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Forced marriage, divorce, and the ecology of marital self-determination: findings from research with Orthodox Jews in New York 强迫婚姻、离婚和婚姻自决的生态:对纽约正统犹太人的研究结果
IF 2.6 Q1 PSYCHIATRY Pub Date : 2026-06-01 Epub Date: 2025-12-20 DOI: 10.1016/j.ssmmh.2025.100584
Jennifer S. Hirsch , Gloria Fortuna , Jessie V. Ford , Alicia Jen , Jessica L. Weissman , Aarushi H. Shah , Fraidy Reiss
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引用次数: 0
“I've actually surprised myself at what I can do”: Understanding the longer-term experiences of individual placement and support (IPS) embedded within primary healthcare “我对自己能做的事情感到惊讶”:了解初级卫生保健中嵌入的个人安置和支持(IPS)的长期经验
IF 2.6 Q1 PSYCHIATRY Pub Date : 2026-06-01 Epub Date: 2025-12-13 DOI: 10.1016/j.ssmmh.2025.100578
Amanda Kwan , Padmini Thakore , Madelyn Whyte , Taite Beggs , Stephany Berinstein , Jonathan Morris , Skye Barbic

Background

Persons with persistent and multiple barriers (PPMB), including mental health and substance use (MHSU) and other disabilities, often experience inequitable challenges obtaining and sustaining competitive employment opportunities. Specialized employment services, such as Individual Placement and Support (IPS), embedded within primary healthcare settings is one approach being trialed to address these inequities. Little is known about the medium and longer-term experiences of PPMB enrolled in IPS programs integrated within primary healthcare.

Methods

We conducted a longitudinal qualitative study using semi-structured interviews with program clients. We analyzed interviews (12- and 24-months) sequentially and collectively using a reflexive thematic approach. We developed, defined, and named themes iteratively, using annotations throughout the process to record personal reflections and assumptions.

Results

Thirty-one participants were enrolled in the study, with 31 interviews conducted at 12 months and 20 interviews at 24 months after program enrollment. Four key themes and one subtheme were generated: (1) negative work experiences have lasting and cyclical impacts, (subtheme) positive work experiences help break negative employment cycles, (2) health remains a significant barrier across the employment journey, (3) social connection is a foundation for health and employment, and (4) growth takes time: progress through self-discovery and support.

Conclusion

Continuous access to integrated specialized health and employment services are necessary for PPMB to achieve sustainable progress towards health, recovery, and employment. As such, integrated and multi-sector programs need to receive sustained funding and cross-ministerial support to ensure equitable employment opportunities for those with MHSU, PPMB, and other disabilities.
背景:患有持续性和多重障碍(PPMB)的人,包括精神健康和物质使用障碍(MHSU)和其他残疾的人,在获得和维持有竞争力的就业机会方面经常遇到不公平的挑战。为解决这些不平等现象,正在试验的一种方法是,在初级卫生保健环境中提供专业就业服务,如个人安置和支持。在初级卫生保健中纳入IPS项目的PPMB的中期和长期经验知之甚少。方法采用半结构化访谈对项目客户进行纵向定性研究。我们使用反身性主题方法对访谈(12个月和24个月)进行了顺序和集体分析。我们迭代地开发、定义和命名主题,在整个过程中使用注释来记录个人的思考和假设。结果31名参与者被纳入研究,其中31人在项目入组后12个月进行了访谈,20人在项目入组后24个月进行了访谈。研究产生了四个主要主题和一个副主题:(1)消极的工作经历具有持久和周期性的影响,(副主题)积极的工作经历有助于打破消极的就业周期,(2)健康仍然是就业过程中的一个重要障碍,(3)社会联系是健康和就业的基础,(4)成长需要时间:通过自我发现和支持取得进步。结论持续获得综合专业卫生和就业服务是PPMB实现健康、康复和就业可持续发展的必要条件。因此,综合和多部门的项目需要得到持续的资助和跨部门的支持,以确保MHSU、PPMB和其他残疾人有公平的就业机会。
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引用次数: 0
Sanitation-related empowerment resources are associated with women's well-being, anxiety, and depression: findings from Bangladesh, India, Senegal, and Uganda 与环境卫生相关的赋权资源与妇女的福祉、焦虑和抑郁有关:来自孟加拉国、印度、塞内加尔和乌干达的研究结果
IF 2.6 Q1 PSYCHIATRY Pub Date : 2026-06-01 Epub Date: 2025-12-22 DOI: 10.1016/j.ssmmh.2025.100585
Thea Mink , Madeleine Patrick , Amelia Conrad , Tanvir Ahmed , Srishty Arun , Vinod Ramanarayanan , Niladri Chakraborti , Y. Malini Reddy , Abhilaasha Nagarajan , Tanushree Bhan , Sheela S. Sinharoy , Bethany A. Caruso
Recent research has identified linkages between women's sanitation experiences, like safety and privacy, and their mental health. Our study examined associations between sanitation-related empowerment resources (Bodily Integrity, Safety and Security, Privacy, and Time) and mental health outcomes (well-being, depression, and anxiety). We conducted a secondary analysis of cross-sectional data collected in 2021–2022 from household surveys of women in Bangladesh, India, Senegal, and Uganda (n = 2285). Primary exposures were sanitation-related empowerment resources measured using the Agency, Resources, and Institutional Structures for Sanitation-related Empowerment (ARISE) Scales. Three outcomes were assessed: subjective well-being (World Health Organization Well-being Index, WHO-5), anxiety (General Anxiety Disorder measure, GAD-2), and depression (Patient Health Questionnaire, PHQ-2). Linear regressions of WHO-5 scores and negative binomial regressions of PHQ-2 and GAD-2 scores on the four sanitation-related empowerment resources were conducted.
Mean scores for the outcomes were: well-being = 17.2 (SD = 5.9), depression = 1.1 (SD = 1.4), and anxiety = 1.0 (SD = 1.4). Mean scores for primary exposures were: Bodily Integrity = 3.7 (SD = 0.4), Safety and Security = 3.5 (SD = 0.4), Privacy = 3.8 (SD = 0.5), and Time = 3.1 (SD = 0.5). Higher Privacy was associated with higher well-being scores in both regional samples with higher Time additionally associated with higher well-being scores in Bangladesh and India. In Bangladesh and India, higher Bodily Integrity and Time were associated with lower depression scores, and higher Bodily Integrity, Safety and Security, and Time were associated with lower anxiety scores. In Senegal and Uganda, higher Bodily Integrity, Safety and Security, and Privacy were associated with lower depression scores, and higher Privacy was associated with lower anxiety scores. Our findings provide evidence of associations between women's sanitation-related resources of Bodily Integrity, Safety and Security, Privacy, and Time and mental health. Sanitation initiatives should aim to enhance and evaluate women's experiences of these resources given their potential to benefit women's mental health and well-being.
最近的研究已经确定了妇女的卫生经历(如安全和隐私)与她们的心理健康之间的联系。我们的研究调查了与卫生相关的授权资源(身体完整性、安全和保障、隐私和时间)与心理健康结果(幸福感、抑郁和焦虑)之间的关系。我们对2021-2022年从孟加拉国、印度、塞内加尔和乌干达妇女家庭调查中收集的横截面数据进行了二次分析(n = 2285)。主要暴露是使用卫生相关授权机构、资源和制度结构(ARISE)量表测量卫生相关授权资源。评估了三个结果:主观幸福感(世界卫生组织幸福指数,WHO-5)、焦虑(一般焦虑障碍测量,GAD-2)和抑郁(患者健康问卷,PHQ-2)。对四种卫生相关赋权资源的WHO-5评分进行线性回归,对PHQ-2和GAD-2评分进行负二项回归。结果的平均得分为:幸福感= 17.2 (SD = 5.9),抑郁= 1.1 (SD = 1.4),焦虑= 1.0 (SD = 1.4)。初次暴露的平均得分为:身体完整性= 3.7 (SD = 0.4),安全和保障= 3.5 (SD = 0.4),隐私= 3.8 (SD = 0.5),时间= 3.1 (SD = 0.5)。在这两个区域样本中,更高的隐私与更高的幸福感得分有关,而在孟加拉国和印度,更高的时间与更高的幸福感得分有关。在孟加拉国和印度,较高的身体完整性和时间与较低的抑郁得分相关,而较高的身体完整性、安全和保障和时间与较低的焦虑得分相关。在塞内加尔和乌干达,较高的身体完整性、安全和保障以及隐私与较低的抑郁得分相关,而较高的隐私与较低的焦虑得分相关。我们的研究结果为女性的身体完整性、安全和保障、隐私和时间与心理健康等卫生相关资源之间的关联提供了证据。卫生举措应旨在加强和评价妇女对这些资源的体验,因为这些资源有可能有益于妇女的心理健康和福祉。
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引用次数: 0
Response to Leboyer et al., 2026 对Leboyer等人,2026的回应
IF 2.6 Q1 PSYCHIATRY Pub Date : 2026-06-01 Epub Date: 2026-01-29 DOI: 10.1016/j.ssmmh.2026.100589
François Gonon , Henri Gouraud , André Gillibert , Bruno Falissard , Lisa Cosgrove , Kasper P. Kepp , Ioana A. Cristea , Florian Naudet
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引用次数: 0
Between compassion and control: nursing ethos, professional responsibilities, limited resources, and the use of psychotropic drugs in dementia care 在同情和控制之间:护理精神,专业责任,有限的资源,以及痴呆症护理中精神药物的使用
IF 2.6 Q1 PSYCHIATRY Pub Date : 2026-06-01 Epub Date: 2025-11-29 DOI: 10.1016/j.ssmmh.2025.100568
Niklas Petersen
The widespread use of psychotropic medication in long-term care, especially antipsychotics for managing dementia-related behaviours, is controversial due to serious side effects, significant risks, and increased mortality rates. While prescribing authority lies with physicians, nurses often demand treatment and administer as-needed medications at their discretion. This study discusses the ongoing reliance on antipsychotics within the context of structural tensions between person-centred nursing values, multiple professional responsibilities, and resource constraints in long-term care facilities. Drawing on in-depth qualitative interviews with 15 nurses across seven German nursing homes, the study reveals diverse ways in which nursing staff navigate the use of psychotropic medication in dementia care. While nurses' self-descriptions and explicit ethos are framed in humanistic terms – addressing individual needs, promoting health and preserving functional capacities of those in need of care – they also feel responsible for protecting other residents and maintaining organisational stability in the care facilities. While some nurses still try to uphold their person-centred care ethos, seek to resist the rationing of care, and strongly oppose excessive sedation, others set aside their compassionate nursing values in everyday care and rationalise psychotropic medication for managing dementia-related behaviours as a matter of organisational necessity. Moving beyond individualised explanations for the overuse of psychotropic drugs, this study discusses the practices of pharmacological behaviour control as part of a pharmaceuticalisation of dementia care and as emblematic of the broader social-political governance of ageing and dementia.
在长期护理中广泛使用精神药物,特别是用于控制痴呆症相关行为的抗精神病药物,由于严重的副作用、重大风险和死亡率增加而引起争议。虽然处方权属于医生,但护士经常要求治疗,并根据需要酌情给药。本研究讨论了长期护理机构在以人为本的护理价值观、多重专业责任和资源限制之间的结构性紧张关系背景下对抗精神病药物的持续依赖。通过对7家德国养老院的15名护士进行深入的定性访谈,该研究揭示了护理人员在痴呆症护理中使用精神药物的多种方式。虽然护士的自我描述和明确的精神是以人文主义的方式构建的——解决个人需求,促进健康和保持需要护理的人的功能能力——但她们也感到有责任保护其他居民和维持护理机构的组织稳定。虽然一些护士仍然试图坚持以人为本的护理精神,试图抵制护理配给,并强烈反对过度镇静,但其他人在日常护理中搁置了他们富有同情心的护理价值观,并将精神药物合理化,以管理与痴呆症相关的行为,作为组织必要性的问题。除了对过度使用精神药物的个体化解释之外,本研究还讨论了药理学行为控制的实践,作为痴呆症护理药物化的一部分,并作为老龄化和痴呆症的更广泛的社会政治治理的象征。
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引用次数: 0
Time-varying factors predicting adolescent healthcare needs and utilization in a rural Burkina Faso cohort: A two-way fixed effects analysis 时变因素预测青少年医疗保健需求和利用在农村布基纳法索队列:双向固定效应分析
IF 2.6 Q1 PSYCHIATRY Pub Date : 2026-06-01 Epub Date: 2026-01-22 DOI: 10.1016/j.ssmmh.2026.100586
Joshua Krohn , Mamadou Bountogo , Lucienne Ouermi , Ali Sie , Till Bärnighausen , Guy Harling
Adolescent healthcare in low-income countries receives little attention despite their growing population share, significant health challenges and the critical role of youth in shaping future health outcomes. Current research remains largely cross-sectional, limiting capacity to assess causal processes relating to care need and use. We used longitudinal data to examine adolescent need for and use of healthcare in rural Burkina Faso, to identify service gaps and thus targets for intervention.
We analyzed subjective healthcare needs and utilization among adolescents aged 12–20 in a two-round population-representative cohort in 2017–2018. Outcomes were subjective need for healthcare and levels of unmet need. We used individual fixed-effects regression to account for time-invariant characteristics and isolate time-varying effects.
Around half of 1271 adolescents reported healthcare need at each wave, mostly for malaria, injuries, and headaches. Attending school was associated with reduced perceived need (Odds Ratio [OR] 0.52, 95 % confidence interval [CI] 0.15-1.80), while injuries (OR 8.43; CI 3.34-21.30]) and bullying (OR 1.77; CI 0.93-3.40) increased it. Bullying was also associated with higher unmet need (OR 4.79; CI 1.24–18.4). Short-term demographic changes did not predict utilization.
The main time-varying factors influencing subjective health need and utilization of care were precipitating events and educational attainment, rather than sociodemographic factors. Most healthcare contacts were due to acute events and infectious diseases, not prevention programs or non-communicable diseases. Experience of bullying led to significantly higher perceived unmet need—a troubling result suggesting possible interventions both in the short- and long-term.
低收入国家的青少年保健很少受到关注,尽管这些国家的人口比例不断增长,面临重大的健康挑战,青年在塑造未来健康结果方面发挥着关键作用。目前的研究在很大程度上仍然是横向的,限制了评估与护理需求和使用有关的因果过程的能力。我们使用纵向数据来检查布基纳法索农村青少年对医疗保健的需求和使用情况,以确定服务差距,从而确定干预目标。我们分析了2017-2018年两轮人口代表性队列中12-20岁青少年的主观医疗保健需求和利用情况。结果是对医疗保健的主观需求和未满足需求的水平。我们使用个体固定效应回归来解释时不变特征并分离时变效应。在1271名青少年中,约有一半报告说,每一波都需要医疗保健,主要是疟疾、受伤和头痛。上学与感知需求减少有关(优势比[OR] 0.52, 95%可信区间[CI] 0.15-1.80),而伤害(OR 8.43; CI 3.34-21.30)和欺凌(OR 1.77; CI 0.93-3.40)则增加了感知需求。欺凌也与较高的未满足需求相关(OR 4.79; CI 1.24-18.4)。短期人口变化不能预测利用率。影响主观健康需求和护理利用的主要时变因素是突发事件和受教育程度,而不是社会人口因素。大多数医疗接触是由于急性事件和传染病,而不是预防计划或非传染性疾病。欺凌经历导致明显更高的未满足需求——这是一个令人不安的结果,表明可能采取短期和长期干预措施。
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引用次数: 0
Letter to the Editor regarding ‘Advocacy by nonprofit scientific institutions needs to be evidence-based: a case study’ by Gonon et al. (2025) Gonon等人关于“非营利科学机构的倡导需要以证据为基础:一个案例研究”的致编辑信(2025)
IF 2.6 Q1 PSYCHIATRY Pub Date : 2026-06-01 Epub Date: 2026-01-24 DOI: 10.1016/j.ssmmh.2026.100590
Marion Leboyer , Ophélia Godin , Anouck Amestoy , Bruno Aouizerate , Philippe Courtet , Bruno Etain , Emmanuel Haffen , Pierre-Michel Llorca , Franck Schurhoff , Emilie Olié , Antoine Yrondi
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引用次数: 0
The association between social media use and mental health symptoms in middle adolescence: A counterfactual analysis 社交媒体使用与青春期中期心理健康症状之间的关系:一项反事实分析
IF 2.6 Q1 PSYCHIATRY Pub Date : 2026-06-01 Epub Date: 2025-12-18 DOI: 10.1016/j.ssmmh.2025.100582
Xinxin Zhu , Yi Yang , Helen Wright , Lydia Gabriela Speyer , Marie Allitt , Ingrid Obsuth , Patrick Errington , Aja Louise Murray
There has been considerable recent debate surrounding the effects of social media use and adolescents' mental health. A key source of controversy is whether observed associations might be confounded by ‘third variables’ (which influence both social media use and mental health). To address this, we used counterfactual analysis to account for measured confounding. This approach provides estimates of causal effects by comparing observed outcomes with those that would be expected under an alternative exposure condition. We employed it to evaluate the link between social media use (including messaging and visiting social networking websites) at ages 11 and 14 and later mental health issues (including emotional symptoms, self-harm, and/or suicide attempts) at ages 14 and 17. Data was from the UK Millennium Cohort Study (MCS), a nationally representative sample. The study was conducted with the input of a young persons' advisory group, who informed our prioritization of the study research question, helped interpret findings, and identify study limitations. Inverse probability of treatment weighting (IPTW) analyses indicated no significant effects of social media use frequency at age 11 (defined as use on most days) or time spent at age 14 (≥2 h per weekday) on emotional problems or self-harm at age 14 or 17, respectively (analytic n = 3036–4419). The only exception was significant association between higher time spent on social media at age 14 and lifetime suicide attempts at age 17. These findings highlight the importance of considering potential confounders when examining social media use effects. Given that frequency and time-based measures are unlikely to capture the complexity of this association, we recommend future research also apply similar approaches utilizing more nuanced measures.
最近,围绕社交媒体使用和青少年心理健康的影响,出现了相当多的争论。争议的一个关键来源是,观察到的关联是否会被“第三个变量”(影响社交媒体使用和心理健康)所混淆。为了解决这个问题,我们使用反事实分析来解释测量的混淆。这种方法通过比较观察到的结果与在另一种暴露条件下预期的结果来估计因果关系。我们用它来评估11岁和14岁的社交媒体使用(包括短信和访问社交网站)与14岁和17岁以后的心理健康问题(包括情绪症状、自残和/或自杀企图)之间的联系。数据来自英国千年队列研究(MCS),这是一个具有全国代表性的样本。这项研究是在一个年轻人咨询小组的参与下进行的,他们告诉我们研究问题的优先顺序,帮助解释研究结果,并确定研究的局限性。治疗加权逆概率(IPTW)分析显示,11岁时的社交媒体使用频率(定义为大多数时间使用)或14岁时的社交媒体使用时间(每个工作日≥2小时)对14岁或17岁时的情绪问题或自我伤害分别没有显著影响(分析n = 3036-4419)。唯一的例外是,14岁时花在社交媒体上的时间越长,17岁时的终生自杀企图就越高。这些发现强调了在研究社交媒体使用影响时考虑潜在混杂因素的重要性。鉴于基于频率和时间的测量不太可能捕捉到这种关联的复杂性,我们建议未来的研究也采用类似的方法,利用更细微的测量。
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引用次数: 0
An indigenous interpretation of self-determination in service of relational wellness 在关系健康服务自决的土著解释
IF 2.6 Q1 PSYCHIATRY Pub Date : 2026-06-01 Epub Date: 2026-01-27 DOI: 10.1016/j.ssmmh.2026.100593
Arthur W. Blume
Signers of the 2007 United Nations (U.N.) Declaration on the Rights of Indigenous Peoples, including Canada and the United States (U.S.), have committed to protecting the rights of Indigenous peoples including the right to self-determination. First Peoples Nations of Canada and the U.S. have been granted self-determination rights, but often these rights have limitations when it comes to ensuring quality mental health care for their peoples. Self-determination rights have been a major step toward affirming Indigenous national sovereignty over the mental health, but much more can be done. When self-determination parameters were codified within the colonial nations, they reflected a reductionist viewpoint that did not include a relational understanding of wellness or considerations that health and mental health are relational in nature and unrestricted by national boundaries. Relational wellness may not necessarily be addressed by reductionist interpretations of self-determination. A relational interpretation of self-determination is also necessary to account for the interdependent nature of wellness such that relationships between colonial nations and their Indigenous neighbors must be equitably considered and respected. Publicly recognizing and respecting the cultural and scientific parity of Indigenous nations with those of Canada and the U.S. would advance Indigenous relational wellness as committed to in the U.N. Declaration and promote equitable international relationships. Affirming both reductionist and relational self-determination could be mutually beneficial, advancing the relational wellness of Indigenous nations while interdependently and simultaneously advancing the health and mental health of Canada and the U.S.
2007年联合国(un)签署国包括加拿大和美国在内的《土著人民权利宣言》成员国都承诺保护土著人民的权利,包括自决权。加拿大和美国的第一民族被授予自决权利,但在确保其人民获得高质量的精神卫生保健方面,这些权利往往受到限制。自决权是肯定土著民族对心理健康主权的重要一步,但还有很多工作要做。当自决参数在殖民地国家内被编纂时,它们反映了一种简化主义的观点,这种观点不包括对健康的关系理解,也不包括健康和心理健康在本质上是相关的,不受国界限制的考虑。关系健康不一定是由自我决定的还原主义解释来解决的。对自决的关系解释也是必要的,以便考虑到健康的相互依存性质,从而必须公平地考虑和尊重殖民地国家与其土著邻国之间的关系。公开承认和尊重土著民族与加拿大和美国在文化和科学上的平等,将促进土著关系的健康,正如联合国宣言所承诺的那样,并促进公平的国际关系。肯定还原论和关系自决可能是互利的,既促进土著民族的关系健康,又相互依赖,同时促进加拿大和美国的健康和心理健康
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引用次数: 0
An exploratory analysis of self-diagnosis on Reddit Reddit上自我诊断的探索性分析
IF 2.6 Q1 PSYCHIATRY Pub Date : 2026-06-01 Epub Date: 2026-02-12 DOI: 10.1016/j.ssmmh.2026.100597
Amy L. Johnson
Online self-diagnosis is an increasingly common phenomenon. Its ubiquity counters the expectation that people will generally avoid stigmatizing labels like mental illness diagnoses. Yet social media may provide a space for users to anonymously “try on” labels without fear of stigma or social sanction. This article uses exploratory qualitative analysis to examine self-diagnosis on the social media platform Reddit. I document how self-diagnosis is a relational process of identity work involving three steps: a feeling of mental wrongness, proposal of a diagnostic explanation, and request for a community solution. Using sentiment analysis, I also show that posts mentioning self-diagnosis express less negative emotion than those mentioning professional diagnosis. Despite widespread criticism of self-diagnosis, this work suggests that it offers a means of engagement with sympathetic others and a tool to understand the self in a culture dominated by psychiatric thinking.
在线自我诊断是一种越来越普遍的现象。它的普遍存在与人们通常会避免被贴上精神疾病诊断等污名化标签的预期背道而驰。然而,社交媒体可能为用户提供了一个匿名“试穿”标签的空间,而不用担心耻辱或社会制裁。本文采用探索性定性分析来研究社交媒体平台Reddit上的自我诊断。我记录了自我诊断是一个身份工作的关系过程,包括三个步骤:精神错误的感觉,诊断解释的建议,以及要求社区解决方案。通过情绪分析,我还发现提到自我诊断的帖子比提到专业诊断的帖子表达的负面情绪更少。尽管对自我诊断的批评广泛存在,但这项工作表明,它提供了一种与同情他人接触的手段,也是一种在精神病学思想主导的文化中理解自我的工具。
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引用次数: 0
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SSM. Mental health
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