Community Mental Health Journal最新文献

{"title":"\"Because I Am a Female\": Stigma and Safety Perspectives from Racially/Ethnically Diverse Women with Serious Mental Illnesses.","authors":"Aanchal Modani, Kristen Gurdak, Layla Al Neyadi, Melissa E Smith, Erin Kelly, Helle Thorning, John S Brekke, Rohini Pahwa","doi":"10.1007/s10597-024-01346-8","DOIUrl":"10.1007/s10597-024-01346-8","url":null,"abstract":"<p><p>Individuals with serious mental illnesses (SMIs) face safety risks related to their mental health conditions that are often compounded by experiences of trauma, victimization, residence in impoverished neighborhoods, and histories of homelessness. Stigma and safety challenges significantly impact community integration for individuals with SMIs, particularly women, who often bear a disproportionate burden of vulnerability, gender-based stigma, violence, and other inequalities. This study investigates how women with SMIs engage in the meaning-making of their safety and stigma experiences that, in turn, influence their community integration. From a large multi-site study exploring community experiences of racially/ethnically diverse participants with SMIs, a subsample of 28 cis and trans-gender women, who reported experiencing gendered stigma and a lack of safety, were chosen for the current study. The interviews were analyzed using modified principles of Interpretive Phenomenological Analysis (IPA) to understand how women with SMIs made meaning of their safety and stigma encounters in their families, communities, and neighborhoods. IPA analysis resulted in the emergence of themes within a broad category of safety that represented participants' meaning-making about their physical safety and stigma experiences. Specifically, we used the broad themes from an existing framework of safety called 'Navigating Safety' model as sensitizing concepts for our analysis. Physical and psychological aspects of safety for this study were experienced in tandem whereby the women made sense of how their experiences of a lack of physical safety in multiple contexts shaped their sense of self, internalized stigma, and their social relationships. Within the broad theme of physical safety, participants described unsafe neighborhoods, exposure to domestic and intimate partner violence, and vulnerability to sexual violence. Additionally, under psychological safety, we identified how gender-based norms, race and ethnicity, sources of stigma (internalized, familial, and societal), and social isolation contributed to their mental health and social relationships (particularly with family). These findings highlight how the compounding influence of the intersection of multiple stigmatized identities exerts safety challenges on the lives and community experiences of women with SMIs. Focusing on access and affordability of appropriate gender-responsive resources for women, including trauma-informed care, could reduce hospitalizations, mental health symptoms, and stigma so they can safely integrate into their communities.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"420-431"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079525","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":"Virtual Service Delivery in Mental Health and Substance Use Care: A Systematic Review of Preference Elicitation Studies.","authors":"Carly Mallise, Laura Wall, Francesco Paolucci, Kate Davies, Gina La Hera Fuentes, Jessica Wilson, Campbell Tickner, Frances Kay-Lambkin, Milena Heinsch","doi":"10.1007/s10597-024-01350-y","DOIUrl":"10.1007/s10597-024-01350-y","url":null,"abstract":"<p><p>Mental health and substance use disorders affect the lives of many people worldwide. Prevention and treatment of these conditions is important for optimal health and wellbeing, yet service access barriers are common. Virtual models of care may help to reduce barriers to receiving care. However, to facilitate uptake and use of virtual services, they need to appeal to patients and clinicians. This systematic review aimed to synthesise preference elicitation studies to determine what features of virtual mental health and substance use care are preferred by service users and service providers. Following the PRISMA guidelines for systematic reviews, we searched PubMed, PsycINFO, EconLit, MEDLINE, CINAHL, Academic Search Ultimate, and ProQuest Central for all available studies from database inception until May 2023. The Mixed Methods Appraisal Tool was used to assess the methodological quality of included studies. Nineteen studies met the eligibility criteria. However, none examined preferences for elements of different models of virtual care. Across the included studies, we identified 41 unique features that mapped to four themes of mental health and substance use care ('service', 'treatment', 'clinician' and 'additional supports'). Participant preferences were for individual, in-person, effective, flexible, and low-cost treatment. These preferences varied based on demographic factors, such as culture, gender, and participant type (e.g., patients, clinicians, general population). A user-centred approach should be adopted when designing and implementing mental health and substance use services. While preferences for features of mental health and substance use services more broadly are known, preferences for different models of virtual care remain unexplored. Future research should examine what features of virtual services would lead to optimal uptake and use across different users and stakeholders.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"440-461"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Acculturative Stress on the Mental Health of Immigrant Youth: A Scoping Literature Review.","authors":"Doukessa Lerias, Tahereh Ziaian, Emily Miller, Nancy Arthur, Martha Augoustinos, Tara Pir","doi":"10.1007/s10597-024-01351-x","DOIUrl":"10.1007/s10597-024-01351-x","url":null,"abstract":"<p><p>Acculturation after settlement has been identified as a risk factor affecting the mental health of immigrant youth. Increasing rates of immigration and expanding populations of immigrant youth mean that addressing their mental is a priority. Acculturative stress is the stress-response resulting from the effects of multiple stressors that result from the need to acculturate. Among youth within the developmental stages of late adolescence and emerging adulthood, increased sensitivity to stress, and developmental demands, impact their mental health. The effects of acculturative stress place an additional burden on the mental health of immigrant youth. This scoping review examined existing literature that investigated a variety of relationships between acculturative stress and youth mental health. A comprehensive search strategy that focused on studies involving youth, mainly aged between 15-24, with a proximal history of international migration, published between 2012-2022, resulted in a collection of fifty-three studies. This review examined significant relationships between acculturative stress and major depression, anxiety disorders, eating disorders, substance misuse, behavioural problems and poor psychological wellbeing. This scoping review was truly explorative as it included youth from immigrant minorities, had no geographical limits, and included various study designs. Acculturative stress continues to be an important contributor to the mental health of youth who have a proximal history of international migration. This review provided an exploration of the state of research, identified the importance of the settlement context, and provided recommendations for the direction of future studies, supportive policies, and practice considerations, related to the mental health of immigrant youth.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"462-491"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding and Navigating the Unique Barriers Rural Primary Care Settings Face when Implementing Collaborative Care for Mental Health.","authors":"Elizabeth J Austin, Elsa S Briggs, Angel Cheung, Erin LePoire, Brittany E Blanchard, Amy M Bauer, Morhaf Al Achkar, Diane M Powers","doi":"10.1007/s10597-024-01348-6","DOIUrl":"10.1007/s10597-024-01348-6","url":null,"abstract":"<p><p>Rural primary care (RPC) clinics may face unique barriers to implementing the Collaborative Care Model (CoCM). We used mixed methods to explore RPC staff and practice facilitator (PF) perspectives on CoCM implementation. PFs reported on barriers and facilitators experienced after each monthly meeting with clinics (n = 459 surveys across 23 clinics). Data were analyzed descriptively and informed qualitative interviews with a purposive sample (n = 11) of clinic staff and PFs. Interviews were analyzed using Rapid Assessment Process and triangulated with quantitative data. The most prominent barriers experienced were: (1) the COVID-19 pandemic, (2) limited availability of site staff to participate in implementation activities, and (3) hiring of new CoCM staff. Qualitative data further characterized the ways these barriers uniquely influenced RPC settings and promising implementation strategies. RPC settings face unique challenges to CoCM implementation, but several promising implementation strategies - when tailored to RPC contexts - may help.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"401-410"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139553","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":"Early Health Impacts of a Primary Care Consultation Model for People Served by Assertive Community Treatment teams.","authors":"Pavithra Jaisankar, Emily Kingman, Drew LaStella, Elisa Chow, Edward Tabasky, Jeanie Tse","doi":"10.1007/s10597-024-01359-3","DOIUrl":"10.1007/s10597-024-01359-3","url":null,"abstract":"<p><p>The cardiometabolic health outcomes and life expectancy of people living with serious mental illness (SMI) continue to significantly flag behind that of the general population. This study explores the possibility of using the evidence-based Assertive Community Treatment (ACT) model and infrastructure to increase access to primary care and improve cardiometabolic outcomes of people with SMI. Four ACT teams in a large urban area received the services of a primary care consultant who was co-located at a Federally Qualified Health Center (FQHC), met regularly with ACT team clinicians to review a cardiometabolic registry of participants, and engaged participants in primary care services. Health screening rates, primary care utilization, and cardiometabolic outcomes-body mass index, blood pressure, hemoglobin A1c, cholesterol, and tobacco smoking status-were monitored over the course of a year. The efficacy of this integrated care model was also explored through focus groups with ACT team staff and participants. Significant improvements in screening rates were found for the ACT teams that received this integrated care intervention; however, only modest improvements in cardiometabolic outcomes were found. Future longitudinal, multi-site studies are needed to fully determine the impact of integrated care models on the physical health outcomes of this vulnerable population.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"523-530"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371214","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":"Promoting a Clinic-Based Approach to Behavioral Health Integration and Serious Mental Illness in Free and Charitable Clinics Through Project ECHO.","authors":"Kathryn West, Binta Ceesay, Ornella Razetto, Saqi Maleque Cho, Christina Newport, April Hunter, Kanika Mittal, Karen Lee, Sebastian Otero, Daniel Johnson, Doriane Miller, Daniel Yohanna","doi":"10.1007/s10597-025-01461-0","DOIUrl":"https://doi.org/10.1007/s10597-025-01461-0","url":null,"abstract":"<p><p>The integration of behavioral health and serious mental illness assessment and treatment into primary care remains a challenge. While the increase in telehealth usage due to the COVID-19 pandemic helped reduce a key barrier to access, other challenges remain including a shortage of trained providers and an increased demand for services. A collaboration between ECHO-Chicago and Americares established a unique virtual medical education program that provided training and telementoring using the Project ECHO model with the integration of clinic-wide quality improvement (QI) projects. In this paper, we outline the process of adapting the existing Project ECHO^® (Extension for Community Health Outcomes) series on behavioral health integration and serious mental illness to fit the needs of Free and Charitable Clinics (FCCs). This project highlights the process and organizational-wide outcomes of creating a partnership between an ECHO hub and a national cross-section of FCCs to create a telehealth program to improve mental healthcare delivery within the FCC space that can be replicated and scaled more broadly. Through this process, we highlight evaluation methods to examine the impact of ECHO series beyond the individual to the clinic-wide level.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751364","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":"Racialized Immigrants' Encounters of Barriers and Facilitators in Seeking Mental Healthcare Services in Ontario, Canada.","authors":"Zoha Salam, Mirna Carranza, Bruce Newbold, Olive Wahoush, Ameil Joseph","doi":"10.1007/s10597-024-01362-8","DOIUrl":"10.1007/s10597-024-01362-8","url":null,"abstract":"<p><p>Racialized immigrants have low rates of accessing mental healthcare services. However, there are notable differences among immigrant groups (e.g., refugees, international students, dependants). The aim of this study is to understand racialized immigrants' experiences of accessing mental healthcare services at both systemic and individual levels. Through a qualitative descriptive methodology, interviews were conducted in English with 16 racialized immigrants to understand barriers and facilitators encountered. Additionally, focusing on how cultural and social conceptualizations ideas shape mental healthcare services. Interviews were analyzed through Braun & Clarke's six-step method to reflexive thematic analysis in identifying factors. Three major themes were identified: structural constraints, individual influences, and appraisal of services. With the first, racialized immigrants signaled to issues related to the systemic level that included affordability, wait times, and trust in the system. Individual influences highlighted factors of mental health literacy, social supports, stigma, severity of the issues, and awareness of services themselves. Lastly, extending on the previous theme, appraisal of services was reflective of how social and cultural ideals shaped attitudes towards the appropriateness of the provider or services themselves. The findings from this paper emphasize that racialized immigrants are not homogenous in their experiences and attitudes towards mental healthcare services. While there were similarities across different groups in the individual and systemic factors identified, there were key distinctions driven by appraisal of services themselves and if they were congruent based on their needs, more specifically, what was contributing to their negative mental health status.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"556-567"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307294","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":"Development and Implementation of Mental Healthcare Plans in Three Districts in Ghana: A Mixed-Method Process Evaluation Using Theory of Change.","authors":"Kenneth A Ae-Ngibise, L Sakyi, L Adwan-Kamara, T D Cooper, B Weobong, C Lund","doi":"10.1007/s10597-024-01357-5","DOIUrl":"10.1007/s10597-024-01357-5","url":null,"abstract":"<p><p>In Ghana, a severe mental healthcare gap of 95-98% exists due to limited services. Ghana Somubi Dwumadie set out to address this by developing district mental healthcare plans (DMHPs) in three demonstration districts. Following the Programme for Improving Mental Healthcare model, district mental health operations teams were formed and used Theory of Change (ToC) to develop DMHPs. Key elements included training non-specialist health workers and enrolling individuals in relevant healthcare programmes. Evaluation methods included routine data, health facility surveys, and qualitative analysis within the ToC framework. Results showed improved integration of mental health services, enhanced case management through training, and increased service utilisation, shown through 691 service user enrollments. However, there was limited commitment of new resources and no significant improvement in primary care workers' capacity to detect priority mental health conditions. The study concludes that DMHPs, implemented with an integrated approach, can improve mental health service utilisation, contingent on committed leadership, resource availability, and stakeholder engagement.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"509-522"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-based Collaborative Care for Serious Mental Illness: A Rapid Qualitative Evidence Synthesis of Health Care Providers' Experiences and Perspectives.","authors":"Saira Abdulla, Sherianne Kramer, Lesley Robertson, Samantha Mhlanga, Campion Zharima, Jane Goudge","doi":"10.1007/s10597-025-01459-8","DOIUrl":"https://doi.org/10.1007/s10597-025-01459-8","url":null,"abstract":"<p><p>Community-based collaborative care (CBCC) is an effective approach for addressing the needs of people with mental health conditions. However, even with the established components of CBCC in place, CBCCs effectiveness for serious mental illnesses (SMIs) remains unknown. This review aims to synthesize qualitative evidence of health care providers' experiences of CBCC in order to identify key factors that facilitate or hinder collaboration in the specific context of SMIs. We searched databases to identify 3368 studies. The eligibility criteria included qualitative studies focusing on health care providers' experiences in delivering a CBCC intervention for people with SMIs. Studies were included if they had at least 2 of 3 CBCC components: a multidisciplinary team, case management, and structured communication. Thematic analysis was used to synthesise the findings, and the Standards for Reporting Qualitative Research framework was used to assess the quality of included studies. The protocol is registered on Prospero. Of the 19 studies included in our review, 5 had achieved collaboration, which was driven by several key ingredients: the availability of on-site case managers and psychiatrists, or the psychiatrists' willingness to travel to the site; the psychiatrists' efforts in actively engaging and supporting the CBCC team; the primary care clinicians' willingness to collaborate with the team and reduce traditional hierarchical engagement; the team's understanding of CBCC; and case managers with strong interpersonal and professional skills. The inclusion of CBCC components do not guarantee collaboration. The findings emphasise the importance of on-site mental health specialists, clearly defined roles, and proactive providers in achieving collaboration.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718172","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":"A Participatory Survey to Investigate the Long-Term Effectiveness of Adult Psychiatric Services (PSILEAPS): Baseline Data and Recruitment Experiences.","authors":"Tomi Bergström, Tapio Gauffin, Teija Hietasaari, Nina Koivuniemi, Anne Leinonen, Enni Öfverberg, Reetta Viitakoski, Timo Haaraniemi, Katja Partanen, Katariina Rantamaa, Vilhelmiina Yrjänheikki, Tiina Jauhiainen, Annika Olli, Jouko Miettunen, Jouni Petäjäniemi","doi":"10.1007/s10597-025-01462-z","DOIUrl":"https://doi.org/10.1007/s10597-025-01462-z","url":null,"abstract":"<p><p>In clinical psychology and psychiatry, traditional hypothesis testing is challenging due to the subjective and contextual nature of the studied phenomenon. To address this, more exploratory and participatory research is needed. This paper reports recruitment experiences and baseline data of a prospective exploratory cohort study with participatory elements, initiated in mental health services in one Finnish region. The primary aims, design, and survey for data collection were developed through community meetings involving local mental health workers, peer experts, and service users. Over 2 weeks, all mental health service users, their care teams, and social network members were asked to share their views on the reasons for needing services and what aspects of treatment have been or could be helpful or unhelpful. Descriptive statistics summarized baseline data, and simple thematic analysis examined field notes on supporting and hindering aspects of the study design. A total of 117 service users, 54 care team members, and 34 social network members participated, with a service user attrition rate of 40-50%. The study achieved 79% of the target sample size. Women and participants with mood disorder diagnoses and long-term service usage were overrepresented. Findings suggest that integrating participatory research into Finnish public mental health services would require additional resources. Despite its limitations, the collected data will facilitate exploratory research into real-life mental health treatment processes from various perspectives.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604133","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}