Severe mental illness (SMI) is frequently accompanied by substantial impairments in psychosocial functioning. Psychosocial interventions (PSI), therefore, represent an essential component of evidence-based treatment. A key prerequisite for the utilization is adequate knowledge. The aim of this study was to assess the level of knowledge about PSI among individuals with SMI.A cross-sectional multicenter study was conducted among individuals with SMI aged 18 to 65 years (n = 397). Knowledge of PSI, along with sociodemographic, clinical and additional contextual characteristics was assessed. Linear regression analyses were performed to examine associations between PSI knowledge and potential predictors.Overall, participants with SMI were familiar with an average of 10 out of the 17 assessed interventions. Better knowledge was associated with the presence of a chronic physical illness (p = .027), a longer duration of psychiatric problems (p = .030) and higher GAF scores (p = .010). In contrast, having experienced divorce, separation, or widowhood compared to being single (p = .040), as well as having a migration background (p = .003), were associated with lower levels of knowledge.The findings highlight the need for more targeted dissemination of guideline-based information on PSI to individuals with SMI.

Psychiatric readmission following inpatient discharge is common and is frequently used as an indicator of continuity and quality of care in mental health services. Although readmission is often interpreted as a marker of clinical relapse, increasing evidence suggests that psychosocial factors may contribute to post-discharge outcomes. However, evidence on these factors remains fragmented across settings, populations, and healthcare systems.This systematic review synthesised quantitative observational evidence on psychosocial factors associated with psychiatric readmission following discharge from acute inpatient mental health care. A systematic search of PubMed, Scopus, Web of Science, and APA PsycINFO was conducted from database inception in accordance with PRISMA 2020 guidelines. Eligible studies included adult psychiatric inpatients and examined at least one psychosocial factor assessed during admission or prior to discharge in relation to subsequent psychiatric readmission. Due to substantial clinical and methodological heterogeneity, findings were synthesised narratively.Fifteen studies conducted across diverse international healthcare systems were included. The most consistent findings were observed for housing instability, homelessness, and unstable residential context, which were repeatedly associated with psychiatric readmission across population-based, hospital-based, and clinical registry studies. Evidence for socioeconomic disadvantage, employment status, social integration, and social support was more heterogeneous, limited, or dependent on how these constructs were measured and adjusted for.These findings suggest that psychiatric readmission reflects not only clinical trajectories but also broader social vulnerability during the transition from inpatient to community-based care. Integrating systematic assessment of psychosocial circumstances, particularly housing instability and barriers to outpatient follow-up, into discharge planning may be important for improving continuity of care and reducing avoidable psychiatric readmissions.

This study evaluated four Mobile Response Teams (MRTs), providing 24/7 behavioral health crisis intervention services, using retrospective administrative records of calls made to an MRT hotline between May 1, 2024, and April 30, 2025. The sample included 2,300 eligible calls representing 1,960 unique individuals (Mage = 30.01 years, SD = 19.92, Range = 5-89). Programmatic descriptives examined call and final dispositions, method of response, and response times, while chi-square tests assessed bivariate associations and binary logistic regression assessed predictors of final disposition, dichotomized as psychiatric hospitalization vs. diversion. Across the 12-month observational period, 64.8% of cases resulted in diversion, and the average in-person response time was within the State of Florida's 60-minute benchmark. Consistent with the program's "in-person first" model, 95.0% of calls were addressed face-to-face. Significant independent predictors of psychiatric hospitalization included age (adults 18 + years), higher suicide risk scores, presence of a specific suicide plan, law enforcement involvement, call source (school setting), and call reason (suicide attempt/ideation). Findings from this large, ethnically diverse, naturalistic sample demonstrate that MRTs not only divert a substantial proportion of crisis cases from hospitalization but also consistently meet state standards for timely and "in-person first" response, with implications for behavioral health policy and crisis service delivery.

Despite their long history of working with infants and new birthing persons, community health workers (CHWs) could be better utilized to help address the emotional needs of individuals who recently gave birth. We adapted the Thinking Healthy Program (THP), a World Health Organization-endorsed task-sharing model, to assess the feasibility of implementing THP in six community-based organizations (CBOs) in central and western New York. We present results on the feasibility and acceptability from the CHWs, their supervisors, and chief executives of six community-based organizations. Qualitative interviews with stakeholders were carried out prior to program launch, soliciting their input on the role of CHWs and challenges related to implementing the task-sharing approach for working with persons with perinatal mood and anxiety disorders (PMADs). Feedback on knowledge, comfort, confidence and overall ability were collected from CHWs and their supervisors at baseline and post-implementation (i.e., after implementation with two clients). Qualitative interviews identified three themes: 1) the community's need for CHW engagement; 2) the current CHW roles in the management of maternal health, including PMADs; and 3) the CBO/CHWs' ongoing need for resources to continue providing task-sharing approaches. Post-implementation surveys of CHWs revealed mixed results. Although CHWs stated their knowledge, comfort, and confidence in maternal mental health declined, their supervisors noted improvements in the CHWs' skillset. Our findings highlight critical challenges associated with implementing task-sharing approaches that engage CHWs to address PMADs. Our results suggest the need for attention to organizational context; sustained supervision; and strategies to address workforce turnover, burnout, and role clarity.

Improving social functioning for people with schizophrenia-spectrum disorders is a priority for service users, carers and broader society. While many face challenges with social functioning, a proportion do obtain a job, a partner, and other valued social goals. Informal carers are key stakeholders, support recovery and may support service users' social functioning, though some research suggests carer and service user priorities may differ. Research suggests item content in measures of social functioning may not fully capture people's social world. The aim of this study was to explore service user and carer understandings of social functioning and what they value most, to inform intervention and measurement approaches. Semi-structured interviews were conducted with twelve service users and eight carers and audio recorded. Reflexive thematic analysis was conducted on anonymized transcripts with input from a multidisciplinary team and a carer with lived experience. One overarching theme, 'Fitting in and being accepted' reflected service user and carer participants' emphasis on integration and belonging beyond any particular social functioning outcome. Four themes were generated from the analysis: 'the value in performing everyday activities', 'communication and sociability as connection to the world', 'close relationships as central to social functioning and wellbeing' and 'the paradox of work: highly valued but a potentially risky endeavour'. Having a job was considered important but was out of reach for many. Revised expectations meant that service users who had more challenges with social functioning valued basic independence and achieving this helped them feel integrated in society. Service users and carers had broadly similar priorities and expectations for social functioning, with some exceptions including expectations around romantic relationships. Digital communication served as an important means of low pressure connection to others. People with schizophrenia need more social opportunities that fit their circumstances including developing relationships and accessing work. Instruments that measure social functioning may not reflect what service users find meaningful about social functioning, such as feeling accepted and fitting in and their use of digital communication.

Certified Peer Specialists provide optional peer support services (PSS) to individuals with mental health disorders. In this effectiveness study, we describe changes in behavioral health service utilization in Medicaid-enrolled adults receiving PSS compared to propensity-score matched controls. Individuals receiving PSS (n = 2,156) in 2021-2024 were successfully matched 1:2 to individuals receiving outpatient mental health services without PSS (comparison; n = 4,312). Service rates were compared between groups over time (90days before, during, and 90days following the PSS or outpatient episode of care. Rates of services were higher for PSS; utilization for the majority of services declined over time. PSS versus the Comparison was associated with a steeper decline in psychiatric hospitalization, β = -.0190, t(2,932) = -2.61, p = .0090, and crisis service, β = -.0269, t(2,932) = -3.49, p = .0005 following discharge from the episode of care. PSS may successfully maintain recovery-oriented care through diversion from psychiatric hospitalization and increase community tenure resulting in a utilization pattern that is not observed with outpatient mental health service alone.

Housing instability, generally, is associated with a lack of access to care. The present study explores healthcare mobility among Veterans experiencing housing instability to identify the magnitude of this phenomenon and whether it is associated with certain patient characteristics or needs. The sample included 486,675 Veterans with 4 or more healthcare visits during the year following identification of homelessness. Analyses compared (a) baseline characteristics of Veterans who did and did not experience high healthcare mobility (i.e., receipt of healthcare services at 4 or more U.S. Department of Veterans Affairs Medical Centers) and (b) services use during the observation period. Among the sample, 0.7% experienced high healthcare mobility. Veterans with a rural residence had 30% greater odds of high healthcare mobility; baseline use of primary care was associated with reduced odds. The findings represent the combined challenges of accessing healthcare when experiencing housing instability and while residing in a rural area and highlight the need to ensure that there is access to needed care. Future work should assess Veterans' access to community-based resources, particularly in rural areas and new ways of delivering care in these areas.

Growing rates of mental illness among the pediatric population have led to increased morbidity and mortality, with suicide being the second leading cause of death among children aged 10-14. Barriers to mental health (MH) care, including limited access to resources, stigma, and education, perpetuate the crisis. Pediatric primary care providers must seize every opportunity to bridge this gap. This project created an age-appropriate virtual educational program for adolescents aged 12 to 18 on the MH assessment tool, the Patient Health Questionnaire (PHQ-9), which is commonly used during well-child visits. A clinician‑authored slide deck was converted into a 10‑minute Articulate Storyline® module delivered on clinic tablets. Using a backward-design approach, every screen and interaction was mapped to four learning objectives focused on (1) feelings literacy, (2) PHQ-9 comprehension, (3) early-detection awareness, and (4) help-seeking efficacy. As a clinician-designed module not yet formally deployed to the target population, formative feedback was limited to informal review by four adolescent testers prior to final release. Teen testers who reviewed the material requested shorter card-back text, an option to replay narration, and higher color contrast on negative-emotion cards. By grounding the module in the validated PHQ-9 screening tool and evidence-based instructional design principles, and by engaging key stakeholders, the interactive virtual educational program bridges critical MH gaps by educating and empowering adolescents to understand their mental well-being and proactively engage in their care.

Suicide and mental ill-health remain a major global concern, reflected by rising emergency department presentations, however there is growing recognition that these settings often do not meet the needs of individuals in crisis. These settings are often experienced as crowded, traumatic, and poorly equipped for psychological distress, underscoring the need for accessible, community-based alternatives that offer safer, more supportive responses during crisis. This scoping review examines the needs, motivations, and experiences of people using community-based alternatives to emergency departments and explores how peer support and lived experience are embedded in these models. A scoping review was conducted across five academic databases and grey literature sources for publications from the last 20 years. Eligible records included any study design such as quantitative, qualitative, mixed-methods research, service evaluations, and descriptive reports. Records were required to describe short-term, community-based crisis services for adults. Studies involving telehealth, mobile crisis, or hospital-based care were excluded. Titles and abstracts were screened independently by two reviewers. Twelve papers (n = 8 mixed methods, n = 3 qualitative, n = 1 quantitative) were eligible for inclusion. Studies spanned five countries, were mostly published in the past decade, and examined a range of non-clinical crisis models, including crisis cafés, respite centers, stabilization units, and peer-led services. Interventions commonly supported people experiencing suicidal distress, acute anxiety, depression, or significant life stressors. Peer support was central in most models and linked to reduced distress, greater emotional connection, and, in some cases, lower ED use. Barriers included limited availability, geographical inaccessibility, funding constraints, and insufficient aftercare. The diversity of study designs and the limited evaluation data made it difficult to draw broader conclusions about the existing evidence. Long-term outcomes and economic impacts were rarely reported, and few studies compared peer-led and non-peer models. Place-based, community alternatives offer promising, person-centered options for people in distress and may complement existing suicide prevention efforts. Addressing accessibility and funding challenges, along with further research on outcomes and peer support, will help strengthen their role in crisis care.

Mobile messaging interventions can improve engagement and support functional recovery among people with serious mental illness, yet they are seldom implemented in real-world community mental health settings. As part of a randomized controlled trial of a recovery-oriented messaging intervention, community-based clinicians were trained to serve as messaging mobile interventionists. In this qualitative study, we examined their perspectives on barriers, facilitators, and adaptations needed to optimize the acceptability and sustainability of messaging-based care. Semi-structured interviews were conducted with all clinicians (N = 6) who delivered the intervention to 39 clients across two community mental health agencies. Interviews were analyzed using a mixed deductive and inductive thematic approach. Four domains captured clinician perspectives: (1) perceptions of training, supervision, and workflow; (2) benefits for client care and service delivery; (3) challenges to intervention success; and (4) suggested adaptations for intervention design and implementation. Clinicians reported that messaging supported engagement, improved therapeutic relationships, and enhanced individualized care, particularly for clients with depression or social anxiety. They described substantial challenges integrating messaging into daily routines, navigating the technology platform, and adapting clinical skills to a text-based format, especially with clients experiencing cognitive disorganization or symptom-driven communication difficulties. Clinicians recommended clearer role definitions, specific functionality improvements, additional training resources, streamlined goal-setting processes, and flexibility to use synchronous communication when needed. Findings provide concrete guidance for developing improved messaging interventions and strengthening their implementation in community mental health settings based on real-world implementation experiences.