Global Mental Health最新文献

Peer support groups are safe spaces that provide an emotionally and socially supportive environment to individuals, along with practical assistance. The three authors run a peer support group in New Delhi, India, for young adults who face mental health challenges. This study explores the processes of group formation, the nature of participant engagement and the evolving dynamics within the group setting. Drawing on firsthand reflections, the article highlights how peer support groups foster emotional safety, narrative autonomy and identity reconstruction through shared lived experiences. It also outlines the practical challenges of facilitation, including managing boundaries, maintaining group cohesion and adapting to diverse participant needs. The article concludes with mentioning arenas of further growth.

Suicide remains a global public health crisis, claiming over 800,000 lives each year and leaving millions more to struggle with attempts, ideation, or the ripple effect of loss. Traditional prevention strategies often focus on crisis intervention and identifying "warning signs," but these approaches overlook the many who suffer in silence. Drawing on personal experience of suicide loss and a decade-long journey toward suicide literacy, the author argues for a reframing of suicide prevention. She challenges stigma-driven assumptions, underscores the power of honest storytelling, and introduces the concept of "preemptive, protective conversations" as a vital upstream prevention tool. By empowering ordinary people to become suicide prevention advocates equipped with knowledge, compassion, and a willingness to talk openly, we can build stronger connections, dismantle stigma, and create a broader societal safety net. Suicide is preventable, and each of us has a role to play in saving lives.

The implementation of electronic health records (EHRs) in mental health contexts has been slow. Reasons for this include concerns from healthcare professionals regarding the collection of sensitive information and the stigma associated with mental health services. Despite the low uptake of EHRs, the benefits include patients feeling empowered and in control of their own treatment. However, ethnically diverse groups often access mental health services through crisis pathways and have been found to disengage with EHRs. The aim of this review was to explore ethnically diverse groups' perceptions of the utility of mental health EHRs and establish perceived barriers and facilitators to access. MEDLINE, CINAHL, EMBASE, Scopus, PsycINFO, PubMed and Web of Science were searched. Included papers mentioned ethnically diverse groups from the 37 listed countries in the Organisation for Economic Co-operation and Development, and included service users, clients or patients accessing EHRs in mental healthcare settings. Papers were required to be published between 2009 and 2025. Eight papers met all criteria for inclusion, and three themes emerged: language barriers to EHR access, lack of access to technology and perceived impact of EHRs on access to care. Language barriers to EHR access, no access to technology and stigma were significant issues for ethnically diverse groups due to concerns about who has access to the electronic health data. Benefits of accessing EHRs included easier and efficient access to records. EHRs are critical for modern health systems and further work is required to improve EHRs usage in mental health systems for ethnically diverse groups.

Traumatic and stressful life events can have lasting effects on mental health, particularly among older adults in low-resource settings. In Latin America, there is limited qualitative evidence capturing the lived experiences of these events. This study explores how older adults in Peru reflect on traumatic and stressful events throughout their lives, and how these experiences continue to shape their mental health in later life. This qualitative study was nested within the Global Excellence in COPD Outcomes (GECo) study in Lima, Peru. We conducted semi-structured, narrative-based interviews with 38 older adults (≥60 years) with moderate to severe symptoms of depression (Patient Health Questionnaire-9 ≥ 10), anxiety (Beck Anxiety Inventory ≥ 16) or a history of mental health treatment. Four main categories emerged: (1) violence (emotional, physical or sexual), (2) abandonment or loss of close relatives, (3) onset of severe illness or disability and (4) other miscellaneous life disruptions. Participants described their memories of past stressful events as deeply embedded in current thoughts and, in some cases, as shaping how they experience certain emotions in the present. Addressing trauma in older adults may improve well-being in low-resource settings. Recognizing the enduring impact of life-course stressors is crucial for culturally sensitive mental health interventions.

More than 116 million people in Africa live with mental health conditions. However, many African countries lack the infrastructure, training and workforce to effectively manage psychiatric emergencies. This has led to overuse of controversial practices such as physical and chemical restraint and involuntary seclusion, often violating patient rights. We conducted a scoping review of restraint and seclusion practices and their impacts in African clinical settings using the PubMed, Embase, CINAHL, PsycInfo and ProQuest databases. Titles/abstracts and full texts were reviewed for inclusion using the Covidence platform, and 29 studies were included in the final extraction. Restraint and/or seclusion were employed to manage aggression, enable involuntary treatment or prevent self-harm. Patients found restraint and seclusion to be dehumanizing, a cause of posttraumatic stress and a barrier to future help-seeking. Healthcare workers described inadequate training, overuse of restraint and seclusion, injuries and emotional distress after employing these treatments. Further research, intervention development and policy reform are urgently needed to promote humane and patient-centered psychiatric care, including verbal de-escalation training, in underresourced healthcare systems.

Optimising knowledge mobilisation in low- and middle-income countries (LMICs) could prove beneficial for improving mental health care, alleviating the global burden of high prevalence mental health problems and reducing inequalities. This review aimed to systematically review and synthesise the evidence on knowledge mobilisation for mental health improvement in LMICs, identifying barriers and facilitators and recommendations to guide progress. Four electronic databases were searched from inception to March 2024 using free text syntax combining synonyms of knowledge mobilisation, mental health and LMICs. Articles were eligible for inclusion if they were peer reviewed, on the topic of mental health and included evaluation data on knowledge mobilisation undertaken in LMICs. Included studies were quality assessed using the mixed-methods appraisal tool, and data extracted and synthesised narratively, complemented with the use of the framework for knowledge mobilisers and thematic analysis. Seventy-eight studies met the inclusion criteria. Successful knowledge mobilisation within resource-constrained settings was supported by several key facilitators. These include promoting community participation, engaging local stakeholders from the start and maintaining that engagement and building trust through equitable, long-term partnerships. Using structured frameworks helps guide systematic involvement, while fostering local ownership and leadership ensures sustainability and relevance. Knowledge mobilisation in low-resource settings faced several barriers, including limited logistical and financial resources, low literacy levels and a general lack of awareness about psychological interventions. A lack of mental health-specific training and language or translation difficulties further hindered efforts to effectively mobilise and implement mental health knowledge. Future knowledge mobilisation efforts could be strengthened by fostering sustained, trust-based collaborations among stakeholders and engaging policymakers early to ensure optimal alignment and buy-in. Emphasising local beliefs and attitudes is crucial, as is creating inclusive, participatory environments that encourage broad community involvement. Employing culturally responsive, community-driven frameworks can enhance relevance and impact, while rigorous evaluation of mobilisation strategies is critical to guide future research investment and resource allocation. Mobilising mental health knowledge in LMIC shares principles with mobilising other types of knowledge but differs in focus, stakeholders and challenges due to the stigma of mental health problems, its complexity, cultural sensitivity, misconceptions and resistance.

The mental health of Sri Lankan adolescents is of growing concern, given the decades of internal conflict and socio-political instability in Sri Lanka. This aims were to examine the prevalence and determinants of symptoms of common mental health problems (MHP) experienced by school-going adolescents in Sri Lanka. A cross-sectional survey was conducted among school-going adolescents in grades 10-12/13 from seven schools in Gampaha District, Sri Lanka. Depressive/psychological distress symptoms measured using the PHQ-9 /K10, were analysed using mean scale scoring. Psychosocial determinants were measured using JVQ/PBI/AESI/study-specific questions. Associations between MHPs and psychosocial determinants were examined using multiple linear regression models. 24.11% of 1,045 adolescents who completed the surveys reported clinically significant symptoms of depression, and 60.10% reported psychological distress. Higher age, being female, lesser physical activity, smoking, daily social media use, violent victimisation, not living with both birth parents, having ≥2 siblings, low maternal/paternal education, having an overprotective paternal figure, increased academic stress and rural living were associated with higher MHPs. We identified a high prevalence of MHPs among Sri Lankan adolescents, which was multifactorially determined. Modifiable risk factors addressed through public health policies, research and programmes, as well as less-modifiable risk factors addressed through national-level policy changes, are all essential to addressing mental health burdens in this population.

While the links between extreme weather events and mental health have received growing attention, little is known about how climate change impacts adolescent mental health in low- and middle-income climate-affected settings. To address this gap, we conducted a multi-method qualitative study exploring how young adolescents (YAs) aged 10-14 years experience climate-related stressors across six regions in Kenya. Guided by the resource insecurity framework, we thematically analyzed Elder focus groups, YA walk-along interviews and YA participatory mapping workshops. Our findings revealed that food, water and sanitation insecurity contribute to psychological distress, including symptoms of depression and suicidality, and heighten concerns of community violence (e.g., assault, fighting). Water insecurity, particularly the time and distance required for collection, disrupted school attendance, while resource borrowing generated feelings of shame. Food insecurity and larger contexts of poverty were associated with substance use as a coping mechanism, which in turn contributed to school dropout, crime and gang involvement. Poverty also led some youth to run away from home. These findings highlight the urgent need for climate-informed mental health interventions that address co-occurring resource insecurities. To advance adolescent mental health and well-being in climate-affected settings, policy responses must be targeted and multilevel, engaging families, communities and institutions.

An increasing number of studies have sought to explore the applicability of scalable mental health interventions to bridge the adolescent mental health treatment gap. This study aimed to adapt the World Health Organization's mental health intervention Early Adolescent Skills for Emotion (EASE) for urban communities in New York City (NYC). Following the mental health Cultural Adaptation and Contextualization for Implementation framework and in collaboration with three Brooklyn community-based organizations and the NYC Mayor's Office of Community Mental Health, the intervention was intensively workshopped through eight weekly sessions with adolescents (n = 18) and caregivers (n = 12). Documentation of the process followed the Reporting Cultural Adaptation in Psychological Trials criteria. Surface adaptations involved revising the storybook to reflect key challenges faced by adolescents and caregivers of these communities, such as social media usage, economic stressors, and racial diversity. Deep adaptations addressed cultural concepts of distress by incorporating topics such as identity exploration, socioemotional learning, and the mind-body connection. Feedback from stakeholders indicated that the basic components of EASE are relevant for members in their communities, but additional changes would foster greater engagement and community building. These findings will inform upcoming program implementation across NYC and may guide adaptation work in other contexts.

Understanding and responding to patient expectations is crucial for providing high-quality, person-centred mental healthcare, but remains underexplored in humanitarian settings. This study examines the preferences and experiences of Syrian mental health and psychosocial support (MHPSS) service users in Northwest Syria and Türkiye. We conducted structured interviews with 378 displaced Syrians (55% female, mean age: 31 years). Participants completed the Client Satisfaction Questionnaire-8 and responded to nine open-ended questions. An abductive qualitative content analysis guided by the World Health Organization's health system responsiveness framework was used to interpret their accounts. Participants most frequently described the importance of time and understanding (62%), dignity (43%), confidentiality (36%) and continuity of care (31%), with notable variation by gender. Interpersonal aspects of care were crucial for building trust and sustaining service engagement. Service-level factors, such as adequate time with practitioners and integrated and coordinated care, ensured high-quality support in a context of ongoing conflict, displacement and poverty. These findings underscore the importance of embedding person-centred approaches in MHPSS service design and delivery. As efforts to rebuild Syria's health system begin, prioritising service user experiences could improve the quality of care and restore health system trust and legitimacy.