UNASSIGNED: Mental health (MH) conditions are among the most common chronic health conditions in the United States. Previous studies suggested decreased in life satisfaction post-COVID-19 in other populations outside the United States. This study explored the correlations between life satisfaction and MH among diverse community post-COVID-19 pandemic.
UNASSIGNED: A cross-sectional, non-experimental, retrospective study. The primary outcome was the Satisfaction with Life Scale total score (SWLS_TS) and the characteristics of the cases from self-reported information. Statistical software SPSS was used for descriptive and inferential analyses.
UNASSIGNED: About 218 cases were included for analysis. Many of the cases were Asian Americans (n = 185, 84.1%). The multiple linear regression model significantly predicted 5.2% of the variance in SWLS_TS. Three out of 6 predictors significantly contributed to the model (age β = .172, t = 2.42, P = .017, ethnicity β = .148, t = 2.07, P = .039, and no history of MH β = .248, t = 3.31, P = .001).
UNASSIGNED: A diverse population was examined post-COVID-19 pandemic, and the findings suggest a positive correlation with age, ethnicity, and no history of MH with SWLS_TS.

UNASSIGNED: Detection and management of late-life depression largely relies on primary care. Yet in Singapore, older adults are unlikely to seek help for their mental health from their primary care providers. This qualitative descriptive study explores how late-life depression manifests to general practitioners (GPs) in the Singaporean primary care setting.
UNASSIGNED: Twenty-eight private GPs practicing in Singapore were asked about their clinical experience with late-life depression during semi-structured group and individual discussions conducted online. Participants were purposively sampled across age, gender, and ethnicity (Chinese, Malay, Indian). Transcripts were analysed with reflexive thematic analysis.
UNASSIGNED: To GPs, depression in older patients often manifests through somatic symptoms or subtle behavioural changes, only detectable through follow-ups or collateral history. GPs reported that older patients attribute depressive symptoms to normal ageing or do not mention them, particularly within an Asian culture encouraging stoic endurance. GPs perceived late-life depression as reactions to ageing-related stressors, with male, low-income, or institutionalised patients being at particular risk of insidious, severe depression. GPs noted ethnic differences regarding families\' involvement in care, which they described as helpful, but sometimes stress-provoking for patients. Fear of burdensomeness or loss of autonomy/social role could prompt rejection of diagnosis and treatment in patients. GPs considered good patient-doctor rapport as a facilitator at every step of the care process, noting more favourable prognosis in care-concordant patients.
UNASSIGNED: Depression in older adults in Singapore can be covert, with favourable outcomes relying on GPs\' ability to pick up on subtle changes, assess patients holistically, and build rapport with patients and families.
UNASSIGNED: This work was funded by the Division of Family Medicine Research Capabilities Building Budget under the project \"Technology and Compassion: Improving Patient Outcomes Through Data Analytics and Patients\' Voice in Primary Care\" [NUHSRO/2022/049/NUSMed/DFM].

This article explores the historic impact of the COVID-19 pandemic on turnover rates among staff in community mental health and substance use organizations in the United States. While existing literature extensively covers turnover in physical healthcare settings, the mental health and substance use sector\'s unique challenges have received less attention. The study utilizes a six-year dataset from a large multi-service organization in the northeast to analyze turnover patterns before, during, and after the pandemic. Key findings include a spike in turnover during the pandemic, particularly in Hospital Diversion Programs, and significant variations by age and gender. Despite the pandemic not significantly affecting overall turnover rates, the results offer insights into specific groups at risk for turnover, such as staff under 29 years old. The study concludes by discussing the implications for targeted retention strategies, especially as mental health organizations nationwide adopt the Certified Community Behavioral Health Center model.

BACKGROUND: Recent reviews have highlighted the need for participatory research to design and evaluate inclusive, community-based interventions that address the diverse needs of people with lived experience of psychosis, within and beyond the health sector. The SUCCEED Africa consortium aims to co-produce a 6-year programme of research across four countries in West (Sierra Leone, Nigeria) and Southeast Africa (Zimbabwe and Malawi). This protocol describes the pilot study in which SUCCEED\'s intervention, research tools and processes will be tested on a small scale in each country in preparation for future evaluation research.
METHODS: The SUCCEED intervention comprises peer support, case management and livelihood activities for people with lived experience of psychosis. The pilot uses a before-and-after study design investigating change in subjective quality of life in adults diagnosed with a primary psychotic disorder or another mental disorder with psychotic symptoms who are offered the SUCCEED intervention over a 4-month period. Nested within this study are the following: a baseline assessment of the feasibility, acceptability and face validity of the selected measurement tool and validity of proxy versus self-completion; and a multi-method process evaluation examining key process indicators and implementation, service and client-level outcomes. Methods include the following: baseline cognitive interviews; semi-structed observation and routine monitoring and evaluation of service delivery; endline interviews and focus group discussions; and a comparison of provider competencies at endline. At each of the four pilot sites, participants will include the following: ten people with lived experience of psychosis, recruited from either health services or community settings using purposive sampling to maximise variation; up to ten adult family members (one per participant with lived experience) involved in their care; the peer support worker, community support worker and supervisor responsible for delivering the intervention; and the data collectors. Recruitment will take place in July and August 2023.
CONCLUSIONS: To the best of our knowledge, this will be the first study of a community-based intervention incorporating lay-delivered case management, formal peer support and livelihoods activities for people with lived experience of psychosis in sub-Saharan Africa. Findings will be relevant not only to SUCCEED but also to others interested in promoting rights-based approaches to community mental health in low-resource settings.
BACKGROUND: US National Library of Medicine (ClinicalTrials.gov), Protocol reference ID 28346. Initially registered retrospectively July 20/2023: In review.

UNASSIGNED: Black men are one of the most disadvantaged groups when accessing mental health services in the UK. There is extensive guidance from qualitative research on how to bring equity, but it is unclear how this evidence is being implemented.
UNASSIGNED: To systematically review interventions that help Black men access timely and appropriate mental health care and to explore their nature and effectiveness.
UNASSIGNED: We registered on PROSPERO (CRD42022345323). We searched electronic databases up to September 2023 for studies with at least 50% of Black male participants receiving an intervention to improve access to mental health support in community settings. We conducted a narrative synthesis of eligible studies.
UNASSIGNED: Five studies met our inclusion criteria. An important characteristic was discussing thoughts and feelings through peer support, leading to a normalization of experiences.
UNASSIGNED: There is a paucity of research into interventions that support Black men accessing community mental health support. Proactively testing interventions, not just seeking qualitative feedback, is required. Evidence-based strategies to support recruitment of Black men into research is necessary. Commissioners could consider evidence typically seen as less robust to mitigate against an underlying racial bias within research and stimulate the growth of an evidence base.

Georgia has recently made a commendable effort to reform mental health care. The \"Concept on Mental Health Care\" adopted by the Government and the two strategic plans for 2014-2020 and 2021-2031, which aimed to develop comprehensive evidence-based, culturally appropriate, and human rights-oriented mental health care, have promoted the deinstitutionalization and development of community mental health services. Since 2018, new standards of care for mental health ambulatories and mobile teams have been imposed and implemented in the state programme and funded accordingly. The study aimed to investigate the quality of care in community mental health services. As a result, we monitored the mental health ambulatories in all major cities and regional centres of the country (in total, 16 ambulatories) and the mobile teams which had at least two years of experience (in total, 14 mobile teams). The data analyses showed that the new standards for ambulatories and mobile teams increased access to and coverage of mental health care across the country. However, further effort is still needed to achieve comprehensive treatment by mental health care services.
В последние годы, в Грузии были предприняты большие усилия по реформированию системы охраны психического здоровья. В 2013 году правительством Грузии была утверждена «Концепция психиатрической помощи», а также разработаны два стратегических плана на 2014–2020 и 2021–2031 гг, что способствовало процессу деинституционализации и развитию внебольничных служб охраны психического здоровья. С 2018 года в государственной программе были введены новые стандарты оказания помощи для амбулаторий и мобильных бригад и соответственно изменилась система финансирования. Настоящее исследование направлено на изучение качества обслуживания внебольничных служб охраны психического здоровья. Анализ данных мониторинга амбулаторий психического здоровья во всех крупных городах и областных центрах страны (всего 16 амбулатории) и мобильных бригад, которые функционируют, не менее двух лет (всего 14 сервисов) показал, что ведение новых стандартов для внебольничных служб психического здоровья расширило доступ и охват психиатрической помощью по всей стране. Тем не менее необходимы дальнейшие усилия для развития всеобъемлющего, комплексного и основанного на биопсихосоциальном подходе системы психического здоровья в стране.

Sri Lanka is a lower middle-income, small island nation in the Indian Ocean, with a multi-ethnic population of 22 million. The healthcare system of the country is well established and relatively advanced, the delivery of which is free to the consumer. The health indicators of the country are impressive compared to regional figures. Psychiatric care in Sri Lanka has witnessed a rapid development over the last four decades, as the care model transformed from an asylum-based model, established during the British colonial times, to a district-wise hospital-based, care delivery model. Gradually, the teams that provided inpatient and outpatient services at the hospitals also started to provide community-based care. The newly added community-based services include outreach clinics, residential intermediate rehabilitation centres, home-based care, community resource/support centres and telephone help lines. There is no or very little funding dedicated to community-based care services. The teams that deliver community services are funded, mostly indirectly, by the state health authorities. This is so, as these community teams are essentially the same psychiatry teams that are based at the hospitals, which are funded and run by the state health authorities. This lack of separation of the community and hospital teams without separate and dedicated funding is an impediment to service development, which needs to be addressed. However, paradoxically, this also constitutes an advantage, as the provision of care delivery from the hospital to the community is continuous, since the same team provides both hospital- and community-based care. In addition to the essential mental healthcare provision in the community with this basic infrastructure, each community service has improvised and adapted the utilization of other resources available to them, both formally as well as informally, to compensate for their financial and human resource limitations. These other resources are the community officials and the community services of the non-health sectors of the government, mainly the civil administration. Although sustainability may be questionable when services involve informal resources from the non-health sectors, these have so far proven useful and effective in a resource-poor environment, as they bring the community and various sectors together to facilitate services to support their own community.
Шри-Ланка представляет собой небольшое островное государство в Индийском океане с доходами ниже среднего уровня и многонациональным населением в количестве 22 миллионов. Система здравоохранения в этой стране является устойчивой и относительно развитой, медицинские услуги предоставляются потребителям бесплатно. Показатели здоровья в стране являются впечатляющими в сравнении с региональными данными. Службы психиатрической помощи в Шри-Ланке быстро развивались в течение последних сорока лет, поскольку произошла смена модели психиатрической помощи: от модели на основе психиатрических лечебниц, сложившейся во времена, когда страна была колонией Британии, к модели оказания медицинских услуг на базе районных клиник. Постепенно группы специалистов, которые обеспечивали стационарное и амбулаторное лечение в клиниках, также стали оказывать медицинские услуги на территориальной основе. Новые дополнительные территориальные службы включают в себя выездные медпункты, центры промежуточной реабилитации с постоянным проживанием пациентов, уход на дому, территориальные информационные центры и центры поддержки, а также телефонные службы помощи. Специализированное финансирование территориальных медицинских услуг является очень скудным или вообще отсутствует. Финансирование групп, обеспечивающих функционирование территориальных служб, осуществляется государственными органами здравоохранения, в основном, косвенно. Это связано с тем, что такие территориальные службы, по сути, представляют собой те же службы психиатрической помощи на базе больниц, которые финансируются и управляются государственными органами здравоохранения. Отсутствие разграничения между территориальными и больничными службами и отдельного специализированного финансирования препятствует развитию таких служб, и эта проблема требует решения. Однако парадоксальным образом данная ситуация также является преимуществом, поскольку предоставление медицинских услуг на базе больниц и на территориальной основе осуществляется без перерывов, так как данные услуги оказывает одна и та же группа специалистов. Помимо оказания необходимой психиатрической помощи на территориальной основе с использованием такой базовой инфраструктуры, каждая территориальная служба приспособилась пользоваться другими доступными ресурсами, как официально, так и неофициально, чтобы компенсировать ограниченность финансовых и кадровых ресурсов. Такие ресурсы включают в себя общинных должностных лиц и территориальные правительственные службы, не связанные со здравоохранением (в основном, гражданскую администрацию). Хотя в случае привлечения неофициальных ресурсов из секторов, не связанных со здравоохранением, для оказания медицинских услуг устойчивость системы в долгосрочной перспективе вызывает сомнения, на данный момент в условиях нехватки ресурсов такая практика показала свою эффективность, поскольку она объединяет общество и различные секторы для упрощения предоставления услуг в целях поддержки региона.

Thailand is an upper middle-income country located in the center of mainland Southeast Asia with a population of 66.17 million as of 2021. The aim of this review article is to illustrate the development of community mental health in our country. We have divided the article into five main sections: namely, the mental health service infrastructure, the community mental health system, human resources, mental health financing, public education, and links to other sectors. Mental health care has been integrated into primary care since 1982, resulting in a major shift in focus on mental health at the community level; however, mental health problems and the mental health gap in service accessibility remain present, especially during the current COVID-19 pandemic. Community mental health care has been extended to networks outside the health care system, including the community authorities. It has been provided with psychiatric care and rehabilitation, together with the promotion of mental health and prevention of mental disorders for improving accessibility to services, especially during a pandemic situation. Finally, future challenges to face community mental health have been outlined, such as insufficient staff to develop rehabilitation service facilities for people with chronic, serious mental illnesses; identifying supporting funding from other stakeholders; and mental health care for persons with long COVID living in the community.
Таиланд — страна с уровнем дохода выше среднего, расположенная в центре материковой части Юго-Восточной Азии, с населением 66,17 млн человек в 2021 году. Цель данной обзорной статьи — проанализировать этапы развития амбулаторной психиатрической службы в нашей стране. Статья разделена на пять основных разделов, а именно: система охраны психического здоровья, система амбулаторной психиатрической службы, кадровые ресурсы, финансирование психиатрической помощи, просвещение населения и связи с другими секторами. С 1982 года психиатрическая помощь интегрирована в первичную медико- санитарную помощь, что привело к значительному увеличению внимания к психическому здоровью на общественном уровне; однако проблемы в области психического здоровья и недостаточная доступность психиатрической помощи все еще существуют, особенно во время пандемии COVID-19. Амбулаторная психиатрическая служба охватила структуры, не входящие в систему здравоохранения, в том числе и органы местного самоуправления. Данная служба включает психиатрическую помощь и реабилитацию, а также укрепление психического здоровья и профилактику психических расстройств, ее задача заключается в повышении доступности помощи, особенно во время пандемии. Наконец, рассмотрены требующие решения проблемы амбулаторной психиатрической службы, такие как нехватка персонала для создания реабилитационной службы для людей с хроническими тяжелыми психическими заболеваниями, привлечение финансирования от других заинтересованных сторон, а также забота о психическом здоровье людей с постковидным синдромом в условиях привычной социальной среды.

For the past years, Ecuador has been transitioning away from a hospital-based model of mental healthcare to one that is community-centred. However, challenges associated with hospital-based models endure, notably financial burden faced by those with severe mental health problems (SMHPs) due to labour market discrimination. Employment access for this group is often disregarded in policy planning, despite evidence of its benefits on mental health. Huertomanías, an urban garden initiative in Ecuador founded in 2015, works with individuals with SMHPs, providing work, income, and social inclusion. A case study using a participatory approach was carried out to explore factors that impact the recovery of people with SMHPs. Twelve participants engaged in diverse stages of the research, where several participatory activities were conducted including cognitive mapping, a photovoice project, and interviews. The analysis employed a thematic approach leading to four categories of impact within the urban garden: autonomy (financial and personal), interpersonal relations and relation with the environment, mental health, and family dynamics. A final category of impact was established encompassing external factors (family support and public policy and healthcare services) that influence recovery. Findings suggest that the urban garden promotes autonomy and active participation within society, improves mental health, and transforms family dynamics. Further, this study highlights the importance of community-based mental healthcare (CBMHC), emphasising the need of public policies and healthcare in promoting autonomy through employment and community-centred services. Lastly, the study contributes insights into recovery experiences and CBMHC benefits, informing programme development and similar initiatives in Latin America.

Mental health problems represent a growing global concern. This has intensified since the coronavirus pandemic and is also partly due to greater awareness of the extent of mental health problems and the lack of attention they have received over time. In many high-income countries, increases in service provision have been accompanied by efforts to increase the mental health literacy of the general population. One example of this in Australia, is the mental health first aid training program which is informed by the mental health first aid guidelines created to promote mental health literacy among the general population, reduce stigma, and enable lay people to provide timely support, and facilitate access to health services for a person developing a mental health problem or in a mental health crisis.
Between March 2020 and May 2023, a consortium of researchers from Australia, Argentina and Chile carried out the cultural adaptation of five guidelines (drinking problems, depression, suicide risk, trauma, and psychosis) using the Delphi consensus methodology. Health professionals with expertise in each of the topics and people with lived experience (their own or as informal caregivers) from Argentina and Chile were grouped into separate panels. Over two survey rounds, they evaluated the items from the Australian guidelines and gave their opinion on the importance of their inclusion in the local guidelines. Additionally, they suggested items not included in the Australian guidelines.
This report presents the details of the methodology used and the most significant results of each of the five adapted guidelines, particularly, those of relevance to the Argentinian and Chilean context. The general acceptance of the role of the first aider stands out as an important outcome. However, in comparison to Australia, the first aider’s role was reduced and the health professional role was expanded. Self-help recommendations were typically not endorsed by local experts, suggesting skepticism toward these strategies. Other specific recommendations for each of the guidelines are described and analyzed in this report.
A study of the implementation of training courses based on these guidelines is required to make the necessary adaptations and determine their local usefulness.
Los problemas de salud mental en la comunidad representan una preocupación global creciente, intensificada desde la pandemia por coronavirus y gracias a una mayor conciencia respecto de su extensión y del bajo nivel de atención que recibieron a lo largo del tiempo. En Australia se crearon las primeras guías de primeros auxilios en salud mental para promover un mayor conocimiento de temas de salud mental en la población general, brindar apoyo oportuno, facilitar el acceso a los servicios de salud por esta problemática, y disminuir el estigma asociado al padecimiento mental.
Un consorcio de investigadores de Australia, Argentina y Chile, entre marzo de 2020 y mayo de 2023, realizó la adaptación cultural de cinco guías (consumo problemático de alcohol, depresión, riesgo de suicidio, trauma, y psicosis) siguiendo la metodología de consenso Delphi. Profesionales expertos en cada uno de los temas y personas con experiencia vivida  (propia o como cuidadores informales) conformaron sendos paneles con miembros de Argentina y de Chile. En dos rondas de consulta evaluaron los ítems provenientes de las guías de Australia y opinaron sobre su pertinencia para formar parte de las guías locales. Adicionalmente, sugirieron ítems que no estaban contemplados en las guías australianas.
El presente reporte presenta el detalle de la metodología empleada y los resultados más significativos de cada una de las cinco guías adaptadas y, particularmente, su aplicabilidad para Argentina y Chile. Sobresale la aceptación general del rol del asistente de primeros auxilios en salud mental, aunque también con limitaciones en el rol y funciones en favor del privilegio de profesionales de la salud. Las recomendaciones de auto-ayuda fueron mayoritariamente no aceptadas por los expertos locales, sugiriendo desconfianza respecto de estas estrategias. Otras recomendaciones específicas para cada una de las guías se describen y analizan en este reporte.
Se requiere un estudio de la implementación de la capacitación en base a estas guías para realizar ulteriores adaptaciones y determinar su utilidad local.