Community Mental Health Journal最新文献

{"title":"Mental Health and Individual Resilience in Contexts of Social Vulnerability: Evidence from Rural Texas.","authors":"Elizabeth Ekren, Shadi Maleki, Kanchan Shakya, Melinda Villagran","doi":"10.1007/s10597-026-01653-2","DOIUrl":"https://doi.org/10.1007/s10597-026-01653-2","url":null,"abstract":"","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma and Relationship and Sexual Life in People with Severe Mental Disorders: A Systematic Review.","authors":"Gabriela Díaz-Pérez, Pamela Grandón, Dany Fernández, Camila Navarrete-Valladares","doi":"10.1007/s10597-026-01644-3","DOIUrl":"https://doi.org/10.1007/s10597-026-01644-3","url":null,"abstract":"<p><strong>Background: </strong>Stigma negatively affects the well-being of individuals with severe mental disorders (SMD). However, its specific impact on romantic and sexual intimacy remains fragmented in the literature. This study aimed to identify which aspects of intimate life are affected by stigma and the factors mediating this relationship.</p><p><strong>Methods: </strong>A systematic review following PRISMA-P guidelines was conducted using Scopus, Web of Science, PubMed, EBSCOhost, VHL, and SciELO without date restrictions. Due to high methodological heterogeneity among the 26 included studies, a narrative synthesis was utilized to integrate findings.</p><p><strong>Results: </strong>Findings involving participants with Schizophrenia Spectrum, Bipolar, and Major Depressive Disorders reveal distinct stigma mechanisms. Medication side effects (e.g., sexual dysfunction, weight gain) act as catalysts for internalized stigma, transforming physical symptoms into barriers for romantic desirability. Gender norms exacerbate exclusion: women face intense scrutiny regarding parenting capacity and are vulnerable to intimate partner violence to avoid isolation, while men perceive functional impairment as a failure of masculine identity. Additionally, professional silence regarding sexuality reinforces the 'asexual' stereotype, leaving relational needs unsupported.</p><p><strong>Conclusion: </strong>The results underscore that stigma permeates the intimate lives of individuals with SMD through biological, social, and professional pathways. Clinical practice must urgently integrate sexual health assessments and relational support into routine care. Future interventions should focus on reducing professional bias and supporting the sexual and reproductive rights of this population.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involvement in the Shadows: A Qualitative Interview Study on Informal Caregiver Involvement in the Formal Care Trajectories of Individuals Living with Severe Mental Health Problems.","authors":"Leonarda G M Bremmers, Leona Hakkaart-van Roijen, Carin A Uyl-de Groot, Isabelle N Fabbricotti","doi":"10.1007/s10597-026-01652-3","DOIUrl":"https://doi.org/10.1007/s10597-026-01652-3","url":null,"abstract":"<p><p>Informal caregivers play a crucial and continuous role in supporting individuals living with severe mental health problems, hereinafter referred to as supported individual, yet their involvement in formal care remains poorly understood. While existing research has often focused on professional perspectives or institutional barriers, the lived experiences of caregivers, how they perceive and negotiate their roles and shifts in involvement with formal care, have received limited attention. This qualitative study addresses these research gaps by investigating how twenty informal caregivers experienced their involvement in the formal care trajectories of individuals living with severe mental health problems across different care settings in the Netherlands. Through in-depth interviews, we identified three archetypes of caregiver involvement with formal care: the Active Partner, the Formalized Caregiver, and the Disconnected Caregiver. These archetypes represent different degrees and qualities of caregiver involvement and show how caregivers move between roles over time, influenced by interpersonal relationships, professional attitudes, legal constraints, and systemic challenges. Rather than being fixed, caregiver involvement is shown to be a dynamic, negotiated process shaped by all members of the care triad, the supported individual, the professional, and the caregiver, as well as the broader care system. The study highlights how caregivers who occupy the role of the Formalized Caregiver often assume significant responsibilities without adequate recognition or support, while those positioned as the Disconnected Caregiver is excluded from the formal care trajectory or unable to participate in ways that align with their own wishes and capacities. However, if relationships within the care triad are characterized by trust, open communication, and mutual respect, caregivers can assume the role of Active Partner. By drawing on caregivers' lived experiences, this study offers a nuanced and empirically grounded understanding of caregiver involvement in practice, providing new insights for the development of more inclusive and supportive care systems for caregivers and ultimately the individuals they support.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Racial Discrimination and Prevalence of Major Depressive Disorder Among Black Canadian Youths.","authors":"Folajinmi Oluwasina, Andre M N Renzaho, Delores Mullings, Joanna Henderson, Kwame McKenzie, Hayley Hamilton, Tolulope Sajobi, Ambikaipakan Senthilselvan, Cecile Rousseau, Bukola Salami","doi":"10.1007/s10597-026-01614-9","DOIUrl":"https://doi.org/10.1007/s10597-026-01614-9","url":null,"abstract":"<p><p>Major depressive disorder (MDD) is a complex and multifaceted mental health condition with far-reaching implications for youth well-being and society. This paper examined the prevalence of depressive symptoms consistent with probable MDD and their association with self-reported experiences of racial discrimination within the Black youth population in Canada. This study used a descriptive cross-sectional design. Questionnaires were administered via an anonymous online survey. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), a self-report screening tool, with scores ≥ 10 indicating symptoms consistent with probable MDD rather than a clinical diagnosis. Experiences of discrimination were measured using self-reported items adapted from previously validated discrimination instruments. Data were analyzed using descriptive statistics, chi-square tests, and multivariable logistic regression(p ≤ 0.05). A total of 933 Black youth participated in this survey. Black youth who reported unfair treatment due to their skin colour or race were 18 times more likely to express MDD than those who had not (OR: 18.38; 95% CI: 2.796-7.17 ). Similar associations were observed for self-reported discrimination based on language accent (OR = 4.40; 95% CI: 1.01-19.24) and culture (OR = 12.29; 95% CI: 1.47-12.53). Black youth who have been treated unfairly due to their culture were 12 times more likely to experience MDD than those who had not (OR: 12.29; 95% CI: 1.473-12.530). This study demonstrates a significant association between perceived unfair treatment and depressive symptoms (consistent with probable MDD) among Black Canadian youth. The findings suggest that racial, linguistic, and cultural discrimination are associated with poorer mental health outcomes in this group. Culturally sensitive interventions and policies that promote inclusivity and equity can help Black youth with MDD.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing Coordinated Specialty Care Programs for Psychosis Across the U.S.: State-Level Administrator and Provider Perspectives.","authors":"Oladunni Oluwoye, Ari Lissau, Elizabeth Fraser, Alexandria Selloni, Naje James, Deidre Anglin","doi":"10.1007/s10597-026-01634-5","DOIUrl":"https://doi.org/10.1007/s10597-026-01634-5","url":null,"abstract":"","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing Digital Suicide Risk Screening in Behavioral Health: a Mixed-methods Study of Organizational Adaptation.","authors":"Bri Beverly, Matt Miclette, Hilah Kaufman, Dan Holley, Amanda Brooks, Tom Zaubler","doi":"10.1007/s10597-026-01647-0","DOIUrl":"https://doi.org/10.1007/s10597-026-01647-0","url":null,"abstract":"<p><p>Digital behavioral health platforms extend clinical capabilities beyond traditional appointment-based care, but implementation challenges limit their routine use. Although validated suicide risk screening instruments exist and evidence suggests individuals provide honest responses in digital contexts, how behavioral health organizations implement asynchronous screening remains poorly understood. This exploratory study examined implementation experiences from nine behavioral health organizations that adopted digital suicide screening. Nine behavioral health organizations that implemented remote, asynchronous Columbia Suicide Severity Rating Scale (C-SSRS) screening completed post-implementation surveys. Using a mixed-methods approach combining Interpretative Phenomenological Analysis and VADER sentiment analysis, we identified implementation patterns, organizational adaptations, and provider attitudes across diverse service settings. Implementation challenges clustered into operational, technical, clinical, and systemic domains. Operational challenges involved workflow integration, staff training, and protocol development, while technical challenges included EHR integration, digital divide concerns, and alert volume management. Clinical challenges centered on screening quality, therapeutic rapport, and risk factor evaluation, while systemic challenges reflected resource constraints, crisis response protocols, and staff capacity. Provider attitudes evolved from initial anxiety and role uncertainty in early-stages to strong support among advanced-stage organizations, where 48% expressed very supportive and 32% expressed moderately supportive sentiments. Sentiment analysis of alert-workflow responses indicated generally positive attitudes across organizations (mean score = 0.24 on a scale of -1 to 1). Two preliminary frameworks emerged from analysis: the Service Delivery Ecosystem Framework describes context-specific adaptation patterns observed in this sample, and the Implementation Stage Framework characterizes common progression from initial rollout to mature implementation. These findings offer preliminary considerations for organizations planning digital suicide screening integration.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Providers' Perceptions of Trauma-Focused EBT/EBP Implementation Fidelity: Implementation Process and Individual Influences.","authors":"Stephanie Gusler, Ginny Sprang, Jessica Eslinger, Adrienne Whitt","doi":"10.1007/s10597-025-01553-x","DOIUrl":"10.1007/s10597-025-01553-x","url":null,"abstract":"<p><p>Implementation fidelity is the extent to which an intervention is delivered in the manner in which it was designed. Within randomized-controlled trials (RCTs), fidelity is often rigorously ensured through strategies out of reach for most organizations. This limitation may be of particular concern for trauma-focused evidence-based treatments/evidence-based practices (EBT/EBPs), as the needs of individuals and families seeking trauma-based treatment are often complex, with existing comorbidities that can complicate recovery. The present study used the Consolidated Framework for Implementation Research (CFIR) to examine implementation process and individual characteristics, as well as interactions among these factors in impacting provider's perceptions of fidelity. Data came from 598 primarily child serving mental health providers, who completed an online survey regarding provider demographics, perceptions of personal effectiveness, work experiences such as secondary traumatic stress (STS) and compassion satisfaction, and organizational implementation strategies used for a trauma-focused EBT/EBP. Significant positive associations were found between perceptions of implementation fidelity and compassion satisfaction, implementation strategy use, and personal effectiveness. Further, STS was significantly negatively associated with implementation fidelity. Significant differences were found based on population served and use of consultation calls and in-person supervision. Within a regression model, a significant two-way interaction between STS and implementation strategy use was significant, along with a three-way interaction between STS, implementations strategy use, and personal effectiveness. This study advances our understanding of how fidelity is created, maintained and understood in implementation settings that provide EBT/EBPs to individuals exposed to trauma.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"632-643"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine Outcome Changes Associated with Brief Psychological Interventions Delivered by Assistant Psychologists and Trainee Associate Psychology Practitioners in a Crisis Resolution and Home Treatment Team.","authors":"Lydia Pearson, John Cunningham, Katie Pownell","doi":"10.1007/s10597-026-01650-5","DOIUrl":"https://doi.org/10.1007/s10597-026-01650-5","url":null,"abstract":"<p><p>Psychological interventions are recommended for people under Crisis Resolution Home Treatment Teams (CRHTTs). Non-registered psychology roles (Assistant Psychologists (APs) and Trainee Associate Psychological Practitioners (TAPPs)) are potentially both cost and clinically effective for delivering brief interventions in CRHTTs. This study aimed to quantitatively examine routine outcome change associated with two brief, skills-based interventions (the Crisis Toolbox (CTB) and the Emotion Coping Skills (ECS)) delivered by APs and TAPPs in one CRHTT. A retrospective service evaluation of 490 service users who accessed either the CTB or ECS between June 2020 and February 2025 was employed. The Clinical Outcomes in Routine Evaluation - 10 (Core-10) and Mental Health Confidence Scale (MHCS) measures were completed pre- and post- intervention. Paired samples t-tests were conducted and demographics (age, gender, and ethnicity) collected. There was a statistically significant effect in improving scores on both measures at the post-intervention timepoint (CORE-10: 8.636, 95% CI [7.810 to 9.461], t(297) = 20.586, p < .001; MHCS: -13.537, 95% CI [-14.827 to -12.237], t{293) = -20.568, p < .001). This significant effect remained when looking at males and females separately. Asian and Black ethnic groups were underrepresented in the sample compared to local demographics, whilst other ethnic groups showed similar representation. Findings suggest that CTB and ECS may be clinically effective in reducing distress and increasing confidence in coping with mental health challenges for service users. Additionally, this evaluation has highlighted the need for better understanding UK ethnic minority representation in CRHTTs and consideration of possible barriers to access.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Shared Decision-Making in Youth Psychiatry: a Dynamic Continuum of Decision-Making Practices.","authors":"Raffaella Di Schiena, Pauline Reciputi, Maxime Morsa","doi":"10.1007/s10597-025-01572-8","DOIUrl":"10.1007/s10597-025-01572-8","url":null,"abstract":"<p><p>While shared decision-making (SDM) is widely recognized as a reference model in adult psychiatry, its implementation in youth psychiatry remains under-explored, despite the specific challenges inherent to this field. This exploratory qualitative study investigates how child and adolescent psychiatrists describe and adjust their decision-making practices in clinical care, including their attitudes, strategies, and perceived limits of SDM. Sixteen semi-structured interviews were conducted with youth psychiatrists via videoconferencing. Data were analyzed using thematic analysis. Five overarching themes were developed : (1) the perceived benefits of SDM, such as improved adherence and engagement; (2) a dynamic continuum of decision-making practices, from full collaboration to ethically guided protective decisions; (3) the role of parents as co-participants in the decision-making process; (4) the modulation of the clinician-patient relationship along a vertical-horizontal axis; and (5) contextual influences, including institutional constraints and limited resources. Psychiatrists generally support SDM as a desirable framework. However, their accounts point to a broader and more flexible continuum of practices, in which the degree of sharedness varies depending on factors such as the young person's age, developmental stage, illness severity, crisis situations, and parental involvement. Some practices described by clinicians fall outside strict definitions of SDM and belong instead to the domain of substituted or protective decision-making. These findings invite a nuanced and context-sensitive understanding of decision-making in youth psychiatry.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"803-814"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Crisis Gap: A Scoping Review of Psychological Distress and Help-Seeking Behaviors in Black Americans Using Crisis Hotlines.","authors":"Geremew Werkeshe Wana, Samir Kumar Sarker Rony, Md Rakibul Hasan, Ryan M Combs","doi":"10.1007/s10597-025-01569-3","DOIUrl":"10.1007/s10597-025-01569-3","url":null,"abstract":"","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"766-782"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}