SSM. Mental health最新文献

{"title":"The growing divide: Income inequities in access to mental healthcare in Australia","authors":"Nicole Black,&nbsp;Danusha Jayawardana,&nbsp;David W. Johnston,&nbsp;Trong-Anh Trinh","doi":"10.1016/j.ssmmh.2025.100580","DOIUrl":"10.1016/j.ssmmh.2025.100580","url":null,"abstract":"<div><div>Rising out-of-pocket costs for psychotherapy in Australia have heightened concerns about financial barriers to mental healthcare, particularly for lower-income households, who disproportionately experience psychological distress. Using nation-wide linked administrative records of income and healthcare use, we estimate the magnitude of income-related inequity in psychotherapy use among 5.4 million individuals diagnosed with a mental health condition, and examine how such inequity has evolved over the decade from 2014 to 2023. Our findings show that income-related inequity is substantial, consistently higher among children than among adults, and has nearly doubled over the decade. By 2023, only 32% of low-income children and 40% of low-income adults accessed psychotherapy within three months of receiving a mental health treatment plan, compared with 55% among both high-income children and adults. We rule out changes in complexity of mental health disorders and the introduction of telehealth services as key drivers. We find no discernible difference by gender or age subgroups. Examination of antidepressant use reveals a growing gap in the opposite direction, with lower-income individuals increasingly reliant on medication without psychotherapy, relative to higher-income individuals. This suggests a shift towards lower-cost treatment pathways among disadvantaged groups. Our findings highlight the need for policies to address the increasing costs and other barriers to accessing psychotherapy, especially for lower-income households.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100580"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What comes to mind when you hear the term ‘trauma’? A qualitative study of social representations of trauma in Ireland","authors":"Cliodhna Cadogan ,&nbsp;Helene Joffe ,&nbsp;Kylo Fleischer ,&nbsp;Cliodhna O'Connor","doi":"10.1016/j.ssmmh.2026.100592","DOIUrl":"10.1016/j.ssmmh.2026.100592","url":null,"abstract":"<div><div>Psychological trauma is an increasingly prominent construct in contemporary culture, invoked across diverse contexts of policy, practice, and public discourse. However, little is known about how laypeople conceptualise trauma in everyday life. This qualitative study explored social representations of trauma among residents of the Republic of Ireland. Twenty participants completed interviews that elaborated their associations with the term ‘trauma’. Thematic analysis identified three overarching themes, which represented trauma as (a) an individual journey, (b) a byproduct of social ills, and (c) a cultural construct. More specifically, participants viewed trauma as highly subjective, shaped by individual differences in experiences, responses and outcomes. In parallel, trauma was linked to societal-level phenomena such as war and violence, with social support positioned as key to coping and recovery. Participants were highly sensitive to the growing cultural prominence and widening uses of trauma and expressed ambivalence regarding this trend, welcoming trauma's de-stigmatisation but deploring its potential trivialisation. These findings offer original insights into how trauma is understood beyond clinical settings, informing responsible uses of the concept and ongoing debates about its cultural significance.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100592"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the role of intersectional identity constructs on psychological well-being of Latino men who have sex with men (LMSM) in San Diego, California: A cross-sectional analysis of the NEXUS study","authors":"Angel B. Algarin ,&nbsp;Eileen V. Pitpitan ,&nbsp;Renee El Krab ,&nbsp;Nicole K. Kelly ,&nbsp;Maryam Hussain ,&nbsp;Carl Latkin ,&nbsp;Britt Skaathun ,&nbsp;Heather A. Pines ,&nbsp;Aaron Gutierrez ,&nbsp;Francisco Soto ,&nbsp;Ricardo Vazquez Jr. ,&nbsp;Juan Esparza ,&nbsp;Malek Guerbaoui ,&nbsp;Beth Davenport ,&nbsp;Veronica Moore ,&nbsp;Laramie R. Smith","doi":"10.1016/j.ssmmh.2025.100576","DOIUrl":"10.1016/j.ssmmh.2025.100576","url":null,"abstract":"<div><h3>Background</h3><div>Latino men who have sex with men (LMSM) experience substantial mental health inequities, partly due to intersectional stigma related to their Latino, masculine (i.e., conceptualized as a spectrum of gendered expectations, where both endorsement and non-endorsement of traditional masculine norms shape experience), and sexual identities. While prior research has examined identity valence (e.g., internalized stigma, pride) and magnitude (e.g., centrality, salience), little is known about how these constructs jointly influence mental health from an intersectional lens. This study explores the impact of intersectional identity constructs on psychological well-being among LMSM in San Diego, California.</div></div><div><h3>Methods</h3><div>We analyzed baseline data from 503 participants enrolled in the NEXUS study, a longitudinal cohort investigating intersectional stigma and HIV prevention using social network methods. Participants reported on identity centrality, salience, internalized stigma, and pride across Latino, masculine, and sexual identities. Mental health outcomes included depression (CESD-10), anxiety (GAD-7), and resilience (CD-RISC-10). Structural equation modeling assessed a measurement model of latent intersectional identity constructs and their associations with psychological well-being.</div></div><div><h3>Results</h3><div>Higher intersectional internalized stigma and identity salience were associated with greater depression (β = 0.33, p &lt; 0.001; β = 0.25, p &lt; 0.001) and anxiety (β = 0.33, p &lt; 0.001; β = 0.22, p &lt; 0.001). Identity centrality was negatively associated with depression (β = −0.14, p = 0.037). Pride was positively associated with resilience (β = 0.16, p = 0.038), while internalized stigma was negatively associated (β = −0.25, p = 0.001).</div></div><div><h3>Conclusions</h3><div>Intersectional internalized stigma and identity salience may harm mental health, while centrality and pride show protective effects. Findings highlight the importance of intersectional frameworks in mental health care for LMSM.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100576"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of medical mistrust in racial and ethnic inequities in postpartum mental health care","authors":"Sarah C. Haight ,&nbsp;Jamie R. Daw ,&nbsp;Brian W. Pence ,&nbsp;Jaime Slaughter-Acey ,&nbsp;Chantel L. Martin ,&nbsp;Sarah Verbiest ,&nbsp;Joanna Maselko","doi":"10.1016/j.ssmmh.2026.100588","DOIUrl":"10.1016/j.ssmmh.2026.100588","url":null,"abstract":"<div><h3>Purpose</h3><div>Among a sample of people with postpartum depressive symptoms, we examine the relationship between medical mistrust and receipt of a perinatal mood and anxiety disorder (PMAD) diagnosis and postpartum mental health care by race and ethnicity.</div></div><div><h3>Methods</h3><div>Data are from the 2020 Postpartum Assessment of Health Survey administered at 12–14 mo postpartum across 7 US jurisdictions. The analytical sample included 454 respondents with a positive screen on the Patient Health Questionnaire-2. Self-reported measures included: medical mistrust (measured with the Group-Based Medical Mistrust Scale), PMAD diagnosis by a provider, postpartum mental health care, and race and ethnicity. Survey-weighted risk ratios (RR) were calculated for the relationship between a 1-unit increase in medical mistrust and PMAD diagnosis and care, overall and by race and ethnicity.</div></div><div><h3>Results</h3><div>Higher levels of medical mistrust were reported among individuals that were single, Black, Hispanic, had lower educational attainment, and public/no insurance. Increasing medical mistrust was associated with a moderately increased likelihood of PMAD diagnosis (RR: 1.2; 95 % CI: 0.8–1.0) and a reduced likelihood of receiving postpartum mental health care (RR: 0.9; 95 % CI: 0.8–1.1). The latter largely driven by the suspicion subscale (RR: 0.8; 95 % CI: 0.7–1.0). The relationship between medical mistrust and a reduced likelihood of care was strongest among Black postpartum people for both PMAD diagnosis (RR: 0.6; 95 % CI: 0.0–15.9) and care (RR: 0.9; 95 % CI: 0.4–2.3), though subgroup CIs overlapped.</div></div><div><h3>Conclusion</h3><div>Medical mistrust specifically related to knowledge of health disparities or feelings of suspicion may be related to racial and ethnic inequities in postpartum mental health care.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100588"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Belonging, discrimination, and risk in displacement: Bayesian variable selection in predicting mental health and resilience among refugee adolescents in Greece","authors":"Theoni Stathopoulou ,&nbsp;Konstantinos Bourazas ,&nbsp;Korina Hatzinikolaou ,&nbsp;Eirini Adamopoulou ,&nbsp;Lina Zirganou-Kazolea ,&nbsp;Jennifer Cavounidis ,&nbsp;Natalia Spyropoulou ,&nbsp;Giampaolo Nicolais ,&nbsp;Catherine Panter-Brick ,&nbsp;Richard F. Mollica","doi":"10.1016/j.ssmmh.2025.100574","DOIUrl":"10.1016/j.ssmmh.2025.100574","url":null,"abstract":"<div><div>Background: Understanding the mental health challenges of refugee adolescents is critical for informing targeted educational policies and interventions. Yet few studies identify which school-based factors most strongly relate to their resilience and well-being. This study draws on a multi-informant dataset from 170 refugee students attending school in Greece, applying Bayesian variable selection to identify key predictors of mental health outcomes. Methods: We collected student (<span><math><mrow><mi>n</mi><mo>=</mo><mn>170</mn></mrow></math></span>), teacher (<span><math><mrow><mi>n</mi><mo>=</mo><mn>165</mn></mrow></math></span>) and parent/guardian (<span><math><mrow><mi>n</mi><mo>=</mo><mn>124</mn></mrow></math></span>) data about each student (Strengths and Difficulties Questionnaire, SDQ; Child and Youth Resilience Measure-Revised, CYRM-R); sense of belonging, school attendance. We ran two models, one based on student self-reports, the other based on teacher, parent, and guardian data. Results: The self-reported sense of belonging was the most consistent protective factor of SDQ and CYRM-R outcomes, while bullying, discrimination, and disrupted schooling were associated with greater vulnerability. In triangulated analysis, student self-reports contributed the largest share of predictive information, followed by adult reports Discussion: This study highlights the importance of centering youth perspectives in mental health assessment and intervention and the critical role of inclusive school environments and educational continuity in supporting refugee integration. The Bayesian approach offers a robust framework for guiding evidence-based interventions for supporting the integration of refugee students in host-country educational settings.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100574"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial stressors related to extreme weather events and multiple resource insecurities: qualitative insights from refugee youth in an Ugandan humanitarian setting","authors":"Carmen H. Logie ,&nbsp;Ofir Sivan ,&nbsp;Rachel Leggett ,&nbsp;Moses Okumu ,&nbsp;Miranda Loutet ,&nbsp;Frannie MacKenzie ,&nbsp;Simon Odong Lukone ,&nbsp;Nelson Kisubi ,&nbsp;Lesley Gittings ,&nbsp;Peter Kyambadde ,&nbsp;Caetano Dorea ,&nbsp;Manjulaa Narasimhan","doi":"10.1016/j.ssmmh.2025.100579","DOIUrl":"10.1016/j.ssmmh.2025.100579","url":null,"abstract":"<div><div>Extreme weather events (EWE) contribute to heightened psychosocial stressors through complex pathways, including by worsening resource insecurities. Refugee settlements globally are disproportionately exposed to EWE compared with host national populations, yet refugees' experiences of resource insecurity-related psychosocial stressors in low-income humanitarian settings are understudied. Our study focused on understanding the lived experiences of psychosocial stressors in the context of EWE and resource insecurity among refugee youth in Bidi Bidi Refugee Settlement, Uganda. This qualitative study involved 32 walk-along interviews with a purposive sample of refugee youth aged 16–24 (16 men, 16 women); youth led the interviewer to 1–3 places where they obtained food, water, and/or sanitation resources, discussed the place's meaning and impact on wellbeing, and took photos. We also conducted 12 in-depth interviews with key informants with expertise in refugee youth wellbeing, EWE, and/or resource security. We conducted framework thematic analysis informed by resource scarcity and water insecurity-related distress frameworks. Participant narratives reflected four key themes regarding linkages between EWE, resource insecurities, and psychosocial distress: 1) material deprivation and uncertainty (sub-themes: drought-related food and water insecurity; flooding-related infrastructure and agricultural damage); 2) shame of social failure (sub-themes: sanitation insecurity stressors; unemployment and food insecurity distress and related substance use); 3) interpersonal conflict, including multi-level violence (sub-themes: increased violence; concerns about crime and theft); and 4) coping and asset management strategies (sub-themes: social and economic infrastructure; social capital; household relations). Together findings suggest the need for integrating psychosocial support within social and economic opportunities and poverty reduction with refugee youth.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100579"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The alter-Native psy-ence of Indigenous well-being: Relational expressions of self and expansive attributions of personhood","authors":"Joseph P. Gone","doi":"10.1016/j.ssmmh.2026.100591","DOIUrl":"10.1016/j.ssmmh.2026.100591","url":null,"abstract":"<div><div>Fifty years ago, Congressional passage of the Indian Self-Determination and Education Assistance Act heralded a new era in U.S. Indian affairs, ostensibly repudiating the long history of federal intrusion, domination, and control of American Indian lives. Since then, <em>self-determination</em> has come to define federal Indian policy, so much so that the term remains in widespread colloquial usage throughout Indian Country. Even as Tribal governments assumed administrative control of their own human services during this time, inequities in the mental health status of Indigenous communities have persisted. In response, American Indian communities have engaged, critiqued, and recast knowledge and expertise in the mental health professions. The result is an “alter-Native psy-ence” of mental health, comprising Indigenous visions of flourishing vitality and holistic well-being. In these enduring views of a good life, Indigenous communities retain esteem for <em>both</em> personal autonomy and capacious relationality. This fusion of regard for exercising agency and freedom alongside regard for fulfilling roles and duties entails a dynamic configuration of selfhood-in-relation to others. Moreover, these others include both human and non-human persons, for whom personhood itself is defined by the capacity to exercise agency, autonomy, and self-determination. In this article, description and illustration of relational Indigenous expressions of self and expansive Indigenous attributions of personhood illuminate diverse forms of well-being that extend well beyond the culturally myopic orientations of the mental health professions. Recognition of these alter-Native modalities of living by the “psy” disciplines harbors potential for Indigenous \"survivance\" and “futurity” in robust anticolonial fashion.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100591"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Transforming mental health care in Kenya: The critical role of routine outcomes monitoring in specialized services” [SSM - Mental Health 8 (2025) 100570]","authors":"Clara Paz,&nbsp;Anne A. Obondo,&nbsp;Ian Kanyanya,&nbsp;Caleb Othieno,&nbsp;Manasi Kumar","doi":"10.1016/j.ssmmh.2026.100628","DOIUrl":"10.1016/j.ssmmh.2026.100628","url":null,"abstract":"","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100628"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Romanian version of the regulating emotions in parenting scale: psychometric properties and measurement invariance across mothers and fathers and across parents' psychological distress levels","authors":"Costina-Ruxandra Poetar ,&nbsp;Ionuț Stelian Florean","doi":"10.1016/j.ssmmh.2025.100514","DOIUrl":"10.1016/j.ssmmh.2025.100514","url":null,"abstract":"<div><div>The present study aimed to investigate the psychometric properties, factorial structure, and measurement invariance of the Romanian version of the Regulating Emotions in Parenting (REPS) scale. This was a cross-sectional study conducted in Romaniawith parents (N = 1566, <em>M</em>_age = 40.84 years, <em>SD</em> = 6.42) of children and adolescents aged 8–17 years old. Psychometric properties were tested via Confirmatory Factor Analysis (CFA), Multigroup CFA, Pearson's correlation, and Cronbach's alpha. The three-factor solution of REPS was confirmed (RMSEA = .077, CFI = .99, TLI = .99). Measurement invariance was supported for parents' psychological distress levels (difference between configural and scalar models: RMSEA = .007, ΔCFI = −.001, ΔTLI = .003), and across parents' sex (difference between configural and scalar models: ΔRMSEA = .011, ΔCFI &lt; −.001, ΔTLI = −.003). Thus, the comparison of the latent means of REPS across parents' distress levels and sex was supported. The scale provided good internal consistency (Cronbach's Alpha was .78 or higher) and concurrent validity with measures of parenting practices (e.g., the correlation between adaptive strategies and positive parenting practices was r = .37) and parents' psychological distress (e.g., the correlation between adaptive strategies and psychological distress was r = −.33). The results are consistent with previous literature, and their implications are discussed.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100514"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring for loved ones as community: Supporting caregivers of Native Hawaiians living with dementia","authors":"Alexandra Malia Jackson ,&nbsp;Adrienne Dillard ,&nbsp;B. Puni Kekauoha ,&nbsp;Mahealani Mahiai Austin ,&nbsp;Pokiʻi Balaz ,&nbsp;Errol Kiaʻi Lee ,&nbsp;Natlie Dutro ,&nbsp;Paige Mayeda ,&nbsp;Angeliyah Kahoku Dutro ,&nbsp;Kelly O'Sullivan ,&nbsp;Jordan P. Lewis ,&nbsp;Scott K. Okamoto ,&nbsp;Kenneth Hepburn ,&nbsp;Raven H. Weaver","doi":"10.1016/j.ssmmh.2025.100483","DOIUrl":"10.1016/j.ssmmh.2025.100483","url":null,"abstract":"<div><div>Caregiving interventions can reduce caregiver burden and promote caregiver competence, yet caregiving is rooted in culture, with differing impacts of the caregiving role. Culturally adapted interventions may better address the unique experiences of diverse family caregivers. In this exploratory study, we aimed to adapt the Savvy Caregiver Program (SCP), an evidence-based caregiving intervention, with a Native Hawaiian community in Hawaiʻi. First, a community action board (CAB) and research team tailored the curriculum to include Hawaiian values, language, proverbs and examples while maintaining the program core components. Then, Native Hawaiian adults participated in the preliminary adapted program, ʻAuamo Kuleana O Nā Maʻi Poina (ʻAuamo Kuleana). We describe the experiences of caregiving for a Native Hawaiian adult living with ADRD and how we obtained feedback to refine ‘Auamo Kuleana prior to pilot testing. Individuals who participated in the 7-week session of ʻAuamo Kuleana (<em>N</em> = 6) were asked to complete a survey and a focus group or interview to share their experiences and provide feedback that informed a process evaluation of the program. The CAB and research team analyzed qualitative data using thematic analysis. Only one participant was actively providing care; the other five participants were interested in proactive training to support their community. Caring as a community was a common theme. Participants shared positive feedback about ʻAuamo Kuleana and participants appreciated the tailored content. As such, no changes were made to the program. Two suggestions were identified: include all family members in the program to be in alignment as a ʻohana (family) in providing care and add information about planning for their own care. Future Native Hawaiian-focused caregiving interventions should consider incorporating cultural practices and values, proactive training about dementia and caregiving, caring as a community, and family-centered (rather than dyadic) caregiving.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100483"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}