BACKGROUND: Emerging evidence indicates that individuals with type 2 diabetes (T2D) are more prone to mental health issues than the general population; however, there is a significant lack of data concerning the mental health burden in Chinese Americans with T2D.
OBJECTIVE: The aim of this study was to explore the comorbid mental health status, health-seeking behaviors, and mental service utilization among Chinese Americans with T2D.
METHODS: A cross-sectional telephone survey was performed among 74 Chinese Americans with T2D in New York City. We used standardized questionnaires to assess mental health status and to gather data on mental health-seeking behaviors and service utilization. Descriptive statistics were applied for data analysis.
RESULTS: A total of 74 Chinese Americans with T2D completed the survey. Most participants (mean age 56, SD 10 years) identified as female (42/74, 57%), were born outside the United States (73/74, 99%), and had limited English proficiency (71/74, 96%). Despite nearly half of the participants (34/74, 46%) reporting at least one mental health concern (elevated stress, depressive symptoms, and/or anxiety), only 3% (2/74) were currently using mental health services. Common reasons for not seeking care included no perceived need, lack of information about Chinese-speaking providers, cost, and time constraints. The cultural and language competence of the provider was ranked as the top factor related to seeking mental health care.
CONCLUSIONS: Chinese Americans with T2D experience relatively high comorbid mental health concerns yet have low service utilization. Clinicians may consider team-based care to incorporate mental health screening and identify strategies to provide culturally and linguistically concordant mental health services to engage Chinese Americans with T2D.

UNASSIGNED: Mental health at the workplace (WMH) is an important indicator for the optimum functioning of a medical institute. To establish an effective WMH, it is essential to understand the level of awareness, perceptions, and felt needs of students and staff of a medical institute regarding mental health services within the campus.
UNASSIGNED: A cross-sectional web-based survey was conducted in an institution of national importance in Central India using a semistructured questionnaire based on Kobo Toolbox. Felt need for periodic mental health screening within the institutional campus (FN-S) and felt need of having a separate cell for mental healthcare of students and employees (FN-C) were analyzed using univariable and multivariable logistic regression.
UNASSIGNED: A total of 526 out of 2190 eligible students and staff completed the survey (response rate 24.1%). About half of the participants were not aware, of whom to contact on campus in case of mental health concerns (MHCs), more than three-fourths were not aware of the rights for seeking treatment, and three-fourths thought that getting diagnosed with an MHC would negatively impact their academic course or work. There was a high felt need for mental health screening services (91.1%), and almost two-thirds felt the need for a separate mental health cell. The FN-S was higher among those from rural areas, those not using social media, those without a preexisting MHC, and those without FN-C. FN-C was higher in those not using social media, those having sleep disturbances, those with unawareness of the rights of a mentally ill person, those without any MHC, and those not having FN-S.
UNASSIGNED: Active efforts are needed to roll out a mental health screening policy and separate mental health cells within the medical institute. Future research should focus on a qualitative inquiry into the details of the above findings.

BACKGROUND: Avoidant/restrictive food intake disorder (ARFID) is a serious, albeit under-researched, feeding or eating disorder. This exploratory study utilized data from adult respondents to the National Eating Disorders Association online eating disorder screen to validate items assessing the presence of ARFID and examine the prevalence, clinical characteristics, and correlates of a positive ARFID screen.
METHODS: Among 50,082 adult screen respondents between January 2022 and January 2023, the prevalence of a positive ARFID screen was calculated. Chi-square tests and t-tests compared demographics, eating disorder attitudes and behaviors, suicidal ideation, current eating disorder treatment status, and eating disorder treatment-seeking intentions between respondents with possible ARFID and other eating disorder diagnostic and risk categories. Clinical characteristics of respondents with possible ARFID were also examined.
RESULTS: 2378 (4.7%) adult respondents screened positive for ARFID. Respondents with possible ARFID tended to be younger, male, and have lower household income, and were less likely to be White and more likely to be Hispanic/Latino than most other diagnostic/risk groups. They had lower weight/shape concerns and eating disorder behaviors than most other diagnoses and higher BMI than those with AN. 35% reported suicidal ideation, 47% reported intentions to seek treatment for an eating disorder, and 2% reported currently being in treatment. The most common clinical feature of ARFID was lack of interest in eating (80%), followed by food sensory avoidance (55%) and avoidance of food due to fear of aversive consequences (31%).
CONCLUSIONS: Findings from this study indicated that ARFID was prevalent among adult screen respondents and more common among individuals who were younger, male, non-White, Hispanic, and lower income relative to those with other eating disorders, at risk for an eating disorder, or at low risk. Individuals with possible ARFID frequently reported suicidal ideation and were rarely in treatment for an eating disorder. Further research is urgently needed to improve advances in the assessment and treatment of ARFID and improve access to care in order to prevent prolonged illness duration.
This study examined data from adult respondents to a publicly available online eating disorders screen adult to examine the prevalence, clinical characteristics, and correlates of a positive ARFID screen. 4.7% of respondents screened positive for ARFID. A positive ARFID screen was more common among respondents who were younger, male, non-White, Hispanic, and lower income relative to those in other eating disorder diagnostic/risk categories. Respondents with possible ARFID frequently reported suicidal ideation and were rarely in treatment for an eating disorder. Lack of interest in food or eating was the most common clinical feature among those with possible ARFID.

Food insecurity (FI), characterized by limited or uncertain access to adequate food, has been associated with eating disorders (EDs). This study explored whether FI was associated with ED behaviors, ED diagnosis, current treatment status, and treatment-seeking intentions among adults who completed an online ED screen.
Respondents to the National Eating Disorders Association online screening tool self-reported demographics, FI, height and weight, past 3-month ED behaviors, and current treatment status. Respondents were also asked an optional question about treatment-seeking intentions. Hierarchical regressions evaluated relations between FI and ED behaviors, treatment status, and treatment-seeking intentions. Logistic regressions explored differences in probable ED diagnosis by FI status.
Of 8714 respondents, 25 % screened at risk for FI. FI was associated with greater binge eating (R2Change = 0.006), laxative use (R2Change = 0.001), and presence of dietary restriction (R2Change = 0.001, OR: 1.32) (ps < .05). Having FI was associated with greater odds of screening positive for a probable ED or as high risk for an ED (ps < .05). FI was not associated with current treatment status or treatment-seeking intentions (ps > .05).
Findings add to existing literature supporting a relation between FI and EDs. Implications include a need to disseminate EDs screening and treatment resources to populations affected by FI and to tailor treatments to account for barriers caused by FI.

OBJECTIVE: Face-to-face evaluation is the most important in psychiatric evaluation, but smart healthcare, including non-face-to-face evaluation, can be beneficial considering the situation in which face-to-face evaluation is limited or the preventive aspect of mental illness. In this paper, we aimed to check whether mental health screening tests have the same significance as paper-based tests even when collected through mobile applications.
METHODS: A smart mental healthcare screening test was conducted on the 1,327 community subjects. We measured two indicators of depression (Patient Health Questionnaire 9-item scale, PHQ-9) and anxiety (Generalized Anxiety Disorder 7-item scale, GAD-7) to check mental health conditions.
RESULTS: The average Cronbach\'s alpha value of the PHQ-9 questionnaire was good at 0.870. As a result of PHQ-9\'s principal component analysis, one component with an eigenvalue of 1 or more was identified, which is suitable to be described as a single factor. The average Cronbach\'s alpha value of the GAD-7 was 0.919. The structural validity of the GAD-7 was confirmed through principal component analysis.
CONCLUSIONS: Our results show that PHQ-9 and GAD-7 scales performed through mobile applications can have the same meaning as paper-based tests. Surveys using a tablet PC, or smartphone application can monitor residents\' mental health and accumulate data. Based on these data, smart mental health management can check the mental health of residents and treat mental illness in connection with medical services.

UNASSIGNED: Avoidant/restrictive food intake disorder (ARFID) is a serious, albeit under-researched, feeding or eating disorder. This exploratory study utilized data from adult respondents to the National Eating Disorders Association (NEDA) online eating disorder screen to validate items assessing the presence of ARFID and examine the prevalence, clinical characteristics, and correlates of a positive ARFID screen compared to other probable eating disorder/risk categories.
UNASSIGNED: Among 47,705 adult screen respondents between January 2022 and January 2023, the prevalence of a positive ARFID screen was calculated. Chi-square tests and t-tests compared demographics, eating disorder attitudes and behaviors, suicidal ideation, current eating disorder treatment status, and eating disorder treatment-seeking intentions between respondents with possible ARFID and other eating disorder diagnostic and risk categories. Clinical characteristics of respondents with possible ARFID were also examined.
UNASSIGNED: 2,378 (5.0%) adult respondents screened positive for ARFID. Respondents with possible ARFID tended to be younger, male, and have lower household income, and were less likely to be White and more likely to be Hispanic/Latino than most other diagnostic/risk groups. They had lower weight/shape concerns and eating disorder behaviors than all other diagnoses but higher BMI than those with AN. 35% reported suicidal ideation, 47% reported intentions to seek treatment for an eating disorder, and 2% reported currently being in treatment. The most common clinical feature of ARFID was lack of interest in eating (80%), followed by food sensory avoidance (55%) and avoidance of food due to fear of aversive consequences (31%).
UNASSIGNED: Findings from this study indicated that ARFID was prevalent among adult screen respondents and more common among individuals who were younger, male, non-White, Hispanic, and lower income relative to those with other eating disorders or at risk for an eating disorder. Individuals with possible ARFID frequently reported suicidal ideation and were rarely in treatment for an eating disorder. Further research is urgently needed to improve advances in the assessment and treatment of ARFID and improve access to care in order to prevent prolonged illness duration.

BACKGROUND: Children\'s Advocacy Centers (CACs) use multidisciplinary teams to investigate and respond to maltreatment allegations. CACs play a critical role in connecting children with mental health needs to evidence-based mental health treatment, especially in low-resourced rural areas. Standardized mental health screening and referral protocols can improve CACs\' capacity to identify children with mental health needs and encourage treatment engagement. In the team-based context of CACs, teamwork quality is likely to influence implementation processes and outcomes. Implementation strategies that target teams and apply the science of team effectiveness may enhance implementation outcomes in team-based settings.
METHODS: We will use Implementation Mapping to develop team-focused implementation strategies to support the implementation of the Care Process Model for Pediatric Traumatic Stress (CPM-PTS), a standardized screening and referral protocol. Team-focused strategies will integrate activities from effective team development interventions. We will pilot team-focused implementation in a cluster-randomized hybrid type 2 effectiveness-implementation trial. Four rural CACs will implement the CPM-PTS after being randomized to either team-focused implementation (n = 2 CACs) or standard implementation (n = 2 CACs). We will assess the feasibility of team-focused implementation and explore between-group differences in hypothesized team-level mechanisms of change and implementation outcomes (implementation aim). We will use a within-group pre-post design to test the effectiveness of the CPM-PTS in increasing caregivers\' understanding of their child\'s mental health needs and caregivers\' intentions to initiate mental health services (effectiveness aim).
CONCLUSIONS: Targeting multidisciplinary teams is an innovative approach to improving implementation outcomes. This study will be one of the first to test team-focused implementation strategies that integrate effective team development interventions. Results will inform efforts to implement evidence-based practices in team-based service settings.
BACKGROUND: Clinicaltrials.gov, NCT05679154 . Registered on January 10, 2023.

UNASSIGNED: The prevalence of mental health problems in adolescents has been identified as a global concern. Early screening and identification can offer benefits in terms of primary prevention and reduced healthcare costs. This study aimed to develop a tool to assess the risk of developing mental health problems in adolescents.
UNASSIGNED: The study followed an exploratory sequential design and was divided into five phases. The Multidimensional Psychosocial Risk Screen (MPRS) is a newly developed self-report measure. The various steps in its development and validation have been elaborated. The MPRS was evaluated with a sample of 934 adolescents aged 12-18, spread across the 8th-12th grade.
UNASSIGNED: Exploratory and confirmatory factor analyses revealed a robust factor structure. The extracted five factors were named as Parent-Child Relationship (PCR), Self-Concept (SC), Teacher-Student Dynamics (TSD), Social Media Use (SMU), and Peer Interaction (PI). The reliability of the subscales ranged from 0.60 to 0.80. The overall reliability of the scale was good (a = 0.87). Convergent validity of the scale was established using standard measures of risk factors and emotional and behavioural problems.
UNASSIGNED: The MPRS can be considered an effective tool with an adequate factor structure and good psychometric properties. It can be beneficial in the early detection of vulnerabilities to mental health problems in adolescents and, therefore, seen as a key element in primary prevention and fostering individualized interventions.

During the COVID-19 pandemic, health care systems were faced with the urgent need to implement strategies to address the behavioral health needs of health care workers. A primary concern of any large health care system is developing an easy-to-access, streamlined system of triage and support despite limited behavioral health resources.
This study provides a detailed description of the design and implementation of a chatbot program designed to triage and facilitate access to behavioral health assessment and treatment for the workforce of a large academic medical center. The University of California, San Francisco (UCSF) Faculty, Staff, and Trainee Coping and Resiliency Program (UCSF Cope) aimed to provide timely access to a live telehealth navigator for triage and live telehealth assessment and treatment, curated web-based self-management tools, and nontreatment support groups for those experiencing stress related to their unique roles.
In a public-private partnership, the UCSF Cope team built a chatbot to triage employees based on behavioral health needs. The chatbot is an algorithm-based, automated, and interactive artificial intelligence conversational tool that uses natural language understanding to engage users by presenting a series of questions with simple multiple-choice answers. The goal of each chatbot session was to guide users to services that were appropriate for their needs. Designers developed a chatbot data dashboard to identify and follow trends directly through the chatbot. Regarding other program elements, website user data were collected monthly and participant satisfaction was gathered for each nontreatment support group.
The UCSF Cope chatbot was rapidly developed and launched on April 20, 2020. As of May 31, 2022, a total of 10.88% (3785/34,790) of employees accessed the technology. Among those reporting any form of psychological distress, 39.7% (708/1783) of employees requested in-person services, including those who had an existing provider. UCSF employees responded positively to all program elements. As of May 31, 2022, the UCSF Cope website had 615,334 unique users, with 66,585 unique views of webinars and 601,471 unique views of video shorts. All units across UCSF were reached by UCSF Cope staff for special interventions, with >40 units requesting these services. Town halls were particularly well received, with >80% of attendees reporting the experience as helpful.
UCSF Cope used chatbot technology to incorporate individualized behavioral health triage, assessment, treatment, and general emotional support for an entire employee base (N=34,790). This level of triage for a population of this size would not have been possible without the use of chatbot technology. The UCSF Cope model has the potential to be scaled, adapted, and implemented across both academically and nonacademically affiliated medical settings.

The present study sought to identify if there is distinct mental health symptomology among child welfare-involved youth depending on the category of adverse childhood experiences (ACEs) endorsed. A chart review of child welfare-involved youth (N = 129, ages 8-16) and caregiver reported ACEs and mental health/trauma symptoms was conducted. A K-means cluster analysis used ACE scores to identify groups of youth along two dimensions: household dysfunction and child abuse/neglect. The first cluster identified had low ACE scores outside of their system involvement (n = 62), the second predominantly endorsed household dysfunctions (n = 37), and the third predominantly endorsed abuse/neglect (n = 30). One-way analysis of variance tests revealed that youth in the systems-only cluster differed from youth in the other groups, while the two high ACE category groups did not differ from each other on mental health/trauma symptoms. These results have important implications for the screening and treatment referral processes in the child welfare system.