The pharmacist in support of mental health: active role in increasing compliance with psychotropic drugs

Limited research concerning existing inequities in mental health care and support services in the United Kingdom captures perceptions and lived experiences of the significantly underrepresented Muslim population. Underpinned by social constructivist theory, we used consultation to facilitate public and patient involvement and engagement (PPIE) to identify inequities in mental health care and support experienced by Muslims from minoritised ethnic communities living in deprived areas in Liverpool, UK. The rationale was to (a) better inform standards and policies in healthcare and (b) provide a psychologically safe space to members of the Muslim community to share perceptions and experiences of mental health care and support services. To ensure trustworthiness of the data, member checking was adopted. This paper describes the procedure to achieving this consultation, including our recruitment strategy, data collection and analysis as well as key findings. Twenty-seven consultees attended the women's consultation and eight consultees attended the men's consultation. Consultees were from Yemeni, Somali, Sudanese, Egyptian, Algerian, Pakistani and Moroccan communities and share the Islamic faith. Four key interlinked themes were identified from consultees' narratives: (1) broken cycle of trust; (2) an overmedicalised model of care; (3) community mental health prevention initiatives; and (4) culturally conscious training and education. The Muslim population has identified numerous barriers to accessing mental health support and there is a need to resource activities that would aid deeper understanding of mental health support needs through continuous and meaningful community initiatives. This would afford mental health practitioners and organisations opportunities for developing realistic anti-racism strategies, effectively adopting social prescription, strengthening partnerships and collaborations aimed at supporting delivery of evidence-based mental health care provisions to tackle mental health inequities. This paper reports on the involvement and engagement of Muslims from minoritised ethnic communities living in the Liverpool city region.

BackgroundAustralian rural and regional communities are marked by geographic isolation and increasingly frequent and severe natural disasters such as drought, bushfires and floods. These circumstances strain the mental health of their inhabitants and jeopardise the healthy mental and emotional development of their adolescent populations. Professional mental health care in these communities is often inconsistent and un-coordinated. While substantial research has examined the barriers of young people’s mental health and help-seeking behaviours in these communities, there is a lack of research exploring what adolescents in rural and regional areas view as facilitators to their mental health and to seeking help when it is needed. This study aims to establish an in-depth understanding of those young people’s experiences and needs regarding mental health, what facilitates their help-seeking, and what kind of mental health education and support they want and find useful.MethodWe conducted a qualitative study in 11 drought-affected rural and regional communities of New South Wales, Australia. Seventeen semi-structured (14 group; 3 individual) interviews were held with 42 year 9 and 10 high school students, 14 high school staff, and 2 parents, exploring participants’ experiences of how geographical isolation and natural disasters impacted their mental health. We further examined participants’ understandings and needs regarding locally available mental health support resources and their views and experiences regarding mental illness, stigma and help-seeking.ResultsThematic analysis highlighted that, through the lens of participants, young people’s mental health and help-seeking needs would best be enabled by a well-coordinated multi-pronged community approach consisting of mental health education and support services that are locally available, free of charge, engaging, and empowering. Participants also highlighted the need to integrate young people’s existing mental health supporters such as teachers, parents and school counselling services into such a community approach, recognising their strengths, limitations and own education and support needs.ConclusionsWe propose a three-dimensional Engagement, Empowerment, Integration model to strengthen young people’s mental health development which comprises: 1) maximising young people’s emotional investment (engagement); 2) developing young people’s mental health self-management skills (empowerment); and, 3) integrating mental health education and support programs into existing community and school structures and resources (integration).

Children and adolescents with a history of adverse childhood experiences (ACEs) are more likely than their peers to develop mental health difficulties, but not enough is known about their help-seeking behaviours and preferences. We aimed to determine whether ACEs are associated with access to and perceived unmet need for mental health services and support amongst secondary school students. We used multi-level logistic regression with data from the 2020 OxWell Student Survey to assess whether ACEs were associated with (1) prior access to mental health support and (2) perceived unmet need for mental health services in a community sample of English secondary school students. We assessed ACEs as a cumulative score from the Center for Youth Wellness Adverse Childhood Experiences Questionnaire: Teen Self-Report version and accounted for current mental health difficulties as measured by the 25-item Revised Children's Anxiety and Depression Scale (RCADS). Our analysis included 2018 students across 64 schools, of whom 29.9% (598/2002) reported prior access to mental health support. Of those not reporting prior access, 34.1% (469/1377) reported a perceived unmet need for services. In the unadjusted models, cumulative ACE scores were significantly positively associated with both prior access to mental health support (odds ratio (OR)=1.36; 95% confidence interval (CI): 1.29-1.43) and perceived unmet need for mental health services (OR=1.47; 95% CI: 1.37-1.59), meaning that students who had experienced adversity had a greater chance of having previously accessed support as well as perceiving an unmet need for services. After adjusting for mental health difficulties and other sociodemographic variables, cumulative ACE scores were positively associated with prior access (adjusted OR (aOR)=1.25; 95% CI: 1.17-1.34 with a significant interaction between RCADS and ACE scores, aOR=0.88; 95% CI: 0.84-0.93) as well as perceived unmet need (aOR=1.32; 95% CI: 1.21-1.43 with a significant interaction between RCADS and ACE scores, aOR=0.85; 95% CI: 0.78-0.91). Although it is encouraging that adolescents with experience of adversity are more likely than their peers with similar levels of depression and anxiety symptoms to have accessed mental health support, there remains a concern that those who have not accessed support are more likely to perceive an as-yet unmet need for it. Mental health support must be available, accessible and acceptable to all who need it, especially for those groups that traditionally have not accessed services, including the more marginalised and vulnerable populations.

This study explored the emerging role of ChatGPT in mental health and psychological support. Employing a narrative case study approach, I examined vignettes from users who interacted with ChatGPT for various mental health and psychological needs. These cases were purposively sampled. The analysis revealed a diverse range of applications for ChatGPT, including coping with grief and loss, simulating conversations with deceased loved ones, seeking emotional support, developing social skills, managing ADHD symptoms, and serving as an on-demand mental health resource. Users consistently reported finding comfort, practical assistance, and immediate accessibility in these interactions. However, highlighted also are the potential risks associated with AI-assisted mental health support. These included the possibility of reliance on AI, complications in natural grieving processes, and the blurring of boundaries between AI and human connections. This paper emphasizes that ChatGPT may provide valuable support, but it should not be seen as a replacement for human therapists or comprehensive mental health treatment plans. The study also suggests that AI chatbots like ChatGPT are emerging as complementary tools in mental health support. However, their integration into mental health care requires careful consideration of ethical implications, privacy concerns, and the preservation of essential human elements in therapeutic relationships. Further research is recommended to guide the development of effective and ethical AI-assisted mental health and psychological support.

BACKGROUND Barriers to accessing mental health support are common experiences reported by university students. Digital tools can improve equitable access to the indicated level of support and provide actionable insight and recommendations. OBJECTIVE This study aimed to evaluate the acceptability and effectiveness of a web-based self-guided mental health and well-being support platform (U-Flourish Platform) that was tailored specifically for university students. METHODS The i-spero® platform was adapted in partnership with students to provide evidence-based well-being plans, mental health symptom tracking, and automated alerts and recommendations based on self-report data from students. After providing informed consent, students registered to access the platform and completed baseline demographic information and weekly validated screening measures of anxiety (GAD), depression (PHQ), and well-being (SWEMWEBS) over 8 weeks. At 6 weeks, students completed a user-experience survey. Paired t-tests were used to compared symptom scores and chi-squared tests assessed changes in symptom screening status over the 8-week period. Unadjusted logistic regression was used to assess whether baseline demographic factors and symptom screening status were associated with user-experience outcomes. RESULTS The analyses included data from 404 consenting students. At 6-weeks, most students (75%) expressed satisfaction with the platform, felt it was easy to use and understand (85%), and found the platform helpful for supporting their mental health (58%). Adherence was relatively high (76%) and attrition was relatively low (26%) after 6 weeks but reduced substantively thereafter; associated with timing of the end of incentivized use and end of term examinations and assignments. Mean anxiety (1.55 vs. 2.19, p<.0001; Cohen’s d=0.36), depression (0.94 vs. 1.36, P=.0001; Cohen’s d=0.33), and well-being (24.87 vs. 22.28, P<.0001, Cohen’s d=0.34) scores were improved at 8-Weeks vs baseline, with the greatest positive effects for students who screened positive for anxiety (Cohen’s d=1.16) and depression (Cohen’s d=2.22) at baseline. There was no evidence of differences in user-experience across demographic factors (i.e. gender, international student status, and lifetime history of a mental disorder) or baseline screening status, except for males who had lower odds (OR=0.40, 95% CI: 0.18-0.90) of finding the platform easy to use compared to female students. Of the 404 student-users, 142 created at least one well-being plan, with 75% and 57% of them being endorsed as helpful and being satisfactory in the support they provided, respectively. Most students reported satisfaction with the Platform (75%), it being easy to use (85%), and it having a positive impact on their mental health (58%). CONCLUSIONS Evidence supports that a self-guided digital well-being and mental health support platform is an acceptable and useful resource for university students. Therefore, student-tailored digital tools should be considered as part of an integrated and comprehensive whole-university approach for student well-being and mental health support.

“Watching my family being killed by terrorists made me really depressed”: Mental health experiences, challenges and needed support of young internally displaced persons in northern Nigeria

Lesbian, gay, bisexual, trans, queer/questioning, plus young people have a higher risk of poor mental health in comparison to cisgendered heterosexual young people, and they underutilise mental health services and support. In addition, there is a paucity of research conducted in United Kingdom examining mental health early intervention provision for lesbian, gay, bisexual, trans, queer/questioning, plus young people. To produce a model of what works for early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people and increase understanding of lesbian, gay, bisexual, trans, queer/questioning, plus young people's access to, navigation of, and engagement with mental health support. This was a multi-methods theory-led case study evaluation with three distinct stages: (1) a meta-narrative review of existing literature to develop a theoretical framework to explain effective mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people; (2) an online and offline service mapping exercise to locate current mental health early intervention support for lesbian, gay, bisexual, trans, queer/questioning, plus young people in the United Kingdom in order to produce a service typology; and (3) a theory-led case study evaluation of 12 case study sites selected from the service typology produced in stage 2, to establish the components of appropriate quality, early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people. Stage 1 produced an interdisciplinary theoretical framework indicating that early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus youth must prioritise addressing normative environments that marginalise youth, lesbian, gay, bisexual, trans, queer/questioning, plus identities and mental health problems. Stage 2 mapping found 111 services, the majority in urban settings in England. There was an absence of mainstream National Health Service support that specifically addressed the needs of lesbian, gay, bisexual, trans, queer/questioning, plus young people. The majority of lesbian, gay, bisexual, trans, queer/questioning, plus youth mental health support was provided by voluntary/community organisations. Stage 3 case study evaluation found that an intersectional, youth-rights approach is the most appropriate way to deliver early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people. Youth rights should underpin mental health support to address the multiple marginalisation, isolation and stigmatisation that lesbian, gay, bisexual, trans, queer/questioning, plus young people may experience and to enable them to make informed independent decisions about their own bodies and lives, and for the right to freedom of safe self-expression to be upheld. The model that we have produced contains 13 principles that are necessary to the provision of mental health support, and to improve access to, engagement with, and navigation of mental health services. In the United Kingdom, a rights-based approach to mental health service provision is not prominent. In addition, at the time of writing, lesbian, gay, bisexual, trans, queer/questioning, plus young people are facing active legislative and policy attacks on their human rights. This study provides the first large-scale theory-led evaluation of early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people with common mental health problems. The resulting intersectional, youth-rights approach provides evidence on ways of improving lesbian, gay, bisexual, trans, queer/questioning, plus young people's mental health. Further research on the implementation of an intersectional, youth-rights approach to early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people with mental health problems is required. This study is registered as PROSPERO CRD42019135722. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/09/04) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 47. See the NIHR Funding and Awards website for further award information.

The rapid evolution of large language models (LLMs), such as Bidirectional Encoder Representations from Transformers (BERT; Google) and GPT (OpenAI), has introduced significant advancements in natural language processing. These models are increasingly integrated into various applications, including mental health support. However, the credibility of LLMs in providing reliable and explainable mental health information and support remains underexplored. This scoping review systematically maps the factors influencing the credibility of LLMs in mental health support, including reliability, explainability, and ethical considerations. The review is expected to offer critical insights for practitioners, researchers, and policy makers, guiding future research and policy development. These findings will contribute to the responsible integration of LLMs into mental health care, with a focus on maintaining ethical standards and user trust. This review follows PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines and the Joanna Briggs Institute (JBI) methodology. Eligibility criteria include studies that apply transformer-based generative language models in mental health support, such as BERT and GPT. Sources include PsycINFO, MEDLINE via PubMed, Web of Science, IEEE Xplore, and ACM Digital Library. A systematic search of studies from 2019 onward will be conducted and updated until October 2024. Data will be synthesized qualitatively. The Population, Concept, and Context framework will guide the inclusion criteria. Two independent reviewers will screen and extract data, resolving discrepancies through discussion. Data will be synthesized and presented descriptively. As of September 2024, this study is currently in progress, with the systematic search completed and the screening phase ongoing. We expect to complete data extraction by early November 2024 and synthesis by late November 2024. This scoping review will map the current evidence on the credibility of LLMs in mental health support. It will identify factors influencing the reliability, explainability, and ethical considerations of these models, providing insights for practitioners, researchers, policy makers, and users. These findings will fill a critical gap in the literature and inform future research, practice, and policy development, ensuring the responsible integration of LLMs in mental health services. DERR1-10.2196/62865.

Within a number of fields, research on mental health support available for graduate students is scant. Research on mental health support among online students is even more limited. Mental health within library and information science (LIS) has been discussed largely outside of the scholarly realm via webinars, mental health zines, and Twitter chats. As the majority of students pursuing a master’s degree in LIS (MLIS) go through online programs, student awareness of and access to mental health support through their university is unknown. Through content analysis, this original study explores the online resources for mental health counseling and support readily available for MLIS students in American Library Association–accredited programs.

BackgroundA growing gap has emerged between people with mental illness and health care professionals, which in recent years has been successfully closed through the adoption of peer support services (PSSs). Peer support in mental health has been variously defined in the literature and is simply known as the help and support that people with lived experience of mental illness or a learning disability can give to one another. Although PSSs date back to several centuries, it is only in the last few decades that these services have formally evolved, grown, and become an integral part of the health care system. Debates around peer support in mental health have been raised frequently in the literature. Although many authors have emphasized the utmost importance of incorporating peer support into the health care system to instill hope; to improve engagement, quality of life, self-confidence, and integrity; and to reduce the burden on the health care system, other studies suggest that there are neutral effects from integrating PSSs into health care systems, with a probable waste of resources.ObjectiveIn this general review, we aimed to examine the literature, exploring the evolution, growth, types, function, generating tools, evaluation, challenges, and the effect of PSSs in the field of mental health and addiction. In addition, we aimed to describe PSSs in different, nonexhaustive contexts, as shown in the literature, that aims to draw attention to the proposed values of PSSs in such fields.MethodsThe review was conducted through a general search of the literature on MEDLINE, Google Scholar, EMBASE, Scopus, Chemical s, and PsycINFO. Search terms included peer support, peer support in mental health, social support, peer, family support, and integrated care.ResultsThere is abundant literature defining and describing PSSs in different contexts as well as tracking their origins. Two main transformational concepts have been described, namely, intentional peer support and transformation from patients to peer support providers. The effects of PSSs are extensive and integrated into different fields, such as forensic PSSs, addiction, and mental health, and in different age groups and mental health condition severity. Satisfaction of and challenges to PSS integration have been clearly dependent on a number of factors and consequently impact the future prospect of this workforce.ConclusionsThere is an internationally growing trend to adopt PSSs within addiction and mental health services, and despite the ongoing challenges, large sections of the current literature support the inclusion of peer support workers in the mental health care workforce. The feasibility and maintenance of a robust PSS in health care would only be possible through collaborative efforts and ongoing support and engagement from all health care practitioners, managers, and other stakeholders.

Students who are marginalised based on varying identities, backgrounds and characteristics are highly vulnerable to mental health challenges, but many do not receive appropriate support from healthcare services. Several barriers have been identified, including cultural and systemic factors. Therefore, everyday coping strategies and support in different settings are vital. This study examines the mental health coping strategies and support needs among marginalised students in the United Kingdom (UK). We analysed qualitative and quantitative data from a cross-sectional survey conducted between December 2021 and July 2022. Statistical analysis was conducted on data obtained using the abbreviated version of the Coping Orientation to Problems Experienced Inventory (Brief-COPE). Qualitative content analysis was applied to data collected using open-ended questions. From a subsample of 788 further and higher education students, 581 (73.7%) students (M = 25 years, SD = 8.19) were categorised as marginalised based on ethnicity, sex/gender, sexuality, religious beliefs, first language, birth country, age (i.e., mature students), and having special education needs/disabilities. Marginalised students had significantly higher scores for problem-focused, emotion-focused and avoidant coping strategies/practices compared to other students. Coping strategies included talking to friends and family, practising religion or spirituality, engaging in creative/innovative activities like hobbies, using entertainment as a distraction, waiting to see if things improve and isolating. Students expressed a need for improved or tailored services, additional academic support, and appropriate social support. These included contemporary approaches to support mental health, such as online provisions, regular mentor/personal tutor meetings, lowered academic pressures and opportunities for organised peer support. The findings from this study highlight significant and timely evidence on coping strategies and support needs among a wide range of marginalised student groups in the UK. This study provides important knowledge that is useful to inform personalised culturally appropriate mental health support that can be offered in education settings.

Mental health challenges are common in individuals with cancer, but accessing support remains a gap, particularly in outpatient oncology. Real-world factors influencing staff's ability to integrate mental health assessment and support into workflows are unclear. We aimed to (1) identify and explore factors influencing the assessment and management of mental health in outpatient oncology and (2) identify factors that influence normalising support for mental health during cancer treatment. Through an exploratory qualitative approach, data was collected via focus groups with oncology healthcare professionals at a major metropolitan hospital. Reflexive thematic analysis revealed seven themes. Staff recognised the critical need for mental health support during treatment. However, staff participation in mental health assessment and referral processes was impeded by feelings of futility due to the lack of available oncology-specific services. Staff reported insufficient resources and time constraints, and reliance on experiential knowledge rather than the preferred support from clinicians with mental health training. Staff highlighted inequities in access to mental health support which exacerbate disparities in care provision. Staff reported that a lack of role clarity and responsibilities hindered monitoring of patient mental health management and contributed to a perceived lack of accountability. Short-term initiatives such as improved documentation, creation of central referral pathways and clinical supervision for all staff were reported as desirable. While systemic resource constraints were acknowledged, oncology staff also identified several feasible, shorter-term initiatives they felt would be helpful and desirable until mental health professionals can be integrated into oncology outpatient care.

BackgroundThis qualitative study explores the experiences of peer support workers (PSWs) and service users (or peers) during transition from in-person to virtual mental health services. During and following the COVID-19 pandemic, the need for accessible and community-based mental health support has become increasingly important. This research aims to understand how technological factors act as bridges and boundaries to mental health peer support services. In addition, the study explores whether and how a sense of community can be built or maintained among PSWs and peers in a virtual space when connections are mediated by technology. This research fills a gap in the literature by incorporating the perspectives of service users and underscores the potential of virtual peer support beyond pandemic conditions.MethodsData collection was conducted from a community organization that offers mental health peer support services. Semi-structured interviews were conducted with 13 employees and 27 service users. Thematic analysis was employed to identify key themes and synthesize a comprehensive understanding.ResultsThe findings highlight the mental health peer support needs that were met through virtual services, the manifestation of technology-based boundaries and the steps taken to remove some of these boundaries, and the strategies employed by the organization and its members to establish and maintain a sense of community in a virtual environment marked by physical distancing and technology-mediated interrelations. The findings also reveal the importance of providing hybrid services consisting of a mixture of in person and virtual mental health support to reach a broad spectrum of service users.ConclusionsThe study contributes to the ongoing efforts to enhance community mental health services and support in the virtual realm. It shows the importance of virtual peer support in situations where in-person support is not accessible. A hybrid model combining virtual and in-person mental health support services is recommended for better accessibility to mental health support services. Moreover, the importance of organizational support and of equitable resource allocation to overcome service boundaries are discussed.

Mental health impacts on college campuses are on the rise. According to the National College Health Assessment, students reported increased depression and anxiety symptoms that overwhelmed their studies. Recent studies show that 1 in 6 undergraduates felt too depressed to function, 1 in 5 felt overwhelming anxiety, and 1 in 15 seriously considered suicide (Rafal et al.). This is exacerbated by a time of great uncertainty and stress due to the COVID-19 pandemic. How can campuses prepare a safety net of non-clinical mental health support to best support students? The purpose of this Action Research study was to develop a model for graduate student education to aid future Student Affairs practitioners in identifying and intervening in emerging mental health issues of undergraduate students. The study utilized a Collaborative Learning Community to discuss the issues at hand and create a pilot program for Master's students at one Student Affairs program. Research findings include the application of a foundation of mental health literacy, needed understanding and support of high-risk populations, recommended graduate student preparation, and a need to redefine roles of Student Affairs practitioners around mental health support. The overarching conclusion is that the field of Student Affairs must redefine its role around non-clinical mental health support. This should be done by integrating a theory/practice approach founded in mental health literacy into Master's preparation programs. This would include specific information on mental health disorders, warning signs, risk factors, mental health support, high-risk populations, and trauma-informed practice.--Author's abstract

Background:Depression and anxiety are commonly reported (40% and 11%-52%) among adults receiving dialysis, compared with ~10% among all Canadians. Mental health in dialysis care is underrecognized and undertreated.Objective:(1) To describe preferences for mental health support reported by Albertans receiving dialysis; (2) to compare depression, anxiety, and quality-of-life (QOL) domains for people who would or would not engage in support for mental health; and (3) to explore sociodemographic, mental health, and QOL domains that explain whether people would or would not engage in support for mental health.Design:A cross-sectional survey.Setting:Alberta, Canada.Patients:Adults receiving all modalities of dialysis (N = 2972).Measurements:An online survey with questions about preferences for mental health support and patient-reported outcome measures (Patient Health Questionnaire–9 [PHQ-9], Generalized Anxiety Disorder–7 [GAD-7], and Kidney Disease QOL Instrument–36 [KDQOL-36]).Methods:To address objectives 1 and 2, we conducted chi-square tests (for discrete variables) and t tests (for continuous variables) to compare the distributions of the above measures for two groups: Albertans receiving dialysis who would engage or would not engage in support for mental health. We subsequently conducted a series of binary logistic regressions guided by the purposeful variable selection approach to identify a subset of the most relevant explanatory variables for determining whether or not people are more likely to engage in support for mental health (objective 3). To further explain differences between the two groups, we analyzed open-text comments following a summative content analysis approach.Results:Among 384 respondents, 72 did not provide a dialysis modality or answer the PHQ-9. The final data set included responses from 312 participants. Of these, 59.6% would consider engaging in support, including discussing medication with a family doctor (72.1%) or nephrologist (62.9%), peer support groups (64.9%), and talk therapy (60%). Phone was slightly favored (73%) over in person at dialysis (67.6%), outpatient (67.2%), or video (59.4%). Moderate to severe depressive symptoms (PHQ-9 score ≥10) was reported by 33.4%, and most respondents (63.9%) reported minimal anxiety symptoms; 36.1% reported mild to severe anxiety symptoms (GAD-7 score ≥5). The mean (SD) PHQ-9 score was 8.9 (6.4) for those who would engage in support, and lower at 5.8 (4.8) for those who would not. The mean (SD) GAD-7 score was 5.2 (5.6) for those who would engage in support and 2.8 (4.1) for those who would not. In the final logistic regression model, people who were unable to work had 2 times the odds of engaging in support than people who are able to work. People were also more likely to engage in support if they had been on dialysis for fewer years and had lower (worse) mental health scores (odds ratios = 1.06 and 1.38, respectively). The final model explained 15.5% (Nagelkerke R2) of the variance and with 66.6% correct classification. We analyzed 146 comments in response to the question, “Is there anything else you like to tell us.” The top 2 categories for both groups were QOL and impact of dialysis environment. The third category differed: those who would engage wrote about support, whereas those who would not engage wrote about “dialysis is the least of my worries.”Limitations:A low response rate of 12.9% limits representativeness; people who chose not to participate may have different experiences of mental health.Conclusions:Incorporating patients’ preferences and willingness to engage in support for mental health will inform future visioning for person-centered mental health care in dialysis.