Access To Mental Health Care Research Articles

Wellbeing in stroke and aphasia (WISA): protocol for a feasibility study setting up an accessible service offering psychological therapy to people with post-stroke aphasia

Background and aimFollowing a stroke, around a quarter of people will have aphasia, a language disability. Aphasia can have a devastating long-term impact on a person’s psychological wellbeing, yet their language difficulties make it challenging to access mental health care. The Wellbeing In Stroke and Aphasia (WISA) study aims to evaluate the feasibility of setting up an accessible psychological service for people with aphasia.MethodsThe service will be open to people with post-stroke aphasia (n = 30) who live in the UK, are able to access the service either in the university clinic or via telehealth and are not currently receiving therapy from a mental health professional. Participants will be offered up to 8 therapy sessions over 6 months, either one-to-one, with family, or in a group. The intervention is Solution Focused Brief Therapy (SFBT), a brief psychological therapy, delivered by speech and language therapists with training in SFBT under the supervision of a stroke-specialist clinical psychologist. As part of this service, a protocol for addressing mental health care has been developed. Feasibility will be assessed by monitoring referral rates, therapy received, discharge processes, resource capability, costs, challenges, and adverse events. Patient-reported outcome measures collected pre and post intervention will assess mental wellbeing, mood, participation, and satisfaction with therapy and the service. A purposive sample will take part in in-depth interviews following therapy.DiscussionGiven the high levels of psychological distress in this client group, there is a need to investigate innovative ways to provide accessible and acceptable psychological support.

“How can I seek a consultation if I don’t have a high fever ?”: Barriers to Mental Healthcare Access for Women in the Perinatal Period in Rwanda

“How can I seek a consultation if I don’t have a high fever ?”: Barriers to Mental Healthcare Access for Women in the Perinatal Period in Rwanda

Disparities and Medical Expenditure Implications in Pediatric Tele-Mental Health Services During the COVID-19 Pandemic in Mississippi.

Tele-mental health (TMH) services, including both mental and behavioral healthcare (MBH) services, emerged as a cornerstone in delivering pediatric mental healthcare during the coronavirus disease 2019 (COVID-19) pandemic, yet their utilization and effects on healthcare resource utilization (HCRU) and medical expenditures remain unclear. To bridge the gap, this study aims to investigate the association between TMH utilization and sociodemographic factors and assess its associated HCRU and medical expenditures within a pediatric population in Mississippi. Studying 1,972 insured pediatric patients who accessed outpatient MBH services at the study institution between January 2020 and June 2023, age, race, insurance type, rural residency, and household income were identified as key determinants of TMH utilization. Adjusting for sociodemographics, TMH utilization was associated with 122% more MBH-associated outpatient visits and 36% higher related medical expenditures, but 27% less overall medical expenditures. This study reveals sociodemographic disparities in pediatric TMH utilization, highlights its role in augmenting outpatient mental healthcare access, and shows its potential for cost savings. Future efforts should aim at fostering more digitally inclusive, equitable, and affordable pediatric mental healthcare services.

A Medical Student-Inspired Advocacy Effort to Improve Pediatric Mental Health Services

The demand for pediatric mental health services has exceeded the supply of mental health providers for decades and increased significantly during the COVID-19 pandemic. Given the federal administration’s interest in passing a major funding bill to address the COVID-19 pandemic, the authors recognized an opportunity to collaborate in an advocacy effort to request federal financial support for Pediatric Mental Health Care Access Programs (PMHCAPs). The challenges of the pandemic and limited travel became assets as the advocacy team, who lived hundreds of miles apart in 2 states, met virtually with each other and with Congressional staff during February of 2021 on a tight timeline. In March of 2021, President Biden signed the American Rescue Plan that provided $80 million for PMHCAPs.

What does it take to offer high-quality, community-based, accessible mental health care in Lebanon?

Background: Armed conflict, economic collapse, the 2020 explosion, the COVID-19 pandemic, and persistent political and social instability have had severe impact on mental health in Lebanon. Aim: To highlight the critical elements for setting up a free community-based mental health care centre in Lebanon. Methods: Following the Beirut blast in 2020, a non-government organization started providing free, essential, personcentred, and holistic mental health care to residents in Lebanon through a multidisciplinary team of psychiatrists, psychologists, social workers, and mental health nurses. Results: During its first year of operation, the health centre provided 5392 free mental health consultations to 590 beneficiaries. Majority (67%) of the beneficiaries were female, and nearly half (45%) were aged 18–24 years. The most prevalent mental health disorders were major depressive disorder, generalized anxiety disorder and post-traumatic stress disorder. Beneficiaries self-reported a 70% improvement in depression and a 76% improvement in anxiety after 3 months of treatment. Conclusion: Based on our experience, we advocate the community-based model as an effective approach to delivering mental health interventions and recommend a continuous evaluation of its impact in community settings.

Closing the gap in access to child mental health care: provider feedback from the Wisconsin Child Psychiatry Consultation Program

BackgroundMental illnesses are common among children and negatively impact wellbeing during childhood as well as later in life. However, many children with these conditions are not able to access needed mental health care. The Wisconsin Child Psychiatry Consultation Program (WI CPCP) was created to reduce gaps in access to care by providing primary care providers with referral resources, access to behavioral health consultations, and training on mental health topics.ObjectivesThe purpose of this study was 1) to assess the effectiveness of the WI CPCP in Milwaukee County, providing specific insights into provider’s ability to care for child mental health, and 2) identify challenges Milwaukee PCPs faced in providing mental health care to child patients and contextualize these challenges in a conceptual framework of access to health care.MethodsA cross-sectional mixed-methods secondary data analysis was conducted using data collected from online baseline and nine-month follow-up surveys completed by providers participating in the program practicing in Milwaukee County from 2014 to 2022. Provider confidence and skill in providing mental health care was analyzed quantitatively using Two-sample Wilcoxon rank-sum (Mann–Whitney) tests (baseline vs. follow-up survey responses) and descriptive statistics (follow-up survey only). Provider challenges to providing mental health care were analyzed qualitatively using a thematic analysis research approach.ResultsResults from quantitative analyses showed that provider confidence and skill in treating childhood anxiety and depression improved from baseline to follow-up. Results from qualitative analyses were categorized by factors within and beyond the scope of WI CPCP. Within the scope of WI CPCP, providers reported a lack of knowledge of referral options and a lack of training in mental health care as well as a lack of knowledge in assessing and treating mental disorders. Still, many barriers to mental healthcare access persist that are beyond the scope of WI CPCP, such as long wait times and a lack of insurance coverage.ConclusionsThis study supports the effectiveness of the program to improve access to care for children. However, there is a need for additional solutions such as better reimbursement for mental health professionals and expanded insurance coverage.

Mental health service use and shortages among a cohort of women living with HIV in Canada

BackgroundThe prevalence of mental health conditions among women with HIV in Canada ranges between 29.5% and 57.4%, highlighting the need for accessible mental health care. We aimed to (1) describe the availability and use of mental health services among women with HIV and (2) identify characteristics associated with reporting that shortages of these services presented a problem in their care.MethodsBaseline data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study were analysed. Self-reported availability and use of mental health services were examined using descriptive statistics. Participants indicated whether a lack of mental health support was a problem in their care. Logistic regression models were constructed to determine associations between sociodemographic, clinical, and psychosocial characteristics and reported problematic shortages.ResultsOf 1422 women, 26.7% (n = 380) used mental health services in the last year, which most accessed through their HIV clinic. Thirty-eight percent (n = 541) reported that a shortage of mental health support was a problem in their care. Among this subset, 22.1% (n = 119) used services at their HIV clinic, 26.5% (n = 143) reported available services but did not use them, and 51.4% (n = 277) either indicated that these services were unavailable, did not know if such services were available, or were unengaged in HIV care. Factors associated with reporting problematic shortages included rural residence [adjusted odds ratio (aOR): 1.69, 95% confidence interval (CI): 1.03–2.77], higher education level (aOR: 1.43, 95% CI: 1.02–2.02), and higher HIV stigma score (aOR: 1.03, 95% CI: 1.02–1.03). Conversely, African/Caribbean/Black identity (aOR: 0.37, 95% CI: 0.26–0.54), history of recreational drug use (aOR: 0.56, 95% CI: 0.39–0.81), and Quebec residence (aOR: 0.69, 95% CI: 0.50–0.96) were associated with lower odds of reporting service shortages.ConclusionOur findings highlight the HIV clinic as the primary location of mental health service use. However, existing services may not be sufficient to reach all patients or meet specific needs. Furthermore, the low uptake among those reporting a shortage suggests a lack of connection to services or patient knowledge about their availability. Characteristics associated with reporting shortages reflect geographic and socioeconomic disparities that must be accounted for in future service design.

Interdisciplinary Applications of AI: Dermatology and Psychology

Artificial Intelligence (AI) is profoundly transforming interdisciplinary domains like dermatology and psychology, providing revolutionary possibilities in the areas of diagnosis, treatment, and patient care. AI-driven solutions in dermatology are improving diagnostic accuracy by analyzing medical photos to identify skin disorders such as melanoma with a level of precision comparable to that of professional dermatologists. These technologies utilize machine learning algorithms that have been trained on extensive datasets to detect minor patterns and anomalies in skin lesions. This enables the early detection of skin conditions and the creation of personalized treatment strategies. Moreover, artificial intelligence (AI) assists in optimizing the efficiency of workflows, minimizing diagnostic inaccuracies, and enhancing the availability of dermatological treatment, particularly in places with limited access to healthcare services. Within the field of psychology, artificial intelligence (AI) has a significant influence. It is utilized to assess individuals' mental well-being by analyzing their text and speech patterns, employing techniques such as natural language processing and sentiment analysis. Artificial intelligence algorithms have the capability to observe and analyze patient interactions, offering immediate and accurate observations regarding emotional states and possible psychological illnesses. The incorporation of AI enables more precise evaluations and prompt actions, enhancing conventional therapeutic methods. In addition, chatbots and virtual therapists that utilise artificial intelligence provide instant assistance and ongoing supervision, thereby extending the accessibility of mental health care. The integration of AI with dermatology and psychology not only improves diagnostic skills and treatment results but also highlights the significance of interdisciplinary collaboration in advancing healthcare. By using artificial intelligence (AI), these industries can utilize data-driven analysis to provide more accurate, tailored, and easily accessible healthcare, thereby enhancing patient results and quality of life.

Financial Distress in Genitourinary Cancer: Insights From CDC National Health Interview Survey.

This study leverages CDC National Health Interview Survey data to examine Financial Distress (FD) among genitourinary (GU) cancer survivors, specifically prostate cancer (PC), kidney cancer (KC), and bladder cancer (BC). It investigates the economic impacts faced by these patients, especially in relation to disparities in insurance coverage and its effects on material, psychological, and behavioral aspects of FD. We retrospectively analyzed responses from GU cancer survivors, stratifying by cancer status and age (18-64 years, ≥65 years). Medical financial hardship was divided into three domains: material, psychological, and behavioral. Associations between cancer history, hardship, and clinical factors were assessed using generalized ordinal logistic regressions. Significant health care access disparities were found, particularly for mental health services, with 25% of younger BC survivors and 4.7% of younger KC survivors reporting affordability issues, in contrast to 2.7% of noncancer individuals. Dental care was also problematic, with higher avoidance rates among younger BC (27%) and KC (15%) survivors compared with the general population. Surprisingly, noncancer individuals reported more difficulty in affording prescriptions than BC survivors across both age groups. PC survivors, however, showed lower FD across all domains versus noncancer controls, indicating fewer concerns about medical bills and a lesser tendency to forgo care. The study underscores significant gaps in the financial support system for GU cancer survivors, with urgent needs in mental and dental health care access. Policy interventions, including comprehensive insurance reforms, are imperative to alleviate the financial burdens on these individuals.

Keeping Color in Mind: Racial Disparities within Mental Health Care

Health is a fundamental human right, not a privilege, or is it? Systematic issues curated throughout history have fostered the existence of public health disparities at all levels. Still, the level of impact and who it has affected most almost directly correlates with the color of one’s skin. While medical health inequality remains a pressing matter for disadvantaged groups, the mental health concern for people of color (POCs) is neither researched nor discussed enough. Despite the multitude of barriers, it is critical to address mental well-being to prevent and eliminate suicides, introduce strategies to reduce the impacts of mental illness and consider the role that race has when administering tests and treatment. The review of relevant literature will analyze the current research done on racial prejudices and how they adversely affect marginalized groups, why they continue to exist despite prior efforts, and proposed solutions to challenge these discrepancies. Its objective is to increase awareness and education regarding mental health disparities and how they relate to people of color to ultimately aid in diminishing the continuation of these unjust practices and catalyze vital changes in both POCs’ right to impartial access and quality of mental health care.

A global perspective: Access to mental health care for perinatal populations

Perinatal mental health care differs around the world. We provide a global perspective on the current status of service provision, barriers and facilitators to access, and strategies to improve access in high-income and low- and middle-income countries across five continents (Asia, Africa, Europe, North America and South America). Many of the countries considered do not have universal healthcare coverage. This poses a challenge to perinatal mental health care access. However, there are other social and structural barriers to access, including stigma and other sources of marginalization and discrimination. Yet there are opportunities discussed herein to learn more about what perinatal mental health services work for what populations* and in what circumstances, by adopting a global lens to examine innovative solutions utilized across geographical settings.

Scope-of-Practice Expansions Associated with Reduced Racial Disparities in Pediatric Mental Health Care.

To examine the association between scope-of-practice (SoP) regulations and racial disparities in pediatric mental health services. We used the National Survey of Children's Health (2016-2020; n = 33,790) to examine racial disparities in unmet mental health care needs and receipt of mental health medication between states with and without SoP expansions for psychologists and nurse practitioners (NP). Our primary outcomes were (1) unmet mental health care needs and (2) receipt of mental health medication. We examined heterogeneous treatment effects of SoP expansion on the outcomes using logistic regression with interaction terms between SoP expansion and race/ethnicity. We estimated population-level racial disparities for both outcomes stratified by SoP expansion to identify differences in racial disparities. The psychologist SoP expansion-associated reduction in unmet need was 15.8 percentage-points (CI= -25.3, -6.2) larger for Other-race children than for White children. The psychologist SoP expansion-associated increase in medication was 5.1%-points (CI=. 0.8, 9.4) larger for Black children and 5.6%-points (CI = 0.5, 10.8) for Other-race children. No differences were found for NP SoP expansion. Racial disparities in both outcomes were lower in psychologist SoP expansion states but varied in NP SoP states. Expanded SoP was generally associated with lower racial disparities in pediatric mental health care access.

Suicide Prevention: A Comprehensive Review

The phenomenon of suicide is a significant concern for public health globally, as it ranks among the top causes of mortality in different age demographics. The objective of this analysis is to offer a thorough examination of existing strategies for preventing suicide, which include psychological, medical, and community-based approaches. Through evaluating the efficacy of diverse interventions and pinpointing areas that require enhancement, this article aims to contribute to the creation of more comprehensive and all-encompassing frameworks for suicide prevention. The analysis emphasizes the significance of early identification, availability of mental healthcare, and the influence of societal support in reducing the risks associated with suicide.

Challenges and Implications for Substance Use and Mental Healthcare Among Under-Resourced Women in the COVID-19 Era.

The COVID-19 pandemic exacerbated disparities in mental healthcare and substance use disorder (SUD) treatment access, especially in under-resourced communities. This study aimed to comprehend the experiences of under-resourced women with SUD during the pandemic, their knowledge and attitudes towardit, and its impact on substance use and treatment access. A cross-sectional study included 66 under-resourced women receiving medically managed withdrawal treatment at a community residential SUD center. Data collection occurred between November 2021 and August 2022, utilizing a 75-item instrument covering COVID-19 exposure and its impact on health, substance use, treatment access, vaccination status, beliefs, and knowledge. Descriptive analyses summarized the data. Participants faced various challenges during the pandemic. Many reported increased substance use, especially alcohol, opioids, benzodiazepines, and nicotine. Mental health stability was negatively affected, exacerbating existing disorders and limiting mental healthcare access.A majority (56.1%) reported that their chronic mental health disorder was less stable during the pandemic. Twenty (30.3%) participants reported that they had been diagnosed with a new mental health disorder since the pandemic, and 28.8% reported that it was harder for them to access mental healthcare during the pandemic. Job loss, housing instability, and financial strain were prevalent. Half (n=33, 50%) received a COVID-19 vaccine dose, while 27.3% (n=18) declined vaccination due to knowledge gaps and religious beliefs. The majority (n=41, 62.1%) worried about securing basic needs such as groceries and medication, with 64.6% (n=42) expressing a desire to cope using alcohol or drugs. This study expands upon previous research by examining the effect of the COVID-19 pandemic on mental health in the context of substance use disorder treatment. Unlike previous data, which focused solely on substance use behaviors, our study delves into the impact of the pandemic on co-occurring mental health disorders. Findings underscore the need for gender-responsive and culturally appropriate SUD treatment. Vaccine hesitancy, as reflected in the study, necessitates more effective, tailored evidence-based informational campaigns. Efforts must focus on enhancing mental healthcare access, reducing stigma, and supporting individuals with co-occurring conditions amidst this evolving COVID-19 health crisis.

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

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

Exploring Young Adults' Reluctance to Engage With Psychiatric Hospitals in Erbil, Iraq: Identifying Barriers to Psychiatric Care.

In Erbil, Iraq, the reluctance of young adults to engage with psychiatric services is influenced by a complex array of barriers, including stigma-related, attitudinal, and instrumental factors that hinder effective mental healthcare access. This study aimed to identify these specific barriers to accessing psychiatric care among young adults in Erbil. The study utilized a cross-sectional online survey conducted between April 5th and May 1st, 2024. Data collection was carried out through purposive sampling and involved a comprehensive questionnaire. Electronic informed consent was obtained from all participants before they started the survey, which collected demographic data and utilized the Barriers to Access to Care Evaluation (BACE v3) tool. Statistical analysis was conducted using SPSS version 27 (IBM Corp., Armonk, NY). Descriptive statistics (frequency and percentage) were used for categorical data, while the mean and standard deviation characterized continuous variables. Chi-square tests, including Fisher's exact test and odds ratio (OR), were used to analyze categorical data, with a significance level set at p < 0.05. A total of 407 participants were enrolled in the study. The study highlighted several barriers to mental health care. Stigma-related barriers were significant, with participants fearing being seen as weak (mean score = 2.14, SD = 0.96) and concerns about being labeled "crazy" (mean score = 1.80, SD = 1.19). Regarding attitudinal barriers, there was a notable preference for dealing with issues independently (mean score = 2.04, SD = 0.98) and a tendency towardresolving problems without professional help (mean score = 1.88, SD = 0.98). Additionally, instrumental barriers were identified, including the rare availability of culturally diverse mental health professionals (mean score = 1.78, SD = 1.09) and practical difficulties such as arranging transportation to appointments (mean score = 0.61, SD = 0.87). The study demonstrated that young adults in Erbil face significant stigma and attitudinaland instrumental barriers to accessing psychiatric care. In response to these findings, it is recommended for the government to prioritize mental health awareness, actively destigmatize mental health issues, and improve service accessibility to foster a supportive care environment. Additionally, mental health professionals and educational institutions should collaborate to provide targeted support programs and resources for young adults.

Health Needs and Priorities of an Underserved Karenni Refugee Community: A Community Needs Assessment.

Southeast Asian refugee communities are frequently underserved by social and medical systems and experience profound health and health care inequities. The purpose of this study was to detail the health needs, priorities, and health care utilization of the Karenni, a Southeast Asian refugee community, in Forsyth County, North Carolina. A mixed-mode survey (i.e., online and in-person) was distributed in Kayah, Burmese, and English to Karenni adults in Forsyth County. Quantitative and qualitative questions focused on community health needs, health and public health service utilization, and social determinants of health. 101 Karenni adults completed the survey, with a total of 91 participants completing the quantitative portion (N = 91). Utilization of health care and public health services was low and impacted by individual- and contextual-level barriers, such as limited English profi-ciency and social determinants of health (e.g., lower levels of education and employment compared to state and national averages). Mental health, chronic pain, and health care access were highlighted as prominent community concerns while theh plaw theh jie (togetherness) and community organizations were described as community strengths. Data were collected using convenience sampling, and limited knowledge from the Karenni community regarding research served as a barrier to recruitment. Some sensitive questions (e.g., income) also experienced higher levels of missingness. This assessment highlights the need to increase engagement with and lower barriers to care for the Karenni community in Forsyth County, North Carolina. To produce culturally congruent and acceptable care, public health and health care systems should partner with the community to identify and address community needs and priorities, harness assets, and mitigate health and health care inequities.

Identifying Challenges and Solutions for Improving Access to Mental Health Services for Rural Youth: Insights from Adult Community Members.

Semi-structured, key informant interviews were conducted by telephone with adult community members, including parents, teachers, and healthcare providers. Participants answered questions related to barriers to mental healthcare access that confront youth and approaches to improving access. Detailed, de-identified field notes were analyzed using conventional content analysis. Limited resources and stigma were the two primary barriers to accessing mental healthcare that youth encounter in the community. Limited resources included lack of services and transportation, inconsistent funding and mental health programming, and workforce shortages. Stigma associated with seeking mental healthcare was of particular concern for youth with diverse identities who experience additional stigma. Improving access to mental healthcare for rural youth will require building a strong mental health workforce and championing efforts to reduce stigma associated with help-seeking.

Afghan refugees at risk in the UK: enhancing healthcare access and integration.

Following Kabul's fall in August 2021, there was influx of Afghan refugees in the UK. Southampton's Bridging Hotel provided temporary shelter to 22 families, totaling 116 individuals. The Living Well Partnership (LWP); assumed primary care provision for these vulnerable residents facing health inequalities. Enhancing refugee healthcare access and integration into the NHS system. Improving healthcare education, boosting confidence in appropriate healthcare use, and utilisation of electronic consultations effectively. Working with the local authorities, primary care services were brought to the hotel. Regular 3-hour drop-in sessions with a health and wellbeing coach were established and attended by residents. Non-identifiable data was recorded in individual patient care records and summarised quantitatively. Qualitative data was collected via a pre-established questionnaire during the sessions. RESULTS: Identified issues included language barriers, mental health problems, infectious diseases, contraception, and healthcare access. Language barriers were addressed with interpreters. Fifty-nine patients accessed support services, with 13 benefiting from e-consultations, and nine requiring on-site medical consultations in a 3-month period. Mental health support and infectious disease referrals were facilitated. Access challenges were mitigated by transitioning to e-consultations or face-to-face appointments. Outcomes included improved patient independence, awareness of healthcare processes, familiarity with LWP services, and confidence in navigating the NHS. A multifaceted approach is vital for addressing language and access barriers for refugees. Providing educational resources through facilitated groups empowered refugees and improved healthcare access. This initiative highlights the importance of organised support for vulnerable populations during crises and can be applied more widely.

Culturally and Linguistically Diverse Community Access and Utilisation of the Mental Health Service: An Explanation Using Andersen’s Behavioural Model

Andersen’s Behavioural Model of Health Service Use (ABMHSU) is a multilevel model that helps understand the factors influencing health service access and utilisation. This framework is a widely used model for health service use in general, as well as in immigrant populations and vulnerable populations. ABMHSU, in this project, provided a framework to explain how the mental health nurses’ cultural competence can influence the Victorian CALD community members’ mental health care access and utilisation. A unique model of ABMHSU in the current multiple-method project provided a theoretical framework for examining the factors associated with people from the CALD community accessing mental health services in an Australian context to answer the research questions. The key findings of the research were discussed with reference to the extant literature and with triangulation of research results with the ABMHSU in the context of Victoria. The researchers argue that even though predisposing, enabling, and need factors are necessary to determine whether a person is selected for expert care for mental health issues, these factors alone are insufficient. Ongoing research is essential to ascertain the potential of mental health nurses’ cultural competence education and cultural responsiveness in addressing the mental health service access and utilisation of the heterogeneous CALD communities. Additional research is advocated to identify the supplementary factors, as there is a dearth of research exploring the potential of ABMHSU worldwide.