Access To Mental Health Services Research Articles

A cross-sectional study of prevalence and correlates of self-harm and suicidal ideation in older adults with dual sensory loss.

Loss of vision and hearing (dual sensory loss: DSL) presents risk factors for self-harm and/or suicidal ideation, although this has rarely been examined for older adults. This study estimated the prevalence of thoughts about self-harm and suicide ideation in a national sample of adults with DSL in Denmark. All 513 people aged 50 years or older who were registered with the national provider of service for people with DSL in Denmark were eligible to participate. Surveys were returned by 290 participants. Participants were mostly female (70%) and aged 50-100 years (M=81). Surveys contained questions related to thoughts of self-harm and suicide as well as physical, mental, and social wellbeing. In total, 17% of participants reported thoughts of self-harm and/or suicide in the past two weeks. Not participating in social activities, poorer self-rated health, and presence of more depressive symptoms were associated with self-harm and suicidal ideation. Factors that were associated with self-harm and suicidal ideation were lower levels of emotional support, non-participation in social activities, and symptoms of depression. These finding highlight the importance of ongoing mental health screening and support for older adults with DSL, especially in ensuring accessible mental health services.

Longitudinal experiences and risk factors for common mental health problems and suicidal behaviours among female sex workers in Nairobi, Kenya.

Female sex workers (FSWs) are at high risk of mental health problems and suicide risk. Few longitudinal studies have examined risk factors for poor mental health among FSWs. Maisha Fiti is a longitudinal study among FSWs randomly selected from Sex Worker Outreach Programme clinics across Nairobi. Behavioural-biological survey data were collected at baseline (n = 1003, June-December 2019), midline (n = 366) (Jan-March 2020) and endline (n = 877) (June 2020-Jan 2021). Women reporting mental health problems were offered counselling services. Multivariable mixed logistic regression models were used to examine factors associated with mental health problems and suicidal behaviours. There was a decline in the proportion of women reporting any mental health problem (depression and/or anxiety and/or PTSD) (baseline: 29.9%, midline: 13.3%, endline: 11.8%). There was strong evidence that any mental health problem was associated with recent hunger (aOR 1.99; 95% CI 1.37-2.88) and recent violence from non-intimate partners (2.23; 95% CI 1.55-3.19). Recent suicidal behaviour prevalence was similar across survey rounds (baseline: 10.2%; midline: 10.2%; endline: 10.4%), and was associated with recent violence from non-intimate partners (aOR 1.96; 95% CI 1.31-2.95), recent hunger (aOR 1.69; 95% CI 1.15-2.47) and having an additional employment to sex work (aOR 1.50; 95% CI 1.00-2.23). Our study found a decline in mental health problems but high levels of persistent suicidal behaviours among FSWs. Syndemic risk factors including food insecurity and violence were longitudinally associated with mental health problems and recent suicidal behaviours. There is a need for accessible mental health services for FSWs, alongside structural interventions addressing poverty and violence.

Perceived Barriers And Facilitators To Access Mental Health Services Among Pakistani Adolescents

Introduction: Mental health problems have a high rate of prevalence among adolescents in Pakistan, however, the tendency to access mental health professionals for the treatment has been low due to some barriers. The current review focuses on those barriers and identifies the relevant facilitators in reducing the barriers to enhance the well-being of adolescents. Methodology: By considering the objective of the study, the adolescents whose age ranged between 10-19 years were included, the research work done during 2012-2018 was accessed through Pub Med, Science Direct, Google Scholar and SAGE articles. The key terms mental health services, adolescents, barriers, facilitators were used to locate the articles. Result: Most prevailing barriers were found as stigmatizing belief, lack of awareness, preference for other sources and scarcity of mental health services. Social support from significant others, finding an expression for the problems, customized mental health advertisements, increased awareness about mental health and providing online services for mental health problems can facilitate for reducing reluctance in adolescents for accessing mental health help services. Discussion: Mental health awareness programs can facilitate in reducing the above-mentioned barriers. This review can make it easier to lower down the perceived barriers among adolescents which consequently encourage them to seek help they require. Recommendations for future research are further discussed.

Asian-Americans in COVID-19: A Literature Review of Mental Health Status and Service Use

Objectives: Reports of racial discrimination against Asian Americans has surged during the Covid-19 pandemic. The goal of this paper is to provide an overview of Asian Americans' mental health status during Covid-19 and an assessment of the barriers and disparities within Asian Americans mental health service delivery. Methods: Four databases and the publisher The Lancet were chosen to search journal articles regarding Asian Americans' mental health status and service use. The increasing racial discrimination was examined as a critical parameter to assess Asian Americans' mental health status. The accessibility of mental health services and the responsiveness of Asian Americans appropriate needs were studied by gender, subgroups and other moderating factors. Results: A total of 49 studies met the review criteria. Asian Americans encountered increasing coronavirus-related discrimination and presented a deteriorated mental health state during Covid-19. A high rate of informal/non-professional mental health service use and an overall low rate of professional service use were found in Asian Americans. Inaccurate self-reporting and diagnosis, language barriers, financial difficulty, and the lack of health insurance and education are contributing factors of the unmet needs of Asian Americans when seeking mental health services. Conclusions: Possible reasons that explain Asian Americans mental health issues reside in socio-economic factors such as cultural differences, limited English proficiency, and low prevalence rates of health insurance and education. Evidence-based policies against racism, inter-ethnic connections, and cultural identity understanding are needed on national and community levels to address Asian hate crimes and discrimination. Virtual mental health services, culture-specific forms of intervention and treatment responses and appropriate education about Asian American mental health issues can help improve Asian Americans' mental health conditions.

A homeschool-based cognitive behavioral program to improve adolescent mental health.

Anxiety and depression are prevalent in the adolescent population and can have significant consequences. Treatment recommendations are established but rates of utilization remain low, often due to a lack of access to mental health providers. Availability of mental health services in a school-based setting may increase access, but homeschooled children do not have access to these services. Additionally, the COVID-19 pandemic has increased the number of homeschooled children and compounded the problem of adolescent mental health disorders. This pilot evidence-based practice project aimed to increase access to cognitive behavioral therapy (CBT) in adolescents. Eight students from a local homeschool cooperative participated in the Creating Opportunities for Personal Empowerment (COPE) program. A Friedman test was used to evaluate median differences on anxiety and depression screening instruments at baseline, program completion, and 1 month after the program. Students also completed an adapted COPE program evaluation. Median scores on screening instruments decreased from pre-COPE to 1 month after, although results were not statistically significant. Students reported that the COPE program was helpful, and they learned new ways to deal with their thoughts, feelings, and behaviors. COPE is a feasible option to increase access to CBT in a homeschool setting.

Albanian Migrants in Cyclades: Contact with Mental Health Services and Implications for Practice

The purpose of this study was to examine the potential differences between Albanian migrants and Greeks in the islands of Paros and Antiparos with regard to seeking help from the local public mental health service, namely the Mobile Mental Health Unit of NE Cyclades Islands (EPAPSY-NGO). The study’s instruments include the Global Assessment of Functioning (GAF) and a questionnaire for recording psychosocial profile data and information concerning contact with the services. The results showed that significantly less Albanian migrants contacted the mental health services in the past in comparison to Greeks. When using the service, the Albanians were more likely to see a psychiatrist in the Unit, rather than a psychologist-psychotherapist, and they more often received prescriptions for medication. There was a significantly higher dropout rate among Albanian migrants. This study highlights the different aspects of access and use of mental health services among Albanian migrants compared with native residents. Further research should focus on the factors related to early dropouts and difficulties accessing mental health services in rural areas, in order to develop more focused and effective interventions and improve the quality of care provided.

The case for a diversion option to trauma-informed community-based primary mental health services for young people following early encounters with police.

There is a convergence between the peak age of onset of mental illness, offending behaviour and associated risk of crime victimization. This study compared self-reported childhood maltreatment and mental health outcomes among a cohort of help-seeking young people who disclosed either a prior criminal charge, crime victimization, or both, to those who did not report any such experiences. The outcomes may inform the development of a diversion option for young people at a first or early encounter with police. The Transitions Study (N= 802; mean age=18.3 years; 66% female) baseline and 12-month follow-up data were analysed in relation to childhood maltreatment (Childhood Trauma Questionnaire) and changes in mental health (Kessler Psychological Distress Scale and Social and Occupational Functioning Assessment Scale) among young people attending headspace centres in Australia. Outcomes were compared between those young people reporting a prior criminal charge and/or crime victimization and those who did not. Young people who reported a prior criminal charge or crime victimization reported higher frequency and severity of childhood maltreatment, than those who did not. Both groups reported a reduction in psychological distress following youth mental health service access at 12-month follow-up, however functional improvement was only evident for young people who did not report a prior criminal charge or crime victimization. Higher rates of reported childhood maltreatment and reduced psychological distress following service access supports trialling a diversion option to a trauma-informed community-based primary mental health service for young people following an early encounter with police.

Risk perception, mental health impacts and coping strategies during COVID-19 pandemic among Filipino healthcare workers.

BackgroundCOVID-19 pandemic has caused an extraordinary situation, especially for the healthcare workers (HCWs), leading to increased psychological stress. The aim of the study was to estimate the prevalence of different grades of anxiety and depression across different centers in the Philippines and identify demographic factors associated with them.Design and MethodA cross-sectional, web-based, multi-center study was conducted among HCWs of Philippines from April 20- May 20, 2020. The study instruments used were the Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9). Risk perception scores were analyzed using Mann-Whitney and Kruskal-Wallis test. Logistic regression was done to identify factors significantly associated with symptoms of anxiety and depression determined.ResultsA total of 516 HCWs were included in the study. Most of them have anxiety symptoms (70.74%), but only half of them have symptoms of depression (50.97%). In addition, gender, age, marital status, living status, occupation, work premises, and availability of mental health services were significantly associated with the participants' anxiety symptoms. In contrast, gender, marital status, occupation, and work premises were significantly associated with depression symptoms.ConclusionThis study reiterates the fact and demonstrates that COVID-19 has disrupted the mental well-being of HCWs in the Philippines. Majority of HCW was psychologically affected by COVID-19. Therefore, there is a dire need to address mental illness amongst HCWs and frame guidelines based on proven algorithms to overcome these mental illnesses.

Characteristics of people who died by suicide: record review of two and half years from the National Referral Hospital, Bhutan

Introduction
 To address the suicide issue in the country, the Royal Government of Bhutan implemented a three year suicide prevention action plan from 1st July 2015 to 30th June 2018. As part of that action plan a national suicide registry was established under the Ministry of Health in January 2016 to collect comprehensive national data on suicide. The purpose of this study is to generate national information on suicide by analysing the suicide cases investigated and reported to suicide registry by the Forensic Department during the first two and half years. 
 Methodology
 The study is a descriptive, retrospective and quantitative analysis of the suicide cases investigated by the Forensic Department from 1st January 2016 to 30th June 2018. The variables included the characteristics of the suicide victims.
 Result
 Majority of the victims were young adults with no or low education and were either unemployed or employed with less income. 56.7% of the victims were women. Majority of them did not have physical illness or disability. About 45% had some form of mental health issues. Majority of them experienced some form of acute stressful event prior to committing suicide.
 Conclusion
 Improved socioeconomic conditions through gainful employment, easily accessible mental health services and social support networks as well as population with good social and emotional skills will contribute to prevention of suicide in the country. 

Assessment and treatment of depression in people with multiple sclerosis: A qualitative analysis of specialist clinicians’ experiences

BackgroundDepression is common in people with multiple sclerosis (MS), with lifetime prevalence estimates between 25 and 50%. Depression is commonly underdiagnosed and undertreated in people with MS. This qualitative study assessed current practices, as well as facilitators and required resources to improve detection and management of depression in people with MS. MethodsMS clinicians living in Australia were recruited through MS healthcare provider clinics and networks for online interviews. Interviews were transcribed and coded in NVivo for framework analysis. ResultsParticipants included 15 MS specialists: nine nurses and six neurologists. Participants appreciated that depression was a common symptom of MS, and that untreated depression impacted patients’ wellbeing, medication adherence, capacity for self-care, employment, and interpersonal relationships. Participants did not routinely screen for depression and noted that they lack the time and skills to manage depression once identified, most often recommending patients see their general practitioner. Clinicians recognised that people with MS commonly experience barriers to identifying and managing depressive symptoms, however few clinics provide information or discussion about depression as a symptom of MS with patients. ConclusionParticipants indicated a need for evidence-based guidance, more education and training to improve practices including screening for depression, and an urgent need for local referral pathways to affordable and accessible mental health services for people with MS. Findings suggest a need for better collaborative management of depression and improvement of systematic practices related to depression information, screening and treatment support.

Organizational Readiness for Implementing an Internet-Based Cognitive Behavioral Therapy Intervention for Depression Across Community Mental Health Services in Albania and Kosovo: Directed Qualitative Content Analysis.

BackgroundThe use of digital mental health programs such as internet-based cognitive behavioral therapy (iCBT) holds promise in increasing the quality and access of mental health services. However very little research has been conducted in understanding the feasibility of implementing iCBT in Eastern Europe.ObjectiveThe aim of this study was to qualitatively assess organizational readiness for implementing iCBT for depression within community mental health centers (CMHCs) across Albania and Kosovo.MethodsWe used qualitative semistructured focus group discussions that were guided by Bryan Weiner’s model of organizational readiness for implementing change. The questions broadly explored shared determination to implement change (change commitment) and shared belief in their collective capability to do so (change efficacy). Data were collected between November and December 2017. A range of health care professionals working in and in association with CMHCs were recruited from 3 CMHCs in Albania and 4 CMHCs in Kosovo, which were participating in a large multinational trial on the implementation of iCBT across 9 countries (Horizon 2020 ImpleMentAll project). Data were analyzed using a directed approach to qualitative content analysis, which used a combination of both inductive and deductive approaches.ResultsSix focus group discussions involving 69 mental health care professionals were conducted. Participants from Kosovo (36/69, 52%) and Albania (33/69, 48%) were mostly females (48/69, 70%) and nurses (26/69, 38%), with an average age of 41.3 years. A directed qualitative content analysis revealed several barriers and facilitators potentially affecting the implementation of digital CBT interventions for depression in community mental health settings. While commitment for change was high, change efficacy was limited owing to a range of situational factors. Barriers impacting “change efficacy” included lack of clinical fit for iCBT, high stigma affecting help-seeking behaviors, lack of human resources, poor technological infrastructure, and high caseload. Facilitators included having a high interest and capability in receiving training for iCBT. For “change commitment,” participants largely expressed welcoming innovation and that iCBT could increase access to treatments for geographically isolated people and reduce the stigma associated with mental health care.ConclusionsIn summary, participants perceived iCBT positively in relation to promoting innovation in mental health care, increasing access to services, and reducing stigma. However, a range of barriers was also highlighted in relation to accessing the target treatment population, a culture of mental health stigma, underdeveloped information and communications technology infrastructure, and limited appropriately trained health care workforce, which reduce organizational readiness for implementing iCBT for depression. Such barriers may be addressed through (1) a public-facing campaign that addresses mental health stigma, (2) service-level adjustments that permit staff with the time, resources, and clinical supervision to deliver iCBT, and (3) establishment of a suitable clinical training curriculum for health care professionals.Trial RegistrationClinicalTrials.gov NCT03652883; https://clinicaltrials.gov/ct2/show/NCT03652883

Gender-Affirming Mental Health Care Access and Utilization Among Rural Transgender and Gender Diverse Adults in Five Northeastern U.S. States.

Transgender and gender diverse (TGD) populations are burdened by substantial mental health disparities. The mental health needs of TGD people in rural areas remain largely unknown. This study sought to characterize gender-affirming mental health service access and utilization in a sample of TGD adults from predominantly rural areas in the northeastern United States. A nonprobability sample of 241 TGD adults was recruited from 25 counties across Connecticut, Massachusetts, New Hampshire, New York, and Vermont. Participants completed a cross-sectional computer-administered survey, including self-reported mental health and mental health care needs. Bivariate and multivariable models were fit to examine the association of mental health service utilization with: sociodemographics; health insurance coverage; name and gender marker change; mental health symptoms; perceived stigma; mental health, substance use disorder, and somatic diagnoses; and violence victimization. Primary outcomes were utilizing either psychotherapy or psychopharmacology, both, or neither service. Around 68.9% of the sample resided in rural areas. Fifty-one percent of respondents currently utilized at least one gender-affirming mental health service (48.5% psychotherapy, 18.7% psychopharmacology, 16.2% both services). Common barriers to gender-affirming mental health services were lack of trained providers, lack of mental health integration with primary care, financial costs, difficulty scheduling, distances that were too far, and transportation issues. Factors most important in choosing a mental health care provider were health insurance, gender-affirming care, rapport, and availability. Access to and utilization of gender-affirming mental health services was suboptimal in this sample. Achieving mental health equity will require addressing barriers experienced by TGD people in rural areas.

Effect of police enforcement and extreme social inequalities on violence and mental health among women who sell sex: findings from a cohort study in London, UK

ObjectivesTo examine legal and social determinants of violence, anxiety/depression among sex workers.MethodsA participatory prospective cohort study among women (inclusive of transgender) ≥18 years, selling sex in the last 3 months...

Prescription medication misuse among students in Lithuanian universities

Abstract Background Prescription drug misuse (PDM) is a known problem in Lithuania. However little information is known regarding the characteristics of prescription drug misusers and the extent of this problem among students of Lithuanian universities. This study attempted to further understand PDM by examining prevalence, PDM type, and students' attitudes towards PDM. Methods Survey data was collected in December 2020 - January 2021 via an online survey. 974 students from 8 State Universities of Lithuania completed the survey. Results include lifetime, past-year, past-month prevalence of PDM with analysis performed separately for stimulants, sedatives/tranquilizers, and sex, PDM was also analyzed according to stress levels, university year, etc. Results Lifetime prevalence of prescription sedative and tranquilizers misuse among students was 21% (CI 95% 18.6- 23.7), of stimulants - 5,4% (CI 95% 4.2- 7.1). Statistically significantly more male students misused prescription stimulants. Prevalence of PDM increased up to the 4th year of university. Primary reasons for PDM are to suppress anxiety and stress -62,4%, ‘to feel good/get high' -31 %, to improve academic performance -18%. 20.5% of the students that participated in PDM reported combining PDM with illicit drug use, 19.5% - with alcohol use and 7.6% used several prescription drugs non medically at once. Most students (61%) receive prescription medication from family members or friends and pay no attention to patient information leaflet. Conclusions These results further suggest the importance of assessing PDM risk factors for young adults. Students who often feel stress, anxiety are more likely to participate in PDM. Effective monitoring and prevention strategies should be developed. Key messages There is a need to increase public health literacy and to introduce innovative interventions to build mental resilience of young people. Greater availability of mental health services to students is likely to reduce PDM.

Outlook Regarding Mental Illness In Patients And Caregivers In Eastern Nepal

Introduction: Mental health is an integral component of overall health. Various factors along with stigma affect knowledge, perspectives and behavior of the people ultimately affecting help seeking and treatment. The patient and their caregivers are directly involved in overall management and outcome. Hence ascertaining those aspects among them is important and so are aims of this study. Material And Method: A cross sectional comparative study was carried out among 160 participants (80 patients and 80 caregivers) visiting neuropsychiatry outpatient department of a tertiary care hospital. Data was collected through semi-structured proforma and Attitude towards mental illness questionnaire (modified). Data were analysed by using SPSS version 25 and Microsoft excel. Results: The socio-demographic profiles between both groups were similar. About 75% from both the groups had good knowledge about mental illness. Almost 60% from both groups had positive perception/attitude regarding mentally ill and mental illness with an only significant difference in relation to rights to mentally ill. More than 70% from both groups had positive attitude regarding help-seeking with only significant difference in view about people with mental illness seeking help from psychiatrist. About 50% from both groups had positive attitude regarding care and treatment. Conclusion: With good knowledge and positive attitude/perception regarding mental illness, self-stigma persisted regarding some domains. Despite positive attitudes for help-seeking, ambivalent views regarding care and treatment into both groups necessitate easy accessibility and upgrading of mental health services.

World mental health, your mental health

In the article, the author discusses mental health issues worldwide, particularly the need to address the inequalities in the access of mental health services, and the mental health policy of Public Health England (PHE).

10.1 DEVELOPMENT OF TELE-PARTIAL HOSPITALIZATION PROGRAMS

The pandemic prevented smooth running of the live groups in the child and adolescent partial hospitalization programs (PHPs), due to the social distancing guidelines. The need for mental health services for children was exacerbated due to limited peer interactions. Transitioning of the traditional partial programs to tele-PHP was a pressing need of the hour to maintain mental health services for children. This presentation highlights the various steps that were taken in the development of a successful tele-child PHP. First, the challenge was to adapt to a HIPAA-compliant virtual platform. After a trial, a HIPAA-compliant virtual platform was selected for telehealth delivery, and staff was appropriately trained. Individual email links were used to connect with patients for group therapy, individual and family therapy, and medication management. Initially, intakes were limited to inpatient unit discharges, and completed in-person and subsequent follow-up services were provided virtually. Eventually, all services were moved to virtual platforms, and community referrals were accepted. Staff was available on-site for in-person evaluation if needed. Next, electronic outcome measures were integrated to be completed by the parents/patients at home at intake and discharge. Meeting licensure requirements was important because physicians needed to be licensed in the state where the patient was. Transitioning from traditional to tele-PHP was a challenging yet inspiring path. Tele-PHP was able to run smoothly within 1 to 2 weeks and was running virtual groups from March 2020 to July 2020, which moved to hybrid programming thereafter. It led to the increased access of mental health services for children including patients with social anxiety and autism spectrum disorder, who responded better to telehealth platforms, with improvement in participation and engagement in the program. Restrictions due to the pandemic led to the development of tele-PHP, despite various challenges and roadblocks. It helped us learn that telehealth services could be a potential long-term-care approach for the partial program and a reliable solution. Extensive research is needed to evaluate the effectiveness of the tele-PHP.

Public Attitudes Toward Psychiatric Hospitals: A Rural-Urban Comparative Public Survey in Odisha State, India.

Background: Integration of psychiatric care with public health services and offering mental health care services to patients from lower socioeconomic status remains a global challenge. Scarcity of funds and professional workforce in psychiatric hospitals contribute to this situation. However, negative attitudes in the population are also a known impediment to patients seeking mental health services. This study aimed to assess the attitudes toward psychiatric hospitals among the urban and rural population in India.Subjects and Methods: The study was carried out amongst the general population in Odisha, India. The total sample (n = 988) includes 496 respondents from an urban-setting, and 492 respondents from rural parts of the district. Participants were selected by using simple random-sampling from the Asian Institute of Public Health (AIPH) data base. A standardized seven-item questionnaire was adopted, with responses indicated on a 5-point Likert-scale. Interviews were fully structured and conducted face-to-face.Results: Level of education (B = −0.192, ß = −0.320, p < 0.000) and urban-rural comparison (B = −0.272, ß = −0.189, p < 0.000) significantly influenced attitudes toward psychiatric hospitals. Gender, age, and religious beliefs did not show any significant effect on attitudes toward psychiatric hospitals. Individuals in rural areas and those with lower education levels showed more negative attitudes toward psychiatric hospitals.Conclusion: Negative attitudes toward psychiatric hospitals from those living in rural areas as well as those with lesser education may be reflective of the lack of availability, accessibility, affordability, and credibility of such mental health services. The Mental Health Care Act in India is a progressive legislation which might improve the situation of the provided services and, consequently, reduce negative attitudes in the years to come.

Aprender Haciendo: Undergraduate Curriculum Development for a Latinx Mental Health Service-Learning Course

Service-learning provides an experientially-based pedagogical approach that can increase student engagement in the learning environment and promote the development of cultural competency when working with diverse populations. This article reports on the curriculum development of a Latinx mental health undergraduate service-learning course that discussed disparities in Latinx access and utilization of mental health services and used service-learning as a teaching method to increase students’ cultural awareness and skills by putting their knowledge into practice in community-based settings. We provide an overview of the course including specific guidelines for readings, assignments, and group facilitation for future application of this course in Latinx mental health. Students of this course have developed critical awareness of their identities as it relates to their work with Latinxs, and a continued commitment to meet community needs. We briefly discuss challenges in implementing similar ethnically-rooted and service-learning multicultural psychology curriculum.

Establishing Independent and Integrated Student-Run Behavioral Health Clinics to Address Mental Health Disparities in Gainesville, Florida

Florida continues to rank among the highest states for mental health diagnoses in the nation. Alachua County, which is home to the Gainesville community, continues to experience significant disparity in diagnoses versus access to behavioral health interventions. A significant contributor to this disparity may be the socioeconomic wellbeing of the region, where many individuals report low socioeconomic status and limited access to medical insurance. Gainesville is also home to an advanced network of primary care services and specialties to meet community needs. Among these networks is an established system of student-run medical clinics for uninsured/underinsured patients. New to this system is a psychology graduate student-run behavioral health clinic with an integrated primary care system working hand-in-hand with other medical services. The present article aims to (1) describe the development of an independent, student-run behavioral health clinic model by a graduate student team and (2) describe the implementation/integration of this new clinic model within a free clinic network to meet a need for accessible mental health services, as well as provide patients with an opportunity for integrated care. Current barriers, facilitators, and plans for the models moving forward are discussed.&#x0D; &#x0D;