Mental health science最新文献

In Sub-Saharan Africa (SSA), despite a high prevalence of mental health conditions, less than 10% of those living with mental illness access professional mental health services (MHS). This systematic review aimed to identify, appraise, and synthesise studies conducted in SSA seeking to understand the barriers and facilitators to accessing MHS for adults in SSA. A systematic search of PsycINFO, MEDLINE, and CINAHL databases was conducted using key terms (Barriers, Facilitators, Access, Mental Health Services, and Sub-Saharan Africa) with 16 studies meeting the eligibility criteria for inclusion. The quality of the included studies was assessed using the Critical Appraisal Skills Programme (CASP) and Joanna Briggs Institute (JBI) Critical Appraisal tools based on the articles’ study methodology. Data from the included studies were extracted using a standardised proforma and grouped into source details, methodology, participants’ characteristics and the main finding(s). A narrative synthesis was adopted to systematically summarise and evaluate included studies. Only nine of 46 Sub-Saharan African countries were represented in the included studies. Barriers included lack of or little knowledge of mental disorders and professional services; negative attitudes held towards mental health services; cultural and religious beliefs leading to over-reliance on traditional and spiritual interventions; and stigmatising beliefs that included self-stigmatisation, stigma and discrimination from family, the community, and healthcare providers. Facilitators to accessing mental health services were more limited and included awareness of mental disorders and the services offered; social support and acceptance by family members and the community; and the availability of community-based mental health services. This systematic review identified barriers such as limited knowledge, stigma, and reliance on traditional interventions inhibiting access to mental health services in Sub-Saharan Africa. The region's limited representation and scarcity of facilitators highlights an urgent need for targeted interventions to improve mental health accessibility.

Youth involved in the juvenile justice system are more likely to have a substance use disorder and/or suicidality (e.g., suicidal thoughts and behavior) compared to other youth. Although parental support and monitoring may play an important role in youth substance use and suicidality outcomes, the potential mechanisms have not been elucidated. Our purpose was to evaluate the extent to which parental support and monitoring were associated with latent, continuous construct scores of suicidality and substance use and to determine whether youths’ hopelessness may indirectly affect these relationships among a sample of youth referred to the juvenile justice system. The sample included juvenile justice-referred youth aged 14–17 (N = 77; 69% White, 58% male, 74% non-Hispanic). The primary predictors of interest were parental support and monitoring, measured by the Parent Support Scale and Parental Monitoring Scale. The primary potential mediator of interest was hopelessness. Linear regression was used to model continuous suicidality and substance use severity scores, measured via a computer adaptive test, on parental support and monitoring. We tested hopelessness as a potential mediator. All analyses controlled for age, sex assigned at birth, race, ethnicity, and family income. After adjustment, parental support was associated with decreased suicidality severity (β = −0.30, p = 0.002). Parent support and monitoring were associated with youth-reported hopelessness. The indirect mediation effects of hopelessness in the relationship between parental support (β = −0.18 [SE, 1.73]), as well as parental monitoring (β = −0.17 [SE, 0.20]), and suicidality severity were statistically significant. Parental support and youth hopelessness may be important intervention targets for improving and addressing disparities in substance use and suicidality among juvenile justice-referred youth. Hope-based interventions may be effectively integrated into existing juvenile justice programs, and their potential to improve both mental health and behavioral outcomes among justice-involved youth should be examined.

Contrary to the “model minority” stereotype of being exceptionally healthy and successful, Asian American (AA) youth experience mental health disparities and are less likely to seek help. In 2020, suicide was the leading cause of death for AA youth aged 10–19. Parenting is essential for promoting youth mental health, and AA parenting is unique in the context of acculturation and enculturation. However, the impact of parenting on youth mental health among AA families remains underexplored and unsynthesized. This review aims to synthesize existing literature from 2003 onward on parenting and mental health outcomes among AA youth. Four databases were searched, yielding 44 articles published after 2003 for inclusion. Empirical studies meeting the following criteria were included: population focused on AA youth, study conducted in the U.S., included a mental health outcome, and included a parenting measure. Findings emphasize the importance of parenting in shaping the mental health outcomes of AA youth. Intergenerational acculturation gaps and family conflicts are associated with increased mental health risks, while parental warmth/support and family cohesion serve as protective factors. These findings highlight the need for culturally tailored parenting interventions to improve AA youth mental health. Future research should evaluate or adapt existing evidence-based parenting programs to ensure cultural appropriateness and effectiveness in improving mental health of AA youth, ultimately reducing mental health disparities.

Queer, trans, and Two-Spirit native youth experience exponential increases in risk for health disparities, yet little is known about their distinct mental health needs. There remains a dearth of literature examining the unique intersection of Indigeneity, gender and sexuality, and age. As Indigenous populations in the United States have grown in the past decade, it is imperative to develop a comprehensive understanding of QT2S native youth mental health. The present work seeks to bridge the fields of scholarship on native youth and LGBTQ communities' mental health disparities to illuminate gaps in scientific understanding of QT2S native youth mental health. The current paper will discuss theoretical frameworks, methodological considerations, and mental health disparities scholarship on QT2S youth, concluding with research recommendations toward developing a scientific understanding of QT2S native youth mental health disparities.

The mental health needs of older people in prison (OPiP) are considerable but remain overlooked. This review aimed to develop an Initial Programme Theory (IPT) to understand how the mental health needs of OPiP can be addressed and how mental health care for older people in the community could be adapted for the prison environment. A review and realist synthesis pertaining to the mental health needs of OPiP was conducted across three stages, including: (1) a systematic review of empirical work; (2) a scoping review of prison guidance documents; and (3) a scoping review of community mental health guidance documents. Synthesis of eligible literature and development of the IPT followed realist principles and was supplemented by a stakeholder workshop of experts by personal and occupational experience. Overall, 122 sources were included. The IPT suggested that prisons can address the mental health needs of OPiP via micro-level mechanisms (i.e., screening, assessment, care planning, intervention, continuity of care/release), meso-level mechanisms (i.e., accommodation, environment, activities, religion/spirituality, peer support, family support) and macro-level mechanisms (i.e., staff training/education, governance). Each mechanism is underpinned by trauma-informed, integrated and patient-centered care principles and their implementation should be guided by a local assessment of prison-specific needs. Our IPT provides a framework for how prisons can address the mental health needs of OPiP, informed by community care provision, via several mechanisms across different levels. Future research should build on this work to inform a full evaluation of its impact on meaningful outcomes to promote equivalency of care for OPiP and non-discriminatory access to mental health support for those at risk of marginalization.

To understand the factors that preserve mental health amongst a diverse population of adolescents, we examined links between neighborhood-level resources, adolescents' self-reported personal assets (low perceived stress, meaning and purpose, life satisfaction), parent-reported family assets (household income, maternal mental health) and adolescents' self-reported depressive and anxiety symptoms. Participants included a racially and ethnically diverse national sample of 4325 adolescents (10–21 years) from the Environmental influences on Child Health Outcomes (ECHO) program. Neighborhood-level resources were not directly associated with depressive or anxiety symptoms. However, higher levels of personal and family assets were related to lower levels of symptoms, regardless of neighborhood resources (ß's: −0.09 to 0.55). Last, high neighborhood resources compensated for the absence of one asset—low perceived stress. For adolescents with levels of perceived stress that were just 0.17 SD above the sample mean, neighborhood resources were negatively associated with depressive symptoms. Findings did not vary across racial and ethnic groups. Results support the development of asset building endeavors that bolster positive child assets in adolescents and families to reduce mental health disparities. Implications for programs that seek to promote mental health amongst minoritized youth are discussed.