Mental Health Crisis Research Articles

A "Whole Child Approach": Parent Experiences with Acute Care Hospitalizations for Children with Autism Spectrum Disorder and Behavioral Health Needs.

Children with Autism Spectrum Disorder (ASD) experience increased hospitalizations as compared to the general population, particularly in the context of mental health crises. Given the unique needs of children with ASD and behavioral health needs that can either lead to or emerge during hospitalization, an understanding of hospital experiences is critical. To date, research on caregiver experiences in acute care medical hospital settings is limited. Therefore, the purpose of this qualitative study was to investigate caregiver experiences with inpatient care for children with ASD and behavioral health needs, including factors and practices that impacted or were desirable for care. Two focus groups were conducted with a total of 12 parents of children with ASD admitted to a large pediatric hospital. Data were analyzed using interpretive description. Emerging themes pointed to the child, family, and staff factors and practices that intersect to influence hospitalization experiences. Child factors included the child's communication, sensory, behavioral, medical, and safety needs. Family factors included the family's relationship with the healthcare team, own needs, and advocacy experiences. Staff factors included staff communication practices, comfort, and knowledge when providing care. Overall, this research demonstrates the complexity of factors and practices that impact the behavioral health hospitalization experience for children with ASD and their caregivers. Experiences varied widely and were guided by the unique needs of each child. Findings point to care practices that can be adopted to best meet the needs of all stakeholders during hospitalization and offer implications for future educational initiatives.

Exploring Buddhist Literature and Philosophical Counseling Techniques: A Pathway to Social and Cultural Resilience in Strengthening Asia

Buddhism, one of the most profound philosophical systems in Asia, has historically influenced the social, cultural, and intellectual fabric of many Asian societies. This study explores the literature of Buddhism and the techniques of Buddhist philosophical counseling, investigating their contemporary relevance and impact on strengthening the socio-cultural cohesion across Asia. The motivations behind this study stem from the need to understand how ancient wisdom can address modern-day challenges such as mental health crises, social fragmentation, and ethical dilemmas. By examining canonical Buddhist texts and contemporary interpretations, this research seeks to demonstrate how Buddhist teachings—particularly those related to mindfulness, compassion, and interdependence—can be applied through counseling practices to enhance individual well-being and foster collective harmony. The methodology involves a comprehensive review of Buddhist literature, along with qualitative analysis of case studies where Buddhist philosophical counseling has been effectively integrated into modern counseling practices in Asian contexts. The major conclusions indicate that Buddhist techniques offer a unique approach to counseling, emphasizing inner transformation and ethical living, which align with the core values of many Asian societies. This study holds significant implications, as it highlights how Buddhist counseling not only addresses individual psychological needs but also promotes social solidarity, cultural continuity, and regional unity in Asia, especially in times of globalization and rapid modernization. The findings contribute to a deeper understanding of how ancient Buddhist philosophies can be effectively harnessed to address the contemporary issues facing Asia today, reinforcing both personal growth and collective resilience.

PAKISTANI YOUTH AND THEIR CURRENT FINANCIAL NEEDS. DO WE HAVE A PLAN?

Pakistan has been experiencing a financial crisis for several years, characterized by inflation and rising debt. These economic difficulties have had a significant impact on the country's young, who make up a significant portion of the population. In addition, current political crises and inflation have exacerbated the situation, leading to an increase in adolescent mental health crises.

Variable and dynamic associations between hot weather, thermal comfort, and individuals’ emotional states during summertime

The effects of heat exposure on negative affect are thought to be central to the observed relationships between hot summer days and deleterious outcomes, such as violent crime or mental health crises. As these relationships are likely to be magnified by the effects of climate change, a better understanding of how consistent or variable the effects of hot weather on affective states is required. The current work combines data gathered from an ecological momentary assessment (EMA) study on individuals’ thermal perceptions, comfort, and affective states in outdoor environments during their daily lives with high spatiotemporal resolution climate-modeled weather variables. Using these data, associations between objective weather variables (temperature, humidity, etc.), perceived heat (thermal perception and comfort), and affective states are examined. Overall, objective weather data reasonably predicted perception and comfort, but only comfort predicted negative affective states. The variance explained across individuals was generally very low in predicting negative affect or comfort, but within-person variance explained was high. In other words, while there may be a relatively consistent relationship between temperature and psychological experience for any given person, there are significant individual differences across people. Age and gender were examined as moderators of these relationships, and while gender had no impact, participant age showed several significant interactions. Specifically, while older adults tended to experience more thermal discomfort and perceived higher temperatures as hotter, the relationship between discomfort and negative affect was lower in older adults. Taken together, these results emphasize the importance of thermal discomfort specifically in predicting negative affect, as well as the high inter-individual variability in thermal perceptions and comfort for the same ambient temperatures.

One element of the emergency department nurse burnout epidemic – who can help? Based on a qualitative exploratory case study

ABSTRACT Background Nurses are responsible for a substantial portion of the care patients receive in emergency departments and must be well-equipped to deal with the associated environmental challenges, including managing patients in crises, boarding, and overcrowding. These challenges lead to adverse impacts, like burnout. This study identified training as a resource to reduce the prevalence of nurse burnout. Methods This qualitative case study employed the Job Demands-Resources model to explore the experiences of one hundred and eleven nurses regarding their preparedness to manage patients undergoing mental health crises and associated boarding and overcrowding. Data were collected from July to August 2023 using anonymous surveys, a burnout inventory, semi-structured interviews, and focus groups. Results 75% reported experiencing burnout, with over half expressing feelings of inadequacy due to insufficient training. Those not reporting burnout indicated a strong support system at work and felt adequately trained. The imbalance between job demands and resources influenced motivational and health impairments. Conclusion The study aimed to bridge literature gaps by examining the link between training and burnout, offer empirical evidence and recommendations to academic and healthcare leaders to promote the well-being of nursing staff, and highlight the critical need for supportive training and resources to diminish burnout.

The transnational mental health burden of Haiti's alleged collapse: preliminary findings from The Haitian Well-Being Study.

Transnational drug trafficking, political unrest, gang violence, and paramilitarism, which are pervasive in Haiti, have resulted in a mental health crisis for the broader Haitian community. This study explores the mental well-being of Haitians in Haiti and the United States by identifying barriers and facilitators to mental health through the lived experiences of men and women. Four Focus group discussions conducted in April and November 2023 engaged 28 participants (20 women and eight men) aged between 23 and 60 years from locations in Haiti (Port-au-Prince, Cite Soleil, Cayes, Cap-Haitien, Saint-Marc) and the United States. Discussions revolved around the definition of mental health, stressors, coping mechanisms, risk and protective factors, and barriers to mental health care. Six principal themes emerged: 1- Chronic Traumatic Stress: continued violence, political instability, unemployment, lack of social support, adverse childhood experiences, family separation, and forced displacement were significant sources of stress. 2- Increased Health Burden: Participants reported experiencing chronic physical and psychological symptoms [i.e., hypertension, anxiety, depression, sleep issues, substance abuse, suicidal ideations, characteristics of post-traumatic stress disorder (PTSD)], which were attributed to Haiti's social, political, and infrastructure collapse. 3- Risk Factors: limited access to mental health services, pervasive hopelessness, scarcity of opportunities, and stigma were identified as significant risks. 4- Future Uncertainty: widespread concerns regarding the future predominated. 5- Multigenerational Concerns: Significant anxiety concerning the mental health and development of children, as well as the functionality of mental health practitioners, was noted. 6- Coping and Protective Factors: Effective coping strategies include mental stimulation, peer support, managing digital consumption, engaging in leisurely activities, such as listening to music, and faith/spirituality. The study's findings underscore the sociopolitical and economic crisis in Haiti, which has resulted in violence and a dismantle of political, educational, financial, and health infrastructures. These factors were identified as the primary source of chronic distress, contributing to widespread mental health issues, adverse physical symptoms, and disruption in daily life. The implications for practice, healing, research & policy are discussed.

An inpatient mental health placement for paramedic undergraduate students: a pilot study

BackgroundThe prevalence of mental and behavioural illnesses in the Australian community is increasing. Paramedics are frequently the first health responders to a mental health crisis, and their workload associated with mental health presentations is also increasing. The present study explored the experience and perspectives of undergraduate paramedic students who participated in a pilot mental health placement.MethodsA pilot workplace learning opportunity was established in which students completed a portion of their community service hours in an inpatient mental health setting at Port Macquarie Base Hospital. Eight students attended and completed the placement and were administered the Clinical Placement Evaluation Questionnaire.ResultsStudent responses to this placement experience were overwhelmingly positive. The data showed that all the students responded “Strongly Agree” or “Agree” to each of the survey items. Thematic analysis of the qualitative data yielded four central themes related to benefits, additional training and education, nursing staff, and improvements.ConclusionsThis pilot study suggests that mental health placements for paramedics have meaningful educational value and can impact student learning. Since this pilot study, mental health placements have been permanently included as part of the undergraduate curriculum in our institution.

Reducing mental health emergency visits: population-level strategies from participatory modelling

BackgroundEmergency departments (EDs) are often the front door for urgent mental health care, especially when demand exceeds capacity. Long waits in EDs exert strain on hospital resources and worsen distress for individuals experiencing a mental health crisis. We used as a test case the Australian Capital Territory (ACT), with a population surge of over 27% across 2011–2021 and a lagging increase in mental health care capacity, to evaluate population-based approaches to reduce mental health-related ED presentations.MethodsWe developed a system dynamics model for the ACT region using a participatory approach involving local stakeholders, including health planners, health providers and young people with lived experience of mental health disorders. Outcomes were projected over 2023–2032 for youth (aged 15–24) and for the general population.ResultsImproving the overall mental health care system through strategies such as doubling the annual capacity growth rate of mental health services or leveraging digital technologies for triage and care coordination is projected to decrease youth mental health-related ED visits by 4.3% and 4.8% respectively. Implementation of mobile crisis response teams (consisting of a mental health nurse accompanying police or ambulance officers) is projected to reduce youth mental health-related ED visits by 10.2% by de-escalating some emergency situations and directly transferring selected individuals to community mental health centres. Other effective interventions include limiting re-presentations to ED by screening for suicide risk and following up with calls post-discharge (6.4% reduction), and limiting presentations of frequent users of ED by providing psychosocial education to families of people with schizophrenia (5.1% reduction). Finally, combining these five approaches is projected to reduce youth mental health-related ED presentations by 26.6% by the end of 2032.ConclusionsPolicies to decrease youth mental health-related ED presentations should not be limited to increasing mental health care capacity, but also include structural reforms.

Assessing access: Texting hotline app provides mental health crisis care for economically deprived youth

BackgroundDue to rapidly increasing youth suicides in the U.S state of Utah, the legislature funded creation of a 24/7 texting-based smartphone app in Spanish and English targeting Utah's school aged population. Recent research elsewhere (in the Netherlands) suggests cost inhibits help seeking among the economically disadvantaged. We evaluate the relationship between poverty and app usage during the onset of the COVID-19. MethodLocal demographics, social determinants of health and COVID-19 infection rates were modeled using a Bayesian spatio-temporal approach examining usage rates. ResultsWhen controlling for generally researched suicide crisis covariates, app usage is shown to vary depending on economic status of the population, with the largest relative increases in use among disadvantaged youth. DiscussionThis bilingual Spanish/English, texting (SMS) based, smart phone app crisis hotline proved effective at providing adolescents from certain populations access to mental health care. The groups discussed are in Census Block Groups (CBGs – neighborhoods) with higher poverty, and/or lower population density (rural areas). The usage of the crisis hotline by these populations increased relative to the overall population as the COVID-19 pandemic unfolded. However, adolescents from areas of higher mobility (our proxy for housing insecure) and those in areas with larger non-White populations had a relative decrease in usage.

Suicide prevention skills training in pre-clerkship medical students: a pilot study

When equipped with the skills to recognize and intervene effectively, peers are well positioned to be early responders to near-peers in mental distress. This pilot study provides a framework for providing suicide prevention skills training to pre-clerkship medical students with the aim to improve early peer-to-peer detection and initial aid for mental health crises. This training is effective in improving students’ self-reported comfort to provide early intervention to peers with declining mental health. Participants felt strongly that this training merits integration into core medical education and did not identify the added courseload as a major burden. Other programs should consider adopting such an initiative.

A Pilot Study in Adapting the Chronic Care Model to Address Shortage of Child and Adolescent Psychiatry.

There is a nationwide shortage of child and adolescent psychiatrists. This, combined with the mental health crisis caused by the coronavirus 2019 pandemic has lead to low access to care for many individuals. Child Psychiatry Access Programs have been developed to address this need, but we believe they are not sufficient to care for complex cases. We propose that the Chronic Care Model can address these issues by providing, more longitudinal and and faster access to mental health care for patients. Our pilot study had 50 children and adolescent participants in our clinic model, which included the use of trainees supervised by an attending. We found that the mean wait time to appointment with a child and adolescent psychiatrist was 13.54 ± 14.8days, which is significantly shorter by that reported by other studies. We believe our model clinic may be helpful in a variety of settings and want to share it with other psychiatrists.

We are a spider’s web: Friendship in times of mental health crisis

Community responses to those experiencing mental health crisis and distress are important. However, in Australia and many other colonised countries, responses to distress have become highly medicalised, punitive, individual and privatised. Exploring friendship responses to mental health crisis may increase the possibilities for building on community connectedness and local support networks. The work described in this paper aimed to make visible the acts of care, solidarity, friendship and mutuality that friends and members of the community have taken up in response to someone close to them experiencing distress. The work was guided by intentional peer support and narrative practices including re-authoring, collective documentation and outsider witnessing.

Health survey on anxiety, depression, and stress in Afghanistan: A large-scale cross-sectional study amid ongoing challenges

BackgroundOne of the most significant events in recent Afghan history is the rise of the Taliban and the war that followed, which had profound impacts on the lives of Afghans. The present study examined the mental health of Afghans living under the Taliban government.MethodsBetween June 5, 2023 and February 12, 2024, a cross-sectional study was conducted among the Afghan population in three key regions of Afghanistan. Data were collected using a pre-tested structured questionnaire. The 21-item Depression, Anxiety and Stress scale (DASS-21) was utilized to assess depression, anxiety and stress of the Afghan population. Ethical permission for this study was granted by the Afghanistan Center for Epidemiological Studies (ACES). Logistic regression models were employed to explore the relationship between socio-demographic characteristics and depression, anxiety, and stress among 2,698 participants.ResultsThe prevalence of depression was 72.05%, anxiety was 71.94%, and stress was 66.49%. Multiple regression analysis indicated that gender (being female), economic status (being poor), residency (living in rural areas), education level (being illiterate), being a cigarette smoker, and having experienced a bad event during the past month were significantly associated with depression, anxiety and stress.ConclusionThe findings of the present study show very high levels of anxiety, depression, and stress, most likely reflecting the profound impact of recent political, social, and economic changes. Notably, a significant majority of participants, particularly females and individuals above 35 years of age, reported severe to extremely severe mental health symptoms. The mental health crisis in Afghanistan is a complex and urgent issue that requires a comprehensive and compassionate response.

Implementation and Service Delivery Status of the Mental Health Law in the Province of Zamboanga del Norte

Mental health had been a growing concern while mental illness had been increasing in number worldwide. The enactment of the Mental Health Law or RA 11036 in 2018 hoped to bring about better delivery of mental health services as well as uphold the rights of patients. This led the proponent to investigate the implementation and service delivery status of the mental health law in the province of Zamboanga del Norte. Employing a descriptive-qualitative design, the study assessed the implementation of the various government agencies on the Mental Health Law as well as the delivery of mental health services in the province of Zamboanga del Norte. There were 50 mental health professionals interviewed through phone, messenger, and Google form using a structured interview guide. Data gathered through the interviews were analyzed using thematic analysis. Results revealed that most of the government agencies were able to implement the law rating from 35.72% to 100% of the implementation. Eleven themes emerged such as poor knowledge about the mental health law, no proper seminars/training about mental health law, mental health is not a priority program, lack of coordination with the various agencies involved, difficulty managing mental health crises, non-inclusive mental health program, insufficient mental health services, multitasking of mental health providers, lack of mental health professionals, stigmatized attitude towards mental illness and support from LGU. It was revealed in this study that the implementation of the mental health law in the province is not fully implemented. Furthermore, the delivery of mental health services is also insufficient. As a recommendation, the primary implementing agency must exert more effort in cascading the law to all implementing agencies and mental health professionals down to the barangay level for the law to be understood and implemented. In addition, mental health services should be improved as well as the inclusion of a mental health facility.

Use of Emergency Mental Health Dispatch Training by a 9-1-1 Medical Dispatcher Assisting a Caller Expressing Suicidal Intent: A Case Report.

A growing number of individuals with unmet mental health needs in the United States rely on emergency medical services during mental health crises, and 9-1-1 emergency medical dispatchers (EMD) are often a critical lifeline to help. Unfortunately, current industry-standard dispatching protocols and training required for EMD certification largely lack specificity for managing 9-1-1 calls related to mental health emergencies. The purpose of this report is to illustrate the value of additional targeted training for EMDs that enables them to more effectively assist callers struggling with mental illness or suicidal thoughts. We review a 9-1-1 call in which an EMD utilized specific strategies and language learned during a 3-day emergency mental health dispatch (EMHD) training course to assist a middle-aged male who was expressing suicidal intent with a firearm. Key principles and phrasing from the training were used successfully by the EMD to dissuade the caller from self-harm, and he was ultimately safely met by first responders on scene and transported for care. We also share post-call recollections and reactions from the EMD to demonstrate how in addition to reducing risks for callers and their families, EMHD training has the potential to reduce on-scene risks for field responders and may increase confidence and mitigate negative stress responses in EMDs. Emergency medical services systems in the United States should continue to explore enhanced training and protocols to improve care for 9-1-1 callers experiencing mental health crises.

Mental health crisis in the youth and rebound in sexually transmitted infections.

Mental health crisis in the youth and rebound in sexually transmitted infections.

Mental health disparities among sexual and gender minority students in higher education

Objective: There has been an ongoing mental health crisis among sexual and gender minority (SGM) populations. This continues amidst rising population-level depression and suicide rates, especially among students in higher education. This work aims to understand changes in SGM student mental health over time. Participants: N = 483,574 responses to the Healthy Minds Study (2007C2022) were examined from 18 to 35-year-old U.S. college and university students. Methods: Linear and logistic regressions were used to examine associations between SGM identity and mental health. Mediation and structural equation modeling were used to examine potential links among risk factors. Results: On average, ∼18% of students identified as SGM, which included a 6-fold increase in SGM self-identification across this 15-year period. Depression rates increased over time; ∼12% of students reported major depression. SGM students were 3.18 times (z = 111.16, p < .001) more likely to report depression than non-SGM students (26.85% vs. 8.53%). Disproportionate discrimination and lack of school belonging partially explained SGM disparities in depression. SGM students were twice as likely to utilize therapy (z = 115.42, p < .001) but half as likely seek help from family (z = 55.48, p ≤ .001). Conclusions: Academic institutions must take concrete steps to reduce barriers mental health care, combat discrimination, and bolster community belonging and interpersonal support for SGM students.

Pediatric inpatient psychiatric beds needed to meet demand

Inadequate availability of pediatric psychiatric beds is partially attributed to the worsening pediatric mental health crisis, along with children who increasingly have prolonged emergency department visits while awaiting definitive mental health care, according to a research letter published online last month in JAMA Pediatrics.

Providing LGBTQIA+ affirming mental health services in schools: A cultural adaptation of dialectical behavior therapy Skills Training for Emotional Problem Solving for Adolescents (DBT STEPS-A).

Despite growing concerns related to the youth mental health crisis and the well-being of sexual and gender minority youth, specifically, most mental health interventions fail to meet the unique needs of this population. Research and clinical guidance have recommended that approaching mental health treatments through a lens of minority stress and intersectionality can be particularly helpful in addressing the mental health concerns of LGBTQIA+ (lesbian, gay, bisexual, transgender, questioning/queer, intersex, and asexual, with the '+' capturing other identities within the gender and sexually diverse population) youth. Because many adolescents do not have access to mental health care, schools have an important role to play in meeting the mental health needs of LGBTQIA+ youth. To address these issues, we propose LGBTQIA+ affirming adaptations to the dialectical behavior therapy (DBT) Skills Training for Emotional Problem Solving for Adolescents (STEPS-A) curriculum using Pachankis et al.'s (2023) Adaptation Model to provide practitioners with a culturally affirming model of this social-emotional curriculum, while highlighting the utility of this framework in adapting other evidence-based interventions in schools. We walk readers through each module of DBT STEPS-A and provide rationale for adapting these skills for LGBTQIA+ youth. We offer specific adaptations that facilitators can make through psychoeducation and skills training. For example, we provide sample dialectics that mirror the experience of minority stress and propose examples of coping skills that are relevant for LGBTQIA+ youth (e.g., distracting and self-soothing to tolerate distress). Finally, the role of school psychologists in meeting the mental health needs of LGBTQIA+ youth is discussed along with implications for practice and future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Ready or not…here we grow! Evaluating the competency of nursing faculty in supporting nursing student mental health: A quantitative investigation

BackgroundCollege students are amid a mental health crisis with campuses seeing the highest rates of mental health disorders in over a decade. College nursing students stand out as particularly affected, experiencing elevated levels of anxiety, stress, and depression compared to the general student population. At the forefront of addressing this issue are college faculty, especially nursing faculty, who play a unique role in identifying and referring students with mental health needs due to their close interactions in smaller teaching-learning settings such as clinicals, simulations, and one-on-one validations. AimThis study evaluated the perceived competency, knowledge, engagement, and fear levels of nursing faculty in supporting the mental health of Bachelor of Science in Nursing students. Additionally, the study explored whether faculty members with prior MH training differed in these levels. MethodsSurvey data from 63 faculty members employed across six prominent nursing schools in the southeast region of the United States, all offering Bachelor of Science in Nursing programs, were analyzed. Employing a cross-sectional design, the study utilized the “College Mental Health Perceived Competency Scale” (CMHPCS) to assess faculty's competence, knowledge, engagement and fear in supporting student mental health. ResultsAmong the 63 participants, significant differences were observed in engagement levels between nursing faculty with and without prior mental health training (p < .012). Overall, the surveyed nursing faculty demonstrated high levels of competence, engagement and knowledge and low levels of fear in supporting the nursing student's mental health. ConclusionThe results prompt recommendations for future research aimed at developing a comprehensive approach to equip nursing faculty with effective mental health training and interventions. Such efforts seek to empower student nurses with the tools necessary to support their own mental health, enabling them to competently care for patients and communities.