Accessing a diagnosis and receiving adequate care and support for dementia can often be subject to various inequalities. Personal-, community-, and infrastructure-level factors can contribute to and often intersect in causing unequal health and care outcomes. With a paucity of evidence to inform solutions for dementia inequalities, the aim of this public consultation exercise was to explore potential solutions to inequalities in dementia diagnosis and care with different dementia stakeholders.

Utilising a future workshop approach, we conducted 11 in-person and remote consultation workshops to discuss experienced barriers of accessing diagnosis and care; discuss an ideal-world scenario where no barriers exist; and solutions to reach more equitable dementia diagnosis and care with people with dementia, unpaid carers, health and social care professionals, and third sector representatives. Discussions were synthesised by the research team and one public consultation group and mapped against the Dementia Inequalities model.

A total of 131 different stakeholders in dementia attended 11 workshops across England. Solutions were identified across three layers of inequalities, with the majority of solutions proposed on a community and infrastructure level. Examples included link workers, a social care career pathway, Community Champions, adequate home equipment, and digital training. Some solutions require Governmental input, such as creating career pathways in the social care workforce, similar to the NHS, to train and maintain good paid carers, as well as a cross-UK national dementia strategy raising the priority of dementia and required changes.

Dementia inequalities could be addressed via diverse and holistic approaches. With limited evidence to date on the impact of some of the proposed solutions, future research needs to build on these recommendations and design and test suitable interventions.

Opioid prevention personnel who interface with overdose events are at a risk of emotional challenges, though little research has explored their emotional experiences and self-care strategies. We explored the emotional experiences and self-care strategies to manage mental and emotional challenges among individuals who work in overdose prevention and response.

This was a qualitative study. Using a phenomenological approach, we conducted in-depth key informant interviews (KIIs) with forty-six purposively selected opioid overdose prevention and response personnel from August 2022 to March 2023 in two counties in Wisconsin using an interview guide. Data were coded and analyzed using MAXQDA. The coding was both deductive and inductive based on the domains and constructs of the Consolidated Framework for Implementation Research (CFIR).

Three themes were discovered from the data under the individual, intervention and inner setting domains of the CFIR framework: the burden of the intervention and its emotional effects; self-care strategies; and organizational mental health related support to overdose prevention and response personnel. Most opioid overdose prevention personnel experienced emotional strain, with feelings of guilt, self-doubt, and mental exhaustion intensified by personal loss and lived experiences. The key self-care strategies to manage emotional strain included professional practices like trauma-responsive methods, creation of personal boundaries, and social support from peer networks. Individual techniques like journaling, music, therapy, were also reported. Different institutions supported responders by providing resources such as mental health days, therapy access, and employee assistance programs.

Most overdose prevention and respose personnel experience emotional strain and mental exhaustion. A strong emphasis on self-awareness, compassion, and teamwork is crucial for fostering resilience and sustaining mental health among the personnel. Organizational initiatives to promote mental health and proactive wellness play a critical role in self-care among individuals who work in overdose prevention and response. This study contributes to the limited evidence on the mental health challenges of overdose prevention and response personnel and the need to prioritize their mental wellness.

Veteran death by suicide is a complex issue made up of many factors. Despite the high need for mental health treatment, and treatments that specifically target suicide, evidence-based psychotherapies (EBPs) are difficult to access, even more so in rural areas. In concordance with the 2018 National Strategy for Preventing Veteran Suicide, VA suicide prevention leadership developed Suicide Prevention 2.0 (SP 2.0) to implement a public health model that includes community-based prevention strategies and improves clinical interventions within VA. The Suicide Prevention 2.0 Clinical Telehealth program was implemented in each of VA's 18 regional Clinical Resource Hubs and expanded clinical intervention strategies within VA by implementing four EBPs for Suicide Prevention (EBP-SP) via telehealth: the Safety Planning Intervention, Problem-Solving Therapy for Suicide Prevention, Cognitive Behavioral Therapy for Suicide Prevention, and Dialectical Behavior Therapy.

A wide variety of implementation strategies were used (e.g., access new funding, training, consultation, create new clinical teams). The primary inclusion criterion for veteran referral to SP 2.0 Clinical Telehealth is a recent history of suicidal self-directed violence. Implementation was guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework and RE-AIM was used as an evaluation framework.

By April 2023, SP 2.0 Clinical Telehealth services were available in all 18 regions and in 139 of 139 (100%) VA health care systems in the U.S. By the end of September 2024, the program had hired 137 therapists and retained 78.10% in their role, and 100% were trained in two or more EBP-SPs. By the end of September 2024, the program received 23,628 referrals nationwide. Increasing referral rates year over year suggests ongoing sustained reach.

SP 2.0 Clinical Telehealth represents the first and only enterprise-wide fully virtual evidence-based treatment program for veterans with a recent history of suicidal self-directed violence. The program's implementation was successful in reaching all VISNs and all VA health care systems in the U.S. The SP 2.0 Clinical Telehealth program can be used as a model for other large health care systems looking to improve provision of evidence-based interventions for suicide prevention.

Canada has endorsed the Joint United Nations Programme on HIV/AIDS (UNAIDS) target to end the HIV epidemic by 2030. However, Canada has reported increases in HIV diagnoses for five consecutive years since 2019, with Manitoba's provincial rates three times the national average. This study examines mental health factors that may impact engagement in care among people living with HIV in Manitoba.

For this qualitative study, 32 Manitoban women, men and gender-diverse people living with HIV completed semi-structured interviews on barriers and facilitators to HIV care; as well, we incorporated quantitative measures on childhood trauma and empowerment. Thematic analysis revealed four themes: experiences of hardship, substance use as coping, resilience, and empowerment.

Most participants reported experiencing numerous hardships, including severe childhood trauma, interpersonal violence, HIV stigma, racism, and socioeconomic-related stressors. These adversities likely synergistically exacerbate participants' current mental health concerns, undermining HIV treatment engagement and adherence. Despite these challenges, many participants described gaining empowerment and demonstrated resilience through health-promoting behaviors (e.g., enlisting social supports). A key sentiment among participants was that while they feel supported by their HIV care providers, they require additional supports for substance use, mental health, and social determinants of health such as housing, which interfere with engagement in HIV care providers, they require additional supports that address key social determinants of health, including substance use, precarious housing, and mental health support to address traumatic experiences, as these factors interfere with engagement in HIV care.

The diverse experiences of participants may worsen mental health and hinder HIV treatment engagement. However, simultaneously, participants demonstrated resilience and empowerment in their daily lives. Future research should focus on strengthening resilience, empowerment, and mental health to improve outcomes for PLHIV in Manitoba.

To achieve the UNAIDS targets, it is essential to conduct research and implement evidence-based mental health interventions, along with related strategies that foster resilience and empowerment in this population.

Maternal anxiety represents a substantial public health concern, particularly among women who are attending Maternal and Child Health (MCH) hospitals. This study investigated anxiety prevalence and risk factors among MCH hospital female attenders in Henan Province, a region demographically representative of national trends, during the peak winter medical demand of December 2024.

A cross-sectional study using convenience sampling was implemented to recruit 745 maternal participants from 5 MCH hospitals (comprising three Grade A tertiary hospitals and two other hospitals) in Henan Province of China during December 2024. Maternal anxiety was assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7). Knowledge regarding maternal and child healthcare and self-efficacy in accessing healthcare services were evaluated using the self-developed Maternal and Child Health Knowledge Scale (Cronbach's α = 0.932) and the Self-Efficacy in Healthcare Access Scale (SEHAS) (Cronbach's α = 0.964). Statistical analyses were performed using univariate and multivariate logistic regression models to determine the association between sociodemographic/clinical factors and anxiety symptoms.

The overall prevalence of anxiety was 30.5% (95% CI: 26.8-34.1%). Anxiety was significantly associated with hospital level, departmental affiliation, and participants' knowledge regarding healthcare. Specifically, higher anxiety levels were found among females attending Grade A tertiary MCH hospitals versus other hospitals (Reference: Other hospital; Grade A tertiary hospital, AOR = 2.318, 95% CI = 1.580-3.402), and being in the Pediatric Department was a stronger risk factor than being in the Maternity Department (AOR = 0.501) or reproductive services (AOR = 0.584). Additionally, lower scores in maternal healthcare knowledge (AOR = 0.967, 95% CI = 0.940-0.995) and self-efficacy in healthcare access (AOR = 0.954, 95% CI = 0.913-0.997) were significantly correlated with increased anxiety symptoms.

Our findings highlight a critical need for the integration of mental health screening and tailored interventions within maternal healthcare frameworks. Enhancing maternal health literacy, improving accessibility to psychological support, and developing specific interventions based on healthcare settings and departments are crucial for addressing anxiety and improving maternal health outcomes.

Studies increasingly suggest Trauma Center Trauma-Sensitive Yoga (TCTSY) can reduce psychopathology among women who experienced sexual trauma. However, barriers inhibit in-person engagement in TCTSY interventions, particularly among underserved women.

This single-arm pilot study examined the efficacy of a virtual 10-week TCTSY intervention for 27 sexual trauma survivors seeking care at a public safety-net hospital. Women self-reported posttraumatic stress disorder (PTSD), depression, and anxiety symptoms preintervention and 2-weeks and 3-months postintervention.

Women who completed seven or more sessions experienced a reduction in PTSD, depressive, and anxiety symptoms following the intervention (t _avg = -2.36, p_avg = 0.035) with effects largely sustained at the 3-month follow-up (t _avg = -2.16, p_avg = 0.054). These effects were weaker when including women who completed six sessions (t _avg = -2.09, p_avg = 0.065), suggesting greater symptom reduction with increased session attendance (i.e. "dose effects") for a virtual TCTSY treatment.

Overall, results from this study provide preliminary but promising evidence that a brief telehealth intervention can contribute to measurable improvements in trauma-related outcomes for underserved women. Given the affordability and accessibility of virtual TCTSY relative to other trauma interventions, these findings may hold important implications for public health and healthcare policy, including support for bolstered virtual healthcare infrastructure and the integration of trauma-informed yoga interventions into outpatient mental healthcare practices.

Yoga, an ancient discipline originating in India, primarily considered a spiritual practice, has now evolved into a recognized therapeutic modality addressing various health conditions, including chronic diseases, mental health disorders, and stress-related ailments. Despite its proven benefits and growing evidence base, the integration of yoga therapy into mainstream healthcare in India faces significant barriers. Key challenges include the perception of yoga as a spiritual or wellness practice rather than a clinical treatment, cost concerns limiting access for lower-income populations, and a lack of standardization in training, certification, and therapeutic protocols. Facilitators, however, indicate promising opportunities for broader acceptance. These include increasing public interest, government initiatives by bodies like the Ministry of AYUSH, and a growing body of research validating yoga's therapeutic efficacy. Efforts to establish regulatory frameworks and standardized guidelines are gaining momentum, fostering the credibility and integration of yoga therapy into healthcare systems. This article explores these barriers and facilitators influencing the utilization of yoga therapy in India and proposes strategies to enhance its adoption. By addressing misconceptions, improving accessibility of yoga healthcare professionals, efforts for standardization and regularization of education, and increasing collaboration between yoga practitioners and medical professionals, yoga therapy has the potential to become a cornerstone of holistic healthcare in India.

To assess the long-term impact of the Individual Placement and Support (IPS) model on employment outcomes among individuals with severe mental illnesses (SMIs) and personality disorders (PDs) in Italy, and to examine the role of sociodemographic and clinical factors over a 42-month period.

We analyzed a 42-month longitudinal cohort of 1,408 IPS participants from seven Community Mental Health Centers in northern Italy. Data on demographics, diagnoses, and employment history were collected. Employment outcomes were compared across diagnostic groups and by nativity using Chi-square and Kruskal-Wallis tests.

Employment rates varied significantly by diagnosis. Participants with schizophrenia, PDs, and depression achieved higher job acquisition rates, whereas those with addiction disorders and milder psychiatric conditions faced greater barriers. Native participants were more likely to obtain employment, although job retention rates were comparable between groups. Job tenure differed across diagnoses, with those with addiction disorders showing shorter employment durations.

The IPS model improves employment for individuals with SMIs and PDs, though disparities by diagnosis and nativity remain. Tailored interventions are needed to promote more inclusive and equitable vocational rehabilitation.

Portland Street Response (PSR) is an alternative first response program located in Portland, Oregon. The program assists individuals experiencing mental health crises by providing an unarmed first response in non-violent situations that ordinarily would be responded to by armed police officers. In order for such programs to thrive, collaboration with other organizations is crucial. Service-providing organizations are uniquely prepared to collaborate with programs such as PSR due to their proximity to vulnerable communities. Currently, there is a lack of information about the perspectives of service providers concerning alternative first response programs, particularly regarding their motivations for collaboration. The current study utilizes qualitative interviewing methods to examine motivation to collaborate. Qualitative interviews were conducted with 16 participants and then analyzed to uncover key themes. The current study resulted in themes pertaining to motivations for collaboration, including the importance of building relationships, establishing and maintaining trust, and themes pertaining to shared values, such as a commitment to equity. The current study also revealed the importance of concrete program features in relation to collaboration, specifically access to resources and mobility. This research has implications for other alternative first response programs collaborating with local service providers in communities across the US.

Borderline personality disorder (BPD) is widely presented as an objective psychiatric diagnosis describing emotional and relational distress. However, feminist, decolonial, neurodiversity and lived experience-led scholarship demonstrates that BPD emerged within colonial, cisheteronormative, misogynist and neuronormative epistemologies that moralise distress and regulate identity, self-expression and access to care. This paper critically examines BPD as a diagnostic construct and governance technology that produces iatrogenic harm through epistemic injustice, structural exclusion and moralised interpretations of need. It explores how the diagnosis discredits lived experience knowledge, justifies care withdrawal and obscures sensory, cultural and structural determinants of distress and considers the implications for mental health nursing practice. A critical discourse analysis was conducted across psychiatric literature, policy documents, historical diagnostic texts and lived experience scholarship, treating psychiatric language and categorisation as technologies of power shaping credibility and clinical response. The analysis shows that BPD operates less as a clinical description than as a regulatory framework maintained through gendered, colonial and cisheteronormative norms. Dominant narratives of dependence, attachment theory and emotional expression obscure trauma, sensory differences and structural violence, while legitimising coercive and exclusionary practices. Mental health nurses are positioned at the frontline of enacting these logics, often experiencing moral distress. The BPD diagnosis lacks epistemic, cultural and ethical legitimacy. Its continued use undermines therapeutic safety and trust. A harm reduction transition away from the BPD construct is required, prioritising relational safety, sensory-informed and culturally responsive care, epistemic humility and lived experience leadership.