Access To Mental Health Services Research Articles

Anxiety and Depression Prevalence in Free Clinic Patients

Background: Disparities in mental health services are often observed in under-resourced low-income communities, which are at an increased risk for compromised mental health. By surveying patients at JayDoc Free Clinic, a student-run free clinic (SRFC) in Kansas City, Kansas, this study sought to as-sess the prevalence of depression and anxiety and compare screening outcomes among various de-mographic groups seeking safety-net care.Methods: From May through November 2022, patients aged 12 and older were offered a Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and demographic survey. Demo-graphic variables included household income, gender, insurance status, and race and ethnicity. GAD-7 and PHQ-9 questionnaire scores were categorized into minimal, mild, moderate, or severe catego-ries. Relationships between demographic variables and scores on screening questionnaires were an-alyzed using multivariable analyses, with linear regression and analysis of variance one-way tests for significance (p-value <0.05).Results: Of 232 participants who consented to the study, 222 completed the GAD-7 and 228 com-pleted the PHQ-9. In comparison to 2019 United States national data, the percentage of respondents experiencing anxiety and depression was greater across all severity classifications. Approximately 18.1% reported symptoms of moderate to severe anxiety and 21.5% reported symptoms of moderate to severe depression, compared to national distributions of 6.1% and 7%, respectively. Of 232 participants, 54 completed the demographic survey. There was no correlation between PHQ-9 scores or GAD-7 scores and gender, household income, insurance status.Conclusion: While no association was identified between screening outcomes and demographic var-iables, the findings that the prevalence of anxiety and depression at JayDoc SRFC is greater than na-tional rates reaffirm the need for accessible mental health services for patients receiving care at SRFCs. This study provides insight into the status of mental health in an SRFC patient population and discusses mental health screening implementation at SRFCs.

TELEPSYCHIATRY VS IN-PERSON CONSULTATION DURING COVID-19 PANDEMIC: A COMPARISON ACROSS DIAGNOSIS.

Since the onset of COVID-19 pandemic, telepsychiatry is being used at a massive scale, but without assessing its edge over traditional in-person consultation. The aim of this study was to compare the sociodemographic and clinical profile of cases seeking online consultations with those seeking in-person consultations when the second wave of COVID-19 pandemic hit India. In this record based cross-sectional study, we compared age, gender and clinical profile 6048 patients seeking in-person consultation with 2446 patients seeking teleconsultation. Patients with severe mental disorders and substance use disorders were more in the in- person group while those with common mental disorders (Depression, anxiety, and sexual disorders) were more in the telepsychiatry group. However, these differences were statistically non-significant. A non-significant but slightly lesser average age was noted in the telepsychiatry group across both male (p=0.44) and female gender (p=0.32). No significant difference was noted across both genders between both groups. This suggests that teleservices could serve as an alternative and innovative approach to bridge the treatment gap in psychiatry. This study draws attention to the need of expanding and strengthening telepsychiatry further, even after the pandemic that can impart convenient, affordable, and accessible mental health services.

207 Building a community-academic partnership to facilitate translational research and identify and reduce barriers to mental healthcare services and resources in the Rio Grande Valley of South Texas

OBJECTIVES/GOALS: Clinical and epidemiological studies focusing on Hispanics/Latinos are often designed by academic researchers with little input from mental health professionals in underserved communities. Our objective is to establish an academic-community partnership in South Texas to help improve mental health outcomes of Hispanics. METHODS/STUDY POPULATION: Hispanics in the Rio Grande Valley (RGV, South Texas) are burdened with high rates of diabetes and obesity, and interventions have been identified for these conditions, but there is less information about strategies that may help improve their mental health status and address needs. We have explored mental health and psychological factors in Hispanics/Latinos in Latin America (Gil etal., 2021) and consider community participation in the research process to be an understudied topic. Thus, in the present study, we recruited mental health professionals in the RGV to establish an academic-community partnership as a strategy to facilitate translational research that focuses on RGV Hispanics. Partners worked as a team to generate information, identify problems and solutions, and design future projects. RESULTS/ANTICIPATED RESULTS: Our academic team (at the University of Texas Rio Grande Valley) successfully established a partnership with the Cameron County Mental Task Force (CCMHTF), a non-profit organization in South Texas that seeks to “meet the mental and behavioral health needs of the people” in South Texas. The CCMHTF comprises 12 board members that are representative of RGV mental health providers: counselors, social workers, academic clinicians, hospital and county employees, and mental and behavioral health facility providers/clinicians. Our partnership generated qualitative descriptions of the mental health needs of RGV Hispanics/Latinos and barriers to access and utilization of mental health services in South Texas. In the future (phase 2 of the study), we plan to report results of focus groups and mental health assessments. DISCUSSION/SIGNIFICANCE: Hispanics/Latinos are underrepresented in clinical/translational research, and this lack of representation is particularly true for Hispanics/Latinos living along the U.S.-Mexico border of the RGV, South Texas. Our academic-community partnership may serve as a model to facilitate translational research in underserved Hispanic communities.

Stigma Associated with Mental Illness: Perspectives of Judges and Lawyers in Lebanon

IntroductionLegal professionals frequently encounter forensic mental health issues in the criminal justice system. These issues can significantly impact the outcome of cases, making it essential to understand the attitudes and perceptions of these experts towards mental illness. Despite a high number of individuals with mental illness in prisons, the availability of forensic mental health services is limited. While prior research has shown widespread stigma towards mental illness, there hasn’t been a study assessing the attitudes of judges and lawyers.ObjectivesThis study aims to investigate the stigma related to mental health among Lebanese legal professionals.MethodsAn online questionnaire was sent to judges and lawyers practicing in Lebanon. The survey included a section on demographics and personal data with the following scales: Reported and intended behavior scale (RIBS) which measures mental health stigma–related behavior and Perceived devaluation and discrimination scale (PDD) measuring the extent to which a person believes that most people will devalue or discriminate against someone with a mental illness.Results A total of 215 participants, with a mean age of 38.69 and a mean 13.16 years of experience, completed the questionnaire. Most were female (62.8%) and worked as civil attorneys (47.4%). Only a minority received instruction on mental health or mental health law during training (10.7% and 8.8%). About a quarter believed their education on mental health issues was sufficient (27%). Participants with positive attitudes (RIBS) were more likely to have a family member with a mental illness (p value = .001), feel comfortable handling cases involving mental health (p value = .001), and have lived with someone with a mental illness (p value = .007). Feeling adequately educated about mental health issues was associated with lower perceived stigma (PDDS, p value = .021). No significant associations with stigma scores were found for factors like age, gender, occupation, years of experience, contact with a mental health professional, taking psychotropic medications, disclosing personal mental health issues to friends or co-workers, receiving education on mental illness or mental health law, or working with individuals with mental health issues.ConclusionsThe findings imply that enhancing mental health education and awareness within the legal profession could be a key strategy to reduce stigma and improve the overall treatment of individuals with mental health issues within the criminal justice system in Lebanon.Disclosure of InterestNone Declared

Adolescent and caregiver perceptions of addressing mental health in inflammatory bowel disease.

Adolescents with inflammatory bowel disease (IBD) are at an increased risk of anxiety and depression compared to peers, but availability of mental health services in IBD clinics does not meet patients' needs, and use of primary care services for mental health screening and care is low. This study provides qualitative data regarding adolescent and caregiver perspectives on addressing mental health in IBD. Interviews were conducted with adolescents with IBD and caregivers of adolescents with IBD. Interview transcripts were coded and analyzed for prominent themes. Thirteen adolescents and fourteen caregivers were interviewed. Three primary themes emerged: mental health stigma makes discussing it more difficult, physician-adolescent trust makes conversations about mental health easier, and asking about mental health directly can help adolescents feel comfortable. Adolescents and caregivers highlighted the importance of considering each patient and their family individually when choosing how to discuss mental health. Fostering trust with adolescents with IBD is vital to addressing mental health. While encouraging standardized screening is important, the most patient-centered approach to mental health involves considering families individually to identify and address mental health challenges. Given the increased risk of anxiety and depression in pediatric patients with IBD, all providers encountering these patients should be equipped to discuss mental health non-judgmentally.

Mobile Application Software as Guidance and Counselling Tool for Students of Federal College of Education, Gidan Madi

This project aims to develop a Mobile Application Software as a Guidance and Counselling Tool for Students of Federal College of Education Gidanmadi, Sokoto State, Nigeria. The goal is to provide students with a convenient, accessible, and effective way to access mental health services and support. The project involves a needs assessment, literature review, conceptual framework development, user interface design, mobile application development, usability testing, data analysis, design changes and evaluation. The methodology will be tailored to the specific needs and goals of the research, and may involve different stages and methods depending on the context and resources available. The expected results of developing a mobile application software as a guidance and counselling tool for students include increased accessibility, improved student well-being, enhanced counselor efficiency, greater student engagement, increased student retention, and improved student satisfaction. At the end of the research the students can be able to use the mobile application software for easy access to counselling and guidance services that can help them cope with various challenges they face in their academic and personal life. Guidance and counseling, Information and communication technology, Mobile application

Adapting the Number of Questions Based on Detected Psychological Distress for Cognitive Behavioral Therapy With an Embodied Conversational Agent: Comparative Study.

The high prevalence of mental illness is a critical social problem. The limited availability of mental health services is a major factor that exacerbates this problem. One solution is to deliver cognitive behavioral therapy (CBT) using an embodied conversational agent (ECA). ECAs make it possible to provide health care without location or time constraints. One of the techniques used in CBT is Socratic questioning, which guides users to correct negative thoughts. The effectiveness of this approach depends on a therapist's skill to adapt to the user's mood or distress level. However, current ECAs do not possess this skill. Therefore, it is essential to implement this adaptation ability to the ECAs. This study aims to develop and evaluate a method that automatically adapts the number of Socratic questions based on the level of detected psychological distress during a CBT session with an ECA. We hypothesize that this adaptive approach to selecting the number of questions will lower psychological distress, reduce negative emotional states, and produce more substantial cognitive changes compared with a random number of questions. In this study, which envisions health care support in daily life, we recruited participants aged from 18 to 65 years for an experiment that involved 2 different conditions: an ECA that adapts a number of questions based on psychological distress detection or an ECA that only asked a random number of questions. The participants were assigned to 1 of the 2 conditions, experienced a single CBT session with an ECA, and completed questionnaires before and after the session. The participants completed the experiment. There were slight differences in sex, age, and preexperimental psychological distress levels between the 2 conditions. The adapted number of questions condition showed significantly lower psychological distress than the random number of questions condition after the session. We also found a significant difference in the cognitive change when the number of questions was adapted based on the detected distress level, compared with when the number of questions was fewer than what was appropriate for the level of distress detected. The results show that an ECA adapting the number of Socratic questions based on detected distress levels increases the effectiveness of CBT. Participants who received an adaptive number of questions experienced greater reductions in distress than those who received a random number of questions. In addition, the participants showed a greater amount of cognitive change when the number of questions matched the detected distress level. This suggests that adapting the question quantity based on distress level detection can improve the results of CBT delivered by an ECA. These results illustrate the advantages of ECAs, paving the way for mental health care that is more tailored and effective.

“I didn’t want to leave my country” – mental health services as experienced by Bosnian refugees in Australia

PurposeDespite the substantial body of international research exploring the effects of forced migration on mental health and the obstacles faced by refugee cohorts in accessing mental health services, there is a lack of in-depth studies specifically focusing on Bosnian refugees in Australia – one of the largest ethnic groups of displaced peoples. This qualitative investigation seeks to convey the experiences of mental health services by five Bosnian refugees in Melbourne, highlighting perceived pathways and barriers to service utilisation. This study aims to address two primary research questions: firstly, what characterises the experiences of Bosnian refugees in Australia when accessing mental health services? Secondly, what are the main barriers encountered by this population when seeking mental health services?Design/methodology/approachThis study used qualitative inquiry and in-depth interviews to investigate the experiences of Bosnian refugees with mental health services in Australia. Data was collected through face-to-face interviews with five Melbourne-based Bosnian refugees who had previously accessed mental health services. Participants were recruited from community groups or associations using purposive sampling. Thematic analysis was used.FindingsKey themes were revealed, such as the crucial role of social and community services, preferences for individual vs group therapy, potential re-traumatisation from therapeutic engagement, distrust of government-run mental health services and concerns regarding psychopharmaceutical prescription practices. Addressing barriers to mental health service access necessitates a multifaceted approach, including flexible social and community service support, an increased number of co-ethnic professionals and a recognition of cultural variations for effective service provision. Implementing these strategies can enhance help-seeking behaviours, provide culturally appropriate mental health services and improve the experiences of Bosnian refugees in Australia.Originality/valueTo the best of the authors’ knowledge, this study is the first to qualitatively explore how Bosnian refugees in Melbourne perceived the adequacy and availability of mental health services upon arrival to Australia. They are a large and potentially vulnerable community, due to experiences of war trauma and dislocation from country of origin. A lack of understanding regarding how this cohort engage with mental health services can lead to persistent inequities and ineffective service provision. This study identifies unique experiences and perspectives of Bosnian refugee participants, including distrust of government-run mental health services, and concerns regarding psychopharmaceutical prescription practices. This research is expected to contribute positively to the discourse on mental health service provision for Bosnian refugees and wider refugee communities in Australia.

The experience of seeking and accessing help from mental health services among young people of Eastern European backgrounds: A qualitative interview study.

Most lifetime mental health problems (MHP) start before the age of 25. Yet young people-particularly those of minority backgrounds-often do not seek or access professional help. In the UK, young people of Eastern European (EE) backgrounds represent a large minority group; however, little is known about their experiences of MHP and help-seeking. In this study, we aim to understand the help-seeking process from the perspectives of EE young people. We used a qualitative study design with semi-structured individual interviews. The results were analysed using reflexive thematic analysis. Twelve young people (18-25 years) of EE backgrounds, living in Oxfordshire, UK, took part. All participants had experienced a severe MHP and were identified in the community. EE young people's experiences of MHP and help-seeking were driven by a sense of being caught between different cultures and simultaneously needing to navigate the potentially contrasting expectations of both cultures. This process was reinforced or tempered by the perceived continuing influence of young people's families, that is, families with more open views about MHP made it easier for young people to navigate through the process of help-seeking. Young people's internalised cultural and familial beliefs about MHP affected their decision-making when experiencing difficulties, their levels of trust in services, and perceived sense of resourcefulness and ability to cope. Recognising and responding to the cultural tension that young people of EE backgrounds may experience can help us to develop more accessible and inclusive mental health services.

Insights of Healthcare Workers and Community Members on Mental Health Perception and Practices in Meru County, Kenya

Mental health is a neglected field in many low and middle-income countries, such as Kenya, where information on the prevalence of mental health conditions is scarce. This problem is aggravated by an uneven distribution of mental health service providers and widespread ignorance and stigma around mental illness in the general population. The study in Meru County, Kenya, aimed to assess the knowledge, attitudes, and practices of healthcare workers and community members regarding mental health. The study, a descriptive cross-sectional survey, involved 535 community members and 109 healthcare workers, employing both qualitative and quantitative methods. Data was collected through household surveys, key informant interviews, and focus group discussions and analysed using univariate frequencies, descriptive statistics, and thematic analysis. The study revealed that 39% of community members had a family member with a mental health condition, while 68% of HCWs had been diagnosed with such conditions. Mental illness was often attributed to supernatural causes, genetics, substance abuse, and socio-economic pressures. A significant gap was found in the availability of counselling services in health facilities, with only 29.4% of HCWs reporting their presence. The perception of the affordability and accessibility of mental health services varied greatly between HCWs and community members. Additionally, while HCWs reported the availability of free medication, community members experienced shortages. The study also noted differing attitudes towards patients with mental illness in terms of respect and dignity and highlighted the use of traditional healers and religious leaders for mental health issues. This study contributes valuable insights into the state of mental health in Kenya, highlighting the high burden of mental illness, limited availability of services, and prevalent myths and misconceptions. It underscores the need for improved healthcare worker training, public awareness, and stronger health systems to address mental health issues effectively in Kenya and similar rural environments

Assessment of the feasibility of a community-based mental health training programme for persons with disabilities by non-specialists from different stakeholders’ perspectives in Bangladesh

IntroductionBangladesh is a developing country where 11% of the population has at least one disability, but no community-level mental health service is available. There is limited evidence of the burden of mental health issues and health-seeking behaviour among this population. This study assessed the feasibility of a training intervention for persons with disabilities, where peer support providers provided community-based disability-inclusive mental health services.MethodsFour stakeholder groups participated in this qualitative study: peer responders (trained persons with disabilities), trainers, representatives of organisations of persons with disabilities and disability-specific organisations, and officials of international and national non-governmental organisations. Two types of qualitative interviews were used to collect data, and thematic analysis techniques were utilised.ResultStakeholders perceived the peer responder training programme as acceptable for persons with disabilities to develop themselves as peer support providers, with potential benefits including increased mental health literacy, ensuring accessible mental health services, and improving the well-being of persons with disabilities. Potential challenges included receiving training and delivering services. Increased training duration, more fieldwork, supervision opportunities, and refresher training were recommended to mitigate training challenges. Financial support and formal community recognition were deemed necessary for training delivery.ConclusionThe peer responder training programme was feasible to ensure accessible mental health services for persons with disabilities, build a workforce to screen for mental health conditions, and provide appropriate referrals. A multi-sectoral collaboration of government and non-governmental institutions is recommended to policy advocates to expand the peer responder training programme in the mainstream mental healthcare system.

The Role of Cultural Factors in Attention Deficit Hyperactivity Disorder (ADHD) Diagnosis in Children in Nigeria

This paper explores the influence of cultural factors on the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) in Nigerian children. Examining traditional beliefs, societal norms, and the impact of stigma, the study addresses the challenges within the cultural context. Critiquing Western diagnostic criteria and exploring alternative explanatory models rooted in indigenous perspectives highlight the need for a culturally informed diagnostic approach. Additionally, the paper discusses the limited availability of mental health services, cultural barriers to seeking professional help, and the significance of cultural competence in ADHD diagnosis. Collaborative efforts with traditional healers and community leaders are emphasized. Ultimately, the study aims to contribute to a more inclusive and culturally sensitive approach to ADHD diagnosis in Nigeria.

Perceived anxiety and depression and associated factors among women inmates with a long-term sentence in Thailand.

In Thailand, the growing prevalence of mental health problems among the increasing number of adult female prisoners has emerged as a significant public health concern. However, studies on the health of women prisoners are primarily conducted in Western societies, and studies in other countries are rare. Thailand, a non-western country, is no exception to this. The objectives of this study were to assess the current levels of anxiety and depression among women drug offenders in Thailand and to identify possible associated factors. Data were collected from a sample consisting of 554 women drug offenders serving sentences of eight years or more. Stratified random sampling with proportionate stratification was employed during the data collection. The female inmates were being held in three categories of prisons: correctional institutions, central prisons, and provincial prisons. A single question was used to measure self-perceived levels of anxiety and depression: none, moderate, or substantial. Ordered logit regression was employed in the data analysis. One out of five (21.1%) of the inmates in the sample reported no perceived current anxiety and depression, 61.7% reported moderate anxiety and depression, and 17.1% reported having substantial perceived levels of anxiety and depression. It was found that chronic health conditions or disease, concerns about economic status, and feelings of shame were associated with the perceived anxiety and depression reported by the inmates. The study's findings suggest that integrated mental health services that emphasize a holistic approach that acknowledges the intersectionality of women's mental health and societal gender roles should be provided in prisons. Regular mental health screening and accessible mental health services are essential for all incarcerated women. Empowerment programs during confinement can boost self-esteem and thus lead to better post-release outcomes. The government should also implement programs to alleviate the financial burden on prisoners' households.

Reducing wait times and avoiding unnecessary use of high-cost mental health services through a Rapid Access and Stabilization Program: protocol for a program evaluation study.

Emergency psychiatric care, unplanned hospital admissions, and inpatient health care are the costliest forms of mental health care. According to Statistics Canada (2018), almost 18% (5.3 million) of Canadians reported needing mental health support. However, just above half of this figure (56.2%) have reported their needs were fully met. In light of this evidence there is a pressing need to provide accessible mental health services in flexible yet cost-effective ways. To further expand capacity and access to mental health care in the province, Nova Scotia Health has launched a novel mental health initiative for people in need of mental health care without requiring emergency department visits or hospitalization. This new service is referred to as the Rapid Access and Stabilization Program (RASP). This study evaluates the effectiveness and impact of the RASP on high-cost health services utilization (e.g. ED visits, mobile crisis visits, and inpatient treatments) and related costs. It also assesses healthcare partners' (e.g. healthcare providers, policymakers, community leaders) perceptions and patient experiences and satisfaction with the program and identifies sociodemographic characteristics, psychological conditions, recovery, well-being, and risk measures in the assisted population. This is a hypothesis-driven program evaluation study that employs a mixed methods approach. A within-subject comparison (pre- and post-evaluation study) will examine health services utilization data from patients attending RASP, one year before and one year after their psychiatry assessment at the program. A controlled between-subject comparison (cohort study) will use historical data from a control population will examine whether possible changes in high-cost health services utilization are associated with the intervention (RASP). The primary analysis involves extracting secondary data from provincial information systems, electronic medical records, and regular self-reported clinical assessments. Additionally, a qualitative sub-study will examine patient experience and satisfaction, and health care partners' impressions. We expect that RASP evaluation findings will demonstrate a minimum 10% reduction in high-cost health services utilization and corresponding 10% cost savings, and also a reduction in the wait times for patient consultations with psychiatrists to less than 30 calendar days, in both within-subject and between-subject comparisons. In addition, we anticipate that patients, healthcare providers and healthcare partners would express high levels of satisfaction with the new service. This study will demonstrate the results of the Mental Health and Addictions Program (MHAP) efforts to provide stepped-care, particularly community-based support, to individuals with mental illnesses. Results will provide new insights into a novel community-based approach to mental health service delivery and contribute to knowledge on how to implement mental health programs across varying contexts.

The impact of long-term care insurance pilot on the mental health of older adults: Quasi-experimental evidence from China

The Chinese government launched pilot programs for a long-term care insurance system in response to the ongoing increase in the aging population. This study uses the difference-in-differences (DID) model to analyze the impact of long-term care insurance on older adults' mental health based on China Health and Retirement Longitudinal Study (CHARLS) four-period panel data from 2011 to 2018. This study found that long-term care insurance reduced Center for Epidemiological Studies Depression Scale (CES-D) scores among older adults by 1.059 points. Moreover, there was an improvement of 0.181 and 0.870 points in mental status and scenario memory scores, respectively. The impact of the long-term care insurance pilot program on improving the mental health of older adults was more pronounced, especially for those with chronic diseases or disabilities as well as those living in rural and western regions. This study also revealed that long-term care insurance enhances mental health by reducing medical expenses and increasing daily companionship and social interaction. Therefore, a pilot study of long-term care insurance showed a significant improvement in the mental health of older adults. To provide a comprehensive care service system for older adults, the government should expand the scope of the pilot program and increase the accessibility of mental health services for older adults.

Pediatric Mental Health Care and Scope-of-Practice Expansions.

To examine the association between psychologist and nurse practitioner scope-of-practice (SoP) regulations and pediatric mental health service access. A nationally representative sample of children with mental health needs was identified using 5 years of National Survey of Children's Health (2016-2020). Utilization was measured in two ways: (1) unmet mental health care needs and (2) receipt of mental health medication. Expanded SoP for psychologists and nurse practitioners was measured based on the child's state of residence and the year of the survey. The associations between both SoP expansion and both outcomes were assessed using logistic regression models adjusted for multiple covariates. The probability of having unmet mental health needs was 5.4 percentage points lower (95% CI - 0.102, - 0.006) for children living in a state with psychologist SoP expansion; however, there was no significant difference in unmet mental health needs between states with and without NP SoP expansion. The probability of receiving a mental health medication was 2.0 percentage points higher (95% CI 0.007, 0.034) for children living in a state with psychologist SoP expansion. Conversely, the probability of receiving a mental health medication was 1.5 percentage points lower (95% CI - 0.023, - 0.007) for children living in a state with NP SoP expansion. Expanded SoP for psychologists is associated with improved access to pediatric mental health care in terms of both unmet need and receiving medication. Expanded SoP for NPs, however, was not associated with unmet need and lower receipt of medication.

Translation and cross-cultural adaptation of seventeen widely-used assessment instruments for child and adolescent mental health in Greece

BackgroundIn the context of Greece, many instruments measuring constructs pertinent to child and adolescent mental health lacked a locally-validated, freely-available version. As part of a nationwide survey, we translated and cross-culturally adapted a collection of seventeen brief, largely-employed assessment tools that can be used at scale.MethodsThis study is part of the Child and Adolescent Mental Health Initiative in Greece (CAMHI), a capacity-building program focusing on enhancing mental health care for children and adolescents living in Greece. We conducted a nationwide survey assessing mental health symptoms, parenting practices, service availability and quality, mental health literacy and stigma, and professional practices within the country. As part of this process, we selected outcomes and instruments after consulting the International Consortium for Health Outcomes Measurement (ICHOM) and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). From our selection, we identified 17 instruments that did not have a Greek-validated version available for use. These instruments were translated and cross-culturally adapted following a structured procedure, including independent back-and-forth translations, synthesis of versions, expert revision, and pilot testing. Some instruments were slightly modified to meet CAMHI survey purposes.ResultsA cross-culturally adapted version in Greek was made available for the following instruments: Pediatric Symptoms Checklist (PSC); Deliberate Self Harm Inventory (DSH) (modified); Child and Adolescent Trauma Screen-2 (CATS-2); ABCD Screen Use (modified); Swanson, Nolan, and Pelham-IV (SNAP-IV); Parent Behavior Inventory (PBI); Mental Health Literacy Scale (MHLS)—(modified); Australian Mental Health Vignettes; Reported and Intended Behavior Scale (RIBS); Barriers to Access to Care (BACE) (modified); Experience of Service Questionnaire (ESQ) (modified); and Multitheoretical List of Therapeutic Interventions (MULTI-30) (modified).ConclusionA collection of these widely-used assessment tools is now adapted for the local context and freely accessible at [https://osf.io/crz6h/]. Researchers and health professionals in Greece can utilize this resource to screen, evaluate, and monitor various constructs related to mental health in accordance with the most effective practices.

Prevalence and acceptability of psychological and/or economic intimate partner violence, and utilization of mental health services by its survivors in Lithuania.

Lithuania has one of the highest averages in the European Union when it comes to psychological and/or economic intimate partner violence (PE-IPV). IPV survivors are several times more likely to have mental health conditions than those without IPV experiences. The aim of this article is to study the prevalence, characteristics and attitudes of PE-IPV survivors in Lithuania, and the predictors of them accessing mental health services. A cross-sectional study based on a national survey representative of the adult population. The survey was implemented by a third-party independent market research company employing an online survey panel. Logistic regression models were used in the analysis. Almost 50% of women in Lithuania experience PE-IPV. Females are significantly more likely to experience it than males. The vast majority of women find PE-IPV unacceptable; however, only one-third of survivors seek any type of help. Only one-tenth approach mental health services, with divorcees being at higher odds of doing so. Further research is needed to explore predictors and contextual factors of why IPV survivors seek mental healthcare, or not. Policy implications include the need to eliminate IPV and mental health stigma; develop accessible mental health services and effective treatment approaches.

Reconsidering the discontinuation of M.Phil. programs in clinical psychology and psychiatric social work: An imperative for India's mental health future.

This viewpoint critically examines the New Education Policy (NEP) 2020's decision to discontinue M.Phil. programs in Clinical Psychology and Psychiatric Social Work in India. It explores the crucial roles these programs play in addressing the country's shortage of mental health professionals and evaluates the potential impact of this decision on mental healthcare. The article advocates for the necessity of these programs in maintaining the quality and accessibility of mental health services and calls for a reconsidered policy approach that balances educational reforms with the specialized needs of the mental health sector.

Depression care integration in tuberculosis services: A feasibility assessment in Pakistan.

The co-occurrence of depression among tuberculosis (TB) patients is a critical issue, contributing to poor treatment outcomes, prolonged hospitalisations and increased healthcare expenses. The objective of this study was to assess the feasibility of delivering a co-designed depression care pathway within TB services in Pakistan. Mixed-method study. Routine depression screening for TB patients was conducted at three TB facilities in Peshawar, Pakistan, encompassing primary, secondary and tertiary care settings. All patients aged 18 or above (male and female) attending the three TB facilities between November 2021 and February 2022 were included in the study using the consecutive sampling technique. A total of 301 people with confirmed TB, within the past 4 weeks, visited the three TB care facilities; 191/301 patients were screened for depression. Approximately 35% of the 191 TB patients screened positive for depression, with varying severity levels. Qualitative findings highlighted the acceptability of integrated depression care, emphasising the importance of open communication and empathetic attitudes. Barriers to integration include stigma, logistical challenges, patient noncompliance and cost burdens. Facilitators included the empathetic attitude of healthcare providers and the availability of mental health services within the same facility. There is a high burden of depression in patients with TB, highlighting the pressing need for mental health support in this population. Acceptability of integrated care was evident, with factors such as co-located mental health services, training healthcare providers and provider empathetic attitudes playing a crucial role. Further research is required to evaluate the effectiveness of the integrated TB-depression screening systems towards improved health outcomes, implementation, scalability and impact on the broader healthcare system. To create a more inclusive and comprehensive TB and depression care pathway, we gathered input from both service providers and service users (TB patients, their carers). Reflective meetings with community leaders, social activists and health professionals from various sectors were also conducted during pathway delivery to get their insights. Power, gender and age imbalances were addressed by encouraging participation of patients and carers across gender and age groups. This approach ensured that the perspectives of all stakeholders were considered in the development of the care pathway.