Stigma and Mental Health

Despite the high prevalence of mental disorders and epilepsy in low- and middle-income countries, nearly 80% of patients are not treated. In Madagascar, initiatives to improve access to epilepsy and mental health care, including public awareness and training of general practitioners (GPs), were carried out between 2013 and 2018. Our study's main objective was to assess the effectiveness of these initiatives, two to five years post-intervention.

Stigma exacerbates power imbalances and societal disparities, significantly impacting diverse identities and health conditions, particularly for low and middle-income countries (LMICs). Though crucial for dismantling harmful stereotypes, and enhancing healthcare utilisation, existing research on anti-stigma interventions is limited with its condition-focused approach. We aimed to thoroughly evaluate peer-reviewed and non-peer-reviewed literature for a comprehensive review of anti-stigma interventions for diverse identities and all health conditions in LMICs.

Many people with mental health issues recover and re-establish their identity and find hope and meaning in life, irrespective of symptom burden. Recovery can be supported through learning and education, aiming at strengthening self-management and coping skills. Such education offered by peers with lived experience is rare and scarcely reported. The aim was to assess the perceived value of an educational intervention, called the Patient School (PS), organized within a psychiatry organization by employed patient peers with lived experience.

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.

Digital contact tracing uses automated systems and location technology embedded on smartphone software for efficient identification of individuals exposed to COVID-19. Such systems are only effective with high compliance, yet compliance is mediated by public trust in the system. This work explored the perception of individual's trust and expectation of the broader Test and Trace system in the United Kingdom (UK) with the upcoming release of the National Health Service's (NHS) COVID-19 app as a case example.

Health care workers have been exposed to COVID-19 more than people in other professions, which may have led to stigmatization, discrimination, and violence toward them, possibly impacting their mental health. We investigated (1) factors associated with stigma, discrimination, and violence, (2) the association of stigma, discrimination, and violence with mental health, (3) everyday experiences of stigmatization, discrimination, and violence. We chose a combination of a quantitative approach and qualitative content analysis to analyze data collected at three time points: in 2020, 2021 and 2022. A higher age was associated with lower odds of experiencing stigma, discrimination, and violence, whereas female gender was related to more negative experiences. The intensity of exposure to COVID-19 was associated with greater experience with stigmatization, discrimination, and violence across all three years (for example in 2022: odds ratio, 95% confidence interval: 1.74, 1.18-2.55 for mild exposure; 2.82, 1.95-4.09 for moderate exposure; and 5.74, 3.55-9.26 for severe exposure, when compared to no exposure). Stigma, discrimination, and violence were most strongly associated with psychological distress in 2020 (odds ratio = 2.97, 95% confidence interval 2.27-3.88) and with depressive symptoms in 2021 (odds ratio = 2.78, 95% confidence interval 2.12-3.64). Attention should be given to the destigmatization of contagious diseases and the prevention of discrimination, violence, and mental health problems, both within workplaces and among the public.

The international education sector is important not only to Australian society, but also to the national economy. There are growing concerns about the potential wellbeing challenges facing international students in their host country, owing to acculturative stress; including loneliness, isolation and experiences of racism. Risks include poor mental health and decreased likelihood to access support due to stigma, language and cultural barriers, not knowing where to seek help, and poor mental health knowledge.

Intergenerational family care, which was upended by the HIV epidemic in sub-Saharan Africa (SSA), may return to a pre-HIV era arrangement as access to antiretroviral therapy (ART) expands and treated adults can once again provide support for older household members. Empirical research has demonstrated positive 'spillover effects' of ART uptake from treated adults to younger generations, yet much less is known about the nature and breadth of such effects to older generations. This study explores the role and lived experiences among adults who take up ART and those of an older generation with whom they live.

Getting a diagnosis of dementia does not equate to equitable access to care. People with dementia and unpaid carers face many barriers to care, which can vary within, and across, different countries and cultures. With little evidence across different countries, the aim of this scoping exercise was to identify the different and similar types of inequalities in dementia across Europe, and provide recommendations for addressing these.

Stigmatized groups may experience psychological distress. Yet, some studies show no significant relation between stigma and mental health outcomes. This systematic review investigates the link between anticipated and internalized stigma, and one mental health outcome, depression. We aimed to (1) determine whether anticipated and internalized stigma predict levels of depression, and (2) review the quality of evidence for this link. We searched PsycInfo, PubMed and EMBASE databases. Eighty-three studies (N = 34,705) met our inclusion criteria, across five stigma categories: Sexual and gender minorities; HIV/AIDS; Illness or disability-related (non-HIV); Weight, and Other. We reviewed evidence within each category and study design and developed a narrative synthesis. Sixty studies (72.3%) supported the proposed link, which varied across categories from 53.6% to 100%. Using the NIH quality assessment tool, most studies were of fair quality. Most cross-sectional studies (76.7%) straightforwardly supported the positive relation between internalized and/or anticipated stigma and depression, while only 40% of longitudinal studies did. Implications for the study of stigma and mental health outcomes are discussed.

Recent studies show that, despite providing some relief, feedback about being at risk for psychosis often triggers negative emotional reactions. Inspired by Tversky and Kahneman's (1981) work on the framing effect and medical framings that favors positive framing like "life-threatening" over "high-risk for death," this study tested the hypothesis that positive reframing of psychosis risk (PR) could alleviate these concerns. To establish the justifiability and feasibility of testing this hypothesis with patients and their families, the study first sought to test whether mental health professionals (MHPs) view positive framing as superior to present state-of-the-art approaches.

Research indicates that exposure to conflict, natural disasters, and internal displacement can increase mental health conditions. Since the end of the civil conflict within Sri Lanka, the country has worked to increase access to mental health services to meet the needs of conflict-affected populations, however, gaps remain. To address this, integration of mental health services into primary care can reduce the strain on growing specialized care. As part of a larger study primary care practitioners (doctors), public health professionals (nurses, midwives), and community representatives (teachers, social workers) were trained to deliver mental health services in primary care across the heavily impacted Northern Province. The aim was to reduce mental health stigma among enrolled healthcare workers and community representatives by 50%.

Married individuals and those in committed romantic relationships generally report having better mental health outcomes than their single or divorced counterparts. However, studies of romantic relationships for adults with mental illness have often ignored rewarding aspects of romantic relationships and have focused primarily on relationship difficulties. In this study, 23 adults with serious mental illness in long-term romantic relationships described their relationship strengths and struggles in small focus group discussions. Content analysis was used to characterize themes from participant accounts. Overall, participants described deep emotional bonds with their partners, a mutual willingness to work on their relationship, and good communication skills as relationship strengths. Mental health symptoms and internalized stigma were identified as major contributors to relationship struggles. Participants spontaneously identified intentional strategies that they used to navigate mental health challenges in their relationship that included self-directed, partner-directed, and couple-directed actions. Implications of findings for research and practice are discussed.

Understanding the root cause of mental illness stigma is necessary to adopt effective management strategies.

The vast majority of children with Attention-Deficit Hyperactivity Disorder (ADHD) do not have access to proper diagnosis and treatment in China. The goal of this project is to identify the challenges and facilitators in implementing a Canadian ADHD Shared Care Pathways program in pediatric settings in Shanghai region.

Since 1950, public communication about the neurobiological-psychosocial basis of mental illness from the diathesis-stress model has promoted reception to treatment yet violent/dangerous stereotypes have increased during this period. Moreover, public mental health communication efforts have predominantly diffused in English-language media, excluding Spanish/Latinx media and its consumers from these efforts. To inform future mental health communication strategies, this study leverages high versus low diffusion of public mental health communication across English and Spanish/Latinx media to examine public mental health communication effects on stigma and treatment beliefs via neurobiological-psychosocial beliefs.

Stigmatised attitudes are known to be associated with negative outcomes in schizophrenia, yet there is little focus on the role of stigma in the recovery process. Attempts to develop interventions to reduce self-stigma in schizophrenia have not been found effective. This paper presents a theoretical integration based on a narrative review of the literature. PsycINFO, Medline and Embase databases were searched up to the 11th December 2023. Studies were included if they were: i) empirical studies using qualitative, quantitative or mixed methods studies investigating mental health stigma; ii) included participants based in the United Kingdom, fluent in English, between the ages of 16 and 70, meeting criteria for a schizophrenia spectrum diagnosis. Fourteen studies were included. In Part 1, we propose a novel theoretical model derived from a synthesis of service-user perspectives on the relationship between stigma and schizophrenia. Stigmatised attitudes were commonly perceived to be caused by a lack of education and further exacerbated by disinformation primarily through the media and cultural communities. Stigma led to negative self-perceptions, negative emotional responses, social isolation and increased symptom severity, ultimately acting as a barrier to recovery. In Part 2, we identify several factors that ameliorate the impact of stigma and promote clinical and subjective recovery among service-users: education, empowerment, self-efficacy, self-acceptance, hope and social support. We argue that the notion of stigma resistance may be helpful in developing new interventions aimed at promoting recovery in individuals with schizophrenia. Wider implications are discussed and recommendations for future research and practice are explored.

One in seven adolescents globally are affected by mental health conditions, yet only a minority receive professional help. School-based mental health services have been endorsed as an effective way to increase access to mental health support for people at risk, or currently presenting with mental health conditions, throughout adolescence. Despite this, low treatment utilisation prevails, therefore the aim of this review is to contribute insights into the processes related to adolescents' accessing and engaging with essential targeted mental health support within schools.

The Brief Educational Workshops in Secondary Schools Trial (BESST) is an England-wide school-based cluster randomised controlled trial assessing the clinical and cost-effectiveness of an open-access psychological workshop programme (DISCOVER) for 16-18-year-olds. This baseline paper describes the self-referral and other recruitment processes used in this study and the baseline characteristics of the enrolled schools and participants.

To estimate lifetime prevalence, risk, and treatment for mental disorders and their correlates in Qatar's general population for the first time.

Self-stigma in parents of children with mental illness is an area easily overlooked by mental health providers. Many studies have shown that self-stigma in parents may result in social interaction avoidance, lower self-esteem, increased psychological pressure, and so on. However, a comprehensive picture of how parents of children with mental illness in China experience self-stigma is lacking.

Contingency management (CM) is the most effective treatment for reducing methamphetamine use. We sought to understand why CM has not been taken up to manage methamphetamine use disorder in Australia.

Internally displaced people (IDP) in Iraq are 1.2 million (as March 2023). Protracted refugee status endangers the mental health, especially of minorities who survived persecution and conflict, such as the Yazidis. This study aims to identify the mental health needs of Yazidi adolescents and young adults (AYA) in the IDP camp of Bajed Kandala (Iraqi Kurdistan).

São Caetano do Sul, a city in southeastern Brazil, boasts exemplary social indicators and healthcare services, with a population of 162,763 and a density of 9,736.03 inhabitants/km². Allocating 25% of its budget to healthcare, the city's mental healthcare services adhere to the National Mental Health Policy. Structured services include a CAPS-II, CAPS-AD, outpatient teams, and teams in various locations. Initiatives since 2000 include inaugurating a CAPS-AD in 2006, a psychiatric emergency service in 2010, and a CAPS-II in 2016, relocating CAPS-AD in 2019, and establishing the Cuca Legal Project in 2022. São Caetano do Sul has a Mental Health Risk Classification Protocol to aid clinical decision-making. Developing care lines for various groups, it offers programs like smoking prevention, school psychology, and obesity support. Collaborating with community centers, these facilities serve as teaching environments. The mental health care network focuses on five axes: Communication, Care, Prevention, Management, and Education, with specific proposed actions and competencies. Despite progress, challenges remain. Expanding access, reducing stigma, and implementing robust monitoring are crucial. São Caetano do Sul's experience offers valuable insights for similar urban settings in LMICs developing mental health programs.

The World Health Organization reported that 80% of new HIV diagnoses in Europe in 2014 occurred in Central and Eastern Europe. Romania has a particularly high HIV incidence, AIDS prevalence, and number of related deaths. HIV incidence in Romania is largely attributed to sexual contact among gay and bisexual men. However, homophobic stigma in Romania serves as a risk factor for HIV infection for gay and bisexual men. The Comunică intervention aims to provide a much-needed HIV risk reduction strategy, and it entails the delivery of motivational interviewing and cognitive behavioral therapy skills across 8 live text-based counseling sessions on a mobile platform to gay and bisexual men at risk of HIV. The intervention is based on the information-motivation-behavior and minority stress models. There is preliminary evidence suggesting that Comunică holds promise for reducing gay and bisexual men's co-occurring sexual (eg, HIV transmission risk behavior), behavioral (eg, heavy alcohol use), and mental (eg, depression) health risks in Romania.

The COVID-19 pandemic has affected the mental health of healthcare workers worldwide, with frontline personnel experiencing heightened rates of depression, anxiety, and posttraumatic stress. This mixed-methods study aimed to assess the mental health toll of COVID-19 on healthcare workers in Malawi. A cross-sectional survey utilising the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) was conducted among 109 frontline healthcare workers. Additionally, in-depth interviews were conducted with 16 healthcare workers to explore their experiences and challenges during the pandemic. The results indicated a high prevalence of COVID-19-related depression (31%; CI [23, 41]), anxiety (30%; CI [22, 40]), and PTSD (25%; CI [17, 34]) among participants. Regression analysis revealed significantly higher rates of depression, anxiety, and PTSD among healthcare workers in city referral hospitals compared to district hospitals. Qualitative findings highlighted the emotional distress, impact on work and personal life, and experiences of stigma and discrimination faced by healthcare workers. The stress process model provided a valuable framework for understanding the relationship among pandemic-related stressors, coping resources, and mental health outcomes. The findings underscore the urgent need for interventions and support systems to mitigate the mental health impact of COVID-19 on frontline healthcare workers in Malawi. Policymakers should prioritise the assessment and treatment of mental health problems among this critical workforce to maintain an effective pandemic response and build resilience for future crises.

This study is descriptive research aiming to identify factors influencing the stigma experienced by college students with coronavirus disease 2019 (COVID-19), focusing on COVID-19 pandemic stress, depression, and fear of negative evaluation as the main variables.

Poor mental health among U.S. adolescents has reach epidemic proportions, with those from the Middle East and North African region exhibiting increased risk for distress and suicide ideation. This mixed-methods study analyzes quantitative data from first- and second-generation Arab adolescents (n = 171) and qualitative data from a participatory study conducted with 11 adolescents of the same population to understand the role of cultural resources in coping. Drawing on the Intersectional Theory of Cultural Repertoires in Health, we show that: 1) cultural resources underlie meaning-making throughout coping; 2) coping strategies are inseparable from the influence of peer and familial relationships, as dictated through the social norms and other cultural resources; 3) collectively held repertoires of coping can promote belonging, affirm identity, and protect against discrimination; and 4) the outcomes of coping strategies, and the culturally informed meaning individuals make of these outcomes, influence their future coping behaviors.

Despite advances in care, people with epilepsy experience negative health events (NHEs), such as seizures, emergency department (ED) visits and hospitalizations. This analysis using baseline data from an epilepsy self-management clinical trial targeting people from rural regions and other underserved populations assessed the relationship between demographic and clinical variables vs. NHEs.

The stigma associated with sexual victimization (SV) can add to the psychological burden on survivors. We compared experiences of SV and SV stigma by survivor gender and sexuality and evaluated the relevance of public and internalized sources of this stigma to their psychological functioning. An online survey containing measures of SV type (sexual harassment and assault), public SV stigma, internalized SV stigma (self-blame, self-shame, anticipated-shame), and psychological functioning (depression, anxiety, stress, and post-traumatic stress disorder [PTSD] symptomatology) was completed by 877 women and 211 men aged 18 to 66 years ( = 30.2,  = 8.06), of whom 73.9% were heterosexual and 26.1% identified as a sexual minority (same-sex-attracted, bisexual, pansexual, or asexual). Sexual harassment and assault were more prevalent in women and sexual minority men. Analysis of Covariance (ANCOVA) with age and SV frequency as covariates also revealed poorer psychological functioning in sexual minority men, and higher levels of SV stigma in sexual minority women and men. Multigroup path analyses further showed that exposure to public stigma was associated with poorer psychological functioning, that internalized stigma partly mediated these associations, and that the magnitude of the associations (particularly those involving self-shame and anticipated shame) was often greater in men and sexual minorities. The results add to our understanding of the role of gender and sexuality in the experience, internalization, and psychological impact of SV-related stigma on survivors. The results also highlight the need for societal shifts toward acknowledging and validating experiences of SV in men and sexual minorities, alongside women, and the development of intersectionality-informed interventions for SV stigma in survivors.

Major Depressive Disorder (MDD) is one of the commonest mental disorders affecting more than 250 million people globally. Patients with chronic illnesses had higher risks for developing MDD than the general population. Neurolathyrism is a chronic illness characterized by lifelong incurable spastic paralysis of lower extremities; causing permanent disability. It is highly prevalent in Dawunt district, Ethiopia; with a point prevalence of 2.4%. Despite this, there were no previous studies assessing the prevalence of MDD among patients with neurolathyrism in Ethiopia.

Pregnant women with a history of mental disorders, neglect, or low social support are at increased risk of mental health problems. It is crucial to identify psychosocial risk factors in early pregnancy to reduce the risk of short- and long-term health consequences for mother and child. The Antenatal Risk Questionnaire has been found acceptable as a psychosocial screening tool among pregnant women in Australia, but it has not been tested in a Scandinavian context. The aim of this study was to explore the experiences of pregnant women when using the Antenatal Risk Questionnaire and the Edinburgh Postnatal Depression Scale as part of a model to identify psychosocial vulnerabilities in pregnancy in Denmark. We conducted individual interviews ( = 18) and used thematic analysis. We identified two main themes: (1) Feeling heard and (2) An occasion for self-reflection. Overall, the pregnant women deemed the online ANRQ/EPDS acceptable as a screening tool. The screening model provided a feeling of being heard and provided an occasion for self-reflection about mental health challenges related to pregnancy and motherhood. However, some women expressed that the screening raised concerns and fear of the consequences of answering honestly. A non-judgmental, open, emphatic, and reassuring approach by clinicians may help reduce stigma.

Workplace mental health is an important global health concern.

The role of an addiction clinical nurse specialist (ACNS) is focused on individuals who misuse drugs and alcohol, and several benefits of the role have been identified in the literature. When people who misuse substances are admitted to acute general hospitals, there is an opportunity to engage with them and ensure they access support services to facilitate their recovery.

The experiences and perceptions of Community Health Workers toward mental illness are vital for tailoring interventions, reducing stigma, improving access to services, and fostering community engagement in mental health initiatives.

In North America, LGBTQ+ youth have high rates of cannabis use and face mental health issues. We conducted a photovoice study to describe the perspectives, needs, and motivations of forty-six LGBTQ+ youth who use cannabis as they access mental healthcare services. Participants' photographs were discussed in individual semi-structured interviews conducted by peer researchers. Following a thematic analysis of the interview transcripts, we first found that, beyond medication, LGBTQ+ youth sought mental health services facilitating introspection to better understand their sexual and gender identities and mental health. Second, participants sought affirming health professionals but often felt judged by providers. Third, access to desired services was often described as uncertain and taxing, which impacted their mental health. Fourth, participants' agency was determined by their experience with mental health services, which translated into resilience to tackle access challenges and cannabis use to mitigate their mental health struggles. Our findings point to the need for mental healthcare delivery that goes beyond medication provision but which in addition foster therapeutic processes based on a holistic understanding of mental health. A trusting dynamic between health professionals and LGBTQ+ youth is imperative to counteract the feelings of stigma experienced by LGBTQ+ youth using cannabis in Canada.

Perinatal mental health is a major public health problem that disproportionately affects people from racial and ethnic minority groups. Community-based perinatal mental health programs, such as peer support groups, are essential tools for the prevention and treatment of perinatal depression. Yet, little is known about racial and ethnic disparities in accessibility and utilization of community-based perinatal mental health programs.

This study examined the preliminary impact of group-cognitive behavioral therapy (G-CBT) and a family-strengthening intervention delivered via multiple family groups (MFG-FS) on HIV stigma, parenting stress, and the mental health of caregivers of adolescents living with HIV. We analyzed data from the Suubi4Stigma study (2020-2022), a two-year pilot randomized clinical trial for adolescents and their caregivers (N = 89 dyads), recruited from nine health clinics in Uganda. Adolescent-caregiver dyads were randomized to three intervention conditions delivered over three months, with data collected at baseline, three and six-months follow-up. We fitted mixed-effects linear regression models to test the effect of the interventions on caregiver outcomes over time. At six months, caregivers randomized to the MFG-FS condition reported lower levels of stigma by association (mean difference = -1.45, 95% CI = -2.52 - -0.38, p = 0.008), and stigma and discrimination attitudes (mean difference = -3.84, 95% CI = -4.63 - -3.05, p < 0.001), compared to Usual care condition. In addition, caregivers of adolescents randomized to the G-CBT condition reported lower levels of stigma and discrimination attitudes at three months (mean difference = -5.18, 95% CI = -9.13 - -1.22, p = 0.010), and at six months (mean difference = -6.70, 95% CI = -9.28 - -4.12, p < 0.001). Caregiver mental health and parenting stress significantly reduced over time regardless of intervention condition. Findings point to the importance of incorporating stigma reduction components within psychosocial interventions targeting adolescents and families impacted by HIV.

The literature is consensual regarding the academic community exhibiting higher levels of mental disorder prevalence than the general population. The potential of digital mental health apps for improving access to resources to cope with these issues is ample. However, studies have yet to be performed in Portugal on individuals' attitudes and perceptions toward digital mental health applications or their preferences and decision drivers on obtaining mental health care, self-assessment, or treatment.

Long Covid is often stigmatised, particularly in people who are disadvantaged within society. This may prevent them from seeking help and could lead to widening health inequalities. This coproduced study with a Community Advisory Board (CAB) of people with Long Covid aimed to understand healthcare and wider barriers and stigma experienced by people with probable Long Covid.

Limited awareness, social stigma, and access to mental health professionals hinder early detection and intervention of internet gaming disorder (IGD), which has emerged as a significant concern among young individuals. Prevalence estimates vary between 0.7% and 15.6%, and its recognition in the International Classification of Diseases, 11th Revision and Diagnostic and Statistical Manual of Mental Disorders, 5th Edition underscores its impact on academic functioning, social isolation, and mental health challenges.

Labeling terms for high-risk state for psychosis, such as 'ultra-high risk' (UHR), 'attenuated psychosis syndrome' (APS), and 'at-risk mental state' (ARMS), have been criticized for their potential to lead to stigma. Hence, mental health service users in Melbourne recently proposed new terms illustrating the at-risk concept ['pre-diagnosis stage' (PDS), 'potential of developing a mental illness' (PDMI), and 'disposition for developing a mental illness' (DDMI)]. We aimed at testing the suitability of these existing and new terms in the clinical settings of early psychiatric intervention in Japan.

The 2022-2024 global mpox outbreak, occurring primarily in the sexual networks of gay, bisexual and other men who have sex with men (GBMSM), has not been accompanied by a focus on patient perspectives of illness. We explore the experiences of GBMSM diagnosed with mpox in England to understand needs for social and clinical support.

The stigma and discrimination experienced by individuals with an alcohol/substance use disorder often extends to the family members and friends who provide care, which is known as courtesy stigma. This courtesy stigma can lead to isolation, poor mental health and might impact the quality-of-care these individuals provide. The aim of this study was to examine the frequency of experienced courtesy stigma/discrimination in individuals in a family support service for a loved one's substance use, and to examine any cross-sectional associations with changes in mood, health- and social-related outcomes. Thirty-six individuals (25 female) with a mean age of 51.91 years took part in an ecological momentary assessment study in which the experience of courtesy stigma/discrimination and measures of mood, health (e.g. alcohol use, nicotine use, healthy eating, sleep, physical activity) and social connections were taken 3 times per day for fourteen days. Across 1029 competed assessments (compliance ∼68%), there were 122 (∼11%) reports of courtesy stigma/discrimination. The most common sources of stigma/discrimination were from family members (∼43% of occurrences) and friends (∼31% of occurrences). Experiencing this stigma/discrimination was associated with increases in alcohol and nicotine use, as well as reductions in healthy eating, physical activity, sleep, social connections, and mood. The experience of courtesy stigma/discrimination was common in a sample of individual's who support a loved one with alcohol or substance use disorder. These experiences are associated with changes in health and social behaviors and may lead to a poorer quality of care.

Persons with mental illnesses may experience stigma from their immediate family members in addition to other forms of stigma. Using semi-structured interviews, we investigated experiences of familial mental illness stigma among 15 people diagnosed with mental illnesses in a mid-sized city in Canada. We identified five themes that speak to participants' experiences of familial mental illness stigma and ways to reduce it. The themes include the following: diagnosis as a 'double-edged sword,' potential familial isolation, familial stigma as societal stigma localized, stories of acceptance, and confronting potential familial mental illness stigma. Participants' narratives indicate that familial mental illness stigma is rooted in the broader social or public stigma, which sees its way into familial relations as well. This stigma takes various forms, including relationship bias or unfair treatment, breakdown in romantic relationships, loss of status, verbal and emotional abuse, exclusion from decision-making, and alienation within their immediate and extended families. Familial mental illness stigma experiences negatively impact participant's psychological well-being and personal empowerment. However, participants also shared ways that family members create supportive environments or actively confront or prevent stigma. Overall, this study has contributed to knowledge on mental illness stigma, particularly familial mental illness stigma from the perspective of participants living with a mental illness in a high-income country. Suggestions for future research include a focus on strategies to prevent ongoing familial mental illness stigma and large-scale studies to explore familial mental illness stigma to understand why families might perpetrate stigma.

Victimisation of persons with severe mental illness is recognised as an urgent global concern, with literature pointing to higher rates of violent victimisation of persons with severe mental illness than those of the general population. Yet, for low income countries, there is a huge gap in the literature on the risk, character and victims' in-depth experiences of victimisation of persons with severe mental illness. We explore the lived experiences and meanings of victimisation of persons with severe mental illness in Uganda, and discuss their implications for care of the mentally ill.

Limited research has explored the relationship between self-determination theory constructs (basic psychological needs, autonomous/controlled regulation) and internalized weight stigma (IWS). This cross-sectional, online study surveyed 480 U.S. women aged 18-40 between 2021 and 2022. We hypothesized that need frustration and controlled weight regulation would relate to higher IWS, which would be associated with dysfunctional eating, distress, and lower life satisfaction. Conversely, we predicted that need satisfaction, autonomous regulation, and body satisfaction would be associated with reduced IWS, dysfunctional eating and distress, and higher life satisfaction. Structural equation modeling demonstrated an acceptable model fit (CMIN/DF = 2.95, CFI = 0.90, RMSEA = 0.06, SRMR = 0.07), accounting for 74% of IWS variance. Findings indicate the relevance of self-determination theory in understanding IWS, supporting a dual-process model whereby adverse and adaptive outcomes follow distinct pathways. Longitudinal studies are warranted to validate psychological needs and regulatory styles as mechanisms for IWS development and to assess generalizability across diverse populations.

Recent studies have indicated that clinical high risk for psychosis (CHR-P) is highly specific for psychotic disorders other than pluripotential to various serious mental illnesses. However, not all CHR-P develop psychotic disorder only, and psychosis can occur in non-psychotic disorders as well. Our prospective cohort study aims to investigate the characteristics and clinical outcomes of a pluripotent high-risk group with the potential to develop a diverse range of psychiatric disorders.

Mental health (MH) problems in youth are prevalent, burdening, and frequently persistent. Despite the existence of effective treatment, the uptake of professional help is low, particularly due to attitudinal barriers.

This article is part of the EKB-study which explores lived crisis and treatment experiences of mental health professionals in Berlin and Brandenburg. It addresses the disclosure of mental health workers' lived experiences in their workplace.

Health-related stigma is associated with adverse outcomes including depression, stress and reduced engagement in health behaviours which are particularly harmful in pregnancy and the postpartum. Women with gestational diabetes mellitus (GDM) report negative psychosocial experiences and may be at risk of stigma related to the condition. We aimed to understand women's experiences of GDM-specific stigma. Individual interviews were conducted with = 53 women living in the UK with a current or past (within 4 years) GDM. Grounded theory methodology was used to analyse the data. Four themes were identified: (1) Preconceptions and misconceptions; (2) Locating, regaining, and negotiating agency; (3) Tension about and resisting the dominant discourse of stigma; and (4) Reclaiming control over the body. GDM-specific stigma was diverse and far reaching and may have broader implications for perinatal mental health and postnatal wellbeing. It is pertinent to investigate possible prospective associations between GDM-specific stigma, and biomedical and mental health outcomes.

Despite clinical recommendations, only 24.9% of infants in the United States are exclusively breastfed at 6 months of age, and women who use formula report facing stigma and feeling like a failure. Individual experiences are often influenced by master narratives such as "breast is best," and stories can reveal how the discourse may manifest unintended effects, potentially eliciting guilt and shame, which are known to result in negative maternal mental outcomes, including depression and anxiety. The purpose of this research was to use a narrative framework to analyze the stories of women who used formula and determine how they interpreted the master narrative of "breast is best." We conducted interviews with 20 women who had used formula within the first 6 months after giving birth and had an infant no older than 12 months at the time of the interview. Qualitative analysis revealed that women integrated "breast is best" into their stories, and that the master narrative influenced conceptions of themselves as mothers including the bonded mother, the good mother, the shameful mother, and, ultimately, the multitudinous mother. Participants who used formula within the first six months desired that messaging about breastfeeding, particularly in online spaces, move away from all-or-nothing framing and instead show the diversity of infant feeding experiences. It is important to consider how breastfeeding discourse evolves online, considering the unintended effect of stigma, its impact on mental health, and the potential for individuals interacting in these spaces to curate more nuanced narrative messaging about breastfeeding to improve maternal and infant health.

Chronic skin disorders in children frequently are visible and can cause stigmatization. However, the extent of stigmatization from chronic skin disease and association with mental health needs further study.

We aimed to assess whether viewing expert witness evidence regarding the mental health of Johnny Depp and Amber Heard in the 2022 court case in the USA would affect viewers' attitudes towards the mental health of the two protagonists and towards mental illness in general. After viewing excerpts of the cross-examination evidence, 38 trial-naive undergraduate students completed the Prejudice towards People with a Mental Illness (PPMI) scale.

WHAT IS KNOWN ON THE SUBJECT?: According to recent estimates, 10.4% of adults are patients with substance abuse, which is almost double the global rate. Rural areas are typically marginalized, compounded by a lack of access to mental health care, creating a startling disparity in suffering from drug use issues among rural cohorts. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Drawing on data from a descriptive comparative design would provide a distinctive picture related to the similarities and/or differences in relation to craving and how it affects perceived stigma and suicidal risk among patients using old versus novel psychoactive substances. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Substance abuse is a leading public health concern that forces nurses to encompass it into their agendas to tackle this looming problem. Addiction rehabilitation services are frequently run by nurses. They are well-versed in supporting patients during their journey to recovery and enabling them to adjust to a new lifestyle.

Black adults who smoke and have HIV experience immense stressors (eg, racial discrimination and HIV stigma) that impede smoking cessation success and perpetuate smoking-related health disparities. These stressors also place Black adults who smoke and have HIV at an increased risk of elevated interoceptive stress (eg, anxiety and uncomfortable bodily sensations) and smoking to manage symptoms. In turn, this population is more likely to smoke to manage interoceptive stress, which contributes to worse HIV-related outcomes in this group. However, no specialized treatment exists to address smoking cessation, interoceptive stress, and HIV management for Black smokers with HIV.

Self-stigma and negative attitudes toward mental illness have been identified as significant barriers that hinder individuals from seeking psychological assistance, leading to adverse consequences in their lives.

In the United States, Asian and Pacific Islander (A/PI) communities have faced significant discrimination and stigma during the COVID-19 pandemic. We assessed the association between discrimination and depression, anxiety, and loneliness symptoms among Asian or Pacific Islander adults (n = 543) using data from a 116-item nationally distributed online survey of adults (≥ 18 years old) in the United States conducted between 5/2021-1/2022. Discrimination was assessed using the 5-item Everyday Discrimination Scale. Anxiety, depression, and loneliness symptoms were assessed using the 2-item Generalized Anxiety Disorder, 2-item Patient Health Questionnaire, and UCLA Loneliness Scale-Short form, respectively. We used multivariable logistic regression to estimate the association between discrimination and mental health. Overall, 42.7% of participants reported experiencing discrimination once a month or more. Compared with no discrimination, experiencing discrimination once a month was associated with increased odds of anxiety (Adjusted Odds Ratio [aOR] = 2.60, 95% CI = 1.38-4.77), depression (aOR = 2.58, 95% CI = 1.46-4.56), and loneliness (aOR = 2.86, 95% CI = 1.75-4.67). Experiencing discrimination once a week or more was associated with even higher odds of anxiety (aOR = 6.90, 95% CI = 3.71-12.83), depression, (aOR = 6.96, 95% CI = 3.80-12.74), and loneliness (aOR = 6.91, 95% CI = 3.38-13.00). Discrimination is detrimental to mental health, even at relatively low frequencies; however, more frequent discrimination was associated with worse mental health symptoms. Public health interventions and programs targeting anti-A/PI hate and reducing A/PI mental health burden are urgently needed.

Repeated stigmatization due to group membership constitutes a recurrent stressor with negative impact on physical and mental health (minority stress model). Among European countries, Romania ranks low on LGBT+ (lesbian, gay, bisexual, and transgender people. The "+" represents individuals whose identities do not fit typical binary notions of male and female [nonbinary]) inclusion, with 45% of Romanian LGBT+ respondents reporting discrimination in at least 1 area of life in the year preceding the survey. Importantly, while all LGBT+ people might experience minority stress, younger sexual minority individuals are more prone to the detrimental impacts of stigma on their mental and physical health. As such, interventions are necessary to improve the inclusion climate within schools, where young people spend most of their time. Until now, most interventions addressing this topic have been conducted on undergraduate students in Western countries, with no studies conducted in countries that have widespread anti-LGBT+ attitudes.

Mental disorders are common among people with HIV (PWH) and are associated with poor HIV outcomes. Despite high unmet mental health needs among PWH, use of evidence-based mental health screening and treatment protocols remains limited at HIV treatment facilities across low-resource settings. Integrating mental health services into HIV care can reduce this gap. This study's objective was to explore factors that influence integration of mental health screening and treatment into HIV clinics in Cameroon.

Addiction nurses are highly skilled providers of holistic care and ensuring workforce sustainability is key to providing quality care to a traditionally marginalised group of healthcare consumers. The aim of this study was to explore perceived stigma towards the addiction nursing speciality, addiction nursing (also known as alcohol and other drug nursing) and its impact on workforce sustainability, retention and recruitment. Secondary analysis of qualitative interview data with nurses (n = 50) and survey data (n = 337) was conducted as part of a workforce mapping exercise in 2019. COREQ reporting guidelines were used. After structural coding was applied, three themes emerged: stigma experienced by clients of alcohol and other drug treatment services, stigma experienced by addiction nurses and a lack of awareness of the specialty of addiction nursing itself. Participants overwhelmingly felt that these forms of stigma made addiction nursing less attractive to new entrants, particularly new nurses and posed a threat to the sustainability of the specialty. The findings from this study indicate that urgent attention is required to address stigma towards individuals who use alcohol and other drugs, and the nurses providing care for them. Furthermore, creating awareness of the addiction nursing specialty is paramount to ensure workforce sustainability and to improve care for individuals who use alcohol and other drugs. Beyond addiction nurses, our results indicate that stigma towards other specialties (such as mental health nursing) is a substantive barrier to workforce sustainability.

Mental health (MH) is extremely relevant when referring to people living with a chronic disease, such as people living with HIV (PLWH). In fact - although life expectancy and quality have increased since the advent of antiretroviral therapy (ART) - PLWH carry a high incidence of mental disorders, and this burden has been exacerbated during the COVID-19 pandemic. In this scenario, UNAIDS has set new objectives for 2025, such as the linkage of at least 90% of PLWH to people-centered, context-specific MH services. Aim of this study was to determine the prevalence of MD in PLWH followed at the Clinic of Infectious Diseases of the University of Bari, Italy.

To improve our practices of today and to overcome the problems that confront us at present, the behavioral health field must anticipate what the future is likely to bring. Such foresight is particularly important right now because of the changes and disruptions that have occurred due to the COVID-19 pandemic over the past 3 years. We begin by recounting major developments in the mental health field since the founding of the National Institute of Mental Health (NIMH) more than 70 years ago, including some firsthand experiences of the senior author. Subsequently, we review the present situation of the behavioral health field with particular attention to the effects of COVID-19 and our current workforce crisis. Likely future scenarios are then described in two principal domains: clinical developments and community developments. Clinical developments over the next decade are likely to include much more self-directed, integrated, virtual, and personalized care. Community developments are likely to include self-empowering community interventions, better population health management, new collaborations with public health, and continued efforts to address stigma. To increase the probability of the future described, several facilitators are also outlined to create the conditions under which expected future developments can be expected to flourish. These include addressing the behavioral health workforce crisis, modernizing behavioral health clinical training, fostering opportunities for cross-sector work, fostering opportunities to engage in policy issues, creating centers of excellence for innovation in behavioral health, and fostering an integrated framework that undergirds behavioral health. The future we have described holds considerable promise for the behavioral health field and for all who suffer from mental or substance use conditions. We must begin working today to turn this potential future into tomorrow's reality. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The current study applied survival analysis to examine factors associated with nondisclosure of human immunodeficiency virus (HIV) serostatus among mothers living with HIV (MLH) who had participated in a cognitive-behavioral intervention to disclose their HIV status to their children.

Suicide bereavement entails profound social stressors, including stigma and communication barriers, which can impair social support for suicide loss survivors (SLS). Despite recognized benefits of empathetic interactions, social support, and self-disclosure in mitigating adverse mental health outcomes after suicide loss, we lack a comprehensive understanding of the factors influencing perceived social support among SLS within their broader social environments. To address this gap, our study explores the diverse social experiences of SLS beyond their immediate circles. Specifically, we identify characteristics that define both supportive and non-supportive social experiences of SLS, as well as the facilitators and barriers to social support in the context of suicide bereavement.

Food insecurity can have lasting physical and mental health consequences. The experience of food insecurity within a household may disproportionately impact mothers because they tend to manage the household food environment.

The benefits and harms of identifying carriers in childhood have long been debated with European Guidelines advising against this practice. Yet over a thousand carriers are identified via newborn bloodspot screening per year in the United Kingdom alone. One of the concerns about identification is the impact it has on an individual's identity. This, in part, will be determined by how parents and peers view carriers, particularly during young adulthood. To address the paucity of research looking at how carriers are perceived by peers, this study sought to explore the views of young adults, who themselves are not carriers, toward carriers. As the narratives around COVID-19 increased, the salience of the term "carrier", the impact of such narratives on perceptions, was also explored. Twenty-five 18-25 year olds participated in a diary-interview study in the United Kingdom during 2021 to explore their perceptions of carriers via hypothetical scenarios. Data were analyzed using thematic analysis. Interviewees believed carriers would experience stigma-including societal and self-stigma. This was because people used existing illness beliefs to make sense of carrier status about which they had low levels of understanding. Interviewees believed carriers would experience challenges in familial and romantic relationships due to others' judgments. They also believed parents of carriers would experience a burden around making reproductive decisions, with clear views on what society would view as acceptable choices. Importantly interviewees felt knowledge of ones' own carrier status conferred complex communication challenges within relationships. These findings suggest an urgent need for more research and support for young adults entering a key stage in life for identity formation who have knowledge of their carrier status. The results suggest that support targeted toward the carrier regarding navigating complex communication and targeted more broadly to avoid stigma based on misunderstanding should be researched and developed.

We investigated the experiences of Brazilian gay men with HIV, focusing on the moment of diagnosis and its potential biopsychosocial impacts. This clinical-qualitative study involved 15 participants interviewed online and synchronously by a clinical psychologist in 2021. Thematic analysis was employed to analyze the data. Interpretations were grounded in Minority Stress Theory. Four thematic axes emerged, including "Diagnostic Revelation", "Social and Internalized Stigma", "Biopsychosocial Effects of Living with HIV", and "Gratitude for Treatment Advances and the Brazilian Health System". The diagnosis was often experienced as traumatic, exacerbated by the absence of empathy and emotional support from healthcare providers. Participants commonly reported guilt, fear upon learning of their HIV status, social isolation, loneliness, lack of social support, and damage to affective-sexual relationships. Many also noted a decline in mental health, even those without HIV-related medical complications. Despite over 40 years since the HIV epidemic began, the prevalence of homophobia and serophobia among gay men remains widespread, including within the multidisciplinary teams of specialized services. This indicates that the stigma associated with homosexuality and HIV persists, despite significant biomedical progress in the diagnosis and treatment of the infection, particularly in Brazil.

Existing literature documents high rates of experienced violence in asylum seekers. Despite this high prevalence, experiences of traumatic stress are neither necessary nor sufficient grounds for claiming asylum, without documented experiences of persecution. The aim of the current study is to better understand the role of co-occurring pre-migratory social determinants, stigma, and trauma on the experiences of persecution among asylum seekers in the United States.

Suicidal thoughts and behaviors (STBs) are prevalent within the Lesbian, Gay, Bisexual, Transgender, and Queers (LGBTQ) community, often exacerbated by challenges in accessing care and the perceived stigma and discrimination tied to disclosing one's identity. Digital health interventions that offer psychosocial self-help present a promising platform to reach individuals at risk of STBs, especially those who may not engage with conventional health services. This review aimed to assess the role of digital-based intervention in reducing STBs among LGBTQ individuals.

The literature unequivocally demonstrates that lesbian, gay, and bisexual (LGB) individuals experience disproportionate mental health and social wellbeing impacts. Here, we respond to recent calls for research in the field of sexual minority health to better understand why various overlapping and intersecting identities can further drive health disparities. In this paper, we focus on the specific intersections of ethnicity and sexuality for Asian LGB individuals and the role of internalized stigma in driving poorer mental health outcomes for this group. We recruited 148 LGB Asian participants residing in the United States ( = 22.82 years, = 4.88) to participate in our online cross-sectional survey in which we collected data on their internalized stigma, levels of guilt and shame about their sexuality, and measures of depression, anxiety, and distress. Contrary to our predictions, there were no bivariate relationships between internalized sexual stigma and any of the mental health outcomes. However, a parallel mediation analysis revealed that guilt, but not shame, mediates the relationship between internalized sexual stigma and all mental health outcomes (depression, anxiety, and stress) for LGB Asian American individuals. This research highlights the important of exploring additional variables that may exacerbate of protect against poor mental health for individuals with multiple intersecting identities.

Violent behaviour exhibited by psychiatric patients is a major problem faced by their family members. Agitated violent patients constitute a part of all emergency psychiatry treatment, and family members carry out most of the care for the mentally ill. Caring for the mentally ill is a burden for the caregivers, and they face difficulties and problems that affect their health and well-being.

Young people in Colombia present high rates of mental health problems, to which the country's history of armed internal conflict contributes in complex ways. Mental health services in Colombia are fragmented, inadequate, and difficult to access for many. Young people's help-seeking is often hindered by mental health stigma and/or poor experiences with services. This paper presents a thematic analysis of qualitative data from a mixed-methods study aimed at developing and testing a mental health intervention for Colombian youths. We draw upon theoretical lenses from scholarly work on stigma and Sen's 'capabilities approach' to inform our analysis of interviews and group discussions with staff and young people involved in the state-funded human capital building programme 'Jovenes en Acción' (JeA). By illustrating how study participants talked about stigma, vulnerability, mental health services organisation, and the challenges of discussing mental health topics in a learning environment, we illuminate aspects of mental health support and anti-stigma interventions that might need enhancing. In particular, we suggest that more emphasis on 'community competencies' as complementary to and interrelated with individual competencies would strengthen young people's individual and collective resources for mental wellbeing while being in line with the sociocritical principles of existing human capital-enhancing programmes.

The COVID-19 pandemic has hugely affected the world and human lives, the economy, and lifestyles. The pandemic control measures, such as lockdowns, forced many people to migrate from their destination to their source in various states, leading to increased vulnerability of migrants. The present review aimed to explore the different health, economic, and social impacts on internal migrants of India during the pandemic. The publications on internal migration and COVID-19 from India were retrieved from PubMed and Google Scholar using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 159 articles were extracted, of which 28 were reviewed. The articles published after March 1, 2020, were included in the review, irrespective of the design. Out of 28 articles, only half were original studies; the rest were either perspective, opinion, and review studies or editorial and commentary papers. Depression, anxiety, and stress due to job loss and lockdown were the major health issues documented. There was livelihood disturbance due to loss of income, such as inability to pay rent, loans, borrowing from relatives, and fear of its consequences. The migrants also faced stigma and discrimination from the villagers. The review also highlighted that although the government implemented various schemes to help the migrants, the majority were left out due to the non-availability of identity proof and ration cards. The safeguarding measures for these unregistered migrants must be facilitated to access health, economic, and social protection. Although various publications have focused on the mental health of the migrants, the socio-ecological aspects have been least explored, which calls for further studies. The literature on the impact of COVID-19 on other vulnerable populations like women and children and access to healthcare services is also scant, which needs to be explored further.

Increased rates of mental health disorders and substance use among youth and young adults have increased globally, furthering the strain on an already burdened mental health system. Digital solutions have been proposed as a potential option for the provision of timely mental health services for youth, with little research exploring mental health professional views about using such innovative tools. In Alberta, Canada, we are evaluating the implementation and integration of a digital mental health (dMH) platform into existing service pathways. Within this paper we seek to explore mental health professionals' perceptions of the barriers and facilitators that may influence their utilization of digital MH-enabled measurement-based care (MBC) with the youth who access their services.

Adolescents with HIV (AWH) face the double burden of dealing with challenges presented by their developmental phase while coping with stigma related to HIV, affecting their mental health. Poor mental health complicates adherence to daily treatment regimens, requiring innovative psychosocial support strategies for use with adolescents. We assessed the effectiveness of a mindfulness and acceptance-based intervention on the mental health of AWH in Uganda. One hundred and twenty-two AWH, mean age 17 ±1.59 (range 15 to 19 years), 57% female, receiving care at a public health facility in Kampala were enrolled in an open-label randomized trial (ClinicalTrials.gov: NCT05010317) with assessments at pre-and post-intervention. The mindfulness and acceptance-based intervention involved weekly 90-minute group sessions for four consecutive weeks facilitated by two experienced trainers. Sessions involved clarifying values, skillfully relating to thoughts, allowing and becoming aware of experiences non-judgmentally, and exploring life through trial and error. The control group received the current standard of care. Three mental health domains (depression, anxiety, and internalized stigma) were compared between the intervention and control groups. A linear mixed effects regression was used to analyze the effect of the intervention across the two time points. Results showed that the intervention was associated with a statistically significant reduction in symptoms of depression (β = -10.72, 95%CI: 6.25, -15.20; p < .0001), anxiety (β = -7.55, 95%CI: 2.66, -12.43; p = .0003) and stigma (β = -1.40, 95%CI: 0.66 to -2.15; p = .0004) over time. Results suggest that mindfulness and acceptance-based interventions have the potential to improve the mental health of AWH.

Despite the implementation of patient-centred care, mental health issues remain a significant risk factor and comorbidity for Tuberculosis (TB) disease. Mental health issues being co-morbidities to TB are likely to increase the disease burden of the affected population. This study therefore investigated the prevalence and impact of mental health issues in Tuberculosis (TB) patients.

South Africa has one of the highest rates of HIV/tuberculosis (TB) co-infection, and poor engagement in HIV/TB care contributes to morbidity and mortality. In South Africa, community health workers (CHWs) are tasked with re-engaging patients who have dropped out of HIV/TB care. CHWs have described substantial challenges with substance use (SU) and depression among their patients, while patients have described CHW stigma towards SU and depression as barriers to re-engagement in care. Yet, CHWs receive little-to-no training on SU or depression. Therefore, we piloted Siyakhana, a brief CHW training to reduce stigma related to SU and depression while improving skills for re-engaging these patients in HIV and/or TB care. This study evaluated the preliminary effectiveness (stigma towards SU and depression; clinical competence assessed via roleplay) and implementation (quantitative ratings of feasibility, acceptability, appropriateness, adoption; semi-structured written qualitative feedback) of Siyakhana among CHWs and supervisors (N = 17) at pre- and post-training assessments. SU stigma significantly decreased (F(1,16) = 18.94, p < 0.001, ηp2 = 0.54). Depression stigma was lower than SU stigma at both timepoints and did not significantly decrease after training. CHW clinical competency towards patients with SU/depression significantly improved (t(11) = -3.35, p = 0.007, d = 1.00). The training was rated as feasible, acceptable, appropriate, and likely to be adopted by CHWs and their supervisors. Nonjudgmental communication was commonly described as the most useful training component. Based on this pilot, the training is being refined and evaluated in a larger randomized stepped-wedge clinical trial.

There is little known about the family and community maltreatment of the offspring born of the genocidal rape and the offspring's self-perceptions and how they influence their recovery from mental health problems. This study aimed to examine how the mental health prognosis of these offspring could be influenced by the family or community perceptions and attitudes toward them and their self-perception and coping strategies.

Global mental health services face challenges such as stigma and a shortage of trained professionals, particularly in low- and middle-income countries, which hinder access to high-quality care. Mobile health interventions, commonly referred to as mHealth, have shown to have the capacity to confront and solve most of the challenges within mental health services. This paper conducted a comprehensive investigation in 2024 to identify all review studies published between 2000 and 2024 that investigate the advantages of mHealth in mental health services. The databases searched included PubMed, Scopus, Cochrane and ProQuest. The quality of the final papers was assessed and a thematic analysis was performed to categorize the obtained data. 11 papers were selected as final studies. The final studies were considered to be of good quality. The risk of bias within the final studies was shown to be in a convincing level. The main advantages of mHealth interventions were categorized into four major themes: 'accessibility, convenience and adaptability', 'patient-centeredness', 'data insights' and 'efficiency and effectiveness'. The findings of the study suggested that mHealth interventions can be a viable and promising option for delivering mental health services to large and diverse populations, particularly in vulnerable groups and low-resource settings.

Correctional workers (CWs) are frequently exposed to potentially traumatic events in the workplace, leading to an increased prevalence of mental health concerns. Online psychotherapy can address many of the barriers CWs face when seeking adequate mental health care. Despite their benefits, CWs' experience using digital mental health interventions is relatively unknown. This information could be valuable in developing enhanced care delivery to improve recruitment, retention, satisfaction, and treatment outcomes.

Integrating mental health services into HIV clinics is recognized as a promising strategy. However, the literature reveals gaps, particularly in the unique context of Northern Uganda, where factors such as historical conflict, stigma, and limited resources pose potential barriers.

Schools are critical venues for supporting LGBTQ+ youth well-being. Implementing LGBTQ-supportive practices can decrease experiences of stigmatization, discrimination, and victimization that lead to adverse mental health outcomes like anxiety, depression, and suicidality. However, schools are also subject to a wide range of outer-context pressures that may influence their priorities and implementation of LGBTQ-supportive practices. We assessed the role of emergent outer-context determinants in the context of a 5-year cluster randomized controlled trial to study the implementation of LGBTQ-supportive evidence-informed practices (EIPs) in New Mexico high schools.

People living with chronic hepatitis B (PLCHB) are recommended to follow a lifelong monitoring regimen and face increased risk of liver cancer. Additionally, PLCHB frequently encounter stigma and discrimination, and relationship disruptions because of their chronic hepatitis B (CHB). Social support plays a key role in coping with chronic illnesses; however, this is inadequately assessed for PLCHB. This study aims to assess the physical, social, and mental impacts of living with CHB, the strategies PLCHB utilize to cope with their disease, and how social support-or lack of-impacts their journey with hepatitis B. The study was promoted through the Hepatitis B Foundation social media platforms, interested individuals filled-in a form expressing their interest to participate. The researcher conducted 24 telephone interviews in English, with PLCHB ≥18 years of age residing in the United States (U.S.) and Canada. Questions focused on the lived experiences of CHB and explored social support mechanisms that helped PLCHB. PLCHB experience a wide range of impacts (physical, social, and mental) that negatively affect their quality of life. Participants reported that receiving social support from their close network of individuals, hepatitis B community, or healthcare providers positively influenced their perspective on their future health and helped them adhere to treatment. The physical, social, and mental impacts of living with hepatitis B significantly affect the quality of life of PLCHB, calling for more research to document these impacts, and design integrated care models to address them. Social support appears to play an essential role in helping PLCHB cope with their disease and should be further studied.

Psoriasis is a chronic autoimmune inflammatory skin condition characterized by erythema, papules, and scales. It imposes a heavy psychological and social strain on both patients and their families. Surprisingly, there's limited research delving into the disease burden and coping strategies of spouses contending with psoriasis.

Suicide is a leading cause of death for perinatal women. It is estimated that up to 50% of women with mental health issues during pregnancy and/or after birth are not identified, despite regular contact with healthcare services. Screening items are one way in which perinatal women needing support could be identified. However, research examining the content validity and acceptability of suicide-related screening items with perinatal women is limited.

Exposure to gender-related minority stressors, the negative experiences and beliefs that stem from anti-trans stigma increases transgender and gender diverse (TGD) people's vulnerability to experiencing poor mental health outcomes. This study examined if the relationships between experiences of minority stress and mental health outcomes were mediated by early maladaptive schemas: mental representations shaping the way people view themselves, others and the world. Drawing from a schema therapy perspective, the study additionally examined if caregivers' failure to meet TGD people's core emotional needs was associated with mental health outcomes and if schemas similarly mediated these relationships. A total of 619 TGD adults completed an online survey about early maladaptive schemas, core emotional needs, gender-related minority stress and psychological distress and wellbeing. Causal mediation analyses indicated that caregivers who did not meet TGD people's core emotional needs and greater experiences of minority stress were associated with increased distress and lower wellbeing. These relationships were mediated by schema severity, particularly the disconnection and rejection and impaired autonomy domains. These findings provide empirical support for the schema therapy model's assumption that unmet core emotional needs are associated with schema formation. For TGD people, maladaptive beliefs about the self, others and world can form in response to manifestations of anti-trans stigma within the individual, their interpersonal relationships, community and broader society. Caregivers' failure to meet needs, plus experiences of minority stress throughout the individual's system, leads to greater distress and lower wellbeing; however, clinical interventions targeting schemas may improve outcomes for this at-risk group.

Depression is a growing concern in university students and resilience has shown to play a protective role. The impact of stigma is still under-explored, with reference to its moderating role between depression and resilience. The present study investigate such a relationship among Italian university students.

Employing three cycles of Design Science Research (DSR) to develop a mobile app 'ESSC (Excellent Self Supervised HIV Care)' to improve self-management among people living with HIV (PLWH).

Mental health professionals are tasked with making difficult clinical decisions in treatment settings. In the forensic system, decision making regarding staff supervised community outings (SSCOs) provides a significant challenge due to the need to balance patient liberties, mental health recovery, and public safety. This study explored the characteristics and rehabilitative nature of SSCOs, characteristics of patients attending SSCOs, and any adverse events that occurred during the outings. Employing a cross-sectional design, 110 patients who participated in SSCOs over a one-year period from a Canadian Forensic Psychiatric Hospital were included. Clinical records were reviewed to capture patient and SSCO variables. Descriptive analyses were used to calculate participant, risk, SSCO, and adverse event characteristics. Qualitative analysis was used to explore the purpose of SSCOs and rehabilitative progress that occurred during the outings. Patients attending SSCOs were comprised of long-stay patients with over half having committed a violent index offence. Almost 75% of patients had a moderate/high risk for violence and 50% of the patients had a moderate/high risk of absconding. During the study period, 463 SSCOs were completed. Most outings focused on developing skills for daily living and staff comments suggested many patients developed skills in these areas. Despite considerable risk profiles and public concern regarding forensic patients having community access, there was a single occurrence of unauthorized leave and no instances of violence or substance use. This research can disrupt stigma, demonstrating that SSCOs support a specific rehabilitative intent, promote community reintegration, and maintain public safety.

Perceived stigmatization and low self-esteem are linked to poorer mental health outcomes, but their impact on treatment-seeking thresholds and the importance of outpatient service location remain unclear. The study included 525 outpatients of the University Psychiatric Clinic (UPK) Basel, Switzerland, of whom 346 were treated at inner city services and 179 at services located on the main site of the UPK at the outer city limits. Perceived discrimination and devaluation (PDD), self-esteem (SE), treatment-seeking threshold (TST), and accessibility were measured via a self-reported questionnaire. The PDD consisted of 12 items evaluating beliefs about the level of stigma towards individuals with mental illness in the general population on a 5-point Likert scale. SE, TST and accessibility were assessed through single-item 7-point Likert scales. PDD and SE were positively correlated ( < 0.001), suggesting that lower perceived stigma was linked to higher self-esteem, and were not associated with TST. The relationship between PDD and SE remained consistent after controlling for age, gender, and nationality. Age was negatively correlated with TST ( = 0.022), while gender did not significantly influence any of the variables. There was little variation regarding PDD, with emergencies at the site of the psychiatric clinic and substance use disorder (SUD) patients reporting higher levels of stigmatization. Emergency patients and those with SUD and personality disorder reported the lowest SE ratings. TST showed a broad range and was highest for emergency services and transcultural psychiatry patients. Differences in accessibility were mainly linked to the location, with outpatient service users in the inner city reporting better accessibility ( < 0.001) and higher SE ( = 0.009). In comparison to patients using services with planned contacts only, patients in emergency settings differed by higher TST ( = 0.018) and better ratings of accessibility ( = 0.004). In conclusion, there was a relevant amount of stigmatization, impaired self-esteem, and, for some outpatient services, high thresholds to seek treatment. Future research should explore other factors influencing TST. The findings highlight the need to address stigmatization and accessibility when planning mental health services.

Despite extensive research on clinical treatments for depression, there remains a significant gap in understanding of the lived experiences and recovery journeys of those with depression. This study sought to explore the recovery process through an "anti-stigmatizing" lens, emphasizing the cultural-psychological mechanisms at play and the importance of personal narratives in shaping the recovery trajectory.

Medical students experience high levels of stress, often due to academic demands, which can adversely affect their mental health. However, they frequently hesitate to seek and underutilise available mental health services. This study aimed to assess the perceived need for mental health services and identify the barriers to seeking help among undergraduate medical students.

People living with mental illness (PWMI) have significantly reduced life expectancy compared to the general population, yet mental healthcare providers (MHCPs) do not regularly prescribe exercise, despite its proven health benefits.

Patient-Reported Experience Measures (PREMs) are gaining significance in the field of psychiatry, with patient satisfaction being a key measure. However, it is unclear if patient satisfaction in psychiatry is influenced by variables outside the treatment setting. This brief report thus examines the possible impact of perceived discrimination and devaluation (PDD) on patient satisfaction in the psychiatric outpatient setting. Data from 1,126 individuals who were undergoing or had recently completed treatment at 15 outpatient centers of the Psychiatric University Clinic in Basel, Switzerland, was analyzed. Patient satisfaction was assessed using the Münsterlingen Patient Satisfaction Questionnaire (MüPF), and perceived stigma was measured with the Perceived Discrimination Devaluation Scale. The results revealed a positive small effect size relationship between MüPF and PDD, suggesting that patients who perceived less stigma report higher treatment satisfaction. This relationship may affect most ratings, with the total MüPF score remaining relatively robust against this potential influence. Linear regression analysis indicated that a one-unit increase in PDD score could lead to a maximum change of 1.8 points on the 7-point Likert scale for the MüPF item correlating highest with PDD and 0.4 points on the total MüPF score. These findings highlight the importance of considering perceived stigma when evaluating patient satisfaction with psychiatric outpatient treatment. Future research should investigate associations between stigma, patient satisfaction, treatment outcome, as well as other external factors that may influence patient satisfaction in psychiatric settings.

Caring for the mentally ill involves numerous challenges, including financial difficulties, stigma, and psychosocial issues, among others. Unpaid family caregivers must endure these challenges as they continue their care for their relatives with mental illness. Despite these burdens and their concomitant effects on both the patients and their caregivers, there is no evidence of this burden in the Bolgatanga municipality. This study explored the burden on family caregivers providing care for mentally ill relatives in the Bolgatanga Municipality of the Upper East Region of Ghana. The study employed a phenomenological research design. Fifteen family caregivers were purposively sampled from two secondary-level health facilities. In-depth interviews were conducted, audio-recorded, and transcribed verbatim. NVivo 12 pro software was used for data analysis. Thematic analysis was conducted following Braun and Clarke's approach. The study identified three themes including social, physical, and psychological burdens. Under social burden, financial challenges and stigma were identified, weight loss was identified as a physical burden, and poor concentration as a psychological burden. These themes represent the challenges encountered by the family caregivers as they provided care for their mentally ill relatives. There is a need to provide support for family caregivers including respite, formation of support groups, and financial support to alleviate family caregivers of the burdens they endure. Additionally, it is imperative to integrate mental health services into the national health insurance scheme to alleviate the financial burden on family caregivers.

Stress is a challenge among non-specialist health workers worldwide, particularly in low-resource settings. Understanding and targeting stress is critical for supporting non-specialists and their patients, as stress negatively affects patient care. Further, stigma toward mental health and substance use conditions also impacts patient care. However, there is little information on the intersection of these factors. This sub-analysis aims to explore how substance use and mental health stigma intersect with provider stress and resource constraints to influence the care of people with HIV/TB. We conducted semi-structured interviews (=30) with patients (=15) and providers (=15, non-specialist health workers) within a low-resource community in Cape Town, South Africa. Data were analyzed using thematic analysis. Three key themes were identified: (1) resource constraints negatively affect patient care and contribute to non-specialist stress; (2) in the context of stress, non-specialists are hesitant to work with patients with mental health or substance use concerns, who they view as more demanding and (3) stress contributes to provider stigma, which negatively impacts patient care. Findings highlight the need for multilevel interventions targeting both provider stress and stigma toward people with mental health and substance use concerns, especially within the context of non-specialist-delivered mental health services in low-resource settings.

Organisational and individual barriers often prevent university students from seeking mental health support. Digital technologies are recognised as effective in managing psychological distress and as a source of health-related information, thus representing useful options to address mental health needs in terms of accessibility and cost-effectiveness. However, university students' experiences and perspectives towards such interventions are little known.

Despite the evidence for the effectiveness of psychosocial interventions for perinatal depression, their uptake is low in Low- and Middle-Income Countries. Reasons for this include the lack of contextually adapted interventions and mental health specialists to deliver them. This study aimed to test the acceptability and feasibility of a psychosocial intervention for perinatal depression, the Thinking Healthy Programme-Peer Delivered, adapted for use in rural Malawi. A multi-method evaluation of feasibility and acceptability of the intervention was conducted using a one-group pretest-posttest quasi-experimental design and an exploratory qualitative study. Pre-post intervention change in depression scores (paired t-test) and recruitment, retention and session adherence rates were calculated. Qualitative data were collected through 29 in-depth interviews (22 mothers and 7 peer volunteers) and 1 Focus Group Discussion (18 mothers). Thematic analysis approach was used to analyse qualitative data. Seven (7) out of 8 peer volunteers were successfully trained to deliver the intervention. A total of 31 pregnant women with Edinburgh Postnatal Depression Scale (EPDS) score ≥12 were offered intervention, of whom 24 were enrolled (recruitment rate 77.4%). Out of these 24 women, 22 completed the intervention (retention rate 91.6%). Mean difference between pre- and post-test EPDS scores one week after 8th session was 7.59 (95% CI 4.98 to 10.19), p<0.001. Qualitative evaluation showed that the intervention was acceptable despite some challenges including stigma and issues around incentivization of peer volunteers. The Thinking Healthy Programme-Peer Delivered, adapted for use in Malawi, was feasible to deliver and acceptable to its target population. The intervention may be useful in management of perinatal depression in primary care settings in Malawi. However, definitive trials are needed to evaluate its effectiveness.