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Police attendance in mental health contexts is often traumatic for the person in crisis, their family and first responders. Existing literature on police involvement in mental health responses tends to focus on police perspectives. Scholarship exploring lived experience perspectives is limited, yet is crucial for informing programmes, policies and reforms. We present findings from one of the first projects co-produced with people with lived experiences of being apprehended by police under mental health legislation. Interviews were conducted with twenty participants who had experience(s) of police apprehension across Australia. Findings highlight the social disadvantage experienced by participants prior to being apprehended and that use of force (such as tasering, pepper spraying and restraining in locked police vans) was common and over-used. Our study identified that police apprehension has lasting and wide-ranging impacts, leading to loss of employment, trauma, property damage, negative self-perceptions, discrimination, and fear of future police responses. Some participants were also apprehended by police while experiencing family violence and were misidentified as perpetrators. We argue police use of force mirrors the use of force within mental health services, with participants not experiencing a clear separation between police and mental health responses. The article shares participants' ideas for change, including response models based on human rights, police non-attendance and peer-led initiatives. Our findings suggest the need for investment in alternatives to police responses and further research involving lived experience perspectives to inform out understanding of mental health crisis responses. [ABSTRACT FROM AUTHOR]

This paper outlines the development of standardized scenarios used to assess the efficacy of Crisis Intervention Team (CIT) training in a randomized, controlled trial. The objective was to create scenarios that accurately simulate mental health crisis situations for law enforcement officers, ensuring that each scenario tests specific CIT skills relevant to real-world encounters. Our process involved building an interdisciplinary team and drawing from the knowledge and experience of professionals in law enforcement, mental health, and performance arts to design a set of scenarios that are both realistic and challenging. The scenarios were developed to represent mental health crises that officers frequently encounter, such as mania, psychosis with agitation, and depression with suicidality. Each scenario requires officers to demonstrate CIT-specific skills such as verbal de-escalation, empathy, and critical decision-making. Our structured approach to developing these scenarios provides a replicable model for future studies that aim to assess the real-world effectiveness of mental health training for law enforcement as well as other professional groups. [ABSTRACT FROM AUTHOR]

Background: The 4 decades of conflict have particularly exacerbated the mental health of Afghan war widows, a population that has not been extensively studied in this context. Aim: This study aims to fill the gap in the literature by providing robust data on the prevalence of depression and anxiety symptoms and identifying associated factors among Afghan war widows. Methods: A cross-sectional study was carried out in 2023, interviewing war widows from four community health centers in Kandahar, Afghanistan. We employed a validated Patient Health Questionnaire and Generalized Anxiety Disorder Scale. A multivariable binary logistic regression model was used to determine factors associated with depression and anxiety symptoms. Results: The prevalence of depression and anxiety symptoms was 57.9% (95% CI: 52.7%–62.8%) and 61.5% (95% CI: 56.4%–66.4%), respectively. There were significant differences in the prevalence of mental health symptoms across our population with different sociodemographic and health-related profiles (in particular, time since widowhood, household income, history of comorbidity, and level of social support). Conclusion: The stark prevalence of mental health issues among Afghan war widows underscores an overlooked humanitarian crisis. The findings call for immediate mental health interventions, tailored to the sociopolitical realities of Afghanistan. [ABSTRACT FROM AUTHOR]

The term 'mental health crisis' is a widely used concept in clinical practice and research, appearing prominently in mental health literature across healthcare and social science disciplines. Within these contexts, the term is frequently either left undefined or defined rather narrowly, confined to clinical observations or guidelines targeted at healthcare providers and negating the multifaceted nature of crisis as described by those with lived experience. Therefore, the aim of this paper is to explore the characteristics of and provide a conceptual definition for the concept of 'mental health crisis'. Rodgers' method of evolutionary concept analysis was employed and 34 articles, ranging from 1994 to 2021 and a variety of disciplines, were analysed. The results highlighted the contrast between clinically oriented surrogate terms and related concepts and those used by individuals with lived crisis experience. Antecedents of crisis included underlying vulnerabilities, relational dysfunction, collapse of life structure and struggles with activities of daily living. The concept's attributes encompassed the temporality of crisis, signs and symptoms of crisis, functional decline and crisis in family and caregivers. Finally, the consequences comprised looking inward for help, looking outward for help, and opportunities and dangers. This concept analysis serves as a foundational step in understanding 'mental health crisis' and its various dimensions, facilitating more nuanced discussions and interventions in the realm of mental healthcare. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Involuntary detention is a legislative power that allows people to be taken against their will for a mandatory mental health assessment and is known to be a restrictive and traumatizing process for patients.While there is some literature examining police/ambulance and mental health worker co‐response models, the conclusions are mixed as to whether they reduce rates of involuntary detentions in mentally ill people.The Police, Ambulance, Clinician Early Response (PACER) model is an example of a tri‐response mental health crisis response team whose role is to respond and assess people thought to be experiencing a mental health crisis.There is little literature to determine whether PACER tri‐response model reduces incidents of involuntary detention when compared with standard police and/or ambulance responses. What this paper adds to existing knowledge?: This paper describes the outcomes of patients assessed by a PACER team, compared with patients who were assessed by police or ambulance.It demonstrates that PACER may reduce unnecessary involuntary detentions through expert mental health assessment for patients coming to emergency services for assistance. It is one of only two published studies examining a tri‐response model. What are the implications for practice?: The results of this study may support health and policing policymakers to implement PACER models as a means of reducing involuntary detentions, reducing demand for emergency departments, reducing time spent by emergency services responding to people experiencing mental health crisis and improving outcomes for people with mental illness. Background: Involuntary detention is a common method of enforcing mental health assessment and treatment; however, it is associated with poor patient outcomes and high emergency service and hospital demand. Aim: To examine the association between (1) Police, Ambulance, Clinician, Early Response (PACER) model, (2) police or (3) ambulance response and rates of involuntary detention of mentally ill people. Methods: A retrospective observational study using routine administrative data in an Australian City, over a 12‐month period (2019–2020). Results: Over a 12‐month period, 8577 people received crisis mental health intervention in the study setting. We observed an 18% increase in the relative risk of being involuntarily detained by police, and a 640% increase in the relative risk of being detained by ambulance. The PACER team detained 10% of their total presentations, as compared with 12% by police and 74% by ambulance. Involuntary detentions enacted by PACER were more likely to convert to a post‐detention hospitalization (72%), when compared with police (27%) and ambulance (17%). Discussion: PACER was associated with lower rates of involuntary detention and higher rates of post‐detention hospitalization when compared to police and ambulance response. Implications for Practice: PACER cohort experience more positive outcomes than with police or ambulance cohorts. [ABSTRACT FROM AUTHOR]

As the number of children and young people (CYP) attending the emergency department (ED) with a mental health crisis is increasing, it has become evident that neither the environment nor the training for general paediatricians is adequate to meet CYPs' mental health needs. This short article provides an essential toolkit for paediatricians and other healthcare professionals working with CYP. It provides a resource encompassing skills and knowledge to promote understanding of mental health crises and strategies to address these when CYP are in ED or admitted to the ward. It will allow general paediatricians to address the agitation and distress experienced by many CYP in EDs or on paediatric wards and use verbal de-scalation techniques rather than medications. The toolkit highlights how to take an appropriate mental health history, perform a mental state examination and if necessary medical investigations required, as well as providing an overview of the legal framework under which mental health conditions are managed in different age groups. A short section highlights the most common mental health issues and their management. Lastly, the CAMHS structure is explained to support the multi-professional collaboration needed to ensure CYP are managed appropriately between teams and have the best support and care possible in the ED and on paediatric wards. [ABSTRACT FROM AUTHOR]

The Fayetteville, AR, Police Department (FPD) initiated a co-response program in 2021, partnering with social workers to respond to individuals in crisis. Originally started with a University of Arkansas School of Social Work (UA) internship, the Crisis Intervention Response Team (CIRT) has grown over time. The program now includes two full-time co-response teams, two social work interns, and plans for further expansion. UA provides support for the program through continued internships, clinical supervision, and program evaluation. This article reports on one aspect of the UA program evaluation focusing on FPD employees' perspectives on integrating social workers into their department and how those perspectives have changed over time as the program has expanded. Through semi-structured interviews and survey data collected in 2021 and 2023, this research highlights key factors contributing to the program's successes and continued challenges. The results provide valuable insights, suggestions, and other factors to consider for similar police departments when making decisions whether to establish or expand co-response initiatives. [ABSTRACT FROM AUTHOR]

ABSTRACT A number of people experiencing a mental health crisis who present to a hospital emergency department (ED) do not wait (DNW) for assessment or care and leave. This phenomenon is poorly understood and offers an opportunity to enhance quality of care. We sought to understand the characteristics and reasons of those who DNW for assessment or care, and what happens after leaving the ED. We used a semi‐structured telephone interview method with open‐ended and single choice responses. Participants were recruited from Eastern Health hospitals who had been referred from the ED for specialist mental health care. Respondents (N = 42) tended to be female adults in their 30s, accompanied by another person, and seeking short‐term relief and long‐term care for a mental health crisis. It became increasingly obvious over time to participants that the cost of waiting was outweighed by the benefit of leaving. A range of factors were identified that took them to this tipping point. Over half reported their condition as having improved and did not seek further care after leaving the ED. Respondents thought a comfortable ‘safe place’ and communication that conveyed respect and reduced uncertainty while waiting would reduce early leaving. There were challenges in engaging a DNW population. Nonetheless this study offers valuable insights into this phenomenon in an ED setting. Many of the expressed views for reducing DNW appear to be reasonable and achievable. [ABSTRACT FROM AUTHOR]

Mental health has become increasingly important for the applied sport psychologist, a factor which may include screening, promoting literacy, individual support, and educational programs. However, despite of this importance, few checks have been made on the perceived preparedness of sport psychologists to undertake this work and whether differences may exist between those recently qualified compared to experienced practitioners. Underpinned by the theoretical domains framework, 62 Health and Care Professions Council registered practitioner sport and exercise psychologists (30 females: age: M = 46.13 years and SD = 10.44 years and 32 males: age: M = 43.25 years and SD = 10.47 years) completed an online survey to assess whether they felt equipped to address the mental health dimension of their work. The survey comprised three sections: Demographic and background information, a series of statements (n = 31) adapted from the determinants of implementation behavior questionnaire, and three questions with space for free text comments, inviting participants to explain their level of preparedness to incorporate and deliver mental health interventions. A 6 × 12 analyses of variance yielded significant differences between domain ratings but not across levels of experience or interactions. Data from free text comments were analyzed thematically and categorized into the following three themes: (a) complementing the performance role, (b) awareness of professional boundaries, and (c) importance of further continued professional development. Combined, although practitioners emphasized importance, preparedness ratings ranged from neutral to somewhat agree, calling for further specific sport psychology‐based mental health training. Highlights: An online survey, underpinned by the theoretical domains framework, was used to assess whether registered sport and exercise psychology practitioners in the United Kingdom felt prepared to undertake the mental health dimension of their work.Analysis through ANOVA yielded no significant differences across experience or interactions, suggesting that preparedness and implementation do not differ regardless of whether recently qualified or experienced practitioners. Furthermore, average ratings across all domains revealed practitioners feel only "somewhat prepared" to address client needs in this area.Free text comments provided additional insight to levels of preparedness where practitioners noted the frequent necessity to offer mental health support, why it complements the performance focus, and how they are uniquely placed to understand the specific contextual demands, yet were cognizant of their competencies, knowledge base, and boundaries.Calls for further specific sport psychology‐based mental health training are warranted by the professional bodies in the United Kingdom to ensure practitioners feel equipped to address this increasingly important factor of their work. [ABSTRACT FROM AUTHOR]

This article uses data from a doctoral thesis concerning service users' views on what works for them in relation to their mental health wellness following a suicidal ideation/attempt in Aotearoa New Zealand. In particular, it focuses on the experiences of service users regarding mental health crisis team responses and what they wanted from their crisis teams specifically. Participants indicated that what they wanted was to feel heard, respected and not judged, consistent with the core conditions of therapeutic alliance within such professions as social work, counselling and psychology. Social work has a valuable role to play in emphasising and advocating for social, contextual and non-medical responses within crisis teams and service delivery. [ABSTRACT FROM AUTHOR]

This article offers a narrative analysis of the contributing factors of moral distress (MD) and moral injury (MI) among mental health clinicians working amidst humanitarian crises. It discusses the impact of moral stress on therapeutic relationships in mental health trauma. The article originated from the author's experience developing a peer‐to‐peer support program at a nongovernmental organization (NGO) and conducting peer‐to‐peer support for mental health clinicians and healthcare providers in Ukraine and Turkey. A significant amount of literature has documented the detrimental effects of MD and MI on mental health, job sustainability, and resilience of healthcare providers and first responders. The negative effects of MD and MI are particularly relevant in trauma counseling, where clinicians must draw upon the use of self to develop therapeutic relationships with their clients. This process demands a high level of moral reasoning and self‐awareness, which can be severely tested under the morally challenging conditions of a humanitarian crisis. There is an imperative need to deepen our understanding and to swiftly address the factors that precipitate MD and MI in mental health clinicians working in crisis zones. By doing so, we aim to bolster their resilience and the enduring nature of their commitment to help and save others. This, in turn, will not only contribute to saving more lives but also enable those who are affected by trauma to flourish in the aftermath of their experiences. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has had a well-evidenced impact on adolescents, who are especially sensitive to pandemic disruptions given the critical role of socialization in their development. In Chile too, evidence shows increases in mental health complaints among adolescents over the lockdown period. Our study aimed at exploring the experiences of Chilean adolescents regarding their mental health during the lockdown and school closure (March 2020-December 2021), and during the return to on-site education (2022) as informed by adolescents and school staff, with a focus on family, school, and social sources of risk and support for adolescents' wellbeing during these periods. Methods: Using a qualitative approach, we conducted semi-structured interviews with 19 adolescents and 16 staff members from schools in an urban area of Chile. Results: Through thematic analysis, we generated five themes: [1] Adolescents in a mental health crisis, comprising a range of distressing experiences and mental health problems. This crisis was fueled by alterations in the functioning of adolescents' systems: [2] Broken support systems (peers and school); [3] The school agenda must go on, reflecting schools' strict compliance with the educational curriculum; and [4] Blurred boundaries between home and school life and within the family. Finally [5], Development will (try to) find its way describes how most participants experienced a bouncing back to wellbeing in the course of the school year upon return, and how some developmental milestones took place despite the abnormal conditions, providing evidence for resilience amid pandemic adversity. Conclusions: The findings give insight into how the exchanges between the adolescent and the social systems they are embedded in were interfered. The results help us understand the challenges for mental health during and after the pandemic, and highlight adolescents' capacity to thrive as normality was restored. The results also underscore the importance of upholding stability across adolescents' systems and routines, in order to mitigate impacts on wellbeing amid abnormal circumstances. The findings are relevant for development-informed initiatives in policy design in the aftermath of the pandemic and in future crisis management responses. [ABSTRACT FROM AUTHOR]

The key goal of the mental health nurse practicing in emergency mental health care services is ensuring that their patients have access to best practice mental health care. The aim of this study was to examine mental health nurses' perceptions of their role in and preparation for providing mental health care services for pediatric emergency department patients. A qualitative constructivist method was employed. Inductive data were gathered using a focus group discussion model employing open-ended questions as probes. The participants were nine experienced practicing mental health nurses. Discussion was facilitated through detailed probing of the nurses' experiences in providing care for clients in emergency departments. Four principal themes emerged from the data about mental health nurses' experiences during the provision of emergency care: (i) barriers to adequate care provision; (ii) problems among populations; (iii) pediatric special needs; and (iv) the general need for improvements to mental health care. Each participant in this study asserted that they endorse the introduction of care by specialized mental health nurses in emergency care departments to better serve this population in Saudi Arabia. Inclusion and acceptance of psychiatric mental health nurses as full members of the multidisciplinary emergency department team, improved education and training opportunities, standards-based evaluation by collegial supervisors, availability of tools for assessment, and recognition of the role of pediatric psychiatric mental health nurses in emergency department care were goals expressed by the focus group members. Plain language summary: Nurse perceptions of pediatric mental health emergency care The MHNP emergency service need improve the standard of care for pediatric patients presenting in the ED by removing the typical stages between assessment, referral, and subsequent therapeutic program. Accessible Summary What is known on the subject? The MHNP emergency service needs to improve the standard of care for pediatric patients presenting in the ED by removing the typical stages between assessment, referral, and subsequent therapeutic program. What does this paper add to existing knowledge? Additional research is required to investigate the service to improve access to in-progress care via enhanced bonds and channels with general practitioners and specific discipline services. What are the implications for practice? Establishing and assessing this broadened MHNP role will also help to highlight the advantages of advanced nursing practice in modern healthcare in Saudi Arabia. By providing efficient access to mental health expertise and more simplified synchronization of care, the ED can increase awareness about mental health and positively affect patient outcomes. [ABSTRACT FROM AUTHOR]

During and subsequent to a natural disaster, there is an expectation that certain elements of society will continue to operate with a degree of normalcy. For example, it is expected that emergency medical services will continue to function and remain reliable for the community served. Expectations such as these are based on the presumed reliability of government and the assumption that those responsible for the relevant infrastructure will have made plans to ensure it remains functional and taken steps to mitigate known weaknesses. The COVID-19 pandemic provides a case in point. Specifically, data captured during the pandemic are now the subject of ongoing review and analysis, and the findings from such studies are being used to inform planning and preparedness for the next public health disaster. This particular study was conducted in response to circumstantial evidence indicating that frontline workers in the healthcare profession may share some of the same ambivalence towards transmission mitigation as seen in the general population when confronted with new and emerging communicable diseases. This is a concern, as when medical personnel are either unable or unwilling to take reasonable steps to protect themselves and their patients, it undermines the readiness of the essential service. To explore this situation in greater depth, the study examines the real-time responses from a sample of frontline personnel interviewed during the pandemic. The results indicate that there are a number of opportunities to improve workforce readiness to assure reliable continuity during the next outbreak, epidemic or pandemic. [ABSTRACT FROM AUTHOR]

A service evaluation was conducted to explore staff perception of the role of assistant psychologists (APs) working in a Crisis Resolution and Home Treatment Team (CRHTT). Four APs were employed on a pilot scheme and embedded in four CRHTTs across Hywel Dda University Health Board (HDUHB). Using a mixed-methods survey, data were collected from staff working with these CRHTTs (N = 26). Quantitative results reported that the participants perceived the contribution of the AP as 'very valuable' to both the team and its patients. Qualitative results identified two overarching themes (Additional Value and Additional Expectations) and five themes (with subthemes): (1) A Stepping Stone; (2) A Different Perspective; (3) More is Needed; (4) Clarifying the Remit; and (5) The Impact on Discharge. Integrative analysis indicated that there is a need to improve staff understanding of the role and its remit. Further evaluation and research is needed to ensure greater understanding and clarification of the role. [ABSTRACT FROM AUTHOR]

The article discusses programs and policies addressing perinatal mental health crisis at the national, state, and local levels in the U.S. Initiatives at the population level aimed at improving the quality of care for perinatal individuals and their newborns and infants, the perinatal psychiatry access programs being implemented by states, and the benefits of the behavioral health model called collaborative care model (CoCM).

This study examined how organizations may promote their employees' mental health in difficult times. Drawing from organizational crisis communication and organizational health promotion research, it proposed and tested a dual-process model that links leadership health support, an essential dimension of organizational health culture, with organizational leaders' crisis communication (i.e. use of ethical-base responses) and workers' self-care awareness and perceived stress in a crisis. Through a survey of 502 full-time U.S. employees conducted during COVID-19, we found that organizational leaders' use of ethical-base responses predicted employees' enhanced self-care awareness and decreased stress levels. Further, leadership health support provided a double-buffer effect to sustain employee mental health by directly bolstering employees' self-care awareness and organizational leaders' use of ethical-base responses. The findings of this study bridge the gaps in organizational health promotion and crisis communication literature and offer practical suggestions for organizations seeking to foster employees' mental health challenges during crises. [ABSTRACT FROM AUTHOR]

The mental health system is impacted by extreme delays in the provision of care, even in the face of suicidal behaviour. The failure to address mental health issues in a timely fashion result in a dependence on acute mental health services. Improvement to the mental health care system is impacted by the paucity of information surrounding client profiles admitted to inpatient settings. Using archival data from 10,865 adolescents 12–18 years of age (Mage = 14.87, SDage = 1.77), this study aimed to examine the characteristics of adolescents admitted to psychiatric inpatient services in Ontario, Canada. Multivariate binary logistic regression revealed that adolescents reporting interpersonal polyvictimization, greater family dysfunction and higher risk of suicide and self-harm had a greater likelihood of an inpatient mental health admission. The interRAI Child and Youth Mental Health assessment can be used for care planning and early intervention to support adolescents and their families before suicide risk is imminent. [ABSTRACT FROM AUTHOR]

Research examining the effects of COVID-19 on the criminal legal system—including the demand for police services—is accumulating. However, few empirical inquiries have sought to examine the pandemic's effect on mental health and wellbeing by analyzing calls for service (CFS) involving emotionally disturbed persons (EDP). This study examines CFS received pre- and post-pandemic by Houston's crisis intervention team (CIT). By examining visual trends and using interrupted time-series analysis (ITSA), we analyze COVID-19's immediate and long-term effects. In the current study we examine three distinct call types: (1) Risk to others; (2) Risk to self; and (3) Welfare calls. Findings demonstrate significant increases in the overall CFS after the implementation of the initial stay-at-home order in Houston, with some differences in trends based on call type. These findings further our understanding of COVID-19's impact on mental health and wellbeing during the pandemic through the lens of the increased demand for police services. Specific implications for the study site department are discussed, and to the extent possible, general implications for other departments with CIT programs. [ABSTRACT FROM AUTHOR]

Psychological hotlines are widely used, convenient, and effective means to help people overcome their stress reactions. In this article, we focused on integrating somatic and mental-micro interventions into the psychological assistance hotline process. In addition to verbal communication, dance movement therapy based on the body-mind interaction can help clients re-establish their connection with psychological resources, such as creativity and resilience in addition to verbal communication. Based on the basic steps and core points of the SAFER-R model, we explored how embodied movement elements can be applied to the hotline setting for body-mind micro-interventions. Furthermore, we proposed the CREATE model and explained how it can be used to intervene and realise the basic functions of psychological hot line service through four case vignettes. Through this article, we added new perspectives and options for the provision of psychological support during public health events, and we enriched the working methods of psychological hotline assistance. [ABSTRACT FROM AUTHOR]

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BACKGROUND: Telehealth utilization exploded during the COVID‐19 pandemic, including within school‐based health programs. School‐based tele‐behavioral health can help programs overcome barriers of access to care, but the current state and effectiveness of such programs are unknown. METHODS: A scoping literature review was conducted. Studies were included if they described in‐school behavioral health services delivered via telehealth for children ages 5 to 18. From the included studies, population, location, setting, intervention, telehealth modality, clinician type, and outcomes assessed were extracted. FINDINGS: Eighteen studies met inclusion criteria. All described psychotherapy or medication management delivered by psychologists (n = 7) and/or psychiatrists (n = 11). Treatment included psychotherapy (N = 8), psychiatric consultation (N = 7), medication management (N = 4), crisis stabilization (N = 1), and caregiver education (N = 1). Eight studies provide qualitative or quantitative outcomes, with 4 examining clinical effectiveness. CONCLUSIONS: Despite limited findings in the literature, school‐based tele‐behavioral health is feasible, effective, and acceptable for delivery of behavioral health care to children and adolescents. [ABSTRACT FROM AUTHOR]

Context: To address the considerable burden of mental health need in the United States, Congress passed the National Suicide Hotline Designation Act in 2020. The act rebranded the national suicide prevention lifeline as 988, a three-digit number akin to 911 for individuals to call in the case of a mental health emergency. Surprisingly little is known about American attitudes toward this new lifeline. Methods: The authors use a demographically representative survey of 5,482 US adults conducted June 24–28, 2022, to examine the influence of mental health status, partisan identification, and demographic characteristics on public awareness of the new 988 lifeline, public support for the lifeline, and intention to use it. Findings: The authors find that while only a quarter of Americans are aware of the lifeline, support for the 988 lifeline is widespread, with more than 75% of Americans indicating they would be likely to use the new number if needed. The authors identify key disparities in awareness, support, and intended use, with Republicans, individuals with low socioeconomic status, and Blacks less supportive of the 988 lifeline and in some cases less likely to use it. Conclusions: The results point to the need for additional interventions that increase public awareness of 988 and reduce disparities in program knowledge, support, and intention to use. [ABSTRACT FROM AUTHOR]

This collaborative paper explores the interconnections between climate change and the mental health and well‐being of Indigenous women in Western Canada. As the impacts of climate change intensify globally, vulnerable populations, particularly Indigenous communities, face disproportionate and multifaceted challenges. Centering on Indigenous women in Western Canada, this study explores how the climate crisis magnifies Indigenous communities' mental health disparities. Drawing from the Indigenist feminist research approach, the investigation focuses on Indigenous women's lived experiences, perceptions, and land‐based coping strategies amidst climate challenges, while simultaneously addressing the unique social, cultural, and historical factors influencing their mental health vulnerabilities within the context of climate change. The findings shed light on the complex relationships between environmental degradation, ongoing colonial impacts on traditional practices, and the mental well‐being of Indigenous women. Concluding with implications for policy and community‐led interventions, this research contributes to the discourse on the intersectionality of climate change impacts and mental health, particularly focusing on Indigenous women in Western Canada. [ABSTRACT FROM AUTHOR]

Hospital social workers play a critical role during public health emergencies such as the COVID-19 pandemic. This study examined how hospital social workers describe essential roles and responsibilities in mental health care. In response to an exploratory survey, 97% of participants (N = 225) stated that hospital social workers provide essential services and using inductive content analysis, five essential responsibilities of social work practice emerged: (1) counseling, intervention, and support, (2) suicide and crisis intervention, (3) support for families, (4) clinical case management, and (5) interprofessional collaboration and support. We discuss implications for social work practice in mental health. [ABSTRACT FROM AUTHOR]

Suicide is a critical public health issue in the United States, recognized as the tenth leading cause of death across all age groups (Centers for Disease Control and Prevention, 2020). Despite the Islamic prohibition on suicide, suicidal ideation and suicide mortality persist among Muslim populations. Recent data suggest that U.S. Muslim adults are particularly vulnerable, with a higher attempt history compared to respondents from other faith traditions. While the underlying reasons for this vulnerability are unclear, it is evident that culturally and religiously congruent mental health services can be utilized to steer suicide prevention, intervention, and postvention in Muslim communities across the United States. However, the development of Suicide Response toolkits specific to Muslim populations is currently limited. As a result, Muslim communities lack a detailed framework to appropriately respond in the event of a suicide tragedy. This paper aims to fill this gap in the literature by providing structured guidelines for the formation of a Crisis Response Team (CRT) through an Islamic lens. The CRT comprises of a group of individuals who are strategically positioned to respond to a suicide tragedy. Ideally, the team will include religious leaders, mental health professionals, healthcare providers, social workers, and community leaders. The proposed guidelines are designed to be culturally and religiously congruent and take into account the unique cultural and religious factors that influence Muslim communities' responses to suicide. By equipping key personnel in Muslim communities with the resources to intervene in an emergent situation, provide support to those affected, and mobilize community members to assist in prevention efforts, this model can help save lives and prevent future suicide tragedies in Muslim communities across the United States. [ABSTRACT FROM AUTHOR]

Background: Mental health crisis care includes emergency departments (EDs), crisis phone lines and crisis alternatives. Currently, there is an overreliance on EDs to provide mental health crisis care, with evidence that responses are often inadequate to meet the needs of people experiencing mental health crises. However, the complexities of how individuals experience crisis care across the varying contexts of EDs, crisis phone lines and crisis alternatives remain underresearched. Method: This study used a hermeneutical phenomenological approach to understand the lived experience of accessing care during a mental health crisis. Thirty‐one Australian adults who had accessed crisis services at ED, phone lines and/or crisis alternatives participated in in‐depth interviews. Results: The findings are organised across the temporal narratives of participants' experiences from (1) point of contact, (2) positive and negative care experiences and (3) enduring impacts. Several themes were generated during these phases. The findings demonstrate the interrelated nature of care experiences and enduring impacts. With some exceptions, care received within EDs was harmful, resulting in lasting adverse effects. Responses from crisis phone lines were mixed, with participants appreciating the accessibility of after‐hour phone support but finding standardised risk assessments unhelpful. Responses from crisis alternatives to ED were promising, aligning with the need for validation and human connection, but were not always accessible or easy to mobilise during a crisis. Notably, across all settings, positive effects were firmly attributed to the quality of the relationship with specific crisis providers. Conclusion: The findings bring into sharp focus the lived experience of people accessing crisis care and contribute to the shortage of literature on subjective experiences. Providers may better meet the needs of those experiencing mental health crises by understanding the enduring impact of these interactions and the role of human connection beyond a focus on risk assessment, thereby providing opportunities for a joint understanding of risk and meaning‐making. Furthermore, understanding the subjective experience of crisis care can guide reforms to ED and develop crisis alternatives to better meet the needs of people in crisis. Patient or Consumer Contribution: The first author and the third author are in designated lived experience (Consumer) roles. The first author conducted the interviews and was explicit regarding their lived experience when engaging with participants. Service users were involved as advisors to the study and provided input into the design. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and associated public health measures altered patterns of help-seeking for mental health, with increases in emergency department utilisation reported. We examined the association between COVID-19 restrictions and adult emergency department (ED) mental health presentations in Victoria, Australia, through secondary analysis of data from 39 public EDs across the state. Participants were all patients (18+ years) presenting between 1 January 2018 and 31 October 2020 with mental health or intentional self-harm. The main outcome was number of presentations for each mental health condition, by patient age, socioeconomic status (SES), location, and ED triage category. We used a Poisson regression model to compare predicted monthly ED presentations based on trends from 2018, 2019 and 2020 (up to 31 March), with observed presentations during the initial months of the COVID-19 pandemic (1 April to 31 October 2020). There was an average of 4,967 adult mental health presentations per month pre-COVID-19 (1 January–31 March 2020) and 5,054 per month during the COVID-19 period (1 April–31 October 2020). Compared to predicted incidence, eating disorder presentations increased 24.0% in the COVID-19 period, primarily among higher SES females aged 18–24 years. Developmental/behavioural disorder presentations decreased by 19.7% for all age groups. Pandemic restrictions were associated with overall increases in monthly adult ED presentations for mental health, with some disorders increasing and others decreasing. Accessibility of acute mental health services needs to be addressed to meet changing demand and ensure services are responsive to changes in presentations resulting from future public health challenges. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to describe the experience and practice of an intervention process for mental health crisis with 14,093 students living in a suddenly quarantined campus during the COVID‐19 pandemic. Methods: An expert committee of psychiatrists, psychologists and student counsellors was formed to manage the psychological crisis experienced by students. The committee provided online and onsite support, disclosed timely information, attended various online courses and facilitated various activities. Using the PHQ‐9, GAD‐7 and ISI scales, psychological weekly reports, student files and emergencies, students who were likely to have a crisis event were screened, and their degree of crisis was evaluated. A "one person–one case–one team" intervention was conducted for high‐risk students. Results: Of the 14,093 students, 11,121 finished all three online questionnaires. Based on the results of the screening tests, 732 students were placed in the prioritised attention group, 293 in the crisis group and 33 (10 [3.41%] male and 23 [7.85%] female) showed severe suicidal intentions. In total, 186 (3.26%) students declared poor sleep quality, while 610 (10.05%) students were found to have depression. The number of students affected with generalised anxiety was 650 (10.77%). Clinical intervention was successful with no untoward incidents. Conclusions: With strong support from the government, and the cooperation between multidisciplinary experts and the comprehensive intervention programme, the study obtained positive results. However, the limitations include the partial online survey responses and incomplete records of intervention. Nevertheless, the findings of this study could provide a foundation for further research. [ABSTRACT FROM AUTHOR]

COVID-19 has continued to bring devastation to children and families, even 1 year into the pandemic. The rise of the Black Lives Matter movement has also led to renewed attention to systemic racism in the United States and awareness of how the pandemic has further exacerbated health inequities that disproportionately affect communities of color. Pediatric hospital social workers have played a key role since the beginning of the pandemic in responding to the resulting behavioral health crisis and helping to address social disparities. There is a need to understand how the roles and experiences of pediatric social workers have evolved during the first year of the pandemic. In this qualitative study, a series of practice-setting based focus groups were conducted with social workers to capture (a) what has changed or stayed the same since the beginning of COVID-19, (b) thoughts and experiences on diversity, equity, and inclusion with particular attention to race and racism, and (c) perspectives about the long-term implications of COVID-19 on the profession of social work. The Framework Method was used to analyze data, from which six superordinate themes emerged: burnout/coping; the impact of patient acuity; awareness of racial inequity in patient care; awareness of social determinants of health; social worker inclusion in hospital decision-making and policy reform; and grief/racial inequity. An overview of what has stayed the same, what has changed, and what the future may hold for pediatric hospital social workers is reviewed. [ABSTRACT FROM AUTHOR]

Law enforcement officers are frequent first responders to people experiencing mental health or suicide crises. Yet, as communities consider expanding crisis response options, we know very little about the nature of these calls that could inform decision making about which crisis response is best suited for the situation. This study is an exploratory, descriptive assessment of contextual factors, both individual and situational, of mental health and suicide crisis calls. Our dataset includes 166 calls to 9-1-1 related to a mental health emergency or suicide crisis. The majority were calls related to suicide (125 calls, 75%), which included more contextual factors than mental health crisis calls. Most calls resulted in the subject being transferred to the local emergency department (60%) or were resolved on scene (12%). Police use of force was rare, and no arrests were reported. The implications of these findings for communities developing alternatives to law enforcement crisis response are discussed. [ABSTRACT FROM AUTHOR]

Background: The world faces a mental health crisis with elevated rates of depression, anxiety, and post-traumatic stress, leaving a profound impact on daily quality of life (QOL). Current treatments show varying degrees of efficacy and carry burdensome challenges. Evidence exists for use of an innovative neurotechnology to reduce symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD), but the science is lacking for use in the general population. Purposes: The purpose of this pilot study was to explore the effects of microcurrent neurofeedback on depression, anxiety, PTSD symptoms, and QOL in adults. Methodology: This was a one-group, exploratory pilot study that tested outcomes of depression, anxiety, PTSD risk, suicide risk, and QOL in 20 adults using convenience sampling. IASIS microcurrent neurofeedback (I-MCN) was the intervention that was delivered twice a week for 10 weeks; data collection was baseline, 5 weeks, and 10 weeks. Results: Depression, anxiety, PTSD risk, and QOL improved significantly by the 10th and 20th session; suicidal risk showed nonsignificant reduction. Use of a more feasible interventional procedure established a foundation for use in clinical settings for the population. Conclusions: Using a more simpler procedure than what was used in a previous study reflected positive outcomes earlier and sustained over 10 weeks. This safe and effective technology carries rare but easily overcome adverse effects and could be an alternative to existing treatments or treatment-resistant conditions. Implications: Advanced practice nurses can apply the evidence to reduce symptoms of depression, anxiety, and PTSD. Randomized controlled trials and testing on diverse populations are needed. [ABSTRACT FROM AUTHOR]

Gold Card SA is a four-session structured psychological intervention offered soon after an acute crisis presentation to people with symptoms characteristic of borderline personality disorder. This study describes individual and system-level outcomes from a large-scale health-care improvement initiative to implement Gold Card SA across South Australia. An uncontrolled pre-post study design was utilized examining service user (n = 332) patient-reported outcome measures and hospital service utilization records (6 months before and after Gold Card SA). Mixed-effects negative binomial regression analysis revealed a significant decrease in rates of service utilization across emergency department presentations (63%), mental health-related inpatient admissions (65%), and bed days (82%). Linear mixed-effect regression indicated large reductions in borderline symptoms and nonspecific psychological distress, and small to moderate improvements in psychosocial functioning. People presenting with or experiencing borderline personality disorder symptoms may benefit from a brief crisis intervention embedded within a stepped care model. [ABSTRACT FROM AUTHOR]

This editorial from the journal Frontiers in Digital Health discusses the importance of addressing mental health needs during times of crisis and the potential of digital platforms in providing accessible and affordable mental health care. It emphasizes the need to focus on vulnerable and marginalized populations and raises ethical concerns related to digital mental health research. The editorial mentions six papers published on this research topic, including three that specifically focus on mental health challenges induced by the COVID-19 pandemic. These papers explore the effectiveness of online cognitive behavioral therapy, the challenges faced by social workers, and the impact of virtual classes on the social-emotional development of youth. Additionally, the editorial mentions a study protocol on mental health interventions for young adults in post-conflict regions in Colombia. The study aims to design and pilot mental health support interventions within the existing Youth-in-Action program in Colombia, with the goal of addressing mental health concerns among socioeconomically vulnerable young populations in low- and middle-income countries. [Extracted from the article]

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]

Emergency inpatient admissions of children and adolescents are more difficult if the patient is admitted involuntarily and/or the caregivers or custodians of institutional care are absent. The present study aimed to clinically characterize involuntary versus voluntary admissions by examining the reasons for presentation and associated factors. We retrospectively analyzed patients who presented to the emergency department of a hospital for child and adolescent psychiatry in Bavaria, Germany, and were admitted as inpatients for crisis intervention in the 4th quarter of 2014–2018. Reasons for presentation, clinical and sociodemographic characteristics, and type of admission (voluntary versus involuntary) were analyzed for 431 emergency inpatient admissions. A total of 106 (24.6%) patients were involuntarily admitted. In a binominal logistic regression, presentation due to alcohol consumption, deviant social behavior, and psychosocial burden was positively associated, whereas difficulties at school and depression were negatively associated, with the likelihood of involuntary admission. 58.5% of the 123 unaccompanied patients were admitted involuntarily. Reasons for the presentation of unaccompanied and voluntary inpatient admissions were suicidal thoughts, psychosocial burden, and externalized aggression. A substantial number of child and adolescent psychiatric admissions represent emergency admissions. Involuntarily admitted patients and unaccompanied children/adolescents represent a non-negligible proportion of clinical routine and the clinical and legal background factors need to be further clarified in future studies. This study is registered in the German Clinical Trials Register (24 September 2019, DRKS00017689). [ABSTRACT FROM AUTHOR]

Mental health and suicide are serious concerns in the U.S. Though many adults report struggling with their mental health, a significant proportion do not receive care for various reasons including stigma, limited availability, long wait times, inability to pay, and a lack of culturally appropriate options. Helplines can be used to fill gaps in care and, though currently underutilized, are a significant focus of the federal government in the implementation of 988. To better understand the factors that facilitate and impede the utilization of helplines, we conducted 14 focus groups with 95 college students attending a public university and two private colleges in upstate New York between April 2019 and October 2020. Participants included undergraduates, graduate students, LGBTQIA + students, student-athletes, and international students. Participants shared several reasons for using helplines including convenience, comfort, immediate support, and privacy and anonymity. On the other hand, participants expressed hesitation as they expected ingenuine interactions with operators and a lack of continuity, they feared police involvement, and they felt that helplines are not for them, as they are marketed for those in a mental health or suicide crisis and their issues are not that severe. LGBTQIA + participants provided additional reasons as to why they use and do not use LGBTQIA+-specific helplines. Together, our findings suggest the need for improved education, marketing, and training around helplines and may be used to inform the implementation and promotion of 988 in its early stages. [ABSTRACT FROM AUTHOR]

By addressing the academic imperative for mental health education and crisis intervention, this exploratory study evaluates the desirability and availability of undergraduate education in recognizing and supporting mental health conditions and crises in hospitality and tourism industry settings. Hospitality and tourism management faculty and undergraduate students were surveyed through an online survey. The majority of faculty and students agreed mental health is important to learn in the classroom to prepare for industry, yet the majority have neither taught nor learned about mental health education and crisis intervention. The findings contribute to how educational leadership influences mental health training integration in classroom instruction. Recommendations included conducting feasibility studies with hospitality management educators on the integration of mental health in classroom learning; conducting larger, more generalizable studies on the effects of such education; and integrating effective mental health and crisis intervention training for hospitality management educators and students into curricula across the field. [ABSTRACT FROM AUTHOR]

Copyright of Saúde e Sociedade is the property of Universidade de Sao Paulo, Faculdade de Saude Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: National suicide prevention strategies are general population-based approaches to prevent suicide by promoting help-seeking behaviors and implementing interventions. Crisis helplines are one of the suicide prevention resources available for public use, where individuals experiencing a crisis can talk to a trained volunteer. Samaritans UK operates on a national scale, with a number of branches located within each of the United Kingdom's 4 countries or regions. Objectives: The aim of this study was to identify any differences in call duration across the helpline service in order to determine whether service varied interregionally and intraregionally and to determine the impact of calls answered in the same region as the caller, compared with calls answered in a different region on the duration of calls made from landlines to Samaritans UK. Methods: Calls may be routed by Samaritans, wherein the telephony system sends the call to the next available volunteer, irrespective of location; therefore, individuals may be routed to a branch within the same region as the caller's current region (intraregional calls) or routed to a branch that is in a different region from that of the caller's current region (interregional calls). The origin of calls by region was identified using the landline prefix of the anonymized caller identifier, along with the region of the destination branch (as branch details are recorded in the call details record). First, a Levene's test of homogeneity of variance was carried out for each condition, that is, England calls and Scotland calls. Thereafter, for each condition, a one-way ANOVA or one-way analysis of means was carried out to evaluate any significant differences in call duration. Results: ANOVA results showed that there are significant differences in call durations between intraregional calls and interregional calls (P<.001). Across all conditions within this study, callers stayed on the phone for a shorter period of time when routed to a branch that is within the same region as the call origin than if they were put through to a branch within a different region than the call origin. Conclusions: Statistical analyses showed that there were significant differences between interregional and intraregional calls. On average, callers to crisis helplines stayed on the phone for a shorter period of time if they were routed to a branch within the same region in which the call originated than if they were routed to a branch in a different region of origin. The findings from this study have practical applications, which may allow crisis helplines to manage their resources more effectively and improve caller satisfaction with the service. [ABSTRACT FROM AUTHOR]

Background: Individuals with developmental disabilities (DD) experience increased rates of emotional and behavioral crises that necessitate assessment and intervention. Psychiatric disorders can contribute to crises; however, screening measures developed for the general population are inadequate for those with DD. Medical conditions can exacerbate crises and merit evaluation. Screening tools using checklist formats, even when designed for DD, are too limited in depth and scope for crisis assessments. The Sources of Distress survey implements a web-based branching logic format to screen for common psychiatric and medical conditions experienced by individuals with DD by querying caregiver knowledge and observations. Objective: This paper aims to (1) describe the initial survey development, (2) report on focus group and expert review processes and findings, and (3) present results from the survey's clinical implementation and evaluation of validity. Methods: Sources of Distress was reviewed by focus groups and clinical experts; this feedback informed survey revisions. The survey was subsequently implemented in clinical settings to augment providers' psychiatric and medical history taking. Informal and formal consults followed the completion of Sources of Distress for a subset of individuals. A records review was performed to identify working diagnoses established during these consults. Results: Focus group members (n=17) expressed positive feedback overall about the survey's content and provided specific recommendations to add categories and items. The survey was completed for 231 individuals with DD in the clinical setting (n=161, 69.7% men and boys; mean age 17.7, SD 10.3; range 2-65 years). Consults were performed for 149 individuals (n=102, 68.5% men and boys; mean age 18.9, SD 10.9 years), generating working diagnoses to compare survey screening results. Sources of Distress accuracy rates were 91% (95% CI 85%-95%) for posttraumatic stress disorder, 87% (95% CI 81%-92%) for anxiety, 87% (95% CI 81%-92%) for episodic expansive mood and bipolar disorder, 82% (95% CI 75%-87%) for psychotic disorder, 79% (95% CI 71%-85%) for unipolar depression, and 76% (95% CI 69%-82%) for attention-deficit/hyperactivity disorder. While no specific survey items or screening algorithm existed for unspecified mood disorder and disruptive mood dysregulation disorder, these conditions were caregiver-reported and working diagnoses for 11.7% (27/231) and 16.8% (25/149) of individuals, respectively. Conclusions: Caregivers described Sources of Distress as an acceptable tool for sharing their knowledge and insights about individuals with DD who present in crisis. As a screening tool, this survey demonstrates good accuracy. However, better differentiation among mood disorders is needed, including the addition of items and screening algorithm for unspecified mood disorder and disruptive mood dysregulation disorder. Additional validation efforts are necessary to include a more geographically diverse population and reevaluate mood disorder differentiation. Future study is merited to investigate the survey's impact on the psychiatric and medical management of distress in individuals with DD. [ABSTRACT FROM AUTHOR]

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

Background: Artificial Intelligence (AI) applications are widely researched for their potential in effectively improving the healthcare operations and disease management. However, the research trend shows that these applications also have significant negative implications on the service delivery.Purpose: To assess the use of ChatGPT for mental health support.Methods: Due to the novelty and unfamiliarity of the ChatGPT technology, a quasi-experimental design was chosen for this study. Outpatients from a public hospital were included in the sample. A two-week experiment followed by semi-structured interviews was conducted in which participants used ChatGPT for mental health support. Semi-structured interviews were conducted with 24 individuals with mental health conditions.Results: Eight positive factors (psychoeducation, emotional support, goal setting and motivation, referral and resource information, self-assessment and monitoring, cognitive behavioral therapy, crisis interventions, and psychotherapeutic exercises) and four negative factors (ethical and legal considerations, accuracy and reliability, limited assessment capabilities, and cultural and linguistic considerations) were associated with the use of ChatGPT for mental health support.Conclusion: It is important to carefully consider the ethical, reliability, accuracy, and legal challenges and develop appropriate strategies to mitigate them in order to ensure safe and effective use of AI-based applications like ChatGPT in mental health support. [ABSTRACT FROM AUTHOR]

Crisis Resolution and Home Treatment Teams (CRHTTs) provide mental health support for people experiencing crises and its employees are at high risk of occupational stress. Reflective Practice Groups (RPGs) hold promise for reducing staff burnout. However, to date, there have been no evaluations of RPGs delivered in CRHTT settings. This study aimed to explore staff experiences of RPGs delivered in one CRHTT. All CRHTT staff members who had attended at least one RPG were approached to take part. Participants completed two supervision questionnaires and a semistructured interview. Descriptive statistics were calculated to quantify staff experiences and qualitative themes were generated using thematic analysis. Thirteen people participated, all of whom reported positive experiences of RPGs. Three qualitative themes also emerged comprising 'core components of RPGs' 'benefits to staff' and 'challenges of RPG delivery'. Staff value RPGs delivered in CRHTT settings, which may reduce staff burnout and contribute to workforce development. [ABSTRACT FROM AUTHOR]

Mental health crises cause significant distress and disruption to the lives of individuals and their families. Community crisis care systems are complex, often hard to navigate and poorly understood. This realist evidence synthesis aimed to explain how, for whom and in what circumstances community mental health crisis services for adults work to resolve crises and is reported according to RAMESES guidelines. Using realist methodology, initial programme theories were identified and then tested through iterative evidence searching across 10 electronic databases, four expert stakeholder consultations and n = 20 individual interviews. 45 relevant records informed the three initial programme theories, and 77 documents, were included in programme theory testing. 39 context, mechanism, outcome configurations were meta‐synthesized into three themes: (1) The gateway to urgent support; (2) Values based crisis interventions and (3) Leadership and organizational values. Fragmented cross‐agency responses exacerbated staff stress and created barriers to access. Services should focus on evaluating interagency working to improve staff role clarity and ensure boundaries between services are planned for. Organizations experienced as compassionate contributed positively to perceived accessibility but relied on compassionate leadership. Attending to the support needs of staff and the proximity of leaders to the front line of crisis care are key. Designing interventions that are easy to navigate, prioritize shared decision‐making and reduce the risk of re‐traumatizing people is a priority. [ABSTRACT FROM AUTHOR]

We aimed to conduct the first systematic narrative review and quality appraisal of existing evidence on the psychological consequences of crime in older victims in the community and psychological interventions. We searched five databases to identify all peer-reviewed literature published in English on psychological impact and/or interventions for older crime victims and quality appraised these using the Mixed-Methods Appraisal Tool, following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (Prospero: CRD42019140137). Evidence from included studies were narratively synthesized, along with their strengths and limitations. We found 20 studies on psychological distress in older victims, four of which included interventions. From these, we identified 30 different impacts including symptoms of anxiety, depression, post-traumatic stress disorder, emotions including humiliation and self-blame, and behavioral changes. Only feasibility interventions have been published, although promising results were reported for cognitive-behavioral informed treatments for depression and anxiety. Studies were wide-ranging in aims, crimes included, and outcomes used. Recommendations for improving the evidence-base and to raise the profile of this neglected population have been provided. [ABSTRACT FROM AUTHOR]

Objectives. To determine the burden of mental health disorders among children enrolled in Michigan's Flint Registry in the context of a local public health crisis and a nationally declared pediatric mental health crisis. Methods. This survey-based study included 1203 children aged 3 to 17 years whose caregivers enrolled them in the Flint Registry between December 2018 and March 2020 and who completed a follow-up survey between October 2020 and March 2022. The baseline and follow-up surveys included caregiver reports of childhood anxiety and depression and overall mental health wellness. Results. At enrollment, Flint Registry caregivers reported significantly higher rates of anxiety and depression among their children than caregivers reported nationally (12.9% vs 9.4% and 8.2% vs 4.4%; P <.001). Flint Registry caregivers also reported declines in their children's overall mental health wellness at follow-up, t (1472) = −4.17; P <.001. Conclusions. Our findings reveal a disparate burden of pediatric mental health disorders and exemplify the health inequities vulnerable populations face. Public Health Implications. More proactive and preventive steps should be taken to lessen this burden, especially in chronically disadvantaged communities that experience public health crises. (Am J Public Health. 2023;113(12):1318–1321. https://doi.org/10.2105/AJPH.2023.307406) [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic had a profound negative effect on mental health worldwide. The hospital emergency department plays a pivotal role in responding to mental health crises. Understanding data trends relating to hospital emergency department usage is beneficial for service planning, particularly around preparing for future pandemics. Machine learning has been used to mine large volumes of unstructured data to extract meaningful data in relation to mental health presentations. This study aims to analyse trends in five mental health-related presentations to an emergency department before and during, the COVID-19 pandemic. Methods: Data from 690,514 presentations to two Australian, public hospital emergency departments between April 2019 to February 2022 were assessed. A machine learning-based framework, Mining Emergency Department Records, Evolutionary Algorithm Data Search (MEDREADS), was used to identify suicidality, psychosis, mania, eating disorder, and substance use. Results: While the mental health-related presentations to the emergency department increased during the COVID-19 pandemic compared to pre-pandemic levels, the proportion of mental health presentations relative to the total emergency department presentations decreased. Several troughs in presentation frequency were identified across the pandemic period, which occurred consistently during the public health lockdown and restriction periods. Conclusion: This study implemented novel machine learning techniques to analyse mental health presentations to an emergency department during the COVID-19 pandemic. Results inform understanding of the use of emergency mental health services during the pandemic, and highlight opportunities to further investigate patterns in presentation. [ABSTRACT FROM AUTHOR]