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The Social Emotional Health Survey–Secondary (SEHS-S) assesses adolescents’ psychological dispositions associated with positive psychosocial development. The present study extended SEHS–S research by validating the SEHS-S with a nonwestern sample of Japanese junior high school students (Grades 7–9; N = 1,181) and investigating sex and grade level difference in Covitality and four domains of positive psychological dispositions (Belief-in-Self, Belief-in-Others, Emotional Competence, and Engaged Living). The confirmatory factor analyses supported the internal validity of the SEHS-S with a second-order model. Higher Covitality scores predicted higher life satisfaction, school connectedness, and prosocial behavior and lower emotional symptoms, conduct problems, inattention/hyperactivity, and peer problems, evidence of concurrent validity. Analyses supported the factorial invariance for different sex and grade level. Females reported higher Belief-in-Others and Emotional Competence and lower Belief-in-Self and Engaged Living than males. Grade 9 students reported higher Covitality, Belief-in-Self, Emotional Competence, and Belief-in-Others than Grade 8 students. These results support expanding the use of the SEHS–S as a universal wellness screener in Japanese junior high schools to identify the social–emotional strengths of all students. Further study needs to establish how to use the SEHS–S most effectively with Japanese junior high school students in a culturally sensitive manner.

To further examine the relationship between bedtime media use and sleep in adults by taking relevant covariates into account and testing hypothesised mediating and moderating pathways. Bedtime media use and sleep outcomes were examined by questionnaire in 4188 adults (59 % women, aged 19–94 years) from the Specchio cohort based in Geneva, Switzerland. We tested associations between bedtime media use and sleep (bedtimes, rise times, sleep latency, sleep duration, sleep quality, insomnia, and daytime sleepiness), adjusting for prior sleep, mental health, and health behaviours; whether bedtime media use mediates associations between individual susceptibility factors (age, chronotype, and mental health) and sleep; and whether individual susceptibility factors moderate associations between bedtime media use and sleep. Often using a screen in the 30 minutes before going to sleep at night was associated with a late bedtime (≥midnight; OR [95 % CI] = 1.90 [1.44,2.51], p < 0.001), a short sleep duration (<7 h; 1.21 [1.01,1.46], p < 0.05), and excessive daytime sleepiness (Epworth score >9; 1.47 [1.25,1.74], p < 0.001), adjusting for all covariates. Bedtime media use partly mediated the association between younger age and an evening chronotype and these sleep outcomes. Mental health moderated the association between bedtime media use and sleep quality/insomnia, such that the former was only associated with poorer sleep quality/insomnia among individuals with better mental health. Frequent bedtime media use was associated with various sleep outcomes, independently of relevant covariates. Limiting the use of screens at bedtime is important to promote sleep among adults. Individuals with poorer mental health likely require additional support to improve their sleep quality. • Frequent bedtime media use is associated with sleep outcomes in adults. • These associations hold after adjustment for relevant covariates. • Bedtime media use mediates associations between individual characteristics and sleep. • Mental health moderates the association between bedtime media use and sleep quality. [ABSTRACT FROM AUTHOR]

Introduction: Mental health conditions (i.e. depression or anxiety) are the most common complication of pregnancy and childbirth in the United States (U.S.) and are associated with increased maternal and infant morbidity and mortality. Research has demonstrated a relationship between stress and mental health diagnoses in pregnancy; therefore, it is concerning that military families face unique challenges which contribute to additional stressors among spouses of active-duty (AD) military personnel during the perinatal period. The objective of this scoping review was to understand the current state of research on perinatal stress or perinatal mental health among American spouses of AD military personnel. Methods: The Boolean phrase was created in consultation with 2 health science librarians and the following databases searched in October 2023: PubMed, Embase, Military and Government Collection, CINAHL, and PsychINFO. 2 reviewers identified 481 studies for screening once duplicates were removed. After applying inclusion and exclusion criteria, 21 studies remained for data extraction and analysis. Results: Most of the studies were quantitative, took place in the southern U.S., and the most represented military branch was Air Force. Most of the studies included both AD military members and AD spouses; 28% focused solely on AD spouses. Samples were not racially diverse, and findings identified racial disparities in perinatal mental health conditions. There was a wide variety in outcome measures, including the following general categories: (1) stress, anxiety, and/or depression, (2) maternal-infant attachment, (3) group prenatal care, and (4) deployment focus. Our review identified the following concepts: spouses most at risk for perinatal mental health conditions, the need for perinatal mental health screening, and the need for social support. Conclusions: Findings from the identified studies indicate a need for additional research in this area. Additionally, findings highlight circumstances unique to this population that result in an increased risk of stress and/or mental health conditions during the perinatal period. Such challenges demand improved mental health screening and additional resources for this population. Meeting the needs of this unique population also requires significant funding and policy change to allow for increased access to mental health resources and to ensure the health of the birthing person and infant. [ABSTRACT FROM AUTHOR]

Objective Design Methods Results Conclusions Impact Reporting Method Patient or Public Contribution To describe Syrian refugee women's experiences of the barriers to access mental health services for postpartum depression (PPD).A descriptive qualitative study was conducted.Fifteen purposefully selected Syrian refugee women who scored ≥10 on the Edinburgh Postnatal Depression Scale participated in the semi‐structured telephone interviews. Transcripts were coded verbatim and analysed thematically according to the dimensions of Levesque's model of patient‐centred access to healthcare. Data were collected between August 2022 and February 2023.Five themes with 14 subthemes were identified: (1) approachability covered lack of knowledge and misconceptions related to PPD and its treatment, lack of awareness of available psychosocial services and perceived need of mental health treatment; (2) acceptability comprised being a refugee, stigma of mental illness, cultural preferences of healthcare provider and language barrier; (3) availability and accommodation encompassed transportation barrier and location of the centre, no support for childcare and lack of time; (4) affordability included financial difficulties and health insurance coverage; (5) appropriateness comprised no screening for PPD and intermittent services with limited focus on mental health.The findings of this study reveal that Syrian refugee women experienced multi‐faceted complex barriers to access mental health services for PPD. It is important for health professionals, including nurses, and policymakers to address the cultural mental health needs of this population and establish strategies to protect their legal and health rights.Our study has important practice and policy implications for establishing strategies designed specifically for refugee mothers to mitigate their perceived barriers to PPD treatment and ultimately improve their mental health.The Consolidated Criteria for Reporting Qualitative Research was used.No patient or public contribution. Participants were Syrian refugee women with PPD symptoms and contributed only to the interviews and member checking. [ABSTRACT FROM AUTHOR]

Background: General mental health inpatient units hold a valuable place in the stepped system of care, and for identification and treatment of people with eating disorders (EDs) or disordered eating behaviours (DEBs). This study aimed to pragmatically evaluate an evidence-informed screening and care pathway, alongside a staff education program, implemented to improve identification and treatment access for consumers with EDs and DEBs, with co-occurring psychiatric conditions, on a general mental health ward. Methods: A mixed methodology design was mapped to the RE-AIM implementation framework. It encompassed medical record audits across two 3-month time points pre and post implementation of the pathway, and key informant consumer and health professional interviews. Results: Process and implementation data were compared for three-month periods pre (2019, n = 348) and post-implementation (2021, n = 284). Post-implementation, intake SCOFF screening occurred in 94.7% of admissions. People with ED/DEBs diagnoses were 35 times more likely to have a SCOFF score ≥ 2 (OR = 35.2, p <.001) with the odds of identifying previously undiagnosed DEBs 3.3 times greater (p =.002). Post-implementation, for those with an ED/DEB, dietitian referrals (p <.001) and micronutrient supplementation (p =.013) were more likely. For those with weight and height data, both absolute (-1.1 kg ± 2.2 vs. 1.3 kg ± 2.3; p <.001) and percentage weight change were significantly higher post-implementation with similarities across BMI categories. Universally, consumers and health professionals expressed that the service had "changed care for the better" encouraging therapeutic relationships, mediated by trust, that resulted in better consumer outcomes. 50 health professionals undertook tailored ED and meal support therapy education. They noted that their knowledge and confidence improved allowing value to be seen in understanding EDs and the role for care within general mental health. Conclusions: This study demonstrated that an articulated screening and care pathway could be feasibly implemented in general mental health. The evaluation demonstrated advances in ED detection and management with noted improvements in management access, care planning, physical monitoring and weight gain outcomes. Understanding stakeholders' experiences of new care practices enabled the identification of enablers and barriers for implementation, and avenues to optimise care for consumers with EDs in the general mental health setting. Plain English summary: This study looked at how to improve the identification and treatment of people with eating disorders or disordered eating behaviours in general mental health inpatient units. We wanted to see if a new screening and care pathway, along with educating staff, could make a positive difference. We checked medical records and interviewed consumers and health professionals before and after implementing these changes. After the changes, nearly all admissions were screened for eating disorders, and high scores were linked to actual eating disorders. The chances of finding disordered eating behaviours were also higher. People with eating disorders were more likely to be referred to a dietitian and have micronutrient supplements after the changes. There were also positive changes in weight for those with available data. Both consumers and health professionals said the service had improved care, building better relationships and trust. Examining and understanding people's experiences helped identify how to make care even better for those with eating disorders in general mental health settings. [ABSTRACT FROM AUTHOR]

Background: A longer duration of untreated psychosis (DUP) is associated with poorer treatment outcomes. Screening for psychosis spectrum disorders in the primary care setting could help support the earlier detection and treatment of individuals in need. However, the acceptability of screening for psychosis in this setting as part of routine care is currently unknown. Methods: We conducted a qualitative interview study with providers and service users who participated in an early psychosis screening program conducted in an integrated behavioral health primary care (IBH-PC) setting. Interviews were recruited from one of eight WellSpace Federally Qualified Health Center IBH-PC clinics in the Sacramento, CA area. Transcripts of the recorded interviews were analyzed using thematic analysis. Results: In total, 12 providers and eight service users participated in the interviews. Most service user and provider participants were supportive of psychosis screening in an IBH-PC setting, but not as part of the general practitioner consultation due to the brief, non-behavioral health nature of many of the appointments, and the expected low prevalence of psychosis in this population. The support of leadership, adequate training and support, staff turnover, and organizational changes were all seen to impact the successful implementation of the program. Different barriers and facilitators were considered important at each stage of the process from introducing the screening procedures to service users; to determining when, where, and how to screen; and how to effectively manage the referral and post-referral stages. Conclusions: Despite the additional challenges of screening in an IBH-PC setting relative to secondary mental health services, the process was considered acceptable and feasible to providers and service users. Services that plan to conduct psychosis screening in their clinics need to consider the challenges and their potential solutions to implementation at each stage of the screening process. [ABSTRACT FROM AUTHOR]

ABSTRACT Exposure to traumatic and/or violent events is an inherent part of the first responder role, which increases the risk of developing acute and chronic mental health symptoms and conditions. Suicidality for Australian first responders have recently increased with prevalence considered much higher compared with the general population. To inform specific recommendations for Australian first responders, there is a need to establish what evidence is available regarding these issues within the Australian context. The aim of this scoping review was to explore the impacts of trauma on the mental health of Australian first responders, the strategies recommended to address these issues and any unique needs in rural contexts. A scoping review was undertaken following PRISMA guidelines for scoping reviews. Peer‐reviewed articles on Australian first responder mental health from seven databases were screened for inclusion. This review highlights that despite available evidence on the types of traumas and adverse mental health outcomes experienced, less evidence exists pertaining to intervention effectiveness. There are major gaps in evidence within rural and remote contexts which hinders effective planning and delivery of support for rural and regional first responders. Clinicians such as mental health nurses, particularly in rural areas, need to be aware of these gaps which impact planning and delivery of support and are in prime position to ensure screening, interventions and strategies are used and evaluated to determine their suitability for rural first responders. [ABSTRACT FROM AUTHOR]

As screens have become ubiquitous in modern-day society, investigating the effects of high screen time on mental health is highly warranted. In the past decade, many studies have determined that higher levels of screen time engagement are associated with adverse mental health outcomes like anxiety and depression. However, the nature of the relationship between screen time and mental health requires further investigation to gain a better understanding of its mechanisms and properties. The purpose of this study is to utilize a nationally representative data set to (1) examine how factors like sex, age, and socioeconomic status moderate the relationship between screen time and mental health in Canadian youth and (2) determine whether this relationship supports the Goldilocks hypothesis or an exposure-response curve. It was hypothesized that (1) young, female, lower socioeconomic status individuals will be more strongly associated with poor mental health, and that (2) mental health will peak at low screen time usage, therefore, supporting an exposure-response curve. A series of moderation analyses concluded that young, male, lower socioeconomic status individuals strongly moderated the relationship between screen time and poor mental health compared to their counterparts. Furthermore, three out of the four mental health (presence of mood disorder, presence of anxiety disorder, and depression severity) measures peaked at an average of 12 hours and 19 minutes of screen time per week, hence, supporting the exposure-response curve. [ABSTRACT FROM AUTHOR]

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ObjectivesMethodResultsConclusions\nKey PointsTo produce national clinical norms for WASC-Y, examine the internal consistency of the WASC-Y scales, compare scores from a clinical sample with previously published community sample data, and test the degree to which other scales predict the Suicide Scale.We analysed WASC-Y data from 1226 Aboriginal youth who had presented to mental health services between 2007 and 2022 and compared their scores to the original community norms.Our sample shows a higher level of mental health risk than does the normative sample that varied according to gender. We found high levels of suicidal behaviour in the clinical sample: 41.5% admitted to thoughts of suicide and 25.0% reported one or more suicide attempts. One in 23 reported a high likelihood that they would attempt suicide again. Knowing someone who has suicided was associated with higher Suicide Risk. Linear modelling showed that Suicide Risk is predicted by a combination of all other WASC-Y scales and gender, with females at higher risk than males. There is emerging evidence that Cultural Resilience provides some mitigation of Suicide Risk.Our data provide the first culturally and psychometrically valid national mental health profile of Aboriginal youth accessing mental health services, including separate clinical norms for males and females. Aboriginal youth present with serious levels of suicide and mental health risk that urgently require improved access to clinically and culturally competent services. Our findings provide evidence of construct validity, in that scale scores showed meaningful associations with each other and with other variables in expected ways.What is already known about this topic: The WASC-Y stands alone as a culturally valid, psychometrically sound, and clinically valid screening tool to assess Aboriginal youths’ suicide risk, mental health risk, and cultural resilience.WASC-Y norms were derived from a non-clinical sample of 13- to 17-year-old school students in Western Australia.Clinical norms for WASC-Y are needed.The WASC-Y stands alone as a culturally valid, psychometrically sound, and clinically valid screening tool to assess Aboriginal youths’ suicide risk, mental health risk, and cultural resilience.WASC-Y norms were derived from a non-clinical sample of 13- to 17-year-old school students in Western Australia.Clinical norms for WASC-Y are needed.What this paper adds: We now have separate clinical norms for male and female Aboriginal youth that show high rates of suicidal ideation and behaviour.Suicidal ideation and behaviour are significantly higher among Aboriginal youth who know someone close to them who has suicided than among those who do not.Linear modelling indicates that scores on the Suicide Scale are best predicted by a combination of all other WASC-Y scales and gender.We now have separate clinical norms for male and female Aboriginal youth that show high rates of suicidal ideation and behaviour.Suicidal ideation and behaviour are significantly higher among Aboriginal youth who know someone close to them who has suicided than among those who do not.Linear modelling indicates that scores on the Suicide Scale are best predicted by a combination of all other WASC-Y scales and gender. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Discussion Few individuals with eating disorders (EDs) receive treatment. Innovations are needed to identify individuals with EDs and address care barriers. We developed a chatbot for promoting services uptake that could be paired with online screening. However, it is not yet known which components drive effects. This study estimated individual and combined contributions of four chatbot components on mental health services use (primary), chatbot helpfulness, and attitudes toward changing eating/shape/weight concerns (“change attitudes,” with higher scores indicating greater importance/readiness).Two hundred five individuals screening with an ED but not in treatment were randomized in an optimization randomized controlled trial to receive up to four chatbot components: psychoeducation, motivational interviewing, personalized service recommendations, and repeated administration (follow‐up check‐ins/reminders). Assessments were at baseline and 2, 6, and 14 weeks.Participants who received repeated administration were more likely to report mental health services use, with no significant effects of other components on services use. Repeated administration slowed the decline in change attitudes participants experienced over time. Participants who received motivational interviewing found the chatbot more helpful, but this component was also associated with larger declines in change attitudes. Participants who received personalized recommendations found the chatbot more helpful, and receiving this component on its own was associated with the most favorable change attitude time trend. Psychoeducation showed no effects.Results indicated important effects of components on outcomes; findings will be used to finalize decision making about the optimized intervention package. The chatbot shows high potential for addressing the treatment gap for EDs. [ABSTRACT FROM AUTHOR]

Numerous studies suggest that subjects suffering from a mental health condition before the COVID‐19 pandemic were at higher risk of contagion, but mostly are cross‐sectional or retrospective. The BIOVAL‐D‐COVID‐19 is a longitudinal cohort study design with 922 subjects who full filled two evaluations from an online survey of Spanish residents before and during the pandemic. Mental health conditions assessed were: Major Depressive Episode (MDE), Generalised Anxiety Disorder (GAD), Suicidal Thoughts and Behaviours (STB) and subthreshold of panic and bipolar disorder (BD). Mental health screening instruments used were: the Spanish version of the Composite International Diagnostic Interview (CIDI) version 3.0 for the evaluation of MDE, the GAD‐7 scale to evaluate GAD; STB was evaluated with four items from the CIDI questionnaire. Panic Disorder and BD were screened from a modified and self‐reported version of the CIDI. A bivariate plus five logistic regression models were developed for each mental health condition adjusted by socio‐demographic variables; employment status; general and physical health; comorbidity; and including all previous variables and the other mental health conditions. We found in bivariate model that MDE; GAD and STB were statistically significant risk factors of contagion of COVID‐19. The logistic regression models developed reveal that having a previous GAD (aOR 3.30 1.31–8.31) or STB (aOR 2.16 CI 95% 1.01–4.62) was statistically significant associated with COVID‐19 contagion, independently of all variables included. MDE was not a risk factor of contagion when it was adjusted by comorbidity (aOR 0.99 CI 95% 0.47–2.09). It is recommended to detect those subjects with previous GAD or STB as vulnerable groups of infection to reduce contagion rates. [ABSTRACT FROM AUTHOR]

Anxiety is the most common form of mental health disorder, affecting millions of people worldwide. Psychosocial interventions such as mindfulness and cognitive behavioral therapy (CBT) have been suggested as an effective treatment in the management of general anxiety and anxiety disorders, with emerging evidence also suggesting the effectiveness of hypnosis. Moreover, anxiety has shown to be linked to the onset and development of several cardiovascular diseases (CVD), which are the leading cause of global death. In this paper, we review the current literature to examine the role that anxiety has on the onset and development of CVD and summarize the current knowledge on the role that hypnosis and hypnotherapy have in reducing anxiety, also explaining how this can impact the cardiovascular system and the prevention of CVD. Review of the evidence suggests that hypnosis and hypnotherapy are effective in treating anxiety and may positively affect the heart and the cardiovascular system, reducing sympathetic activation and increasing parasympathetic tone, potentially preventing the onset of CVD related to increased sympathetic activation. However, further studies are required to further understand how hypnosis and hypnotherapy affect the cardiovascular system through investigation of the neurophysiological components of the hypnotic state and of the mind-body relationship. Healthcare systems should embed mental health screening in patients at risk of developing CVD as part of the clinical pathway and consider the role that hypnosis and hypnotherapy may play in the management of CVD. [ABSTRACT FROM AUTHOR]

This document is an abstract from the Journal of Eating Disorders, summarizing various research studies and presentations related to eating disorders. The studies cover topics such as the effectiveness of training programs for clinicians, the role of body image beliefs in eating disorder development, the intersection of eating disorders and fertility care, and the engagement of people with eating disorders in disability insurance schemes. Other studies explore the correlation between videoconferencing use and body image concerns, the use of embodiment illusions in treating mental disorders, and the mental health literacy of eating disorders among sport coaches. The article also discusses specific programs and interventions for eating disorders, the influence of parental comments on adolescents, and a digital learning platform called PeerED for peer workers in the eating disorder sector. Additionally, the document includes a systematic review of interventions for disordered eating in individuals with diabetes and a collection of abstracts covering various topics related to eating disorders and body image. [Extracted from the article]

Many women experience new onset or worsening of existing posttraumatic stress disorder (PTSD) symptoms during pregnancy and the early postpartum period. However, perinatal PTSD symptom profiles and their predictors are not well understood. Participants (N = 614 community adults) completed self-report measures across three methodologically similar longitudinal studies. Mixture modeling was used to identify latent subgroups of trauma-exposed women with distinct patterns of symptoms at pregnancy, 1-month, and 3-month postpartum. Mixture modeling demonstrated two classes of women with relatively homogenous profiles (i.e., low vs. high symptoms) during pregnancy (n = 237). At 1-month postpartum (n = 391), results suggested a five-class solution: low symptoms, PTSD only, depression with primary appetite loss, depression, and comorbid PTSD and depression. At 3-months postpartum (n = 488), three classes were identified: low symptoms , elevated symptoms, and primary PTSD. Greater degree of exposure to interpersonal trauma and reproductive trauma, younger age, and minoritized racial/ethnic identity were associated with increased risk for elevated symptoms across the perinatal period. Only a subset of potential predictors of PTSD symptoms were examined. Replication with a larger and more racially and ethnically diverse sample of pregnant women is needed. Results highlight limitations of current perinatal mental health screening practices, which could overlook women with elevations in symptoms (e.g., intrusions) that are not routinely assessed relative to others (e.g., depressed mood), and identify important risk factors for perinatal PTSD symptoms to inform screening and referral. • Perinatal posttraumatic stress disorder (PTSD) symptoms are understudied. • The elevated symptom profile during pregnancy demonstrated homogeneity. • PTSD symptoms were differentiated across profiles during the postpartum period. • Interpersonal/reproductive trauma, age, and race/ethnicity predicted increased risk. • Perinatal PTSD symptoms should be routinely assessed by health care professionals. [ABSTRACT FROM AUTHOR]

Increasingly over the past decade, there has been a demand of more thorough documentation of the quality of reading assessments. Yet, available documentation of high-quality measures are often restricted to general framework descriptions providing psychometric information as a token of test quality. In a modern view of validity, understanding what is being measured and how scores are calculated is a prerequisite for good interpretation and use of test scores. The present article aims to document the research and development process of a national adaptive screening test for reading difficulties, in which the envisioned interpretation and use of test scores is guiding the work. Given the mandatory nature of this test the sample consist of 49,828 third grade students aged 8. Significant outcomes from this design process involve detailed information on: (a) choice of sub-tests and item formats, (b) selection of high quality items, (c) choice and design of adaptive model, and finally, a statement on the challenges that are still to bemet for such a test to function optimally. The present paper is among the first to, in an open and detailedmanner, describe the development process as well as qualities and challenges of an adaptive reading screening test for students of this young age. [ABSTRACT FROM AUTHOR]

Childhood represents a critical window for the emergence and treatment of mental health disorders, yet many are not being identified, or are identified too late to receive adequate intervention. This systematic review (Prospero registration: CRD42022299560) aimed to determine the effectiveness and acceptability of parent reported universal mental health screening (UMHS) to improve the early identification of children at-risk of mental health difficulties, and to identify barriers and enablers that may influence parental engagement. Six databases were searched in February 2022 for peer-reviewed, primary research. Studies conducted in targeted populations, evaluating psychometric properties, or focused on screening non-psychological problems were excluded. Ten studies examined parent reported (n = 3,464 parents) UMHS for children from birth to 18 years, suggesting an overall scarcity of research. Findings are presented in a table of study characteristics and a narrative summary of acceptability, effectiveness, barriers, and enablers. Quantitative findings indicated that parents generally support and accept UMHS. Research assessing effectiveness was limited, although two studies indicated increased referrals and referral adherence following positive screens. Confidentiality and stigma were commonly identified barriers. Quality assessment using the Mixed Methods Appraisal Tool indicated that studies varied in quality, meeting four to seven of the seven quality criteria. Understanding and addressing parent attitudes to UMHS across settings is necessary for the successful implementation of screening and improvement of child mental health outcomes. More high-quality research studies, including randomized controlled trials are therefore needed to examine the acceptability and effectiveness of UMHS for parents and their children. [ABSTRACT FROM AUTHOR]

Objective: Prostate cancer can significantly impact mental wellbeing, creating uncertainty and morbidity. This study described patterns of psychotropic medication and mental health service use, as a proxy measure for mental health problems, 5 years before and 5 years after prostate cancer diagnosis. Methods: Population‐based registry data were linked with Pharmaceutical Benefits Scheme and Medicare Benefits Schedule data for all prostate cancer patients diagnosed in South Australia between 2012 and 2020 (n = 13,693). We estimated the proportion and rates of psychotropic medication and mental health service use before and after diagnosis. Multivariable adjusted interrupted time series analyses (ITSA) were conducted to uncover temporal patterns. Results: Fifteen percent of men commenced psychotropic medications and 6.4% sought out mental health services for the first time after diagnosis. Psychotropic medication use rose from 34.5% 5 years before to 40.3% 5 years after diagnosis, including an increase in use of antidepressants (from 20.7% to 26.0%) and anxiolytics (from 11.3% to 12.8%). Mental health service use increased from 10.2% to 12.1%, with the increase mostly being general practice mental health visits (from 7.8% to 10.6%). Multivariable ITSA indicated a significant rise in medication and service utilisation immediately before and in the first 2 years following prostate cancer diagnosis. Conclusion: There is a clear increase in psychotropic medication use and mental health service use around the time of prostate cancer diagnosis. Mental health outcomes of men with prostate cancer may be improved with early mental health screening, particularly during the diagnosis process, to enable early intervention. [ABSTRACT FROM AUTHOR]

Little is known with regard to due process and forensic assessment capacities in Africa, where over one million are deprived of their liberty on any given day. A rapid situation assessment explored multi-stakeholder perspectives regarding the situation of people with a mental illness in the Malawi prison system. In-depth interviews were conducted with 10 regional professional stakeholders, 18 former prisoners, and five prison staff from two maximum-security prisons. Reflexive thematic analysis yielded five themes; occurrence of mental illness among people living in prison; prison environment exacerbating harm and levels of mental illness; security responses to the presence of psychiatric disorders; availability and coverage of specialist psychiatric and psychological care; and diversion, other non-custodial measures and continuity of care on release. Narratives highlight the substantial causal impact of the prison environment in amplifying existing and new mental illness, vulnerability and exploitation of people with a mental disorder. Malawi prisons are hampered by lack of specialist forensic capacity nationally; centralized mental health surveillance system; and insufficient skilled staff to conduct evidence-based screening and care. Security operations implement the use of pharmacological and physical restraint measures at times. Faith-based organizations play an important role in providing psychological and spiritual support. Release and reintegration require family involvement. A cross departmental intersectoral partnership response spanning government ministries, key civil society organizations, the Malawi Prison Inspectorate and Malawi Human Rights Commission is warranted. Recommendations include alleviation of prison congestion, prison staff capacity building and investment in forensic mental health services with adequate geographic coverage. [ABSTRACT FROM AUTHOR]

This letter, published in the Journal of General Internal Medicine, presents the findings of a study on the delivery of survivorship care among individuals with cancer. The study used a national survey of ambulatory care utilization and found that the provision of survivorship care was suboptimal. Cancer patients were less likely to receive services for physical activity, nutrition counseling, mental health screening/counseling, substance abuse screening/counseling, and home health services compared to patients without cancer. The study highlights the need for improved survivorship care practices as the number of cancer survivors is expected to increase in the future. [Extracted from the article]

Introduction This article reviews process and performance of an innovative effort leveraging virtual health to manage unmet demand for behavioral health and substance use disorder services across a large military region. This effort began in June 2022 and included nearly all of the Defense Health Agency Region—Europe's military behavioral health and substance abuse clinics participating. The two goals of improving access to behavioral health and substance use services for active duty service members and improving utilization of the military clinics were employed. Operational and remote locations with known care gaps could access services as well. Connecting services to the point of need is an established strength of virtual health delivery systems of care. Materials and Methods A team consisting of clinical leaders and Virtual Medical Center—Europe staff developed a centralized screening process and simple business rules. When a clinic was unable to meet its access-to-care standard of 28 days, the patient requesting or referral from a remote location, was offered a virtual video option with a provider from another clinic with availability. Centralized screening was created and staffed by three technicians. The Behavioral Health Integrated Support Network (BHISN) screening clinic assessed appropriateness of virtual care using established exclusion criteria. Once screened, the patient was scheduled for an appointment with one of the 31 therapists in 14 participating clinics in a 3- to 5-day window. The military health system's video connect platform was used. Results Between June 2022 and November 2023, 131 patients who were unable to find routine care in their home clinic were screened, scheduled, and completed a virtual visit with one of the 31 participating therapists from 14 behavioral health and substance use clinics. Seventy-eight (59%) participants were active duty empaneled to military treatment facilities in Europe and 53 (39%) were active duty enrolled in Tricare Prime Remote and deployed to remote locations with limited care. Forty-four percent of patients were recommended for continued virtual therapy or counseling kept their first follow-up demonstrating good follow-up care using a virtual option. The overall no-show rate was low at 7%. Care and consultation were successfully delivered using video visits to location in 18 countries in three geographic Europe, the Middle East and, Africa. Conclusion The Virtual Medical Center—Europe, Army Europe Behavioral Health, and Substance Use leadership work collaboratively to plan and optimize program performance. For BHISN to function as intended requires key dedicated support staff, such as mental health and social services assistants to screen and coordinate virtual care. Scheduling can be performed by a central cell requiring clinics to relinquish some local control in the interest of meeting patient demand in large and diverse area that covers three continents. BHISN shows promising initial success by providing a process of managing demand and connecting requests for behavioral health and substance use care leveraging capacity from all clinics using a virtual video service in a diverse operating environment. [ABSTRACT FROM AUTHOR]

To explore the needs, expectations, and experiences of asylum-seeking parents and unaccompanied minors under the age of 18 years on the initial health assessment for children and adolescents and access to care upon entry in the Netherlands, We conducted five semi-structured focus group discussions with asylum-seeking parents and unaccompanied minors, from Syria, Eritrea, Afghanistan, and other Middle-East and African countries, supported by professional interpreters. To triangulate findings, semi-structured interviews with health care professionals involved in care for refugee children were conducted. Transcripts of focus group discussions were inductively and deductively coded and content analyzed; transcripts of interviews were deductively coded and content analyzed. In total, 31 asylum-seeking participants: 23 parents of 101 children (between 0 and 18 years old), 8 unaccompanied minors (between 15 and 17 years), and 6 healthcare professionals participated. Parents and minors expressed that upon entry, their needs were met for vaccinations, but not for screening or care for physical and mental health problems. Parents, minors, and health professionals emphasized the necessity of appropriate information and education about health, diseases, and the health system. Cultural change was mentioned as stressful for the parent–child interaction and parental well-being. Conclusion: The perspectives of refugee parents and unaccompanied minors revealed opportunities to improve the experience of and access to health care of refugees entering the Netherlands, especially risk-specific screening and more adequate education about health, diseases, and the Dutch health care system. What is Known: • Refugees have specific health needs due to pre-flight, flight, and resettlement conditions. Health assessment upon entry was non-obligatory in the Netherlands, except for the tuberculosis screening. Health needs were not always met, and refugees experienced barriers in access to care. What is New: • The initial health assessment met the needs concerning vaccinations but mismatched the needs regarding physical and mental health assessment. Screening for specific risk-related diseases and mental health could enable refugee parents and minors to engage better with the health system. [ABSTRACT FROM AUTHOR]

Background: A systematic review on acceptability, feasibility, equity and resource use was conducted as part of updating recommendations from the Public Health Agency of Canada on prenatal screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). Methods: Information sources, including MEDLINE® All, Embase and Cochrane CENTRAL (January 2003-January 2021) electronic databases were searched for studies that assessed acceptability, feasibility, equity and resource use of screening for CT or NG in pregnant persons aged =12 years. The Risk of Bias Assessment Tool for Non-Randomized Studies was used for quality assessment and a narrative synthesis was prepared. Results: Of the 1,386 records identified, nine observational studies (approximately 5,000 participants) and three economic evaluations met the inclusion criteria. In general, pregnant persons and healthcare providers accepted screening. Most pregnant persons and partners supported universal testing for CT. Pregnant persons preferred non-invasive sampling Methods. Inequities in feasibility (accessibility to screening) exist in certain populations. Studies have shown that targeted screening can miss cases. Screening all pregnant persons for CT has net cost savings compared to no screening. Limitations include not identifying eligible literature on acceptability of prenatal screening for NG among partners of pregnant persons and some studies with increased risk populations that restrict the generalizability of the findings highlighting areas for future research. Conclusion: Prenatal screening for CT and NG is generally acceptable among pregnant persons and healthcare providers. Evidence has shown that targeted screening can miss cases. The findings were included when updating PHAC's recommendations on prenatal screening for CT and NG. This work was presented at the Society of Obstetricians and Gynaecologists of Canada's 2024 Annual Clinical and Scientific Conference in Edmonton, Alberta. [ABSTRACT FROM AUTHOR]

This study describes mental health and psychosocial screening processes, access to care and interventions provided to children with upper limb musculoskeletal conditions. A cross-sectional e-survey study was conducted of 107 healthcare professionals who work with children with congenital hand and upper limb differences and brachial plexus birth injuries. Of them, 41 (38%) reported that they routinely screen for mental health and psychosocial concerns. Few (12%) reported the use of standardized outcome measures. In total, 51 (48%) healthcare professionals reported that there was a waiting list for mental health services at their institution. Collectively, healthcare professionals were unsatisfied with the staffing, access to care and types of interventions available. Reported barriers to care included the growing need for mental health support, lack of resources and poor continuity of care after referrals. Future research should focus on identifying and validating a mental health screening tool and investigating the processes affecting access to mental health care. Level of evidence: IV [ABSTRACT FROM AUTHOR]

Objective: The authors measured implementation of Zero Suicide (ZS) clinical practices that support identification of suicide risk and risk mitigation, including screening, risk assessment, and lethal means counseling, across mental health specialty and primary care settings. Methods: Six health care systems in California, Colorado, Michigan, Oregon, and Washington participated. The sample included members ages ≥13 years from 2010 to 2019 (N=7,820,524 patients). The proportions of patients with suicidal ideation screening, suicide risk assessment, and lethal means counseling were estimated. Results: In 2019, patients were screened for suicidal ideation in 27.1% (range 5.0%–85.0%) of mental health visits and 2.5% (range 0.1%–35.0%) of primary care visits among a racially and ethnically diverse sample (44.9% White, 27.2% Hispanic, 13.4% Asian, and 7.7% Black). More patients screened positive for suicidal ideation in the mental health setting (10.2%) than in the primary care setting (3.8%). Of the patients screening positive for suicidal ideation in the mental health setting, 76.8% received a risk assessment, and 82.4% of those identified as being at high risk received lethal means counseling, compared with 43.2% and 82.4%, respectively, in primary care. Conclusions: Six health systems that implemented ZS showed a high level of variation in the proportions of patients receiving suicide screening and risk assessment and lethal means counseling. Two opportunities emerged for further study to increase frequency of these practices: expanding screening beyond patients with regular health care visits and implementing risk assessment with lethal means counseling in the primary care setting directly after a positive suicidal ideation screening. [ABSTRACT FROM AUTHOR]

This article examines the role of mental health, substance use, and comorbidity in relation to time to reincarceration. Our study included all people released from provincial correctional facilities in British Columbia, Canada, from 2012 through 2014 (N = 13,109). Using data from a mental health screening tool, we examined the relationship between four diagnostic groups (mental health needs alone, substance use disorders alone, co-occurring disorders, and no disorders) and time to reincarceration over a 3-year follow-up period. We found that people with co-occurring disorders and substance use disorders were at substantially elevated risk of reincarceration compared with those with no disorders or mental health needs alone. Mental health needs alone was not significantly associated with reincarceration after adjusting for covariates. Correctional, health, and social services must work synergistically to improve health and criminal justice outcomes, particularly for people with substance use and co-occurring disorders. [ABSTRACT FROM AUTHOR]

College student athletes face unique, sport-related stressors that may lead to, or exacerbate, mental health (MH) concerns and symptoms. Although the National Collegiate Athletic Association has identified MH screening as a best practice, minimal data exist regarding contemporary screening practices. We explored National Collegiate Athletic Association Division I (DI), Division II (DII), and Division III (DIII) athletic departments' current MH screening practices (N = 264). Compared with DII/DIII (53%), a greater percentage of Division I (89%) conducted formal MH screening. At DII/DIII institutions, athletic trainers were more likely to both administer and review screeners than any other sports medicine professional; sport psychologists primarily oversaw these tasks at DI schools. DI, compared with DII/DIII, institutions were more likely to have had a student athlete attempt suicide (62% vs. 40%) and participate in inpatient treatment (69% vs. 43%). There is a clear need for the National Collegiate Athletic Association to continue to promote policies that support MH screening and to create mechanisms in which it can monitor institutional involvement. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) and borderline personality disorder (BPD) often co-occur, with 20 % of adults with MDD meeting criteria for BPD. While MDD is typically diagnosed by symptoms persisting for several weeks, research suggests a dynamic pattern of symptom changes occurring over shorter durations. Given the diagnostic focus on affective states in MDD and BPD, with BPD characterized by instability, we expected heightened instability of MDD symptoms among depressed adults with BPD traits. The current study examined whether BPD symptoms predicted instability in depression symptoms, measured by ecological momentary assessments (EMAs). The sample included 207 adults with MDD (76 % White, 82 % women) recruited from across the United States. At the start of the study, participants completed a battery of mental health screens including BPD severity and neuroticism. Participants completed EMAs tracking their depression symptoms three times a day over a 90-day period. Using self-report scores assessing borderline personality disorder (BPD) traits along with neuroticism scores and sociodemographic data, Bayesian and frequentist linear regression models consistently indicated that BPD severity was not associated with depression symptom change through time. Diagnostic sensitivity and specificity may be restricted by use of a self-report screening tool for capturing BPD severity. Additionally, this clinical sample of depressed adults lacks a comparison group to determine whether subclinical depressive symptoms present differently among individuals with BPD only. The unexpected findings shed light on the interplay between these disorders, emphasizing the need for further research to understand their association. • Depression symptoms were measured through ecological momentary assessments (EMAs) three times a day over a ninety-day period. • Borderline personality disorder traits were not linked to instability of overall or individual depressive symptoms across time. • Findings diverged from expectations and highlight the need for further research on the relationship between BPD and MDD. [ABSTRACT FROM AUTHOR]

The arrival of one's first child is a known risk factor for mental illness, yet investigations on fathers' mental health are limited. We conducted a longitudinal investigation on paternal depression and anxiety in the nine years surrounding the transition to fatherhood. Using a national cohort of French men (CONSTANCES, n = 6299), we investigated the prevalence and associated risk factors of mental illness amongst first-time fathers. Responses to the Center for Epidemiological Studies Depression (CES-D) and 12-item General Health Questionnaire (GHQ-12) scales were used to identify clinically significant symptom scores. Self-declared mental illness was also reported by participants. Group-based modelling was used to identify latent trajectory groups for both measures. Levels of self-declared anxiety (averaging 4.9 % pre-fatherhood, 7.8 % post) exceeded that of depression (1.9 % pre- fatherhood, 3.3 % post) or other disorders. However, rates of clinically significant symptom scores (17–27 %) were consistently higher. Participants' mental health appeared to worsen from two-years prior to their child's arrival and improve from two-years after. We identified three trajectory groups for fathers' self-declared mental illness: Low stable (90.3 %); Low risk with high temporary increase (5.6 %); and Consistent high risk (4.1 %). Risk factors associated with worsening mental health trajectories were unemployment, not living with one's partner, having had adverse childhood experiences and foregoing healthcare due to financial reasons. All measures of mental illness relied on participant self-reports and are thus subject to bias. This study reveals an important period of heightened psychological vulnerability amongst first-time fathers, emphasising the need for increased and better adapted paternal mental health screening. • Anxiety appeared consistently more prevalent than depression in first-time fathers. • Fathers' mental health appeared to worsen from two-years prior to fatherhood. • Most mental illness trajectories improved two-years after the first child's arrival. • Unemployment and barriers to healthcare associated with worsening mental health • Non-resident fathers had an increased risk of negative mental health trajectories. [ABSTRACT FROM AUTHOR]

Objective: The Royal Canadian Mounted Police (RCMP) Study includes longitudinal multimodal assessments of RCMP cadets from pre-training (i.e., starting the Cadet Training Program [CTP]) to post-deployment and for five years thereafter. The data allow for investigating the multidimensionality of volitional participation in digital health data collection frameworks within serial data collection platforms and the impact of participation inequalities by classifying cadets using the 90-9-1 rule. By classifying cadets as Lurkers, Contributors, and Superusers formally described by the 90-9-1 rule, where 90% of actors do not participate, 9% seldom contribute, and 1% contribute substantially allows for the assessing of relationships between participation inequalities in self-monitoring behaviors as well as whether mental health disorder symptoms at pre-training (i.e., starting the CTP) were associated with subsequent participation. Methods: Participants were asked to complete a Full Assessment prior to their training at CTP, as well as short daily surveys throughout their training. Participation frequency was described using a process where participants were rank ordered by the number of daily surveys completed and classified into one of three categories. Full assessment surveys completed prior to their training at CTP included screening tools for generalized anxiety disorder (GAD), major depressive disorder (MDD), posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), and panic disorder (PD). The Kruskal-Wallis H test was used to assess differences in participation rates between mental health disorder symptom screening groups for each measure at pre-training, and Spearman's Rho was used to test for associations amongst self-reported Full Assessment screening tool responses and the number of daily surveys completed during CTP. Results: There were 18557 daily survey records collected from 772 participants. The rank-ordering of cadets by the number of daily surveys completed produced three categories in line with the 90-9-1 rule: Superusers who were the top 1% of cadets (n=8) and produced 6.4% of all recordings; Contributors who were the next 9% of cadets (n=68) and produced 49.2% of the recordings; and Lurkers who were the next 90% of cadets (n=695) and produced 44.4% of daily survey recordings. Lurkers had the largest proportion of positive screens for selfreported mental health disorders at pre-training. Conclusion: The creation of highly individualized, population-based mental health injury programs has been limited by an incomplete understanding of the causal relationships between protective factors and mental health. Disproportionate rates of disengagement from persons who screen positive for mental health disorders further compounds the difficulty in understanding the relationships between training programs and mental health. The current results suggest persons with mental health challenges may be less likely to engage in some forms of proactive mental health training. The current results also provide useful information about participation, adherence, and engagement that can be used to inform evidence-based paradigm shifts in health-related data collection in occupational populations. [ABSTRACT FROM AUTHOR]

As the global burden of cancer continues to escalate, the holistic care of patients demands innovative approaches that extend beyond medical interventions. This article delves into the transformative landscape of cancer care in Kerala, India, focusing on the intersection of technology and psycho-oncology. Examining the role of the state government, Kerala Startup Mission (KSUM), and individual startups and institutions, including Malabar Cancer Institute and Cochin Cancer Research Centre, we explore how technological innovations, telemedicine, and e-health solutions are actively shaping psycho-oncological support. Leveraging on case studies, we identify notable innovations, including artificial intelligence-based cancer screening, personalized treatment plans, and mental health support. The results signify a paradigm shift toward comprehensive, patient-centric cancer care, potentially influencing broader health care strategies. Despite acknowledging regional specificity and potential biases, the study underscores the transformative role of technological entrepreneurship in revolutionizing cancer care, paving avenues for future research for integrating psycho-oncological support in health care policies and startup initiatives. Overall, the article highlights the evolving landscape in Kerala as a beacon for holistic and patient-centric strategies that prioritize mental health alongside medical interventions. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this literature review is to examine evidence of time trends and birth cohort effects in depressive disorders and symptoms among US adolescents in peer-reviewed articles from January 2004 to April 2022. Methods: We conducted an integrative systematic literature review. Three reviewers participated at different stages of article review. Of the 2234 articles identified in three databases (Pubmed, ProQuest Central, Ebscohost), 10 met inclusion criteria (i.e., adolescent aged United States populations, included information about birth cohort and survey year, focused on depressive symptoms/disorders). Results: All 10 articles observed increases in depressive symptoms and disorders in adolescents across recent survey years with increases observed between 1991 and 2020. Of the 3 articles that assessed birth cohort trends, birth cohort trends were less prominent than time period trends. Proposed explanations for increases included social media, economic-related reasons, changes in mental health screening and diagnosis, declining mental health stigma, increased treatment, and, in more recent years, the COVID-19 pandemic. Conclusions: Multiple cross-sectional surveys and cohort studies documented rising prevalence of depressive symptoms and disorder among adolescents from 1991 to 2020. Mechanisms driving this increase are still unknown. Research to identify these mechanisms is needed to inform depression screening and intervention efforts for adolescents. [ABSTRACT FROM AUTHOR]

We investigated the association between vasomotor symptoms (VMSs) and the onset of depressive symptoms among premenopausal women. This cross-sectional study included 4376 premenopausal women aged 42–52 years, and the cohort study included 2832 women without clinically relevant depressive symptoms at baseline. VMSs included the symptoms of hot flashes and night sweats. Depressive symptoms were evaluated using the Center for Epidemiological Studies Depression Scale; a score of ≥16 was considered to define clinically relevant depressive symptoms. Premenopausal Women with VMSs at baseline exhibited a higher prevalence of depressive symptoms compared with women without VMSs at baseline (multivariable-adjusted prevalence ratio 1.76, 95 % confidence interval [CI] 1.47–2.11). Among the 2832 women followed up (median, 6.1 years), 406 developed clinically relevant depressive symptoms. Women with versus without VMSs had a significantly higher risk of developing clinically relevant depressive symptoms (multivariable-adjusted hazard ratio, 1.72; 95 % CI 1.39–2.14). VMS severity exhibited a dose-response relationship with depressive symptoms (P for trend <0.05). Self-reported questionnaires were only used to obtain VMSs and depressive symptoms, which could have led to misclassification. We also could not directly measure sex hormone levels. Even in the premenopausal stage, women who experience hot flashes or night sweats have an increased risk of present and developed clinically relevant depressive symptoms. It is important to conduct mental health screenings and provide appropriate support to middle-aged women who experience early-onset VMSs. • Premenopausal women who experience VMSs have an increased risk of both present and developed clinically relevant depressive symptoms. • Women with both VMSs and poor sleep quality had the highest risks of clinically relevant depressive symptoms compared to those with neither VMSs nor poor sleep quality. • These results underscore the importance of conducting mental health screenings and providing appropriate support to middle-aged women who experience early-onset VMSs. [ABSTRACT FROM AUTHOR]

Psychosocial factors play an important role in the disease course and illness experience of patients with inflammatory bowel disease (IBD). Consultation with a health psychologist is an important component of care for many IBD patients and provides an opportunity to identify areas of psychosocial concern, recognize coping deficits and strengths, and facilitate treatment recommendations. Psychosocial assessment in IBD requires a nuanced approach that goes beyond general mental health screening and considers the disease-specific concerns that impact patients. In this paper, we outline strategies for an IBD-focused psychological evaluation, including specific guidance for assessing disease-specific concerns of anxiety, depression, post-traumatic stress, sleep, pain, body image disturbance, food-related quality of life, and psychological resilience. [ABSTRACT FROM AUTHOR]

This study assessed feasibility and psychometric properties of the Hebrew parent version of the Pediatric Symptom Checklist (PSC-17), aiming to improve treatment access for children and adolescents with behavioral and mental needs through early screening. The PSC-17 and the Strengths and Difficulties Questionnaire (SDQ) were filled in the waiting room, at three ambulatory clinics in a tertiary pediatric center, by 274 parents using a tablet or their cellphone. Demographic and clinical data were retrieved from patients' files. PSC results were compared to SDQ results and assessed vis-a-vis a psychiatric diagnosis, determined previously and independently by trained pediatric psychiatrists for 78 pediatric patients who attended these clinics. Construct and discriminant validity of the PSC-17 Hebrew version were good. Sensitivity, specificity, and positive and negative predictive values are presented. The PSC-17 (Hebrew version) was found to be a feasible tool for mental health screening at pediatric ambulatory care clinics. [ABSTRACT FROM AUTHOR]

This paper describes the development and psychometric evaluation of a brief self‐report measure (BEACON) to inform universal mental health screening in schools. Items assess symptoms and impairment associated with anxiety and attention/hyperactivity problems (grades 4–11) as well as depression and eating difficulties (grades 6–11), with optional items for suicidality and self‐harm (grades 7–11). Initial item examination based on Item Response Theory (IRT) and classical test theory involved 3844 students in grades 4 through 11 (Study 1) and identified 18 items for grades 4–5 and 31 items for grades 6–11 that fulfilled pre‐set criteria. Study 2 extended testing with 10,479 students in grades 4–11 and added an additional four items assessing impairment associated with eating difficulties for older students (grades 6–11) creating a total of 35 items for grades 6–11. All items, for both grade‐level versions, met the pre‐set criteria for IRT and classical test theory analysis supporting their strength in the measurement of the dimensions of concern. The measure showed good reliability (subscale alphas.87 to.95). Validity was also demonstrated against standard symptom measures, school grades, school absenteeism, and help‐seeking. The BEACON appears to be a psychometrically sound measure to use in the first stage of school‐based screening for mental health problems. [ABSTRACT FROM AUTHOR]

This article examines the issue of maternal health disparities in the US, specifically focusing on racial disparities in maternal mortality rates. It highlights the high rates of maternal mortality in the US compared to other developed countries, with Black women experiencing the highest rates. The article identifies implicit bias in healthcare as a contributing factor, with stereotypes and prejudices affecting the quality of care received by Black women. It also compares maternity care in the US and the UK, emphasizing the overmedicalization of childbirth in the US and the midwife-driven approach in the UK. The importance of access to healthcare and primary prevention is emphasized, as well as addressing social determinants of health. The article discusses the benefits of community support and doula care in improving maternal health outcomes, and efforts to increase access to doula care through Medicaid coverage and private insurance. It also highlights the need for comprehensive programs that address mental health disparities and the role of state governments and financial incentives in driving change. [Extracted from the article]

With the expression "Just transition", the European Commission refers to a new development model to bring in the environmental and digital transition "leaving no one behind". From an investment law perspective, it implies the adoption of several incentives to support new green economy activities or the reconversion of old ones into green and energy-neutral production models. Starting from an analysis of the EU just transition strategy, the paper focuses on the Italian case, investigating the interconnection between just transition funds and other measures (the Single Special Economic Zone and National Recovery and Resilience Program) to verify their effectiveness in terms of investment retention and attraction and their effects in terms of strategic industrial planning. Concerning retention, the Sider Alloys and Acciaierie d'Italia case studies are analyzed. Concerning attraction, as the incentives may appeal to aggressive activities dangerous to the EU and Member States' strategic autonomy, the paper offers an overview of the instruments available for screening and preventing creeping economic operations, especially the proposed reform of the investment screening mechanism and the anti-coercion instrument. In conclusion, the paper proposes the adoption of an ex ante impact assessment, including citizen consultation, aimed at verifying investment concrete capacity to contribute to the just transition process. [ABSTRACT FROM AUTHOR]

Introduction: Advertising tools used by sex workers for solicitation and client screening have been identified as supporting occupational health and safety (OHS); however, sex work legislation continues to criminalize advertising by third parties. We explored how the criminalization of third-party advertising and online censorship shapes indoor sex workers' access to OHS measures such as client screening, and negotiation of prices and services, in addition to income security. Methods: As part of a community-based study in Vancouver, this analysis drew on 47 interviews (2017–2018) with indoor sex workers and third parties (e.g., managers, receptionists). Interview transcripts were coded by applying a collaboratively- developed framework drawing on structural determinants of OHS to explore multilevel risk and protective factors shaping sex work environments, including access to advertising. Results: Participants' narratives highlighted that most third parties provide support with online advertising on behalf of sex workers; however, criminalization limits potential safety and income security mechanisms. Third parties take on the financial and labour burdens of advertising and screening for indoor workers, particularly for racialized, im/migrant workers who might face language barriers. Sex work laws and online censorship severely restrict communication, and resulting vague advertisements undermine sex workers' OHS by limiting advance screening, and negotiation of prices, services, and use of PPE. Conclusions: Third-party criminalization, coupled with online censorship, hinders advertising, with related harms exacerbated for im/migrant sex workers who would otherwise benefit from the OHS measures offered through advertising. Policy Implications: Legislative reforms to decriminalize all aspects of the sex industry, including sex workers' right to third-party advertising, are urgently needed to increase OHS of sex workers. [ABSTRACT FROM AUTHOR]

Objectives: Dental practices can have additional positive impacts on public health by implementing mental health screening and referral to treatment in dental care workflows. In this study, we examined how dental practices identify and address adult patient mental health concerns, attitudes about implementing mental health screening and referral, and potential barriers and facilitators to treatment. Methods: We conducted semi‐structured focus groups with 17 dentists, 10 dental hygienists, and 5 dental assistants/office staff in the South‐Central region of the National Dental Practice‐Based Research Network. Transcribed interviews were analyzed using thematic analysis. Results: We identified five main themes from dental practitioners and office staff responses. Practitioners and office staff: (1) discover patient mental health concerns through record review, patient/caregiver disclosure, and patient observation; (2) respond to patients' mental health concerns by making the patient more comfortable, documenting the concern in the patient's chart, and directly addressing the mental health concern; (3) want a systematic process for mental health screening and referral to treatment in their dental office; (4) recognize potential barriers in implementing health screening and referral to treatment processes; (5) desire training on mental health matters. An overarching theme emerged: developing a trusting relationship with patients. Conclusions: Participants noted the importance of implementing systematic procedures for mental health screening and referral to services into dental practices, while also recognizing the potential barriers for integrating such processes. They also expressed a desire for quality training and resources that can support better care for patients with mental health concerns. [ABSTRACT FROM AUTHOR]

In response to a burgeoning pediatric mental health epidemic, recent guidelines have instructed pediatricians to regularly screen their patients for mental health disorders with consistency and standardization. Yet, gold-standard screening surveys to evaluate mental health problems in children typically rely solely on reports given by caregivers, who tend to unintentionally under-report, and in some cases over-report, child symptomology. Digital phenotype screening tools (DPSTs), currently being developed in research settings, may help overcome reporting bias by providing objective measures of physiology and behavior to supplement child mental health screening. Prior to their implementation in pediatric practice, however, the ethical dimensions of DPSTs should be explored. Herein, we consider some promises and challenges of DPSTs under three broad categories: accuracy and bias, privacy, and accessibility and implementation. We find that DPSTs have demonstrated accuracy, may eliminate concerns regarding under- and over-reporting, and may be more accessible than gold-standard surveys. However, we also find that if DPSTs are not responsibly developed and deployed, they may be biased, raise privacy concerns, and be cost-prohibitive. To counteract these potential shortcomings, we identify ways to support the responsible and ethical development of DPSTs for clinical practice to improve mental health screening in children. [ABSTRACT FROM AUTHOR]

Background: Posttraumatic stress (PTS) and anxiety are common mental health problems among parents of babies admitted to a neonatal unit (NNU). This review aimed to identify sociodemographic, pregnancy and birth, and psychological factors associated with PTS and anxiety in this population. Method: Studies published up to December 2022 were retrieved by searching Medline, Embase, PsychoINFO, Cumulative Index to Nursing and Allied Health electronic databases. The modified Newcastle–Ottawa Scale for cohort and cross-sectional studies was used to assess the methodological quality of included studies. This review was pre-registered in PROSPERO (CRD42021270526). Results: Forty-nine studies involving 8,447 parents were included; 18 studies examined factors for PTS, 24 for anxiety and 7 for both. Only one study of anxiety factors was deemed to be of good quality. Studies generally included a small sample size and were methodologically heterogeneous. Pooling of data was not feasible. Previous history of mental health problems (four studies) and parental perception of more severe infant illness (five studies) were associated with increased risk of PTS, and had the strongest evidence. Shorter gestational age (≤ 33 weeks) was associated with an increased risk of anxiety (three studies) and very low birth weight (< 1000g) was associated with an increased risk of both PTS and anxiety (one study). Stress related to the NNU environment was associated with both PTS (one study) and anxiety (two studies), and limited data suggested that early engagement in infant's care (one study), efficient parent-staff communication (one study), adequate social support (two studies) and positive coping mechanisms (one study) may be protective factors for both PTS and anxiety. Perinatal anxiety, depression and PTS were all highly comorbid conditions (as with the general population) and the existence of one mental health condition was a risk factor for others. Conclusion: Heterogeneity limits the interpretation of findings. Until clearer evidence is available on which parents are most at risk, good communication with parents and universal screening of PTS and anxiety for all parents whose babies are admitted to NNU is needed to identify those parents who may benefit most from mental health interventions. [ABSTRACT FROM AUTHOR]

Background: Perinatal mental health conditions affect 800,000 individuals annually in the United States and are a leading cause of complications in pregnancy and childbirth. However, the impact of these conditions varies across racial and ethnic groups. Portable digital solutions, such as mobile apps, have been developed for maternal mental health, but they often do not adequately cater to the needs of women of color. To ensure the effectiveness and equity of these interventions, it is crucial to consider the unique experiences of perinatal women from diverse racial backgrounds. This qualitative study aims to explore the complex aspects of motherhood, maternal mental well-being, and resilience among perinatal women of color. It also investigates the factors that either hinder or facilitate the use of Virtual Reality (VR) for stress management in this specific demographic. Methods: This research involves two focus groups comprising perinatal women, primarily identifying as Black or Latina, enrolled in the ongoing Nurturing Moms study at the University of Miami Miller School of Medicine. Additionally, feedback is collected from five different participants. The study assesses Nurture VR™, a VR-based program integrating mindfulness techniques, relaxation exercises, and guided imagery for pregnancy and postpartum. Results: Qualitative analysis uncovers five primary themes and 19 sub-themes, addressing the complexities of motherhood, maternal mental health, attitudes towards VR therapy, postpartum care, and the perception of resilience. Participants share challenges related to household management, caregiving, financial stress, breastfeeding, relaxation, sleep, and the significance of social support. Their preferences and reservations regarding VR therapy are also expressed. Conclusion: This study sheds light on the diverse struggles and obstacles faced by women of color during and after pregnancy, with potential repercussions for their mental and sleep health. It underscores the need for mental health screening and analysis of maternal stress-related sleep issues, in addition to the facilitation of social support in maternal health programs. Additionally, it highlights the promise of culturally responsive behavioral treatments, including VR interventions, in offering timely and tailored mental health support to perinatal women, taking into account their intersectional identities. [ABSTRACT FROM AUTHOR]

Background: serious emotional and behavioral problems in children/adolescents can be identified by informants through screening instruments, which can increase their chances of receiving care in mental health services. Objectives: verify and compare serious emotional and behavioral problems in elementary school students depending on school type and correlate these problems with the use of mental health services. Method: observational cross-sectional study with a convenience sample composed of 357 children and adolescents between 6 and 12 years old without mental health complaints, from public and private schools. Instruments: Child Behavior Checklist for Ages 6-18 (CBCL/6-18) and questionnaire for use of mental health services. To identify serious emotional and behavioral problems, critical items from the behavioral problem syndrome scales and scales guided by the CBCL/6-18 DSM were used. Results: different types of serious emotional and behavioral problems were identified using critical items, such as physically attacking other people (16.5%), saying they are going to kill themselves (5.6%), seeing things that don't exist (3, 9%), setting things on fire (7.9%) and hearing sounds or voices that don't exist (2.8%). Bivariate analysis showed that, despite the frequency of these serious emotional and behavioral problems, the use of mental health services was extremely low (0.84%). Conclusion: the critical items of the CBCL/6-18 help to screen for serious emotional and behavioral difficulties that can negatively impact the mental health of children/adolescents. The lack of parental recognition of serious mental health problems still demands theoretical and empirical deepening. [ABSTRACT FROM AUTHOR]

Perinatal depression and anxiety cost the U.S. health system $102 million annually and result in adverse health outcomes. Research supports that cognitive behavioral therapy improves these conditions, but barriers to obtaining cognitive behavioral therapy have prevented its success in pregnant individuals. In this study, the impact of a cognitive behavioral therapy–based intervention on anxiety, depression, stress, healthy lifestyle beliefs, and behaviors in pregnant people was examined. This study used a 2-arm RCT design, embedded in group prenatal care, with one arm receiving a cognitive behavioral therapy–based Creating Opportunities for Personal Empowerment program and the other receiving health promotion content. Black and Hispanic participants (n =299) receiving prenatal care from 2018 to 2022 in New York and Ohio who screened high on 1 of 3 mental health measures were eligible to participate. Participants were randomized into the manualized Creating Opportunities for Personal Empowerment cognitive behavioral therapy–based program, with cognitive behavioral skill-building activities delivered by advanced practice nurses in the obstetrical setting. Outcomes included anxiety, depression, and stress symptoms using valid and reliable tools (Generalized Anxiety Disorder scale, Edinburgh Postnatal Depression Scale, and Perceived Stress Scale). The Healthy Lifestyle Beliefs and Behaviors Scales examined beliefs about maintaining a healthy lifestyle and reported healthy behaviors. There were no statistically significant differences between groups in anxiety, depression, stress, healthy beliefs, and behaviors. There were significant improvements in all measures over time. There were statistically significant decreases in anxiety, depression, and stress from baseline to intervention end, whereas healthy beliefs and behaviors significantly increased. Both cognitive behavioral therapy and health promotion content embedded in group prenatal care with advanced practice nurse delivery improved mental health and healthy lifestyle beliefs and behaviors at a time when perinatal mood generally worsens. This study is registered with clinicaltrials.gov NCT03416010. [ABSTRACT FROM AUTHOR]

Objectives: This study examined diagnostic profiles and trauma history among treatment‐seeking young adults with positive PTSD screens in public mental health care. Methods: Screening for trauma history and PTSD symptoms was implemented in a community mental health service system. 266 treatment‐seeking young adults (aged 18–35) endorsed trauma exposure with a score of at least 45 on the DSM‐IV PTSD Checklist, indicating probable PTSD. Results: Young adults with positive PTSD screens were predominantly female, minority, and diagnosed with mood disorders. Of those with positive screens, only 15% had a chart diagnosis of PTSD; 17.3% (ages 18–24) versus 14.1% (ages 25–35). Variables significantly associated with a decreased likelihood of PTSD detection included a diagnosis of schizophrenia or bipolar disorder, exposure to fewer types of traumatic events, male gender, and white race. Conclusion: Routine PTSD screening for young adults receiving public mental health care should be prioritized to address long‐term impacts of trauma. [ABSTRACT FROM AUTHOR]

Mental health screening instruments are essential in population health research and clinical practice. The strengths and difficulties questionnaire (SDQ) self-report version has been widely used across the globe to screen for mental health problems in adolescent populations. This study aimed to explore the psychometric properties of the Latvian and Russian language versions of the SDQ in a representative sample of a general population of Latvian adolescents and establish the population-based normative scores. This analysis was based on data from the international Health Behaviour in School-aged Children study year 2017/2018 Latvian database. The sample comprised 2683 Latvian and 1321 Russian-speaking 11-, 13-, and 15-year-old adolescents. Significant language-based variance was observed in the mean scores of the externalising subscales of the SDQ, with Latvian-speaking adolescents reporting higher levels of conduct problems and hyperactivity. The reliability was satisfactory (ordinal alpha >0.7) only for the prosocial behaviour, emotional, internalising problems, and total difficulties subscales, while conduct, hyperactivity, peer, and externalising problems scales demonstrated lower internal consistency (ordinal alpha 0.5–0.7). Confirmatory factor analysis (CFA) did not support the hypothesised narrow-band five-factor or broad-band three-factor structure of the SDQ. The normative banding scores were calculated for both language variants. This study suggests that the self-report SDQ must be used cautiously in Latvian adolescents because some SDQ subscales lack reliability. When used in population research, the internalising subscales seem more reliable than the externalising ones. More research is needed regarding the reliability of the SDQ in clinical adolescent populations. [ABSTRACT FROM AUTHOR]

Introduction Reserve and National Guard (RNG) service members face increased risks for psychological and behavioral problems and are unlikely to seek mental health (MH) care after returning from military deployments. This article examines an online intervention (Web-Ed) with regard to participation, screening results, satisfaction, and intent to seek follow-up MH care, with comparisons by gender and post-deployment MH care receipt. Materials and Methods This was a cross-sectional study of 414 RNG service members (214 women and 200 men), who returned from deployments to or in support of the Iraq or Afghanistan wars within the prior 36 months. Participants completed Web-Ed, which includes screening, personalized education, and links to Veterans Health Administration health care. Results Positive post-deployment screening proportions, Web-Ed satisfaction, and intent to seek follow-up care were similar for men and women. Few had received MH care (33% women; 24% men), yet most screened positive on at least one screen (69% women; 72% men). Most indicated that they would recommend Web-Ed to other veterans (71% women; 67% men) and that they received useful information they may not have received otherwise (52% women; 53% men) regardless of gender or prior MH care. Almost half (40% women; 48% men) planned to seek further assessment from a health care provider as a direct result of Web-Ed. Conclusions Efforts to facilitate access to MH care among post-deployed RNG veterans should be ongoing, regardless of the length of time since deployment, Veterans Affairs enrollment status, prior MH care receipt, or gender. Online screening and personalized education engage veterans who have not sought MH care and provide new information to those who have. [ABSTRACT FROM AUTHOR]

Introduction: Anxiety and depressive disorders are highly prevalent mental health conditions worldwide. However, little is known about their specific prevalence in primary care settings. This study aimed to determine the prevalence of depression and anxiety in the primary care population and identify associated patient characteristics. Method: We conducted a cross-sectional study using stratified sampling by age with a self-administered questionnaire survey in Singapore’s National Healthcare Group Polyclinics from December 2021 to April 2022. A total score of Patient Health Questionnaire-9 (PHQ-9) ≥10 represents clinical depression, and a total score of Generalised Anxiety Disorder-7 (GAD-7) ≥10 indicates clinical anxiety. Multivariable logistic regression was used to identify the factors associated with depression and anxiety. Results: A total of 5694 patients were approached and 3505 consented to the study (response rate=61.6%). There was a higher prevalence of coexisting clinical depression and anxiety (DA) (prevalence=5.4%) compared to clinical depression only (3.3%) and clinical anxiety only (1.9%). The odds of having DA were higher among those aged 21–39 years (odds ratio [OR] 13.49; 95% confidence interval [CI] 5.41–33.64) and 40–64 years (OR 2.28; 95% CI 1.03–5.03) compared to those ≥65 years. Women had higher odds of having DA (OR 2.33; 95% CI 1.54–3.50) compared to men. Respondents with diabetes had higher odds of having DA (OR 1.78; 95% CI 1.07–2.94) compared to those without diabetes. Conclusion: Coexisting clinical depression and anxiety are significantly present in the primary care setting, especially among younger individuals, patients with diabetes and women. Mental health screening programmes should include screening for both depression and anxiety, and target these at-risk groups. [ABSTRACT FROM AUTHOR]