Suicide-specific group psychotherapy is a novel approach to suicide prevention with promising supporting data. However, limited research examines telehealth delivery for suicide-specific interventions. This study described treatment engagement and suicide-related coping (SRC) trajectories among Veterans receiving a group suicide safety planning intervention before and after a transition from in-person to telehealth delivery.

Project Life Force (PLF) is a group suicide safety planning intervention evaluated within a randomized clinical trial. During the COVID-19 pandemic, PLF transitioned from in-person to telehealth, creating naturalistic pre-pandemic in-person and pandemic-era telehealth cohorts. This report focused on participants randomized to PLF and described treatment initiation, engagement, completion, and SRC trajectories across cohorts.

: Baseline suicidal ideation and SRC were higher in the pre-pandemic in-person cohort than the pandemic-era telehealth cohort. The telehealth cohort showed higher rates of treatment initiation descriptively than the in-person cohort, while treatment engagement and completion among treatment initiators were more similar across delivery periods. Both cohorts showed improvement in SRC that was sustained over time.

Elevated treatment initiation occurred with virtual delivery of PLF. Both pre-pandemic in-person and pandemic-era telehealth cohorts showed similar patterns of group engagement as well as development and sustainment of SRC over time. As telehealth can reduce barriers to care, these data lend support to the promise of virtual, group-based, suicide-related interventions. Since treatment modality was determined by the pandemic and not randomized, delivery context, cohort characteristics, and pandemic-related factors may have impacted observed patterns. Randomized studies comparing delivery modalities should clarify potential treatment modality differences.

The online version contains supplementary material available at https://doi.org/10.1007/s41347-026-00719-y.

The rapid integration of technology into healthcare led to the creation of the "Digital Navigator" role to support patient uptake of digital health tools. The need for this role is particularly acute in mental health care, where digital tools show promise but patient engagement is low without human support and people with serious mental illness face disproportionate barriers to digital inclusion. However, as no survey of active trainings for this role yet exists, our team assessed existing programs to determine the challenges and opportunities for sustainably integrating this training into healthcare, including mental health settings.

To determine whether these training programs are applicable to digital navigators operating in healthcare settings (including mental health care) by answering the following questions: (1) What do these programs offer in terms of healthcare-relevant content and teaching materials? (2) How are trainees evaluated within these programs? (3) How are these programs accessed and delivered?

A pragmatic search on 6 August 2025, was conducted for programs using the first 5 pages of Google, querying ChatGPT, and referring to the National Digital Inclusion Alliance guide.

Our search found 38 unique results, 29 of which were excluded (Appendix B). While all 9 trainings surveyed covered technological support, fewer covered health-care-specific competencies, and only one included trainer-led evaluation of soft skills. Qualitative summaries of all 9 programs are in Appendix C.

We indicate several directions for improving the applicability and sustainability of these programs within mental healthcare, including evaluation of soft skills through roleplay, training durable troubleshooting skills, utilizing Large Language Models for asynchronous training, leveraging existing volunteer pipelines and upskilling healthcare staff.

Guided by the COM-B (Capability, Opportunity, Motivation) model of behaviour, this qualitative study sought to identify perceived facilitators and barriers influencing university students' decision-making regarding participation in dance and Tai Chi activities.

Semi-structured interviews were conducted with 13 university students (Mage = 26 years; SD = ±8.56). Data were analysed using reflective thematic analysis to deductively identify capability, opportunity, and motivation factors influencing decision-making regarding participation in dance and Tai Chi activities.

Whilst participants recognised several positive physical and mental health outcomes that may result from physical activity, serval barriers were identified regarding participation in dance and Tai Chi. For dance participation, these included confidence issues (n = 8), gender stereotypes (n = 10), financial constraints (n = 10), time limitations (n = 8), and perceived high skill difficulty (n = 4). For Tai Chi, barriers included perception of it being an elderly activity (n = 6), limited advertising (and thus awareness) in western contexts (n = 6), and social media anxiety regarding uniqueness (n = 4). Perceived facilitators of participation included social media exposure for dance (n = 5), family support for both activities (n = 3), and knowledge of health benefits, particularly for Tai Chi (n = 11).

The study reveals gender stereotypes in dance and age-related perceptions of Tai Chi as presenting barriers for participation, alongside with practical constraints of time and finances. Findings suggest that dance and Tai Chi health interventions should leverage social media platforms for promotion, addressing stereotypes, focus on beginner-friendly approaches, and emphasise immediate and long-term benefits. Dance interventions should incorporate contemporary and culturally aligned genres to enhance appeal among younger demographics.

Effective nursing handover is essential for ensuring patient safety and continuity of care, particularly in critical care settings where patients are highly complex and clinical decisions must be made rapidly. Occupational stress is prevalent among critical care nurses and has been associated with impaired performance and communication failures. Clinical decision-making is a core professional competency that may influence how stress affects handover quality; however, limited evidence has examined its combined effects.

To examine the impact of job stress and clinical decision-making on handover competency among critical care nurses and to test the mediating role of clinical decision-making in this relationship.

A multicentre cross-sectional descriptive study was conducted in six hospitals in Egypt. Using a convenience sampling approach, participants completed self-administered, self-report questionnaires. Data were analysed using descriptive statistics, correlation analysis, multiple linear regression and mediation analysis with Hayes' PROCESS Macro (Model 4).

A total of 410 critical care nurses were recruited for the study. They reported moderate levels of job stress, strong clinical decision-making abilities and high handover competency. Job stress was negatively correlated with both clinical decision-making (r = -0.242, p < 0.001) and handover competency (r = -0.218, p < 0.001), while clinical decision-making was positively correlated with handover competency (r = 0.332, p < 0.001). Regression analysis showed that higher educational level, rotating shifts and stronger clinical decision-making predicted higher handover competency, whereas higher job stress predicted lower competency. Mediation analysis revealed that clinical decision-making partially mediated the relationship between job stress and handover competency, with significant direct, indirect and total effects.

Clinical decision-making plays a pivotal mediating role in the relationship between job stress and handover competency among critical care nurses. Job stress directly and indirectly impairs handover performance by diminishing nurses' decision-making capacity.

Interventions aimed at reducing job stress and strengthening clinical decision-making, such as stress-management programs, simulation-based training and structured handover protocols, may enhance communication quality and patient safety in critical care settings.

Parents of infants admitted to the neonatal intensive care unit (NICU) face barriers to postpartum care and are at risk for adverse mental health outcomes. The Postpartum Care in the Neonatal Intensive Care Unit (PeliCaN) study evaluated a novel doula-coordinated, midwife-delivered care model for NICU parents. This secondary analysis compared mental health outcomes between participants randomized to the PeliCaN intervention versus usual postpartum care.

Postpartum parents of preterm infants < 34 weeks admitted to the NICU with an anticipated stay > 1 week were included. Doulas provided individualized emotional and informational support and coordinated a postpartum midwifery visit within the NICU. Mental health outcomes were compared between groups, including Edinburgh Postnatal Depression Scale (EPDS) scores at enrollment and 6 months postpartum and Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) scores at 6 months postpartum.

Of 37 participants enrolled in the parent trial, 34 completed mental health screening and were included. At 6 months postpartum, intervention participants had lower mean EPDS scores (4.82 vs. 5.82; P = 0.56) and PCL-5 scores (18.7 vs. 22.2; P = 0.40) compared with usual care, though not statistically significant. No participants endorsed thoughts of self-harm on EPDS screening at baseline or 6 months postpartum. However, two intervention participants experienced neonatal deaths and disclosed acute suicidality to their doulas outside of screening. Both were connected to emergency psychiatric care.

Although screening scores did not differ significantly between groups, doulas identified and facilitated intervention for acute suicidal crises in two high-risk NICU parents, an important exploratory clinical finding that highlights the value of doula-led postpartum support models.

ClinicalTrials.gov registration information (for the original PeliCaN Trial) Date of registration: August 22, 2022. Date of initial participant enrollment: November 29, 2022. Clinical trial identification number: NCT05510284. URL: https://clinicaltrials.gov/study/NCT05510284 .

Meaningful youth involvement has gained attention in mental health research, especially in collaborative approaches such as Patient and Public Involvement (PPI) and Responsible Research and Innovation (RRI). While both aim to support inclusive research, there is limited clarity on how they are conceptualised and used in projects together with young people. This scoping review examines how PPI and RRI approaches are defined and implemented in mental health research involving young people as collaborators rather than solely as research participants.

The included studies were empirical, peer-reviewed articles published in English that involved young people (aged 10-25 years) as collaborators in shaping mental health-related research, interventions, or products beyond their contributions as study participants, and used PPI, RRI, or related collaborative approaches. Reference to terms such as "participatory research" alone was not treated as evidence of involvement; eligibility required young people to have a reported collaborative role. Eight bibliographic databases (Scopus, Web of Science, MEDLINE, PsycINFO, CINAHL, ASSIA, PsycARTICLES, and IBSS) were searched on 21 February 2024. Following the JBI methodology and PRISMA-ScR guidelines, records were screened. Data were then charted from the included papers to capture study characteristics, definitions and applications of PPI and RRI, and the modes and reported forms or roles of youth involvement.

Thirty-two papers were included, most were published from 2022 onwards, originated from high-income English-speaking countries, and defined and applied PPI more frequently than RRI. However, both approaches lacked operational clarity. Key terms such as co-production, co-design, and participatory research were widely but inconsistently used, often without clear definitions or sufficient information to establish whether young people were involved as partners rather than solely as research participants. Explicit discussions related to power or intersectional barriers to youth involvement were rare. Some studies reported involving large numbers of young people, including up to 339 youths, raising questions about feasibility and depth of involvement.

This review highlights promising trends in extending youth involvement in mental health research, but also reveals important conceptual and ethical limitations. The findings emphasise the need for clearer definitions, explicit distinctions between meaningful youth involvement and being researched as a study's participant, more inclusive research practices, and stronger commitments to equity. Expanding future research is crucial for advancing responsible and collaborative approaches in youth mental health.

Repetitive transcranial magnetic stimulation (rTMS) is an established intervention for treatment-resistant depression, but only a minority of patients achieve remission, and characteristics associated with response are lacking. Sum-score analyses of the Hamilton Depression Rating Scale (HDRS) obscures how distinct symptom clusters change over time.

To identify distinct longitudinal symptom-cluster response trajectories during dorsolateral prefrontal rTMS and to determine baseline characteristics associated with trajectory membership.

This cohort study used data from the THREE-D randomized clinical trial (conducted from 2013 to 2016 at 3 Canadian academic hospitals), applying group-based multitrajectory modeling to mood, anxiety, insomnia, and somatic symptom cluster scores over 4 weeks of rTMS. Analysis was performed in 2024 to 2026. Participants were adults aged 18 to 65 years with major depressive disorder. Outcome assessors were blinded to treatment allocation.

Once-daily high-frequency (10 Hz) or intermittent theta-burst rTMS to the left dorsolateral prefrontal cortex for 4 to 6 weeks.

Primary outcomes were sum scores of 4 previously validated HDRS-17 symptom clusters. Trajectories were derived using group-based multitrajectory modeling; baseline characteristics associated with membership were examined with weighted multinomial logistic regression.

Of 414 randomized participants, 26 were excluded, leaving 388 in the analytic cohort (mean [SD] age, 42.33 [11.48] years; 229 female [59.02%]). Four trajectory groups were identified: optimal response (119 participants [30.67%]); partial response, high anxiety (128 participants [32.99%]); partial response, low anxiety (91 participants [23.45%]); and minimal response (50 participants [12.88%]). Final response and remission rates ranged from 83.48% and 65.22%, respectively, in the optimal response group to 0% in the minimal response group. Compared with the partial response, high anxiety reference, minimal response was associated with younger age (odds ratio [OR], 0.95; 95% CI, 0.92-0.99; P = .01), benzodiazepine use (OR, 2.73; 95% CI, 1.24-6.05; P = .01), lower baseline anxiety (OR, 0.73; 95% CI, 0.60-0.89; P < .001), and higher baseline mood symptoms (OR, 1.35; 95% CI, 1.13-1.61; P < .001).

In this cohort study of adults with treatment-resistant depression, 4 longitudinal symptom-cluster response trajectories were identified, with marked divergence in clinical outcomes. Baseline anxiety severity and benzodiazepine use were associated with trajectory membership and may inform personalized treatment planning, although prospective studies are required.

A diet low in FODMAP may negatively affect the gut microbiota of some Irritable Bowel Syndrome (IBS) patients, despite alleviating symptoms. This pilot study comprehensively explores the effects of a 3-week ur gut^® supplementation on gut microbiota, gut health, dietary intake, sleep, mental health and quality of life (QOL) in individuals with IBS following a low FODMAP diet.

Adult participants (n = 26, 3 males) completed a randomised, double-blind controlled study. Participants were provided with either ur gut^® (n = 13) or placebo (n = 13) for 3 weeks after a 1-week baseline. At baseline and end of intervention, blood, 24-h faecal samples and 3-day weighed-food diaries were collected. Validated questionnaires were used to evaluate mental health, sleep, QOL and gut symptoms. Participants reported daily IBS symptoms and wore a wrist-based actigraphy to capture daily sleep.

During the intervention, both groups maintained baseline stable gut symptoms and sleep patterns. After the intervention, the ur gut^® group had lower energy (P < 0.05) and protein (P < 0.01) intake compared to the placebo group, and increased resistant starch intake (P < 0.001) compared to baseline. Changes in overall genus-level gut microbiota composition (P < 0.01), including Ruminococcus E (5.5-fold increase, P < 0.01), were observed. ur gut^® improved GI-specific anxiety (P = 0.01) and sexual subscale of QOL (P < 0.05).

Compared with placebo, ur gut^® increased dietary fibre intake, improved gut microbiota and gastrointestinal-specific anxiety without negatively impacting sleep, despite no changes observed in faecal and blood biomarkers. This provides a dietary strategy to support gut health without compromising symptom control in IBS. Australia and New Zealand Clinical Trial Registry http://www.anzctr.org.au/ , ACTRN12620000032954.

This study investigates psychological change in individuals with Borderline Personality Disorder (BPD) using the MMPI-2-RF within the context of a multicenter randomized controlled trial (RCT), as part of the BOOTS project. A sample of 81 participants completed pretreatment and follow-up MMPI-2-RF (36 months later) and satisfied the standard MMPI-2-RF validity criteria. Change versus stability was examined in terms of mean levels as well as individual relative rankings over time, and reliable change indices. In general, moderate to large mean effect-sizes were observed across the hierarchy of the MMPI-2-RF scales, which were quite consistent in pattern with the recent BOOTS outcome paper, albeit with smaller effect-sizes. In terms of rank order stability and proportion attaining reliable change, generally more patients shifted position on internalizing scales than on externalizing scales, but this may in part be an artifact of more historical items on the latter. Although the present study is specific to individuals meeting criteria for BPD, we argue that inspection of the MMPI-2-RF pattern of change may have more broad clinical utility in profiling change in psychopathology over time or treatment.

Despite the central role of home care in aging societies, little is known about the daily work processes and short-term strain experienced by home care nurses. This observational field study addresses this critical research gap by investigating the nursing tasks and short-term strain reported by home care nurses and nursing assistants in Germany. Using workplace observations and short surveys in combination, this study observed 46 German home care nurses from 25 organizations. Nursing tasks were coded in five-minute intervals, and strain outcomes (fatigue, engagement, monotony, mental satiation) were assessed at three points during each shift (i.e. start, three hours after start, and end). The results showed that most working time was spent on direct care (45%), with significant portions dedicated to travel (25%), administration, and documentation. Personal hygiene and medication administration accounted for the largest shares of direct care. Registered nurses performed more clinical nursing whereas nursing assistants focused on basic care activities. Shift type influenced nursing task patterns. Work intensity was significantly related to task allocation. Engagement declined significantly over the shift, whereas mental exhaustion showed a u-shaped pattern. Specific tasks, such as personal hygiene and contact with relatives, were associated with higher exhaustion, whereas rest breaks correlated with lower mental satiation. The results point to the high work intensity and multitasking demands in home care and the necessity for qualification-based task delegation as well as structured breaks. This study contributes observational insights on how nurse tasks and strain evolve over home care shifts. Practical implications for strain prevention highlight the need for supportive structures (e.g. staffing, task delegation, and regular breaks) as well as preventive measures to ensure both the quality of care for older adults and the health of home care nurses.