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AbstractThis review explores the transformative potential of Artificial Intelligence (AI) in the light of evolving threats to planetary health, particularly the dangers posed by the climate crisis and its emerging mental health impacts, in the context of a climate-vulnerable country such as the Philippines. This paper describes the country’s mental health system, outlines the chronic systemic challenges that it faces, and discusses the intensifying and widening impacts of climate change on mental health. Integrated mental healthcare must be part of the climate adaptation response, particularly for vulnerable populations. AI holds promise for mental healthcare in the Philippines, and be a tool that can potentially aid in addressing the shortage of mental health professionals, improve service accessibility, and provide direct services in climate-affected communities. However, the incorporation of AI into mental healthcare also presents significant challenges, such as potentially worsening the existing mental health inequities due to unequal access to resources and technologies, data privacy concerns, and potential AI algorithm biases. It is crucial to approach AI integration with ethical consideration and responsible implementation to harness its benefits, mitigate potential risks, and ensure inclusivity in mental healthcare delivery, especially in the era of a warming planet. [ABSTRACT FROM AUTHOR]

AbstractMigration process is a well-known risk factor for a number of mental disorders, particularly psychotic, trauma-related and major mood disorders. However, refugees and asylum seekers (RAS) often face several challenges in accessing mental health facilities, leading to treatment delays, resulting in worse prognosis and increased risk of referral to the emergency departments or receiving coercive measures, including involuntary hospitalizations in the psychiatric settings. This review aims to delineate the prevalence of coercive measures within the RAS population and identify potential predictors for such interventions, in order to highlight possible preventive strategies. The relevant PubMed, Scopus and Web of Science databases were searched for papers. Twenty-three articles were included in the review. Our findings highlight that the RAS population is at higher risk of being coerced compared to the native population due to clinical factors, cultural differences and the many barriers to the access to mental health services. Since coercive measures are often harmful and lead to a worse clinical outcome and possible (re)traumatization of patients, specific strategies to prevent this phenomenon are urgently needed. [ABSTRACT FROM AUTHOR]

The bio-medical model of 'mental health' and 'mental illness' that relates to the relationship between wellbeing and distress informs psychopathology and dominates conceptualisation in many Western Educated Industrialised Rich Democratic (WEIRD) populations. This paper aims to critique the model, questioning the appropriateness of psychopathology as a conceptual framework when working as a Western trained clinician with populations such as in China, Japan, Asia, the Middle-East and Africa. The paper also considers the cultural appropriateness of western notions of psychopathology when working inter-culturally in relation to the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support in Emergency Settings, and the Review of the Implementation of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. [ABSTRACT FROM AUTHOR]

A combination of structural barriers, inadequate student welfare provision and the absence of psycho-social and academic support make higher education access for forcibly displaced students challenging. Many of these students will have experienced many stressful and potentially traumatic events that may have or may continue to impact their mental health and wellbeing. This article draws on reflections by educators and findings from eight interviews with students who participated in a twelve-week preparatory course for access to higher education for refugees and asylum seekers in the United Kingdom. The paper firstly problematizes trauma as an organizing concept and challenges the dominant deficit approaches in forced migration studies when working with displaced students. Then, based on qualitative data collected from students and educators, it explores how creative skills were integrated and the importance of the student's voice as a culturally sustaining pedagogical approach to strengthening trauma-informed teaching approaches. The programme was designed to strengthen individual agency and promote well-being and mental health. Finally, this paper argues that working collaboratively with forcibly displaced students from an asset-based stance appeared critical in creating and sustaining a welcoming higher education environment which could contribute to promoting mental health. [ABSTRACT FROM AUTHOR]

The climate and ecological crisis will constitute the defining public health challenge of the twenty-first century, posing an unprecedented global threat to all determinants of health, and to healthcare delivery systems. We believe that mental health professionals have a crucial role to play in responding to this crisis. Whilst responding to the mental health consequences of the climate crisis will remain a key role for us as mental health professionals, we argue that our remit goes beyond this, and should include advancing public understanding of the climate crisis, highlighting its impact on physical and mental wellbeing, and advocating for systemic changes to limit its impending harms. This paper is an urgent call to action for all mental health professionals to take up a role in the context of the climate and ecological crisis. This paper will describe the relationship between mental health and climate change, and frame it within wider systemic and conceptual frameworks. It will demonstrate that as mental health professionals we are well placed to act as leaders of change—arguing that we have a duty to do so—and suggest actions that can be implemented depending on interests, skill sets and opportunities. [ABSTRACT FROM AUTHOR]

Several lines of evidence indicate the prevalence of mental health disorders in Transgender (TG) individuals is higher than that of cisgender individuals or the general population. In this systematic review, we aim to propose a summary of some of the most significant research investigating mental health disorders' prevalence among this population. We performed a double-blind systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting (PRISMA) on PUBMED/MEDLINE and SCOPUS, specifically using peer-reviewed articles examining the mental health status of transgender (TG) individuals. This review did not exclude any research based on publication date. The last search was performed in February 2022. The employed search strategy led to the selection of 165 peer-reviewed articles. The majority of these papers presented a cross-sectional design with self-reported diagnoses and symptoms, signaling a significant prevalence of mental health disorders amongst TG Individuals. Of the reviewed articles, 72 examined the prevalence of mood and anxiety disorders; 8 examined eating disorders; 43 examined the prevalence of suicidal or self-harm ideation or behaviors; 5 papers examined the prevalence of trauma and stress-related disorders; 10 examined the frequency of personality disorders; 44 examined substance use disorders; and 9 papers examined the prevalence of autism spectrum disorder. Finally, 22 studies reported on the prevalence of TG individuals diagnosed with co-morbid mental health disorders or unspecified mental disorders. Our findings coincide with existing research, which indicates TG individuals do experience a higher prevalence of mental health disorders than that of the general population or cisgender individuals. However, further research is needed to address the existing gaps in knowledge. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, transgender, intersex, queer people and minority gender identities and sexualities (LGBTIQ+) are often stigmatized and experience discrimination in health care settings, leading to poorer mental health outcomes and unmet needs compared to heterosexual and cisgendered peers. It is thus imperative that mental health providers consider and address structural challenges in order to reduce mental health inequalities of this population. This narrative review assessed the barriers that may prevent access to care and the pathways for care in LGBTIQ + communities. PubMed, PsycInfo, Embase, and Scopus were searched for papers published between December 2021 and February 2022. A total of 107 papers were included with studies reflecting five themes: (1) Unmet mental health needs; (2) Young people; (3) Substance abuse and addiction; (4) Barriers and pathways to care; and (5) Interventions. Findings demonstrate that LGBTIQ + people experience stigmatization and higher rates of substance misuse and mental ill health, which may lead to barriers in accessing health care services, and fewer tailored interventions being provided. These findings have implications for policy, health care screening, and how specialist services are structured. Substantial gaps in the evidence-base exist, and future research should examine how mental health care providers can challenge social issues that maintain discriminatory and stigmatizing practices, and support LGBTIQ + individuals to sustain their resilience. [ABSTRACT FROM AUTHOR]

Racism and racial discrimination heavily impact on health and mental health of ethnic minorities. In this conceptual paper and narrative review, we aim to report on relevant evidence from the international literature describing the prevalence and the qualitative aspects of mental illness due to racism and ethnic- discrimination in different settings and populations. Some variables related to racism, such as cultural, institutional, interpersonal factors, as well as the concepts of perceived and internalised racism will be described and discussed. These are relevant characteristics in the explanatory model of the relationship between racism and mental health. Epidemiological data on the prevalence of depressive and psychotic symptoms as well as substance abuse/misuse among ethnic minorities in large catchment areas, such as United States and United Kingdom, will be represented. We conclude that anti-racism policies are essential in order to address racism and racial discrimination around the world. Pluralistic societies should be promoted in order to understand mental illnesses among ethnic and cultural minorities. Also, anti-racism programs should be delivered in the educational and health-care settings and their impact evaluated. [ABSTRACT FROM AUTHOR]

Love is the core of human experience and central to our meaning in life and wellbeing, yet it is also a complex concept full of ambiguity and contradiction. The main purpose of this paper is fourfold: Firstly, we want to clarify questions such as 'What is the meaning of love?' and 'Why is meaning of love so important to us?' Secondly, we want to explain why love is both suffering and essential for our happiness and mental health. Thirdly, we identify the major types of love and clarify which types are constructive and which are destructive. We also identify the key dimensions of true love. Finally, we emphasise that love does not always mean happiness; rather, it is meant to be a school to teach us important lessons and to make us complete. Therefore, we need to embrace suffering and at the same time cultivate the constructive types of love to improve our mental health and to make the world a more compassionate place. [ABSTRACT FROM AUTHOR]

Mental health of social minorities is a challenge of modern psychiatry. It is largely described that people reporting sexual, cultural, religious variations are exposed to an amount of social stress deriving from the contrast between their minority status and the dominant societal norms and values. Minority stress leads to higher level of psychosocial distress and mental illness among these vulnerable populations. This conceptual research paper reports on evidences regarding the mental health issues related to the minority social condition and proposes a set of actions to address these challenges in a global perspective. Specifically, political, social and educational interventions are discussed in order to contrast stigma, discrimination, promote integration and health services for vulnerable populations. Policymakers are invited to deliver ad-hoc policies on minorities and homeless people with specific funding to address related public mental health issues. Educational programs are encouraged in the school setting as well as in the training of health care professionals in order to improve the level of acceptance and competencies in the treatment of minorities' health needs. We firmly believe there is no healthy society without healthy minorities. [ABSTRACT FROM AUTHOR]

People with severe mental disorders report significantly poorer physical health and a higher mortality rate compared with the general population. Several interventions have been proposed in order to challenge this mortality gap, the promotion of physical activities represents one of the most important strategies. In fact, in people with severe mental disorders, physical activity can improve body composition, quality of life, personal functioning, self-esteem, cognition, and cardiorespiratory fitness, as well as reducing affective, psychotic and anxiety symptoms, cardiometabolic burden and increase the global recovery. While sport-based programs are consistently being proposed as an integral part of effective personalized treatment approaches for people with severe mental disorders, their routine implementation is hampered by poor working task integration among different professionals and the lack of training programmes for sport professionals focused on people with severe mental disorders. In this paper, we will: (a) review the efficacy of exercise/sport-based interventions for people with severe mental disorders; (b) describe the main difficulties in engaging patients with severe mental disorders in these interventions; and (c) report the results of the first study on the best practices available in Europe in the field of sport and mental health carried out in the context of the European Alliance for Sport and Mental Health (EASMH) project. According to the EASMH survey, sport-based psychosocial interventions are not frequently available in mental health services, with significant differences at the European level. In the near future, it would be advisable to promote the integration and collaboration between mental health professionals and sport professionals, in order to improve the dissemination and availability of sport-based interventions in routine clinical practice. The EASMH project aims to fill this gap by creating a network of collaborators, researchers and stakeholders with different backgrounds in order to improve the dissemination of sport-based rehabilitation interventions and by developing an innovative training programme for sport coaches in order to improve their skills in interacting and building an effective relationship with people with severe mental disorders. [ABSTRACT FROM AUTHOR]

Urbanisation processes and anthropogenic actions led to a significant increase in pollution levels, with relevant consequences on global health. In particular, noise pollution demonstrated an association with cardiovascular, metabolic, and respiratory diseases. Furthermore, increasing evidence underlined the possible role of air and noise pollution in the development of psychiatric disorders. In this narrative review, evidence concerning the relationship between noise pollution and the emergence of psychiatric symptoms or psychiatric disorders is summarised. After the literature search process was completed, 40 papers were included in the present review. The exposure to road-, rail-, and air- traffic represented a risk factor for the emergence of affective disorders. This could also be mediated by the occurrence of circadian rhythms disturbances or by noise annoyance and noise sensitivity, both influencing psychological well-being and health-related quality of life. Fewer studies concentrated on special populations, particularly pregnant women and children, for whom noise pollution was confirmed as a risk factor for psychopathology. The better clarification of the complex interaction between noise pollution and mental health may help to identify subjects at risk and targeting specific prevention and intervention strategies in the urban environment. [ABSTRACT FROM AUTHOR]

The contribution and role of psychologists, psychiatrists or mental health practitioners in working alongside forced migrants may take many forms. The guidance on which this paper is based, came about when several members of the British Psychological Society (including those with lived experience and insight and those who had set up services); became aware of the need for good practice guidance for clinicians working with refugees, asylum seekers including forced migrants across Britain. These guidelines cover a range of areas where clinicians work with individuals in clinical contexts, schools, nurseries, colleges and within community organisations. [ABSTRACT FROM AUTHOR]

Resettlement schemes can offer refugees an opportunity to rebuild their lives and to heal from loss and trauma. Mental health services in host countries may have an important role to play in aiding refugees in this journey to recovery. However, facilitating the process of healing for refugees raises challenges for mental health services working within Western medicalised settings. Recovery and wellbeing for resettled refugees also depends upon an interaction of variables at a wider systemic level, that go beyond the direct remit of mental health services. Based on the experience of delivering a mental health screening and treatment programme for resettled Syrian refugees in the UK over a 5-year period, this paper reflects on these challenges and suggests that future resettlement schemes in the UK be designed in accordance with the principles of trauma-informed care. This means putting safety, trust, choice, collaboration, empowerment and respect for inclusion and diversity at the core of the services provided for resettled refugees. [ABSTRACT FROM AUTHOR]

Suicide among internally displaced people remains an under-researched public health issue especially in conflict affected countries. Given the limited and sometimes inaccessible mental health services, there is a need for scalable evidence-based suicide prevention programmes that could be delivered by trained and supervised non-specialists. The Suicide First Aid Guidelines approach aims to support humanitarian workers who deal directly with children and families with the appropriate knowledge and skills to identify and support those at risk of suicide until they can access further specialized support services or until the crisis passes. This paper presents the findings of an online pilot training of 56 humanitarian workers from different sectors (e.g. Child Protection, Nutrition and Mental Health and Psychosocial Support) in conflict affected areas in Syria. The quantitative and qualitative evaluations were based on pre- and post-training questionnaires and revision journals completed between training sessions. Suggestions and examples provided in the journals and during the trainings were incorporated into the succeeding trainings. This was to contextualize and modify the gatekeeper training to fit the Syrian context and provide adaptations for future research and suicide prevention guidelines. Overall, the evaluation indicated that the pilot training raised awareness and improved participants' knowledge on how to assist a suicidal person, including warning signs. It also contributed to a positive change in attitude or beliefs towards suicide. Although the pilot training was considered adequate for the Syrian context some improvements were suggested. [ABSTRACT FROM AUTHOR]

281 million people were recorded as having migrated across national borders by the United Nations in 2021, this equates to approximately 3.6 percent of the world's population. Forced migrants/refugees account for 12 per cent of all international migrants. A percentage of these people will not speak the language of their new country fluently. If they are to access and utilize mental health services, they will require access to an interpreter. This paper provides guidance on working with interpreters in health settings when the work is either face to face or on-line. These guidelines are based on those written by the authors for the British Psychological Society. Working effectively with interpreters should be a skill in the repertoire of every clinician. This is to ensure that equal opportunities are upheld and that certain groups (including forced migrants) are not denied access to mental health services. Interpreters may also assist with teaching clinicians about diverse cultural views surrounding mental health and well-being. They may also advise on idioms of distress, cultural meanings and expression of emotional problems across cultures, explanatory health models and contextual factors which may help extend the repertoire of clinicians. The guidelines cover key recommendations for practice, booking and finding an interpreter, preparation before the consultation/meeting, practical considerations, preparation with the interpreter, during the meeting/consultation, issues to address after the meeting, written translations, psychometric testing, working by telephone or online and other issues to consider when working with an interpreter. These are reproduced below (with the permission of the BPS) in a shortened and updated form. Undertake a language needs analysis of the population covered by your service or Trust and consider how you will best meet needs. If you have not undertaken training in working with interpreters, undertake a training course. If you are working with an interpreter unexpectedly and training is not feasible, read these or other relevant guidelines and allocate time to consider the issues or discuss them with a more experienced colleague. Check that the interpreter is qualified and appropriate for the consultation/meeting and speaks the service user's first language. Allocate 10–15 minutes in advance of the session to brief the interpreter about the purpose of the meeting and to enable them to inform you about any cultural issues which may have bearing on the session. Be mindful of issues of confidentiality and trust when working with someone from a small language community as the service user may be anxious about being identifiable and mistrustful of an interpreter's professionalism. This has particular relevance when working with forced migrants. State clearly that you alone hold clinical responsibility for the meeting. Commit to a collaborative working relationship based on trust and mutual respect. Match if appropriate for gender, age or religion, avoid using relatives and never use a child. Create an atmosphere where each member of the triad feels able to ask for clarification if anything is unclear and be respectful to your interpreter, they are an important member of the team who makes your work possible. Be aware of the well-being of your interpreter and mindful of the risk of vicarious traumatization. Consider what support they will be offered, and if they are subcontracted from an external agency, be aware that there is often little support provided by their employer. At the end of the session always allocate 10–15 minutes to debrief the interpreter about the session and offer support and supervision as appropriate. Extreme caution should be exercised when considering the use of translated assessment measures as languages and concepts are not interchangeable and results may therefore not be valid or meaningful. All written translations used should have been back translated to ensure they are fit for purpose. Commissioners of health services need to ensure that there are clear pathways to support for all members of their local community including those who do not speak the majority language. [ABSTRACT FROM AUTHOR]

This paper presents an overview of the importance of mental health services for unaccompanied asylum-seeking children in the United Kingdom. It reviews what mental health support appears to be available in the United Kingdom following an on-line search which took place in Spring 2021 and using information gathered through 22 interviews and focus groups with stakeholders. The latter group are defined as people working with asylum-seeking children. The primary stakeholders were local authority staff, although interviews were also conducted with local government associations (London Councils, the Local Government Association), NHS bodies and the voluntary sector. Often, further relevant stakeholders were identified during interviews. The report details the aims, methodology and context, before the findings are presented which is followed by recommendations for improving mental and social care provision for unaccompanied asylum-seeking children in the United Kingdom. [ABSTRACT FROM AUTHOR]

Converging global evidence highlights the dire consequences of climate change for human mental health and wellbeing. This paper summarises literature across relevant disciplines to provide a comprehensive narrative review of the multiple pathways through which climate change interacts with mental health and wellbeing. Climate change acts as a risk amplifier by disrupting the conditions known to support good mental health, including socioeconomic, cultural and environmental conditions, and living and working conditions. The disruptive influence of rising global temperatures and extreme weather events, such as experiencing a heatwave or water insecurity, compounds existing stressors experienced by individuals and communities. This has deleterious effects on people's mental health and is particularly acute for those groups already disadvantaged within and across countries. Awareness and experiences of escalating climate threats and climate inaction can generate understandable psychological distress; though strong emotional responses can also motivate climate action. We highlight opportunities to support individuals and communities to cope with and act on climate change. Consideration of the multiple and interconnected pathways of climate impacts and their influence on mental health determinants must inform evidence-based interventions. Appropriate action that centres climate justice can reduce the current and future mental health burden, while simultaneously improving the conditions that nurture wellbeing and equality. The presented evidence adds further weight to the need for decisive climate action by decision makers across all scales. [ABSTRACT FROM AUTHOR]

The feelings and hopes of young people around the world are often neglected in policymaking and research, with consequences for both their wellbeing and the effectiveness of humanity's response to the climate crisis. Many of them are distressed by climate change's impacts, the inaction of political and corporate leaders, the ways other people respond to their feelings, and the lack of support they have to share their feelings or get involved in meaningful climate-related work. This paper is written by a group of twenty-three concerned young people from fifteen countries. It provides a first-hand account of our deepest feelings, how these feelings affect our daily lives, the support we want to help us cope, and our hopes for a radically more compassionate future. The results are particularly relevant to policymakers, mental health professionals, journalists, educators, and people working with young people more widely. [ABSTRACT FROM AUTHOR]

In April 2022, the Intergovernmental Panel on Climate Change stated clearly that without immediate and deep reductions in greenhouse gas emissions, it would be impossible to limit global temperature rise to 1.5 °C above pre-industrial levels. A growing body of research shows an increasing reaction to witnessing or experiencing current climate impacts and concern regarding apparent inaction in response, manifests as negative cognitive, emotional, and behavioural responses, including eco-anxiety. This commentary contends that nature-based activities (NBAs) have a potentially important, but currently neglected, role to play in supporting those experiencing eco-anxiety. However, existing research limitations hinder their adoption in the United Kingdom's social prescribing agenda and they remain a largely untapped therapeutic resource that need to be mainstreamed into clinical and social care provision. The paper calls for investment in research that advances our understanding of the individual and community benefits of NBAs, the longevity of their impact, and their associated, comparative and opportunity costs. [ABSTRACT FROM AUTHOR]

A growing body of research shows the inimical impact of climate change on people's mental health. However, attention to mental health providers at the frontlines is rather sparse, especially in climate-vulnerable countries. This commentary aims to present the perspectives and experiences of mental health providers within the context of climate change in the Philippines. Specifically, this paper explicates the challenges faced by mental health providers in trying to address the increasing climate-related distress experienced by many Filipinos and the recent progress in promoting climate change and mental health nexus in the country. The recommendations offered in this commentary will hopefully provide the basis for a more comprehensive mental health framework that incorporates climate change and supports mental health providers in their pursuit to preserve Filipino mental health on a warming planet. [ABSTRACT FROM AUTHOR]

The aim of this paper is to share our experiences of engaging with the climate crisis as citizens and mental health professionals (MHPs). We hope the outputs will usefully validate the experiences of fellow MHPs and support them to reflect on their role in this crisis. We came together as eight MHPs, participating in group discussions and one-one interviews with the first author to reflect on our experiences. The collaboratively generated themes reflect how engagement with the crisis has: (i) disrupted our personal and professional experiences; (ii) helped us adapt and grow; and (iii) enabled us to live, work and act in more accordance with our values. A key reflection was that these experiences are not linear and we continue to wrestle with our responses to the climate crisis. Discussions also elicited visions of how mental health paradigms could be better adapted to meeting the escalating public health need that this crisis is generating. We conclude by advocating for MHPs to process and respond to the climate crisis and recognize that their skills can make a vital contribution to this global challenge. [ABSTRACT FROM AUTHOR]

Poor mental health is a global concern and is exacerbated by recent challenges concerning COVID-19 and the climate emergency, with significant consequences to individuals and to society. Increasing evidence demonstrates that nature-based approaches (NBAs) have numerous benefits to mental health services and the people they support with mental health needs. Despite these benefits, understanding how to integrate these approaches into practice is challenging. In this paper, we report our findings from a recent qualitative study with staff from a CAMHS inpatient unit who had recently undergone NatureWell Facilitator training. This is a particular approach to working with people in nature developed by The Natural Academy. Participants identified the importance of implementation of discreet, novel NBAs, as well as integrating nature into current practice, the benefits when fostering psychologically safe and therapeutic relationships with staff, and the clinical and operational factors when carrying out NBAs in these settings. [ABSTRACT FROM AUTHOR]

This commentary offers stories of hope and regeneration in the face of the interconnected crises we face. Those of us in the health sector have the opportunity to undo the false separation that has arisen between the care we offer ourselves and the care we offer our natural spaces. Access to a healthy environment offers myriad health benefits and has been declared a human right. Beyond this, cultivating a sense of kinship with the natural world unlocks further mental health benefits and promotes a deep sense of meaning and vitality. Widespread restoration of nature, combined with the equitable reconnection of people to these restored environments, must become one of the most important aspects of public health in this century. This paper, written from a UK perspective, describes examples where people are already weaving these strands together and offers practical suggestions for healthcare professionals who want to know how this relates to their role and their everyday practice. [ABSTRACT FROM AUTHOR]

The unprecedented changes in our society because of COVID-19 and the fourth industrial revolution (4IR) shows that our healthcare system and the medical approach to psychotherapy can no longer meet the mental health needs of society. This paper first described the negative impact of COVID-19 and 4IR on our mental health. Then, following a brief critique of the medical model, this paper proposes that the future of psychotherapy needs to be based on the more inclusive and integrative framework of existential positive psychology (PP 2.0), which emphasizes flourishing through suffering. Finally, the paper emphasizes Viktor Frankl's cure and Wong's integrative meaning therapy. It concludes that integrative meaning therapy represents the future of psychotherapy, because it is situated in the area of interactions of at least three traditions: Clinical psychology, existential psychology, and positive psychology. This integrative model is holistic, recognising humans as bio-psycho-social-spiritual beings and considers several theoretical perspectives in both diagnosis and treatment. [ABSTRACT FROM AUTHOR]

This paper aimed to review the literature regarding the impact of discrimination on substance use disorders among Sexual Minorities (SM), with a focus on alcohol, opioids, stimulants, polydrug use, chemsex, cannabis and tobacco, as well as inequalities in the access to health care services. It is alarmingly clear that SM report higher rates of morbidity if compared to the general population. Health care delivery inequalities have also been reported in this special population. Also, the lack of data from low- and middle-income countries on substance use among SM is a major concern. Certainly, discrimination play a key-role among leading factors to substance abuse, continued use, disorders, and lower levels of preventive and treatment interventions. However, it may be difficult to estimate the impact of discrimination because of the lack of research data and different methodologies of literature studies. Moreover, SM are differently categorized and defined and evidences may be not comparable between studies. There is an urgent need of strategic guidelines and research investments aimed at prioritizing these populations disproportionately impacted by substance use. Equity-oriented policies and programs can facilitate opportunities and decrease substance use in these vulnerable subgroups, including community- and peer-led initiatives and nonjudgmental and inclusive health services. [ABSTRACT FROM AUTHOR]

The mental health of lesbian, gay, bisexual, transgender, queer, intersexual (LGBTQI) individuals is significantly influenced by many factors such as difficulties in coming-out, poor acceptance, isolation and discrimination as well as minority-related stress. LGBTQI individuals, in fact, show a significant higher risk of mental health conditions, substance- use disorders and suicide. In addition, mental health services access may be difficult for personal and social barriers as well as a lack of adequate and specific mental health support. This review aims to assess and describe international policies, guidelines, position statements and recommendations regarding the promotion and protection of mental health rights for LGBTQI people. The search has been focussed on peer-reviewed papers, Governmental and Mental Health Association- Guidelines and Position Statements, Health Agencies - Guidelines and Position Statements (with a specific focus on mental health), LGBTQI Alliances and Foundations Publishing (with a specific focus on mental health). In addition, relevant international initiatives, and projects in the field of LGBTQI mental health will be described. [ABSTRACT FROM AUTHOR]

The present paper invites a critical reflection, from a decolonial perspective, on the importance of considering gender in the approach to mental health problems. From a methodological point of view, this critical position includes consideration of the hermeneutic condition of the intersection between gender, race and other social historical determinants. It also explores the development and the incorporation of a gender perspective as an expression of decolonial thought, in approaches to mental health in the Cuban context. The paper draws on the critique of colonial thought in relation to psychology and gender. It analyses the history and the development of these ideas from the academic experience developed in the East of Cuba, a place on the periphery, a context that is distant and distinct from Havana, which is often seen as the main scientific centre and point of reference. As such, this paper includes a critique of colonial power with respect to the geographical location of the profession of psychology. In this way, it contributes to the central objective of promoting awareness of decolonial thinking, with an emphasis principally on gender and as a way to favour the professional development of clinical psychology in all of Cuba. [ABSTRACT FROM AUTHOR]

Bullying victimisation is a serious risk factor for mental health problems in children and adolescents. School bullying prevention programs have consistently produced small to moderate reductions in victimisation and perpetration. However, these programs do not necessarily help all students affected by bullying. Paradoxically whole-school programs lead to higher levels of depression and poorer self-esteem for students who continue to be victimised after program implementation. This may be because some elements of whole-school programs make victims more visible to their peers, thus further eroding their peer social status. Three main identified risk factors for children and adolescents who continue to be victimised following school bullying prevention programs are peer rejection, internalising problems, and lower quality parent-child relationships. All are potentially modifiable through family interventions. A large body of research demonstrates the influence of families on children's social skills, peer relationships and emotional regulation. This paper describes the theoretical foundations and empirical evidence for reducing the incidence and mental health outcomes of school bullying victimisation through family interventions. Family interventions should be available to complement school efforts to reduce bullying and improve the mental health of young people. [ABSTRACT FROM AUTHOR]

Social exclusion and poverty are associated with increased mental health issues. In addition, the current political and civil conflicts worldwide are also considered as leading factors to mental disorders and substance use disorders. The Compassion, Assertive action, Pragmatism and Evidence (CAPE) index comprises nine country-level measures and highlights the need for assistance in countries with a high degree of vulnerability. Several findings from previous studies reported a broad relationship between CAPE indices and increased levels of mental disorders and substance use. In this paper, we identified the prevalence of mental disorders and substance use disorders among those countries reporting higher (i.e., highest CAPE Index scores) as well as lower (i.e., highest Quality of Life Index scores) vulnerability. We extracted prevalence data from the Institute for Health Metrics and Evaluation global database in 2019. There was a lower prevalence of mental (12.5%) and substance use (1.7%) disorders in highly vulnerable countries than less vulnerable ones (15.1% and 3.5%, respectively). These findings suggest an urgent need for early detection of mental and substance use disorders in vulnerable countries: increasing mental health literacy among non-specialized health professionals in these regions may greatly improve the level of detection and treatment. [ABSTRACT FROM AUTHOR]

Natural disasters are large-scale adverse events resulting from natural processes of the earth, often associated with death, trauma, and destruction of property. They threaten harm or death to a large group of people; cause disruption of services and social networks and a communal loss of resources; and involve identifiable mental and physical health outcomes, among those affected. While majority of individuals who experience a traumatic event due to natural disasters do not develop psychopathology, natural disasters can threaten our psychological well-being in many ways and they can result in both short and long-term psychological distress and thus create a significant burden of mental health conditions on individuals and the community affected by them. In this paper we provide a narrative review that focuses on the mental health effects of natural disasters. We discuss effective, evidence-based interventions that can help enhance the sense of safety, hope, and optimism, as well as serve to promote social connectedness for those who are impacted. We describe how these interventions, developed by keeping in mind the cultural context and the needs of the community, can be provided pre, peri and post-disaster period to improve the adverse mental health effects of the disaster. [ABSTRACT FROM AUTHOR]

Urban mental health studies traditionally search for causal relationships between elements of the city and the prevalence of mental disorders. This paper discusses the importance of (re)thinking the 'lived urban experience' from the perspective of city residents about how the immediate environment affects their mental health and how people cope with inequalities. A participatory-action research was implemented in a peripheral area of São Paulo – Brazil, in which volunteers from the territory made phone calls to neighbours to provide emotional support during the COVID-19 pandemic. Weekly supervision meetings were held between volunteers and researchers to discuss the experiences shared by community counterparts. Narratives have shown that the lived experience in the city is mediated by multiple layers of 'urban insecurities'. These difficulties pressured people to organise and resist in face of pervasive inequalities as well as to respond to unfolding experiences of social suffering. We highlight the potential of participatory methodologies to observe the ways in which subjects face their structural issues and the suffering that emerge in these circumstances. The understanding of how these conflicts are lived at a subjective level can support studies that are wondering about the mechanisms of how social conflicts 'get under the skin'. [ABSTRACT FROM AUTHOR]

Disasters invariably result in a surge in demand for mental health services, and this surge quickly exceeds available mental health resources. The pursuit of alternative sources of psychological support for communities adversely affected by disasters has therefore been necessitated. This paper describes the application of an awarding-winner, empirically validated, model for psychological support and its applicability for enhancing community disaster mental health resources that are consistent with United Nations' recommendations for a "whole society" approach to disaster mental health. The model utilises the concept of peer-based psychological support. Peer psychological support is defined as the utilisation of individuals specially trained in the provision of acute psychological crisis interventions and psychological first aid, but who do not possess professional-level training or licensure in one of the mental health disciplines. These peer-based crisis intervention services may be delivered telephonically, via the internet, or face-to-face. This model, referred to as Reciprocal Peer Support (RPS), is the peer support activity provided at Rutgers University Behavioural HealthCare (UBHC) National Center for Peer Support in a variety of peer programs. More than 20 years of peer support interventions have been reviewed and assessed to clarify the lessons learned for the application of RPS as a prime exemplar for the utilization of peer support during and after a disaster. The Cop 2 Cop, NJ Vet 2 Vet, and several other UBHC peer support programs, which conform to best practices criteria, have been created, sustained, and expanded based on the RSP principles discussed in this article. RPS and derivative applications for human-made disasters such as the terrorist events of 9/11/2001 as well as natural disasters such as Hurricane Katrina or the COVID- 19 pandemic represent platforms for the implementation of peer psychological support and the establishment of a peer-based continuum of psychological connection. [ABSTRACT FROM AUTHOR]

There is considerable evidence to suggest that individuals with mental illness as well as their carers and families are discriminated against across a number of domains. It is also well recognized that people with mental illness are likely to die younger than their counterparts who do not have mental illness. We propose that a Magna Carta is urgently needed to protect the rights of people with mental illness and help reduce discrimination. In this paper a background and rationale for this is offered alongside suggestions for reducing discrimination. The simple message is this; progress in health, economic, environmental and global development will not be made without improvements in mental health. The reasons are equally straightforward as mental illnesses cause more disability than any other health condition and bring enormous pain and suffering to individuals, their families and communities. These impacts lead to early death, damage to the economy and restrain individual progress. Every country needs to take urgent responsibility for defending the rights of individuals with mental illness. [ABSTRACT FROM AUTHOR]

Research in mental health is a complex phenomenon that requires the use of more than one technique. It is extremely crucial to study and understand people's perceptions, beliefs, healing practices and coping strategies related to mental health. Stipulating only one between the medical/biomedical and medical anthropology perspectives may not be adequate to understand the dynamics of mental health research. The number of variables and components associated with the respondents and their social environments give diverse results. Research on mental health is very crucial and different from other kinds of health-related researches. Thus, while conducting mental health research, it is important that the researchers be careful in choosing and applying appropriate methodology. It is a very critical field of research, requiring Interdisciplinary research methodological approaches. An eclectic strategy is required to give an innate understanding of the phenomenon of mental health. Studies should follow both anthropological and epidemiological notions to understand human behaviour, for better management and planning of the mental health services. The proposed paper discusses 'cultural epidemiology' as a methodology and explores its contribution to the contemporary mental health research. [ABSTRACT FROM AUTHOR]

This paper provides ethnographic evidence on how coloniality shapes the making of Latin American psychologists. A critical ethnography was conducted at a psychology training institution in Ecuador, consisting of twelve months of participant observation; forty-one semi-structured interviews; and analysis of academic discourse, photos, videos and relevant social media content. The research was guided by the tradition of Critical Psychology – specifically Liberation Psychology – and Critical Discourse Analysis. Findings suggest the pervasiveness of coloniality in the making of Ecuadorian psychologists and, hypothetically, of others in Latin America and the wider Global South. Interpretations also highlight the non-essentialist, non-dichotomist, 'messy' nature of such processes, a consideration which may advance current ethical and analytical debates on decolonisation. Echoing ongoing critical arguments, authors suggest that a 'help-as-war' metaphor is a category with potential value to contribute to such advancement, an approach that has important theoretical and pragmatic implications for researchers and practitioners. [ABSTRACT FROM AUTHOR]

Paediatric medical psychology is a specialised field within clinical health psychology focussed on the behavioural, developmental, and psychological needs of children, adolescents, and families in healthcare contexts. Paediatric medical psychologists address a myriad of problems by employing evidence-based evaluations and interventions in order to support the well-being of paediatric patients and their families. In this paper, we provide an overview of paediatric medical psychology including the education and training required to be a paediatric psychologist followed by common problems addressed by paediatric psychology, the settings paediatric psychologists work in, and the services they provide. Discussion concludes with future application of integrating paediatric psychology throughout the continuum of care to optimise adjustment and health of paediatric patients. [ABSTRACT FROM AUTHOR]

Mental health disorders cause a large burden on global public health, with many patients living years with the disability. However, many doctors are ill-equipped to treat mental health disorders given inadequate training during their undergraduate years. In some countries, psychiatry is even considered an elective course rather than a core module. There is, therefore, a pressing need to improve the training of medical students in managing mental health disorders. Measures need to be implemented to attract students to choose psychiatry as their career. Given the developments in the fields and the challenges currently faced by trainees and early career psychiatrists, changes may also be made to the training programme in the postgraduate stage to unify the variations across the world in terms of the training duration and format. This paper will describe the ways that undergraduate and postgraduate psychiatry training may be ameliorated to improve the delivery of mental healthcare around the world and to equip doctors to face challenges in the future. [ABSTRACT FROM AUTHOR]

Global mental health is a comparatively new area of study and research that is concerned with addressing inequities and inequalities in mental health provision across the globe. In recent years concerted efforts have been made to scale up mental health services in low- and middle-income countries (LMIC). As such, there has been tendency to view LMIC as recipients of mental health-related knowledge, rather than providers of knowledge. Critics have referred to the prevailing flow of information from high-income countries (HIC) to LMIC as a form of medical imperialism. To redress the apparent imbalance in knowledge exchange, this paper reflects on valuable lessons that HIC can potentially learn from LMIC in terms of supporting mental well-being. Specifically, the paper reflects on how a greater willingness to embrace pluralism in HIC may facilitate people to engage with forms of support that they believe to be appropriate for them. The paper also explores examples of what are termed 'counterflows' of knowledge; ideas that have originated from LMIC that are influencing mental health-related practice in HIC. Barriers to potential counterflows are discussed. [ABSTRACT FROM AUTHOR]

This paper provides a narrative review of the knowledge on inter-personal violence and abuse (IPVA) in adolescents’ intimate relationships. It draws on the authors’ own research, published reviews, and a rapid review on IPVA victimization and mental health outcomes for adolescents. The research reviewed identified associations between adolescent IPVA and substance misuse, depressive symptoms and PTSD, eating disorders and suicidal thinking, and behaviour in young people. Generally, girls appeared more likely to report severe mental health outcomes than boys. Adolescents rarely disclose IPVA to adults and delivering preventative programmes that promote knowledge and help seeking may offer a means of building on young people’s tendency to seek help from friends. These preventative interventions, usually delivered in schools, need to be closely linked to support services for adolescents who disclose abuse. While there are some practice examples of emerging interventions for both victims and perpetrators of adolescent IPVA, there is as yet little robust evidence regarding their effectiveness. [ABSTRACT FROM PUBLISHER]

Domestic violence and abuse is a considerable international public health problem, which is associated with mental disorders in both women and men. Nevertheless, victimization and perpetration remain undetected by mental health services. This paper reviews the evidence on mental health service responses to domestic violence, including identifying, referring, and providing care for people experiencing or perpetrating violence. The review highlights the need for mental health services to improve rates of identification and responses to domestic violence and abuse, through the provision of specific training on domestic violence and abuse, the implementation of clear information sharing protocols and evidence-based interventions, and the establishment of care referral pathways. This review also highlights the need for further research into mental health service users who perpetrate domestic violence and abuse. [ABSTRACT FROM PUBLISHER]

This paper uses the framework of the applied social science needs/rights antinomy to describe the efforts of Israel's mental health system in transforming a hospital-based orientation to services for individuals with a severe mental illness, to a community-based recovery orientation. On the one hand, a rationale for the provision of services to individuals with a severe mental illness that stresses these individuals' needs can justify the allocation of society's limited resources by referring to an objectively determinable set of psychiatric needs. However, this rationale may establish an inherent asymmetry between the adequate help provider and deficient help user. On the other hand, a rationale for providing psychiatric rehabilitation services that stresses the fundamental symmetry between the help provider and the help user is empowering, thus consistent with the recovery approach. However, this rationale does not provide a mechanism for negotiating the vague boundary between mental health and mental illness. Israel's mental health system has operationalized a policy that emphasizes rights as well as needs by legislating for a comprehensive set of rehabilitation services that individuals meeting the eligibility criteria may receive. This paper discusses this approach's achievements, challenges and implications for future policy, research, and practice. [ABSTRACT FROM AUTHOR]

During the last two decades, the number of international migrants worldwide has constantly risen. In this context, cross-cultural dimensions of psychological disorders receive increased attention, especially depression, anxiety and post-traumatic stress disorders among the migrant population. In this paper we propose a theoretical framework for the understanding of migrant mental health. This framework combines elements from Berry's acculturation model and Antonovsky's salutogenic theory. The former illustrates the main factors that affect an individual's adaptation in a new cultural context. The term acculturative stress denotes unresolved problems resulting from intercultural contact that cannot be overcome easily by simply adjusting or assimilating. The latter specifies the relationship between culturally associated stress and mental health more distinctive, introducing the concepts of generalized resistance resources and sense of coherence that determine mental health outcomes of migrants during acculturative stress periods. Specifically, we provide an integrative framework of acculturation and salutogenesis that helps to integrate inconsistent findings in the migrant mental health literature. The current paper focuses on the effect of resource factors for positive mental health outcomes in the migrant population and summarises some implications for future research activities. [ABSTRACT FROM AUTHOR]

The notion of salutogenesis was developed by Aaron Antonovsky to achieve a fundamental innovative approach to promoting mental health. Within the concept of salutogenesis, the author defined the sense of coherence (SOC) as a global life orientation, and he suggests that it emerges in the early years of childhood. In order to develop coherence and its components it is necessary to explore certain health resources. In this paper the following questions will be discussed: (1) which are the individual and social resources to keep healthy, and (2) how can these resources be activated? Selected empirical findings will be presented to respond to these research questions. The results show that resources such as self-worth and a sense of belonging are fundamental health factors. They can be developed most effectively in the early years of childhood and through the formal educational system, e.g. in kindergartens and primary schools. However, the findings show that professionals need to be trained to be able to deliver educational programmes in terms of salutogenesis. At the same time, experience shows that promoting health resources in children successfully depends on the participation of the parents and their support by the professional educators. This paper aims to present new ideas and experiences in the area of a practical realization of the concept of salutogenesis in educational systems. Particularly, health promotion programmes, for example 'The I am I programme' (Krause, 2009), could be implemented successfully in kindergartens with a high quota of children with an immigrant background, due to the fact that this programme includes the reflection and experience of cultural traditions, food, songs, dancing, and family rituals. [ABSTRACT FROM AUTHOR]

There is now an abundance of research which has demonstrated that military personnel who deploy on operations are at increased risk of suffering a variety of mental health difficulties in the immediate and long-term post-deployment period. One consequence of these research findings has been the development of a variety of programmes which attempt to mitigate the increased psychological risk and to assist personnel who are returning from a deployment to make a smooth transition home. Using a three-tiered prevention model, this article reviews some of the key post-deployment issues facing the UK Armed Forces and highlights the recent interventions which have been put in place to promote successful adjustment in the early post-deployment period. The paper is based upon research identified through a thorough literature search for studies which focused on this area and included a recognized measure of mental health as an outcome. The paper focuses on three main areas; psychological decompression, psycho-education and screening. The current philosophical approaches to post-deployment mental health problems of some of the UK's coalition partners are also discussed. [ABSTRACT FROM AUTHOR]

The article discusses various papers published within the issue including a paper by Enrique Baca et al. on the role of Spain and Portugal in the psychiatry and mental health fields of Latin America, another by Jorge J. Rodriguez on the psychiatric and mental health systems across Latin America and the Caribbean, and another by Renato D. Alarcon and colleagues examining the role of identity with respect to personality development.

This paper examines the concept of resilience in the context of children affected by armed conflict. Resilience has been frequently viewed as a unique quality of certain 'invulnerable' children. In contrast, this paper argues that a number of protective processes contribute to resilient mental health outcomes in children when considered through the lens of the child's social ecology. While available research has made important contributions to understanding risk factors for negative mental health consequences of war-related violence and loss, the focus on trauma alone has resulted in inadequate attention to factors associated with resilient mental health outcomes. This paper presents key studies in the literature that address the interplay between risk and protective processes in the mental health of war-affected children from an ecological, developmental perspective. It suggests that further research on war-affected children should pay particular attention to coping and meaning making at the individual level; the role of attachment relationships, caregiver health, resources and connection in the family, and social support available in peer and extended social networks. Cultural and community influences such as attitudes towards mental health and healing as well as the meaning given to the experience of war itself are also important aspects of the larger social ecology. [ABSTRACT FROM AUTHOR]

This paper is based on the Bruce Burns Memorial Trust Lecture, Terrorism and Mental Health, presented in October 2005, in Birmingham. In addition to written sources, it is informed by the author's experience and contact with military and police experts in this arena over 28 years as a member of the British Army. The diagnosis and treatment of post traumatic mental disorders are not addressed in this paper. The author explores the general phenomenon of terrorism, in an endeavour to inform understanding of terrorist acts. He stresses the need for contextualisation of acts of terror, their perpetrators, their effects on populations and individuals, and attention to the psychology of groups. The author aims to invite and inform further thought and debate on the subject by raising a wide range of issues which do not sit comfortably within a strict psychiatric, research-based paradigm. The author covers a brief history of terrorism; organisational requirements of terror groups and the process of recruiting personnel to them; the means, motives and opportunities terrorists exploit in their work; the need for communication with terror groups; sacrificial death; governmental responses to terrorist acts and fear and mental health. The author proposes that terrorist organisations perform some of the functions of a family; that acts of terror are 'propaganda by deed'; that terrorism, or more precisely the media's treatment of it, breeds 'formless fears' which may directly lead to the development of fear-based symptoms and illness within societies. He notes that terrorism is an enterprise from which many players ('experts', media, politicians, etc.) benefit; that terrorism has its shadow in counter-terrorism, which may range from benign to malignant and that psychiatry could, in this context, acknowledge its bias towards individual psychologies and rectify its lack of understanding of groups and the behaviours of individuals within them. [ABSTRACT FROM AUTHOR]

The objectives of this paper are to develop insights into the mind of the terrorist, to conduct a review of health impacts on the health of populations, especially from the point of view of mental health impacts caused by terrorist attacks and to discern the role to be played by forensic psychiatry in emergencies caused by terrorist actions. These objectives are developed at the population level and at the individual level from the point of view of a description of the terrorist and of victim's need for forensic intervention and representation. On entrance, the paper starts with a general frame of definitions and a historical overview of terrorism as an ancient, purposeful, political tool used to change a situation objectionable to the terrorist group via intimidation of a captive population. People are used as expendable pawns and become psychologically captive to the aims of the terrorist group. As well, the paper reviews the new reality of bioterrorism and the use of improved technologies to inflict expensive damage to national infrastructures and massive loss of life. [ABSTRACT FROM AUTHOR]

This paper describes the mental health and psychosocial response to the Boxing Day tsunami in Sri Lanka. The need to deal with the immediate psychological distress of survivors and provide psychosocial support after the tsunami was recognized early by the President of Sri Lanka and advisory group set up. In conjunction with the WHO regional office and local representatives, a National Plan of action for management and delivery of psychosocial and mental health care needs was set up. Advice was provided on the right type of psychological approaches to use when dealing with survivors–for example, not forcing people to relive their experiences, listening without offering opinions and not diagnosing or labelling people as suffering from post-traumatic stress disorder (PTSD). The early response and community level work are described in this paper as well as how this has led to a new level of disaster preparedness and a new national mental health policy and proposals for new mental health legislation. [ABSTRACT FROM AUTHOR]