Psychiatric disorders among employment requiring firearms.

Perceived Effectiveness of Medications Among Mental Health Service Users With and Without Alcohol Dependence

Predictors of Likelihood and Intensity of Past-Year Mental Health Service Use in an Active Canadian Military Sample

COVID-19 and Stress-Related Disorders.

Utilization of Emergency Medical Transports and Hospital Admissions Among Persons With Behavioral Health Conditions

In 2004, the American Academy of Pediatrics (AAP) Board of Directors formed the Task Force on Mental Health and charged it with developing strategies to improve the quality of child and adolescent mental health* services in primary care. The task force acknowledged early in its deliberations that enhancing the mental health care that pediatricians and other primary care clinicians† provide to children and adolescents will require systemic interventions at the national, state, and community levels to improve the financing of mental health care and access to mental health specialty resources. Systemic strategies toward achieving these improvements are the subject of other publications of the task force: “ Strategies for System Change in Children's Mental Health: A Chapter Action Kit ” (chapter action kit),1 “Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration,”2 and “Enhancing Pediatric Mental Health Care: Strategies for Preparing a Community.”3 The task force also recognized that enhanced mental health practice will require competencies not currently achieved by many primary care clinicians; in the policy statement “The Future of Pediatrics: Mental Health Competencies for Pediatric Primary Care,”4 the task force collaborated with the AAP Committee on Psychosocial Aspects of Child and Family Health to outline these competencies and propose strategies for achieving them. This report offers strategies for preparing the primary care practice itself for provision of enhanced mental health care services. The task force proposes incrementally applying chronic care principles to the care of children with mental health and substance abuse problems as primary care clinicians apply them to the care of children with chronic medical conditions such as asthma. Most primary care clinicians will find that significant gaps exist between their current practice and the proposed ideal. The task force offers guidance in … Address correspondence to Jane Meschan Foy, MD, Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157. E-mail: jmfoy{at}wfubmc.edu

To provide a model to estimate human resource needs for community-based mental health services in South Africa. A situation analysis was conducted of current community-based mental health service provision in South Africa, which comprise outpatient and emergency services, residential care and day care. Service utilisation rates and staffing needs were estimated for two levels of service coverage, using data from the situation analysis, local epidemiological studies and consultation with key stakeholders. For a population of 100,000 people, 7.3-23.8 full-time equivalent staff would be required to provide services in outpatient services, 14.9-41.6 in day care and 11.5-23.0 in residential care at minimum and full coverage levels respectively. The model can facilitate rational planning by requiring transparency and accountability in the assumptions used. This method can be adapted to a range of countries, by entering relevant country data. The model fills a gap, particularly in low- and middle-income countries, where community-based mental health services are sparse, and decisions regarding allocations to them are hampered by a lack of good quality data. The results of the model are limited by the quality of data and the assumptions upon which the modelling are based.

BackgroundMigrants in host countries are at risk for the development of mental health conditions. The two aims of the study were to describe routine diagnoses of mental disorders among migrant patients at primary healthcare level and the associated risk factors, and to test the utility of an innovative migrant mental health assessment by evaluating whether the health professionals followed the recommendations proposed by the clinical decision support system (CDSS) tool. MethodsA cross-sectional study was carried out in eight primary care centres (PCCs) in four non-randomly selected health regions of Catalonia, Spain from March to December 2018. Routine health data and mental health diagnoses based on the International Classification of Diseases (10th edition), including mental, behavioural and neuro developmental disorders (F01-F99), symptoms and signs involving emotional state (R45), and sleep disorders (G47), were extracted from the electronic health records. The proportion of mental health conditions was estimated and logistic regression models were used to assess any possible association with mental health disorders. The utility of the mental health assessment was assessed with the proportion of questionnaires performed by health professionals for migrants fulfilling the mental health screening criterion (country of origin with an active conflict in 2017) and the diagnoses given to the screened patients. ResultsOf 14,130 migrants that visited any of the PCCs during the study period, 7,358 (52.1 %) were women with a median age of 38.0 years-old. There were 520/14,130 (3.7 %) migrant patients diagnosed with a mental disorder, being more frequent among women (342/7,358; 4.7 %, p-value < 0.001), migrants from Latin-America (177/3,483; 5.1 %, p < 0.001) and those who recently arrived in Spain (170/3,672; 4.6 %, p < 0.001). A lower proportion of mental disorders were reported in migrants coming from conflicted countries in 2017 (116/3,669, 3.2 %, p = 0.053).Out of the 547 mental health diagnoses reported in 520 patients, 69/14,130 (0.5 %) were mood disorders, 346/14,130 (2.5 %) anxiety disorders and 127/14,130 (0.9 %) sleeping disorders. Mood disorders were more common in migrants from Eastern Europe (25/2,971; 0.8 %, p < 0.001) and anxiety disorders in migrants from Latin-America (126/3,483; 3.6 %, p < 0.001), while both type of disorders were more often reported in women (p < 0.001).In the adjusted model, women (aOR: 1.5, [95 % CI 1.2–1.8, p < 0.001]), migrants with more than one visit to the health center during the study period (aOR: 4.4, [95 %CI 2.8–6.8, p < 0.001]) and who presented an infectious disease (aOR: 2.1, [95 %CI 1.5–3.1, p < 0.001]) had higher odds of having a mental disorder.Lastly, out of the 1,840 migrants coming from a conflicted country in 2017 who were attended in centres where the CDSS tool was implemented, 29 (1.6 %) had a mental health assessment performed and the tool correctly identified one individual. ConclusionsMental health is a condition that may be overlooked in migrants at primary healthcare. Interventions at this level of care must be reinforced and adapted to the needs and circumstances of migrants to ensure equity in health services.

The central place of psychiatry in health care worldwide.

This study sought to investigate the rates and correlates of homelessness, especially mental illness, among adult jail inmates. Data from a national survey of jail inmates (N=6,953) were used to compare the proportion of jail inmates who had been homeless in the previous year with the proportion of persons in the general population who had been homeless in the previous year, after standardization to the age, race and ethnicity, and gender distribution of the jail sample. Logistic regression was then used to examine the extent to which homelessness among jail inmates was associated with factors such as symptoms or treatment of mental illness, previous criminal justice involvement, specific recent crimes, and demographic characteristics. Inmates who had been homeless (that is, those who reported an episode of homelessness anytime in the year before incarceration) made up 15.3% of the U.S. jail population, or 7.5 to 11.3 times the standardized estimate of 1.36% to 2.03% in the general U.S. adult population. In comparison with other inmates, those who had been homeless were more likely to be currently incarcerated for a property crime, but they were also more likely to have past criminal justice system involvement for both nonviolent and violent offenses, to have mental health and substance abuse problems, to be less educated, and to be unemployed. Recent homelessness was 7.5 to 11.3 times more common among jail inmates than in the general population. Homelessness and incarceration appear to increase the risk of each other, and these factors seem to be mediated by mental illness and substance abuse, as well as by disadvantageous sociodemographic characteristics.

Intersection of Mental Health and Dysphonia: A Scoping Review

Special Report: Women’s Reproductive Mental Health—A Clinical Framework

Mental and somatic health is often impaired among transgender persons. Studies regarding coexisting mental and somatic health outcomes among transgender persons are limited. To assess health diagnoses and medicine use among transgender persons compared with cisgender controls. This register-based national cohort study included data from January 1, 2000, to December 31, 2021. Transgender persons were included on the first date of receipt of a transgender identity contact code. Controls included 10 age-matched cisgender men (n = 5) and women (n = 5) for each transgender person. Statistical analyses were conducted from September to December 2024. The main outcomes were International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis codes and medicine use in a 5-year period up to the first date of transgender contact code for most commonly occurring mental and physical illnesses. The main outcomes were determined after data collection. The cohort included 3812 transgender persons (1993 transmasculine persons [52.3%] with a median age of 19 years [IQR, 15-24 years] and 1819 transfeminine persons [47.7%] with a median age of 23 years [IQR, 19-33 years]) and 38 120 cisgender controls. The odds for a mental health diagnosis was up to 12 times higher among transgender persons compared with cisgender controls. Among transmasculine and transfeminine persons, neurotic, stress-related disorders (transmasculine: adjusted odds ratio [AOR], 4.70 [95% CI, 4.02-5.50]; transfeminine: AOR, 5.27 [95% CI, 4.28-6.49]); developmental disorders, including autism (transmasculine: AOR, 11.67 [95% CI, 8.85-15.39]; transfeminine: AOR, 9.39 [95% CI, 7.05-12.50]); mood (affective) disorders (transmasculine: AOR, 5.41 [95% CI, 4.32-6.77]; transfeminine: AOR, 5.61 [95% CI, 4.16-7.57]); and behavioral disorders (transmasculine: AOR, 4.50 [95% CI, 3.61-5.62]; transfeminine: AOR, 4.15 [95% CI, 3.19-5.39]) were the most frequent mental health diagnoses compared with cisgender controls of the opposite sex at birth. Transmasculine persons had higher odds for somatic diagnosis codes of diabetes (AOR, 2.00 [95% CI, 1.12-3.56]), asthma (including chronic obstructive lung disease; AOR, 1.40 [95% CI, 1.06-1.85]), injury and poisoning (AOR, 1.28 [95% CI, 1.15-1.41]), and pain (AOR, 1.29 [95% CI, 1.12-1.49]) compared with control cisgender women. Among transfeminine persons, somatic diagnosis codes of infection (AOR, 1.68 [95% CI, 1.33-2.13]), anemia (AOR, 3.08 [95% CI, 1.36-6.97]), diabetes (AOR, 1.95 [95% CI, 1.25-3.05]), sleep apnea (AOR, 3.41 [95% CI, 1.84-6.31]), and pain (AOR, 1.31 [95% CI, 1.08-1.58]) were more frequent compared with control cisgender men. Transgender persons had higher use of psychopharmacologic medicine, antacids, and laxatives compared with cisgender controls (transmasculine persons vs control cisgender women, antipsychotics: AOR, 6.20 [95% CI, 5.07-7.59]; hypnotics-sedatives: AOR, 4.45 [95% CI, 3.78-5.23]; antacids: AOR, 1.25 [95% CI, 1.07-1.45]; and laxatives: AOR, 1.53 [95% CI, 1.17-1.99]; transfeminine persons vs control cisgender men, antipsychotics: AOR, 4.74 [95% CI, 3.92-5.74]; hypnotics-sedatives: AOR, 3.01 [95% CI, 2.53-3.57]; and antacids: AOR, 1.32 [95% CI, 1.12-1.56]). Mental health diagnoses and use of psychopharmacologic drugs were coexisting with somatic diagnoses and use of drugs for somatic diseases. This cohort study of Danish transgender persons and cisgender controls found significantly higher risks for mental and somatic health diagnoses among transgender persons. Coexistence of mental health outcomes and somatic health outcomes among transgender persons could be associated with stress encountered due to belonging to a gender identity or sexual orientation minority group; mental and physical morbidity should be considered an integrated part of transgender care.

The Link Between Homeless Women's Mental Health and Service System Use

Patients with sickle cell disease (SCD) experience a broad range of mental health disorders placing them at risk for more complicated hospitalizations for pain. The current study examined the impact of mental health disorders on admission rates and hospital length of stay (LOS) for vaso-occlusive pain events (VOE) in pediatric patients with SCD. Patients (5-18 years old) with a primary discharge diagnosis of SCD with crisis were acquired through the Pediatric Health Information System and categorized by history of mental health disorders (mood disorder, anxiety disorder, disruptive behavior disorder, and substance use disorder). Using a retrospective cohort design, hospital admission rates for VOE were examined as the primary outcome and LOS as a secondary outcome. A total of 5,825 patients accounted for 23,561 admissions for SCD with crisis with approximately 8% of the patients having a mental health diagnosis. Longer LOS was found among patients with a history of any mental health diagnosis (P < 0.0001) and within the mood disorder (P < 0.0001), anxiety disorder (P < 0.0001), and substance use disorder (P = 0.01) subtypes. Hospital admissions rates for VOE were higher among patients with a history of any mental health diagnosis (P < 0.0001) and within the mood disorder (P < 0.0001), anxiety disorder (P < 0.0001), disruptive behavior disorder (P = 0.002), and substance use disorder (P < 0.0001) subtypes. Pediatric patients with SCD and a history of a mental health diagnosis have longer LOS and higher admission rates for management of VOE. Ultimately, these findings suggest that mental health pose a challenge to the management of sickle cell pain.

Cancer Risk Factors Among Adults with Serious Mental Illness