Community Mental Health Journal[JOURNAL]
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200 papers
Commercial-Friendly Mental Health Narratives Undermine Community Mental Health: A Call for Action.
Cosgrove L, Pelton-Flavin K, McCarty S … +4 more , Baez A, Abi-Jaoude E, Cooper C, Shaughnessy A
Community Ment Health J · 2026 May · PMID 42189352 · Publisher ↗
Community mental health aims to provide effective care to all people, especially those living with serious mental illness. However, commercial influences undermine the ability to provide this needed care. In this comment...
Community mental health aims to provide effective care to all people, especially those living with serious mental illness. However, commercial influences undermine the ability to provide this needed care. In this commentary, we use the commercial determinants of health (CDoH) framework to analyze dominant mental health narratives that frame the mental health crisis as an individual problem, encourage mental health screening, and support the commercialization of mental health. To counter this intra-individual approach, we offer nuanced narratives that are robust enough to facilitate effective and focused care across the continuum of care: mental health promotion and prevention, mental health treatment, and recovery-oriented solutions.
Consumer Perspectives on a Consumer-led Short-stay Crisis Stabilisation Unit (CSU) as an Alternative to Emergency Departments for the Treatment of Acute Mental Health Crises.
McCosker L, Van Engelen H, Gigante T … +5 more , Carter L, Tsai T, Naik S, Turner K, Sarma S
Community Ment Health J · 2026 May · PMID 42189351 · Publisher ↗
A significant and growing number of people present to hospital emergency departments (EDs) with mental health crises (distress, agitation, behavioural disturbance, suicidal ideation, etc.). However, EDs are crowded, nois...
A significant and growing number of people present to hospital emergency departments (EDs) with mental health crises (distress, agitation, behavioural disturbance, suicidal ideation, etc.). However, EDs are crowded, noisy, and busy places, and they are not always the most appropriate environments for management of a mental health crisis. There is increasing interest in the use of therapeutic environments for people experiencing an acute mental health crisis which, with time and intervention, is likely to reduce in severity of distress or resolve. This paper reports on one such unit, a Crisis Stabilisation Unit (CSU), in Queensland, Australia. It is the first published evaluation of a CSU which has focused on consumers' perspectives. Consumers were sent a brief, mixed-methods electronic survey after discharge from the CSU, and 657 responded. Consumers rated their experiences in the CSU, the impact of the CSU on their mental health and wellbeing, and their experiences in comparison to ED (if applicable). They gave positive feedback about the CSU staff including the lived-experience peer support workers, the clinical care they received, and the atmosphere and environment in the CSU. They provided constructive feedback about the processes of admission to and discharge from the CSU, and about the waiting time to see a clinician. Consumers identifying as Aboriginal and/or Torres Strait Islander, culturally and/or linguistically diverse, a person with a physical disability, and/or LGBTIQAP+ also rated the CSU highly. Significantly, consumers agreed that the CSU gave them hope for recovery, empowerment, and dignity and respect. They were strongly supportive of the broader use of CSU-like models of care for people experiencing a mental health crisis.
A Critical Juncture for Civilian-led Crisis Response Services.
Giacomantonio C, Horn C
Community Ment Health J · 2026 May · PMID 42183969 · Publisher ↗
Abstract loading — click title to view on PubMed.
Association Between Patient Health Questionnaire-4 Composite Score and Depression Diagnoses in a Free Clinic Setting: Pooled Cross-sectional Study.
Katoju SV, Diana J, Moothedan E … +5 more , Kunta A, Nguyen O, Daga A, Motwani K, Feller D
Community Ment Health J · 2026 May · PMID 42171962 · Publisher ↗
This study aimed to examine the predictive validity of the Patient Health Questionnaire-4 (PHQ-4) in identifying depression diagnoses among patients in a student-run free clinic (SRFC) setting. This pooled cross-sectiona...
This study aimed to examine the predictive validity of the Patient Health Questionnaire-4 (PHQ-4) in identifying depression diagnoses among patients in a student-run free clinic (SRFC) setting. This pooled cross-sectional study utilized electronic health record data from the Equal Access Clinic Network, a network of SRFCs affiliated with the University of Florida. All adult patients who completed PHQ-4 screening questions between October 2015 and February 2020 and had a corresponding ICD-10 diagnostic code were included (n = 2,498). The PHQ-4 composite score, calculated from binary responses to four mental health screening questions, served as the primary independent variable. The primary outcome was provider-diagnosed Major Depressive Disorder (MDD), defined by ICD-10 code F32.9. A multivariable logistic regression model, adjusted for age, sex, race/ethnicity, employment, and marital status, was used to evaluate the association between PHQ-4 scores and provider-diagnosed MDD. Higher PHQ-4 composite scores were significantly associated with increased odds of receiving an MDD diagnosis (adjusted OR = 2.047; 95% CI: 1.830-2.289; p < 0.001). The average PHQ-4 score was 1.17 (SD = 1.47), with 47.2% of patients scoring ≥ 1. Non-White patients, including those identifying as Black or from other underrepresented groups, had significantly lower odds of MDD diagnosis compared to White patients. The PHQ-4 is a strong predictor of MDD diagnoses in a free clinic setting and may serve as an efficient, low-burden screening tool for mental health concerns in underserved populations. Its integration into free clinic settings may support earlier identification and intervention, though disparities in diagnosis across racial and ethnic groups warrant further investigation.
Self-disclosure to Peers and Changes in Personal Recovery in Community-dwelling People with Mental Disorders: A One-year Longitudinal Study.
Yokoyama K, Shimokihara S, Miyajima R … +8 more , Yama K, Shimada K, Shibuya S, Kobayashi M, Morimoto T, Ishii T, Yabe S, Ikeda N
Community Ment Health J · 2026 May · PMID 42171961 · Publisher ↗
This study examined whether overall and domain-specific self-disclosure to peers at baseline was prospectively associated with changes in personal recovery over one-year among community-dwelling adults with mental disord...
This study examined whether overall and domain-specific self-disclosure to peers at baseline was prospectively associated with changes in personal recovery over one-year among community-dwelling adults with mental disorders in Japan. A longitudinal questionnaire survey was conducted among adults with mental disorders. Self-disclosure was assessed using the Self-Disclosure Scale for People with Mental Illness, and personal recovery was measured with the Japanese version of the Recovery Assessment Scale. Linear mixed-effects models were used to examine recovery at baseline and at one-year follow-up as a continuous outcome, including time, baseline self-disclosure, and their interaction, with random intercepts for participants. Models were adjusted for age, sex, and service utilization. Fifty-four participants (mean age = 41.1 years; 48% female) responded to both the baseline and follow-up surveys. Mean recovery scores did not change significantly over one year. In domain-specific analyses, greater baseline self-disclosure about mental illness and psychiatric disability was associated with less positive changes in recovery over one year (Estimate = - 4.162, SE = 1.589, 95% CI [- 7.316, - 1.008], p = 0.010). Conversely, no significant time-by-disclosure interactions were observed for the other disclosure domains (life conditions, own strengths, and experiences of distress). Among community-dwelling people with mental disorders, baseline self-disclosure about mental illness and psychiatric disability to peers was associated with less positive changes in personal recovery over one year, whereas the other disclosure domains were not significantly associated with changes over time. These findings suggest that disclosure about mental illness and psychiatric disability in peer contexts may have context-dependent implications. Moreover, they underscore the importance of fostering safe and supportive peer environments that respond constructively to such disclosures within recovery-oriented care.
A Scoping Review of Technology/Digital Support Tools for Informal Mental Health Carers: Impacts on Well being and Experience.
Walker F, Aggar C, Bissett M … +2 more , Baker JR, Prassos T
Community Ment Health J · 2026 May · PMID 42159940 · Publisher ↗
INTRODUCTION: Informal carers provide essential support to individuals with mental health conditions, yet often experience poor well being and limited access to traditional supports due to stigma, time constraints, and g...
INTRODUCTION: Informal carers provide essential support to individuals with mental health conditions, yet often experience poor well being and limited access to traditional supports due to stigma, time constraints, and geographic barriers. Self-accessible digital tools may offer a flexible and scalable solution. This scoping review explores the impact of self-accessible digital support tools on the well being and experience of informal carers of individuals with mental health conditions. METHODS: Five databases were searched for peer-reviewed studies (2015-2025) evaluating digital tools for carers of individuals with mental health conditions, excluding neurocognitive disorders. Nine studies met the inclusion criteria and were assessed using the Mixed Methods Appraisal Tool. RESULTS: Seven unique digital tools were identified (three mobile apps, four web-based tools). Professionally developed tools appeared to be associated with greater improvements in caregiver burden, emotional regulation, and quality of life. Codesigned digital tools were positively received for their flexibility and relevance, but had mixed clinical outcomes and engagement challenges. DISCUSSION: Findings suggest that while digital tools can benefit carers, digital literacy, usability, and sustained engagement are critical factors. Codesign alone does not guarantee improved outcomes, particularly when user involvement is limited or underreported. Future research should further investigate codesigned interventions, with clear reporting of development processes and strategies that promote sustained use. CONCLUSION: Digital interventions can enhance the well being and experience of informal mental health carers, particularly those that are codesigned and multifactorial to address carer needs. Strengthening these tools has the potential to support carers and reduce systemic strain on mental health services.
Uncertainty of Fit - Serving People with Borderline Personality Disorder on an Assertive Community Treatment Team Setting: Experiences and Perspectives of Clinicians from a Flexible ACT Team.
Law S, Kassam A, Beder M … +5 more , Zaheer J, Osagie J, Eisenach D, Levy M, Bergmans Y
Community Ment Health J · 2026 May · PMID 42126729 · Publisher ↗
People with Borderline Personality Disorder (PBPD) have been historically excluded from Assertive Community Treatment (ACT) teams. The 'gold standard' ACT service model in community psychiatry aims to serve people with s...
People with Borderline Personality Disorder (PBPD) have been historically excluded from Assertive Community Treatment (ACT) teams. The 'gold standard' ACT service model in community psychiatry aims to serve people with serious mental illness (SMI), typically diagnosed with psychotic and mood disorders. For various clinical, administrative, and model innovation reasons, PBPD are notably present on ACT teams, presenting unique clinical challenges; yet clinician perspectives and experiences are little known. Qualitative study using semi-structured interviews and thematic analysis on experiences and perspectives of clinicians from a well-established ACT team in an academic setting that transitioned to a Flexible ACT team in Toronto, Canada. Clinicians reported working with PBPD presents unique training, skills, clinical, team, system, and personal level challenges Five main themes included: (1) Lack of specific training among clinicians in serving people with BPD; (2) Diverse views of suitability of ACT for PBPD; (3) Specific challenges for clinicians working with PBPD on ACT; (4) Positive aspects of using ACT to serve PBPD; (5) Potential adaptive changes to ACT teams working with PBPD. Conclusion: Having PBPD on ACT teams is a little acknowledged and less known area of ACT and has significant impact on ACT services. Further attention to training and skill building, service adaptation, and research that improve care and therapeutic relationships with PBPD on ACT are warranted. Having PBPD on ACT teams is a little acknowledged and less known area of ACT and has significant impact on ACT services. Further attention to training and skill building, service adaptation, and research that improve care and therapeutic relationships with PBPD on ACT are warranted.
The Impact of Government-Funded Brief Psychological Interventions on Mental Health: A Longitudinal Evaluation of the Italian "Psychological Bonus" Policy.
Benzi IMA, La Tona A, Zarbo C … +10 more , Carone N, Liotti M, Smeriglio R, Compare A, Di Nuovo S, Lazzari D, Camussi E, Lingiardi V, Lo Coco G, Parolin LAL
Community Ment Health J · 2026 May · PMID 42120772 · Publisher ↗
The COVID-19 pandemic amplified an ongoing mental health crisis in Europe. In response, the Italian Ministry of Health introduced the "Psychological Bonus," a government-funded initiative aimed at improving access to bri...
The COVID-19 pandemic amplified an ongoing mental health crisis in Europe. In response, the Italian Ministry of Health introduced the "Psychological Bonus," a government-funded initiative aimed at improving access to brief psychological interventions (BPIs). This longitudinal study examined the effectiveness of these publicly funded BPIs in reducing psychological distress, anxiety, and depression among a large sample of Italian patients, while also exploring the moderating roles of therapy continuation, therapist orientation, and treatment setting. A total of 1,541 participants were assessed at baseline (T0), post-treatment (T1), and six-month follow-up (T2) using the CORE-10, GAD-7, and PHQ-9. Longitudinal trajectories were analyzed using Linear Mixed Models, controlling for age, sex, and session count. Separate models examined the impact of therapy continuation, therapist orientation, and treatment setting (in-person, online, or blended). Significant reductions in psychological distress, depression, and anxiety from baseline to post-treatment were maintained at follow-up, with effect sizes ranging from medium to large across outcomes and timepoints (d = 0.54-0.80). A small but significant attenuation of psychological distress gains was observed between post-treatment and follow-up, while depression and anxiety scores remained stable. Continuation of therapy after the funded sessions did not significantly moderate symptom trajectories. Likewise, no significant differences in change trajectories emerged across therapist theoretical orientations or treatment settings. The findings provide strong support for the effectiveness of the "Psychological Bonus" as a publicly funded BPI, helpful in addressing widespread mental health needs across different therapeutic and delivery models, representing a promising model for mental health policy.
Peer Employment Learning Center (PELC) Pilot Project: From Mental Patient to Peer Support Provider.
Ashcraft L, Blum P, Cronise R … +3 more , Martin C, Johnson G, Karyczak S
Community Ment Health J · 2026 May · PMID 42105188 · Publisher ↗
PURPOSE: The Peer Employment Learning Center (PELC) was developed to train individuals under conservatorship in locked settings to work as Peer Support Specialists (PSS) in the same facility where they receive mental hea...
PURPOSE: The Peer Employment Learning Center (PELC) was developed to train individuals under conservatorship in locked settings to work as Peer Support Specialists (PSS) in the same facility where they receive mental health treatment. Simultaneously, leaders and staff are trained in recovery practices to facilitate culture change. METHODS: A convergent mixed methods design was used to evaluate the feasibility of the PELC program to accomplish its goals. Eighteen individuals under involuntary conservatorship enrolled in a PSS training and a supervised internship. Fifteen leaders enrolled in PSS training alone. Staff enrolled in workshops on recovery practices. Quantitative data included pre-post test scores, completion statistics, and pre-post RSA survey scores. Qualitative data included notes from a PSS alumni meeting and leader/staff reflections. RESULTS: 100% of PSS candidates (n = 18) and 100% of leaders (n = 15) completed the 80-hour PSS training with significant pre-post test score improvements (PSS: 36% to 95%, p < 0.001; Leaders: 70% to 96%, p < 0.001). 83% of PSS candidates completed the internship, and 55% were hired part-time at the facility. Staff RSA scores showed significant improvements in "Choice" (p = 0.02) and "Inviting" (p = 0.05) subscales; client RSA scores remained stable. Themes highlighted identity transformation, whiplash, and hope for successful employment for PSS alumni; empowering clients, personal and professional authenticity, and a culture of connection for leaders and staff. Qualitative themes were integrated with quantitative findings for a richer understanding of results. CONCLUSIONS: It is feasible to train and employ individuals under conservatorship as PSS within locked settings. Success requires a dual-track approach: empowering PSS in their new role while systematically educating leaders and staff to foster a recovery-oriented culture.
Mental Health and Individual Resilience in Contexts of Social Vulnerability: Evidence from Rural Texas.
Ekren E, Maleki S, Shakya K … +1 more , Villagran M
Community Ment Health J · 2026 May · PMID 42104125 · Publisher ↗
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Stigma and Relationship and Sexual Life in People with Severe Mental Disorders: A Systematic Review.
Díaz-Pérez G, Grandón P, Fernández D … +1 more , Navarrete-Valladares C
Community Ment Health J · 2026 May · PMID 42090085 · Publisher ↗
BACKGROUND: Stigma negatively affects the well-being of individuals with severe mental disorders (SMD). However, its specific impact on romantic and sexual intimacy remains fragmented in the literature. This study aimed...
BACKGROUND: Stigma negatively affects the well-being of individuals with severe mental disorders (SMD). However, its specific impact on romantic and sexual intimacy remains fragmented in the literature. This study aimed to identify which aspects of intimate life are affected by stigma and the factors mediating this relationship. METHODS: A systematic review following PRISMA-P guidelines was conducted using Scopus, Web of Science, PubMed, EBSCOhost, VHL, and SciELO without date restrictions. Due to high methodological heterogeneity among the 26 included studies, a narrative synthesis was utilized to integrate findings. RESULTS: Findings involving participants with Schizophrenia Spectrum, Bipolar, and Major Depressive Disorders reveal distinct stigma mechanisms. Medication side effects (e.g., sexual dysfunction, weight gain) act as catalysts for internalized stigma, transforming physical symptoms into barriers for romantic desirability. Gender norms exacerbate exclusion: women face intense scrutiny regarding parenting capacity and are vulnerable to intimate partner violence to avoid isolation, while men perceive functional impairment as a failure of masculine identity. Additionally, professional silence regarding sexuality reinforces the 'asexual' stereotype, leaving relational needs unsupported. CONCLUSION: The results underscore that stigma permeates the intimate lives of individuals with SMD through biological, social, and professional pathways. Clinical practice must urgently integrate sexual health assessments and relational support into routine care. Future interventions should focus on reducing professional bias and supporting the sexual and reproductive rights of this population.
Involvement in the Shadows: A Qualitative Interview Study on Informal Caregiver Involvement in the Formal Care Trajectories of Individuals Living with Severe Mental Health Problems.
Bremmers LGM, Hakkaart-van Roijen L, Uyl-de Groot CA … +1 more , Fabbricotti IN
Community Ment Health J · 2026 May · PMID 42082891 · Publisher ↗
Informal caregivers play a crucial and continuous role in supporting individuals living with severe mental health problems, hereinafter referred to as supported individual, yet their involvement in formal care remains po...
Informal caregivers play a crucial and continuous role in supporting individuals living with severe mental health problems, hereinafter referred to as supported individual, yet their involvement in formal care remains poorly understood. While existing research has often focused on professional perspectives or institutional barriers, the lived experiences of caregivers, how they perceive and negotiate their roles and shifts in involvement with formal care, have received limited attention. This qualitative study addresses these research gaps by investigating how twenty informal caregivers experienced their involvement in the formal care trajectories of individuals living with severe mental health problems across different care settings in the Netherlands. Through in-depth interviews, we identified three archetypes of caregiver involvement with formal care: the Active Partner, the Formalized Caregiver, and the Disconnected Caregiver. These archetypes represent different degrees and qualities of caregiver involvement and show how caregivers move between roles over time, influenced by interpersonal relationships, professional attitudes, legal constraints, and systemic challenges. Rather than being fixed, caregiver involvement is shown to be a dynamic, negotiated process shaped by all members of the care triad, the supported individual, the professional, and the caregiver, as well as the broader care system. The study highlights how caregivers who occupy the role of the Formalized Caregiver often assume significant responsibilities without adequate recognition or support, while those positioned as the Disconnected Caregiver is excluded from the formal care trajectory or unable to participate in ways that align with their own wishes and capacities. However, if relationships within the care triad are characterized by trust, open communication, and mutual respect, caregivers can assume the role of Active Partner. By drawing on caregivers' lived experiences, this study offers a nuanced and empirically grounded understanding of caregiver involvement in practice, providing new insights for the development of more inclusive and supportive care systems for caregivers and ultimately the individuals they support.
Implementing Coordinated Specialty Care Programs for Psychosis Across the U.S.: State-Level Administrator and Provider Perspectives.
Oluwoye O, Lissau A, Fraser E … +3 more , Selloni A, James N, Anglin D
Community Ment Health J · 2026 May · PMID 42081007 · Publisher ↗
Over the past decade coordinated specialty care (CSC) programs for psychosis have proliferated across communities throughout the U.S. Although considered the gold standard of care for early psychosis, several states do n...
Over the past decade coordinated specialty care (CSC) programs for psychosis have proliferated across communities throughout the U.S. Although considered the gold standard of care for early psychosis, several states do not have CSC, and among states that do, there is limited availability in underserved communities, and implementation often varies based on geographical locations. We aimed to explore the views of state-level administrators and CSC providers regarding factors that inform the implementation and sustainability of CSC programs in community settings. Between June 2023 and January 2024, 10 state-level administrators/policy makers and 25 mental health providers from early intervention programs for first episode psychosis were purposively recruited across the United States to participate in semi-structured interviews. Transcripts were analyzed using thematic analysis and deductive approaches which classified themes into program planning during pre-implementation and sustaining CSC after the implementation. Qualitative findings revealed four themes: (1) service demand; (2) organizational infrastructure; (3) community partnerships and outreach; and (4) model and service components. Service demand and organization infrastructure primarily influenced state-level decision making as to where CSC programs would be implemented. Community partnerships and outreach and model and service components’ themes highlight cultural and community-level considerations after CSC programs were implemented. The perspectives and experiences revealed from this study may guide the types of organizational, geographical, and cultural considerations necessary to address in future CSC implementation and sustainability efforts.
Factors Influencing Racial Discrimination and Prevalence of Major Depressive Disorder Among Black Canadian Youths.
Oluwasina F, Renzaho AMN, Mullings D … +7 more , Henderson J, McKenzie K, Hamilton H, Sajobi T, Senthilselvan A, Rousseau C, Salami B
Community Ment Health J · 2026 May · PMID 42081006 · Publisher ↗
Major depressive disorder (MDD) is a complex and multifaceted mental health condition with far-reaching implications for youth well-being and society. This paper examined the prevalence of depressive symptoms consistent...
Major depressive disorder (MDD) is a complex and multifaceted mental health condition with far-reaching implications for youth well-being and society. This paper examined the prevalence of depressive symptoms consistent with probable MDD and their association with self-reported experiences of racial discrimination within the Black youth population in Canada. This study used a descriptive cross-sectional design. Questionnaires were administered via an anonymous online survey. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), a self-report screening tool, with scores ≥ 10 indicating symptoms consistent with probable MDD rather than a clinical diagnosis. Experiences of discrimination were measured using self-reported items adapted from previously validated discrimination instruments. Data were analyzed using descriptive statistics, chi-square tests, and multivariable logistic regression(p ≤ 0.05). A total of 933 Black youth participated in this survey. Black youth who reported unfair treatment due to their skin colour or race were 18 times more likely to express MDD than those who had not (OR: 18.38; 95% CI: 2.796-7.17 ). Similar associations were observed for self-reported discrimination based on language accent (OR = 4.40; 95% CI: 1.01-19.24) and culture (OR = 12.29; 95% CI: 1.47-12.53). Black youth who have been treated unfairly due to their culture were 12 times more likely to experience MDD than those who had not (OR: 12.29; 95% CI: 1.473-12.530). This study demonstrates a significant association between perceived unfair treatment and depressive symptoms (consistent with probable MDD) among Black Canadian youth. The findings suggest that racial, linguistic, and cultural discrimination are associated with poorer mental health outcomes in this group. Culturally sensitive interventions and policies that promote inclusivity and equity can help Black youth with MDD.
Implementing Digital Suicide Risk Screening in Behavioral Health: a Mixed-methods Study of Organizational Adaptation.
Beverly B, Miclette M, Kaufman H … +3 more , Holley D, Brooks A, Zaubler T
Community Ment Health J · 2026 May · PMID 42068516 · Publisher ↗
Digital behavioral health platforms extend clinical capabilities beyond traditional appointment-based care, but implementation challenges limit their routine use. Although validated suicide risk screening instruments exi...
Digital behavioral health platforms extend clinical capabilities beyond traditional appointment-based care, but implementation challenges limit their routine use. Although validated suicide risk screening instruments exist and evidence suggests individuals provide honest responses in digital contexts, how behavioral health organizations implement asynchronous screening remains poorly understood. This exploratory study examined implementation experiences from nine behavioral health organizations that adopted digital suicide screening. Nine behavioral health organizations that implemented remote, asynchronous Columbia Suicide Severity Rating Scale (C-SSRS) screening completed post-implementation surveys. Using a mixed-methods approach combining Interpretative Phenomenological Analysis and VADER sentiment analysis, we identified implementation patterns, organizational adaptations, and provider attitudes across diverse service settings. Implementation challenges clustered into operational, technical, clinical, and systemic domains. Operational challenges involved workflow integration, staff training, and protocol development, while technical challenges included EHR integration, digital divide concerns, and alert volume management. Clinical challenges centered on screening quality, therapeutic rapport, and risk factor evaluation, while systemic challenges reflected resource constraints, crisis response protocols, and staff capacity. Provider attitudes evolved from initial anxiety and role uncertainty in early-stages to strong support among advanced-stage organizations, where 48% expressed very supportive and 32% expressed moderately supportive sentiments. Sentiment analysis of alert-workflow responses indicated generally positive attitudes across organizations (mean score = 0.24 on a scale of -1 to 1). Two preliminary frameworks emerged from analysis: the Service Delivery Ecosystem Framework describes context-specific adaptation patterns observed in this sample, and the Implementation Stage Framework characterizes common progression from initial rollout to mature implementation. These findings offer preliminary considerations for organizations planning digital suicide screening integration.
Routine Outcome Changes Associated with Brief Psychological Interventions Delivered by Assistant Psychologists and Trainee Associate Psychology Practitioners in a Crisis Resolution and Home Treatment Team.
Pearson L, Cunningham J, Pownell K
Community Ment Health J · 2026 May · PMID 42065842 · Publisher ↗
Psychological interventions are recommended for people under Crisis Resolution Home Treatment Teams (CRHTTs). Non-registered psychology roles (Assistant Psychologists (APs) and Trainee Associate Psychological Practitione...
Psychological interventions are recommended for people under Crisis Resolution Home Treatment Teams (CRHTTs). Non-registered psychology roles (Assistant Psychologists (APs) and Trainee Associate Psychological Practitioners (TAPPs)) are potentially both cost and clinically effective for delivering brief interventions in CRHTTs. This study aimed to quantitatively examine routine outcome change associated with two brief, skills-based interventions (the Crisis Toolbox (CTB) and the Emotion Coping Skills (ECS)) delivered by APs and TAPPs in one CRHTT. A retrospective service evaluation of 490 service users who accessed either the CTB or ECS between June 2020 and February 2025 was employed. The Clinical Outcomes in Routine Evaluation - 10 (Core-10) and Mental Health Confidence Scale (MHCS) measures were completed pre- and post- intervention. Paired samples t-tests were conducted and demographics (age, gender, and ethnicity) collected. There was a statistically significant effect in improving scores on both measures at the post-intervention timepoint (CORE-10: 8.636, 95% CI [7.810 to 9.461], t(297) = 20.586, p < .001; MHCS: -13.537, 95% CI [-14.827 to -12.237], t{293) = -20.568, p < .001). This significant effect remained when looking at males and females separately. Asian and Black ethnic groups were underrepresented in the sample compared to local demographics, whilst other ethnic groups showed similar representation. Findings suggest that CTB and ECS may be clinically effective in reducing distress and increasing confidence in coping with mental health challenges for service users. Additionally, this evaluation has highlighted the need for better understanding UK ethnic minority representation in CRHTTs and consideration of possible barriers to access.
Assessing Factors that Influence Psychiatric Referral Time and Postpartum Follow-Up in Obstetric Patients.
Womer L, Harmanli D, Leininger L … +3 more , McBride H, Jalali S, Tabi S
Community Ment Health J · 2026 Apr · PMID 42060190 · Publisher ↗
There is a clear shortage of psychiatric care in the population of peripartum obstetric patients in the United States(Kelly et al., 2001; Claridad, 2025). There is variability in both screening for mental illness and ava...
There is a clear shortage of psychiatric care in the population of peripartum obstetric patients in the United States(Kelly et al., 2001; Claridad, 2025). There is variability in both screening for mental illness and availability of psychiatric care which leads to a substantial gap in healthcare for such patients, particularly non-white patients. Additionally, during the postpartum period, the attendance rates to medical appointments are affected by race, ethnicity and socioeconomic status, further perpetuating the aforementioned healthcare disparity(Wilcox et al., 2016). The key purpose of this study was to understand if and how rates of seeing a reproductive psychiatrist are affected by psychiatric referral time (prenatally versus postnatally) and, if and how seeing a reproductive psychiatrist affect postpartum healthcare follow in obstetric patients. Patients referred to the reproductive psychiatrist between January to December of 2023 were chart reviewed in EPIC and data was recorded in RedCap (N=71). Data recorded included: age, ethnicity, education, employment, marital status, substance use, and medical factors such as psychotropic medication use and psychiatric diagnoses. Separate Chi Squared tests were employed to evaluate two variables including: referral time (before delivery versus after delivery versus unknown) and if patients were lost to follow up after delivery (yes versus no), respectively. There were 71 obstetric patients evaluated with a mean age of 28 and an age range of 17-39. Most were Black (N=31) or Hispanic/ Latino (N=24). The results indicate that patients referred prenatally had 3.26 times higher odds of meeting with the reproductive psychiatrist (N = 44, 62%) compared to those referred postnatally (p = 0.0002). Patients with a history of substance use, marijuana use, presence of long-term romantic partners, use of prescribed psychotropic medications, history of any bipolar disorder, and had their diagnosis made by the reproductive psychiatrist were associated with higher rates of being referred to psychiatry prenatally, while patients diagnosed with postpartum depression were associated with higher rates of being referred postnatally. The odds of patients who met with the reproductive psychiatrist (N=43, 61.4%) being lost to postpartum healthcare follow up were 3.63 times lower compared to the odds of patients who did not meet with the psychiatrist (p=0.012). Furthermore, patients who used alcohol, had a diagnosis of postpartum depression, had their mental health conditions diagnosed by the reproductive psychiatrist, were taking a prescribed psychotropic medication, particularly antidepressants including sertraline and escitalopram, were associated with lower rates of being lost to postpartum healthcare follow up. Patients who were unemployed were associated with higher rates being lost to healthcare follow up. This study explores how timing of psychiatric referral in obstetric patients affects postpartum healthcare appointment attendance, highlighting the role of early psychiatric intervention in potentially improving postpartum healthcare engagement. Knowledge of these findings may encourage providers to consider psychiatric referral more readily. Similarly, by understanding individual factors that independently influence psychiatric referral time and healthcare follow up rates, providers can bring awareness to what impacts their decision, or lack thereof, to refer patients to psychiatry.
Childhood Trauma and its Association with Internalized Stigma in Serious Mental Illness.
Thomas S, McBride L, Chalker SA … +2 more , Chang C, Depp C
Community Ment Health J · 2026 Apr · PMID 42056624 · Publisher ↗
Approximately 80% of individuals with serious mental illness have experienced childhood trauma. Childhood trauma is associated with internalized stigma, or negative beliefs about one’s own mental illness. However, it is...
Approximately 80% of individuals with serious mental illness have experienced childhood trauma. Childhood trauma is associated with internalized stigma, or negative beliefs about one’s own mental illness. However, it is unclear how specific types of childhood trauma are associated with internalized stigma. 185 adults with SMI were recruited from three locations: University of California, San Diego, University of Texas at Dallas, and University of Miami. In this cross-sectional study, participants completed the Childhood Trauma Questionnaire, which captured childhood trauma experiences including emotional abuse, emotional neglect, physical abuse, physical neglect, and sexual abuse. Participants also completed the Internalized Stigma of Mental Illness Scale. We found significant associations between the severity of all types of childhood trauma and internalized stigma, including emotional abuse (rs =.31, p < .01), emotional neglect (rs = .24, p < .01), physical abuse (rs = .18, p = .02), physical neglect (rs =.16, p = .03), and sexual abuse (rs = .17, p = .02). Regression analyses showed that childhood trauma predicted greater internalized stigma (R2 = .066, p < .01), with emotional abuse emerging as the only unique predictor when all subscales were considered simultaneously (R2 = .067, p = .015). The severity of all subtypes of childhood trauma was significantly associated with internalized stigma; however, only emotional abuse uniquely predicted internalized stigma when all subtypes were considered together. These findings suggest that childhood trauma, particularly emotional abuse, may be related to self-stigmatizing beliefs, highlighting the potential value of trauma-focused therapy in addressing these challenges.
Assessing the Needs of Community Mental Health Service Users with Chronic Physical Health Conditions: A Cross-Sectional Study.
Martsynkevych S, Rakhra K, Iruthayarajah J … +3 more , Stergiopoulos V, Ashcroft R, Sirotich F
Community Ment Health J · 2026 Apr · PMID 42056623 · Publisher ↗
Co-occurring mental and chronic physical health conditions (CMPHC) are associated with greater functional impairment, poorer physical health, reduced quality of life, and increased mortality, with affected individuals li...
Co-occurring mental and chronic physical health conditions (CMPHC) are associated with greater functional impairment, poorer physical health, reduced quality of life, and increased mortality, with affected individuals living an estimated 10–20 years less than the general population. However, the specific unmet health and social needs of community mental health service users living with CMPHC remain unexplored. This study examined sociodemographic, diagnostic, service use, and need factors associated with CMPHC among community mental health service users. Secondary analysis of clinical data from 16,726 individuals enrolled in case management programs in Ontario, Canada, was conducted in this cross-sectional study. Data were collected between January 1, 2017, and December 31, 2022, using the Ontario Common Assessment of Need (OCAN) during routine clinical assessments by trained mental health professionals. Overall, 20.1% of clients had CMPHC. Older age showed the strongest association (AOR = 6.69 for age 65 + versus < 25), followed by unmet physical health needs (AOR = 2.29). Marital status, living arrangements, and socioeconomic factors including employment, education and income sources were also significantly associated. Primary care attachment, depressive disorders, “other” mental health diagnoses, and unmet food needs were independently associated with higher odds of CMPHC. CMPHC is common among community mental health service users and is independently associated with unmet physical health needs and socioeconomic disadvantage. These findings underscore the importance of systematically identifying CMPHC and suggest the need for service models that strengthen coordination between physical and mental health care while addressing the social determinants of health within community-based settings.
An Equal Role for Lived Experience-Led Mental Health Research.
Heinsvig Poulsen C, Serup Rasmussen K, Høgh Egmose C … +2 more , Ebersbach B, Falgaard Eplov L
Community Ment Health J · 2026 Apr · PMID 42053722 · Publisher ↗
Lived experience-led mental health research remains marginalized despite policy calls for recognition and inclusion. The co-produced ‘Paths to Everyday life’ (PEER) trial showed that group-based peer support improves per...
Lived experience-led mental health research remains marginalized despite policy calls for recognition and inclusion. The co-produced ‘Paths to Everyday life’ (PEER) trial showed that group-based peer support improves personal recovery, functioning and quality of life in community settings yet faced epistemic biases favoring clinical or service-defined outcomes, ethics restrictions on peer facilitation, and rejections from high-impact journals. This commentary urges funders, editors, and ethics bodies to promote power-sharing, user-defined measures like empowerment, and community-driven trials for equitable, sustainable mental health research and care.
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