Training Of Mental Health Professionals Research Articles

The Impact of Existentialism on Contemporary Mental Health Practices

Purpose: The general objective of this study was to explore the impact of existentialism on contemporary mental health practices. Methodology: The study adopted a desktop research methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library. Findings: The findings reveal that there exists a contextual and methodological gap relating to the impact of existentialism on contemporary mental health practices. Preliminary empirical review revealed that integrating existential principles into contemporary mental health practices significantly enhanced psychological well-being by fostering self-awareness, personal growth, and the ability to cope with existential anxieties. It demonstrated that existential therapies offered a more holistic and personalized approach to mental health care, addressing both symptomatic relief and underlying existential concerns. Additionally, the study highlighted the importance of cultural sensitivity, emphasizing that culturally adapted existential therapies were more effective and accessible across diverse cultural contexts, thereby improving mental health outcomes globally. Unique Contribution to Theory, Practice and Policy: The Existential Theory, Humanistic Theory and Cognitive Behavioural Theory may be used to anchor future studies on the impact of existentialism on contemporary mental health practices. The study recommended integrating existential principles into psychological theories, training mental health professionals in existential therapeutic approaches, and developing culturally adapted versions of these therapies. It emphasized the need for mental health policies to recognize the importance of existential concerns and support the inclusion of existential therapies in standard care. The study also suggested revising mental health education curricula to incorporate existential psychology, providing continuing education for current practitioners, and increasing public awareness to destigmatize existential issues. These steps aim to enhance theoretical frameworks, clinical practices, and policy development in mental health care.

The Philosophy of Technology and Its Impact on Human Values

Purpose: The general objective of this study was to explore the impact of existentialism on contemporary mental health practices. Methodology: The study adopted a desktop research methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library. Findings: The findings reveal that there exists a contextual and methodological gap relating to the impact of existentialism on contemporary mental health practices. Preliminary empirical review revealed that integrating existential principles into contemporary mental health practices significantly enhanced psychological well-being by fostering self-awareness, personal growth, and the ability to cope with existential anxieties. It demonstrated that existential therapies offered a more holistic and personalized approach to mental health care, addressing both symptomatic relief and underlying existential concerns. Additionally, the study highlighted the importance of cultural sensitivity, emphasizing that culturally adapted existential therapies were more effective and accessible across diverse cultural contexts, thereby improving mental health outcomes globally. Unique Contribution to Theory, Practice and Policy: The Existential Theory, Humanistic Theory and Cognitive Behavioural Theory may be used to anchor future studies on the impact of existentialism on contemporary mental health practices. The study recommended integrating existential principles into psychological theories, training mental health professionals in existential therapeutic approaches, and developing culturally adapted versions of these therapies. It emphasized the need for mental health policies to recognize the importance of existential concerns and support the inclusion of existential therapies in standard care. The study also suggested revising mental health education curricula to incorporate existential psychology, providing continuing education for current practitioners, and increasing public awareness to destigmatize existential issues. These steps aim to enhance theoretical frameworks, clinical practices, and policy development in mental health care.

TRAUMA, ADDICTION, AND THE PATH TO RECOVERY AFTER THE KAHRAMANMARAŞ EARTHQUAKES

The 2023 Kahramanmaraş earthquakes in Turkey, characterized by their suddenness and severity, have highlighted the acute need to understand and address the psychological aftermath of such natural disasters. This article examines the intersection of trauma and addiction that frequently follows such catastrophic events. It delves into the widespread psychological distress and the documented rise in post-traumatic stress disorder, anxiety, depression, and addictive behaviors among the affected populations. The review synthesizes findings from global earthquake studies, including those from Japan, Nepal, Italy, Iran, Pakistan, Haiti and China, to draw parallels and learn from previous experiences in managing post-disaster mental health challenges. The article proposes a multi-pronged approach to intervention that includes immediate responses such as Psychological First Aid and longer-term strategies like sustained psychological counseling and community-based support. It acknowledges the complexity of integrating cultural nuances into these interventions and highlights the importance of ethical considerations, political coordination, and the need for training mental health professionals in trauma-informed care. Challenges such as resource limitations, infrastructural damage, cultural barriers, and the need for long-term sustainability of mental health programs are discussed. Furthermore, the article stresses the importance of supporting the mental health of professionals and volunteers working in disaster zones, who are at risk of burnout and secondary trauma. Innovative and adaptable interventions, supported by rapid and responsive research, are advocated to improve mental health outcomes. This comprehensive review contributes to the discourse on disaster response, emphasizing that addressing both trauma and addiction is essential for the holistic recovery of affected individuals and communities.

Short report: Integrated evaluations for autism spectrum disorder in pediatric primary care clinics.

Primary care providers often screen for autism during well child visits in the first few years of life and refer children for diagnostic evaluations when needed. However, most children do not receive a diagnosis until years later which delays access to services. Racism, socioeconomic status, and other systemic inequalities that limit access to health care further delay diagnostic evaluations. Mental health clinicians who work in primary care clinics can help address barriers to accessing diagnostic evaluation services once they are recommended by their primary care provider. However, mental health clinicians who work in primary care typically do not have training in diagnosing autism. The goal of this study was to evaluate a program training mental health professionals working in an urban primary care setting, primarily serving Black and Latinx families insured by Medicaid, to provide autism diagnostic evaluations. Two hundred and fifty children completed evaluations through the Autism in Primary Care (APC) program. The wait time to access an evaluation through APC was significantly shorter than through standard avenues of care (e.g. referring to a separate autism clinic). Referring primary care providers and caregivers endorsed high levels of satisfaction with the program. Conducting autism evaluations in primary care settings offers a promising opportunity to improve earlier diagnosis and treatment access for families, reduce inequities in care, and increase caregiver and child well-being.

Ethical and practical considerations for mandating suicide prevention training for mental health professionals.

Ethical and practical considerations for mandating suicide prevention training for mental health professionals.

Messages from rainbow rangatahi to mental health professionals in training

ABSTRACT Past research has shown significant inequities in mental health outcomes between rainbow and non-rainbow people, particularly for youth. Rainbow youth report mixed experiences when accessing support, signalling the need for increased rainbow competency training for mental health professionals (MHPs). While previous research has explored the experiences of rainbow young people, little research has sought direct messages from rainbow youth to training MHPs. The current study presents a thematic analysis of messages from rainbow rangatahi (14–24 years) to training MHPs. We identify six themes: (1) check your assumptions, (2) treat us with empathy and respect, (3) earn our trust, (4) you need to self-reflect, (5) balance getting to know me with educating yourself, and (6) hear our stories. Participants’ responses describe their experiences within the mental health sector and in life, and their recommendations for what practitioners should both implement and avoid in their practice. We reflect on whether current recommendations for MHPs working with rainbow people align with these messages. Finally, we discuss the possibility of personal narratives enacting social change. The findings of the current study reflect the need for rainbow cultural competency training, grounded in the voices of rainbow people, to become mandatory for all MHPs.

Supporting future doctors: Mental health help-seeking behaviour in medical students at the University of Witwatersrand, Johannesburg, South Africa

Abstract Studies have shown that medical students may have higher rates of mental distress than the general population. Serious consequences thereof include academic failure, substance use and suicide attempts. In the wake of recent media reports of suicide in university students, mental health help-seeking behaviours and associated barriers to help-seeking in clinical year medical students at the University of Witwatersrand were examined. It was found that although formal mental healthcare was viewed favourably, medical students most often sought assistance from family members or friends rather than trained mental health professionals. The most commonly reported barriers to seeking mental healthcare were lack of time (primarily due to academic obligations) and fears of stigma and discrimination from colleagues and superiors. The need for support structures to be more easily accessible to medical students is highlighted by these findings, as well as the importance of lecturers and university staff being more familiar with the mental health screening of medical students.

Supporting future doctors: Mental health help-seeking behaviour in medical students at the University of Witwatersrand, Johannesburg, South Africa

Abstract Studies have shown that medical students may have higher rates of mental distress than the general population. Serious consequences thereof include academic failure, substance use and suicide attempts. In the wake of recent media reports of suicide in university students, mental health help-seeking behaviours and associated barriers to help-seeking in clinical year medical students at the University of Witwatersrand were examined. It was found that although formal mental healthcare was viewed favourably, medical students most often sought assistance from family members or friends rather than trained mental health professionals. The most commonly reported barriers to seeking mental healthcare were lack of time (primarily due to academic obligations) and fears of stigma and discrimination from colleagues and superiors. The need for support structures to be more easily accessible to medical students is highlighted by these findings, as well as the importance of lecturers and university staff being more familiar with the mental health screening of medical students.

Нові стандарти підготовки фахівців сфери охорони психічного здоров’я на етапі післядипломної освіти.

Abstract. The article deals with the issues of quality training of professionals in the field of mental healthcare, which is an urgent problem in the context of the war in Ukraine. Postgraduate medical education is an important stage of their training and is included in the ongoing professional development of psychiatrists as a process of continuous enhancement of professional knowledge and skills. Specialization is one of the types of training for mental health professionals. Taking into consideration the complex challenges of the current stage of postgraduate education development in Ukraine and the new standards of higher education introduced in our country, the academic staff of the Department of Psychiatry, Psychotherapy and Medical Psychology of Shupyk National Healthcare University of Ukraine has developed an educational programme of specialization in Psychiatry. The aim of this programme is to train professionals capable of solving complex tasks and innovative problems in the field of mental healthcare, as well as preventive mental health, psychodiagnostics, psychocorrection and treatment of mental health-related diseases which are characterized by uncertainty of conditions and requirements and may require research and/or innovation. Its main task is to develop key competencies in the field of mental healthcare. The programme consists of educational and practical components and is designed for 900 hours, which is 30 ECTS credits. There are 202 hours of independent work, which is 22% of the total. This should facilitate more active involvement of participants of the educational process in learning, as well as delegate the responsibility for acquiring knowledge and skills to them. An important component of the programme is the list of mandatory competences (integral, general and professional) that doctors must acquire during the learning cycle and that will determine their ability to successfully carry out professional activities. Programme learning outcomes, as well as matrices of compliance with the defined results, competences and components of the educational programme have been introduced to determine the effectiveness of the educational process. Thus, this educational programme of specialization in Psychiatry reflects modern changes in the training of professionals at the postgraduate level of medical education.

EMPOWER@HOME:CONNECTED - TESTING A PILOT GROUP INTERVENTION FOR DEPRESSION AND LONELINESS IN OLDER ADULTS

Abstract Homebound older adults experience high rates of depression, social isolation, and loneliness, which adversely impacts physical and mental well-being. Accessing psychotherapy to address these concerns can be logistically challenging and cost prohibitive. This study examined the feasibility and preliminary effect of a novel group-based internet cognitive-behavioral therapy program called Empower@Home:Connected. The intervention was implemented over nine consecutive weekly sessions in small virtual groups (4-6 participants). These sessions were facilitated by trained mental health professionals and incorporated psychoeducational material, cognitive-behavioral therapy exercises, and socialization. Measurements on primary and secondary outcomes were gathered before and after completion of the intervention. In this preliminary pilot trial (NCT05732740), participants averaged 68 years and of those that attended the first session (n = 25), nearly all completed the program (n = 24). Session attendance was high, with an average session attendance rate of 94.70%. Following program completion, participants had statistically significant reductions in depressive symptoms (Cohen’s d = 1.01). Participants also had reductions in loneliness that trended towards statistical significance (p = 0.07); changes in social isolation were not statistically significant. Of the participants, 21 out of 23 expressed satisfaction with the program and would recommend it to peers. For secondary outcomes, analyses revealed significant improvements in anxiety and health-related quality-of-life. In this pilot feasibility trial, Empower@Home:Connected reduced depressive symptoms among older adults. The high adherence and satisfaction rates suggest acceptability. While the intervention produced improvements on several measures, further exploration is warranted to determine long-term impact and efficacy relative to other existing interventions.

Evaluation of a new online cognitive remediation therapy (CIRCuiTSTM) training for mental health professionals.

Cognitive remediation (CR) improves cognition and aids recovery in people with psychosis. An active therapist provides increased benefit, but CR training for therapists is not routinely available, so CR has limited scalability. This study describes the development and evaluation of the first online CR therapist training programme. An online CR training, based on expert and novice therapist consultations, was developed, and then pilot tested with novice trainees and changes made to produce the evaluation version. Feasibility, acceptability, and training benefits were assessed in a group of naïve UK NHS mental health professionals. Training engagement with a group of clinicians who accessed the programme for professional development was compared to those who paid fees. Most mental health professionals finished training and passed the knowledge test, indicating that training enhanced clinicians' knowledge. Fee-paying trainees had significantly faster completion times and a higher proportion finished in the recommended time. Those who were successful at passing the knowledge questionnaire had significantly fewer years in practice. The majority were satisfied with the programme, felt they had made considerable progress and that training would allow them to begin practicing CR, and would recommend the training to colleagues. This online CR training programme was feasible, acceptable to participants and showed benefits for clinicians. It improved knowledge even in the most junior of staff who have had less time to develop clinical know-how.

Navigating unique challenges and advancing equitable care for children with ADHD in Africa: a review.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that presents distinct challenges for African children due to a complex interplay of social, economic and cultural factors. This review examines the various obstacles faced by children with ADHD in Africa, focusing on the lack of awareness and stigma surrounding the disorder, limited access to mental health services, educational system constraints, economic limitations and cultural beliefs and practices. The review underscores the significance of public awareness campaigns and educational initiatives to dispel myths and misconceptions surrounding ADHD. These efforts should target the general public, educators, healthcare professionals, religious leaders and traditional healers. Crucial to addressing this issue is strengthening mental health services, especially in rural and underserved areas, through increased funding and the availability of trained mental health professionals specialised in ADHD diagnosis and treatment. Integrating mental health services into primary healthcare systems is proposed to enhance accessibility for children with ADHD. By training primary care providers to recognise ADHD symptoms and provide initial support and referrals, early identification and intervention can be facilitated. Addressing the affordability and accessibility of ADHD treatment is a priority, with policy recommendations including subsidising medications and therapies and providing financial assistance to families in need. A call for collaborative efforts between governments, nongovernmental organisations and pharmaceutical companies is advocated to ensure that ADHD treatment is affordable and widely available.

COVID-19 Pandemic Lessons for Creating Effective Mental Health Safety Nets in Lower Middle-Income Countries.

The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to mental health globally, particularly in low- and middle-income countries (LMICs) such as Pakistan. This narrative review aims to synthesize the literature on the impact of the pandemic on mental health in LMICs, the challenges and opportunities for mental health system reform, and the role of safety nets in promoting mental health.A comprehensive search was conducted in several electronic databases, resulting in 35 articles being included for review. Data were extracted and analyzed to identify key themes and trends.The COVID-19 pandemic has led to a significant increase in the prevalence of mental health problems in LMICs, particularly anxiety and depression. This burden is disproportionately borne by vulnerable populations, including women, front-line workers, and those living in poverty. The pandemic has highlighted pre-existing weaknesses in mental health systems in LMICs, including inadequate funding, lack of trained mental health professionals, and stigmatization of mental illness. However, it has also presented opportunities for reform, such as increased awareness and political will, and the use of technology to expand access to mental health services. Building effective safety nets, including social protection programs and community-based interventions, can promote mental health and address social determinants of mental illness.The COVID-19 pandemic has underscored the urgent need for mental health system reform and the development of effective safety nets in LMICs. Policymakers should prioritize investment in mental health and address the social determinants of mental illness to build more resilient societies.

Combining mHealth Technology and Pharmacotherapy to Improve Mental Health Outcomes and Reduce Human Rights Abuses in West Africa: Intervention Field Trial.

In West Africa, healers greatly outnumber trained mental health professionals. People with serious mental illness (SMI) are often seen by healers in "prayer camps" where they may also experience human rights abuses. We developed "M&M," an 8-week-long dual-pronged intervention involving (1) a smartphone-delivered toolkit designed to expose healers to brief psychosocial interventions and encourage them to preserve human rights (M-Healer app), and (2) a visiting nurse who provides medications to their patients (Mobile Nurse). We examined the feasibility, acceptability, safety, and preliminary effectiveness of the M&M intervention in real-world prayer camp settings. We conducted a single-arm field trial of M&M with people with SMI and healers at a prayer camp in Ghana. Healers were provided smartphones with M-Healer installed and were trained by practice facilitators to use the digital toolkit. In parallel, a study nurse visited their prayer camp to administer medications to their patients. Clinical assessors administered study measures to participants with SMI at pretreatment (baseline), midtreatment (4 weeks) and post treatment (8 weeks). Seventeen participants were enrolled and most (n=15, 88.3%) were retained. Participants had an average age of 44.3 (SD 13.9) years and 59% (n=10) of them were male. Fourteen (82%) participants had a diagnosis of schizophrenia and 2 (18%) were diagnosed with bipolar disorder. Four healers were trained to use M-Healer. On average, they self-initiated app use 31.9 (SD 28.9) times per week. Healers watched an average of 19.1 (SD 21.2) videos, responded to 1.5 (SD 2.4) prompts, and used the app for 5.3 (SD 2.7) days weekly. Pre-post analyses revealed a significant and clinically meaningful reduction in psychiatric symptom severity (Brief Psychiatric Rating Scale score range 52.3 to 30.9; Brief Symptom Inventory score range 76.4 to 27.9), psychological distress (Talbieh Brief Distress Inventory score range 37.7 to 16.9), shame (Other as Shamer Scale score range 41.9 to 28.5), and stigma (Brief Internalized Stigma of Mental Illness Scale score range 11.8 to 10.3). We recorded a significant reduction in days chained (1.6 to 0.5) and a promising trend for reduction in the days of forced fasting (2.6 to 0.0, P=.06). We did not identify significant pre-post changes in patient-reported working alliance with healers (Working Alliance Inventory), depressive symptom severity (Patient Health Questionnaire-9), quality of life (Lehman Quality of Life Interview for the Mentally Ill), beliefs about medication (Beliefs about Medications Questionnaire-General Harm subscale), or other human rights abuses. No major side effects, health and safety violations, or serious adverse events occurred over the course of the trial. The M&M intervention proved to be feasible, acceptable, safe, and clinically promising. Preliminary findings suggest that the M-Healer toolkit may have shifted healers' behaviors at the prayer camp so that they commit fewer human rights abuses.

Predictors of Satisfaction and Value of Advanced Training for Mental Health Professionals in Wartime Ukraine

The full-scale escalation of Russia’s war against Ukraine in 2022 created a surge of mental health issues, requiring urgent, evidence-based interventions to reduce trauma and mitigate stress. Reflecting recommendations from leading specialists in the field, Ukrainian mental health professionals sought to develop appropriate skills and knowledge for working in wartime through advanced training programs. This study aimed to investigate the experiences of Ukrainian mental health professionals having completed advanced training in mental health topics in wartime. A survey design was adopted, using the purposefully developed, and validated ‘Wartime Learning Satisfaction Scale’. Regression analysis assessed the hypothesized contribution of four scales (Education, Educator, Learner, and War) to the perceived value of advanced training and learners’ satisfaction. Respondents (n = 271) were trained in up to 30 courses (M = 4.27, SD = 3.03) lasting from two to over 120 h. Regression analysis revealed different predictors for satisfaction and value of the courses. Advanced training resulted in higher satisfaction with learning if it matched professional goals of mental health professionals and perceived higher value when relevant to societal demand, consistently constructed, practically useful, and not solely focusing on war-related issues. Respondents who completed all advanced training courses they were interested demonstrated significantly higher confidence in working in wartime. These findings are essential for effective mental health practice during wartime.

Beyond recovery: toward rights-based mental health care - A cluster randomized wait-list controlled trial of a recovery and rights training for mental health professionals with or without first person accounts.

Mental health models grounded in Recovery and Rights are driving the advancement of transformative care systems through multifaceted actions, which encompass Continuing Professional Development. The objective of this work is to evaluate a training activity developed through a participatory process that included people with lived experience of psychosocial distress, their relatives, and mental health professionals. The training focused on alternatives to diagnosis, recovery principles, rights-based care, and peer support. The evaluation followed a cluster randomized wait-list controlled design. Four hundred eighty-eight health professionals from eight care centers were randomized to three experimental conditions: a wait list control, which underwent a one-month interval between the baseline assessment and the training activity, and two experimental groups, with or without first-person accounts, which accessed the training immediately after completing the baseline assessment. The dependent variables measured at all follow-ups were beliefs and attitudes toward mental health service users' rights. One hundred ninety-two professionals completed at least one follow-up and were included in the analyses. We observed different evolutions of experimental and control groups with statistically significant differences for tolerance to coercion and total beliefs and attitudes scores. No differences were observed between the groups with or who attended training activities with or without first person accounts. Upon receiving the training activity, the control group had an evolution equivalent to the experimental groups. The results of this evaluation project provide compelling evidence for the need to expand recovery and rights training activities to reach a larger audience of mental health professionals These training activities hold the potential to positively influence the beliefs and attitudes of mental health professionals, ultimately contributing toward a better future for individuals with lived experience of psychosocial distress.

Technology-assisted cognitive-behavior therapy delivered by peers versus standard cognitive behavior therapy delivered by community health workers for perinatal depression: study protocol of a cluster randomized controlled non-inferiority trial

BackgroundThe lack of trained mental health professionals is a key barrier to scale-up of evidence-based psychological interventions in low and middle-income countries. We have developed an app that allows a peer with no prior experience of health-care delivery to deliver the cognitive therapy-based intervention for perinatal depression, the Thinking Healthy Programme (THP). This trial aims to assess the effectiveness and cost-effectiveness of this Technology-assisted peer-delivered THP versus standard face-to-face Thinking Healthy Programme delivered by trained health workers.MethodsWe will employ a non-inferiority stratified cluster randomized controlled trial design comparing the two formats of intervention delivery. A total of 980 women in the second or third trimester of pregnancy with a diagnosis of Major Depressive Episode, evaluated with the Structured Clinical Interview for DSM-V Disorders (SCID), will be recruited into the trial. The unit of randomization will be 70 village clusters randomly allocated in a 1:1 ratio to the intervention and control arms.The primary outcome is defined as remission from major depressive episode at 3 months postnatal measured with the SCID. Data will also be collected on symptoms of anxiety, disability, quality of life, service use and costs, and infant-related outcomes such as exclusive breastfeeding and immunization rates. Data will be collected on the primary outcome and selected secondary outcomes (depression and anxiety scores, exclusive breastfeeding) at 6 months postnatal to evaluate if the improvements are sustained in the longer-term. We are especially interested in sustained improvement (recovery) from major depressive episode.DiscussionThis trial will evaluate the effectiveness and cost-effectiveness of a technology-assisted peer-delivered cognitive behavioral therapy-based intervention in rural Pakistan. If shown to be effective, the novel delivery format could play a role in reducing the treatment gap for perinatal depression and other common mental disorders in LMIC.Trial registrationThe trial was registered at Clinicaltrials.gov (NCT05353491) on 29 April 2022.

Manipal model of telepsychiatry.

Telepsychiatry can be understood as an interactive mental health service providing mode using information and communication technology. In recent decades, services provided under the umbrella term of telepsychiatry expanded to cater clinical services, diagnostic services, interventions, therapies, education, and research. Since telepsychiatry has been practiced in India for two decades, various models have emerged to meet the country's demands and the logistics that are available. Both synchronous and asynchronous modes of telepsychiatry had been in practice in India depending on the availability of logistics. Most of the telepsychiatry services in India had focused on providing clinical care to reach the unreached population. Furthermore, telepsychiatry had been used to train mental health professionals and healthcare workers from other disciplines. However, not many models had incorporated the idea of hands-on training of the postgraduates/trainees of psychiatric social work (PSW) in telepsychiatry under supervision. This was addressed in the Manipal model of telepsychiatry. Manipal model of telepsychiatry has begun in 2016 with a novel idea to train mental health profession trainees in addition to cover other clinical services, research, and education. In the last eight years, four centers of Karnataka state have been covered under this model with progressive growth in a number of patients and this acted as a hands-on training model for the postgraduate trainees in starting telepsychiatry services independently. Furthermore, it provided an opportunity to develop the organization skills of trainees, improved their oratory skills, and improved their expertise in using information technology for mental healthcare delivery.

Developing digital mental health tools for youth with diabetes: an agenda for future research.

Youth living with diabetes face a concurrent challenge: managing a chronic health condition and managing the psychosocial and developmental changes that are characteristic of adolescence and young adulthood. Despite these unique challenges, psychological support is often difficult for youth with diabetes to access due to a lack of trained mental health professionals and other resource constraints. Digital wellbeing tools offer the potential to improve access to psychological support for this population. However, very few digital wellbeing tools exist for youth with diabetes. Of those that do exist, very few are evidence-based therapies, undermining their contribution to the field. Given the increasing global prevalence of diabetes in young people, the support necessitated by the challenges experienced by this population is not always accessible in a face-to-face setting and cannot be effectively scaled to meet demand. To support the health and wellbeing of youth with diabetes, there is a clear need to develop digital interventions that are widely accessible to users, but, more saliently, grounded in empirical evidence that supports their efficacy. Thus, the purpose of this paper is to offer an agenda for future research, including insights into which psychological techniques and behavioral change theories may be a good conceptual fit for digital mental health interventions, and how these tools may be best developed and utilized by the individuals that need them. Scalable, evidence-based wellbeing tools for this population are urgently required to improve psychological outcomes, and potentially, improve the equity of service access.

Mental health impact of the catastrophic 2023 earthquake on Turkish youth: psychological distress amidst humanitarian crisis

On February 6, 2023, Türkiye was struck by a devastating earthquake with a magnitude of 7.8, a natural disaster of enormous destruction. As a result, many citizens succumbed to mortality, suffered immense physical and psychosocial harm, and the properties of the survivors suffered severe damage. Adolescents and the youth sector in particular are at an increased risk of developing psychiatric disorders1. Hence, policymakers and stakeholders need to pay attention to this understudied sector to prevent and manage health care issues associated with the recent earthquakes. Because of their rapid appearance, ferocity, and devastation, earthquakes exert unequivocal stress events2. Previous studies have demonstrated that posttraumatic stress disorder (PTSD) is frequently linked to earthquakes, which have a significant psychological influence on individuals and hinder their early return to normal activities while prolonging unpleasant emotions3. Moreover, prior traumatic encounters and childhood abuse have a significant impact on the mental health of adolescent survivors3. Recalling fear, triggering memories, or experiencing panic and anxiety is one of the most notable effects of the possibility and persistence of PTSD. These symptoms have a rapid impact on mental health and, according to studies and personal experience, are associated with the initiation and risk of developing PTSD3. In addition, this disorder comprises mood disorders, such as dysthymia and anxiety, with the diagnosis being connected to the existence of PTSD following the earthquake3. The majority of adolescent survivors’ experience intrusive flashbacks and posttrauma ruminations, also known as event-related ruminations, which result from the shaking of beliefs after excruciating occurrences2. Adolescents may experience varying levels of trauma following the earthquake, with one of the most significant elements influencing the intensity being the loss of family members and the damage of homes, which causes a dramatic change in their lives2,3. Adolescent trauma survivors are thought to focus more on the negative aspects of traumatic cues as a result of automatic ruminations that reduce an individual’s ability to avoid them. The most recent earthquake in Türkiye since 1939 had the largest recorded magnitude, and it damaged an area of around 400 km24. The chronicity of adolescent survivors’ mental health and quality of life are impacted by postearthquake difficulties including eviction, destroyed homes, or injuries. These variables are more likely to be subjected to harsher conditions in the aftermath of the traumatic event3. According to a study, those who have experienced partial or full PTSD symptoms for 2 years may continue to experience them for the following 10 years5. The Turkish government faces a serious task in constructing a suitable plan to aid the afflicted youth alongside heal those affected and develop a prosperous generation. In response to the rising prevalence of adolescent mental health issues, the World Health Organization (WHO) is assisting the Turkish government through its regional concept of operations, working in partnership with the Turkish Ministry of Health to provide mental health services throughout all impacted areas4. It is advised to conduct a structured examination of adolescent psychological distress symptoms. This may be achieved by interviewing teenagers, preferably without their parents present to prevent emotional bias and distress disguise. This mediates a secure clinical setting in which to discuss their traumatic experience to receive appropriate care6. Moreover, following the early emergency comeback, children and caregivers will warrant additional specialized trauma healing interventions that will be crucial in assisting youth in maintaining their well-being while also being impacted by the risk and protective factors that came with the Türkiye earthquake7. Offering extensive training for mental health professionals is highly advised, so that the symptoms of PTSD and other disorders are revealed more rapidly, and hence managed more sufficiently6. Not only should face-to-face therapy be offered, but also eHealth methods should be adopted to expand the range of benefited adolescents throughout all regions of Türkiye6. There is a need to break the stigma surrounding mental health, that acts as a barrier preventing individuals from seeking help. Moreover, community and political engagement and improvement of disaster management goals accountability and identifying gaps are essential steps. Through sustained research identification of predictors may help formulate postdisaster relief and rehabilitation efforts to further reduce the psychological distress in such a humanitarian crisis. Ethical approval Not applicable. Sources of funding The authors have not received any financial support for this manuscript. Author’s contribution O.U.: conceptualization, project administration, writing—review and designing. H.A.: reviewing the first draft and revising. J.W.: reviewing and editing. All authors approved the final manuscript and submission. Conflicts of interest disclosure The authors declare that they have no financial conflict of interest with regard to the content of this report. Research registration unique identifying number (UIN) Abubakar Nazir. Guarantor Abubakar Nazir. Data availability statement Not applicable.