Disclosure of a mental health problem carries both risks and benefits. It can be seen as a measure of perceptions of the social environment in which people with mental health problems live, work and study. A nationally representative Australian survey conducted in 2014 showed that, in many settings, non-disclosure was more common than disclosure. This study aimed to investigate whether disclosure in a broad range of settings has changed since the 2014 national survey.

Large nationally representative surveys of Australian adults were conducted in 2014 and 2024. For each, those who reported a mental health problem or were experiencing high psychological distress (n = 1381 in 2014, n = 2613 in 2024) were asked about disclosure in multiple settings. Regression analyses were used to explore whether changes between survey years were significant at p < 0.01, adjusting for sociodemographic variables of age, gender, education level, language spoken at home, country of birth and type of mental health problem. Secondary analyses assessed the sociodemographic and mental health problem characteristics associated with changes.

In 2024, participants were less likely than in 2014 to have disclosed to friends, partners, family members and some people in the neighbourhood, with relative risk ratios (RRRs) ranging from 0.33 (99% confidence interval [CI]: 0.23, 0.48; p < 0.001) for all family members to 0.64 (99% CI: 0.46, 0.88; p < 0.001) for some people in the neighbourhood. Workplace disclosure did not change significantly. For health professionals not involved in mental health treatment, the RRRs of disclosure were higher in 2024 than in 2014 (RRR = 1.56 [99% CI: 1.16, 2.10; p < 0.001] for disclosure to some and RRR = 2.31 [99% CI: 1.61, 3.32; p < 0.001] for disclosure to all).

Except for disclosure to health professionals not involved in mental health treatment, there have been decreases or no changes in disclosure of a mental health problem in most settings over the last 10 years. This likely reflects both perceptions of, and actual, reductions in supportive social environments. Urgent action is needed to ensure that, for people who do disclose a mental health problem, the benefits strongly outweigh the risks.

This study aims to examine the longitudinal associations between work-family conflict (WFC) and mental health among working parents. Specifically, we investigated whether within-person changes in WFC and family-to-work conflict (FWC) are associated with changes in mental health.

Data from the Household, Income and Labour Dynamics in Australia survey were used to employ within-person fixed effects regression analysis to examine associations between WFC and mental health in working-age adults (18-64 years) with parental responsibilities for children ≤14 years. The outcome, general mental health and overall psychological well-being, was assessed using the Mental Health Inventory-5 scale as a continuous variable with scores ranging from 0 to 100. Both dimensions of WFC, measured as continuous variables ranging from 1 to 7 with higher scores indicative of greater conflict (work-to-family and family-to-work), were interrogated, as were gender differences. Exposures, outcome and covariates were assessed repeatedly across the 21-year follow-up period.

A total of 7,265 participants (46,564 observations) across waves 2001-2021 who were working-age parents engaged in paid employment with children ≤14 years, with at least two waves of data and non-missing data were included in the analyses. Mean (SD) duration of follow-up was 6.1 (3.7) years and 6.7 (4.2) years for mothers and fathers, respectively. A total of 49.6% of participants were female, and the mean baseline age was 35 years for both mothers and fathers. Increasing WFC was negatively associated with mental health in women (β coefficient = -1.25 [95% CI: -1.45, -1.05]) and men (β coefficient = -1.21 [95% CI: -1.40, -1.02]). Increasing FWC was associated with worse mental health in women (β coefficient = -1.09 [95% CI: -1.33, -0.85]) and men (β coefficient = -1.51 [95% CI: -1.75, -1.28]).

Changes in both WFC and FWC over time are associated with changes in mental health for women and men. More attention needs to be devoted to identifying and implementing strategies to enable working parents to cope with or reduce WFC.

Psychosocial factors represent modifiable targets relevant to alleviate depression risk. While individual psychosocial risks are well-documented, their combined status across multiple life domains is underexplored. We aimed to construct a novel multidimensional composite score of psychosocial status and explore its association with incidence of depression.

A total of 336,922 individuals (mean age 56.21 years) without depression at baseline from the UK Biobank were included. Psychosocial status was assessed across four dimensions (recent stressful events, current psychiatric symptoms, social contact and socio-economic status) using 18 factors. A composite psychosocial score was constructed by weight effect of each factor, with higher values indicating lower level of psychosocial status. Using Cox proportional hazards models to evaluate the associations between individual psychosocial factor, psychosocial score and the risk of depression.

During a median follow-up of 13.60 years, 14,806 depression cases were identified. Low household income, recent depressive symptoms, loneliness and financial difficulties emerged as the most significant predictors of depression across four domains, with hazard ratios (HRs) of 3.82 (95% confidence intervals [CIs]: 3.43-4.26), 3.09 (2.99-3.19), 2.46 (2.37-2.54) and 1.96 (1.88-2.04), respectively. Each one-point increase in the psychosocial score was associated with a 42% higher depression risk. Compared to individuals with high psychosocial status, those in the medium- and low-level groups had an adjusted HR of 1.71 (95% CI: 1.62-1.81) and 4.36 (95% CI: 4.15-4.58), respectively.

These findings highlight that psychosocial factors collectively represent modifiable targets for preventing depression, with interventions addressing the combined status of these domains likely offering greater impact than focusing on isolated factors.

To translate and validate the traditional Chinese version of the Knowledge and Attitudes to Mental Health Scale (KAMHS) among Hong Kong adolescents.

Workshops for mental health literacy (MHL) were conducted between July and August 2024 for Form 3 to Form 6 students aged 13 to 18 years from 10 invited secondary schools. Participants were asked to complete an online survey for the collection of data regarding age, sex, year of study, family affluence, general well-being, life satisfaction, mental health, and loneliness. MHL was assessed using the KAMHS and the Mental Health Literacy Questionnaire - Short Version for Young Adults (MHLq-SVa). The Reported and Intended Behaviour Scale (RIBS) was used to assess four actual and four intended behavioural outcomes. Structural validity of KAMHS was assessed using confirmatory factor analysis (CFA). Convergent and divergent validity of KAMHS were examined against the MHLq-SVa and the RIBS. Internal consistency of KAMHS subscales was evaluated using McDonald's omega and Cronbach's alpha. Test-retest reliability of KAMHS was assessed.

In total, 102 female and 33 male adolescents (mean age, 15.8 years) were included in the analysis. For structural validity, CFA of the refined 25-item, five-factor KAMHS yielded factor loadings ranging from 0.43 to 0.99 and good fit indices. For construct validity, three of the 22 convergent hypotheses were supported. The KAMHS subscale of lack of public stigma was strongly correlated with the RIBS (Spearman's r = 0.65, p < 0.001). The KAMHS subscale of understanding mental disorders and their treatments was moderately correlated with the MHLq-SVa subscale of erroneous beliefs / stereotypes (Spearman's r = 0.39, p < 0.001). The KAMHS subscale of understanding how to optimise and maintain good mental health was moderately correlated with the MHLq-SVa subscale of self-help strategies (Spearman's r = 0.46, p < 0.001). Additionally, all 26 divergent hypotheses were supported. Internal consistency of KAMHS subscales was good (McDonald's omega = 0.76-0.91). Test-retest reliability of KAMHS was high (Pearson's r = 0.75, p < 0.001).

The traditional Chinese version of the KAMHS shows preliminary psychometric validity for assessing MHL among Hong Kong Chinese adolescents.

To investigate whether burnout mediates the association between personal distress and compassion satisfaction after adjustment for age and sex.

Mental health professionals who had direct contact with patients and >6 months of work experience were invited to complete an online survey using convenience sampling through social media groups across Thailand between 25 August 2023 and 25 October 2023. Personal distress was assessed using the Personal Distress subscale of the Thai version of the Interpersonal Reactivity Index. Burnout and compassion satisfaction were measured using the Burnout and Compassion Satisfaction subscales of the Thai version of the Professional Quality of Life Scale, version 5. Mediation analyses were conducted. Age and sex were entered as covariates. Indirect effects were estimated using 5000 bootstrap resamples.

In total, 96 women and 32 men (mean age, 36.4 years) were included in the analysis. Among the participants, 55.5% were psychologists, and 40.6% worked in Bangkok. Personal distress was positively correlated with burnout (r = 0.50, p < 0.001) and negatively correlated with compassion satisfaction (r = -0.31, p < 0.001), whereas burnout was negatively correlated with compassion satisfaction (r = -0.62, p < 0.001). In mediation analyses, higher personal distress was associated with higher burnout (B = 0.479, p < 0.001). Higher burnout was associated with lower compassion satisfaction (B = -0.643, p < 0.001). In the total-effect model, higher personal distress was associated with lower compassion satisfaction (B = -0.313, p = 0.002). When burnout was included in the model, the direct effect of personal distress on compassion satisfaction became non-significant (B = -0.006, p = 0.952). Bootstrap analyses demonstrated an indirect effect of personal distress on compassion satisfaction through burnout (B = -0.308, 95% confidence interval = -0.443 to -0.186). Age was negatively associated with burnout (B = -0.111, p = 0.003) and positively associated with compassion satisfaction (B = 0.102, p = 0.012).

Burnout appeared to mediate the association between personal distress and compassion satisfaction among Thai mental health professionals. Higher levels of personal distress were associated with greater burnout, which in turn was associated with lower compassion satisfaction.

To identify themes among patients on conditional discharge (CD) residing in care homes regarding their understanding of CD and their perspectives on the revised CD guidelines.

Patients on CD aged 18 to 64 years who attended the Tuen Mun Mental Health Centre of Castle Peak Hospital, Hong Kong, were able to read and write Chinese and communicate in Cantonese, and resided in one of two residential care homes for persons with disabilities were identified. Eligible patients were invited to participate in focus-group discussions through purposive sampling. Two focus groups were conducted, each comprising eight participants. Focus-group discussions were guided by 10 semi-structured questions related to (1) participants' understanding of CD and (2) their perspectives on the revised CD guidelines. Participants were encouraged to provide honest and authentic responses and to express their opinions freely in a relaxed, non-judgemental atmosphere; the facilitators remained highly attentive to verbal and non-verbal indicators of social desirability bias. Audio recordings of the discussions were transcribed, coded, and analysed using inductive thematic analysis.

In total, 15 men and one woman (mean age, 57.1 years) completed two focus-group discussions in September 2025. Inductive thematic analysis identified six themes: understanding of the CD mechanism, professional support under CD, impact of CD, recall mechanism, review mechanism through multidisciplinary case conferences, and pamphlet providing information on CD.

Patients on CD residing in long-stay care homes considered that the revised CD guidelines enhanced their understanding and acceptance of the CD mechanism, particularly its supportive elements. Nonetheless, perceptions of CD as punitive and uncertainty regarding recall and review procedures highlight the need for clearer communication and patient engagement. Improvements in explanations through individualised staff guidance, transparent review processes, and bilingual pamphlets may foster trust, autonomy, and compliance among patients under CD.

To compare individuals assigned male at birth (AMAB) and assigned female at birth (AFAB) in terms of sociodemographics, psychiatric comorbidities, requests for gender-affirming interventions, service utilisation (waiting times and private versus public care), barriers to gender-affirming interventions, regret after gender-affirming interventions, and death by suicide.

Medical records of consecutive patients referred to the Gender Identity Clinic for gender-affirming interventions between 1 November 2016 and 31 December 2022 were retrospectively reviewed.

In total, 349 AMAB and 260 AFAB were included in the analysis. Although 51.6% of service users had tertiary education or above, the unemployment rate was disproportionately high at 16.4%. Compared with AFAB, AMAB were older at referral and were more likely to be unemployed and have divorced or married. AMAB had higher rates of psychiatric comorbidities than AFAB (31.5% vs 24.2%), particularly autism spectrum disorder and previous suicide attempts. AFAB had a higher rate of requesting gender-affirming surgeries than AMAB (73.4% vs 56.2%). The waiting times for endocrine assessment substantially increased from approximately 105 days in 2017 and earlier to >400 days in 2022, reflecting unmet service demand. Barriers to gender-affirming surgery were primarily related to pending appointments for surgeries. Four AMAB reported regret after feminising genital reconstructive surgery. Two AMAB and one AFAB died by suicide while awaiting service.

AMAB and AFAB service users differ in sociodemographic characteristics, mental health profiles, and treatment requests. The unmet demand for gender-affirming interventions and prolonged waiting times underscore the need to improve equitable access to medically necessary healthcare, particularly for AMAB.

Each year, nearly 3 million Americans are hospitalized for traumatic injuries, and many experience significant psychological distress during recovery. Between 20% and 40% of trauma survivors develop post-traumatic stress disorder (PTSD) and/or depression within a year, leading to substantial individual and economic costs. Sustainable interventions that enhance continuity of care and reduce psychiatric morbidity are needed. Trauma centers are uniquely positioned to improve behavioral health trajectories post-injury. We examined the impact of a brief, single-session bedside intervention that aimed to reduce acute distress and promote mental health follow-up, which was delivered in the context of a stepped-care mental health model in a Level I trauma center.

We examined uptake of the brief bedside intervention, its impact on patients' participation in mental health follow-up screening, and psychiatric symptoms 30 days post-injury.

Among 887 adult patients who screened positive for PTSD/depression risk, 683 (77.0%) were offered the brief bedside intervention, 555 (81.3%) of whom accepted. Of those, 452 (81.4%) received it; 103 (18.6%) were missed due to patient/provider unavailability or early discharge. Violent injury was significantly associated with receipt of the brief bedside intervention and engagement in the mental health follow-up screening. After adjusting for violent injury, patients who received the intervention were 84% more likely to engage in the 30-day mental health follow-up screening (odds ratio=1.84; 95% CI=1.19-2.85). In contrast, the intervention did not significantly improve follow-up screening rates for survivors of violent injury. Bedside intervention completion was not significantly associated with PTSD and depression symptoms at 30 days or with referrals.

Bedside behavioral health interventions may enhance mental health follow-up screening rates for nonviolent trauma patients, but appear insufficient for victims of violence. These findings highlight a critical gap for violently injured patients, suggesting the need for integration with specialized, culturally responsive violence intervention programs.

Level II, therapeutic/care management type.

Excessive alcohol use can impair working memory, potentially hindering treatment outcomes. Suggestion-Based Cognitive Rehabilitation (SBCR), a hypnotic technique of potential benefit for restoring working memory in brain injury patients, may hold promise for alcohol use disorder (AUD). This randomized controlled trial compared SBCR-hypnosis to mindfulness-based hypnosis among individuals in AUD treatment. Forty-one participants who were at an inpatient facility were randomized to four weekly sessions of either intervention. Pre- and post-intervention assessments included working memory, well-being, alexithymia, abstinence confidence, and therapeutic alliance. Three-month follow-ups assessed relapse, abstinence confidence, and mental health. Analyses included repeated measures ANOVA, recurrent event regression, and structural equation modeling informed by factor analysis. No significant between-group differences emerged. However, both groups showed improved well-being. Exploratory analysis identified a latent therapeutic improvement factor influenced by trait absorption. Structural equation modeling revealed that SBCR-hypnosis predicted greater therapeutic alliance improvement, which further predicted reduced relapse, enhanced abstinence confidence, and improved mental health. Although SBCR-hypnosis was not superior on clinical AUD outcomes, it may uniquely enhance therapeutic alliance, a potential mechanism worth exploring in future studies.

Polysaccharides, widely distributed in plants, fungi, algae, and bacteria, have garnered increasing attention as promising natural agents for mood regulation due to their diverse chemical structures, bioactivities, and safety profiles. Mood disorders, including depression and anxiety, remain major global health challenges with limited treatment options, prompting interest in polysaccharide-based dietary interventions. This review consolidates current findings from in vitro, in vivo, and clinical research on polysaccharides' potential to modulate neuroimmune responses, influence the gut microbiota-brain axis, regulate neurotransmitter synthesis, attenuate oxidative stress, and alter metabolic pathways relevant to mood regulation. Notably, polysaccharides derived from Lycium barbarum and Astragalus exhibit antidepressant and anxiolytic effects in experimental and clinical contexts. Despite promising outcomes, variability in polysaccharide composition, intervention protocols, and assessment methods constrains definitive conclusions. To fully realize the neuropsychological benefits of polysaccharides within mental health nutrition, rigorous large-scale clinical trials and detailed structure-function analyses are imperative. These efforts will advance polysaccharides as viable functional food components for managing mood disorders.