Purpose Integrating mental health care and related behavioural interventions into routine primary care delivered by community health workers (CHWs) remains promising, yet challenging. This paper aims to share strategies for such integration. Design/methodology/approach This paper draws on real-world implementation experiences from care delivery programmes and research studies that used task-sharing to integrate mental health care within routine CHW activities. Observations from research and practice are combined with existing global mental health evidence to derive key implementation insights. Findings Four key insights are identified. Firstly, integration is most effective when it shifts existing care towards evidence-based practice, rather than when it adds new tasks. Secondly, to ensure quality of care delivery, task-sharing for mental health care requires skills-focused ongoing supervision, which can be supported by digital tools. Thirdly, enabling CHWs to deliver care at the point of contact (rather than only conducting screening and referral) enhances credibility, engagement and access. Fourthly, strengthening system-level strategies increases support for healthcare workers, including CHWs and primary care providers, to provide mental health services in primary care settings. Originality/value This paper provides practice-based insights into how mental health care can be integrated within real-world community health systems. It offers specific and actionable strategies to strengthen existing tasks, build supportive supervision for CHWs, deliver care rather than only conduct screening and strengthen system-level support for healthcare workers.
PurposeThis study aims to explore the efficacy of mental health policies implemented in Hong Kong during the COVID-19 pandemic and to identify strategic priorities for advancing policy and practice in the post-pandemic period. Design/methodology/approachUsing a scoping review methodology, this study synthesises existing literature on mental health challenges experienced in Hong Kong during the pandemic. The analysis is structured around the health policy triangle framework, which examines policy content, context, actors and processes to evaluate current mental health strategies and guide future policy development. FindingsThe review identifies a broad spectrum of pandemic-related mental health risk factors, including the characteristics of the outbreak, enforcement of protective measures and social distancing, diminished social capital, restricted access to face-to-face healthcare, media-driven anxiety and fears of infection or transmission. While the government assumed a central role in implementing public health measures, public opinion largely attributed successful pandemic management to community-led initiatives. These findings emphasise the need for mental health policies that are inclusive, adaptive and grounded in community engagement, alongside practice trajectories that prioritise accessibility, responsiveness and integration of community-based approaches. Originality/valueThis study adopts a policy-focused lens by applying the health policy triangle framework to examine mental health governance in Hong Kong. It integrates empirical evidence from the pandemic with policy analysis, offering insights into policy directions and practice trajectories that can strengthen mental health systems in the post-COVID-19 context.
Purpose This study aims to examine how socio-demographic, public policy and urban planning conditions jointly shape multiple dimensions of mental health in the USA. Design/methodology/approach This study uses hierarchical linear regression analysis. Findings Policy and urban-contextual factors are strongly associated with emotional distress, although their effects vary across mental health dimensions. Specifically, government efforts aimed at helping poor people, supporting sick individuals, addressing urban problems and enhancing neighborhood safety are significantly associated with lower levels of sadness. Nervousness is similarly influenced by policy orientations toward sick people and by perceived safety, while anxiety is most strongly associated with the economic policy and the capacity of governments to resolve urban problems. By contrast, socio-demographic influences exhibit differentiated patterns across mental health outcomes. Originality/value Mental health is not shaped by a single set of determinants but instead reflects a layered structure in which individual, institutional, urban factors interact in outcome-specific ways.
Purpose Student mental health and help-seeking are growing concerns in STEM higher education, yet evidence from North African counselling services remains limited. This study aims to examine whether field-of-study change between upper-secondary track and university discipline was associated with primary presenting need.Design/methodology/approach Anonymised routine records from 401 undergraduate service users at a Moroccan public faculty of science (2015-2018) were analysed using chi-square tests and binary logistic regression.Findings Academic/study-related concerns represented 74.8% of consultations and psychosocial/social-welfare/basic-needs concerns 25.2%. Field-of-study change was associated with lower adjusted odds of psychosocial/social-welfare/basic-needs presentation, indicating more academic/study-related concerns. Later year of study showed higher odds, especially in the gender-adjusted sensitivity analysis. Supporting analyses contextualised where field change was concentrated and found no significant alignment between scholarship status and baccalaureate distinction.Originality/value Routine educational-pathway information can help low-threshold counselling services interpret intake needs and organise guidance/referral pathways in underrepresented STEM settings.
Purpose - Young unemployed individuals with mental health problems face elevated risk of poor health, which complicates their reintegration into the labor market. Despite its public health relevance, this group remains insufficiently explored. This study aims to examine unemployed young adults aged 18-29 years with mental disorders and their health-related quality of life (HRQoL), considering both physical and mental dimensions. The authors further analyzed associations with sociodemographic, employment-related and health-related factors. Design/methodology/approach - The authors analyzed cross-sectional data from the LIPSY project, including 148 unemployed participants with at least one ICD-10 F-diagnosis. HRQoL was measured using the 12-item Short-Form Survey (SF-12), providing a physical component summary (PCS) and a mental component summary (MCS). Two multiple regression analyses tested associations between HRQoL (outcomes: PCS, MCS) and predictors: age, gender, education, partnership status, duration of unemployment (<= 24 vs > 24 months), work experience, work ability score (WAS), depressive symptoms (patient health questionnaire) and somatization (mini-symptom checklist). Findings - Higher PCS was associated with being female and with higher self-perceived work ability, whereas longer unemployment, previous work experience and somatization were linked to lower PCS. Higher MCS was related to greater work ability and longer unemployment, while depressive symptoms were negatively associated. Originality/value - The data show that both physical and mental HRQoL are substantially impaired in young unemployed individuals with mental health disorders. This highlights the need for targeted support in healthcare and vocational rehabilitation.
PurposeWomen in Nepal face a heightened risk of poor mental health, with increasing evidence suggesting their social circumstances as key contributing factors. Yet, no research has explored how pressures to have children or achieve larger family sizes, embedded within Nepal's highly pronatalist context, are associated with women's mental health. In this context, the authors aimed to examine the association of pregnancy coercion with probable depression and symptoms of anxiety.Design/methodology/approachThe authors used the 2022 Nepal Demographic and Health Survey, which is a nationally representative data set. The authors applied logistic regression analyses to understand the association of pregnancy coercion with probable depression and symptoms of anxiety.FindingsThe authors found that 6% and 8% of women reported probable depression and symptoms of anxiety, respectively. The adjusted logistic regression analysis revealed that women who have experienced pregnancy coercion were more likely to report probable depression (aOR = 2.15, 95% CI = 1.52, 3.04) and symptoms of anxiety (aOR = 2.56, 95% CI = 1.80, 3.63) compared to women who have not experienced pregnancy coercion.Originality/valueIt may be especially important to develop a comprehensive and integrated mental health program aimed at women of reproductive age in Nepal. Part of this holistic approach may seek to empower women, specifically increasing their reproductive autonomy, where they are given greater power to decide on the number of children they desire to have. This can be approached from a human rights perspective, considering the association between pregnancy coercion and women's exposure to depression and anxiety disorders.
Purpose Coastal communities in Bangladesh are increasingly affected by environmental and socioeconomic stressors like salinity intrusion, livelihood vulnerability and food insecurity, all of which may have profound implications for mental health. This study aims to investigate the concurrent effects of these stressors on poor mental health and well-being among individuals residing in the southwestern coastal region of Bangladesh. Design/methodology/approach The methodology for this study uses the International Panel on Climate Change-defined Livelihood Vulnerability Index. The Household Food Insecurity Access Scale was also used. Chi-square tests and multivariate logistic regression were used to identify significant associations between poor mental health and variables including salinity extent, food insecurity, livelihood vulnerability, income level, gender and access to antenatal care. Findings The analysis revealed that individuals exposed to high salinity (AOR = 23.49; p < 0.001), severe food insecurity (AOR = 2.24; p = 0.015) and high livelihood vulnerability (AOR = 2.05; p = 0.046) were significantly associated with poor mental health. Other key predictors included low income, female gender, lack of antenatal care and absence of NGO support. Practical implications This study highlights a strong association between environmental stressors and poor mental health in coastal Bangladesh. Interventions aimed at improving mental well-being in these regions must adopt an integrated approach, addressing environmental challenges alongside socioeconomic vulnerabilities. Originality/value This innovative method advances a more thorough investigation of the relationship between livelihood vulnerability and mental health brought on by salinity among residents of Bangladesh's southwest coastal region.
Purpose-This paper aims to examine how digital platform architectures shape the psychological, behavioral and civic experiences of Generation Z. It challenges deficit-based views of "mindlessness," situating distraction, procrastination and diminished attention within the structural logics of the attention economyrather than individual failure. Design/methodology/approach-This commentary synthesizes illustrative and representative evidence from psychological, cognitive, sociological and policy literatures across Indian and global contexts to advance a conceptual account of platform-induced mindlessness as a socio-technical phenomenon, rather than undertaking a systematic or exhaustive review. Findings-Excessive smartphone use, algorithmic personalization and media multitasking erode attentional control, academic performance and emotional resilience while weakening face-to-face interaction and civic participation. These patterns reflect engagement-maximization strategies embedded in digital infrastructures and marka shift from situational distraction to structurally conditioned cognition. Originality/value-By reframing mindlessness as a systemic rather than moral issue, this paper advances the concept of structural accountability in digital life. It calls for reforms in platform governance, digital literacy and public policy to promote psychological well-being and civic inclusion through collective and interdisciplinary responsibility.
PurposeThe issue of suicide is one of the prominent issues in India mitigation of which is a challenge to ensure sustainable development. This study aims to look into the possible long-run association of economic development and suicide. Further, this study has made an effort to identify socio-economic factors that may stimulate suicide.Design/methodology/approachThe present work is based on time series data for the period covering 1991-2023. This study used the ARDL Bound Test Approach after performing stationarity tests of the time series variables to estimate the coefficient.FindingsThe result of ARDL Bound test and error correction model reveals the existence of a long-run association between suicide and per-capita income, along with other macro-economic indicators. The result of the ARDL estimation shows that 1% per-capita income growth causes a 0.9% decline in suicidal mortality in India.Research limitations/implicationsThe findings of this study suggest that economic growth may be an effective means of promoting the quality of life for people. Suicide rate, to a large extent, is associated with the quality of life or a parameter of unhappiness that may be controlled by focusing on quantitative as well as qualitative aspects of economic development. The lack of availability of data for socio-psychological parameters is an observed limitation of this study.Originality/valueAlthough there are numerous works undertaken on the linkage between economic development and suicides but with respect to India, there is little research covering different aspects of economic determinants of suicides in India.
PurposeTeacher wellbeing significantly impacts educators, students and school climates. This study aims to explore relationships between teachers' demographic characteristics, school contexts, professional support, recent policy shifts (e.g. classroom cell phone bans) and comfort with emerging technologies like artificial intelligence (AI), with their mental wellbeing.Design/methodology/approach US PK-12 teachers (n = 672) were surveyed in March-April 2025, and hierarchical regression analysis was conducted to explore relationships with predictors and teacher mental wellbeing.FindingsFindings revealed that stronger administrative, colleague and parental support positively predicted wellbeing. Comfort with AI, identifying as black and teaching in a hybrid or microschool context also correlated positively with teacher mental wellbeing outcomes.Originality/valueThis study extends the literature by analyzing how teacher demographics, school contexts, professional supports and emerging policies/technologies predict teacher mental wellbeing in a large national sample.
PurposeThis study aims to analyze age-standardized prevalence of mental disorders in Sierra Leone from 2000 to 2019, examining sex inequalities.Design/methodology/approachThis study provides a novel examination of sex-based disparities in mental disorder prevalence in Sierra Leone over a 19-year period, contributing to the limited body of research on mental health equity in low-resource settings. By leveraging WHO's Health Equity Assessment Toolkit, it offers valuable insights into gender inequalities that can inform targeted policy interventions.FindingsAge-standardized prevalence of mental disorders in Sierra Leone was stable from 2000 to 2019, declining from 12,211.2 to 12,154.0 per 100,000. Females had higher rates than males. Female prevalence in 2000 was 12,753.4 (95% CI: 11,612.0-14,000.4) versus 11,605.7 (95% CI: 10,587.1-12,780.0) for males. The sex gap peaked at 1,257.8 cases in 2015 before reaching 1,232.6 in 2019, with females maintaining 10% higher prevalence (R = 1.1). PAF ranged from -5.0% to -5.3% and PAR from -605.5 to -618.4 cases.Research limitations/implicationsThis study adopts a cross-sectional design, which limits the ability to establish causality between sex-based differences and mental disorder prevalence. Additionally, the data may not fully capture contextual factors such as socioeconomic conditions, cultural stigma, or access to mental health services in Sierra Leone, which could influence the observed disparities. Future longitudinal studies are needed to explore causal relationships and the impact of these external factors on mental health outcomes over time.Originality/valueUsing WHO's Health Equity Assessment Toolkit, this study analyzed mental disorder prevalence per 100,000 population by sex.
PurposeTypically, Canada accepts approximately 25,000 refugees from various nations annually. Around 40,000 Syrian refugees arrived in Canada between November 2015 and the end of January 2017. Multiple factors can negatively influence the sociocultural adaptation of Syrian refugee families in Canada, such as language barriers, limited access to health services, limited employment opportunities and challenges in developing a social network and finding social support in the host country. Thus, this study aims to explore the challenges in adaptation that newly resettled Syrian refugee families are facing in Montr & eacute;al, Qu & eacute;bec.Design/methodology/approachSemi-structured interviews were completed with eight Syrian refugee mothers regarding their experiences and needs. Themes were derived through thematic analysis of the qualitative data.FindingsThe themes "Relational isolation of refugee families in education contexts," "Loss of foundation and attachment to the past for adult refugees" and "Intensified emotion work post-resettlement" emerged from the semi-structured interviews. Future research should focus on language education and social support for adult refugees, as well as refugee mothers' well-being and social support needs and their experiences vis-& agrave;-vis emotion work and coping.Research limitations/implicationsFuture research must investigate the experiences and needs of refugee mothers more specifically, as they carry a disproportionate responsibility of emotion work through and after resettlement. More research focusing on social support and positive relationship building within the host country society is needed.Practical implicationsLanguage education services, particularly for adult refugees, must be embedded in community-building that allows for more naturalistic learning and practice of the local language. Language barriers remain a central obstacle for refugees who are not adequately supported and equipped in their learning.Social implicationsRefugee adults, and particularly mothers, require more opportunities for building social networks and gaining community and social support. Broader efforts of awareness and sensitivity to the experience of refugee families are required in social and educational institutions.Originality/valueThe present study presents a bottom-up qualitative account of the challenges in adaptation newly resettled refugee families are facing. The experiences of refugee mothers are unique, as both being a refugee and a mother bring about specific risk factors and challenges.
PurposeThis paper addresses the escalating mental health crisis among college students characterized by rising rates of anxiety, depression and suicidal ideation. It illustrates a multitiered public health prevention model designed to mitigate crisis indicators and overcome internal barriers to accessing care. This paper aims to describe the impact of this model on college student mental health within a campus community.Design/methodology/approachThis paper details the implementation and evaluation of the prevention model at a small, private university situated in the mid-Atlantic region of the United States. An action inquiry design was used to examine the model's impact over a three-year period. The model incorporated three distinct tiers: primary prevention through campus-wide mental health literacy campaigns; secondary prevention via a student-staffed counseling clinic; and tertiary prevention by utilizing the Safety Planning Intervention.FindingsFollowing the model's implementation, outcome evaluations demonstrated a significant reduction in student mental health crises. Data revealed a 10.4% decrease in therapy sessions and a 68% reduction in off-campus psychiatric referrals over three years. These findings suggest the model's potential impact on the complex mental health needs of college students.Originality/valueThis action inquiry provides a framework for other institutions and practitioners by demonstrating the efficacy of an integrated, public health-oriented approach to campus mental health.
Purpose This commentary aims to examine the evolving role of diversity, equity and inclusion (DEI) policies in mental health care. It highlights both the benefits (such as improved cultural responsiveness and patient outcomes) and the criticisms related to ideological overreach, tokenism and polarisation. Design/methodology/approach A narrative, evidence-informed review of existing research and organisational practices was conducted, integrating meta-analytic findings, clinical observations and policy developments to provide a balanced perspective on DEI. Findings While DEI initiatives can foster psychological safety, enhance trust and reduce disparities, their impact is often undermined by inconsistent implementation and a lack of empirical evaluation. This commentary identifies the need for evidence-based approaches, rigorous outcome measurement and constructive dialogue to bridge polarised viewpoints. Originality/value This study offers a timely synthesis of current debates around DEI in mental health, presenting a neutral and reflective framework that moves beyond binary narratives of support or opposition.
Purpose This study aimed to assess the prevalence of suicidal ideation and attempts among adolescent students in Waling Municipality, Syangja District, Nepal and identify associated psychosocial and demographic factors. It focused on emotional distress, school environment and interpersonal experiences such as breakups and violence. Design/methodology/approach A school-based cross-sectional quantitative study was conducted among 183 students (grades 9–12) using a structured self-administered questionnaire. Participants were selected through multistage stratified random sampling. Data were analyzed using descriptive statistics, chi-square tests and logistic regression to identify predictors of suicidal ideation. Findings Suicidal ideation was reported by 13.1% of adolescents. Female students and those from non-Brahmin/Chhetri ethnic groups were more likely to report suicidal ideation. Adolescents experiencing emotional distress and those exposed to negative school environments also had a higher likelihood of ideation. A poor school environment significantly reduced the odds of suicidal ideation (AOR = 0.062, p = 0.003), whereas participation in volleyball or basketball markedly increased the odds (AOR = 15.5, p = 0.003). Prior suicide attempts and frequent depressive episodes strongly heightened the risk of suicidal ideation. Research limitations/implications The cross-sectional design limits causal inferences. Data from a single municipality and reliance on self-reports may affect generalizability and accuracy. Practical implications Findings support school-based mental health interventions, educator training and efforts to improve school climate. The study highlights adolescent mental health as a public health priority in Nepal, emphasizing the need for stigma reduction, supportive environments and community engagement. Social implications This research highlights the urgent need to address adolescent mental health as a public health priority in Nepal. The findings suggest that stigma, lack of emotional support and insufficient mental health infrastructure contribute to suicidal ideation among adolescents. By drawing attention to the role of school environment, the study promotes a holistic, community-based approach to mental well-being. Empowering adolescents through safe spaces, emotional expression and accessible psychosocial support could help mitigate suicide risks. Raising awareness among parents, schools and policymakers is crucial to fostering a supportive ecosystem for adolescents in both rural and urban Nepalese settings. Originality/value This is one of the few Nepalese studies exploring diverse psychosocial factors of adolescent suicidal ideation, providing actionable insights for educators, health professionals and policymakers.
Purpose-This study examines the feasibility of whether data collected daily at a crisis center could advise post-disaster response efforts following the 2023 Maui wildfires in Hawai'i, with an aim to inform both short- and long-term behavioral health and recovery efforts for those impacted. Design/methodology/approach-Included in this study were Maui fire-related contacts received between August 8 and December 31, 2023, compared to the same months in 2022 and 2023. Confidence intervals for two proportions at the 95% level were calculated to identify significant differences (p < 0.05). Findings-"Post-disaster needs" in August 2023 peaked at 41.06% and trended downward to 8.14% by December 2023. "Mental health issues" increased from 26.57% in August to 41.86% in December. Maui fire-related contacts with a primary concern of "suicidal crisis/thoughts" increased to a high of 9.30% in December, from a low of 2.90% in August 2023. Research limitations/implications-These findings aligned with results from other disaster-related behavioral health studies, suggesting that using real-time crisis center data in the aftermath of a disaster can reliably inform response and recovery efforts for affected individuals. Additionally, results identified significant behavioral health trends of those affected by the 2023 Maui wildfires. Originality/value-To the authors' knowledge, this is one of the few studies to analyze individual-level data collected daily at a crisis center in the aftermath of a wildfire.
Purpose-Despite the established psychological cost of adolescent obesity, current literature fails to thoroughly explore how some psychosocial mechanisms, i.e. bullying, family and body image, are mediating mental health consequences. Moreover, research is largely concentrated in high-income countries, which limits global generalizability. Design/methodology/approach-The review followed the PRISMA 2020 guidelines to promote transparency and replicability. Data mapping and search strategy: Databases searched included PubMed (n = 25), ScienceDirect (n = 15), Emerald Insight (n = 5) and others (n = 25). Keywords used for Boolean search were "adolescent obesity," "mental health," "depression," "self-esteem," "bullying" and "body image." Reference management was performed with the help of Zotero software. Screening process: In total, 70 articles were found initially. Duplicate and noneligible studies were removed (n = 10), leaving 50 articles. Another 5 were screened out as irrelevancies, and 45 full texts were screened out, excluding another 5 for lack of peer review or obsolete methodology. Thirty peer-reviewed high-quality articles were finally included. Inclusion criteria: Studies were eligible for inclusion if they were related to adolescents (10-19 years old); assessed mental health outcomes related to overweight or obesity; published in the range 2000-2024 and peer-reviewed; and reported clear data on psychosocial interventions or mediators. Findings-RQ1 - Mental health outcomes: Obese adolescents are at greater risk of depression, anxiety and low self-esteem. This relationship is strengthened by internalized stigma and negative self-perception. RQ2 - Psychosocial mediators: Psychological responses are greatly influenced by stigma, teasing and family dynamics. Adolescent victims of frequent bullying have depressive symptoms regardless of BMI. RQ3 - Methodological and cultural gaps: Few longitudinal studies exist, and most use Western-dominated samples. Cross-sectional studies limit causal inference, and there is heterogeneity in operationalization of psychological constructs. RQ4 - Interventions: Fewer than half of the studies offered interventions. These were most commonly cognitive-behavioral therapy, family-based interventions or school-based body image improvement. Holistically integrated treatments that address mental and physical health at the same time are still scarce. Research limitations/implications-Limitations include overrepresentation of studies from high-income nations, overreliance on cross-sectional data, decreased focus on resilience development and cultural interventions and inconsistent theoretical model application. Originality/value-This review critically examines the role of overweight and obesity in the trends of mental health outcomes among adolescents from 1988 to 2024. It also emphasizes the vital role played by weight status in determining psychological health as well as mental health outcomes. Obese status has been associated with risk for anxiety and depression, though interventions for improved mental health are also an area of future study. However, the area is limited by a lack of longitudinal research, methodological balance and varied cultural settings. Future studies should focus on developing resilience and evidence of health-care systems' capacity in addressing physical and mental health-care needs.
