Community Mental Health Journal最新文献

The current study assessed associations between negative experiences with police and self-directed violence (SDV) among a United States (US) sample of Black young adults ages 18-29 reporting lifetime police stops. Data come from the "INtervening on Self-Harm and Policing to Increase Racial Equity" (INSPIRE) survey (N = 672) and were collected between December 2023 and March 2024. This high-risk sample exhibited elevated rates of self-harm ideation or NSSI (27.23%) and attempted suicide (48.22%). Findings also revealed that, net of covariates, both police discrimination and arrest increased the relative risk of self-harm or NSSI by 257% and 242%, respectively. These police experiences also significantly increased the risk of attempted suicide. When examining specific forms of police discrimination, discrimination by race, immigration status, and sexual orientation emerged as significant predictors of one or more SDV outcomes. Results signal a need for SDV screenings among Black young adults with a history of negative experiences with police discrimination and arrest in the US.

The U.S. mental health crisis requires new tools to address mental healthcare needs. Data dashboards are a means of sharing community health data on many topics, including mental health. Unfortunately, many "community" dashboards are designed without stakeholder input. This article outlines the creation of the State of Texas Mental Health Dashboard and how researchers incorporated stakeholder feedback throughout its development. Researchers conducted nine focus groups with community stakeholders from two Texas counties. This feedback illustrated some key differences between designers' priorities and what stakeholders considered most relevant. Designers prioritized access to state and local mental health data. While stakeholders found the data useful, they also advocated for tools to identify community mental health resources. Our findings illustrate how excluding stakeholder voices from the design process could have omitted a key element needed to address mental healthcare needs and provides a process for ensuring that local input drives the design process.

Clinical leverages and pressures are often utilized in psychiatric treatment settings. Clinicians know they are controversial but think of them as useful and relatively harmless. Perception of coercion is known to be deleterious to therapeutic relationship and clinical outcomes. We assessed individuals (N = 137) receiving care in outpatient and community psychiatric settings in a Canadian urban center regarding their current experiences of clinical leverage (in finance, housing, access to/custody of children, and family), and perception of coercion. Analyses show clinical leverage are common (34.8% overall), with access to child and family (15.7%), and financial (14.6%) leverages being most common. Generalised linear models indicated that psychiatric symptomology (p < 0.001) and current financial leverage (p = 0.035) were positively associated with perceptions of coercion. The results highlight that clinical leverages are widespread, associated with perception of coercion, and are likely harmful with negative impact on patient care and outcomes. Efforts to mitigate these impacts are needed.

The Clubhouse model of psychosocial rehabilitation has supported the recovery of people with serious mental illness for over 75 years, but many of the roughly 350 Clubhouses are not well-integrated into the larger health care system, limiting their reach. This article examines Clubhouses' and psychiatric providers' interactions and experiences to understand the nature of and barriers to partnerships. The directors of Clubhouses affiliated with Clubhouse International were surveyed, examining their attitudes and practices around collaboration with psychiatric providers. To provide context, psychiatric providers were also surveyed regarding their understanding of and experiences with Clubhouses. Findings reveal broad support among both Clubhouse directors and psychiatrists for enhancing partnerships, despite current barriers, limited interactions, and the need for greater mutual understanding. Key considerations that emerged include the importance of maintaining the Clubhouse model's distinct non-clinical, community-based, and member-directed identity in any integration efforts.

Understanding the current state of equity, diversity, and inclusion (EDI) within the crisis line sector is essential to enhancing accessibility and acceptability of crisis line services for all. Through an intersectional lens, we examined 9-8-8 crisis line workers' personal and work demographics, training, resources, perceived competencies in supporting diverse populations. We conducted an electronic survey of crisis line responders and leadership in Canada. Data was analyzed using descriptive statistics, Fisher's test, and Mann-Whitney U/Kruskal-Wallis H tests. Open ended responses were analyzed using content analysis. 323 surveys were completed. Analysis revealed statistically significant associations between respondent demographics, training satisfaction, access to resources, and perceived competency in supporting diverse communities. Conclusion: The findings indicate the need for new approaches to recruitment and training in the crisis line sector to enhance the inclusivity of crisis services for all individuals seeking mental health support.

As mental health needs rise, creative and timely solutions are essential. Leveraging the expansion and flexibility of virtual services to create telehealth and hybrid offerings is crucial for addressing systemic barriers in mental health, enhancing accessibility, and providing flexible, comprehensive care options for diverse patient populations. This article discusses the development of a mental health urgent care program within a large medical system in a densely populated, under-resourced community. The program was designed to address common community mental health barriers across multiple care entry points, including ambulatory settings, emergency care, and consultation services. Using a multipronged approach, this program aims to improve patient access, care continuity, and outcomes. The authors encourage others to consider adopting a similar programmatic infrastructure to reduce mental health care barriers in their communities.

Autism is a rapidly growing phenomenon, with rates of diagnosed autism in the community rising every decade. Autism and traits of autism are also regularly part of presentation at youth mental health services, including early psychosis services. In early psychosis services young people's symptoms tend to be formulated through a psychosis lens, rather than a neurodevelopmental lens which can lead to unnecessary medicalised treatment, and treatment plans that do not consider the possible impact of neurodiversity. The following paper explores autism and traits of autism in relation to youth early psychosis, examining the complexity in accurate formulation, and the possible impacts for young people. Future directions for how services can address this issue and more effectively tailor treatment to young people are also discussed.

This pilot study evaluated the feasibility of the technology specialist intervention, which assists clients in achieving mental health recovery and well-being goals via existing digital tools in a real-world community mental health setting. Thirteen adult clients with serious mental illness and their providers completed baseline, 3-, and 6-month assessments, including goal setting, self-efficacy, activation, and acceptability measures, along with weekly ecological momentary assessments. Clients selected goals and corresponding tools, used the tools steadily, and showed improvement in activation and self-efficacy. Most participating clients (82%, n = 9) and providers (80%, n = 8) found the intervention acceptable. These preliminary findings show that the technology specialist intervention is promising and warrants further testing.

To mitigate barriers to care among youth (12-25 years), community-based organizations have increasingly integrated peer support as a complement to clinical mental health care; however, information regarding the integration process is lacking. To explore organizational perspectives regarding the contexts and mechanisms underlying integration of peer support for youth accessing mental health services from community-based, youth-serving organizations. Representatives from community-based youth-serving organizations completed a survey describing the contexts in which they are located and their experiences integrating peer support. Text responses were analyzed using directed content analysis. 21 organizations serving youth aged 11-29 years responded. Three generic categories were identified: 1) Context is key and safe environments, 2) Supportive organizations and valuing lived experience, 3) Benefits for peer support providers and receivers and purposeful integration into the organization. Peer support integration requires valuing of the lived experience of peers and creation of a safe organizational environment.