Unique Mental Health Research Articles

Long-COVID stress symptoms: Mental health, anxiety, depression, or posttraumatic stress.

Currently, there is no single profile of mental health sequela in long-coronavirus disease (COVID) patients, impacting identification, treatment, and exacerbating stigma among this population. This article highlights the rationale for mental health professionals to consider a summary of mental health symptoms in long-COVID patients. This article provides an overview of the existing literature regarding the health and mental health impact of long COVID on patients and proposes an approach to conceptualizing mental health symptoms in individuals living with long COVID. This article summarizes the health and mental health impacts of long COVID and underscores the limitations of the current approach to measuring and screening mental health symptoms in long-COVID patients. Long-COVID patients have reported new and worsening mental health symptoms; most frequently reported are depression, anxiety, posttraumatic stress disorder (PTSD), and insomnia. The article concludes by proposing the notion of long-COVID stress symptoms and calls for mental health researchers to identify the unique and complex mental health profiles emerging among this patient population. Though some long-COVID patients survived life-threatening illnesses and may, therefore, meet the formal criteria for PTSD, many will present with posttraumatic symptomology that mimics PTSD but may not arise from life-threatening medical trauma. A better understanding of the mental health burden of long-COVID stress symptoms is essential to providing efficient and effective mental health treatment, supporting physicians treating long-COVID patients, and enhancing access to and utilization of medical services. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

‘Is it worth potentially dealing with someone who won't get it?’: LGBTQA+ university students’ perspectives on mental health care

ABSTRACT LGBTQA+ university students have unique mental health needs and high rates of mental distress compared to their cisgender heterosexual peers; however, it is likely that many LGBTQA+ individuals remain untreated or receive inappropriate or insensitive care. The aim of this study was to explore the experiences and preferences in mental health care of LGBTQA+ university students in Aotearoa New Zealand. Twenty-eight young adults participated across 12 focus groups or interviews in which they were asked about their experiences and preferences. We used thematic analysis to identify patterns of meaning in the data. Researchers developed three themes of I can do this on my own, but others should seek help; you have to be lucky to access mental health care; and ‘therapists just need to be a bit more like up with the programme’. The results of this study mirror those found in more general studies of LGBTQA+ mental healthcare experiences, however, also adds to considerations for university campus healthcare services. The findings of this study should be considered by all mental health providers working with LGBTQA+ young adult university students.

How Medical Education Can Address the Unique Mental Health Stressors of Students of Color.

How Medical Education Can Address the Unique Mental Health Stressors of Students of Color.

(030) Mental Health and Unmet Healthcare Needs of Female Sex Workers in Baltimore, Maryland

Abstract Introduction Female sex workers (FSW) experience unique mental health and well-being challenges that intersect with their sex work and sexual health. Further, they often experience discrimination and stigma within healthcare settings, leading to delayed or forgone healthcare. Throughout the COVID-19 pandemic, FSW faced unique limitations on their ability to gain financial compensation, which can amplify existing social inequities and morbidities (i.e. poor mental health) among this marginalized population. Objective As poor mental health is associated with increased risk of acquiring HIV and other sexually transmitted infections (STI), it is critical to understand the unique mental health strains of FSW in order to improve their engagement in and quality of mental and sexual healthcare. Methods Participants were purposively sampled for in-depth qualitative interviews to ensure a diversity of experience from an existing cohort study of COVID-19 testing in Baltimore, Maryland. The semi-structured interview includes questions about aspects of sex work most salient for mental health (and their changes during COVID) including: their relationship with street-based sex work, police interactions, violence, safety, substance use and overdose. Two independent coders conducted a thematic analysis using inductive and deductive codes. Results Preliminary results from qualitative interviews (n=14) with FSWs demonstrate a diversity of experience throughout the COVID-19 pandemic and its impact on mental health, self-management practices, stigmatizing and unsafe experiences, and barriers to healthcare. Despite many having a primary care physician, many participants did not report receiving care that was respectful or culturally sensitive to their sex work; participants who did not report having a primary care physician had a harder time seeking care. Multiple FSWs described formal psychiatric diagnoses but often noted that they were not on consistent medication due to financial instability and prescription side-effects. Moreover, self-medication through drugs was a prevalent theme, as barriers to accessing treatment for mental illness required that they find alternate means to address their symptoms. Cultivating self-management strategies (e.g., getting high, writing in a journal, finding a place to release emotions, focusing on work) that serve as alternatives to primary care treatment was common. Themes also included isolation during COVID, and a lack of a strong support system to discuss feelings of stress, depression, and anxiety. Conclusions Results show that FSW have a unique constellation of factors that negatively impact their mental health, but often lack access to culturally sensitive and non-stigmatizing care. Healthcare providers must be educated on the healthcare concerns of FSWs and their intersections with the unique social determinants they face. Disclosure No

Patterns of demoralization and anhedonia during early substance use disorder treatment and associations with treatment attrition

BackgroundAlthough depressive symptoms represent a promising therapeutic target to promote recovery from substance use disorders (SUD), heterogeneity in their diagnostic presentation often hinders the ability to effectively tailor treatment. We sought to identify subgroups of individuals varying in depressive symptom phenotypes (i.e., demoralization, anhedonia), and examined whether these subgroups were associated with patient demographics, psychosocial health, and treatment attrition. MethodsPatients (N = 10,103, 69.2 % male) were drawn from a dataset of individuals who presented for admission to SUD treatment in the US. Participants reported on their demoralization and anhedonia approximately weekly for the first month of treatment, and on their demographics, psychosocial health, and primary substance at intake. Longitudinal latent profile analysis examined patterns of demoralization and anhedonia with treatment attrition as a distal outcome. ResultsFour subgroups of individuals emerged: (1) High demoralization and anhedonia, (2) Remitting demoralization and anhedonia, (3) High demoralization, low anhedonia, and (4) Low demoralization and anhedonia. Relative to the Low demoralization and anhedonia subgroup, all the other profiles were more likely to discontinue treatment. Numerous between-profile differences were observed with regard to demographics, psychosocial health, and primary substance. LimitationsThe racial and ethnic background of the sample was skewed towards White individuals; future research is needed to determine the generalizability of our findings to minoritized racial and ethnic groups. ConclusionsWe identified four clinical profiles that varied in the joint course of demoralization and anhedonia. Findings suggest specific subgroups might benefit from additional interventions and treatments that address their unique mental health needs during SUD recovery.

Mental Health Impacts of Climate Change for Birthing People and the Provider's Role.

Mental Health Impacts of Climate Change for Birthing People and the Provider's Role.

Acne and its association with internalizing problems

AbstractAcne vulgaris or “acne” is a prevalent and burdensome cutaneous condition that has been linked with unique mental health implications. Clinical (i.e., general and social anxiety, and major depression) and subclinical indicators (e.g., excessive worry, social self‐consciousness, and low self‐esteem) of internalizing disorders have been associated with acne across demographics (e.g., age groups and cultures). Considering the persistent burden of disease associated with these mental health outcomes, our primary aim was to concretely synthesize the relation between acne and internalizing symptoms. A secondary aim was to address the role that combined oral contraceptives and isotretinoin (e.g., Accutane), widely prescribed medical treatments for acne, may play in this relation as both have been linked to depression and anxiety. We discuss practical implications that may strengthen the effective biopsychosocial management of acne for suffering individuals. This review actively upholds and amplifies the call for longitudinal research that integrates the developmental psychology and dermatology literature to effectively treat acne in its entirety, including mental health.

The Geography of Mental Health, Urbanicity, and Affluence

Residential location has been shown to significantly impact mental health, with individuals in rural communities experiencing poorer mental health compared to those in urban areas. However, the influence of an individual's social group on the relationship between residential location and mental health outcomes remains unclear. This study disaggregates the rural-urban binary and investigates how geography and social groupings interact to shape mental health outcomes. Merging data from PLACES and Claritas PRIZM, we conducted a hotspot analysis, generated bivariate choropleth maps, and applied multiscale geographically weighted regressions to examine the spatial distribution of mental health and social groupings. Our findings reveal that mental health is influenced by complex interactions, with social groups playing a critical role. Our study highlights that not all rural and urban areas are alike, and the extent to which social groups influence mental health outcomes varies within and across these areas. These results underscore the need for policies that are tailored to meet the unique mental health needs of individuals from different social groups in specific geographic locations to inform policy interventions that more effectively address mental health disparities across diverse communities.

Mental Health Diagnoses, Health Care Utilization, and Placement Stability on Antipsychotic Prescribing Among Foster Care Youth.

This study sought to examine how mental health diagnoses, health care utilization and foster care placement instability affect antipsychotic prescribing and how these factors may contribute to disproportionate antipsychotic prescribing among youth in foster care. This retrospective cohort study utilized EHR data that were linked to administrative child welfare data. Two outcome variables were analyzed: 1) any antipsychotic prescription documented and 2) number of antipsychotic prescriptions documented. Predictor variables included foster care status, number of unique mental health diagnoses, counts of health care encounters over the study period, and counts of foster care placements. Covariates included gender, persons of color, and age in years. Models were estimated using logistic regression for the dichotomous outcome and Poisson regression for the count outcome. Increased antipsychotic prescribing among children in foster care persists even after accounting for mental health diagnoses and health care utilization. However, the number of placements modified the effect of foster care involvement on antipsychotic prescribing such that after 2 placement changes, the odds of being prescribed an antipsychotic surpassed the effect of foster care involvement. More mental health diagnoses, more inpatient and emergency health care encounters, and more foster care placements were associated with an increased odds of being prescribed an antipsychotic and an increased count of antipsychotic prescriptions. Decreased primary care encounters were associated with increased odds of antipsychotic prescriptions, and decreased specialty encounters were associated with higher counts of antipsychotic prescriptions. Placement instability is associated with disproportionate antipsychotic prescribing among youth in foster care.

DEVELOPMENT, DELIVERY AND EVALUATION OF MICRO-CERTIFICATE MENTAL HEALTH AMBASSADORSHIP COURSE

Mental illnesses can impact anyone. However, those who suffer from mental ill health can face stigma contributing to a barrier in help-seeking behaviour. The Brain and Mind Institute, at the Aga Khan University (BMI AKU) aims to create a small ‘army’ of mental health ambassadors for mental health awareness, identification, and referral for those in need of help for their mental well-being. This is a narrative of designing, approving, standardising, delivering, evaluating and a proposing future evolution of a unique Micro-certificate Mental Health Ambassadorship course.

Gender and Racial/Ethnic Disparities in Undergraduate and Graduate Students' Mental Health and Treatment Use Amid the COVID-19 Pandemic.

The COVID-19 pandemic has negatively impacted numerous people?s mental health and created new barriers to services. To address the unknown effects of the pandemic on accessibility and equality issues in mental health care, this study aimed to investigate gender and racial/ethnic disparities in mental health and treatment use in undergraduate and graduate students amid the COVID-19 pandemic. The study was conducted based on a largescale online survey (N = 1,415) administered during the weeks following a pandemic-related university-wide campus closure in March 2020. We focused on the gender and racial disparities in current internalizing symptomatology and treatment use. Our results showed that in the initial period of the pandemic, students identified as cis women (p < .001), non-binary/genderqueer (p < .001), or Hispanic/Latinx (p = .002) reported higher internalizing problem severity (aggregated from depression, generalized anxiety, intolerance of uncertainty, and COVID-19-related stress symptoms) compared to their privileged counterparts. Additionally, Asian (p < .001) and multiracial students (p = .002) reported less treatment use than White students while controlling for internalizing problem severity. Further, internalizing problem severity was associated with increased treatment use only in cisgender, non-Hispanic/Latinx White students (pcis man = 0.040, pcis woman < 0.001). However, this relationship was negative in cis-gender Asian students (pcis man = 0.025, pcis woman = 0.016) and nonsignificant in other marginalized demographic groups. The findings revealed unique mental health challenges faced by different demographic groups and served as a call that specific actions to enhance mental health equity, such as continued mental health support for students with marginalized gender identities, additional COVID-related mental and practical support for Hispanic/Latinx students and promotion of mental health awareness, access, and trust in non-White, especially Asian, students are desperately needed.

Wellbeing and mental health interventions for Indigenous children and youth: A systematic scoping review

IntroductionKey policy directives from Canada, Australia, New Zealand, Norway and the United States (CANNZUS countries) highlight the importance of addressing the unique and complex wellbeing and mental health needs of Indigenous school-aged children and youth. This systematic scoping review of the peer reviewed and grey literature identifies the extant evidence about the conditions, strategies and impacts of wellbeing and mental health screening, management and referral pathways for Indigenous children and youth in CANNZUS countries. MethodsA search for peer reviewed and grey literature was conducted of 17 electronic databases and 13 clearinghouses and websites in each of the included countries. Search results were imported into Endnote X9 with titles and abstracts screened against inclusion criteria. The full texts of selected publications were screened by at least two blinded reviewers. Data extracted from the full texts included: authorship, year and publication type; country, target group, sample size and intervention setting, intervention type and study design, outcome measures and reported outcomes. ResultsThe searches produced 3223 peer reviewed and 278 grey literature publications (after duplicates were removed) giving a total of 3501 references. Screening resulted in 15 papers arising from 14 intervention studies in primary health care services, education, juvenile justice and community settings. Only 9 of the 15 publications evaluated an intervention; 6 were program descriptions. The review identified four key approaches to improve wellbeing and mental health care for Indigenous children and youth – cross-service collaboration, professional education, intervention quality and appropriateness, and enhancing direct service provision pathways. Intervention outcomes included acceptability, appropriateness and effectiveness. Discussion/conclusionThe small number of studies found suggests that this research niche area is still in development, with few evaluations of interventions. Identification of interventions within the four broad strategy areas is useful, and the review has some value in guiding the tailored development of interventions in other sites. Further Indigenous-led investigations of wellbeing are needed to identify what works to improve wellbeing and mental healthcare for Indigenous children and youth.

PHYSICAL AND MENTAL HEALTH OUTCOMES AMONG OLDER MILITARY VETERANS

Abstract Older veterans are a unique health population, with physical and mental health outcomes impacted by the positive health aspects of military social capital as well as the negative aspects of military-related hazards. This symposium focuses on physical and mental health outcomes among older military veterans both before COVID-19, and during the COVID-19 pandemic. Three studies address veteran health outcomes pre-pandemic. Two of the pre-pandemic studies focus on veteran-only samples in order to determine whether aspects of marital quality predicted levels of loneliness, and risk factors for trauma re-engagement among those with medical illness. The third pre-pandemic study examines whether the increased mortality risk observed among older veterans compared to nonveterans varies by combat status. Two studies address veteran health outcomes during the COVID-19 pandemic. The first uses a sample of older veterans with PTSD who were surveyed pre-pandemic and during the pandemic in order to ascertain the mental and physical health impact of the pandemic. The second COVID-19 study uses data from a study of Veterans Affairs’ Home Based Primary Care (HBPC) providers to learn about the best practices discovered to ensure COVID-19 vaccination uptake by some of the most vulnerable older veterans. Results from each of these studies will shed light on policies and practices needed to ensure the best physical and mental health outcomes for older military veterans.

COVID-19 WIDOWHOOD OR PANDEMIC WIDOWHOOD: EXAMINING THE DIFFERENTIAL IMPLICATIONS FOR MENTAL HEALTH

Abstract Millions of COVID-19 widows worldwide face elevated mental health risks that foreshadow worsening physical health and elevated mortality. It remains unknown whether the excess mental health problems for COVID-19 widows are a result of the “bad death” experiences from COVID-19 (e.g., unexpected death and high levels of medical intervention) or pandemic-induced social changes (e.g., social isolation and limited funerals). This study examines whether older adults whose spouses died of COVID-19 disease have worse mental health (self-reported depression, loneliness, and trouble sleeping) than those whose spouses died from causes other than COVID-19 before and during the pandemic. We used Survey of Health, Ageing and Retirement in Europe data collected before (Wave 8, fielded October 2019 to March 2020) and during the pandemic (COVID-19 Supplement-2, fielded June to August 2021) to compare three groups whose spouses died (a) before the pandemic, (b) from COVID-19 during the pandemic, and (c) from non-COVID-19 causes during the pandemic. We find those spouses died from COVID-19 have higher risks of self-reported depression, loneliness, and trouble sleeping than those losing a spouse before the pandemic. However, losing a spouse due to non-COVID-19 causes during the pandemic is not significantly associated with worse mental health compared to pre-pandemic scenarios. During the pandemic, older adults whose spouses died from COVID-19 report higher risks of loneliness than those spouses died from non-COVID-19 causes. This study suggests losing a spouse due to COVID-19 presents unique mental health risks for older adults, clarifying prior theories about mental health impacts of pandemic bereavement.

Recent and Frequent Mental Distress Among Women with a History of Military Service, 2003-2019.

Examining women veterans' self-reported mental health is critical to understanding their unique mental and physical health needs. This study describes self-reported mental distress over a 17-year period among cross-sectional nationally representative samples of women in the USA using data from the Behavioral Risk Factor Surveillance System (BRFSS) core national surveys from 2003 to 2019. Nationally representative prevalence estimates of self-reported mental distress were compared between women veterans and their (1) men veteran and (2) women civilian counterparts. In each year examined, women veterans report significantly more days of recent mental distress and significantly higher prevalence of frequent mental distress than their men veteran counterparts. In several years, women veterans also report greater levels of recent and frequent mental distress than women civilians. These findings highlight the long-standing high prevalence of self-reported poor mental health among women veterans and suggest that specific efforts to address mental health among women veterans as a unique population may be warranted.

Mental health of sexual and gender minority youth in Austria: scoping review and research agenda based on international evidence

A robust body of international evidence documents that lesbian, gay, bisexual, transgender, and other youth with diverse sexual orientations and/or gender identities (i.e., sexual and gender minority youth) face unique mental health vulnerabilities but are also equipped with unique resources. However, it is unclear to what extent these findings are applicable to sexual and gender minority youth in Austria, because the sociolegal and developmental contexts differ across countries. According to PRISMA guidelines, we conducted asystematic scoping review (1)to identify published studies on the mental health of sexual and gender minority youth in Austria, and, based on this, (2)to derive research recommendations supplemented by international evidence. We searched five scientific databases (PsycInfo, PSYNDEX, PubMed, Scopus, Web of Science; March 2022) and additionally contacted researchers and community leaders to find pertinent studies. Only two published empirical studies on the mental health of sexual and gender minority youth in Austria could be located, reflecting the sparse state of research in Austria. Against this background, we outline adetailed research agenda following asocio-ecological approach. Including sexual orientation and non-binary gender identities in population-based studies to assess onset, prevalence, and trajectory of mental health burdens, as well as conducting targeted, resource-based, and developmentally sensitive research on all levels seem paramount to reduce health disparities and societal stigma and to support sexual and gender minority youth in their development.

Prevalence and factors associated with tobacco use among beneficiaries attending the youth mental health promotion clinics (Yuvaspandana Kendra) in India: A case-record analysis.

Chewing tobacco and smoking among youth leads to poor health outcomes. Understanding the factors associated with chewing tobacco and smoking is thus important for interventions. A case-record analysis among 10340 youth (aged 15-35 years) attending a unique mental health promotion program, Yuva Spandana, across the state of Karnataka in southern India, was performed to assess prevalence of chewing tobacco and smoking. Multiple logistic regression was applied to determine the factors associated with their use. Overall, the prevalence of chewing tobacco and smoking among beneficiaries was 3% and 2.1%, respectively. The risk of tobacco chewing and smoking increased with age and risk was higher among males, married individuals and among all occupational categories, other than students. Adjusted odds ratios of chewing tobacco were found to be highest among business/salaried beneficiaries (AOR=3.48; 95% CI: 2.27-5.34), followed by ever married beneficiaries (AOR=3.41; 95% CI: 1.27-9.17). Adjusted odds ratios of smoking tobacco were highest among males (AOR=12.89; 95% CI: 7.5-22.14), followed by emotional experience of feeling worthless (AOR=4.19; 95% CI: 2.78-6.32), beneficiaries with poor relationship with family members (AOR=3.79; 95% CI: 1.38-10.44), and business/salaried beneficiaries (AOR=2.90; 95% CI: 1.79-4.7). Strength of association of males with smoking was much higher (AOR=12.89; 95% CI: 7.5-22.14) than compared with chewing tobacco (AOR=2.49; 95% CI: 1.89-3.28). Early identification of these factors associated with chewing tobacco and smoking will help in focusing on youth specific health promotion and interventions to improve their overall health and wellbeing.

Strengthening Response Toward Promoting Mental Health in India: A Narrative Review.

Mental health is an essential component of human development. It deals with human ideas and emotions, and it helps to lead a good life by paving the way for healthy minds. The absence of a healthy mind is a substantial hindrance to personal, societal, and national economic, political, and social functioning. For a long time in India, mental illness has been shrouded in stigma, ignorance, and superstition. The National Mental Health Program (NMHP) has undergone major strategic revisions throughout its existence, from instituting a district as the entity for program planning and implementation under the District Mental Health Program (DMHP) to integrating it with the National Rural Health Mission to productively scale up the program. Many researchers reviewed the program, which was also evaluated by governing and non-governmental institutions. Financial and human capital restrictions, a lack of public involvement, inefficient training, poor non-governmental organization/private cooperation, and a deficit of solid monitoring and evaluation system have all hampered the program's impact. A thorough study of the literature on India's unique mental health initiatives was conducted using particular Medical Subject Heading (MeSH) terms, including "community mental health program,""mental health project,""innovative in mental health programs," and "India,"and Boolean operators "AND/OR." The MeSH keywords used were as follows: mental health projectOR ("mental health project" [Mesh] OR "innovative in mental health programs" [Mesh]) AND community mental health program AND("community mental health program" [Mesh]), India OR ("India" [Mesh]). A preliminary search was conducted in Google Scholar and the PubMed database. A total of 55 indexed papers were found, of which 24 articles were duplicates, hence they were removedand the research eventually contained 31 investigations. Over time, it has become clear that a strong focus on community mental health is critical, and that the DMHPand NMHP, in terms of coverage and utilization of their service components, need to be strengthened. As with many other public health programs, public awareness and information, education, and communication programs must be the most important components for change to occur at the community level.Many tactics and innovations also help to democratize mental health care by allowing the integration of mental health programs into primary care, which is more equitable in the long run and leads to "good mental health for everyone."

Integrating evaluation data to enhance treatment planning for students with ASD

AbstractAccurate assessment across the various characteristics of autism spectrum disorder (ASD) and its comorbidities can help guide intervention planning. This introduction to the second issue of a double special issue on ASD assessment highlights assessment of various characteristics of and comorbidities with ASD to assist with treatment planning. For instance, anxiety and attention deficit hyperactivity disorder are two of the most common comorbidities with ASD. Educational, clinical, and medical interventions for individuals with ASD can vary based on the unique cognitive and additional mental health needs of the individual.

South Asian youth mental health in Peel Region, Canada: Service provider perspectives.

The Peel Region of Toronto, Canada is home to over a third of the province's South Asian population. Youth are at a vulnerable time period in terms of their mental health. South Asian youth populations may face additional challenges to their mental health such as acculturative stress, intergenerational conflict, and racism and discrimination. This qualitative study set out to understand the mental health concerns and service access barriers experienced by South Asian youth populations in the Peel Region of Toronto, Canada from the perspective of mental health service providers. In-depth semi-structured interviews were carried out with mental health service providers (n = 22) who work with South Asian youth living in Peel Region. Thematic analysis was used to elucidate themes related to mental health stressors and service access barriers experienced by youth. According to mental health service providers, South Asian youth navigate a number of unique stressors related to the domains of culture, religion, and family dynamics, experiences of discrimination, the impact of migration, beliefs around mental illness and help-seeking, help-seeking trajectories and therapy recommendations, and lastly, sex differences. Mental health service providers outlined steps needed to effectively address the unique mental health challenges, best practice guidelines, and recommendations for working with South Asian youth, families, and communities to provide a practical and nuanced overview on how a multi-level strategy for mental health care can effectively meet the needs of South Asian youth populations.