Community Mental Health Journal[JOURNAL]
Sun
200 papers
Service User Perceptions of Mental Health Emergency Response in New York City.
Samost D, Martinez M, Shepard V … +2 more , Vasilchenko M, Yanos P
Community Ment Health J · 2026 Jul · PMID 42399556 · Publisher ↗
Mental health emergency response (initiated after calling centralized phone systems such as 911 in the United States and Canada) is a highly impactful, but understudied, component of the mental health service system. The...
Mental health emergency response (initiated after calling centralized phone systems such as 911 in the United States and Canada) is a highly impactful, but understudied, component of the mental health service system. The present study used qualitative methods to examine the experience of receiving mental health emergency services and explore recommendations to improve future response. Twenty-three persons from New York City who self-identified as having interacted with mental health emergency services completed in-depth interviews and detailed 40 incidents of receiving mental health emergency services; interviews were analyzed using a deductive analytic approach. Major themes included participants perceiving responders as aggressive and using some type of force (including the act of putting on handcuffs). Participants typically reported being hospitalized, with roughly half of participants reporting dissatisfaction with the outcome. Prominent themes included experiencing aggression from police and feeling stigmatized by responders, while others experienced fair treatment from police officers and experienced them as professional and non-threatening. Participants felt that emergency mental health responders should be curious, conversational, non-judgmental and not aggressive, and that responders should primarily be comprised of mental health professionals and peers. Findings have important implications for how the mental health service system responds to perceived emergencies, and suggest that alternatives to traditional police-based responses need to be more widely implemented.
Social Determinants of Anxiety, Worry, and Depression Among Adults in Detroit: Differential Associations Across Outcomes.
Rodriguez-Franco O, Yasarapu S, Dean C
Community Ment Health J · 2026 Jul · PMID 42399555 · Publisher ↗
Social determinants of health play a significant role in driving mental health disparities, yet comparatively little is understood about whether these factors affect different forms of psychological distress in distinct...
Social determinants of health play a significant role in driving mental health disparities, yet comparatively little is understood about whether these factors affect different forms of psychological distress in distinct ways. Using data from Wave 12 of the Detroit Metro Area Communities Study (N = 2,238), this study examined associations between selected social determinants and self-reported anxiety, worry, and depression among Detroit adults. Outcomes reflected symptom frequency over the prior seven days. Separate survey- weighted ordinal logistic regression models were estimated for each outcome, adjusting for age, gender, race/ethnicity, education, income, employment, health insurance, and neighborhood satisfaction. Interaction terms between age and gender and between race/ethnicity and education were also evaluated. Nearly half of respondents reported at least one day of anxiety, worry, or depression in the preceding week, with anxiety being the most frequently reported mental health indicator, followed by worry and depression. Older age and greater neighborhood satisfaction were consistently associated with lower odds of distress across all models. Higher income was associated with reduced odds of worry and depression, while recent employment was linked to lower odds of worry. Initial gender differences diminished after adjusting for socioeconomic and contextual factors. Some interaction effects suggested that the relationship between educational attainment and mental health varied across racial and ethnic groups, though these findings require cautious interpretation due to model convergence limitations. These results highlight the importance of neighborhood and socioeconomic conditions in shaping mental health within historically marginalized urban communities, and point to the need for place-based and equity-focused approaches to addressing psychological distress.
Perspectives of Young People with Early Psychosis on Physical Health.
Hui TT, Olasoji M, Garvey L
Community Ment Health J · 2026 Jul · PMID 42397466 · Publisher ↗
Young people experiencing early psychosis including those at ultra-high risk of psychosis and those with an at-risk mental state, are found to have a higher risk of developing preventable physical health conditions. Unde...
Young people experiencing early psychosis including those at ultra-high risk of psychosis and those with an at-risk mental state, are found to have a higher risk of developing preventable physical health conditions. Understanding how psychosocial wellbeing and physical health literacy play a role in adopting positive health behaviour change is paramount in promoting physical health outcomes in early psychosis. The aim of this study was to explore the perspectives of young people with early psychosis on physical health, their experience of accessing physical health care, and ways to promote positive health behaviour change. This study utilised an exploratory descriptive qualitative approach. Participants were recruited through a metropolitan specialised youth early psychosis program that provides specialised support and care to young people with early psychosis. Ten young people aged between 16 and 25 years, who were clients of the early psychosis program, participated in semi-structured interviews individually. Three main themes were identified using reflexive thematic analysis: (i) How I view my physical health, (ii) The journey of accessing physical health care, and (iii) Adoption of positive health behaviour change. This study highlighted that young people are worried about changes in their physical health, with a strong desire to improve their wellbeing. A number of psychosocial factors were identified in this study as hindering their ability to adopt positive health behaviour change, complicated by limited physical health literacy and barriers to accessing physical health resources and care within mental health services. Addressing these factors is fundamental in driving sustainable positive health behaviour change.
From Stigma to Recognition in Dual Diagnosis Care: A Multilevel Conceptual Framework.
Dale KY, Sæbjørnsen SEN, Ødegård A
Community Ment Health J · 2026 Jul · PMID 42393345 · Publisher ↗
People experiencing co-occurring mental health problems and substance use disorders face some of the most fundamental challenges in contemporary mental health and addiction services. Despite longstanding policy commitmen...
People experiencing co-occurring mental health problems and substance use disorders face some of the most fundamental challenges in contemporary mental health and addiction services. Despite longstanding policy commitments to integrated care, dual diagnosis care remains characterized by persistent fragmentation. Existing multilevel perspectives have advanced understanding of how stigma contributes to exclusion across healthcare systems, yet provide less guidance for explaining how continuity of care is established and sustained across interconnected institutional, organizational, and relational contexts. Drawing on a conceptual synthesis of empirical and theoretical literature, this article develops a multilevel framework integrating recognition theory, stigma theory, and ecological systems theory. The framework conceptualizes dual diagnosis care as shaped by interacting stigma- and recognition-related processes operating across macro (institutional), meso (organizational), and micro (relational) levels. Fragmentation and continuity are understood as emergent outcomes of the degree of alignment or misalignment between these processes across levels of care. Recognition is conceptualized not merely as a feature of interpersonal encounters, but as a coordinating principle through which institutional commitments, organizational arrangements, and relational practices may become aligned to support continuity, participation, legitimacy, collaboration, and trust. By extending existing multilevel perspectives beyond explanations of exclusion alone, the framework provides an analytical lens for understanding why fragmentation may persist despite policy commitments to integrated care and how continuity may emerge when recognition-supporting conditions are aligned across systems of care.
Knowledge About Psychosocial Interventions Among Individuals With Severe Mental Illness: Results of a Cross-Sectional Study.
Stein SN, Kraake S, Pabst A … +19 more , Breilmann J, Hasan A, Allgöwer A, Kilian R, Falkai P, Ajayi K, Brieger P, Frasch K, Halms T, Heres S, Jäger M, Küthmann A, Putzhammer A, Schneeweiß B, Schwarz M, Becker T, Riedel-Heller SG, Kösters M, Gühne U
Community Ment Health J · 2026 Jul · PMID 42384141 · Publisher ↗
Severe mental illness (SMI) is frequently accompanied by substantial impairments in psychosocial functioning. Psychosocial interventions (PSI), therefore, represent an essential component of evidence-based treatment. A k...
Severe mental illness (SMI) is frequently accompanied by substantial impairments in psychosocial functioning. Psychosocial interventions (PSI), therefore, represent an essential component of evidence-based treatment. A key prerequisite for the utilization is adequate knowledge. The aim of this study was to assess the level of knowledge about PSI among individuals with SMI. A cross-sectional multicenter study was conducted among individuals with SMI aged 18 to 65 years (n = 397). Knowledge of PSI, along with sociodemographic, clinical and additional contextual characteristics was assessed. Linear regression analyses were performed to examine associations between PSI knowledge and potential predictors. Overall, participants with SMI were familiar with an average of 10 out of the 17 assessed interventions. Better knowledge was associated with the presence of a chronic physical illness (p = .027), a longer duration of psychiatric problems (p = .030) and higher GAF scores (p = .010). In contrast, having experienced divorce, separation, or widowhood compared to being single (p = .040), as well as having a migration background (p = .003), were associated with lower levels of knowledge. The findings highlight the need for more targeted dissemination of guideline-based information on PSI to individuals with SMI.
Psychosocial Factors Associated with Psychiatric Readmission Following Inpatient Discharge: A Systematic Review.
Martínez-Montás GF, Moreta-Manzueta GE, Colón-Santana OR
Community Ment Health J · 2026 Jun · PMID 42371376 · Publisher ↗
Psychiatric readmission following inpatient discharge is common and is frequently used as an indicator of continuity and quality of care in mental health services. Although readmission is often interpreted as a marker of...
Psychiatric readmission following inpatient discharge is common and is frequently used as an indicator of continuity and quality of care in mental health services. Although readmission is often interpreted as a marker of clinical relapse, increasing evidence suggests that psychosocial factors may contribute to post-discharge outcomes. However, evidence on these factors remains fragmented across settings, populations, and healthcare systems.This systematic review synthesised quantitative observational evidence on psychosocial factors associated with psychiatric readmission following discharge from acute inpatient mental health care. A systematic search of PubMed, Scopus, Web of Science, and APA PsycINFO was conducted from database inception in accordance with PRISMA 2020 guidelines. Eligible studies included adult psychiatric inpatients and examined at least one psychosocial factor assessed during admission or prior to discharge in relation to subsequent psychiatric readmission. Due to substantial clinical and methodological heterogeneity, findings were synthesised narratively.Fifteen studies conducted across diverse international healthcare systems were included. The most consistent findings were observed for housing instability, homelessness, and unstable residential context, which were repeatedly associated with psychiatric readmission across population-based, hospital-based, and clinical registry studies. Evidence for socioeconomic disadvantage, employment status, social integration, and social support was more heterogeneous, limited, or dependent on how these constructs were measured and adjusted for.These findings suggest that psychiatric readmission reflects not only clinical trajectories but also broader social vulnerability during the transition from inpatient to community-based care. Integrating systematic assessment of psychosocial circumstances, particularly housing instability and barriers to outpatient follow-up, into discharge planning may be important for improving continuity of care and reducing avoidable psychiatric readmissions.
Community Health Worker Intervention to Decrease Substance Use Disorder Readmissions in Medicaid-Enrolled Adults.
Hutchison SL, Mengle DE, Karpov IO … +3 more , Pooler TL, Herschell AD, Edwards JF
Community Ment Health J · 2026 Jun · PMID 42364054 · Publisher ↗
Community Health Workers (CHW) are individuals with an understanding of the communities they serve, employed within healthcare and human service systems to assess health and social needs of community members and connect...
Community Health Workers (CHW) are individuals with an understanding of the communities they serve, employed within healthcare and human service systems to assess health and social needs of community members and connect individuals to needed services. In this study, CHWs employed by a behavioral health managed care organization (BHMCO) were trained in a care coordination intervention to address reasons for substance use disorder (SUD) admission, health-related determinants, and motivation for ongoing treatment, with the goal to improve care and reduce readmissions. This observational cohort study included 865 Medicaid-enrolled adults with SUD hospitalization or residential service in 2021-2024; 593 individuals (68.6%) received the CHW Intervention. Outcomes included the BHMCO's paid service claims. Rate of readmission for those receiving the intervention was low (5.7%); approximately half (49.8%) received follow up services within 30 days of admission. Models adjusting for differences between those with and without the intervention (n = 272) showed higher odds for 7- and 30-day follow up for those with CHW contact. The present effort shows positive impact of the work of CHWs when part of a behavioral health treatment team on quality of care for individuals with SUD.
Reframing Mental Health Crisis Response: Building Evidence Without Law Enforcement at the Core.
Patel A, Phan V, Louie K … +1 more , DeVylder J
Community Ment Health J · 2026 Jun · PMID 42364053 · Publisher ↗
Concerns around the overuse of policing to address mental health concerns have fueled growing recognition of the need for alternatives to traditional law enforcement responses to mental health crises. This has given rise...
Concerns around the overuse of policing to address mental health concerns have fueled growing recognition of the need for alternatives to traditional law enforcement responses to mental health crises. This has given rise to the implementation of interdisciplinary response models, including police-only responses and the widespread adoption of Crisis Intervention Team (CIT) Training, as well as co-responder models and mobile crisis response. However, the body of research on the effectiveness of these models is still emerging. Researchers and scholars have conventionally centered law enforcement in much of this work, whether aiming to understand how police address crises or comparing non-police or co-response models to police-led responses. Limitations in data availability, standardized language, measurement, and operational definitions-combined with a lack of clarity around partnerships-make it difficult to understand which models are being implemented and how they function across communities. Addressing these limitations may expose an opportunity to shift away from police as the default and to consider possibilities for crisis systems in which mental health support is provided without routine law enforcement involvement.
Task Shifting and Sharing in Indian Mental Health: Four Case Studies Through the Lens of the SHIFT-SHARE Framework.
Das S, Fearon D, Grant L
Community Ment Health J · 2026 Jun · PMID 42362972 · Publisher ↗
India experiences a wide mental health (MH) treatment gap, with around 0.73 psychiatrists per 100,000 people, and a massive unmet need for common MH disorders. Task shifting and sharing (TS/S), which is moving tasks from...
India experiences a wide mental health (MH) treatment gap, with around 0.73 psychiatrists per 100,000 people, and a massive unmet need for common MH disorders. Task shifting and sharing (TS/S), which is moving tasks from specialists to less-specialised providers, offers a solution but lacks systematic implementation guidance. Unlike more procedural clinical tasks, MH care can involve multiple entry points, varied task types, and contexts where, often, trust outweighs credentials. This paper describes TS/S models in Indian MH space, identifying implementation lessons. We undertook a qualitative assessment, using interviews, focus groups, and observations, studying four organisations (cases): with models of CHW-led screening and rehabilitation across 700 villages in rural Gujarat, multi-level community teams operating 80 clinics in coastal Kerala, corporate peer MH first aiders serving 200,000 + employees, and a planned security force nurse counsellor programme. Data were analysed through SHIFT-SHARE v1.0, a new six-stage guiding framework for TS/S implementation, complemented by alignment measures that we developed for cross-case comparison. Organisations developed novel approaches like deconstructing cognitive behavioural therapy (CBT) into shiftable components, engaging traditional healers as collaborative partners, and cross-subsidisation models for sustainability. However, monitoring and evaluation emerged as the weakest link across cases, and funding structures often failed to recognise clinical services, medication, and supervision as important components of TS/S. MH TS/S differs from procedural task transfer: success needs philosophical alignment among providers, community-suitable capacity building, and outcome measures looking at recovery beyond symptoms. Effective MH TS/S means redesigning services around trust and accessibility instead of delegating professional tasks downward.
South Florida's Mobile Response Teams: Characteristics, Outcomes, and Implications for Behavioral Health Crisis Care.
Proctor SL, Cabrera I, Blanco D … +1 more , Newcomer JW
Community Ment Health J · 2026 Jun · PMID 42319683 · Publisher ↗
This study evaluated four Mobile Response Teams (MRTs), providing 24/7 behavioral health crisis intervention services, using retrospective administrative records of calls made to an MRT hotline between May 1, 2024, and A...
This study evaluated four Mobile Response Teams (MRTs), providing 24/7 behavioral health crisis intervention services, using retrospective administrative records of calls made to an MRT hotline between May 1, 2024, and April 30, 2025. The sample included 2,300 eligible calls representing 1,960 unique individuals (M = 30.01 years, SD = 19.92, Range = 5-89). Programmatic descriptives examined call and final dispositions, method of response, and response times, while chi-square tests assessed bivariate associations and binary logistic regression assessed predictors of final disposition, dichotomized as psychiatric hospitalization vs. diversion. Across the 12-month observational period, 64.8% of cases resulted in diversion, and the average in-person response time was within the State of Florida's 60-minute benchmark. Consistent with the program's "in-person first" model, 95.0% of calls were addressed face-to-face. Significant independent predictors of psychiatric hospitalization included age (adults 18 + years), higher suicide risk scores, presence of a specific suicide plan, law enforcement involvement, call source (school setting), and call reason (suicide attempt/ideation). Findings from this large, ethnically diverse, naturalistic sample demonstrate that MRTs not only divert a substantial proportion of crisis cases from hospitalization but also consistently meet state standards for timely and "in-person first" response, with implications for behavioral health policy and crisis service delivery.
Community Health Workers in Perinatal Mental Health: Feasibility and Challenges of Implementing a Task-Sharing Model.
Ramanathan S, Keefe R
Community Ment Health J · 2026 Jun · PMID 42313328 · Publisher ↗
Despite their long history of working with infants and new birthing persons, community health workers (CHWs) could be better utilized to help address the emotional needs of individuals who recently gave birth. We adapted...
Despite their long history of working with infants and new birthing persons, community health workers (CHWs) could be better utilized to help address the emotional needs of individuals who recently gave birth. We adapted the Thinking Healthy Program (THP), a World Health Organization-endorsed task-sharing model, to assess the feasibility of implementing THP in six community-based organizations (CBOs) in central and western New York. We present results on the feasibility and acceptability from the CHWs, their supervisors, and chief executives of six community-based organizations. Qualitative interviews with stakeholders were carried out prior to program launch, soliciting their input on the role of CHWs and challenges related to implementing the task-sharing approach for working with persons with perinatal mood and anxiety disorders (PMADs). Feedback on knowledge, comfort, confidence and overall ability were collected from CHWs and their supervisors at baseline and post-implementation (i.e., after implementation with two clients). Qualitative interviews identified three themes: 1) the community's need for CHW engagement; 2) the current CHW roles in the management of maternal health, including PMADs; and 3) the CBO/CHWs' ongoing need for resources to continue providing task-sharing approaches. Post-implementation surveys of CHWs revealed mixed results. Although CHWs stated their knowledge, comfort, and confidence in maternal mental health declined, their supervisors noted improvements in the CHWs' skillset. Our findings highlight critical challenges associated with implementing task-sharing approaches that engage CHWs to address PMADs. Our results suggest the need for attention to organizational context; sustained supervision; and strategies to address workforce turnover, burnout, and role clarity.
"I need to talk, to talk to people": a qualitative study of service user and carer views and priorities for social functioning in schizophrenia-spectrum disorders.
Long M, Moncrieff J, Smith R … +3 more , Crellin N, Stansfeld J, Davies N
Community Ment Health J · 2026 Jun · PMID 42313327 · Publisher ↗
Improving social functioning for people with schizophrenia-spectrum disorders is a priority for service users, carers and broader society. While many face challenges with social functioning, a proportion do obtain a job,...
Improving social functioning for people with schizophrenia-spectrum disorders is a priority for service users, carers and broader society. While many face challenges with social functioning, a proportion do obtain a job, a partner, and other valued social goals. Informal carers are key stakeholders, support recovery and may support service users' social functioning, though some research suggests carer and service user priorities may differ. Research suggests item content in measures of social functioning may not fully capture people's social world. The aim of this study was to explore service user and carer understandings of social functioning and what they value most, to inform intervention and measurement approaches. Semi-structured interviews were conducted with twelve service users and eight carers and audio recorded. Reflexive thematic analysis was conducted on anonymized transcripts with input from a multidisciplinary team and a carer with lived experience. One overarching theme, 'Fitting in and being accepted' reflected service user and carer participants' emphasis on integration and belonging beyond any particular social functioning outcome. Four themes were generated from the analysis: 'the value in performing everyday activities', 'communication and sociability as connection to the world', 'close relationships as central to social functioning and wellbeing' and 'the paradox of work: highly valued but a potentially risky endeavour'. Having a job was considered important but was out of reach for many. Revised expectations meant that service users who had more challenges with social functioning valued basic independence and achieving this helped them feel integrated in society. Service users and carers had broadly similar priorities and expectations for social functioning, with some exceptions including expectations around romantic relationships. Digital communication served as an important means of low pressure connection to others. People with schizophrenia need more social opportunities that fit their circumstances including developing relationships and accessing work. Instruments that measure social functioning may not reflect what service users find meaningful about social functioning, such as feeling accepted and fitting in and their use of digital communication.
Behavioral Health Service Utilization for Users of Peer Support Services Versus Matched Controls.
Hutchison SL, MacDonald-Wilson KL, Karpov I … +2 more , Carney T, Herschell AD
Community Ment Health J · 2026 Jun · PMID 42310232 · Publisher ↗
Certified Peer Specialists provide optional peer support services (PSS) to individuals with mental health disorders. In this effectiveness study, we describe changes in behavioral health service utilization in Medicaid-e...
Certified Peer Specialists provide optional peer support services (PSS) to individuals with mental health disorders. In this effectiveness study, we describe changes in behavioral health service utilization in Medicaid-enrolled adults receiving PSS compared to propensity-score matched controls. Individuals receiving PSS (n = 2,156) in 2021-2024 were successfully matched 1:2 to individuals receiving outpatient mental health services without PSS (comparison; n = 4,312). Service rates were compared between groups over time (90 days before, during, and 90 days following the PSS or outpatient episode of care. Rates of services were higher for PSS; utilization for the majority of services declined over time. PSS versus the Comparison was associated with a steeper decline in psychiatric hospitalization, β = -.0190, t(2,932) = -2.61, p = .0090, and crisis service, β = -.0269, t(2,932) = -3.49, p = .0005 following discharge from the episode of care. PSS may successfully maintain recovery-oriented care through diversion from psychiatric hospitalization and increase community tenure resulting in a utilization pattern that is not observed with outpatient mental health service alone.
Healthcare Mobility among United States Military Veterans with Experience of Housing Instability.
Montgomery AE, DeRussy A, Nelson R … +3 more , Richman J, Tsai J, Byrne T
Community Ment Health J · 2026 Jun · PMID 42301555 · Publisher ↗
Housing instability, generally, is associated with a lack of access to care. The present study explores healthcare mobility among Veterans experiencing housing instability to identify the magnitude of this phenomenon and...
Housing instability, generally, is associated with a lack of access to care. The present study explores healthcare mobility among Veterans experiencing housing instability to identify the magnitude of this phenomenon and whether it is associated with certain patient characteristics or needs. The sample included 486,675 Veterans with 4 or more healthcare visits during the year following identification of homelessness. Analyses compared (a) baseline characteristics of Veterans who did and did not experience high healthcare mobility (i.e., receipt of healthcare services at 4 or more U.S. Department of Veterans Affairs Medical Centers) and (b) services use during the observation period. Among the sample, 0.7% experienced high healthcare mobility. Veterans with a rural residence had 30% greater odds of high healthcare mobility; baseline use of primary care was associated with reduced odds. The findings represent the combined challenges of accessing healthcare when experiencing housing instability and while residing in a rural area and highlight the need to ensure that there is access to needed care. Future work should assess Veterans' access to community-based resources, particularly in rural areas and new ways of delivering care in these areas.
Educating Adolescents About Assessing Mental Health During Well Care Visits.
Magerl K, Char A, Swan BA
Community Ment Health J · 2026 Jun · PMID 42301554 · Publisher ↗
BACKGROUND: Growing rates of mental illness among the pediatric population have led to increased morbidity and mortality, with suicide being the second leading cause of death among children aged 10-14. Barriers to mental...
BACKGROUND: Growing rates of mental illness among the pediatric population have led to increased morbidity and mortality, with suicide being the second leading cause of death among children aged 10-14. Barriers to mental health (MH) care, including limited access to resources, stigma, and education, perpetuate the crisis. Pediatric primary care providers must seize every opportunity to bridge this gap. This project created an age-appropriate virtual educational program for adolescents aged 12 to 18 on the MH assessment tool, the Patient Health Questionnaire (PHQ-9), which is commonly used during well-child visits. METHODS: A clinician‑authored slide deck was converted into a 10‑minute Articulate Storyline module delivered on clinic tablets. Using a backward-design approach, every screen and interaction was mapped to four learning objectives focused on (1) feelings literacy, (2) PHQ-9 comprehension, (3) early-detection awareness, and (4) help-seeking efficacy. RESULTS: As a clinician-designed module not yet formally deployed to the target population, formative feedback was limited to informal review by four adolescent testers prior to final release. Teen testers who reviewed the material requested shorter card-back text, an option to replay narration, and higher color contrast on negative-emotion cards. CONCLUSION: By grounding the module in the validated PHQ-9 screening tool and evidence-based instructional design principles, and by engaging key stakeholders, the interactive virtual educational program bridges critical MH gaps by educating and empowering adolescents to understand their mental well-being and proactively engage in their care.
Community-Based Crisis Care Beyond the Emergency Department: A Scoping Review.
Pusey K, Ferguson M, Ennals P … +1 more , Procter N
Community Ment Health J · 2026 Jun · PMID 42298175 · Publisher ↗
Suicide and mental ill-health remain a major global concern, reflected by rising emergency department presentations, however there is growing recognition that these settings often do not meet the needs of individuals in...
Suicide and mental ill-health remain a major global concern, reflected by rising emergency department presentations, however there is growing recognition that these settings often do not meet the needs of individuals in crisis. These settings are often experienced as crowded, traumatic, and poorly equipped for psychological distress, underscoring the need for accessible, community-based alternatives that offer safer, more supportive responses during crisis. This scoping review examines the needs, motivations, and experiences of people using community-based alternatives to emergency departments and explores how peer support and lived experience are embedded in these models. A scoping review was conducted across five academic databases and grey literature sources for publications from the last 20 years. Eligible records included any study design such as quantitative, qualitative, mixed-methods research, service evaluations, and descriptive reports. Records were required to describe short-term, community-based crisis services for adults. Studies involving telehealth, mobile crisis, or hospital-based care were excluded. Titles and abstracts were screened independently by two reviewers. Twelve papers (n = 8 mixed methods, n = 3 qualitative, n = 1 quantitative) were eligible for inclusion. Studies spanned five countries, were mostly published in the past decade, and examined a range of non-clinical crisis models, including crisis cafés, respite centers, stabilization units, and peer-led services. Interventions commonly supported people experiencing suicidal distress, acute anxiety, depression, or significant life stressors. Peer support was central in most models and linked to reduced distress, greater emotional connection, and, in some cases, lower ED use. Barriers included limited availability, geographical inaccessibility, funding constraints, and insufficient aftercare. The diversity of study designs and the limited evaluation data made it difficult to draw broader conclusions about the existing evidence. Long-term outcomes and economic impacts were rarely reported, and few studies compared peer-led and non-peer models. Place-based, community alternatives offer promising, person-centered options for people in distress and may complement existing suicide prevention efforts. Addressing accessibility and funding challenges, along with further research on outcomes and peer support, will help strengthen their role in crisis care.
"Technology is Amazing… But Right Now, I Just Don't Know": Real-world Implementation Experiences and Adaptation Recommendations for Message-based Care in Community Mental Health.
Tauscher J, Larsen A, Struve G … +3 more , Brian R, Guler J, Ben-Zeev D
Community Ment Health J · 2026 Jun · PMID 42298174 · Publisher ↗
Mobile messaging interventions can improve engagement and support functional recovery among people with serious mental illness, yet they are seldom implemented in real-world community mental health settings. As part of a...
Mobile messaging interventions can improve engagement and support functional recovery among people with serious mental illness, yet they are seldom implemented in real-world community mental health settings. As part of a randomized controlled trial of a recovery-oriented messaging intervention, community-based clinicians were trained to serve as messaging mobile interventionists. In this qualitative study, we examined their perspectives on barriers, facilitators, and adaptations needed to optimize the acceptability and sustainability of messaging-based care. Semi-structured interviews were conducted with all clinicians (N = 6) who delivered the intervention to 39 clients across two community mental health agencies. Interviews were analyzed using a mixed deductive and inductive thematic approach. Four domains captured clinician perspectives: (1) perceptions of training, supervision, and workflow; (2) benefits for client care and service delivery; (3) challenges to intervention success; and (4) suggested adaptations for intervention design and implementation. Clinicians reported that messaging supported engagement, improved therapeutic relationships, and enhanced individualized care, particularly for clients with depression or social anxiety. They described substantial challenges integrating messaging into daily routines, navigating the technology platform, and adapting clinical skills to a text-based format, especially with clients experiencing cognitive disorganization or symptom-driven communication difficulties. Clinicians recommended clearer role definitions, specific functionality improvements, additional training resources, streamlined goal-setting processes, and flexibility to use synchronous communication when needed. Findings provide concrete guidance for developing improved messaging interventions and strengthening their implementation in community mental health settings based on real-world implementation experiences.
Prioritization of Oral Health among Safety-Net Behavioral Health Professionals: An Explanatory Sequential Mixed Methods Study.
Lapidos A, Cullen J, Flores E … +5 more , Hagaman B, Hershberger M, Stroud Q, Kim S, Rulli D
Community Ment Health J · 2026 Jun · PMID 42250159 · Publisher ↗
Abstract loading — click title to view on PubMed.
The Process of Piloting Psychiatric Services at a Medical Student-Run, Shelter-Based Free Clinic.
Cacioppo AM, Hollender M, Ikedionwu I … +3 more , Kromash J, Matuska M, Ehsan D
Community Ment Health J · 2026 Jun · PMID 42240778 · Publisher ↗
Student-run free clinics (SRFCs) enable medical students to care for communities disproportionately burdened by mental illness and health inequities. More literature is needed on the process of piloting psychiatric servi...
Student-run free clinics (SRFCs) enable medical students to care for communities disproportionately burdened by mental illness and health inequities. More literature is needed on the process of piloting psychiatric services in the SRFC setting. In 2021, a team of medical students piloted psychiatric services at an existing SRFC within a transitional housing facility for women affected by domestic violence. This article narratively describes and reflects on this process. The process of piloting psychiatric services included (1) assessing the need for psychiatric services; (2) establishing stakeholder and institutional support; (3) defining the mission, scope of practice, and liability coverage; (4) defining the roles and responsibilities of medical student volunteers; (5) training medical student volunteers to deliver psychiatric care; (6) establishing a clinic workflow; (7) establishing access to and protocols for prescribing for psychotropic medications; (8) partnering with community behavioral health providers; (9) planning for prospective program evaluation; (10) preparing the clinic for psychiatric care delivery; and (11) evaluating implementation and outcomes. The successful pilot of psychiatric services at this SRFC was facilitated by its use of existing infrastructure and the commitment of its student leaders and faculty mentors. That said, this initiative would have benefited from a formal needs assessment and literature review and faced challenges with prospective program evaluation. This article provides a roadmap for medical students and physicians at other SRFCs who aspire to fill gaps in access to psychiatric care for patients from underserved communities and enhance medical education in psychiatry at their institutions.
Correction: Effects of the Japanese Version of Metacognitive Training on Self-Efficacy and Sense of Coherence in Community-Dwelling Patients with Schizophrenia: A Pilot Study.
Kuroda K, Hori T, Hayashi A
Community Ment Health J · 2026 May · PMID 42217134 · Publisher ↗
Abstract loading — click title to view on PubMed.
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