Introduction: For the first time COP28 have included Public Health in their climate change discussions. Given progress on climate change has many hurdles, from domestic, economic and corporate pressures, it is pertinent to explore what impact this inclusion might have and what specific challenges there might be in relation to global mental health.Purpose: This positioning paper considers whether the implication of the inclusion of Health at COP28 might bring about transformation in the way Global Mental Health is addressed. It also considers how it might transform how mental health professionals, but also all others involved in working with people with mental health issues, transform mental health. The paper considers challenges to be faced going forward and potential solutions. The author acknowledges they are sharing their position on this subject, but in doing so, hopes to generate wider discussion.Methodology: As this is a positioning paper, data has been derived from the argument and counter argument within the paper. Therefore, there is a possibility of the risk of bias. Results: Plans to improve mental health globally have focused on replicating a Western, Global North model. Despite over 10 years of the WHO Mental Health Action Plan, there continues to be a growing mental health pandemic, worsened by Covid-19. Mental ill- health is caused by multiple factors, many are national, regional and even localized. The Western Global North model does not factor this in sufficiently to bring about improvement.Conclusion: This paper evaluated whether by including ‘Health’ at the recent COP28, it would help transform Global Mental Health. What became clear, after reviewing previous policies and action plans, was that significant change and improvement had not occurred. Policy makers and professionals approach needs to focus on preventing mental ill-health rather than treating after the event. Additionally, decolonisation of policies and professionals education is required to co-create sustainable resilience with people/communities and reduce mental ill-health.

Introduction: While the detrimental impact of the Russian-Ukrainian War on mental health of Ukrainian population has been well-documented, less attention has been given to mental health workers (MHWs) providing mental health support services amid the war. Purpose: To examine levels of domain-specific well-being in Ukrainian MHWs; identify and quantify the relative importance of factors associated with well-being; and examine interactions of risk and protective factors in relation to each well-being domain. Methodology: A convenience sample of 178 MHWs completed a survey that assessed their well-being, and sociodemographic, war-related, mental health, and psychosocial characteristics. Results: Lower levels of mental health difficulties such as anxiety and posttraumatic stress symptoms, and higher levels of psychosocial factors such as higher optimism, gratitude, and presence and search for meaning were associated with higher well-being. MHWs with high levels of protective psychosocial factors were more likely to report higher well-being even in the presence of mental health difficulties. Conclusions: Results of this study provide insight into the levels and correlates of multiple well-being domains among Ukrainian MHWs amid the ongoing war. They further suggest that interventions to mitigate mental health difficulties and bolster protective psychosocial factors may help promote well-being in this population

Purpose: This paper describes and documents an innovative blended learning Global Mental Health: Trauma and Recovery certificate training course. This course combines a two-week face-to-face training in Orvieto, Italy with a five-month follow-up online virtual training as a learning experience for global health care practitioners. Continuing medical education (CME) accreditation is offered upon completion. This course utilized an innovative blended learning model with a community of practice approach, a combination of lectures and discussions, and online in-depth group case study discussions. Methodology: Data was collected by self-reported anonymous evaluation by participants of three continuous years of the CME Global Mental Health: Trauma and Recovery certificate training course sponsored by Harvard Medical School. One hundred fifty-five participants (n= 39 in 2011; n = 57 in 2012; n=59 in 2013) underwent a pre- and post-course evaluation to determine sustained confidence in performing medical and psychiatric care to traumatized patients and communities, as well as to determine their learning of the Global Mental Health Action Plan (GMHAP). Results: Over the course of three independent years, a total of 155 participants were evaluated. There was evidence for significant improvement in their confidence levels in all clinical areas (diagnosis; treatment of trauma; use of psychotropic medication) when comparing baseline to completion of the six-month course. All ten dimensions of the GMHAP and nine medical and psychiatric aspects of treatment revealed significant improvement in confidence levels. Regression analysis also indicated similar results after the adjustment of demographic covariates. Physicians and participants with mental health and social work background had significantly higher confidence. Participants who were MD’s or psychiatrists had higher confidence in most of the categories of confidence except for self-care, understanding culture, collaboration, and policy and financing. The model showed no difference in learning based upon gender and level of development of country of origin. Conclusion: The evaluation of this blended learning CME program provides evidence of significant enhancement of clinical practice and planning skills in health care practitioners working with highly traumatized patients and communities worldwide. This successful training over the past 18 years has gone far to achieve the health and mental health capacity building as requested by the Ministers of Health from post-conflict societies in the historic Rome meeting in 2004.

Introduction: Mental health issues are prevalent, yet their treatment remains inadequate. Tuberculosis presents substantial mental health challenges. Their co-occurrence is a frequent phenomenon. However, the integration of mental health professionals or services is not a common practice. Purpose: To review the evidence about the relation between tuberculosis and mental health, and its consequences concerning the implementation of policies and services. Methodology: We conducted a comprehensive review using the MeSH terms "Tuberculosis" and "Mental Health" on PubMed, spanning from 2011 to December 2021. We identified and assessed systematic reviews, regular reviews, scoping review and meta-analyses for their appropriateness and relevance. Results: A total of 341 studies were accessed for eligibility and 19 studies were included. Mental disorders and tuberculosis are frequent comorbidities. Their relation is commonly described as “syndemic”. Shared risk factors, social vulnerabilities, and upstream social determinants are prevalent in both conditions. There is a potential for the integration of both conditions into policy and service organization. Conclusions: Mental disorders treatment gap could be shortened by addressing mental health problems among TB patients. The WHO Global End TB Strategy prioritizes integrated patient-centered care, and fostering collaborative partnerships between tuberculosis and mental health services could enhance its implementation

Introduction: Environmental-related hazards are a global problem; consequently, an Environmental Worry Index (EWI) was developed; however, the psychometric properties of this scale in the Spanish population are unavailable. Purpose: The objective of this study was to adapt and examine the psychometric properties of an Environmental Worry Inventory (EWI) in a Spanish-speaking student population.Methodology: This study adopted a cross-sectional design. It used a snowball sampling technique to collect data using the compact questionnaire comprise of EWI, Climate Anxiety Scale (CAS), and Big Five Inventory (BFI-15) from 251 participants in 2023 among students of Autonomous University of Ciudad Juárez (UACJ), Juárez, Mexico.Results: Results of exploratory factor analysis (EFA), the Kaiser-Meyer-Olkin (KMO=0.891) and Bartlett's Test of Sphericity (p < 0.001) showed adequate data. Confirmatory factor analysis (CFA; ?2 (5) = 78,595, CFI = 0.94, and RMSEA=0.078) demonstrated adequate goodness of fit. EWI was associated with CAS, and neuroticism dimension of BFI-15. It has an acceptable overall Cronbach Alpha coefficient (? = 0.890); the two subscale factors’ reliability coefficients ranged from .80 to .89. Conclusion: The study concluded that EWI is reliable, valid and recommended for use among Mexicans especially the Spanish speaking students.

Mental Health: Global Challenges Journal is an open access peer-reviewed journal, whose main aim is to promote dialogue and debate on topics such as Mental Health, Mental Health Care Systems, international studies on MHC systems in the context of global social challenges. The Journal was originally founded for publication of the materials from the International Conference on Mental Health Care “Mental Health: global challenges of XXI century”. The journal especially encourages manuscripts which may be of interest to policy makers and/or practitioners.

Introduction: Mental health challenges remain a pressing issue, underscored by the glaring gap between the elevated demand and the scarce resources. Research has highlighted the effectiveness of integrating mental health services with primary care services, particularly in low-resource settings. Purpose: The objective of this research was to evaluate the perceived implications and feasibility of integrating basic mental health services into an existing community-based family planning initiative in Pakistan. By adopting a community-driven and co-produced methodology, our study not only ensured a deeper resonance with local needs but also paved the way for a sustainable and transformative uptake of mental health services in low-resource settings. This co-produced strategy, anchored in mutual collaboration and shared expertise with the community, promises a more holistic, enduring, and adaptive integration of essential health services within community frameworks.Methodology: This study utilized a qualitative research approach to obtain a comprehensive understanding of the program's feasibility and potential for expansion. Interview tools and guides, tailored to the regional language, were developed by the Research Associate to gather insights from the lady health workers involved in delivering the intervention, as well as from the clients. Overall, our team conducted 24 interviews, of which 9 were with the lady health workers and 15 with clients. The interviews were facilitated by the Research Associate and a Psychologist.Results: Utilizing the socio-ecological model, we thematically analyzed factors at individual, interpersonal, and community levels that support or hinder the integration of mental health services with existing community-based programmes. We also examined the intervention's impact on its users and the healthcare providers.Our analysis underscores the significant potential of integrating mental health services into existing community-based health programmes, such as family planning, in low-resource settings. Predominant themes highlighted women's willingness to use these services, influenced by strong relationships and trust in the lady health workers, ease of access to services, and community support. Identified barriers to integration included prevailing poverty, a preference for direct financial incentives in addition to counseling, confidentiality concerns in tight-knit communities, and the lingering stigma surrounding mental health.Conclusion: Our findings highlight the value of community collaboration in healthcare, particularly in low-resource settings. The co-production approach blends professional guidance with local insights, fostering community ownership and enhancing program sustainability. As the first to merge mental health with family planning in Pakistan, our research suggests that future health initiatives can greatly benefit from community-driven methods, leading to more sustainable and transformative health outcomes.

Introduction: To promote mental health globally, including low-and middle-income countries, research and advocacy are essential. The Republic of The Gambia is one of the smallest countries in the world and is the focus of this research. Purpose: This study examines social and cultural aspects of access to mental health treatment in The Gambia, West Africa. Methodology: The population of focus consisted of adults over 18 living in The Gambia. The methodological approach was a qualitative phenomenological study involving semi-structured interviews conducted via Zoom, by a researcher from The Gambia. Results: Data were collected from 17 participants living in The Gambia at the time of the study. A team of analysts with diverse backgrounds evaluated transcripts and identified five themes highlighting social and cultural conceptualizations of mental health and mental illness, sociocultural determinants of health, interventions, barriers to care, and legal frameworks to support mental health change. Conclusions: The findings from this study are significant for mental health providers who seek to understand different perceptions of mental health and mental illness and the associated stigma. Furthermore, this study suggests several opportunities for mental health advocacy in The Gambia

Introduction: The stigmatization of mental healthcare services and users is a barrier to the achievement of mental wellness present on a global level. 800000 suicides are estimated each year, 25 suicide attempts for every suicide (ratio of 25:1), and in 2017 estimated a prevalence > 10% of people suffering from mental disorder or substance abuse (global data). The stigmatization is a multifactorial phenomenon and process that involves different factors, which overall cause health, social and economic damage. Slowing down and reducing access to mental health and well-being pathways due to their influence in the community, also affect social relationships and self-determination. Purpose: to identify and describe the process, causes, and factors of stigmatization. Propose destigmatization activities led by the medical educator. Methodology: The manuscript develops a proposal focused on the destigmatization process of mental health/wellbeing services and users, through the guidance of the medical educator as a figure of connection between different professions (interdisciplinary and multidisciplinary), and between different stakeholders. Conclusion: each identifies factor described, can be involved in the destigmatization process to generate inclusion, through different social interventions led by the role of the medical educator, with the aim of supporting access to patient support processes and quality of life in communities, generating inclusion through destigmatization

Introduction: COVID-19 was responsible for widespread disturbance throughout the educational system and was harmful in a variety of ways. In particular with regard to the state of a student’s psychological health. Purpose: This study examines the relationship between psychological distress (depression, anxiety, and stress) and coping strategies among the students of a private university in Bangladesh during the COVID-19 pandemic. Methodology: A cross-sectional web-based survey was conducted from September 2020 to December 2021 on 951 respondents using the DASS-21 and Brief-COPE questionnaires. Results: The majority of students were experiencing mild to extremely severe depression (75.8%), anxiety (88.5%), and stress (79.1%). The level of stress (p<.001), anxiety (p<.001), and depression (p=.23) was significantly higher among the female students compared with male students. This study also highlights the coping strategies of students. However, sex differences were not profound in adopting coping strategies. The results also showed significant correlation between some Brief-COPE measures, such as acceptance and self-blame (r=.708, p<.001); use of informational support and emotional support (r=.599, p<.001). Conclusion: As the prevalence of mental health disorders was found to be higher among private university students, university authorities should seek necessary assistance from mental health professionals to support their students in overcoming psychological distress not only related to the pandemic but also related to their day-to-day life activities.