Search Results (618)

Background/Objectives: The incorporation of peer support within mental health services has shown benefits for service users’ recovery and engagement, yet implementation is often hindered by role ambiguity and limited institutional recognition. The aim of this study is to explore the experiences of workers in a programme that provides peer support within a personal assistance model. The focus is on how they perceive the shaping of their professional role and their integration within care teams, rather than on evaluating service outcomes or effectiveness. Methods: An interpretive qualitative methodology with an exploratory approach was used. The study was conducted in a single organisational setting and focused on the self-reported experiences of personal assistants. Fieldwork was conducted in 2025 with ten personal assistants. Data were obtained through individual semi-structured interviews and one focus group with the same participants. A thematic content analysis combining inductive and deductive coding strategies was conducted using MAXQDA (version 24.11). Results: Findings indicate that the Personal Assistant role was perceived as reducing some of the ambiguity commonly associated with peer support, due to a clearer contractual framework and a more explicit delineation of functions. However, tensions persisted in relation to its hybrid professional identity, experiences of task overload, and ongoing gaps in coordination with traditional professional roles. Key facilitators included institutional support, accessible coordination, a supportive culture of care, and informal peer networks. Perceived benefits were reported for service users, including increased trust, hope, and autonomy, as well as for assistants, who described enhanced professional purpose and progress in their own recovery, alongside risks of emotional strain. Conclusions: Analysing the perspective of participants, the personal assistance model may represent a promising framework for the professionalisation of peer support through functional clarity, continuous supervision, and recognition of experiential knowledge. Further progress requires strengthening internal communication, expanding training opportunities, and enhancing the structural participation of personal assistants in decision-making. The study contributes an exploratory qualitative perspective to the growing literature on integrating lived-experience professionals into mental health services. Full article

Francophone populations outside Quebec were disproportionately affected by the COVID-19 crisis. Despite French being one of Canada’s official languages, access to information and services in French remains limited. This study examined Francophone families’ (FF) post-pandemic health and well-being needs (PPHW) in the Canadian Prairie provinces. An online survey assessed PPHW needs among 319 FF in Alberta (AB), Saskatchewan (SK), and Manitoba (MB). Respondents ranked PPHW needs from a predefined list; logistic regression analyzed socio-demographic influences. Divided into AB/SK and MB cohorts, sociodemographic profiles were statistically distinct for many variables, but with similarities found in gender of respondents (women: 73% in AB/SK, 79% in MB), marital status (married: 81% in AB/SK, 88% in MB), area of residence (urban: 86% in AB/SK, 81% in MB), and number of children (2 children: 49% in AB/SK, 41% in MB). Three high-priority needs were shared across provinces: (1) access to recreational, athletic, and artistic activities in French for children (variations by child gender); (2) access to French healthcare professionals (variations by education level and language difference); and (3) social activities in French for families. AB/SK respondents prioritized mental health services in French for adults and youth. MB families prioritized belonging to a Francophone community (variations by gender of children) and education services in French (variations by age of children). Understanding these common and province-specific priorities can inform policy and service planning. Full article

Digital transformation poses significant challenges to employee well-being, particularly in public administration, where hierarchical structures, increasing digitalization pressures, and high mental health-related absenteeism underscore the need to understand individual and job demands and resources. This study explores these aspects from the perspectives of employees and supervisors in public administration. Between September 2023 and February 2024, semi-structured interviews were conducted with eight employees and eleven supervisors from public administration organizations in Northern Germany and analyzed using deductive–inductive qualitative content analysis based on the Job Demands-Resources model. Identified individual resources included technical affinity, error tolerance, and willingness to learn, while key job resources involved early and transparent communication, attentive leadership, technical support, and counseling services, with most job resources linked to leadership behavior and work organization. Reported job demands comprised insufficient participation, inadequate planning, and lengthy procedures, whereas personal demands included fears and concerns about upcoming changes and negative attitudes toward transformation. The variation in perceived demands and resources highlights the individuality of the employees’ experiences. The findings provide initial insights into factors influencing psychological well-being at work during digital transformation, emphasizing the importance of participatory communication, employee involvement, leadership awareness of stressors, and competence development. Future research should employ longitudinal and interventional designs to improve causal understanding and generalizability. Full article

Spirituality and religion are underrecognized components of mental health and substance use (MHSU) care for youth of African descent. This study explores the dual role of spirituality and religion in influencing the help-seeking behaviors, recovery journeys, and care outcomes of youth of African descent aged 18 to 25 residing in Nova Scotia, Canada. Drawing on findings from a Canadian Institutes of Health Research (CIHR) funded community-based study using mixed methods, including interviews, focus groups, and arts-based approaches, the research highlights both the supportive and ambivalent roles spirituality plays in MHSU care. Participants shared themes such as spiritual reflection as a turning point, the assurance of a higher power, the culturally responsive support of faith-informed providers, and the significance of meditation and unseen connection as healing tools. While the narratives of research participants attested to the role of spiritual and religious practices in offering a sense of belonging, hope, and culturally aligned care, they may also reinforce stigma or act as a barrier to accessing formal MHSU services. These themes were derived from qualitative analysis of in-depth interviews with 60 youth participants. Through the lens of Ubuntu and Afrocentric paradigms, this paper calls for a more holistic and culturally inclusive approach to care, one that respects or honors the spiritual and communal lives of youth of African descent. It also reinforces the importance of training MHSU care providers to recognize, respect, and integrate spirituality as a legitimate component of wellness and recovery for help-seeking youth of African descent. Full article

The global population aged 65 and older is expected to double from 761 million in 2021 to 1.6 billion by 2050. Despite often being treated separately in clinical practice and policy, oral health and mental health are fundamentally interconnected in older adulthood, forming a bidirectional relationship that exacerbates disability, social inequity, and systemic healthcare challenges. This narrative review aims to summarize the two-way relationship between mental and oral health and emphasize their combined impact on systemic health, social engagement, and independence among ageing populations. The bidirectional relationship has profound clinical significance. Untreated oral diseases induce chronic pain and cause social embarrassment, aggravating pre-existing depression and anxiety. Periodontal disease can worsen systemic conditions such as diabetes, cardiovascular disease, and dementia via a shared inflammatory pathway. Conversely, mental health issues—including depression, anxiety, cognitive decline, and the use of psychotropic medications—reduce motivation for oral care, prompt dental neglect, and affect salivary function, deteriorating oral health. Despite clear connections, systemic gaps persist, including fragmented healthcare systems, financial barriers, stigma, lack of awareness, and caregiver burnout. To address these challenges, strategies such as developing integrated care models to unify dental and mental health services, reforming policies to prioritize oral and mental health parity, advocating anti-stigma campaigns to clear the misconceptions, and implementing community-based healthcare programmes to reach underserved older adults are essential. By recognizing oral health as a vital component of mental resilience, societies can transform ageing into an era of empowered well-being, where the mouth–mind connection promotes holistic health rather than functional decline. Full article

In the face of rapid aging, depression in later life has become a prominent issue in urban public health and environmental research. As potential places for social activities and emotional healing, the social stayability of shaded community spaces is an essential environmental factor influencing the mental well-being of the elderly. In order to overcome the challenge of depression relief in later life, it is important to investigate what attributes of social stayability in shaded spaces influence the mental well-being of the elderly, as well as their gap structures. This study innovatively develops a fuzzy multi-criteria decision-making method and builds an analytical framework combining Fuzzy-BWM and VIKOR to comprehensively evaluate three dimensions of physical accessibility, facilities, and spatial conditions, and environmental comfort and safety of shaded spaces. Using the Pioneer community in Panyu, Guangzhou, and the Yuehan community in Macau as empirical cases, this study integrates expert judgment and residents’ perception data to identify the key attributes and gap structure of shaded space stayability in mitigating depression-related psychological risk and promoting emotional restoration and psychological well-being among older adults. The results show that facilities and spatial conditions have the greatest impact on social stayability. The two attributes of sitting comfort and public service facilities are the dominant factors that affect stay intention and emotional recovery. Environmental comfort and safety have a secondary but stable supporting effect on psychological security. This study reveals the coupling relationship between functional configuration and perceptual experience and advocates for the transformation of urban renewal thinking from spatial optimization to psychological health promotion. This study’s results offer theoretical support and policy implications for building restorative, inclusive, and age-friendly cities. The findings provide a quantitative basis for decision making regarding sustainable community space governance and intervention prioritization. Full article

The loss of urban nature and declining biodiversity pose significant challenges to the sustainability of cities and the well-being of their inhabitants. Existing initiatives such as the Taskforce on Nature-related Financial Disclosures (TNFD) have begun to address ecological risks in real estate, but they still address mental health, biodiversity, and social equity only partially as non-financial values. This article adopts an integrative review and conceptual framework approach. It develops a nature-based accounting framework for urban real estate that combines principles of traditional Chinese architecture with contemporary sustainability metrics. The study reviews ecological theory, nature-related accounting, and evidence on biodiversity and mental health, and then undertakes an operational mapping from classical site planning, courtyard design, water management, and community structures to measurable indicators that remain compatible with TNFD-aligned reporting. The framework groups indicators into three main domains: nature-related conditions, ecosystem service pathways, and human well-being outcomes. It also outlines simple procedures for normalising and combining these indicators at the project scale to support assessments of biodiversity, microclimate, mental health, and basic aspects of cost-effectiveness and social accessibility in urban real estate projects. The paper provides a structured, heritage-informed basis for future applications and empirical testing, helping to incorporate biodiversity, mental health, and equity into urban real estate assessment. Full article

Background/Objectives: Suicide is the second leading cause of death among adolescents and young adults. Those suffering from psychiatric illnesses are at particular risk. Our study, conducted at an outpatient mental health facility in Northern Italy, aimed at delineating demographic and psychopathological features of youths aged 16–29 who attempted suicide and were referred to our community-based outpatient service. Methods: We identified 63 subjects, most of whom suffered from personality disorders, mood disorders, and schizophrenia spectrum disorders. Analysis of variance and post hoc pairwise comparisons were performed. Results: Inferential analysis yielded significant results in terms of age at index suicide attempt across diagnostic groups. Patients with personality disorders attempted suicide at a younger age (M = 18.70) compared to those with schizophrenia spectrum disorders (M = 23.64; η² = 0.32). Conclusions: Our findings highlighted the period of transition from adolescence to adulthood as a stress on the need of preventive approaches towards suicidality in young people in both clinical and non-clinical settings. Moreover, the difference of age at index suicide attempt across different diagnostic groups stresses the need for tailored clinical interventions based on the specific psychopathological trajectories and natural histories of the diseases. Full article

The location of mental health services in schools increases access for children and youth. This may be especially important in rural communities, where youth have more significant mental health needs and less access to services. Yet, few studies exist that explore the outcomes of student participation in school-based services. The present study evaluates student behavioral health needs and outcomes, as measured by the strengths and difficulties questionnaire (SDQ), of students (N = 43) participating in therapeutic mental health services (Tier 3) provided in three rural Midwest communities in the United States. At baseline, SDQ scores indicated that over half of students’ total difficulties scores fell in the Borderline or Abnormal categories, and over 40% of students demonstrated high needs related to emotional problems and hyperactivity. At the conclusion of services, students experienced statistically significant improvements in mean scores (compared to baseline) in total difficulties, externalizing problems, and internalizing problems, and on subscales measuring emotional problems, conduct problems, and hyperactivity. Significant differences were not found in the subscales measuring peer problems and prosocial behavior. High levels of satisfaction with services were also reported. Limitations and conclusions are discussed. Full article

First Nations children remain dramatically over-represented in Australia’s Out-of-Home Care (OOHC) system, particularly in New South Wales (NSW), which continues to report the highest numbers nationally. This narrative review, grounded in a relational First Nations Standpoint Theory and decolonising research paradigms, to critically examine the systemic, structural, and historical factors contributing to these disproportionalities. Drawing on interdisciplinary evidence across law, criminology, education, health, governance studies, and public policy, the analysis centres Indigenous-authored scholarship and contemporary empirical literature, including grey literature, inquiries, and community-led reports. Findings reveal that the OOHC system reproduces the colonial logics that historically drove the Stolen Generations. Macro-level structural drivers—including systemic racism, Indigenous data injustice, entrenched poverty and deprivation, intergenerational trauma, and Westernised governance frameworks—continue to shape child protection policies and practices. Micro-level drivers such as parental supports, mental health distress, substance misuse, family violence, and the criminalisation of children in care (“crossover children”) must be understood as direct consequences of structural inequality rather than as isolated individual risk factors. Current placement and permanency orders in NSW further compound cultural disconnection, with ongoing failures to implement the Aboriginal and Torres Strait Islander Child Placement Principle (ATSICPP). Contemporary cultural rights and Indigenous Cultural and Intellectual Property (ICIP) frameworks highlight the urgency of restoring Indigenous authority in decision-making processes. The literature consistently demonstrates that cultural continuity, kinship networks, and ACCO-led models are sort to produce stronger long-term outcomes for children. The review concludes that genuine transformation requires a systemic shift toward Indigenous-led governance, community-controlled service delivery, data sovereignty, and legislative reform that embeds cultural rights and self-determination. Without acknowledging the structural drivers and redistributing genuine power and authority, the state risks perpetuating a cycle of removal that mirrors earlier assimilationist policies. Strengthening First Peoples governance and cultural authority is therefore essential to creating pathways for First Nations children to live safely, remain connected to family and kin, and thrive in culture. Full article

Background/Objectives: Early motherhood is a risk factor for the mother-child relationship during the perinatal period, implying that intrusive or withdrawn maternal behavior and possibly abusive behavior can have short- and long-term consequences for child development. Methods: This study aimed to evaluate the preliminary effectiveness of a short mentalization community video feedback intervention designed to improve maternal mentalization, maternal communication, and behavior quality of adolescent and young mothers. Twenty-six young and adolescent mother-infant dyads were recruited at an Italian outpatient hospital service for adolescent and young parents with a one-group pre-test/post-test design. The participants (n = 15) received four video feedback sessions focused on mentalization and affective communication. At 3 infant months, risk factors associated with young motherhood were assessed. At 3 infant months (pre-intervention) and 9 months (post-intervention), the quality of maternal communication and behavior has been evaluated with Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE), and maternal mind-mindedness was assessed. Results: At the end of the intervention, the results showed significant improvements in maternal communication quality and mind-mindedness, especially in decreasing disrupted maternal affective communication (p = 0.005) and non-attuned mind-mindedness comments (p = 0.005). Conclusions: This study highlighted good acceptance of the intervention in a public health context and the effectiveness of a short mentalization community video feedback intervention to improve maternal mind-mindedness and communication quality between young mothers and their infants. The preliminary findings of this pilot study could be useful for implementing similar interventions aimed at young parents in community contexts. Full article

Background/Objectives: Maternal mental health concerns are a leading cause of maternal morbidity and mortality, disproportionately impacting Black mothers in the United States. Structural racism and social determinants of health contribute to increased risks of perinatal mental health issues, limited access to formal services, and adverse health outcomes for Black mothers. While formal mental health services are underutilized, Black mothers employ a variety of culturally relevant and context-specific strategies to support their mental health. This study seeks to understand the barriers, preferences, and experiences that guide their decision-making and inform culturally responsive care. Methods: This qualitative study employed thematic analysis of in-depth interviews conducted with 12 Black mothers aged 20–39 residing in a midwestern metropolitan area. The research explored individual experiences, preferences for support, and perspectives on healthcare to identify pathways for advancing mental health equity. Results: Three major themes emerged: (1) Expanding conceptions of mental health support beyond traditional services, emphasizing preferences for culturally congruent, convenient, and stress-decreasing interventions; (2) The salience of past experiences and identities in shaping support preferences and decisions; (3) What healthcare professionals can do, the knowledge and skills healthcare professionals can gain, and the actions that they can to become more helpful to Black mothers. The importance of healthcare professionals embodying nonjudgmental, patient, and caring attributes, as well as strengths-based, culturally responsive approaches in care. Conclusions: Advancing mental health equity for Black mothers requires increased awareness of existing disparities, barriers to care, and the strengths embedded within their communities. This research provides actionable insights for healthcare providers, policy makers, and researchers to identify, assess, and respond to the unique needs of Black mothers through culturally responsive and participatory approaches. Findings have implications for intervention design, theory development, and policy reform to improve mental health outcomes. Full article

Background: Better understanding factors leading to suicide and prevention opportunities is a global public health priority. This qualitative pilot study tested whether reviewing inquest recordings could generate insights during COVID-19 and inform public health prevention programmes across a predominantly rural and coastal area where there are significant health inequalities. Methods: Fifty-five inquest recordings reached a suicide conclusion between March 2020 and January 2021. Stratified sampling was used to obtain two samples from each month. Template analysis was employed to thematically analyse data from 30 inquests. Results: Risk factors during this period were social isolation, anxiety, difficulty in routine creation and maintenance, low mood and economic impact. Remote working in a more rural/coastal area impacted both healthcare service users and staff. Lockdown and other multiple risk factors impacted those at increased risk of poor mental health and suicide. Conclusions: There is a need to identify those at risk and with deteriorating mental health. All age trauma-informed approaches are needed to prevent individuals from reaching crisis along with more equitable services and community support due to the complex nature of suicide. This requires consideration of digital access/exclusion, training, continuity of care and enhanced care of those with additional needs and multiple vulnerabilities. Full article

Mental health services have an interest in maintaining psychosocial safety for consumers, carers, and staff alike. While much discussion around safety in service delivery pertains to the likelihood of patients engaging in damaging behaviours, we take the position that community attitudes towards safety offer more expansive, relational, and spatial definitions of safety. In a survey consisting of a mix of open and closed questions of 279 Australians aged 16–87 years, participants were asked to comment on their experiences of safety and unsafety in emergency mental health service use, as well as what they consider to be a safe or unsafe service. Applying a thematic analysis to the data, findings showed that emergency departments are not safe or appropriate for mental health consumers. Participants had heterogenous but largely consistent ideas about what made a service safe. Elements of safety mentioned by participants included a therapeutic orientation to time; service predictability; sensory dimensions of safety; and feeling understood. For some participants, notions of safety and unsafety dictated not only their satisfaction with services but overall likelihood of service use, thereby emphasising the critical importance of community attitudes towards safety in service design and delivery. Full article

Background and Objectives: Mental health recovery is conceived as a personal process going beyond symptom remission and thus involving identity reconstruction, search for meaning and active participation in everyday life. This study aimed to analyze the influence of life history, identity, competence and context on the recovery process of people with mental illness. Methods: A qualitative phenomenological study was conducted and registered in the Open Science Framework. Participants were 159 individuals diagnosed with mental disorders who attended a community mental health association. Data were collected using the standardized Occupational Performance History Interview-II (OPHI-II) and analyzed through an inductive phenomenological approach with researcher triangulation. Results: Findings showed that life history is central to recovery, as it helps rebuild identity, recognize personal capacities and restore a sense of continuity. Daily occupations and social support emerged as key factors for inclusion and participation. Conclusions: Results highlight the importance of integrating biographical narratives and occupational perspective into mental health interventions through a standardized tool that surpasses traditional diagnosis-based or methodologically weak approaches. This perspective fosters practices aligned with individuals’ values, goals and contexts, promoting autonomy, empowerment, and social inclusion. These findings may inform person-centered recovery programs in community services. Full article