Journal of Mental Health最新文献

Background: Emerging adulthood is a peak period for mental health problems, and transition to university heightens both risks and opportunities. Targeted interventions may support students with pre-existing conditions, but the evidence base has not been systematically updated since 2021.

Methods: Following PRISMA guidelines, we searched MEDLINE, PsycINFO, Embase, and ERIC (2015-2025) for peer-reviewed studies evaluating interventions supporting students with diagnosed or self-reported mental health conditions during transition to higher education. Eligible designs included quantitative pre-post and controlled studies. Data extraction followed the TIDieR checklist, and risk of bias was assessed using a modified NIH tool.

Results: Eight studies (five interventions) were identified. Four interventions used controlled designs, three were randomised controlled trials. Common components included peer mentorship, goal setting, psychoeducation, and skills for independence. Several targeted help-seeking barriers, empowerment, and loneliness. Interventions were generally acceptable, with evidence of improvements in educational outcomes, adjustment, and depressive symptoms, but not anxiety. Most were opt-in, reliant on disclosure, and none were university-led.

Conclusion: Targeted interventions show promise in supporting students with mental health conditions during university transition. However, evidence remains limited, heterogeneous, and predominantly North American. Larger, equity-focused, and university-led trials are urgently required.

Background: Depression and anxiety are highly comorbid conditions, which may impact treatment response.

Aims: We intended to examine how depression and anxiety symptoms change during psychological interventions for adults and how the initial severity is associated with distinct trajectory classes.

Methods: We identified papers examining longitudinal changes in depression and anxiety. Trajectory classes were grouped into responders, improvers and non-improvers. Narrative synthesis, alongside meta-analysis, was applied to explore the number and nature of classes, their associations with study characteristics and predictors of trajectory class membership. This study was pre-registered on International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023393155), and the authors followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance.

Results: We identified 18 papers, including 22 models with two to six classes. Responding and non-improving classes prevailed. Meta-regression revealed no characteristics associated with the proportion of these classes. Initial depression and anxiety levels predicted trajectory class membership for each other, but not always non-response. Unemployment, suicidality, social functioning impairment, treatment type and medication use predicted following non-responding trajectory.

Conclusion: Our findings highlight the complex relationship between initial anxiety and depression severity and their changes during psychological interventions. They provide practitioners with insights into factors associated with non-response patterns of symptom change.

Background and aims: While some digital supports aid in improving young people's mental health, there is a dearth of information regarding the most effective ways to involve young people in the co-production of digital technologies. User input is essential, particularly for marginalised young people who are often excluded. The aim of this scoping review was to examine recent literature on the most common co-production processes of digital mental health supports with marginalised young people.

Method: A scoping review was conducted to identify literature published since 2021, written in English, focusing on co-production processes of digital mental health supports with marginalised young people aged 16-25. Basic information, data relating to the research question and key findings were extracted. A combination of Excel and Covidence management software was used to collate the charted data and manage the screening process. Studies were included if they used innovative youth-led approaches in the design, development, implementation or evaluation of digital mental health supports ranging from mental health promotion to targeted interventions.

Results: Out of 2341 studies initially screened, 21 studies published between 2021 and 2023 with a range of study designs and evidence were included. The studies reported on engagement with marginalised young people in the design, implementation, and/or evaluation of digital mental health technologies. The review examined qualitative and mixed methods studies from eleven countries, with most co-produced digital supports relating to mental health promotion and prevention. Most common were supports targeting general mental health and mental wellbeing. More than half of the studies included representation from LGBTQ+ young people, followed by ethnic minorities and migrants, but few included other marginalised groups. Only 6 of 21 studies used innovative approaches and many typically involved young people in only one of the co-production processes with design identified as most common. Finally, passive rather than active participation of young people was found to be pronounced. This limits young people's opportunities to shape the outcome to the data collection process only.

Conclusion: Given the extent to which marginalised groups are actually involved in co-production, the review suggests the need for young people to be more actively involved in all co-production processes of digital mental health technologies. Offering a diverse range of methods through innovative, participatory approaches can facilitate more effective engagement from young people and provide an environment that is inclusive to a range of voices and perspectives. Lastly, the lack of inclusion of marginalised groups such as young people with a disability, or youth living in rural areas is an important issue to consider for future research.

Background: Individuals living with serious mental illness (SMI) face pervasive stigma, with damaging effects on their intimate lives. Although evidence suggests individuals might endorse stereotypes about their romantic relationships, no tool has addressed self-stigma in this domain.

Aims: This study aimed to develop and validate the Intimate Relationship Self-Stigma Scale (IRSS), specifically, to determine its structural and construct validity, as well as the internal consistency and test-retest reliability.

Methods: This instrument was co-constructed with peer support workers living with SMI. Using a bipolar semantic differential format, the IRSS captures both self-stigmatizing beliefs and positive self-perceptions. Items were generated through focus groups and literature review. Participants with SMI (N = 150) completed the IRSS online, along with measures of internalized stigma, self-esteem, and romantic functioning.

Results: Exploratory factor analyses supported a four-factor structure-Disclosure Effects, Self-Attractiveness, Stability, and Intimacy Needs-explaining 48.6% of the variance. Subscales demonstrated satisfactory internal consistency (ω = .69-.87), test-retest reliability (ICC = .79-.93), and expected correlations with related constructs.

Conclusion: The IRSS fills a critical gap in recovery-oriented mental health care by providing a comprehensive assessment of internalized stigma in romantic contexts while simultaneously capturing positive self-perceptions. Further validation, including confirmatory factor analyses and cross-cultural validity, is warranted.

Background: Recovery-focused person/patient reported outcome measures (PROMs), are important for recovery-oriented services, but workers have been slow to embed them within practice. Little is known about factors that influence workers use of these measures.

Aim: To synthesise peer reviewed literature regarding the enablers and barriers mental health workers report to using recovery-focused PROMs in practice.

Methods: Five databases were searched. Data were extracted from publications meeting the inclusion criteria, tabulated, and presented graphically. A qualitative thematic analysis was also conducted.

Results: Only six of 30 recovery-focused PROMs had any published work reporting staff experiences of using them. Aspects influencing PROM use included: organisational and structural factors; value alignment; tool psychometrics; perceived relevance to practice and people accessing service; whether staff deemed tools to be useful and meaningful, and ease of use and access.

Conclusions: More work is needed to address worker needs if recovery-focused tools are to be used routinely to collaboratively support people to explore their own recovery-related strengths and priorities. Both tool specific aspects, and organisational structures, that can support or hinder workers to use these tools in routine and recovery-oriented ways.

Prisma/prospero: The PRISMA extension for Scoping Reviews (PRISMA-ScR) was followed. Prospero does not accept protocols for scoping reviews.

Background: Trends in news being increasingly accessed via social media warrants more attention to how mental illness and suicide news is being communicated on social platforms, which have the potential to amplify or mitigate stigma in wider audiences.

Aims: This study aimed to determine how mental illness and suicide are portrayed in Facebook posts by Australian news organisations, and examine engagement trends with these posts.

Method: A systematic search of 22 Australian news Facebook pages was conducted on Meta's CrowdTangle database for posts about mental illness or suicide over a 1-year period.

Results: Of the 1343 Facebook news posts identified, over half (55%) comprised "helpful" content. News posts featuring people with lived experience were the most common topics with helpful content, however harmful content was still prominent. Problematic content in news posts often included sensationalist, trivialising, or "suffering" language, and stigmatising or sensationalist quotes. Public engagement with news posts did not differ based on alignment with media guidelines.

Conclusions: There is substantial room for improvement in how mental illness and suicide-related news is communicated on social media. Ensuring this aligns with responsible media guidelines will reduce public exposure to content that can perpetuate stigma and increase harms.

Background: Mental health nurse practitioners represent a workforce with capacity to significantly contribute to meeting public need for psychotherapy.

Aim: The purpose of this scoping review study is to synthesize evidence regarding mental health nurse practitioner use of psychotherapy.

Methods: Arksey and O' Malley's framework was used to guide the review which sought and synthesized papers written in English published between January 2000- April 2025 describing mental health nurse practitioners use of psychotherapy.

Results: Sixteen papers were included, nine written in the United States, four from Australia, and one each from South Africa, the Netherlands and Korea. Studies revealed that mental health nurse practitioners utilize a wide range of psychotherapy to assist people throughout the lifespan and across diverse settings. However, despite such wide-ranging and valuable service provision regulatory barriers often restrict mental health nurse practitioners' delivery of psychotherapy.

Conclusion: Evidence outlined in this scoping review challenges governments, policy advisors and service managers to better support mental health nurse practitioners as they seek to serve their communities by providing psychotherapy alongside other forms of mental healthcare.

Background: The self-presentation of psychiatric disorders on social media has generated a countermovement of sceptics who believe some are "faked" for reasons of self-promotion. This has been the focus of a Reddit forum called r/FakeDisorderCringe, an active community with almost 300,000 members. Given the influence of online discourse on public attitudes, understanding which diagnoses attract the most scepticism and what conversational themes surround these concerns is important in understanding lay controversies in mental health.

Methods: We used topic modelling using Latent Dirichlet allocation, a natural language processing technique, to analyse over 850,000 forum posts from August 2020 to December 2022 to identify the main topics.

Results: Topic modelling identified 15 topics, of which several identified specific disorders: anxiety, depression, OCD (obsessive-compulsive disorder), ADHD (attention deficit and hyperactivity disorder), autism, Tourette's syndrome and tics, and DID (dissociative identity disorder). Other topics included faking and attention-seeking, school and childhood context, trauma and abuse, validity of self-diagnosis, medical research evidence, gender identity and sexuality, profanity, and sarcasm-laden commentary.

Conclusions: This scepticism does not mirror previously identified public doubts about the legitimacy of specific diagnoses and seems to more commonly focus on conditions that have seen a recent increase in diagnosis in young people.

Background: Quality mental health services are pivotal in addressing mental health issues worldwide. Despite this importance, many countries face challenges in providing accessible, high-quality mental health care.

Aims: This study examines the nexus between mental health services and worry about mental health issues across different countries.

Methods: This study used data from the Lloyd's Register Foundation 2021 World Risk Poll, the OECD, the World Health Organization, and Our World in Data. The variables include worry about the personal harm that mental health issues could cause, mental health services (i.e. service facilities, service availability, and service utilisation), and estimated prevalences of major mental disorders.

Results: The results revealed that structural components - specifically the availability of mental health outpatient facilities - were associated with less worry about mental health issues across countries. However, no significant association was observed between process components - such as service utilisation - and worry about mental health issues. Additionally, the association between the prevalence of various mental disorders and worry about mental health issues showed mixed results.

Conclusions: The findings emphasise the importance of increasing the availability of these facilities to ensure universal access to essential mental health care, thereby improving mental well-being across both low-income and high-income countries.