Mental Health Care Practice Research Articles

Heritage sites in the 21st century: virtual tours and digital artefacts, an online example

ABSTRACT Former asylums are often significant heritage sites for their architecture and what they can tell us about mental health care practices. One example is the historic Mayday Hills asylum in Beechworth, Victoria, Australia. Built in Italianate style and set in extensive grounds, it is under National Trust protection for its heritage and historical significance. In this article, we outline the creation of a pilot online virtual tour of Mayday Hills and the nearby Beechworth Cemetery. We used curation as a methodology, informed by the concept of crystallisation. Innovative digital imagery was crafted through drone footage and virtual technology. The website includes narratives and reminiscences from former staff and others associated with the institution, along with a blog written by the research team. Maydayhills.org.au demonstrates the feasibility of using virtual technology to depict how mental illness was once treated in Australia. The website is available to anyone unable to travel to Beechworth and to enrich the experience of those visiting in person. This online digital space is now essential for the preservation of history, memories and material culture given that many original buildings are being repurposed. It complements the built and natural environment of Mayday Hills asylum and Beechworth Cemetery.

Mental health recovery in a collectivist society: Saudi consumers, carers and nurses' shared perspectives.

In 2019, the World Health Organization urged a global shift towards recovery-focused practices in mental health care. In Western nations, this transition often prioritised individualism over collectivism. In contrast, collectivist societies prioritise recovery through community and social support. This study explored mental health recovery from the perspectives of consumers, carers and registered nurses in a mainly collectivist society (Saudi Arabia) using a qualitative exploratory descriptive design. Sixteen consumers, ten carers and eight registered nurses participated in online semi-structured interviews. Inductive thematic analysis was employed to analyse English-translated versions of the 34 interviews. Consolidated criteria for reporting qualitative studies 32-item checklist were used. The study found that recovery was perceived as a process of transforming towards living a meaningful life of goals and values supported by trusted people who share moments of comfort and empowerment. A unique finding was the 'bond of recovery' a collectivist value that aid consumers' community integration in society. Saudi consumers' experiences of recovery were similar to consumers' movement narratives of recovery. Future research should establish a recovery-focused educational program that incorporates our findings into a recovery-oriented approach. This will facilitate providing a collaborative care between consumers, carers and nurses that centres around consumers' recovery goals and values.

Mental Health Provider Reach and Engagement in a Countywide Training Initiative.

Many training initiatives are underway to increase implementation of evidence-based practice (EBPs) in mental healthcare. However, little is known about what types of trainings and supports yield the highest reach and engagement. Supported by a tax-funded, countywide initiative to improve access to quality care for youths, the current mixed methods study evaluates mental health (MH) provider reach, or registering for the training initiative, and engagement, or participation in training activities, for several EBP training and implementation supports. MH providers were offered free 1) formal EBP workshops, 2) a biweekly learning community, 3) individual case consultation, and 4) confidential online clinical feedback system. To register, interested providers (N = 698) completed a web-based assessment measuring clinical practice information, organizational implementation climate, and EBP knowledge, attitudes, and practices. Thirteen providers, selected via purposeful sampling stratified by level of participation, completed semi-structured qualitative interviews. While the training initiative achieved high reach (66% of county agencies had a provider register), far fewer providers engaged substantially in training. Quantitative results indicated that providers whose professional discipline was not psychology, had higher baseline EBP knowledge, more extensive use of common evidence-based strategies, and less extensive use of other therapy strategies, engaged in more training. Rapid qualitative analysis of interviews expanded upon these findings and illuminated provider, organizational, system, practical, and training activity-specific barriers and facilitators to engagement. Findings suggest the importance of identifying strategies for improving provider engagement in training activities beyond workshops. Implications for future research and training initiatives are discussed.

Living with depression and diabetes: A qualitative study in Bangladesh and Pakistan.

Diabetes and depression are both serious health conditions. While their relationship is bidirectional and each condition adversely affects outcomes for the other, they are treated separately. In low and middle income countries, such as Bangladesh and Pakistan, health systems are already stretched and the integration of diabetes and depression care is rarely a priority. Within this context through interviews with patients, healthcare workers and policy makers the study explored: lived experiences of people living with depression and diabetes, current practice in mental health and diabetes care and barriers and perspectives on integrating a brief psychological therapy into diabetes care. The findings of the study included: differing patient and practitioner understandings of distress/depression, high levels of stigma for mental health and a lack of awareness and training on treating depression. While it was apparent there is a need for more holistic care and the concept of a brief psychological intervention appeared acceptable to participants, many logistical barriers to integrating a mental health intervention into diabetes care were identified. The study highlights the importance of context and of recognising drivers and understandings of distress when planning for more integrated mental and physical health services, and specifically when adapting and implementing a new intervention into existing services.

Preliminary Psychometric Evaluation of Novel Measures of Therapist Practice Related to LGBTQ+ Clients.

Culturally competent and equitable mental healthcare for LGBTQ+ people is critical for addressing mental health inequities for this population. Tools to assess therapists' practice with LGBTQ+ clients are needed for research and clinical efforts related to mental healthcare equity goals. We conducted a preliminary assessment of the reliability and validity of a novel 28-item self-report measure assessing therapist practice with LGBTQ+ clients. We examined the construct validity using factor analyses, the convergent and criterion validity using intercorrelations with LGBTQ-affirming knowledge, self-efficacy, and attitudes, and the internal consistency using Cronbach alpha. Our overall total LGBTQ+ practice measure demonstrated excellent internal consistency (Cronbach's alpha = 0.91) and was strongly associated with LGBTQ+ knowledge (rho = 0.377), self-efficacy (rho = 0.633), and LGBTQ+ attitudes (rho = 0.305). We also identified two subscales: "Commitment to Continued Learning" and "Affirmative Practices", which demonstrated similarly strong internal consistency and tests of validity. Our novel measure of overall LGBTQ+ practice, including two subscales, demonstrated strong reliability and validity. These findings have important implications for practice and research in mental healthcare for LGBTQ+ clients. Future research exploring these measures in relationship to mental healthcare outcomes is recommended.

Comparison of coercive practices in worldwide mental healthcare: overcoming difficulties resulting from variations in monitoring strategies.

Coercive or restrictive practices such as compulsory admission, involuntary medication, seclusion and restraint impinge on individual autonomy. International consensus mandates reduction or elimination of restrictive practices in mental healthcare. To achieve this requires knowledge of the extent of these practices. We determined rates of coercive practices and compared them across countries. We identified nine country- or region-wide data-sets of rates and durations of restrictive practices in Australia, England, Germany, Ireland, Japan, New Zealand, The Netherlands, the USA and Wales. We compared the data-sets with each other and with mental healthcare indicators in World Health Organization and Organisation for Economic Cooperation and Development reports. The types and definitions of reported coercive practices varied considerably. Reported rates were highly variable, poorly reported and tracked using a diverse array of measures. However, we were able to combine duration measures to examine numbers of restrictive practices per year per 100 000 population for each country. The rates and durations of seclusion and restraint differed by factors of more than 100 between countries, with Japan showing a particularly high number of restraints. We recommend a common set of international measures, so that finer comparisons within and between countries can be made, and monitoring of trends to see whether alternatives to restraint are successful. These measurements should include information about the total numbers, durations and rates of coercive measures. We urge the World Health Organization to include these measures in their Mental Health Atlas.

What’s in a Refusal? Methodological and Ethical Notes from an Ethnography of Mental Health Care in Rural Ghana

Drawing on fifteen months of ethnographic fieldwork conducted between 2013 and 2022 on experiences of madness and practices of mental health care in rural southwestern Ghana, in this paper I propose to take as a point of departure, a specific episode in which the relatives of Fadhila—a girl I had first met at the psychiatric unit, where she was diagnosed as “psychotic”—refused to give consent to record an interview with me. The refusal was motivated by the strict instructions that Fadhila and her family were given by the traditional healer who was taking care of her: among many other things, the girl was not allowed to come close to any electronic device and her family felt it was unsafe to record an interview at their house. The refusal had to do with Fadhila being a “patient” as much as it had to do with another refusal: that of drugs and psychiatrisation. Indeed, the refusal had to do with spirits, the spirits that occasionally possessed Fadhila and were trying to make her a healer, according to her, her family members, and the traditional specialists they had visited. The refusal, however, may also have been a polite, indirect way to “withdraw consent”—to use the jargon of informed consent forms and ethics review committees. Though Fadhila and her family kept inviting me to their place, welcomed me warmly in subsequent occasions, and conversed with me about many things including the girl’s “condition,” that episode pushed me to reconsider the limits of formal consent and the need to constantly question it and re-establish it—a complex dynamic that sometimes the bureaucracy of “ethical clearance” processes in academia may contribute, paradoxically, to erase. Analysing this ethnographic episode in light of the powerful concept of ethnographic refusal introduced by Audra Simpson, I propose a reflection on the ethical and methodological implications of considering people as “sources” in ethnographies of madness and mental health.

Improvements in the quality of the parent-child relationship following treatment with an integrated family approach.

This study investigated changes in the emotional availability of the parent and the child in the dyadic relationship, parental reflective functioning, and parental perception of the relationship with their child following treatment with an integrated family approach in adult and child mental health care services. The aim of the study was to investigate if an integrated family approach in treatment contributes to good practice in mental health care. Children of parents with a mental disorder are at increased risk for developing mental health problems themselves during lifetime. Infants are extremely vulnerable for environmental influences. Parents with mental disorders are at risk for mis-attuned behavior and non-optimal emotional availability. This increases the risk of adverse cascading effects on the parent-child relationship and child development. A secure parent-child relationship is an important protective factor against the intergenerational transmission of mental disorders. Although treatment of the parental mental disorder is important, it does not automatically change undesirable patterns in the parent-child relationship. Therefore, an integrated family approach to mental health treatment is recommended. This study involved a mixed methods design using questionnaires, an observation instrument and semi-structured interviews. The variables examined were the quality of the parent-child interaction, the parental perspective on their relationship with the child, their problems with child upbringing, and on their parental reflective functioning. The clinical sample consisted of 50 patients with a variety of mental disorders and their young children. After finishing the integrated treatment the quality of the parent-child interaction had improved significantly. Likewise, we found a significant improvement in parental perception regarding the relationship with the child and the parental role. The majority of the parents interviewed showed that they were better able to mentalize about themselves, their child and their relationship with the child, but the data from the questionnaire showed mixed results regarding parents' reflective functioning. Treatment with an integrated family approach to mental health care in which the parental role of the patient, the young child, and the parent-child relationship are integrated in treatment, can be a valuable addition to the current practice of mental health care in which patients are commonly perceived as individuals.

Bringing together the World Health Organization's QualityRights initiative and the World Psychiatric Association's programme on implementing alternatives to coercion in mental healthcare: a common goal for action.

Stakeholders worldwide increasingly acknowledge the need to address coercive practices in mental healthcare. Options have been described and evaluated in several countries, as noted recently in major policy documents from the World Health Organization (WHO) and World Psychiatric Association (WPA). The WHO's QualityRights initiative promotes human rights and quality of care for persons with mental health conditions and psychosocial disabilities. A position statement from the WPA calls for implementation of alternatives to coercion in mental healthcare. We describe the engagement of both the WHO and WPA in this work. We discuss their mutual aim to support countries in improving human rights and quality of care, as well as the differences between these two organisations in their stated goals related to coercion in mental healthcare: the WHO's approach to eliminate coercion and the WPA's goal to implement alternatives to coercion. We outline and critically analyse the common ground between the two organisations, which endorse a similar range of rights-based approaches to promoting non-coercive practices in service provision, including early intervention in prevention and care and other policy and practice changes. Advocacy and action based on an agreed need to find practical solutions and advances in this area have the power to build consensus and unify key actors. We conclude that persons with lived experience, families, mental health professionals and policy makers are now coming together in several parts of the world to work toward the common goals of improving quality, promoting human rights and addressing coercion in mental health services.

Overcoming Barriers to Mental Health Care for All: Interview With Ya-Shu Liang, PhD

Discover specific ways that practitioners can sometimes “drop the ball” when it comes to supporting people of different sociocultural groups. Dr. Ya-Shu Liang joins with ideas for patients, practitioners, and even psychology students to help reduce disparities in mental health care practices. Episode made possible by CSPP Alliant International University.

The Work and Social Adjustment Scale (WSAS): An investigation of reliability, validity, and associations with clinical characteristics in psychiatric outpatients.

This study, the first to assess the reliability and validity of the Work and Social Assessment Scale (WSAS) in Norwegian routine mental health care, examines differences in functional impairment based on sick leave status, psychiatric diagnosis, and sex. Including 3573 individuals from community mental health services (n1 = 1157) and a psychiatric outpatient clinic (n2 = 2416), exploratory factor analysis (EFA) on subsample 1 and confirmatory factor analysis (CFA) on subsample 2 were utilized to replicate the identified factor structure. EFA supported a one-factor model, replicated by the CFA, with high internal consistency (α = .82, ω = .81). Patients on sick leave reported greater impairments in all aspects of functioning, except for relationships, with the largest effect size observed in the reported ability to work (d = .39). Psychiatric outpatients with major depressive disorder were associated with difficulties in home management, private leisure activities, and forming close relationships. Patients with attention-deficit/hyperactivity disorder reported less impairment than those with other disorders. Patients with personality disorders reported more relationship difficulties than those with PTSD, ADHD, and anxiety. No differences were found in the perceived ability to work between diagnoses. Women had a higher impairment in private leisure activities, whereas men reported more impairment in relationships. The demonstrated reliability and validity suggest that WSAS is a valuable assessment tool in Norwegian routine mental health care. Variations in functional impairment across sick leave status, sex, and psychiatric diagnoses highlight the importance of integrating routine assessments of functional impairment into mental health care practices. Future research should combine WSAS with register data to allow for a broader understanding of treatment effectiveness, emphasizing improvements in functional outcomes alongside symptom alleviation.

Evaluating Open Dialogue in Italian mental health services: evidence from a multisite prospective cohort study.

This longitudinal study aimed to quantitatively document and evaluate the implementation and outcomes of the Open Dialogue (OD) approach within Italian Mental Health Departments (MHDs), focusing on the ratings of OD-network meetings by patients and their families and assessing the clinical outcomes over a span of 12 months. Over the course of the study, 58 patients participated in 517 OD-network meetings, demonstrating a high level of satisfaction with the care received, as evidenced by the Session Rating Scale (SRS) and Outcome Rating Scale (ORS). Clinically, significant improvements were observed in the Global Assessment of Functioning (GAF), Clinical Outcomes in Routine Evaluation (CORE-OM), and the Lubben Social Network Scale (LSNS), indicating enhanced psychological and social functioning. The SRS scores showed that satisfaction with the meetings increased over time, while the ORS indicated that both patients and their social networks perceived gradual improvements throughout the therapy. The OD approach within Italian MHDs was successfully implemented and well-received by patients and their social networks, yielding significant clinical improvements. These findings suggest the feasibility and effectiveness of integrating the OD model into the Italian public mental health system, supporting its potential for broader application in diverse healthcare settings. The study highlights the importance of continuous engagement and evaluation to maintain high standards of practice and suggests that OD can be a valuable addition to existing mental health care practices, promoting recovery through inclusive, dialogue-based interventions.

Patient’s Consent and Autonomy in Jerry Pinto’s Em and the Big Hoom

This paper addresses the idea of patient consent in the Indian mental health care system. Mental hospitals tend to treat patients as machines. The personhood of the sufferer is treated as invalid. The paper argues that the conventional clinical practice dehumanizes patients, neglecting their autonomy and perpetuating the stigma associated with a psychiatric diagnosis. In contrast, through the narrative voice of Imelda’s son, Jerry Pinto’s novel Em and the Big Hoom (2012) intimately intertwines the experiences of mental illness within the broader context of familial struggles. Em refuses to become a mere statistic or a diagnostic label, embodying the agency to shape her narrative beyond the constraints of clinical definitions. The novel challenges the flawed clinical gaze and provides an alternative narrative that portrays an ambitious woman who does not succumb to the definitions of her illness. These alternative narratives resist reductionist perspectives, offering a more comprehensive understanding of mental illness that transcends clinical definitions. This paper critically examines the novel’s portrayal of patient autonomy and consent, shedding light on the implications for mental health care practices in India. It explores how the text serves as a catalyst for reevaluating conventional clinical perspectives and fosters a more compassionate and patient-centric mental health care system.

COMMUNITY-BASED MENTAL HEALTH INTERVENTIONS IN AFRICA: A REVIEW AND ITS IMPLICATIONS FOR U.S. HEALTHCARE PRACTICES

This study critically examines community-based mental health interventions in Africa and their implications for U.S. healthcare practices. The primary aim was to explore the effectiveness of these interventions and assess their potential integration into the U.S. healthcare framework. The methodology employed was a comprehensive literature review, focusing on recent peer-reviewed articles and reports. This approach facilitated an in-depth analysis of the evolution of mental health care models, the significance of community-based approaches in African contexts, and their relevance to U.S. healthcare systems The findings reveal that African community-based mental health models are distinct in their emphasis on community engagement, integration with traditional practices, and the pivotal role of non-governmental organizations. These elements have contributed significantly to their success and offer valuable insights for U.S. mental health care enhancement. The study also identified key research gaps, providing a foundation for future scholarly work. In conclusion, the study highlights the potential benefits of incorporating African community-based mental health strategies into U.S. practices. The recommendations emphasize the need for economic alignment, sociocultural training in psychiatric education, a coherent value appraisal framework, and policy integration. These strategic suggestions aim to foster a more inclusive, culturally sensitive, and effective mental health care system in the U.S., drawing on the successful experiences from African models. This research contributes significantly to the global mental health discourse, offering a unique perspective on cross-cultural learning and adaptation in mental health care practices.
 Keywords: Community-Based Mental Health, African Models, U.S. Healthcare, Mental Health Care, Global Mental Health.

Clinical teaching practices in maternal mental health care: An integrated review.

WHAT IS KNOWN ABOUT THE TOPIC?: Mental health-related problems in pregnancy are now becoming a global health concern. However, most studies have reported that midwives are unable to assess and support maternal mothers due to poor preservice education. The findings of these studies needed to be explored further from the available literature to address the gap. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The paper has identified maternal mental health core competencies and innovative clinical teaching strategies that nurse educators can utilize when supporting students theoretically and during clinical practice so that students should be adequately prepared for maternal mental health practice. Challenges and recommendations for clinical teaching were also identified. However, there are still gaps in the literature related to the effectiveness of teaching strategies to promote competence acquisition in maternal mental health. WHAT ARE THE IMPLICATIONS FOR EDUCATION?: The study results can be used by nurse educators to develop effective clinical teaching practices in maternal mental health care. The findings can be used in the development of best clinical teaching guidelines for maternal or perinatal mental health to be used by nurse educators for the undergraduate midwifery training programmes. ABSTRACT: Introduction Maternal mental health problems are commonly experienced by women; however, they are usually not adequately recognized and treated by midwives in Malawi. Evidence suggests poor preservice education by nursing colleges which affects the development of essential maternal mental health competencies. Aim The aim of the study was to review existing evidence on clinical teaching practices by nurse educators in teaching student midwives maternal mental health care. Method Integrative review method was used, and various databases were searched. Out of 1768 articles, 27 research articles met the inclusion criteria. The critical appraisal skills programme checklist tools were used to assess data quality. Thematic analysis was done by comparing, grouping and integrating data. Results Six themes emerged, namely: core maternal mental health competencies, professional regulation, interactive teaching strategies, collaborative partnerships, capacity building and shortage of resources. Discussion Clinical teaching is an important aspect of midwifery education. Utilizing student-centred teaching approaches helps students acquire competencies in maternal mental health care. Further research is required to identify the effectiveness of the clinical teaching methods. The Implication to Practice The study results can assist nurse educators to provide comprehensive clinical teaching practices in maternal mental health care which will aid in the development of maternal mental health competencies among student midwives.

Systematic review of the relationship between Islamic-Sufi spirituality and practice and mental well-being

ABSTRACT This systematic review examines research on Sufi spirituality and mental well-being. Earlier investigations have focused on general spiritual practice in mental health care and found a connection between spirituality and mental health. In this systematic review, we aimed to explore existing research specifically considering the relationship between Sufi spirituality and mental well-being and examine the quality of this research. We identified 49 papers published between the years 2007–2022. Our findings revealed a positive connection between Sufi spirituality and reducing anxiety and depression in patients. However, most studies were of low quality. This review highlights the need to provide more comprehensive and higher quality research to redress the methodological limitations of the current evidence base.

Can Mental Health Care Become More Human by Becoming More Digital?

Abstract Over the past two decades, advances in digital technologies have begun to transform three aspects of mental health care. The use of sensors and artificial intelligence (AI) have provided new, objective measures of how we think, feel, and behave. The ease of connecting and communicating remotely has transformed the brick-and-mortar practice of mental health care into a telehealth service, increasing access and convenience for both patients and providers. And the advent of digital therapeutics, from virtual reality for treating phobias to conversational agents for delivering structured therapies, promises to alter how treatments will be delivered in the future. These digital transformations can help to solve many of the key challenges facing mental health care, including access, quality, and accountability. But digital technology introduces a new set of challenges around trust, privacy, and equity. Despite high levels of investment and promotion, there remain profound questions about efficacy and safety of digital mental health technologies. We share our experiences from the front lines creating digital innovations for mental health, with a focus on what a digital transformation of care could deliver for millions with a serious mental illness.

Etomidate versus propofol for electroconvulsive therapy: An intraindividual comparative study during the COVID-19 pandemic

ObjectivesThe Coronavirus disease 2019 (COVID-19) pandemic markedly influenced mental health care practices, notably regarding electroconvulsive therapy (ECT). This was due to the redistribution of anesthetic agents used during ECT such as propofol, for intensive care units. Because in our center propofol was switched to etomidate to avoid ECT activity discontinuation, we undertook this study in order to compare Propofol and Etomidate regarding electroencephalographic seizure duration and stimulus intensity. MethodsWe performed a retrospective and comparative study, each patient being its own control. We included patients with at least two courses of ECT on propofol and two others with etomidate over the period from September 2019 to April 2021, regardless of the psychiatric diagnosis. Our data collection process notably targeted stimulus intensity, seizure duration recorded using electroencephalography, and medication used for anesthetic induction. ResultsOverall, we included 18 patients with a male: female ratio of 1:2.6 and a mean (and standard deviation) age of 62.7±13.4 years. We found that the mean intensity of stimulation was significantly lower with etomidate when compared to propofol (425.3±250.0 vs. 658.9±280.2 mC, P=0.001). The mean duration of electroencephalographic seizure was significantly higher with etomidate in comparison to propofol (53.5±16.6 vs. 35.0±12.2seconds, P<0.001). ConclusionBy using each patient as its own control, our study found that etomidate, while compared to propofol, was related to a lower level of stimulatory intensity and a longer electroencephalographic seizure duration.

The Ableist and White Supremacist Origins of U.S. Policing and Connections to Involuntary Hospitalization

This paper discusses the impact of White supremacy, ableism, and U.S. policing on both the history and current state of psychology and sheds light on ways that psychologists can acknowledge and divest from carceral White supremacist practices in mental healthcare. Because of how oppression and intersectionality function within a White supremacist society, not all Black lives have been equally valued by non-Black Americans. Similarly, White supremacy and ableism have had lasting impacts on the public perception of disabled people. Connecting the historical origins of the U.S. policing system to the current practices of the U.S. police system, this paper argues that the police have always been about controlling “disorder.” Similarly, psychology and the larger mental health field have a troubled history of controlling Black, Brown, and disabled bodies. Recommendations for ways therapists can unlearn therapy practices stemming from White supremacy cultural practices (e.g., carceral therapeutic practices and biased mental health care) are provided along with action items for mental health practitioners to maintain a commitment to undoing the harm from these historic and systemic issues.

Predicting non-improvement of symptoms in daily mental healthcare practice using routinely collected patient-level data: a machine learning approach.

Anxiety and mood disorders greatly affect the quality of life for individuals worldwide. A substantial proportion of patients do not sufficiently improve during evidence-based treatments in mental healthcare. It remains challenging to predict which patients will or will not benefit. Moreover, the limited research available on predictors of treatment outcomes comes from efficacy RCTs with strict selection criteria which may limit generalizability to a real-world context. The current study evaluates the performance of different machine learning (ML) models in predicting non-improvement in an observational sample of patients treated in routine specialized mental healthcare. In the current longitudinal exploratory prediction study diagnosis-related, sociodemographic, clinical and routinely collected patient-reported quantitative outcome measures were acquired during treatment as usual of 755 patients with a primary anxiety, depressive, obsessive compulsive or trauma-related disorder in a specialized outpatient mental healthcare center. ML algorithms were trained to predict non-response (< 0.5 standard deviation improvement) in symptomatic distress 6 months after baseline. Different models were trained, including models with and without early change scores in psychopathology and well-being and models with a trimmed set of predictor variables. Performance of trained models was evaluated in a hold-out sample (30%) as a proxy for unseen data. ML models without early change scores performed poorly in predicting six-month non-response in the hold-out sample with Area Under the Curves (AUCs) < 0.63. Including early change scores slightly improved the models' performance (AUC range: 0.68-0.73). Computationally-intensive ML models did not significantly outperform logistic regression (AUC: 0.69). Reduced prediction models performed similar to the full prediction models in both the models without (AUC: 0.58-0.62 vs. 0.58-0.63) and models with early change scores (AUC: 0.69-0.73 vs. 0.68-0.71). Across different ML algorithms, early change scores in psychopathology and well-being consistently emerged as important predictors for non-improvement. Accurately predicting treatment outcomes in a mental healthcare context remains challenging. While advanced ML algorithms offer flexibility, they showed limited additional value compared to traditional logistic regression in this study. The current study confirmed the importance of taking early change scores in both psychopathology and well-being into account for predicting longer-term outcomes in symptomatic distress.