International Journal of Mental Health Systems最新文献

{"title":"Enhancing confidence in evidence-based psychological trauma care and implementation research: training program for clinicians in Ukraine.","authors":"Tetiana Nickelsen, Gregory N Muller, Shaunna L Clark, Oleksandr Bordiuzhenko, Israel Liberzon, Marcia Ory","doi":"10.1186/s13033-025-00690-w","DOIUrl":"10.1186/s13033-025-00690-w","url":null,"abstract":"<p><p>Since the Russian invasion in February 2022, millions of Ukrainians have been exposed to war-related trauma, with projections indicating hundreds of thousands of individuals will develop debilitating trauma/stressor-related disorders. Ukraine faces a critical shortage of mental health professionals trained in evidence-based care (EBC) for post-traumatic stress disorder (PTSD), and even fewer with expertise in implementation research. This study examined changes in clinicians' confidence in implementing evidence-based trauma care and conducting implementation research following a comprehensive training program. Forty-one Ukrainian mental health professionals attended a five-day training workshop in Lviv, Ukraine, covering evidence-based PTSD treatments and implementation research frameworks. Participants completed pre- and post-training surveys that assessed their confidence levels and perceived barriers. Data was analyzed using Wilcoxon signed-ranks tests, multiple regression, and thematic analysis. Participants demonstrated significant increases in confidence in both implementing evidence-based trauma care and conducting implementation research. Training efficacy was independent of professional background and years of experience. Thematic analysis identified key barriers to implementing EBC and in conducting implementation research. Findings highlight the need for continued effort to address the identified barriers to adapting EBC in a Ukrainian context. This training model may serve as a foundation for developing a sustainable mental health workforce capable of addressing the severe trauma burden in Ukraine.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"33"},"PeriodicalIF":3.8,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12625362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551360","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 for youth mental health: agility and adaptiveness to enhance stakeholder engagement and knowledge sharing.","authors":"Sarah Piper, Victoria Loblay, Yun Ju Christine Song, Grace Yeeun Lee, Samantha Huntley, Olivia Iannelli, Nicholas Ho, Seyed Hossein Hosseini, Catherine Vacher, Alexis Hutcheon, Paul Crosland, Kristen Tran, Kim-Huong Nguyen, Chloe Gosling, Jordan van Rosmalen, Kayla Andrade, Ian B Hickie, Jo-An Occhipinti","doi":"10.1186/s13033-025-00687-5","DOIUrl":"10.1186/s13033-025-00687-5","url":null,"abstract":"<p><strong>Background: </strong>Australia's mental health system needs to expand rapidly to meet the growing demand for care by young Australians. Participatory systems modelling (PSM) has emerged as a valuable method for guiding strategic decision-making in mental health policy.</p><p><strong>Methods: </strong>This paper evaluates the participatory methods and approaches utilised in a series of PSM workshops focused on the development of a youth mental health decision-support tool for the Brisbane South region, Queensland. Baseline and two follow-up timepoints of semi-structured interviews were conducted with a range of local stakeholders, including mental health professionals, service managers, commissioning organisations, and young people with lived experience.</p><p><strong>Results: </strong>Participants emphasised the need for diversity of stakeholder representation in workshops, but acknowledged the challenge of recruiting young stakeholders and culturally diverse stakeholders. Clear communication and education around the decision-support tool, as well as the utilisation of flexible methods for obtaining stakeholder input, both served to empower stakeholders in their contributions to the workshops and strengthen stakeholder engagement and knowledge sharing.</p><p><strong>Conclusions: </strong>The adoption of more adaptive and flexible workshop activities, and a move away from more structured systems modelling workshop 'scripts', is required to engage diverse participants within the youth mental health space. Results suggest knowledge sharing and stakeholder engagement is an active process that is developed along the course of the workshops, enabled by education and clear communication, empowering participants to meaningfully contribute. Future PSM workshops should continue to develop additional activities and more targeted engagement with youth stakeholders to enhance their contributions.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"32"},"PeriodicalIF":3.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12551232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369112","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":"Picturing a mental health journey: experience of a participatory photovoice approach to presenting recovery narratives of people with lived experiences and caregivers in Ethiopia.","authors":"Eshetu Girma, Bethel Ayele, Charlotte Hanlon, Petra C Gronholm, Dristy Gurung, Wubalem Fekadu, Graham Thornicroft, Brandon A Kohrt","doi":"10.1186/s13033-025-00689-3","DOIUrl":"10.1186/s13033-025-00689-3","url":null,"abstract":"<p><strong>Background: </strong>PhotoVoice is a participatory approach that uses photography to offer a useful platform for sharing the stories of people with mental health conditions whose voices are often marginalized. This study aimed to explore the experiences of people with lived experiences and caregivers in constructing brief recovery narratives presented at training sessions that highlight their experiences before, during, and after mental health treatment.</p><p><strong>Method: </strong>A participatory photovoice study was carried out with 16 participants from the Sodo district, Ethiopia. The participants were people with lived experiences (n = 8) and caregivers (n = 8) selected via purposive sampling. Field notes, photographs and testimonies arising from the PhotoVoice sessions were analysed together with in-depth interviews with participants. The data were analysed via narratives used during photovoice sessions and thematic analysis.</p><p><strong>Results: </strong>The PhotoVoice training experience was mostly positively received and brought to light a variety of perceived benefits through providing an inclusive understanding of mental health and related misconceptions and by addressing stigma and discrimination-related myths in the community. Furthermore, the participants reported the benefit of being engaged in productive activities that improved their communication and relationships with other people. The photographs revealed the stigmatized experiences of participants seeking alternative treatment solutions and challenges in accessing and gaining awareness of mental health. Stress and fear of public speaking and negative feedback from their family and community were the main barriers to participation in the photoVoice sessions.</p><p><strong>Conclusions: </strong>This study shows that PhotoVoice training has important value in eliciting insights from participants' lived experiences. The findings indicate that this approach is important for the empowerment of people with lived experiences and their family members and for coping with the stigma and discrimination they encounter. Stakeholders working in mental health can use and adapt this participatory technique to empower service users and family members and reduce the impacts of stigma associated with mental illnesses.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"31"},"PeriodicalIF":3.8,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287280","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":"Examining the effects of engagement with an app-based mental health intervention: a secondary analysis of a randomized control trial with treatment non-compliance.","authors":"Angel Y Wang, Melissa Vereschagin, Chris G Richardson, Richard J Munthali, Hui Xie, Kristen L Hudec, Tiana Mori, Lonna Munro, Daniel V Vigo","doi":"10.1186/s13033-025-00688-4","DOIUrl":"10.1186/s13033-025-00688-4","url":null,"abstract":"<p><strong>Background: </strong>Minder is a mental health and substance use mobile application found to have a small but significant effects in a recent randomized trial. Poor engagement has been identified as a common threat to the effectiveness of digital mental health tools that is not accounted for in intention-to-treat analyses. The objective of this study is to conduct a prespecified secondary analyses to identify factors associated with engagement and examine the impact of engagement on trial outcomes.</p><p><strong>Methods: </strong>1489 students were randomized to either the intervention (n = 743) or waitlist control (n = 746). Primary outcomes were changes in anxiety (General Anxiety Disorder 7 (GAD-7)), depression (Patient Health Questionnaire 9 (PHQ-9)), and alcohol consumption (US Alcohol Use Disorders Identification Test-Consumption Scale (USAUDIT-CS)) at 30-days. Secondary outcomes included frequency of substance use and mental wellbeing (Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWS)). A Complier Average Causal Effect (CACE) analysis was conducted using 3 separate criteria reflecting differing engagement levels: (1) a binary measure: use of any app component, (2) a continuous measure: number of unique days of app use, and (3) an ordinal measure: number of components accessed within the app.</p><p><strong>Results: </strong>80.4% of participants used at least one app feature. Statistically significant differences were observed in app utilization across gender, ethnicity, having a history of depression or anxiety, higher baseline PHQ-9, higher SWEMWS, and poor/fair overall self-assessed mental and physical health. Any use of Minder was associated with significantly lower scores on the GAD-7 (adjusted group mean difference = - 1.09, 95% CI - 1.60 to - 0.57; P < .01) and PHQ-9 (adjusted group mean difference = - 0.84, 95% CI - 1.41 to - 0.27; P < .01) with increasing number of unique utilization days or components accessed associated with increased reductions. Any use of Minder was associated with significantly higher scores on the SWEMWS (adjusted group mean difference = 0.93, 95% CI 0.46 to 1.39; P < .01) and lower frequency of cannabis use (adjusted group mean difference = - 0.15, 95% CI - 0.23 to - 0.06; P < .01) with increased app utilization associated with larger improvements.</p><p><strong>Conclusions: </strong>The CACE analysis identified significant dose-response relationships indicating that increased use of the Minder app leads to larger effects that can reach levels of clinical significance.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05606601 (November 3, 2022); https://clinicaltrials.gov/ct2/show/NCT05606601 .</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"30"},"PeriodicalIF":3.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259632","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":"Evaluating provider training in stepped care 2.0 and one-at-a-time services among mental health and addiction providers.","authors":"Kaitlyn N Mahon, Laura M Harris-Lane, Alesha King, Monte Bobele, AnnMarie Churchill, Peter Cornish, Bernard Goguen, Sheila N Garland, Alexia Jaouich, Joshua A Rash","doi":"10.1186/s13033-025-00683-9","DOIUrl":"10.1186/s13033-025-00683-9","url":null,"abstract":"<p><strong>Background: </strong>Stepped Care 2.0 (SC2.0) and One-at-a-Time (OAAT) approaches can help address challenges related to accessing effective addiction and mental health (A&MH) services. OAAT services, available by walk-in or appointment, were implemented in New Brunswick (NB) as the first step in developing a provincial stepped care framework in alignment with NB's A&MH action plan. This study sought to evaluate the impact of online training courses in SC2.0 and OAAT service delivery on providers' knowledge, readiness, and capabilities to implement OAAT services in A&MH clinics, within the broader context of the provincial SC2.0 model.</p><p><strong>Methods: </strong>Providers employed with A&MH services (e.g., social workers, nurses, psychologists) across NB completed asynchronous training courses in SC2.0 and OAAT services as part of a provincial implementation initiative. Over 400 providers volunteered to complete questionnaires related to this training (N = 401). Knowledge acquisition questionnaires were developed based on SC2.0 course content and administered pre- and post-training. Providers also completed a post-training knowledge acquisition questionnaire on OAAT services. Providers completed questionnaires on acceptability, appropriateness and feasibility of training courses, and self-efficacy post-training. Qualitative interviews were conducted with 28 providers to further understand their experiences with training courses in SC2.0 (n = 12) and OAAT services (n = 16).</p><p><strong>Results: </strong>Mean percentage of correct responses at post-course for SC2.0 and OAAT services was 67.2% (SD = 15.9%) and 75.7% (SD = 15.7%), respectively. A modest, but significant, increase in knowledge of SC2.0 was observed post-training. Courses were deemed acceptable, appropriate and feasible, and resulted in favorable outcome expectancies. Moreover, providers reported modest self-efficacy to enact SC2.0 following training. Providers made recommendations to receive additional resources and training in SC2.0 and OAAT services to further enhance confidence to integrate key principles into practice.</p><p><strong>Conclusions: </strong>Asynchronous training courses in SC2.0 and OAAT services supported the provincial practice change initiative in NB. In line with the COM-B model of behavior change, course barriers and facilitators were identified and provide insights into ways in which these courses, and related implementation projects involving training healthcare professionals, could be adapted to help create and sustain change.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"29"},"PeriodicalIF":4.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974239","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 effects of a task shifted multi-component mental health intervention to support prosthetic and orthotic service users in Cambodia: a non-randomised controlled study.","authors":"Alan Maddock, Thearith Heang, Nil Ean, Sisary Kheng, Paul Best, Nerrolyn Ramstrand","doi":"10.1186/s13033-025-00681-x","DOIUrl":"10.1186/s13033-025-00681-x","url":null,"abstract":"<p><strong>Background: </strong>Mental health disorders are major public health challenges, particularly in low- and middle-income countries such as Cambodia, where chronic shortages in mental health services and human resources exist. These issues are compounded for marginalized groups such as persons with physical disabilities due to their being at a higher risk of psychological distress and PTSD symptoms. The development of effective and accessible mental health systems in Cambodia will require evidence-based culturally appropriate mental health interventions. There are insufficient good-quality studies which have been completed to draw firm conclusions about the effectiveness of culturally appropriate mental health interventions in Cambodia. The aim of this study was to evaluate the effectiveness of a task shifted multi-component mental health intervention (named 'Friendship groups') at reducing psychological distress and PTSD, worry, rumination and increasing mindfulness among cohort of prosthetic and orthotic (P&O) service users.</p><p><strong>Methods: </strong>From March 2023 to June 2024 data (N = 465) were collected as part of a mental health screening programme for P&O service users across Cambodia. Participants experiencing mild to moderate psychological distress were screened and invited to participate in this study. Due to ethical considerations a non-randomised controlled trial design with repeated measures (pre-post intervention) was conducted to evaluate the effects of Friendship groups (N = 33) against a non-active control condition (N = 39).</p><p><strong>Results: </strong>When compared to the control condition the Friendship groups were found to have a moderate to large effect on psychological distress, and a small to moderate effect on rumination. The Friendship group participants experienced reduced PTSD symptoms, worry and improved mindfulness post group but these changes were not significant when compared to the control condition.</p><p><strong>Conclusions: </strong>The results from this study evidence the acceptability and effectiveness of Friendship groups at reducing psychological distress. Our results also provide clear guidance that if Friendship groups are implemented across P&O services in Cambodia, P&O service users are likely to experience reduced psychological distress. These findings also add to the growing literature supporting the need for culturally adapted task shifted mental health interventions in low- and middle-income countries, where access to specialised care remains limited.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"28"},"PeriodicalIF":4.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974185","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":"Adolescent utilization of school based mental health services in the United States.","authors":"Laura Grunin, José A Pagán, Gary Yu, Allison Squires, Sally S Cohen","doi":"10.1186/s13033-025-00684-8","DOIUrl":"10.1186/s13033-025-00684-8","url":null,"abstract":"<p><strong>Background: </strong>Over 14 million adolescents have a diagnosable mental, behavioral, or emotional disorder yet only 20% receive adequate mental health services. There is a critical need to identify accessible and effective pathways to treatment. School based mental health services (SBMHS) are an optimal setting for timely identification, effective management, and convenient delivery of evidence-based mental health care.</p><p><strong>Methods: </strong>Using data from the 2019 National Survey on Drug Use and Health, we employed structural equation modeling to examine the relationships between utilization of SBMHS and school and academic engagement, religiosity, self-reported depressive symptoms, and parental monitoring and support.</p><p><strong>Results: </strong>Higher levels of parental monitoring and support (ß = -0.044, p < 0.05) and religiosity (ß = -0.027, p < 0.05) along with lower levels of school and academic engagement (ß = 0.069, p < 0.001) were associated with decreased adolescent utilization of SBMHS. Adolescents reporting a higher number of depressive symptoms on a scale of 1 to 9 (ß = 0.221, p < 0.001) were more likely to utilize SBMHS compared to their counterparts. Self-reported depressive symptoms mediated the relationship between all latent variables (parental monitoring and support [ß = -0.222, p < 0.001]; religiosity [ß = -0.051, p < 0.001]; school and academic engagement [ß = -0.067, p < 0.001]) and adolescent utilization of SBMHS.</p><p><strong>Conclusion: </strong>Findings from this study offer psychologists, teachers, counselors, school nurses, and administrators specific determinants of service use that can be used to develop strategies for adolescent mental health assessment, increase SBMHS utilization among those in need, and support overall emotional well-being.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"27"},"PeriodicalIF":3.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884111","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":"Proof of concept studies in mental health systems research: strategy and steps.","authors":"Luis Salvador-Carulla, Hossein Tabatabaei-Jafari, Cindy Woods, Sue Lukersmith","doi":"10.1186/s13033-025-00682-w","DOIUrl":"10.1186/s13033-025-00682-w","url":null,"abstract":"<p><strong>Background: </strong>The implementation of interventions, digital tools, and policy plans in health systems research is highly complex. Proof-of-Concept (PoC) studies facilitate the development of these applications although they are rarely conducted or reported in mental health research. This paper describes the principles and processes to conduct PoC studies in mental health systems research.</p><p><strong>Method: </strong>The Technology Readiness Level in Implementation Sciences (TRL-IS) serves as the reference framework for this study. A 'lessons learned' process was applied to refine the concepts and develop a research strategy based on previous experiences with PoC studies. This process incorporated insights gained from a scoping review, case studies and discussion with both a core group and an extended group of experts.</p><p><strong>Results: </strong>PoC studies assess the workability of an application, formulating the basic concept and determining whether its functionality can be transformed into a real prototype to be tested as intended via a pilot study and later demonstrated in the real world. The strategy to conduct PoC studies should be part of the analysis of readiness of any application in health system's research. The first four levels of readiness in the TRL-IS scale include (1) foundational knowledge, (2) formalised prior knowledge base, (3) completion of a workable PoC, and (4) prototyping. It's design requires input from experts in all four levels. Twenty-three main elements relevant to PoC have been identified in these four phases.</p><p><strong>Discussion: </strong>PoC is generally omitted (or not reported) in mental health systems research. Researchers should be actively encouraged to overcome this omission. A common language, classification and vocabulary is needed for implementation science which incorporate this domain. The description of the specific activities conducive to PoC and prototyping should be provided. Training on the use of the TRL-IS framework including expert knowledge should also be promoted in mental health system research.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"25"},"PeriodicalIF":3.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884112","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":"Suicide among youth and young adults in Canada: bereaved parents' perspectives on the systems of care.","authors":"Toula Kourgiantakis, Deborah Cooper, David Cooper, Shelley Craig, Eunjung Lee, Jori Jones, Carrie K Y Lau, Romy-Naïma Tousignant, Jonathan B Singer, Marjorie Johnstone, Juveria Zaheer","doi":"10.1186/s13033-025-00680-y","DOIUrl":"10.1186/s13033-025-00680-y","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BACKGROUND: Suicide is the second leading cause of death among youth and young adults aged 15–24 in Canada. Emergency departments often serve as the first point of contact for identifying suicide risk, particularly for youth and young adults, partly due to the inaccessibility and unavailability of community mental health services. Almost half of the youth who die by suicide visit an emergency department in the year preceding their death, and up to 90% have untreated mental health and substance use concerns. Studies have found that parents describe youth mental health services as harmful, fragmented, inaccessible, and inadequate in meeting their children’s needs. Significant gaps remain in our understanding of the experiences with the systems of care for youth who die by suicide. Parents are uniquely positioned to provide vital insights, enhancing our understanding of the role that systems of care play in addressing and preventing suicide. The aim of this study was to better understand how bereaved parents describe the systems of care that provided services to their youth prior to the suicide. METHODS: This qualitative study used a community-based participatory research approach in partnership with Eli’s Place, a rural residential treatment centre currently in development for young adults with serious mental illness. Participants were eligible if they were parents or caregivers residing in Ontario, Canada, of a youth or young adult under the age of 30 who died by suicide. Semi-structured interviews were conducted, and data were analyzed using thematic analysis. RESULTS: Seventeen participants took part in the study, including 12 mothers and five fathers. The ages of the youth ranged from 12 to 29 years, with a mean age of 18. Most of the youth had diagnosed mental health and addiction-related concerns, and most had received mental health services. Our analysis of parents’ experiences and perspectives identified eight key themes, highlighting critical gaps in the mental health systems involved in their youth’s care: (1) barriers in accessing services; (2) gaps in continuity and coordination of care; (3) absence of guidelines for assessments, treatment, and safety planning; (4) inconsistent quality of care; (5) inadequate training and education for service providers; (6) insufficient involvement of parents and caregivers; (7) limited psychoeducation for youth and families; and (8) experiences of bullying, racism, and discrimination, with a lack of accountability. CONCLUSIONS: Youth suicide is a serious public health concern that requires a systems of care approach, incorporating integrated services with coordinated care and child- and family-centred approaches. In 2024, Canada introduced its first National Suicide Prevention Action Plan, marking a significant and promising advancement in suicide prevention. However, its effectiveness in reducing suicides across Canada will depend on robust implementation, supported by strong political leadersh","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"26"},"PeriodicalIF":4.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884113","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":"Care coordination for persons with mental health challenges: a scoping review.","authors":"Anton N Isaacs, Zoe Duncan","doi":"10.1186/s13033-025-00679-5","DOIUrl":"10.1186/s13033-025-00679-5","url":null,"abstract":"<p><strong>Background: </strong>Care coordination is commonly employed to assist individuals with mental health challenges [MHCs]. However, its implementation in mental health contexts is inconsistent. The term, 'care coordination' is also used interchangeably with integrated care and case management. This review aims to (1) consolidate the literature on how, and in what contexts, care coordination has been used to help adults with MHCs access care from more than one service and (2) describe the challenges and benefits of implementing care coordination for adults with MHCs from the perspective of service providers, care coordinators and service users.</p><p><strong>Methods: </strong>This is a scoping review that adopted methodological aspects of Arksey and O'Malley and those proposed by the Joanna Briggs Institute.</p><p><strong>Results: </strong>Care coordination has been employed in a range of clinical and non-clinical settings. Eligibility for care coordination was predominantly restricted to individuals at high risk of deterioration or those unable to access multiple services independently. Care coordinators worked individually or as part of a team and were mostly mental health nurses or social workers. Care coordination was reported to include both clinical and non-clinical tasks. Clinical tasks included medication management, preparing coordinated treatment plans and implementing crisis triage. Non-clinical tasks included acceptance of referrals, identification of service user needs, developing a plan for service involvement, implementation of the said plan, and monitoring of outcomes. Benefits of care coordination included improved access to services, reduced consumer distress, and self-harming behaviour, a team approach to care, decrease in psychiatric hospitalisations, emergency room visits and arrests, and better interservice collaboration. Challenges to care coordination included continuing unmet needs, lack of service availability and health insurance, unclear processes causing confusion, difficulties in engaging with some service users, administrative complications, large consumer load and staff shortages, incompatibility of technology between systems, insufficient funding and limited community support agencies.</p><p><strong>Conclusion: </strong>A better understanding of care coordination is needed that includes indications, eligibility criteria, coordination tasks, expected outcomes, as well as organizational and service system requirements.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"19 1","pages":"24"},"PeriodicalIF":3.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876012","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}