Current Mental Health Care Research Articles

A Review of Current Digital Mental Health Care Applications for Anxiety Symptoms and Future Prospects.

Since the impact of the coronavirus disease-2019 pandemic, the need for efficiency in medical services has become more urgent than ever. The digital treatment market is rapidly growing worldwide and digital therapeutics (DTx), a major part of the digital medical services, is also emerging as a new paradigm for treatment, with its industry growing rapidly as well. Increasing research is done on the effectiveness of mobile DTx in improving mental health conditions such as insomnia, panic, and depression. This review paper investigates 1) the functions and characteristics of mobile digital mental health care applications for the treatment of anxiety symptoms, 2) extracts common attributes of the applications, and 3) compares them with existing traditional treatment mechanisms. Among the 20,000 mental health management applications that have been developed so far, 8 applications that are relatively widely used were selected and reviewed. Check-in, self-help tips, quick relief, journal, courses for practice are common features of the digital mental health care applications for anxiety and are also widely used feature in the cognitive behavioral therapy. Based on this review, we have proposed the essential elements and directions for the development of a Korean digital mental health care applications for anxiety disorders.

Deinstitutionalization in Georgia-why it is so slow

IntroductionMental health reform represents one of the most transformative changes in the field of healthcare, as it not only changes the forms of services but also the nature of services offered. While many countries have successfully implemented such reforms, others, including Georgia, have struggled with a protracted and inconsistent process. Despite decades of advocacy by professionals for deinstitutionalization and the development of community-based services, psychiatric hospital treatment continues to dominate in Georgia.ObjectivesThe purpose of the review is to explore the concept of deinstitutionalization within the mental health landscape and assess its status in the context of Georgia. It aims to study the lessons learned from successful deinstitutionalization and illuminate achievements and challenges surrounding deinstitutionalization in Georgia’s reality.MethodsA qualitative analysis including desk review, in-depth interviews and focus group discussions was conducted. Proceeding from the research objectives we analyzed the existing legislation, strategic documents and clinical practices concerning individuals with mental disorders; Interviews were also conducted with key informants on the shortcomings and problems in deinstitutionalization practicesResultsThe review findings reveal, that despite recent progress such as the development of community mobile teams and increased funding allocated for community services within mental health budget, several issues persist: there is no agreement among stakeholders on how to restructure existing hospital beds and financial provisions remain unresolved. The field of mental health in Georgia suffers from a lack of human resources. Attracting new personnel, ensuring regional distribution, and enhancing qualifications are necessary components of deinstitutionalization that require the involvement of all stakeholders, coordinated and time-planned action. The current mental healthcare system in Georgia is characterized by a lack of coordination and collaboration among its various components. Establishing patient care pathways with clear referral criteria is crucial for improving the efficiency of mental health services. This research highlights that successful deinstitutionalization requires additional funds, time, and trained people. Institutions should have a long-term (3-5) year development plan, detailing the source of funding, activities to be implemented, and expected outcomes. In the absence of such a plan, progress remains sporadic, intermittent, uncoordinated, and less effective.ConclusionsIn conclusion, the protracted nature of deinstitutionalization in Georgia requires a multifaceted approach involving various stakeholders. By addressing identified challenges and promoting coordination among mental health components, Georgia can guide a more effective course toward a community-based, patient-centered mental healthcare system.Disclosure of InterestNone Declared

Paved with good intentions: How our systems intersect to create health disparities for multiply marginalized youth.

Youth who hold multiply marginalized identities often experience barriers in accessing care following psychiatric hospitalization METHODOLOGY: The following commentary piece shares a case amalgamation from a multidisciplinary gender clinic in a tertiary care children's hospital which illustrates the myriad of ways that our current mental healthcare systems fail to connect youth efficiently and effectively to the evidence-based, culturally relevant, and affirming care that they require, particularly youth experiencing overlapping systems of discrimination and disadvantage. This piece highlights the inaccessibility of dialectical behavior therapy for multiply marginalized youth, and outlines suggestions for improving access to high-quality care for minoritized youth engaging in suicidal behavior.

A reflection of the current status of the mental healthcare system in South Africa

In this paper we begin by highlighting the large treatment gap in South Africa for mental health conditions. We then describe the mental health services available, including the provision of evidence-based treatments in South Africa at each level of care, using the WHO's optimal mix of mental healthcare services as a framework. The optimal mix of services pyramid includes the following domains: informal services, which comprise self-care and informal community mental health care (including religious and traditional healers), primary care mental health services, psychiatric services provided at general hospitals, community mental health services, specialist services and long-stay facilities. In South Africa, mental healthcare services are concentrated at the apex of the pyramid within secondary hospital and specialist services, with fewer resources available at other levels of care, particularly at the community level. Barriers to access and delivery of evidence-based treatments at each level of care are discussed, including the current mental healthcare system resourcing and structure which drives the focus on the provision of medications and specialized services for patients with serious mental health conditions. The results of research conducted locally in collaboration with the Department of Health to address this gap, particularly regarding care for common mental health conditions in community settings, are described. Finally, we provide recommendations for the way forward to ensure that high-quality mental health services at all levels of care are delivered in an equitable, acceptable and effective manner.

Mental health care utilization in individuals with high levels of psychosis-like experiences: Associations with race and potentially traumatic events.

Objective: Racial inequities in mental health care utilization (MHCU) are well documented. Marginalized racial groups are more likely to report psychosis-like experiences (PLEs) and are at elevated risk for racial discrimination and trauma, impacting PLE severity. Little is known about how factors associated with race impact treatment seeking among individuals reporting PLEs. The present study examined associations between race, trauma, discrimination, PLEs, and MHCU among people endorsing high levels of PLEs. Method: Participants were Asian/Asian American, Black/African American, or White/European American college students ages 18-25 years meeting PLE self-report measure cutoff scores (N = 177). Binary logistic and multiple linear regressions were used to examine associations between past, current, and prospective MHCU and race, potentially traumatic events, discrimination, and PLEs. Results: Participants endorsing more PLEs were more likely to report past and current treatment and to be considering future services. Asian/Asian American and Black/African American participants were less likely to endorse past, current, and prospective future mental health care. Potentially traumatic events predicted increased utilization of past treatment. Conclusions: Results suggest service differences among participants, such that Black/African American and Asian/Asian American young adults reporting PLEs were less likely than White/European American counterparts to seek treatment even when accounting for traumatic events and discrimination. These findings highlight the need to further elucidate MHCU among marginalized racial groups experiencing psychosis-like symptoms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Elimination of restrictive interventions: Is it achievable under the current mental healthcare landscape?

The 2021 release of the report from the Royal Commission into Victoria's Mental Health System suggested 65 recommendations to improve a mental healthcare system that was described as "broken". Several of these recommendations relate to the use of restrictive interventions, such as restraint (both physical and mechanical) and seclusion. These interventions continue to be used in Victorian inpatient mental health facilities today, often in response to aggression and violence towards staff, visitors, family and other consumers. Several health services have committed to the substantial reduction or elimination of the use of restrictive interventions. In this perspective paper, we argue that significant investment is required to achieve this goal. Pressure on mental health nursing staff to cease using restrictive interventions without viable alternatives to de-escalation, restrictions in the built environment, workforce constraints and a lack of education provided early in nursing careers need to be addressed before we can achieve the elimination of restrictive interventions. We recommend that substantial investment in mental health inpatient units, the mental health nursing workforce, and a systemic shift in the role of the mental health nurse are required to attain sustained reduction and potential elimination of restrictive interventions.

Treatment of US Children With Attention-Deficit/Hyperactivity Disorder in the Adolescent Brain Cognitive Development Study

Characterizing the extent and pattern of unmet needs for treatment of children with attention-deficit/hyperactivity disorder (ADHD) could help target efforts to improve access to ADHD medications and outpatient mental health care. To describe current ADHD medication use and lifetime outpatient mental health care among a large national sample of children with ADHD. This study uses cross-sectional survey data from the first wave of the Adolescent Brain and Cognitive Development Study (n = 11 723), conducted from June 1, 2016, to October 15, 2018, among 1206 school children aged 9 and 10 years who met parent-reported Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria for current ADHD. Statistical analysis was performed from March 23, 2022, to March 10, 2023. Current ADHD medications including stimulants and nonstimulants, lifetime outpatient mental health care, or either treatment. Weighted results are reported. Among a sample of 11 723 children, 1206 had parent-reported ADHD (aged 9-10 years; 826 boys [68.2%]; 759 White, non-Hispanic children [62.2%]), 149 (12.9%) were currently receiving ADHD medications. Children receiving ADHD medications included a significantly higher percentage of boys (15.7% [121 of 826]) than girls (7.0% [28 of 108]), White children (14.8% [104 of 759]) than Black children (9.4% [22 of 206]), children of parents without a high school education (32.2% [9 of 36]) than of parents with a bachelor's degree or higher (11.5% [84 of 715]), and children with the combined subtype of ADHD (17.0% [83 of 505]) than with the inattentive subtype (9.5% [49 of 523]). Approximately 26.2% of children (301 of 1206) with parent-reported ADHD had ever received outpatient mental health care. Children receiving outpatient mental health care included a significantly higher percentage of children whose parents had a high school education (36.2% [29 of 90]) or some college (31.0% [109 of 364]) than a bachelor's degree or higher (21.3% [153 of 715]), children with family incomes of less than $25 000 (36.5% [66 of 176]) or $25 000 to $49 999 (27.7% [47 of 174]) than $75 000 or more (20.1% [125 of 599]), and children with the combined subtype of ADHD (33.6% [166 of 505]) than with the predominantly inattentive subtype (20.0% [101 of 523]) or the hyperactive-impulsive subtype (22.4% [34 of 178]) of ADHD. This cross-sectional study of children with parent-reported ADHD suggests that most were not receiving ADHD medications and had never received outpatient mental health care. Gaps in treatment, which were not directly associated with socioeconomic disadvantage, underscore the challenges of improving communication and access to outpatient mental health care for children with ADHD.

The development of mental health care in Guangzhou, China

As an upper-middle-income country, China has a vast territory, a large population and substantial variations in the nature of mental health service provision. Guangzhou, one of the five biggest cities in China, is considered as indicative of the current development of mental health services in a more economically developed part of China. In this paper, we first introduce mental health services in Guangzhou and their historical development: from the rising development of mental health care (1949 to the mid-1960s), the stagnant development period of the psychiatric hospitals (1966–1976), the rapid development period of the psychiatric hospitals (1978 to the 1990s), to the integrated development period of community mental health care (2000–2020). This historical trajectory partly reflects the development of mental health services across China. Second, from the public health perspective, we introduce the current mental health care delivery system and resources in Guangzhou, including the psychiatric specialist hospitals, psychiatric units of general hospitals, and community mental health care. Third, based on the current mental health service system, we highlight community mental health care in Guangzhou. We will describe these elements of the mental health system under the following headings: organizational setup, management, and services. We also explore the design of community mental health service models and the challenges in the post-covid-19 era. Finally, we provide considerations and recommendations for mental health service delivery in Guangzhou in the future.

A smoking cessation intervention for people with severe mental illness treated in ambulatory mental health care (KISMET): study protocol of a randomised controlled trial

BackgroundSmoking among people with severe mental illness (SMI) is highly prevalent and strongly associated with poor physical health. Currently, evidence-based smoking cessation interventions are scarce and need to be integrated into current mental health care treatment guidelines and clinical practice. Therefore, the present study aims to evaluate the implementation and effectiveness of a smoking cessation intervention in comparison with usual care in people with SMI treated by Flexible Assertive Community Treatment (FACT) teams in the Netherlands.MethodsA pragmatic, cluster-randomised controlled trial with embedded process evaluation will be conducted. Randomisation will be performed at the level of FACT teams, which will be assigned to the KISMET intervention or a control group (care as usual). The intervention will include pharmacological treatment combined with behavioural counselling and peer support provided by trained mental health care professionals. The intervention was developed using a Delphi study, through which a consensus was reached on the core elements of the intervention. We aim to include a total of 318 people with SMI (aged 18–65 years) who smoke and desire to quit smoking. The primary outcome is smoking status, as verified by carbon monoxide measurements and self-report. The secondary outcomes are depression and anxiety, psychotic symptoms, physical fitness, cardiovascular risks, substance use, quality of life, and health-related self-efficacy at 12 months. Alongside the trial, a qualitative process evaluation will be conducted to evaluate the barriers to and facilitators of its implementation as well as the satisfaction and experiences of both patients and mental health care professionals.DiscussionThe results of the KISMET trial will contribute to the evidence gap of effective smoking cessation interventions for people treated by FACT teams. Moreover, insights will be obtained regarding the implementation process of the intervention in current mental health care. The outcomes should advance the understanding of the interdependence of physical and mental health and the gradual integration of both within the mental health care system.Trial registrationNetherlands Trial Register, NTR9783. Registered on 18 October 2021.

Caveats of mental healthcare act-2017: Recommendation for amendments.

Dear Sir, The rights-based framework in the current Mental Healthcare Act 2017 (MHA-2017) has received a wider acceptance in the minds of policymakers, patients, caregivers, judicial officers, and mental health professionals.[1,2] However, there appears to be a huge gap between acceptance in our minds and implementation at the ground level. Theoretical knowledge of MHA-2017 and the inability to translate it into practice in most of the general hospitals in the country due to systemic issues has created a dilemma in the minds of psychiatry residents. Therefore, it is necessary to have periodic sensitization programs for psychiatry trainees as well as psychiatrists to learn about changing scenarios in mental health legislation in the past five years.[3] The only discipline of Medicine that carries special significance beyond ethical practice involving beneficence, autonomy, non-maleficence, and justice is psychiatry. This practice and the respect for the rights of a person to bring about optimum mental health outcomes have been legally guided. Forensic psychiatry has started to evolve as a subspecialty of psychiatry.[4] However, are psychiatrists in the country confident in dealing with legal issues evolving in the aftermath of MHA-2017 and imparting this practice to postgraduate trainees? Is clinical practice synchronizing with the legal framework? Are we dealing with the paradox of MHA-2017? Are budding psychiatrists across the country in dilemma with regard to MHA-2017? The response of different states is varied in terms of readiness of infrastructure, the constitution of the State Mental Health Authority (SMHA), the functioning of Mental Health Review Boards (MHRB), and overall dismal application of MHA-2017. Are there hasty translations of Western World rules on the infertile grounds of India? More than four years after passing the act, the current level of functional implementation does not appear to be a healthy indicator for the growth of mental health services in the country. This could provoke lawmakers to bring out the amendments to MHA-2017 to best suit the mental health services and practices of the country. In the absence of functional MHRBs, the practical caveats that may require amendments may include providing electroconvulsive therapy (ECT) to children and use of hospital beds for day-care procedures in psychiatry that include but are not limited to the somatic therapies in psychiatry such as administration of electroconvulsive therapy and repetitive transcranial magnetic stimulation (rTMS). It also includes short-term observation for a few hours in a general hospital following administration of long-acting injectables (LAI) antipsychotics and assessment for the appearance of acute side effects such as post-injection delirium sedation syndrome, and acute dystonia and oculogyric crisis. The other concerns requiring immediate attention for the functioning of MHRB include notifying advance directives, continuing admission under special circumstances, and provision of separate wards for children and women under psychiatry in a general hospital. These amendments could also add the role of MHRBs for adolescents involved in juvenile delinquency, child custody, termination of parental rights, and other related issues.[5] The protection of the rights of a person with mental illness should not be viewed as safeguarding oneself from the practice of psychiatry in the absence of full-fledged implementation of MHA-2017. This could be important for making a provision for the psychiatrist witnessing nonsexual or sexual boundary violation to notify the MHRB in advance, a point not placed in MHA-2017. The spirit of the MHA-2017 also does not clarify the role of the Consultation Liaison Psychiatrist and its effective practice in different departments under general hospital units. Further, the role of the psychiatrist in cases requiring cognizance of other specified acts such as the Prevention of Child Sexual Offense (POCSO) Act, Narcotics and Psychoactive Substances (NDPS) Act, The Rights of Persons with Disabilities (RPwD) Act, Right To Information (RTI) Act, etc. should also be viewed in parallel with MHA-2017. Authors emphasize the opportunity of teaching programs to highlight the gaps in training and implementation of MHA-2017.[6] The absence of functional implementation of MHA-2017 requires the churning of thoughts of stakeholders to amend a few provisions such as the formation of the transitional local hospital review board till formal MHRBs are functional.[7] This letter encourages clinicians and researchers to assess the compliance status of Indian states with MHA-2017 and to provide feasible solutions through systematic scientific research. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Community Mental Health Care in Aotearoa New Zealand: Past, Present, and the Road Ahead.

The healthcare system in Aotearoa New Zealand is currently undergoing a far-reaching overhaul. When it comes to mental health reforms, it is helpful to look at the road ahead, while paying attention to the road behind. Policies and services concerning the mental health and addiction sectors have undergone various reforms; first, during the transition from a hospital-centered to the current community-based system, and second, in the successive attempts to improve this system. In this article, we provide an overview of the current mental health and addiction health care system. We also discuss the impact of colonization on community mental health, the emergence of community-based mental health and addiction policy and services in Aotearoa New Zealand, and the challenges along the way. Finally, we identify five key areas requiring special attention during the current period of reform. Over all, we believe there is broad support for reducing the emphasis on individualized approaches to mental wellbeing and moving all systems and structures towards models inclusive of social context, including approaches that incorporate service users' perspectives, family, communities, and culture. We look forward to policy and services with a much stronger orientation to the diverse needs of our population.

Nurse Educators’ Pedagogical Approaches Addressing Student Nurses’ Mental Health Care Competence: A Qualitative Study

Nurses’ mental health care competence is vital for addressing the current mental health care crisis’ demand for quality in mental health care and services. These challenges also involve educational institutions. In the mental health course of the bachelor’s nursing curriculum, nurse educators face multiple tasks and challenges concerning preparing students for their clinical placement. This study aimed to explore and describe nurse educators’ pedagogical approaches across three universities. The study applied a qualitative and descriptive design, and data were collected from individual qualitative interviews with 13 experienced nurse educators. A content analysis approach in lines with Graneheim and Lundman was used to analyse the data. The content analysis resulted in one theme and three categories, and each category was characterised by three subcategories. The theme intentionally preparing student nurses for mental health care competence served as an overarching theme describing the educators’ overall reflections and descriptions. The three categories were: activating students for the mental health context; caring for students on a personal level; and supporting students in grasping the scope of nursing within the mental health context. These categories described the varieties and complexity of nurse educators’ pedagogical approaches addressing student nurses’ mental health care competence.

Mixed-methods investigation of barriers and needs in mental healthcare of adults with autism and recommendations for future care (BarrierfreeASD): study protocol

IntroductionAutism refers to an early-onset neurodevelopmental condition with characteristic impairments and difficulties in practical living skills, which persist across the lifespan such that adults with autism often require substantial support...

Implementing Alternatives to Coercion in Mental Health Care

Abstract BodyThe use of coercive measures in Medicine represents a controversial issue. Even when they comply with all rules and procedures and are enacted with the intention to address the health needs of the patient, and/or protect the patient and/or others, they always represent an infringement of fundamental personal rights and require strong ethical justification.In Psychiatry the debate around coercive measures has led to a theoretical impasse, as the attempt to solve an ethical dilemma may expose mental health care to other ethical challenges and questions of competing rights. At the same time, the ongoing debate has contributed to raise the awareness that coercive practices are over-used, and mental health care is in need of a profound transformation towards recovery-oriented systems of care.The implementation and dissemination of alternatives to coercive practices is an essential component of such transformation. Relevant research has provided tools and documented successful practices, and initiatives aimed at making these resources available and adapted to different contexts are being promoted by international organizations, professional associations and associations of users and carers.1The profound transformation of current mental health care towards recovery-oriented systems of care requires resources and shared goals among the different stakeholders. Integrated and personalised care pathways, respect of human rights, shared decision making, and involvement of users and carers are essential components of this transformation.DisclosureNo significant relationships.

Risk Factors for Working in Confined Spaces: Contributions for Psychosocial Assessment

Abstract The recommendation of standards for companies supports the safety of workers. This study aimed to describe the psychosocial risk factors perceived by personnel that work in confined spaces. Qualitative study, conducted via interviews with 50 employees. Data were processed using the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software, with a descending hierarchical classification. The psychosocial risk management model identified five risk dimensions and described the interface between the categories of work context and content: interpersonal relationships (29.58%), task planning (23.50%), role in the organization (17.83%), home-work interface (15.10%), and workload and work pace (13.97%). The risk factors identified from the workers’’ perspective allow reviewing psychosocial assessment, management practices, and the advancement of scientific knowledge, essential to rethink current legislation and mental health care for professionals that work in confined spaces.

Prevalence of Post-Traumatic Stress Disorder and its Associated Factors among Nepali Army Service Members and Veterans: 15 Years Post Insurgency

Globally, mental health problems constitute a serious public health problem, contributing 14 % to the global burden of disease. The aim of this epidemiological study was to identify prevalence rates of post-traumatic stress disorder (PTSD), factors associated and its relationship with combat exposure in a post-insurgency period in Nepali army personnel and Veterans. This cross-sectional study was conducted among 300 adults in 2021. In the study both quantitative and qualitative mixed approach with descriptive design was followed. The outcome measures used in the study were locally validated with PCL-M and combat exposure scale. Of the sample, 9 % met threshold for PTSD. The association of variable in reference to age, rank, education and service years with PTSD showed that Age group and Education in current study did not show significant association. However, PTSD with years of service and rank showed significant association. The study also showed a significant relationship between combat exposure and PTSD. There is a significant association between different level of education and combat exposure as well. Overall, the prevalence rates of PTSD in the sample are comparable to other studies conducted with populations affected by conflict and with refugees. However, the findings underscore the need to address the current mental health care awareness and resources in combatants who were exposed to traumatic events during combat in insurgency period. Traumatic exposure predicted increase in PTSD.

Promoting Access to Children’s Mental Health Care Services: Strategy and Policy Implications

In recent years, children’s mental illness has become a major problem; but little is known about the problems and the available literature does not address this issue properly. The present study was meant to examine the current mental health care situations to promote access to services for children in Addis Ababa. The data have been cautiously collected through multiple data collection tools such as semi-structured interviews, focus group discussions, and questionnaires. The data analysed and interpreted from wider perspectives. The study result indicated insufficient mental health policies, limited access to specialized treatment, shortage of human resources, lack of early treatment, and preventive programs/education. There is a need for the comprehensive strategies and mechanisms which take the relevant variables into account to strengthen specialized care and awareness among society via integrating the study evidence into practices. The authors described very significant implications for future actions such as conducting further empirical studies, regular discussions with responsible stakeholders, etc.

International Students' Mental Health Care in China: A Systematic Review.

International students in China are facing difficulties while adapting their Chinese culture, and their life is influenced by the widespread of the Coronavirus Disease 2019 (COVID-19), and caring for their mental health is currently challenging. As a result, our aim is to explore the current mental health care of this minority in China and to provide useful suggestions for future research and institutes. We used the systematic review method, and it was conducted on 11 existing pieces of literature. Our results confirm the unsatisfying psychological situation of international students and the lack of research in this area. We focus on the causes and symptoms of mental problems and explore the effectiveness of methods.

Conventional and complementary health care use and out-of-pocket expenses among Australians with a self-reported mental health diagnosis: a cross-sectional survey

BackgroundMental health disorders are a global health concern. In Australia, numerous national reports have found that the current mental healthcare system does not adequately meet the needs of Australians with mental illness. Consequently, a greater understanding of how people with a mental health disorder are using the broader healthcare system is needed. The aim of this paper is to explore conventional and complementary health care use and expenditure among Australian adults reporting a mental health disorder diagnosis.MethodsA cross-sectional online survey of 2,019 Australian adults examined socio-demographic characteristics, complementary and conventional health care use and the health status of participants.Results32 % (n = 641) of the total sample (N = 2019) reported a mental health disorder in the previous 3 years. Of these, 96 % reported consulting a general practitioner, 90.6 % reported using prescription medicines, 42.4 % consulted a complementary medicine practitioner, 56.9 % used a complementary medicine product and 23 % used a complementary medicine practice. The estimated 12-month out-of-pocket health care expenditure among Australians with a mental health disorder was AUD$ 4,568,267,421 (US$ 3,398,293,672) for conventional health care practitioners and medicines, and AUD$ 1,183,752,486 (US$ 880,729,891) for complementary medicine practitioners, products and practices. Older people (50–59 and 60 and over) were less likely to consult a CM practitioner (OR = 0.538, 95% CI [0.373, 0.775]; OR = 0.398, 95% CI [0.273, 0.581] respectively) or a psychologist/counsellor (OR = 0.394, 95% CI [0.243, 0.639]; OR = 0.267, 95% CI [0.160, 0.447] respectively). People either looking for work or not in the workforce were less likely to visit a CM practitioner (OR = 0.298, 95% CI [0.194, 0.458]; OR = 0.476, 95% CI [0.353, 0.642], respectively).ConclusionsA substantial proportion of Australian adults living with a mental health disorder pay for both complementary and conventional health care directly out-of-pocket. This finding suggests improved coordination of healthcare services is needed for individuals living with a mental health disorder. Research examining the redesign of primary health care provision should also consider whether complementary medicine practitioners and/or integrative health care service delivery models could play a role in addressing risks associated with complementary medicine use and the unmet needs of people living with a mental health disorder.

Mental health outcomes and help-seeking behaviours among Egyptian medical students: A cross-sectional study.

Approximately half of the population in Egypt is under the age of 25. Globally, mental illness represents the highest burden of disease in this age group. Yet in Egypt, there is still no youth-specific mental health system in place and the vast majority of young people do not have access to any professional mental health support. The objective of this study was to describe the mental health needs of Egyptian youth and the resources they use when seeking help. An online cross-sectional survey was distributed among medical students at Tanta University in Egypt. Of the 707 individuals who completed the survey (90.9% response rate), 60.5% were female, 62.0% lived in urban and suburban areas, and the mean age of the sample was 20.5 (±1.8) years old. More than half (54%) of the students reported that they had been affected by mental health problems at some point in their lives. Anxiety and depression were the most common problems. Regarding help-seeking behaviours, participants mainly searched the web or spoke to peers and relatives; few reported approaching medical professionals. The majority of participants (59.7%) reported being disappointed with the current mental health care system in Egypt. There is a high prevalence of mental challenges among Egyptian youth and the health care system is not adequately prepared to respond to their needs. E-Mental Health and online interventions seem to be a promising solution that could increase access to mental health services for Egyptian youth.