Journal of Mental Health最新文献

Background: Reducing barriers to engagement in mental health services by meeting people in the communities "where they are" has potential to reach those who would be otherwise disengaged.

Aims: This study explores the potential of laundromats as a space to reach individuals with elevated social, mental health, and suicide risk.

Methods: Participants (N = 197) were recruited from over 50 laundromats across San Antonio, Texas. Rates of mental health conditions and suicide risk were compared to national estimates, and analyses were supplemented with bootstrapped samples.

Results: The majority (60%) of participants indicated one or more financial need. Participants were significantly more likely to report poor/fair mental health and screen positive for suicidal ideation relative to the national average. In a multivariable logistic regression, suicidal ideation was related age, education and housing insecurity prior to the addition of mental health. Over 1/3 of participants indicated an interest in receiving behavioral health services at a laundromat.

Conclusions: Laundromat customers in San Antonio, Texas reported poorer mental health and elevated suicidal ideation relative to the national average. Current utilization of mental health services was low with many participants indicating an interest in receiving services at the laundromat, suggesting an opportunity for community intervention.

Background: In Canada, more than 4,500 people die by suicide annually, with individuals diagnosed with psychotic disorders being at significantly higher risk. Although the risk factors for suicide in this population are well-established, the assessment of suicide risk remains underexplored.

Aim: This study examines the practices of mental health professionals working with clients with a psychotic disorder in relation to suicide risk assessment, using the Theory of Planned Behavior (TPB) as a theoretical framework.

Method: A survey of 148 professionals across Canada was conducted to assess factors influencing the frequency and thoroughness of suicide risk assessments.

Results: Despite our perceived behavioral control scale having psychometrical flaws, results revealed that social norms were a significant predictor of systematic suicide risk assessments. Professionals identified a lack of time, training, and inadequate clinical tools as major obstacles to thorough assessments. Despite the widespread availability of suicide risk assessment training, many professionals did not feel adequately prepared or confident in conducting such assessments, particularly with clients with a psychotic disorder.

Conclusion: The findings highlight the need for enhanced support, training, and organizational changes to improve the systematic assessment of suicide risk in this vulnerable population.

Background: The week following discharge from inpatient psychiatry is a time of exponentially increased risk of death by suicide among people diagnosed with a mental illness. Yet, a significant number of individuals do not receive timely outpatient follow-up upon being discharged from hospital. Psychosocial interventions that target suicidality initiated within inpatient psychiatry may help to prepare individuals for this vulnerable transition.

Aims: To explore the range and nature of research on psychosocial interventions targeting suicidality in the context of inpatient psychiatry and to identify the components and intended mechanisms of studied interventions as well as their mode and dose of delivery, adaptations, outcomes measured, and overall results.

Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and in line with the Preferred Reporting for Systematic Reviews and Meta-Analyses extension for Scoping reviews. Studies that described psychosocial interventions initiated in adult psychiatric inpatient units aimed at addressing suicidality were included.

Results: A total of 77 articles were included in the review, most of which employed quantitative research methods, were published after 2019, and were conducted in the United States. Most interventions studied were based on cognitive behavioral approaches, incorporated a review of factors that led to a person's suicidality, strategies for managing emotions, and safety planning. Participants' narratives as to what was helpful for them centred around the themes of being acknowledged, being listened to, and increasing self-awareness.

Conclusions: Cognitive behavioral therapy underlies most interventions targeting suicidality in inpatient psychiatry. There is a need for research that explores patients' experiences of engaging in specific suicide targeted interventions and that sheds light on the relational aspect of interventions targeting suicidality.

Background: The Emergency Department (ED) is a key setting for suicide risk assessments. In the UK, mental health professionals (MHPs) in psychiatry liaison teams assess suicide risk.

Aim: This study aimed to explore how MHPs in EDs experience and approach the assessment of suicide risk for people presenting for suicidal ideation and/or self-harm.

Methods: We interviewed 22 MHPs from one hospital (England) on their views of conducting psychosocial assessments. Interviews were recorded, transcribed and analysed using inductive thematic analysis.

Results: MHPs described various challenges, summarised in four main areas: the complexity of assessing suicide risk and lack of confidence in some patients/ accounts, the dynamic nature of risk, the impact/barrier of a structured assessment form, and institutional pressures and lack of resources. We identified views and attitudes that delegitimise patients. While such practices at an individual level need to be addressed, we posit this reflects organisational pressures that stifle practitioners' ability to prioritise therapeutic alliance.

Conclusions: It is unsurprising that MHP experience moral injury that can be manifested as amplify biases and compassion fatigue. This calls for changes to support staff striving to make assessments therapeutic and we recommend both top-down and bottom-up initiatives to improve the experiences of MHPs and their patients.

Background: Since the first suicide helpline was established in 1953, telephone support helplines have expanded globally. One such helpline is Samaritans. Previous studies on Samaritans have explored volunteers' perspectives and examined the number of calls users make.

Aims: The aim of this study was to capture the users' experiences of Samaritans' helpline in Ireland.

Methods: A mixed methods methodology, incorporating quantitative (cross-sectional) and qualitative (qualitative descriptive) elements was adopted. Participants accessed surveys via Samaritans' website. At the end of the survey, participants could self-select to partake in 1:1 online interviews. Quantitative data were analysed using descriptive statistics; qualitative data were analysed using reflexive thematic analysis.

Results: A total of 395 respondents completed the survey. Telephone was the most prominent format of contact with Samaritans, at 88.6% (n = 350). Mental health was cited as the main reason callers connected with Samaritans. Almost half of respondents felt supported a lot (47.3%, n = 187). Qualitative analysis identified three themes: Availability, Accessibility, Anonymity; Connecting with Volunteers; and Expectations of Samaritans' Services.

Conclusions: Samaritans' services are highly valued by those who engage with them. However, there is a need to enhance public awareness about the specific supports Samaritans provide, and the formats of contact that are available.

Background: Although research has shown that stigma toward people with mental illness (PMI) differs among different types of healthcare providers, the direction and underlying mechanisms of the relationship between familiarity with PMI and stigma toward PMI remain unclear.

Aims: The aims were to examine the associations between familiarity with and stigma toward PMI among healthcare providers, explore the mediating role of mental health knowledge (MHK) and test whether the relationship varies among mental health care providers and general health care providers.

Methods: A total of 2874 healthcare providers from seven cities completed an online survey assessing familiarity, MHK, stigma. Moderated mediation analyses were conducted using PROCESS macro.

Results: Health providers who were more familiar with PMI knew more about mental illness, and those who knew more about mental illness had less stigma toward PMI. The effect of MHK on stigma was stronger in mental health care provider than general health care providers.

Conclusions: This study lends support to intergroup contact theory. When designing anti-stigma interventions for healthcare providers, their work experience and organizational context should be considered. Healthcare providers need to realize the effects that their stigma might have on PMI and the public.

Background: Emotional reactions to the ongoing climate crisis, termed eco-distress, eco-anxiety or climate anxiety, are experienced more and more frequently by patients. However, evidence-based recommendations for practitioners on how to deal with eco-distress are scarce. The aim of this study was to provide a guideline for working with eco-distress in counseling and psychotherapy, based on the analysis of practitioners' perspectives.

Methods: Three semi-structured in-depth focus group interviews were conducted with n = 23 psychotherapists in training who had taken part in three different scenarios of eco-distress with standardized patients. Transcripts were analyzed from a phenomenological perspective, employing thematic analysis.

Findings: Three superordinate themes were identified: (1) "Necessary Basic Understandings;" (2) "Particularities of the Psychotherapeutic Relationship"; and (3) "Useful Skills." Based on the thematic analysis, a guideline for practitioners was developed.

Implications: The presented guideline can inform current practice and form a basis for the development of trainings on dealing with eco-distress. It enables practitioners to familiarize themselves with the specific aspects of dealing with eco-distress in counseling and psychotherapy and to integrate these into their existing competencies.

Background: Positive Working Alliance (WA) is linked to better treatment. Factors influencing WA between patients with Schizophrenia Spectrum Disorders (SSD) and staff are unclear. This study explores the relationship between WA and variables evaluated using the Experience Sampling Method (ESM).

Methods: The final sample includes 55 patients and 43 staff members. ESM was used to track patients' daily activities and emotions during the day. Generalised Linear Models (GLM) were applied to investigate associations between WA and ESM variables, and k-means clustering was performed to group patients.

Results: Patients hospitalized for 1-5 years are associated with lower patient-related WA ratings (p = 0.040), while staff-related WA ratings are positively influenced by time spent "Getting around" (p = 0.024), "With other people" (p = 0.006), and "Alone" (p = 0.031). Cluster analysis shows that comprising patients who mainly spend time alone, has more severe symptoms and a weaker WA than patients who spend more time with others.

Discussion: Extended hospitalisation is linked to lower WAI-P ratings, due to reduced trust and disengagement. Conversely, greater social interaction and mobility are associated with improved WAI-P and WAI-T ratings, suggesting that social and functional activity strengthens the WA. These findings highlight the importance of interpersonal connection and autonomy in supporting effective therapeutic relationships.