International Journal of Mental Health Systems最新文献

{"title":"Bridging clinical needs and economic barriers: a national survey of antidepressant prescribing across 25 hospitals in Thailand.","authors":"Pornjira Pariwatcharakul, Krittisak Anuroj, Nopporn Tantirangsee, Keerati Pattanaseri, Chonnakarn Jatchavala, Nitchawan Kerdcharoen, Papan Thaipisuttikul, Kanthee Anantapong, Lampu Kosulwit, Nuth Graipaspong, Pavarud Puangsri, Poom Chompoosri, Tiyarat Kayankit, Pavita Chongsuksiri, Sirina Satthapisit, Songpon Lodthanong, Amornrut Bangphichet, Veevarin Charoenporn, Saratcha Tiensuntisook, Kamolvisa Techapoonpon, Warut Aunjitsakul, Kantanut Yutrirak, Kritta Supanimitamorn, Tidarat Puranachaikere, Apichat Saengsin, Maneekwan Rujirojsuwan, Orapa Khemtong, Panklow Siriarchawatana, Pawaris Asawalertsaeng, Pawitra Mongkolnaowarat, Pichapuk Jarasrassamee, Ploypan Wangrotjanarat, Tattaporn Suksintaranon, Warith Mongkolnaowarat, Warot Lamyai, Wattanapong Pansawat, Witchuda Chantarat, Pavat Aroonpet, Nutthaporn Jaisamut Sakunphaet, Naratip Sa-Nguanpanich, Lakkana Thongchot, Dutsadee Juengsiragulwit, Burin Suraaroonsamrit, Shih-Ku Lin, Takahiro A Kato, Woraphat Ratta-Apha","doi":"10.1186/s13033-026-00719-8","DOIUrl":"10.1186/s13033-026-00719-8","url":null,"abstract":"<p><strong>Background: </strong>Prescribing patterns are highly influenced by national healthcare structures. This study aimed to investigate the current antidepressant prescribing patterns, associated diagnoses, and the impact of financial barriers on clinical decision-making in Thailand.</p><p><strong>Methods: </strong>We conducted a multicenter national survey on psychotropic drug prescribing across 25 Thai hospitals from December 2023 to March 2024. Utilizing the Research on East Asia Psychotropic Prescription Patterns (REAP-AD3) protocol for antidepressant data, we integrated country-specific modules assessing patient economic burden and physician preferences.</p><p><strong>Results: </strong>Data from 604 patients were analyzed. Selective serotonin reuptake inhibitors (SSRIs) were the most prescribed class (70.2%), followed by tricyclic antidepressants (TCAs) (13.9%) and serotonin antagonist and reuptake inhibitor (SARI) trazodone (12.7%). Most common antidepressant users' diagnoses were depressive disorders (55.0%), followed by substance use (15.2%) and psychotic disorders (13.7%). A substantial number of psychiatrists reported feeling restricted by financial and reimbursement limitations related to each prescription, specifically citing limited drug availability (21.9%, n = 131), the patient's reimbursement scheme (36.3%, n = 217), and the patient's financial status (33.9%, n = 203). In addition, 34.3% (n = 205) indicated that they wanted to change the current prescription if there were not any financial barriers, especially for patients currently on TCAs (49.4%, χ² = 10.16, p = 0.001). Indirect costs per visit (transportation and opportunity costs) frequently exceeded direct monthly medication expenses.</p><p><strong>Conclusion: </strong>SSRIs were the most commonly prescribed antidepressant in Thailand. However, financial constraints may have contributed to the use of TCAs against clinician preference. Policy revisions addressing both medication access and indirect costs are essential to allow psychiatrists to prescribe antidepressants according to clinical needs, which may sustainably optimize mental health outcomes in Thailand.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399527","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":"Rethinking AI in youth mental health: promise, perils, and ethical integration.","authors":"Andy Man Yeung Tai, Ian Hickie, Will Capon, Ante Prodan, Agam Sanghera, Michael Krausz, Frank Iorfino","doi":"10.1186/s13033-026-00714-z","DOIUrl":"10.1186/s13033-026-00714-z","url":null,"abstract":"<p><p>The transformative role of Large Language Models (LLMs) in youth mental health care as intelligent agents that can support patient engagement and augment healthcare delivery has been explored in this commentary. By acting as personalized virtual assistants for both patients and providers, LLMs have the potential to offer real-time, context-aware support, improving administrative workflows within mental health services. However, there is increasing concern within the research community regarding overinflation of claims surrounding large language models in mental healthcare. Technology companies often overstate their capabilities, creating unrealistic expectations that may lead to detrimental outcomes for patients. This paper critically examines the opportunities and limitations, advocating for greater transparency and rigorous scrutiny in the application of AI within sensitive domains such as mental health. It underscores the need for developmentally appropriate engagement, cultural sensitivity, and the integration of human expertise alongside AI to ensure ethical and effective collaboration in mental healthcare interventions.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354242","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":"Does primary care level psychotherapy associate with later use of long-term psychotherapy - longitudinal register-based cohort study among Finnish occupationally active individuals.","authors":"Heli Järnefelt, Jaakko Airaksinen, Erkki Heinonen, Aki Vuokko, Ari Väänänen, Sanna Selinheimo","doi":"10.1186/s13033-026-00720-1","DOIUrl":"10.1186/s13033-026-00720-1","url":null,"abstract":"<p><strong>Background: </strong>One key question for current psychotherapy research is how limited resources should be used efficiently to optimise treatment pathways. We examined how primary care level (PCL) psychotherapy, a history of mental disorder, and sociodemographic factors are associated with the later probability of receiving long-term rehabilitative psychotherapy.</p><p><strong>Methods: </strong>This longitudinal observational cohort study based on a register data from the Gaps in Mental Health-Related Work Disability and Treatment Outcomes (GapMind) project, which combines data from national registers (Statistics Finland and the Social Insurance Institution of Finland) and the largest occupational health service (OHS) provider in Finland. The study population comprised Finnish occupationally active individuals aged 15-65 (N = 1,261,320). Data on the use of PCL psychotherapy in the OHS between 2019 and 2020 were combined with data on age, gender, socioeconomic status, education, history of mental disorders (including psychotropic medication purchases, sickness absences, pensions, and use of OHS due to mental disorders), and somatic disabling comorbidities and four-model logistic regression analyses were conducted. The primary outcome was the use of long-term psychotherapy during 2020-2022.</p><p><strong>Results: </strong>Participation in PCL psychotherapy (OR 7.05-15.51) and a history of mental disorders (OR 1.67-4.25) were associated with a higher probability of receiving subsequently long-term rehabilitative psychotherapy. Higher age, female gender, and higher socioeconomic status were also associated with an elevated likelihood of engaging in long-term rehabilitative psychotherapy.</p><p><strong>Conclusions: </strong>Participation in PCL psychotherapy, and various clinical and sociodemographic factors were associated with an increased probability of receiving later long-term psychotherapy. These findings may support healthcare systems in leveraging this information to better anticipate the need for long-term psychotherapy.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346905","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":"Discovery colleges in youth mental health systems: developmentally adapted recovery-oriented learning environments.","authors":"Jared Omundo, Manuel Föcker, Simon Alexander Stiehl, Shiblu Miah, Michael Schulz, Orkan Okan","doi":"10.1186/s13033-026-00718-9","DOIUrl":"10.1186/s13033-026-00718-9","url":null,"abstract":"<p><strong>Background: </strong>Youth mental health systems worldwide face increasing demand, workforce shortages, and fragmented pathways to care. Addressing these challenges requires approaches that extend beyond specialist clinical treatment to incorporate prevention, participation, education, and recovery-oriented support. While Recovery Colleges are increasingly established within adult mental health services, their youth-adapted counterparts commonly referred to as Discovery Colleges remain underexplored within youth mental health systems research. This narrative review synthesises emerging literature to examine the conceptual foundations, developmental adaptations, and potential system-level role of Discovery Colleges within youth mental health care.</p><p><strong>Methods: </strong>A narrative review approach was employed to synthesise emerging literature on Discovery Colleges and related recovery-oriented educational initiatives. Peer-reviewed publications, programme descriptions, and implementation reports were analysed to examine the defining principles, developmental relevance, organisational characteristics, and system-level implications of Discovery Colleges within youth mental health contexts.</p><p><strong>Results: </strong>The synthesis identified four interrelated conceptual domains characterising Discovery Colleges: (1) recovery-oriented learning models and developmental adaptation; (2) mechanisms of engagement and participation; (3) organisational and professional implications; and (4) cross-sector positioning within youth mental health ecosystems. The findings suggest that Discovery Colleges can be conceptualised as developmentally responsive and recovery-oriented learning environments operating at the intersection of education, community support, and mental health care. The review further highlights important tensions relating to implementation, safeguarding, fidelity, sustainability, and cross-sector integration.</p><p><strong>Conclusions: </strong>Discovery Colleges may represent a promising recovery-oriented innovation within youth mental health systems by reframing mental health support as a collaborative, participatory, and educational process rather than solely a clinical intervention. However, the current evidence base remains limited and largely exploratory. Further empirical, developmental, and implementation-focused research is required to evaluate their effectiveness, sustainability, and long-term contribution to integrated youth mental health systems.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13292328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310097","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":"Integrating ESG indicators and behavioral factors to estimate the mental health index in Italy.","authors":"Resta Emanuela, Logroscino Giancarlo, Peter Preethymol, Costantiello Alberto, Leogrande Angelo","doi":"10.1186/s13033-026-00716-x","DOIUrl":"10.1186/s13033-026-00716-x","url":null,"abstract":"<p><p>This article examines the relationship between behavioral and Environmental, Social, and Governance (ESG) variables and the Mental Health Index (MHI) of Italian regions from 2016 to 2023. The use of descriptive statistics, cluster analysis, and forecasting models is employed for descriptive and exploratory purposes, as well as for forecasting regional disparities in mental health. Relative stability at the state level and persistent territorial variability are evident in the MHI derived from the ISTAT-BES indicators, with the North and Centre performing better than the South, except for notable improvements in disadvantaged regions such as Calabria and Campania. Behavioral factors, particularly sedentariness, smoking, and multimorbidity, are consistently associated with adverse trends for mental health, while adequate nourishment and exposure to urban green spaces are found to be protective. ESG-related factors, including occupational security and judicial efficacy, also contribute to these inequalities, attributing mental health status as part of the more general system effects of institutions and environments. Cluster analysis identifies distinct regional typologies based on aggregated behavioral and ESG patterns, while the predictive model highlights multimorbidity, smoking, and sedentary behavior as the most relevant factors negatively associated with the Mental Health Index (MHI), and urban green availability as a key factor positively associated with it. They point out that Italian mental health disparities are not only associated with behavioral determinants of individuals, but must be addressed from a multi-faceted ESG perspective. Policy reactions also mean that public health responses must attend not only to lifestyle risk factors but also structural determinants and incorporate active living promotion, reduction of smoking prevalence, investment in green infrastructures, and improvement of governance efficiency.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297055","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 literacy among nurses at community health centers in rural Rwanda.","authors":"Marie Chantal Ingabire","doi":"10.1186/s13033-026-00715-y","DOIUrl":"10.1186/s13033-026-00715-y","url":null,"abstract":"<p><strong>Aim: </strong>To assess mental health literacy and its association with professional variables among community health center (CHC) nurses.</p><p><strong>Background: </strong>Mental health problems are highly prevalent in post-conflict countries, but access to treatment is acutely limited. The integration of mental health care into primary healthcare (PHC) is one of the key recommended strategies to scale up access to treatment. However, little is known about PHC nurses' mental health literacy (MHL).</p><p><strong>Method: </strong>Seventy-four nurses (46 women, 28 men) were recruited from 13 CHCs in the western province of Rwanda. Participants answered a questionnaire about their professional characteristics and MHL, namely, the recognition of mental disorders depicted in clinical vignettes, knowledge of risk factors for mental disorders, and knowledge of helpful people and interventions.</p><p><strong>Results: </strong>Most participants correctly identified Posttraumatic Stress Disorder (63.5%), followed by depression (60.8%), Somatic Symptom Disorder (51.3%), schizophrenia (51.3%), and Generalized Anxiety Disorder (25.7%). The majority of participants correctly recognized the risk factors for mental disorders (e.g., death of a loved one), but a considerable proportion endorsed false causes (e.g., evil possession, weakness of character). Most participants indicated that psychologists/counselors were helpful for all the disorders. Education and in-service mental health training were not associated with MHL.</p><p><strong>Conclusions: </strong>The mental health literacy of CHC nurses is limited in different ways. Strengthening both academic and continual mental health training programs may enhance nurses' MHL and, consequently, early detection and treatment of mental disorders.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297015","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":"Harnessing hope: a psychological strategy for achieving the sustainable development goals.","authors":"Kathryn Goetzke, Veronica O'Brien","doi":"10.1186/s13033-026-00699-9","DOIUrl":"10.1186/s13033-026-00699-9","url":null,"abstract":"<p><p>The 2023 SDG Report reveals a concerning trend: weak progress on over 50% of SDG targets in the last three years, with 30% stalled or regressing. Failure to make progress towards goals may lead to a rise in negative affective states, including anxiety and depression. Hope is a teachable skill that leads to positive outcomes in psychiatric and medical health, education, the workplace, and overall well-being. Teaching hope globally using established programming and dissemination of hope science is vital for SDG progress by teaching everyone the essential skill of hope. Literature for this narrative review was compiled based on keyword relevance, relevancy, and recency. Findings on hope's relationship to the SDGs and actionable strategies are discussed.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260255","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":"Participatory systems modelling to improve mental health systems in Bogotá, Colombia: stakeholders' perspectives, experiences and networks.","authors":"Adriane Martin Hilber, Salvador Camacho, Mónica Natalí Sánchez Nítola, Dèbora L Shambo-Rodríguez, Grace Yeeun Lee, Laura Ospina-Pinillos, Jo-An Occhipinti","doi":"10.1186/s13033-026-00704-1","DOIUrl":"10.1186/s13033-026-00704-1","url":null,"abstract":"<p><strong>Background: </strong>Participatory Systems Modelling (PSM) offers an opportunity to deliver robust, contextually relevant, and suitable models for informing strategic responses to complex public health challenges. For mental health care systems, PSM benefits from multi-sectoral participants' social and emotional capital for building consensus on priorities and policy objectives that can influence decision-making.</p><p><strong>Methods: </strong>In Bogotá, Colombia, we evaluated a PSM process that developed an interactive decision support tool that can inform policymaking on the selection of programs and services to mitigate social, economic, and health system drivers of youth mental health outcomes including suicidal behaviour. Using the CHaRL Framework, we explored changes in perceptions or beliefs of participants on the functionality of the (mental health) system and its drivers. Multi-sectoral participants including youth with lived experience participated in three workshops to collectively inform the building of the model. Pre-post-tests, a survey and observations of the PSM process were conducted.</p><p><strong>Results: </strong>Through the participatory process, participants increased knowledge and understanding of the mental health care system, its drivers and constraints of performance for youth in Bogotá. Due to active engagement, a credible and comprehensive tool was created, reflective of the complexity of the system, and focused on what participants and evidence show are high priority interventions. Participants' concerns around trust in the model shifted positively over the course of the workshops. Skepticism in policymakers' capacity to use the model increased participant recognition of the need to advocate for its use.</p><p><strong>Conclusion: </strong>Participatory processes help to overcome stakeholder hesitancy by offering an important starting point for building trust and partnership for effecting change in health systems. Consideration of participant bias at the start of the process could strength the validity and use of the results in the longer term.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057628","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":"Could seasonal patterns in ECT use impact service delivery? A nationwide study.","authors":"David Barruel, Marion Plaze, Valérie Dauriac-Le Masson","doi":"10.1186/s13033-026-00713-0","DOIUrl":"10.1186/s13033-026-00713-0","url":null,"abstract":"<p><strong>Background: </strong>The practice of electroconvulsive therapy (ECT) is constrained by limited resources. Anticipating recurrent peaks in demand is therefore essential for optimizing resource planning within public healthcare systems. This study examined seasonal patterns of ECT utilization in France over an extended period.</p><p><strong>Method: </strong>We analyzed data from the French national administrative and medical database. Seasonal patterns in monthly ECT utilization time series from 2017 to 2023 were investigated using robust statistical methods.</p><p><strong>Results: </strong>We observed a clear seasonal pattern with a 12-month periodicity in monthly ECT utilization, accounting for 16% of the variance in use, with a major peak in December and a mean relative amplitude of 13.1%. Seasonal variation was observed across sex, age and diagnostic subgroups, although it was less pronounced among patients aged 24 years or younger and those with schizophrenia. Across all subgroups, ECT activity consistently peaked at the onset of winter, between November and December.</p><p><strong>Conclusion: </strong>These findings emphasize the need for ECT providers in France to anticipate recurrent winter peaks in activity. Proactive healthcare policies should ensure that medical staffing and equipements ressources are adjusted to accommodate predictable winter peaks in ECT demand.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018250","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":"New policies, old habits: why and how Dutch mental healthcare moves towards collaboration.","authors":"T S van Dijk, C de Koning, M Felder, W K van der Scheer, R T J M Janssen","doi":"10.1186/s13033-026-00708-x","DOIUrl":"10.1186/s13033-026-00708-x","url":null,"abstract":"<p><strong>Background: </strong>Hindered by staff shortages, high workloads and rising waiting lists, mental healthcare services across Europe struggle to provide accessible, appropriate, and timely care for those who need it. In the past, governments tried to tackle large-scale issues in mental healthcare with profound policy changes, such as deinstitutionalization, decentralization and marketization. In the Netherlands, where mental healthcare is also under pressure, many policymakers and other influential stakeholders believe that policy changes aimed at stimulating collaboration between providers, third-party payers and other domains are a solution to the increasing challenges. This research analyses how a collaborative logic unfolds in a complex sector dominated by a market logic.</p><p><strong>Methods: </strong>By analyzing policy documents and conducting interviews with representatives of healthcare organizations and health insurers, we explored both the systssemic and cultural barriers that challenge collaboration in mental healthcare.</p><p><strong>Results: </strong>Findings show that, while collaboration is framed as a key strategy to resolve issues in mental healthcare, the entrenched market logic has fostered negative perceptions and lasting mistrust between mental healthcare stakeholders. These perceptions make collaboration difficult.</p><p><strong>Conclusion: </strong>Challenges related to collaboration are not only systemic or financial in nature but are deeply rooted in belief systems, norms and values. A fundamental shift in these areas is essential to foster a more cooperative practice in mental healthcare.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976435","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}