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Coaches' knowledge, attitudes, and beliefs about mental health—or mental health literacy (MHL)—affect teams' mental health climates and the detection, referral, and treatment of athletes' mental health concerns. Thus, assessing collegiate coaches' MHL, and factors related to its presence, is critical. Using the Mental Health Literacy Scale, 1,571 NCAA (National Collegiate Athletic Association) coaches were surveyed regarding their MHL and demographic and mental health experience factors. Overall, 99.9% of the coaches surveyed believe that athletes' mental health affected their sport performances. Through hierarchical regression analyses, coaches' exposure to mental health treatment, perceived helpfulness of mental health treatment, gender (i.e., woman), years coaching (i.e., fewer years), and current NCAA division (i.e., Division III) were significantly related to their MHL, explaining 15.5% of variance. However, coaches' race/ethnicity did not reach significance. Recommendations regarding increasing coaches' MHL and hiring appropriately trained and licensed mental health and sport psychology professionals are offered. [ABSTRACT FROM AUTHOR]

Assistant coaches play an important role in National Collegiate Athletic Association (NCAA) athletic departments and spend substantial amounts of time working with student-athletes, yet no research to date has examined their knowledge of mental performance and mental health services. Therefore, the purpose of this study was to learn about NCAA Division I assistant coaches' understanding and use of mental performance and mental health services. Thirteen assistant coaches employed at universities with at least one mental performance consultant and one licensed mental health provider were interviewed. Thematic analysis procedures were used, and five themes were constructed: (a) day-to-day responsibilities of the assistant coach, (b) needing both mental performance and mental health services, (c) factors influencing understanding of mental performance and mental health services, (d) factors impacting student-athlete utilization of mental performance and mental health services, and (e) confusion between mental performance and mental health services. [ABSTRACT FROM AUTHOR]

Athletes ( I N = i 584) completed the Group Environment Questionnaire (Carron et al., 1985) to measure perceptions of cohesion and the SPLIT to assess athlete leadership behaviors. using structural equation modelling (SEM), the results showed the athlete leadership dimensions of task- and change-oriented leadership were positively related to the cohesion dimensions of ATG-T ( =.19, I p i <.05; =.62, I p i <.05, respectively) and GI-T ( =.16, I p i <.05; =.62, I p i <.05, respectively). B An examination of positive body image, sport-confidence, and sport performance evaluations in Jamaican athletes b I Chelsi Ricketts, Michigan State University; Leapetswe Malete, Michigan State University; Nicholas D. Myers, Michigan State University; André G. Bateman, The University of the West Indies, Mona, Jamaica; Caryl James Bateman, The University of the West Indies, Mona i Body image research in sport has primarily examined athletes' risk for developing body-related psychopathologies (e.g., negative body image, eating disorders), despite evidence of higher positive body image in athletes compared to non-athletes. It was hypothesized that (a) body and functionality appreciation would exert positive direct effects on sport-confidence, (b) sport-confidence would exert a positive direct effect on sport performance evaluations, and (c) body and functionality appreciation would exert positive indirect effects on sport performance evaluations through sport-confidence. The purpose of this study was to validate an athlete-reported version of the CLSS-Q. In total, 528 (high school, I n i = 346; college, I n i = 182) student-athletes completed the athlete-reported version of the 36-item CLSS-Q. To assess the factor structure of the athlete-reported CLSS-Q, we conducted a series of exploratory structural equation models (ESEM) and confirmatory factor analyses (CFA). [Extracted from the article]

Rates of hospitalizations and emergency department (ED) visits due to self-harm are important indicators for understanding the impact of the COVID-19 pandemic on mental health. The objective of this study was to assess changes in self-harm hospitalizations and ED visits in Canada during the first two years of the pandemic. Rates of self-harm hospitalizations and ED visits during the pandemic were predicted based on regression analyses that modeled trends over a 5-year pre-pandemic period from fiscal year 2015 to 2019. The ratios of observed and model predicted (expected) rates in 2020 and 2021 were estimated separately to assess changes during the pandemic. Overall, rates of self-harm hospitalizations and ED visits were lower than expected during the pandemic, especially in 2020. In 2021, rates for females returned to near-expected levels; but they remained lower than expected for males. Females aged 10–14 years had higher than expected rates. The rate ratio of observed rate over expected rate was 1.2 in 2020 but further increased to 1.8 in 2021 for both hospitalizations and ED visits. Higher than expected rates were also observed among females aged 15–19 years in 2021 only. Suicide attempts and non-suicidal self-harm cases could not be distinguished. We observed lower than or close to expected rates of self-harm hospitalizations and ED visits during the pandemic for most population groups. The increased rates for young females highlights the importance of continued surveillance post-pandemic and targeted mental health services and suicide prevention programs. • This study assessed changes in self-harm hospitalizations and ED visits in Canada during the COVID-19 pandemic. • In 2020, overall rates of self-harm hospitalizations and ED visits were lower than expected. • In 2021, rates for females returned to near-expected levels; but they remained lower than expected for males. • Females aged 10–19 years had increased rates during the pandemic, especially for females aged 10–14 years in 2021. • The findings highlight the importance of continuing surveillance post-pandemic and targeted mental health services. [ABSTRACT FROM AUTHOR]

Aims and method: There are numerous challenges in the recruitment and retention of the medical workforce in psychiatry. This mixed-methods study examined the role of psychiatry clinical attachments for international medical graduates (IMGs) to enhance recruitment and retention. An online survey was launched to capture views and perceptions of IMGs about clinical attachments. The quantitative and qualitative responses were analysed to elicit findings. Results: In total, 92 responses were received, with respondents commonly from India, Pakistan and Egypt. Respondents were mostly aged 25–34, with ≥3 years of psychiatry experience. Over 80% expressed strong interest in completing a psychiatry clinical attachment and believed it would support career progression. Qualitative data indicated that IMGs hoped to gain clinical experience and understanding of the National Health Service (NHS). They wished for a clearer, simpler process for clinical attachments. Clinical implications: Clinical attachment can be mutually beneficial, providing IMGs with opportunity to confidently start their psychiatry career in the UK and enhance medical recruitment in mental health services across the NHS. [ABSTRACT FROM AUTHOR]

Aims and method: The prevalence of delaying psychiatric care until the patient has received 'medical clearance', and the definitions and understanding of 'medical clearance' terminology by relevant clinicians, are largely unknown. In a service evaluation of adult liaison psychiatry services across England, we explore the prevalence, definitions and understanding of 'medical clearance' terminology in three parallel studies: (a) an analysis of trust policies, (b) a survey of liaison psychiatry services and (c) a survey of referring junior doctors. Content and thematic analyses were performed. Results: ' Medical clearance' terminology was used in the majority of trust policies, reported as a referral criterion by many liaison psychiatry services and had been encountered by most referring doctors. 'Medical clearance' was identified as a common barrier to liaison psychiatry referral. Terms were inconsistently used and poorly defined. Clinical implications: Many liaison psychiatry services seem not to comply with guidance promoting parallel assessment. This may affect parity of physical and mental healthcare provision. [ABSTRACT FROM AUTHOR]

Purpose The complexity of patients with mental healthcare needs cared for by clinical pharmacists is not well delineated. We evaluated the complexity of patients with schizophrenia, bipolar disorder, and major depressive disorder (MDD) in Veterans Affairs (VA) cared for by mental health clinical pharmacist practitioners (MH CPPs). Methods Patients at 42 VA sites with schizophrenia, bipolar disorder, or MDD in 2016 through 2019 were classified by MH CPP visits into those with 2 or more visits ("ongoing MH CPP care"), those with 1 visit ("consultative MH CPP care"), and those with no visits ("no MH CPP care"). Patient complexity for each condition was defined by medication regimen and service utilization. Results For schizophrenia, more patients in ongoing MH CPP care were complex than those with no MH CPP care, based on all measures examined: the number of primary medications (15.3% vs 8.1%), inpatient (13.7% vs 9.1%) and outpatient (42.6% vs 29.7%) utilization, and receipt of long-acting injectable antipsychotics (36.7% vs 25.8%) and clozapine (20.5% vs 9.5%). For bipolar disorder, more patients receiving ongoing or consultative MH CPP care were complex than those with no MH CPP care based on the number of primary medications (27.9% vs 30.5% vs 17.7%) and overlapping mood stabilizers (10.1% vs 11.6% vs 6.2%). For MDD, more patients receiving ongoing or consultative MH CPP care were complex based on the number of primary medications (36.8% vs 35.5% vs 29.2%) and augmentation of antidepressants (56.1% vs 54.4% vs 47.0%) than patients without MH CPP care. All comparisons were significant (P < 0.01). Conclusion MH CPPs provide care for complex patients with schizophrenia, bipolar disorder, and MDD in VA. [ABSTRACT FROM AUTHOR]

Objective: Culturally safe service provision is essential to improving social and emotional wellbeing among Aboriginal and Torres Strait Islander communities, and to eliminating health inequities. Cultural safety is about ensuring that all people have a safe and healing journey through services, regardless of their cultural background. In this project, we aim to (1) understand how Aboriginal and Torres Strait Islander peoples conceptualise cultural safety, and (2) co-design a qualitative interview for the next phase of this project, where we plan to learn about experiences of cultural safety within mental health services. Methods: We conducted six focus groups (in one metro and two regional areas, Western Australia). Following an Aboriginal Participatory Action Research methodology, we yarned with Aboriginal and Torres Strait Islander mental health service users, carers, community members, mental health professionals and Cultural Healers about cultural safety. Results: Participants described a culturally safe service as one where Aboriginal cultural knowledges, life experiences, issues and protocols are understood and acknowledged, and reported that mainstream mental health services are not currently culturally safe. Participants emphasised the importance of building trust, rapport, reciprocity and following appropriate relational processes when designing a qualitative interview for the next phase. Conclusions: A lack of cultural safety in mental health services is likely to contribute to the disparity in outcomes between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Embedding cultural safety into research design allows for authentic community engagement and facilitates knowledge sharing around ways to improve cultural safety in mental health services. [ABSTRACT FROM AUTHOR]

Indigenous Psychology within Australia reflects the traditional knowledges of Aboriginal and Torres Strait Islander Peoples and their understanding of the cultivation of relational social and emotional wellbeing (SEWB). However, these perspectives are poorly incorporated into dominant "Western" psychological theories and practice, such as Cognitive Behaviour Therapy (CBT). This represents a barrier to the cultural safety of current mental health practice and its decolonisation within Australia. This study brought together CBT Practitioners and Practitioners of an Aboriginal Wellbeing practice ("Wayapa") to engage in a series of yarns (guided focus groups) to share perspectives, insights, and stories on their own and each other's practices. Indigenous qualitative research approaches including Research Topic Yarning were engaged to decolonise the research environment and support dialogue at the cultural interface of the two practices. Through experiencing Wayapa, CBT practitioners reflected on gaps in their own practice, with an enthusiasm for the opportunities that Wayapa provided to decolonise their practice. Wayapa practitioners were able to celebrate the holistic nature of their practice and the possibility for it to inform dominant "Western" psychological theories and practice, such as CBT, and encourage a more connected and culturally safe way of working with First Nations peoples. Creating safe cultural interfaces between "Western" and Indigenous Psychologies, and building awareness of the value of Aboriginal grounded wellbeing models, can help to promote and expand culturally safe practices within Australian psychological practice. What is already known about this topic: The cultural safety and relevance of CBT for Aboriginal and/or Torres Strait Islander Peoples remains uncertain. There is limited knowledge of Aboriginal wellbeing practices and Indigenous Psychologies amongst non-Indigenous Australian mental health practitioners, including psychologists. Broadened understanding of Aboriginal wellbeing practices such as Wayapa Wurrrk, may contribute to decolonising psychology in Australia. What this topic adds: CBT and Wayapa share common and unique tools and concepts that can support the social emotional wellbeing of all Australians. Wayapa Wurrrk concepts such as earth mindfulness and the centring of Country as a foundation for wellness and social emotional wellbeing represent gaps in current CBT practice. Work at the cultural interface of "Western" and Indigenous Psychology offers a pathway to promote appreciation for, and active utilisation of, Indigenous psychologies including the social emotional wellbeing framework (SEWB). In this article, we recognise both Aboriginal and Torres Strait Islander Peoples as the First Nations of Australia. We acknowledge and pay respect to the knowledge that Aboriginal and Torres Strait Islander cultures are unique, all with their own languages, knowledge systems, beliefs, and histories. We recognise the collective terms they prefer also vary. With respectful consideration to these preferences, typically we will specify Aboriginal and/or Torres Strait Islander Peoples when referring to First Nations Peoples in this article. From time to time, we use the term Indigenous. However, we note that for many Aboriginal and Torres Strait Islander Peoples, this is not preferred. As such, we have only used this where we are referencing it's use from another source, or it is the established use of the term, such as its use in "Indigenous knowledges". Where referring to individual Aboriginal and/or Torres Strait Islander people, we have endeavoured to incorporate their preferences, including for example, reference to the Country they are connected to. [ABSTRACT FROM AUTHOR]

This preliminary study investigates factors related to reduced access to mental healthcare among women in the perinatal period. We enrolled 145 pregnant women followed in OB-GYN services, using the Edinburgh Postnatal Depression Scale as a clinical measure for depression symptoms. We observed low levels of adherence to psychiatric screenings and referrals. Our findings confirm the importance of improving access to mental healthcare for women in the perinatal period. [ABSTRACT FROM AUTHOR]

Workplace-related factors are associated with the risk of depression. Despite implementation of workplace health promotion (WHP) programmes in China to promote the physical and mental well-being of workers, the relationship between WHP and depression has received limited attention. This study investigated the association between WHP service utilisation and depressive symptoms among workers. This was a cross-sectional survey. A researcher-designed questionnaire was used to collect information on socio-demographic and occupational characteristics, WHP service utilisation, and mental health status. The Lasso method was used for variable selection to achieve dimension reduction, and logistic regression was used to assess the association between WHP service utilisation and depressive symptoms. The analysis included 11,710 workers, of whom 17.0% had depressive symptoms. Lasso regression resulted in 6 of 18 WHP services showing significant negative associations with depressive symptoms, including occupational safety training, mental health services, health check-ups, sports activities, fitness rooms, and healthy canteens. The logistic regression results showed that, after adjusting for sociodemographic and occupational factors, utilisation of these six services was associated with a decreased likelihood of depressive symptoms. The adjusted odds ratio (aOR) was 0.84 (95% confidence interval [CI]: 0.73–0.96) for occupational safety training, aOR: 0.82 (95% CI: 0.68–0.99) for mental health services, aOR: 0.80 (95% CI: 0.71–0.90) for health check-ups, aOR: 0.68 (95% CI: 0.57–0.80) for sports activities, aOR: 0.59 (95% CI: 0.47–0.74) for fitness rooms and aOR: 0.72 (95% CI: 0.59–0.87) for healthy canteens. Utilisation of WHP services was associated with a lower prevalence of depressive symptoms. Implementation of WHP services and the provision of a supportive workplace environment should be prioritised to benefit the mental health of workers. [ABSTRACT FROM AUTHOR]

In this article, we focus on a particular kind of emotional impact of the pandemic, namely the phenomenology of the experience of moral injury in healthcare professionals. Drawing on Weber's reflections in his lecture Politics as a Vocation and data from the Experiences of Social Distancing during the COVID-19 Pandemic Survey, we analyse responses from healthcare professionals which show the experiences of burnout, sense of frustration and impotence, and how these affect clinicians' emotional state. We argue that this may relate to the ethical conflicts they experience when they are forced to make clinical decisions where there are no optimal outcomes, and how in turn that impacts on their own emotional state. We then further examine the notion of 'burnout' and the phenomenology of 'moral injury'. Our argument is that these experiences of moral injury across a range of clinicians during the pandemic may be more prevalent and long-standing in psychiatry and mental health than in other areas of healthcare, where ethically difficult decisions and resource constraints are common outside times of crisis. Hence, in these clinical arenas, moral injury and the phenomenology of emotional changes may be independent of the pandemic. The insights gained during the pandemic may provide wider insights into the challenges of developing services and training the workforce to provide appropriate mental health care. [ABSTRACT FROM AUTHOR]

The mental health vulnerability of children and young people in foster and adoptive families is well recognised, which has led to the development of dedicated posts and care pathways in mental health care provision. This article reports on learning resulting from local quality improvement work in a single child and adolescent mental health service team. This work was concerned with the 'front door' of access to care for these groups and specifically addresses initial consultations with adoptive parents and adoption professionals, reporting findings from an analysis of reports from consultations undertaken over a 13-month period between April 2021 and May 2022. The analysis highlights that support can be sought by these parents and professionals for diverse issues relating to mental health which is also indicative of a high level of need amongst children and young people involved with specialist mental health provision. The analysis also has wider implications for practice in demonstrating the benefits of attending to clinical data to contribute meaningfully to practice-based scholarship in this type of specialist setting. [ABSTRACT FROM AUTHOR]

Objective: Telepsychiatry items in the Australian Medicare Benefits Schedule (MBS) were expanded following the COVID-19 pandemic. However, their out-of-pocket costs have not been examined. We describe and compare patient out-of-pocket payments for face-to-face and telepsychiatry (videoconferencing and telephone) MBS items for outpatient psychiatric services to understand the differential out-of-pocket cost burden for patients across these modalities. Methods: out-of-pocket cost information was obtained from the Medical Costs Finder website, which extracted data from Services Australia's Medicare claims data in 2021–2022. Cost information for corresponding face-to-face, video, and telephone MBS items for outpatient psychiatric services was compared, including (1) Median specialist fees; (2) Median out-of-pocket payments; (3) Medicare reimbursement amounts; and (4) Proportions of patients subject to out-of-pocket fees. Results: Medicare reimbursements are identical for all comparable face-to-face and telepsychiatry items. Specialist fees for comparable items varied across face-to-face to telehealth options, with resulting differences in out-of-pocket costs. For video items, higher proportions of patients were not bulk-billed, with greater out-of-pocket costs than face-to-face items. However, the opposite was true for telephone items compared with face-to-face items. Conclusions: Initial cost analyses of MBS telepsychiatry items indicate that telephone consultations incur the lowest out-of-pocket costs, followed by face-to-face and video consultations. [ABSTRACT FROM AUTHOR]

Background: Loneliness has increased since the COVID-19 pandemic and negatively impacts mental health. This study examined relationships between loneliness and mental health among adults using a digital mental health platform. Methods: A purposive sample of 919 participants (97% response rate) who were newly enrolled in the platform completed a survey on loneliness, depression, anxiety, well-being, stress, social support, and comorbidities at baseline and 3 months. Platform engagement was tracked during this period. We examined baseline differences between lonely and non-lonely participants; associations between loneliness, mental health symptoms, and comorbidities; and changes in loneliness and mental health through engagement in any form of care. Results: At baseline, 57.8% of the sample were categorized as lonely. Loneliness was associated with younger age, fewer years of education, and the presence of a comorbidity (p values <.05). Baseline loneliness was associated with greater depression, anxiety, and stress and lower well-being and social support (ps <.001). The percentage of lonely participants decreased at follow-up (57.6% to 52.9%, p =.03). Those who improved in loneliness improved in mental health symptoms, well-being, and social support (ps <.001). Lonely participants who engaged in any form of care reported a greater reduction in loneliness than those who did not engage (p =.04). Conclusions: This study confirms previous findings of the high prevalence of loneliness among adults and risk factors for increased loneliness. Findings highlight the potential of digital platforms to reach lonely individuals and alleviate loneliness through remote mental health support. [ABSTRACT FROM AUTHOR]

The mental health and substance use treatment experiences of racially and ethnically minoritised women who have experienced sexual violence is not well understood. To address this we conducted a systematic review and meta‐synthesis of qualitative studies. Our search strategy included electronic searches of 18 databases and grey literature, citation tracking and reference list screening. Studies were eligible if they presented qualitative data from racially and/or ethnically minoritised women or girls, who had experienced sexual violence at any age and described their experiences of receiving treatment from statutory mental health and/or substance use services. Studies were analysed using meta‐ethnography. Fourteen papers based on 12 individual studies were included. Analysis developed three main themes: (1) understanding minoritised women holistically, (2) processing the trauma and beginning the healing and (3) the need for social connectedness and empowering relationships. For minoritised women to benefit from treatment, mental health and substance use services need to challenge the dynamics of the multiple traumas minoritised women experience. Knowledge and understanding of the racial trauma minoritised women experience is limited and many are subjected to further harm from racist practices occurring in some treatment services. Offering culturally safe, trauma‐informed care which promotes anti‐racist practices may help improve mental health and substance use service responses to minoritised women who have experienced sexual violence. [ABSTRACT FROM AUTHOR]

Trauma‐informed care has emerged as a prominent strategy to eliminate coercive practices and improve experiences of care in mental health settings, with advocacy from international bodies for mental health reform. Despite this, there remains a significant gap in research understanding the integration of trauma‐informed care in mental health nursing practice, particularly when applied to the acute mental health or hospital‐based setting. The study aimed to explore the experiences of mental health nurses employed in acute hospital‐based settings from a trauma‐informed care perspective. The study design was qualitative, using a phenomenological approach to research. A total of 29 nurses employed in acute mental health or hospital‐based environments participated. Three over‐arching themes were uncovered: 'Embodied Awareness': highlighting mental health nursing emotional capabilities are deeply rooted in bodily awareness. 'Navigating Safety': signifying spatial elements of fear and how some mental health nurses' resort to coercive or restrictive practices for self‐preservation. 'Caring Amidst Uncertainty': revealing the relational influences of security guards in mental health nursing. The study reveals a significant gap in trauma‐informed care implementation when applied to the context of mental health nursing practice in this setting. Limited evidence on trauma‐informed care for mental health nurses, coupled with inadequate workforce preparation and challenging work environments, hinder the effective integration of it. To genuinely embed TIC in acute mental health settings, the study emphasises the need for a thorough exploration of what this entails for mental health nurses. [ABSTRACT FROM AUTHOR]

Mechanical restraint is a commonly used restrictive practice worldwide, although reducing its use is an international priority. Interventions to reduce mechanical restraint are needed if reducing mechanical restraint is to succeed. Therefore, this systematic review aimed to examine evaluated evidence‐based interventions that seek to reduce the incidence of and/or time in mechanical restraint in adult mental health inpatient settings. The JBI framework was used to guide this systematic review. The search strategy included peer‐reviewed primary research literature published between 1999 and 2023. Two authors independently conducted the systematic search, selection process and data extraction process. Forty‐one studies were included in this review. Using content analysis, we grouped interventions into four categories: (I) calm‐down methods, (II) staff resources, (III) legal and policy changes and (IV) changing staff culture. Interventions to reduce mechanical restraint in adult mental health inpatient settings have shown some promise. Evidence suggests that a range of interventions can reduce the incidence of and/or time in mechanical restraint. However, controlled trials were lacking and consensus was lacking across studies. Furthermore, specific findings varied widely, and reporting was inconsistent, hampering the development of interventions for this issue. Further research is needed to strengthen the evidence base for reducing mechanical restraint in mental health inpatient settings. [ABSTRACT FROM AUTHOR]

Objective: Racial/ethnic disparities in the prevalence of psychiatric disorders have been reported, but have not accounted for the prevalence of the traits that underlie these disorders. Examining rates of diagnoses in relation to traits may yield a clearer understanding of the degree to which racial/ethnic minority youth in Canada differ in their access to care. We sought to examine differences in self/parent-reported rates of diagnoses for obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders after adjusting for differences in trait levels between youth from three racial/ethnic groups: White, South Asian and East Asian. Method: We collected parent or self-reported ratings of OCD, ADHD and anxiety traits and diagnoses for 6- to 17-year-olds from a Canadian general population sample (Spit for Science). We examined racial/ethnic differences in trait levels and the odds of reporting a diagnosis using mixed-effects linear models and logistic regression models. Results: East Asian (N = 1301) and South Asian (N = 730) youth reported significantly higher levels of OCD and anxiety traits than White youth (N = 6896). East Asian and South Asian youth had significantly lower odds of reporting a diagnosis for OCD (odds ratio [ OR ]East Asian = 0.08 [0.02, 0.41]; OR South Asian = 0.05 [0.00, 0.81]), ADHD (OR East Asian = 0.27 [0.16, 0.45]; OR South Asian = 0.09 [0.03, 0.30]) and anxiety (OR East Asian = 0.21 [0.11, 0.39]; OR South Asian = 0.12 [0.05, 0.32]) than White youth after accounting for psychiatric trait levels. Conclusions: These results suggest a discrepancy between trait levels of OCD, ADHD and anxiety and rates of diagnoses for East Asian and South Asian youth. This discrepancy may be due to increased barriers for ethnically diverse youth to access mental health care. Efforts to understand and mitigate these barriers in Canada are needed. [ABSTRACT FROM AUTHOR]

This document provides a comprehensive list of references and resources related to the diagnosis, treatment, and management of substance use disorders (SUDs) and co-occurring mental health disorders. It includes a wide range of sources, such as articles, reports, guidelines, and textbooks, covering topics such as prevalence, early intervention, treatment approaches, and the impact of substance use on mental health. The document aims to provide valuable information for researchers and individuals seeking to understand and address SUDs and their associated challenges. [Extracted from the article]

COVID-19 presented significant challenges to psychiatric staff, while social distancing and remote working necessitated digital communications. NHS England prioritised staff wellbeing. Arts-based creativity interventions appear to improve psychological wellbeing, so this study evaluated online Creativity Workshops as a staff support response for COVID-19-related stress. Participants were staff from a South London NHS psychiatric hospital. Group Creativity Workshops were facilitated via Microsoft Teams. Acceptability data on pre- and post-workshop mood and attitudes were self-reported by participants. Feasibility data were gathered from adherence to number of workshop components delivered. Eight workshops were delivered in May-September 2020 (N = 55) with high adherence to components. Participants reported significantly increased positive mood and attitudes towards themselves and others; and decreased stress and anxiety. Online Creativity Workshops appear feasible and acceptable in reducing stress in psychiatric staff. Integrating a programme of Creativity Workshops within healthcare staff support may benefit staff wellbeing. [ABSTRACT FROM AUTHOR]

Exposure to toxins—such as heavy metals and air pollution—can result in poor health and wellbeing. Recent scientific and media attention has highlighted negative health outcomes associated with toxic exposures for U.S. military personnel deployed overseas. Despite established health risks, less empirical work has examined whether deployment-related toxic exposures are associated with declines in mental and physical health after leaving military service, particularly among the most recent cohort of veterans deployed after September 11, 2001. Using data from 659 U.S. veterans in the VISN 6 MIRECC Post-Deployment Mental Health Study, we tested whether self-reported toxic exposures were associated with poorer mental and physical health. At baseline, veterans who reported more toxic exposures also reported more mental health, β = 0.14, 95% CI [0.04, 0.23], p = 0.004, and physical health symptoms, β = 0.21, 95% CI [0.11, 0.30], p < 0.001. Over the next ten years, veterans reporting more toxic exposures also had greater increases in mental health symptoms, β = 0.23, 95% CI [0.15, 0.31], p < 0.001, physical health symptoms, β = 0.22, 95% CI [0.14, 0.30], p < 0.001, and chronic disease diagnoses, β = 0.15, 95% CI [0.07, 0.23], p < 0.001. These associations accounted for demographic and military covariates, including combat exposure. Our findings suggest that toxic exposures are associated with worsening mental and physical health after military service, and this recent cohort of veterans will have increased need for mental health and medical care as they age into midlife and older age. [ABSTRACT FROM AUTHOR]

The intersection of social risk and race and ethnicity on mental health care utilization is understudied. This study examined disparities in health care treatment, adjusting for clinical need, among 25,780 Medicare Advantage beneficiaries with a diagnosis of a psychiatric disorder. We assessed contributions to disparities from racial and ethnic differences in the composition and returns of social risk variables. Black and Hispanic beneficiaries had lower rates of mental health outpatient visits than Whites. Assessing composition, Black and Hispanic beneficiaries experienced greater financial, food, and housing insecurity than White beneficiaries, factors associated with greater mental health treatment. Assessing returns, food insecurity was associated with an exacerbation of Hispanic-White disparities. Health care systems need to address the financial, food and housing insecurity of racial and ethnic minority groups with psychiatric disorder. Accounting for racial and ethnic differences in social risk adjustment-based payment reforms has significant implications for provider reimbursement and outcomes. [ABSTRACT FROM AUTHOR]

Heart rate variability biofeedback (HRVB) is an efficacious treatment for depression and anxiety. However, translation to digital mental health interventions (DMHI) requires computing and providing real‐time HRVB metrics in a personalized and user‐friendly fashion. To address these gaps, this study validates a real‐time HRVB feedback algorithm and characterizes the association of the main algorithmic summary metric—HRVB amplitude—with demographic, psychological, and health factors. We analyzed HRVB data from 5158 participants in a therapist‐supported DMHI incorporating slow‐paced breathing to treat depression or anxiety symptoms. A real‐time feedback metric of HRVB amplitude and a gold‐standard research metric of low‐frequency (LF) power were computed for each session and then averaged within‐participants over 2 weeks. We provide HRVB amplitude values, stratified by age and gender, and we characterize the multivariate associations of HRVB amplitude with demographic, psychological, and health factors. Real‐time HRVB amplitude correlated strongly (r =.93, p <.001) with the LF power around the respiratory frequency (~0.1 Hz). Age was associated with a significant decline in HRVB (β = −0.46, p <.001), which was steeper among men than women, adjusting for demographic, psychological, and health factors. Resting high‐ and low‐frequency power, body mass index, hypertension, Asian race, depression symptoms, and trauma history were significantly associated with HRVB amplitude in multivariate analyses (p's <.01). Real‐time HRVB amplitude correlates highly with a research gold‐standard spectral metric, enabling automated biofeedback delivery as a potential treatment component of DMHIs. Moreover, we identify demographic, psychological, and health factors relevant to building an equitable, accurate, and personalized biofeedback user experience. Heart rate variability biofeedback (HRVB) is an efficacious treatment for depression and anxiety, although translation to digital mental health interventions (DMHI) is hindered by the lack of normative data for real‐time HRVB metrics. This research demonstrates the utility of HRVB algorithms tailored to age and gender for DMHIs. The translation of precision care HRVB algorithms into DMHIs and other real‐world settings will improve engagement and real‐world effectiveness of biofeedback interventions for common mental health symptoms. [ABSTRACT FROM AUTHOR]

Purpose: This study examined treatment outcomes (depression and anxiety symptoms) up to 24 months after completion of a therapist‐supported digital mental health intervention (DMHI). Methods: The sample consisted of 380 participants who participated in an eight‐week DMHI from February 6, 2017 to May 20, 2019. Participants reported depression and anxiety symptoms at eight timepoints from baseline to 24 months. Mixed‐effects modelling was used to investigate symptom changes over time. The proportion of participants meeting criteria for treatment response, clinically significant change, and remission of depression and anxiety symptoms were calculated, including proportions demonstrating each outcome sustained up to each timepoint. Results: Multivariate analyses yielded statistically significant reductions in depression (β = −5.40) and anxiety (β = −3.31) symptoms from baseline to end of treatment (8 weeks). Symptom levels remained significantly reduced from baseline through 24 months. The proportion of participants meeting criteria for clinical treatment outcomes remained constant over 24 months, although there were linear decreases in the proportions experiencing sustained clinical outcomes. Conclusions: Treatment gains were made for depression and anxiety symptoms at the end of treatment and up to 24 months. Future studies should determine the feasibility of integrating post‐treatment programmes into DMHIs to address symptom deterioration. [ABSTRACT FROM AUTHOR]

Objective: The Interpersonal Theory of Suicide (ITS) could help identify differences in groups of suicidal adolescents and inform treatment. Method: Latent Profile Analysis (LPA) using thwarted belongingness (TB), perceived burdensomeness (PB), hopelessness, and capability was conducted on data from an at‐risk clinical sample (N = 500). The ITS prediction that changes in TB and PB are associated with changes in suicidal ideation was tested using admission and discharge data. Results: Latent Profile Analysis identified three profiles with increasing complexity and severity on ITS factors. The profiles were labelled low‐severity (7.6% of participants), moderate‐severity (45.2%), and high‐severity (47.2%). ITS predictions were partially supported for the full sample and only for the high‐severity and moderate‐severity subgroups, whereby changes in TB were significantly associated with changes in suicidal ideation over the course of treatment. However, changes in PB were only significant in the moderate‐severity subgroup, and none of the ITS predictions were supported in the low‐severity subgroup. Additionally, effect sizes for changes in TB and PB were modest in all analyses. Conclusions: Our findings highlight the importance reducing low belongingness in youth, which is a component of all supported interventions of youth suicide prevention. However, given the modest association of changes in ITS variables had with changes in suicidal ideation, it may be fruitful to elaborate on the relative importance on types of low belongingness or include other non‐ITS variables. [ABSTRACT FROM AUTHOR]

Future planning is a way of supporting people with intellectual disabilities and their families to think about their support needs as both groups age. Adults with intellectual disabilities, family members, and service providers are often involved in planning processes. However, it is unclear whose perspectives dominate in the literature and how these might vary. A scoping review of qualitative studies (2012–2022) was undertaken to identify which perspectives are present in research on adults with intellectual disabilities and future planning, and to examine key aspects of their future planning experience. The perspectives of parents and siblings predominate in the research. Those of adults with intellectual disabilities and service providers are underrepresented. The views of adults with intellectual disabilities need to be elevated in future planning and they need to be meaningfully involved in planning processes. Focus on the experiences of service providers is likewise needed. [ABSTRACT FROM AUTHOR]

This study investigated the extent to which behaviour support services are accessible under Australia's National Disability Insurance Scheme (NDIS). We conducted semi-structured interviews with families who support a member with an intellectual disability and challenging behaviour. We analysed this data with a supply and demand access framework initially designed for health care and described the lived experiences of participants and their families accessing behaviour supports. Results show that while the NDIS has improved participants' ability to pay for behaviour (and other) supports, this financial capacity represents only one of six other important aspects of access. Families compensate for the shortcomings of the marketised environment which has arisen under the NDIS. This raises questions about the responsibilities of support provision, which is obscured in the new NDIS system and places responsibility for successfully accessing behaviour supports onto the family of the person with an intellectual disability. [ABSTRACT FROM AUTHOR]

The effects of psychotherapy for men perpetrating violence toward their female partners have been found to be modest or equivocal; therefore, further research is necessary to determine how therapists can intervene to help clients stop acting violently. To obtain a better understanding of successful therapist strategies in a particular case, we conducted an interpretive phenomenological analysis of interactional patterns and change processes during therapy sessions in four carefully selected cases - two cases in which the use of violence ended after the completion of therapy (violence ended) were compared with two cases in which the client completed therapy but continued to act violently (violence continued). The client's use of violence was addressed repeatedly in all four cases, but the scripting of such events varied between the two case types. I) Violence ended: Joint explorations of the script of "the annoying other" led to therapist strategies that fostered new experiences of the states of mind of the client and partner. This seemed to help clients develop more caring and safer ways of relating to their partner. II) Violence continued: Engagement in the script of "hopeless me" was associated with therapist strategies that relied more on explanations of the client's vulnerability to acting violently. This seemed to hinder deeper comprehension of the clients' use of violence and the needs and intentions of their partners. Contrary to expectations, engagement in the script of "the annoying other" facilitated exploration of emotional states in both the client and his significant other. We present some empirically derived principles for moment-to-moment therapist strategies that facilitated in-session change with men acting violently toward their partner. [ABSTRACT FROM AUTHOR]

Neighborhood violence is an adverse childhood experience which impacts millions of U.S. children and is associated with poor health outcomes across the life course. These effects may be mitigated by access to care. Yet, the ways in which exposure to neighborhood violence shapes children's health care access have been understudied. This is a cross-sectional analysis of 16,083 children (weighted N=67,214,201) ages 1 to <18 years from the 2019 and 2021 National Health Interview Survey. Guardians were asked about preventive care access, unmet health needs, and health care utilization in the last year. Changes associated with exposure to neighborhood violence were estimated using marginal effects from multivariable logistic regression models adjusted for year, age, sex, race/ethnicity, parental education, family structure, rurality, income, insurance type, insurance discontinuity, and overall reported health. Of 16,083 sample children, 863 (weighted 5.3% [95% CI 4.8–5.7]) reported exposure to neighborhood violence, representing a weighted population of ∼3.5 million. In adjusted analyses, exposure to violence was associated with forgone prescriptions (adjusted difference 1.2 percentage-points (pp) [95%CI 0.1–2.3]; weighted national population impact 42,833 children), trouble paying medical bills (7.7pp [4.4–11.0]; 271,735), delayed medical (1.5pp [0.2–2.9]; 54,063) and mental health care (2.8pp [1.1–4.6]; 98,627), and increased urgent care (4.5pp [0.9–8.1]; 158,246) and emergency department utilization (6.4pp [3.1–9.8]; 227,373). In this nationally representative study, neighborhood violence exposure among children was associated with unmet health needs and increased acute care utilization. Evidence-based interventions to improve access to care and reduce economic precarity in communities impacted by violence are needed to mitigate downstream physical and mental health consequences. [ABSTRACT FROM AUTHOR]

Objectives: In 2018, approximately 2.3 million children in the United States had unmet healthcare needs (UHCN). To date, studies examining associations between UHCN and parent stress and support have had limited generalizability. This study aimed to investigate the relationship between children's UHCN and parenting stress and support using a nationally representative sample. Additionally, this study aimed to assess associations between unmet mental health needs and these parental well-being measures. Methods: Households with children ages 0–17 and complete data on UHCN in the combined 2016, 2017, 2018, and 2019 cohorts of the National Survey of Children's Health (NSCH) met inclusion criteria. Logistic regressions were used to evaluate associations between overall UHCN and outcome measures of parental coping, aggravation, emotional support, and neighborhood support. Associations between mental UHCN and these outcome measures were analyzed in a subset limited to children with mental health conditions. Regressions were adjusted for potential confounders, including demographics, household income, medical home status, and health insurance (adequacy/type). Results: In our sample of 131,299 children, overall UHCN were associated with poorer parental coping (aOR = 5.35, 95% CI: [3.60, 7.95]), greater parental aggravation (aOR = 3.35, 95% CI: [2.73, 4.12]), and non-supportive neighborhood (aOR = 2.22, 95% CI: [1.86, 2.65]). Mental UHCN were similarly associated with parental coping and aggravation and neighborhood support in the mental health subset. Conclusions for Practice: Healthcare professionals must address the needs of children with UHCN and collaborate with community organizations and child advocates to promote coordinated and comprehensive care and adequately support caregivers. Significance: What is already known on this subject?: Research has shown that parenting stress and support may impact a child's patterns of healthcare utilization. However, the relationship between parenting stress/support and unmet healthcare needs, rather than utilization, has yet to be explored in a large, nationally representative dataset. What this study adds?: In a nationally representative sample of children in the United States, overall unmet healthcare needs were found to be associated with poorer parental coping, greater parental aggravation, and living in a non-supportive neighborhood. Mental unmet healthcare needs were associated with the same measures among children with mental health conditions. [ABSTRACT FROM AUTHOR]

Background: Current evidence indicates that intellectual disability and gender are both factors in differential usage of services. However, there are limited data about the demographic and service usage patterns of people with intellectual disability who use mental health services. This is particularly true in relation to women with intellectual disability with mental ill health. Interrogation of large‐scale linked data sets can provide valuable insights into patterns of service usage among marginalised groups. Method: A large collaborative data linkage project was assembled with the overarching aim of providing an epidemiological profile of the health (including mental health), health service use, mortality and other service system contacts of people with intellectual disability in New South Wales (NSW), Australia. These linked data were used to interrogate the demographic, diagnostic and service use profiles of women with intellectual disability who have sought mental health support in NSW. Results: The linked data demonstrated important differences in patterns of diagnosis and service use for women with intellectual disability and mental health disorders, when compared to women without intellectual disability and men with and without intellectual disability, with mental health disorders. The diagnostic profile of women with intellectual disability reflected the gendered nature of diagnoses found in the wider population. Women with intellectual disability also experienced higher rates of diagnostic instability than other groups. Conclusions: The intersection between gender, intellectual disability and mental health has an effect on diagnostic profile and patterns of service use for women with intellectual disability. These differences are important and may impact targeted service delivery and planning for women with intellectual disability who have sought mental health support. Accessible summaries: Gender and intellectual disability both affect the ways that people use mental health services, especially women. There is not much research done about this topic. More research is needed to understand this better. We looked at how women with intellectual disability use mental health services in New South Wales. We found that women with intellectual disability used services differently to women without intellectual disability. We also found that they used services differently than men did. Knowing more about how women use these services means that we can make sure services meet the needs of these women. [ABSTRACT FROM AUTHOR]

Risk factors for psychological distress among help-seeking youth are poorly understood. Addressing this gap is important for informing mental health service provision. This study aimed to identify risk factors among youth attending Jigsaw, a youth mental health service in Ireland. Routine data were collected from N = 9,673 youth who engaged with Jigsaw (Mean age = 16.9 years, SD = 3.14), including presenting issues, levels of psychological distress, age, and gender. Confirmatory Factor Analysis identified thirteen factors of clustering issues. Several factors, including Self-criticism and Negative Thoughts, were strongly associated with items clustering as psychological distress, however these factors were poorly predictive of distress as measured by the CORE (YP-CORE: R2 = 14.7%, CORE-10: R2 = 6.9%). The findings provide insight into associations between young people's identified presenting issues and self-identified distress. Implications include applying appropriate therapeutic modalities to focus on risk factors and informing routine outcome measurement in integrated youth mental health services. [ABSTRACT FROM AUTHOR]

This article discusses the need for direct funding to support Native nations and Indigenous community health organizations in developing and implementing Indigenous systems alignment frameworks. These frameworks aim to align health care, behavioral health, public health, and social service systems to meet the needs and goals of Indigenous communities. The article highlights the importance of customary relationships between tribal leaders and citizens, as well as partnerships with non-tribal and governmental entities, in achieving effective and culturally congruent approaches to community health. The findings from the Indigenous Systems Alignment study confirm the relevance and applicability of the Georgia Health Policy Center's Framework for Aligning Sectors, while also emphasizing the unique perspectives and contributions of Indigenous worldviews, political sovereignty, and lived realities. The article concludes with recommendations for increasing funding, promoting Indigenous knowledge and community-centered research, and providing training on tribal sovereignty and Indigenous data sovereignty/governance to non-Indigenous partners. [Extracted from the article]

Context: To address the considerable burden of mental health need in the United States, Congress passed the National Suicide Hotline Designation Act in 2020. The act rebranded the national suicide prevention lifeline as 988, a three-digit number akin to 911 for individuals to call in the case of a mental health emergency. Surprisingly little is known about American attitudes toward this new lifeline. Methods: The authors use a demographically representative survey of 5,482 US adults conducted June 24–28, 2022, to examine the influence of mental health status, partisan identification, and demographic characteristics on public awareness of the new 988 lifeline, public support for the lifeline, and intention to use it. Findings: The authors find that while only a quarter of Americans are aware of the lifeline, support for the 988 lifeline is widespread, with more than 75% of Americans indicating they would be likely to use the new number if needed. The authors identify key disparities in awareness, support, and intended use, with Republicans, individuals with low socioeconomic status, and Blacks less supportive of the 988 lifeline and in some cases less likely to use it. Conclusions: The results point to the need for additional interventions that increase public awareness of 988 and reduce disparities in program knowledge, support, and intention to use. [ABSTRACT FROM AUTHOR]

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

Accessible Summary: What is known on the subject?: Seclusion is a harmful and traumatising intervention for people accessing mental health services.People who are subject to seclusion in inpatient mental health services often first experience this within the first 24 h following admission.There is limited research examining how recent contact with services impacts the likelihood of seclusion when people are admitted to inpatient services. What the paper adds to existing knowledge?: Males, Māori and Pasifika experience higher rates of seclusion within the first 24 h following inpatient admission.People perceived by clinicians as overactive, aggressive, disruptive or agitated are seven times more likely to be secluded within the first 24 h.People referred from police or justice services are three times more likely to be secluded within the first 24 h.People who had frequent contact with community mental health services prior to inpatient admission were less likely to be secluded. What are the implications for practice?: The first 24 h of inpatient admission is a critical focus for eliminating the use of seclusion. Initial interactions with people recently admitted should focus on nurturing relationships and reducing distress.Mental health staff should consider the person's cultural needs, referral pathway, recent service contact and baseline ratings on the Health of the Nation Outcomes Scales (HoNOS) when working proactively to prevent the use of seclusion in the first 24 h following admission.Strengthening the focus on nurturing relationships, cultural understanding and non‐coercive de‐escalation approaches requires leadership support and strategic workforce development. Introduction: People who experience seclusion in inpatient mental health services often do so within the first 24 h following admission. There is limited research examining the potential contributing factors, particularly recent contact with services. Aim/Question: To identify factors associated with seclusion within the first 24 h following admission into acute inpatient mental health services. Method: A retrospective analysis was undertaken using routinely collected data from Aotearoa New Zealand mental health services. Results: A higher likelihood of seclusion within the first 24 h following admission was associated with: males, Māori, Pasifika, referrals from police/justice services, inpatient transfers, recent contact with crisis assessment teams and clinician perceptions of aggression, problematic substance use, cognitive problems and hallucinations or delusions. Recent contact with community mental health services was associated with a lower likelihood. Discussion: People's cultural needs, referral pathway, recent service contact and HoNOS scores should be considered when working to prevent the use of seclusion in the first 24 h following admission. Implications for Practice: The first 24 h following inpatient admission is a critical period for preventing the use of seclusion. Nurturing relationships, cultural understanding and use of non‐coercive de‐escalation approaches can support better outcomes for people recently admitted. [ABSTRACT FROM AUTHOR]

Introduction: Sexual health is essential to the overall health. People suffering from severe mental illness (SMI) experience a deterioration in their sexual health. These patients and their caregivers seem unwilling to engage in a dialogue concerning sexual health within the context of mental health care. Aim: The study investigated nurses' and care assistants' beliefs and attitudes regarding the sexual health of people with SMI on the psychiatric care pathway. Methods: Twenty semi‐structured interviews were conducted with nurses and care assistants. Data were subject to a thematic analysis. Results: Three main themes emerged: (1) The formalization of the care approach towards people with a SMI in hospitals; (2) the place given to sexual health in psychiatry units; (3) nurses and care assistants are not equipped to deal with patients' sexual health. Discussion: Caregivers consider that sexual health is a fundamental right and an indicator of good health. They nevertheless believe that the psychiatric hospital remains a place of acute care where sexual health is not considered. Implication for Practice: This research justifies that it is necessary to question the representations of nurses and care assistants before implementing a tailored intervention that integrates the consideration of sexual health into the holistic care of the patient on the psychiatric care pathway. [ABSTRACT FROM AUTHOR]

Introduction: Nursing staff are frequently exposed to high‐risk patient behaviours within inpatient health services, yet staff commonly report a lack of training and support in managing these behaviours. Aim: The aim of the study was to examine nursing staff experiences of high‐risk behaviours in inpatient mental health settings. Methods: Four electronic databases (CINAHL, Medline, PsycINFO, EMBASE) were searched. The protocol for this review was prospectively registered in PROSPERO (Ref: CRD42022334739). A meta‐synthesis of nursing staff's experiences of high‐risk behaviours in inpatient mental health settings was conducted. Results: We identified 30 eligible studies. Six themes were constructed from the meta‐synthesis: the social contract of care; the function of risk behaviours; the expectation of risk; risk as a relational concept; navigating contradictions in care; the aftermath. Discussion: Nursing staff conceptualize risk as a meaningful behaviour shaped by patient, staff and environmental factors. Managing risk is an ethical dilemma for nursing staff and they require more training and support in ethical risk decision‐making. Implications for Practice: Inpatient mental healthcare services should formulate and manage risk as a relational concept comprising staff, patient and environmental factors. Future research and clinical practice should place further consideration on the varied experiences of different types of risk behaviours. Relevance Statement: Nursing staff are frequently exposed to high‐risk patient behaviours within inpatient health services, yet staff commonly report a lack of training and support in managing these behaviours. This systematic review offers insights into how high‐risk behaviours are experienced by nursing staff and makes recommendations about how to improve the understanding and management of them. Inpatient mental healthcare services should formulate and manage risk as a relational concept comprising staff, patient and environmental factors. Future research and clinical practice should place further consideration on the varied experiences of different types of risk behaviours. [ABSTRACT FROM AUTHOR]

Generalized anxiety disorder (GAD) is a prevalent and chronic mental health condition, associated with considerable individual and economic burden. Despite the availability of effective treatments, many individuals do not access support. The current study explores treatment histories, barriers to help‐seeking, and cognitive behavioral therapy (CBT) treatment preferences for individuals with clinically significant GAD symptoms. The utility of Health Belief Model (HBM) in predicting help‐seeking is also examined. A cross‐sectional design with 127 participants (Mage = 29.17; SD = 11.86; 80.3% female) was used. Sixty‐two percent of participants reported previously seeking psychological treatment, and approximately 28% received CBT in the first instance. The most influential treatment barriers were a desire to solve the problem on one's own (M = 1.96, SD = 0.96), followed by affordability (M = 1.75, SD = 1.15) and feeling embarrassed or ashamed (M = 1.75, SD = 1.06). The most preferred treatment modes were in‐person individual treatment (M = 7.59, SD = 2.86) followed by remote treatment via videoconferencing (M = 4.31, SD = 3.55). Approximately 38% of the variance in intention to seek treatment was associated with the HBM variables, with perceived benefit of treatment being the strongest predictor. Results have the potential to inform mental health service delivery by reducing treatment barriers and aligning public health campaigns with benefits of psychological treatments. [ABSTRACT FROM AUTHOR]

My research is situated within the literature looking at the processes of deinstitutionalisation of the mental health system through the lived geographies placed in between the walls of the asylum. It addresses mental health geographers' call for a situated knowledge about mental health and, by using the Italian psychiatric experience of the 1960s and 1970s as an example, stresses the importance of looking at care in both spatial and relational terms. Through a geographical understanding of the Italian psychiatric reform, that goes from Franco Basaglia's renowned work to the underrepresented experience of Turin, in northwest Italy, I will examine how space is intertwined with processes of mental health care. Additionally, I assess the role played by the interaction between spatial and relational elements in potentially enabling patients' self‐determination, empowerment and inclusion. The case of Turin—the story of which will be told through the analysis of archival material from a grassroots association called Associazione per la Lotta contro le Malattie Mentali—will serve to expand the common narrative around the Italian lesson and to give resonance to the instrumental role played at the time by both patients and civil society. By looking at the key events that led to the gradual dismantlement of the traditional psychiatric institutions in the metropolitan area of Turin, this paper contributes to the spatial turn in mental health studies, calling upon researchers to look at past achievements as something we still need to learn from and safeguard. [ABSTRACT FROM AUTHOR]

Background: The Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) is a well-established, clinically feasible measure of quality of life concerns when assessing relatively severe clinical populations of adult patients. To what degree might the Q-LES-Q-SF facilitate identifying quality of life concerns among parents of adolescents receiving outpatient services for psychosocial concerns for which parents are often involved in service delivery, such as social anxiety? Objective: We tested the Q-LES-Q-SF in a mixed-clinical/community sample of adolescents receiving a social anxiety evaluation and their parents. Method: We examined 134 adolescents aged 14–15 years old and their parents. Parents completed self-reports on the Q-LES-Q-SF as well as self-reports on several domains relevant to understanding their mental health. Further, parents completed reports about adolescent and family functioning known to contribute to psychosocial impairments linked to adolescent social anxiety. Results: We observed strong internal consistency estimates for the Q-LES-Q-SF. Scores taken from the Q-LES-Q-SF demonstrated significant links with survey measures designed to assess various domains of adolescent, parent, and family psychosocial functioning. Further, scores taken from the Q-LES-Q-SF uniquely related to measures of both adolescent and parent social anxiety. Conclusions: The findings support use of a short, clinically feasible measure (Q-LES-Q-SF) to assess quality of life among parents seeking mental health services for their adolescents. As such, the study informs future work that tests the ability of the Q-LES-Q-SF to screen for or identify parents whose quality of life may impact their involvement in the delivery of anxiety-related services to their adolescent. [ABSTRACT FROM AUTHOR]

Background: Integrated primary care (IPC) can address prevalent behavioral health concerns identified in pediatric office visits, but research on IPC consultation patterns is limited. Objective: This study investigated variation in consultation rates across presenting problems, patient sociodemographic factors, and IPC treatment duration. Method: Retrospective electronic health record data were extracted for 970 patients seen in 12 pediatric primary care sites and for whom behavioral health consultation was requested between June 2018 and December 2019. Logistic regressions were used to examine associations between sociodemographic variables, consultation reasons, and IPC visit type. We used multiple linear regression to assess the association between consultation reason and treatment duration. Results: Anxiety (36.2%) and disruptive behavior (29.7%) were the most common consultation reasons. Consultation requests for internalizing (anxiety, mood) problems were more prevalent in school-aged children and adolescents, whereas consultations for disruptive behavior (tantrums) and health-related issues (toileting, sleep concerns) were common in early childhood. Girls were less likely to receive consultation requests for attention deficit/hyperactivity disorder (ADHD) and autism/developmental concerns compared to boys, but more likely to receive consultation for internalizing problems. Consultation requests varied by patient race, ethnicity, visit type, and insurance type. Treatment duration after consultation was longer among patients with consultation requests for ADHD and for depression/mood concerns. Conclusions: Age-related behavioral health consultation patterns in IPC conform with expected developmental trends; however, sociodemographic findings suggest opportunities for enhancing care. Additional research is needed on IPC consultation given its promise for early identification, prevention, and treatment of pediatric mental health concerns. [ABSTRACT FROM AUTHOR]

Transgender and gender diverse (TGD) youth, individuals whose gender identity is different from the sex that was assigned at birth, report higher rates of mental health and emotional challenges and are approximately twice as likely to access psychiatric inpatient services compared with cisgender peers. 1 Existing research has suggested that the minority stress that TGD youth face from having to navigate transphobic cultural contexts and systems (eg, unsupportive parents/caregivers, school staff, peers) may play a key factor in mental health disparities, such as increased risk of depression, anxiety, suicidal ideation, suicide attempts, and nonsuicidal self-harm. 1,2 These higher rates of mental health challenges among TGD youth offer an explanation as to why these youth access inpatient services significantly more frequently than cisgender peers. Research has found that TGD youth often experience discrimination during psychiatric inpatient admissions (eg, being misgendered during admission intake, facing stigmatization for an evolving gender identity, and receiving care from staff who have not been trained to provide gender-affirming care), 3 despite professional organizations, such as the American Academy of Child and Adolescent Psychiatry, underscoring the importance of TGD youth receiving psychiatric care that is inclusive and affirming. 4 Given that the inpatient setting offers a unique opportunity to facilitate positive and affirming changes for TGD youth, it is essential for providers to have a strong understanding of what affirmative care looks like within this context to best support this vulnerable patient population and reduce experiences of discrimination. [ABSTRACT FROM AUTHOR]

Background: Helplines for post‐secondary students have emerged in the last decade to address the growing mental health needs and increasing help‐seeking of this population in ways that are responsive to their needs and preferences. However, there is no publicly available evidence of the effectiveness of helplines for post‐secondary students. Aims: This study evaluated the outcomes of Good2Talk, a helpline for post‐secondary students in Ontario, Canada, that offers professional counselling and information and referral services related to mental health, addictions and well‐being. Methods: In this cross‐sectional study, purposive sampling was used to recruit post‐secondary students who contacted Good2Talk between March 2016 and March 2020. Data were collected using post‐call questionnaires. Paired samples t‐tests and multinomial logistic regression analyses were used to analyse the data from 619 post‐secondary students. Results: Participants reported significant decreases in distress and increases in their ability to face their concern after contacting the helpline. Feeling understood and low pre‐call distress were significant predictors of low post‐call distress. Confidence in their abilities and having a better plan were significant predictors of high post‐call ability to face their concern. Age, gender and number of previous calls to the helpline were not significant predictors of positive outcomes. Most participants reported that they would recontact the helpline and recommend the helpline to a peer. Conclusion: The study indicates that counselling and information and referral services can be effective in reducing distress and increasing post‐secondary students' abilities to address their mental health concerns. [ABSTRACT FROM AUTHOR]

Formulating goals in therapy may facilitate young people and parents/carers' engagement in mental health support settings. A number of goal taxonomies have been developed, which involve organising goals set at the outset of therapy into themes. Goal taxonomies are considered useful for service planning and outcome purposes. In order to build on the knowledge about what young people choose as goals, and to best support good practice, it is important to explore the links and differences between the existing goal taxonomies. A systematic review was conducted to identify goal taxonomies based on goals set using the goal‐based outcome (GBO) tool. Framework analysis was conducted to investigate the extracted goal taxonomies. Overall, four core concepts were identified: "Goals targeting specific issues, symptoms, emotions, and behaviours," "Return and engage in activities," "Personal growth goals" and "Interpersonal goals." Goals regarding specific issues, personal growth and interpersonal relationships were present in most studies. Using these overarching core concepts could be useful for practitioner‐level, or service‐level organisation of goal data, for activities such as service planning and delivery. [ABSTRACT FROM AUTHOR]