental health services clinical practice, and provide practical recommendations to reduce the gap. [ABSTRACT FROM AUTHOR]

Background: Mental health is crucial for overall well-being, but rural areas often face difficulties in accessing mental health services and understanding psychiatric disorders. Aim: This study aimed to address these issues by assessing the prevalence of psychiatric disorders among adults in rural Jammu and examining how socio-cultural and demographic factors are related to these disorders. Methods: A sample of 1,016 adults from rural Jammu was surveyed using the Mini International Neuropsychiatric Interview (MINI). Data were collected through house-to-house visits conducted by trained investigators. Descriptive and inferential statistics, including frequency distribution and odds ratio, were employed to analyze the data respectively. Results: Overall, 20.67% of the participants had a psychiatric disorder. Alcohol dependence was the most common condition, affecting 12.30% of the individuals, followed by generalized anxiety disorder at 3.14%. The study found significant associations between psychiatric disorders and several factors. Specifically, older people were more likely to have psychiatric disorders, with an odds ratio of 3.7 [2.07-6.59]. Married individuals also had a higher likelihood of experiencing psychiatric disorders (OR: 2.3 [1.55-3.54]). Those with less schooling were at an increased risk, with an odds ratio of 7.77 [2.31-26.09], and people from lower socioeconomic backgrounds were more likely to have these disorders as well (OR: 5.1 [2.4-10.5]). Discussion and conclusion: The findings underscore the complex association between socio-demographic factors and mental health outcomes in rural areas of Jammu region. Addressing these disparities requires targeted interventions and policies that account for the unique socio-cultural contexts of rural populations. By understanding the specific challenges faced by these communities, policymakers and healthcare providers can develop more effective strategies to enhance mental health services and promote well-being. [ABSTRACT FROM AUTHOR]

Background: Severe mental illness results in an enormous social and economic burden on affected individuals, their families, and communities, especially in developing countries, such as Ethiopia. Objective: The aim of this study was to assess the level of depression among caregivers of patients with severe mental illness in Debre Tabor Town, Northwest Ethiopia in 2023. Methods: This institution-based explanatory mixed study was conducted at Debre Tabor Compressive Specialized Hospitals between September 30 to October 30, 2023. A systematic random sampling technique was used to select 260 study participants, and a public health questionnaire was used to assess depression. Epicollect5 was used to collect data, which were then exported to the SPSS-25 for analysis. Variables with a p -value <0.25 were considered candidates for the multivariate logistic regression analysis. The odds ratios with a 95% confidence interval were used to determine the strength of the association. An in-depth interview was conducted with 11 participants, selected using purposive sampling. Results: The prevalence of depression was 31.3% (95% CI = 29.7–38.6). The multivariate analysis showed that being female (AOD = 2.43, CI = 1.42–7.23), divorced/widowed (AOD = 1.8, CI = 1.32–6.34), poor social support (AOD = 2.2, CI = 1.9–5.87), and perceived stigma (AOD = 2.33, CI = 0.24–13.22) were positively associated with depression. The qualitative results suggest that being female, illiterate, severity of the illness, poor social support, and stigma were factors for depression. Conclusions and recommendations: The prevalence of depression was high among caregivers of patients with severe mental illness. Female sex, being divorced or widowed, being illiterate, poor social support, and perceived stigma were the contributing factors. This implies that a greater focus on caregivers and the government increases mental health literacy and mental health community services. [ABSTRACT FROM AUTHOR]

Introduction: Anxiety disorder is one of the most prevalent mental disorders. Mindfulness-based cognitive therapy (MBCT) is effective for treating anxiety disorders. However, no studies have investigated the cost-effectiveness of MBCT for anxiety disorders. We aimed to conduct a cost-effectiveness analysis alongside a randomized controlled trial (RCT) to clarify the cost-effectiveness of MBCT for anxiety disorders. Methods: A cost-effectiveness analysis alongside an RCT was conducted for 8 weeks in 40 patients with anxiety disorders at a university hospital. Patients (1) aged 20–75 years; (2) who were diagnosed with panic disorder/agoraphobia or social anxiety disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria; and (3) who provided written consent were analyzed. The participants were allocated randomly (1:1 ratio) to the augmented MBCT group (i.e., MBCT plus treatment as usual [TAU]) or TAU (waitlist control) group. The cost-effectiveness was assessed using the incremental cost-effectiveness ratio (ICER), which is the ratio of the incremental costs divided by the incremental state-trait anxiety inventory- state (STAI-S), state-trait anxiety inventory- trait (STAI-T), and quality-adjusted life years (QALYs). The QALYs were estimated using The Japanese version of EuroQoL five-dimensional 3-level questionnaire. The unit cost data were derived from the government-regulated fees. This study was conducted from a public healthcare insurance perspective. No discount rates were considered. Results: A total of 38 participants with complete data were included in the analysis. The MBCT was JPY 13,885 more than the cost of TAU and was associated with a STAI-S, STAI-T, and QALY increase of 10.13, 12.00, 0.009 respectively. The ICER were JPY 1,371 (USD13) per STAI-S, JPY 1,157 (USD 11) per STAI-T, and JPY 1,566,357 (USD 14,940) per QALY respectively. MBCT had an 77.5% probability of being cost-effective at a willingness to pay threshold in Japan (JPY 5,000,000 per QALY). The results of the four one-way sensitivity analyses supported the robustness of the base-case analysis findings. Discussion: Augmented MBCT for anxiety disorders is cost-effective compared with TAU post-treatment from a public healthcare insurance perspective. Future studies should include long-term observations, and analysis from a societal perspective. [ABSTRACT FROM AUTHOR]

The urgency of researching this topic is one of the most urgent for Ukrainian society and law enforcement agencies. At this stage, Ukraine is not only about the struggle for independence, for values, Ukraine is primarily about development and innovation. A fairly basic and fundamental vector or direction of the country for guaranteeing human and citizen rights, as well as ensuring a safe environment, has been established. Ratification and adoption of international acts in the field of human rights and freedoms is a step towards increasing the level of protection of citizens’ rights, first of all it shows the country’s responsibility and obligation to meet international standards. Quite often, during the performance of tasks of maintaining public order and fighting crime, police officers, in addition to establishing the facts of crimes, must carry out proper communication, especially with persons who have mental disorders, such as autism (ASD). It is quite interesting that the issue of autism in Ukraine is not new, but it is not sufficiently researched. Especially in the law enforcement system. This article is aimed at theoretical research and coverage of the problem of barrier-freeness in the activities of the National Police of Ukraine during communication with persons who have mental disorders. The work analyzes the foreign experience of the concept of autism in the context of police work and the peculiarities of interaction with persons with various mental disorders. The principles and methods of ensuring unimpeded access to police services and measures aimed at improving the effectiveness of communication with this category of persons are considered. This study aims to determine the optimal strategies of police interaction with persons with mental disorders in order to ensure safety and protect their rights. On the basis of theoretical research, practical recommendations will be offered regarding the training of police officers in the skills of communication and interaction with this audience in order to improve the quality of service to persons with mental disorders in the activities of the National Police of Ukraine. [ABSTRACT FROM AUTHOR]

Background: Perinatal depression has become a global public health issue with a high prevalence rate. Multiple studies have confirmed the effectiveness of music intervention. Still, the current form of offline intervention ignores issues such as convenient transportation and the stigma of diseases that pregnant women are concerned about, resulting in poor adherence. This randomized controlled study will evaluate the impact of music intervention on depression, anxiety, and stress in perinatal women through the WeChat application. In addition, the usability of the WeChat application and the adherence of PND women will also be evaluated. Methods: This randomized, open, single-center parallel controlled trial randomly divided 110 women with perinatal depression who met the inclusion criteria into a smartphone-based music intervention group and usual care group in a 1:1 ratio. The main outcome measures will consist of EPDS and WeChat application usability score. The secondary outcome measures will consist of GAD-7, CPSS, and Knowledge-Attitude-Practice questionnaire scores. Discussion: This study will test the effectiveness of music intervention based on the WeChat application for perinatal depression and the usability of the WeChat application, to provide practical guidance for perinatal mental health care. Trial Registration: This protocol was registered at the Chinese Clinical Trials.gov (Identifier: ChiCTR2400088924) on August 29, 2024. [ABSTRACT FROM AUTHOR]

Background: Many parents with a mental illness report a desire for both recognition of their parental role and support for themselves and their children. However, parents are often fearful of negative judgements from professionals about their ability to be a parent, which inhibits raising concerns about their children with clinical teams. Consequently, an essential first step to supporting families is for professionals to proactively identify which patients are parents, although evidence indicates this is not consistently part of services. Professionals could play a pivotal role in guiding parents about how to talk to their children about their mental illness; this in turn can facilitate family functioning and enable children to access evidence-based interventions. This approach is crucial for mitigating the well-documented intergenerational risk of poorer outcomes and mental illness in children of affected parents. This study aimed to explore adult mental healthcare professionals' beliefs and experiences of talking with patients about: i) their role as parents ii) communication with their children about mental illness. Methods: Semi-structured qualitative interviews were conducted with 19 adult mental healthcare professionals with 4-30 years' experience of working with adult patients under the care of NHS adult mental healthcare services in England. Audio recordings were transcribed verbatim and analysed using an inductive coding approach following the principles of thematic analysis. Result: All participants recognised their responsibility to identify patients' children through routine safeguarding protocols, but supporting patients around telling their children the diagnosis was less common. Many participants expressed concerns that raising the topic of children with patients could conflict with other parts of their professional role or would not be welcomed. Obstacles to these conversations were identified, across individual, environmental and organisational factors. Potential facilitators included specific staff training and resources for clinical teams and families around how to tell children about mental illness. Conclusion: Adult mental healthcare professionals would benefit from enhanced training on the importance and methods of guiding parents to communicate with their children about mental illness. This should include routine identification of which patients are parents and recognition of the impact of an adult's mental illness on the wider family system. [ABSTRACT FROM AUTHOR]

Aim: Our aim was to assess the burden of children and adolescents' mental health problems on the Slovenian outpatient healthcare system before, during and after the pandemic. Methods: In a retrospective analysis of healthcare indicators from 2008 to 2023, we analysed data from the National Institute of Public Health. Key domains included initial visits for mental and behavioural disorders (MBDs) to primary care for the population aged 0–19; the number of referrals to an initial assessment with a child and adolescent psychiatrist (CAP) at the secondary level for the population aged 0–17 along with the corresponding waiting times; and the number of urgent referrals for the population aged 0–17 to emergency mental health centres at the tertiary level. The calculations included rates per 1000 people. Descriptive statistics and diagrams were used to compare the data. Segmented linear regression analysis (SLR) was conducted on the primary healthcare data to identify the distinct temporal point indicating an increase. Results: Comparing the average rates of the 2020–2022 period to those of the 2018–2019 period, there was a 20% increase in initial visits to primary care, a 23% increase in the referral rate to a CAP at the secondary level, and a 41% increase to the tertiary level of care. In secondary care, a four- to sevenfold increase in waiting times for the initial CAP assessment was observed between 2019 and 2023. The incidence of initial visits to primary healthcare services for MBD increased from 2008 to 2019 (average annual growth rate of 4.5%). The average annual growth rate for the 2020–2022 period tripled to 13.9%. The SLR showed that the trend of accelerating growth could have begun in 2017 for the 0–5 age group and possibly for the 15–19 age group as well. Conclusions: After the initial decline in 2020, all levels of the Slovenian healthcare system faced an increased burden of MBD in children and adolescents from 2021 to 2022 compared to pre-pandemic levels. Nevertheless, a portion of this increase aligns with longitudinal growing trends from 2008 onwards. Tackling the crisis requires urgent national action, significant improvement in organization, and investments in mental health. [ABSTRACT FROM AUTHOR]

Objectives: Telemedicine has emerged as a crucial tool in addressing public health requirements, particularly during a pandemic. This aligns with the third Sustainable Development Goals (SDGs) objective of ensuring healthy lives and promoting well‐being for all ages. The current generation demonstrates a greater proficiency in modern technology, prompting researchers to investigate their views and behavior trends in telemedicine. Methods: This research is aimed at examining the telemedicine adoption patterns of Generation Y and Generation Z by dividing them into two groups. Study Group 1 is comprised of those who have known modern technology but have yet to gain experience in using telemedicine. Meanwhile, Study Group 2 is comprised of those who had used telemedicine services. Utilizing structural equation model (SEM) analysis, this research investigates the magnitude of influence exerted by various determinants on an individual's tendency to utilize telemedicine. Results: Findings from both study groups indicate that younger generations have positive attitudes towards telemedicine, significantly influencing their willingness to use telemedicine. Furthermore, the level of readiness for change emerges as a crucial factor in determining the degree of affective commitment to change, continuance commitment to change, and normative commitment to change. In addition, the participants' affective experience state significantly influences all three dimensions of commitment to change. Conclusion: The results suggest the importance of fostering a positive and pragmatic understanding of telemedicine among young people. This can be achieved by encouraging the use of telemedicine services and fully adopting the shift to telemedicine. Therefore, it is crucial to prioritize the development of a positive view towards telemedicine, provide excellent service experiences, and promote social flexibility to attract a large user base, especially among the younger population. [ABSTRACT FROM AUTHOR]

The Senedd Children, Young People and Education Committee in Wales published an inquiry report on disabled children's access to education and childcare, highlighting significant barriers and shortcomings in mainstream settings. The report includes 32 recommendations to address these issues. The Welsh Government responded to the report, acknowledging the concerns raised and committing to work towards inclusive childcare and education. Additionally, the committee published an interim report on the implementation of education reforms in Wales, focusing on the Additional Learning Needs system and the Curriculum for Wales rollout. The report highlights concerns about a decrease in children identified with ALN and the need for a knowledge- and skills-rich approach to education. [Extracted from the article]

Background Aim Findings Conclusion This research study explores how therapists in the United Kingdom (UK) navigate the issue of loneliness when working with destitute asylum seekers (DAS). Loneliness and social isolation have adverse effects on the mental and physical health of individuals, and migrants, including asylum seekers and refugees, are particularly vulnerable to these challenges.The study aimed to provide valuable insights into the strategies employed by therapists to address loneliness in this specific population and may contribute to the development of effective interventions and programmes in mental health services for asylum seekers.Braun and Clarke's reflexive thematic analysis of focus group data revealed two main themes: (1) perceived factors that impact loneliness and (2) therapeutic strategies for alleviating loneliness.This paper concludes with a discussion of the findings of this study and provides recommendations for future research directions, aiming to further enhance our understanding and support for DAS in addressing loneliness and to continue improving mental health services for this vulnerable population. [ABSTRACT FROM AUTHOR]

ABSTRACT Rationale Aims and Objectives Method Results Conclusion This service evaluation details the process of introducing Single Session Therapy (SST) with families to a Child and Adolescent Mental Health Service in the United Kingdom. SST is a model of short‐term psychotherapy intervention which can be applied to family contexts to provide timely mental health support.This service evaluation had two objectives: (1) Review the existing evidence base and literature for SST. (2) Evaluate the implementation of a new SST treatment pathway in CAMHS, including patient experiences and satisfaction with the service.SQUIRE Guidelines are used to report on this new knowledge of healthcare. This evaluation used qualitative methods to evaluate the impact of the new service. The team also used existing frameworks within the Trust, namely discharge data, which is collected routinely as part of service evaluation.This evaluation suggests positive support for this model, and that many families appreciate and value the opportunity to build on strengths and work toward their goals as families. This project outcome appears to support some of Talmon's (1990) findings that the most commonly attended number of sessions is one, and that of those who attended only one session, many perceived the session as useful. Waiting times for our service are extremely long. The pace and structure around goals and solutions could feel both galvanising, as some reported, but others felt it was an insufficient response to the severity of their difficulties.More high‐quality research is needed before judgments can be made around the cost‐effectiveness or efficacy of SST over existing approaches in the United Kingdom. While implementing SST should not be used to justify reduction in existing interventions, it offers a positive additional service for young people experiencing mental health difficulties and their families. [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]

Background: The abandonment of psychotherapeutic treatments is influenced by various factors, including patient characteristics, therapist traits, and the therapeutic relationship. Despite the well-documented importance of these factors, limited empirical research has focused on the role of the therapeutic relationship and the characteristics of therapist-patient dyads in predicting treatment dropout. This study protocol outlines a longitudinal research project aimed at predicting dropout and non-response in psychotherapy for individuals with personality disorders. The research seeks to identify predictive factors related to psychotherapy outcomes, focusing on patient, therapist, and dyadic elements. Specifically, the study will examine the influence of therapist characteristics (e.g., personality traits, countertransference, responsiveness) on treatment outcomes, explore the impact of relational factors (e.g., treatment expectations, epistemic trust, therapeutic alliance) on therapy effectiveness, and assess how the therapeutic alliance within therapist-patient dyads affects the likelihood of dropout and non-response. Methods: The longitudinal study will include 100 therapist-patient dyads (200 participants) recruited from various Mental Health Services in Milan, Italy. Validated instruments will be administered to both patients and therapists at four-time points: T0 (baseline), T1 (3 months), T2 (6 months), and T3 (1 year). Data will be collected at baseline and at the one-year mark to evaluate the relationships between therapist, patient, and dyadic factors and treatment outcomes. Discussion: Identifying predictive variables associated with high dropout rates can help preempt treatment discontinuation, reducing the financial and operational burdens on mental health services. Understanding these factors will enable the development of targeted interventions to improve treatment engagement and reduce attrition. This approach could enhance outcomes for individuals with personality disorders and lead to more efficient resource allocation and sustainable delivery of mental health care. [ABSTRACT FROM AUTHOR]

Objective: Mental health problems and vocational disengagement are often linked for young people in a self-reinforcing cycle. Integrated Individual Placement and Support (IPS) services can help to not only overcome educational/vocational challenges but also improve mental wellbeing. Methods: In a matched cohort study, we compared improvement rates in mental health and wellbeing outcomes for young people aged 15 to 25 who had received at least two integrated IPS services with those who had received standard youth mental health services only. Data came from headspace, Australia's National Youth Mental Health Foundation. The sample comprised 2128 participants: 544 received integrated IPS services; 1584 received standard mental health services. Results: Four out of five IPS clients (81%) achieved positive outcomes on at least one of three mental health measures, a significantly higher proportion than matched clients who received standard services (75%). Logistic regressions estimated a 22% to 36% higher likelihood of achieving significant improvement for IPS clients. Greater improvements were evident for quality of life and potentially psychosocial functioning, but not psychological distress. Conclusions: Integrating an IPS program within a clinical setting not only achieves positive vocational outcomes, but also supports improvements in quality of life, psychosocial functioning and psychological distress that are greater or equal to the outcomes achieved through standard clinical care. [ABSTRACT FROM AUTHOR]

Integrated and collaborative care models, in which mental/behavioral health providers work closely with primary care providers within a primary care setting, help support the quadruple aim of improved health outcomes, patient satisfaction, provider experience, and lower cost. In this paper, we describe patients' general perspectives of integrated care and their unique experiences accessing this care within one health system. Qualitative (interviews with patients) and quantitative (surveys with patients) methods were used to collect and analyze these results separately and together. The results highlight important features to the provision of integrated care from the perspective of patients using integrated care. They include the importance and experience of access, whole-person care and a team-based approach, the availability and use of telehealth when appropriate, having high quality mental health providers, scheduling and service usage suggestions, and means to connect with longer-term services for ongoing mental health care when needed. [ABSTRACT FROM AUTHOR]

Background: Home-based care (HBC) services have gained global attention for their potential to reduce caregiver burden among informal caregivers of persons with dementia (PwDs), who experience high caregiving intensity. However, research on HBC and its effects on dementia caregiving in China remains limited. Methods: Data were collected from primary caregivers of PwDs in Jiangsu Province, China. Caregiving intensity and HBC utilization were measured using self-developed instruments. Caregiver burden was assessed by The Burden Scale for Family Caregivers-short. Factor analysis was employed to decompose HBC services. Hierarchical multiple regression analysed the moderating effects of HBC on the relationship between caregiving intensity and burden. Results: A community sample of 318 caregiver and PwDs dyads was included. Caregivers averagely aged 62.16 years, with 61% being female, 84% not employed, and 66.2% having low income. PwDs aged 77.45 years averagely, with 52.8% being female and an average behavioural problems score of 42.27. Caregivers averaged 15.19 on response measures. The number and time spent on ADL-based tasks were positively associated with caregiver burden (β = 0.26, p <.001; β = 0.16, p <.01). However, attendance and time of supervision tasks were not significant predictors of burden. HBC services in China comprised four dimensions: Referral service, Household care, Skilled care, and Mental health service. While these did not directly predict caregiver burden, they moderated the associations between ADL-based tasks and caregiver burden (β=-0.25, p <.001; β=-0.24, p <.001; β=-0.23, p <.001; β=-0.20, p <.001), between time of ADL-based tasks and caregiver burden (β=-0.17, p <.001; β=-0.18, p <.001; β=-0.17, p <.001; β=-0.15, p <.01), and between the attendance at supervision tasks and caregiver burden (β=-0.11, p <.05; β=-0.20, p <.001; β=-0.17, p <.001; β=-0.17, p <.001). Only Referral service buffered the relationship between supervision time and caregiver burden (β = -0.13, p <.01). Conclusion: Informal caregivers of PwDs face high caregiving intensity and burden. HBC services may moderate this relationship, with different services playing varying roles. Further research is essential to explore the impact of supervision levels and develop effective strategies to enhance HBC services for dementia caregiving in China. [ABSTRACT FROM AUTHOR]

Background: Individuals with psychotic disorders face an increased risk of physical health issues, leading to reduced life expectancy. Despite recommendations to integrate physical health promotion into mental healthcare, challenges persist, and mortality from somatic diseases continues to rise. Understanding healthcare providers' perspectives is crucial to overcoming these barriers. This study aims to explore the experiences of healthcare providers working in direct patient care and as unit heads regarding factors influencing health promotion in Swedish psychosis outpatient units. Methods: A qualitative descriptive study was conducted in two specialized psychosis outpatient units. Thirteen healthcare providers, including clinical case managers and three heads of units, were individually interviewed. Thematic analysis was used to analyze the data. Results: Three main themes were generated: (1) Health care providers' attitudes and competence. The health care provider's values and beliefs influenced the engagement in health promotion. (2) Patient-related aspects. Understanding how different patient life components shaped the physical health and need for measurements (3) Organizational prerequisites. Prioritizing resources and leadership impact the experience of health promotion. Clinical case management appeared as a promising approach to coordinate/integrate physical and mental health care, evident in themes 1 and 3. Conclusions: Beyond organizational factors, healthcare providers' skills, patient understanding, and ethical reflection influence their motivation to engage in physical health promotion. The study included only 13 participants, representing various professions, including managers who provided specific leadership perspectives. Clinical case managers appear well-suited to address physical health promotion due to their proficiency in shared decision-making and coordination. [ABSTRACT FROM AUTHOR]

Background: Functional Communication Disorders (FCDs) are one specific presentation of Functional Neurological Disorder (FND). FND is characterised by neurological symptoms, such as sensory and motor symptoms, which are not explained by neurological disease. Speech and language therapists (SLTs) have expertise in managing communication disorders, including FCDs, though is not known is what clinicians do in practice to treat and manage FCDs. Aim: To explore the clinical practices of SLTs who regularly manage FCDs in the UK, including the assessment and intervention approaches taken. Methods & Procedures: An online survey was developed using Qualtrics software and piloted before dissemination. Participants were experienced SLTs working in the UK who managed at least three FCD referrals a year. The survey was developed with a mix of qualitative and quantitative questions. The survey was disseminated via social media and professional networks. Outcomes & Results: There were 73 completed responses to the survey. Participants reported working with a range of FCDs clinically, with functional stuttering and articulation disorders seen most frequently. SLTs reported working with a wide range of multidisciplinary professionals when managing patients with FCDs, though lack of access to mental health professionals was raised as an issue. SLTs reported using a combination of formal and informal communication assessments. Interventions varied, with a wide range of psychological approaches informing treatment. Lack of specific training, evidence base and negative attitudes around functional neurological disorder (FND) were raised as ongoing issues. Conclusions & Implications: Therapists encountered a wide range of FCDs as part of their clinical practice, though there was a significant disparity in the service and interventions offered. SLTs feel their input can be effective, but lack the resources, training and evidence‐based interventions to provide adequate care. WHAT THIS PAPER ADDS: What is already known on the subject: FCDs are one manifestation of FND and can present as a wide range of communication disorders. SLTs encounter FCDs as part of clinical practice, but report feeling unsure and underprepared to manage these disorders. Consensus recommendations have provided some guidance on how to manage these disorders, though what was not known was what practising SLTs are doing in practice with FCD patients: what assessment, intervention and management strategies they use, and what they feel are the facilitators and barriers to effective management. What this study adds to the existing knowledge: This is the first UK‐wide survey of FCD SLT clinical practice. The survey found that SLTs are seeing a range of FCDs as part of their clinical practice. SLTs reported that they feel their input is effective, that they had confidence in their ability to provide assessment and intervention, and that SLT for FCDs should be routine. SLTs reported using a wide variety of approaches to assessment and intervention. Barriers to effective management included a lack of resources, training, negative staff attitudes towards FND, and lack of research and evidence‐based interventions. What are the practical and clinical implications of this work?: This survey has found that SLTs working across the UK are providing input for patients with FCDs, but frequently reported feeling isolated and lacking clinical peer support. This shows the potential for networking groups to support SLTs to learn and share resources. There is a training need for SLTs and other healthcare professionals to tackle pervasive negative attitudes towards FND. Common themes in intervention approaches were found, but there was variability in the specific approach taken. This requires further research to guide SLTs on the best evidence‐based practice. [ABSTRACT FROM AUTHOR]

In recent times, the world has witnessed unprecedented challenges, with the COVID-19 pandemic being a major disruptor to various aspects of daily life. This article delves into the profound impact of pandemics on primary care, specifically focussing on changes in antidepressant prescriptions and mental health referrals before, during, and after lockdowns in England, UK. In this retrospective study, we used anonymised individual-level electronic health record data from general practitioner (GP) practices in the North of England, UK. We applied a negative binomial-logit hurdle model and a multinominal logit regression model to assess the impact on antidepressant prescriptions and GP referral types, respectively. The initiation of antidepressant prescriptions showed a notable decrease during and post lockdowns, with a minor uptick in ongoing antidepressant prescriptions during the lockdown periods. Over the course of lockdowns and beyond, there was a growing trend of patients being referred to social prescribing interventions. Notably, individuals from ethnic minorities were more inclined to receive fewer medical treatments and more social prescribing interventions. The increase in antidepressant prescriptions during the pandemic-related lockdowns was expected due to these challenging circumstances. Reduced referrals to secondary mental health services occurred as online counselling services were deemed inappropriate by some doctors, and patients were hesitant to seek face-to-face help. Notably, there was a rise in social prescribing referrals, emerging as a valuable resource for psychological support amid heightened mental health strain. Additionally, ethnic minority patients were less likely to receive medical treatments but more likely to be referred to social prescribing services. Despite the inevitable negative impacts of the COVID-19 pandemic, these findings highlight the active role of non-clinical support in a social model of health, addressing unmet needs and reducing barriers to mental health care for certain groups. [ABSTRACT FROM AUTHOR]

Objective: Few individuals with eating disorders (EDs) receive treatment. Innovations are needed to identify individuals with EDs and address care barriers. We developed a chatbot for promoting services uptake that could be paired with online screening. However, it is not yet known which components drive effects. This study estimated individual and combined contributions of four chatbot components on mental health services use (primary), chatbot helpfulness, and attitudes toward changing eating/shape/weight concerns ("change attitudes," with higher scores indicating greater importance/readiness). Method s : Two hundred five individuals screening with an ED but not in treatment were randomized in an optimization randomized controlled trial to receive up to four chatbot components: psychoeducation, motivational interviewing, personalized service recommendations, and repeated administration (follow‐up check‐ins/reminders). Assessments were at baseline and 2, 6, and 14 weeks. Results: Participants who received repeated administration were more likely to report mental health services use, with no significant effects of other components on services use. Repeated administration slowed the decline in change attitudes participants experienced over time. Participants who received motivational interviewing found the chatbot more helpful, but this component was also associated with larger declines in change attitudes. Participants who received personalized recommendations found the chatbot more helpful, and receiving this component on its own was associated with the most favorable change attitude time trend. Psychoeducation showed no effects. Discussion: Results indicated important effects of components on outcomes; findings will be used to finalize decision making about the optimized intervention package. The chatbot shows high potential for addressing the treatment gap for EDs. [ABSTRACT FROM AUTHOR]

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]

The use of restrictive practices within health and social care has attracted policy and practice attention, predominantly focusing on children and young people with mental health conditions, learning disabilities and autism. However, despite growing appreciation of the need to improve care quality for people living with dementia (PLWD), the potentially routine use of restrictive practices in their care has received little attention. PLWD are at significant risk of experiencing restrictive practices during unscheduled acute hospital admissions. In everyday routine hospital care of PLWD, concerns about subtle and less visible forms of restrictive practices and their impacts remain. This article draws on Deleuze's concepts of 'assemblage' and 'event' to conceptualise restrictive practices as institutional, interconnection social and political attitudes and organisational cultural practices. We argue that this approach illuminates the diverse ways restrictive practices are used, legitimatised and perpetuated in the care of PLWD. We examine restrictive practices in acute care contexts, understanding their use requires examining the wider socio‐political, organisational cultures and professional practice contexts in which clinical practices occurs. Whereas 'events' and 'assemblages' have predominantly been used to examine embodied entanglements in diverse health contexts, examining restrictive practices as a structural assemblage extends the application of this theoretical framework. [ABSTRACT FROM AUTHOR]

There has been a decline in the rural population of India from nearly 82% to about 65% over the past six decades. The National Mental Health Survey of India (2015–2016) reported a lower prevalence of mental disorders in rural areas compared with urban ones. Mental health services in the country are skewed towards the urban areas, and more families are pushed below the poverty line while getting treatment for a member with mental illness. India has expanded its District Mental Health Programme over the past two decades, and it now covers nearly all the districts in the country. Despite that, significant numbers of people with mental disorders, ranging from 70–90%, do not receive adequate treatment. This paper discusses the rural–urban divide in the mental health services, examining the problem and need, and the initiatives taken by the government of India in this direction. [ABSTRACT FROM AUTHOR]

This paper presents a pioneering pilot implementation of group dialectical behaviour therapy (DBT) for adolescents with maladaptive coping in Qatar's child and adolescent mental health services. The project highlights the positive effect on patient satisfaction and the potential for early intervention with adolescents displaying emotional dysregulation. This pioneering initiative was consistent with local cultural values, stressing the importance of interconnectedness in mental health interventions. The impact of the initiative stresses its significance in diverse cultural contexts, urging further adoption regionally for improved mental health outcomes, particularly among adolescents displaying features of an emerging emotionally unstable personality disorder. [ABSTRACT FROM AUTHOR]