Search Results (2,675)

This paper examines whether the establishment of “Key Controlled Areas for Air Pollution Prevention and Control” and its associated policy package in China improved residents’ health. Based on data from the China Health and Retirement Longitudinal Study (CHARLS) 2011–2018, Our study finds that this command-and-control environmental regulation is associated with notable declines in residents’ morbidity from asthma, lung disease, and heart disease, while also producing preventive effects. Potential channel analysis indicates that these health improvements operate through reduced air pollution, heightened public environmental concern, and enhanced residents’ lung function. Heterogeneity analysis indicates that the respiratory benefits for asthma are larger among rural residents, males, and the in-service group; the benefits for lung disease are larger among rural residents, females, and the in-service group; the cardiovascular benefits for heart disease are larger among urban residents, females, and the retired group. Furthermore, this paper also finds that the establishment of this policy and its associated policy package is significantly associated with lower residents’ medical expenditures and improved subjective and mental health. Full article

Background and objectives: Despite the substantial global burden of mental illnesses, there remains limited evidence evaluating the effectiveness of inpatient Models of Care (MOCs) for adolescents. This paper compares the effectiveness of an innovative MOC, the Brief Intervention MOC (BIMOC), with the Traditional MOC in an acute adolescent inpatient unit. Comparisons were based on clinical outcome measures and several Key Performance Indicators (KPIs) (length of stay, 28-day readmission rate, 7-day follow-up rate, seclusion rate, and self-harm incidents), which were tracked over the subsequent years to evaluate BIMOC’s effectiveness and sustainability. Materials and Methods: A retrospective, single-center, quasi-experimental non-randomized before-and-after study using historical controls was conducted. Clinical outcomes were assessed using the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the Children’s Global Assessment Scale (CGAS). Service-level KPIs were compared across models. Descriptive statistics, paired-samples t-tests, Cohen’s d, and z-tests were used to evaluate changes within models and compare outcomes between models. Results: Within the BIMOC, both acute and crisis subgroups showed substantial improvements, with mean CGAS scores increasing from 27.67 to 49.76 and mean HoNOSCA scores decreasing from 19.30 to 9.96 (p < 0.001). Overall, both models demonstrated significant improvements from admission to discharge. Effect size analysis indicated greater functional gains under the BIMOC compared with the TMOC (d = 1.89 vs. 1.22; z = −3.694, p = 0.0002), while no statistically significant difference in symptom improvement was detected between the two MOCs (z = −0.769, p = 0.4418). KPI data analysis identified favorable patterns in several service-level indicators during the BIMOC period compared to the TMOC period, including reduced length of stay (21.0 vs. 13.6 days), reduced 28-day readmission rates (11.9–17.0% vs. 8.1%), and increased 7-day follow-up completion (approximately 60% vs. 76.8%). Conclusions: The study suggests that a structured and integrated inpatient MOC (BIMOC) incorporating multidisciplinary collaboration, family involvement, and coordinated discharge and follow-up processes may support positive clinical and service-level outcomes in adolescent mental health inpatient settings. However, given the observational before-and-after design, the findings should be interpreted cautiously and do not establish causality. Full article

POI and EOI are rare but impactful conditions among adolescents and young adults (AYAs). Little is known about the timing and incidence of mental health (MH) conditions among AYAs diagnosed with POI/EOI. Data were collected using MarketScan Medicaid administrative claims among females aged 12–25 with POI/EOI. Merative™ MarketScan^® Research Databases are large, de-identified U.S. administrative healthcare claims databases that contain individual-level information on enrollment, inpatient and outpatient medical services, and outpatient prescription drug claims. The databases include commercially insured individuals, Medicare beneficiaries with employer-sponsored supplemental coverage, and selected Medicaid populations. Claims are linked longitudinally using unique encrypted patient identifiers, allowing individuals to be followed over time across healthcare settings. In addition to healthcare utilization, the databases include demographic characteristics, diagnosis and procedure codes, dates of service, and payment information, making them well suited for epidemiologic, health services, and outcomes research. We characterized prevalence and timing of MH diagnoses, examined MH subtypes, and estimated new-onset MH among those without prior MH. Comparisons were made to demographically matched controls without POI/EOI (matched on age and calendar time) and to diagnosis-anchored comparator groups. Among 859 AYAs with POI/EOI, 53.9% had any MH diagnosis, including 32.9% with MH diagnoses before and after POI/EOI diagnosis and 11.9% with new-onset MH after POI/EOI diagnosis. Of all anxiety disorders, 60.1% were present pre- and post-diagnosis, while 25.4% were new-onset after diagnosis. Depressive disorders showed a similar pattern, with 58.1% being pre- and post-diagnosis MH group and 22.3% being new-onset. In total, 49.4% of individuals with trauma-related disorders had the diagnosis both before and after POI/EOI diagnosis, while 30.1% had it as a new-onset. In adjusted models, POI/EOI was associated with increased odds of MH diagnoses after diagnosis (aOR ~2.1, 95% CI ~1.4–3.1). Prior MH diagnoses were the strongest predictor of MH after diagnosis (aOR ~12.1). AYAs with POI/EOI experience substantial MH burden, with elevated risk of new-onset MH conditions following diagnosis. Findings highlight the importance of early MH screening and integrated care models for AYAs. Full article

Mental health significantly impacts state performance, productivity, public services, health care costs, and tax revenue. The 5.0 Revolution has redefined productive work as continuous, raising expectations for constant activity and responsiveness and heightening work-related stress. Excessive work stress, known as burnout, is not classified as a medical condition but is recognized as “unmanaged work burnout syndrome.” This research examines the need to strengthen legal frameworks to provide preventive protection against burnout for employees. The researcher conducted doctrinal research using primary legal sources, including the Law of the Republic of Indonesia Number 13 of 2003 concerning Manpower (as amended), the Law of the Republic of Indonesia Number 2 of 2022 concerning Job Creation, Law No. 17 of 2023 concerning Health, the Regulation of the Minister of Health Number 3 of 2023 concerning Health Service Tariff Standards, and the Regulation of the Minister of Health Number 19 of 2024 concerning Community Health Centers. We also reviewed secondary sources, such as scientific journal articles and books. We analyzed these sources using legal interpretation and synthesis, applying grammatical and systematic methods. To strengthen the legal framework, we recommend providing psychological consultation services in companies, implementing mental health screenings for employees, and enhancing psychological well-being services at health centers. Full article

Background/Objectives: Patient access to cannabinoid-based therapies in Brazil has expanded with the availability of regulated Cannabis-derived products (CDPs). This study explored CDP prescribing practices among Brazilian physicians. Methods: Between September 2024 and March 2025, a national online survey assessed physician characteristics, prescribing status, and reasons for non-prescription. Among prescribers, we analyzed CDP formulations, brands, indications, patient age groups, and time to therapeutic response. Bivariate and multivariable analyses identified factors associated with CDP prescribing. Results: A total of 333 physicians participated in the study, including 305 prescribers and 28 non-prescribers. Most CDP prescribers worked in private practice settings (67.9%). Specific training in CDP prescribing was the factor most strongly associated with a higher likelihood of prescribing (adjusted OR, 100.73; 95% CI, 12.77–794.72; p < 0.001), while lack of knowledge was the main reason for non-prescription. Although some physicians reported prescribing national products, imported products remained predominant (75.8% vs. 24.2%). Products provided through patient associations were also frequently mentioned. Predominant indications included mental and behavioral disorders, neurological diseases, and pain. Oil-based cannabidiol (CBD) formulations were the most frequently prescribed and were generally administered orally or sublingually. Older patients were the most frequently reported recipients of CDP prescriptions, and most physicians reported observing therapeutic effects within 30 days. Conclusions: Despite an evolving regulatory framework, clinical practice remains challenged by gaps in clinical training and disparities in patient access. Full article

Newcomer youths (i.e., young immigrants, refugees, international students) represent a growing community across Canada, and their transition into school systems is critical to their wellbeing. School integration represents a novel vantage point by which to explore the immigration experiences of newcomer youth who are adjusting to student life. Service providers (e.g., administrative staff, guidance counsellors, settlement workers, etc.) are critical partakers in the school integration of newcomer youth. This qualitative study employed a social constructionist perspective and an integrated social justice lens. The central research questions guiding this inquiry included (1) How do participants understand newcomer youths’ experiences of school integration? And (2) What are the ways in which participants support newcomer students in high schools? In-depth, semi-structured, qualitative interviews were conducted with six service providers in one designated high school. A thematic analysis led to the development of five salient themes: (1) supporting academic needs, (2) life outside of school, (3) mental health concerns, (4) connections in school, and (5) gaps in the education system. Results of this study highlight the larger systemic issues that continue to impede the experiences of newcomer youth in schools. Implications for service providers working with newcomer youth in schools are presented. Full article

Individuals with a history of suicide attempt may face complex decisions about whether, when, and how to disclose their suicidal behavior history. However, little is known about how they navigate these decisions within family, social, and mental health care contexts. This qualitative study examined disclosure decision-making among biological mothers with a documented history of suicide attempt whose children aged 5–17 years had received behavioral health services. Structured clinical and demographic assessments were used to characterize the sample, followed by semi-structured qualitative interviews. Eleven audio-recorded interviews were included in the qualitative analysis. Mothers described disclosure decisions within the context of prior experiences of judgment and dismissal, stigma surrounding mental health and suicide, distrust of mental health care, structural and family stressors, and discomfort with vulnerability. Mothers also described conditions that facilitated disclosure, including close relationships with trust and open communication, and pro-mental health care attitudes. Findings suggest that disclosure of suicide attempt history is a context-dependent decision shaped by experiences across interpersonal, social, structural, and individual contexts. Rather than supporting disclosure as uniformly beneficial or harmful, these findings highlight the need for individualized, developmentally appropriate support for individuals considering whether, when, and how to discuss a suicide attempt history. Full article

The United States has long been a destination for immigrants seeking better economic opportunities and an improved quality of life, and among these populations, Muslim women represent a particularly vulnerable group facing unique challenges. First-generation Muslim immigrant women in America navigate a complex web of intersecting stressors that significantly impact their mental health and overall wellbeing. Despite the pervasiveness of mental health and heightened attention on mental health challenges post COVID-19, research on the mental health of the Muslim community—particularly immigrant Muslim women in the United States—is seldom studied. This qualitative study utilized a focus group among a purposive sample of immigrant Muslim women to explore the multifaceted mental health challenges with particular attention to how racism, Islamophobia, and acculturative stress create cumulative mental health burdens. Thematic analysis revealed five major themes highlighting the various mental health challenges faced by participants: experience encountering racism and discrimination, the importance of faith and Islamic practice in addressing mental health challenges, the role of family and peers in addressing mental health challenges, and mental health service utilization. These findings underscore the importance of culturally responsive mental health services and community-based interventions that recognize the intersection of migration, discrimination, and religious identity in shaping the mental health experiences of immigrant Muslim women. Full article

This study explored pharmacy students’ lived experiences of mental health support structures at a University in South Africa. A qualitative phenomenological design was employed, with data collected through semi-structured interviews (n = 20) and document analysis of institutional mental health resources (2020–2024). Thematic analysis revealed five interrelated themes: awareness and visibility of support; barriers to access and utilization; institutional responses to mental health crises; cultural and contextual misalignment; and informal support and coping strategies. Although formal support services were available, students experienced them as fragmented, reactive, and insufficiently integrated into academic life. Barriers to access included long waiting times, stigma, and concerns about confidentiality. Institutional responses to crises were perceived as academically focused, with limited psychological follow-up. Students relied heavily on informal networks, including peers, family, and spirituality. These findings highlight a disconnect between institutional provision and student experience, underscoring the need for more integrated, culturally responsive, and student-centred approaches to mental health support within pharmacy education. Full article

Rural men in Australia experience poorer health outcomes compared to their urban counterparts, often due to barriers such as limited access to services, cultural norms around masculinity, and geographic isolation. This study explored the motivations underlying rural men’s participation in a student-led health promotion activity conducted by first-year paramedicine students at a large agricultural event. Using semi-structured verbal surveys with 60 participants, qualitative data were collected and analysed through an inductive content analysis approach. Three key themes were created to represent the reasons men engaged in the activity and the impact it had: factors that encouraged engagement and built trust, meeting multiple needs, and giving to student learning for the future. Participants were drawn to the activity by a welcoming environment, peer encouragement, and the consistent presence of health promotion at the event. Health promotion provided an opportunity for men to access basic health assessments, reflect on their wellbeing, and engage in conversations about physical and mental health in a supportive setting. Many participants also expressed a strong motivation to contribute to student learning, particularly through experiential interactions that allowed students to develop technical and interpersonal skills. The findings highlight the value of embedding health promotion activities in familiar, community-based settings and demonstrate the multitude of benefits for rural men. This research contributes to the growing evidence supporting innovative, community-engaged models of work-integrated learning that address health disparities while enhancing student education and rural workforce development. Full article

Adapting psychological interventions from High-Income Countries (HICs) to Low- and Middle-Income Countries (LMICs) is often needed because developing new treatments requires significant resources. Contextual adaptation improves acceptability, practicality, and effectiveness in diverse settings. However, few studies clearly describe the frameworks guiding these adaptations. Our review examined the literature on conceptual and procedural frameworks for culturally adapting psychological interventions aimed at youth depression and anxiety and identified common challenges. We searched several databases for studies that had culturally adapted psychological treatments in LMICs. We used the Reporting Cultural Adaptation in Psychological Trials (RECAPT) framework to gather data and guide the thematic analysis. We reviewed 25 studies; most (n = 23) reported formative work but lacked detailed, step-by-step descriptions of the adaptation processes. When frameworks were described, processes were often unclear, making it difficult to determine what constitutes adaptation and how to implement it. The review underscores the need for more structured, detailed reporting of adaptation frameworks. Clearer documentation is vital for better understanding and successful implementation. Based on these findings, we suggest ways to improve reporting practices for the cultural adaptation of psychological interventions. We recommend (1) explicit reporting of step-by-step adaptation processes using established frameworks and (2) systematic documentation of cultural and contextual modifications based on identified conceptual and process frameworks using reporting guidelines such as RECAPT. Full article

Background: Mental health disorders are an increasing concern in Saudi Arabia, including in the Eastern Province, where one study found that of the 42.5% of medical students who reported a clear need for mental health services, only 16.2% had actually used them. Stigma and other psychosocial factors are thought to shape help-seeking behavior, yet comparative studies remain scarce. This study compares attitudes toward seeking professional psychological help, and perceived stigma, between students in health-related and non-health-related programmes at King Faisal University. Methods: In this cross-sectional study, 589 students at King Faisal University, Saudi Arabia, were recruited through convenience sampling. Data were collected with an online, self-administered questionnaire covering sociodemographic characteristics and three validated Arabic instruments: the Attitudes Toward Seeking Professional Psychological Help–Short Form (ATSPPH-SF), the Stigma Scale for Receiving Psychological Help (SSRPH), and the Hopkins Symptom Checklist-25 (HSCL-25). Results: Of the 589 respondents, 580 (98.5%) were included in the analysis—279 (48.1%) health-related and 301 (51.9%) non-health-related students. Most were aged 18–21 (76.9%), Saudi nationals (96.9%), single (91.9%), and of middle income (79.2%). Attitudes toward seeking professional psychological help did not differ significantly between health-related and non-health-related students (Welch’s t(566) = −1.48, p = 0.138, Cohen’s d = −0.12, a negligible effect). Perceived stigma (SSRPH) was significantly higher among health-related students (10.85 vs. 10.16; t(578) = 2.56, p = 0.011). Perceived social stigma was inversely and significantly associated with attitudes toward seeking professional psychological help (r = −0.262, p < 0.001). Together, stigma and psychological distress (HSCL-25) explained a modest 7.9% of the variance in help-seeking attitudes (R² = 0.079). Conclusions: Health-related and non-health-related students at this single university did not differ significantly in their attitudes toward seeking professional psychological help. Perceived stigma showed the stronger association with less favorable attitudes, whereas psychological distress was associated with a smaller, positive association. These findings, from a single-center convenience sample, point to a need for stigma-reduction efforts and confidential mental health services at King Faisal University. Full article

Background/Objectives: Mental disorders represent a major public health challenge, particularly in ageing populations. This study aimed to analyse the incidence of mental disorders requiring hospital admission in Aragón (Spain), compare the epidemiological and clinical characteristics of adults aged ≥65 years with the overall adult population, and evaluate temporal and geographical variations in incidence. Methods: A retrospective population-based study included all incident cases of mental disorders requiring hospital admission in Aragón between 2021 and 2024. Data from the Aragón Healthcare Big Data Platform (BIGAN) were analysed using descriptive statistics, multivariable logistic regression, and Poisson regression. Results: A total of 3057 incident cases were identified. The average annual incidence was 57.12 per 100,000 inhabitants in the overall adult population and 51.70 per 100,000 among adults aged ≥65 years. Older adults were more frequently women and showed higher rates of disability, polypharmacy, mood disorders (F3), and organic mental disorders (F0), whereas schizophrenia spectrum disorders (F2) and readmissions were less frequent. Organic mental disorders (OR = 12.28), mood disorders (OR = 2.50), disability (OR = 3.50), and polypharmacy (OR = 6.88) were independently associated with older age. Incidence remained relatively stable but showed geographical variation, with higher rates among older adults concentrated in predominantly mountainous counties. Conclusions: Adults aged ≥65 years showed an average annual incidence comparable to the overall adult population but exhibited a distinct clinical and geographical profile. These findings support integrated, age-sensitive, and territorially adapted mental healthcare strategies for ageing populations. Full article

HIV-related stigma constitutes a critical structural determinant that adversely affects mental health and treatment outcomes among people living with HIV (PLWH) in Tunisia. Rooted in cultural conservatism, legal criminalization, and institutional discrimination, this stigma engenders social exclusion, the systematic removal of individuals from community participation. It further fosters internalized shame, precipitating depression, anxiety, and treatment non-adherence. Evidence was synthesized from English- and French-language literature published between 2014 and 2026, identified through targeted searches of PubMed, Scopus, Web of Science, Google Scholar, and grey literature sources from UNAIDS, WHO, and Tunisian governmental authorities. This narrative review synthesizes recent epidemiological data indicating a 0.1% general population prevalence but 13% among men who have sex with men (MSM), with only 26% testing coverage. Situated within trauma-informed, social determinants of health, and public health frameworks, this analysis identifies specific vulnerabilities for women and older adults living with HIV. Integrated approaches combining healthcare-provider training, legal reform, and culturally tailored mental health services are essential to mitigate the harms of stigma and improve equitable health outcomes in Tunisia. Full article

Psychotropic medication is widely used in the treatment of severe mental illness, yet its impact on spirituality—understood as relating to the transcendent—remains underexplored. This qualitative study examines how individuals who have reduced or discontinued medication experience and navigate spirituality. In-depth, semi-structured interviews were conducted with seven former inpatients, and data were analyzed thematically within an existential–phenomenological framework. Participants described diverse spiritual and extraordinary experiences intertwined with symptoms and medication use. They navigated these by managing medication as a double-edged sword that both protected and numbed spirituality; by attempting, with varying degrees of success, to make sense of their experiences within “illness” or “spirituality” frameworks; and by seeking relational support. The findings suggest that tapering psychotropic medication may be not only a pharmaceutical process but also an existential and spiritual one. Mental health services may enhance recovery by acknowledging spirituality, engaging with patients’ meaning-making around extraordinary experiences, and recognizing the complex role of medication while making room for ambiguity, uncertainty, and mystery as sources of existential hope. Full article