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ABSTRACT Eating disorders encompass a spectrum of mental health conditions that are characterised by a preoccupation with eating, exercise, body weight or shape. The trajectory of eating disorders can result in hospitalisation for medical complications, such as electrolyte imbalance, extremely low weight and other medical issues that require urgent inpatient attention. Typically, care for adolescents with medically compromised eating disorders occurs in general medical settings, with most care provided by nurses who may or may not have the training and experience to provide quality care for this complex mental health condition. The aim of this scoping review is to examine literature surrounding the experience of nurses caring for adolescents admitted to general medical wards (non‐mental health settings) with medically compromised eating disorders. We used Arksey and O'Malley's (2005) five‐step scoping review process to conduct this review. A systematic search of the literature located 476 relevant papers, and after screening, 10 were included in the final review. Most included papers were qualitative in methodology, with one using a mixed‐methods design. The papers examined in this scoping review found common themes among nurses who were providing care for adolescents with medically compromised eating disorders being cared for in medical wards (non‐mental health settings): a lack of preparation to care for individuals with eating disorders, a high emotional and psychological toll on nurses providing care and a degree of stigma towards adolescents with eating disorders, including a belief that eating disorders were a ‘choice.’ This review indicates that to provide quality and safe care for adolescents with eating disorders admitted to general medical wards, nurses require specialised training. In addition, the care of adolescents with medically compromised eating disorders requires the support of trained mental health nurses, especially where nurses on general medical wards are novice or have limited mental health training. We recommend further research into support structures to prevent burnout and turnover that is prevalent when providing care to individuals with eating disorders. [ABSTRACT FROM AUTHOR]

The article discusses the ethical considerations surrounding school-based mental health screening and service provision. It highlights the importance of universal mental health screening in schools as a means to identify and support students with mental health needs. The commentary emphasizes the challenges in supporting high-risk students and ensuring that referrals made after screening lead to increased student use of mental health services. The analysis calls for improved practices and research to enhance the effectiveness of mental health screening and referral processes in schools. [Extracted from the article]

ABSTRACT BACKGROUND METHODS RESULTS IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY CONCLUSIONS While adolescent mental health needs have continued to rise, schools have become a central location for adolescents seeking support for mental health needs, and approximately 96% of public schools in the United States report providing some form of mental health care to students. This study aims to explore school social workers' current challenges and priorities in their roles.Qualitative focus groups with current school social workers in Virginia (N = 16) were conducted for this study. Participants worked in middle and high schools for a minimum of 3 years across the state. Braun and Clarke's steps for thematic analysis were used to guide coding and themes.The current study found 3 primary themes: (1) role confusion due to vast scope of responsibilities within their schools; (2) a disconnect between desired roles and assigned roles and responsibilities; and (3) lack of formal model of service provision.Focus should be placed on the integration of current models of school social work practice to ensure the effective utilization of their services.The study reveals important information regarding the current and future state of school social work practice. [ABSTRACT FROM AUTHOR]

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

Background: The increasing trend of patients with mental health conditions seeking emergency care is a global phenomenon. Numerous studies have emphasized the importance of emergency physicians' ability to recognize and manage psychiatric emergencies, both for patient well-being and societal safety nets. With the growing demand for emergency care related to mental health conditions, it is crucial to assess whether emergency physicians possess sufficient confidence and capabilities to adapt to these changes. Against this backdrop, our study aimed to explore the factors influencing emergency physicians' management of acute psychiatric emergencies and to critically evaluate whether current training programs adequately align with societal expectations for psychiatric emergency care. Methods: A cross-sectional survey, disseminated online by the Taiwan Society of Emergency Medicine, targeted 936 attending physicians and 449 residents in 43 Resident Review Committee approved training hospitals in winter 2021. The questionnaire covered participant demographics, skill requirements, and confidence in managing acute psychiatric patients independently. Statistical analyses included descriptive statistics, chi-square tests, medians (IQRs), and Wilcoxon rank-sum tests. Results: Out of 229 participants, 63.8% were attending physicians, and 81.7% were affiliated with medical centers. Psychiatrists led 69.9% of emergency psychiatric training curricula, and 66.8% reported that their clinical psychiatric training outcomes were assessed by psychiatrists. Clinical seniority, training hospital level, and the average number of patients with an acute psychiatric presentation seen in a daily shift influenced physicians' self-reported confidence in managing acute psychiatric patients independently. Medical center training improved capability in managing psychiatric emergencies in the elderly, while encountering a higher average number of patients with an acute psychiatric presentation seen in a daily EM shift was associated with better performance, especially in managing specific populations. Conclusions: Our nationwide study highlights how clinical seniority, training hospital level, and patient volume per shift influence emergency physicians' confidence in managing acute psychiatric patients. However, there remains room for improvement, particularly in addressing the needs of specific patient populations. These findings underscore the importance of refining training curricula to bridge these gaps and enhance the quality of psychiatric emergency patient care. [ABSTRACT FROM AUTHOR]

The mental health of medical students is a crucial concern in contemporary medical education. This manuscript reports the availability and shape of psychological support for medical students in Poland in the backdrop of the COVID-19 pandemic and the Ukrainian crisis. A survey comprising 10 questions was distributed to 22 medical schools in Poland, with a 59% response rate. The findings reveal that psychological support programs are predominantly managed by internal university units. Funding sources vary, with some universities utilizing internal budgets and others leveraging European funds or external projects. The support modalities are primarily hybrid, catering to student preferences. Limitations exist in the number of consultations, although some universities provide extended support based on student needs. Assistance is offered in multiple languages, with additional programs like stress-reduction workshops and mindfulness training being available in several universities. A notable increase in demand for psychological support post-COVID-19 was reported, with some universities establishing their programs during or after the pandemic. The commentary highlights the rising need for mental health services among medical students and underscores the importance of flexible, inclusive, and well-funded support. The effective functioning of these programs aligns with the broader objective of fostering a resilient and emotionally balanced healthcare workforce. [ABSTRACT FROM AUTHOR]

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]

Background: Understanding the heterogeneity of opioid overdose fatalities is critical to developing effective preventive interventions. This study examines patterns of care contacts among people who subsequently died from opioid overdose. The aim was to identify distinct groups of deceased individuals, based on their contacts with different care agencies in their last year of life. Methods: A retrospective registry study was conducted in Skåne, Southern Sweden. All recorded opioid overdose fatalities during the study period were included, n = 191. Latent class analysis was used to identify patterns of care contacts in the last year of life. Results: Three distinct classes were identified: "Few care contacts," with limited interaction with any services; "Social service contacts," comprising individuals who predominantly had contacts with the social services and, to a lesser extent, with prison and probation services; and "Numerous care contacts," with extensive contacts with both healthcare and social services. The "few care contacts" class comprises about half of the population. This is an important finding, since this group has not been clearly visible in previous research. The analysis indicates significant gaps in service provision, particularly regarding substance use treatment and mental health support. Conclusions: Using a person-centred approach, this article offers a novel way of analysing care contacts among people who subsequently died from opioid overdose. The identification of distinct groups, particularly a large group of people with minimal contact with the community care system, highlights the need for more targeted outreach and support work. Developing targeted interventions in emergency and inpatient care settings may provide an opportunity to reach the group with few care contacts. [ABSTRACT FROM AUTHOR]

Background: Working in accident management centers and medical emergencies makes employees face psychological tensions and leads to a decrease in their work quality and endangering the lives of patients. Therefore, any solution to reduce their tension will be valuable. This study was conducted to investigate the effect of acceptance and commitment-based therapy (ACT) on work-related rumination and job fatigue among the employees of the Emergency and Medical Accident Management Center of Alborz Province, Iran. Methods: This study is an experimental research with intervention and control groups conducted between January 16, 2019, and July 8, 2019. Sixty-four employees were selected based on the entry criteria and randomly assigned to two groups. People in the intervention group participated in 8 sessions of 2-hour therapy based on acceptance and commitment. Questionnaires for demographic information, work-related rumination, and occupational recovery/exhaustion were used to collect data. The intervention was conducted with univariate and multivariate covariance analysis. Results: The findings showed that the average job fatigue reached 16.78 11.44 from 37.06 ± 16.70 in the pre-test with a decrease of 20.28 points. Also, the average of all rumination dimensions related to work decreased in the post-test. The findings showed that the effectiveness of treatment based on acceptance and commitment therapy was confirmed on job fatigue and all its components and all dimensions of work-related rumination (p < 0.05). The partial eta square index was greater than 0.14 in all cases and showed the significant effectiveness of the intervention on all components of work-related rumination and job fatigue. Conclusion: Treatment based on acceptance and commitment reduced rumination and job fatigue. It is recommended to practice this intervention to improve personnel's mental health and the quality of services provided to patients. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Background: In Australia, lived experience peer support workforces are expanding making it one of the fastest growing emerging disciplines in transdisciplinary mental health settings. This article provides insight for organisations on the contextual realities peer workers face, increases understanding of peer support services to improve service delivery environments and contributes to mental health systems reform. This study aimed to qualitatively explore peer support workers experience integrating into and working within transdisciplinary mental health service teams. Method: Semi-structured interviews were undertaken with 18 peer support workers currently working in mental health services in Australia. The research was a qualitative descriptive study design. All data collected were analysed utilising thematic analysis. Results: Peer workers found their experience in the workplace was influenced by their colleagues and the organisation's understanding of the peer role. Factors relating to organisational culture and climate were a central theme throughout discussions noting that a negative climate was perceived as harmful to peer workers. Themes established through results include (1) the role of leadership, (2) attitudes and behaviours of colleagues, (3) provision of psychologically safe environments, (4) the organisations messaging and use of language and (5) organisational structures and policy. Conclusion: This study contributes to evidence for the impact of organisational culture on integrating and supporting peer support workers in mental health service delivery. This study provides insights into peer worker experiences integrating into transdisciplinary teams, confirming findings established in previous studies, highlighting a lack of movement or change in workplace culture to support peer worker integration into mental healthcare settings. [ABSTRACT FROM AUTHOR]

Introduction: This Rapid Review (RR) aimed to assess the current literature over the past decade to determine the prevailing evidence regarding compulsory treatment* in eating disorders (ED). It is hoped that the review will help inform a consensus opinion as to whether this course of action confers significant clinical benefit, and importantly, to whom it should apply. The review also explores alternative options to involuntary care. Methods: Four indexing databases (OVID; ProQuest; Web of Science; PubMed/MedLine) were searched using variations of the following keywords: "coercive/detained/involuntary/least restrictive care" "treatment refusal" "incarcerated/forced/compulsory admission" "moral/ethic/legal/mental health act" "eating disorder". Research was restricted to articles published between 2013 and 2023 and included grey literature. Results: Of 9911 articles retrieved, 34 were included for final analyses, exploring ethical, legal, and physical and mental health outcomes of compulsory treatment. Studies comprised review papers, cohort studies, cross sectional research, case series reports, ethnography, commentary papers and grey literature. The majority of studies focused on individuals with anorexia nervosa (AN). Only two papers considered compulsory treatment in individuals with other eating disorders (EDs) Findings largely align with previous reviews suggesting compulsory treatment saves lives but comes at a therapeutic and personal cost. It remains unknown as to who may benefit from compulsory treatment. The decision to invoke compulsory treatment remains with the clinician and is a responsibility that is likely to be faced by most in their care of individuals with EDs. Conclusions: Significant gaps remain in the published literature and a clear road map for a clinician-informed decision on the submission of a compulsory treatment for a person with ED does not yet exist. Further, there is little evidence as to who is most likely to benefit from compulsory treatment. There is consensus that efforts should be concentrated on reducing instances of compulsory treatment and minimising coercion through the development of open, transparent and trusting relationships between individuals and their treating clinician. Co-produced research and the development of clinical guidelines guided by the voices of individuals with lived experience are needed to ensure minimisation of potential harm. Plain English Summary: Eating disorders are complex psychological disorders with numerous significant physical health consequences associated with lethality including heart attack, irregular heartbeat, dehydration, blood clots, and risk of suicide. Without indicated intervention for physical deterioration in the acute stages of illness, individuals are likely at best to develop a chronic course and at worst to lose their life. Despite this, individuals frequently refuse intervention and medical treatment due to fear of weight gain, the interruption of behaviours that are experienced as protective and the effects of past experiences of care. Many report a sense of hopelessness and fear due to past unsuccessful and at times harmful treatments. This presents treating clinicians with a practical and ethical conundrum: should treatment be delivered to an individual against their will? Researchers, policymakers, law professionals and lived experience alike are challenged as to the legal and ethical bounds around which practitioners can act with beneficence when considering compulsory treatment of an individual with an eating disorder. A Rapid Review was commissioned by the Victorian Government Department of Health to summarise the extant literature on the compulsory treatment* of individuals with eating disorders. * Involuntary treatment' and 'compulsory treatment' are synonymous, but we have chosen the term that is best understood by the general public/informed readers. [ABSTRACT FROM AUTHOR]

Depression is the second leading-cause of disability in China. Although studies have shown that more than 80% of patients with advanced schistosomiasis (AS) suffer from anxiety and depression, these study groups are all hospitalized patients with AS and do not represent the extent of the disease in the whole group. To our knowledge, there are no studies assessing the severity of depression in patients with other forms of schistosomiasis japonicum. Therefore, it is necessary to evaluate the occurrence and potential risk factors of depression in the schistosomiasis endemic population. This cross-sectional study was conducted in Jiangxi Province, where schistosomiasis is relatively common in China, as the investigation site. The Patient Health Questionnaire-9 (PHQ-9) scale was selected to assess the depressive symptoms in the study population. At the same time, basic personal information of the research subjects and relevant socio-economics and schistosomiasis endemic area indicators were collected. The survey results show that AS has the highest incidence of depression (34.35%), while non-advanced schistosomiasis (N-AS) and control group (CG) have 22.35% and 22.24% respectively; the incidence of depression in AS is significantly higher than in N-AS and CG, while there is no statistical significance in the comparison between N-AS and CG; the incidence of mild depressive symptoms accounts for 61.08%-75.54% of the total incidence of depression in different groups; multivariate analysis shows that the occurrence of moderate/severe depressive symptoms in the AS group was significantly related to above 60 years old, male, the combination of other serious diseases, personal financial difficulties, and marshland and lake endemic areas. In the N-AS group, the occurrence of moderate/severe depressive symptoms was significantly related to the combination of other serious diseases, personal financial difficulties, significant correlation between marshland and lake endemic areas and the level of control of schistosomiasis epidemics. In conclusion, depression is still relatively common among patients with schistosomiasis patients, especially those with AS. It is recommended that the government and relevant departments consider mental health care when developing prevention and control work in schistosomiasis-endemic areas, in order to effectively protect the physical and mental health of schistosomiasis patients and residents in endemic areas. [ABSTRACT FROM AUTHOR]

This is a qualitative study exploring the perceptions of mental health among Somali women living in London. Participants, over the age of 18, female and identifying as Somali, were recruited from a community centre in West London. Seven participants were recruited and semi-structured interviews were conducted to better understand perceptions of mental health, care-seeking, treatment and different understandings of these issues within the Somali community in London. Interview transcripts were imported into NVIVO version 14 to be coded, and description-focussed coding and thematic analysis were used to interpret key themes. Concerns around judgement, shame and stigma are key issues affecting attitudes towards mental health in this group. Other important issues affecting conceptualisations and attitudes towards mental health were intergenerational differences, isolation from the community, stigma and secrecy. Participants also reported the importance of protective factors, particularly faith and family in their lives. This research adds to existing literature in exploring perceptions of mental health in Somali communities in the UK and such research is helpful in identifying cultural barriers to recognition and treatment of mental health within this community. [ABSTRACT FROM AUTHOR]

Background: Locking or confinement of persons with severe mental illness has been common in Indonesia. In 2010, the Ministry of Health declared a policy that persons who were locked (pasung) should be unlocked or freed (bebas) from confinement and provided mental health services. This study is an empirical evaluation of the effectiveness of one Bebas Pasung program in Indonesia at two-year follow-up. Methods: From medical records in Soerojo Mental Hospital, Magelang, Central Java, 114 persons with severe mental illness who had been unlocked, treated, and returned to the community from four districts served by the hospital were identified. At two-year follow-up, 62 caregivers were able to be contacted and willing to participate in a study. Data were collected from hospital records about condition of the patient at time of "unlocking" and at discharge, and primary caregivers were interviewed about the previous locking and care of the patient since return, as well as experiences of caregiving. Results: We provide descriptive data concerning history of illness, reasons for locking, type of confinement, and care of the individual since return. 58% of those unlocked were men, 80% had diagnoses of schizophrenia, and mean age was 35. At follow-up, 24% of this sample had been re-locked; only 44% took medications regularly, including 33% of those re-locked and 47% of those not relocked. A majority cared for themselves, half were partially or fully productive, and the quality of life of family caregivers improved significantly since their family member was unlocked, treated, and returned home. Conclusions: This program successfully unlocked, treated, and returned to their homes persons with severe mental illness living in pasung or restraints. Findings suggest such unlocking programs need to be linked more closely to community-based mental health and rehabilitation services, maintain care of the patient, and provide a path toward recovery. [ABSTRACT FROM AUTHOR]

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

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

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

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

Mental illnesses arise from dysfunction in the brain. Although numerous extraneural factors influence these illnesses, ultimately, it is the science of the brain that will lead to novel therapies. Meanwhile, our understanding of this complex organ is incomplete, leading to the oft-repeated trope that neuroscience has yet to make significant contributions to the care of individuals with mental illnesses. This review seeks to counter this narrative, using specific examples of how neuroscientific advances have contributed to progress in mental health care in the past and how current achievements set the stage for further progress in the future. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion and Conclusions Psychological resilience has emerged as a key construct of interest in the study of substance use. However, very few studies have examined resilience among individuals who are actively using drugs. Furthermore, many studies of psychological resilience have focused on individual‐level factors. This study addresses the call for a more ‘ecological’ approach to the study of resilience by exploring how socio‐structural vulnerabilities may shape individuals' assessment of their own ability to cope.The Peer Harm Reduction of Maryland Outreach Tiered Evaluation study conducted a cross‐sectional survey of people who used opioids in Baltimore, Maryland, USA (n = 565). Resilience was measured using the 10‐item Connor‐Davidson Resilience Scale. We used linear regression to examine the association between resilience and stressors commonly encountered by individuals who use drugs, including both chronic, enduring stressors (e.g., homelessness, food insecurity) and discrete, event‐based stressors (e.g., overdose, arrest).We observed a negative relationship between self‐reported resilience and chronic stressors. Specifically, individuals who reported experiencing three (β = −4.08; p = 0.002) or four (β = −4.67; p = 0.008) types of chronic stress had significantly lower resilience scores. Additionally, we found that an unmet need for mental health treatment was associated with reduced resilience (β = −1.74; p = 0.040) and greater educational attainment was associated with increased resilience (β = 2.13; p = 0.005).Overlapping experiences of socio‐structural vulnerability, as well as access to mental health care, may influence how individuals who use drugs evaluate their own resilience. Interventions that seek to promote the resilience of this population should focus on addressing structural drivers of marginalisation and barriers to mental health treatment. [ABSTRACT FROM AUTHOR]

Background/Objectives: Empowerment in medicine and psychiatry involves patients gaining control over health-related decisions, improving treatment adherence, outcomes, and satisfaction. This concept is especially significant in psychiatric care due to the complex challenges of mental health conditions, including stigma and impairment of emotional and cognitive functioning. We aim to investigate the correlations between patient trust, decision-making involvement, symptom severity, and perceived empowerment among individuals with Major Depression. Methods: Patients with Major Depressive Disorder were recruited in the "Policlinico G. Rodolico" psychiatry outpatient clinic from November 2022 to June 2023. Inclusion criteria: ages 18–65, ability to consent, stable condition, psychiatric medication history, and recent consultation. Exclusion criteria: psychotic features, bipolar disorder, substance abuse, high suicide risk, and severe comorbidities. Measures included the User Scale for Measuring Empowerment in Mental Health Services (SESM), Trust in Oncologist Scale (TiOS), Clinical Decision-Making Style for Patients (CDMS-P), and Hamilton Depression Rating Scale (HAM-D). Analysis used Kendall's Tau correlation and Two-One-Sided Tests procedure. Results: Seventy-three patients completed the study. No relationship was found between decision-making involvement and perceived empowerment (τ = −0.0625; p = 0.448), or between trust in psychiatrists and empowerment (τ = 0.0747; p = 0.364). An inverse correlation existed between patient involvement in therapy management and trust (τ = −0.2505; p = 0.002). Depression severity inversely correlated with empowerment (τ = −0.2762; p = <.001), but not with trust or decision-making involvement. Conclusions: The lack of significant correlations suggests that decision-making involvement and trust alone may not suffice to enhance empowerment. Trust may encourage patient passivity, while skepticism might drive active involvement. Higher empowerment is associated with less depressive symptoms, highlighting its potential connection with patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Given that the majority of suicide decedents visit primary care in the year preceding death, primary care has been identified as a key setting in which to engage patients at risk for suicide in mental health services. The objective of this research was to identify barriers and facilitators to engagement in mental health services among primary care patients at risk for suicide to inform the development of strategies to increase engagement. Methods: Seventy-four semi-structured qualitative interviews were conducted with primary care patients (n = 20), primary care (n = 18) and behavioral health (n = 12) clinicians, mental health intake coordinators (n = 4), and health system and clinic leaders (n = 20). Patients who had been referred for mental health services from primary care and reported an elevated score (≥ 1) on item 9 on the Patient Health Questionnaire at the time of referral were eligible to participate. Eligible clinicians and leaders were employed in a primary care or behavioral health setting in a single large health system with an integrated mental health program. Interviews typically lasted 30–60 min, were completed over video conference or phone, and were coded by members of the research team using a rapid qualitative analysis procedure. Results: Participants were primarily female (64.9%), white (70.3%) and non-Hispanic/Latine (91.9%). The most identified barriers to mental health care engagement were waitlists, capacity limits, insurance, patient characteristics, communication, collaboration, and/or difficulties surrounding travel. The most commonly cited facilitators of engagement included telehealth, integrated care models, reminders, case management support, psychoeducation, motivational enhancement, and scheduling flexibility. Concrete suggestions for improving engagement in mental health services included increasing communication between providers, streamlining referral and intake processes, providing reminders and follow ups, and advocacy for increased reimbursement for suicide risk assessment. Conclusions: Results underscore the myriad barriers patients at risk for suicide encounter when attempting to engage in mental health care in a primary care setting. Facilitators of engagement and suggestions for improving connections to care were also identified, which can inform the design of implementation strategies to improve engagement in mental health services among primary care patients at risk for suicide. Trial registration: ClinicalTrials.gov Identifier: NCT05021224 (Registered August 19, 2021). [ABSTRACT FROM AUTHOR]

The article highlights the importance of point-of-care testing for hepatitis C virus (HCV) ribonucleic acid (RNA) as a vital step towards achieving elimination goals. Topics discussed include the effectiveness of combined point-of-care antibody and HCV RNA testing in improving testing and treatment rates, the implementation of successful testing programs in diverse settings, and the necessity for research and investment in testing strategies for enhanced accessibility.

Background: Young adult suicidality is worldwide a prevalent mental health problem and the number one cause of death, with devastating consequences for individuals and their families, and substantial economic costs. However, psychological and pharmacological treatments currently recommended in guidelines for treatment of high-risk youth for fatal suicide have limited effect. In line with the World Health Organization's (WHO) recommendation to involve the family in treatment of these youth, attachment-based family therapy (ABFT) was developed, a 16-week attachment and emotion-focused treatment, implemented in mental health care settings across various European countries in the past years, and becoming increasingly popular among therapists. However, the (cost-)effectiveness of ABFT has not been studied in emerging adults. In the proposed pragmatic randomized controlled trial (RCT), we aim to evaluate the effectiveness and cost-effectiveness of ABFT compared to treatment as usual (TAU) on suicidality, as delivered in daily practice. Methods: This pragmatic multicenter study in the Netherlands and Belgium includes 13 participating sites. Participants are suicidal young adults (≥ 31 SIQ-JR score) between 16 and 30 years old who seek mental health treatment (n = 142) and their caregivers. The primary outcome is suicidality (SIQ-JR), with assessments at baseline, post-intervention (5 months after baseline), 3, 6, and 12 months after intervention. We predict that, compared to TAU, ABFT will lead to a stronger reduction in suicidality and will be more cost-effective, over the course of all time points. We also expect stronger decreases in depressive symptoms, given that suicidality is very common in individuals with depressive disorder, as well as more improvement in family functioning, autonomy, entrapment, and young adult attachment, in the ABFT condition. Discussion: This study can contribute to improving the care for suicidal youngsters with high mortality risk. Treatment of suicidal emerging adults is understudied. The results will inform clinical guidelines and policy makers and improve treatment of suicidal emerging adults. Trial registration: This trial is registered on ClinicalTrials.gov (NCT05965622, first posted on July 28, 2023). [ABSTRACT FROM AUTHOR]

Background: Adolescent mental health (AMH) is a critical issue worldwide, particularly in West Africa, where it is intensified by socio-economic, cultural, and security challenges. Insecurity and the presence of mining sites expose adolescents to hazardous environments, substance abuse, and adulterated alcohol, further aggravating their mental health. Despite these severe issues, research on AMH in this region remains limited. This study aims to analyze the provision of AMH services in Burkina Faso, Ghana, and Niger, highlighting the unique challenges these countries face within the broader West African healthcare context. Methods: The study adopted a multi-stage, stratified sampling design to collect data from primary healthcare centers (PHCs) in the three countries. Using STATA.17, Descriptive analysis was conducted on the data related to availability of AMH services, types of mental health disorders treated, resources available, and OPD attendance rates. The analysis also incorporated factors such as the rural-urban divide and the presence of national guidelines for AMH services. Results: The findings reveal a significant shortfall in the provision of AMH services across the region, with less than 30% of PHCs across all the countries offering these services. The study also highlights a pronounced rural-urban disparity in AMH service availability, a general absence of national guidelines for AMH care, and low OPD attendance rates. Conclusion: The study highlights the urgent need for comprehensive policy reform and targeted interventions to enhance AMH services in West Africa. Key policy reforms should include the development and implementation of national guidelines for AMH care and integration of AMH services into primary healthcare. Additionally, efforts should focus on capacity building through the training of mental health professionals, increasing public awareness to reduce stigma, and ensuring equitable resource allocation across rural and urban areas. Improving AMH care is essential not only for the well-being of adolescents but also for driving broader socio-economic development in the region. [ABSTRACT FROM AUTHOR]

Background: Men and women differ in the mental health issues they typically face. This study aims to describe gender differences in preferences for mental health treatment options and specifically tries to identify participants who prefer AI-based therapy over traditional face-to-face therapy. Method: A nationally representative sample of 2,108 participants (53% female) aged 18 to 74 years completed a choice-based conjoint analysis (CBCA). Within the CBCA, participants evaluated twenty choice sets, each describing three treatment variants in terms of provider, content, costs, and waiting time. Results: Costs (relative importance [RI] = 55%) emerged as the most critical factor when choosing between treatment options, followed by provider (RI = 31%), content (RI = 10%), and waiting time (RI = 4%). Small yet statistically significant differences were observed between women and men. Women placed greater importance on the provider, while men placed greater importance on cost and waiting time. Age and previous experience with psychotherapy and with mental health apps were systematically related to individual preferences but did not alter gender effects. Only a minority (approximately 8%) of participants preferred AI-based treatment to traditional therapy. Conclusions: Overall, affordable mental health treatments performed by human therapists are consistently favored by both men and women. AI-driven mental health apps should align with user preferences to address psychologist shortages. However, it is uncertain whether they alone can meet the rising demand, highlighting the need for alternative solutions. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Background Methods Results Conclusion Relevance to Clinical Practice No Patient or Public Contribution To analyse the literature on parents' experiences of accessing mental health services with their adolescents for mental health challenges in Ireland.Health systems globally have inadequately addressed mental health service needs resulting in notable gaps between population needs and access to adolescent mental health services.This scoping review followed Arksey and O'Malley's six‐stage framework and PRISMA‐ScR reporting guidelines. Five electronic databases SocINDEX, MEDLINE, CINHAL, Scopus and EBSCO were searched and reference lists screened 2015–2024.Twenty‐three studies were included. Applying Braun and Clarke's thematic analysis identified three themes: adolescent community mental health services for adolescents with mental health challenges, accessing mental healthcare services via emergeny departments for adolescents with mental health challenges and parents' experiences of accessing mental health services for their adolescents with mental health challenges.Parents' experiences of accessing mental health services for their adolescents are not fully understood, and further research is required to map key concepts to inform practice and policymaking.The findings from this scoping review highlight challenges for adolescent mental health services in Ireland and internationally. Heightening awareness of these issues is necessary to improve the clinical practice of nurses.This was a scoping review study. [ABSTRACT FROM AUTHOR]

The psychosocial needs of people with acquired brain injury (ABI) have been neglected based on ableist assumptions of incapability to participate in mental health treatment. Although people without disabilities benefit from evidence‐based mental health supports, these treatments remain inaccessible for those with disabilities after ABI. Discursive simplifications used in dominant conceptualisations of health and disability may maintain this inaccessibility. This paper examines the role of discursive constraints in concealing the complexities of ABI recovery, undermining the gradients of mental health exclusion among different ABI subpopulations, and muddying possibilities for enhancing mental health accessibility. An alternate discourse that challenges disabling societies in service of centring the whole person is proposed. Discursive opportunities are thus created by conceptualising the objective and subjective dimensions of disability as intermeshed, providing both the motivation to incentivise mental health inclusion, as well as a method to achieve it. By recognising the unavoidable impact of bodily impairments on social participation, participatory ideals can be actualised by accommodating ABI‐related disabilities in mental health treatments. The possibilities for transformative research and practice are illuminated through examples of mental health treatments that have been preliminarily adapted using accommodations, and a research agenda for realising these possibilities is proposed. [ABSTRACT FROM AUTHOR]

Background: Adolescents and young adults (AYAs) receiving hematopoietic cell transplantation (HCT) are at high risk of poor psychosocial health. This study aimed to determine whether the Promoting Resilience in Stress Management (PRISM) intervention mitigated these risks during the first 6 months posttransplant. Methods: This multisite, parallel, randomized trial was conducted from April 2019 to March 2023. Eligible AYAs were aged 12–24 years, English speaking, and within 1 month of HCT for cancer or cancer predisposition syndrome. They were assigned 1:1 to PRISM (a brief, skills‐based intervention targeting "resilience resources" [stress management, goal setting, cognitive reframing, and meaning making]) or usual care (UC). Outcomes included total symptoms of depression and anxiety (Hospital Anxiety and Depression Scale; primary outcome), hope (Snyder Hope Scale), resilience (10‐item Connor–Davidson Resilience Scale), and health‐related quality of life (HRQOL; Pediatric Quality of Life Inventory Cancer Module). Analyses leveraged multivariable linear regressions; exploratory analyses assessed the influence of baseline depression or anxiety. Results: Of 94 enrolled and randomized AYAs, the mean age was 16.7 years (SD, 4.2); 43 (46%) were female, 56 (60%) were non‐Hispanic White, 22 (23%) were Hispanic, and nine (10%) were Black. Most (77%) had leukemia. Of n = 50 randomized to PRISM and n = 44 to UC, 37 (74%) and 33 (73%) completed all study procedures, respectively. In intention‐to‐treat analyses, PRISM did not affect 6‐month depression and anxiety (β = −1.1; 95% CI, −3.7 to 1.5), hope (β = 0.83; 95% CI, −3.3 to 4.9), resilience (β = −0.01; 95% CI, −3.0 to 3.0), or HRQOL (β = 1.5; 95% CI, −4.7 to 7.9). Among AYAs with preexisting anxiety or depression, PRISM recipients reported greater 6‐month improvements in hope (score change, +3.71; SD, 6.9) versus UC recipients (score change, −2.76; SD, 6.5) (p =.04). Conclusions: Resilience coaching did not influence outcomes in this sample. Exploratory findings suggest it may be more effective when directed toward those with concurrent distress. In a randomized trial conducted during the COVID‐19 pandemic among adolescents and young adults receiving hematopoietic cell transplantation for cancer or cancer predisposition, standardized resilience coaching did not influence patient‐reported depression. Exploratory findings suggest it may have promoted hopeful patterns of thoughts in the subset of participants who reported preexisting depression or anxiety. [ABSTRACT FROM AUTHOR]

Intermittent Explosive Disorder (IED) is a common, chronic, and impairing psychological condition characterized by recurrent, affective aggressive behavior. IED is associated with a host of cognitive and affective symptoms not included in the diagnostic criteria which may be a valuable indicator of heterogeneity in IED—such information can be useful to enhance understanding and treatment of this disorder in mental health settings. A preliminary investigation conducted on cognitive-affective symptom heterogeneity in individuals with a history of IED demonstrated that level of emotional dysregulation primarily differentiated IED subgroups, however the sample size was limited, and almost half of the individuals did not have current IED (only lifetime IED). The present study addressed these limitations by conducting a latent class analysis of cognitive-affective symptoms among a large (n = 504) sample of individuals diagnosed with current IED. The latent IED classes were then externally validated on several adverse outcomes, historical precursors, and demographic variables. Statistical and clinical indicators supported a four-class model, with classes primarily distinguished by patients' severity of emotion dysregulation. The two moderate emotion-dysregulated classes both endorsed callous-unemotional traits and low empathy relative to other classes, a finding which differs from the initial investigation. An external validation of the four classes revealed that they significantly differed on severity outcomes (e.g., aggression, suicide attempts, antisocial behavior, global functioning, comorbidities) and historical precursors (e.g., aversive parental care, childhood maltreatment). These findings provide further insight into the heterogeneity within IED and the associations of such variability with important precursors and clinical outcomes. • Intermittent Explosive Disorder (IED) involves recurrent and impairing aggression. • It is important to examine heterogeneity among those diagnosed with current IED. • Latent class analysis of cognitive-affective tendencies reveals four IED subgroups. • IED subgroups confer varying risk for adverse outcomes and historical precursors. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is a complex neurodegenerative disorder characterized by memory impairment and cognitive decline. Current treatments are limited, especially for late-stage AD. However, recent observations of terminal/paradoxical lucidity in patients with severe dementia suggest that cognitive decline may be reversible, at least temporarily. This phenomenon may be due to the formation of neural bypasses that restore cognitive functions. Additionally, there is growing interest in the potential of psychedelics, such as DMT, LSD, and psilocybin, to rewire the brain and enhance neuroplasticity. These substances have shown promise in reducing Aβ accumulation, improving cognitive impairment, and inducing positive emotional states. Microdosing psychedelics is also being explored as a potential treatment for AD. However, integrating psychedelics into mainstream clinical practice for dementia presents challenges, including the need for robust clinical evidence, ethical considerations, and regulatory hurdles. Despite these challenges, the study of terminal lucidity and psychedelics offers innovative pathways for the treatment of AD, particularly in its advanced stages. [Extracted from the article]

Background: Even though human rights advocacy is a part of mental health care, psychiatric nurses in South Africa's primary healthcare (PHC) setting face substantial challenges when advocating for the rights of mental health care users (MHCUs). The study aimed to develop a conceptual framework to facilitate psychiatric nurses' advocacy for mental healthcare users' human rights in a PHC setting. Methods: A qualitative, exploratory, descriptive, and contextual design was used to investigate the psychiatric nurses' experiences advocating for MHCUs' human rights in a PHC setting. Three phases were followed: the empirical phase, the classification of concepts, and a development phase. Following the empirical phase, a conceptual framework was developed to facilitate psychiatric nurses' advocacy for MHCUs human rights in a PHC setting. Results: Three themes were derived from focus group interviews with psychiatric nurses in the empirical phase. These themes yielded the central concept as 'the facilitation of empowerment' of psychiatric nurses in advocating for MHCUs' human rights. The central concepts were also classified. A conceptual framework was developed that included the relationship, working and termination phases. Conclusion: The study described the development of a conceptual framework to facilitate psychiatric nurses' advocacy for mental healthcare users' human rights in a PHC setting. Psychiatric nurses play a key role in advocating for the human rights of MHCUs. This task is important and should be implemented from the government to the societal level, including all stakeholders. [ABSTRACT FROM AUTHOR]

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

Introduction Objective Design Findings Discussion Conclusion Growing the mental health peer workforce holds promise for rural communities, but we currently lack an understanding of the guidance available to support the development, implementation and sustainability of this workforce in rural settings.Study aims are to: (1) determine the extent and nature of the literature that provides guidance for growing the peer workforce in rural mental health services; and (2) identify and explore any guidance relevant to rural peer work services dedicated to First Nations communities, including those promoting social and emotional well‐being within this body of literature.A scoping review method was employed to identify relevant peer‐reviewed and grey literature published between 2013 and 2022 across PsychInfo, Medline, Embase and CINAHL, Scopus and Informit HealthInfoNet databases, as well as targeted organisation websites and Google Advanced Search.A total of 26 unique studies/projects were included from the US, UK, Canada and Australia with public mental health, non‐government/for purpose and private sector service settings represented in the literature. Grey literature, such as reports of evaluations and frameworks, formed the majority of included texts. While there is a lesser volume of rurally focused literature relative to the general peer work literature, this is a rich body of knowledge, which includes guidance concerning services dedicated to First Nations communities. Via synthesis critical considerations were identified for the development, implementation and sustainability of peer work in rural mental health services across six domains: ‘Working with community members and stakeholders’, ‘Organisational culture and governance’, Working with others and in teams, Professional expertise and experience, Being part of and working in the community and ‘Local mental health services capacity’.While there are considerations relevant across a range of settings, the domains of: ‘working with community members and stakeholders’, ‘being part of and working in the community’ and ‘local mental health services capacity’, capture additional, distinct and nuanced challenges and opportunities for growing the peer work in rural services.The literature offers insights valuable for service planning, policy development and the allocation of resources to support rural peer workforce growth. [ABSTRACT FROM AUTHOR]

Patients and healthcare practitioners have commended the systems' effectiveness, ease, and user-friendliness in several situations. Utilizing cutting-edge ideas and methods from the multidisciplinary domains of electricity, computing, medical engineering, and medicine, mobile healthcare (m-health) technology advances these professions' contributions to healthcare systems. The monitoring and delivery of healthcare interventions are becoming increasingly dependent on mobile phones. Because of their sophisticated processing functions, improved preferences, and wide range of capabilities, they are frequently referred to as pocket computers. Their advanced sensors and intricate software programmers increase the viability and innovation of m-health solutions. To design the m-health application, the design science research methodology (DSRM) framework was used. Additionally, the architecture for connecting the hospital information system and mobile device network together was established. Additionally, a few exemplary intelligent healthcare applications are examined to demonstrate how data analytics and mobile computing can be used to improve the quality of healthcare services. [ABSTRACT FROM AUTHOR]

Objective: Studies have shown the adverse psychological impact of polycystic ovary syndrome (PCOS), but the state of mental health in adolescents with PCOS remains unclear. Thus, we performed a systematic review and meta-analysis to investigate the prevalence and severity of depression and anxiety, as well as potential effects on self-esteem and quality of life (QoL) in this specific population. Methods: We systematically searched four electronic databases: PubMed, Embase, Web of Science, and the Cochrane Reviews database for articles published until 25/8/2024. We considered observational studies in which the subjects were adolescent girls with PCOS who had reported symptoms including anxiety, depression, self-esteem, and QoL. The Review Manager version 5.4 was used to analyze the available data extracted. We used the Newcastle-Ottawa Quality Assessment Scale (NOS) to evaluate the quality of selected studies. A funnel plot was utilized to assess the risk of literature bias, and a forest plot was used to represent the combined outcomes. This systematic review was previously registered in PROSPERO with the registration number CRD42022382036. Results: We included 11 studies in the systematic review and conducted metaanalyses on 10 of them. Adolescents with PCOS reported a higher risk of depression (OR = 2.21, 95% CI: 1.23 to 4.00, p = 0.008) and a higher level of depression scores (SMD = 0.43, 95% CI: 0.16 to 0.71, p = 0.002) than controls. There were no significant differences in anxiety (OR = 1.90, 95% CI: 0.52 to 6.96, p = 0.33; SMD = 0.19, 95% CI: -0.21 to 0.59, p = 0.36), self-esteem (SMD = -0.17, 95% CI: -0.85 to 0.52, p = 0.64), and QoL (SMD = -0.15, 95% CI: -0.42 to 0.11, p = 0.26) between the two groups. Conclusions: Our research indicated that adolescents with PCOS experienced more severe depressive symptoms than those without PCOS. This highlights the importance of evaluation and early treatment of mental health in PCOS. More clinicians should pay attention to the mental health of adolescent girls with PCOS through this study. [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]

As mental health issues become increasingly prominent, we are now facing challenges such as the severe unequal distribution of medical resources and low diagnostic efficiency. This paper integrates finite state machines, retrieval algorithms, semantic-matching models, and medical-knowledge graphs to design an innovative intelligent auxiliary evaluation tool and a personalized medical-advice generation application, aiming to improve the efficiency of mental health assessments and the provision of personalized medical advice. The main contributions include the folowing: (1) Developing an auxiliary diagnostic tool that combines the Mini-International Neuropsychiatric Interview (M.I.N.I.) with finite state machines to systematically collect patient information for preliminary assessments; (2) Enhancing data processing by optimizing retrieval algorithms for efficient filtering and employing a fine-tuned RoBERTa model for deep semantic matching and analysis, ensuring accurate and personalized medical-advice generation; (3) Generating intelligent suggestions using NLP techniques; when semantic matching falls below a specific threshold, integrating medical-knowledge graphs to produce general medical advice. Experimental results show that this application achieves a semantic-matching degree of 0.9 and an accuracy of 0.87, significantly improving assessment accuracy and the ability to generate personalized medical advice. This optimizes the allocation of medical resources, enhances diagnostic efficiency, and provides a reference for advancing mental health care through artificial-intelligence technology. [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. [ABSTRACT FROM AUTHOR]

Background/Objectives: Ethnic identity development is associated with positive mental health in young adults from ethnic minority groups. How a sense of belonging and attachment to one's ethnic culture is related to personal mental health recovery remains unexplained. This study examines the experiences of ethnic minority young adults in the U.S. to understand the aspects of culture and identity development that are relevant to their recovery processes. Methods: Young adults who were living with chronic mental disorders were recruited from four rehabilitation programs. Interviews produced quantitative and qualitative data. An explanatory sequential mixed methods design was used to integrate the qualitative findings from a sub-group of young adults (n = 44) with the results from the quantitative study. Directed content analysis was used to analyze the qualitative data, and the integrated data were analyzed in joint displays. Results: The prominent themes characterizing ethnic identity development in personal recovery were (a) cultural history, traditions, and values; (b) mental illness stigma within the ethnic community; and (c) bias and discrimination in mental health services. Young adults with high ethnic identity development reported having more support from family, but they also described experiences with stigma and racism. Conclusions: The integrated results suggest that ethnic identity development promotes mental health recovery in minoritized young adults through social support and improved well-being and resilience. Experiences of intersectional stigma and structural racism associated with ethnic identity can interfere with self-determination and access to care among minoritized Hispanic/Latine, Black, and multiracial young adults in the U.S. [ABSTRACT FROM AUTHOR]

Background: Kerala is a state in south India, appreciated for its education, better health indicators and quality of life. However, there is a proportionately high prevalence of mental health illnesses and suicides reported in the state. It is unclear if there is any disparity in the gender categories in this. With this systematic review, we aim to systematically study the gender disparity in the prevalence of mental health (MH) issues among adolescents, younger and older adults in Kerala. Methods: A search strategy was built and several databases like Pubmed, Cochrane, Scopus, EMBASE, EBSCOhost, Web of Science, and ProQuest were used alongside grey literature to identify relevant articles. The study was conducted according to the PRISMA guidelines following a prespecified protocol. After relevant data extraction, the estimates were pooled using random effects model due to the high heterogeneity assessed by tau-squared, Cochran Q, and prediction interval. Subgroup analyses, and meta-regression were used to reduce heterogeneity. We also identified the influence and heterogeneity contributed by individual studies using influence plots, Baujat plot, clustering, and performed several sensitivity analyses. Results: Twenty articles were included in the review and meta-analysis. The pooled odds ratio of mental health illnesses amongst females compared to males in Kerala was 1.31 (95% CI: 1.0 − 1.73) and falls within a prediction interval of 0.38 to 4.53. The individual studies showed high heterogeneity (I2 = 92%, p = p < 0.01) and hence, subgroup analysis was done for several prespecified subgroups based on etiology, geography, demography, study settings, and age groups. Heterogeneity was significantly reduced by subgrouping based on etiology, study setting and age (p, 0.001, p < 0.001, p = 0.001). In etiologic subgrouping the highest pooled odds was in comorbidities associated MH issues (2.54) and least in non-specific (0.97). In age subgrouping, the highest pooled odds was in elderly (2.53) and least in adolescents (0.63). The odds was highest in health care facility (2.21) and least in educational institution (0.78) based studies. Meta-regression based on the size of the study failed to reduce heterogeneity. Interpretations: A gender disparity was evident in the prevalence of mental health issues, with a higher Odds in females especially among the elderly and adults. A Gender transformative approach in legislative, health systems and policy frameworks will be the answer to this. [ABSTRACT FROM AUTHOR]

Background: Peer support workers provide support for people experiencing mental health conditions based on their own lived experience of mental health problems. Assessing fidelity to core ingredients of peer support is vital for successful implementation and intervention delivery. Modifications to its implementation are needed when scaling up to different socio-economic settings, raising further uncertainty about fidelity. As part of a large multi-centre study on peer support called Using Peer Support In Developing Empowering Mental Health Services (UPSIDES), we developed and evaluated the psychometric properties of the UPSIDES Fidelity Scale. Methods: We constructed the fidelity scale based on an initial item pool developed through international expert consultation and iterative feedback. Scale refinement involved site-level expert consultation and translation, resulting in a service user-rated 28-item version and a peer support worker-rated 21-item version assessing receipt, engagement, enactment, competence, communication and peer support-specific components. Both versions are available in six languages: English, German, Luganda, Kiswahili, Hebrew and Gujarati. The scale was then evaluated at six study sites across five countries, with peer support workers and their clients completing their respective ratings four and eight months after initial peer support worker contact. Psychometric evaluation included analysis of internal consistency, construct validity and criterion validity. Results: For the 315 participants, item statistics showed a skewed distribution of fidelity values but no restriction of range. Internal consistency was adequate (range α = 0.675 to 0.969) for total scores and all subscales in both versions. Confirmatory factor analysis indicated acceptable fit of the proposed factor structure for the service user version (χ2/df = 2.746; RMSEA = 0.084) and moderate fit for the peer support worker version (χ2/df = 3.087; RMSEA = 0.093). Both versions showed significant correlations with external criteria: number of peer support sessions; perceived recovery orientation of the intervention; and severity of illness. Conclusions: The scale demonstrates good reliability, construct and criterion validity, making it a pragmatic and psychometrically acceptable measure for assessing fidelity to a manualised peer support worker intervention. Recommendations for use, along with research and practical implications, are addressed. As validated, multi-lingual tool that adapts to diverse settings this scale is uniquely positioned for global application. Trial registration: ISRCTN, ISRCTN26008944. Registered on 30 October 2019. [ABSTRACT FROM AUTHOR]

Objective: This study, the first to assess the reliability and validity of the Work and Social Assessment Scale (WSAS) in Norwegian routine mental health care, examines differences in functional impairment based on sick leave status, psychiatric diagnosis, and sex. Method: Including 3573 individuals from community mental health services (n1 = 1157) and a psychiatric outpatient clinic (n2 = 2416), exploratory factor analysis (EFA) on subsample 1 and confirmatory factor analysis (CFA) on subsample 2 were utilized to replicate the identified factor structure. Results: EFA supported a one-factor model, replicated by the CFA, with high internal consistency (α =.82, ω =.81). Patients on sick leave reported greater impairments in all aspects of functioning, except for relationships, with the largest effect size observed in the reported ability to work (d =.39). Psychiatric outpatients with major depressive disorder were associated with difficulties in home management, private leisure activities, and forming close relationships. Patients with attention-deficit/hyperactivity disorder reported less impairment than those with other disorders. Patients with personality disorders reported more relationship difficulties than those with PTSD, ADHD, and anxiety. No differences were found in the perceived ability to work between diagnoses. Women had a higher impairment in private leisure activities, whereas men reported more impairment in relationships. Conclusion: The demonstrated reliability and validity suggest that WSAS is a valuable assessment tool in Norwegian routine mental health care. Variations in functional impairment across sick leave status, sex, and psychiatric diagnoses highlight the importance of integrating routine assessments of functional impairment into mental health care practices. Future research should combine WSAS with register data to allow for a broader understanding of treatment effectiveness, emphasizing improvements in functional outcomes alongside symptom alleviation. [ABSTRACT FROM AUTHOR]

Background: The use of digital tools such as electronic patient portals in different health care disciplines and settings has been increasing, but the rate of implementation in clinical practice still lags behind expectations. While studies have linked the use of electronic patient portals to positive health outcomes for patients, studies addressing the viewpoints of healthcare providers are rare. Methods: We performed an online survey of attitudes of healthcare providers towards an electronic patient portal for mental health hospitals. The portal was developed by five communal providers of mental health care in different regions in Germany. The survey was carried out during the early phase of implementation of the portal. Results: Twenty project leaders and 37 clinicians from five different mental health hospitals answered the questionnaire (response rate: 45% and 28%). Overall, acceptance of online applications among respondents was high. The healthcare providers mentioned perceived benefits (e.g. accessibility of new patient groups, use of therapy-free periods) as well as a number of technical, structural, organizational and staffing barriers for successful implementation in hospital settings (e.g. workload of healthcare providers and lack of staff, limited digital competences, unstable WLAN). Conclusion: The perceived barriers and facilitators of the implementation of online applications and electronic patient portals in mental health hospitals identified by healthcare providers may be taken into account. Improving commitment of the healthcare providers to implementation and use of digital interventions may help foster digitalisation in mental health hospitals. [ABSTRACT FROM AUTHOR]

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

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

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

ABSTRACT Aim(s) Design Methods Data Source Results Conclusion Implications for the Profession and/or Patient Care Reporting Method Patient or Public Contribution To describe the characteristics and perceived effectiveness of clinical supervision mental health nurses are receiving and further explore any statistical correlations between the perceived effectiveness and satisfaction with the supervisee, supervisor and supervision characteristics.A cross‐sectional survey.An online survey was distributed to nurses working in public mental health services in Victoria, Australia. A universal recruitment approach was used, and 422 nurses participated in the survey. Of these, 220 nurses who are participating in clinical supervision were eligible for the MCSS‐26 survey.A licensed MCSS‐26 questionnaire.Mental health nurses in the studied environment were likely to receive individual supervision from a senior mental health nurse, with the most common frequency being monthly for 31–60 min, and half receiving it within their workplace location. Half of the participants chose their own supervisor. Our findings indicate that nurses who engage in clinical supervision outside of their immediate workplace and receive individual supervision from a nurse of the same grade perceive higher effectiveness. We also found that clinical nurses may find it most difficult to engage in effective clinical supervision due to time constraints.This study uniquely contributes to the current clinical supervision literature by reporting the uptake and detailed characteristics of supervision, a facet often overlooked in existing research.This study reported the characteristics of the supervision, supervisor and the supervisee that are associated with the effective clinical supervision. These insights can lead to tailored implementation strategies that consider the specific roles and settings of nurses.CROSS (Sharma et al. 2021).No patient or public contribution. [ABSTRACT FROM AUTHOR]

ABSTRACT Countries around the world are experiencing both a growing need for mental health services and major gaps in the delivery of mental healthcare. The World Health Organisation's 2022 report on mental health emphasised co‐designed and systems‐level innovations responsive to the voice of those with lived experience. However, evidence for implementing such methodologies is sparse. Group model building (GMB), a participatory systems‐based approach, has been used in various fields, but its application is limited within mental healthcare settings. It is recognised as a valuable tool for engaging stakeholders, including those with lived experience, in understanding and redesigning health systems and services. The participatory approach aligns with the mental health sector's shift towards co‐design and person‐centred care. This study assessed the acceptability of GMB as a method for co‐design within mental healthcare, aiming to explore its potential for meaningful collaborative improvement and systems‐level insights. Participants from a regional Mental Health and Drug and Alcohol Service (MHDAS) engaged in GMB workshops and focus groups. Eighteen individuals, including lived experience workers and healthcare professionals, provided feedback that informed adjustments to the workshops' design, language, timing and facilitation techniques, enhancing GMB's relevance for mental health co‐design. The findings demonstrate the value and acceptability of the adapted GMB process in acute mental healthcare, marking a significant step towards evidence‐based, person‐centred service improvement. This study highlights the potential effectiveness of participatory methods in identifying and addressing systemic challenges, paving the way for future mental health reforms. Future work will focus on implementing and evaluating co‐designed interventions, aiming for more inclusive and effective mental healthcare and advancing innovation and reform in the field. [ABSTRACT FROM AUTHOR]

ABSTRACT Mental health service integration currently has no consensus definition and exists in a variety of settings, including primary care, addiction treatment and chronic disease management, and mental health nurses have often experienced efforts at service integration with varying degrees of success. The intent of mental health service integration is to enable collaboration between mental health services and other healthcare providers to improve service access and the care provided to individuals with mental health issues or mental illness. This scoping review aimed to explore service integration between mental health services and with a specific focus on those evaluated in peer‐reviewed, primary literature, to determine facilitators and barriers to service integration. Using the Arksey and O'Malley's framework for scoping reviews, we located 3148 studies, with screening narrowing final papers for inclusion to 18. Facilitators to service integration included clinician education, adequate resourcing and an interdisciplinary approach, while barriers included staff factors such as a reluctance to work with individuals with mental illness, consumer level barriers such as poor mental health literacy, ‘territorialism’ among staff and organisational climate. Research indicates that service integration is an effective means to detect and treat mental health issues in settings that do not traditionally provide mental health care, lowering the costs of providing healthcare and providing improved care for mental health needs; however, there are several barriers to be addressed to achieve full implementation of integration models. [ABSTRACT FROM AUTHOR]