World mental health, your mental health

Do Canada and the United States Differ in Prevalence of Depression and Utilization of Services?

Community Mental Health Centers (CMHCs) and Federally Qualified Health Centers (FQHCs) are critical access points for families with adolescents needing mental health care, especially those enrolled in Medicaid. However, barriers exist which may reduce their accessibility. This study aims to describe the availability and accessibility of outpatient mental health services for children and adolescents at safety-net health centers in a large metropolitan county. Approximately one year after the COVID-19 pandemic began in the U.S., a comprehensive sample of 117 CMHCs and 117 FQHCs were called and administered a 5-minute survey. Approximately 10% of health centers were closed, and 20% (28.2% of FQHCs and 7.7% of CMHCs) reported not offering outpatient mental health services. Despite CMHCs having 5.4 more clinicians on staff on average, reported wait times were longer at CMHCs than FQHCs. These findings indicate that online directories intended to be a comprehensive and accessible resource, such as the SAMHSA Treatment Locator, are often inaccurate or out-of-date.

Mental Health Care Reforms in Latin America: Child and Adolescent Mental Health Services in Mexico

INTRODUCTION: Victoria is one of the most multicultural states in Australia. Many CALD communities in Victoria may have encountered complicated migration journeys and complex life stressors during their initial settlement, leading to adverse mental health concerns. This diversity necessitates public policy settings to ensure equity and access in health services planning and delivery. While the MH policies and services take cultural diversity into account, there needs to be more implementation of those components of MH policies that relate to the particular needs of various CALD communities in Victoria. Even though mental health services prevent and address mental health issues, many barriers can impair CALD community access and utilisation of mental health services. Furthermore, the recent Royal Commission inquiry into the Victorian Mental Health system drives a renewed policy imperative to ensure meaningful engagement and cultural safety of all people accessing and utilising mental health services (Department of Health, 2023). This study focused on the perspectives of people from CALD communities in Victoria regarding their mental health service needs, understandings of and experiences with mental health services to prepare an education package for mental health nurses as part of a larger multi-method research project. A qualitative descriptive design was used to collect and analyse the perspectives of 21 participants in Victoria, using telephone interviews, followed by thematic analysis. The themes and sub-themes identified were: Settling issues; Perceptions of understanding of mental health issues (help-seeking attitudes toward mental health issues; the need for CALD community education); perceived barriers to accessing and utilising mental health services in Victoria (socio-cultural and language barriers; stigma, labelling and discrimination; knowledge and experience of accessing health facilities); experience with mental health services and professionals. Community participation, mental health professional education and robust research regarding the mental health needs of CALD people are some of the recommended strategies to improve access and utilisation of mental health services in Victoria. The current study can contribute to the existing knowledge, understanding, practice and quality improvement as it vividly portrays the issues of various CALD communities in Victoria. The findings of this study imply that CALD MH service users and their families are likely to benefit in terms of improved service assessment and quality of MH care and equity when MHNs undertake CC training and bring that into their practice.

The World Health Organization declared COVID-19 as a pandemic in March 2020. COVID-19 has since caused a significant increase in mental health problems at national and global levels. This study assessed the views of key mental health stakeholders regarding the state of mental health service provision in Malawi and the pandemic's impact on the sector. The study utilised a qualitative approach through key informant interviews (KIIs) conducted using a semi-structured interview guide. The interviews were audio recorded in English language and were manually transcribed for thematic analysis by generating codes re-classified into themes, sub-themes and quotes. The results are categorised into five themes. Firstly, the availability of mental health services. All experts confirmed the lack of availability of the mental health services especially at the lower levels of care. Currently, only 0.3% of facilities offer mental health services in Malawi. Moreover, although mental health services are part of the essential health care package and, therefore, are supposed to be provided for free in public facilities at all levels, the services are centralised and only functional at a tertiary level of care in public facilities. Secondly, funding sources for mental health in public and private facilities. We learnt that public facilities depend on donor sources and there is lack of prioritisation in budget allocation for mental health services. Whereas private facilities, their major source of funding is user fees. Thirdly, government's response in the provision of mental health services during COVID-19. Almost all experts echoed that government took a proactive approach to address the mental health needs of its population during the pandemic. There was increased collaboration between the government and the private sector to provide psychosocial and counselling services to health workers working directly with COVID-19 patients in isolation centres. Furthermore, to increase awareness of the general population on where to seek counselling services. Lastly, challenges in the provision of mental health services were highlighted and how the pandemic acerbated the challenges including shortage in human resources for health and inadequate funding. This study underscores the urgency of addressing mental health challenges in Malawi. Policymakers must prioritize the decentralization of mental health services, explore funding opportunities, and build on the successful collaboration with the private sector. These measures will not only enhance the accessibility and quality of mental health services but also ensure that mental well-being is a central component of public health efforts in Malawi.

This study investigates the effects of gender, age, perceived socioeconomic status, and attitudes toward mental health treatment, alongside the awareness and accessibility of mental health services, on the propensity of Asian international undergraduate and graduate students in U.S. colleges to seek mental health support. Utilizing an online survey, responses from a diverse group of 116 participants, aged 18 and above, from universities across the nation were examined through correlation analysis. Findings indicated no significant gender differences in attitudes toward mental health treatment. However, factors such as higher educational level, superior socioeconomic background, longer U.S. residency, and increased awareness and accessibility of mental health services positively influenced attitudes. This quantitative study extends previous qualitative research addressing similar questions, filling a gap by offering broader empirical insights into this population’s mental health service utilization. The outcome underscores the need for university counseling centers to develop targeted interventions that acknowledge the needs of Asian international students. Future research should explore the longitudinal impacts of these factors on mental health help-seeking behaviors to inform ongoing service improvement.

Background: Mental health awareness and access to services in rural Pakistan are limited, with residents facing barriers such as stigma, financial constraints, and inadequate services, particularly in rural Sindh. Objective: This study assessed mental health awareness and service utilization among the rural population of Sindh, Pakistan. Methodology: A cross-sectional, descriptive study was conducted from September 17, 2021, and September 17, 2022, with ethical approval from the Gambat Medical College Ethical Review Committee. A simple random sampling technique recruited n=478 participants from rural districts of Sindh (Thatta, Badin, Tharparkar). Data were collected using a structured questionnaire, including sociodemographic information and mental health awareness, utilizing the Mental Health Knowledge Schedule (MAKS). Data were examined by adopting descriptive statistics as well as logistic regression in SPSS. Results: The majority of participants (81.7%) believed in medical treatments for mental illness, and 70.3% supported the availability of mental health services at the communal level. However, 80.7% reported a lack of local mental health services, with financial constraints (68.8%) and social stigma (61.1%) as major barriers. Education level and occupation significantly influenced mental health knowledge, with those having higher education and professional occupations showing greater awareness (p<0.01). Conclusion: Mental health awareness is moderate, with significant knowledge gaps, especially among those with lower education. Barriers such as financial constraints and stigma hinder service utilization, highlighting the need for community-based mental health services and educational initiatives in rural Sindh. Keywords: mental health awareness, rural population, Sindh, mental health services, barriers

Immigrant and refugee populations experience life stressors due to difficult migration journeys and challenges in leaving one country and adapting to another. These life stressors result in adverse mental health outcomes when coupled with a lack of adequate support-enhancing resources. One area of support is access to and use of mental health services to prevent and address mental health concerns. Immigrant service providers in Canada support the integration and overall well-being of newcomers. This study focuses on immigrant service providers' perceptions of access to and use of mental health services for immigrants and refugees in Alberta. A qualitative descriptive design was used to collect and analyse the perspectives of 53 immigrant service providers recruited from nine immigrant serving agencies in Alberta between November 2016 and January 2017. Data were collected using a combination of individual interviews and focus groups, followed by thematic data analysis to identify relevant themes. Barriers to access and use of mental health services include language barriers, cultural interpretations of mental health, stigma around mental illness, and fear of negative repercussions when living with a mental illness. Strategies to improve mental health service delivery include developing community-based services, attending to financial barriers, training immigrant service providers on mental health, enhancing collaboration across sectors in mental health service delivery, and advancing the role of interpreters and cultural brokers. Overall, immigrant service providers present a nuanced view of the complex and inter-related barriers immigrants and refugees experience and identify potential approaches to enhancing mental health service delivery.

Mental health after China's prolonged lockdowns

Mental health challenges among youth have emerged as a pressing public health issue globally, especially in low- and middle-income countries like Pakistan. Despite the growing burden, awareness and access to mental health services remain limited due to stigma, cultural misconceptions, and inadequate institutional support. Bahawalpur, being a semi-urban region in Southern Punjab, lacks localized data on the awareness and barriers faced by its youth in seeking mental health care. The purpose of this study was to assess the level of awareness, attitudes, and perceived barriers toward mental health among youth residing in Bahawalpur, Pakistan. This descriptive cross-sectional study was conducted among 70 young individuals aged between 15 and above 30 years from both rural and urban areas of Bahawalpur. A non-probability purposive sampling technique was used. A convenient sampling technique was used to choose the participants, and IBM SPSS Statistics 27.0.1 was used for analysis after a close ended questionnaire was used to gather data. Among the 70 participants, 52.9% were female and 47.1% were male. The majority of respondents (55.7%) were aged 19–22 years, with 64.3% having completed bachelor’s level education. Most participants (81.4%) lived in urban areas, and 80% identified as students. An overwhelming 97.1% reported having heard the term “mental health,” and 57.1% had received mental health information at school, college, or work. However, only 35.7% knew of any local mental health services. Attitudinally, 77.2% agreed or strongly agreed that people with mental illness are dangerous, while 71.4% agreed that mental health issues should be treated like physical conditions. Common barriers identified included stigma, lack of awareness, and religious misconceptions. Notably, 68.6% believed mental health issues were a sign of personal weakness. This study highlights both promising levels of awareness and persistent barriers surrounding mental health among youth in Bahawalpur. While most participants recognize the importance of mental health, misconceptions and lack of service accessibility limit help-seeking behavior. These findings underscore the urgent need for community-based awareness campaigns, school-level mental health education, and culturally appropriate interventions to reduce stigma and improve access to youth mental health services.

This paper proposes a framework for comprehensive, collaborative, and community-based care (C4) for accessible mental health services in low-resource settings. Because mental health conditions have many causes, this framework includes social, public health, wellness and clinical services. It accommodates integration of stand-alone mental health programs with health and non-health community-based services. It addresses gaps in previous models including lack of community-based psychotherapeutic and social services, difficulty in addressing comorbidity of mental and physical conditions, and how workers interact with respect to referral and coordination of care. The framework is based on task-shifting of services to non-specialized workers. While the framework draws on the World Health Organization’s Mental Health Gap Action Program and other global mental health models, there are important differences. The C4 Framework delineates types of workers based on their skills. Separate workers focus on: basic psychoeducation and information sharing; community-level, evidence-based psychotherapeutic counseling; and primary medical care and more advanced, specialized mental health services for more severe or complex cases. This paper is intended for individuals, organizations and governments interested in implementing mental health services. The primary aim is to provide a framework for the provision of widely accessible mental health care and services.

This paper proposes a framework for comprehensive, collaborative, and community-based care (C4) for accessible mental health services in low-resource settings. Because mental health conditions have many causes, this framework includes social, public health, wellness and clinical services. It accommodates integration of stand-alone mental health programs with health and non-health community-based services. It addresses gaps in previous models including lack of community-based psychotherapeutic and social services, difficulty in addressing comorbidity of mental and physical conditions, and how workers interact with respect to referral and coordination of care. The framework is based on task-shifting of services to non-specialized workers. While the framework draws on the World Health Organization’s Mental Health Gap Action Program and other global mental health models, there are important differences. The C4 Framework delineates types of workers based on their skills. Separate workers focus on: basic psychoeducation and information sharing; community-level, evidence-based psychotherapeutic counseling; and primary medical care and more advanced, specialized mental health services for more severe or complex cases. This paper is intended for individuals, organizations and governments interested in implementing mental health services. The primary aim is to provide a framework for the provision of widely accessible mental health care and services.

Meso-level Comparison of Mental Health Service Availability and Use in Chile and Spain

New Models of Collaboration Between Criminal Justice and Mental Health Systems

Using Communication Complex as our theoretical framework, we explored socially constructed notions about mental health from a complexity informed perspective. Through qualitative interviews we investigated the availability of mental health services provided at three universities—one in Wrocław, Poland; one in Semarang, Indonesia; and the third in Indianapolis, Indiana, United States. From our interviews we interpreted several salient themes across all three cultures. Discussions about mental health services are meaningless without first defining mental health in pursuit of ascertaining what counts as caring for one's mental health—a process which raises a host of epistemological and ontological questions in both the academic setting and the larger social milieu. These conversations also reified the importance of considering one's whole health, how stigma plays a role in defining mental health “issues”, and what stories are being told about the nature of mental health across several cultures. We argue that there is a deeper, reflexive relationship between the ways people talk about mental health and what services are offered that goes beyond traditional notions of what mental health “is” and what counts as a mental health service.