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Background: Inaccessible services and poor communication are barriers to successful transitions between adolescent and adult mental health services, for which digital communications (DC) offer a possible solution. Aims: To investigate the role of DC, including smartphone apps, email and text, given the known barriers and facilitators of mental health service transitions reported in the literature. Methods: Use of Neale's (2016) iterative categorisation technique to undertake a secondary analysis of qualitative data collected for the Long-term conditions Young people Networked Communication (LYNC) study. Results: DC were used successfully by young people and staff in ways that ameliorated known barriers to service transitions. They engendered responsibility in young people, promoted service access and contributed to client safety, particularly in times of crisis. DC risks included over-familiarity between young people and staff, and the possibility that messages could go unread. Conclusions: DC have the potential to facilitate trust and familiarity during and after transition to adult mental health services. They can strengthen young people's perceptions of adult services as supportive, empowering and available. DC can be used for frequent 'check-ins' and remote digital support for social and personal problems. They provide an additional safety net for at-risk individuals, but require careful boundary setting. [ABSTRACT FROM AUTHOR]

Objective: The aim of this article was to examine the concept of mental health and the policies that have been advanced to improve the wellbeing of the population. Conclusions: In the last century there have been many changes in the phenomena of psychiatric disorder, the management of those disorders and the outcomes. All of the changes have largely been due to the efforts of those working pragmatically at the coalface. There is little to suggest that the plans and programs advanced in the last half century have achieved more than enhancing the status of those who advance them. Conclusion: It is difficult to define mental health and equally difficult to develop a comprehensive program that will benefit the whole field. [ABSTRACT FROM AUTHOR]

The devastation of the Covid-19 pandemic on society raised the question of how best to gauge society's psychological adaptation to continually evolving global disruptor events, such as Covid-19. This paper aims to illustrate the use of different approaches to monitor society's psychological response to Covid-19, in order to argue for a more comprehensive, multi-model, approach. The results from different approaches are presented in two studies employing measures of mental disorders and mental distress, respectively, using South African samples for demonstration. The first study presents findings from repeat administration of measures of common mental disorders (major depressive and generalized anxiety disorders) across three consecutive years, while the second study presents findings from mood response profiles (measured with the Brunel Mood Scale) collected across five time points during the Covid-19 pandemic. Both studies showed that the Covid-19 pandemic was temporally associated with adverse mental health outcomes across the mental health continuum, and that mental health profiles were associated with both time since onset of Covid-19 and subsequent wave occurrence. Elevated prevalence of common mental disorders, as well as fluctuating patterns of mood response profiles, are discussed against the context of Covid-19. The paper concludes that a multi-modal approach, for instance measuring specific mental disorders as well as more general mental distress, is crucial to comprehensively understand society's psychological adaptation to major disruptor events, and guide health sector responses. The paper serves as a reminder to continue to observe mental health more inclusively to appropriately respond to the psychological needs of communities. Plain Language Summary: Measuring mental health across Covid-19 waves The impact of Covid-19 on mental health raised the question of how can we best measure how society adapts, psychologically, to major events that disrupt life. This article looked at two specific ways to measure and monitor society's psychological response to Covid-19. The first study looked at the prevalence of mental disorders, and the second looked at levels of mental distress. Both studies used South African samples to demonstrate this. The first study presented data from a repeat administration of scales that identify depressive and anxiety disorders, completed across three consecutive years. The second study presented findings from mood response profiles (measured with the Brunel Mood Scale) collected across five time points during the Covid-19 pandemic. The results showed that the pandemic was associated with adverse mental health outcomes—across the mental health continuum—and that mental health profiles were associated with both time since the start of Covid-19 and fluctuated with the subsequent waves across the pandemic time-line. This article demonstrated the importance of using a multi-modal approach to fully understand society's psychological response to major life disruptions. It also acted as reminder to monitor mental health continuously to be able to respond to the psychological needs of communities. [ABSTRACT FROM AUTHOR]

Objectives: This paper describes the rationale for and development of an innovative mental health service for people aged over 65 years living in Northern and Eastern Melbourne, Victoria, Australia. Conclusion: The Healthy Ageing Service (HAS) was established in July 2020 to provide care for people aged over 65 years experiencing mild-to-moderate mental health concerns. It embraces a prevention and early intervention model of care. It provides primary consultation and brief intervention, secondary consultation, and capacity building to the primary healthcare sector. This innovative service is a Commonwealth-funded partnership between two tertiary mental health service providers that incorporates the recommendations from two major Royal Commissions. It demonstrates a service that acts as a bridge between primary and specialist mental health care, thereby extending mental health services to target the 'missing middle' and is potentially a model for mental health service provision throughout Victoria and Australia. [ABSTRACT FROM AUTHOR]

MHCA mandates monthly reporting to the MHRBs of restraints imposed on the PwMI in the MHEs (Section 97). CB-MH services must be strengthened by effectively implementing DMHP and CB-MH services for ensuring the rights of PwMI to receive treatment in the least restrictive environment. Sir, The Mental Health Care Act, 2017,[1] was implemented in the country for ensuring the rights of persons with mental illness (PwMI).[2] Since its launch, it has been critiqued by the scientific community, highlighting its shortcomings and issues with implementation.[3]-[5] However, such critiques did not explicitly highlight the issues with the implementation of the MHCA in routine clinical discourse. [Extracted from the article]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Statelessness in Canada is an emerging site of inquiry with recent investigations into its causes and consequences, focusing on legislative and policy analyses and the lived experiences of stateless persons. Yet, health care experiences generally and access to mental and physical health care in particular remain under-researched. This study attempts to bridge this gap by examining how statelessness impacts physical health, mental health, access to health care services, and overall well-being. To answer these questions, we conducted semi-structured interviews with stateless or formerly stateless persons to understand their views and experiences. The study reports on negative health outcomes in four broad areas: The limited ability of stateless persons (SPs) to access health care. Mental health challenges. The failure to treat health issues until they have reached a dangerous point and the reliance on self-care strategies. The negative impact of lack of status on four social determinants of health: employment, education, housing, and food security. From these findings, the paper makes three arguments: Legal Status is a key determinant of health and lack of status leads to negative health outcomes. SPs heavily depend upon others for their life-needs, which can lead to exploitation and encourage forms of adaptive and negotiated agency. SPs in Canada experience a physical and mental liminality [a condition of uncertainty]. The paper concludes that Canada should recognize stateless individuals either as stateless or as Canadian nationals, and should implement a context-tailored institutional response to statelessness. [ABSTRACT FROM AUTHOR]

Executive Summary: Millions of Venezuelans have fled their country in hopes for a better future outside the political and financial turmoil in their home country. This paper examines the self-reported needs of Venezuelans in the United States and Colombia. Specifically, it looks at perceived discrimination in each country and its effect on the service needs of Venezuelan immigrants. The authors used data from a larger project conducted in October to November 2017 to perform a qualitative content analysis on the specific services that participants and others like them would need following immigration. The sample consisted of 647 Venezuelan immigrant adults who had migrated to the United States (n = 342) or Colombia (n = 305). Its findings indicate statistically significant differences between the two countries. Venezuelan immigrants in the United States were more likely to identity mental health and educational service needs, while those in Colombia were more likely to list access to healthcare, help finding jobs, and food assistance. When looking at perceived discrimination, means scores for discrimination were significantly greater for participants who indicated needing housing services, who indicated needing assistance enrolling children in school and who indicated needing food assistance, compared to participants who did not list those needs. Venezuelans who had experienced greater negative context of reception were less likely to indicate needing mental health services, where 11.9 percent of those who did not perceive a negative context of reception responded that they needed mental health services. Evaluating existing service networks will be essential in working to bridge the gap between the services provided to and requested by Venezuelans. Collaboration between diverse government actors, community-based organizations (CBOs) and other stakeholders can help identify gaps in existing service networks. CBOs can also facilitate communication between Venezuelan immigrants and their new communities, on the need to invest in necessary services. [ABSTRACT FROM AUTHOR]

Context: Participation in sports during youth is typically beneficial for mental health. However, it is unclear whether elite sport contexts contribute to greater risk of psychological distress or disorder. The aims of this paper are to highlight conceptual issues that require resolution in future research and practice, and to examine the key factors that may contribute to the mental health of elite youth athletes (EYAs). Evidence Acquisition: A narrative overview of the literature combined with the clinical and research expertise of the authors. Study Design: Narrative overview. Level of Evidence: Level 5. Results: EYAs experience a range of biopsychosocial developmental changes that interact with mental health in a multitude of ways. In addition, there are various sport-specific factors that contribute to the mental health of EYAs that may become more prominent in elite contexts. These include - but are not limited to - patterns relating to athlete coping and self-relating styles, the nature of peer, parental, and coach relationships, organizational culture and performance pressures, and mental health service provision and accessibility. Conclusion: A range of critical factors across individual, interpersonal, organizational, and societal domains have been shown to contribute to mental health among EYAs. However, this evidence is limited by heterogeneous samples and varied or imprecise terminology regarding what constitutes "youth" and "elite" in sport. Nevertheless, it is clear that EYAs face a range of risks that warrant careful consideration to progress to best practice principles and recommendations for mental health promotion and intervention in elite youth sport. SORT: Level C. [ABSTRACT FROM AUTHOR]

This paper presents the hypothesis that psychotherapy seeks to produce changes in attitudes and behaviour through transformation of meanings. Patients come to psychotherapy because they are demoralized by the menacing meanings of their symptoms. The psychotherapist collaborates with the patient in formulating a plausible story that makes the meanings of the symptoms more benign and provides procedures for combating them, thereby enabling the patient to regain his morale. As a result, he feels better and functions more effectively, leading to progressive improvement. Various implications and limitations of this hypothesis are explored. [ABSTRACT FROM AUTHOR]

Mental health literacy (MHL) is a significant component in understanding mental health disparities in vulnerable populations. Due to the unique structure and pressures of American college sport, attention to student-athletes' MHL is critical, especially now that the National Collegiate Athletic Association (NCAA) is requiring member institutions to offer mental health services to their athletes. Utilizing online surveys of both athletes (N = 205) and non-athlete students (N = 205), this paper offers a descriptive look at the MHL of student-athletes. We found that both athletes and non-athlete students had above average levels of MHL, but high rates of mental health stigma. With a foundation in contact theory, the paper provides recommendations on how to utilize student-athletes' mental health knowledge to decrease mental health stigma and increase MHL campus wide. [ABSTRACT FROM AUTHOR]

As he continues with comparisons between ego analytic development and Winnicott's conception, Wallerstein doesn't quite seem to grasp the novelty and depth of Winnicott's work. The Mixed Reception To Winnicott And The Ambiguity And Strength Of His Writing Given the density of Winnicott's "concern" paper and his audience's immersion in American ego psychology, it may well be that many in Topeka that day were not fully oriented to the paper's intricate choreography, even if they were quite interested in their British visitor. Keywords: Winnicott; Menninger; Anna Freud; ego psychology; concern; Wallerstein; religion; development; death instinct; aggression; psychosis; borderline EN Winnicott Menninger Anna Freud ego psychology concern Wallerstein religion development death instinct aggression psychosis borderline 469 489 21 08/26/21 20210601 NES 210601 [39] presented "The Development of the Capacity for Concern" at the Topeka Psychoanalytic Society on October 12, 1962.[2] The Topeka Society was closely tied to the Menninger Clinics. Wallerstein: An Ego Psychological Reading of Winnicott [29], who was then beginning his mid-career ascendancy to leadership roles in both psychoanalysis and academic psychiatry, offered four "comments under separate headings" and in connection with them asked questions and invited "clarifying comment from Dr. Winnicott."[7] Wallerstein's comments were respectful and complex. [Extracted from the article]

Objectives: Doctors' mental health has received renewed attention given the epidemic of burnout, high suicide rates and the recent pressures of the COVID-19 pandemic. Internationally, various service designs and primary prevention initiatives have been trialled to address these needs. Systemic barriers such as stigma as well as individual characteristics of doctors have historically prevented access to mental health services. This paper outlines the Australian service context from which a new publicly funded doctors' mental health programme emerged. Methods: A narrative review of current services and a description of the challenges is outlined. Results: A picture of urgency and unmet needs emerged with particular challenges, such as the need for privacy. Conclusions: Doctors' mental health is an urgent priority with direct impacts on patient safety and care. The complex context and the unmet need suggest the focus must go far beyond burnout and has prompted the establishment of a new service model designed to complement existing services in the Australian context, to be described in a sister paper. [ABSTRACT FROM AUTHOR]

The article examines the biological and pharmacological approaches in treating anxiety and depression. The memory bias in depression and the perceptual bias in anxiety were discussed together with negative bias in subjective risk estimation. The effects of cognitive and drug therapy in depression was also taken into account.

The article presents information on a research regarding the neuropsychological assessment of neurodegenerative diseases using the computer program Cambridge Neuropsychological Test Automated Battery (CANTAB). The use of CANTAB in the neuropsychiatry can improve the quality of the tests since computerized tests have many advantages such as precision, speed and reliability. CANTAB is designed to test different aspects of mental functioning in order to construct performance profiles for patients.

The article presents information on a research regarding the treatment of psychiatric disorder using computerized assessments. The Programmable Questionnaire System that contains a computer program and series of questions has been used as a tool for computerized assessments. To operate the interview driver and to prepare the questionnaire file, specialized knowledge of computing is not required.

This position paper from the Canadian Journal of Psychiatry discusses the mental health needs of the 2SLGBTQ+ community and the historical stigma and discrimination they have faced. It addresses the removal of homosexuality as a mental disorder and the ongoing debate around gender dysphoria. The paper emphasizes the negative impact of stigma and discrimination on mental health and the barriers to healthcare faced by 2SLGBTQ+ individuals. It concludes with recommendations for inclusive and nondiscriminatory care. Additionally, the document provides a glossary of terms related to 2SLGBTQ+ issues, emphasizing the importance of understanding and respecting diverse identities and experiences within the community. It also discusses the history of psychiatric treatment and ongoing challenges in accessing appropriate mental healthcare. Another document focuses on mental health and well-being for 2SLGBTQ+ individuals, highlighting the negative impact of stigma and discrimination on mental health. It emphasizes the importance of acceptance and support from family and peers, addresses barriers to healthcare, condemns conversion therapy, and provides recommendations for creating inclusive environments. Lastly, a glossary of terms related to the 2SLGBTQ+ community is provided, emphasizing the importance of using inclusive language and respecting individuals' chosen names and pronouns. The glossary includes definitions for various terms and acknowledges that these terms may vary and evolve over time. It also highlights the need for inclusive materials, gender-neutral facilities, and non-discriminatory policies. [Extracted from the article]

The scarcity of organs for transplant and significant rates of organ transplantation failure mean it is important to identify factors relating to transplant success and failure. Experiencing psychosis or mania is often seen as a contraindication for transplant, and many transplant teams have been cautious at transplanting people with significant mental health difficulties. In this paper we explore whether there is any evidence to support this attitude towards psychiatric diagnosis and transplantation; consider modifiable risks to transplantation; and ask what is needed to provide equitable care for individuals with experience of psychosis. To place context to our discussion, we present the experience of a person who had a history of psychotic experience and who was assessed for double lung transplant. [ABSTRACT FROM AUTHOR]

Provides guidelines for clinical care related to the practice of psychotherapies. Reflection on the clinical experiences of Canadian psychiatrists; Differentiation between psychiatric management and formal psychotherapies; Ethical guidelines for psychotherapies; Factors for effective therapeutic bond between the patient and the psychiatrist.

The article discusses the prevalence of mental illness among people with mental disabilities. According to the Development Team for the Mentally Handicapped, one out of eight people with mental disabilities suffer from mental illness which need psychiatric treatment and nursing care. One study concluded that neurosis is common among women who are in the child-bearing period. It explains how mental illness and behaviour problems among people with mental disabilities could be lessened.

Mental health challenges among students remain a complex and widespread problem facing school leaders. Though schools are a front-line pathway for providing mental health services, many struggling youth are not receiving the professional help they need (Atkins, Hoagwood, Kutash, & Seidman, 2010; Findlay, 2017). Creative and collaborative solutions are needed to bridge the mental health gap. School leader support is essential to the successful implementation of mental health interventions (Forman, Olin, Hoagwood, Crowe, & Saka, 2009). This paper summarizes the novel approach taken by school and community leaders in one rural Ontario community who jointly piloted a school-based social worker (SBSW) role to support secondary schools in two districts. Interviews with five district leaders (four involved in designing the intervention and the SBSW who piloted the role) reveal conditions necessary for the pilot to take place, as well as leader involvement in setting up, supporting, monitoring the new role. Interviews highlighted multiple ways which the pilot improved student mental well-ness: one-on-one and group counselling sessions, charting fresh pathways networks of support available to students, creating a safe space for student and staff drop-ins, among other benefits to schools and stakeholders involved in the pilot. Results also detail three challenges leaders encountered along the way: stakeholder agreement, role clarity, and the temporary design of the role. Findings underscore how school-based social workers show promise in addressing rising mental health challenges. [ABSTRACT FROM AUTHOR]

In this research note, we present a critical moment we had as a research team in our work preparing qualitative data for its analysis in which an unanticipated social justice issue was triggered. The moment was related to determining the best ways to anonymize the information—in particular, how to replace what were perceived as "male" and "female" gendered names, family relationships, and roles with the labels of "she/her/mother/daughter" or "he/his/father/son". The paper begins with a review of the main "do's and don'ts" of data preparation, followed by our reflections of the social justice issue. Through our differently positioned reflections, we complicate the task of data preparation by revealing the ways in which cis-dominance is upheld by cis-normativity, cis-genderism, and heteronormativity. We end with recommendations for practices that uphold the values and goals of social justice by resisting cis-dominance and challenging the erasures of peoples with fluid genders and identities. [ABSTRACT FROM AUTHOR]

Objective: This paper updates clinicians and service leaders on evidence bases relevant to rehabilitation for older Australians with mental illness. Methods: Narrative review of literature and relevant public domain data supported by reflections on NSW service development. Results: There is a paucity of high-quality evidence regarding mental health rehabilitation in older people. Available evidence supports integrating lessons from physical healthcare with adaptations of 'adult' mental health rehabilitation. Adaptation is required to respond to the specific needs, strengths and service use of older people with mental illness. Challenges for older people include ageism, increased physical and cognitive comorbidities, lower access to mental health services and earlier residential aged care entry. Strengths of older people include an ongoing desire for recovery, ongoing developmental change and often closer connections with carers and GPs. Evidence is consistent with evaluation of relevant NSW service models and initiatives including the Pathways to Community Living Initiative. Integration of recovery-oriented practice and wellness models may provide a framework for future innovative inpatient and community-based models. Conclusions: There is sufficient evidence to guide development of models of rehabilitation with older people, but innovation and evaluation are essential if older people are to have equal opportunities in their recovery journeys. [ABSTRACT FROM AUTHOR]

Objective: Engagement with secondary mental health services after an emergency department presentation with suicidal behaviours may be an important strategy for reducing the risk of repeat attempts. Our aim was to examine secondary mental health service contact following a presentation to emergency department with suicidal behaviours. Methods: A systematic review of papers published between 2000 and 2020 was undertaken. This identified 56 papers relating to 47 primary studies. Data were extracted and summarised separately by age group: (1) young people, (2) older adults and (3) adults and studies with participants of 'all ages'. Results: Studies in young people (n = 13) showed, on average, 44.8% were referred and 33.7% had contact with secondary mental health services within 4 weeks of emergency department discharge. In comparison, in adult/all ages studies (n = 34), on average, 27.1% were referred to and 26.2% had mental health service contact within 4 weeks. Only three studies presented data on contact with mental health services for older adults, and proportions ranged from 49.0% to 86.0%. Conclusion: This review highlights poor utilisation of secondary mental health service following emergency department presentation for suicidal behaviours, and further research is needed to identify the reasons for this. Crucially, this information could assist in the allocation of resources to facilitate the timely implementation of suicide prevention services. [ABSTRACT FROM AUTHOR]

Background: Mental health issues are common among college students, and structured services have been proven to enhance outcomes. Despite increased enrolment for higher education in India, college mental health services remain sparse. JEEVANI is the first structured state-wide college mental health service in India. This paper describes its framework and provides an overview of its functioning during the initial five months. Methods: In 2019–2020, the Directorate of Collegiate Education, Government of Kerala, implemented the program in 66 colleges catering to approximately 60,000 students. Qualified counsellors were trained to identify issues and provide interventions and early referrals, using a stepped-care approach. They conducted awareness programs to promote mental health and reduce stigma. Results: The services were accessed by 2,315 students during the assessment period (October 2019 to February 2020). The beneficiaries were predominantly females (54.1%). Over a third (38.8%) belonged to the lower socio-economic strata, and 2.5% had significant vulnerabilities. Although no syndromal diagnoses were made, anxiety and depression were the most common presentations. The counsellors provided 3,758 individual sessions and facilitated support for students who reported academic difficulties or interpersonal issues. Severe mental illness was detected in 54 students, and referrals for specialist mental health input were initiated in 68. Conclusion: Describing the framework, sharing the technical material, and providing an overview of its functioning from a resource-constrained setting in India may encourage higher education institutions in low- and middle-income countries to consider similar projects. [ABSTRACT FROM AUTHOR]

Telepsychiatry is well established in many countries, but there is still little information about its use in routine health care. We reviewed the literature for information on the use of telepsychiatry in mental health services. From 1033 publications identifiedin the literature search and through references froma separate project, 16 studies or descriptions of the routine use of telepsychiatry services were selected for further review. Eleven of these articles dealt primarily with video conferencing and five with telephone-based services. Clinical use of video conferencing in the programmes described by the reviewed papers was modest, with an average of 16 consultations per month. Three of the telephone-based services had large numbers of clients. The papers we reviewed gave limited consideration to the healthcare systems in which telepsychiatry was provided and to the use of conventional mental health services. Telepsychiatry appears to still be a niche technology in many health systems. A lack of champions for the technology and reimbursement problems may contribute to the limited use of this area of telemedicine. [ABSTRACT FROM AUTHOR]

Objective: Managing mental health patients during the COVID-19 pandemic has been a global challenge. Current workforce arrangements tend to separate those skilled in caring for highly infectious medical patients from those whose specialism is in managing co-morbid mental health, substance misuse and/or behaviours of concern, including potential non-compliance with community or health care directives. This paper reports an innovative service development through the emergency establishment of a temporary COVID-positive mental health ward in response to a local outbreak in Melbourne. Method: A case study of service reorientation is presented, examining barriers and enablers to effective care of co-morbid mental illness, addiction and COVID-19. Results: Establishing a skilled multidisciplinary workforce across mental health and infectious disease is the most important consideration in optimising care. Other issues included suitable physical space, security arrangements and inter-disciplinary communication. Conclusions: The paper holds insights for managing mental health care during potential future infectious disease outbreaks across the country. [ABSTRACT FROM AUTHOR]

This article presents a description of a specific Indigenous research methodology, Kaupapa Māori Research (KMR), followed by a discussion of the potential contribution that KMR and other Indigenous frameworks make toward understanding and addressing widespread mental health inequities affecting the world's Indigenous peoples. The contribution of existing qualitative KMR to the fields of health and mental health in New Zealand is discussed, and innovative approaches employed within these studies will be outlined. This paper describes the utility of KMR methodology which informed the development of qualitative interviews and the adaptation of an analytic framework used to explore the impact of systems on the experiences of Māori (the Indigenous peoples of New Zealand) with bipolar disorder (BD). This paper adds to others published in this journal that describe the value, inherent innovation, and transformative potential of KMR methodologies to inform future qualitative research with Indigenous peoples and to enact systemic change. Transformation is achieved by privileging the voices of Māori describing their experiences of mental health systems; presenting their expert critique to those responsible for the design and delivery of mental health services; and ensuring equal weight is given to exploring the clinical, structural and organizational changes required to achieve health equity. It is proposed that this approach to research praxis is required to ensure that studies do not perpetuate institutional racism, which requires close adherence to Indigenous research priorities and partnership with Indigenous peoples in all steps of the research process. [ABSTRACT FROM AUTHOR]

The article discusses the theoretical objectives of liaison psychiatry. Information on the each style of liaison psychiatry, advantages and disadvantages is also presented. Liaison style provides wider psychiatric service and care tailored to patients' individual needs. In consultation style, patients are scattered through different medical wards and their psychological needs are left to busy nurses with no psychiatric knowledge.

Background: A recent UK Government draft Heath White Paper follows the NHS England long term plan when it states that NHS England requires "a new framework that builds on changes already being made as well as building in the flexibility to support the system to tackle challenges of the future". At present the structure of Health and Social Care Services UK reporting to Government seems unhelpfully complex and opaque. Objective: The purpose of this paper is to contribute to the building of a new framework using a generic approach to identify and use 'systemic processes' to facilitate the integration of Health and Social Care services in NHS England and elsewhere. Methods: We highlight some of the critical issues that are currently hindering integration and set out a new way of understanding the structure of NHS England through an 'inside-out' analysis of systemic processes. Results: We describe and give three examples of existing systemic processes as 'Consulting a patient', 'Enhancing a Single point of access' - to mental health services and 'Delivering health and social care services England'. Conclusions: Rethinking the interactions between existing organisations could arguably bring considerable benefits including cost savings, better co-ordination, less 'admin' stress on staff where the work is done and provide more organisational adaptability in an uncertain future. Ultimately our suggestions are aimed at helping people to deliver better patient care - the impelling purpose of all health and social care services. [ABSTRACT FROM AUTHOR]

Objectives: As mental health services move towards implementing 'Trauma-informed care', there is a need to consider the challenges posed within services and systems. This paper raises some of the challenges associated with integrating TIC into the current public mental health system.. Conclusion: The lack of clarity about expectations of trauma-informed approaches causes difficulties for its integration into services, but the wider political context of mental health services is also of relevance. Transparent and ongoing debate is required about approaches to mental health care, to ensure the system meets the needs of those who require it, while questioning what other purposes it may be serving at social and political levels. [ABSTRACT FROM AUTHOR]

Background: Eating disorders are as common in Māori, the Indigenous people of Aotearoa-New Zealand, as they are in non-Māori; however, research has focused on the experiences of non-Māori. This paper will describe explanatory factors, treatment experiences and what helps with recovery for Māori. Methods: Kaupapa Māori research methodology informed the methods and analysis. Fifteen semi-structured interviews comprised thirteen Māori participants with eating disorders (anorexia nervosa, bulimia nervosa and binge eating disorder) and two whānau (support network) members. A thematic analysis was undertaken by a first cycle of coding that used deductive structural coding to identify data describing participants' perceived causes of eating disorders, their experience of treatment and recovery. A second cycle of coding used inductive analysis with descriptive and pattern coding. Results: Three overarching themes were antecedents (cumulative exposure), treatment (a system of complexities) and recovery (resource empowerment). Antecedents comprised cumulative exposure to body and sporting ideals and adversity as causal factors of eating disorders. In the treatment theme, a system of complexities critiqued rural settings for generalised mental health services, allocation of Māori cultural support, the economic burden of treatment, culturally incongruent treatment (methods, values) and a weight-focused discharge criterion. Recovery (resource empowerment) found appropriate health information, self-determination and connection to Māori culture and whānau aspirations helped with recovery. Conclusion: The diversity of birdcalls reminds us of the individuality of eating disorders. Health practitioners are reminded that just as the Tūī, Kākā and Kererū possess their own unique birdcalls, so do Māori with eating disorders and their whānau have their own experiences, needs and required treatment responses. [ABSTRACT FROM AUTHOR]

Objective: Person-centred growth-oriented language and care are considered vital for achieving favourable outcomes in mental health care. Personal testimonies detailed in the Final Report of the Royal Commission into Victoria's Mental Health System (RCVMHS) illustrate the need for a more compassionate and hope filled system, and demonstrate the opportunity to achieve this through embedding best practice person-centred growth-oriented language. A current gap exists in understanding the process and language involved in individuals growing to mental health. Recovery has long been the paradigm for people in the mental health system 'returning to baseline', a stark contrast to our lived experience. We experienced a new beginning post decline, daily personal growth and healing, aiming for constant improvement as we work towards mental health, a status that many may not have even experienced before becoming unwell. Conclusions: Person-centred growth-oriented care includes healing, supportive relationships with the 'caregivers' ideally being transformation specialists; knowing and understanding the process of daily personal growth. While the system is metamorphosing, it is highly recommended to embed person-centred growth-oriented language and care to aid in the transformation of individuals in the service. [ABSTRACT FROM AUTHOR]

Objective: Clinical reasoning in psychiatry may be considered to be more challenging than in other branches of medicine because of its highly subjective nature. The literature on systematic approaches to the teaching of clinical reasoning in psychiatry is lacking, and we propose an approach that may assist educators and learners. Method: A systematic approach with a theoretical underpinning in logical inferences will be proposed as a teaching and learning tool. Conclusion: This paper complements our previous paper on psychiatric case formulation and expands our model of a theoretical framework for diagnostic reasoning and case formulation in psychiatry. Our approach also serves as a tool to assist in integrating the diverse clinical knowledge base in psychiatry. [ABSTRACT FROM AUTHOR]

Objective: Doctors' mental health has received increased focus recently and has been met with a variety of systemic responses. A Professional Support Unit (PSU) in a public hospital was established to address service gaps. This paper aims to describe the care of doctors referred to this service. Methods: Participants in the first four cases were referred to the PSU and assessed by the first author. Results: The cases revealed: (i) variety of referral sources, symptom presentations and backgrounds of doctors referred to a dedicated doctors' health service; and (ii) the person-centred, multi-modal treatments and adjunctive services required. Conclusion: Doctors' mental health is an urgent priority, with direct impacts on patient safety and care. The mix of patients presented here suggest difficulties beyond burnout and highlight the workings of a new service model designed to complement existing services in the Australian context. [ABSTRACT FROM AUTHOR]

Introduction: Challenges accessing behavioural health services in rural and underserved areas are compounded by severe shortages of behavioural health specialists, and difficulties placing patients. Tele-emergency (tele-ED) behavioural health is a promising solution for enhancing access to specialists and assisting in patient placement. This paper describes two tele-ED behavioural health models in the Midwest delivering mental- and substance use disorder services to rural and underserved adult populations.Methods: We performed an in-depth examination of two tele-ED behavioural health programmes and their consultation processes. We provide a retrospective case-control analysis of patient characteristics, patient diagnoses, and disposition status for each model. Data were collected from 19 spoke hospitals across the two programmes between November 2015 and December 2017.Results: Tele-ED was activated in 15% of the Avera Health sample and 58% of the Union Hospital sample. This is primarily a reflection of the sample selection process in each model and how each programme is operationalised. Suicide and/or poisoning by drugs were the most frequent diagnoses followed by mood disorders. Rate of transfer to another inpatient facility was much higher for tele-ED cases than controls in both models.Discussion: This paper describes how two distinct tele-ED behavioural health models operating in unique contexts address challenges in access and placement for patients in rural and underserved areas presenting to EDs with behavioural health conditions. The notable difference in disposition rates between cases and controls is indicative of the impact each model is having on care practices and processes. [ABSTRACT FROM AUTHOR]

Objective: We describe an independent model of clinical academic mental health services research that is able to provide synthesised views for medico-political organisations that are engaged in advocacy for national and state evidence-based policy and planning of mental healthcare.Conclusions: CAPIPRA focuses on independent research and policy analysis using publicly available datasets on population mental health at national and state/territory levels, published in international and national peer-reviewed journals (>50 papers since 2019). We partner with medico-political organisations in evidence-based advocacy across a wide range of issues. [ABSTRACT FROM AUTHOR]

Children entering custody within the child welfare system have been found to have high levels of trauma and significant behavioral health needs. In this paper, authors demonstrate how a structured functional well-being assessment can be used with the custody population to promote an understanding of behavioral health needs, inform case planning, and measure functional improvement over time. Specifically, this paper will: (a) briefly describe how two states implemented a common standardized assessment of functioning to inform case planning and measure well-being progress of children in the custody of a public child welfare system (b) examine what this common assessment tool reveals about the strengths and needs of children entering custody across two sites and (c) describe the magnitude of change in functional improvement measured across 6 months. This paper will contribute to the existing knowledge by sharing possible themes in functioning related to children entering custody while examining changes in functioning over time. Implications for practice, policy, and future research will be discussed. [ABSTRACT FROM AUTHOR]

Web-based interventions (WBIs) have become increasingly important in mental health treatment. At the same time, WBIs for individuals who committed sexual offenses against children (ICSOC) are increasingly being developed and implemented. Despite this trend, it is unclear which treatment components make WBIs for ICSOC effective and what needs to be considered for successful implementation. Moreover, only few evaluation studies are available. The goal of this viewpoint paper, that includes a comprehensive literature review, is to provide criteria for the development, evaluation, and implementation of WBIs for ICSOC or for individuals who feel at risk of committing sexual offenses against children. The criteria are drawn from guidelines for WBIs in general psychiatry, in forensic psychiatry, and for ICSOC. For the latter, an overview of current WBIs for ICSOC and for individuals who feel at risk of committing sexual offenses against children will be provided. [ABSTRACT FROM AUTHOR]

Recovery Colleges are an innovative education-based approach to support mental health recovery that, following the recent Royal Commission, will have to be established in every area mental health service within the state of Victoria. This paper describes the rationale, benefits and some of the key considerations to successfully establish Recovery Colleges. The establishment of Recovery Colleges has the potential to drive culture change within mental health services and embed recovery orientation within service provision as well as engaging service users in their own recovery journey. There are significant challenges, however, in implementing the collaborative, co-produced model within the constraints of a publicly funded mental health clinical service. This paper considers some of the practice implications for public mental health services in developing and integrating Recovery Colleges. The paper, like everything we do at the Recovery College, is co-produced and co-authored – in this case, by a lived experience expert, a medically trained expert and a research/writing expert. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Quantification of the social climate of mental health care environments has received considerable attention. Investigations of the resulting measures indicate that social climate is associated with individual outcomes including patient satisfaction and staff burnout. Interest has grown in developing interventions to improve social climate in anticipation of subsequent related benefits. This study aimed to identify and critically review research about the effectiveness of interventions for improving social climate in inpatient adult acute mental health settings. Methods: Systematic review reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Comprehensive terms were used to search multiple electronic databases from inception to July 2019. Information about intervention type(s), complexity was extracted and study quality was assessed. Results: Twenty-three papers met inclusion criteria of which 20 used a pretest–posttest study design and three employed randomized and/or controlled designs. Interventions were environmental/structural, operational/process-oriented and developmental/person-oriented in nature and they ranged in complexity. The Ward Atmosphere Scale was the most common outcome measure used. Following quality assessment, six studies were judged to be sufficiently robust in terms of quality, theory-base, user-inclusion, and outcomes evaluation to contribute credibly to the evidence base. Of these, four complex person- and process-oriented intervention studies and two less complex structural/environmental intervention studies resulted in positive outcomes. Conclusion: There is limited strong evidence that interventions positively influence measures of ward social climate in acute adult mental health settings. Such measures should not be the sole criterion of success when evaluating change. Decisions about implementing change to improve social climate should be informed by meaningful proxy measures including the views and preferences of service users and other stakeholders. Studies using stronger designs are required to establish the ability of interventions to improve social climate. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To describe a recent process by which mental health service sector leaders identified key elements of strategic, systemic and structural mental health reform. These elements could guide an incoming Federal government. Method: The paper describes the process undertaken by the Sydney Mental Health Policy Forum between 2019 and 2022. This work generated principles, key domains and finally a set of actions. Results: Five immediate actions were identified that are cost neutral or require minimal investment. Five further actions requiring realignment of existing funds and/or new funds were also identified. Conclusions: The task of mental health reform in Australia is both large and overdue. Continued investment in fragmented or piecemeal programmes and services will not propel desired change. Reform must facilitate new regional control of planning, funding and responding to community mental health needs. The actions identified by the Forum set out a menu of opportunities to guide reform over the life of the next Parliament, starting now. [ABSTRACT FROM AUTHOR]

Background: Cognitive behaviour therapy (CBT) is an empirically supported psychotherapy with applications across psychiatric disorders. The demand for nonpharmacological interventions is increasing in the developing world. Unfortunately, existing resources are unable to cater to treatment and training needs. Methods: The aim of the current paper is to provide a description of the format of a series of CBT training workshops and their clinical impact in a psychiatric tertiary care center in north India. Over a period of nine years, nine training workshops were conducted. CBT concepts and skills sets were inculcated in faculty and student participants, using teaching strategies based on adult learning techniques. Results: The workshops resulted in a tremendous increase in the number of patients taken up for CBT. While therapeutic and training outcomes were not systematically assessed, the naturalistic outcomes (60 out of 85 patients completed therapy; improvement reported by >90% of the completers) are encouraging and showcase capacity building by means of CBT training in these workshops. Conclusions: CBT training workshops are an effective way to impart CBT skills and, therefore, to build CBT expertise in a resource-poor setting. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the editor discusses the various articles published within the issue on such topics as men's mental health, mental health services, and victim-blaming in public health.

The global community has been significantly impacted by the COVID-19 global pandemic. LGBTQ+ (i.e., lesbian, gay, bisexual, transgender, queer, etc.) youth may face increased stressors amidst the pandemic given their significant mental and sexual health disparities, pervasive rejection — including quarantining in homes with heightened risk of abuse and victimization, and a lack of access to essential resources. Responsive supports are needed at this time for vulnerable LGBTQ+ youth, particularly tailored mental health supports. This critical reflexive paper will highlight, as qualitative social work researchers and practitioners, the swift response to the needs of vulnerable LGBTQ+ youth across Canada during this pandemic. We provide a transparent account of how we have utilized critical reflexivity, cultivated through qualitative research, to support LGBTQ+ youth. This article will elucidate the importance of critical reflexivity in effectively transitioning essential offline mental health services for LGBTQ+ youth to a technology-mediated mental health affirmative intervention. The aim of this paper is to provide qualitative researchers and practitioners practical direction through important insights gleaned by supporting marginalized LGBTQ+ youth during particularly trying times such as a global pandemic. [ABSTRACT FROM AUTHOR]

The article offers information about the position paper entitled "Share Mental Health Care in Canada", which proposes to enhance the working relationship between family physicians and psychiatrists. The working group of the Canadian Psychiatric Association and the College of Family Physicians of Canada has described the obligations and responsibilities of each of the two medical specialties in a proposed shared care model for the treatment of mental illness. The position paper highlights the current difficulties experienced between family physicians and psychiatrists, which poor communication and lack of contact between members of each of the 2 specialty groups.

This article is a reaction paper to the article in this journal issue entitled Human Service Cartels: The Soft Repression of the Mediocracy by David Stoesz. As such, it addresses two significant questions about the Stoesz article. One question is as follows: Are we really talking about a cartel? The other question is as follows: Isn't it the power elite that promotes societal control and repression? [ABSTRACT FROM AUTHOR]