Mental Health Policy Research Articles

Incidence of Panic Disorder Diagnoses After Celebrity Disclosures of Panic Disorder in South Korea

The persistent stigma associated with mental health conditions is a major challenge worldwide. Celebrities may improve this by openly discussing their own mental health issues, potentially influencing public attitudes and encouraging individuals to seek treatment for these conditions. To evaluate the impact of celebrity mental health disclosures on the incidence and prevalence of panic disorder diagnosis in South Korea. This cohort study included the entire South Korean population from January 2004 to December 2021, as reflected in the National Health Insurance Service data. Analysis was conducted from May 2022 through January 2024. Time periods analyzed included the timeframe before (from January 2004 to December 2010) and after the public disclosures of panic disorder by 3 high-profile Korean celebrities between December 2010 and January 2012 (from January 2011 to December 2021). Monthly incidence and prevalence of panic disorder, defined by the presence of a clinical diagnosis of the condition. Trends were assessed using interrupted time series analysis with autoregressive integrated moving average models. To assess public interest in panic disorder, trends in search data were analyzed, examining the association between the timing of increased searches and changes in the incidence and prevalence of panic disorder. Data on obsessive-compulsive disorder (OCD) were included as a control. The study covered the entire population of South Korea, including 48 559 946 individuals in January 2004 and 52 593 886 individuals in December 2021. Before 2011, the mean (SD) annual prevalence of panic disorder was stable at 560 (140) persons per 100 000 persons per year. The celebrity disclosure in December 2010 was associated with higher monthly incidence rates of panic disorder, as measured by insurance claims data, changes that were observed in both the level (5.8 persons; 95% CI, 2.2-9.5 persons) and slope (0.78 persons per month; 95% CI, 0.19-1.40 persons per month) per 100 000 persons. By 2021, the observed annual prevalence per 100 000 persons reached 7530 persons, an increase of 775.6% compared with the 860 persons (95% CI, 330-1400 persons) estimated if the disclosures had not occurred. Internet searches anticipated changes in monthly prevalence with a lag of 2 or 3 months (F = 4.26, P = .02 and F = 3.11, P = .03, respectively). The celebrity disclosures had no significant association with the incidence or prevalence of OCD. In this observational cohort study, celebrity disclosure of mental health conditions was associated with a sustained reduction in stigma, as reflected in increased help-seeking behavior for the condition over more than a decade. This underscores the influential role celebrities can play in shaping public health perceptions and behaviors, offering valuable insights for the development of future mental health policies and public awareness campaigns.

An incongruence between policy, practice, and cultural values: implications for mental health services in Namibia

ABSTRACT Mental health access, provisions, and utilization of social services in Namibia have seen challenges as well as opportunities for improvement. In this article, the authors 1) discuss Namibia’s antiquated mental health law and policies, 2) discuss the current landscape of social work and mental health in Namibia and similarly situated countries, 3) explore five-to-ten year projections for development, 4) discuss preventative and innovative solutions to address mental health in Namibia in the context of the grand challenge related to eradicate social isolation, and 5) explore opportunities for social work practice and research.

Building on Recovery: Embracing Community Inclusion in Mental Health Policies and Services.

Recovery is real and has had a transformative impact on mental health policies and services, including shifting the focus from chronicity and symptom management to the realization that individuals with mental health issues can lead meaningful lives. However, recovery has been defined, described, understood, and measured in a wide variety of ways that may account for misuses and abuses in its application and possible stagnation in its impact. It is argued that the mental health field must now build upon the strong foundations of recovery by integrating a well-established rights-oriented framework. While recovery emphasizes personal growth and hope, a rights-based perspective underscores inherent dignity, autonomy, and opportunities for acceptance and embrace in engaging in valued social roles. The addition of a rights-based framework - community inclusion, to conversations involving recovery, is aligned with the origins of recovery and how it is commonly understood, and also connects the mental health field to the dramatic positive impacts that have emerged from the longstanding centrality of this concept in the broader disability community.

The Role of Implementation Climate in Moderating Educator Use of Evidence-Based Practices and Outcomes for Autistic Students.

Ensuring effective use of evidence-based practice (EBP) for autism in schools is imperative due to the significantly increasing number of autistic students receiving school services each year. High-quality EBP use has proven challenging in schools. Research indicates implementation climate, or how EBP are supported, rewarded, and valued, and EBP resources are related to successful implementation. However, limited understanding of system-level contextual factors that impact EBP implementation for school-based providers makes development of appropriate implementation supports challenging. Understanding these factors is crucial for selecting and tailoring implementation strategies to support EBP scale up. In this observational study, California school-based providers (n = 1084) completed surveys related to implementation climate, leadership, autism experience and EBP implementation (use, competence, knowledge). Student outcomes included state level academic and behavioral indicators. Using an implementation science framework (Aarons et al., in Administration and Policy in Mental Health and Mental Health Services Research 38:4-23, 2011) and multilevel modeling, we examined the relationship between EBP Implementation and student outcomes and the moderation effects of provider and district level factors. Higher implementation climate predicted better EBP implementation outcomes, and proved more impactful when provider hands-on autism experience was low. Greater EBP resources predicted a higher percentage of students who met math standards only when district poverty level was high. Our findings suggested moderating effects on EBP implementation from both provider and system level factors. Implementation climate and resources may be especially key in addressing equity issues related to high poverty schools in which teachers often have less autism experience.

CLINICAL PSYCHOLOGY IN THE EU: A COMPARATIVE ANALYSIS OF BEST PRACTICES

Clinical psychology plays a vital role in promoting mental health and well-being across the European Union (EU). With diverse cultural, social, and systemic contexts, understanding the best practices in clinical psychology is crucial for improving mental health care services. This article provides a comprehensive comparative analysis of clinical psychology practices across various EU member states, highlighting effective methodologies, training standards, and systemic frameworks. The primary aim of this article is to explore and evaluate the therapeutic approaches, training and professional development standards, and systemic frameworks utilized in clinical psychology across different EU countries. By identifying and comparing these practices, the article seeks to highlight the most effective methods and propose recommendations for enhancing mental health care in the region. The study employs a mixed-methods approach, including a thorough literature review, structured surveys, and semi-structured interviews with clinical psychologists, policymakers, and experts from various EU member states. Additionally, case studies from selected countries provide detailed insights into practical applications and outcomes. Quantitative data is analyzed using statistical methods, while qualitative data is interpreted through thematic analysis. The analysis reveals significant variation in therapeutic approaches, with the UK and Germany emphasizing evidence-based practices such as Cognitive Behavioral Therapy (CBT), while Sweden focuses on preventive strategies and public health integration. Training and professional development standards are most rigorous in Germany and the UK, ensuring high-quality practice. The Netherlands and Italy showcase the benefits of innovative and community-based care models. Overall, countries with robust mental health policies and integrated care systems tend to achieve better clinical outcomes. The findings underscore the importance of adopting evidence-based practices, enhancing training standards, and fostering therapeutic diversity to address complex mental health issues. Cross-border collaboration and knowledge exchange among EU member states can further refine and harmonize clinical psychology practices.

Bridging the Void: Unraveling Mental Health Policies for the Older Adults in Pakistan's Tapestry- A Literature Review

This literature review focuses on the significant difficulties in mental health policies for older individuals in Pakistan. As the world population ages and the old population in South Asian countries, particularly Pakistan, grows, there is a clear dearth of specialized care for the aging populace. The assessment of literature highlights major challenges such as limited government funding, the influence of the nuclear family trend, and a lack of mental health training. Despite the obvious need for focused strategies, Pakistan has made little progress. Existing policies must be restructured immediately to line with the World Health Organization's active aging framework and the United Nations MIPAA (Madrid International Plan of Action on Ageing). The review emphasizes the need for enhanced visibility, stakeholder collaboration, government financing for research, and policy restructuring about older adults mental health. There is major need to address the stereotypes and stigma related to aging which have negative impact on their quality of life and health. Establishing geriatric expertise in health care and creating policies for a quality aging process, is deemed necessary to enhance the mental health of older adults in Pakistan.

The role of peer support in recovery among clients with mental illness attending the psychiatric service in a tertiary hospital in Malaysia: a qualitative study

BackgroundThe understanding that mental health recovery is a personal and subjective experience informs mental health policies in many countries. However, most of the populations in these studies are from the West, limiting their applicability in Asia. Peer support in mental health refers to helping and mentoring people who have overcome similar obstacles. Despite being proven to be effective in promoting recovery, little is known about its use in Malaysian psychiatric patients. This study aims to explore the participants’ perspectives on their concept of recovery and how the peer support group (PSG) aid them to achieve recovery.MethodologyThis study was conducted on clients with mental illness who attended the PSG provided by the Community Psychiatry and Psychosocial Intervention Unit in National University Malaysia Medical Centre. A qualitative generic inductive approach was employed in this thematic exploratory study. Purposive sampling was the method used to collect the data for this thematic exploratory study. In-depth interviews of 11 study participants were audio recorded and transcribed verbatim. Data were analyzed using Braun and Clarke (2006) descriptive thematic analysis method.ResultsThe findings of this study highlighted six key themes; three pertaining to the participants’ perspectives on the meaning of recovery (1. Gaining self-reliance and social inclusion, 2. Personal growth and improved life circumstances in recovery, and 3. Symptoms improvement) and another three pertaining to how the peer support group aids recovery (1. Empowerment and growth through peer support, 2. Promoting well-being, 3. Social connection and support).ConclusionThe findings of this study provide valuable insights into the perspectives of psychiatry clinic patients enrolled in PSG on the concept of recovery and the role of such groups in their recovery journey. The findings demonstrated that the PSG complemented the participants’ perspectives on recovery, reinforcing the notion that a comprehensive and person-centered approach to mental health services is essential for successful and sustained recovery outcomes.

The darkness of reacculturation: examining factors influencing depression among Chinese international student returnees in the post-COVID-19 era.

In the aftermath of the COVID-19 pandemic, the reintegration of Chinese international student returnees intersects with China's critical effort to combat a significant brain drain of highly skilled talents, highlighting an unprecedented psychological battleground. This convergence underscores the urgent need for nuanced research to navigate the uncharted territory of their mental health. Employing Bayesian analysis supported by Markov Chain Monte Carlo (MCMC) algorithms, this study examined depression prevalence and associated factors among 1,014 Chinese returnees. The sample comprised 44.87% male participants (455), 51.58% female participants (523), and 3.55% identifying as "Others" (36), with an age distribution of 61.74% aged 18-30 (626), 28.80% aged 31-40 (292), and 9.47% aged 41-50 (96). The mean age of participants was 29.6 years, ranging from 18 to 50 years. PHQ-9 diagnoses revealed alarming levels of depression, with 47.9% exhibiting a moderately severe degree of depressive disorder. Our findings highlight the intricate interplay between identity clusters- "homestayers" (those leaning towards a Chinese cultural identity), "navigators" (those with a bicultural identity), and "wayfarers" (those leaning towards a foreign cultural identity)-and the likelihood of depression. Specifically, homestayers showed a clear and strong negative association, navigators demonstrated a positive association, and wayfarers had a positive yet unclear correlation with depression levels. Furthermore, acculturation, age, and gender showed no significant effects, whereas education mildly mitigated depression. Based on these findings, we suggest the implementation of better-tailored mental health support and policies to facilitate smoother reintegration.

Identifying mechanisms of youth mental health promotion: A realist evaluation of the Agenda Gap programme

Promoting youth mental health is a critical public health priority and merits robust policy and practice responses, inclusive of youth-centred and upstream interventions that address the root factors contributing to mental health outcomes. To that end, non-familial youth-adult relationships can powerfully impact youths’ healthy development, mental health and well-being, and capacities for enacting change within home, school, and policy contexts. Agenda Gap is a youth mental health promotion programme based on this principle, in which adult facilitators support youth (aged 15–24) in co-exploring activities focused on mental health promotion and policy advocacy, while fostering supportive, trusting intergenerational relationships. This study presents a realist evaluation of Agenda Gap, drawing on realist qualitative interviews with youth participants (n = 18) and adult collaborators (n = 4). We constructed 15 initial programme theories in four theoretical areas that we subsequently explored via analysis of the realist interview data. The analysis used the middle-range theories of ‘Third Space’ and ‘Third Place’ to conceptualize and articulate how causal mechanisms were produced from the non-familial youth-adult relationships that are foundational to the programme. Results are presented across 10 context-mechanism-outcome (CMO) configurations in three sections: (1) Agenda Gap Facilitation Activates ‘Third-Space/Third-Place’ Mechanisms; (2) Youth Enhance Personal Mental Health while also Supporting Mental Health of Friends and Family; (3) Youth Become Inspired and Informed to Act as Advocates and Policy Change Agents. Taken together, these findings provide insights into the important mechanisms of non-familial intergenerational trust building and demonstrate how a strengths-based conceptualization of youth mental health supports mental health maintenance, promotion, and advocacy for this population.

Suicidal ideation and suicide attempts among students aged 12 to 24 after the lifting of COVID-19 restrictions in China: prevalence and associated factors.

To investigate the prevalence and associated factors of suicidal ideation and suicide attempts among adolescent and young adults in China from December 14, 2022 to February 28, 2023, when COVID-19 restrictions were lifted. Students in middle and high schools and colleges and universities in the province of Sichuan, China were asked to complete on-line cross-sectional surveys. Information was collected about sociodemographics, experiences related to the COVID-19 pandemic, suicidal ideation and suicide attempts. Participants also filled out the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 and the Social Support Rate Scale surveys. Factors associated with suicidal ideation or suicide attempts were explored using logistic regression. Of the 82,873 respondents (aged 12 to 24 years), 21,292 (25.7%) reported having thought of suicide at least once in their lifetime, 10,382 (12.5%) reported having thought about suicide within the previous 12 months, and 1,123 (1.4%) reported having attempted it within the previous 12 months. Risk of lifetime suicidal ideation was higher among middle school students than among older students. Risk of suicidal ideation and risk of suicide attempts correlated directly with severity of symptoms of depression and anxiety, and inversely with level of social support. Greater risk of suicidal ideation and suicidal attempts was associated with: being female, living in an urban environment, attending a boarding school, currently being in love, having parents who divorced or remarried, having parents who exhibit non-authoritative parenting behavior, having higher family income, having been COVID-19 infected, having been quarantined for a long time, and being dissatisfied with one's education. Suicidal ideation and suicide attempts remain prevalent among young people in China. The potential associated factors identified in our study may be useful for targeting appropriate psychosocial interventions and developing mental health policies.

Progress on Mental Health Policy to Improve Service Access and Quality for Older Adults: Recent Successes, Proposed Legislation, and Strategies for Sustainability

Progress on Mental Health Policy to Improve Service Access and Quality for Older Adults: Recent Successes, Proposed Legislation, and Strategies for Sustainability

Barriers to help-seeking, accessing and providing mental health support for medical students: a mixed methods study using the candidacy framework

BackgroundThe mental health of medical students is a national and international problem increasing in both demand and acuity. Medical students face barriers to accessing mental health support that is clinically effective, timely and appropriate for their needs. This mixed methods study aimed to explore experiences of these barriers and the challenges to health service delivery aligned to the Candidacy Framework.MethodsOne hundred three medical students studying at The University of Sheffield completed an online survey comprising the CCAPS-34 and follow-up questions about service access and use. Semi-structured interviews with a nested sample of 20 medical students and 10 healthcare professionals explored barriers to service access and provision. A stakeholder panel of medical students and professionals met quarterly to co-produce research materials, interpret research data and identify touchpoints by pinpointing specific areas and moments of interaction between a medical student as a service user and a mental health service.ResultsMedical students who experienced barriers to help-seeking and accessing support scored significantly higher for psychological symptoms on the CCAPS-34. Uncertainty and fear of fitness to practice processes were important barriers present across all seven stages of candidacy. The fragmented structure of local services, along with individual factors such as perceived stigma and confidentiality concerns, limited the progression of medical students through the Candidacy Framework (a framework for understanding the different stages of a person’s journey to healthcare).ConclusionThis study outlines important areas of consideration for mental health service provision and policy development to improve access to and the quality of care for medical students.

The S20 Brazilian Mental Health Report for Building a Just World and a Sustainable Planet: Part I.

This is the first part of two documents prepared by experts for the Brazilian S20 mental health report. These reports outline strategies aimed at addressing the exacerbated mental health challenges arising from a post-pandemic world. Ongoing psychiatric epidemiology research has yielded evidence linking mental health with intricate social determinants, including gender, race/ethnicity, racism, socioeconomic status, social deprivation, and employment, among others. More recently, the focus has expanded to also encompass violence and social oppression. By prioritizing prevention and early intervention, harnessing technology, and fostering community support, we can mitigate the long-term impact of mental disorders emerging in life. Utilizing evidence-based practices and forging partnerships between the health and education sectors, S20 countries can promote health and safety of their student population, thereby paving the way for a more promising future for the next generations. The first document focuses on addressing the mental health concerns of vulnerable populations, catering to the needs of children, youth, and aging populations, assessing the current state of alcohol and drug addictions, scaling up psychosocial interventions in primary care, exploring the potential integration of health and educational systems, and emphasizing the imperative adoption of human rights in mental health policies.

The S20 Brazilian Mental Health Report for Building a Just World and a Sustainable Planet: Part II.

This is the second part of the Brazilian S20 mental health report. The mental health working group is dedicated to leveraging scientific insights to foster innovation and propose actionable recommendations for implementation in Brazil and participating countries. In addressing the heightened mental health challenges in a post-pandemic world, strategies should encompass several key elements. This second part of the S20 Brazilian Mental Health Report will delve into some of these elements, including: the impact of climate change on mental health, the influence of environmental factors on neurodevelopmental disorders, the intersection of serious mental illness and precision psychiatry, the co-occurrence of physical and mental disorders, advancements in biomarkers for mental disorders, the utilization of digital health in mental healthcare, the implementation of interventional psychiatry, and the design of innovative mental health systems integrating principles of innovation and human rights. Reassessing the treatment settings for psychiatric patients within general hospitals, where their mental health and physical needs are addressed should be prioritized in mental health policy. As the S20 countries prepare for the future, we need principles that stand to advance innovation, uphold human rights, and strive for the highest standards in mental health care.

Addressing Mental Health Challenges in Nepal: A Review of Policies, Status, and Strategies for Improvement

Mental health is a crucial aspect of overall well-being, encompassing an individual's emotional, psychological, and social well-being. In Nepal, mental health issues are a significant concern, with challenges related to governance, policy implementation, and service delivery. This review examines the mental health status in Nepal, analyzes existing policies, and proposes strategies for improvement. Databases, including ScienceDirect, Springer, NepJol, PubMed, and Google Scholar, were searched to gather relevant literature. The review identified key challenges in Nepal's mental health system, including the lack of a revised and fully implemented mental health policy, discriminatory provisions in the legislation, inadequate planning and funding at the district level, and limited workforce and resources. Despite positive developments, such as including mental health in general health policies and NGO involvement, significant barriers remain. To improve mental health in Nepal, it is essential to implement public policies favoring mental health, train individuals in personal skills, promote healthy lifestyles, and intervene through community actions. These strategies aim to create supportive environments and increase awareness of mental health issues, ultimately improving the population's overall well-being.

Towards comprehensive mental health promotion in Australian universities: A call to action with priorities for institutional change.

While comprehensive mental health promotion inherently involves individuals, there is an ongoing need to address large-scale determinants of people's mental health and wellbeing-particularly policies and environments. To have the best possible chance of creating positive change, mental health promotion must also work throughout key mediating structures such as places of education and work. This includes universities. Yet, in their efforts to address student and staff mental health and wellbeing, Australian universities have demonstrated limited uptake of comprehensive mental health promotion approaches. In this commentary, I discuss a recent review of Australia's higher education system-the Australian Universities Accord-as a catalyst for strengthening institutional action and change through a comprehensive mental health promotion lens. I discuss key findings-and silences-made clear throughout the review process. I then advocate several urgent priorities for university-level change-across institutional assessment, institutional accountability and performance, and institutional leadership and power-if Australia's universities are genuinely committed to improving mental health and wellbeing among students and staff.

A user perspective on youth mental health services: Increasing help‐seeking behaviour requires addressing service preferences and attitudinal barriers

AbstractAimAlthough the incidence of mental health problems is highest in young people, the majority do not seek help. Reducing the discrepancy between need for care and access to services requires an understanding of the user perspective, which is largely lacking. This study aimed to examine preferences for mental health service attributes and their relative importance among young people, as well as the potential impact on actual help‐seeking intentions.MethodsYouth aged 16–24 years (N = 258) participated in a discrete choice experiment. In addition to choosing which service would suit their needs most out of two service options in nine choice sets, participants were asked whether they would consult the chosen service in the case of mental health problems. Demographic information was also collected, as well as their current mental health status, experience with and perceived barriers to care. Panel mixed logit models were estimated.ResultsYoung people's preferences were mostly driven by the attribute ‘format’, with a preference for individual rather than group therapy. Other attributes, in order of importance, were ‘wait times’ (short), ‘cost’ (low), ‘healthcare professionals' expertise’ (particular experience with working with youth aged 12 to 25 years), and ‘location’ (house in a city). However, a majority of young people would not consult the service they had indicated, mainly due to attitudinal barriers such as wanting to deal with problems on their own (self‐reliance).ConclusionsAddressing psychological barriers to access care should be a priority in mental health policies. Furthermore, entry point services, in particular, should be able to provide the option of individual treatment.

The role of caregivers in mental health and child development policy and practice

The role of caregivers in mental health and child development policy and practice

Exploratory analysis on payment mechanisms to Community Mental Health Centers in Chile using mixed grounded theory.

Research on psychiatric deinstitutionalization has neglected that reforms in this field are nested in a health system that has undergone financial reforms. This subordination could introduce incentives that are misaligned with new mental health policies. According to Chile's National Mental Health Plan, this would be the case in the Community Mental Health Centers (CMHC). The goal is to understand how the CMHCpayment mechanism is a potential incentive for community mental health. A mixed quantitative-qualitative convergent study using grounded theory. We collected administrative production data between 2010 and 2020. Following the payment mechanism theory, we interviewed 25 payers, providers, and user experts. We integrated the results through selective coding. This article presents the relevant results of mixed selective integration. Seven payment mechanisms implemented heterogeneously in the country's CMHC are recognized. They respond to three schemes subject to rate limits and prospective public budget. They differ in the payment unit. They are associated with implementing the community mental health model negatively affecting users, the services provided, the human resources available, and the governance adopted. Governance, management, and payment unit conditions favoring the community mental health model are identified. A disjointed set of heterogeneously implemented payment schemes negatively affects the community mental health model. Formulating an explicit financing policy for mental health that is complementary to existing policies is necessary and possible.

Enhancing post-traumatic stress disorder patient assessment: leveraging natural language processing for research of domain criteria identification using electronic medical records

BackgroundExtracting research of domain criteria (RDoC) from high-risk populations like those with post-traumatic stress disorder (PTSD) is crucial for positive mental health improvements and policy enhancements. The intricacies of collecting, integrating, and effectively leveraging clinical notes for this purpose introduce complexities.MethodsIn our study, we created a natural language processing (NLP) workflow to analyze electronic medical record (EMR) data and identify and extract research of domain criteria using a pre-trained transformer-based natural language model, all-mpnet-base-v2. We subsequently built dictionaries from 100,000 clinical notes and analyzed 5.67 million clinical notes from 38,807 PTSD patients from the University of Pittsburgh Medical Center. Subsequently, we showcased the significance of our approach by extracting and visualizing RDoC information in two use cases: (i) across multiple patient populations and (ii) throughout various disease trajectories.ResultsThe sentence transformer model demonstrated high F1 macro scores across all RDoC domains, achieving the highest performance with a cosine similarity threshold value of 0.3. This ensured an F1 score of at least 80% across all RDoC domains. The study revealed consistent reductions in all six RDoC domains among PTSD patients after psychotherapy. We found that 60.6% of PTSD women have at least one abnormal instance of the six RDoC domains as compared to PTSD men (51.3%), with 45.1% of PTSD women with higher levels of sensorimotor disturbances compared to men (41.3%). We also found that 57.3% of PTSD patients have at least one abnormal instance of the six RDoC domains based on our records. Also, veterans had the higher abnormalities of negative and positive valence systems (60% and 51.9% of veterans respectively) compared to non-veterans (59.1% and 49.2% respectively). The domains following first diagnoses of PTSD were associated with heightened cue reactivity to trauma, suicide, alcohol, and substance consumption.ConclusionsThe findings provide initial insights into RDoC functioning in different populations and disease trajectories. Natural language processing proves valuable for capturing real-time, context dependent RDoC instances from extensive clinical notes.