Community Mental Health Journal最新文献

Adolescent suicide is a critical social issue with profound and lasting individual and collective consequences. This umbrella review examines factors associated with adolescent suicidal behavior through the socioecological framework of prevention and seeks to identify gaps in the existing literature. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included a comprehensive search of the of the Web of Science, Scopus, and Cochrane databases in both English and Spanish, covering the period from 2018 to 2024, using terms related to adolescence and suicidal behavior. Out of 6,138 articles identified, 37 met the quality criteria and were selected for analysis. The studies highlighted individual risk factors such as age, gender, belonging to ethnic or gender minorities, emotional disorders, self-destructive behavior, emotional regulation, and experience of physical or emotional pain. Interpersonal factors such as parental relationships, sexual abuse, social isolation, peer pressure, and loneliness were also found. However, the review revealed a worrying lack of studies on societal and community factors and a paucity of research focusing on protective factors. The study highlights the need to include factors related to the physical and social environments that influence health and behavior in future research, as well as to enhance the resources and strengths of adolescents.

Traditional forms of psychiatric crisis treatment increasingly are being buttressed by services along the Psychiatric Crisis Continuum of Care, such as short-term crisis stabilization services and peer crisis services. The UT Health Living Room (LR) is an outpatient crisis counseling service that adds three promising elements to the Continuum: (1) it integrates outpatient treatment plans into crisis counseling, (2) provides care in a space and with staff who are familiar to patients, and (3) provides training in evidence-based crisis intervention. We examined two-year LR feasibility and outcome data. Mixed-method analyses used longitudinal clinic data and patient self-report measures. Results provide initial support for the feasibility, cost effectiveness and clinical effectiveness of the LR. Limitations include non-blinded ratings, limited experimental control, and simple cost-effectiveness methodology. The UT Living Room is feasible and offers novel elements to help patients in community clinics address emotional crises.

Recovery is real and has had a transformative impact on mental health policies and services, including shifting the focus from chronicity and symptom management to the realization that individuals with mental health issues can lead meaningful lives. However, recovery has been defined, described, understood, and measured in a wide variety of ways that may account for misuses and abuses in its application and possible stagnation in its impact. It is argued that the mental health field must now build upon the strong foundations of recovery by integrating a well-established rights-oriented framework. While recovery emphasizes personal growth and hope, a rights-based perspective underscores inherent dignity, autonomy, and opportunities for acceptance and embrace in engaging in valued social roles. The addition of a rights-based framework - community inclusion, to conversations involving recovery, is aligned with the origins of recovery and how it is commonly understood, and also connects the mental health field to the dramatic positive impacts that have emerged from the longstanding centrality of this concept in the broader disability community.

Introduction: There is a need within counselling and psychotherapy to ensure their ability to respond to endemic presences such as the COVID-19 pandemic, by utilising rapid technological advances without compromising effectiveness. To do so, existing research about online group therapy must be built upon to provide a comprehensive understanding of the efficacious delivery of this therapy modality. Thus, a systematic review was conducted to collate what is currently known in the published and grey literature on online group therapy, using the PRISMA framework. Thirty-three articles were identified as including information regarding facilitating group therapy online. After appraising each article using appropriate quality appraisal tools, a thematic analysis was conducted on the papers, arriving at seven main themes summarising the main findings regarding online versus in-person groups, group planning, counselling micro skills, group processes, ethics, technology, and unique online therapy issues. There is a growing but incomplete body of knowledge that informs the group therapist regarding the ethical delivery of groups online. A more comprehensive review can enable group therapists to feel confident they are across best practice guidelines. Limitations and research implications are considered.

Certified peer support specialists (CPSS) are used as a paraprofessional workforce to engage hard-to-reach populations, including people experiencing homelessness. Thematic analysis was used to explore with CPSS (N = 7) what contributed to their effectiveness when working with this population. Participants were recruited at a HUD lead organization in the southeastern United States. Open-ended semi-structured questions were used in online, synchronous interviews. Themes related to three areas, experience, competence, and the organization, contributed to participants being effective. Specifically, interviewees observed that their lived experiences and abilities to speak a common language with clients contributed to their effectiveness. They identified how personal qualities and unique skillsets suited them for the work. Participants also valued the training they received; certification helped them to develop competencies and to balance vulnerability, empathy, and connection. Finally, participants attributed their effectiveness to clarity about their roles within the organization, supervision, attention to self-care, and co-worker support. Findings from this study may have implications for the value of lived and learned knowledge coexisting in organizations serving those who experience homelessness.

Global Burden of Disease (GBD) estimates have significant policy implications nationally and internationally. Disease burden metrics, particularly for depression, have played a critical role in raising governmental awareness of mental health and in calculating the economic cost of depression. Recently, the World Health Organization ranked depression as the single largest contributor to global disability. The main aim of this paper was to assess the basis upon which GBD prevalence estimates for major depressive disorder (MDD) were made. We identify the instruments used in the 2019 GBD estimates and provide a descriptive assessment of the five most frequently used instruments. The majority of country studies, 356/566 (62.9%), used general mental health screeners or structured/semi-structured interview guides, 98/566 (17.3%) of the studies used dedicated depression screeners, and 112 (19.8%) used other tools for assessing depression. Thus, most of the studies used instruments that were not designed to make a diagnosis of depression or assess depression severity. Our results are congruent with and extend previous research that has identified critical flaws in the data underpinning the GBD estimates for MDD. Despite the widespread promotion of these prevalence estimates, caution is needed before using them to inform public policy and mental health interventions. This is particularly important in lower-income countries where resources are scarce.

Trauma and adversity significantly impact on morbidity and mortality. Hence, trauma-informed care is proliferating practice and research contexts. However, the evidence base for organisational wide trauma-informed care is far from conclusive, with the extant literature providing low quality and conflicting evidence. The purpose of this umbrella review of systematic reviews, is to summarise the existing evidence on trauma-informed care implemented at the organisational level. The preferred reporting items for systematic review and meta-analyses (PRISMA) was used to conduct an umbrella review. Six databases were searched; Academic Search Complete, APA Psych Articles, Cochrane Library, Embase, Scopus, and the Web of Science, supplemented with bibliography searches. Articles were included if they were peer reviewed in the English language from inception to 2024 and reported on trauma-informed care with an implementation context. The Joanne Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses was used to assess the quality of the included reviews. Findings are mapped to the 10 trauma-informed care implementation domains described by the Substance Use and Mental Health Service Administration (SAMHSA) and reported using a narrative synthesis. The search strategy yielded 5,297 articles, of which (N = 14) systematic reviews are included. The reviews had a combined study count of (N = 311), with a total sample size of (N = 157,724). Most reviews used a narrative synthesis to report results, with no meta-analyses. Critical appraisal categorised the reviews as 28% high quality, 22% moderate quality, and 50% as low quality. Most reviews (50%), were conducted on youth populations, with school settings being the most studied context. There was a great deal of heterogeneity across the reviews, with 62 different models of trauma informed approaches discussed. The composition of the individual studies included in each systematic review were generally of low quality with mixed findings of effectiveness and implementation. Findings are discussed for moving forward with trauma-informed care implementation. Trauma-informed care is proposed as a system wide intervention to improve outcomes for service users, however the research base is still under scrutiny. Emerging research identifies the benefit of using the 10 trauma-informed implementation domains to shift cultural practices. Further research needs to be undertaken in various contexts with different populations.

Co-occurring mental health concerns are prevalent among substance use recovery housing residents. We sought to explore how residents with co-occurring mental health and substance use needs experience recovery housing. We conducted semi-structured interviews with residents (N = 92) in recovery homes across Texas and developed themes through thematic analysis. Residents note that living in a group home can exacerbate anxiety and paranoia, especially during periods of high turnover. Overwhelmingly, however, residents believe recovery housing improves their mental health. Residents use their shared lived experiences to support one another. Residents also express appreciation for the transition period offered by recovery housing, allowing them to solidify their recoveries before fully re-entering society. Participants describe recovery homes as a critical support for their co-occurring mental health and substance use concerns. These results provide key insights on how to better support mental health in recovery housing.

Child and adolescent mental health are major public health concerns in the US. Overall, 20% of US children have a reported mental health condition, while an estimated 40% will be diagnosed with one by age 18. Despite these concerns, little is known about factors associated with access to mental health services among children and adolescents. We analyzed data from a sample of 6655 children (aged 6 to 17 years) with either anxiety and/or depression drawn from the 2020-2021 National Survey of Children's Health (NSCH). A multivariable logistic regression model was fit to investigate predisposing, enabling, and need factors associated with caregiver's (i.e., parent or other guardian) perceived access to mental health services for their children. Approximately 50.8% of caregivers perceived obtaining mental health services for their children to be somewhat difficult, very difficult, or impossible. Children meeting criteria for having a medical home had lower odds of experiencing such difficulties (adjusted [a]OR = 0.38; 95% CI: 0.30-0.49). Further, compared to children who sometimes or never had health insurance coverage for mental or behavioral health needs, children who were always insured (aOR: 0.19; 95% CI 0.14, 0.25) and those who usually had coverage (aOR: 0.38; 95% CI 0.28, 0.51) had lower odds of experiencing perceived difficulties in obtaining care. The results indicate several enabling and need predictors of perceived access to mental health services--highlighting potential structural barriers to care access. Efforts to address access challenges should adopt a multifaceted approach and be tailored to families living in poverty, those with limited health coverage, and minoritized children with less than optimal general health.

Homeless seniors confront distinct challenges regarding their mental health needs and service access. This study aims to illuminate the mental health landscape of homeless seniors by examining the prevalence of mental illness, utilization of mental health services, and perceived need for mental health care. The study comprises 177 homeless seniors in New York, NY. Findings indicate 10.2% experiencing depression, 10.2% schizophrenia, and 5.7% bipolar disorder. Despite high prevalence, there is a significant gap between diagnosed mental health conditions and service utilization, with only 50% of those with depression seeking care. Perceived need for mental health services emerges as a critical aspect of the study, with over half of those suffering from depression (61.1%; n = 11), PTSD (75%; n = 3), schizophrenia (77.8%; n = 14), and other mental illnesses (100%; n = 1) expressing a need for mental health care. Also, mental health conditions, loneliness, and levels of social support play significant roles in a need for mental health services.