Help For Mental Health Issues Research Articles

‘I Can't See Myself Seeking Help’: The Influence of Clinical Placements on Nursing Students' Stigmatising Beliefs and Intentions to Seek Help for Their Own Mental Health Issues: A Prospective Cohort Study

ABSTRACTMental health conditions such as anxiety, depression and psychosis represent a global health challenge. Stigma surrounding mental health continues to hinder help‐seeking behaviours for people with mental illness and as this study demonstrates, nursing students as well. However, if student nurses are reluctant to seek help for mental health issues, how can others be expected to do so? This reluctance poses challenges in mental health nursing, impacting both care provision and nursing education. The present study seeks to explore the influence of traditional versus non‐traditional mental health clinical placements on second‐year nursing students' stigmatising beliefs and intentions to seek help for mental health issues. Employing a prospective cohort design using the TREND checklist, the study sampled second‐year nursing students assigned to either traditional hospital‐based or non‐traditional recovery‐focused mental health clinical placements. Using validated scales, stigmatising beliefs and help‐seeking intentions were measured before and after the placements. Statistical analyses were conducted to assess changes in these variables over time and across placement settings. A significant impact of placement setting on help‐seeking intentions was observed, with students in non‐traditional placements showing an increased willingness to seek help. Additionally, non‐traditional placements were found to significantly reduce stigmatising beliefs in all measured domains, suggesting that these settings may provide a more conducive environment for fostering positive attitudes towards mental health. Recovery‐focused placements appear to offer experiences that can diminish stigma and encourage more positive perceptions and intentions related to mental health support.

Non-traditional mental health clinical placements: An effective means for reducing self-stigma in pre-registration nursing students.

Pre-registration nursing students report high rates of stigma, leading to low help-seeking attitudes when seeking help for mental health issues. Traditional mental health clinical placements can improve stigma related to attitudes and social distance for pre-registration nursing students. There are nil recorded clinical placement interventions that have decreased self-stigma for pre-registration nursing students, with this study highlighting a clinical placement model that is effective in significantly decreasing self-stigma. The knowledge around the mental health struggles experienced by pre-registration nursing students, and the effect of a non-traditional mental health placement in decreasing self-stigmatizing attitudes in this population, is important for the future of retaining mental health nurses. There is an opportunity to use the clinical placement model presented, and design interventions for nursing students that aims to promote help-seeking behaviours. INTRODUCTION: Traditional mental health clinical placements can improve pre-registration nurse stigma toward mental illness, particularly in measures of attitudes and social distance. However, they have not yet been shown to improve self-stigma, which affects mental health disclosure and help-seeking behaviour. The present study investigates nursing students' stigma following a non-traditional mental health placement immersed alongside people living with mental illness. Three stigma subtypes were measured using the Opening Minds Scale for Healthcare Providers: Attitudes, Social Distance, and Disclosure/Help-seeking. Pre-registration nurses (N = 848) completed the instrument pre- and post-placement. A multivariate analysis of variance (MANOVA) identified a large effect of placement on stigma (p < .001, = .101). Post hoc pairwise comparisons revealed all three types of stigma decreased after the non-traditional placement (Attitudes: p < .001, = 0.09, Social Distance: p < .001, = 0.07, Disclosure/Help-seeking: p < .001, = 0.04). These findings emphasize that attending a non-traditional mental health clinical placement can effectively reduce multiple types of nursing student stigma. Further research in this area could focus on which attributes of the clinical placement setting foster positive help-seeking. These results are noteworthy for stigma surrounding disclosure/help-seeking, as traditional (i.e. hospital-based) mental-health clinical placements have been found ineffective in reducing nursing student stigma in this domain. Further research into the effectiveness of non-traditional clinical placements in reducing nursing students' stigma regarding mental health disclosure and help-seeking, is required.

Nordic Larp as a Method in Mental Health Care and Substance Abuse Work: Case SÄRÖT

SÄRÖT trilogy was a pilot project, testing and developing Nordic Larp as a method in mental health- and substance abuse work. The larps took place in southern Finland in autumn 2020 and illustrated the experiences of mental health patients, substance abusers, and their bystanders. Data was collected from all three larps, and from their preparations and follow ups, aiming to figure out: -How did SÄRÖT impact its participants well-being? -What features of SÄRÖT were transformative? and -How could SÄRÖT be further developed into an actual method for mental health- and substance abuse work? Multiple methods, including WHO5 questionnaire, observation, workshops, email interviews, and free feedback, were used to gather versatile data out of a relatively narrow pool of respondents. Although WHO 5 is not a diagnostic tool, it has been successfully used to measure change in (experienced) well-being in art therapy groups1. Triangulation and theme analysis were used to analyze the data. Most of the WHO5 answers from before the games differed from the ones after the games, indicating a change in their well-being. In the interviews, observation, and free feedback the respondents reported changes in the way they experience their current situation in life. A new willingness for discussion or receiving help came up in several feedbacks and interviews. Some reported having processed their own traumas, gaining tools for dealing with e.g., PTSD, or making active changes such as applying for a new job, getting help for mental health issues, or turning to social workers because of the SÄRÖT experience. According to Moreno2, empathizing with the portrayed character is transformative. It also enables facing reality from a new perspective, providing tools for our own lives3. SÄRÖT is an example of this transformativity. However, the most impactful part of SÄRÖT were the workshops and conversations after the games, which is reminiscent to replication therapy4. SÄRÖTs transformativity was partly caused also by SÄRÖT having an objective, and the participants being aware of it. SÄRÖT has potential to become a purposeful tool for healthcare, service, or a product, if it is further developed with health care professionals and larp-designers. 1 Zubala et al. 2016; Topp et al. 2015 2 Moreno 1946 3 Carlson 2004, 75 4 Serbin &amp; Allen 1968; see also Lehto 2021, 76

Anxiety, Stress and Depression in Overseas Medical Students and its Associated Factors: A Descriptive Cross-Sectional Study at Jalalabad State University, Jalalabad, Kyrgyzstan

Background: Stress can be described as a mental state of tension or be concerned brought on by an unpleasant circumstance. Stress is an ordinary human reaction that encourages us to face challenges and dangers in life. According to the WHO, four out of every five college students are contemplating or have attempted suicide. Medical education is considered as demanding because students undergo several psychological transformations. It is estimated that half of all significant adult psychiatric illnesses, including depression, begin before the age of fourteen. 75 % of college students do not seek help for mental health issues. (1)  Materials and Methods: A cross-sectional study was conducted in three months period of time from the month September till November 2023, among 150 students of various years at Jalalabad State Medical University using online Google forms. The study was conducted using DASS 21-item questionnaire to assess the level of stress, anxiety, and depression among students. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 22.0 software. Ethical approval was taken from the University.  Result: In the study 9% of people reported having a moderate to extremely severe degree of stress, anxiety 27.3% and depression was found among 4% respectively in students. Stress and study of year were substantially correlated. (p = 0.007). Anxiety and extracurricular activities were found to be significiant (p = 0.004). Extracurricular activities and depression were linked. (p = 0.029) and the type of family they belong to (p = 0.015). While stress and depression were shown to be uncommon among medical students, anxiety was found to be more common, which might be related to a variety of factors such as new environments, difficult subjects, complex terminology, etc.  Conclusion: It is important to highlight the points like financial issues, home sick, behaviour of teachers and friends etc would be the stressful elements that might lead to increase the psychological problem among medical student. Following research endeavors in this domain ought to endeavor to address these constraints. In any event, we believe that our results emphasize the necessity of putting policies in place to protect and, where appropriate, improve the mental health and general wellbeing of medical students.

Seeking professional help for mental health issues in Slovenia: Prevalence and associated factors

Abstract Background The aim of the study was to examine the prevalence of seeking professional help for mental health issues and explore its association with sociodemographic factors, various aspects of mental health literacy, and symptom severity. Methods A cross-sectional survey was conducted from November 2021 to January 2022 using a probability sample of Slovenians aged 18-64 (prepared by The Statistical Office of the Republic of Slovenia). Of the 9000 participants invited, 2677 (52.2% males) completed the survey (30% response rate) either online (78.9%) or in paper format (21.1%). The prevalence of mental health issues and professional help-seeking was assessed using self-developed questions. Logistic regression was used to test the probability of seeking professional help, with predictor variables including sociodemographic, Depression literacy questionnaire (D-lit), Anxiety literacy questionnaire (A-lit), Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS), General Help-Seeking Questionnaire (GHSQ), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Assessment (GAD-7), General mental health (self-developed question). Results Among those who reported having mental health issues currently or in the past (44% of the sample), 46.6 % had never sought professional help. The logistic regression model was statistically significant (p &amp;lt; 0.001, χ2 (df)= 214,637(16)), revealing that women, older participants, those with higher score on A-lit, GHSQ, and those participants which reported worse general mental health were more likely to seek professional help. The variable D-lit, as well as PHQ-8, GAD-7, and subjective social status, were not significant predictors. For education and the variable IASMHS, only some of the predictors were statistically significant. Conclusions The study highlights the need for systematic approaches and targeted interventions at the national level to promote and enhance seeking professional help for mental health issues. Key messages • The study found a large help-seeking gap for mental health issues, with only specific aspects of mental health literacy (eg anxiety literacy) being significant predictors of seeking professional help.

Factors associated with suicide in physicians: a silent stigma and public health problem that has not been studied in depth.

Suicide is a complex and multifaceted public health issue that affects individuals from all walks of life, including healthcare professionals such as physicians. According to research, physicians have a higher risk of suicide compared to the general population, with an estimated suicide rate that is two to three times greater than that of the general population. Suicide in physicians can have devastating consequences, not only for the individual but also for their patients and colleagues. The factors contributing to suicide in physicians are numerous and often interrelated. Physicians are exposed to numerous stressors in their daily lives, including long work hours, high workload, burnout, and exposure to traumatic events. These stressors can lead to mental health problems such as depression, anxiety, and substance use disorders, which in turn can increase the risk of suicide. In addition to work-related stressors, personal factors such as relationship problems, financial stress, and a history of mental health problems can also contribute to suicide risk in physicians. Stigma and shame around seeking help for mental health issues may also prevent physicians from seeking treatment, exacerbating the problem. Understanding the complex factors that contribute to suicide in physicians is crucial for developing effective prevention strategies. For this reason, it is necessary to know the behavior of this phenomenon and the factors associated with a higher risk of suicide in this population. However, taking into account that different regions of the world vary in socioeconomic, cultural, professional, occupational, and health attributes, it is to be expected that the behavior of these risk factors will also be heterogeneous. At present, it is presumed that there is a significant gap in the evidence, due to a predominance of evidence on this topic from high-income countries. Considering the importance of having a comprehensive understanding of the risk factors for suicide in the medical population and possible strategies to mitigate this condition, the aim of this review is to analyze the most recent evidence on these factors, and to assess the quality of the evidence and gaps that need to be studied further.

Understanding the utility of "Talk-to-Me" an online suicide prevention program for Australian university students.

Australian university students are at risk of experiencing poor mental health, being vulnerable to self-harm and suicidal ideation. "Talk-to-Me" is a suicide ideation prevention Massive open online course (MOOC) previously showing it can support Western Australian university students' knowledge of identifying and responding to suicide ideation in themselves and others. A multi-site one-group pre-test/post-test design with a 12-week follow-up explored the efficacy of "Talk-to-Me" for university students Australia-wide, evaluating the influence of COVID-19 and location. Overall, 217 students (55% female; mage = 24.93 years [18, 60]) enrolled in this study from 2020 to 2021. Participants' responses to suicidal statements, mental health literacy, generalized self-efficacy, help-seeking behavior, and overall utility of the program were collected at baseline, post-MOOC (10 weeks from baseline) and 12-week follow-up. The effect of time and location interaction was explored using a random-effects regression model. Findings indicated significant improvement in participants' knowledge of positive mental health support strategies (ES = 0.42, p < 0.001) and recognizing appropriate responses to suicidal statements (ES = 0.37, p < 0.001) at 10-weeks, with further improvement at 12 weeks follow-up (ES = 0.47 and 0.46, p < 0.001). Students reported higher generalized self-efficacy at the 12-week follow-up compared to baseline (ES = 0.19, p = 0.03) and an increased tendency to seek professional help for mental health issues (ES = 0.22, p = 0.02). These findings provide preliminary evidence of the efficacy of the "Talk-to-Me" program in supporting ‎university students across Australia to increase their suicide-related knowledge and skills, ‎general self-efficacy, and overall mental fitness.

Effects of Listening to Music on Mental Health of Nigerian Undergraduate Students

Aim: The impact of music on mental health, specifically among Nigerian undergraduate students, is an area yet to be fully explored. This study therefore sought to investigate the impact of music listening habits on the mental health of Nigerian undergraduate students.&#x0D; Methodology: This study employed a cross-sectional survey research design. The population of this study comprised of students from three tertiary institutions in Moor Plantation, Ibadan, Nigeria, namely: Federal College of Animal Health and Technology, Institute of Agricultural Research and Training, and Federal College of Agriculture. A random sampling technique was employed to select four hundred (400) undergraduate students who were studying for the National Diploma (ND) and Higher National Diploma (HND) respectively.&#x0D; Results: A majority of the respondents (56.75%) listen to music several times a week, with 78% admitting to listening to music while studying. The genres most listened to were Hip hop (35.15%) and Gospel (27.12%). Most students reported feeling happier (39.87%) and more relaxed (33.26%) after listening to music, indicating a positive influence on mood and emotion. Furthermore, 83% of respondents claimed their mood influenced the type of music they chose to listen to, and 71.50% noted that different genres affected their mood distinctly. When asked about their mental health status, most students rated their mental health as good (71.25%) or excellent (26.75%). The majority acknowledged that music significantly influences their mood (87.25%), reduces stress levels (84%), and helps with concentration (85.25%). Up to 95.25% of the students have used music as a coping mechanism during emotional distress. Despite these benefits, a small percentage (2%) observed negative impacts on their mental health linked to their music listening habits. Overall, a significant 86.25% of students believe music positively influences their mental health. Notably, only 2.75% of students have sought professional help for mental health issues, and of these, 72.73% were recommended music as a therapeutic tool. Up to 93% expressed openness to the idea of music therapy.&#x0D; Conclusion: These findings underscore the potential of music as a tool for enhancing mental health among Nigerian undergraduate students. However, the observed negative impacts on a minority of students highlight the need for further exploration and potential regulation of music-based interventions.

Public stigma and attitudes towards seeking professional psychological help of undergraduate Psychology students and students of other majors in Hanoi, Vietnam

ABSTRACT The study aims to compare the differences in stigma and attitudes regarding seeking psychological professional help for mental health issues between undergraduate students who major in Psychology andother majors. Methods: There were 408 participants. All participants are undergraduate students in Hanoi, Vietnam. Results: The results indicated that students who major in Psychology had significantly lower stigma and more positive attitudes towards seeking professional mental health services compared to their counterparts. Majoring in Psychology might inform the students more about the effectiveness ofmental health services, which can lead to a decrease in stigma against seeking treatment. Conclusion: The study’s results highlight the importance of providing appropriate mental health education to undergraduate students to reduce stigma and improve help-seeking attitude.

Online Psychotherapy: A Pandemic Dilemma

Covid Pandemic has allowed people to reflect, explore their emotions, their strengths and deficiencies, how they affect them and how to address them. The globally observed, pandemic induced social distancing, has also precipitated disturbances in the domain of mental health. Almost the entire population worldwide, went through series of lockdowns, resulting in people getting isolated, some feeling trapped in the stressful environment of a forced shared living palace—homes. This precipitated in exposing conflicts of various types and degrees, encountering a common emotion—grief. With no access to professionals in traditional format, the online networking boom has given a ray of hope to the people in need. This research-based article explores how online therapy is being seen as a reliable and important tool for people needing help for mental health issues, by conducting a survey on the youth of Delhi-NCR. This research article explores the ways in which people reached mental health professionals and how internet-based therapies increased manifolds during pandemic. A total of 54% participants of the survey agreed to engage in online therapy practice in situation of need.

FAA combats stigma around pilots seeking help

The Federal Aviation Administration (FAA) continues trying to communicate to airline pilots that seeking needed help for mental health issues will not ground their careers.

Supporting the Mental Health of Medical Graduates in the Post-Pandemic Era- Strategies for Success

The COVID-19 pandemic has significantly affected themental health of the entire world especially the frontlineworkers such as medical and paramedical staff. Eventhough the medical field is considered a highlydemanding job, the pandemic brought its challenges.The uncertainty of a new virus along with its effects onthe human body, patients presenting with varyingseverity, long working hours, the psychological burdenfrom isolation, and mortality have caused severalmental health issues for healthcare workers. Manystudies conducted have shown significant psychologicaldisorders such as anxiety, insomnia, depression, andeven post-traumatic stress disorder in many healthcareworkers. The post-pandemic era has opened our eyes toaddress and recognize these issues faced by frontlineworkers. It has become vital that we promote mindfulpractices among healthcare workers, remove the stigmaaround taking help for mental health issues and createan environment where workers can easily take upcounseling services for these issues. To maintain theeffectiveness of the healthcare system, it has becomeimportant to seriously consider mental health issuesfaced by frontline workers and work diligently toimprove their mental health.

Urban–ruraljustice

<scp>Urban–rural</scp>justice

РОЗВИТОК НАВИЧОК САМОДОПОМОГИ У КОНТЕКСТІ ПРАКТИЧНОЇ ПІДГОТОВКИ МАГІСТРІВ ФАРМАЦІЇ З ПИТАНЬ ПСИХІЧНОГО ЗДОРОВ'Я

Background. The aftermath of the war in Ukraine highlights the harmful effects of stressful situations on both the local population and pharmaceutical professionals. Undertaking preventative measures to maintain the mental well-being of the population, while also establishing selfhelp mechanisms in the workplace for issues related to mental health, will improve the quality of pharmaceutical care in the field of drug sales and curb early professional burnout among pharmacists. The purpose of this study is to perform a comparative analysis of educational and professional programmes in the specialty of 226 Pharmacy, Industrial Pharmacy, with the objective of assessing the level of masters of pharmacy training in facilitating their own mental health. The study will further investigate the incorporation of relevant course components in the curriculum. Methods. To attain the research goal, the authors utilized scientific literature, worldwide documents, official websites of academic Hiher education institutions, educational and professional programmes within the specialty of 226 Pharmacy, Industrial Pharmacy employing comparative analysis, systematisation, and generalisation methods. Results. The article presents a comparative analysis of educational and professional courses for Masters of Pharmacy in the 226 Pharmacy, Industrial Pharmacy Speciality. The documents and research findings of international scholars have been systematised to tackle the training of pharmacists to handle stressful situations and emergencies. Conclusions. The research conducted indicates that self-help in the workplace of pharmacists is a prevalent global practice, and it has been incorporated into specialised mental health education programmes in various countries. The authors believe that incorporating the best educational practices from Masters of Pharmacy training to include self help for mental health issues in the workplace into national educational and professional programmes in the 226 Pharmacy, Industrial Pharmacy specialty shows promise.

Analysis of Adolescent Barriers in Seeking Help for Mental Health Issues

Although previous research has hypothesized that barriers such as misconceptions and shame associated with mental health would hinder not only university students but younger adolescents as well, there has not been a systematic review that explores this topic in depth. In this study, we looked at four major kinds of barriers that adolescents face in seeking help for mental issues. The lack of mental health literacy is a general problem of society at large and this affects adolescents too. Another common issue arises from the stigma and negative attitudes and beliefs associated with mental health issues. Apart from these two issues, something specific to adolescents was the unique situation of adolescents not having complete control over where they received mental health like at school or through the intervention of guardians. This leads to confidentiality and trust issues that are unique to adolescent lives. Other practical barriers that were uncovered like cost and logistics issues are also captured. With this analysis, this paper also discusses solutions that may be effective in overcoming these barriers. &#x0D;

PA licensure questions, the Americans with Disabilities Act, and seeking medical care.

This study built on a recent publication to explore physician assistant (PA) licensure renewal applications, as well as PA likelihood to seek help for physical or mental health conditions. We were able to obtain licensure renewal applications from 47 states. A national survey was then conducted to explore the connection between licensure questions and help-seeking behavior. Only 18 states were consistent with the Americans with Disabilities Act (ADA) in their approach to initial and renewal applications. Thirty-five percent of PAs expressed reluctance to seek help for a mental health issue due to concerns about licensure repercussions. States with applications that were inconsistent with the ADA were significantly more likely to express these concerns. Considerable stigma exists among PAs regarding seeking help for mental health issues. Problematic licensure questions increase this reluctance. Advocacy is needed to reduce stigma of mental health and substance use, and to modernize licensure applications.

Investigation of the Depression Status of Asian American Adolescents

Depression is one of the most common mental disorders in the United States, and past studies have shown a concerning increase in the rates of depression in youth populations over time. Furthermore, depression is an especially important issue for Asian Americans because of the impact of anti-Asian violence due to the COVID-19 pandemic. While Asian American adolescents are reluctant to seek help for mental health issues, past research has found a prevalence of depressive symptoms in them that have yet to be fully investigated. There have been studies conducted to understand and observe the impacts of multifarious factors influencing the mental well-being of Asian American adolescents; however, they have been generally limited to qualitative investigation, and very few have attempted to quantitatively evaluate the relationship between depression levels and a comprehensive list of factors for those levels at the same time. To better quantify these relationships, this project investigated the prevalence of depression in Asian American teenagers mainly from the Greater Philadelphia Region, aged 12 to 19, and, with an anonymous survey, asked participants 48 multiple-choice questions pertaining to demographic information, daily behaviors, school life, family life, depression levels, school and family support against depression. Each multiple-choice question was assigned as a factor and variable for statistical and dominance analysis to determine the most influential factors on depression levels of Asian American adolescents. The results were validated via Bootstrap analysis and t-tests. While certain influential factors identified in this survey are consistent with the literature, such as parent-child relationship and peer pressure, several dominant factors were relatively overlooked in the past. These factors include the parents’ relationship with each other, the satisfaction with body image, sex identity, support from the family and support from the school. More than 25% of participants desired more support from their families and schools in handling depression issues. This study implied that it is beneficial for Asian American parents and adolescents to take programs on parents’ relationship with each other, parent-child communication, mental health, and sex identity. A culturally inclusive school environment and more accessible mental health service would be helpful for Asian American adolescents to combat depression. This survey-based study paves the way for further investigation of effective approaches for helping Asian American adolescents against depression.

Men's Psychotherapy Use, Male Role Norms, and Male-Typical Depression Symptoms: Examining 716 Men and Women Experiencing Psychological Distress.

Men as compared to women are half as often affected by depressive and anxiety disorders and seek significantly less help for mental health issues than women. Adherence to traditional male role norms (AtTMRN) may hinder men from describing prototypical depression symptoms and from seeking psychotherapy. The current study compared whether AtTMRN, gender role identity, or the experience of prototypical or male-typical externalizing mental health symptoms were associated with psychotherapy use in men and women. In an anonymous online survey, 716 participants (37% men) reporting to currently experience psychological distress were examined. Information was obtained on psychotherapy use, depression and anxiety symptoms, gender role identity, and traditional male role norms. Although experiencing similar levels of depression, men compared to women showed a reduction in psychotherapy use by 29%. Masculine role identity was directly associated with reduced psychotherapy use in men (β = −0.41, p = 0.029), whereas AtTMRN was not (men: β = −0.04, p = 0.818; women: β = −0.25, p = 0.064). Higher externalizing depression symptomatology (β = −0.68, p = 0.005), but not prototypical depression symptomatology (β = −0.02, p = 0.499), was associated with reduced psychotherapy use in men but not women (p > 0.05). Interactions revealed that men, but not women, with high AtTMRN use psychotherapy only when exhibiting elevated symptom levels. The results corroborate previous reports showing reduced psychotherapy use in men as compared to women and identify elevated masculine role identity and male-typical externalizing depression symptomatology as direct factors associated with reduced psychotherapy use in psychologically distressed men. AtTMRN interacts with mental health symptoms to predict psychotherapy use, indicating that men with high AtTMRN only use psychotherapy when exhibiting high symptomatology.

Barriers and facilitators to accessing mental health services after child maltreatment in foster care: An Austrian survivors’ perspective

Many trauma survivors seem to be reluctant to seek professional help for mental health issues. The present study aimed to enhance the understanding of perceived barriers and facilitators to mental health service use in adult survivors of institutional abuse (IA) in foster care. It further aimed to explore survivors’ suggestions on how to increase mental health service use. Semi-structured interviews were conducted with 46 adult IA survivors. The interview guideline comprised questions regarding (1) self-perceived barriers and (2) facilitators to mental health services, as well as (3) suggestions on how to facilitate mental health service use. A thematic analysis was conducted to identify themes from the interview transcripts. Barriers and facilitators were compared with previous findings of a systematic review on trauma survivors. The most prominent barrier themes were Lack of knowledge and treatment-related doubts, Concerns related to stigma, shame & rejection, and Trauma-specific barriers. A barrier that seemed to be characteristic for IA survivors was Previous negative experiences with child care workers or other professionals in foster care institutions. Key themes that were identified from the survivors’ suggestions were also found in the perceived facilitators, namely Specific psychotherapist recommended by significant others, professionals, or institutions, as well as Treatment costs covered. Receiving Social support from significant others or professionals was a further prominent facilitator to mental health service use. These findings reinforce the importance of multi-professional strategies and evidence-based interventions to increase CM survivors’ mental health service use.

Do PA licensure questions violate the Americans with Disabilities Act?

Negative stigma related to mental health diagnoses is common in both clinicians and the public. Questions about physical and mental conditions on licensure applications often are overly broad and may violate the Americans with Disabilities Act (ADA). This study investigated state physician assistant (PA) licensing applications relating to physical and mental health, and their consistency with the ADA. We collected PA state licensure applications from all 50 states and the District of Columbia. To be considered consistent with the ADA about physical conditions, an application had to only contain questions about a current (within the past year) physical health condition that impaired the applicant's ability to practice as a PA, or not include any questions about physical health. Questions that asked for speculation about possible future situations were considered inconsistent with the ADA. Nearly 57% of state PA licensing applications were consistent with ADA guidelines on physical conditions; 51% were consistent for mental health conditions. Many state PA licensing boards include questions about physical and mental health conditions that are not limited to current impairment. These licensure questions could violate the ADA, and may reduce PAs' willingness to seek help for mental health issues. Balancing public safety with clinician health is a challenge. Further research and action are needed to optimize PA licensure questions on physical and mental health.