Lindenfeld Z, Mauri AI, Rouhani S
… +1 more, Willison CE
Community Ment Health J
· 2026 Jan · PMID 40760237
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OBJECTIVE: This study examines the prevalence of specialized police responses to persons experiencing a mental health crisis across U.S. law enforcement agencies and explores whether organizational and community factors...OBJECTIVE: This study examines the prevalence of specialized police responses to persons experiencing a mental health crisis across U.S. law enforcement agencies and explores whether organizational and community factors are associated with their presence. METHODS: This study used 2020 data from a nationally representative survey of over 2,500 law enforcement agencies. The primary outcomes included whether agencies implemented one of four responses: (1) designated unit, (2) designated personnel, (3) addressed mental health without designated unit or personnel, or (4) did not address. Logistic regression models assessed factors associated with each response type. RESULTS: Over half (51.0%, n = 1,349) of agencies addressed mental health but lacked designated units or personnel, while 6.9% (n = 183) did not specifically address mental health. Larger agencies, agencies located in urban areas, as well as those with external partnerships, and a higher number of use of force complaints were significantly more likely to designate a unit or personnel. CONCLUSIONS: Fewer than half of law enforcement agencies have responses for mental health crises. Further research is needed to identify barriers and facilitators to adopting specialized responses, particularly among rural and under-resourced agencies.
Lau G, Chapman J, Bennett S
… +6 more, Meredith P, Sewell J, Johnston D, Butler C, Parker A, Wyder M
Community Ment Health J
· 2025 Nov · PMID 40748447
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People with mental illness have poor physical health outcomes. While clinical staff recognise the value of physical health in mental healthcare, they report low confidence and a lack of resources and training. As a resul...People with mental illness have poor physical health outcomes. While clinical staff recognise the value of physical health in mental healthcare, they report low confidence and a lack of resources and training. As a result, physical health needs are often unaddressed in routine care. A physical healthcare therapies capability framework (PHC TCF) was developed to support staff in developing capability in addressing the physical health needs of consumers of a large public mental health service. The aims of the current study were to evaluate: (i) staff capability in physical healthcare and the association with provision of service; (ii) changes in capability and service provision. Self-rated PHC TCF level and Provision of Service (POS) statistics for physical health assessment and intervention over 12-months were analysed. The nursing profession was associated with higher PHC TCF level than Allied Health (p <.01). While there was no significant change in PHC TCF levels, POS significantly increased over 12 months (z = -2.69, p =.007). This study demonstrated that a PHC TCF may be a useful tool to reinforce and implement physical health interventions in public mental health services.
Community Ment Health J
· 2025 Nov · PMID 40748446
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People living with bipolar disorders may face a range of treatment challenges, however, the treatment needs of those living with bipolar disorder in Australia have not been directly assessed. The present study aimed to e...People living with bipolar disorders may face a range of treatment challenges, however, the treatment needs of those living with bipolar disorder in Australia have not been directly assessed. The present study aimed to explore the treatment and care preferences of people living with bipolar disorder in Australia. Participants were part of a large co-designed survey that assessed preferred settings, barriers, and access to treatment. A total of 494 participants provided responses regarding preferred treatment settings with 188 (38%) preferring the public system, 175 (35%) private, and 153 (31%) indicating a preference for both/either private or public care. The setting that was most frequently endorsed was at home (n = 343; 69%), then outpatient (n = 155; 31%), and inpatient (n = 93; 19%). Affordability, resourcing, geographical and timely access, improving education and addressing stigma were reported as key unmet needs, indicating that more work is needed to improve access to care for Australians.
Borkenhagen D, Messier G, Masrani T
… +6 more, Gunn E, Bahji A, Barry R, Seitz D, Patten S, Dimitropoulos G
Community Ment Health J
· 2025 Nov · PMID 40742657
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Adolescents with existing mental health and substance use disorders are at higher risk for homelessness, and being homeless can further exacerbate these issues. However, no systematic review has specifically assessed the...Adolescents with existing mental health and substance use disorders are at higher risk for homelessness, and being homeless can further exacerbate these issues. However, no systematic review has specifically assessed the prevalence of mental health and substance use disorders among homeless adolescents using validated diagnostic measures. The objective of this study was to determine the prevalence of mental health and substance use disorders among adolescents experiencing homelessness, based on studies employing validated diagnostic measures. A systematic search was conducted across electronic databases, including AMED, Cochrane, Embase, CINAHL, PsycINFO, MEDLINE, and PubMed, from inception through February 3, 2024. Studies were included if they assessed the prevalence of mental health and substance use disorders using validated diagnostic measures in adolescents aged 12-17 years who were experiencing homelessness. Data extraction was performed using Covidence and reviewed for accuracy by two independent reviewers. Weighted average prevalence rates for mental health and substance use disorders among homeless adolescents were calculated, along with 95% confidence intervals (CIs). Out of 7,729 citations, 116 studies were reviewed in full, and two studies met all criteria (N = 226). The most common mental health disorder identified, based on diagnostic classifications used in earlier versions of the DSM and ICD, was drug abuse disorder (43%, 95% CI [34, 53]), followed by disruptive behavior disorder (39%, 95% CI [25, 53]) and alcohol abuse disorder (38%, 95% CI [28, 48]). This systematic review highlights the limited evidence available on the prevalence of mental health and substance use disorders among homeless adolescents from studies using validated diagnostic measures. Further research is essential to enhance understanding and to develop data-driven intervention strategies to better address the needs and challenges faced by this vulnerable population.
Community Ment Health J
· 2025 Nov · PMID 40728796
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Electroconvulsive Therapy (ECT) remains a stigmatized treatment despite its well-established efficacy and safety in various psychiatric conditions. Among individuals with schizophrenia-who already face high levels of ill...Electroconvulsive Therapy (ECT) remains a stigmatized treatment despite its well-established efficacy and safety in various psychiatric conditions. Among individuals with schizophrenia-who already face high levels of illness-related stigma-ECT-related stigma may represent an additional barrier to treatment acceptance. This case-control study aimed to examine how direct experience with ECT, either personally or through a family member, influences knowledge, perceptions, and treatment acceptance among individuals with schizophrenia and their relatives. A total of 200 participants, including 100 individuals with schizophrenia (50 with prior ECT experience and 50 without) and 100 of their relatives, completed standardized assessments measuring cognitive function, symptom severity, internalized stigma, attitudes toward psychiatric medications, and ECT-related knowledge and perceptions. The results showed that patients and relatives with prior ECT experience demonstrated higher levels of knowledge and more positive perceptions of ECT compared to those without such experience. Patients with previous ECT were also more likely to accept future ECT, and this acceptance was associated with more favorable attitudes toward psychiatric medications. While internalized stigma levels did not significantly differ between groups, higher stigma in patients was correlated with more negative beliefs about mental illness among their relatives. These findings suggest that individuals with firsthand ECT experience and their families may serve as effective advocates for reducing stigma and promoting informed decision-making in schizophrenia care.
Whyte M, Schols-Flett K, Ferrara B
… +4 more, Warren C, Wenger M, Dimitropoulos G, Barbic S
Community Ment Health J
· 2026 Jan · PMID 40719969
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Youth peer support workers (YPSWs) use lived/living experience to provide support. However, there is a knowledge gap about service impact on YPSWs themselves. To understand (1) impact being a YPSW has on well-being, (2)...Youth peer support workers (YPSWs) use lived/living experience to provide support. However, there is a knowledge gap about service impact on YPSWs themselves. To understand (1) impact being a YPSW has on well-being, (2) experience of being a YPSW, and (3) barriers and facilitators of being a YPSW. Eighteen YPSWs at an integrated youth services (IYS) initiative in British Columbia, Canada, completed semi-structured interviews in fall 2023. Interviews were analysed thematically using an inductive approach. Themes were identified relating to the YPSW role extending beyond employment, providing a sense of purpose and contributing to personal and professional growth as a low-barrier employment opportunity. YPSWs also identified barriers and facilitators within their role. Findings highlight the value of YPSWs as an occupation and the distinction of this role. To strengthen the profession and increase supports for YPSWs, the development of clear policies and standards is essential.
Community Ment Health J
· 2025 Nov · PMID 40705240
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Mental health support workers (MHSWs) are an important workforce within the mental health care system. Research shows that support services delivered by MHSWs are effective at improving the outcomes of individuals with m...Mental health support workers (MHSWs) are an important workforce within the mental health care system. Research shows that support services delivered by MHSWs are effective at improving the outcomes of individuals with mental illness. However, there is also literature suggesting that this group of workers are facing many challenges in their roles. This qualitative systematic review sought to explore, analyze and synthesize available primary research literature on the experiences of MHSWs with the aim of identifying the barriers to and facilitators of effective delivery of their roles. An electronic search of Medline, CINAHL, PsycINFO, and Web of Science was conducted for studies from database inception to March 28, 2025. Additional search was conducted via Google Scholar and in the reference lists of the included articles. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research was used to assess the methodological quality of included articles. Fourteen primary research articles met the eligibility criteria and were included in the review. Data synthesis from these articles generated 116 findings and 20 categories, which were aggregated into four synthesized findings: a supportive work environment, service user care barriers, professional and role-related barriers, and operational and support barriers. The review highlights the importance of a supportive work environment in the delivery of support work roles. However, several barriers were also identified and recommendations that can be used to inform practice and policies of mental health support work provided. If addressed, the identified barriers can be translated into facilitators that would enhance the provision of quality care to people with mental illness and enhance the overall job satisfaction of MHSWs.
Community Ment Health J
· 2025 Nov · PMID 40699479
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The Cannabis Use Disorders Identification Test-Revised (CUDIT-R) is an eight-item screening tool designed to identify problematic cannabis use. The present study intended to assess the psychometric properties of the meas...The Cannabis Use Disorders Identification Test-Revised (CUDIT-R) is an eight-item screening tool designed to identify problematic cannabis use. The present study intended to assess the psychometric properties of the measure in a youth sample. N = 76 participants completed the CUDIT-R and a measure of cannabis consumption. All participants underwent an assessment for a current cannabis use disorder using the Structured Clinical Interview for DSM-IV. The CUDIT-R exhibited good internal consistency (Cronbach's α = 0.76) and concurrent validity with a cannabis consumption measure. Discriminant validity was demonstrated with an area under the ROC curve of 0.96. The CUDIT-R proved to be a reliable and valid screening tool amongst youth with heavy cannabis use, which suggests the scale has clinical utility.
Weatherly C, Abdelghani M, Cook GR
… +5 more, Irfan M, Meirose J, Gaveras E, Johnson N, Roth KB
Community Ment Health J
· 2025 Nov · PMID 40699478
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Rural communities in the United States (US) are disproportionately burdened with higher suicide rates than non-rural ones, facing structural and cultural barriers that make it less likely for suicidal individuals to obta...Rural communities in the United States (US) are disproportionately burdened with higher suicide rates than non-rural ones, facing structural and cultural barriers that make it less likely for suicidal individuals to obtain help. Community-based interventions have been called for to address the need for integrative approaches relevant to the rural landscape. To facilitate increased adaptation/implementation of rural suicide prevention programming, we conducted a scoping review of the literature to evaluate the state-of-the-science. Following PRISMA-ScR guidelines, we searched for and identified relevant peer-reviewed literature across four databases, using dual screening/extraction throughout. We extracted information on key article characteristics, program descriptions, and methodological approaches to identify trends, gaps, and emergent themes. 29 articles were included in this review. Studies predominantly focused on suicide prevention for youth, particularly amongst Indigenous communities, with papers also concentrating on medical settings and US veterans. While a wide range of intervention and evaluation approaches were employed, few studies measured clinical outcomes, utilized theoretical frameworks or official rural definitions, or used comprehensive prevention strategies. This review offers investigators a guide to the existing evidence base and growing patterns in the field of suicide prevention in rural US areas. Results highlight the dearth of literature on prevention programming in this much needed yet overlooked area of study. Future intervention research should consider using context-specific rural classifications, relevant clinical outcomes, and comprehensive theory-backed strategies embedded in their approach.
Giovannetti O, Francis E, Pauley N
… +1 more, Arbour S
Community Ment Health J
· 2025 Nov · PMID 40694300
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Mental health stigma is a pervasive issue which can adversely affect patient care and outcomes. Stigma may manifest through discrimination and negative stereotypes, and can be damaging when inadvertently perpetuated by p...Mental health stigma is a pervasive issue which can adversely affect patient care and outcomes. Stigma may manifest through discrimination and negative stereotypes, and can be damaging when inadvertently perpetuated by practitioners and trainees. This study aims explore the effect of experiential learning in decreasing stigma measured by changes in the perceived attitudes and behaviours of trainees at a specialized mental health hospital. Participants (N = 139) are trainees who were scheduled to undergo clinical or non-clinical placement at a mental health hospital. Participants completed a demographic survey prior to placement and a qualitative student evaluation after placement. Validated scales measuring changes in attitude (MICA-4) and behaviour (RIBS), were used as both pre- and post-placement evaluations. Trainee placement variations were accounted for using correlation analysis of the MICA-4 and RIBS data. Most participants identified as females with a college or university education, in their second to fourth years of study. Analysis of both MICA-4 (P = 0.0001) and RIBS (P = 0.009) revealed significant differences between pre-placement and post-placement scores on stigma-related attitudes and behaviours, respectively. These results were supported by qualitative responses which revealed alignment with recovery-oriented philosophy and reflections of stigma. Overall, this study demonstrates possible benefits of experiential learning in mental health care settings to address stigma in clinical and non-clinical trainees.
Community Ment Health J
· 2025 Nov · PMID 40690137
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This study aimed to provide a systematic review of Tai Chi interventions in psychosis and their impact on positive and negative symptoms, cognitive deficits and quality of life. There is growing evidence that the mind-bo...This study aimed to provide a systematic review of Tai Chi interventions in psychosis and their impact on positive and negative symptoms, cognitive deficits and quality of life. There is growing evidence that the mind-body practice of Tai Chi has value in treating and preventing mental health-related problems, such as stress and anxiety. However, it is unclear whether they are effective or beneficial in serious mental illnesses such as psychosis. A systematic review was conducted in accordance with PRISMA guidelines. The review protocol was registered (PROSPERO). The review examined studies which included adults with diagnosed psychotic disorders who participated in treatment studies examining Tai Chi or Qigong interventions using quantitative measures of positive and negative symptoms, cognitive deficits and quality of life. The search was conducted in August 2024. Data were extracted by two independent researchers and analysed using a narrative synthesis approach. Three-hundred and eighty one papers were screened with six studies included in the final review. Publications spanned from 2012-2022. All studies were based in Asia. Tai Chi interventions were acceptable, and well-tolerated. Outcomes indicated small-medium effective sizes in improving negative symptoms, and cognitive deficits. However largely, these improvements were not maintained over time. The current review suggests that Tai Chi is an acceptable, well-tolerated intervention in individuals with long-term psychotic illnesses in Asian populations There is tentative evidence that it may have a positive impact for negative symptoms and cognitive deficits. Well-controlled studies should be encouraged in Western settings.
Morandi S, Bonsack C, Boubaker K
… +1 more, Silva B
Community Ment Health J
· 2025 Nov · PMID 40679721
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Community treatment orders (CTOs) are legal procedures that authorise compulsory community mental health care for people with severe mental disorders. Since their introduction in Switzerland in 2013, the Swiss Canton of...Community treatment orders (CTOs) are legal procedures that authorise compulsory community mental health care for people with severe mental disorders. Since their introduction in Switzerland in 2013, the Swiss Canton of Vaud (846'300 inhabitants) has been engaged in the monitoring of CTOs. This study describes the use of this measure in the Canton of Vaud over the 10 years since its introduction and examines the profile of people undergoing CTOs during this period, the form that these measures took and the factors associated with their duration and outcome. Between 2013 and 2022, 530 CTOs have been ordered. As their incidence remained low and fluctuated between 5 and 10 CTOs per 100'000 inhabitants, their prevalence rose from 5 to 25 per 100'000 inhabitants. The profile of people placed under CTOs was comparable to that observed in other studies. The measures concerned mainly Swiss male in their forties, single or divorced/separated, living independently and under legal guardianship. The main diagnosis was schizophrenia, schizotypal or delusional disorders. On the 31st of December 2022, 329 CTOs (62.1%) had been discharged. Their average duration was slightly more than two years. Among the 329 CTOs discharged at the 31st of December 2022, five groups were identified according to the reasons for discharge: CTO success (38.7%), breached conditions with (24.0%) and without involuntary hospitalisation (11.5%), death of the patient (13.0%) and other reasons for discharge (12.8%). Prototypical situations for each group were identified.
Community Ment Health J
· 2025 Nov · PMID 40650836
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An unavoidable piece of the American healthcare system that is often overlooked concerns billing and payment in community mental health agencies. Practitioners are faced with ethical dilemmas surrounding productivity bil...An unavoidable piece of the American healthcare system that is often overlooked concerns billing and payment in community mental health agencies. Practitioners are faced with ethical dilemmas surrounding productivity billing that require their ability to strike a delicate balance between efficiency and providing quality care. In line with the American Psychological Association's Ethical Principals of Psychologists and Code of Conduct (2017), this paper examines ethical issues for mental health agencies and managers employing productivity-driven billing practices and reviews the impact these models have on practitioners and their clients. More specifically, it will speak to ethical concerns that impact not only the practitioners who are working at these agencies, but also the clients who are directly affected by the implementation and structure of this model. We conclude with a discussion regarding how agencies can play a more significant role in reducing unethical practices by improving operational standards to maximize quality care.
Browne J, Kunicki Z, Jarskog LF
… +6 more, Sheeran P, Abrantes AM, Elliott T, Gonzalez O, Penn DL, Battaglini C
Community Ment Health J
· 2025 Nov · PMID 40643782
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Physical activity improves mental health in individuals with schizophrenia. Yet, limited access, low motivation, and social isolation make participation in face-to-face programs challenging. This 16-week pilot randomized...Physical activity improves mental health in individuals with schizophrenia. Yet, limited access, low motivation, and social isolation make participation in face-to-face programs challenging. This 16-week pilot randomized controlled trial examined differences in symptoms and loneliness between adults with schizophrenia that were randomized to a virtual group-based walking program ("Virtual PACE-Life", n = 17) or Fitbit Alone (n = 20). The Positive and Negative Syndrome Scale and UCLA Loneliness scale were administered at baseline, 8 weeks, 16 weeks, and one-month follow-up. Standardized effects (SE) and confidence intervals from mixed effects models were used to evaluate group differences. Results demonstrated small-to-moderate effects (SE: 0.1-0.3) on total, negative, disorganization, excitement, and emotional distress symptoms favoring Virtual PACE-Life; however, negligible effects were observed for positive symptoms or loneliness. Despite the small sample size, these findings may suggest symptom but not loneliness benefits of a virtual group-based physical activity program for people with schizophrenia.
Fried J, McQuistion HL, Marrelli J
… +5 more, Hampton MC, Wu L, LeGeros A, Lanina O, Frankle WG
Community Ment Health J
· 2025 Nov · PMID 40622668
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This study aims to evaluate the quality and potential clinical benefits of a novel program, called the Enhanced Treatment and Recovery (EnTRy) Program, which provides Coordinated Specialty Care (CSC) without limits on di...This study aims to evaluate the quality and potential clinical benefits of a novel program, called the Enhanced Treatment and Recovery (EnTRy) Program, which provides Coordinated Specialty Care (CSC) without limits on diagnosis, age, or treatment time to individuals with serious mental illnesses (SMI). To assess recovery of participants, we compared the baseline Substance Abuse and Mental Health Services Administration (SAMSHA) National Outcome Measures (NOMs) in patients enrolled in EnTRy to that at 6 months and 12 months. To explore whether EnTRy provided benefits over standard treatment, we compared the time engaged in treatment for the EnTRy cohort with that of a historic sample from the same clinical site. Participants were significantly less likely to have a psychiatric hospitalization in the past 30 days during follow-up assessment at 6 months (19% at baseline, 1% at 6 months, (χ (1, N = 1006) = 91, p<0.0001) and 12 months (16% at baseline, 1% at 12 months, χ (1, N = 486) = 37.633, p<0.0001). Participants were similarly less likely to have psychiatric emergency service encounters in the past 30 days at 6 months (18% at baseline, 1% at 6 months, χ (1, N = 1004) = 86.808, p < 0.0001) and at 12 months (16% at baseline, 2% at 12 months, χ(1, N = 486) = 32.387, p= 0.0001). Patients enrolled in the EnTRy program remained engaged with care for significantly longer than a historical sample (p< 0.0001 by Mantel-Cox logrank) with a logrank hazard ratio of 2.0 (CI 1.65- 2.43). Age and diagnosis-unlimited CSC may be particularly effective for individuals with SMI who recently received hospital level care and may help maintain gains in individuals who have aged out of programs dedicated to first episode psychiatric illness.
Community Ment Health J
· 2025 Nov · PMID 40580277
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Climate anxiety can motivate adaptive behaviors but can become debilitating when excessive. People with schizophrenia are particularly vulnerable to extreme climate events, yet little is known about their climate-related...Climate anxiety can motivate adaptive behaviors but can become debilitating when excessive. People with schizophrenia are particularly vulnerable to extreme climate events, yet little is known about their climate-related concerns. This study examines climate anxiety levels and perceptions of government responses in outpatients with schizophrenia to inform targeted mental health interventions. From March to July 2024, 108 adult outpatients with schizophrenia participated in semi-structured interviews using two validated surveys assessing climate-related emotions and beliefs about government responses. Many participants reported moderate climate anxiety, with some dissatisfaction regarding government actions. Severe functional impairments due to climate anxiety were uncommon. Understanding climate anxiety in people with schizophrenia, an easily overlooked vulnerable group to climate change-related morbidity and mortality, is critical to enhance preparedness and mitigate psychiatric and physical health risks.
Community Ment Health J
· 2025 Nov · PMID 40553307
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A growing number of police departments in the United States have adopted specialized training models to handle situations involving people with mental illness (PWMI), including the Crisis Intervention Team (CIT) model an...A growing number of police departments in the United States have adopted specialized training models to handle situations involving people with mental illness (PWMI), including the Crisis Intervention Team (CIT) model and other models with reduced training hours (OMRTH). However, research on police chiefs' attitudes toward these training models, especially those working in rural areas, remains limited. To address this gap in the literature, this study explored the attitudes of rural police chiefs across two states regarding two categories of police training models (the CIT model and OMRTH) and examined factors influencing their viewpoints. The results revealed that chiefs in rural areas demonstrated favorable attitudes toward the CIT model but negative attitudes toward OMRTH. Policy implications and suggestions for future research are discussed.
Community Ment Health J
· 2025 Oct · PMID 40553306
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Australia's National Disability Insurance Scheme (NDIS) provides individualised funding to eligible people with disability to purchase required services and supports. However, people with psychosocial disability have exp...Australia's National Disability Insurance Scheme (NDIS) provides individualised funding to eligible people with disability to purchase required services and supports. However, people with psychosocial disability have experienced challenges in accessing these supports. In response, the NDIS introduced psychosocial recovery coaching as a 'recovery oriented' support for people with psychosocial disability. This study, based on research undertaken with an Australian organisation providing psychosocial recovery coaching, aims to identify outcomes of this support and how these relate to the CHIME-D recovery framework and broader evidence on peer-delivered mental health support. The study shows that overall, participant experiences and outcomes of psychosocial recovery coaching align strongly with the CHIME-D recovery framework, and with the NDIS stipulated goals and responsibilities of psychosocial recovery coaching service delivery. This paper contributes new knowledge on the outcomes of psychosocial recovery coaching and suggests that future iterations of NDIS psychosocial supports should align with personal recovery outcomes-including those identified by people with psychosocial disability.
Holcomb LA, Koob C, Treado B
… +5 more, Mayo R, Cartmell KB, Barkin J, Dickes L, Eichelberger K
Community Ment Health J
· 2025 Nov · PMID 40542924
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This study explored the experiences of postpartum individuals in early substance use disorder (SUD) recovery and key aspects of their social networks using the Socioecological Model (SEM). We conducted a qualitative stud...This study explored the experiences of postpartum individuals in early substance use disorder (SUD) recovery and key aspects of their social networks using the Socioecological Model (SEM). We conducted a qualitative study of 22 postpartum individuals (< 1 year since delivery) in residential SUD treatment from July to November 2023. Transcribed, audio-recorded interviews were analyzed using Atlas.ti, with findings organized by SEM levels. Participants, primarily White (81.8%), single (86.3%), and living below the poverty line (81.8%), reported opioid (40.1%) and stimulant (81.8%) use disorders. Challenges spanned SEM levels, including navigating parenthood, accessing trauma-informed care, and overcoming structural barriers such as housing instability, transportation, and childcare access. Findings underscore the need for family-centered, trauma-informed recovery programs and flexible policies addressing childcare and social service barriers to support long-term recovery and maternal well-being.