This article describes the development and validation of a capability-based well-being scale: 'Escala de Bienestar Kankuamo' (EBK; the Kankuamo Well-Being Scale). The EBK is designed to measure the well-being of the Indigenous Kankuamo community of Colombia from an intercultural perspective. The mixed-methods study was composed of two phases. In phase I, an initial 27 items, which had been generated using qualitative data from a previous study, were reviewed and adjusted through workshops with the Kankuamo community. In phase II, an adapted list of 28 items was piloted within the Kankuamo communities (sample  = 213). A preliminary exploratory factor analysis was carried out. The internal consistency of the EBK was measured using McDonald's ω. Convergent and divergent validity were tested with the World Health Organization-Five Well-Being Index (WHO-5) and the Patient Health Questionnaire-9. Incremental validity was tested through a hierarchical regression analysis to determine the effect on the WHO-5 of age, gender, community and EBK. The exploratory factor analysis resulted in a 14-item scale with seven domains: (1) Relating (to others and one's emotions), (2) Guiding principles, (3) Choice of healthcare, (4) Self-grown food, (5) Community contributions, (6) Agency and (7) Respect and equality. The EBK had high internal consistency (McDonald's ω = 0.86). Statistical analyses aimed at determining the convergent and divergent validity were inconclusive, suggesting a need for caution in using western standardised mental health measures in Indigenous communities because these may lack adequate cultural fit. The findings of the current study identify local priorities and needs, and evidence the feasibility of operationalising the capability approach for Indigenous populations.

The number of African refugees migrating to North America (the United States and Canada) has increased significantly over the past decade. Notwithstanding, the prevalence of mental health disorders among African refugees signals an urgent need to address them. We reviewed mental health interventions tailored to African refugees in North America, identified existing gaps, and suggested mental health services improvement recommendations. Using PRISMA guidelines, we identified ( = 1,164), screened ( = 989), assessed ( = 79), and included ( = 7) peer-reviewed articles detailing interventions that addressed mental health and its associated concerns among African refugees in North America. Our results showed that pre-migration perils and acculturation stressors exacerbated mental health concerns such as anxiety, depression, dysphoria, and post-traumatic stress disorder symptoms. Interventions that culturally adapted cognitive behavior therapy, peer support, and psycho-education effectively reduced mental health symptoms and improved life satisfaction. Future interventions should contextualize and incorporate African cultural beliefs and practices within community settings to promote mental health services.

Sweden Finns are one of five officially recognized national minority groups in Sweden. As a group, Sweden Finns have been socioeconomically underprivileged in comparison with the Swedish majority population, and tend to be worse off in terms of somatic health. However, the literature on mental health among Sweden Finns has not previously been systematically appraised. The aim of this scoping review was to synthesize the available evidence on mental health among Sweden Finns or, when the minority terminology is not used in the literature, among individuals in Sweden with a Finnish background (including the so-called Finnish war children). Systematic literature searches in MEDLINE, Web of Science, and PsychINFO were performed. A total of 46 publications met the inclusion criteria; however, very few made use of the self-identification principle central to official Swedish minority politics. The synthesized evidence shows that Sweden Finns tend to be worse off in terms of mental health compared with the Swedish-born majority population, even after adjusting for socioeconomic factors. They are more often diagnosed with various serious psychiatric disorders, such as schizophrenia and other psychotic disorders. Alcohol and other substance-use disorders are also more common. Moreover, substantially higher suicide rates are consistently reported in this group, although no recent studies exist. The few published qualitative studies emphasize the importance of cultural competence in the care of elderly Sweden Finns with neurocognitive deficits. More qualitative and ethnographically oriented research is needed to explore causal pathways behind the observed patterns and to guide potential preventive measures.

The term "dual pandemics" refers to the intersection of the COVID-19 pandemic and ongoing systemic racism faced by Black Americans, highlighted by police killings during COVID-19. This study aimed to understand how these dual pandemics impacted Black college students' mental health. Data from 102 participants over 18 years of age was collected via an open-ended qualitative question on Qualtrics and analyzed using thematic analysis. Three themes emerged: 1) Cognitive, emotional, and physiological reactions to the killings, 2) Increased awareness of racial insensitivity and cruelty, and 3) Increased distrust of systems. The findings provide insight into how the dual pandemics exacerbate existing disparities, systemic trauma, and stress for Black college students, underscoring the urgent need for systemic change. We advocate for racial trauma-informed mental health support in response to police violence.

Many evidence-based practices in autism aim to improve outcomes for both family and child. Caregiver-implemented intervention is one example of such evidence-based practice as it aims to strengthen caregivers' capacity in a natural environment. Although caregiver-implemented interventions in early autism intervention are supported by research and used by many practitioners and families, marginalized families of young autistic children from diverse cultural or linguistic backgrounds require additional adaptations to these interventions for increased contextual fit. Without these adaptations, interventions may not be equitably accessible among marginalized families who are underrepresented in autism research. While literature suggests that cultural adaptation of interventions may be an effective way to ensure equitable implementation, it is still difficult to claim its effectiveness among these populations without appraising the quality and rigor of cultural adaptation. Therefore, we conducted a review of 16 studies of caregiver-implemented interventions that were culturally adapted or tailored using the Cultural Adaptation Checklist, a novel tool for appraising the quality of cultural adaptation based on the ecological validity framework and implementation science. The results revealed great variation and use of a wide range of practices in cultural adaptation. Limitations of current literature and implications for future research are discussed.

This qualitative study explored the relationship between experiences of stigma and discrimination, and internalized stigma in people with severe mental disorders residing in Gran Concepción, Chile. Twelve participants were selected from a secondary care health center through a maximum variation sampling. Data were collected using semi-structured in-depth interviews, followed by reflective thematic analysis. Responses addressed four themes: 1) perception of the diagnosis; 2) perception and experiences of stigmatization and discrimination; 3) self-perception and internalized stigma; and 4) work. Most participants conceptualized psychiatric diagnoses in negative terms and reported experiences of stigmatization in the family, school, community, work, and health environments. However, only those exposed to stigma in the health area described internalized stigma. This finding highlights the paradoxical role of health services, which, instead of functioning solely as spaces of support and treatment, may also become central settings for the development of internalized stigma, underscoring the need to critically review institutional and professional practices. The study suggests that experiences in the health services may be crucial for the development of internalized stigma.

This qualitative study explores barriers to accessing treatment for Major Depressive Disorder (MDD) among Latino adults in the United States, with a novel focus on how these barriers were described based on participants' preferred language. Fifty Latino individuals ( = 24 primarily Spanish-speaking;  = 26 primarily English-speaking) participated in Zoom interviews and completed a demographic survey and the Patient Health Questionnaire-9 (PHQ-9) MDD self-report measure in their preferred language. Thematic analysis of interview data identified barriers across three levels: individual (e.g., stigma, service literacy, treatment readiness, caretaking responsibilities), provider (e.g., language barriers, cultural humility, perceived care quality), and clinic (e.g., cost, time constraints, waitlists, geographical access). While many challenges were shared across groups, key differences emerged. Spanish-speaking participants emphasized the importance of bilingual providers and described feelings of mistrust, communication fears, and concerns about emotional safety when language concordance was absent. English-speaking participants described prioritizing working with bicultural providers who demonstrated cultural humility and a nuanced understanding of possible intergenerational and structural stressors. Structural barriers, such as cost and scheduling, were often compounded by emotional experiences such as shame and mistrust, underscoring the need for both system-level and culturally responsive solutions. These findings reinforce the need for equity-informed strategies that attend to the intersection of language, culture, and structural barriers to MDD treatment.

In Canada, mental health disparities persist among racialized populations, including Black, Indigenous and other people of color. A major barrier to equitable care is the lack of adequate training of mental health professionals on racial issues. To address this unmet need, Cénat and colleagues introduced the Providing Antiracist Mental Health Care online training course. This contains five modules addressing: (a) awareness of racial issues, (b) assessment adapted to the needs of racialized individuals, (c) a humanistic approach to medication management, (d) treatment approaches for issues related to racism, and (e) providing tailored antiracist mental healthcare to children, adolescents, and families from racialized communities. This article discusses the implementation of this training among mental health providers in a school board in Ontario, Canada ( = 27), assessing changes in participants' multicultural awareness, knowledge, and skills at pre-, post-, and follow-up timepoints. The results show the ability of the Providing Antiracist Mental Health Care training course to effectively enhance multicultural awareness ((2, 21) = 10.52,  < .001), knowledge ((2, 21) = 11.88,  < .001) and skills ((2, 21) = 5.21,  = .014) among mental health providers in ethnically diverse schools. The total score improved significantly ((2, 20) = 12.17,  < .001) from pre-test to post-test, and follow-up, and no significant decrement from the post-test to follow-up was observed ( = 2.81,  = 0.16;  = .861). This study brings evidence supporting the need for sustained and comprehensive antiracist training initiatives to foster racial equity in mental health and improve outcomes in care for racialized individuals.

Large numbers of refugees from Iraq continue to resettle in the United States, but there is limited information about the mental health and psychosocial wellbeing of ethnoreligious Yazidi refugees in a U.S. resettlement context. Thus, we sought to answer the following questions: (1) How do different groups of Yazidi refugees experience and perceive mental health and psychosocial wellbeing?; (2) What are Yazidi refugees' preferred help-seeking strategies and supportive resources to promote psychosocial resilience?; and (3) What role does future-making play in the psychosocial resilience of Yazidi refugees? To answer these questions, we conducted four age- and gender-disaggregated focus groups with 28 Yazidi refugees living in the U.S. Midwest. Using narrative and matrix analysis approaches, we generated three themes highlighting the importance of hope and future-making in individual and collective psychosocial resilience: (1) psychosocial distress and the precarity of future-making out-of-place, (2) perceptions of mental health and psychosocial help-seeking using unfamiliar systems of care, and (3) liminality, cultural negotiation, and future-making. Our findings reveal an interplay between the cultural and structural dimensions of wellbeing and suggest an ecosocial-structural approach is essential for effective mental health and psychosocial support (MHPSS) with Yazidi refugees.

Posttraumatic stress disorder (PTSD) in refugees has been linked to poor social outcomes. Self-stigma appears to be a potential barrier to social engagement in refugees with PTSD, however research into this relationship is scarce. As such, the study aimed to 1) investigate whether self-stigma of PTSD (SSPTSD) and self-stigma of seeking help (SSOSH) underlie the association between PTSD and reduced social engagement in refugees, and 2) identify psychological mechanisms underpinning the association between PTSD and both types of self-stigma. In this online study, 262 Arabic-speaking refugees who had resettled in Australia completed measures indexing PTSD, two types of self-stigma (SSPTSD and SSOSH), social engagement outcomes (help-seeking behaviour, perceived social support), and potential mechanisms (self-esteem, hope, and negative help-seeking beliefs). Path analyses revealed that greater PTSD symptom severity was associated with reduced help-seeking behaviour via greater SSOSH and lower perceived social support via greater SSPTSD. Path analyses also revealed that greater PTSD symptom severity had an indirect effect on both types of self-stigma via greater negative help-seeking beliefs and an indirect effect on SSPTSD via lower hope. Findings demonstrate the deleterious effect of self-stigma on refugee mental health, yet also indicate potential intervention targets to reduce the negative impact of self-stigma.

Previous studies have found that Taiwanese comfort women survivors faced multiple forms of trauma from the comfort women system, and that societal prejudice against women's sexual victimization further impacted their marriages. However, there is minimal research exploring how sexual trauma may have impacted comfort women survivors' experiences of motherhood, alongside the consequences of survivors' experiences on subsequent generations. This article explores the perceptions of eight family members, including the second and third generations, of three deceased Taiwanese Han-Chinese ethnicity comfort women survivors. In particular, we trace family members' perspectives of survivors' mothering, and how family members were impacted by their mother's experiences as a comfort woman. To ensure participants' anonymity, findings are presented using composite narratives. The narratives illustrate the ways in which survivors' sexual trauma reportedly impacted survivors' family formation and mothering, and had long-term effects on survivors' offspring. According to family members, ambivalent mother-daughter relationships and conflictual relationships resulting from the preferential treatment of the male offspring were found. In addition, family members' psychological well-being, marriages, personality, and parenting were impacted by survivors' sexual trauma and conflictual family dynamics. Nevertheless, participants showed great strength and capacity under challenging circumstances and actively undertook their healing journey. We highlight the importance of providing culture-driven multilayered services for the families of comfort women survivors to foster intergenerational resilience, enabling them to continue to "walk out of the shadows" of conflict-related sexual violence.

The aim of this study was to compare the knowledge and beliefs about attention-deficit/hyperactivity disorder (ADHD) between first-generation Chinese Canadian and European Canadian parents, and to evaluate the efficacy of an existing translated ADHD information resource to improve their ADHD literacy. A community sample of 28 first-generation Chinese Canadian and 28 European Canadian parents of elementary school-aged children completed questionnaires measuring ADHD knowledge, treatment attitudes and perceived stigma, both before and after reading an informational pamphlet about ADHD. Compared with European Canadian parents, Chinese Canadian parents initially had less knowledge and more stigma about ADHD but had greater increases in knowledge and medication acceptability after passive psychoeducation. For both groups, passive psychoeducation increased ADHD stigma, but did not impact the already high acceptability for parent training intervention. Passive psychoeducation can improve mental health literacy among ethnic minority groups, but further work needs to tailor resources to address specific gaps in mental health literacy and recognize the need for concurrent stigma-reduction methods.

While the impact of trauma on the well-being of forced migrants has been widely researched, there is still a notable lack of understanding regarding the consequences of collective trauma experiences within this population. This scoping review aims to explore and understand the current state of literature regarding collective trauma among forced migrants. A systematic review of the literature was conducted using Academic Search Complete, Ethnic Diversity Source, PsychINFO, Psychology and Behavioral Sciences Collection, Social Work Abstract, and SocINDEX. Of the 78 studies identified, 19 met inclusion criteria: peer-reviewed journal article; published between 2002-2022; written in English; involved forced migrants; and explored collective trauma. Six major themes were identified: (1) exploration of collective trauma; (2) impacts of collective trauma: (3) intergenerational trauma; (4) resilience and resistance; (5) practice and policy failures of the West; and (6) solutions to healing. Results support the inclusion of collective trauma in future research on forced migrant populations and advocate for interventions grounded in collective healing.

Implementation of community mental health in Indonesia has been limited and under-resourced. (physical restraint and confinement) is still commonly used and many people do not receive formal mental health care. While pluralistic use of traditional and faith healing and psychiatric services is common, the relationship between the two systems is ambiguous and overlooked in mental health policy. Meanwhile, examples of collaboration between health professionals and traditional and faith-based healers (TFHs) for mental health exist in various settings, including Indonesia. However, there is limited research on the lived experiences and everyday practices of those engaged in such partnerships, including mental health workers, healers, and families, and what makes them successful. This paper presents findings from the visual research project 'Together for Mental Health' to illustrate the facilitators and barriers to pluralistic collaborations in the Indonesian context. Our focus was on partnerships that were already established, rather than those implemented as part of research projects or interventions. Using visual ethnography, we observed eight case studies in locations representative of the three main religions in the country: Java (predominantly Muslim), Bali (Hindu), and Flores (Roman Catholic). We conducted filmed ethnographic observations of collaborative practices and in-depth interviews with 20 mental health professionals, 12 TFHs, 28 people living with mental health conditions, and 16 caregivers. The study found converging themes related to facilitating factors and barriers in practices of pluralistic collaboration for mental health care in Indonesia. Facilitating factors included actors' role perception and motive, openness to collaboration, and negotiations of care. Barriers included negative role perceptions, inadequate infrastructure, and unfavourable social environments. Findings suggest potential for successful collaboration between TFHs and formal mental health practitioners, drawing on lessons from existing good practices. To support future pluralistic collaboration for mental health care, incorporating these lessons into professional education and policies and stronger mental health care governance are needed.

Exposure to violence can have positive consequences for its victims, resulting in what has been called post-traumatic growth (PTG). The existing literature has discussed multiple aspects of PTG, but how civilians who are victims of violence in armed conflicts may experience PTG is less well understood. This article aims to understand civilians' strategies for coping with violence that may contribute to PTG in the context of the Swat Conflict (2007-2009) in north-western Pakistan. Because the strategies employed are context-specific, it further explores how the local culture informed and influenced victims' responses. The research involved fieldwork including in-depth interviews and focus group discussions (FG) with 150 participants. A thematic analysis of the data found that victims deployed four strategies: seeking strength and refuge in religion, cultivating social connections and support, distractive measures, and individual adjustment. Although individual differences exist, local culture can influence the impact of violence and support victims' long-term recovery.

In recent years, new identities have emerged for psychiatric "patients" in China, such as "users," "survivors," and "peers." This article draws on my long-term research on and engagement with the country's mental health field to explore the emergence of these identities as translations of globally circulating ideas and practices. Rather than viewing them as mere derivatives of Euro-American originals, I demonstrate that they are strategic translations initiated by activists and academics to resist the hegemony of biomedical and institutional psychiatry, and that they have created opportunities for policy and service reform, recognition, and empowerment. However, my analysis also reveals that the global and local authority these translations leverage has produced exclusion and marginalization. In particular, the mandate for self-advocacy against institutions underlying activists' promotion of the user and survivor identities could overlook people's vulnerability, dependency, and differences in communities. Meanwhile, attempts by academics like me to establish peer supporters as recognized paraprofessionals within the system could reproduce existing hierarchies and generate new frictions among persons with lived experience. I suggest that academics, activists, and other stakeholders involved in translating identities in the Global South should critically examine the processes and their potentially oppressive power effects, to reflect on our gatekeeping roles and center the diverse leadership of impacted individuals, and to boldly experiment with new forms of translation together for continuous (self-)decolonization.

In 2016, the Ola During Children's Hospital (ODCH) in Freetown, Sierra Leone, introduced the country's first and only Children and Adolescent Mental Health (CAMH) service with treatments based on a biomedical understanding of mental illness. The service at ODCH contrasts with the prevailing traditionally defined mental health landscape in and around Freetown, Sierra Leone, which largely relies on supernatural and spiritual explanatory models. The study investigates how service-users perceive the biomedical treatment practices and makes a first attempt at examining how the different services relate to each other. Semi-structured interviews were conducted with eight female caregivers of children and adolescents with mental illness (aged 6-19), as well as with two traditional healers, two religious healers, and five mental health nurses. The interviews were thematically analysed following Braun and Clarke's six-phase approach, with Arthur Kleinman's concept of "explanatory models" (EMs) serving as the primary analytical lens to examine how understandings of illness shape perceptions and help-seeking behaviour. The study concludes first that biomedical explanations about children's mental health conditions were well received by care seekers and help to improve their understanding of the condition and ways to deal with it; second, the concept of EMs can be helpful to understand different help-seeking behaviours of caregivers of children with mental illness in Sierra Leone, however, this concept has to be taken as flexible and people adapt to what they are exposed to; and third, a scale-up of CAMH services should include awareness-raising among health practitioners and show itself open to cooperate with non-biomedical practitioners under certain conditions.

There is some evidence that Sufi music as a receptive music therapy might be beneficial for treatment of common psychological disorders, and mental well-being. The aim of this study was to test the feasibility of Sufi music intervention for adults with mild to moderate levels of depression and anxiety, attending Turkish community centres in England. This was a pilot randomised controlled trial of a 4-week Sufi makam music intervention with 60 participants conducted in two Turkish community centres in the UK with assessments at baseline, mid-intervention (2 weeks), post intervention (4 weeks) and at 2 weeks follow-up. The recruitment and retention rates in the intervention arm during the four weeks were 94.5% and 93.3%, respectively. The intervention was acceptable for most of the participants. According to analysis of clinical outcomes, Sufi music intervention was not associated with any clinical improvement in the music group relative to the control group when the means were compared at T3. However, when the results were adjusted for baseline scores as control variables in the linear regression, anxiety levels of the music group were significantly lower than the control group at the end of trial ( = .013), and mental and spiritual well-being had a statistically significant increase in the music group at the end of trial ( = .002;   001, respectively). The Sufi music therapy intervention was found to be feasible, acceptable and convenient to deliver, and the recruitment and retention rates in the intervention group were high. Furthermore, assessment of the clinical outcomes suggests that the intervention may reduce anxiety and improve mental and spiritual well-being.

Religion is central to the theory and practice of cultural psychiatry because it is an important determinant of health, wellness and resilience, and it shapes illness experience, coping and recovery. Religious identity and practice can also result in stressful situations and predicaments that lead to mental health problems. This editorial essay introduces a thematic issue of on religion and spirituality and outlines key components of religious competency in clinical care. Articles in this issue present new research on the role of religion and spirituality in mental health, clinical approaches to working with religious patients, the development of religious interventions, the negative effects of religious practice, and the complex interplay between religion, culture and context. Given its central role in people's lives, religion is a key consideration in psychiatric assessment and treatment and can be an important resource for mental health promotion.

Mediumship is a well-accepted spiritual practice in Brazil relating to the grief process and beliefs in the afterlife. For this reason, there is considerable interest among Brazilians in trying to determine whether mediums can obtain information beyond what can be obtained through conventional means (Anomalous Information Reception - AIR). However, there is a dearth of in-depth qualitative studies about these issues. This study aimed to investigate reported AIR in a mediumistic trance and the meaning of this information to the family of the deceased. In a controlled observation-based study, following 43 seconds of filmed interaction with the parents, the medium wrote a letter attributed to their deceased son. Information obtained or deducible from the medium-sitter interaction was excluded from the items of information verifiable in the letter. The degree of accuracy and specificity of the remaining items were investigated in three interviews with the parents and through the deceased's documents and objects. An expert carried out a handwriting analysis of the letter's signature. The medium produced 19 items of information, one of which could not be evaluated, one that was unrecognized, two that were deducible, nine that were generic and six specific. Items of information described the deceased's present and past habits, plans, and distinguishing physical characteristics which came across to the parents as unlikely to be obtained through routine interactions or by chance. Comparison of signatures is common in mediumistic practice, and in this case, the signature had some general similarities to that of the deceased, but there were many differences in more subtle aspects. The production of six verifiable items of information that had not previously been communicated to the medium through conventional means illustrates what many Brazilians believe to be AIR phenomena. Qualitative studies of AIR can shed light on the practice of mediumship and its mental health implications, especially with respect to grief and loss in the Brazilian context.

In South Africa, neuropsychiatric disorders rank third in their contribution to overall burden of disease. Stigma, lack of mental health awareness, and limited access to health services and to appropriate treatment contribute to the high level of unmet need for treatment of neuropsychiatric conditions. Little is known about how young adults make decisions to access mental health services and how their adult family members influence these decisions. This study explored young adults' perceptions of the influence their adult family members on their own mental health service uptake. We conducted semi-structured in-depth interviews with a convenience sample of 21 people (18-24 years) from KwaZulu-Natal Province (KZN). Thematic analysis of interviews found that: young people had partial knowledge of mental health conditions and services; both adult family members as well as peers and other community members influenced mental health care seeking behaviours. Participants who had accessed mental health services attested to their long-term benefit. Transition to adulthood was a time of mental health challenges. The results point to the need to scale up community-level awareness on mental health conditions in rural South Africa. This can include targeted education interventions to increase knowledge of mental health, and ways to adjust to the stresses of the transition to adulthood. More research is needed to further understand the gendered dimensions of peers' influence of mental health service uptake.