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Covid-19, the disease caused by severe acute respiratory syndrome coronavirus 2 is recognised as one of the most challenging global events of the twenty-first Century. The detrimental impact of the pandemic resulted in high rates of infection, morbidity, and mortality, with health-care workers firmly positioned on the frontline of this unparalleled international crisis. An emerging literature detailing the impact of COVID-19 on health-care practitioners identifies high levels of depression, anxiety, and distress. Accordingly, there are calls for the implementation of effective interventions to tackle the impending spectre of psychological morbidities and staff burnout. While it is important to explore new approaches, it is also valuable to examine how existing strategies, such as reflective practice, can be repurposed to specifically address practitioner well-being. This requires a reimagining of reflective practice and a reimagining of the reflective practice contexts in which reflective activity occurs. This paper presents The Reflective Practice Integrative Framework, which illustrates how reflective practice can be used to address the complex aims of supporting effective patient care, while also facilitating practitioner well-being. The Reflective Organisational Learning Framework is also presented which can be used to develop effective reflective practice environments through single, double, and/or triple loop learning. [ABSTRACT FROM AUTHOR]

Aim: To examine the intergenerational impact of systemic racism on mental health, depicting the evolution and patterns of anxiety symptoms and the application of the Bowenian family therapy to understand the interrelatedness and long‐standing impact of intergenerational trauma in African American families. This article highlights interventions that increase awareness of and promotes physical and mental health for African American populations. Design: Discursive Paper. Method: Searching literature published between 2012 and 2022 in PubMed, SCOPUS, EBSCO Host and Google Scholar, we explored factors associated with systemic racism and generational anxiety. Discussion: Evidence‐based literature supports the application of the Bowenian family therapy theoretical framework to understand the intergenerational impact of systemic racism and to address the transmission of anxiety symptoms in African American populations. Conclusion: Culturally appropriate interventions are needed to decrease anxiety symptoms in an attempt to heal intergenerational trauma and to improve family dynamics in African American populations. Impact to Nursing Practice: Nurses play an integral role in providing holistic quality patient‐centred care for African American populations who have experienced racial trauma. It is critical for nurses to implement culturally responsive and racially informed care with patients that focuses on self‐awareness, health promotion, prevention and healing in efforts to address racial trauma. Application of Bowenian family therapy can aid in the reduction of both intergenerational transmission of racial trauma and generational anxiety. No Patient or Public Contribution: There was no patient or public involvement in the design or drafting of this discursive paper. The authors reviewed the literature to develop a discussion. [ABSTRACT FROM AUTHOR]

Mental health and wellbeing are increasingly threatened in the current post-pandemic times, with stress, especially in students, reaching preoccupying levels. In addition, while many educational programs are unidimensional (i.e., lacking integration between physical, emotional and cognitive elements), there are ways to promote physical, social and mental health in children and adolescents. In this opinion paper, we will discuss the importance of an integrative approach for health development and examine relevant factors, such as awareness and emotional intelligence. We will highlight evidence ranging from behavioral to electrophysiological, structural and molecular, and report several recent studies supporting the effectiveness of a holistic approach in supporting wellbeing and creativity in children and adults, and detailing a specific paradigm named the Quadrato Motor Training (QMT). QMT is a specifically structured movement meditation, involving cognitive, motor and affective components. Finally, we will support a holistic view on education, integrating motion, emotion and cognition to develop a person-centered, or in this case student-centered, approach to wellbeing and health. [ABSTRACT FROM AUTHOR]

The article focuses on the reasons behind the rejection of papers submitted to the Journal of Mental Health, highlighting the increasing number of submissions and the rigorous review process. Topics include the importance of meeting submission criteria, considerations during the scientific evaluation process, and specific guidelines for different types of studies, such as prioritizing international importance and avoiding redundant research on topics like COVID-19.

Introduction: A positive childbirth experience promotes women's health, both during and beyond the perinatal period. Understanding what constitutes a positive childbirth experience is thus critical to providing high‐quality maternity care. Currently, there is no clear, inclusive, woman‐centered definition of a positive childbirth experience to guide practice, education, and research. Aim: To formulate an inclusive woman‐centered definition of a positive childbirth experience. Methods: A six‐step process was undertaken: (a) Key concepts associated with a positive childbirth were derived from a rapid literature review; (b) The key concepts were used by interdisciplinary experts in the author group to create a draft definition; (c) The draft definition was presented to clinicians and researchers during a European research meeting on perinatal mental health; (d) The authors integrated the expert feedback to refine the working definition; (e) A revised definition was shared with women from consumer groups in six countries to confirm its face validity; and (f) A final definition was formulated based on the women's feedback (n = 42). Results: The following definition was formulated: "A positive childbirth experience refers to a woman's experience of interactions and events directly related to childbirth that made her feel supported, in control, safe, and respected; a positive childbirth can make women feel joy, confident, and/or accomplished and may have short and/or long‐term positive impacts on a woman's psychosocial well‐being." Conclusions: This inclusive, woman‐centered definition highlights the importance of provider interactions for facilitating a positive childbirth experience. Feeling supported and having a sense of control, safety, and respect are central tenets. This definition could help to identify and validate positive childbirth experience(s), and to inform practice, education, research, advocacy, and policy‐making. [ABSTRACT FROM AUTHOR]

Violence against nurses is a disturbing trend in healthcare that has reached epidemic proportions globally. These violent incidents can result in physical and psychological injury, exacerbating already elevated levels of stress and burnout among nurses, further contributing to absenteeism, turnover, and intent to leave the profession. To ensure the physical and mental well-being of nurses and patients, attention to the development of strategies to reduce violence against nurses must be a priority. Caring knowledge—rooted in the philosophy of care—is a potential strategy for mitigating violence against nurses in healthcare settings. We present what caring knowledge is, analyze its barriers to implementation at the health system and education levels and explore potential solutions to navigate those barriers. We conclude how the application of models of caring knowledge to the nurse-patient relationship has the potential to generate improved patient safety and increased satisfaction for both nurses and patients. [ABSTRACT FROM AUTHOR]

The article comments on the anxiety and mental health problem facing editors in preventing the publication of scientific misconduct and fraud and paper mill activities and calls for the protection of the scientific record. It attributes the problem with paper mill-produced manuscripts to pressure on academics, educational workload in universities and funding. It suggests having an authorship policy, investigation of suspected unethical behavior and peer review to combat publishing misconduct.

Introduction: Many women experience giving birth as traumatic. Although women's subjective experiences of trauma are considered the most important, currently there is no clear inclusive definition of a traumatic birth to help guide practice, education, and research. Aim: To formulate a woman‐centered, inclusive definition of a traumatic childbirth experience. Methods: After a rapid literature review, a five‐step process was undertaken. First, a draft definition was created based on interdisciplinary experts' views. The definition was then discussed and reformulated with input from over 60 multidisciplinary clinicians and researchers during a perinatal mental health and birth trauma research meeting in Europe. A revised definition was then shared with consumer groups in eight countries to confirm its face validity and adjusted based on their feedback. Results: The stepwise process confirmed that a woman‐centered and inclusive definition was important. The final definition was: "A traumatic childbirth experience refers to a woman's experience of interactions and/or events directly related to childbirth that caused overwhelming distressing emotions and reactions; leading to short and/ or long‐term negative impacts on a woman's health and wellbeing." Conclusions: This definition of a traumatic childbirth experience was developed through consultations with experts and consumer groups. The definition acknowledges that low‐quality provider interactions and obstetric violence can traumatize individuals during childbirth. The women‐centered and inclusive focus could help women to identify and validate their experiences of traumatic birth, offering benefits for practice, education, and research, as well as for policymaking and activism in the fields of perinatal mental health and respectful maternity care. [ABSTRACT FROM AUTHOR]

BACKGROUND: Since the inception of the Youth Risk Behavior Surveillance System in 1991, all surveys have been conducted in schools, using paper and pencil instruments (PAPI). For the 2019 YRBSS, sites were offered the opportunity to conduct their surveys using electronic data collection. This study aimed to determine whether differences in select metrics existed between students who completed the survey electronically versus using PAPI. METHODS: Thirty risk behaviors were examined in this study. Data completeness, response rates and bivariate comparisons of risk behavior prevalence between administration modes were examined. RESULTS: Twenty‐nine of 30 questions examined had more complete responses among students using electronic surveys. Small differences were found for student and school response rates between modes. Twenty‐five of 30 adolescent risk behaviors showed no mode effect. CONCLUSIONS: Seven of 44 states and DC participated electronically. Because survey data were more complete; school and student response rates were consistent; and minor differences existed in risk behaviors between modes, the acceptability of collecting data electronically was demonstrated. [ABSTRACT FROM AUTHOR]

Insomnia symptoms are frequent during peripartum and are considered risk factors for peripartum psychopathology. Assessing and treating insomnia and related conditions of sleep loss during peripartum should be a priority in the clinical practice. The aim of this paper was to conduct a systematic review on insomnia evaluation and treatment during peripartum which may be useful for clinicians. The literature review was carried out between January 2000 and May 2021 on the evaluation and treatment of insomnia during the peripartum period. The PubMed, PsycINFO, and Embase electronic databases were searched for literature published according to the PRISMA guidance with several combinations of search terms "insomnia" and "perinatal period" or "pregnancy" or "post partum" or "lactation" or "breastfeeding" and "evaluation" and "treatment." Based on this search, 136 articles about insomnia evaluation and 335 articles on insomnia treatment were found and we conducted at the end a narrative review. According to the inclusion/exclusion criteria, 41 articles were selected for the evaluation part and 22 on the treatment part, including the most recent meta-analyses and systematic reviews. Evaluation of insomnia during peripartum, as for insomnia patients, may be conducted at least throughout a clinical interview, but specific rating scales are available and may be useful for assessment. Cognitive behavioral therapy for insomnia (CBT-I), as for insomnia patients, should be the preferred treatment choice during peripartum, and it may be useful to also improve mood, anxiety symptoms, and fatigue. Pharmacological treatment may be considered when women who present with severe forms of insomnia symptoms do not respond to nonpharmacologic therapy. [ABSTRACT FROM AUTHOR]

Drawing from research on 'paper technologies' conducted by medical historians Volker Hess and Andrew Mendelsohn, among others, this article explores how Adolf Meyer (1866–1950) and his staff at the Phipps Psychiatric Clinic used customized punch cards to develop an alternative conceptualization of schizophrenia: 'parergasia.' It begins by examining 'dementia praecox,' the conceptual precursor to both schizophrenia and parergasia, to explain how earlier paper technologies used to track patients transferred to asylums generated prognostic assumptions that precluded deinstitutionalization and community-based care. It then describes how Meyer's staff modified these technologies to define parergasia in opposition to dementia praecox and other diagnoses that resulted in prolonged hospitalization, primarily by conducting follow-up studies on discharged patients that correlated outcomes with various social factors. After demonstrating how the standardized forms used in these studies limited the possible metrics of recovery, it concludes by suggesting how Meyer's research influenced leaders of the community mental health movement, and prefigured later trends in psychiatric services. [ABSTRACT FROM AUTHOR]

Open Dialogue is a need‐adapted approach to mental health care that was originally developed in Finland. Like other need‐adapted approaches, Open Dialogue aims to meet consumer's needs and promote collaborative person‐centred dialogue to support recovery. Need‐adapted mental health care is distinguished by flexibility and responsiveness. Fidelity, defined from an implementation science perspective as the delivery of distinctive interventions in a high quality and effective fashion is a key consideration in health care. However, flexibility presents challenges for evaluating fidelity, which is much easier to evaluate when manualization and reproducible processes are possible. Hence, it remains unclear whether Open Dialogue and other need‐adapted mental health interventions can be meaningfully evaluated for fidelity. The aim of this paper was to critically appraise and advance the evaluation of fidelity in need‐adapted mental health care, using Open Dialogue as a case study. The paper opens a discussion about how fidelity should be evaluated in flexible, complex interventions, and identifies key questions that need to be asked by practitioners working in need‐adapted mental health care to ensure they deliver these interventions as intended and in an evidence‐based fashion. [ABSTRACT FROM AUTHOR]

Harmful Sexual Behaviour (HSB) has been regularly documented as a demanding area of practice within the United Kingdom (UK). The aim of this paper is to share a practice model developed in an under-resourced inner London borough. The HSB forum is formed of a multi-agency group of professionals and runs monthly providing a platform for practitioners to seek consultation for young people they are working with who are displaying HSB's. Initial feedback for the forum from practitioners has been consistently positive and they have valued specifically the opportunity to formulate, have clear directions, and the multi-disciplinary perspective. In addition, most reported feeling empowered to implement the recommendations suggested. Given the shared vulnerability factors between those displaying HSB's and other at-risk young people such as those who are being sexually exploited, this model provides an innovative way that practitioners can be supported by multiple agencies where there is a lack of specialist services. [ABSTRACT FROM AUTHOR]

From Longing to Belonging: A Practical Guide to Including People with Disabilities and Mental Health Conditions in Your Faith Community: Shelly Christensen, ed. (Inclusion Innovations, 2018). xix + 312 pp. Christensen uses her own experiences, research, and disability literature to explore facets of inclusion and exclusion in faith communities. Christensen writes, " I We all have good intentions to be the kind of inclusive community where people with disabilities and mental health conditions feel that they belong. [Extracted from the article]

Background: Appropriate and timely response in urgent situations requires vast knowledge and physical and mental preparedness. Since emergency medical technicians are the first professional respondents in the health system, selecting the right people to study in this field is very important. Because there is no specific model in Iran to propose the indicators in the selection of applicants for this field, the present study was conducted to offer some indicators for the admission of prehospital emergency medical students. Materials and Methods: This research was conducted using a mixed qualitative and quantitative approach in three steps: reviewing the relevant texts, meetings of scientific and operational experts, and determining the validity and reliability of the content. After finalizing, the areas and indicators of student selection were used in the interview process of candidates in 2020. SPSS v. 24 software was used for quantitative data analysis. Results: The selection tool for prehospital emergency medical students included 4 areas (with 26 criteria): 1) general qualifications area with 8 criteria (documents concerning degree and identity, written GPA of diploma, entrance exam score, type of diploma, special abilities, working in relief organizations, gaining a scientific-sports position, and interviewing of faculty members); 2) physical health with 7 criteria (height, body mass index, visual health, hearing health, stuttering, organ dysfunction-physical disability, and chronic debilitating diseases); 3) psychological status with 5 criteria (orderliness, responsibility, quick and correct decision making, stress management, and belief in teamwork); and 4) physical fitness with 6 criteria (1600-m run, 45-m speed-run, 4x9 m run, sit-up, long jump, and Swedish swimming in 30 s). Conclusion: Given the vital importance of prehospital emergency medical jobs as the front line of the health system response, selecting the right people will play a significant role in increasing the quality of services provided, increasing patient satisfaction, and ultimately improving health of the community. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the effectiveness of Transference-focused Psychotherapy (TFP) and Acceptance and Commitment Therapy (ACT) on promoting the mental health and psychological capital of staff working in hospitals covered by social security in Tehran Province. Methods: The present study was a quasi-experimental research with pre-test and post-test. The statistical population of the present study was the personnel working in hospitals covered by social security in Tehran Province. A total of 120 personnel from three hospitals were randomly divided into two experimental groups and one control group (40 people in each group). All three groups answered the Mental Health Questionnaire (Symptom Checklist-90-R (SCL-90-R)) and Psychological Capital Questionnaire (PCQ) as a pre-test. Then, the transfer-oriented treatment group and the acceptance and commitment treatment group (during eight sessions) received the experimental intervention and the control group did not receive any kind of intervention. At the end of the sessions, all three groups answered the questions of the SCL-90-R and PCQ again. Multivariate analysis of covariance was used to analyze the colected data. Results: The results of the present study showed that both TFP and ACT were effective in promoting the mental health of staff working in hospitals covered by social security. There was also a difference between the effectiveness of TFP and ACT in promoting the mental health of staff working in hospitals covered by social security. Thus, in the TFP group, the components of anxiety, morbid fear, psychosis, and paranoia gained significantly lower scores compared to the ACT group. Regarding the components of psychological capital, the ACT group scored significantly lower than the TFP group. Conclusion: Both methods can be used by counselors and therapists to promote the mental health of staff working in hospitals covered by social security. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to assess the sexual and mental health of women suffering from connective tissue diseases and to determine the potential interrelationships between the studied clinical variables and sexual and mental health. Methods: The study was conducted in a group of women with connective tissue diseases. To assess somatic health, we used The Health Assessment Questionnaire (HAQ-DI), and to assess sexual health, we used the Female Sexual Function Index (FSFI) and Sexual Satisfaction Questionnaire (KSS). The mental health was assessed by using the Hospital Anxiety and Depression Scale (HADS-M) and the PERMA-Profiler (PL). Results: The study involved 81 women suffering from connective tissue diseases, especially rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS) and juvenile idiopathic arthritis (JIA). Clinical symptoms of sexual dysfunction were observed in 54% women. The biggest difficulties occur in sexual desire, orgasm and arousal. Patients had symptoms of anxiety and depressive disorders. Higher levels of anxiety and depression are associated with poorer overall sexual functioning and better overall sexual functioning, and all its dimensions are associated with a higher level of mental well-being. There was also an observed relationship with the functional limitation due to pain and duration of the disease. Conclusion: The study confirms the existence of difficulties in the sexual functioning of women suffering from connective tissue diseases and shows the relationship between sexual and mental health and basic disease. The observed relationships are important information in the treatment and medical care of people with this group of rheumatic diseases. Key Points • The article presents one of the few studies about sexual functioning of Polish population women with connective tissue diseases. • The aim was to assess the sexual and mental health of women with various connective tissue diseases and determine the potential interrelationships between the clinical variables and sexual and mental health. • The study confirms difficulties in the sexual functioning of women with connective tissue diseases. The biggest difficulties occur in sexual desire, orgasm and arousal. Patients also had mental disorders symptoms. • The study presents conclusions and indications which may be important and help specialists approach the treatment process in an interdisciplinary way. [ABSTRACT FROM AUTHOR]

The COVID-19 Psychological Wellbeing Study was designed and implemented as a rapid survey of the psychosocial impacts of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known as COVID-19 in residents across the United Kingdom. This study utilised a longitudinal design to collect online survey based data. The aim of this paper was to describe (1) the rationale behind the study and the corresponding selection of constructs to be assessed; (2) the study design and methodology; (3) the resultant sociodemographic characteristics of the full sample; (4) how the baseline survey data compares to the UK adult population (using data from the Census) on a variety of sociodemographic variables; (5) the ongoing efforts for weekly and monthly longitudinal assessments of the baseline cohort; and (6) outline future research directions. We believe the study is in a unique position to make a significant contribution to the growing body of literature to help understand the psychological impact of this pandemic and inform future clinical and research directions that the UK will implement in response to COVID-19. [ABSTRACT FROM AUTHOR]

Recently, the Association of University and College Counseling Center Directors (AUCCCD) published a White Paper on a multidimensional understanding of organizational structures for counseling centers (Mitchell, Oakley & Dunkle 2019). This article provided a historical overview of such structures, argued that there is no one optimal structure for all campuses, provided recommendations for factors to consider in related decision-making, and advocated for collaboration regardless of structure. The authors of this article extend the conversation by elaborating on some of the ethical issues involved in collaboration, as the White Paper did not address the limits of acceptability in such processes. Given that the authors are psychologists, we will be focusing on the Ethical Principles for Psychologists and Code of Conduct (2017) of the American Psychological Association (APA). Similar language can be found in the ethical codes of other mental health professionals, and we note these sources as well. [ABSTRACT FROM AUTHOR]

Introduction: One of the vital skills which has an impact on emotional health and well-being is the regulation of emotions. In recent years, the neural basis of this process has been considered widely. One of the powerful tools for eliciting and regulating emotion is music. The Anterior Cingulate Cortex (ACC) is part of the emotional neural circuitry involved in Major Depressive Disorder (MDD). The current study uses functional Magnetic Resonance Imaging (fMRI) to examine how neural processing of emotional musical auditory stimuli is changed within the ACC in depression. Statistical inference is conducted using a Bayesian Generalized Linear Model (GLM) approach with an Integrated Nested Laplace Approximation (INLA) algorithm. Methods: A new proposed Bayesian approach was applied for assessing functional response to emotional musical auditory stimuli in a block design fMRI data with 105 scans of two healthy and depressed women. In this Bayesian approach, Unweighted Graph-Laplacian (UGL) prior was chosen for spatial dependency, and autoregressive (AR) (1) process was used for temporal correlation via pre-weighting residuals. Finally, the inference was conducted using the Integrated Nested Laplace Approximation (INLA) algorithm in the R-INLA package. Results: The results revealed that positive music, as compared to negative music, elicits stronger activation within the ACC area in both healthy and depressed subjects. In comparing MDD and Never-Depressed (ND) individuals, a significant difference was found between MDD and ND groups in response to positive music vs negative music stimuli. The activations increase from baseline to positive stimuli and decrease from baseline to negative stimuli in ND subjects. Also, a significant decrease from baseline to positive stimuli was observed in MDD subjects, but there was no significant difference between baseline and negative stimuli. Conclusion: Assessing the pattern of activations within ACC in a depressed individual may be useful in retraining the ACC and improving its function, and lead to more effective therapeutic interventions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has changed life in Europe and globally. The pandemic affects both individuals and the broader society across many domains, including physical and psychological health, the economy and general welfare. The measures taken to counteract the pandemic have significantly altered daily life and, along with the threat of contracting the coronavirus and uncertainties surrounding future developments, created a complex system of stressors with a negative impact on public mental health. This paper aims to outline the ESTSS strategy to address mental health issues related to COVID-19 and focuses on (1) trauma-informed policies, (2) capacity building, (3) collaborative research and (4) knowledge-exchange. To facilitate implementation of a trauma-informed approach and appropriate measures, ESTSS has developed a toolkit of recommendations on mental health and psychosocial assistance to be provided during the different phases of crisis and its aftermath. To promote capacity building, ESTSS offers a certification programme based on a curriculum in psychotraumatology and corresponding on-line training to the European community of mental health professionals. To assure evidence-based approaches and methods tailored to current circumstances, ESTSS has initiated a pan-European research project with international cooperation aimed at studying the mental health consequences of the pandemic, with a focus on psychological trauma and other stress-related reactions. To foster knowledge-exchange, the European Journal of Psychotraumatology (EJPT), the official journal of ESTSS, is publishing a special issue on COVID-19. [ABSTRACT FROM AUTHOR]

Over the last few decades, medical and surgical advances have led to a growing population of individuals living with congenital heart disease. The challenges of this condition can reach beyond physical limitations to include anxiety, depression and post-traumatic stress disorder. To date, these psychological outcomes have been neglected; yet, they need not be inevitable. The factors contributing to these difficulties are considered here, drawing on current evidence and neuropsychological theories including the novel application of polyvagal theory. Suggestions for developing psychologically informed medical and social care to improve mental health, wellbeing and recovery and influence policy and training are proposed (See supplemental material for video abstract). [ABSTRACT FROM AUTHOR]

Aims: This position paper illustrates how Educational Psychological Services (EPSs) have been instrumental through ever more systemic and universal ways of working to identify links between the needs within Scottish schools and targeted and universal nurturing approaches. Method: This paper will initially demonstrate the appropriateness of a nurturing approach within a Scottish context, as a response to issues related both to mental health and to poverty. It will then continue by exploring how at both local and national levels, nurture-based practices have been embedded into policies and practice due to the influence of EPSs. It will demonstrate this through reference to the national context and the local authority (LA) level, using North Ayrshire Council (NAC) as an exemplar of how this can be achieved. Findings: This paper will state that, while national and local policy have influenced the focus of EPSs' priorities, so too has EPSs' knowledge of psychology influenced national and local policy regarding nurturing approaches. Limitations: This position paper is drawn from the Scottish education system and may not be fully representative of other contexts. Conclusion: There is an ongoing cycle of mutual influence, enabling the continual development of good practice within schools. This can offer a template of systemic working for the future development of the profession of the educational or 'school psychologist' on a wider scale. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the documentation of pro re nata (PRN) medication for anxiety and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process. Background: The ability to accurately document patients’ symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, Nursing process and critical thinking, Saddle River, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552) and considerable information missing (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker et al., 2008, J Clin Nurs, 17, 1122–1131). Design: The project was a mixed‐method, two‐phase study that collected data from two sites. Methods: In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice. Results: Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration. Conclusions: We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation. Relevance to clinical practice: Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be made through training, using structured report templates and by switching to electronic databases. [ABSTRACT FROM AUTHOR]

Conflict-affected youth are at risk for poor psychological and social outcomes, yet few receive mental health services. Strategies to expand access and sustain evidence-based interventions (EBIs) across novel delivery platforms must be tested. The present study was a hybrid type II implementation-effectiveness trial using a cluster randomized design. The primary goal was to evaluate feasibility and impact of using the collaborative team approach to deliver the Youth Readiness Intervention (YRI), an EBI, integrated into a youth entrepreneurship program (ENTR) with quality control in post-conflict Sierra Leone. Youth were screened and randomly assigned to control, ENTR, or combined YRI and ENTR (YRI+ENTR). Implementation outcomes were dissemination and implementation indicators, competence, and fidelity. Effectiveness outcomes were emotion regulation, psychological distress, and interpersonal functioning. Secondary outcomes were third-party reporter assessments of youth functioning and behavior. Data were collected and analyzed from 1,151 youth participants and 528 third-party reporters. Scores on implementation constructs, competence, and fidelity demonstrated acceptable intervention response and quality. YRI+ENTR participants showed overall improvements in depression (β = −.081, 95% CI −0.124 to −0.038, d = −0.154) and anxiety (β = −.043, 95% CI −0.091 to −0.005, d = 0.082) symptoms compared with control participants. Community leaders indicated that YRI+ENTR participants demonstrated improvements in overall work or training performance compared with control participants (β = −.114, 95% CI 0.004 to 0.232, d = 0.374). Integration of EBIs such as the YRI into youth employment programs has the potential to address limited reach of EBIs in conflict and post-conflict settings. A collaborative team implementation approach can facilitate integration and fidelity. In a Hybrid Type-II Implementation-Effectiveness trial conducted in Sierra Leone, researchers tested a Collaborative Team Approach (CTA) for delivering an evidence-based mental health intervention, the Youth Readiness Intervention (YRI), within a youth entrepreneurship program. A total of 1,151 youth participated in the study, with outcomes measured on youth mental health indicators of emotional regulation, psychological distress, and interpersonal functioning, as well as implementation indicators, competence, and fidelity. Results demonstrated that the integrated YRI and entrepreneurship program led to significant improvements in depression and anxiety symptoms compared to the control group. Community leaders also noted enhanced overall performance in YRI participants, suggesting that integrating evidence-based interventions into youth employment programs can effectively address mental health challenges in low-resource regions. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper received support from a program designed to increase minority representation in science. Youth FORWARD Phase 2 YRI and EPP Study; https://clinicaltrials.gov/ ; NCT03542500. Youth Functioning and Organizational Success for West African Regional Development (Youth FORWARD): Study Protocol; https://doi.org/10.1176/appi.ps.202000009. [ABSTRACT FROM AUTHOR]

This scoping review offers insight into researcher well-being when working with sensitive and traumatic topics in a qualitative research context. The study identified existing empirical research concerning researcher well-being and mental health. The databases included SSCI, ASSIA < IBISS, Scopus, Social Policy and Practice, PsycInfo, Social Science Database/Social Science Premium Collection (Proquest), and Open Grey. An international search was conducted, with no time constraints on publication dates to gather as wide a selection as possible. 55 papers met the criteria. We found that the terminology used within the papers was not consistent which necessitated grouping the (self-) reflection/reflexive practices researchers used and categorizing them under the umbrella term SRR practices. The research questions were: 1. Which disciplines or fields are conducting SRR practices on sensitive topics? 2. What SRR practices do researchers employ in the context of sensitive research? 3. What were the self-reported outcomes from using SRR practices as a tool of researchers working on sensitive research? A key finding of the scoping review is that many researchers who work on sensitive topics feel unprepared and receive little or no training or support for SRR practices. This poses particular challenges for early career researchers. We also identified that qualitative researchers have developed a range of SRR practices to manage the emotional impact of their sensitive research work. Many authors of the scoped papers stress the importance of peer-support as well as formal and informal debriefing meetings. Another key SRR practice discussed by many researchers is reflexive journaling. Our scoping review suggests that if it is combined with other activities, self-reflexive journaling can be an excellent way to acknowledge and assess the emotional impact of sensitive research. [ABSTRACT FROM AUTHOR]

Aim Findings Discussion The purpose of this paper was to critically evaluate the use of chatbots as an eHealth resource for substance use disorder. It considers their past, present and future use, including the progression of the new wave of generative chatbots.This paper finds chatbots for substance use disorder to be an underutilised resource, noting that there are few solutions and that these have limitations. It identifies that, along with limitations with general chatbot design, there are also serious ethical concerns given the vulnerabilities of the target population.How a collaborative design can address some of the limitations is discussed, as well as the restrictions this could pose to leveraging the latest technological advances. The ethical concerns presented in the applied use of both existing and prospective chatbots are explored, and how there is a need to safeguard users in matters of mental health support. [ABSTRACT FROM AUTHOR]

AbstractThis paper explores institutional leaders’ perceptions of learning and teaching involved in facilitating and assessing Student Evaluations of Teaching (SET) survey instruments across Australian regional universities. It focuses on how they understand the function of SET, strategies used to mitigate bias, and potential residual harm. Through adopting a combination of inductive and deductive research processes and a thematic analysis through the ethical lens of nonmaleficence (first, do no harm), we report that leaders in learning and teaching perceive SET as a form of surveillance and Quality Assurance ‘performance’, recognise inherent biases inhabited in SET reports, and identify how these biases negatively impact academics through a lack of systematic harm mitigation strategies. The paper’s critical – and novel – contributions include an increased understanding of how SET inflicts harm towards women and other marginalised academic groups through systematic and authorised microaggressions and how SET contravenes universities’ duty of care to employees. It recommends an expansion of the principle of nonmaleficence beyond potential harm to research subjects, including those who undertake research or evaluation (such as academics), particularly if these impact them. [ABSTRACT FROM AUTHOR]

Mauli ola, optimal health and wellbeing from a Hawaiian perspective, is achieved by being pono, or morally just and upright, and maintaining an intricate balance physically, mentally, spiritually, and emotionally through one's relations. Cultural practices, including practices that foster a connection to the water, land, ocean, and natural environment, may serve as protective and resilience factors, thereby promoting health and wellbeing. This paper starts by sharing the genealogical foundations of cultural practices in Hawai'i as the foundations of Native Hawaiian lifestyles and ways of knowing. The paper proceeds with data analyses that aim to better understand the role of cultural practices in relation to connectedness to 'Āina (the land, nature, and the environment, which nourish our bodies) and Native Hawaiian health based on cross-sectional correlations and qualitative data. The findings demonstrate the importance of cultural practices, specifically 'Āina practices, and identify 'Āina protection, restoration, and conservation as major health priorities. The correlations demonstrate statistically significant relationships between cultural practices; a physical, mental, spiritual, and emotional connection to 'Āina; and health outcomes. These findings continue to support literature and other declarations that support healthcare and medicine that are culturally grounded in Indigenous values and traditional systems of medicine. [ABSTRACT FROM AUTHOR]

Introduction: Implementation science (IS) offers methods to systematically achieve the Ending the HIV Epidemic goals in the United States, as well as the global UNAIDS targets. Federal funders such as the National Institutes of Mental Health (NIMH) have invested in implementation research to achieve these goals, including supporting the AIDS Research Centres (ARCs), which focus on high‐impact science in HIV and mental health (MH). To facilitate capacity building for the HIV/MH research workforce in IS, "grey areas," or areas of IS that are confusing, particularly for new investigators, should be addressed in the context of HIV/MH research. Discussion: A group of IS experts affiliated with NIMH‐funded ARCs convened to identify common and challenging grey areas. The group generated a preliminary list of 19 grey areas in HIV/MH‐related IS. From the list, the authors developed a survey which was distributed to all ARCs to prioritize grey areas to address in this paper. ARC members across the United States (N = 60) identified priority grey areas requiring clarification. This commentary discusses topics with 40% or more endorsement. The top grey areas that ARC members identified were: (1) Differentiating implementation strategies from interventions; (2) Determining when an intervention has sufficient evidence for adaptation; (3) Integrating recipient perspectives into HIV/MH implementation research; (4) Evaluating whether an implementation strategy is evidence‐based; (5) Identifying rigorous approaches for evaluating the impact of implementation strategies in the absence of a control group or randomization; and (6) Addressing innovation in HIV/MH IS grants. The commentary addresses each grey area by drawing from the existing literature (when available), providing expert guidance on addressing each in the context of HIV/MH research, and providing domestic and global HIV and HIV/MH case examples that address these grey areas. Conclusions: HIV/MH IS is key to achieving domestic and international goals for ending HIV transmission and mitigating its impact. Guidance offered in this paper can help to overcome challenges to rigorous and high‐impact HIV/MH implementation research. [ABSTRACT FROM AUTHOR]

Introduction: Research with young people (YP) is ethically challenging and bound in a complex maze of issues relating to power, voice and representation. Such sensitivities mean that the challenges raised in researching marginalised YP are often hard to navigate. This paper reports on research carried out with YP to explore links between mental health, school exclusion and involvement in criminal gangs. It aims to provide a practical guide to negotiating some of the methodological and ethical challenges experienced. Method: In‐depth interviews conducted with 28 YP (aged 14–24 years) who were gang involved or seen to be at risk of gang involvement. Research was conducted in youth clubs, alternative provision and youth justice settings. Results: Observations/Reflections We reflect on how navigating ethics can create barriers to involving YP as primary informants in research. We consider why it is important to overcome these hurdles and how public engagement work with recognised gatekeepers and the use of creative interview methods can facilitate meaningful encounters, where YP feel able to share valuable insights into their lives. Conclusion: Alongside a number of specific learning points, the paper reflects on theories behind research with YP, including the need for recognition of power imbalances and reflexivity. It concludes with thoughts on the practical realities of achieving meaningful participation or an 'authentic voice' with marginalised groups and the importance of this in informing policy and practice. Patient or Public Contribution: The focus of this work was to collect experiences of YP who are recognised as gang‐involved or at risk of being so, with a view to informing health and education policies. The scoping study for the project involved extensive public engagement work with YP exploring and trialling suitable methods of accessing, recruiting and ultimately interviewing this target group. This is central to the discussion within the body of the paper. [ABSTRACT FROM AUTHOR]

North American rates of adolescent social media use hover between 98 and 100%, with 45% of adolescents reporting being online "almost constantly". Despite its prevalence, social media use is also controversial. If social media is now woven into the fabric of social interactions, what are the mental health implications for youth growing up in "a digital age"? This paper discusses the potential applications of transdisciplinarity by considering the question in three ways: first, the polarized research is presented, suggesting that social media has the power to either positively or negatively direct youths' social and psychological trajectories; second, the dichotomy is challenged; and third, transdisciplinary applications are considered. As a complex, novel, and nuanced topic, the study of social media, peer relationships, and mental health demands a paradigm that is able to accommodate complexity, nuance, and novelty in a critical, reflexive and meaningful way. Transdisciplinarity presents scholars an opportunity to tackle this challenge. This paper discusses the prevailing research surrounding social media, peer relationships, and mental health to challenge the good/bad binary and lay the foundation for approaching this topic from a transdisciplinary lens in future research. [ABSTRACT FROM AUTHOR]

This paper discusses the lasting impact of the Covid-19 pandemic on research ethics in social sciences by focusing on the concept of vulnerability. We unpack the current conceptualisations of vulnerability and their limitations and argue for the need to reconceptualise vulnerability as multidimensional, consisting of both universal and contextual dimensions, as well as their dynamic interplay. Multidimensional vulnerability is inspired by and relevant to social science research during the pandemic but can also be useful in other contexts such as climate change or conflict. The paper puts forwards several considerations about how this revised concept of vulnerability may be useful when evaluating ethical dimensions of social science research. [ABSTRACT FROM AUTHOR]

This paper examines suicide prevalence among Nigerian youth struggling to find meaning in life. Frustrated by unattainable ideals, they experience despair. The study explores religion's role in providing support for meaning-seeking individuals. Utilizing an explorative approach, the paper highlights how religion can play a role in offering solidarity, morality, and hope as vital resources for creating a meaningful life. It introduces "Pastrotherapy" as a pastoral care approach to addressing existential questions. Findings emphasize the importance of religious communities and leaders in promoting resilience and addressing underlying causes of despair. This study reveals how religious beliefs and practices support Nigerian youth facing existential challenges, shedding light on the intersection of religion, meaning-making, and mental health. [ABSTRACT FROM AUTHOR]

Background: According to the United Nations Commissioner for Refugees (UNHCR), children and adolescents represent 41% of all forcibly displaced individuals. They have to deal with conflicts, violence, and the many difficulties of flight and resettlement during a critical stage of their emotional, social, cognitive, and physical development. They are more likely to experience mental health problems during migration. Despite the several known risk factors, it is frequently challenging for refugees and asylum seekers to get mental health care. In this paper we review available studies on interventions aimed at promoting mental health and at preventing common mental disorders in immigrant adolescents and children. Methods: The relevant PubMed, Scopus, PsychINFO and Web of Science databases were searched for papers published until March 21, 2023, using ("immigrants" OR "migration" OR "asylum seekers" OR "refugees") AND ("promotion" OR "prevention") AND ("mental health" OR "mental disorders" OR "psych*") AND ("children" OR "adolescents" OR "young adults") as search string. Fourteen articles qualified for the detailed review. Results and Conclusions: The majority of available interventions, although highly heterogeneous in format and content, showed significant improvement in several psychopathological dimensions, including trauma-related symptoms, psychological stress, anxiety, depressive and cognitive symptoms. Available studies on interventions for the prevention of mental disorders and the promotion of mental health in refugees and asylum seekers children and adolescents indicate that provided interventions were associated with a global improvement for participants. Implementation strategies to improve their scalability are highly needed. [ABSTRACT FROM AUTHOR]

This perspective paper presents a discussion around the issues of sexual violence (SV) in rural and remote areas and the associated discourses of shame. The authors propose that shame of SV adds additional trauma to survivors, further impacting survivors' mental health which may be exacerbated in rural areas. Shame is a complex emotion that can result in increased feelings of guilt, humiliation, and embarrassment. Shame has been identified as an underlying risk factor and a mechanism for post‐assault mental health problems. We propose it can be particularly pronounced for women subjected to sexual assault in rural or remote areas. This paper will explore the link between SV and shame, explain how shame attached to SV may be used as an informal social control mechanism for women, particularly in rural and remote areas, and discuss the role of health practitioners, particularly mental health nurses, who play a key role in supporting people impacted by SV. SV is an insidious social phenomenon that can have profound consequences for individuals, families, and communities. Addressing shame and stigma is a crucial component of supporting survivors of SV in rural and remote areas. There is a need for targeted community‐led interventions and responsive support services to address the complex and multifaceted issues contributing to SV in rural and remote communities. [ABSTRACT FROM AUTHOR]

Objective: While co‐occurring mental health conditions are the norm in eating disorders, no testable protocol addresses management of these in psychotherapy. Method: The literature on managing mental health conditions that co‐occur with eating disorders is outlined and reviewed. Results: In the absence of clear evidence to inform managing co‐occurring mental health conditions, we advocate for use of an iterative, session‐by‐session measurement to guide practice and research. We identify three data‐driven treatment approaches (focus solely on the eating disorder; multiple sequential interventions either before or after the eating disorder is addressed; integrated interventions), and the indications for their use. Where a co‐occurring mental health condition/s impede effective treatment of the eating disorder, and an integrated intervention is required, we outline a four‐step protocol for three broad intervention approaches (alternate, modular, transdiagnostic). A research program is suggested to test the usefulness of the protocol. Discussion: Guidelines that provide a starting point to improving outcomes for people with eating disorders that can be evaluated/researched are offered in the current paper. These guidelines require further elaboration with reference to: (1) whether any difference in approach is required where the co‐occurring mental health condition is a comorbid symptom or condition; (2) the place of biological treatments within these guidelines; (3) precise guidelines for selecting among the three broad intervention approaches when adapting care for co‐occurring conditions; (4) optimal approaches to involving consumer input into identifying the most relevant co‐occurring conditions; (5) detailed specification on how to determine which adjuncts to add. Public significance: Most people with an eating disorder also have another diagnosis or an underlying trait (e.g., perfectionism). Currently no clear guidelines exist to guide treatment in this situation, which often results in a drift away from evidence‐based techniques. This paper outlines data‐driven strategies for treating eating disorders and the accompanying comorbid conditions and a research program that can test the usefulness of the different approaches suggested. [ABSTRACT FROM AUTHOR]

The quality of the very early emotional experiences in a child's life are recognized today as foundational in the mental health of becoming an adult. Unsurprisingly, clinicians and health authorities agree on the importance of early detection and treatment of any mental health issues experienced by the preschool child. This is even more important and challenging as young children do not yet have the language skills necessary to express their distress. But do the caregivers in charge of these populations have the best tools at their disposal to carry out that important mission in an efficient and scientifically robust manner reflecting the latest research findings and scientific literature? This is the question we try to answer in this paper. We revisited the theoretical underpinnings behind the concept of mentalization as playing a key role in the ability to understand the other's inner reality. We then carried out an extensive review of scientific papers written over the past 30 years on the subject. We examined mental representations of the adult on the child and analyzed those mentalizations as key inputs. We focused on extracting cross analyses of the mentalizations of one child by several adults with different functions in the life of the child. In this process, we used the PRISMA methodology applied to large international medical databases. We found that the qualitative approach, usually associated with a lengthy process, has been overwhelmingly used in trying to assess patients' mental states and to analyze the mentalizations on the patient, adult or child. Furthermore, cross analyses of mentalizations from more than one adult on a given child were almost nonexistent, despite having high epistemic and clinical potential. There is a dearth of reliable quantitative tools, able to capture and analyze the mentalizations on a patient, that are scientifically robust, transposable, and easy to implement in a clinical setting. The absence of such tools for medical professionals in charge of assessing preschool children contributes, in our view, the low detection and poor treatment of mental disorders in that particularly vulnerable population. We believe there is here an urgent unmet need and that such tools should be designed, validated, and deployed into the target populations as early as possible. [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]

This paper sheds light on the substantial challenges faced by schools today in the UK, especially in the aftermath of a negative school inspection report. Stigmatised and labelled as 'faliing' and with limited support, staff within these schools are often emotionally exhausted and professionally traumatised (Jeffrey & Woods, 1996), when they begin the arduous journey towards school improvement. A longitudinal study, implemented within a secondary school located in an economically and socially disadvantaged region of Wales, focuses on the outcomes of a school-wide talent development program, with a strong emphasis on coaching, made available to staff in all roles, from caretaking to leadership. Through the adoption of a data-driven, strategy-aligned, professional development programme, this paper describes how the internal talent of the whole school was harnessed and directed towards a transformative shift: one that took the school from an initial inspection assessment of 'in significant need of improvement' to a more favourable 'satisfactory' rating and beyond. Central to this programme was a coaching initiative aimed at bolstering staff self-efficacy, which over time resulted in significant improvements in staff wellbeing, team resilience and overall performance, benefiting both staff and students across the school. This study highlights the efficacy of an inclusive, school-wide approach to staff development, with coaching playing a pivotal role in driving positive change. [ABSTRACT FROM AUTHOR]

Personalisation, which tailors to individual preferences, is considered a possible route for improving engagement with digital mental health (DMH) products. Despite claims about the presence and importance of personalised features, evidence about their extent and impact is limited. The study objective was to review evidence from published research to investigate and characterise the contribution of personalisation to engagement and effectiveness.Research papers were retrieved using keywords, with 139 papers being fully examined and 61 meeting our eligibility criteria. Most of the eligible articles reviewing DMH systems have weak to intermediate forms of personalisation (45). Only nine were coded as having strong, adaptive personalisation. Of the 40 articles which evaluated the personalisation effectiveness, 28 were qualitative indicating user preference for personalised features. The 16 controlled, quantitative designs lacked a non-personalised intervention, making it difficult to determine the added value. Effect sizes calculated from available data showed minimal differences in effectiveness compared to non-personalised apps.Our review indicates mixed evidence of personalisation’s performance in DMH interventions. Generally, there is a lack of good quality evidence to isolate specific contributions of personalisation. Opportunities were identified for improved evaluation, however caution is required when implementing more sophisticated methods of DMH personalisation. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic impacted children, adolescents, and their families, with significant psychosocial consequences. The prevalence of anxiety, depression, and self-injurious behaviors increased in our youth, as well as the number of suicide attempts and hospitalizations related to suicidal ideation. Additionally, parents' mental health saw increasing rates of depression, irritability, and alcohol use combined with worsening family function, child-parent connectedness, positive family expressiveness, and increases in family conflict. In light of these statistics, we created CHATogether (Compassionate Home, Action Together), a pilot family-centered intervention using multi-faceted psychotherapeutic approaches to improve familial communication and relational health between adolescents and their parents. This paper discusses the implementation of the CHATogether intervention at the Adolescent Intensive Outpatient Program (IOP), providing an example of the intervention through an in-depth pilot case, and evaluation of the program's acceptability and feasibility. Methods: This paper describes a case in detail and evaluation from a total of 30 families that completed CHATogether in the initial pilot. Each family had 4–6 one-hour CHATogether sessions during their 6-week treatment course at the IOP. Before and after CHATogether, adolescents and their parents separately completed a questionnaire designed to explore their perceived family conflicts. After completion of the program, participants completed a brief quality improvement survey to assess their overall experience with CHATogether. In the reported case, the family completed Patient-Reported Outcomes Measurement Information System (PROMIS) depressive and anxiety symptoms scales, Conflict Behavior Questionnaires (CBQ), 9-item Concise Health Risk Tracking Self-Report (CHRT-SR9), and help-seeking attitude from adults during distress and suicide concerns. Results: The pilot case showed a trend of improvement in reported depressive and anxiety symptoms, child-parent conflicts, subfactors of suicide risk including pessimism, helplessness, and despair, help-seeking acceptability from parents for suicide concerns, and the establishment of individualized family relationship goals. Preliminary feedback from participating families demonstrated positive effects on intra-family communication and improvement in the overall family dynamic. Adolescents (n = 30/30) and their parents (n = 30/30) rated "strongly agree" or "agree" that their families had benefited from CHATogether and welcomed participation in future program development. Conclusion: This study presents CHATogether as a novel family-centered intervention to address post-pandemic family mental health stress, especially when a family system was disrupted and negatively affected the mental health of children and adolescents. The intervention facilitated positive child-parent communication on a variety of topics, through tools such as emotional expression and help-seeking behavior. The reported pilot case and evaluation suggested CHATogether's acceptability and feasibility in a clinical context. We also provided quality improvement feedback to guide future studies in establishing the efficacy of CHATogether and other similar models of clinical family interventions. [ABSTRACT FROM AUTHOR]

Music therapy research has traditionally been somewhat fragmented into different research traditions. This paper argues that the burgeoning field of enactivism could provide important theoretical integration to music therapy research and practice. Stressing the interdependence of mind, brain, body, and environment, enactivism has provided theoretical integration in several fields, not least music cognition and psychiatry. This paper is the first focused theoretical contribution that applies relevant enactivist theory to music therapy. After a reflection on theoretical developments in music therapy, we provide a general introduction to enactivism and its multiple origins in human and biological sciences and present its existing contributions to understanding mental illness and musicking. We also make a specific contribution, through discussion of an example of free music improvisation. Providing an enactive analysis of the sense of agency in this practice, we argue that music improvisation, especially in therapy, might work particularly well for people with severe mental illness because improvisation strengthens and flexes the disturbed sense of agency that often characterizes such mental health challenges. Finally, we discuss strengths and weaknesses of the proposed framework and suggest future potential studies to better evaluate the potential contribution of enactivism to the research and practice of music therapy. [ABSTRACT FROM AUTHOR]

Despite the emerging body of literature on the benefits of youth peer support, there is also evidence that peer support can have unintended negative impacts on peers themselves. It is important to explore what aspects of the peer role contribute to these difficulties in order to mitigate risks. This paper uses a participatory approach to examine the unique attributes of youth peer practice and the related challenges. We conducted semi-structured interviews and focus groups with both peer and non-peer staff from a community-based youth mental health program that provides peer support services (N = 29). Thematic analyses were completed using QSR NVivo. Analyses capture the defining features and related challenges of the peer support role (self-disclosure, boundaries, role confusion and dynamic recovery), and risk factors that affect peers (stigma, exposure to harm and burnout). This paper contributes to the literature on peer support as well as youth participatory evaluation. The findings will be useful to support the development of improved organizational contexts for peer practice and more effective peer support programming. [ABSTRACT FROM AUTHOR]

The supply / demand issue in behavioral health care is a well-established fact, and the mental health toll of the COVID-19 pandemic continues to add challenges to an already taxed system. Existing healthcare models are not set up to adequately address the increasing mental health related needs. As such, innovative models are needed to provide patients with access to appropriate, evidence-based behavioral health care within routine clinical care. This paper introduces Precision Behavioral Health (PBH) as an example of such a model. PBH is an innovative, digital first care delivery model that provides an ecosystem of evidence-based digital mental health interventions to patients as a frontline behavioral health treatment within routine care in a large multispecialty group medical center in the United States. This paper describes the implementation of PBH within a practice research network set-up as part of an integrated behavioral health department. We will present how our team leveraged the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance; "What is RE-AIM?," n.d.) implementation science framework, which emphasizes the design, dissemination, and implementation processes at the individual, staff, and organizational levels, to prioritize key implementation constructs to enhance the successful integration of PBH within routine care. We describe how each of these constructs were operationalized to aid data gathering for rapid evaluation and lessons learned. We discuss the benefits of these types of initiatives across multiple stakeholders including patients, providers, organizations, payers, and digital intervention vendors. [ABSTRACT FROM AUTHOR]

Background: Telehealth for paediatric speech and language therapy became one of the most salient modes of service delivery during the COVID‐19 pandemic. Evidence for speech and language therapy services via telehealth in comparison to face‐to‐face delivery demonstrates promising outcomes, and studies have begun to explore practitioner and client experiences. However, across the literature, many critical elements of services are overlooked, and there is a need to frame the evidence base within a theoretical model that can draw out practical implications that consider the range of factors having an impact on clinical implementation in real‐world contexts. The APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side‐effects, and Equity) criteria offer such a model. The current study explored practising UK speech and language therapists' (SLTs) clinical experience of telehealth through the lens of the APEASE criteria and aimed to identify recommendations for future service provision from the practitioner perspective. Methods: An online survey structured using the APEASE criteria was developed in collaboration with the UK Royal College of Speech and Language Therapists. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using reflexive thematic analysis. Results: Four hundred and thirty‐eight qualified and practicing UK paediatric SLTs completed the survey. Telehealth was broadly acceptable and practicable to SLTs yet there remains some uncertainty about its efficacy and cost‐effectiveness compared to face‐to‐face interventions and how equitable it is for different population groups. SLTs reported that effective implementation of telehealth services was dependent upon several contextual factors; affordability was a perceived barrier to clients having access to telehealth resources, intervention via telehealth was perceived as more acceptable than assessment, and whilst many SLTs welcomed aspects of telehealth, there were concerns about the physical and mental health consequences for practitioners. Six themes for the future development of telehealth in paediatric speech and language therapy were identified: (1) balanced and tailored services; (2) technology and equipment; (3) information and communication; (4) capacity building; (5) monitoring and evaluation; and (6) leadership and governance. Conclusions: Outcomes highlight promising, concerning and uncertain aspects of telehealth in paediatric speech and language therapy. SLTs value a flexible and tailored approach to service delivery and recommend that effective leadership, clear communication, ongoing policy and guidance development, upskilling of users and careful evaluation of impact are required to ensure optimal implementation. The APEASE criteria offer a valuable opportunity to enhance and streamline practice and research to ensure sustainable implementation of telehealth in the paediatric speech and language therapy services of tomorrow. WHAT THIS PAPER ADDS: What is already known on this subject: The COVID‐19 pandemic led to the increased use of telehealth as a main mode of service delivery in paediatric speech and language therapy. Pre‐COVID‐19, evidence for the use of telehealth in this field included small‐scale experimental studies that reported on children with particular disorders and explored telehealth outcomes in comparison to face‐to‐face delivery. The realities of at‐scale clinical practice were not well‐represented, and critical elements of service such as cost‐effectiveness were often overlooked in the paediatric literature. Furthermore, despite emerging global evidence for temporary telehealth responses to the crisis in speech and language therapy, the long‐term and future use of telehealth remains unclear. What this paper adds to existing knowledge: The current study applied the lens of the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side‐effects, and Equity) criteria, which were used in this case to consider socioeconomic, ecological and cultural factors to capture an overarching understanding of the use of telehealth in paediatric speech and language therapy, and to inform the role of telehealth in future, longer‐term and at‐scale service development. Results indicated emerging trends in UK paediatric speech and language therapists' (SLTs') perceptions of telehealth and SLTs perceived a hybrid approach to service delivery, combining mostly face‐to‐face services with some telehealth, was likely to continue in the future. We identified six themes to guide the future development of telehealth in paediatric speech and language therapy services: (1) balanced and tailored services; (2) technology and equipment; (3) information and communication; (4) capacity building; (5) monitoring and evaluation; and (6) leadership and governance. What are the potential or actual clinical implications of this work?: UK SLTs believe that speech and language therapy services using telehealth should be reflective, tailored and flexible to meet the requirements and circumstances of the children, young people and families served, as well as the physical and emotional needs of practitioners. SLTs recommend that this service development is clearly communicated to all stakeholders and suggested that those using telehealth should be supported through appropriate training, and ongoing effectiveness should be monitored. Telehealth is here to stay and the APEASE criteria offer a unique opportunity to ensure sustainable models of service delivery; to support co‐ordinated leadership at the local, national and international levels and the development of policy and clinical guidance. [ABSTRACT FROM AUTHOR]

Acute and chronic operational and organizational stress dysregulate associated neuroendocrine responses and have been shown to increase health risks and occupational performance errors. The current paper addressed a research gap comparing biopsychosocial stress measures and its interaction on police lethal force errors during realistic critical incident (CI) scenarios. A combined sample (n=101) of frontline and tactical police officers completed externally valid, live-action scenarios requiring lethal force decisions paralleling field experiences. Officers provided diurnal and reactive (pre-to-post CI) salivary cortisol samples, and self-reported mental health and stress symptoms. Higher cortisol awakening response significantly predicted increased odds of committing a lethal force error by 6.45%. However, further regressions deemphasizing influential outliers via logarithmic transformations (as per Psychoneuroendocrinology expert consensus guidelines⁠—Stalder et al., 2016) revealed a no longer significant association. Reactive cortisol did not predict lethal force error across all subsamples. Consistent with previous literature, several significant relationships between mental health symptoms and cortisol were observed. The use of cortisol in field research presents a number of collection, control, and cost challenges. Furthermore, outliers are necessary to include in analyses to represent the potential cortisol dysregulation in police officers deemed 'fit for duty' by their respective organizations. The current findings suggest that diurnal cortisol is heavily influenced by outlier values, and reactive cortisol may be too subtle to predict lethal force errors during acute stress. While purposeful for predicting long-term health outcomes, pursuit of alternative measures may be more suitable for assessing acute operational errors in field research. [ABSTRACT FROM AUTHOR]