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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]

Identity is a complex concept that can be informed by various factors, involving biological, psychological, experiential, and social influences. Specifically, one's social identity refers to the ways in which individuals can adopt attributes from established collective categories, like cultural identities, ethnic identities, gender identities, and class identities, amongst others. Social identity can encompass unique and diverse interactions at an individual level, known as micro-identities, that may be selectively expressed, hidden, or downplayed, contingent on distinct sociocultural settings. However, the formation of social identity is recurrently defined in opposition to perceptions of the Other, which can entail adverse paradigms of marginalisation, stigma, and discrimination. Although this theory of Otherness has been developed across different fields, particularly sociology, it may be important in psychiatric contexts as it can engender inherent risk factors and mental health inequalities. Consequently, this paper seeks to bring attention towards these issues, exploring the construction of Otherness and its detrimental outcomes for psychiatry, such as systemic discrimination and disparities in therapeutic support, alongside recommended initiatives to mitigate against the effects of Otherness. This may require multifactorial approaches that include cultural competency training, interventions informed by micro-identities and intersectionality, patient advocacy, and structural changes to mental health policy. [ABSTRACT FROM AUTHOR]

Numbers are ubiquitous to modern existence and have evolved with humanity over millenia. They structure, record and quantify human behaviour, spiritual belief systems and the evolution of innovation across all spheres of life. Furthermore, cultural identities and interpersonal expression often have numerical components to them for instance rites of passage, population demography and fiscal measures. The salience of numbers in both historical and contemporary cultural life arguably plays a role in individual psyches and the experience of distress or wellness. This paper illustrates the cultural relativism of numbers through superstition and foreboding to auspiciousness in different societies. As a short hand for the quantification of multiple phenomena in low literacy to high technology populations, rural and urban societies as well as traditional and evolving societies, numbers have and will continue to be core to all cultures as they have from prehistoric to contemporary times. [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]

Lesbian, gay and bisexual people continue to suffer minority stress around the world, but particularly in Africa, the Middle East and Eastern Europe. This anti-homosexual prejudice can enter into the therapist–client relationship and seriously damage the outcome of psychotherapy, particularly in instances where therapists regard their clients’ sexuality as contributing to their psychological difficulties. This paper takes an historical perspective to research on the attitudes of a range of professionals who provide talking therapies or other types of psychological support to their clients who are lesbian, gay or bisexual. The nature and origins of prejudice, its effects on LGB clients, and how it might best be addressed are considered. Challenging the ethics and evidence base for treatments that purport to change sexual orientation, as well as asking heterosexual therapists to reflect on their own heteronormative assumptions, are crucial to effecting change and ensuring LGB people are treated equally to their heterosexual counterparts. [ABSTRACT FROM PUBLISHER]

Australia has been implementing routine outcome measurement in its specialized public sector mental health services for over a decade. It uses a range of clinician-rated and consumer-rated measures that are administered at set times during episodes of inpatient, ambulatory and community residential episodes of care. Routine outcome measurement is now embedded in service delivery, and data are made available in a variety of ways to different audiences. These data are used by policy-makers and planners to inform decisions about system-wide reforms, by service managers to monitor quality and effectiveness, and by clinicians to guide clinical decision-making and to promote dialogue with consumers. Consumers, carers and the general community can use these data to ensure that services are accountable for the care they deliver. This paper describes the status quo in Australia with respect to routine outcome measurement, discusses the factors that led to its successful implementation, and considers the steps that are necessary for its continued development. [ABSTRACT FROM AUTHOR]

It has been suggested that cognitive behaviour therapy (CBT) needs adaptation for it to be effective for patients from collectivistic cultures, as currently CBT is underpinned by individualistic values. In prior studies we have demonstrated that CBT could be adapted for Pakistani patients in Southampton, UK, and for local populations in Pakistan. Findings from these studies suggest that CBT can be adapted for patients from collectivistic cultures using a series of steps. In this paper we focus on these steps, and the process of adapting CBT for specific groups. The adaptation process should focus on three major areas of therapy, rather than simple translation of therapy manuals. These include (1) awareness of relevant cultural issues and preparation for therapy, (2) assessment and engagement, and (3) adjustments in therapy. We also discuss the best practice guidelines that evolved from this work to help therapists working with this population. We reiterate that CBT can be adapted effectively for patients from traditional cultures. This is, however, an emerging area in psychotherapy, and further work is required to refine the methodology and to test adapted CBT. [ABSTRACT FROM AUTHOR]

Current evidence strongly points to significant parental concerns about exposing their children to psychopharmacological medications. This is true even with stimulant medications for attention deficit/hyperactivity disorder (ADHD), an evidence-based treatment for children. Theory and prior evidence would predict that parents' hesitancy to give their children psychopharmacological medication is likely due to what they hear from family and friends about medication's untoward effects. That social networks impact problem definition, treatment evaluation, and service use is well established. However, it is not known how parents make treatment decisions as they cope with the reality that their child might benefit from psychopharmacological medication. The qualitative research described in this paper addresses this gap. A conceptual model is presented that describes parents' treatment decisions and participation in their children's care as they shift from parenting a child with behavioural problems to parenting a child who eventually requires psychopharmacological medication. Further research is needed to evaluate how this model can offer a more comprehensive understanding of how parents respond to a diagnostic label and various treatment options. It is hoped that this research will stimulate innovative approaches for tailoring treatments that are respectful of the individual needs of children and their families. [ABSTRACT FROM AUTHOR]

As a social justice issue, it is suggested that racialised identity may represent a critical moderator in the association between racism and adverse mental health. We performed a meta-moderation analysis of studies on racialised identity, racism and adverse mental health in children and adolescents. We searched Pubmed, Web of Science, SocINDEX, PsychInfo, Medline, CINAHL and EBSCO Academic Search Ultimate for peer-reviewed articles published between January 2013 and December 2022. Nine studies, encompassing 2146 Black, Moroccan, Turkish, Indigenous, South Korean, Latinx and Multi-heritage children and adolescents between the ages of 7 and 16, were included, covering depressive symptoms, substance use, internalising symptoms and externalising symptoms. A random effect meta-analysis reported a medium size positive correlation of 0.26 (95% CI = 0.20–0.32) between racism and adverse mental health. A comparison between internalising and externalising symptoms revealed a smaller positive correlation of 0.25 (95% CI = 0.09–0.41) for internalising symptoms and a slightly larger positive correlation of 0.30 (95% CI = 0.19–0.41) for externalising symptoms. A small negative moderation of −0.07 (95% CI = −0.17 to 0.02) was found for racialised identity in the association between racism and internalising symptoms, whilst no moderation was found between racism and externalising symptoms. Overall, a negligible moderation of −0.02 (95% CI = −0.08–0.05) was found for racialised identity in the association of racism to adverse mental health. These findings suggest that the effect of racism on internalising symptoms is slightly stronger for children and adolescents with lower racialised identities and slightly weaker for those with higher racialised identities. [ABSTRACT FROM AUTHOR]

Research on the transgender population is often limited to their medical care, and in particular to their mental well-being. The social and family environment in which a social gender role transition takes place is often overlooked. Although research is limited, this article reviews the existing literature on the family aspect of a gender transition. Articles regarding three different aspects were selected for this review: first, the issue of parenthood during transition and the experiences of children with a transgender parent, second, the experiences of partners and ex-partners of transgender individuals, and third, the experiences of parents with a gender variant child. Articles were restricted to those with a focus on family members and situations during transition. For all three contexts, several mediating factors, both individual and social, were distinguished. Various challenges for future research were identified. [ABSTRACT FROM PUBLISHER]

An introduction is presented in which the editor discusses various reports within the issue on topics including the concept of heroic doubling, the notion of broadcast terrorism, and the use of a model of co-operation in Denmark to make the police, social services, and psychiatry share information.

The journey of positive psychology becoming an established discipline (approximately 20 years) has seen both theoretical and empirical attention given to identity level, cognitive, behavioural and perceptual ways in which the 'best in us' can be identified and developed via what have come to be called 'positive psychology interventions' (PPIs). However, when we consider the anticipated impact of the 4IR on individuals we can predict the experiences of job losses, job change, and potentially the need for individuals to have multiple forms of work at any one time. If 'work' is viewed as one of the contributory structures to the nature of individual identity, then the consequences of the 4IR will impact the individual sense of identity, with a potential consequence to an individual sense of purpose, well-being and health. The article suggests that these experiences, psychologically, will be both an 'identity crisis' and an 'existential crisis'. This article proposes that there is an urgency of need and innovation to support individuals facing this change. Drawing on concepts of 'Positive Psychology 2.0' or 'Existential Positive Psychology' the article recommends two forms of PPIs as a potential support to affected individuals through an innovation in their nature and content which might offer a support to preserving and strengthening the sense of identity and of personal 'fit' while the backdrop of work and employment becomes volatile. Used in this way, the interventions would seek to influence the challenging existential experience of these job losses within the context and definition of existential positive psychology. The need for sensitive, cultural application and research on efficacy is discussed. [ABSTRACT FROM AUTHOR]

This study aimed at qualitatively exploring the development of a sense of coherence (SOC) among systemic family therapist trainees (FTT) over a 3-year period. It was conducted in a private family therapy training institute in central Germany. The sample consisted of 66 trainees. The components of SOC and their general health played an important role in the development of FTTs throughout the three training years. Findings show that the SOC component of meaningfulness (motivation) was most frequently mentioned and most important to participants' personal and professional development, followed by comprehensibility (understanding of self, others and the context) and finally by manageability (coping with challenges based on personal, social and professional resources). The three SOC components fostered a positive self-care approach in FTTs and improved health and well-being over the 3 years. Visions of FTT at the end of the training show that they aim at personal and professional growth and development in the Fourth Industrial Revolution (4IR). [ABSTRACT FROM AUTHOR]

Shared decision-making (SDM) means that clinicians and the patient make decisions about the treatment together. Regarding drug treatment in eating disorders (EDs), such decisions may include psychopharmacological treatment for the ED itself, medications for potential co-morbid psychiatric disorders, pharmacological strategies to alleviate the health consequences of an ED, or 'pro re nata' (PRN) medication which is given in acute care when required. Decisions regarding drug treatment in EDs should be specific in terms of the active pharmacological substance, its dose, its route of administration, and the duration of treatment. Decisions should be made with regard to the specific health risks of patients with EDs and the entire treatment approach, and should take alternative measures, additional therapies, and specific combinations of therapies into account. The differences in the expectations of patients, carers, and clinicians towards drug treatment, the lack of specific suggestions in clinical practice guidelines, and the lack of approved psychopharmacological treatment options make SDM necessary, but also a challenge. However, SDM may be limited due to the patient's impaired insight or limited capacity due to the ED. Thus, the legal framework must be taken into consideration. [ABSTRACT FROM AUTHOR]

Evaluations to objectively assess minimum competency are not routinely implemented for training and supervision in global mental health. Addressing this gap in competency assessment is crucial for safe and effective mental health service integration in primary care. To explore competency, this study describes a training and supervision program for 206 health workers in Uganda, Liberia, and Nepal in humanitarian settings impacted by political violence, Ebola, and natural disasters. Health workers were trained in the World Health Organization's mental health Gap Action Programme (mhGAP). Health workers demonstrated changes in knowledge (mhGAP knowledge, effect size, d = 1.14), stigma (Mental Illness: Clinicians' Attitudes, d = −0.64; Social Distance Scale, d = −0.31), and competence (ENhancing Assessment of Common Therapeutic factors, ENACT, d = 1.68). However, health workers were only competent in 65% of skills. Although the majority were competent in communication skills and empathy, they were not competent in assessing physical and mental health, addressing confidentiality, involving family members in care, and assessing suicide risk. Higher competency was associated with lower stigma (social distance), but competency was not associated with knowledge. To promote competency, this study recommends (1) structured role-plays as a standard evaluation practice; (2) standardized reporting of competency, knowledge, attitudes, and clinical outcomes; and (3) shifting the field toward competency-based approaches to training and supervision. [ABSTRACT FROM AUTHOR]

As the need for mental healthcare services within correctional settings in the US increases, so does the need for a mental health workforce that is motivated to work within such systems. One potentially effective method by which to increase the number of psychiatrists working in jails, prisons, and parole clinics is to provide exposure to these environments during their training. Correctional settings can serve as unique training sites for medical students and psychiatric residents and fellows. Such training experiences can provide a host of benefits to both trainees and staff within the correctional mental health system. Alongside many potential benefits exist substantial potential barriers to coordinating correctional training experiences, including both programme directors’ and residents’ concerns regarding safety and enjoyment and negative perceptions of inmate and prisoner patients. The establishment of academic affiliations with correctional institutions and didactic instruction on commonly encountered clinical issues with inmate populations may be methods of diffusing these concerns. Improving residents’ and fellows’ training experiences offers a hope for increasing the attractiveness of a career in correctional psychiatry. [ABSTRACT FROM AUTHOR]

Rates of mental illness and self-harm are very high among women prisoners. Questionnaires assessed prisoners' knowledge of and attitudes towards mental health problems, and relevant behavioural intentions before and after the intervention, to evaluate the effectiveness of a comedy show in a women's prison to reduce mental health stigma and improve coping and help-seeking for mental health problems. The intervention appeared to have been successful in improving some aspects of prisoners' knowledge about the effectiveness of psychotherapy (Z = − 2.304, p = 0.021) and likelihood of recovery from mental health problems (Z = − 2.699, p = 0.007). There were significant post-intervention increases in the proportion who stated they would discuss or disclose mental health problems with all but one of the sources of help in the questionnaire, which was consistent with the increases in the number of prisoners who rated themselves as likely to start using different sources of help or prison activities. There was no improvement in intentions to associate with people with a mental health problem. The intervention appeared effective in improving factors that might increase help-seeking and improve coping, but not those that would change behaviour towards others with a mental health problem. [ABSTRACT FROM AUTHOR]

Despite the need to improve the quantity and quality of psychiatry training in sub-Saharan Africa (SSA), very little is known about the experiences of psychiatric trainees in the region. This is the first study examining psychiatric trainees in a low-income country in SSA. It was carried out as part of the needs assessment for a unique Medical Education Partnership Initiative (MEPI) programme to find African solutions for medical shortages in Africa. We approached all doctors who had trained in post-graduate psychiatry in Zimbabwe in 2010 and conducted in-depth qualitative interviews with all except one (n = 6). We analysed the data using constant comparison and thematic analysis. Trainees described the apprenticeship model as the programme's primary strength, through providing clinical exposure and role models. Programme weaknesses included shortages in information sources, trainee salaries, trainers, public health education, and in the mental health service. Most respondents were, however, eager to continue practising psychiatry in Zimbabwe, motivated by family ties, national commitment and helping vulnerable, stigmatized individuals. Respondents called for sub-speciality training and for infrastructure and training to do research. Resources need to be made available for psychiatric trainees in more SSA settings to develop public health competencies. However, investment in psychiatry training programmes must balance service provision with trainees' educational needs. Directing investment towards needs identified by trainees may be a cost-effective, context-sensitive way to increase retention and learning outcomes. [ABSTRACT FROM AUTHOR]

Patients from collective cultures with a tradition-bound Islamic cultural background (e.g. people from the Middle East and some Far-East countries such Pakistan and Indonesia), have a different perception of disease and different conceptions of healing, which up till now have not been sufficiently appreciated in modern multimodal therapeutic approaches and health management. Taking patients' value systems into consideration in a culture-sensitive way, with reference to their notions of magic, healing ceremonies and religious rituals and especially patterns of relations and experience in the treatment of psychological diseases in medical psychotherapeutic work, with due regard to scientific psychotherapeutic standards, can be used as an intercultural resource and lead to establishing partnership-like relationships between patients and therapists. [ABSTRACT FROM AUTHOR]