Adolescents living with HIV (ALHIV) in sub-Saharan Africa experience profound mental health challenges including depression, anxiety, and suicidal ideation. Evidence-based psychological interventions specifically designed for this population remain scarce, particularly family-based approaches in resource-limited settingsThis study explored ALHIV's perceived mental health transformation following participation in culturally adapted Multiple Family Group Therapy (MFGT) in Ghana.Qualitative study nested within a randomized controlled trial (NCT06701942) conducted in Lower Manya Krobo District, Ghana. Nineteen ALHIV who completed the 10-MFGT core content sessions. MFGT intervention participated in three focus group discussions. Data were analyzed using Braun and Clarke's reflexive thematic analysis.Three major themes emerged: (1) Pre-Intervention Mental Health Crisis, (2) Psychological Change Mechanisms, and (3) Mental Health Transformation. Pre-intervention, ALHIV described experiencing profound mental health crisis-level distress including active suicidal ideation with method-specific planning, emotional dysregulation, and existential foreclosure. Intervention mechanisms facilitating transformation included cognitive reframing through culturally resonant metaphors, dual-level universality (peer and intergenerational family), biomedical knowledge (U = U) as psychological intervention, and emotional catharsis in safe spaces. Post-intervention, participants described substantial perceived improvements in mental health characterized by reduced suicidal ideation, emotional regulation gains, reduced anxiety, and greater psychological peace.Culturally adapted family-based group therapy was associated with meaningful mental health improvements, including reduced suicidal ideation. Participants described shifts in emotional wellbeing, coping, and family cohesion, though the qualitative design precludes causal claims. Findings support the feasibility of task-shifted, family-centered interventions in resource-limited settings and underscore the need to integrate mental health screening and family-based support into HIV diagnosis protocols. Trial registration Clinical trials.gov ( NCT06701942 )
Long-acting injectable antipsychotics (LAI) may be beneficial for patients with schizophrenia (SCZ) or bipolar I disorder (BPI) compared with oral antipsychotics. We aimed to assess the association of LAI use on all-cause mortality and disruptive life events (DLE) among patients recently diagnosed with SCZ or BPI. We conducted a retrospective cohort study using adult patients meeting study eligibility criteria in Kaiser Permanente Southern California (KPSC) during 2007–2019. The index event for cohort entry was the first mental health related emergency department or inpatient encounter after initial diagnosis of SCZ or BPI. Two study arms were defined by the medication history within 180 days after index events: received LAI (LAI arm) and received oral antipsychotics only (oral-only arm). Unadjusted and adjusted two-sample comparisons were performed, where adjusted analyses used propensity score matching to balance observed characteristics. Outcomes were occurrence of specific DLEs (arrests, bankruptcy, and judgment filings), occurrence of any DLE, and all-cause mortality during the year after index events. The cohort had 3,667 patients in the oral-only arm and 218 in the LAI arm. Compared with the oral-only arm, the LAI arm had lower risks in all outcomes qualitatively. The rarity of the outcome and limited sample size in the LAI arm limited statistical power: adjusted risk difference was -1.68% for occurrences of any DLE (95% CI: -3.44%, 0.08%, p < 0.10), and -0.46% for all-cause mortality (95% CI: -0.98%, 0.06%, p < 0.10). Patients with SCZ or BPI taking LAIs may be associated with lower risk of DLE and mortality within the one-year period after index than those who took oral antipsychotics only. Larger studies are needed to further confirm these associations.
The present study analyze the prevalence and factors associated with suicide risk in nursing students in the post-pandemic context, considering academic burnout, academic engagement, and symptoms of depression, anxiety, and stress as predictors. through a cross-sectional and correlational study conducted in a public university in Northern Chile. with a168 nursing undergraduates’ sample. Validated instruments were administered, including the Beck Hopelessness Scale, the Utrecht Work Engagement Scale, the Maslach Burnout Inventory–Student Survey, and the DASS-21. Descriptive analyses, Pearson correlations, and multiple linear regression were conducted. A total of 11.31% of students met the predefined BHS threshold for elevated suicide-related risk. In the same sample, symptoms of depression, anxiety, and stress showed high prevalence rates. Suicide risk was negatively associated with vigor and dedication, while positively associated with low academic efficacy and depression. The regression model explained 54% of the variance in suicide risk ( Adj.R² = 0.54; p < 0.001), with Depression ( β = 4.04), Vigor ( β = 0.63), Academic Efficacy ( β = 0.88), and the interaction between Depression and Vigor ( β = -0.69) being significant predictors in the model. Suicide risk in nursing students transcends traditional clinical factors, as it is shaped by the interaction between personal resources and mental health symptoms. These findings underscore the need for prevention and psychosocial support programs in nursing schools.
The global mental health field increasingly recognizes the importance of involving people with lived experience of mental ill-health in research, policy, services, and systems. However, recognition and representation have not consistently translated into meaningful authority. The current essay examines the conceptual and structural questions underlying this gap: what constitutes experiential knowledge; how lived experience is transformed into expertise; how experiential, clinical, academic, and policy knowledge interact; and how institutions can distinguish genuine co-production from symbolic participation or incognito tokenism. Drawing on participatory traditions within and beyond mental health and community-led practice, the essay argues that experiential knowledge is neither a substitute for professional expertise nor subordinate to it. Instead, these forms of knowledge should operate reciprocally, with epistemic authority shifting according to whose knowledge is most relevant to the question at hand. At the same time, the authors distinguish this fluid exchange of epistemic authority from the more entrenched institutional power governing resources, leadership, and decision-making. The essay examines how power, institutional readiness, context, crisis, and intersectional diversity shape whether participation becomes structural or merely symbolic. A case study from Nunavut, Canada, illustrates both the consequences of externally imposed systems and the possibilities created when Indigenous knowledge and authority determine terms of engagement. Practical recommendations for moving from consultation toward co-governance are put forward to support decision-makers within global mental health seeking to operationalize meaningful lived-experience engagement rather than simply endorse it.
Arts-based programs are increasingly used to support people living with dementia and their care partners; however, there has been a limited focus on multi-modal, participatory performing arts programs offered in both virtual and in-person formats. We completed an evaluation of the Lincoln Center Moments (LCM) program, a free dyadic arts program grounded in four pillars: Validation/Personhood, Social Engagement, Self-Expression, and Artistic Stimulation. An exploratory mixed-methods program evaluation was conducted with 23 dyads (N = 46). Quantitative measures included program satisfaction, social engagement, and arts engagement. Post-session interviews were coded using an evaluative framework aligned with program pillars. Program satisfaction was high across both modalities. Care-partner-reported arts engagement for PLWD increased from pre- to post-season among the in-person subgroup but not the virtual subgroup; modality-specific analyses were exploratory. Social engagement scores were similar across formats, although in-person attendees were more likely to report friendships with others. Qualitative data supported all four LCM pillars. LCM was perceived as engaging and supportive by participants in both virtual and in-person settings. Participants who were initially hesitant to engage described greater comfort and willingness to participate over time. Participant feedback suggests that programs like LCM may provide inclusive, accessible spaces for creative engagement - particularly for those unable to attend mainstream performances. Future researchers should explore hybrid delivery formats and assess longer-term dyadic outcomes.
