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In this paper we respond to this special issue's critical focus on mental health in education by considering the medicalised and homogenising approaches to the mental health of young people and the severely negative consequences for young people. Our argument is underpinned by the need to destabilise the hegemony of the current dominant discourses and practices of mental health used in education. The problem with these discourses and practices, informed by particular forms of psychiatry and psychology, is precisely their dominance and their popularised proxy take-up of these. We firstly outline this problem, explore the emergence and saturation of a 'damaged self' in education and consider the impact on young people. We offer counter-narratives that involve a reframing of the self in relation to ethics, politics, capability and the arts and can assist in countering the psy-dominance in education. The paper concludes with some reflections on how teachers might work against the damaging effects of the psy-disciplines and instead support young people in finding their counter-narrative selves.

Service users and their families have raised concerns about safety in current acute mental health service delivery. Restrictive interventions are routinely used across mental health settings despite increasing awareness of the negative impacts. Underfunding and risk-averse management practices are implicated as key challenges. Utilizing a scoping review and thematic analysis method, this review explored the existing literature of mental health staff perspectives across various settings (including psychiatric wards and emergency departments), focusing on their experience of restrictive interventions. Four themes were developed: 1. Safety (both staff and patient); 2. Barriers to staff reducing their restrictive interventions; 3. Strength in current practice; 4. Recommendations for change. Key gaps in the literature were the limited perspectives of emergency and crisis clinicians (despite these areas being settings where restrictive interventions are utilized) and limited perspectives from allied health disciplines (despite their employment as clinicians in these settings). It also noted a divide between staff and patient safety, as though these concerns are mutually exclusive rather than cooccurring, which is the experienced reality. Advocacy bodies, governments and the media are calling for a reduction in restrictive interventions in crisis settings. This research synthesis proposes that, to achieve this, clinical staff must be involved in the process and their perspectives actively sought and drawn upon to enable reform. [ABSTRACT FROM AUTHOR]

This paper was written in the framework of my internship at the National Commission for Bioethics and Technoethics of the Hellenic Republic. It constitutes an attempt at exploring the ethical and legal dilemmas of the medical practice of telepsychiatry. Telepsychiatry, as well as other forms of telemedicine, has become a prevalent way through which patients gain access to healthcare and with many research papers reporting on its effectiveness and advantages, telepsychiatry has gained a lot of proponents in the scientific and healthcare community. However, several questions regarding the ethical and legal nature of the practice remain unanswered and this can put patients and other users of telemental health services under risk for basic rights violations. In this paper, at first the scientific data supporting the use of telepsychiatry will be cited. In addition to that, there will be discussion of several ethical dilemmas that have been reported concerning the use of telemedicine in psychiatry during the past few years and there will be reference to the medical code of ethics. Following that, there will be reference to the existing legislation for telepsychiatry in Greece and the legal issues that can arise will be analyzed. In spite of the fact that the advantages and ethical pitfalls of telepsychiatry are common in many countries, the focus of this paper will be on Greece’s code of medical ethics and legislation due to the lack of relevant bibliography on the matter, even though telepsychiatry is widely used by Greek patients. Finally some suggestions will be made on what ought to be ameliorated in regards to the current conditions, so as to make sure telepsychiatry is in line with the basic principles of bioethics. [ABSTRACT FROM AUTHOR]

Mental health services are under unprecedented pressure with overwhelming referrals and a current waiting list of 1.2 million people of all ages. The cross-government White Paper 'No health without mental health' was launched 12 years ago detailing the importance of wellbeing services in the creation of mentally healthy communities through health promotion and illness prevention. While primary care, community services and psychiatry are pivotal in the treatment of mental Illness/disorder, mental health care per se is on a continuum, and a great deal of work can be undertaken in communities by wellbeing services to prevent avoidable referrals. This paper proposes a broad framework of education and training for wellbeing/positive mental health services, primary and community care, and nurses working in Community Mental Health Treatment Teams and Home Treatment Teams to ensure all those working with potentially vulnerable adults and children are regulated and meet national standards for mandatory mental health education and training. [ABSTRACT FROM AUTHOR]

Personality disorders in homeless people pose a challenge to the medical community and society, requiring specialized approaches for these superdifficult patients. The prevalence of personality disorders is higher in homeless populations than in the general population. However, there is a knowledge gap regarding personality disorders among people experiencing homelessness, and the implications of this lack of recognition are substantial. This paper provides a brief narrative review of personality disorders among homeless individuals. The primary importance and specificity of these disorders in this population remain unexplored. We searched PubMed and Web of Science databases in February and November 2023 using the keywords 'homeless' and 'personality disorder', and selected fifty-eight studies to be included in this literature review. The main themes of the results were personality disorders in homeless individuals and comorbid psychiatric disorders; risk factors and other psychological and behavioral data; clinical and intervention outcomes; and challenges linked to assessment, treatment, and intervention. The homeless population experiences significant diagnostic variability and the diagnosis of personality disorders is still evolving, contributing to difficulties in diagnosis, assessment, and treatment. A future challenge is to raise clinical awareness and optimize research knowledge, assessment, and intervention in personality disorders among homeless individuals with comorbid psychiatric disorders. [ABSTRACT FROM AUTHOR]

Online self-diagnosis of psychiatric disorders by the general public is increasing. The reasons for the increase include the expansion of Internet technologies and the use of social media, the rapid growth of direct-to-consumer e-commerce in healthcare, and the increased emphasis on patient involvement in decision making. The publicity given to artificial intelligence (AI) has also contributed to the increased use of online screening tools by the general public. This paper aims to review factors contributing to the expansion of online self-diagnosis by the general public, and discuss both the risks and benefits of online self-diagnosis of psychiatric disorders. A narrative review was performed with examples obtained from the scientific literature and commercial articles written for the general public. Online self-diagnosis of psychiatric disorders is growing rapidly. Some people with a positive result on a screening tool will seek professional help. However, there are many potential risks for patients who self-diagnose, including an incorrect or dangerous diagnosis, increased patient anxiety about the diagnosis, obtaining unfiltered advice on social media, using the self-diagnosis to self-treat, including online purchase of medications without a prescription, and technical issues including the loss of privacy. Physicians need to be aware of the increase in self-diagnosis by the general public and the potential risks, both medical and technical. Psychiatrists must recognize that the general public is often unaware of the challenging medical and technical issues involved in the diagnosis of a mental disorder, and be ready to treat patients who have already obtained an online self-diagnosis. [ABSTRACT FROM AUTHOR]

Targeted school-based programs seem to be a promising approach to help adolescents in need. Nevertheless, successful implementation and evaluation of such programs is challenging. However, there is limited knowledge about (overcoming) the challenges of implementation and experimental evaluation of school-based programs. The goal of the present paper is, therefore, to improve future research by describing the challenges encountered and lessons learned during two randomized controlled trials (RCTs) to study the effectiveness of two skills-training programs reducing school or social stress. In this way, we aim to inform others who plan to implement and evaluate such programs in schools using an RCT design. Some of the challenges encountered apply to all effectiveness studies, such as the recruitment and retention of participants; others are more "intervention at school" specific, such as scheduling the programs and assessments. Our experiences show that it is possible to effectively implement and evaluate targeted programs promoting adolescent mental health in secondary schools with RCTs, even during a worldwide health pandemic, but that it requires investing sufficient time in keeping close and regular contact as well as clear communication between the involved parties. Moreover, high levels of flexibility are needed in adjusting scheduled meetings for intervention and research while keeping track of the entire process for each school and individual participant. [ABSTRACT FROM AUTHOR]

The Philippine Mental Health Act upholds the rights and inclusivity of all people, regardless of gender and sexual orientation, within mental health services and programmes. Nevertheless, a noteworthy challenge lies in the inadequate attention given to the needs of LGBT+ individuals within the medical and health professions education in the country. Therefore, it is imperative to integrate LGBT+ mental health into psychiatric residency training. To address this gap, this paper proposes the inclusion of concepts relevant to LGBT+ mental health, including minority stress, intersectionality, identity concealment and LGBT+-affirming practices, to enhance the understanding and response to the needs of LGBT+ Filipinos. [ABSTRACT FROM AUTHOR]

Accessible Summary What Is Known on the Subject What the Paper Adds to Existing Knowledge What Are the Implications for Practice Introduction Methods Findings Discussion Conclusion Following their experience, patients with physical restraints often experienced traumatic sensations. The experiences of healthcare professionals' (HCPs') are primarily concerned with moral distress or conflicts between loyalty to the treatment and oppression of the patient's freedom when implementing RIs. Improving the competency of HCPs can help establish therapeutic relationships rooted in compassionate care and facilitate appropriate assessments to determine whether and how often RIs are necessary. Furthermore, fostering an environment that guarantees patient safety and dignity, assuring a sufficient staffing ratio, and providing opportunities to share RI experiences can help improve the quality of care and build safe environments for RIs. Effective interaction between HCPs and patients, thorough patient assessment, and compassionate patient care may improve competency of HCPs intervene RIs procedures. Creating a safe therapeutic environment, including improvements to structural environments, increasing the staff‐to‐patient ratio, establishing organizational policies that guarantee staff debriefing, provide emotional support, provide appropriate training programs to HCPs to their coping skills during RIs also reduce the use of RIs and improve the quality of mental health care. Restrictive interventions (RIs) are used in psychiatric inpatient units for ensuring safety. However, few studies have comprehensively reviewed physical restraint and seclusion experiences from the perspectives of both patients and healthcare professionals' (HCPs'). This study aims to gain an in‐depth understanding of the RI experiences of mental health inpatients and HCPs.A meta‐synthesis was undertaken of qualitative studies exploring the RI experiences. Five electronic databases were searched and additional manual searches were performed for studies published within the last decade. Twelve articles were included, and a thematic analysis was conducted. The Critical Appraisal Skills Program (CASP) checklist was used to assess data quality.Two main subthemes were identified: ‘Competency of HCPs’ (three subthemes: interaction between patients and HCPs, assessment methods, and care) and ‘systems’ (three subthemes: environment, protocols with training, and debriefing), including both positive and negative experiences.The Competency of HCPs and the ward environment are critical factors related to patients' unmet needs. Effective interactions between HCPs and patients, thorough patient assessments, and compassionate patient care are important elements of RI implementation.An environment that guarantees safety and care with dignity, sufficient staffing ratios, and opportunities to share RI experiences may improve quality of care and create safe environments for RIs. [ABSTRACT FROM AUTHOR]

This paper investigates the trends in erectile dysfunction research by integrating individual keywords such as COVID-19, mental health, psychiatry, and drug use. The study spans a six-year period from September 21, 2017, to September 21, 2023, and utilizes resources from the National Library of Medicine. For instance, the quantity of relevant documents is determined using the Google search engine. A custom date range can be set on the browser via tools, and the search is limited to the nih.gov site domain. The phrase-site search command used is executed with "erectile dysfunction" COVID-19 site:nih.gov. The result revealed that from Sept 2021 to 2022, research on COVID-19 and erectile dysfunction spiked. However, the previous year saw a rise in studies linking drugs or mental health with erectile dysfunction. Meanwhile, psychiatry-focused publications have consistently grown. The time-series trends of erectile dysfunction linked to COVID-19 are substantiated by a comprehensive literature review. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: This article outlines the important and varied role of sports psychiatrists in Japan and highlights the unique challenges and contributions of sports psychiatry to improving the mental health and performance of athletes. The report emphasizes the need for accurate assessment, diagnosis and treatment of mental health problems in athletes and recognizes the cultural stigmas and pressures specific to competitive sport in Japan. Methods: The paper first reviews the development of sports psychiatry with reference to the founding principles of the International Society for Sports Psychiatry and the Japan Association of Sports Psychiatry. It examines the integration of sport into psychiatric care and vice versa and indicates the value of research in the relationship between exercise and mental well-being. Results: This paper also explores the development of comprehensive diagnostic guidelines, the creation of tailored therapeutic approaches in clinical practice, the promotion of collaborative research to advance the field, and the educational development of psychological specialists. The role of sport psychiatrists in education and public awareness is examined, as well as the importance of destigmatizing mental illness in sport and improving mental health literacy among athletes and their support networks. Conclusion: Overall, this article describes the evolving and multifaceted role of sports psychiatrists in Japan, highlighting their crucial contributions to athlete care, research, education and public awareness. It advocates a flexible and adaptable approach to meeting the ever-changing demands of sports and upholding the mental health needs of athletes.

Accessible summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? Introduction Aim Method Results Discussion Implications for Practice The use of restrictive interventions is described as a violation of patients' rights and autonomy. It must only be used as a last resort to manage dangerous behaviour, to prevent or reduce the risk of mental health patients harming themselves or others. International mental health policy and legislation agree that when restrictive interventions are applied, the least restrictive alternative should be chosen. The results are ambiguous, as to which restrictive intervention is preferred over others, but there are tendencies towards the majority preferring observation, with mechanical restraint being the least preferred. To make the experience less intrusive and restrictive, certain factors are preferred, such as a more pleasant and humane seclusion room environment, staff communicating during the application and staff of same gender applying the intervention. When applying restrictive interventions, mental health professionals should consider environment, communication and duration factors that influence patient preferences, such as the opportunity to keep some personal items in the seclusion room, or, when using restraint, to communicate the reason and explain what is going to happen. More research is needed to clarify patients' preferences regarding restrictive interventions and their views on which are the least restrictive. Preferably, agreement is needed on standard measures, and global use of the same definition of restrictive interventions. The use of restrictive interventions is a violation of patients' rights that causes physical and psychological harm and which is a well‐known challenge globally. Mental health law and legislative principles and experts agree that when restrictive interventions are applied, the least restrictive alternative should be used. However, there is no consensus on what is the least restrictive alternative, especially from the patient perspective.To investigate the literature on mental health patients' preferences regarding restrictive interventions applied during admission to a psychiatric hospital.An integrative review informed by the PRISMA statement and thematic analysis were undertaken.There were tendencies towards patients preferring observation and, for the majority, mechanical restraint was the least preferred restrictive intervention. Factors such as environment, communication and duration were found to influence patients' preferences.There is a lack of agreement on how best to measure patients' preferences and this complicates the choice of the least restrictive alternative. Nonetheless, our findings show that staff should consider environment, communication and duration when applying restrictive interventions.More research on restrictive interventions and the least restrictive alternative is warranted, but agreement is needed on standard measures, and a standard global definition of restrictive interventions. [ABSTRACT FROM AUTHOR]

Dissociative Identity Disorder is a mental disorder in which seemingly independent identities arise within the same body. It is a disorder that raises profound questions about our understandings of certain theological concepts and doctrines, especially if one can consider the different identities to be different persons. In this paper, I shall provide support for this claim by exploring the implications that Dissociative Identity Disorder can have for our understanding of the indwelling of the Holy Spirit. After outlining two models of the indwelling that have been proposed in the contemporary analytic literature, I am going to explain the problem that Dissociative Identity Disorder seems to raise for these models. I will then consider various potential solutions and shall highlight which I find to be the most convincing. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject What the paper adds to existing knowledge What are the implications for practice Introduction Aims Method Results Implications for practice The Health of the Nation Outcome Scales (HoNOS) is a widely used clinical measure designed to rate and monitor the outcomes of service users accessing specialist mental healthcare. Since its development (in 1996), numerous research studies have confirmed the HoNOS captures the aspects of care that it purports to (validity), and that clinicians' ratings are consistent both over time, and between different raters (reliability). In 2018, the HoNOS was reviewed with updates made to some terminology and other revisions intended to remove ambiguity in the guidance for raters. However, although the new version (HoNOS 2018) was accompanied by a recommendation that its validity and reliability be re‐tested this was not undertaken. To our knowledge, this is the first study to re‐assess the updated tool's reliability by measuring the level of agreement between different raters. Our findings confirm that there is an acceptable level of consistency between student mental health nurses that have been trained to use the (new) HoNOS 2018. The HoNOS is nationally mandated for use by all specialist mental healthcare providers in the UK. Our findings provide some assurance that, with appropriate update training and monitoring of organisational‐level data sets, the original HoNOS glossary can safely be replaced with the HoNOS 2018 to ensure more contemporary routine outcome measurement can occur. The Health of the Nation Outcome Scales (HoNOS) is a well‐established clinician rated outcome measure for use in mental health services. Following an international review, an updated version (HoNOS 2018) was published with a recommendation that its psychometric properties be re‐tested prior to widespread implementation. To date, only one such study has been published.To test the inter‐rater agreement levels for HoNOS 2018.Third‐year student mental health nurses received training to complete the HoNOS 2018. Following this timetabled session, they were each invited to independently rate two, randomly selected, videos of (simulated) patient interviews. The resulting data were then analysed to calculate the tool's internal consistency and inter‐rater agreement levels.The 55 participants provided 106 ratings from four vignettes. Cronbach's alphas and McDonalds omegas confirmed the revised tool's internal consistency was acceptable. Average measure intraclass correlation coefficients for the four patient vignettes indicated excellent reliability.This study provides initial assurance that the HoNOS 2018 is a reliable clinician rated outcome measure suitable for use in routine clinical practice by relatively inexperienced mental health practitioners with limited training. [ABSTRACT FROM AUTHOR]

Accessible summary What Is Known on the Subject? What the Paper Adds to Existing Knowledge What are the Implications for Practice? Introduction Aim Methods Results Discussion Implications for Practice Mental health care can be delivered remotely through video and telephone consultations. Remote consultations may be cheaper and more efficient than in person consultations. Accessing community mental health care through remote consultations is perceived as not possible or beneficial for all service users. Delivering remote consultations may not be practical or appropriate for all clinicians or community mental health teams. Remote consultation cannot be a ‘one‐size‐fits‐all’ model of community mental health care. A flexible approach is needed to offering remote consultation that considers its suitability for the service‐user, service and clinician. Responding to COVID‐19, community mental health teams in the UK NHS abruptly adopted remote consultations. Whilst they have demonstrable effectiveness, efficiency, and economic benefits, questions remain around the acceptability, feasibility and medicolegal implications of delivering community mental health care remotely.To explore perceived advantages, challenges, and practice adaptations of delivering community mental health care remotely.Ten community mental health teams in an NHS trust participated in a service evaluation about remote consultation. Fifty team discussions about remote consultation were recorded April–December 2020. Data analysis used a framework approach with themes being coded within a matrix.Three major horizontal themes of operations and team functioning, clinical pathways, and impact on staff were generated, with vertical themes of advantages, challenges, equity and adaptations.Remote consultation is an attractive model of community mental healthcare. Clinical staff note benefits at individual (staff and service‐user), team, and service levels. However, it is not perceived as a universally beneficial or practical approach, and there are concerns relating to access equality.The suitability of remote consultation needs to be considered for each service‐user, clinical population and clinical role. This requires a flexible and hybrid approach, attuned to safeguarding equality. [ABSTRACT FROM AUTHOR]

Dans cette communication, nous montrons que la littérature sur la prévalence des troubles psychiatriques et liés à l'usage de substances en milieu pénitentiaire est riche. Son interprétation se heurte toutefois à plusieurs difficultés : (i) une grande hétérogénéité des systèmes judiciaire et de soins de santé mentale entre les pays et (ii) des spécificités de l'environnement carcéral parfois négligées dans la méthodologie des études. Forts de ce constat, nous développons les résultats d'un certain nombre de travaux de référence sur la prévalence des troubles psychiatriques et liés à l'usage de substances dans les prisons françaises. Nous discutons enfin les perspectives en termes d'épidémiologie psychiatrique en milieu pénitentiaire. In this paper, we show that the literature on the prevalence of psychiatric and susbtance use disorders in prisons is substantial. However, there are a number of difficulties one encounters in interpreting this literature: (i) there is considerable heterogeneity between countries' judicial and mental health care systems, and (ii) the specific features of the prison environment are sometimes overlooked in the methodology used to conduct such studies. With this in mind, we discuss a number of benchmark studies on the prevalence of psychiatric and substance use disorders in French prisons. Finally, we discuss the perspectives for psychiatric epidemiology in prisons. [ABSTRACT FROM AUTHOR]

Nurses working in correctional and forensic mental health settings face unique challenges in the provision of care to patients within custodial settings. The subjectivities of both patients and nurses are subject to the power relations, discourses and abjection encountered within these practice milieus. Using a poststructuralist approach using the work of Foucault, Kristeva, and Deleuze and Guattari, this paper explores how both patient and nurse subjectivities are produced within the carceral logic of this apparatus of capture. Recognizing that subjectivities are fluid and dynamic, and capable of change, Deleuze and Guattari's concept of deterritorialization will illustrate opportunities for resistance, where nurses can begin to practice outside the dominant carceral logic (and restrictions) of the system. [ABSTRACT FROM AUTHOR]

ObjectiveThe concept of caring stress and its specific management has received less attention than other dimensions of stress in nurses. Therefore, to clarify the concept of caring stress, a scoping review study was designed. This scoping review aimed to investigate the concept of caring stress among clinical nurses and examine the strategies used for its management.MethodsThis review employed a scoping review methodology to comprehensively map the essential concepts and attributes of the phenomenon by drawing on a wide range of sources. International databases including PubMed, Scopus, Web of Science, Google Scholar, and Scientific Information Database (SID) were searched to gather relevant studies published until October 1, 2023. MESH terms included “caring stress”, “care”, “stress”, “nurse”, and “stress management” were used. Two reviewers independently collected data from full-text papers, ensuring that each paper underwent assessment by at least two reviewers.ResultsOut of 104,094 articles initially searched, 22 articles were included in this study. High workloads, transmitting the infection, stressful thoughts, stressful emotions, and stressful communications were the significant concepts and factors of caring stress among nurses. Also, rest breaks during patient care shifts, playing music in the ward, and denial of critical situations were examples of positive and negative coping and management ways to reduce caring stress.ConclusionEffective stress management strategies can lead to better patient care and safety. Stressed nurses are more likely to make errors or become less vigilant in their duties, impacting patient outcomes. By addressing caring stress, clinical practice can prioritize patient well-being. Further research is required to delve deeper into this critical issue concerning nurses in the future.

In the face of the unprecedented public health crisis caused by the novel coronavirus pneumonia epidemic, front-line health workers are under enormous mental pressure. This paper aims to explore the mental health challenges faced by front-line health workers in the early stages of a public health emergency, such as stress, anxiety, and depression. At the same time, the factors that increase their mental stress are analyzed, and practical measures are put forward to prevent and manage mental health problems, aiming at improving the quality of medical treatment during public health emergencies. This paper has some reference value for people engaged in mental health prevention.

Recent developments in the fields of natural language processing (NLP) and machine learning (ML) have shown significant improvements in automatic text processing. At the same time, the expression of human language plays a central role in the detection of mental health problems. Whereas spoken language is implicitly assessed during interviews with patients, written language can also provide interesting insights to clinical professionals. Existing work in the field often investigates mental health problems such as depression or anxiety. However, there is also work investigating how the diagnostics of eating disorders can benefit from these novel technologies. In this paper, we present a systematic overview of the latest research in this field. Our investigation encompasses four key areas: (a) an analysis of the metadata from published papers, (b) an examination of the sizes and specific topics of the datasets employed, (c) a review of the application of machine learning techniques in detecting eating disorders from text, and finally (d) an evaluation of the models used, focusing on their performance, limitations, and the potential risks associated with current methodologies.

Adverse climatic changes around the globe and predictions of catastrophic and irreversible alteration in global weather patterns, temperature rise, and coast-line habitability require a careful examination of consequences on the resilience and mental health of people who will endure these changes. This paper is concerned with the South Pacific region. This geography has benefited from a relatively stable climate that is seen in the lush and vibrant natural world with many unique species of plants and animals exclusively found here. This paper examines the psychological profile of the people in the South Pacific using an evolutionary framework, and considers their local climate risks and lifestyle patterns with the aim of exploring possible mental health trajectories.

Background: This study aims to identify disability classes among people with schizophrenia spectrum disorder, depression, anxiety or diabetes via the WHODAS 2.0; investigate the invariance of disability patterns among the four diagnostic groups; and examine associations between disability classes and sociodemographic variables. Methods: Patients seeking treatment for schizophrenia spectrum disorder, depression, anxiety or diabetes (n=1076) were recruited. Latent class analysis was used to identify disability classes based on WHODAS 2.0 responses. Measurement invariance was tested using multi-group latent class analysis. Associations between classes and sociodemographic variables were tested via multinomial logistic regression. Results: A five-class solution was identified; examination of model invariance showed that the partially constrained five-class model was most appropriate, suggesting that class structure was consistent while class membership differed across diagnostic groups. Finally, significant associations were found between class membership and ethnicity, education level, and employment status. Conclusions: The results show the feasibility of using the WHODAS 2.0 to identify and compare different disability classes among people with mental or physical conditions and their sociodemographic correlates. Establishing a typology of different disability profiles will help guide research and treatment plans that tackle not just clinical but also functional aspects of living with either a chronic psychiatric or physical condition. [ABSTRACT FROM AUTHOR]

Background: Transgender, non-binary, and/or gender expansive (TNG) individuals experience disproportionately high rates of mental illness and unique barriers to accessing psychiatric care. Integrating TNG-specific psychiatric care with other physical health services may improve engagement, but little published literature describes patient and clinician perspectives on such models of care. Here we present a formative evaluation aiming to inform future projects integrating psychiatric care with physical health care for TNG individuals. Methods: In this qualitative pre-implementation study, semi-structured interview guides were developed informed by the Consolidated Framework for Implementation Research to ensure uniform inclusion and sequencing of topics and allow for valid comparison across interviews. We elicited TNG patient (n = 11) and gender-affirming care clinician (n = 10) needs and preferences regarding integrating psychiatric care with other gender-affirming clinical services. We conducted a rapid analysis procedure, yielding a descriptive analysis for each participant group, identifying challenges of and opportunities in offering integrated gender-affirming psychiatric care. Results: Participants unanimously preferred integrating psychiatry within primary care instead of siloed service models. All participants preferred that patients have access to direct psychiatry appointments (rather than psychiatrist consultation with care team only) and all gender-affirming care clinicians wanted increased access to psychiatric consultations. The need for flexible, tailored care was emphasized. Facilitators identified included taking insurance, telehealth, clinician TNG-competence, and protecting time for clinicians to collaborate and obtain consultation. Conclusions: This health equity pre-implementation project engaged TNG patients and gender-affirming care clinicians to inform future research exploring integration of mental health care with primary care for the TNG community and suggests utility of such a model of care. [ABSTRACT FROM AUTHOR]

Background: A growing body of research is addressing the process and science of engaging people with lived experience (PWLE) of mental health challenges and other psychiatric conditions, and family members, in research activities. Objective: This scoping review of reviews synthesizes literature reviews on the engagement of PWLE and family members in research across the field of psychiatry. Method: Systematic searches were conducted in seven bibliographic databases. Records were independently screened first at the title and abstract level, then at the full‐text level. Included were any literature synthesis studies published in English, French, or Spanish in any given year, focusing on the engagement of PWLE and/or family members in research within psychiatry. Twenty records were included. Data were extracted in a spreadsheet and codebook thematic analysis was used across the body of articles to synthesize the findings. Results: Aspects of PWLE engagement have been synthesized in 20 review articles reviewing 376 articles across psychiatry as a whole and several subpopulations, including youth mental health, dementia, neurodevelopmental disorders, people who use drugs, and forensic mental health. Information specific to family engagement is lacking. Barriers, facilitators, and positive impacts of PWLE engagement have been widely reported across domains of research, with a considerable degree of consensus across subpopulations. Some negative impacts and reporting challenges have also been identified. Discussion: This scoping review of reviews provides an overarching understanding of the current state of the science of PWLE and family engagement across psychiatry research. The findings can inform future research practices enriched with a genuine and effective engagement with PWLE and families. Patient or Public Contribution: The authorship team includes members with intersecting lived experience and academic identities. Additional lived experience engagement was not conducted as part of this review. [ABSTRACT FROM AUTHOR]

Ramos et al. paper offers a narrative review of Spanish Organic Law 3/2021, which regulates euthanasia, focusing on its application to individuals with mental disorders. Ramos et al. examine the application of legal prerequisites from an ethical-legal perspective to ascertain the conditions under which psychiatric euthanasia might be considered legitimate and compliant with legal stipulations. Nevertheless, it is apparent that the core ethical inquiries linked to this matter have not been exhaustively investigated. The criteria laid out are, in our assessment, still open to further debate and broader deliberation. Our article emphasizes the need for a comprehensive ethical and legal debate in Spain regarding psychiatric euthanasia. Competency assessment is central to the legislation, but there are concerns about the validity of assessment tools and the subjective nature of interviews. Furthermore, defining irreversible suffering in mental health contexts poses challenges. The article advocates for a deeper understanding of the needs of individuals with mental disorders before considering euthanasia and emphasizes the importance of comprehensive care and psychosocial interventions in reducing the desire for euthanasia. Ultimately, it underscores the ethical complexities of euthanasia in mental health and the necessity of prioritizing comprehensive care in addressing these complexities. [ABSTRACT FROM AUTHOR]

Background: We provide an overview of Qatar's first epidemiological study on prevalence, predictors, and treatment contact for mood and anxiety disorders. Aims: We highlight the importance of the three‐pronged study, its aims, and its key components. Materials & Methods: The first component comprised a probability‐based representative survey of Qatari and non‐Qatari (Arab) adult males and females recruited from the general population and interviewed using the International Diagnostic Interview (CIDI version 3.3). The second component, a clinical reappraisal study, assessed concordance between diagnoses based on the CIDI and independent clinical assessments conducted by trained clinical interviewers. The third component comprised a resting‐state functional magnetic resonance imaging study of healthy survey respondents who were matched to patients with psychosis. Results: 5000 survey interviews provided data on prevalence and treatment of common mental disorders. Clinical re‐interviews (N = 485) provided important diagnostic validity data. Finally, state‐of‐the art structural and functional brain markers for psychosis were also collected (N = 100). Discussion: Descriptive epidemiological data were collected to inform future mental health priorities in Qatar and situates these within a global context. Conclusion: The study fills important gaps in regional and global estimates and establish necessary baseline to develop comprehensive risk estimates for mental health in Qatar's young population. [ABSTRACT FROM AUTHOR]

The fundamental right to equivalence of health care in prison settings encompasses the provision of medication to address mental health conditions. Considering the increased risk for self-harm among individuals dealing with depression, the limited effectiveness of conservative antidepressants is a major challenge in psychiatry. The high prevalence of suicidal tendencies within prison populations underscores the imperative for state-of-the-art pharmacological treatment to uphold adequate health care standards. Notably, the denial of access to effective medication could be deemed a violation of human rights of people living in prison according to international treaties, domestic law, and United Nations normative standards of detention. This article presents the authors' perspective on the accessibility of ketamine treatment in prison settings, discussing psychiatric and legal considerations as well as current challenges in this context. Implementing novel psychopharmacological interventions may alleviate the distress experienced by individuals struggling with depressive symptoms and suicidality. At the same time, unprecedented treatment alternatives bring along potential issues, including limited understanding of long-term effects and the risk of abuse. Given the scarce data-availability, a pressing need exists for further research on the benefits and risks of ketamine treatment within prison populations. [ABSTRACT FROM AUTHOR]

Background: While literature is abundant on the negative mental health impact of the COVID-19 outbreak, few studies focus on the Central and Eastern European region. Objectives: We examined stress, burnout, and sleeping troubles among mental health professionals in the context of psychosocial risk factors related to participation in COVID care during the fourth and fifth waves. Materials and methods: Mental health professionals (N=268) completed an online cross-sectional survey in Hungary, between November 2021 and April 2022. Of the respondents, 58.2% directly participated in COVID care. The main data collection instrument was the Copenhagen Psychosocial Questionnaire (COPSOQ II), including 20 subscales on work-related psychosocial factors and 3 outcome scales (stress, burnout, and sleeping troubles). We added a question on competence transgression, and items on sociodemographic and professional background. Results: Participation in COVID care was associated with higher work pace (59.08 versus 49.78), more role conflicts (55.21 versus 45.93), lower scores on the influence at work (38.18 versus 51.79), predictability (44.71 versus 57.03), reward (55.82 versus 65.03), role clarity (70.19 versus 75.37), social support from supervisor (59.24 versus 65.55), job satisfaction (54.36 versus 62.84), trust regarding management (55.89 versus 67.86), justice and respect (44.51 versus 54.35) scales. Among those involved in COVID care, only the stress score was higher (47.96 vs. 42.35) in the total sample; however, among psychiatrists, both stress (52.16 vs. 38.60) and burnout scores (58.30 vs. 47.06) were higher. Stepwise multiple regression revealed that work-family conflict, emotional demands and workplace commitment were independent predictors of higher stress and burnout scores; furthermore, competence transgression had a significant effect on stress, and being a psychiatric specialist had a significant effect on burnout. These models explained 40.5% of the variance for stress and 39.8% for burnout. Conclusion: During the fourth and fifth waves, although COVID care was more well-organized, psychiatrists, as specialist physicians responsible for the quality of the care, were still experiencing challenges regarding their competence and influence at work, which may explain their increased levels of stress and burnout. [ABSTRACT FROM AUTHOR]

Recent studies have illuminated the potential harms associated with ultra-processed foods, including poor mental health, aggression, and antisocial behavior. At the same time, the human gut microbiome has emerged as an important contributor to cognition and behavior, disrupting concepts of the biopsychosocial 'self' and raising questions related to free will. Since the microbiome is undeniably connected to dietary patterns and components, the topics of nutrition and microbes are of heightened interest to neuroscience and psychiatry. Research spanning epidemiology, mechanistic bench science, and human intervention trials has brought legitimacy to nutritional criminology and the idea that nutrition is of relevance to the criminal justice system. The individual and community-level relationships between nutrition and behavior are also salient to torts and the relatively new field of food crime—that which examines the vast harms, including grand-scale non-communicable diseases and behavioral outcomes, caused by the manufacturers, distributors, and marketers of ultra-processed food products. Here in this essay, we will synthesize various strands of research, reflecting this emergent science, using a notable case that straddled both neurolaw and food crime, Huberty v. McDonald's (1987). It is our contention that the legalome—microbiome and omics science applied in neurolaw and forensics—will play an increasing role in 21st-century courtroom discourse, policy, and decision-making. [ABSTRACT FROM AUTHOR]

Background: Little information is available on the association between gender nonconformity during adolescence and subsequent mental health. While the distress related to gender nonconformity may be socially produced rather than attributed to individual-level factors, further research is needed to better understand the role of psychosocial factors in this context. Method: We analyzed data from the Tokyo Teen Cohort, obtained through random sampling of adolescents born between 2002 and 2004. We used inverse probability weighting to examine the association of gender nonconformity at ages 12 and 14 as a time-varying variable with subsequent mental health at age 16, while accounting for time-fixed and time-varying confounders. Furthermore, we used a weighting approach to investigate the mediating role of modifiable psychosocial factors in this association, addressing exposure-mediator and mediator–mediator interactions. Results: A total of 3171 participants were analyzed. Persistent gender nonconforming behavior at ages 12 and 14 was associated with subsequent depression (β = 2.02, 95% confidence interval [CI] 0.85 to 3.19) and psychotic experiences (β = 0.33, 95% CI 0.14 to 0.52) at age 16. The results remained robust in sensitivity analyses. Approximately 30% of the association between gender nonconformity and depression was consistently mediated by a set of psychosocial factors, namely loneliness, bullying victimization, and relationships with mother, father, and friends. Conclusions: Persistent gender nonconformity during adolescence is associated with subsequent mental health. Psychosocial factors play a vital mediating role in this association, highlighting the essential need for social intervention and change to reduce stigmatization and ameliorate mental health challenges. [ABSTRACT FROM AUTHOR]

Background: There is a growing consensus to reduce the use of restrictive care practices in mental health settings to minimise the physical and psychological complications for patients. However, data regarding restrictive care practice use and factors contributing to variations in the proportion estimates has not previously been synthesised. Aims: This study aimed to synthesise evidence on (1) the pooled proportions of physical restraint, seclusion or chemical restraint in adult mental health inpatients and (2) sources of variability in these proportion estimates. Methods: Studies were identified from Scopus, MEDLINE, PsycINFO, Web of Science, Embase and CINAHL databases following the PRISMA 2020 guidelines. We conducted a meta‐analysis of studies published in English language from 1 January 2010 to 15 August 2022. Binomial data were pooled using a random effect model, with 95% confidence intervals. Meta‐regression was also computed to identify factors that may contribute to variations in the proportion estimates. Results: A total of 77 studies were included in this meta‐analysis. The pooled prevalence of physical restraint, seclusion and chemical restraint was 14.4%, 15.8% and 25.7%, respectively. Data were heterogeneous across studies (I2 > 99%). Reporting practices and geographical locations contributed to the variability in the reported estimates of restrictive care practices, with studies from Asian countries reporting higher proportions. Conclusion: There appear differences between geographical locations in the proportion of restrictive practices in mental health inpatients; however, this is complicated by how these prevalence data have been measured and defined. Consistency in the reporting of restrictive care practices in mental health is required to make valid comparisons between geographical regions, policy settings and practice innovations. Relevance to Clinical Practice: Efforts are needed to develop training programmes and policy changes to ensure consistency in defining and reporting of restrictive care practices in mental health facilities. Patient/Public Contribution: This is a systematic review that analysed data from previously published studies, and there was no patient/public contribution in this study. Protocol Registration: The protocol for this review has been registered to PROSPERO: CRD42022335167. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Dermatological diseases are a common clinical problem in medical practice. Various groups of medications are used in their treatment. Psychiatric disorders also present a significant challenge for modern medicine, some of them may have iatrogenic origins. This study analyzes drugs used in dermatological diseases and their impact on mental health. REVIEW METHODS: This review of the literature collects data from PubMed and Google Scholar about medications used for treating dermatological conditions and their potential impact on mental health. THE STATE OF KNOWLEDGE: Acyclovir, valacyclovir, chloroquine, hydroxychloroquine, tetracyclines, retinoids, glucocorticoids, 5-alpha-reductase inhibitors, dapsone and methotrexate are mentioned in the literature as possible, but rare causes of the onset/exacerbation of various psychiatric symptoms. Comparing to general population, patients with skin disorders suffer more often from depression and anxiety. Those two diseases are mentioned most frequently in the context of psychiatric side effect of drugs discussed in the article. SUMMARY: Psychiatric side effects of drugs used in dermatology are not common. However, given the rising incidence of mental health disorders worldwide, it is important to be aware of them. [ABSTRACT FROM AUTHOR]

This article presents the findings of an Arts and Humanities Research Council (AHRC) project, Objects of the Mind: engaging publics in the material cultures of media and mental health (AH/W002140/1), which was co-investigated by academics at the University of East Anglia and the University of Manchester and curators from across the Science Museum Group (SMG). Through this coinvestigation we sought to tap into public interest in the SMG object collections and the accessibility of popular films (supplied by partners StudioCanal) to engage new audiences for our research on the interactions of psychiatry and cinema. From the museum perspective, we sought to use this research to ask new questions and tell new stories about the SMG objects, and to foster crosscollection dialogue between medicine (Science Museum) and media (National Science and Media Museum) collections. We discuss a range of events, activities and outputs we delivered towards these aims, but focus particularly on three new films we produced that (re)combined museum objects, feature film clips and expert interviews to tell new, enhanced or entangled stories about and across the collections. We will use these three short films to demonstrate three dialogues the project fostered: between museum collections; between histories; and between academic disciplines. [ABSTRACT FROM AUTHOR]

Researchers who are aiming to conduct high quality mental health research in resettled refugee populations are likely to experience multiple challenges in their work. To our knowledge, there is no overview of these challenges and their implications for the quality of research from a researchers' perspective. We conducted a systematic literature search to further complete the overview of challenges. Lastly, we placed the findings of the thematic analysis and the literature search in a conceptual framework derived from the social ecological model of Bronfenbrenner. Our findings indicate that common research challenges, such as high drop-out rate or low treatment fidelity, must be understood in the light of multiple levels such as the individual, microsystem, mesosystem, exosystem and macrosystem level. This will help future researchers to increase the understanding of the complex interplay of factors that play a role when facing challenges in their work and to create possibilities for improvement. [ABSTRACT FROM AUTHOR]

A zero-risk paradigm currently dominates the organization and delivery of mental health care within inpatient settings, giving rise to a proliferation of risk management strategies that are ineffective and produce harms. Drawing on Foucault's confinement and grounded in a comprehensive analysis of the extant literature, we identify three central processes that constitute this paradigm, including: risk is situated within the patient; eliminating risk is a foundational aim; and mental health professionals lead decision-making. Responding to the zero-risk paradigm, this paper proposes a novel safety paradigm comprised of four intersecting components, undertaken collectively by mental health professionals to guide practice: i) holding risk, ii) building capacity, iii) prioritizing relationships, and iv) re-envisioning environments. Foundationally underlying these commitments is direct action toward reducing coercive practices and structures, such as chemical and physical restraints, seclusion, and door locking. Mental health professionals are encouraged to challenge the zero-risk paradigm and its resultant risk management approaches, and embrace a safety paradigm to meaningfully re-orient care toward enhancing patients' safety and well-being during and following hospitalization.

The overlapping COVID-19 crisis and the war starting in 2022 threaten front-line healthcare workers’ mental health, well-being and job retention in Ukraine. This paper provides a synopsis of a panel discussion held by the Global Mental Health Humanitarian Coalition in May 2022 and expert consultations with clinicians between December 2022 and February 2023 on these challenges. The crises created new problems and exacerbated many pre-existing difficulties. We found that healthcare workers had needed to mobilise previously untapped strengths, including portable emergency medical documents and bespoke local psychosocial support services, amid the costs and pressures of ongoing healthcare reforms.

The Philippine Mental Health Act upholds the rights and inclusivity of all people, regardless of gender and sexual orientation, within mental health services and programmes. Nevertheless, a noteworthy challenge lies in the inadequate attention given to the needs of LGBT+ individuals within the medical and health professions education in the country. Therefore, it is imperative to integrate LGBT+ mental health into psychiatric residency training. To address this gap, this paper proposes the inclusion of concepts relevant to LGBT+ mental health, including minority stress, intersectionality, identity concealment and LGBT+-affirming practices, to enhance the understanding and response to the needs of LGBT+ Filipinos.

Abstract: Introduction: Concern about mental health is an increasingly relevant topic in high-performance sport. In this regard, because burnout can be harmful to both the health and performance of athletes, it is of particular importance. Although a great deal of time and effort has been dedicated to the study of athlete burnout, there are still issues that require further work. Therefore, in the present paper, we aim to highlight what, in our perspective, are the most important unsolved issues regarding burnout in athletes. Methods: We brought together expert athlete burnout scholars to offer their perspectives on five unresolved issues in this research area. Results: We describe the following five issues that require further research attention: (i) burnout as a syndrome, (ii) the negative consequences of burnout, (iii) the role of recovery in burnout, (iv) the importance of the social environment, and (v) developing effective interventions to reduce/prevent burnout. Conclusion: Our commentary provides suggestions for future research to help solve these problems, advance our understanding of athlete burnout, and ultimately safeguard the mental health of athletes.

Purpose: This paper describes and documents an innovative blended learning Global Mental Health: Trauma and Recovery certificate training course. This course combines a two-week face-to-face training in Orvieto, Italy with a five-month follow-up online virtual training as a learning experience for global health care practitioners. Continuing medical education (CME) accreditation is offered upon completion. This course utilized an innovative blended learning model with a community of practice approach, a combination of lectures and discussions, and online in-depth group case study discussions.

The Chapter 5 of the Mental Healthcare Act, 2017, referred henceforth as “the Act,” lays down the “rights of person with mental illness” and it forms the core depth of this legislation. The Act makes provision for the care, treatment, and rehabilitation measures to reduce its recurrence. One of the main objectives of the Act is to make inclusion and rehabilitation of mentally ill persons into the society and help in eliminating the stigma attached to mental illness in India. The significance of the new Act is seen as soon as one turns to the facts, an estimated that 20% of Indians are likely to suffer from depression and 14% of Indians have mental disorders as per a WHO report. The Act covers everything from common to severe mental disorders and from mental hospitals to primary health-care centers. The Act decriminalizes the attempt of suicide having the presumption that the person who attempted suicide has undergone severe stress, and the Act mandates helping the person rather than punishing them. The Act provides the right of having access to treatment at affordable cost, and of good quality. The government must provide for a range of services including outpatient as well as inpatient services, medicines free of cost, specialized services of children and adolescents, etc. Another key feature is the implementation of medical insurance for treating those with mental illness at parity with physical illness by all insurers. However, the Act also has some shortcomings such as there is the breach of the fundamental right – “right to privacy” as the Act provides power to the nominated representative to unlimited access to the records of the persons with mental illness. Then, there is the question of the feasibility of implementation of the Act, which is the scarcity of resources, under the budget allocated to the National Mental Health Programme was just rupees 40 crores in FY18. This means that the budget allocated in India for mental health makes up only 0.06% of the total health-care budget. Further, there are only 3800+ registered psychiatrists in India when the need is for at least 13,500 psychiatrists, this explains the 80%–90% treatment gap that exists in India. Under the Act, individual persons living without family members or caregivers would struggle to get appropriate care in a Mental Health Establishment if their capacity is limited, by a mental disorder, even if it is limited for a short while if the medical practitioner tries to treat a person without valid consent, this might make them vulnerable to be charged for negligence and/or be prosecuted for assault or battery. Furthermore, the Act is silent on matters such as management of properties of persons with severe mental illness, rehabilitation, and integration of homeless mentally ill into the community. The Act further provides the police with the power to enter a person's private residence (without a magistrate's approval) if they have reason to believe that an individual is mentally ill. The Act does not mention the use of ambulance to transport such patients. This research paper will discuss all these points and more in detail, analyzing what the current Act offers and where it lacks or falls short of benefitting the ones it is meant to help, care, protect, and rehabilitate.

Introduction: Individuals in the midst of a mental health crisis frequently exhibit instability and face an elevated risk of recurring crises in the subsequent weeks, which underscores the importance of timely intervention in mental healthcare. This work presents a data-driven method to infer the mental state of a patient during the weeks following a mental health crisis by leveraging their historical data. Additionally, we propose a policy that determines the necessary duration for closely monitoring a patient after a mental health crisis before considering them stable. Methods: We model the patient's mental state as a Hidden Markov Process, partially observed through mental health crisis events. We introduce a closed-form solution that leverages the model parameters to optimally estimate the risk of future mental health crises. Our policy determines a patient should be closely monitored when their estimated risk of crisis exceeds a predefined threshold. The method's performance is evaluated using both simulated data and a real-world dataset comprising 162 anonymized psychiatric patients. Results: In the simulations, 96.2% of the patients identified by the policy were in an unstable state, achieving a F1 score of 0.74. In the real-world dataset, the policy yielded an F1 score of 0.79, with a sensitivity of 79.8% and specificity of 88.9%. Under this policy, 67.3% of the patients should undergo close monitoring for one week, 21.6% during 2 weeks or more, while 11.1% do not need close monitoring. Discussion: The simulation results provide compelling evidence that the method is effective under the specified assumptions. When applied to actual psychiatric patients, the proposed policy showed significant potential for providing an individualized assessment of the required duration for close and automatic monitoring after a mental health crisis to reduce the relapse risks. [ABSTRACT FROM AUTHOR]

Background: We plan a scoping review aimed to synthesize what is known about the use of sensory-driven body illusion (BI) interventions for understanding and treating body image disturbance (BID) in people diagnosed with clinical eating disorders (EDs) and people with subclinical ED symptomatology. Our study will provide an outline of the current literature, identify gaps within the literature, and suggest novel directions for future research. Methods/design: The scoping review process will be guided by the methodological framework of Arksey and O'Malley, subsequent recommendations by Levac et al., and the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols Extension for Scoping Reviews guidelines. The following electronic databases will be systematically searched: MEDLINE (via PubMed), Web of Science, PsycINFO, and Scopus. Furthermore, to identify additional studies, we will use a search engine such as Google Scholar, and for grey literature, we will include Proquest for Dissertations and Theses. A search strategy has been identified and agreed upon by the research team in conjunction with a research librarian. Two researchers will screen the titles and abstracts independently and then assess the full text of the selected citations for the inclusion criteria. A third reviewer will be involved in cases of disagreement. Data will be extracted, collated, and charted to summarize all the relevant methods, outcomes, and key findings in the articles. Discussion: A better understanding of this topic will aid in the development and refinement of current treatments aimed at treating BID in people with EDs. Implications and recommendations for research, policy, and practice in the context of the ED community will be discussed. Systematic review registration: https://osf.io/3bcm6/?view_only=83b2e8a2445d4266909992e3dfb51929 [ABSTRACT FROM AUTHOR]