Psychological Services最新文献

Gay and bisexual men experience disproportionate rates mental health challenges including for depression, suicidality and substance use disorders. At the same time, they may face unique barriers to seeking mental health care that is lesbian, gay, bisexual, transgender and queer+ (LGBTQ)-affirming. In this study, we describe and analyze gay and bisexual men's mental health care navigation, with a focus on identifying challenges that arose when seeking care. Between July and September of 2023, 24 individuals participated in in-depth interviews via video-conferencing software. Interviews were transcribed and analyzed using a reflexive thematic approach. Participants reported challenges navigating insurance networks, which often engendered frustration and emotional upset. Participants desired mental health providers that could provide affirming and culturally tailored care, with a preference for providers from the LGBTQ+ community and from their racial or ethnic background. Such needs were complicated by narrow provider networks, limited resources and provider directories replete with inaccuracies and unavailable providers. Participants also highlighted cost-related challenges, including high out-of-pocket costs associated with care and treatment limitations that restricted access to care. Finally, participants reported programing and resources that helped bridge the payment gap or made accessing care more convenient, including community and employer-offered mental health programming, primary care provider-delivered care and telehealth utilization. Our findings support that gay and bisexual men experience challenges when seeking mental health care that also affect the broader population, but may be magnified for this population, particularly for men of color seeking care from a smaller subset of providers prepared to deliver culturally tailored and affirming care to LGBTQ+ individuals. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

This study explores pathways into and out of the criminal justice system for Latinos with co-occurring mental health and substance use disorders, emphasizing missed and successful opportunities for intervention. Using a qualitative design, we retrospectively apply the Sequential Intercept Model-a framework for identifying points of intervention along the justice continuum-to 15 in-depth life history interviews with Latinos in South Texas. By incorporating adverse childhood experiences, mental health symptoms, and substance use onset, we map trajectories across all six intercepts, from community-based services through community corrections. Findings reveal that participants experienced long-term behavioral health issues that remained unaddressed until late-stage criminal justice involvement. Early intercepts, such as community contact, law enforcement, and court diversion, represented the most frequently missed opportunities. Our findings extend prior critiques by illustrating how cultural norms, discretionary policing, and stigma produce "invisible intervention points"-unrecognized points of potential intervention obscured by social and institutional barriers. Cultural stigma, fragmented service systems, and diagnostic exclusion further constrained access to early treatment. Spanish-speaking participants typically engaged only after incarceration or court-mandated referral, whereas English-speaking participants described earlier but untreated symptoms rooted in trauma and instability. Those who received structured care during reentry or community supervision reported greater stability and reduced recidivism. This study demonstrates the utility of serious mental illness as a retrospective analytic tool for assessing service gaps and guiding reform. Findings underscore the need for culturally responsive outreach and cross-agency coordination to reduce criminal justice involvement among Latino populations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Queer people experience high rates of depression and suicidality and are more likely to seek and use mental health services compared to heterosexual people. Few studies have investigated how mental health service experiences regarding sexual orientation and satisfaction/dissatisfaction with these services may be related to demographic characteristics and mental health outcomes among queer people. A national sample of 500 queer adults (M_age = 33.7, SD = 10.0; 60% female; 86% cisgender) in the United States completed an online survey that measured demographic characteristics, depressive symptoms, suicidal outcomes (ideation, planning, and attempts), mental health service experience about sexual orientation, and degree of helpfulness/unhelpfulness of these services. Results showed 39% of participants had talked with a mental health professional about their sexual orientation. Among those, 58% found the experience to be helpful to some degree, 24% found the experience to be unhelpful to some degree, and 18% found the experience neither unhelpful nor helpful. Regression results indicate that compared to individuals who had never talked with a mental health professional about their sexual orientation, those who had an unhelpful experience reported slightly higher levels of depressive symptoms, were nearly three times more likely to have seriously considered suicide, and were nearly four times more likely to have attempted suicide. Lack of education and training for mental health professionals about queer-specific issues, experiences, language, and affirmative practice may contribute to unhelpful experiences. Improvements in training, services, and policies are needed so that service use is helpful and not associated with elevated depression and suicidality. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The goal of this study was to characterize mental health care utilization, including variables associated with initiation of a posttraumatic stress disorder (PTSD) evidence-based psychotherapy (EBP), among veterans with PTSD in the year following a suicide attempt. In a national survey of veterans with a recent suicide attempt, 431 had a diagnosis of PTSD and were included in the present study. Patients completed self-report measures of PTSD symptom severity, stigma, and logistic barriers to care. Mental health utilization data were extracted from the electronic health record. Descriptive statistics were used to characterize mental health care utilization in the year after a suicide attempt, and regression analyses were used to identify patient- and health service-related factors associated with PTSD EBP initiation. The majority of the sample received eight or more outpatient mental health visits in the year following the index suicide attempt (95.8%); however, only 10.4% initiated a PTSD EBP, and even fewer (4.2%) received a minimally adequate treatment dose (e.g., eight or more sessions). PTSD severity, stigma, and logistic barriers to care did not account for significant variance in PTSD EBP initiation. In addition to outpatient psychotherapy, the majority of patients received an antidepressant-related medication (90.7%), and a substantial portion experienced subsequent psychiatric hospitalization (46.2%). Although the majority of patients received eight or more outpatient mental health visits, few engaged in a PTSD EBP, suggesting that additional work is needed to determine how best to time PTSD treatment in the context of a recent suicide attempt. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Veteran women with trauma histories are at greater risk for trauma-related psychopathology and continued stressor exposure. Given that services and resources for veterans are in high demand, it is imperative to identify factors relevant to veterans who are of high need and likely to engage with treatment. This study examined treatment utilization in veteran women who were more reactive (i.e., higher need) versus resilient (i.e., lower need) to stressors. Veteran women (n = 153) with sexual assault histories who took part in a randomized clinical trial were assessed three times over 4 months. Stressor reactivity (SR) was calculated by regressing posttraumatic stress disorder symptoms onto stressor exposure. Outcomes were service utilization indices. Mixed effect models examined between-person (averages) and within-person SR (deviations from person averages) effects relating to outcomes over time. Between-person SR positively related to treatment attendance (per self-report and chart review) and resource areas that veterans reported working on and needing to work on, with evidence of small to medium effects. There was also evidence for between-person SR effects in a subsample with high stressor exposure. There was no evidence of within-person SR effects for these outcomes. There was no evidence of SR effects relating to success at obtaining resources. Results indicate that veterans in highest need of treatment (i.e., more reactive) are also more likely to attend treatment and identify areas for potential intervention. Building on these results, identifying stressor reactive veterans by monitoring of stressors and symptoms may enhance care connection and prevent entrenched stressor-related psychopathology. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

This research explores help-seeking behaviors among first responders through a phenomenological lens, aiming to bridge theoretical knowledge and practical application. The study seeks to contribute to the understanding of help-seeking behaviors among first responders and highlights the importance of addressing mental health concerns in this population. Employing van Manen's (2015) guidance, conversational interviews were conducted to delve into participants' experiences. Data collection involved demographic questionnaires and interviews, which were transcribed for accuracy. Participants were encouraged to freely express themselves. Rigorous methods, including verbatim reporting and peer debriefing, were utilized to ensure accuracy and trustworthiness. Analysis was conducted using Dedoose, with van Manen's six-step phenomenological method guiding the process. Transcripts were coded individually, and common themes were compared across participants to understand their help-seeking experiences. Throughout the process, personal reflections were noted to refine ideas and understand the researcher's emotions and identities. The analysis identified themes such as social stigma and feelings about seeking counseling. These themes provided a deeper understanding of participants' lived experiences and their help-seeking behaviors. This study contributes to the understanding of help-seeking behaviors among first responders, emphasizing the need to address mental health concerns within this population. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

As the incidence of mass casualty incidents (MCIs)-including natural disasters, acts of terrorism, and mass shootings-continues to rise worldwide, the need for health care institutions to develop comprehensive MCI response plans, particularly those that incorporate a dedicated mental health component, has become increasingly urgent. A crucial component of these response plans is ensuring that mental health providers are adequately trained, resourced, and prepared to respond by maintaining a foundational competence in disaster mental health. This article reviews definitions of mass casualty and community disasters, explores psychological outcomes, and presents evidence-based interventions that can be used in the aftermath. It highlights the role of psychology in both immediate and long-term mental health responses, with a particular focus on pediatric psychology. Additionally, we discuss the importance of program development and the clear delineation of administrative roles in responding to MCIs. Our review is grounded in the real-world experience of a pediatric psychology response to a specific MCI that occurred at a Level 1 pediatric trauma center and lessons learned through this experience. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

One of the goals of training behavioral health providers in a treatment approach is for them to use the treatment with the full range of patients for whom the treatment is indicated. Whether certain training models are more effective than others in achieving this goal is unknown. The goal of this study was to examine the impact of behavioral health provider training in prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD) on the use of PE and clinical outcomes among patients with different clinical presentations. Providers (N = 103) working at military behavioral health clinics were randomized to receive a 4-day PE workshop with or without weekly postworkshop consultation for their first two patients and then provided the treatment of their choice to 242 patients with PTSD. Poisson regression analyses and multilevel models tested the moderating effect of PTSD severity, comorbid disorders, anger, and suicidality on provider use of PE components and on patient change in PTSD severity. Results showed that both the presence of a comorbid substance use disorder (SUD) and the total number of comorbid anxiety disorders moderated the impact of provider training on the use of PE. Specifically, providers who did not receive PE consultation used few PE components across comorbid conditions, whereas providers who received consultation used more PE components with patients with comorbid SUD and fewer components with patients with comorbid anxiety disorders. In addition, comorbid SUD and suicidality moderated the impact of training on clinical improvement such that patients with comorbid SUD and patients with suicidality experienced greater PTSD improvement when treated by providers who did versus did not receive postworkshop consultation. Findings demonstrate the impact of postworkshop consultation on therapy implementation and clinical outcomes across common clinical presentations in a military treatment setting. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

There is a loneliness epidemic in the United States. Embedding interventions within primary care may facilitate access to effective treatments for loneliness. This study characterized experiences of loneliness, strategies used to counteract loneliness, and perspectives on loneliness interventions among primary care patients. Semistructured interviews were completed by 17 adults (M_age = 41.9 years, SD = 18.9) who indicated social isolation on routine screens administered within primary care. Interviews were transcribed, and rapid qualitative analysis was performed. Summaries were created, and patterns within the data were grouped into themes. Participants spoke of intrapersonal, relational, and situational/contextual causes of loneliness. All participants reported being aware of strategies to reduce loneliness, with the majority having success using one or more strategies. Opinions were mixed regarding loneliness interventions within primary care, with half of the participants expressing positive impressions toward addressing loneliness in this setting and others voicing skepticism regarding whether primary care was the best setting to address loneliness, even among participants with positive overall impressions. Only two participants reported having spoken with their primary care provider about loneliness. Despite the mixed perspectives, participants indicated that strategies to improve coping and psychological states (e.g., amotivation) and enhance their social engagement would improve their loneliness. In conclusion, perspectives on loneliness interventions within primary care were mixed, suggesting that patient psychoeducation and alliance-building may be needed prior to delivering loneliness interventions in this setting. Given the varied identified causes and needs, multifaceted interventions may be needed to ameliorate the personal and public health burden of loneliness. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Since the onset of COVID-19, health care workers (HCWs) continue to experience many challenges putting them at risk for mental health issues and burnout. Employing organizations offer services, such as mental health care, to help mitigate these issues. However, there is little data on the extent to which those working in the U.S. Army's Medical Department experience these issues and how it affects mental health care utilization. This study sought to further examine these factors among a large sample of military HCWs. Anonymous data were collected from 12,939 active-duty soldiers and civilians working in the U.S. Army's Medical Department in the Fall of 2021. All data were collected via electronic survey containing questions on demographics, health, utilization, and attitudes of mental health care. Results showed that over 85% of HCWs reported willingness to utilize mental health care if they needed it, however, of those that indicated a need for care, almost 40% did not seek/receive it. Decreased likelihood of seeking/receiving care was associated with being Asian (OR = 0.5, p < .001), working in clinical services (OR = 0.8, p = .004) and having less than 1 year of experience (OR = 0.6, p = .003). Those experiencing burnout, barriers to care, and self-reliance were 20%-65% less likely to seek or receive mental health care. This study showed that there is a significant gap among HCWs that need mental health care and those who seek or receive treatment. Determining factors that are associated with utilization among those that need it is an important first step to expanding access to care, increasing utilization, and limiting the negative impact of mental health issues. (PsycInfo Database Record (c) 2025 APA, all rights reserved).