International Journal of Social Psychiatry

Employment is an important social determinant of health and is associated with positive health outcomes. However, individuals who have been diagnosed with borderline personality disorder (BPD) are significantly underrepresented in the workforce. Whilst there is an array of evidence based therapeutic interventions, there remains a gap in knowledge regarding the most effective ways to enhance employment outcomes for people with a diagnosis of BPD.

To explore employment interventions for people with BPD, map the available evidence and identify key concepts and knowledge gaps.

A scoping review was conducted to identify and map the relevant literature. Findings were summarised using a narrative approach. Consultation was provided by a reference group including peer support workers with lived experience of BPD and mental health clinicians.

Seven articles met the inclusion criteria, including non-randomised and case study/series designs and a randomised controlled trial protocol, with participant numbers generally low. All programmes combined a psychotherapeutic component with work related goals; however, there were notable differences in relation to the conceptual/theoretical approach of the psychotherapeutic component and delivery of the work-related components. Barriers and enablers to programme participation and success are explored.

This review provides important insights into the characteristics of vocational rehabilitation interventions for people diagnosed with BPD. The findings will inform the co-production of approaches to support people with BPD to engage in employment.

Psychosis is a mental disorder that, despite its low prevalence, causes high disease and economic burden. Inadequate knowledge, lack of confidence and stigmatising attitudes of healthcare professionals (HCPs) may lead to suboptimal care.

To review the literature exploring HCPs’ knowledge, confidence and attitudes in relation to psychosis care.

A systematic search was undertaken across three databases (MEDLINE, Embase, PsycINFO) using a search strategy encompassing the concepts: ‘healthcare professionals’, ‘knowledge, attitude, and confidence in care’ and ‘psychotic illnesses and symptoms’ to identify relevant records published from 1st January 2002 to 18th March 2022. Results were screened against predetermined inclusion and exclusion criteria by title and abstract, followed by full text. Data were extracted into tables and synthesised narratively.

Initially, 7,397 studies were identified. Following two-stage screening, 24 studies were eligible for inclusion. Of these studies, 16 explored attitudes, four explored knowledge and attitudes, one explored knowledge, one explored confidence, one explored attitudes and confidence in care and one explored all three constructs. Most HCPs in the included studies demonstrated stigmatising attitudes towards people with psychosis. Furthermore, certain HCPs, including nurses and general practitioners, demonstrated low levels of knowledge, while psychiatrists, occupational therapists, psychologists and nurses had low levels of confidence in caring for people with psychosis. Conversely, positive attitudes were also observed in some HCPs resulting from having acquaintances with lived experience of psychosis. The need for additional education and training to improve HCPs’ knowledge and confidence in relation to caring for people living with psychosis was identified.

Most attitudes identified were negative and stemmed from stigma, while some were positive due to HCPs’ compassion and familiarity with psychosis. The level of knowledge and confidence identified were mostly suboptimal, and so further research is required to develop and evaluate tailored interventions to address this gap.

In the literature on stigma, authors often use self-stigma or internalized stigma interchangeably to refer to this type of stigma. This results in a lack of conceptual clarity with negative repercussions for measurement and intervention.

To identify how internalized stigma and self-stigma are conceptualized in people diagnosed with a mental disorder and establish similarities and differences between both concepts.

A scoping review was conducted. Thirty-five studies that conceptualized internalized stigma or self-stigma were selected.

It was identified that the concepts are defined from nine components, and there are more conceptualizations that have points in common than those that consider some component of their own. To gain conceptual clarity, the use of the term internalized stigma is recommended, being a process made up of stages: acceptance of stereotypes and prejudices by people with mental disorders and their subsequent internalization. The latter leads to negative consequences for those affected, which can be understood as the personal impact of this process, which has a crucial socio-cultural component. Lines of research are proposed to provide solidity to studies on this type of stigma.

The term internalized stigma should be used when referring to the type of stigma that includes acceptance, internalization and personal impact for the subjects of the stigma. In contrast, self-stigma should be reserved to refer to stigma that is directed toward the ‘self’ and includes subtypes of stigma.

Artificial Intelligence is ever-expanding and large-language models are increasingly shaping teaching and learning experiences. ChatGPT is a prominent recent example of this technology and has generated much debate around the benefits and disadvantages of chatbots in educational domains.

This study seeks to demonstrate the possible use-cases of ChatGPT in supporting educational methods specific to social psychiatry.

Through interactions with ChatGPT 3.5, we asked this technology to list six ways in which it could aid social psychiatry teaching. Subsequently, we requested that ChatGPT perform one of the tasks it identified in its responses.

ChatGPT highlighted several roles it could fulfil in educational settings, including as an information provider, a tool for debates and discussions, a facilitator of self-directed learning and a content-creator for course materials. For the latter scenario, based on another prompt, ChatGPT generated a hypothetical case vignette for a topic relevant to social psychiatry.

Based on our experiences, ChatGPT can be an effective teaching tool, offering opportunities for active and case-based learning for students and instructors in social psychiatry. However, in their current form, chatbots have several limitations that must be considered, including misinformation and inherent biases, although these may only be temporary in nature as these technologies continue to advance. Accordingly, we argue that large-language models can support social psychiatry education with appropriate caution and encourage educators to become attuned to their potential through further detailed research in this area.

A key feature of South Africa’s state health care strategy since 1994 has been the development and expansion of services towards integrated health care at primary health care level. Within the new system, emphasis has been on the integration of patients with mental health care needs with other patients where multiple health conditions and needs would be addressed simultaneously. As part of a larger study into mental health care in a predominantly rural district, we investigated the experiences of facility managers and mental health service users in rural clinics within the system of care. We were interested both in their views as to the advisability of the integrated model and the ways in which they managed any challenges they may have experienced within the system at local level.

Data were collected through once-off semi-structured interviews with facility managers and mental health care service users to gather qualitative information. Narratives were transcribed and translated into English. Transcriptions were imported to Atlas.ti 22 and analysed through Thematic Analysis.

The integration of mental health care into routine primary health services poses challenges to treatment delivery and to patients who come for treatment. Our study also suggests resegregating mental health care as a possible solution to facilitate service delivery and treatment to service users.

This research provided first insights into facility managers’ and service users’ views of integrated mental health care at primary health care level in this district. While mental health care services have been expanded and integrated into primary health care over recent years, the system may not have been as streamlined as in other parts of the country. The integration of mental health into primary health care can pose various challenges to facilities, health care providers, and mental health service users. Managers in these constrained circumstances have observed that resegregating mental health care from physical treatment, as in the past, may be deemed more effective for health care provision and reception. Generalised integration of mental health treatment with physical care should be approached with caution unless there is wider scale provisioning and greater organisational change.

Among refugees residing in countries of first asylum, such as Malaysia, high rates of psychological distress call for creative intervention responses.

This study examines implementation of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) model promoting emotional well-being and access to services.

The one-session intervention was implemented in community settings by refugee facilitators during 2017 to 2020. 140 Participants including Afghan (n = 43), Rohingya (n = 41), and Somali (n = 56) refugees were randomized to receive either the intervention at baseline, or to a waitlist control group. At 30 days post-intervention, all participants completed a post-assessment. Additionally, after completing the intervention, participants provided feedback on SBIRT content and process.

Findings indicate the intervention was feasible to implement. Among the full sample, Refugee Health Screening-15 emotional distress scores reduced significantly among participants in the intervention group when compared to those in the waitlist control group. Examining findings by nationality, only Afghan and Rohingya participants in the intervention condition experienced significant reductions in distress scores compared to their counterparts in the control condition. Examining intervention effects on service access outcomes, only Somali participants in the intervention condition experienced significant increases in service access compared to the control condition.

Findings indicate the potential value of this SBIRT intervention, warranting further research.

Gender-based violence (GBV) among men is a universally present phenomenon that is mostly unacknowledged. The relative lack of research in this area leads to a deficiency of evidence ascribing due recognition to GBV among men. This, in turn, leads to not identifying it as a social problem, hence, poor development of resources for victims as well as poor help-seeking behaviour patterns are prevalent, especially in Southeast Asia.

We aimed to determine the prevalence of GBV among men in Colombo, Sri Lanka.

A descriptive cross-sectional analytical community survey was conducted to explore GBV against 1280 Sinhala-speaking men, selected using a multistage cluster sampling method in Colombo district, Sri Lanka. The GBV among men questionnaire (GBVMQ) was developed and culturally validated. A multiple logistic regression model was developed and nine correlates of GBV were identified and adjusted odds ratios estimated.

The prevalence of GBV was 35.8% (95% CI 33.1 -38.6). The prevalence of Verbal GBV was 34.7% (95% CI 32.1 -37.5). Childhood sexual abuse was 7.6% (95% CI 6.2 -9.2). Being subjected to ridicule as cowardly or unmanly (AOR = 25.3, 95% CI 5.58 -114.7, P<0.0010), Childhood sexual abuse (AOR = 4.4, 95% CI 1.73 -11.09, P = 0.002) showed positive associations with statistical significance.

The results highlight the importance of having services for men as well as women. Enabling inclusiveness of men in mandates of state and private institutions catering for GBV would be a strategy in moving forward for Sri Lanka.

From March to April 2019, a flood occurred in several regions of Iran. The most affected provinces were Golestan, Lorestan, and Khuzestan.

The present study aimed to determine the prevalence and determinants of psychological distress and depression among the affected adult population 6 months after the event.

A cross-sectional household survey with face-to-face interview was carried out on a random sample of 1,671 adults aged above 15 years living in the flood-affected areas from August to September 2019. We applied GHQ-28 and PHQ-9 for the assessment of psychological distress and depression, respectively.

The prevalence of psychological distress and depression were 33.6% (95% CI [29.5, 37.7]) and 23.0% (95% CI [19.4, 26.7]), respectively. Determinants of psychological distress were a history of mental disorders (Adjusted odds ratio [AOR] = 4.7), primary (AOR = 2.9) or high school (AOR = 2.4) education (vs. university), no compensation received (AOR = 2.1), high damage to assets (AOR = 1.8), the house flooded more than 1 m (AOR = 1.8), female gender (AOR = 1.8), and limited access to health care services (AOR = 1.8). Determinants of depression were unemployment (AOR = 5.3) or being a housewife (AOR = 2.7), a history of mental disorders (AOR = 4.1), high damage to assets (AOR = 2.5), no compensation received (AOR = 2.0), the house flooded more than 1 m (AOR = 1.8), limited access to health care services (AOR = 1.8), and high wealth index (AOR = 1.7).

The results of this study revealed a high prevalence of psychological distress and depression in the flood-affected adult population. The high-risk group, particularly flood victims who had a history of mental disorders, and those exposed to severe damages of flood, should be prioritized for screening, and mental health services.

Mental health stigma is a relevant phenomenon with implications for the people who suffer from it. Despite its importance, no studies have been carried out in Spain at national level with a representative sample of the population.

The aim of this research is to analyze the stigma associated with MHPs in a representative sample of the Spanish population for the first time.

A cross-sectional quantitative descriptive study was carried out with a representative sample of the population (N = 2746). Descriptive analyses and regressions are carried out on the different dimensions of stigma such as attitude, attribution and intention of social distance.

Medium levels of stigma are obtained in stigmatizing attitudes and attributions, and medium-low levels in the intention of social distance. The best predictors of stigma in its different dimensions are attitudes, attributions and intention of social distance themselves. Progressive political ideology is related to less stigma in all dimensions. Knowing someone with mental health problems and talking openly about it together with higher education are also relevant protectors. Mixed results are obtained regarding age, gender and help-seeking.

National programs and campaigns focused on attitudes, attributions and behavioral intentions are necessary to reduce the stigma still present in Spanish society.

There is a growing interest in environmental and social determinants of mental health. However, how distance to healthcare and public transportation affect illness is neglected in schizophrenia research. Here, we are interested in how the availability of mental healthcare and the ways to reach it may be associated with psychosis.

We aim to investigate the association between distances to healthcare units and subway stations and duration of untreated psychosis (DUP) and greater initial severity in an antipsychotic-naïve first episode of psychosis (FEP) sample.

Using 212 untreated FEP patients’ data, we calculated the distances from their residences to the places of interest. Diagnoses comprehended schizophrenia spectrum disorders, depressive and bipolar affective disorders, and substance-induced disorders. Linear regressions were performed with distances as independent variables, DUP and Positive and Negative Syndrome Scale (PANSS) scores as dependent variables.

Longer distance to emergency mental healthcare was related to longer DUP (95% CI: p = .034, B = 0.152) and higher total PANSS (95% CI: p = .007, B = 0.0189); longer distance to community mental healthcare units was related to longer DUP (95% CI: p = .004, B = 0.0204) and higher total PANSS (95% CI: p = .030, B = 0.152). Moreover, a longer distance to the closest subway station predicted longer DUP (95% CI: p = .019, B = 0.170).

Our results indicate that poor healthcare access is related to longer DUP and higher initial PANSS scores. Future research should investigate how investments in mental health access and actions to improve public transport access could impact DUP and treatment outcomes in psychosis patients.

Dissociation remains a controversial topic in terms of its prevalence, cross-cultural validity, and relationship with childhood trauma and adversities.

This study investigated the prevalence of dissociative symptoms and probable dissociative disorders among Chinese high school students and tested the trauma model of dissociation.

A total of N = 1,720 high school students completed standardized measures of positive and adverse childhood experiences (PCEs and ACEs), dissociation, depression, and anxiety.

The prevalence rates of dissociative symptoms and (probable) DSM-5 dissociative disorders (DDs) were 11.2% and 6.9%, respectively. Dissociation was a reliable construct (ICC = .682 to .752, p < .001) and was moderately correlated with general psychopathology (r = .424 with depressive symptoms, r = .423 with anxiety symptoms). Participants with a probable DD reported more ACEs, fewer PCEs, and more mental health symptoms than those without a probable DD. ACEs were significantly associated with dissociative symptoms (β = .107, p < .001) even after controlling for age, depressive, and anxiety symptoms. PCEs moderated the relationship between ACEs and dissociative symptoms.

This is the first report of the prevalence of dissociative symptoms and probable DSM-5 DDs among nonclinical children. We provide cross-cultural evidence that dissociation is a reliable and valid clinical phenomenon associated with psychopathology in children across cultures. The findings partly support the trauma model of dissociation. This study contributes to the limited literature on dissociation in children. It also offers empirical data to facilitate the ongoing controversy about (childhood) trauma and dissociation. Our findings imply that dissociation is cross-culturally associated with childhood adversities, but trauma is not the only, sufficient cause. Theoretical and clinical implications are discussed.

Bipolar disorders (BD) are significant debilitating mental problems. Here, we introduced a novel index as a representative of the quality of care delivered to BD patients worldwide.

The Global Burden of Disease (GBD) 2019 study was the primary data source on BD, including prevalence, incidence, and years lived with disability (YLDs). Secondary indices were created and transformed into a single component that accounted for most of the variation, using the Principal Component Analysis (PCA) method. This component, reported on a scale of 0 to 100, was presented as the quality of care index (QCI). The QCI was estimated in different age groups and areas within a 30-year time frame. Gender disparity ratio (GDR), as the female-to-male ratio of the QCI, was reported.

The Global QCI slightly increased from 50.4 in 1990 to 53.1 in 2019. The GDR value was 0.95 in 2019. The high-middle SDI quintile had the highest QCI estimate of 63.0, and the lowest QCI value of 36.9 was regarding the low SDI quintile. Western-Pacific Region and South-East Asia had the highest and lowest QCI among WHO regions, with estimates of 70.7 and 31.2, respectively. The age group of 20 to 24 years old patients reported the lowest QCI estimate of 30.2, and the highest QCI of 59.8 was regarding 40 to 44 years old patients.

The QCI in BD had only a subtle increase from 1990 to 2019 and is in need of further improvement. Inequalities between different regions and age groups are considerable and require proper attention.

Many psychiatric patients continue to stay for longer duration in psychiatric institutions. Community reintegration and rehabilitation of such patients needs to be explored to ensure appropriate bed occupancy rates and access to in-patient care for newer patients in need of the same.

The aim is to identify the risk and protective factors leading to long-term admission of mentally ill patients in tertiary care hospital.

A cross-sectional study was conducted with all patients in the long-stay ward between May 2018 and February 2023. A retrospective chart review followed by cross sectional assessment of risks and disability was carried out with all the patients living in a long-stay psychiatric ward (N = 101) at a tertiary hospital in Bangalore, India, between May 2018 and February 2023.

The hospital’s average length of stay (LOS) was 5.70 ± 8.30 years. The risk and protective factors for LOS in psychiatric hospitals were analyzed using the Poisson Regression model. The results revealed that the male gender, diagnosis of schizophrenia or psychosis, clinicians’ knowledge of family information, good clinical improvement, and higher participation in ward activities are the protective factors for a shorter hospital stay. While higher age, family history of mental illness, being married and employed, absence of children, and/or having family members rarely visiting the patient at the hospital were some factors that increased the risk of LOS.

This study highlighted the importance of possible LOS predictors in the tertiary care psychiatric hospital. The multi-disciplinary team may utilize risk and protective factors for delayed LOS to introduce comprehensive psychosocial interventions and policies that reduce the risk of delays or length of stay in mental health hospitals.

Among the causes associated with suicide there are social factors such as forced displacement has been described and health factors in general that have an impact on pediatric mental health.

To describe clinical and psychosocial factors, and their relationship with suicidal behavior in a Colombian indigenous community.

The mean age were 9.23 years old, 53.7% male and 46.3% female.

Mixed approach study. A thematic analysis was carried out with the youth of the community to investigate emotional aspects. A descriptive cross-sectional study was carried out and correlations between variables were made.

Correlations were found between suicidal behavior and medical findings. When comparing the mental health disorders and nutritional problems, statistically significant differences were found in the Suicide Risk domain (<.001). This was reaffirmed in the thematic analysis, where factors such as migration and difficulty understanding the language are highlighted as related to suicidal behavior in the pediatric population.

Suicidal behavior should not be approached solely from psychopathology. Hunger, the weakening of one’s own culture, armed conflict, migration, and other clinical conditions are found to be associated with suicidal behavior.

A consequence of the COVID-19 pandemic was that the provision of mental health services was reduced in several countries around the world, while the demand for mental health services increased.

Our study aims to determine any variation in the number of users served, health appointments, and care activities conducted at 58 Peruvian community mental health centers (CMHCs) between March 2019 and October 2021.

Our study used an observational design and analyzed information from the care provided in CMHCs. We evaluate the number of users served, health appointments, and care activities performed per month. The main statistical analysis used segmented regression with Newey-West standard errors, taking into account each month of the evaluation.

We had 988,456 unique users during the period evaluated. Regarding diagnoses, 7.4% (n = 72,818) had a severe mental problem, 39.4% (n = 389,330) a common mental problem, and 53.2% (n = 526,308) others health problems. The study found a reduction in the number of users served and health care appointments at the 58 CMHCs in March 2020, the month in which the closure measures were declared to reduce COVID-19 infections in Peru. This reduction was followed by an upward trend in the three variables during the pandemic in the 58 CMHCs studied. In, November 2020, 9 months after the pandemic started, the deficit in the average number of users served per month was recovered.

Our study suggests that CMHCs in the Peruvian system were able to regain care capacity approximately 1 year after the pandemic. In addition, we discuss the efforts made to respond to mental health needs in the context of a global health crisis.

Internet addiction is an emergent health hazard among adolescents, especially after COVID19. Parenting factors in a family environment specifically, have potential roles in either causing excessive internet usage, or in protecting teenagers from internet addiction.

The aim of the study was to understand factors in parent-adolescent relationship that determine low and excessive internet usage.

A total of 102 adolescents within the age group of 13 to 18 years from two different schools in urban Bengaluru, India were recruited. Data was collected using three instruments namely semi structured tool to assess socio-demographic characteristics, Young’s internet addiction test for internet usage and parental bonding instrument for adolescent perception about parenting dimensions.

Half of the participants were found to have mild to severe levels of internet addiction, and the remaining half had normal levels of internet usage. The results showed that decreased care and increased control from the mother, high autonomy from father and increased rejection from both parents as risk factors associated with adolescent internet excessive use. No other significant associations were found between adolescents’ demographic, academic, peer and school profile and their internet addiction.

As internet has become an inevitable part of our life, parent-adolescent relationship forms an essential moderating factor in adolescents’ internet usage.

In the pandemic era, stressful life events (StressLEv) aggravated the impact on mental health. However, youths exhibited different responses to StressLEv because of diverse coping strategies, social support, and emotional intelligence before and after the pandemic.

To explore the changes in StressLEv and coping strategies before and after the coronavirus 2019 pandemic, as well as report the associations among mental health and related factors in a sample of Chinese youths experiencing the post-pandemic era.

A cross-sectional study using convenience sampling was conducted from July 1 to August 30, 2022, covering 3,038 youths aged 14 to 25 in China. Multiple logistic regression was conducted for crude odds ratios (ORs) and adjusted ORs. The relationships between lasso-selected variables was examined using structural equation modeling.

More StressLEv and limited coping strategies were reported after the pandemic. In the post-pandemic era, BSI-positive youths (youths diagnosed as considered case by Brief Symptom Inventory, BSI) reported more StressLEv (BSI-positive: mean = 75.47; BSI-negative: mean = 28.69), less social support (BSI-positive: mean = 31.81; BSI-negative: mean = 39.22), and lower emotional intelligence (BSI-positive: mean = 75.34; BSI-negative: mean = 89.42). The willingness to engage in mental health counseling (OR: no vs. yes: 1.89; uncertain vs. yes: 4.42), being punished (OR: 1.27), adaptation problems (OR: 1.06), task-oriented coping (OR: 0.95), social diversion coping (OR: 0.90), objective support (OR: 0.90), utilization of social support (OR: 0.81), and regulation of emotion in oneself (OR: 0.94) were associated with mental health. Structural equation modeling supported our theoretical framework.

Pandemic-induced mental health problems should not be ignored. The proposed response mechanisms could guide the development of effective interventions, which can help youths better cope with StressLEv and maintain good mental health.

Mental health (MH) disorders are major causes of disability in Guatemala. Unfortunately, limited academic training and funding resources make MH care inaccessible to most people in rural Guatemala. These disparities leave many indigenous populations without care. Project ECHO™ is an educational model used globally to deliver virtual training for providers in rural/ underserved communities. The aim of this project was to implement and evaluate a Project ECHO™ program bridging MH training gaps for providers who serve rural communities in Guatemala.

The Project ECHO™ curriculum was implemented through a partnership between educational and nonprofit institutions in Guatemala City and the United States. Participants were primary care physicians and nurses working in rural Guatemala as well as medical/nursing/psychology students. Evaluation of its implementation was guided by a RE-AIM framework. Reach, effectiveness, adoption, fidelity, sustainability, acceptability, feasibility, and appropriateness were evaluated using a mixed-methods approach, using a pre-post survey and semi-structured focus groups.

Forty unique participants attended the five sessions. Attitudes about mental health did not change quantitatively but self-efficacy improved in four of five modules. High quality fidelity scores were noted in two of five sessions. Sustainability scores across multiple domains were highly rated. Scores on instruments measuring acceptability, feasibility, and appropriateness were high. Focus groups showed two main themes: the curriculum filled a gap in education and further adaptation of the model might help improve the experience.

Implementation of the Project ECHO™ educational model appeared to have good reach/adoption, showed improvements in self-efficacy, illuminated facilitators and barriers to sustainability, and was felt to be acceptable, feasible, and appropriate. Qualitative analysis supported these conclusions. Future directions would include ongoing evaluation and monitoring of further Project ECHO™ curricular experiences through this partnership and adaptation of this project to other learners and settings in Latin America.

There is limited evidence of the longer-term impact of the COVID-19 pandemic on acute admissions for psychosis in the UK.

We examined the impact of COVID-19 on rates of admissions for first and repeated episode psychosis, and changes in patient profile and seasonal patterns, over a period of 12 months.

We conducted a retrospective case note review of all patients admitted with a primary psychosis (F20-29 ICD 10 diagnosis) to an NHS psychiatric inpatient unit. We compared the 12 months pre-COVID-19 period between 1 March 2019 and 28 February 2020, and the 12 months post-COVID-19 period between 1 March 2020 and 28 February 2021.

The results showed increase rates of admissions post-COVID-19 in both first and repeated episode psychosis, the patient profile had more females and older age in the repeated episode group, with increased employment rates. Combined group data for both pre- and post-COVID-19 periods showed an increased trend in spring and summer admissions, and even though not statistically significant, more pronounced post-COVID-19.

Our findings highlight the effect of the COVID-19 pandemic on acute psychosis admissions over a 12-month period. The results provide evidence for the ‘stress-pathogenesis’ in the context of genetic vulnerability in psychosis. Preventative strategies in the context of the ‘stress-pathogenesis model’, improved access to and responsiveness within NHS transformation efforts needs to be adjusted to fit local need and environmental changes.

Worldwide migration represents a major challenge of the 21st century. Despite the strong association between acculturation and mental health, research findings on underlining mechanisms remain inconsistent. Prior research urges to investigate sample characteristics in a more structured manner.

The purpose of this study was to systematically investigate factors impacting acculturation and depressive symptoms in a large, not exclusively clinical, sample of Vietnamese migrants in Germany.

This study investigated, with multiple regressions, factors (age at arrival, gender, education, religiousness, language skills, residence status, economic status, occupational status, migration motivation, duration of stay, and depressive symptoms) impacting the two dimensions of acculturation, dominant society immersion (DSI) and ethnic society immersion (ESI), in a not exclusively clinical sample (n = 582) of first-generation Vietnamese migrants in Germany. Further, this study examined the relationship between depressive symptoms, DSI and ESI with correlations and acculturation strategies with an ANOVA.

Integration (72.5%) was the most common acculturation strategy, followed by separation (26.8%). In contrast, assimilation (0.5%) and marginalization (0.2%) were very rare acculturation strategies. As predictive factors for DSI lower depressive symptoms scores, male gender, higher education, and better German language skills were found significant. For ESI, less German language skills and older age at arrival were found to be significant. Higher ESI and DSI were correlated to lower depressive symptom scores. Compared to the three other acculturation strategies, integration was linked to the lowest depressive symptoms scores.

The current study identified crucial factors in the acculturation process, such as depressive symptoms, language skills, education, gender, and age at arrival. Our findings emphasize that immersion into both the dominant and the ethnic culture plays an essential supportive role in the mental health of migrants.

A patient’s pathway to care is often characterized by a sequence of actions taken to remedy ill-health. Research exploring the help-seeking behavior of individuals with mental health problems in sub-Saharan Africa is relatively limited. This study assessed the perceptions and experiences of mental illness and treatment among patients with mental illness at two psychiatric facilities in Johannesburg, South Africa.

309 interviewer administered surveys were conducted between January and July 2022. We used a logistic regression model to examine factors associated with receiving treatment for mental illnesses from traditional healers. Semi-structured interviews were conducted with 18 participants during the same period. Interviews were transcribed and translated into English. Data were managed using NVivo 11 software and thematically analyzed.

Results showed that 144 (47%) patients sought mental health care from traditional healers. Higher anxiety symptoms, number of people in the household, believing that traditional medicine can cure mental illnesses, and township living were associated with seeking mental healthcare from traditional healers. Qualitative analysis indicated that participants often believed that mental illness was due to bewitchment and consulted with multiple traditional healers, thus spending large amounts of money for treatment and ultimately delaying access to biomedical care.

Collaborative approaches between traditional healers and biomedical professionals show promise in terms of allowing for improved identification and treatment of individuals with mental disorders.

Depression is a common mental disorder that significantly contributes to the global burden of disease. Studies have consistently reported that migrant workers experience higher levels of depressive symptoms, especially women.

This study aimed to examine the mediation role of sexual self-efficacy on the relationship between psychological wellbeing, and depressive symptoms among young female migrant workers in Vietnam’s industrial zones.

A cross-sectional study was conducted among 1061 female migrant workers aged 18 to 29 from January to November 2020 in Hanoi, Vietnam. Anonymous interview questionnaires were used to collect data on demographic characteristics, psychosocial wellbeing (PWB), sexual self-efficacy, and depressive symptoms. Mediation analysis was conducted to explore the mediation effect of sexual self-efficacy on the relationship between PWB and depressive symptoms.

Nearly 8% of the female migrant workers reported experiencing depressive symptoms. The final mediation model showed that the effect of overall psychological wellbeing on depressive symptoms was partially mediated by sexual self-efficacy. Specifically, 4.1% of the effect of overall PWB on depressive symptoms was mediated through sexual self-efficacy. In the PWB subdimension analyses, sexual self-efficacy mediated 14.3% of the effect of personal growth, 8.8% of the effect of purpose in life, 8.0% of the effect of autonomy, and 7.8% of the effect of environmental mastery on depressive symptoms, respectively.

The study findings demonstrate that sexual self-efficacy plays an important role in the relationship between psychosocial wellbeing and depressive symptoms among female migrant workers in industrial zones in Vietnam. Improving psychosocial wellbeing and promoting sexual health including sexual self-efficacy should be prioritized when addressing depressive symptoms and mental health concerns among industrial zone female migrant workers in Vietnam, which may also be applicable in other low- and middle-income countries with similar socio-cultural settings.

Quality of childcare can predict a child’s emotional and behavioural adjustment throughout the life span. Furthermore, this has major implications for child development and mental health in the long-term. Parents often face major challenges while providing childcare especially during the early years of a child.

This paper describes specific parental concerns in raising a toddler from a mental health developmental perspective.

The study was conducted in urban Bengaluru, India under an exploratory research design using semi-structured interviews. Ten parents participated in the study. Data was analysed using thematic analysis.

Four major themes emerged. The first theme was related to the formation of parental beliefs about parenting which identified several sources such as parenting practices witnessed during childhood, childhood experiences and influence of culture, mass or social media. The second theme to emerge was on concerns related to toddlers which parents had difficulties in understanding as well as managing, specially navigating through sleep and feed pattern, identifying developmental needs and making a meaning of toddlers’ communication styles and content. The third theme showed parental concerns which consisted of areas such as parental stress, physical exhaustion, lack of time for each other or toddler, lack of information about handling toddlers and absence of validation of parental efforts. The final theme was on their current parenting practices with their toddlers which showcased controlling styles, play time but low on quality, inappropriate responses to toddlers’ emotions or behaviours and several culturally practiced measures which were not validated scientifically.

The pre-existing belief among parents about parenting and toddlers’ specific behaviours influence parenting practices. The understanding of the parental challenges is beneficial in developing an appropriate parenting programme focussing on strengthening psychological capacities of toddlers.

Migrant workers make up a third of the population of Saudi Arabia, approximately 13 million. Mental health disorders among this population are common, but very limited data exist currently.

To assess the prevalence of moderate to severe symptoms of depression and stress among a sample of migrant workers in Saudi Arabia. To identify whether migrant-specific factors, such as occupation, nationality, duration of migration, and work characteristics, are associated with depressive and stress symptoms.

A cross-sectional study of 2,123 migrants was conducted in Al Qassim, Saudi Arabia. Depressive and stress symptoms were assessed with the Depression, Anxiety, and Stress Scale (DASS-21). The outcomes were categorized into two levels (i.e. mild or no symptoms versus moderate to severe symptoms). Univariate and multivariate binary logistic regressions were used to assess the relationship with potential covariates.

The prevalence of moderate to severe depressive and stress symptoms was 7.3% and 3.6%, respectively. These did not vary by the duration of stay in the country or weekly work hours. However, there was substantial variance in the symptoms by participants’ nationality and occupation. Participants from Bangladesh were 3.8 (95% CI [1.50, 9.62]) times more likely, and hospital cleaners were 6.5 (95% CI [2.12, 20.07]) times more likely to have depressive symptoms. Similarly, auto-repair workers were 6.3 times more likely to have symptoms of stress (95% CI [1.55, 25.90]).

The prevalence of depressive and stress symptoms varied significantly depending on occupation and country of origin. It would behoove employers to screen for these mental health conditions and refer employees to the relevant healthcare services. Future studies could examine the feasibility of mental health screening programs among migrant employees.

Emerging literature suggests the role of social media in substance use disorders (SUD). This study aimed to explore the content of YouTube videos for persons on SUD treatment/recovery, describing the users’ exposure and engagement metrics and understanding viewers’ perspectives.

We generated a set of 10 key phrases to search on YouTube. Eighty eligible videos were analyzed using a mixed-methods approach. Content analysis of all videos and thematic analysis of 30 videos were done using the three most viewed videos from each key phrase. The reliability of videos was assessed using a modified DISCERN. The total number of views, likes, dislikes, and comments were noted and created engagement metrics. The linguistic analysis of viewers’ comments was done to assess their perspectives.

Sixty-three (78.8%) videos were from the US, and 59 (73.8%) were intended for persons or families with substance misuse. Persons in recovery uploaded 23 (28.7%) videos. We identified five themes – reasons for using drugs, symptoms of addiction, consequences of drug use, how to stop drug use, and expressed tone in the language. The positivity and relative positivity ratios were highest for videos developed by persons in recovery. There was a negative correlation between the relative positivity ratio and content fostering internalized stigma. Words with negative emotional experiences dominated the viewers’ comments.

YouTube content on SUD treatment and recovery is popular and revolves around the biopsychosocial understanding of addiction. There is an urgent need for a language policy and regulation of non-scientific content.

News reporting on mental illness can perpetuate stigma. An understanding of the current picture of such reporting is important to identify areas for improvement. This study investigated the quality of Australian news media coverage of complex mental illness in the context of crime and violence over a 2-year period, prior to the release of new media guidelines.

This research utilised a systematic search of Australian news articles that were published between July 2018 and July 2020 and reported on mental illness in relation to violent crime. Researchers developed a Mental Illness and Crime Reporting Quality Framework to determine quality scores for news articles according to 11 relevant factors in media guidelines. An additional 11 characteristics of articles were extracted for further descriptive analysis.

One-hundred and twenty-eight Australian news articles met inclusion criteria. The average quality score was 50 (SD = 13.91) out of a possible maximum score of 100 (range 11–78). Strengths and weaknesses were identified as some criteria were consistently met, and other criteria were met rarely or not at all. There were emerging trends between quality scores and article characteristics, including publication source, though these analyses were not statistically significant.

The findings indicate that Australian news coverage of complex mental illness and violent crime met half of the criteria of reporting guidelines that minimises risk of perpetuating or reinforcing stigma. This demonstrates significant opportunity to improve the overall quality of media reporting on crime and mental illness. Future research should evaluate the impact of the guidelines on the quality of news reporting after their implementation by utilising a similar methodology, using these findings as a baseline measure.

There is evidence of Indigenous and ethnic minority inequities in the incidence and outcomes of early psychosis. Racism has been implicated as having an important role.

To use Indigenous experiences to develop a more detailed understanding of how racism operates to impact early psychosis outcomes.

Critical Race Theory informed the methodology used. Twenty-three Indigenous participants participated in four family focus group interviews and thirteen individual interviews, comprising of 9 Māori youth with early psychosis, 10 family members and 4 Māori mental health professionals. An analysis of the data was undertaken using deductive structural coding to identify descriptions of racism, followed by inductive descriptive and pattern coding.

Participant experiences revealed how racism operates as a socio-cultural phenomenon that interacts with institutional policy and culture across systems pertaining to social responsiveness, risk discourse, and mental health service structures. This is described across three major themes: 1) selective responses based on racial stereotypes, 2) race related risk assessment bias and 3) institutional racism in the mental health workforce. The impacts of racism were reported as inaction in the face of social need, increased use of coercive practices and an under resourced Indigenous mental health workforce.

The study illustrated the inter-related nature of interpersonal, institutional and structural racism with examples of interpersonal racism in the form of negative stereotypes interacting with organizational, socio-cultural and political priorities. These findings indicate that organizational cultures may differentially impact Indigenous and minority people and that social responsiveness, risk discourse and the distribution of workforce expenditure are important targets for anti-racism efforts.

Previous research suggests that the mental health impacts of the COVID-19 pandemic were stronger during the first months of it. It has also been proposed that those impacts depended on gender and other social determinants.

We aim to describe the change in prevalence of mental health problems (symptoms of common mental disorders [CMD], alcohol, and drug use) between two time periods during the pandemic, and the association of mental health problems with social determinants, in adolescents and young adults in Mexico.

We conducted a repeated cross-section analysis of data from VoCes-19, an online survey in November 2020 to February 2021 and November 2021 to March 2022 (combined n = ×224,099). We assessed the change in the prevalence of mental health problems, the differences in prevalence and change in the prevalence by gender, and the association of social determinants and pandemic-related variables with mental health problems, by means of multivariate regression models.

The prevalence of CMD decreased (46.0% vs. 42.4%), while the prevalence of alcohol (frequent use 8.4% vs. 10.3%) and drug use (4.6% vs. 7.7%) increased. The three conditions increased more among girls/young women and trans/queer/non-binary participants than among boys/young men.

The results point to the importance of considering the gendered social context of young people. A better understanding of the social circumstances that relate with mental health is required to inform interventions for these age groups.

Exclusionary immigration policies rooted in structural racism threaten the wellbeing of Latinx families, increasing stress, anxiety, depression, and distress among immigrant parents. The COVID-19 pandemic has had devastating and disproportionate impacts on communities of color with unique impacts on Latinx immigrant parents in mixed-status families.

From a syndemic theory lens, we explored the convergence of structural racism and the COVID-19 pandemic to explore if the stress of the COVID-19 pandemic may compound harmful immigration-related policies.

Our community-based participatory research cross-sectional study administered 145 surveys among Latinx immigrant parents in mixed-status families in Georgia. We examined the relationship of pandemic stress and perceived statewide immigration policy vulnerability to depressive, anxiety, and PTSD symptoms. We conducted multiple linear regression analyses to test these relationships and their interaction.

We found that that greater perceived policy immigration vulnerability and reported pandemic stress were associated with higher symptoms of depression. Increased PTSD symptoms were also associated with immigration policy vulnerability, but not pandemic stress. Tests to assess if pandemic stress strengthened the relationship between policy vulnerability on depressive, anxiety, and PTSD symptoms revealed no statistically significant interactions.

Our findings suggest that stress of the COVID-19 pandemic and longstanding anti-immigrant policies in Georgia were salient for and related to the mental health of these Latinx immigrant parents.

Access to affordable and clean energy is an essential component of the Sustainable Development Goals and a determinant of physical and mental health. However, the occupied Palestinian territory, the Gaza Strip, has experienced prolonged issues with electricity, water and gas supplies. This has significantly impacted on daily life and the area is on the verge of disaster. This research focused on the mental health effects of the lack of electricity in Gaza which have not been previously documented.

A cross-sectional analytic approach was adopted. A survey was administrated face-to-face with respondents from 350 participating households. Inferential statistical analysis was used to examine the relationship between the domains of anxiety, depression, wellbeing and electricity supply factors. A multiple linear regression model was also utilised.

There is a highly statistically significant link between continuity of electricity and level of anxiety (p < .001). The same effect was reported in the level of depression, and a higher level was observed among residents with an intermittent or disrupted electricity supply, with a statistically significant link between the level of depression and continuity of electricity.

Electricity issues, especially when combined with other stressors associated with living in Gaza, lead to serious mental health concerns. Urgent attention must be given to developing sustainable, reliable and affordable energy supplies for short- and long-term health and community development.

Climate anxiety, one of the negative emotions created by climate change, is particularly prevalent among climate activists and young individuals who hold a more serious concern for environmental issues.

This study aims to determine the effects of climate change awareness on the mental health of young people in Turkey.

Designed as a descriptive and two-group comparative study, the target population of this study comprises young individuals aged 15 to 24 who are climate activists and those who are not. The study data was collected through e-questionnaires administered between March 15 and May 10, 2023, using a demographic characteristics form, a climate change anxiety scale and the Beck Hopelessness Scale. The study was completed with a total of 306 participants, including 103 young individuals who are climate activists and 203 young individuals who are not climate activists.

We determined that young individuals who are climate activists have a high level of climate change anxiety, while those who are not climate activists have a moderate level of climate change anxiety. We found that the levels of hopelessness in both groups are at a mild level. Additionally, within the group of climate activists, we observed that individuals with a higher level of knowledge about climate change tend to exhibit greater levels of hopelessness.

We identified that as awareness and knowledge about climate change increase, climate change anxiety, and hopelessness also increase. There is a need for studies to determine youth-specific mental health interventions to address mental health issues related to climate change awareness.