International Journal of Mental Health Systems最新文献

{"title":"The hidden clock: how chronotype is related to depression, anxiety, and stress in adolescents - insights from the EHDLA study.","authors":"Camila Miño, Lee Smith, Carlos Cristi-Montero, Héctor Gutiérrez-Espinoza, Jorge Olivares-Arancibia, Rodrigo Yañéz-Sepúlveda, Brendon Stubbs, José Francisco López-Gil","doi":"10.1186/s13033-025-00673-x","DOIUrl":"10.1186/s13033-025-00673-x","url":null,"abstract":"<p><strong>Background: </strong>Depression, anxiety, and stress symptoms are common among adolescents; however, studies exploring their relationship with chronotype in European youth populations is scarce. This study aimed to evaluate the association between chronotype status and depression, anxiety, and stress symptoms in adolescents.</p><p><strong>Methods: </strong>A secondary analysis of the Eating Healthy and Daily Life Activities (EHDLA) cross-sectional study was performed in 703 adolescents (56.3% girls) between 12 and 17 years from the Valle de Ricote, Spain. Chronotype preference was assessed using the Morningness/Eveningness Scale in Children (MESC), while symptoms were evaluated using the Depression, Anxiety, and Stress Scale (DASS-21). A robust generalized linear regression model was used to evaluate the associations between chronotype prefernces and symptoms of depression, anxiety and stress in adolescents.</p><p><strong>Results: </strong>After adjusting for potential covariates (sex, age, socioeconomic status, body mass index, sleep duration, physical activity, sedentary behavior, and energy intake), the highest probability of having depression, anxiety, and stress was identified in those with an eveningness chronotype preference (depression: 27.4%, 95% confidence interval [CI] 17.5-40.1%; anxiety: 28.5%, 95% CI 18.6-41.0%; stress: 47.6%, 95% CI 34.1-61.5%). Conversely, the lowest probability was observed in adolescents with a morningness chronotype preference (depression: 11.9%, 95% CI 8.3-16.8%; anxiety: 15.4%, 95% CI 11.2-28.9%; stress: 19.5%, 95% CI 14.7-25.5%). Significant differences were found when comparing participants with the eveningness chronotype to those with a morningness or intermediate chronotype preference (p < 0.05 for all comparisons).</p><p><strong>Conclusions: </strong>Depression, anxiety, and stress symptoms were more likely in adolescents with an eveningness chronotype preference than in those with morningness or intermediate chronotypes. Chronotype preferences should be taken into account for developing interventions that promote better mental health and healthy sleep habits in adolescents.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"16"},"PeriodicalIF":3.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing an integrated depression and tuberculosis care pathway using a co-design approach in a low-resource setting.","authors":"Olamide Todowede, Zara Nisar, Saima Afaq, Sushama Kanan, Aliya Ayub, Rumana Huque, Akhtar Hussain, Mudasser Shehzad, Najma Siddiqi","doi":"10.1186/s13033-025-00670-0","DOIUrl":"10.1186/s13033-025-00670-0","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests the use of a participatory approach for the improvement of TB care, however, there is limited evidence on how integrated depression screening and care could be delivered with TB services. Thus, this study co-designed an integrated care pathway for depression case finding and treatment in TB services, that can be delivered by non-mental health specialists within a low resourced settings.</p><p><strong>Methods: </strong>We conducted a total of 10 'co-design' workshops with people with TB, carers, tuberculosis and mental health healthcare providers between June and August 2021 in Dhaka, Bangladesh and Peshawar, Pakistan. We adapted the 'Hasso Plattner Institute of Design at Stanford University' for our codesign process. Information gathered during the workshop, through recordings and contemporaneous notes taking, was collated, and analysed to develop the integrated care pathways and materials for impmenting the carepathway.</p><p><strong>Results: </strong>We co-designed and developed a culturally adaptable care pathway that integrates depression screening into tuberculosis (TB) care, working closely with people affected by TB and healthcare workers in primary, secondary, and tertiary care settings in Bangladesh and Pakistan. We used PHQ-9 only to identify and screen for depression among people with TB in Bangladesh, whereas both PHQ-2 and PHQ-9 were used for depression screening among the Pakistani population. A trained paramedic or laboratory technologist (Bangladesh) and DOTS Facilitator (Pakistan), working within the TB facilities were identified and agreed to deliver the integrated depression screening services.</p><p><strong>Conclusion: </strong>Stakeholders valued the opportunity to jointly design a care pathway. Iterative and coordinated working with these stakeholders enabled the researchers to understand better, explore and refine the co-design process. This approach assisted in mobilising knowledge about depression and integrating screening for depression within the existing usual TB care pathway, using the lived experience of people with TB and health workers' expertise.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"15"},"PeriodicalIF":3.1,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative life events, inadequate mental health literacy, and emotional symptoms among Chinese college students: a school-based longitudinal prospective study.","authors":"Shichen Zhang, Rong Yang, Yingying Cui, Yi Zhou, Linlin Jiang, Jingjing Xi, Jun Fang","doi":"10.1186/s13033-025-00672-y","DOIUrl":"https://doi.org/10.1186/s13033-025-00672-y","url":null,"abstract":"<p><strong>Background: </strong>Emotional symptoms have emerged as a major public health concern, affecting the mental and physical well-being of college students worldwide. Negative life events and mental health literacy are commonly recognized as significant predictors of emotional symptoms. However, research on their combined effects remains limited, particularly in longitudinal studies. This study aimed to investigate the interaction between negative life events and mental health literacy in relation to emotional symptoms among college students.</p><p><strong>Methods: </strong>A longitudinal study was conducted from November 2021 to June 2022 to assess negative life events, mental health literacy, and emotional symptoms among college students. A total of 3,210 students (mean age: 19.49 ± 0.87 years) were selected using a cluster sampling method in Anhui Province, China. Multivariate logistic regression models were employed to evaluate the combined effects of negative life events and mental health literacy on emotional symptoms.</p><p><strong>Results: </strong>The prevalence of depressive symptoms, anxiety symptoms, and stress symptoms was 15.3%, 19.7%, and 4.2%, respectively. Negative life events were significantly associated with an increased risk of depressive symptoms (RR = 1.568, 95%CI: 1.282-1.918), anxiety symptoms (RR = 1.603, 95%CI: 1.338-1.919), and stress symptoms (RR = 1.717, 95%CI: 1.194-2.470). Additionally, students with inadequate mental health literacy exhibited a higher incidence of depressive symptoms (RR = 1.286, 95%CI: 1.035-1.597) and anxiety symptoms (RR = 1.343, 95%CI: 1.105-1.632) compared to those with adequate mental health literacy. Furthermore, students who experienced high levels of negative life events and had inadequate mental health literacy were at the highest risk of developing depressive symptoms (RR = 2.447, 95%CI: 1.709-3.504) and anxiety symptoms (RR = 2.466, 95%CI: 1.802-3.375).</p><p><strong>Conclusion: </strong>This study did not confirm a direct correlation between mental health literacy and general psychological health. Moreover, due to contextual differences across societies, the generalizability of these findings should be approached with caution. Nonetheless, the results highlight that negative life events and mental health literacy jointly influence emotional symptoms. These findings underscore the importance of interventions aimed at improving college students' mental health literacy and enhancing their ability to cope with negative life events.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"14"},"PeriodicalIF":3.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alternative approaches to standard inpatient mental health care: development of a typology of service models.","authors":"Jessica L Griffiths, Helen Baldwin, Jerusaa Vasikaran, Ruby Jarvis, Ramya Pillutla, Katherine R K Saunders, Ruth E Cooper, Una Foye, Luke Sheridan Rains, Molly Lusted-Challen, Phoebe Barnett, Geoff Brennan, Steven Pryjmachuk, Karen Newbigging, Jo Lomani, Rachel Rowan Olive, Lizzie Mitchell, Patrick Nyikavaranda, Chris Lynch, Karen Persaud, Brynmor Lloyd-Evans, Alan Simpson, Sonia Johnson","doi":"10.1186/s13033-025-00669-7","DOIUrl":"https://doi.org/10.1186/s13033-025-00669-7","url":null,"abstract":"<p><strong>Background: </strong>Inpatient mental health care is an integral part of the continuum of mental health care in many countries, though it can be associated with challenges, such as reliance on coercive practices, negative patient experiences, and limited therapeutic options. Given these issues, there is a growing interest in exploring alternative approaches for individuals experiencing a mental health crisis. This research aimed to identify models which offer an alternative to standard inpatient mental health care across all age groups, both nationally and internationally, and to develop a typology for these alternative models.</p><p><strong>Methods: </strong>A dual literature search and expert consultation research methodology was adopted to identify relevant models. Three typologies of models were developed according to age group and acuity, including: alternatives to standard acute inpatient services for adults; alternatives to longer-stay inpatient services for adults, including rehabilitation and forensic inpatient services; and alternatives to standard inpatient services for children and young people.</p><p><strong>Results: </strong>We identified an array of service models in each typology, some in community settings, some hospital-based and some working across settings. Models varied greatly in characteristics, extent of implementation and supporting evidence.</p><p><strong>Conclusions: </strong>Through this mapping exercise, we have developed three novel typologies of alternatives to standard inpatient care. A range of community-based, hospital-based and cross-setting approaches were identified. The identification of services providing inpatient care in a substantially different way to the standard suggests that some improvements could be provided within existing structures. Potential inequities in access to alternatives were identified for certain groups, such as people who are compulsorily detained, younger children, and young people transitioning between children's and adults' services. These typologies can inform future description, evaluation and comparison of different service models. This research also yields some key considerations for the design, development and implementation of alternative mental health service models and service arrays.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"13"},"PeriodicalIF":3.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of expanded access to mental health care on economic status of households with a person with a mental disorder in rural Ethiopia: a controlled before-after study.","authors":"Yohannes Hailemichael, Damen Hailemariam, Kebede Tirfessa, Sumaiyah Docrat, Atalay Alem, Girmay Medhin, Abebaw Fekadu, Crick Lund, Dan Chisholm, Charlotte Hanlon","doi":"10.1186/s13033-025-00668-8","DOIUrl":"10.1186/s13033-025-00668-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Poverty and mental illness are strongly associated. The aim of this study was to investigate the economic impact of implementing a district level integrated mental healthcare plan for people with severe mental disorders (SMD) and depression compared to secular trends in the general population in a rural Ethiopian setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A community-based, controlled before-after study design was used to assess changes in household economic status and catastrophic out-of-pocket (OOP) payments in relation to expanded access to mental health care. Two household samples were recruited, each with a community control group: (1) SMD sub-study and (2) depression sub-study. In the SMD sub-study, 290 households containing a member with SMD and 289 comparison households without a person with SMD participated. In the depression sub-study, 129 households with a person with depression and 129 comparison households. The case and comparison cohorts were followed up over 12 months. Propensity score matching and multivariable regression analyses were conducted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Provision of mental healthcare in the district was associated with a greater increase in income (Birr 919.53, 95% CI: 34.49, 4573.56) but no significant changes in consumption expenditure (Birr 176.25, 95% CI: -1338.19, 1690.70) in households of people with SMD compared to secular trends in comparison households. In households of people with depression, there was no significant change in income (Birr 227.78, 95% CI: -1361.21, 1816.79) or consumption expenditure (Birr - 81.20, 95% CI: -2572.57, 2410.15). The proportion of households incurring catastrophic OOP health expenditure (COOPHE) at the ≥ 10% and ≥ 40% thresholds were significantly reduced after the intervention in the SMD (from 20.3 to 9.0%, p = 0.002, and 31.9-14.9%, p &lt; 0.001) and in the depression intervention (from 19.6 to 5.3%, p = 0.003, and 25.2-11.8%, p = 0.015). Similarly, COOPHE has declined in the comparison households for SMD (from 15.6% (T1) to 8.2% (T2) (p = 0.035) and for depression comparison households (from12.1-4.1%(p = 0.069). However, there was no significant difference in the proportion of households experiencing catastrophic OOP health care expenditure in the SMD, depression and the comparison groups (p = 0.808 and p = 0.779 ). Despite improvement in income and COOPHE, households of persons with SMD or depression remained impoverished relative to comparison groups at follow-up. Households of people with SMD and depression were significantly less likely to be enrolled in community-based health insurance (CBHI) than comparison households.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The District mental health care plan intervention increased household income and reduced catastrophic out-of- pocket payment. Our findings support global initiatives to scale up mental healthcare as part of universal health coverage initiatives, alongside interventions to support s","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"12"},"PeriodicalIF":3.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health services during the war in Ukraine: 2-years follow up study.","authors":"Irina Pinchuk, Yulia Yachnik, Ryunosuke Goto, Norbert Skokauskas","doi":"10.1186/s13033-025-00667-9","DOIUrl":"10.1186/s13033-025-00667-9","url":null,"abstract":"<p><strong>Background: </strong>Chronic war exposure causes resource shortages, disrupts care for existing health issues, and heavily impacts mental health, increasing the risk of trauma-related psychiatric disorders. Using longitudinal data collected from psychiatric hospitals across Ukraine between January 2022 and May 2024, we aimed to evaluate the functioning and role of these institutions in delivering mental health care during the ongoing war.</p><p><strong>Methods: </strong>We conducted a second follow-up nationwide longitudinal study of Ukrainian inpatient mental health facilities during the Russian invasion that began in February 2022. Responses were obtained from the heads of 34 inpatient mental health facilities. This paper focuses on 25 facilities that participated in all three consecutive surveys, representing 41% of all psychiatric hospitals in Ukraine. Information on hospitalizations, as well as data on the number, displacement, and injuries of staff as of April 2024, was gathered and compared with findings from previous surveys.</p><p><strong>Results: </strong>The number of psychiatric hospitalizations increased two years after the onset of the full-scale war in Ukraine compared to both the pre-war period and six months after the invasion began (433.4 in January 2022, 397.5 in April 2022, and 552.0 in April 2024 per month, respectively). The average proportions of hospitalizations attributed to psychological war trauma across the study waves were 12.2% (January 2022), 13.5% (April 2022), and 17.3% (April 2024), with the differences not reaching statistical significance. The average number of psychiatrists, social workers, and junior nurses per facility declined steadily over the study period. As of April 2024, 21.7% of medical workers in the surveyed facilities had been displaced, and 0.5% had sustained injuries.</p><p><strong>Conclusions: </strong>The number of psychiatric hospitalizations two years into the full-scale war in Ukraine has risen, exceeding both pre-war levels and those recorded six months after the invasion. While hospitalizations related to war trauma have increased, their proportion has remained relatively stable, indicating a sustained demand for trauma-related care.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"11"},"PeriodicalIF":3.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns and predictors of 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys: treatment in the context of perceived need.","authors":"Dan J Stein, Daniel V Vigo, Meredith G Harris, Alan E Kazdin, Maria Carmen Viana, Irving Hwang, Timothy L Kessler, Sophie M Manoukian, Nancy A Sampson, Jordi Alonso, Laura Helena Andrade, Corina Benjet, Ronny Bruffaerts, Brendan Bunting, Graça Cardoso, Stephanie Chardoul, Giovanni de Girolamo, Peter de Jonge, Oye Gureje, Josep Maria Haro, Elie G Karam, Viviane Kovess-Masfety, Jacek Moskalewicz, Fernando Navarro-Mateu, Daisuke Nishi, José Posada-Villa, Kate Scott, Juan Carlos Stagnaro, Cristian Vladescu, Jacek Wciórka, Zahari Zarkov, Ronald C Kessler","doi":"10.1186/s13033-025-00661-1","DOIUrl":"10.1186/s13033-025-00661-1","url":null,"abstract":"<p><strong>Background: </strong>Data from the World Mental Health (WMH) surveys on the coverage cascade has underscored the importance of perceived need for seeking treatment of mental disorders. However, little research has focused on treatment contact after adjusting for perceived need. We do so here in analysis of WMH data.</p><p><strong>Methods: </strong>The WMH data considered here come from 25 community surveys implemented between 2001 and 2019 across 21 countries. n = 12,508 of the n = 117,739 respondents in these surveys aged 18 and older met criteria for one or more 12-month DSM-IV anxiety, mood, or substance use disorders assessed across all these surveys. Information was obtained about 12-month treatment of each disorder. The predictors considered were disorder type, socio-demographics, and history of prior treatment.</p><p><strong>Results: </strong>Twelve-month treatment was obtained for 17.7% of the n = 18,702 12-month person-disorders in the sample, including 34.1% for the 46.5% with perceived need and 3.5% for the 54.5% without perceived need. After adjusting for perceived need, receiving treatment was most strongly associated with disorder characteristics (severity, and highest for major depressive, panic/agoraphobia, and generalized anxiety disorders; lowest for substance use disorders), health insurance, employment status (highest for students, the retired, and the unemployed/disabled), and several aspects of prior treatment. These associations were generally similar in cases with and without perceived need for treatment. 12-month treatment among cases who without perceived need and without history of prior treatment was rare (1.1%).</p><p><strong>Conclusions: </strong>Findings highlight the critical importance of perceived need for obtaining 12-month treatment in the context of other significant predictors involving complexity and severity of disorders and socio-demographic factors. The importance of prior treatment history was quite striking, as was the finding that absence of both perceived need and prior treatment history were associated with a nearly complete absence of treatment. Policy recommendations emerging from these results include the need to increase health literacy, reduce the stigmatization of mental disorder, enhance access through health insurance, and improve the quality of care given the clear evidence that prior experiences with treatment play an important role in determining the likelihood of again seeking treatment for current problems.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"10"},"PeriodicalIF":3.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors for non-secure housing in inpatients of mental health hospitals: findings from a survey in North rhine - Westphalia, Germany.","authors":"Jürgen Zielasek, Ida Haussleiter, Josephine Heinz, Isabell Lehmann, Bianca Ueberberg, Thea Kreyenschulte, Ana Staninska, Georg Juckel, Euphrosyne Gouzoulis-Mayfrank","doi":"10.1186/s13033-025-00664-y","DOIUrl":"10.1186/s13033-025-00664-y","url":null,"abstract":"<p><strong>Background: </strong>Little is known about uptake of mental healthcare services by homeless people and even less is known about those living in precarious housing. The \"WohnLos\" study determined the prevalence of non-secure housing (defined as homelessness or precarious housing) among inpatients of two groups of public mental health hospitals in the state of North Rhine-Westphalia (NRW), Germany.</p><p><strong>Methods: </strong>We conducted a questionnaire survey in the two hospital groups, which provide in- and out-patient mental healthcare for a population of about ten million people. Clinical staff filled in a questionnaire for every inpatient on two record dates in 2020 and 2021. The questionnaire included sociodemographic variables, clinical variables, information on psychiatric care, and information on the individual housing situation.</p><p><strong>Results: </strong>Fifteen of the twenty hospitals participated in the study and provided information on 4252 inpatients (return rate per hospital on average 59%). The prevalence of non-secure housing was on average 16.5% of all cases (7.9% homeless (houseless or roofless) and 8.6% precarious housing (insecure or inadequate)). The prevalence of non-secure housing was highly variable between the hospitals. The highest rates were found in hospitals located in large cities in the Rhineland and the lowest rates in the Ruhr industrial area. Among the patients with non-secure housing, the sociodemographic and clinical characteristics were similar in the subgroups of patients living in homelessness and patients living in precarious housing. Diagnoses of schizophrenia and substance use disorders, younger age, male gender, unemployment and migration background were important factors associated with non-secure housing. Social support was an important protective factor.</p><p><strong>Conclusions: </strong>We identified implementable features of services for mental health inpatients with housing needs, like discharge management initiating psychosocial support from families and professional social services, the implementation of services bridging the gap between inpatient and outpatient settings, and the networking with housing-oriented post-discharge services like housing first and residential care facilities. Our study draws special attention to mentally ill patients living in precarious housing conditions, who constitute half of all mental healthcare inpatients with housing needs in our study, and who have similar psychosocial burden and housing needs as homeless patients.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"9"},"PeriodicalIF":3.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and potential solutions for effective integration of depression care into non-communicable diseases clinics in Malawi: a qualitative end-point evaluation of the SHARP randomized controlled trial.","authors":"Chifundo Colleta Zimba, Jullita Kenala Malava, MacDonald Mbota, Maureen Matewere, Harriet Akello, Christopher F Akiba, Kelsey R Landrum, Abigail Morrison, Vivian Go, Mina C Hosseinipour, Bradley N Gaynes, Michael Udedi, Jones Masiye, Brian W Pence","doi":"10.1186/s13033-025-00663-z","DOIUrl":"10.1186/s13033-025-00663-z","url":null,"abstract":"<p><strong>Background: </strong>The sub-Saharan African Regional Partnership for mental health and capacity building (SHARP) study was a clinic-randomized trial of two implementation strategies for integrating depression screening and treatment into non-communicable diseases' (NCD) clinics in Malawi between 2019 and 2022. We report on the barriers to implementing depression care integration at SHARP study sites and potential solutions.</p><p><strong>Methods: </strong>N = 39 in-depth interviews with participants from all ten sites were conducted, recorded, transcribed, coded in NVivo 12 and analyzed by qualitative experts. We used thematic analysis to identify implementation challenges and potential solutions. The Consolidated Framework for Implementation Research helped to develop guides and organize the results.</p><p><strong>Results: </strong>Outer setting barriers included high workload (due to high patient volume, increased paperwork, shortage of staff), the effects of coronavirus disease 2019 (COVID-19) pandemic, staff turnover and negative provider attitudes. Limited clinic space arose as an inner setting barrier. Workload can be overcome by increasing the number of NCD personnel, decentralizing the depression/NCD services and integrating mental health and NCD documents (implementation process). The COVID-19 pandemic presented unique challenges including fear of interpersonal contact and changes in scheduling staff that were difficult to overcome in the short term. To deal with the effects of staff turnover, participants identified the need for continuous depression training to new providers. Lobbying for more rooms from leadership can address concerns of limited space. To reduce negative provider attitudes, participants urged facility leadership to make themselves available for consultations and mentorship and to provide continuous learning opportunities such as refresher trainings.</p><p><strong>Conclusion: </strong>The experience in the SHARP study highlights the need for a culture of continuous learning and adaptation in healthcare settings, enabling the development of strategies to overcome evolving challenges. Planning for the integration of mental health and NCD care should extend beyond immediate challenges and consider long-term goals and sustainability.</p><p><strong>Trial registration: </strong>This study reports part of the findings from the endpoint evaluation of the SHARP clinical trial that is registered at ClinicalTrials.gov, NCT03711786 first posted 20,181,018.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"8"},"PeriodicalIF":3.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coping strategies for depression among HIV-positive women in Gondar town health facilities, Northwest, Ethiopia: A cross-sectional study.","authors":"Tadele Amare Zeleke, Kassahun Alemu, Tadesse Awoke Ayele, Zewditu Abdissa Denu, Lillian Mwanri, Telake Azale","doi":"10.1186/s13033-025-00665-x","DOIUrl":"10.1186/s13033-025-00665-x","url":null,"abstract":"<p><strong>Background: </strong>Most women living with HIV in low- and middle-income countries remain undiagnosed and untreated for depression. Even though depression has an adverse effect on treatment outcome and disease progression, less attention is given. The progression of depression is influenced by coping mechanism. The aim of this study was to identify the coping strategies used by depressed women living with HIV in Gondar town health facilities, north west, Ethiopia.</p><p><strong>Methods: </strong>Health institution based cross-sectional study was conducted in Gondar town health facilities, in north-western Ethiopia. All women living with HIV (n = 1043) were screened for depression symptoms using the validated Patient Health Questionnaire, 9 item version (PHQ-9). Those who scored ten or more, \"moderate depression among women living with HIV,\" (n = 435) were included in this study. The BRIEF Coping with Problem Experienced (COPE-28) scale was used to assess coping strategies. Construct validity of the brief COPE was evaluated using confirmatory factor analysis with AMOS 23 software. Linear regression model was fitted and beta coefficients were used to interpret the significant factors for coping strategies at p- values < 0.05 with 95% confidence interval.</p><p><strong>Results: </strong>Dysfunctional coping strategy was more widely practiced than emotional focused or problem focused coping strategies. From the emotional coping strategy, spiritual believes and praying coping were the most frequently used coping strategies in the study group. Time taken to initiate antiretroviral therapy (ART) less than 5 years and the increment of viral load were significantly associated with dysfunctional coping strategy. Having 1-2 children and fear of COVID-19 were the significant factors for problem focused coping strategy. An increment in emotion focused coping was associated with food insecurity. Social support and distance from health institutions 5 km or more were found to have a positive association with problem and emotion-focused coping strategies. Conversely, time taken to initiate antiretroviral therapy (ART) 5 years and more negatively correlated with both problem and emotion-focused coping mechanisms.</p><p><strong>Conclusion: </strong>The study revealed that all coping strategies were utilized by depressed women living with HIV (WLWHIV). Strengthening spiritual coping styles proved beneficial in reducing depression among these individuals. It is recommended that depressed WLWHIV practice problem and emotion-focused coping strategies. Additionally, social support enhances both problem and emotion-focused coping approaches. Factors contributing to dysfunctional coping included having started ART less than five years ago and high viral load levels. Therefore, providing holistic support for depressed WLWHIV is essential to improve their mental health.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"7"},"PeriodicalIF":3.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}