Mental Health Act

Depression and obesity are highly comorbid conditions with shared biological mechanisms. It remains unclear how depressive symptoms and body mass index (BMI) interact in relation to inflammation. This cross-sectional study investigated the independent associations of depressive symptoms and BMI with high sensitivity C-reactive protein (hs-CRP), as well as the moderating role of BMI on the depressive symptoms-hs-CRP association.

With the enforcement of the Cannabis Act on 1 April 2024, Germany has adopted one of the most liberal legal approaches to cannabis on the continent. The German model prioritises a non-profit approach and precludes legal market mechanisms. We believe these are the main drivers for increasing cannabis use and related health problems, based on observations following cannabis legalisation in Canada and many states in the U.S. Although legalising cannabis possession and cultivation may not immediately eliminate the illegal market, it is expected to serve public health goals. Despite the overall positive evaluation of the Cannabis Act in Germany, there are three potential areas of concern: the potential for misuse of the medical system, the normalization of cannabis use, and the influence of the cannabis industry. The German model may herald the beginning of a new generation of European cannabis policies, but concerted efforts will be required to ensure that these policy reforms serve rather than undermine public health goals.

This review summarized recent systematic reviews and meta-analyses on randomized controlled trials evaluating acceptance and commitment therapy (ACT). Although the strength of evidence varies, overall there is plausible evidence for the efficacy of ACT for a wide range of areas including depression, anxiety disorders, obsessive-compulsive and related disorders, psychosis, substance use disorders, chronic pain, coping with chronic health conditions, obesity, stigma, and stress and burnout. ACT is also efficacious when delivered in digital self-help formats. Reviews of mediation research indicate ACT works through increasing psychological flexibility.

Fibromyalgia (FM) is a chronic pain disorder characterised by widespread pain, fatigue and cognitive symptoms. Acceptance and commitment therapy (ACT) aims to improve psychological flexibility and has been found to be beneficial in treating chronic pain; however, there are few studies evaluating its efficacy in treating FM.

Abnormalities in auditory processing are believed to play a major role in autism and attention-deficit hyperactivity disorder (ADHD). Both conditions often co-occur in children, causing difficulties in deciding the most promising intervention. Event-related potentials (ERPs) have been investigated and are showing promise to act as potential biomarkers for both conditions. This study investigated mismatch negativity (MMN) using a passive listening task and P3b in an active auditory go/no-go discrimination task. Recordings were available from 103 children (24 females): 35 with ADHD, 27 autistic, 15 autistic children with co-occurring ADHD, and 26 neurotypical (NT) children. The age range considered was between 4 and 17 years, but varied between groups. The results revealed increases in the MMN and P3b amplitudes with age. Older children with ADHD exhibited smaller P3b amplitudes, while younger autistic children showed reduced MMN amplitudes in response to phoneme changes compared to their NT counterparts. Notably, children diagnosed with autism and ADHD did not follow this pattern; instead, they exhibited more similarities to NT children. The reduced amplitudes of phonetically elicited MMN in children with autism and reduced P3b in children with ADHD suggest that the two respective ERPs can act as potential biomarkers for each condition. However, optimisation and standardisation of the testing protocol, as well as longitudinal studies are required in order to translate these findings into clinical practice.

High rates of suicide continue to plague the modern world, with clinicians, researchers, and policymakers working urgently to ameliorate what has been recognized as a worldwide public health crisis. Under American Law, individuals- including health care providers, could generally not be held liable for causing the suicide of another person. This article presents a review of suicide law in the United States in the context of a recent civil case in which a physician with expertise in mental health was sued for the death of an ex-partner who committed suicide in his home. Historical events and landmark legal cases spanning the 15th century to now are examined and presented as a narrative review to inform society and mental health clinicians a-like towards interpreting the changing medical-legal landscape. As modern advances in science continue to discern the critical biopsychosocial factors that contribute to the act of suicide, there is an inevitably growing concern that suicide may no longer be an incomprehensible nor irrational event as has been assumed for centuries. Thus, it may be considered that individual with expertise and qualification to treat a group of individuals at higher risk of suicide (severe mental illness) may be subject to a different standard than the average individual. This article seeks to present a complex matter where no simple or broad-sweeping conclusions can yet be drawn, however remains a critically important matter for mental health clinicians.

Despite existing employment-related legislation and governmental programs, people with disabilities continue to face significant barriers to competitive employment. These obstacles are partially due to biases among employers regarding the contributions of people with disabilities and perceptions about accommodation costs, which can affect their hiring decisions. Existing research on employment barriers and facilitators often treats people with disabilities homogenously and focuses mainly on large companies. This study helps to fill these gaps by exploring the motivations and challenges small employers face when hiring people with disabilities and how their attitudes and willingness to hire vary based on disability type.

Providing physical health and mental health training promotion is necessary for a sustainable change in attitude and lifestyle of diabetic patients. The present study was conducted with the aim of comparing the effect of physical health training and psychological training of the theory of reasoned action (TRA) model on the life quality of patients with type 2 diabetes.

Despite high tobacco use prevalence among those with serious mental illnesses, few Assertive Community Treatment (ACT) programs provide tobacco treatment. Understanding the factors associated with the intentions to engage in tobacco treatment from both provider and consumer perspectives is important. The purpose was to examine ACT providers' intention to provide and consumer intention to engage in tobacco treatment.

Mental health nurses (MHNs) experience a range of stressors as part of their work, which can impact their well-being and turnover intention. There is no prior evidence, however, on MHNs' mental health, well-being, resilience, and turnover intention during the COVID-19 pandemic. The aims of this online survey-based cross-sectional study, conducted during the pandemic, were to explore the psychological distress, well-being, emotional intelligence, coping self-efficacy, resilience, posttraumatic growth, sense of workplace belonging, and turnover intention of n = 144 Australian mental health registered and enrolled nurses; and explore relationships between these variables, in particular, psychological distress, well-being, and turnover intention. There was a higher percentage of MHNs with high (27.78%) and very high psychological distress (9.72%) compared to population norms as measured by the K10. Emotional intelligence behaviours were significantly lower than the population mean (GENOS-EI Short). Coping self-efficacy was mid-range (CSES-Short). Resilience was moderate overall (Brief Resilience Scale), and posttraumatic growth was mid-range (Posttraumatic Growth Inventory; PTGI). Sense of workplace belonging was moderate, and turnover intention was low. Higher levels of psychological distress were associated with higher turnover intention, and lower workplace belonging, coping self-efficacy, well-being, resilience, and emotional intelligence behaviours. Despite the levels of psychological distress, nearly half the sample (n = 71) was 'flourishing' in terms of well-being (Mental Health Continuum Short-Form). To help prevent staff distress in the post-pandemic period, organisations need to proactively offer support and professional development to strengthen staff's psychological well-being, emotional intelligence, and resilience skills. These strategies and group clinical supervision may also support lower turnover.

Youth of parents who are experiencing psychopathology are more likely to develop emotional concerns, and these mental health symptoms can have a deleterious impact on parents' mental health. However, the relationship between the presentation of specific symptoms in parents and youth is infrequently examined. Symptom network analysis is an analytic approach that is increasingly being used to better understand the relationship of symptoms within and between disorders and can also be used to examine symptom relations within a dyad. The present study used symptom network analysis to examine bidirectional relationships among depressive and anxiety psychopathology in a transdiagnostic sample of treatment-seeking youth and their primary caregiver. Parental anhedonia and child worthlessness exhibited the greatest centrality within the network, suggesting that these may act as risk and maintenance factors for parent-child psychopathology and may be important intervention targets. Findings support the use of symptom network analysis to inform an understanding of the complex relationships among parent and child depressive and anxiety symptoms. Future research should consider the use of network analytic methods to examine the temporal relationships between parent and child psychopathology and to inform joint parent-child interventions for those with internalizing concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Previous studies exploring difficult inpatients have mostly focused on psychiatric inpatients.

Regulatory actions are increasingly used to tackle issues such as excessive alcohol or sugar intake, but such actions to reduce sedentary behaviour remain scarce. World Health Organization (WHO) guidelines on sedentary behaviour call for system-wide policies. The Chinese government introduced the world's first nation-wide multi-setting regulation on multiple types of sedentary behaviour in children and adolescents in July 2021. This regulation restricts when (and for how long) online gaming businesses can provide access to pupils; the amount of homework teachers can assign to pupils according to their year groups; and when tutoring businesses can provide lessons to pupils. We evaluated the effect of this regulation on sedentary behaviour safeguarding pupils.

Results from randomized clinical trials of psilocybin in depressive disorders highlight the therapeutic potential of serotonergic psychedelic compounds in mental health disorders. The synthetic 5-hydroxytryptamine 2A receptor agonist 4-hydroxy-,-diisopropyltryptamine (4-OH-DiPT) is structurally similar to psilocin but is reported to have a shorter duration (2-3 h) of psychedelic effects, suggesting the potential for psilocybin-like therapeutic activity with reduced clinical resource burden. Here, we describe the preclinical and translational characterization of RE104, a 4-OH-DiPT prodrug comprising a glutarate moiety designed to cleave rapidly in situ and thus provide reasonable bioavailability of the active drug. Plasma concentration of 4-HO-DiPT over time in PK experiments in rats was correlated with head-twitch intensity. The half-life of 4-OH-DiPT was 40 min after subcutaneous administration of RE104 in rats. In a forced swim test, a single dose of RE104 (1 mg/kg) significantly reduced mean immobility time at 1 week compared with vehicle ( < 0.001), confirming translational antidepressant potential. Taken together, these data with RE104 show that the glutarate ester can act as an efficient prodrug strategy for 4-HO-DiPT, a unique short-duration psychedelic with potential in depressive disorders.

There has been recent discussion in Australia and New Zealand concerning the utility of Clinical Practice Guidelines (CPGs) and the role of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) in their development. The College Board therefore established a Steering Group (SG) to oversee an exploration of options and produce recommendations about contemporary approaches to the development of high-quality evidence-based clinical practice guidance for psychiatry. This paper outlines the SG's conclusions and recommendations, as well as the underlying methods and reasoning. In particular, we discuss best practice and recent developments in the synthesis of research evidence. Account has been taken of the opportunities offered by digital technologies, the proliferation of clinical evidence and awareness of the gains to be made by increased inclusion of lived-experience perspectives. It is recommended that the broader concept of best practice resources (BPRs) as now emphasised in so many fields of service is the most appropriate starting point for the College's role in this area especially as the expertise of the College and its fellows lends itself to the development of a range of BPRs. In conclusion, contemporary guidance needs to be tailored to the requirements of the practitioners seeking it, to articulate the real-world needs and experiences of patients, and to be delivered in a contemporary format that is responsive to rapidly emerging evidence. The experience in Australia and New Zealand may have implications elsewhere for the development of CPGs and BPRs more broadly.

Menopause is a biological process experienced by all people assigned female at birth. A significant number of women experience mental ill health related to the major brain gonadal hormone shifts that occur in their midlife. There is poor understanding and management of the complex mental ill health issues, with the biological brain hormone changes receiving little formal attention. The current treatment advice is to manage this special type of mental ill health in the same way that all mental ill health is managed. This leads to poor outcomes for women and their families. Many women leave the workforce earlier than expected due to menopause-related depression and anxiety, with subsequent loss of salary and superannuation. Others describe being unable to adequately parent or maintain meaningful relationships - all ending in a poor quality of life. We are a large and diverse group of national and international clinicians, lived experience and social community advocates, all working together to innovate the current approaches available for women with menopausal mental ill health. Above all, true innovation is only possible when the woman with lived experience of menopause is front and centre of this debate.

Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021.

Acute traumatic stress symptoms may develop in people who have been exposed to a traumatic event. Although they are usually self-limiting in time, some people develop post-traumatic stress disorder (PTSD), a severe and debilitating condition. Pharmacological interventions have been proposed for acute symptoms to act as an indicated prevention measure for PTSD development. As many individuals will spontaneously remit, these interventions should balance efficacy and tolerability.

This study aimed to investigate whether patients with low back pain (LBP) had impaired lower limb proprioception and its association with somatosensory acuity. Thirty patients with LBP and 30 asymptomatic people volunteered, using Sway Discrimination Apparatus tests to assess somatosensory acuity during voluntary anteroposterior and mediolateral postural sway. Results showed significantly reduced somatosensory acuity in mediolateral sway in LBP patients ( = 0.005) with ankle, knee, and hip proprioception showing significantly impairment compared to asymptomatic controls (all ≤ 0.012). Regression analysis showed that ankle and hip proprioception were significantly associated with somatosensory perception (0.001 ≤  ≤ 0.026, 0.067 ≤ ≤ 0.235). Overall, findings suggested a global deterioration of lower limb proprioception in LBP patients, with ankle and hip proprioception playing crucial role in somatosensory perception.

During COVID-19, governments imposed restrictions that reduced pandemic-related health risks but likely increased personal and societal mental health risk, partly through reductions in household income. This study aims to quantify the public's willingness to accept trade-offs between pandemic health risks, household income reduction, and increased risk for mental illness that may result from future pandemic-related policies.

Individuals with severe mental illness and substance use disorders face complex barriers to achieving physical health. This study aims to explore the barriers and facilitators of primary care access among an Assertive Community Treatment (ACT) team. Semi-structured qualitative interviews were conducted with 14 clients and 7 clinicians from an ACT team at a community mental health center in Connecticut. Data analysis followed a grounded theory approach, with codes and themes emerging iteratively during the interview process. The study identified multifaceted barriers to accessing primary care, including economic challenges, homelessness, and the prioritization of mental health and substance use symptoms over healthcare. The conceptual framework consists of nine dominant themes: clients' attitudes, knowledge, mental health, and motivations ("Client-Level Barriers and Facilitators"); ACT team-directed care coordination and relationship-building as well as primary care provider communication ("Provider-Level Barriers and Facilitators"); and clients' experiences with medical care and socioeconomic status ("Systemic-Level Barriers and Facilitators"). This research provides valuable insights into the various barriers faced by ACT clients in accessing primary care. Improving primary care access for individuals with severe mental illness and substance use disorders is crucial for reducing health disparities in this vulnerable population.

In this month's Policy column, Iwan Dowie discusses the 'deprivation of liberty' - which is used to safeguard patients who may be lacking sufficient mental capacity to manage their own safety. The author, through previous legal cases, shares how the Deprivation of Liberty Safeguards (DoLS)-an amendment to the Mental Capacity Act 2005-came into being, and the importance of community nurses in knowing the DoLS.

Adolescents and young adults (AYA) with chronic illnesses experience an increase in mental health concerns. A mental health screening (MHS) process for hematology and oncology patients was implemented in a single institution. The quality improvement project was conducted to integrate a MHS process, educate providers about the importance of mental health in this patient population, and evaluate the process. The COM-B (capability, opportunity, motivation-behavior) model for behavior change was used to inform strategic planning and Plan-Do-Study-Act (PDSA) methodologies for process improvement. Retrospective chart reviews and surveys were conducted to determine missed screening rates and providers' perceptions, knowledge, attitudes, and skills of the MHS process. Of 334 eligible patient encounters, the missed screening rate was 15.0%, the overall error rate of completing the screening was 3.8%, the error rate of completing the suicide or self-harm indicator was 2.6%, and the missed medical social worker touch point was 4.8%. The rising rates of mental health concerns in AYA hematology and oncology patients call for streamlined MHS processes to improve the identification of patients who may need intervention and services. Processes should be tailored to workflows and available resources. Future PDSA cycles will include providing dedicated nursing education and determining the cost needed to meet the rising mental health needs of the AYA hematology and oncology population.

Libraries in the UK have evolved from traditional book-lending institutions into dynamic community hubs, This study aims to explore the potential of libraries to act as community hubs to promote mental and physical health and wellbeing of community-dwelling adults, drawing on insights from both library users and library staff in England.

The microbiota-gut-brain axis is a promising target to alleviate the growing burden of neurologic and mental health disorders. Dietary polyphenols act on multiple components of the microbiota-gut-brain axis, but this complex relationship requires further attention. This randomized, placebo-controlled, double-blind, crossover trial (ACTRN12622000850774) compared 4 wk of a commercially available flavonoid-rich blackcurrant beverage (FBB; 151 mg anthocyanins, 308 mg total polyphenols) with placebo in 40 healthy females (18-45 y). The primary outcome of stress reactivity was assessed by change in present feelings of stress, mood, and fatigue before and after completing a 20-min cognitive stressor [Purple multitasking framework (MTF)]. Secondary end points included cognitive performance (MTF), mood [profile of mood states (POMS)], sleep (Pittsburgh Sleep Quality Index), fecal microbiome composition and functional potential (shotgun sequencing), and blood biomarker concentrations (brain-derived neurotrophic factor, tryptophan, kynurenine, and interleukin 6). Statistical analyses were conducted on an intention-to-treat basis using linear mixed-effect models. Thirty-eight participants completed both intervention arms. There was no significant treatment effect on the primary outcome of stress reactivity. Compared with placebo, working memory (letter retrieval scores from MTF), and anxiety/tension and anger/hostility domains of the POMS improved with FBB supplementation (time × intervention interaction; < 0.05). There were no treatment effects on gut microbiome composition or functional potential. Baseline abundances of genera and species ( and ) tended to be higher in participants with the greatest improvements in letter retrieval scores with FBB supplementation (nominally significant, < 0.05) In conclusion, 4-wk FBB supplementation improved secondary outcomes of working memory performance during multitasking and mood outcomes in healthy adult females. These results should be confirmed in a larger cohort with a longer duration of follow-up.

The objective was to describe mental health service and psychotropic medicine use among a cohort of Aboriginal young people and quantify their relation to sociodemographic, family and health factors.

The Philippine Mental Health Act upholds the rights and inclusivity of all people, regardless of gender and sexual orientation, within mental health services and programmes. Nevertheless, a noteworthy challenge lies in the inadequate attention given to the needs of LGBT+ individuals within the medical and health professions education in the country. Therefore, it is imperative to integrate LGBT+ mental health into psychiatric residency training. To address this gap, this paper proposes the inclusion of concepts relevant to LGBT+ mental health, including minority stress, intersectionality, identity concealment and LGBT+-affirming practices, to enhance the understanding and response to the needs of LGBT+ Filipinos.

This commentary examines key mental health policies across four transformative historical periods in America: the aftermath of World War II (1939-1946), the Civil Rights Movement (1954-1968), the Great Recession (2007-2009), and the COVID-19 pandemic (2020-2023). The post-WWII era established today's foundational mental health system, emphasizing military personnel, as reflected in the National Mental Health Act of 1946. During the Civil Rights Movement, the focus shifted toward community equality, leading to the Community Mental Health Act of 1963. The economic challenges of the Great Recession, especially affecting young adults, prompted a deep dive into the Affordable Care Act. The social isolation and economic suffering from the COVID-19 pandemic led to the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The article highlights the need for a more inclusive policy development approach, one that recognizes and integrates the unique perspectives of young adults in shaping mental health policies and discourse. It concludes with recommendations to guide future policy evolution for enhanced mental health and societal well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

India is facing a significant increase in the aging population who are at risk for dementia. This review evaluates recent literature on community-based care, focusing on caregiver experiences, challenges and policy initiatives.

The 2023 Australian guideline for assessing and managing cardiovascular disease risk provides updated evidence-based recommendations for the clinical assessment and management of cardiovascular disease (CVD) risk for primary prevention. It includes the new Australian CVD risk calculator (Aus CVD Risk Calculator), based on an equation developed from a large New Zealand cohort study, customised and recalibrated for the Australian population. The new guideline replaces the 2012 guideline that recommended CVD risk assessment using the Framingham risk equation.

Mental health conditions are highly prevalent among US veterans. The Veterans Health Administration (VHA) is committed to enhancing mental health care through the integration of measurement-based care (MBC) practices, guided by its Collect-Share-Act model. Incorporating the use of remote mobile apps may further support the implementation of MBC for mental health care.

The Performance Index (P-Index) is a measure for evaluating mobility-related dual-task performance in older adults. The identification of specific clinicodemographic factors predictive of P-Index scores, however, remains unclear. This cross-sectional study analyzed data from 120 community-dwelling older adults (average age 71.3 ± 11.23 years) to explore clinicodemographic variables that influence P-Index scores during the instrumented timed up and go test. Unadjusted analyses suggested several factors, including age, gender, body mass index, Mini-Mental Status Examination scores, functional reach test performance, history of falls, ethnicity, Geriatric Depression Scale scores, alcohol consumption, and educational levels, as potential predictors of P-Index. However, adjusted multinomial multiple regression analysis revealed Geriatric Depression Scale and Mini-Mental Status Examination scores as the exclusive independent predictors of P-Index classifications, segmented into high, intermediate, or low (percentiles ≤ 25, 26-74, or ≥ 75, respectively). A significant association was observed between the manifestation of depressive symptoms, lower Mini-Mental Status Examination scores, and reduced cognitive-motor performance. The findings implicate depressive symptoms and low cognitive performance as substantial impediments to optimal dual-task mobility within this cohort. Further studies are warranted to examine the efficacy of cognitive stimulation and antidepressant therapy, in augmenting mobility-related dual-task performance among older adults.

: Modified Assertive Community Treatment (ACT) in rural settings may be effective in the care of patients with severe mental illness (SMI) that are difficult to engage in community care. The objective of the present study was to explore the impact of the care by a hybrid ACT team on SMI patients' hospitalizations, length of hospital stay, symptomatology and functioning in a rural community treatment setting in Greece. : The hybrid ACT team is an expansion of the services of the well-established generic Mobile Mental Health Unit in a rural area of Northwest Greece, and delivers home-based care for patients with SMI. This was a 3-year prospective, mirror image, pre-post observational study. Patients' symptomatology, functioning and general outcome were measured with the use of the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Functioning Scale (GAF), and the Health of the Nation Outcome Scale (HοNOS). : The mean age of the 23 enrolled patients was 52.4 years and the mean age of disease onset was 23.5 years, with a mean number of hospitalizations 10.74. Over the 16-month follow-up patients' hospitalizations, both voluntary and involuntary, had been significantly reduced by almost 80%. Length of hospital stay had been significantly reduced by 87%, whereas patients' functioning and symptomatology had been significantly improved, by 17% and 14.5%, respectively. : The model of hybrid ACT in rural areas in Greece may be effective in the treatment of difficult-to-engage patients with SMI and may improve patients' outcomes.

To investigate the effect of psychosocial interventions on emotion regulation outcomes in children and youth (0-23 years). We conducted a meta-analysis using a three-level modeling approach extracting multiple effect-sizes from experimental and quasi-experimental studies. We included 40 interventions from 35 publications involving 3,891 participants and extracted 258 posttreatment effect sizes. Analyses were performed to assess intervention effects on emotion regulation, moderating effects of inclusion of acceptance focus and other potential moderators. Additionally, we examined intervention effects on mental health outcomes. Interventions showed a significant small-to-medium effect on emotion regulation (d = 0.37, 95% CI [0.22, 0.51], p < .001). Similar effects on were found regardless of acceptance-focus. Interventions significantly associated with a higher level of effect (p ≤ 0.045) included ACT, DBT, CBT and behavior parent training interventions. Significant small-to-medium effects were found for mental health outcomes (d = 0.39, 95% CI [0.25, 0.53], p < .001), with a correlation of .56 between overall outcomes across domains. Meta-regression results indicated that psychosocial interventions are moderately effective in improving emotion regulation, with no significant difference in inclusion of acceptance-focus. Findings suggest that emotion regulation is a transdiagnostic process that may inform the development of more beneficial interventions.

Within the US, children and adolescents who engage in sexually abusive behavior are often subjected to sex offender registration and notification requirements, which contribute to stigmatization and forfeiture of their civil rights without empirical basis (Lancaster, 2011; Pickett et al., 2023; Zilney & Zilney, 2009). To date, 39 states subject children with adjudicated sexual offenses to sex offender registration requirements, with most recent estimates revealing that approximately 200,000 youth have been placed on sex offender registries within the US and many are now on the registry as adults (Pickett et al., 2020). This severe response-by both members of the public and policymakers-toward children who engage in inappropriate sexual behavior is imposed upon children and adolescents with adjudicated sexual offenses in an effort to meet goals of reducing sexual violence and increasing community safety. Within the current discourse, we review the history of registration and notification practices for adolescents with sexual offenses, describe what registration and notification policies entail, and then present empirical and theoretical evidence of the harmful outcomes associated with implementation of registration and notification requirements for sexual offenses. Thus, the predominant aim of this discourse is to encourage thoughtful and critical examination of registration and notification policies and their iatrogenic impacts.

The mental and emotional health of persons diagnosed with cancer is frequently affected. The acceptance and commitment therapy (ACT) is one of the psychological interventions that has proven successful in easing these psychological symptoms and enhancing cancer patients' psychological well-being.

The Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018 authorized a major expansion of purchased care in the community for Veterans experiencing access barriers in the Veterans Affairs (VA) health care system.

We examine precursors of child emotional distress during the COVID-19 pandemic in a prospective intergenerational Australian cohort study.

Greening organizations have become a top priority for decision-makers in the 21st century. Psychological ownership can be improved through responsible administration, which, in turn, improves green behavior.

The transition to parenthood is a transformative journey marked by numerous adjustments, presenting both physical and mental health challenges. Recognising the crucial role of a sense of belonging for parental health in this transition, this study delves into the experiences of new parents, exploring the act of "journeying" within their local geographies. Through analysis of an online survey among new parents in suburban Wellington, Aotearoa New Zealand, this study highlights the multifaceted role of journeying, not only as physical movement but as a slow-creeping transformative process that affects connections with local environments, people, and places, highlighting the importance of local geographies in new parents' journey towards belonging.

Detraining is the partial or complete loss of physical training-induced adaptations as a result of exercise interruption or reduction. The COVID-19 pandemic led to the discontinuation of many older adult exercise programs and led to increased depressive symptoms (DS), increased sedentary behavior (SB), and decreased quality of life (QoL).

To provide guidance for the optimal administration of repetitive transcranial magnetic stimulation, based on scientific evidence and supplemented by expert clinical consensus.

Advanced chronic kidney disease (ACKD) is associated with a high risk of adverse cardiovascular and renal events and has a significant impact on quality of life and life expectancy. Several studies have identified areas for improvement in their management in primary care. Some professional and environmental factors can act as key barriers to appropriate care.

The functional-cognitive impact of first-episode psychosis (FEP) is extremely relevant and implies dysfunction from early life stages like adolescence and youth. Like other illnesses, FEP incidence is also influenced by environmental factors. It is necessary to attend to this age group with early interventions and to act on the environmental factors that the literature correlates with increased FEP incidence: socio-economic aspects, social adversity, bullying at school or cannabis use. In this context, identifying the areas of cities where FEP patients concentrate is important to perform early interventions. The spatial analysis of patient distribution in a whole city is one way to identify the most vulnerable areas and to propose psycho-social interventions for the possible prevention and/or early detection of FEP by improving urban mental health.

The growing ability to provide online services has enabled the proliferation of exercise-based telehealth interventions; however, adoption in older adults may be impacted by low digital literacy and "technophobia."

Global forced displacement has been rising steeply since 2015 as a result of wars and human rights abuses. Forcibly displaced people are often exposed to physical and mental strain, which can cause traumatic experiences and poor mental health. Physical activity has been linked with better mental health, although such evidence is scarce among those populations. The purpose of the study was to examine the relationships of self-reported physical activity and fitness with mental health indices among people residing in a refugee camp in Greece as asylum seekers.

Carers of people who are involuntarily admitted to hospital report feeling isolated and unsupported by services. The Independent Review of the Mental Health Act (MHA) recommended that carers be supported. However, no research has directly explored what type of support carers would find most helpful when a relative/friend is involuntary admitted.

In this study, a systematic review of randomized clinical trials conducted from January 2000 to December 2023 was performed to examine the efficacy of psychobiotics-probiotics beneficial to mental health via the gut-brain axis-in adults with psychiatric and cognitive disorders. Out of the 51 studies involving 3353 patients where half received psychobiotics, there was a notably high measurement of effectiveness specifically in the treatment of depression symptoms. Most participants were older and female, with treatments commonly utilizing strains of Lactobacillus and Bifidobacteria over periods ranging from 4 to 24 weeks. Although there was a general agreement on the effectiveness of psychobiotics, the variability in treatment approaches and clinical presentations limits the comparability and generalization of the findings. This underscores the need for more personalized treatment optimization and a deeper investigation into the mechanisms through which psychobiotics act. The research corroborates the therapeutic potential of psychobiotics and represents progress in the management of psychiatric and cognitive disorders.

This qualitative study explores the experiences of peer support workers (PSWs) and service users (or peers) during transition from in-person to virtual mental health services. During and following the COVID-19 pandemic, the need for accessible and community-based mental health support has become increasingly important. This research aims to understand how technological factors act as bridges and boundaries to mental health peer support services. In addition, the study explores whether and how a sense of community can be built or maintained among PSWs and peers in a virtual space when connections are mediated by technology. This research fills a gap in the literature by incorporating the perspectives of service users and underscores the potential of virtual peer support beyond pandemic conditions.

Amyotrophic Lateral Sclerosis (ALS) is a multifactorial neurodegenerative disorder with a significant contribution of non-cell autonomous mechanisms to motor neuronal degeneration. Amongst a plethora of molecules, fractalkine (C-X3-C motif chemokine ligand 1), and Heat Shock Protein 60 (HSP60), are key modulators of microglial activation. The contribution of these molecules in Sporadic ALS (SALS) remains unexplored. To investigate this, fractalkine levels were estimated in Cerebrospinal fluid (CSF) of SALS patients (ALS-CSF;  = 44) by Enzyme-linked Immunosorbent Assay (ELISA) and correlated with clinical parameters including disease severity and duration. CSF HSP60 levels were estimated by Western blotting (ALS-CSF;  = 19). Also, CSF levels of Chitotriosidase-1 (CHIT-1), a microglia-specific neuroinflammatory molecule, were measured and its association, if any, with fractalkine and HSP60 was investigated. Both fractalkine and HSP60 levels were significantly elevated in ALS-CSF. Similar to our earlier observation, CHIT-1 levels were also upregulated. Fractalkine showed a moderate negative correlation with the ALS-Functional Rating Scale (ALSFRS) score indicating its significant rise in mild cases which plateaued in cases with high disease severity. However, no obvious correlation was found between fractalkine, HSP60, and CHIT-1. Our study hints that high fractalkine levels in mild cases might be conferring neuroprotection by combating microglial activation and highlights its importance as a novel therapeutic target for SALS. On the other hand, significantly enhanced levels of HSP60, a pro-inflammatory molecule, hint towards its role in accentuating microgliosis, although, it doesn't act synergistically with CHIT-1. Our study suggests that fractalkine and HSP60 act independently of CHIT-1 to suppress and accentuate neuroinflammation, respectively.

The family caregiver of a person with Alzheimer's disease still experiences, in most cases, negative consequences in their biopsychosocial environment, which are related to the acquisition of this role. However, it has been observed that this fact is not universal in this type of population since benefits can be obtained in the act of caring through the development of resilience. Given this possibility and given that nurses are the health professionals who support people in this illness process, there is an urgent need to identify which non-pharmacological interventions could improve or promote resilience in family caregivers of people with Alzheimer's disease. Therefore, our overall objective was to determine which interventions are useful in promoting resilience in family caregivers of people with Alzheimer's disease through a scoping review. The data were analysed using an adapted version of Arksey and O'Malley's methodological framework, after critically reading the articles with the CasP and MMAT tools. Nine articles were included (five analytical experimental, two quantitative and two mixed). Three types of interventions related to promoting resilience in family caregivers of people with Alzheimer's disease were identified: meditation, multicomponent psychoeducation and creative art; nurses participated as co-therapists in the last two.

Restraint, often linked with limiting an individual's freedom of movement, has become a focal point of extensive discussion and evaluation within the realm of mental healthcare. Striking a delicate balance between ensuring individual safety and minimizing reliance on restraint methods poses a significant challenge. In mental health inpatient settings, the prevalent forms of restraint encompass physical, chemical, environmental, and psychological methods. Paradoxically, the consequences of employing restraint can be severe, ranging from injuries and cognitive decline to sedation and, in extreme cases, fatalities. This paper seeks to offer a nuanced exploration of the landscape surrounding psychiatric patient restraints, considering both global perspectives and specific insights from the Indian context. The guidelines outlined in India's Mental Healthcare Act of 2017, which governs the use of restraint on individuals suffering with mental illnesses, are also examined in detail.

In the United States and elsewhere around the world, people with serious mental illness (SMI) are overrepresented in the criminal justice system. Clinical interventions to divert such individuals out of correctional settings, including Assertive Community Treatment (ACT), have been shown to reduce rates of criminal justice recidivism when modified to allow for the use of court sanctions to encourage treatment adherence. However, these interventions are noted to be underutilized as alternative to incarceration (ATI) programs. This paper summarizes the results of a retrospective cohort study conducted in a New York State forensic psychiatric hospital of 87 pretrial detainees admitted after being found incompetent to stand trial between January 2019 and January 2022. Of these, 49 patients were referred to an ACT team that served as an ATI program. The study outcomes noted that patients referred to this ACT team were 20% less likely to remain in pretrial detention than those that were not. Moreover, patients referred to the ACT program were also 34% more likely to be granted an ATI plea bargain in the community that did not involve serving a prison term. These results suggest that pretrial detainees with SMI are more likely to be granted an ATI program that offers more intensive treatment services such as ACT, due to the capability of such programs to also provide more intensive outreach and community supervision than traditional outpatient mental health service providers.

Walking activity has been associated with reduction in the development of chronic disease, cognitive and physical function impairment, disability, and mortality. The objective of this study was to examine the relationship between walking activity and physical function over 9 years of follow-up among Mexican Americans aged 78 years and older.

The suicide rate in Indonesia is considered low among Asian countries, but the underreporting rate is at a staggering 303%, and the latest reports suggest an increase in suicidal behaviour, particularly among young people. As a multicultural country, Indonesia has a complex system of beliefs about suicide. Thus, various aspects specific to Indonesia must be considered in understanding and preventing suicide. This paper explores Indonesian stakeholders' perspectives through semi-structured interviews and focus group discussions. A total of 9 participants were individually interviewed, and 42 were involved in focus group discussions. They were mainly people with lived experiences of suicide. The other stakeholders were Indonesian experts who have experience in dealing with suicidal behaviour, helping people with a lived experience of suicide, or were involved in suicide prevention. Indonesian stakeholders highlighted various general and contextualised aspects concerning suicide. These aspects included a wide range of cultural beliefs and culturally specific warning signs, which included "" (confusion) and longing for deceased persons. Other cultural beliefs such as viewing suicide as infectious, unpreventable, and guided by ancient spirits, and as an honourable act in some circumstances, also emerged. These findings can inform suicide prevention programs, including suicide prevention guidelines for Indonesia.

Chronic migraine (CM) negatively impacts the quality of life of 2 to 4% of pediatric patients. In adults, CM is frequently linked to medication overuse headache (MOH), but there is a much lower prevalence of MOH in children. A suboptimal response to acute therapies may lead to their reduced use, thus preventing MOH development in children and adolescents. The frequency of patients with CM who do not respond to acute therapies was examined in the present study. We investigated whether the prevalence of MOH was different between responders and non-responders. We also examined whether patients receiving prophylactic therapy had an improved response to acute therapy. Finally, we investigated if there was a difference in the frequency of psychiatric comorbidities between responders and non-responders.

The Medical Emergencies in Eating Disorders (MEED) report was first released by the Royal College of Psychiatrists in 2022 (updated 2023) to aid clinicians in recognising medical compromise due to an eating disorder and to provide guidance for management.

Assertive Community Treatment (ACT) model is the gold standard in community psychiatry serving people with severe mental illness. With its outreach-based design, the pandemic has profoundly affected the operations and functioning of ACT. The Dartmouth ACT Scale (DACTS) provides a standardized comprehensive and quantitative way to evaluate ACT quality. Results could inform nature of impact and identify areas for improvement. Current online survey used DACTS during the pandemic in April-May 2021. Clinical and administrative leadership of the 80 ACT teams in Ontario, Canada cross-sectionally rated ACT quality one-year pre-Covid (2018-2019) and one-year post the start of Covid (2020-2021). The overall pre-Covid Ontario ACT DACTS fidelity was 3.65. The pandemic led to decreases in all domains of DACTS (Human Resources: -4.92%, p < 0.001, 95% CI [0.08-0.27]; Organizational Boundary: -1.03%, p < 0.013,95%CI [0.01-0.07]; and Nature of Services: -6.18%, p < 0.001, 95%CI [0.16-0.26]). These changes were accounted by expected lower face-to-face encounters, time spent with clients, reduction in psychosocial services, less interactions with hospitals and diminished workforces. The magnitude of change was modest (-3.84%, p < 0.001, 95%CI [0.09-0.19]). However, the Ontario ACT pre-Covid DACTS was substantially lower (-13.5%) when compared to that from a similar survey 15 years ago (4.22), suggestive of insidious systemic level loss of fidelity. Quantitative fidelity evaluation helped to ascertain specific pandemic impact. Changes were significant and specific, but overall relatively modest when compared to the larger system level drop over the last decade. There is both evidence for model adaptability and resilience during Covid disruption, and concerns over larger downward drift in ACT fidelity and quality.

Pill dysphagia is a common problem amongst older adults, with significant health consequences. Previous research has found that dysphagia can negatively affect an individuals mental health and wellbeing. However, this research has not been extended to pill-specific dysphagia, which presents distinct differences from the challenges posed by swallowing food and liquids. These differences extend to causes, demographics, and physical health ramifications. This study aimed to address this gap in the literature by investigating the effects of pill dysphagia on the wellbeing of older adults. A community sample of 132 Australians aged 65-97 years completed a survey about their wellbeing and difficulty swallowing pills. Thirty-one participants who met the criteria for pill dysphagia completed further open-ended questions detailing the effects of pill dysphagia and how they manage it. Analyses of the quantitative data indicated that difficulty swallowing pills was unrelated to negative affect but negatively related to positive affect, life satisfaction, and eudemonic wellbeing. Supplementary analyses controlling for health-related variables found no significant relationships between difficulty swallowing pills and wellbeing. Responses to the open-ended questions revealed a range of physical, psychological, and practical impacts of pill dysphagia, and successful and unsuccessful methods used to assist in swallowing pills. The findings partially support the hypothesised effects of pill dysphagia on wellbeing. However, further research is required to establish if more severe pill dysphagia predicts wellbeing over and above self-rated health. Future interventions should incorporate wellbeing promotion strategies for older adults with pill dysphagia.

Emotional eating, the act of consuming food to cope with negative emotions rather than responding to hunger cues, can lead to overeating in an attempt to regulate and alleviate these emotions. This study aimed to assess emotional eating among college students in Israel, specifically during times of war, which present unique and heightened stressors that accumulate on top. A total of 575 participants from the Ashkelon Academic College completed an online questionnaire examining background information, stress levels, and emotional eating symptoms. Our findings indicate that factors, such as being female, not having children, younger age, lower body satisfaction, higher BMI, and increased stress, are predictors of heightened emotional eating. These results highlight risk factors predisposing college students to engage in emotional eating. Developing targeted interventions, particularly campus-based programs to address emotional eating by promoting healthy coping strategies, a positive body image, and stress management skills is needed. In addition, raising awareness concerning emotional eating risks during challenging life transitions and distressing situations is necessary. The college leadership, led by the departments of Nutrition, Psychology, and Public Health, in collaboration with stakeholders in the Israeli Ministry of Health, must consider the mental effects of war on students and their involvement in emotional eating.

Pediatric asthma management is challenging for parents and guardians (hereafter ). We examined (1) how caregivers mentally represent trigger and symptom management strategies, and (2) how those mental representations are associated with actual management behavior.

To explain the new test for complying with the mental health principles under the (Vic).

Adolescents faced with chronic stressors (e.g., financial instability, interpersonal violence) are at heightened risk for developing mental health problems, likely due in part to stressors that interfere with effective emotion regulation. Although mindfulness may help to act as a buffer against the deleterious effects of life stressors, a relatively untested assumption is that adolescents can maintain mindfulness during periods of stress. This paper explores this assumption by investigating the real-time, dynamic relationships among life stressors, mindfulness, and emotion regulation difficulties among adolescents exposed to chronic stressors. Eighty-one participants who were 10-18 years old (M = 14.33; SD = 2.20; 56% male; 57% Non-Hispanic White) completed ecological momentary assessments (EMA) three times a day for 7 days and contributed a total of 1186 EMA reports. Multilevel structural equation modelling revealed that the presence (vs. absence) of stressors was associated with lower momentary mindfulness and greater momentary emotion regulation difficulties concurrently and prospectively. Stressors with greater severity were also concurrently, but not prospectively, associated with lower momentary mindfulness and greater momentary emotion regulation difficulties. Findings highlight that exposure to life stressors may degrade momentary mindfulness and emotion regulation. Given that mindfulness and emotion regulation are closely associated with mental health, these results also demonstrate one way that stressors may contribute to health disparities at the micro-level. Going forward, it will be important to investigate methods of helping adolescents learn to maintain mindfulness and adaptive emotion regulation in the face of stressful events. This study was preregistered (NCT04927286).

We assessed the impact of the COVID-19 pandemic on social determinants of health, mental health, substance use, and access to mental health and harm reduction services among key populations disproportionately impacted by sexually transmitted and blood-borne infections (STBBI).

Residential substance use disorder (SUD) treatment programs are challenged by the differing values of the problem-solving court (PSC) and child welfare (CW) systems, along with communication barriers between staff. This study aimed to understand, from the viewpoints of SUD treatment providers, how divergent values and communication barriers adversely affect women's residential SUD treatment. We conducted qualitative semistructured interviews with 18 SUD treatment clinicians and six directors from four women's residential SUD treatment programs. Using a thematic analysis framework, we identified salient themes across specified codes. Analysis revealed six main themes, suggesting differing values and communication barriers across the SUD, PSC, and CW systems adversely affect the provision of SUD treatment. For differing values, three main themes emerged: (a) unaddressed trauma and fear of mental health treatment seeking; (b) perceptions of mothers with a SUD; and (c) the Adoption and Safe Families Act (ASFA) timeline as a barrier to SUD treatment provision. For communication barriers, three themes emerged: (a) inadequate communication and responsiveness with PSC and CW systems adversely affect treatment coordination, induce patient stress, and treatment disengagement; (b) lack of PSC and CW communication regarding child visitation planning adversely affects treatment motivation and retention; and (c) competing ASFA, PSC, and CW priorities and inadequate cross-system communication adversely affect treatment planning. Treatment providers face significant barriers in providing effective treatment to women simultaneously involved in the CW and PSC systems. Aligning values and addressing communication barriers, changes in policy, and enhanced cross-system training are crucial. Additionally, it is essential to reevaluate the ASFA timeline to align with the long-term treatment needs of mothers with a SUD. Further research should explore the viewpoints of patients, CW, and PSC staff to gain deeper insights into these SUD treatment barriers.

The rise of psychedelics in contemporary medicine has sparked interest in their potential therapeutic applications. While traditionally associated with countercultural movements and recreational use, recent research has shed light on the potential benefits of psychedelics in various mental health conditions. In this review, we explore the possible role of psychedelics in the management of chronic pain and opioid use disorder (OUD), 2 critical areas in need of innovative treatment options. Pain control remains a significant clinical challenge, particularly for individuals with OUD and those who receive long-term opioid therapy who develop marked tolerance to opioid-induced analgesia. Despite the magnitude of this problem, there is a scarcity of controlled studies investigating pain management alternatives for these populations. Drawing from preclinical and human evidence, we highlight the potential of psychedelics to act on shared neurobiological substrates of chronic pain and OUD, potentially reversing pain- and opioid-induced neuroadaptations, such as central sensitization. We elaborate on the multifaceted dimensions of the pain experience (sensory, affective and cognitive) and their intersections that overlap with opioid-related phenomena (opioid craving and withdrawal), hypothesizing how these processes can be modulated by psychedelics. After summarizing the available clinical research, we propose mechanistic insights and methodological considerations for the design of future translational studies and clinical trials, building on a shared clinical and neurobiological understanding of chronic pain and OUD. Our intention is to provide timely perspectives that accelerate the development and exploration of novel therapeutics for chronic pain and OUD amidst the escalating opioid crisis.

Previously, we reported that an inpatient multimodal occupational rehabilitation program (I-MORE) was more effective than outpatient Acceptance and Commitment Therapy (O-ACT) in reducing sickness absence and was cost-effective over a 24-month period. Here we present 7-years of follow-up on sick leave and the cost of lost production.

Eco-anxiety is increasingly recognized as a shared experience by many people internationally, encompassing fear of environmental catastrophe and anxiety about ecological crises. Despite its importance in the context of the changing climate, measures for this construct are still being developed in languages other than English.

Standardized suicide mortality rates per 100,000 population (SMRs) in Japan consistently decreased from 2009-2019, but these decreasing trends were reversed to increase in 2020. To clarify the mechanisms of recent increasing suicide in Japan, temporal fluctuations of SMRs disaggregated by sex and employment status (employed and unemployed individuals) and labor indices such as working hours, wages, and regular employment opportunity index (REO) from January 2012 to June 2023 were analyzed using interrupted time-series analysis. Additionally, temporal causalities from labor indices to SMRs were analyzed using vector autoregressive and non-linear auto-regressive distributed lag analyses. Decreasing trends among employed SMRs of both sexes were attenuated after the enactment of the "Work Style Reform Program" in 2018, but male SMRs were unaffected by the COVID-19 pandemic. However, female employed SMRs sharply increased, synchronized with the "Work Style Reform Act" and the COVID-19 pandemic outbreak (the COVID-19 impact was greater than the "Work Style Reform Act"). Additionally, unemployed SMRs of both sexes sharply increased with the revision and scale-down of countermeasures against economic deterioration caused by COVID-19 ("revision of economic supportive countermeasures against economic deterioration caused by COVID-19"). Unexpectedly, after enacting the "Work Style Reform Act", wages decreased due to possibly decreasing working hours. Increasing REO, which consistently increased, was a protective factor for male suicides, but unemployed SMRs were not affected by any labor indices. It has been established that controlling a heavy workload plays an important role in suppressing the deterioration of physical and mental conditions, including suicide; however, this study suggested that, at least within appropriate ranges of working hours, decreasing working hours due to excessive management probably contributes to increasing suicides of some vulnerable individuals via de-creasing their wages. Although governmental welfare and economic support measures had to be revised according to rapidly changing situations during the COVID-19 pandemic, this study also suggested that temporal gaps among a part of revisions of several welfare and economic support measures were unexpectedly involved in drastically/sharply increasing suicides of unemployed individuals in 2022.

The treatment gap for mental health disorders persists in low- and middle-income countries despite overwhelming evidence of the efficacy of task-sharing mental health interventions. Key barriers in the uptake of these innovations include the absence of policy to support implementation and diverting of staff from usual routines in health systems that are already overstretched. South Africa enjoys a conducive policy environment; however, strategies for operationalizing the policy ideals are lacking. This paper describes the Mental health INTegration Programme (MhINT), which adopted a health system strengthening approach to embed an evidence-based task-sharing care package for depression to integrate mental health care into chronic care at primary health care (PHC).

Loneliness, depression, and cognitive decline are pressing concerns among older adults. This study examines the association between leisure travel participation and these health outcomes in older adults, aiming to provide further evidence of the benefits of leisure travel. Using nationally representative historical data from the 2006 household survey of the Health and Retirement Study, this study conducted a series of regression analyses to investigate the relationship between traveling and the three health outcomes, adjusting for age, sex, race, marital status, education, total wealth, annual income, and difficulty with daily activities. The results reveal that travel patterns in terms of distance are significantly associated with loneliness, depression, and cognitive function. Long-distance travel is positively related to higher cognitive function and a reduction in depressive symptoms, along with lower levels of loneliness, reinforcing the notion that leisure travel can potentially act as a catalyst for improved cognitive and mental health by offering opportunities for enhancing social connections and forming new relationships. The findings on the relationships between participation in leisure travel and mental and cognitive health contribute to the body of evidence supporting the therapeutic value of leisure travel in promoting healthy aging and enhancing the overall well-being in older adults.

Our team of core and higher psychiatry trainees aimed to improve secondary mental health service detection of and response to gender-based violence (GBV) in South East London. We audited home treatment team (HTT), drug and alcohol (D&A) service and in-patient ward clinical records ( = 90) for female and non-binary patients. We implemented brief, cost-neutral staff engagement and education interventions at service, borough and trust levels before re-auditing ( = 86), completing a plan-do-study-act cycle.

In Italy, cultural and professional nursing improvements are reached thanks to the university-based education which marks the clinical competency and the professional autonomy in nursing decision-making.

Fee-for-service is a common payment model for remunerating general practitioners (GPs) in OECD countries. In Norway, GPs earn two-thirds of their income through fee-for-service, which is determined by the number of consultations and procedures they register as fees. In general, fee-for-service incentivises many and short consultations and is associated with high service provision. GPs act as gatekeepers for various treatments and interventions, such as addictive drugs, antibiotics, referrals, and sickness certification. This study aims to explore GPs' reflections on and perceptions of the fee-for-service system, with a specific focus on its potential impact on gatekeeping decisions.

In this article, we will provide a rationale for a web-assisted acceptance and commitment therapy (ACT) approach to loneliness among older adults, drawing upon theories from the literature on adult development and aging, emotion regulation, and loneliness. The intervention program was developed using the principles of ACT, which is a cognitive behavioral approach and unified model of human behavior change and psychological growth. The ACT intervention focuses on developing nonjudgmental present-focused awareness of internal experiences (thoughts, emotions, and memories) through strategies such as acceptance and mindfulness rather than directly modifying or removing them per se. The ACT intervention appears well-suited to assist older adults in coping with the challenges of aging, as the focus is on an individual’s willingness to sit with internal experiences out of one’s control (ie, acceptance), stepping back from negative or critical thoughts and developing greater kindness toward oneself (ie, defusion), discerning what is most important to one’s true self (ie, values), and building larger patterns of effective action based on such values (ie, committed action). The ACT intervention was developed as a resource for older adults who are socially isolated or having difficulty with social connectedness. Eight modules comprise the web-assisted ACT intervention program, which includes reading materials, video clips, and activities. Each module is followed by a summary, a homework assignment, a short quiz to assess learning, and a moderated discussion with a coach. The intervention program begins with reconnecting participants with their values. The goal of the ACT intervention program is to foster flexibility in a participant’s behavior so they can behave consistently with their chosen values, rather than becoming locked into a pattern of behavior that is driven by avoiding distress or discomfort. The ACT intervention approach is both novel and innovative, as it is based on ACT and leverages a behavioral health web platform that is flexible and inclusive in its design. The ACT intervention aims to help older adults become more socially connected, less lonely, and more satisfied with their relationships with other people. The emphasis that ACT places on values and living life in accordance with one’s values renders it an approach ideally suited to older adults. Finally, recommendations for future research regarding this approach to addressing loneliness among older adults is addressed.

Imposter phenomenon (IP) is the internalised experience of self-doubt or mediocracy that leads an individual to believe they do not belong. IP is increasingly recognised across the medical field, from medical school to consultancy, but likely affects different groups to varying extents. The transition in role from medical student to junior doctor can be a time of particularly high stress and insecurities about one's ability can act as a trigger or exacerbator of IP. Foundation doctors can arm themselves against IP by first acknowledging its existence and then actively attempting to dismantle these flawed misconceptions, as well as accessing support and resources available ubiquitously through the foundation programme.

There is increasing evidence of the need for treatment engagement between Persons with Severe Mental Illnesses (PwSMIs) and Mental Health Professionals (MHPs). This therapeutic process involves collaborative work between patients and MHPs, which improves the condition. Community nurses are uniquely positioned to facilitate this process as they act as the focal point of interaction between patients and the health system.

Primary care is at the forefront of addressing the pediatric mental health (MH) crisis due to its broad reach to young children and prevention and health promotion orientation. However, the promise of the delivery system for population impact remains unrealized due to several barriers, including pragmatic screening, decisional uncertainty, and limited access to evidence-based services.

Postpartum weight retention (PPWR) has many health risks. Digital self-monitoring of weight can potentially make postpartum weight management easier. We aim to test to what extent the self-monitoring of weight, steps and mental health through an mHealth application increases postpartum weight loss and reduces the odds of substantial PPWR (≥5 kg).

In response to the increasing number of mentally ill people experiencing homelessness, some policy-makers have called for the expanded use of involuntary commitment, even for individuals who are not engaging in behaviors that are immediately life-threatening. Yet there is no evidence that involuntary commitment offers long-term benefits, and significant reasons to believe that expanding the practice will cause harm. In addition, these proposals ignore research showing that most people with mental illness have the capacity to make medical decisions for themselves. Rather than expanding the use of involuntary commitment, policy-makers should support approaches proven to decrease the prevalence of homelessness, such as supportive housing. In addition, states should reevaluate their commitment standards for persons who pose no risk of harm to others. One promising approach is Northern Ireland's Mental Health Capacity Act of 2016, which establishes a uniform standard for imposing nonconsensual health care interventions, without any distinction between mental illnesses and other conditions in which capacity might be compromised.

In the spring of 2024, the federal government is expected to report on its legislative review of the (2018). One of the most contentious issues is whether to relax restrictions on cannabis promotion. This commentary describes the tension between the public health aims of legalization and the secondary aim of displacing the illicit market. We maintain that among jurisdictions that have legalized cannabis, Canada stands out as having the stated primary objective of safeguarding public health, and its restrictions on promotion are evidence-based and innovative. These measures must be preserved, even in the face of growing industry pressure to loosen them.

Medical health practitioners, particularly those working in cancer units, are vulnerable to poor psychological outcomes. The present study was designed to examine the influence of workplace bullying on the mental health of medical and paramedical staff by testing workplace burnout as a mediating factor.

The continuous spread of the epidemic has inflicted serious harm upon individual's mental well-being, and effective coping mechanisms are associated with positive mental health outcomes. Prosocial behavior and a sense of meaning in life can enhance individuals' subjective well-being, which can subsequently positively impact their mental health. Thus, in the context of epidemic prevention and control, this study investigates the relationship between the meaning in life, prosocial behavior, and coping styles of outstanding physical education students and the impact on their mental health.

Moral education in colleges and universities is an important part of the talent training system, including moral education curriculum, moral education practice, mental health education. Volunteer service is a public welfare act in which volunteers volunteer their time, knowledge, property, technology, with the ultimate goal of helping others and serving the society without personal compensation. As an innovative form of moral education practice in colleges and universities, college students' voluntary service is of great significance in promoting the reform and innovation of moral education, enhancing the affinity, appeal and influence of moral education, and building a positive psychology for college students.

Suicide has emerged as an urgent threat in recent years as COVID-19 impaired the health and economic wellbeing of millions of Americans. According to the Centers for Disease Control and Prevention, the impact of COVID-19 and the ongoing opioid epidemic has "taken a mental, emotional, physical, and economic toll on individuals, families, and communities," increasing the need for innovative solutions to prevent suicide on a national scale. The National Suicide Hotline Designation Act of 2020 established 988 as the universal telephone number for suicide prevention and represents a key federal intervention to address this crisis. However, research on 9-8-8's effectiveness is limited, given the Act's recent enactment and implementation at the federal and state levels. This policy analysis investigates how and to what extent the mental health crisis system in Georgia has improved since the implementation of the 2020 Act as well as the implications of state law on population-level mental health outcomes. Georgia is used as a nationally representative case study for two reasons: (1) Georgia had a robust statewide suicide hotline prior to 2020, providing solid infrastructure on which federal expansion of a suicide hotline number could be built, and (2) the conflicting characteristics of Georgia's mental health system represent several different pockets of the U.S., allowing this analysis to apply to a broad range of states and locales. The paper draws on takeaways from Georgia to propose state and national policy recommendations for equitable interventions to prevent and respond to this form of violence.

This study aimed to explore the views of judo coaches on their perceived knowledge (PK) and needs for education (NE) for training older practitioners. In total, 470 international (Europe = 48%, Americas = 22%, Africa = 23%, Asia = 5% and Oceania = 2%) judo coaches (IJF: level 1 = 55,3%, level 2 = 33%; judo black belt: 3,4 ± 1,7 dan; F = 15%; university education: 68% >BA) responded an online survey encompassing demographic information and 35 items relevant to training older adults (Aging process; Safety and First Aid; Organization & Environment; Physiology and Fitness; Psychology & Mental Health; Teaching & Training) to be rated on a 7-point Likert scale for PK and NE. Non parametric statistics ( > 0.05) was applied to ascertain differences and relationships between PK and NE, respectively. A bivariate go-zone plot was used to highlight items with the lowest PK and the highest NE mean values. The coaches reported high PK (4.5 ± 0.3 pt) and NE (4.7 ± 0.1 pt) values, with significant higher PK values emerging for high education levels and judo experience. In considering their unique needs and special role, the judo coaches presented valuable insights to develop a sustainable educational curriculum tailored to train older judo practitioners.

Trauma experiences, particularly in childhood, have been associated with criminality and mental illness. There is a paucity of research into the crime of murder, trauma and mental illness.

Climate-health literacy is the ability to find, access, understand, interpret, evaluate, and communicate information about the impact of climate change on human health and to make decisions and act accordingly to that information. Climate change affects people's health in numerous ways, both directly and indirectly, by increasing the risks of cardiovascular disease, infections, depression, anxiety disorders, and trauma. It is important for health professionals to understand the complex interaction between climate change and health. A teaching concept is presented that incorporates the core elements of climate-health literacy. On a first level, physical and climatological basics are taught, direct and indirect impacts of climate change on human health, climate protective measures, the psychological background of climate-protective behavior, and professional ethics. Furthermore, via self-awareness and self-reflection, the impact of climate change on the student's mental health should be evaluated. In an advanced level, the direct and indirect impacts of climate change on mental health are taught, coping strategies, resilience, and vulnerability, as well as the role of health-care professionals in the climate crisis. In expert-level lectures, the knowledge can be deepened, and special content like activist burnout can be addressed.

Various psychological theories suggest that a supportive family environment protects the mental health of young adults during stressful life events. However, evidence is limited regarding the protective role of family support during a major public health crisis.

In being an important lifestyle factor, the physical activity influences people's health status, including life expectancy. Specific forms of physical activity are exercises related to hand-to-hand combat in the broadest sense, often overlapping and containing similar elements associated with combat sports (for Western culture) and martial arts (for Far Eastern culture). There are many types of forms of practising hand-to-hand combat exercises, which can be seen as opposing or in some ways complementary, e.g.: "traditional"-e.g., karate or kung fu, practised for hundreds or even thousands of years, usually adhering to moral codes of conduct, and drawing ideas from philosophy, religion vs. "modern"-e.g., American pro wrestling or mixed martial arts-MMA, suggesting a combination of various traditional forms of martial arts. In terms of shaping a healthy lifestyle with mental health elements based on the implementation of hand-to-hand combat exercises, an analysis of these fundamental insights into physical activity is warranted. This study aims to investigate the development direction of the hand-to-hand exercises in Western culture, opposing the "traditional" and "modern" forms.

Gaming is often labeled as sedentary behavior. However, competitive gaming, also known as esports, involves significant cognitive demands and may induce stress. This study aims to investigate whether the psychophysical demands during esports elicit a physiological stress response.

Acceptance and Commitment Therapy (ACT) plays an important role in the treatment of patients with refractory Somatic Symptom Disorder and related disorders with complex problems and/or somatic or psychiatric comorbidity (complex SSD).

The Nigerian mental health law titled the of 1958 has been under scrutiny for violating the human rights of people with mental illness. The call to reform the obsolete has garnered attention from the government, as the law has been unamended for over 60 years.

Evidence from studies among non-Indigenous populations has established the association of poor sleep to mental health issues and supported how improving sleep could reduce the risk of mental ill health. In contrast, for Indigenous people, who experience disproportionate rates of mental ill health, the association between sleep and mental health and the potential of sleep health in reducing the risk and severity of mental health issues have never been fully reviewed. Considering the literature gap, this review assesses the association between sleep and mental health in Indigenous people.

Drawing upon the framework of life course epidemiology, this study aligns with research on the mental health consequences of significant social transitions during early adulthood. The focus is on the variation in initial labour market attachment and the development of depressiveness, assuming that a firm attachment is associated with decreasing depressiveness.

The prestige theory of evolution states that our memory has an intrinsic bias to memorize information from someone of prestige. However, the evidence for information recall is mainly focused on content bias. Considering that the prestige bias can be advantageous in selecting information in contexts of uncertainty, this study assessed whether, in the scenario of the COVID-19 pandemic, the prestige bias would be favored over other models that do not possess the prestige spirit characteristics. The study was conducted through an online experiment, where participants were subjected to reading fictitious text, followed by a surprise recollection. Data were analyzed using a generalized linear mixed model, Poisson family, and logistic regression. The results showed that prestige is only prioritized in the recall due to the family model and does not present any difference from the other models tested. However, it influenced the recall of specific information, suggesting its role as a factor of cultural attraction. Furthermore, we observed that trust in science-oriented profiles can influence the recall of information during a health crisis. Finally, this study highlights the complexity of the functioning of the human mind and how several factors can act simultaneously in the recall of information.

Non-suicidal self-injury (NSSI), which refers to the deliberate act of causing harm to one's own body without the intent to commit suicide, occurs in 20% of youth. Interestingly, approximately 90% of individuals who engage in self-harm report intrusive mental imagery thereof shortly prior to the act of NSSI. Previous research has demonstrated that imagery rescripting (IR) is an effective technique to treat intrusive mental images and associated clinical symptoms, such as emotion dysregulation, in various psychiatric disorders. However, there is no research on IR for adolescents who self-harm. Therefore, the present study aims to investigate the efficacy and feasibility of a two-session short-intervention using IR to reduce NSSI and associated clinical symptoms in adolescents. The intervention was supported by an app-based digital health intervention (DHI).

Teleworkers who are exposed to digital incivilities need to be helped to adapt to teleworking arrangements, maintain close links with their team members, enjoy an effective right to disconnect, be trained in conflict management and set limits to protect their personal lives. This is the only way for teleworkers to remain motivated and efficient at work, in good physical and mental health, even when exposed to digital incivilities, whoever the perpetrator may be. But they can’t act in isolation: they need to be able to rely on the organization to which they belong, on the responsible commitment of management, and on the concerted and relevant action of employee representatives, both trade unions, for the collective negotiation of agreements aimed at reinforcing the protection of teleworkers’ health and working conditions, and elected representatives, to act in the event of infringements of people’s rights.