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This article is based on the results of a survey carried out in 2019 to document health managers and professionals' knowledge concerning their linguistic obligations and the tools promoting active offer in the field of mental health in French, in Ontario and Manitoba. The working hypothesis is that knowledge of the obligations and available tools can contribute to a successful offer of services in French. The more professionals and managers understand their obligations, the more tools they can use to fulfill them. The study shows that there is indeed a link between knowledge of obligations and the use of tools to provide an active offer of mental health services in French. It also highlights the key role of tools to provide French services actively. Cet article presente les donnees d'un sondage realise en 2019 sur la connaissance des gestionnaires et des professionnels ceuvrant dans le domaine de la sante mentale en Ontario et au Manitoba de leurs obligations linguistiques et des outils qui favorisent la pratique de l'offre active de services francais. Letude permet de souligner que plus les professionnels et les gestionnaires comprennent leurs obligations, tant en Ontario qu'au Manitoba, plus ils peuvent profiter des outils existants pour sen acquitter. L'etude montre qu'il existe en effet un lien entre la connaissance des obligations et l'utilisation des outils pour faire de l'offre active de services de sante mentale en francais. Elle permet aussi d'insister sur le role cie des outils pour faire de l'offre active de services en francais., Cette recherche s'inscrit dans le cadre des travaux du GRIPOAS, un partenariat entre des chercheurs universitaires et communautaires qui a pour objectif de favoriser la co-construction des savoirs et la [...]

Self-compassion is a gentle way of relating to oneself, linked to a host of mental health benefits in non-autistic people. Although many autistic individuals report high anxiety and depression symptoms, no research to-date has examined the self-compassion experiences of autistic individuals and determined if self-compassion is associated with psychopathology. Therefore, the purpose of the current study was to address this research gap. The participants (153 autistic and 93 non-autistic adults) completed on online survey and 11 autistic participants were also interviewed. Autistic participants reported significantly lower self-compassion than non-autistic adults, and in both groups, those with higher self-compassion reported higher psychological wellbeing and lower depression symptoms. Demographic predictors of self-compassion were identified. These findings have both clinical and research implications., Author(s): Ru Ying Cai [sup.1] [sup.2] , Vicki Gibbs [sup.1] [sup.3] , Abigail Love [sup.1] , Ainslie Robinson [sup.1] , Lawrence Fung [sup.4] , Lydia Brown [sup.5] [sup.6] [sup.7] Author [...]

Emerging adult military members face occupational stressors that can lead to mental health issues including anxiety, depression, substance use, and PTSD. Serious mental health issues, including depression, and suicidality are increasing among young veterans. More than half of those experiencing a mental health problem do not seek help and could benefit from therapy. This qualitative study (1) revealed barriers to accessing mental health treatment and (2) provided ways to decrease stigma and encourage help seeking. We conducted semi-structured interviews with 26 emerging adult military members and asked about (1) barriers to mental health treatment and (2) ways to decrease these obstacles. Following a thematic analysis approach, two coders employed rigorous coding procedures using reflexive meetings and debriefings to find patterns using Excel and NVivo. Barriers to accessing mental health treatment exist at the systems, peers and leadership, and self-stigma (i.e., internalized) levels due to hegemonic masculinity tenants in the military. Suggestions to improve and encourage mental health treatment include implementing changes at the structural level in the military, increasing knowledge among the public sector, and improving education and training among helping professionals who are serving emerging adult military populations. Destigmatizing mental health treatment is no easy task but working collaboratively with emerging adult military members to understand their perceptions and attitudes can move us in a positive direction., Author(s): Kelly Lynn Clary [sup.1] , Stephany Pena [sup.2] , Douglas C. Smith [sup.3] Author Affiliations: (1) grid.264772.2, 0000 0001 0682 245X, School of Social Work, Texas State University, , [...]

We explored the role of negative performance beliefs and self-focused attention considered central to psychological models of social anxiety but not studied in autism. Firstly, we compared self- and observer ratings of performance on a social task for 71 young autistic people, 41 high and 30 low in social anxiety, finding a significant main effect of social anxiety but not rater. Subsequently, 76 autistic young people, 46 high and 30 low social anxiety completed measures of interoceptive sensibility and focus of attention following a social task. Only heightened interoceptive sensibility fully mediated the relationship between self-ratings of social performance and social anxiety. These findings suggest awareness of bodily sensations are critical to anxiety in social situations with implications for treatment., Author(s): H. Wood [sup.1] , S. Rusbridge [sup.2] , J. Lei [sup.3] , C. Lomax [sup.4] , J. Elliston [sup.5] , A. Russell [sup.6] Author Affiliations: (1) grid.500936.9, 0000 0000 [...]

In 2020, a nationwide shift to telepsychiatry occurred in the wake of the Coronavirus Disease 2019 (COVID-19) pandemic and lockdowns. To assess the rates of telepsychiatry appointment attendance pre- and post-lockdown, we conducted a national, multi-site survey of appointments in 2020 compared to a similar time period in 2019, at outpatient child psychiatry clinics that specialize in the treatment of patients with Autism Spectrum Disorder (ASD) and/or Developmental Disabilities (DD). ASD/DD clinics rapidly shifted to telepsychiatry, returning to pre-pandemic appointment numbers and completion rates within months. We advocate for the continued funding of this care model, discuss the substantial benefits physicians, patients and families have found in using telepsychiatry, and suggest ways to improve future access for ASD/DD telepsychiatry., Author(s): Shikha Verma [sup.1] , Pankhuree Vandana [sup.2] , Takahiro Soda [sup.3] , Kathleen A. Koth [sup.4] , Patricia Aguayo [sup.5] , Rebecca C. Shaffer [sup.6] , Jessica Hellings [sup.7] [...]

This paper investigated the characteristics of mothers of children with a disability who registered for a mental health and wellbeing workshop. The questionnaire measured mental health, health-related behaviours, empowerment, family cohesion, wellbeing and child-related variables. Regression analysis identified factors associated with depressive symptoms and positive wellbeing. Fifty-seven percent of participants (N = 171) had depressive symptoms within the clinical range. Higher symptoms were associated with reduced: empowerment (r = - .39, p < .01); positive-wellbeing (r = - .66, p < .05); and healthy activity (r = - .41, p < .001). Low positive wellbeing ([beta] = .55, p < .001) was the strongest predictor of depressive symptoms. Family cohesion ([beta] = .25, p < .001), was the strongest predictor of positive-wellbeing. Future health and wellbeing interventions that support mothers with high care responsibilities should include psycho-education and strategies to address healthy maternal and family-related behaviour changes., Author(s): Helen M. Bourke-Taylor [sup.1] , Kahli S. Joyce [sup.1] , Sarah Grzegorczyn [sup.2] , Loredana Tirlea [sup.3] Author Affiliations: (1) grid.1002.3, 0000 0004 1936 7857, Occupational Therapy Department, Faculty [...]

Objective. Down syndrome (DS) is the most common cause of intellectual disability. Children with DS may have difficulty accessing psychiatric services because their mental health problems are often unrecognized. This study aimed to assess the mental health needs of children with Down syndrome and the elements that may affect their access and referral to psychiatric services. Methods. In this single-center cross-sectional study, we evaluated 72 children with Down syndrome and assessed the factors affecting their use of mental health services by using a questionnaire completed by parents. We compared the clinical symptom profiles of young preschool-aged children with Down syndrome (n=26) with typical (n=26), developmental delay (n=15), and autism spectrum disorder (ASD) group (n=28) to evaluate mental health problems. The Schedule for Affective Disorders and Schizophrenia for School-Aged Children: Present and Lifetime Version DSM-5 (K-SADS-PL) was administered. Parents completed the child behavior check list for ages 6-18 and 1½-5, depending on the child's age. Results. Although most patients with Down syndrome (51.4%) had psychiatric symptoms reported by parents at the initial assessment, the most frequent reason (62.5%) for applying to our psychiatric clinic was to submit an application for a medical report. The majority of patients with Down syndrome (56%) had a psychiatric disorder, and attention deficit and hyperactivity disorder was the most common diagnosis. Conclusion. Clinicians should not overlook the need for psychiatric assessment, early diagnosis, and collaboration between pediatricians and child psychiatrists, which are crucial during medical evaluation and follow-up of children with Down syndrome., Author(s): Gökçe Yağmur Efendi (corresponding author) [1]; Merve Çıkılı Uytun [2]; Esra Yürümez [2]; Didem Behice Öztop [2]; Tuğba Menteşe Babayiğit [2]; Birim Günay Kılıç [2] 1. Introduction Down syndrome [...]

Many caregivers of autistic people experience mental health issues, and the impact of disruptions due to COVID-19 may present additional challenges for these individuals. This study characterized caregiver stress, anxiety, and resilient coping during COVID-19 and investigated the impact of COVID-19 disruptions, demographic variables, and resilient coping on mental health. The majority of caregivers reported some degree of disruption associated with COVID-19, and more than half reported moderate levels of stress and high anxiety. Resilient coping did not emerge as a moderator between COVID-19 disruptions and caregiver mental health, but instead had a direct effect on outcomes. Future research is needed to understand additional factors impacting the mental health of caregivers of autistic people during the COVID-19 pandemic., Author(s): Kelsey A. Friesen [sup.1] [sup.2] , Jonathan A. Weiss [sup.3] , Stephanie J. Howe [sup.1] [sup.2] , Connor M. Kerns [sup.4] , Carly A. McMorris [sup.1] [sup.2] Author Affiliations: [...]

Objective: Mental health services are often implemented in settings in which mental health is not the primary mission. Schools, primary care clinics, criminal justice and child welfare institutions, and senior centers have been increasingly adding mental health care to their compendium of services owing to the high rates of mental health needs in these settings. Despite numerous challenges to implementing mental health practices in settings where mental health care has not traditionally been a part of the service model, the demand for mental health services in these settings is growing. Implementation science offers a lens through which to understand unique challenges and potential solutions to implementing mental health services in these settings, with the ultimate goal of ensuring the implementation of evidence-based services. Method and Results: In this conceptual article, we discuss common overarching barriers to implementing evidence-based mental health interventions in nonspecialty mental health settings, such as workforce challenges, competing priorities, and financial considerations. Then, using examples from schools and primary care, we elucidate unique contextual considerations and implementation challenges in these settings. Finally, we articulate a research agenda for advancing implementation of evidence-based practices in nonspecialty mental health including highlighting promising implementation strategies (e.g., task shifting, adaptation) and the most relevant implementation outcomes to assess in these contexts (e.g., appropriateness, feasibility). Conclusions: Given that nonspecialty mental health settings deliver a large proportion of mental health care to traditionally underserved populations, there are important public health implications to advancing research in this area and ensuring implemented services are evidence-based. Keywords: dissemination, implementation, implementation science, nonspecialty mental health, Mental health services are increasingly implemented in settings in which mental health is not the primary mission. In the United States, schools, primary care practices, criminal justice and child welfare [...]

Purpose. To investigate the alignment of START with NANDA-I in forensic psychiatric care. Design. A quantitative design was chosen to compare the START instrument with the NANDA-I taxonomy and analyze their alignment. Each item of the START was attempted to be matched with potentially relevant NANDA-I diagnoses, and the matched diagnoses were extracted and presented. Findings. The study demonstrated a strong alignment between START coding and NANDA-I diagnoses, with 99% of the START diagnoses finding a match within NANDA-I. These results support the use of NANDA-I in forensic psychiatric care, which facilitate providing comprehensive care and avoiding sole focus on psychiatric problems. Practice Implications. It is recommended to use a structured nursing taxonomy, such as NANDA-I, in forensic psychiatric care., Author(s): Filip Grbovic [1]; Maria Åling [2]; Lars Strömberg [2]; Monir Mazaheri (corresponding author) [3] 1. Introduction Despite continuing improvement in forensic psychiatric care, the focus of the care remains [...]

Advances in applications of artificial intelligence and the use of data analytics technology in biomedicine are creating optimism, as many believe these technologies will fill the need-availability gap by increasing resources for mental health care. One resource considered especially promising is smartphone psychotherapy chatbots, i.e., artificially intelligent bots that offer cognitive behavior therapy to their users with the aim of helping them improve their mental health. While a number of studies have highlighted the positive outcomes of using smartphone psychotherapy chatbots to handle various anxiety related problems no conclusive data illustrate their effectiveness or warrant their use in mental illness diagnosis and treatment settings. Yet smartphone psychotherapy is highly endorsed by experts in the field of mental health research. In this paper, I focus on the specific features of smartphone psychotherapy chatbots intended for the diagnosis and treatment of mental illness and criticize three popular promises; i.e., (i) they enable early diagnosis and intervention through digital phenotyping; (ii) they defy the stigma of mental illness diagnosis and treatment; (iii) they offer increased access to mental health treatment globally. Going against the popular enthusiasm, I argue smartphone psychotherapy chatbots have epistemic and ethical limitations in the diagnosis and treatment of illnesses. In light of these, I encourage researchers, clinicians, policy makers, patients, and caregivers to pause before jumping on the artificial intelligence bandwagon to seek solutions for mental illness on the grounds of these three promises., Author(s): Serife Tekin [sup.1] Author Affiliations: (1) grid.215352.2, 0000000121845633, Department of Philosophy and Classics, University of Texas at San Antonio, , 1 UTSA Circle, 78249, San Antonio, TX, USA Introduction [...]

Background LGBTQ+ community's higher susceptibility to worse mental health outcomes and more help-seeking barriers compared to the cis-heterosexual population. Despite the LGBTQ+ population facing higher mental health risks, there has been a dearth of research focusing on developing tailored interventions targeting them. This study aimed to assess the effectiveness of a digital multicomponent intervention in promoting help-seeking for mental health issues in LGBTQ+ young adults. Methods and findings We recruited LGBTQ+ young adults aged between 18 and 29 who scored moderate or above on at least 1 dimension of the Depression Anxiety Stress Scale 21 and did not have help-seeking experiences in the past 12 months. Participants (n = 144) were stratified by gender assigned at birth (male/female) and randomly allocated (1:1 ratio) to the intervention or active control parallel condition by generating a random number table, so they were blinded to the intervention condition. All participants received online psychoeducational videos, online facilitator-led group discussions, and electronic brochures in December 2021 and January 2022, with the final follow-up in April 2022. The contents of the video, discussion, and brochure are help-seeking for the intervention group and general mental health knowledge for the control group. The primary outcomes were help-seeking intentions for emotional problems and suicidal ideation and attitudes toward seeking help from mental health professionals at the 1-month follow-up. The analysis was performed by including all participants based on their randomized group regardless of adherence to the protocol. A linear mixed model (LMM) was used for analysis. All models were adjusted for baseline scores. Chinese Clinical Trial Registry: ChiCTR2100053248. A total of 137 (95.1%) participants completed a 3-month follow-up, and 4 participants from the intervention condition and 3 from the control condition did not complete the final survey. Compared with the control group (n = 72), a significant improvement was found in help-seeking intentions for suicidal ideation in the intervention group (n = 70) at post-discussion (mean difference = 0.22, 95% CI [0.09, 0.36], p = 0.005), 1-month (mean difference = 0.19, 95% CI [0.06, 0.33], p = 0.018), and 3-month follow-ups (mean difference = 0.25, 95% CI [0.11, 0.38], p = 0.001). There was also a significant improvement in the intervention condition on the help-seeking intention for emotional problems at 1-month (mean difference = 0.17, 95% CI [0.05, 0.28], p = 0.013) and 3-month follow-ups (mean difference = 0.16, 95% CI [0.04, 0.27], p = 0.022) compared with the control group. Participants' depression and anxiety literacy and help-seeking encouragement related knowledge in intervention conditions showed significant improvements. There were no significant improvements in actual help-seeking behaviors, self-stigma toward seeking professional assistance, depression, and anxiety symptoms. No adverse events or side effects were observed. However, the follow-up time point was limited to 3 months which might not be long enough for drastic mindset and behavioral changes in help-seeking to occur. Conclusions The current intervention was an effective approach in promoting help-seeking intentions, mental health literacy, and help-seeking encouragement-related knowledge. Its brief yet integrated intervention format could also be utilized in treating other imminent concerns confronted by LGBTQ+ young adults. Trial Registration Chictr.org.cn, ChiCTR2100053248., Author(s): Meng Han 1,2, Yinzhe Wang 1,3, Yanwen Zhang 1, Yuanyuan Wang 4, Jianjun Ou 5,*, Daixi Ren 1, Chengxi Cai 1, Kunxu Liu 1,2, Runan Li 1, Jin Han [...]

Context: The COVID-19 pandemic led to an unprecedented lockdown of millions of Americans from the spring of 2020 to the fall of 2020. Studies done on the impact of COVID-19 on mental health and body weight have been important to our understanding of the effects of the pandemic. However, these studies on depression and BMI change have not identified a possible direction of the causality of the relationship between depression and body weight as affected by lockdown measures during a pandemic. Objective: The purpose of this study was to examine whether a diagnosis of depression is associated with changes in BMI during the COVID-19 pandemic for adults (aged [greater than or equal to] 18 years). Study Design and Analysis: Retrospective cohort study Setting or Dataset: EHR data from a family medicine university clinic. Population Studied: Adults >18 years who visited the clinic within a 6- month period prior to lockdown (October 2019-March 2020) and at least once in the 6-month post-lockdown period (September 2020-March 2021). The lockdown period started in March 2020. 1,211 patients were included. Outcome Measures: Dependent variable: change in BMI; Primary independent variable: diagnosis of depression; Confounding variables: age, race/ethnicity, sex, medications, and chronic conditions Results: Mean age was 59.9 (sd=16.5). Patients were mostly female (n=770, 63.6%), white (n=678, 56.0%), and non-Hispanic (n=622, 51.4%). 18.7% (n=227) had a diagnosis of depression. There was a significant difference in BMI change (p0.001]). This association remained while including confounding variables in the model (p=0.009). Further statistical analysis showed that age between 31 and 50 significantly predicted BMI changes in those patients with no depression diagnosis while controlling for confounding variables (p=0.027). Conclusion: Individuals with depression had significant changes in BMI during the COVID-19 pandemic, and age predicted these changes in middle-aged adults (30-50 years old). These findings highlight the importance of identifying and following up with individuals with a diagnosis of depression to alleviate effects on their BMI during extended isolation. Identifying patients who might be susceptible to these changes could lead to patient health outcomes., Presenters Elias Arellano, Susan Franks, PhD, ABPP, Kimberly Fulda, DrPH, Fan Zhang, Sravan Mattevada, MS, Damon Schranz, DO, [...]

Introduction: To assess the burden of depression, anxiety and suicidality; and to determine the impact of integrated menta health and HIV services on treatment outcomes among Thai adolescents and young adults living with HIV (AYHIV). Methods: A multicentre prospective cohort study was conducted among AYHIV (15 to 25 years), and age- and sex-matched HIV-uninfected adolescents and young adults (HUAY). The Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item scales (GAD-7) were used as screening tools for depressive and anxiety symptoms respectively. History of lifetime and recent suicidal ideations/attempts were ascertained. Elevated mental health screening scores were defined as having either significant depressive symptoms (PHQ-9 [greater than or equal to]9), significant anxiety symptoms (GAD-7 [greater than or equal to]10) or suicidality (lifetime; and recent [within two weeks]). Participants meeting these criteria were referred to psychiatrists for confirmatory diagnosis and mental health services. Follow-up assessment with PHQ-9 and GAD-7 was performed one year after psychiatric referral. Results: From February to April 2018, 150 AYHIV and 150 HUAY were enrolled, median age was 19.0 (IQR:16.8 to 21.8) years and 56% lived in urban areas. Among AYHIV, 73% had HIV RNA Conclusions: With the significant burden of MHDs among AYHIV, an integration of mental health services, including menta health screenings, and psychiatric consultation and referral, is critically needed and should be scaled up in HIV healthcare facilities. Keywords: anxiety disorders; depressive disorders; integrated mental health services; psychiatric disorders; suicidality; youth iving with HIV, 1 | INTRODUCTION Mental health disorders (MHDs) are one of the most prevalent non-AIDS-related comorbidities among people living with HIV (PLHIV). Several studies indicate elevated rates of MHDs in this [...]