Culturally responsive peer support services can improve access to and engagement with substance use and mental health services among Latinx persons, but how to implement a culturally responsive peer support program in a Spanish-speaking peer-run behavioral health organization is unclear. This qualitative study used the Consolidated Framework for Implementation Research (CFIR) to explore determinants for implementing a culturally responsive peer support program. We conducted 14 interviews with peer support program leadership, Certified Peer Specialists (CPS), and CPS supervisors about implementation of and experience with the peer support program. Interviews were conducted and analyzed in Spanish and English using constant comparative methods and organized according to the CFIR. Key CFIR elements included: (1) Intervention characteristics: a culturally responsive approach that alleviated stigma while celebrating recovery culture and Latinx peer culture; (2) Outer setting: outside of the study setting, barriers to accessing behavioral health care were driven by cultural differences between providers and clients; (3) Inner setting: A robust model of culturally responsive and linguistically appropriate peer-to-peer supervision and a built environment that fosters a mutual aid-oriented organizational culture; (4) Individuals involved: supervision strengthens CPS knowledge and skills to deliver peer support; (5) Implementation Process: despite organizational supports, CPS work is emotionally draining. Future studies should explore the scalability of the supervision model and other implementation supports described here, using a culturally responsive lens.

Disparities in mental health treatment for low-income, Black and Latinx populations have been well recognized. Beyond structural barriers, a noteworthy concern was whether attitudinal barriers played a major role in initiating and maintaining treatment. More specifically, 35- to 60-year-old Black and Latina women have been understudied regarding their attitudes and preferences for mental health treatment. The purpose of this study was to identify attitudinal enablers and barriers that have prevented midlife low-income, Black and Latina women from North Philadelphia from initiating and continuing mental health treatment.

This study explores what family members of individuals with mental illness hope for, and how their hopes are shaped, sustained, or challenged through participation in a group-based psychoeducational intervention program for informal carers. Although hope is a key concept in recovery-oriented practice, little is known about the hopes of carers themselves, or how hope is supported through preventive interventions.

Measurement-based care (MBC) is an evidence-based practice that can improve the identification of co-occurring mental health conditions and substance use disorders, as well as population differences in care in lower resource settings, through ongoing monitoring of patient-reported symptoms. The current study examined, as reported by different stakeholders prior to implementation, barriers and facilitators of implementing screening tools to monitor mental health and substance use symptoms in the outpatient behavioral health setting at a safety-net hospital. A purposeful sampling approach was used to recruit stakeholders from two outpatient clinics (child, adult) to participate in individual interviews (clinic leadership) and stakeholder-specific focus groups (clinicians and administrative staff). De-identified transcripts were coded using a directed content analytic approach guided by constructs from the Consolidated Framework for Implementation Research (CFIR). A total of 14 clinicians, 6 clinic leaders, and 4 administrative staff participated in interviews and focus groups. Results indicate stakeholder agreement on specific implementation constructs (e.g., patient needs, networks and communication) and unique perspectives influenced by the stakeholders' day-to-day responsibilities. However, there were inconsistent responses regarding networks and communication across stakeholder groups. Clinicians only identified barriers, clinic leadership only identified facilitators, and administrative staff did not identify communication as a barrier or facilitator. Thus, when implementing MBC within a safety-net behavioral health clinic setting, cohesive communication may be perceived differently by clinicians, clinic leadership, and administrative staff and should be validated across staff roles.

The health effects of social conditions such as income, education, and employment have been demonstrated to be persistent and wide-reaching. In this study, we examine the effect of social determinants of health, those conditions in which people live, among individuals with serious mental illnesses (SMI) who are actively engaged with mental health services. Using a sample of 203 clients at a community mental health clinic, this study (1) explores the prevalence of three social determinants of health: food insecurity, homelessness, and neighborhood disorder, and (2) assesses their associations with five outcomes of health, including mental health (overall mental health and life satisfaction) and physical health (overall physical health, number of chronic health conditions, and perceived daily limits). Our findings demonstrated that food insecurity and neighborhood disorder were prevalent within our sample of people with SMI (64% and 93% respectively), while homelessness was not (7%). Furthermore, a series of OLS regressions showed food insecurity and neighborhood disorder to be associated with poor mental and physical health, while homelessness was not significantly associated with any outcomes. These findings suggest that individuals with SMI who are actively engaged in treatment have increased risk of food insecurity and poor neighborhood conditions, which in turn may negatively impact their overall health. We suggest that mental health service providers be aware of the influence of social conditions on their patients and that clinics may be uniquely positioned to identify and intervene for individuals at risk of experiences that may be detrimental to their recovery.

This is the first study to specifically explore the experiences of people with BPD in an IPS employment program. Understanding the experiences of individuals with BPD can assist those delivering IPS employment programs to ensure that they are effectively meeting the needs of this diagnostic group. To understand the experiences and perspectives of individuals who participated in a pilot Individual Placement and Support (IPS) program for people with Borderline Personality Disorder (BPD). Data were gathered through semi-structured interviews with four people who had participated in the pilot program and analysed using reflexive thematic analysis. Participants were invited to provide feedback on draft themes, which informed the final analysis. Factors that shaped the participants' generally positive experiences of the program fell into three broad themes. 'Wanting to do it' came from having work-related goals, a perception that it was the right time and a sense of being in control. 'Somebody on your side' described participants' experience of relationship with their employment consultant being characterised by understanding, encouragement and flexibility. Finally, 'it's all in one place' centred on their experience of the integration of the mental health service and employment program as increasing trust, accessibility, and support. IPS was well accepted by participants in this study with findings highlighting factors that supported this acceptability. Further research investigating the perspectives and outcomes of IPS for individuals with BPD is suggested.

Obesity-associated diseases, such as type 2 diabetes, metabolic syndrome, and dyslipidemia, are common in individuals with mental disorders. The relative contribution of mental disorders, psychotropic medication, and BMI remains unclear. In this cross-sectional study, individuals aged 18-60 years with a BMI ≥ 30 kg/m² were referred to the University Hospital of Southern Denmark, Esbjerg, and screened for diabetes, prediabetes, metabolic syndrome, hypertension, blood lipid abnormalities, liver disease, and sleep apnea. Individuals with mental disorders were compared to those without using binomial logistic regression adjusted for BMI, age, sex, and use of psychotropic medication. We included 345 participants with and 317 without mental disorders, all with BMI ≥ 30 kg/m. Participants with mental disorders were younger (40.9 ± 10.9 vs. 44.2 ± 10.8 years) and had higher BMI (42.8 ± 7.9 vs. 40.9 ± 6.4 kg/m²). Adjusted analyses showed no increased odds of obesity-related disease except for blood lipid abnormalities and steatosis. BMI significantly influenced most models but not the association with blood lipid abnormalities. Apart from blood lipid abnormalities and steatosis, obesity-related diseases in individuals with mental disorders appears to be largely attributable to obesity. Weight management should be prioritized, with additional focus on blood lipid abnormalities.

This study presents a preliminary evaluation of the effectiveness of the GUIA Team's flexible Assertive Community Treatment (ACT) program implemented in Spain, designed for adolescents and young adults with complex mental health conditions. The program addresses fragmented care by coordinating multiple service sectors. Retrospective observational pre-post study with 42 participants aged 14-25 years, assessing treatment adherence, clinical symptoms, hospital service utilization and global functioning. Findings demonstrate a significant reduction in psychiatric emergency visits and involuntary hospitalizations, along with objective improvements in clinical symptomatology and overall functioning, particularly with longer intervention. Treatment adherence was high and outcomes were consistent across a heterogeneous sample, irrespective of primary diagnoses or demographic characteristics. These findings suggest that diagnostic categories alone are limited in predicting outcomes in complex cases, underscoring the importance of functional and recovery oriented models. The study supports the feasibility and clinical value of a flexible ACT model adapted for youth, emphasizing sustained, multidisciplinary and individualized interventions in the patient's natural environment.

Caregivers of persons with mental illness experience stressors and anxiety during the psychiatric hospitalization of a family member. The implementation of a family-centered model could reduce these feelings, and therefore, such a model was developed in Israel. To examine whether the model's implementation makes a difference in the stress and anxiety experienced by caregivers, a comparative study was conducted in two psychiatric hospitals. Questionnaires were delivered twice to caregivers in an intervention group (n = 93) and a control group (n = 75). The anxiety level was lower in the intervention group than in the control group in the second delivery of the questionnaire. In addition, a lower level of anxiety was found in the intervention group in the second delivery of the questionnaire in comparison to the first. The findings, which can be attributed to the model's application, highlight the need for a paradigm shift to a family-centered model in psychiatric hospitals.

This study aimed to evaluate the effectiveness of a CHIME-based psychoeducational group intervention on personal recovery in individuals diagnosed with schizophrenia. A randomized controlled trial with a pretest-posttest design was conducted between January and July 2024. A total of 60 participants receiving services from a Community Mental Health Center and meeting the inclusion criteria were randomly assigned to either the intervention group (n = 29) or the control group (n = 30). The intervention group participated in a structured "CHIME-Based Psychoeducation Program" comprising seven weekly sessions, each lasting approximately 60 min. Outcome measures included the Subjective Recovery Assessment Scale (SRAS), Psychological Resilience Assessment Scale (PRAS), and Schizophrenia Hope Scale (SHS). Assessments were conducted at baseline, post-intervention, and three-month follow-up. Both groups continued to receive standard community mental health services throughout the study. Statistical analyses included descriptive statistics, Chi-square tests, Mann-Whitney U tests, Friedman tests, and intention-to-treat (ITT) analysis for handling missing data. Accordingly, the CHIME-Based Group Psychoeducation Program can be considered an effective intervention to enhance personal recovery, psychological resilience, and hope. ClinicalTrials.gov Identifier number is NCT06284096.

Tobacco use among individuals with behavioral health conditions is higher than in the general population and a leading cause for morbidity and early mortality. This study examines a value-based payment (VBP) model to incentivize provision of tobacco cessation counseling (TCC) and pharmacological treatment with varenicline among 38 behavioral health homes (a person-centered approach to coordinating comprehensive healthcare in behavioral health service settings for individuals with chronic behavioral and physical health conditions) within a non-profit Medicaid behavioral health managed care network utilizing the Behavioral Health Home Plus (BHHP) model. Pre-post comparisons indicate that rates of filled varenicline prescriptions increased in the BHHP population from 10.01 per 1,000 service users to 19.01 per 1,000 service users following implementation of the VBP (p < .0001). Comparisons with other in-network behavioral health service users without BHHP or VBP indicate higher receipt of TCC (p < .0001) and varenicline (p < .0001) among the BHHP VBP group. This study provides some evidence that value-based purchasing may be used to incentivize provider agencies with behavioral health homes to increase access to tobacco cessation treatment for individuals with behavioral health conditions.

Place-based health interventions are becoming popular in public health, but have been less common in behavioral health services. This study implemented mental health screenings with a total of 195 individuals across seven laundromats in Texas from March 2024-April 2025 to examine the potential to treat laundromats as a new, unique setting for place-based behavioral health interventions. The sample of laundromat users was screened for Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD) and asked about their receptiveness to receiving healthcare interventions in laundromats. Multivariable analyses were conducted to examine individual characteristics associated with positive screens for MDD and AUD. Results found that 19.9% of laundromat users screened positive for MDD, which was comparable to county, state, and national estimates. However, 17.4% screened positive for AUD, which was higher than state and national estimates. The majority of the sample was Hispanic, had less than a college education, and reported annual incomes below $50,000. Laundromat users who were aged 60 years or older or who reported financial barriers to healthcare were significantly more likely to screen positive for MDD. Of the total sample, 83 (42.6%) completed a 1-month follow-up assessment and were re-screened for MDD and AUD which revealed no significant changes in rates of either disorder. Generally, participants reported a positive experience with the screenings in laundromats and reported being receptive to receiving other healthcare interventions in laundromats. In conclusion, this study found that providing health screenings in laundromats may reach underserved individuals. Laundromats may serve an important setting for further interventions after screenings.

During the perinatal period, many parents experience mental health difficulties of varying severity, which have been associated with adverse outcomes. Examples include perinatal obsessive-compulsive disorder (OCD) which can be thought to exist on a continuum from subclinical symptoms (e.g., intrusive thoughts (ITs)) to clinical diagnosis of OCD. Similarly postpartum psychosis can range from subclinical 'psychotic like experiences' (PLEs) to clinical diagnosis. These disorders are distinct conditions, yet some argue an overlap or comorbidity in symptoms, including co-occurrence postnatally, and they are therefore explored in tandem in this study. Limited literature explores these difficulties in community perinatal populations, and less is known about distress, or potential associations with parenting experiences. A cross-sectional, quantitative design was applied. Participants were parents in the postnatal period (12 months after birth); they completed an anonymous, online survey, exploring experiences of ITs, PLEs, parenting (perceived competence and stress) and mental health (depression, anxiety, and stress). Of 349 participants, 96% reported at least one IT, 90.8% reported associated distress and 95% engaged in behaviours to cope. Considering PLEs, 89% experienced at least one PLE, 88.8% reported associated distress and 30.4% could be considered 'at-risk' for developing psychosis. Distressing ITs and PLEs were significantly associated with lower perceived competence and satisfaction, increased parenting stress and mental health symptoms, although this relationship was indirectly mediated by depression and anxiety. Males reported more ITs, parenting stress, depression, anxiety, and lower perceived competence than females. More research is needed to better understand ITs and PLEs across and beyond the perinatal period.

In mental health, joint crisis plans facilitate advance care planning between clinicians and patients who experience psychiatric crises. Little research focuses on advance care planning with migrants with mental health problems. This study investigated clinician and interpreter perspectives on the use of joint crisis plans in intercultural and multilingual settings. Focus groups were conducted: two with mental health clinicians (6 participants per group) and two with interpreters (5 to 6 participants per group). The participants in the study identified several challenges associated with using joint crisis plans for patients with a migration background: Diverging ideas about mental health etiologies and roles in decision-making processes; patients' fears of undesirable interferences between joint crisis plans and administrative procedures for residence permits; language barriers; and the collaboration with interpreters. However, interpreters are also found to play a central role by fostering patients' trust in the clinicians and the joint crisis plan.

Prior research has shown the Fordham Risk Screening Tool (FRST) to be accurate in assessment of violence risk when compared to more comprehensive risk assessment instruments. However, a link between any violence risk screening tool and actual markers of violent behavior is absent in the literature. This study, therefore, sought to determine whether the FRST could be used to accurately assess the likelihood of violence, and markers of violence, during an inpatient psychiatric admission. This retrospective health records survey examined data from a consecutive cohort of adults (N = 423) admitted to an inpatient psychiatric unit from the emergency department (ED) from September 1, 2022, through June 30, 2023. Both electronic and manual abstraction strategies were used to evaluate FRST screening tool results collected in the ED and markers of violent behavior during subsequent inpatient hospitalization. When comparing the proportion of subjects who experienced a violent incident while hospitalized in the FRST positive and FRST negative groups, a significant difference was noted with a greater proportion of those with a positive FRST screening experiencing a violent event (33.0% vs. 8.1%, for the positive and negative screening groups, respectively, χ = 41.046, df = 1, p < 0.001). Sensitivity and specificity were 33.0% (95% CI: 24.7%-42.5%) and 91.9% (95% CI: 88.1%-94.6%), respectively. The positive predictive value was 60.3% (95% CI: 47.2%-72.2%) and the negative predictive value was 78.6% (95% CI: 73.9%-82.7%). The area under the receiver operating characteristic curve (AUROC) for the predictive ability of the FRST was 0.305 (standard error [SE] 0.038), 95% CI: 0.230-0.381). Overall, the FRST instrument showed mixed results as a screening tool to detect the potential of violent behavior in admitted psychiatric inpatient adults. While there was a significant difference in violent events between FRST positive and negative groups, metrics assessing predictive validity and reliability of the FRST were limited. Utilization of a screening tool such as the FRST should continue to be paired with additional efforts to evaluate inpatient risk of violent behavior.

Asian Americans (AA) have experienced increased rates of serious mental illness over the past decade. Past research has identified perceived and personal mental illness stigma as significant barriers to seeking treatment for mental health concerns, particularly in the Asian American community. One way to address stigma has been through narratives told from the perspective of community members of a stigmatized identity. Therefore, this study examines the impact of This Is My Brave: Stories from the Asian, Pacific Islander, and Desi American Community (TIMB: SAC; a narrative-based stigma reduction intervention) on audience members. Participants (N = 89; mean age = 27.62[SD = 9.82]) had a significant increase in intentions to seek care and a significant decrease in personal mental illness stigma, perceived mental illness stigma, and anti-Asian American stereotypes from pre-intervention to post-intervention. We did not find any significant differences between AA and non-AA individuals on any of the dependent measures (personal stigma, perceived stigma, anti-racism, anti-Asian attitudes, and intentions to seek care). This study has implications for TIMB: SAC as a stigma reduction intervention.

There is limited research on the impact of art forms, including opera, on audience and cast engagement in understanding mental health needs and support for Veterans at risk for post-traumatic stress disorder (PTSD) and homelessness. This qualitative study explores post-performance discussions from audience and cast members after live performances of an opera about Vietnam Veterans and family members, and their experiences of war-time trauma, housing instability, and receiving services to promote recovery and resilience. Audio-recorded and transcribed comments by Veterans (n=8), family members (n=9), providers (n=5) and cast (n=9) were analyzed using thematic analysis for key themes, with examples of quotes. Main themes included: 1) Struggling Post-military Service, including feeling misunderstood and self-isolation; 2) Finding Hope, through commitment and community; and 3) Healing through the Opera by sharing difficult societal issues, promoting empathy, and sharing resources, with lived experiences shared across themes by Veterans, family members, providers and cast/production team with a peer facilitator. The reflections they shared about their journey from trauma and homelessness through implementing strategies to obtain needed services, were fostered through live opera performances and peer-facilitated, post-discussions.

Implementation fidelity is the extent to which an intervention is delivered in the manner in which it was designed. Within randomized-controlled trials (RCTs), fidelity is often rigorously ensured through strategies out of reach for most organizations. This limitation may be of particular concern for trauma-focused evidence-based treatments/evidence-based practices (EBT/EBPs), as the needs of individuals and families seeking trauma-based treatment are often complex, with existing comorbidities that can complicate recovery. The present study used the Consolidated Framework for Implementation Research (CFIR) to examine implementation process and individual characteristics, as well as interactions among these factors in impacting provider's perceptions of fidelity. Data came from 598 primarily child serving mental health providers, who completed an online survey regarding provider demographics, perceptions of personal effectiveness, work experiences such as secondary traumatic stress (STS) and compassion satisfaction, and organizational implementation strategies used for a trauma-focused EBT/EBP. Significant positive associations were found between perceptions of implementation fidelity and compassion satisfaction, implementation strategy use, and personal effectiveness. Further, STS was significantly negatively associated with implementation fidelity. Significant differences were found based on population served and use of consultation calls and in-person supervision. Within a regression model, a significant two-way interaction between STS and implementation strategy use was significant, along with a three-way interaction between STS, implementations strategy use, and personal effectiveness. This study advances our understanding of how fidelity is created, maintained and understood in implementation settings that provide EBT/EBPs to individuals exposed to trauma.

People experiencing mental illness smoke tobacco at disproportionately higher rates than the general population. Staff at mental health services are well placed to assist clients with smoking cessation, yet such support is often limited by time or knowledge constraints. Guided by the COM-B model, this study explored barriers and facilitators of smoking cessation among people receiving treatment for mental health disorders as perceived by staff members of community mental health services in Brisbane, Australia. Three focus groups were conducted in August-October 2021 with 29 healthcare professionals and peer support workers employed at three community mental health services. Data were analysed qualitatively using a combined deductive and inductive approach to identify themes grouped by the COM-B domains of capability, opportunity, and motivation. Capability barriers included clients' reliance on smoking to manage anxiety or other mental illness symptoms and difficulties engaging with cessation support, while staff knowledge was a facilitator. Opportunity barriers included smoking being perceived as social currency and clients' limited support networks, whereas facilitators included cessation assistance from peer workers and smokefree environments. Motivation barriers were entrenched behaviours and using smoking as a coping mechanism, with facilitators including staff prioritising cessation and peer-led programs. These findings highlight the need for staff training to address misperceptions about smoking, improve confidence in offering cessation support, and foster trust with clients. Expanding the range of available smoking cessation support options, including peer support programs, and creating supportive service environments may enhance smoking cessation success for individuals experiencing mental illness.

Individuals with serious mental illnesses (SMI) face significant health disparities, also affecting physical health. While Community Mental Health (CMH) services primarily support mental recovery, their potential to address the physical health needs of this population remains insufficiently understood. In particular, little is known about how service users conceptualize health and evaluate support efforts - especially with regard to physical well-being. Gaining insight into these perspectives is essential for developing person-centered health promotion strategies that align with users' lived experiences and contribute to reducing persistent disparities. This qualitative study explored, how individuals with SMI understand health in everyday life, how they perceive the role of CMH professionals in supporting their health, and how they make sense of and respond to health promotion efforts - particularly those targeting physical well-being. Twenty-three qualitative interviews with users of CMH services in Germany were analyzed using a reconstructive, comparative approach that aimed to capture meaning-making processes embedded in everyday social practice. Participants expressed three distinct subjective health orientations: (a) agency-oriented, viewing health as the ability to shape one's life according to personal goals; (b) stability-oriented, emphasizing inner balance, emotional control, and predictability; and (c) functionality-oriented, focusing on the capacity to manage everyday tasks. These orientations were conceptually distinct and shaped participants' understanding of health, their attitudes toward CMH services, and their evaluation of health promotion. Health was understood as embedded in daily routines, relationships, and biographical experience. Psychological stability was seen as interconnected and essential for physical well-being. CMH professionals were seen as consistent and trusted partners who promote health through close, everyday relationships and hands-on support. Health promotion and support for physical health was strongly welcomed - if it was voluntary, respectful, and practically integrated into daily life. Health was defined not through symptoms, but as a lived, everyday experience shaped by stability, agency, and biographical context. Health promotion was broadly welcomed when it was voluntary, respectful, and practically embedded in daily life. Although CMH services are primarily focused on mental health, they offer a promising environment for addressing the physical health needs of individuals with SMI.

The collaborative care model (CoCM) is an evidence-based model shown to improve treatment of depression and anxiety in the primary care setting. However, there is limited research on CoCM outcomes in underserved populations and which factors impact outcomes. We performed a retrospective chart review to examine GAD-7 scores for patients (N = 1,034) seen in primary care clinics within an urban, safety-net hospital system. The Wilcoxon signed-rank test and linear mixed models were used. Our population was 81% female and 89% self-identified Black or African American. There were significant reductions on GAD-7 scores from baseline to 3-, 6-, 9-, and 12-months follow-up (p < .001). The analysis suggested gender, patient age, clinic setting, and number of visits were significant. The effect sizes for these covariates were 0.94, 3.77, 1.98, and 0.74, respectively. Further research including patients' social determinants of health and comorbidities may help refine CoCM and optimize its effectiveness.

Recovery Colleges (RCs) are increasingly implemented worldwide, with a fidelity measure recently developed in the United Kingdom (UK). However, RCs may vary based on their operating contexts. In the Netherlands, a key deviation is that RCs are often peer-run rather than co-produced with mental healthcare providers, as outlined in the fidelity measure. This study assessed the measure's suitability in the Dutch context, leading to the development of a reflection tool (Phase 1) which was subsequently evaluated (Phase 2). The development phase involved focus groups with peer facilitators and coordinators from 16 RCs (N = 29) to capture critical elements of Dutch RCs. The tool was piloted (N = 5) and evaluated more broadly (N = 24). The tool provided valuable insights, highlighting shared values among RCs internationally and conceptual differences between Dutch and UK models. The findings raised questions about the boundaries of fidelity in co-created contexts such as RCs.

Members of the U.S. public report negative stereotypes, prejudice, and discrimination towards individuals with a variety of health issues. The present study aimed to identify which health conditions and behaviors are most stigmatized and shed light on the factors that drive variation in stigma. A large, nationally representative sample of U.S. adults (N = 1,096) provided valid online survey responses to the Relative Understanding of Stigma about Health Index (RUSH-I), a novel instrument that assesses perceptions of controllability, knowledge, and perceptions of public stigma for 36 different conditions and behaviors. We hypothesized a positive relationship between controllability and stigma and an inverse relationship between knowledge and stigma. As hypothesized, stigma was substantially higher among conditions and behaviors that participants perceived as more controllable and about which they reported less knowledge. Controllability and knowledge accounted for over two-thirds of the variance in stigma across health issues. At the individual level, however, knowledge was positively related to stigma: Participants who reported more knowledge about a health condition or behavior tended to perceive greater stigma associated with it. Results showed that mental health conditions were generally more stigmatized than physical health conditions. Obesity was a notable exception, ranking as the most stigmatized health condition overall. These findings may help guide public health messaging, especially which conditions should be targets for stigma intervention. The findings also highlight important areas for further research, including elaborating the relationship between knowledge and stigma at both the individual and condition level.

Family caregivers of individuals with schizophrenia frequently experience both significant caregiving burdens and psychological challenges such as anxiety and depression, highlighting the critical need to explore effective psychosocial interventions. This study aims to systematically review the effectiveness of psychosocial interventions for family caregivers of individuals with schizophrenia in China. A comprehensive literature search was conducted across four English databases (PubMed, Web of Science, CINAHL, CENTRAL) and two Chinese databases (WANFANG, CNKI), including studies published from January 1, 2000, to August 1, 2025. The inclusion criteria focused on family caregivers of individuals with schizophrenia in China, with psychosocial interventions as the primary exposure, and caregiver-related outcomes (such as caregiver burden, anxiety, depression, etc.) as primary endpoints. Only randomized controlled trials (RCTs) were considered. A total of 918 records were retrieved, and 11 RCTs were ultimately included in the review, 5 from mainland China and 6 from Hong Kong. The findings demonstrate that psychosocial interventions have a positive impact on alleviating caregiver burden, improving mental health, enhancing positive psychological states, increasing social support, and improving quality of life and life satisfaction. This review suggests that psychosocial interventions may offer potential benefits for family caregivers of individuals with schizophrenia in China. However, due to the limited quality of the available evidence, these findings should be interpreted with caution. Further high-quality, standardized RCTs are needed to validate the efficacy of these interventions and assess their long-term stability.

Young adults with psychotic-spectrum disorder have lower odds of attaining educational goals, partly due to cognitive problems. Cognitive remediation (CR) could improve cognitive- and potentially academic functioning. The current study examined an adapted CR-intervention 'Mindset' aimed at academic functioning for people with a psychotic-spectrum disorder in secondary education. Pilot-feasibility study of Mindset including the experience of nine participants with psychotic-spectrum disorder who received Mindset and six CR trainers. Post-CR interviews with participants and trainers were subjected to qualitative evaluation. Furthermore, preliminary results from pre- to post-CR changes on the College Self-Efficacy Inventory (CSEI), Cognitive Problems and Strategies Assessment (CPSA) and Multidimensional Students' Life Satisfaction Scale (MSLSS) are presented using Reliable Change Index (RCI) and effect-sizes (Cohen's d). Qualitative evaluation showed that overall experience with Mindset was positive for participants and trainers. Mindset was not experienced as too difficult and aligned well with education. However, tailoring to the individual is required. Effect sizes in change from pre- to post-CR were small for school satisfaction (d = 0.25) and self-reported cognitive problems (d = 0.12), small to medium for increases in self-efficacy (d = 0.49) and large for increases in strategy use (d = 3.58). Feasibility of Mindset was good in terms of adaptation and expansion, implementation and limited efficacy. However, concerning acceptability, drop-out prior to Mindset was high and Mindset needs adjustment in terms of individual tailoring and language. Future studies have to attest to its efficacy.

Community participation is critical for health, particularly during young adulthood. Coordinated Specialty Care (CSC) programs for young adults with early psychosis aim to promote community participation; however, research on practices beyond those focused on employment, education, and family relationships is limited. This qualitative study explored CSC programs' community participation practices across a broad range of areas and the factors influencing their implementation. Following a national survey, individual semi-structured interviews were conducted with 11 CSC program leaders to examine ten specific practices. Recorded responses were transcribed and qualitatively analyzed using an integrated thematic analysis approach. Findings revealed that programs implemented a range of practices, including outreach to mainstream organizations, fostering mutual support among clients, facilitating independent community participation, and providing targeted support in spirituality/religion, intimate relationships, and civic engagement activities. Effective leadership, organizational culture, and staff factors (e.g., knowledge, skills, supportive attitudes and behaviors) emerged as key facilitators, while primary barriers included limited resources, staff challenges (e.g., lack of training), and environmental challenges (e.g., stigma, rural settings). Client-level factors, such as motivation and interference from symptoms, and the perceived effectiveness and acceptability of various practices, also impacted implementation. Recommendations include enhancing leadership buy-in, staff training, and creative resource use to overcome barriers and sustain community participation efforts. This study highlights variability across CSC programs and provides actionable strategies to strengthen community participation practices for young adults with early psychosis.

Understanding the factors that influence the adoption and implementation of evidence-based practices (EBPs) is crucial for expanding access to high-quality treatments for serious mental illness (SMI). This study evaluated how provider characteristics and perceptions influence adoption and implementation outcomes of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) in community mental health centers (CMHCs). CMHC providers (N = 124) were trained to deliver TSC to CMHC patients diagnosed with SMI (N = 395). Providers completed measures on demographic and professional characteristics. Additionally, assessments conducted after providers completed TSC training and delivered TSC to a patient measured provider perceptions of TSC (i.e., treatment fit, willingness and confidence) and adoption and implementation outcomes (i.e., referrals, sessions delivered, and treatment completion). Providers reported highly positive perceptions of TSC. Providers' education was associated with number of referrals and treatment completion. Additionally, provider perceptions of the TSC's appropriateness and feasibility at post-training predicted later perception of treatment fit. Overall, findings suggest providers perceive TSC to be well-suited for CMHCs, where provider characteristics are diverse, which bodes well for sustainment and scalability in community settings. Clinical Trial Registration: This study was preregistered on clinicaltrials.gov (identifier: NCT04154631) on November 6, 2019. https://clinicaltrials.gov/study/NCT04154631 .

Our current mental health system is struggling to meet the needs of today's youth and school-based mental health is seen as an integral part of this equation. This involves partnerships between school districts and community-based mental health clinics. The structure of these partnerships can determine aspects of teaming and delineation of roles and responsibilities for both parties. The focus of the present study is to examine the impact of the structure of the partnership on programmatic outcomes. Particular aspects of the structure of the partnership such as type of contracted services agreed to by the mental health provider and resources brought to the agreement by the school including administrative support, office space and funding were investigated. We studied process and outcomes of 59 schools across Wisconsin which were receiving outside mental health services through Children's Wisconsin. The findings revealed that each aspect of the partnership enhanced detectability of emotional and behavioral problems in students, including historically hard to reach diagnoses, increased collaboration between the school team and the community mental health provider, and grew parental involvement in their child's care. The authors conclude that thoughtful planning of the structure of such public/private partnerships can have implications for the mental health care of children and may help align objectives between the education and mental health systems which already have a shared interest in certain indicators of childhood functioning.