Area Of Mental Health Research Articles

Evaluation of New Mental Health Diagnoses After Pediatric Traumatic Injuries at a Level 1 Pediatric Trauma Center

Background Traumatic injury is associated with significant mental health morbidity. To evaluate the need for implementation of active-post injury mental health screening at a Level 1 Pediatric Trauma center, we aimed to characterize all new mental health diagnoses after injury and evaluated for patient or injury factors that may aid in targeting of future screening. Methods A single-center retrospective analysis of trauma patients aged 6-18 years presenting in 2022 was performed. Our primary outcome was a new DSM-5 mental health diagnosis documented after traumatic injury. Patients with and without a new mental health diagnosis were compared by age, sex, race, ethnicity, injury type/mechanism, injury severity score (ISS), intensive care unit (ICU) admission, and length of stay (LOS). Results 492 patients were included. Their median (IQR) age was 13.5 (10.4, 15.4) years. The median (IQR) follow-up interval was 157 (9, 429) days. There were 24 (4.9%) children with a new mental health diagnosis: 12 (50%) with trauma-related stress disorders, with the remaining having diagnoses such as depressive or anxiety disorders. Patients with a new mental health diagnosis had longer LOS (3.0 [1.8, 7.5] vs 2.0 [1.0, 3.3] days, P = 0.02) and were more likely to have sustained penetrating injury ( P = 0.01). There were no differences in demographics, rates of preexisting mental health diagnosis or area deprivation index ( P > 0.05). Discussion There were fewer new mental health diagnoses in our cohort than expected, likely underestimating the acute need. Comprehensive post-injury screening is imperative to sufficiently identify and intervene upon mental health morbidity after pediatric trauma.

EVALUATION OF ANXIETY AND DEPRESSION AMONG NURSING STUDENTS OVER THE COURSE OF A YEAR

Introduction: Anxiety and depression observed in young people are associated with poor quality of life during college, not only in terms of poor eating and lifestyle habits, but also the inability to deal with problems associated with college and their future profession. Each stage of life, with its due concerns and questions, interferes in the level of overload and pressure among college students. Objective: This study aimed to investigate the levels of anxiety and depression among nursing students at a public university in the interior of Paraná, at three different times, over the course of one year. Method: This is a quantitative, descriptive, exploratory study with a longitudinal design. Data collection took place at three different times throughout the year (March, July and November) of 2019, using the Hospital Anxiety and Depression Scale (HADS), validated for Brazil to assess anxiety and depression, as well as an instrument for sociodemographic and academic characterization of the subjects, constructed and validated (face, content and semantics) for this study, by experts in the area of ​​education and mental health. Descriptive and inferential analyses were performed for the variables of interest, as well as the calculation of Cronbach's alpha to assess the internal consistency of the items of the HADS scale. Student's t-test, Analysis of Variance (ANOVA) and one-way ANOVA with repeated measures were used to compare the measures of anxiety and depression, as well as with sociodemographic and academic variables among the students, throughout the three evaluations. Results: Among the 77 participating students, 92.2% were women with a mean age of 21 years; 15.4% were married; 74.6% declared themselves to be Catholic; 65.8% declared themselves to be good students. Age and the fact of having a subject dependency were considered statistically significant when compared between the years of the course. Anxiety averages in the three measures, respectively, for general nursing: 10.0; 9.9; and 9.5, not being considered statistically significant. And for depression: 7.1; 7.4; 7.1 being statistically significant for the third evaluation. There was no statistically significant variation between the evaluation of anxiety and depression levels in the three measures. Conclusion: The levels of anxiety and depression evaluated by HADS, in the General Nursing group were not so expressive quantitatively, but are still higher than other studies involving nursing and/or health area university students. Data from the study indicated no difference in anxiety and depression levels, at different times, throughout the year. Not having reached the population of academics of the course in question, as a whole, in the evaluations carried out, was one of the limitations of the study.New studies are being carried out to try to explain the variations in anxiety and depression levels among students on the Nursing course in question, with methodological approaches that allow the subject studied to have a voice.

Development of Qualified Items for Nursing Education Assessment: The Progress Testing Experience

Aimto analyze the psychometric characteristics of items in the nursing inter-institutional progress testing for the years 2019, 2021, 2022 and 2023. BackgroundProgress testing is a validated method for evaluating professional undergraduate education, aimed at identifying knowledge gain in a continuous and progressive manner, with potential benefits for nursing education. However, for its results to be useful, the evaluation items used in the test must have good psychometric performance. Designa cross-sectional study. Methodsa sample of 377 items (multiple-choice questions) was applied to 4,678 students in four years of progress testing. The difficulty and discrimination indexes were analyzed using descriptive statistics, ANOVA and simple linear regression. ResultsThe average difficulty index of the test items ranged between 0.39 and 0.46. The areas of child and adolescent health, women's health and adult health had the most difficult items, while the areas of management, mental health and public health had the least difficult items. Discrimination index ranged from 0.35 to 0.43. There was a difference between discrimination index between the years of application (p<0.001), with a significant increase in the discrimination index (p<0.001) in the trend analysis. Students in the final years showed lower levels of difficulty and discrimination when compared with students in the initial years, demonstrating that the test is easier and there is less dispersion of performance among students in the final years. ConclusionsThe items are not difficult and have good discrimination. A gradual annual increase in the discrimination index of the items was observed. This study provides useful information for the psychometric analysis and quality assurance of knowledge assessment items, both for the implementation of similar PT experiences and in the use of multiple-choice questions for other knowledge assessment purposes.

61 The HEADS-ED under 6: Validation of a mental health and developmental screening and triage tool

Abstract Background The HEADS-ED screening and triage tool was developed for children 6 years to young adults as a communimetric mental health (MH) and addictions screener to help clinicians identify and communicate areas of need and recommended clinical care. Few clinician-administered tools identify both MH and developmental needs in young children under 6. From a review of milestone tools and in consultation with paediatricians, psychiatrists, and family physicians, the HEADS-ED Under 6 is a MH and developmental screening and triage tool that was developed to screen and flag functional impairment and action required in several areas, including: Home &amp; caregivers, Eating &amp; sleeping, Activities &amp; peers, Development /speech/language/motor, Safety, Emotions &amp; behaviours and Discharge &amp; current resources (see http://heads-ed.com for more background and access to both tools available in English and French). Objectives Our objectives were to examine: 1) feasibility of implementing the new HEADS-ED Under 6 screening and triage tool in community and hospital settings, 2) clinical utility of the tool to assist with clinical decision making, and 3) validity of the tool against a comprehensive assessment. Design/Methods We conducted two implementation and validation studies to examine uptake of the tool and how the tool assists in clinical referral decisions to more specialized and intensive services at 2 sites. For our initial validation study, we piloted and validated the tool at a community MH agency in Ontario for children under the age of 6 from November 2019- March 2021 (N=566). For our cross-validation study, we examined how the tool was implemented within a regional coordinated access service housed in a paediatric hospital in Ontario from June 2021- August 2023 (N=589). Results For our initial validation study, the HEADS-ED Under 6 was widely used by intake workers (95%, N = 536/566) to communicate children’s MH and developmental needs (Figure 1) and assisted in recommending services of varying intensity. The tool showed good concordance with the InterRAI Early Years assessment in similar domains requiring no action (61.1% to 81.6%), requiring action but not immediate (49.2% to 88.0%) and requiring immediate action (66.7% to 100%) for children under 4 years old (p's &amp;lt;.001). Three clinical domains (Eating &amp; sleeping, Development/speech/language/motor, and Emotions &amp; behaviours) also independently predicted an urgent care recommendation (p's &amp;lt; .001). For our cross-validation study, the tool was used for all 589 intake appointments, and 96.4% (N = 568/589) had a level of need documented. HEADS-ED Under 6 clinical domains (.24-.38) and total scores (.52) were significantly correlated with level of need (p&amp;lt;.001). Higher HEADS-ED Under 6 total scores helped intake workers decide on more intense services based on level of need (p&amp;lt;.001; Figure 2). ROC analyses (AUC = .807, SE = 68.5% sensitivity, 79.5% specificity) confirmed a total score of 6 or above helped triage to more targeted and intense services. Conclusion The HEADS-ED Under 6 is a brief, straight-forward, and valid screening and triage tool that can be used by intake workers, physicians, and paediatricians to guide their interview in several areas of MH and development, communicate the severity of the child’s MH and developmental needs, and assist with determining level of need for services. When a HEADS-ED Under 6 total score reaches ≥6, clinicians should advocate for more intensive services when making MH service referrals.

AI-Assisted Diagnosing, Monitoring and Treatment of Mental Disorders: A Survey

Globally, one in seven people has some kind of mental or substance use disorder that affects their thinking, feelings and behaviour in everyday life. People with mental health disorders can continue their normal lives with proper treatment and support. Mental well-being is vital for physical health. The use of AI in mental health areas has grown exponentially in the last decade. However, mental disorders are still complex to diagnose due to similar and common symptoms for numerous mental illnesses, with a minute difference. Intelligent systems can help us identify mental diseases precisely, which is a critical step in diagnosing. Using these systems efficiently can improve the treatment and rapid recovery of patients. We survey different artificial intelligence systems used in mental healthcare, such as mobile applications, machine learning and deep learning methods, and multi-modal systems and draw comparisons from recent developments and related challenges. Also, we discuss types of mental disorders and how these different techniques can support the therapist in diagnosing, monitoring, and treating patients with mental disorders.

Quiet Pandemic Amid COVID-19: A literature review on gamification for mental health

Background: COVID-19 affects individuals both physically and mentally. The key is to address emerging needs with a modest technique that helps boost the positive approach in individuals. Gamification offers attempts to engage users with the non-game approach, and its growing popularity in other fields, such as finance and retail, is evident. Objective: This research aims to study the available literature that analyzes and understands using the Gamification approach for mental health in the pandemic. Methods: The author performed a systematic literature review using the PRISMA technique among the selected articles published until Jul 2023, focusing on Gamification, mental health, and COVID in highly reputed record databases, which were peer-reviewed studies. Therefore, the studies using the standard international language of English were eligible for this Study. Results: The Study identified elevated articles exploring Gamification through mobile application software, web-based platforms, and other tools since COVID-19 limited in-person social contact for individual safety during peak time. Conclusion: There are limited studies of Gamification in mental health, and the existing studies suggest that Gamification supports the betterment of mental health. Future studies can explore the different areas of mental health with gamification-based applications or gamified approaches.

Survey of GP registrars' training experience and confidence in managing children and adolescents with mental health conditions in primary care.

The aim of thisstudy is to assess General Practitioner (GP) trainees' training experience, and confidence in assessing and managing children and adolescents with common mental health conditions in primary care in Ireland. An online anonymous questionnaire was distributed to third and fourth year GP registrars enrolled in the Irish College of General Practitioners training schemes. The online questionnaire evaluated participants' training experiences and confidence levels in key areas of child and adolescent mental health in primary care. Sixty participants completed the survey out of 406, yielding a response rate of 14.8%. The majority (88%) reported no formal training or experience working in Child and Adolescent Mental Healthcare Services (CAMHS) during their GP training scheme. Responses indicated that many participants rated their competency, skills, and knowledge in essential areas of Child and Adolescent Mental Health as needing improvement. Similarly, their awareness of referral pathways and specialty services was below expectations, with poor perceived access to services. A large proportion (91.7%) expressed a definite need for further training in child and adolescent mental health disorders. The results highlight the need for enhanced training and support for GP trainees in the field of Child and Adolescent Mental Health, ensuring their ability to effectively and confidently address these common issues in primary care.

Their stories, our history: Ken Daniels

INTRODUCTION: This article forms part of the “Their stories, our history” series which provides information regarding some of the major contributors to the profession of social work in Aotearoa New Zealand. Ken Daniels is featured in this article. METHODS: A life history methodology is used to document some of the contributions made by Ken Daniels. Life history is a qualitative methodology where various forms of data are used to piece together a narrative. Interviews, documents, articles and other historical artifacts have all contributed to the development of this article. FINDINGS: Ken Daniels has pioneered a number of social work advances in the areas of mental health, social work education and the professionalisation of social work. He has also made outstanding contributions nationally and internationally in the field of assisted human reproduction through a time of rapid change. Using a calm, compassionate and determined approach, Ken has been able to navigate through the complexities of practice, policy and education. CONCLUSIONS: Ken Daniels has exemplified a practice which has centred a generalist social work approach, working in different ways and at different systems levels to achieve desired outcomes.

Behavioural Problems in Preadolescence: Does Nutritional Status Have a Role?

Malnutrition in children and adolescents is a global issue particularly in low- and middle-income countries, while behavioural problems are becoming a growing public health concern in the area of child and adolescent mental health, with very few studies examining their association in preadolescence. This study aimed to assess the epidemiological relationship between malnutrition and behavioural problems in preadolescence. A school based, cross-sectional survey was conducted in Karachi, Pakistan. Total 660, 11- to 12-year-old preadolescents were selected from a middle-class, coeducational school chain. Sociodemographic questionnaires and an officially adapted version of Youth Self-Report Form (YSR), which is the child and adolescent reported version of the Child Behavior Checklist (CBCL), were used to collect data, along with anthropometric assessments following the WHO protocol. Thin and stunted preadolescents had significantly higher odds of internalizing problems (AOR = 2.05, p = 0.003 and AOR = 2.09, p = 0.039, respectively) than normal ones. Overnutrition was not associated with any behavioural issues. According to the Composite Index of Anthropometric Failure, 40% of preadolescents had at least one type of malnutrition and among them about 3% had co-occurring malnutrition (stunted and thin or overweight). They significantly had higher risk of being associated with the internalizing problems (AOR 2.92, p = 0.027). The effect was considerably higher than that associated with stunted or thin only, highlighting the cumulative impact of the co-occurring malnutrition on the internalizing problems. Our study concludes that overnutrition and undernutrition are prevalent in preadolescents, with significant association of undernutrition with internalizing problems. Moreover, our study is the first that reports that the co-occurrence of malnutrition is significantly associated with increased risk of internalizing problems. This study highlights the importance of the link between physical and mental health and emphasizes the need for holistic interventions and programmes for addressing preadolescents' issues.

IMPACT OF MENTAL HEALTH &amp; WELL-BEING ON ACADEMIC PERFORMANCE OF UNIVERSITY STUDENTS

The study was conducted to investigate the impact of mental health and well-being on academic performance of university students. Quantitative research design was adopted for the study. The sample of study comprised 300 university students from both private and public sector universities. A random sampling technique was used to select the study sample. Data was collected by a self-constructed questionnaire designed on a 5-point Likert scale. Experts validated the tool's content. Data analysis was done through SPSS, version 22, including independent frequency distribution, sample t-test, ANOVA, and regression analysis. The results of study offer significant information that showed that mental health and well-being significantly impacted the academic performance of university students. Thus, based on conclusion of study, it was recommended that a great focus on judgment and improvement of missing areas of the students' mental health should be considered by universities, their faculties, and their parents. Moreover, this study may open new interdisciplinary horizons for the future researchers by merging education and psychology to consider the different issues in a tailor-made format.

The handling of hazardous medications by nurses and midwives: A retrospective cohort study

BackgroundOccupational exposure of healthcare workers to hazardous medications can be potentially harmful. Hazardous medications can be carcinogenic, developmentally toxic, reproductively toxic, genotoxic and/or toxic to organs at low doses. These hazardous medications can be used in many healthcare settings, but published research of occupational exposure has focused almost exclusively on cancer services. AimTo identify the healthcare settings where nurses and midwives are responsible for the administration of hazardous medications. MethodA retrospective cohort study was undertaken of all medication administration events occurring during a two-week period at a public metropolitan health service in 2023. All medication administration events from six hospital sites were identified using the electronic (Oracle Health-Cerner-Millennium®) and paper (Chemotherapy Chart) medication administration records. From all of the medications administered, the subset of medications classified as hazardous were identified based on the Victorian Therapeutics Advisory Group Framework for Handling of Hazardous Medicines (2021) and other guidelines. Poisson regression modelling was used to explore associations between the number of hazardous medications and the healthcare area where they were administered (p < 0.001). ResultsOf the 121,567 administration events, 6054 (5.0 %) involved hazardous medications. The healthcare areas with the highest rate of hazardous medication administration events, as a proportion of all medication administration events, were outpatient cancer service (301/695, 43.3 %), birth suite (13/86, 15.1 %) and mental health (404/4011, 10.1 %) areas. During the two-week period, 6054 hazardous medication administration events occurred, involving 117 different medications. The greatest number of these events took place in the medical (1729/6054, 28.6 %) and geriatric (1579/6054, 26.1 %) inpatient healthcare areas. A total of 1258 nurses and midwives were directly involved in either administering, or checking and witnessing the administration of hazardous medications to 996 patients (25.2 % of the total 3958 patients). Most hazardous medications administered to patients were in an oral dosage form (5426/6054, 89.6 %). ConclusionHazardous medications were administered in all healthcare areas, with the exception of endoscopy services. Nurses and midwives were at risk of occupational exposure from hazardous medications.

Humanization of nursing in the context of psychiatric hospitals: perspectives and challenges

In the beginning of psychiatry, the asylum was considered the ideal model for treatment in the area of mental health, where care was based on isolation in prisons, highlighting the lack of humanization and consequently, mistreatment. Psychiatric Reform emerged in Brazil in 1970, with the aim of reverting to the dehumanized form of care, through movements carried out by recently trained professionals in the area of Brazilian psychiatric care. The general objective of this study was to analyze recent literature on the humanization of nursing professionals in the context of psychiatric hospitals. The methodology used was an integrative, qualitative literature review, using publications in the Portuguese language and published between 2013 and 2023, in the databases: Virtual Health Library (VHL) and Scientific Eletronic Library (SCIELO), with the following descriptors: Nursing Care, “Hospitals, Psychiatric”, and Humanization of Assistance. The result was an initial sample of 231 articles and a final sample of eight publications. It is concluded that qualified assistance in the institucional environment is still essential, with the nursing professional being on of the main responsible for this process, considering that the current therapeutic approach to psychiatry is being increasingly directed to the extra-hospital context, becoming further studies on this topic are necessary.

Contextualising mental health: interdisciplinary contributions to a new model for tackling social differences and inequalities in mental healthcare

ABSTRACT Many classical approaches in the area of phenomenological pscyhopathology focus on structures of lived experience of mental illness and overlook the role social context plays in the formation of lived experiences. The paper addresses this issue and contributes to recent research which has pointed out that there is a need for an approach to mental health which investigates the role of context in shaping lived experiences. We propose a conception of contextuality (or situatedness) which we develop in terms of two main characteristics: intersectionality and social relationality of the human condition. We take context to be shaped by social interdependence and by the intersection of multiple factors including gender, race, ethnicity, class, socio-economic status and power relations. We develop this analysis in relation to substance misuse, refer to, and compare, certain case studies and perspectives from Brazil to illustrate our approach which can, however, be applied to other areas of mental health. We suggest that the proposed contextual approach is crucial for an in-depth understanding of psychopathology from a phenomenological perspective and in relation to contemporary ethico-political issues concerning social differences and inequalities in mental health.

Understanding key priority areas of mental health among queer asylum seekers and refugees in Australia through the lens of structural violence: A modified Delphi method study

Abstract Queer asylum seekers and refugees (QASaR) are more likely to have poor mental health compared to non-QASaR. This paper examines key priority areas for refugee services to improve mental health outcomes of QASaR in Australia. The key priority areas were identified through a modified Delphi method (DM), comprised of two stages: a scoping review of literature and three rounds of consensus building process. In the second stage, twenty-one participants were involved, including QASaR, health/social care professionals, and people in policy/funding-related roles. Drawing on Farmer’s understanding of structural violence, our consensus suggests QASaR’s poor mental health is primarily produced by the asylum system, further exacerbated by the lack of safe queer-inclusive refugee services, and can be improved by supporting QASaR-led organizations. Greater investments in QASaR-led organizations and initiatives are needed to improve cultural safety of refugee services and achieve systemic change.

PARTNERSHIP RELATIONS AND THE FEELING OF SUBJECTIVE WELL-BEING

Davit Katamadze E-mail: datoqatamadze@gmail.com Assistant Professor of Batumi Shota Rustaveli State University Georgia, Batumi https://orcid.org/0009-0008-8815-1167 Ketevan Beridze E-mail: k.beridze@bsu.edu.ge Professor of Batumi Shota Rustaveli State University Georgia, Batumi https://orcid.org/0000-0001-6268-7037 Nino Rusieshvili E-mail: niniarusieshvili@gmail.com Teacher, Master of Clinical Psychology, BSU, special teacher of psychology clinic Georgia, Batumi https://orcid.org/0009-0002-6370-5553 Lizi Vekua E-mail: vekualiza10@gmail.com Batumi Shota Rustaveli State University, Third year student of psychology Georgia, Batumi https://orcid.org/0009-0004-2193-2779 Abstract. A person's life satisfaction is determined by various factors: feeling satisfied with oneself and achievements, positive relationships, social involvement, independence, self-acceptance, continuous growth. Our well-being is also greatly influenced by partnership relations. As part of our research, I wanted to find out how much our love relationships govern our sense of subjective well-being. An unhealthy relationship can affect many areas of mental health, life satisfaction, self-perception, and even self-esteem. A positive partner relationship, characterized by factors such as emotional support, friendship, intimacy, and effective communication, is associated with reduced stress levels, improved mood, and greater psychological resilience (Pietromonaco &amp; Collins, 2017). Moreover, the benefits of healthy partnerships go beyond psychological well-being to include aspects of physical health. For example, individuals with satisfying relationships have lower rates of cardiovascular disease, better immune system function, and even longer life spans (Robles &amp; Kiecolt-Glaser, 2003). Having a supportive partner can also enhance individuals' social well-being by providing belonging, validation, and social support during difficult times (Gable &amp; Gosnell, 2013). It is interesting to believe that two people can have such a great influence on each other, that their symbiosis can lead not only to their relationship satisfaction and happiness, but also to the level of well-being, self-acceptance, autonomy, adaptation to the environment, etc. These factors will be discussed in the paper. Romantic relationships are a central aspect of most people's lives. We hypothesize that satisfaction with the partnership affects subjective well-being and life satisfaction. Key words: partnership relations, well-being, satisfaction, partner. JEL classification: Y800

Understanding the treatment experiences of adults diagnosed with early‐onset colorectal cancer: A qualitative study

AbstractObjectiveEarly‐onset colorectal cancer (CRC) incidence in adults aged under 50 is increasing. There is a critical lack of knowledge regarding the challenges faced by early‐onset CRC patients and their experiences of treatment. The aim of this study was to explore the lived experiences of individuals receiving treatment for early‐onset CRC, and the resulting impact on their lives.MethodsSemi‐structured interviews of patients with early‐onset CRC in the UK (n = 21) were conducted from August 2021 to March 2022. Interviews were recorded and transcribed verbatim. Data were analysed using thematic analysis.ResultsResults identified four key themes: (1) early‐onset CRC treatment results in sudden physical, psychological and social impacts in all aspects of life; (2) early‐onset CRC patients have unique supportive care needs which are not recognised in current practice; (3) there is a need for tailored information; (4) a lack of support was identified in the areas of mental health, sexual health and fertility.ConclusionsOur study highlights numerous unique issues experienced by the early‐onset CRC patient group during treatment. There is a need for change in clinical practice, along with the development of international guidelines and tailored resources for both patients and healthcare professionals, in order to improve care.

SADIARV - SISTEMA PARA ASSISTÊNCIA DE DIAGNÓSTICO DE AUTISMO COM REALIDADE VIRTUAL

The use of interactive technologies that use Virtual Reality (VR) in favor of patients in the area of mental health has been seriously expanded and valued, considering that good results are obtained, such as: treatments with greater effectiveness and lower cost, in addition to diversity of data that can be collected to better understand these individuals. However, research and studies on autism spectrum disorders (ASD) are still very recent, but it is known that with early diagnosis the treatment and development of the patient becomes much more efficient, in this sense a tool that specifically helps with diagnosis of autism there is a need. Therefore, this work presents a computational application that makes use of Virtual Reality and Computer Vision to assist professionals in the field in diagnosing patients with ASD. The virtual environments were evaluated by the project researchers, using a specific usability questionnaire, together with a usability scale system (SUS - System Usability Scale), obtaining a final average of 4.63 out of 5.0, being considered suitable for future use on real patients.

Uncovering multi-level mental healthcare barriers for migrants: a qualitative analysis across China, Germany, Netherlands, Romania, and South Africa

BackgroundForced displacement is a significant issue globally, and it affected 112 million people in 2022. Many of these people have found refuge in low- and middle-income countries. Migrants and refugees face complex and specialized health challenges, particularly in the area of mental health. This study aims to provide an in-depth qualitative assessment of the multi-level barriers that migrants face in accessing mental health services in Germany, Macao (Special Administrative Region of China), the Netherlands, Romania, and South Africa. The ultimate objective is to inform tailored health policy and management practices for this vulnerable population.MethodsAdhering to a qualitative research paradigm, the study centers on stakeholders’ perspectives spanning microsystems, mesosystems, and macrosystems of healthcare. Utilizing a purposive sampling methodology, key informants from the aforementioned geographical locations were engaged in semi-structured interviews. Data underwent thematic content analysis guided by a deductive-inductive approach.ResultsThe study unveiled three pivotal thematic barriers: language and communication obstacles, cultural impediments, and systemic constraints. The unavailability of professional interpreters universally exacerbated language barriers across all countries. Cultural barriers, stigmatization, and discrimination, specifically within the mental health sector, were found to limit access to healthcare further. Systemic barriers encompassed bureaucratic intricacies and a conspicuous lack of resources, including a failure to recognize the urgency of mental healthcare needs for migrants.ConclusionsThis research elucidates the multifaceted, systemic challenges hindering equitable mental healthcare provision for migrants. It posits that sweeping policy reforms are imperative, advocating for the implementation of strategies, such as increasing the availability of language services, enhancing healthcare providers’ capacity, and legal framework and policy change to be more inclusive. The findings substantially contribute to scholarly discourse by providing an interdisciplinary and international lens on the barriers to mental healthcare access for displaced populations.

Response to Focus Issue

ABSTRACTBarnett responds to three articles that put the thought of Søren Kierkegaard in conversation with modern popular media. He argues that each of these pieces demonstrates that Kierkegaard's criticism of the burgeoning free press remains relevant today, particularly in the areas of journalistic practice, mental health, and political responsibility. At the same time, however, Barnett wonders if the radical nature of the Dane's critique has been fully considered. For Kierkegaard, in other words, it is not just that popular media have flaws in need of correction; it is that the media constitute “the evil principle in the modern world.”

Adaptación y validación de una versión abreviada de la escala SIPAT de riesgo psicosocial integrado en pacientes con cirrosis hepática candidatos a trasplante hepático (SIPAT-11)

IntroductionPatients with liver cirrhosis who are candidates for liver transplantation must be evaluated both clinically and socially in order to obtain the optimal outcomes and avoid futile therapeutic measures. For the evaluation of the social aspects in these patients, no validated scale in Spanish is available. The SIPAT (Stanford Integrated Psychosocial Assessment for Transplantation) scale is an instrument that measures the social, family and psychological aspects in candidates for solid organ transplantation. The objective of this study is to adapt and validate an abbreviated version of the SIPAT scale in Spanish for patients with liver cirrhosis. Material and methodsProspective observational study carried out in the Hepatology Unit of the La Fe Unversity Hospital in Valencia, by questionnaire validation methodology. To analyze the reliability of the questionnaire, the internal consistency of all variables was calculated, for variability an exploratory factor analysis, and for stability the test-retest test was carried out. Results96 patients who were admitted for decompensated cirrhosis to the Hepatology Unit of the La Fe Hospital in Valencia between November 1, 2017 and January 31, 2017 were selected. 84% were men, the mean age was 60.01 (SD 10.12) years. In 73.2% of those admitted, the etiology of cirrhosis was alcoholic. 14.4% had a Child's stage A, 57.7% B and 27.8% C. The internal consistency of all variables reached a Cronbach's Alpha of 0.766. In the exploratory factor analysis, 6 dimensions of the questionnaire were identified that explain 84.27% of the total variability. To see the stability of the instrument, the measurement was repeated at 2 and 6 months of follow-up, obtaining in the test-retest a kappa agreement of 0.612 and 0.565 respectively. ConclusionThe SIPAT-11 questionnaire has good psychometric characteristics in cirrhotic patients who are candidates for liver transplantation. It is easy to complete and can be administered by professionals who are not specialists in the area of Mental Health.