Emergency departments are seeing an increase in mental health presentations across the globe; however, there are no standard mental health assessment models of care currently being used in emergency departments. This narrative review aims to search the literature and report the mental health models of care used globally. This narrative review conducted a search of 4 medical databases, Medline Complete, CINAHL, Embase and PsychINFO; the research team screened titles and abstracts and reviewed the full text. Risk of bias and quality assessment was conducted by 2 independent researchers. A total of 2461 articles were identified for title and abstract screening; of these, 84 were reviewed in full text and subsequently, 79 articles were excluded, resulting in 5 articles to be included in this narrative review. Two articles assessed the Psychiatric Assessment and Planning Unit (PAPU) model and reported on reduced length of stay; a third article reported a similar model and improved length of stay. Two articles reported models on sub-sample cohorts of mental health: individuals experiencing suicide ideation and individuals experiencing alcohol and substance use issues. The results of this narrative review highlight the lack of literature concerning models of care and mental health assessment in emergency departments. Of the few articles reviewed, a successful model of care and/or assessment requires a dedicated physical space in the emergency department (such as a PAPU), including mental health short stay beds and dedicated mental health staff.

Depression and anxiety are among the most prevalent mental health disorders worldwide, yet existing diagnostic tools do not always align with contemporary classification systems such as the International Classification of Diseases-11 (ICD-11). The study aimed to evaluate the validity and reliability of the International Depression Questionnaire (IDQ) and the International Anxiety Questionnaire (IAQ) in the Turkish population. The primary objectives were to assess the psychometric properties of these new health assessment tools, the only based on the ICD-11, in a culturally diverse setting. Participants were recruited through online survey platforms and university announcements, ensuring a diverse representation of the Turkish adult population. The sample consisted of 2894 individuals (1097 male, 1797 female) aged 18-65, including university students, and community members from various socioeconomic backgrounds. Factor analysis revealed that the IDQ and IAQ maintained their original factor structures, supporting their construct validity. The internal consistency of both the IDQ and IAQ was high, with Cronbach's α coefficients exceeding the threshold of 0.70, indicating acceptable reliability. These tools can be confidently used in both clinical and research settings, facilitating better mental health assessment and intervention strategies in Turkey. The findings suggest that the Turkish versions of the IDQ and the are valid and reliable tools for assessing the severity of depression and anxiety symptoms in Turkish adults. These instruments can support both clinical and research efforts by facilitating early identification of individuals who may benefit from further psychological evaluation.

Background: Understanding the mental health challenges of refugee adolescents is critical for informing targeted educational policies and interventions. Yet few studies identify which school-based factors most strongly relate to their resilience and well-being. This study draws on a multi-informant dataset from 170 refugee students attending school in Greece, applying Bayesian variable selection to identify key predictors of mental health outcomes. Methods: We collected student ( n = 170 ), teacher ( n = 165 ) and parent/guardian ( n = 124 ) data about each student (Strengths and Difficulties Questionnaire, SDQ; Child and Youth Resilience Measure-Revised, CYRM-R); sense of belonging, school attendance. We ran two models, one based on student self-reports, the other based on teacher, parent, and guardian data. Results: The self-reported sense of belonging was the most consistent protective factor of SDQ and CYRM-R outcomes, while bullying, discrimination, and disrupted schooling were associated with greater vulnerability. In triangulated analysis, student self-reports contributed the largest share of predictive information, followed by adult reports Discussion: This study highlights the importance of centering youth perspectives in mental health assessment and intervention and the critical role of inclusive school environments and educational continuity in supporting refugee integration. The Bayesian approach offers a robust framework for guiding evidence-based interventions for supporting the integration of refugee students in host-country educational settings. • We analyzed multi-informant data on refugee adolescents’ mental health difficulties and resilience. • Sense of belonging emerged as the strongest predictor of school-based mental health and resilience. • Bullying, discrimination, and disrupted schooling were associated with increased vulnerability. • Students’ self-reports showed higher predictive validity, while teacher reports aligned more closely with outcomes than caregiver reports. • Findings underscore the importance of inclusive, student-centered school environments.

Reviewing Australian paramedic clinical practice guidelines for persons experiencing a mental health crisis.

AI-powered methods for psychological assessment in adolescence psychological disorders: A systematic review and meta-analysis.

Chronic ankle instability (CAI) is linked to impaired dynamic balance and psychological deficits, potentially hindering optimal rehabilitation outcomes. However, the impact of psychological deficits on dynamic balance has not been explored before. Therefore, the aim of this study is to determine whether mental health factors predict dynamic balance performance in individuals with CAI using the Star Excursion Balance Test (SEBT). This is a cross-sectional observational study performed in a university setting. Forty individuals with CAI (17 men, 23 women) participated in this study. Assessments included psychological profiles (kinesiophobia, self-reported mental health, self-efficacy, global mental health, and functional status via FAAM-Sport). Dynamic balance was evaluated using the SEBT composite and directional scores. Multiple linear regression analyses indicated that the SEBT composite score was significantly predicted by self-efficacy, global mental health and TSK-11, explaining 40% of the variance (F-value=7.82, p<0.01). Further directional analysis revealed that posterior-medial reach was best predicted by self-efficacy, global mental health and TSK-11 (F-value=9.05, p<0.01; 44% variance), while posterior-lateral reach was similarly predicted by self-efficacy, and global mental health (F-value=6.92,P=0.003; 28% variance). Anterior reach performance was most strongly associated with self-efficacy and TSK-11 (F-value=10.26, p<0.01; 36% variance). The findings underscore the importance of psychological factors as key predictors of dynamic balance in CAI. Incorporating mental health assessments into physical rehabilitation may enhance treatment outcomes for individuals with CAI.

Bladder exstrophy and epispadias complex is a rare congenital anomaly with significant medical and psychosocial implications. We employed a dual approach to evaluate the prevalence and risk factors of psychiatric morbidity in bladder exstrophy and epispadias patients, by combining a systematic review with a retrospective national registry study. To evaluate the prevalence and risk factors of psychiatric morbidity in bladder exstrophy and epispadias complex. We conducted a systematic literature review following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, including studies on psychiatric disorders or symptoms and quality of life in bladder exstrophy and epispadias patients of all ages. Article quality was assessed using the Newcastle-Ottawa Scale. Prevalence data for psychiatric conditions and scores from psychiatric and quality-of-life questionnaires were extracted. Additionally, all bladder exstrophy and epispadias patients born in Finland 2001-2006 were identified from national registries. A matched and randomized control group without congenital malformations was selected from the same population. We evaluated the prevalence and risk factors for psychiatric diagnoses in this cohort. Of the 3850 retrieved results, 30 studies with 1179 participants were included. The overall prevalence of psychiatric morbidity was 31 %, [95 % CI 17 %-47 %]. Psychiatric morbidity was highest in adolescents, while morbidity in adults was comparable to the general population. In the Finnish cohort, 80 % (n = 16/20) of bladder exstrophy and epispadias patients had a psychiatric diagnosis compared to 26 % (n = 21/80) of the controls (OR 11.2, [95 % CI 3.37-37.4], p < 0.001). The severity of the anomaly, number of surgeries, maternal unemployment, or maternal psychiatric diagnosis were not significantly associated with increased psychiatric morbidity. Bladder exstrophy and epispadias is associated with an elevated risk of psychiatric morbidity. Our dual approach highlights the need for systematic mental health assessment and support in this population.

With rising bariatric surgery rates, more women of childbearing age are becoming pregnant after bariatric surgery. Bariatric surgery is often associated with psychological diagnoses. While mental health issues are common during pregnancy and postpartum, the effects of bariatric surgery on mental health during these periods is unclear. This review aimed to collate and synthesise available literature regarding the impact of bariatric surgery on mental health during pregnancy and postpartum. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews framework. A systematic search was conducted across five databases (MEDLINE, Embase, CINAHL, Maternity and Infant Care, and Global Health). It included peer-reviewed primary research studies and conference abstracts published in English that reported mental health outcomes of women during pregnancy and postpartum with histories of bariatric surgery. There were no time restrictions for including studies. A narrative synthesis following the Popay et al. framework was performed to summarise and interpret the findings. The available evidence suggest that women who have undergone bariatric surgery may be at increased risk of experiencing depression and anxiety during pregnancy compared to women who have not had bariatric surgery. Factors such as marital status, psychiatric history, and smoking exacerbate these risks. Evidence regarding other mental health disorders and postpartum depression was limited and inconsistent. Pre-pregnancy bariatric surgery may increase the risk of mental health challenges during the perinatal period. Mental health assessments should be integrated into antenatal and postnatal care for women with bariatric surgery histories.

Understanding the neurophysiological basis of learning ability and mental health is becoming increasingly important in neuroscience, education, and clinical psychology. However, many current assessments mainly rely on behavioural or psychometric measures that do not account for internal neural mechanisms. The EEG-Based Learning Ability and Mental Health Assessment (MLA) Framework addresses this gap by combining twelve neuro-cognitive-emotional indicators derived from real-time EEG data. These indicators reflect how effectively a person can stay focused, maintain optimal alertness, regulate emotions, cope with stress, manage fatigue, balance left- and right-brain activity, and remain physiologically prepared to perform. This provides a comprehensive, human-centred view of brain function that illustrates how the brain operates in real-world learning and performance contexts. This conceptual paper examines the theoretical principles of each indicator and consolidates findings from cognitive neuroscience, affective neuroscience, psychophysiology, and EEG research to support the framework. The MLA Framework views brain activity as an interconnected system, offering a clearer understanding of learning readiness and mental state. It is designed for use in education, early screening, mental health assessment, and personalised neurofeedback, while also recognising the ongoing need for further empirical validation and the establishment of robust normative data.

The intersection of immunity and mental health: Immunotherapy's role in modulating depression and neuropsychiatric disorders.

This study presents a multi-class stress detection system based on heart rate variability (HRV) analysis using a deep neural network (DNN) framework. Stress is a significant physiological and psychological factor that affects human health, productivity, and overall well-being, making its timely detection essential in healthcare and human-centered applications. Conventional stress detection methods often rely on binary classification or handcrafted statistical models, which may fail to capture the complex nonlinear patterns present in physiological signals. To address these limitations, the proposed work utilizes HRV features extracted from electrocardiogram (ECG) signals to classify multiple stress levels, enabling a more detailed and realistic assessment of an individual’s stress state. A deep neural network is employed to automatically learn discriminative patterns from HRV data and perform robust multi-class classification of stress conditions such as relaxed, low stress, moderate stress, and high stress. The proposed framework includes signal preprocessing, HRV feature extraction, feature normalization, and DNN-based classification for accurate stress recognition. Experimental evaluation demonstrates that the deep learning-based approach outperforms conventional machine learning models in terms of classification accuracy, robustness, and generalization. The proposed system offers a reliable and intelligent solution for continuous stress monitoring and has significant potential in wearable healthcare, mental health assessment, and real-time physiological monitoring applications.

People living with diabetes (PLWD) faced heightened biomedical and psychosocial risk during the COVID-19 pandemic, yet little is known about their mental health in South Africa. This study examined whether COVID-19 threat appraisals (fear of COVID-19, perceived vulnerability to disease, and COVID-19-related worry) predicted depression, anxiety, posttraumatic stress, and alcohol use among PLWD, and described the prevalence of these outcomes in a post-peak phase of the pandemic. Participants (n = 266) were recruited from public hospitals in the Western Cape and completed sociodemographic and standardised measures. Grounded in Lazarus and Folkman's Stress and Coping theory, hierarchical regression analysis showed that fear of COVID-19 was the most consistent predictor of psychological distress, explaining between 9 and 20% of the variance across outcomes. Study participants reported on average elevated levels of psychological distress, suggesting the need to integrate routine mental health assessment and referral into diabetes care.

Psychological stress is a key driver of short-term blood pressure (BP) elevations and cardiovascular risk, yet its moment-to-moment impact in daily life remains difficult to predict. In this longitudinal observational study, we collected multimodal data from 20 adults with self-reported hypertension, including continuous wearable-derived heart rate and activity, ecological momentary assessment (EMA) stress ratings, and ambulatory BP measurements in free-living conditions. The dataset comprised 3694 EMA responses and 3812 BP measurements collected over approximately four weeks per participant (mean 24.1 ± 8.5 days). We evaluated whether participant-specific ("personalized") models outperform a single pooled population model. Two prediction tasks were examined: (i) prediction of near-term BP elevations from wearable signals and stress EMA responses and (ii) prediction of self-reported stress from wearable signals and BP. Across both tasks, personalized models consistently improved predictive performance. For BP prediction, personalized models achieved a mean AUROC of 0.803, exceeding the population model by 0.235, while for stress prediction they achieved a mean AUROC of 0.849, exceeding the population model by 0.208. These findings suggest that personalized wearable-based models can capture individual patterns of stress and BP dynamics, with direct implications for precision mental health assessment and just-in-time adaptive intervention design in future work.

This study investigated the key factors contributing to occupational stress among custodial officers assigned to the Imus City Jail, a facility managed under the national correctional framework. Given the vital role these officers play in ensuring order and safety within the correctional environment, the research seeks to identify the specific stressors that compromise their well-being and job performance. Utilizing a descriptive-correlational research design, data were gathered through field surveys and researcher-made questionnaire. The respondents included the total population of thirty-five (35) Jail Non-Commissioned Officers - ranging from Jail Superintendent to Jail Officers 1, 2, and 3 - as well as 264 Persons Deprived of Liberty (PDLs), selected using Slovin’s formula from a population of 780. The study assessed variables such as workload, exposure to violence, role ambiguity, administrative support, and the overall physical and psychological demands of the job. Findings reveal that excessive workload, unpredictable environments, lack of administrative backing, and poor work-life balance significantly contribute to heightened stress levels among custodial personnel. In response, the study proposes a targeted stress-management program to address these specific issues. Key components of the proposed program include stress reduction interventions, strengthened institutional support systems, regular mental health assessments, and work-life integration strategies. The implementation of such a program is expected to promote officer well-being, improve operational efficiency, and contribute to a more secure and humane correctional environment. This research emphasizes the urgency of addressing institutional stress and offers a framework for policy development and future studies in correctional management.

Filicide, the intentional killing of a child by a parent or parental figure, presents profound challenges within South Africa (SA)’s justice system. Despite its exceptional nature, filicide is prosecuted under the common-law crime of murder. Although filicide falls within the ambit of common-law murder, the absence of a distinct legal category obscures the unique psychological, relational and socioeconomic factors that differentiate these cases from other homicides. Sentencing practices reveal deep inconsistency, shaped by judicial discretion, the minimum-sentencing regime, and gendered narratives. This article argues that SA should retain filicide within common-law murder but urgently adopt national sentencing guidelines, mandatory pre-sentencing mental health assessments, and integrated prevention pathways linking social services, health systems and law enforcement. Establishing a national filicide database would further strengthen monitoring and policy design. By situating filicide within its broader sociolegal context, this article underscores the need for a co-ordinated, multidisciplinary response capable of preventing tragedy, ensuring consistent, proportionate sentencing, and protecting the country’s most vulnerable group.

Mental health, particularly the early detection of psychological distress among elite athletes, is of critical importance. To make the Sport Mental Health Assessment Tool 1 (SMHAT-1) and the Sport Mental Health Recognition Tool 1 (SMHRT-1) available for German-speaking populations, this study aimed to translate and validate the screening instruments of the SMHAT-1 and the SMHRT-1 into German, as well as to evaluate the psychometric properties of the screening instruments. The SMHAT-1 screening instruments and the SMHRT-1 handout were translated using a systematic seven-step process. Forward translations were performed by native speakers of the target language (German) fluent in the source language (English), followed by back-translations by native speakers of English fluent in German. Validation occurred in three phases: a pilot test with 30 athletes to assess clarity, preliminary psychometric testing with 177 bilingual participants to evaluate criterion equivalence, and full psychometric testing with 235 athletes from regional to Olympic levels. Reliability, construct, and criterion validity were assessed. Internal consistency was acceptable to good for most tools, and all instruments demonstrated strong equivalence with their original versions. The Athlete Psychological Strain Questionnaire (APSQ) exhibited strong convergent validity with the Kessler Psychological Distress Scale (K-10; r = 0.81) and all participants with a self-reported professionally diagnosed mental disorder had APSQ scores above the screening threshold. Prevalence rates highlighted common mental health concerns in athletes, including anxiety (17.0%), depression (23.8%), and disordered eating (36.1%). The German SMHAT-1 demonstrated robust psychometric properties and is a reliable tool for assessing mental health in athletes. The German and English versions of the SMHAT-1 and SMHRT-1 are available for download here: SMHAT-1 German: https://img.olympics.com/images/image/private/w_auto/primary/hr8i8nfbwf8gldsthqgd SMHAT-1 English: https://img.olympics.com/images/image/private/w_auto/primary/ttpbrdzvhofmabszbynq SMHRT-1 German: https://www.olympics.com/athlete365/app/uploads/2021/06/SMHRT-1_german.pdf SMHRT-1 English: https://www.olympics.com/athlete365/app/uploads/2021/06/BJSM-SMHRT-1-Athlete365-2020-102411.pdf

Gait speed, grip strength, and depression are common and often coexist in older adults, and their interaction may provide a comprehensive understanding of fracture risk. This study examined the individual and combined associations of slow gait, weak grip, and depressive symptoms with the risk of fractures in older adults. Sixteen thousand three hundred fifty-seven Australian participants aged ≥ 70years from the ASPirin in Reducing Events in the Elderly (ASPREE) trial were included. Sub-distribution hazard ratios (sHR) and 95% confidence intervals (CI) were estimated using a multivariable-adjusted Fine-Gray model, accounting for death as a competing risk. The sHR for any fractures was 17% higher among participants with slow gait and 23% higher among those with depressive symptoms, while weak grip was not significantly associated. The co-occurrence of slow gait and weak grip was associated with a 23% higher risk of any fracture (sHR = 1.23; 95% CI 1.04-1.46). Slow gait combined with depressive symptoms was associated with a 46% higher risk of any fracture and a 64% higher risk of MOF (sHR = 1.46; 95% CI 1.06-2.01; sHR = 1.64; 95% CI 1.03-2.61, respectively). Weak grip combined with depressive symptoms was associated with a 47% higher risk of any fracture and a 57% higher risk of MOF (sHR = 1.47; 95% CI 1.08-2.00; sHR = 1.57; 95% CI 1.01-2.47, respectively). These associations were stronger among males and those with diabetes. The combination of slow gait with either weak grip or depressive symptoms was more strongly associated with fracture risk than each factor individually. These findings underscore the importance of incorporating physical function and mental health assessments in clinical evaluations of older adults.

Built environment features: Predictors or effect modifiers of post-disaster mental health outcomes? A systematic review.

Osteoarthritis (OA) is a degenerative joint disease characterized. The Mini-Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQoL) scale is used to evaluate the impact of knee/hip osteoarthritis (KOA/HOA) on patients' quality of life (QoL). This study aims to ascertain the consistency and accuracy of the Mini-OAKHQoL Syrian Arabic version. This cross-sectional study translated the original version of the Mini-OAKHQoL into Syrian Arabic using a standard method for language adjustment. The patients completed the Syrian Arabic version and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Short Form-36 (SF-36) scales. The psychometric properties of the Syrian Arabic Mini-OAKHQoL were evaluated using Cronbach's α for internal consistency, intraclass correlation coefficient (ICC) for test-retest reliability, and Spearman's correlation coefficient for convergent validity. Statistical significance was set at p < 0.05. This study included 87 persons with KOA/HOA. The Mini-OAKHQoL demonstrated satisfactory face and content validity. The intraclass correlation coefficient, confidence intervals (ICC = 0.844, 95% CI: 0.76-0.90). for the overall score with a cut-off > 0.5. The Cronbach's α for the categories was satisfactory internal consistency (α > 0.7). Regarding the assessment of convergent validity, physical activities, mental health, pain, and independent items of the Mini-OAKHQoL Arabic version demonstrated moderate to high correlations with the WOMAC and SF-36. The Mini-OAKHQoL is a well-validated and reliable scale for evaluating QoL in patients with KOA/HOA, demonstrating strong utility in both clinical practice and research settings among Arabic-speaking populations.

This bibliometric analysis examines the evolution of research into post-stroke depression (PSD) between 1985 and 2024, evaluating publication trends, key contributions, and thematic shifts in the field. The study analyzed 3146 studies retrieved from the Web of Science Core Collection. Keyword and thematic analyses were conducted using the software tools VOSviewer and CiteSpace. Publications on PSD increased significantly after 2010. China (796 articles) and the United States (615 articles) were the leading countries in research output. Analyses revealed core research themes encompassing depression prevalence, rehabilitation strategies, quality of life, and recovery outcomes. Thematic clusters identified diverse areas of focus, including cognitive impairment, socioeconomic disparities, caregiver roles, alternative therapies, and the influence of culture on PSD management. Emerging trends indicated by citation bursts included "healthcare professionals," "fatigue," and "meta-analysis," pointing to current frontiers in interdisciplinary care, symptom complexity, and evidence synthesis. Highly cited studies emphasized integrating mental health assessments into stroke care and the critical role of rehabilitation in mitigating PSD. The findings illustrate the field's progression from early observational studies to multifaceted investigations addressing the biological, psychological, and social dimensions of PSD. Future research should prioritize multidisciplinary frameworks, culturally sensitive interventions, and innovative therapies. This study underscores the need for holistic rehabilitation models that integrate physical and mental healthcare to improve outcomes for stroke survivors, thereby informing clinical practice, policy, and further research.