Journal of Mental Health最新文献

Background: Mental health nurse practitioners represent a workforce with capacity to significantly contribute to meeting public need for psychotherapy.

Aim: The purpose of this scoping review study is to synthesize evidence regarding mental health nurse practitioner use of psychotherapy.

Methods: Arksey and O' Malley's framework was used to guide the review which sought and synthesized papers written in English published between January 2000- April 2025 describing mental health nurse practitioners use of psychotherapy.

Results: Sixteen papers were included, nine written in the United States, four from Australia, and one each from South Africa, the Netherlands and Korea. Studies revealed that mental health nurse practitioners utilize a wide range of psychotherapy to assist people throughout the lifespan and across diverse settings. However, despite such wide-ranging and valuable service provision regulatory barriers often restrict mental health nurse practitioners' delivery of psychotherapy.

Conclusion: Evidence outlined in this scoping review challenges governments, policy advisors and service managers to better support mental health nurse practitioners as they seek to serve their communities by providing psychotherapy alongside other forms of mental healthcare.

Background: The self-presentation of psychiatric disorders on social media has generated a countermovement of sceptics who believe some are "faked" for reasons of self-promotion. This has been the focus of a Reddit forum called r/FakeDisorderCringe, an active community with almost 300,000 members. Given the influence of online discourse on public attitudes, understanding which diagnoses attract the most scepticism and what conversational themes surround these concerns is important in understanding lay controversies in mental health.

Methods: We used topic modelling using Latent Dirichlet allocation, a natural language processing technique, to analyse over 850,000 forum posts from August 2020 to December 2022 to identify the main topics.

Results: Topic modelling identified 15 topics, of which several identified specific disorders: anxiety, depression, OCD (obsessive-compulsive disorder), ADHD (attention deficit and hyperactivity disorder), autism, Tourette's syndrome and tics, and DID (dissociative identity disorder). Other topics included faking and attention-seeking, school and childhood context, trauma and abuse, validity of self-diagnosis, medical research evidence, gender identity and sexuality, profanity, and sarcasm-laden commentary.

Conclusions: This scepticism does not mirror previously identified public doubts about the legitimacy of specific diagnoses and seems to more commonly focus on conditions that have seen a recent increase in diagnosis in young people.

Background: Quality mental health services are pivotal in addressing mental health issues worldwide. Despite this importance, many countries face challenges in providing accessible, high-quality mental health care.

Aims: This study examines the nexus between mental health services and worry about mental health issues across different countries.

Methods: This study used data from the Lloyd's Register Foundation 2021 World Risk Poll, the OECD, the World Health Organization, and Our World in Data. The variables include worry about the personal harm that mental health issues could cause, mental health services (i.e. service facilities, service availability, and service utilisation), and estimated prevalences of major mental disorders.

Results: The results revealed that structural components - specifically the availability of mental health outpatient facilities - were associated with less worry about mental health issues across countries. However, no significant association was observed between process components - such as service utilisation - and worry about mental health issues. Additionally, the association between the prevalence of various mental disorders and worry about mental health issues showed mixed results.

Conclusions: The findings emphasise the importance of increasing the availability of these facilities to ensure universal access to essential mental health care, thereby improving mental well-being across both low-income and high-income countries.

Background: Reducing barriers to engagement in mental health services by meeting people in the communities "where they are" has potential to reach those who would be otherwise disengaged.

Aims: This study explores the potential of laundromats as a space to reach individuals with elevated social, mental health, and suicide risk.

Methods: Participants (N = 197) were recruited from over 50 laundromats across San Antonio, Texas. Rates of mental health conditions and suicide risk were compared to national estimates, and analyses were supplemented with bootstrapped samples.

Results: The majority (60%) of participants indicated one or more financial need. Participants were significantly more likely to report poor/fair mental health and screen positive for suicidal ideation relative to the national average. In a multivariable logistic regression, suicidal ideation was related age, education and housing insecurity prior to the addition of mental health. Over 1/3 of participants indicated an interest in receiving behavioral health services at a laundromat.

Conclusions: Laundromat customers in San Antonio, Texas reported poorer mental health and elevated suicidal ideation relative to the national average. Current utilization of mental health services was low with many participants indicating an interest in receiving services at the laundromat, suggesting an opportunity for community intervention.

Background: In Canada, more than 4,500 people die by suicide annually, with individuals diagnosed with psychotic disorders being at significantly higher risk. Although the risk factors for suicide in this population are well-established, the assessment of suicide risk remains underexplored.

Aim: This study examines the practices of mental health professionals working with clients with a psychotic disorder in relation to suicide risk assessment, using the Theory of Planned Behavior (TPB) as a theoretical framework.

Method: A survey of 148 professionals across Canada was conducted to assess factors influencing the frequency and thoroughness of suicide risk assessments.

Results: Despite our perceived behavioral control scale having psychometrical flaws, results revealed that social norms were a significant predictor of systematic suicide risk assessments. Professionals identified a lack of time, training, and inadequate clinical tools as major obstacles to thorough assessments. Despite the widespread availability of suicide risk assessment training, many professionals did not feel adequately prepared or confident in conducting such assessments, particularly with clients with a psychotic disorder.

Conclusion: The findings highlight the need for enhanced support, training, and organizational changes to improve the systematic assessment of suicide risk in this vulnerable population.

Background: The week following discharge from inpatient psychiatry is a time of exponentially increased risk of death by suicide among people diagnosed with a mental illness. Yet, a significant number of individuals do not receive timely outpatient follow-up upon being discharged from hospital. Psychosocial interventions that target suicidality initiated within inpatient psychiatry may help to prepare individuals for this vulnerable transition.

Aims: To explore the range and nature of research on psychosocial interventions targeting suicidality in the context of inpatient psychiatry and to identify the components and intended mechanisms of studied interventions as well as their mode and dose of delivery, adaptations, outcomes measured, and overall results.

Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and in line with the Preferred Reporting for Systematic Reviews and Meta-Analyses extension for Scoping reviews. Studies that described psychosocial interventions initiated in adult psychiatric inpatient units aimed at addressing suicidality were included.

Results: A total of 77 articles were included in the review, most of which employed quantitative research methods, were published after 2019, and were conducted in the United States. Most interventions studied were based on cognitive behavioral approaches, incorporated a review of factors that led to a person's suicidality, strategies for managing emotions, and safety planning. Participants' narratives as to what was helpful for them centred around the themes of being acknowledged, being listened to, and increasing self-awareness.

Conclusions: Cognitive behavioral therapy underlies most interventions targeting suicidality in inpatient psychiatry. There is a need for research that explores patients' experiences of engaging in specific suicide targeted interventions and that sheds light on the relational aspect of interventions targeting suicidality.

Background: The Emergency Department (ED) is a key setting for suicide risk assessments. In the UK, mental health professionals (MHPs) in psychiatry liaison teams assess suicide risk.

Aim: This study aimed to explore how MHPs in EDs experience and approach the assessment of suicide risk for people presenting for suicidal ideation and/or self-harm.

Methods: We interviewed 22 MHPs from one hospital (England) on their views of conducting psychosocial assessments. Interviews were recorded, transcribed and analysed using inductive thematic analysis.

Results: MHPs described various challenges, summarised in four main areas: the complexity of assessing suicide risk and lack of confidence in some patients/ accounts, the dynamic nature of risk, the impact/barrier of a structured assessment form, and institutional pressures and lack of resources. We identified views and attitudes that delegitimise patients. While such practices at an individual level need to be addressed, we posit this reflects organisational pressures that stifle practitioners' ability to prioritise therapeutic alliance.

Conclusions: It is unsurprising that MHP experience moral injury that can be manifested as amplify biases and compassion fatigue. This calls for changes to support staff striving to make assessments therapeutic and we recommend both top-down and bottom-up initiatives to improve the experiences of MHPs and their patients.

Background: Since the first suicide helpline was established in 1953, telephone support helplines have expanded globally. One such helpline is Samaritans. Previous studies on Samaritans have explored volunteers' perspectives and examined the number of calls users make.

Aims: The aim of this study was to capture the users' experiences of Samaritans' helpline in Ireland.

Methods: A mixed methods methodology, incorporating quantitative (cross-sectional) and qualitative (qualitative descriptive) elements was adopted. Participants accessed surveys via Samaritans' website. At the end of the survey, participants could self-select to partake in 1:1 online interviews. Quantitative data were analysed using descriptive statistics; qualitative data were analysed using reflexive thematic analysis.

Results: A total of 395 respondents completed the survey. Telephone was the most prominent format of contact with Samaritans, at 88.6% (n = 350). Mental health was cited as the main reason callers connected with Samaritans. Almost half of respondents felt supported a lot (47.3%, n = 187). Qualitative analysis identified three themes: Availability, Accessibility, Anonymity; Connecting with Volunteers; and Expectations of Samaritans' Services.

Conclusions: Samaritans' services are highly valued by those who engage with them. However, there is a need to enhance public awareness about the specific supports Samaritans provide, and the formats of contact that are available.

Background: Emotional reactions to the ongoing climate crisis, termed eco-distress, eco-anxiety or climate anxiety, are experienced more and more frequently by patients. However, evidence-based recommendations for practitioners on how to deal with eco-distress are scarce. The aim of this study was to provide a guideline for working with eco-distress in counseling and psychotherapy, based on the analysis of practitioners' perspectives.

Methods: Three semi-structured in-depth focus group interviews were conducted with n = 23 psychotherapists in training who had taken part in three different scenarios of eco-distress with standardized patients. Transcripts were analyzed from a phenomenological perspective, employing thematic analysis.

Findings: Three superordinate themes were identified: (1) "Necessary Basic Understandings;" (2) "Particularities of the Psychotherapeutic Relationship"; and (3) "Useful Skills." Based on the thematic analysis, a guideline for practitioners was developed.

Implications: The presented guideline can inform current practice and form a basis for the development of trainings on dealing with eco-distress. It enables practitioners to familiarize themselves with the specific aspects of dealing with eco-distress in counseling and psychotherapy and to integrate these into their existing competencies.