Ethnoracially minoritized LGBTQ+ young people demonstrate greater suicide risk than their non-Hispanic White peers, yet limited research exists examining state equality protective factors that can reduce risk, especially among lesbian and bisexual women/nonbinary individuals assigned female at birth (LBWNBI). Guided by a strengths-based approach and integrated theoretical model, we used an observed variable path analysis to examine moderating effects of state racial and LGBTQ+ equality, and interactions between these factors and individual- and interpersonal/community-level protective factors, on prospective associations between intersectional minority stressors and entrapment, and entrapment and suicidal ideation. The analytic sample included 486 ethnoracially minoritized LBWNBI in the National Queer Women's Mental Health Cohort longitudinal study (M_age = 22; 40% Hispanic/Latine, 38% Black/African American, 18% Asian; 51% bisexual) who completed baseline (T1), 3-month (T2), and 6-month (T3) surveys. Intersectional minority stressors at T1 led to greater suicidal ideation at T3 via entrapment at T2. Conjoined state racial and LGBTQ+ equality moderated the relationship between T1 intersectional minority stressors and T2 entrapment to reduce T3 suicidal ideation. This effect was also moderated by individual protective factors, proving especially important for LBWNBI living in states with low equality. Suicide prevention efforts with this population should involve multi-faceted, multi-sectoral policies and interventions that effect transformative change to redress historical and contemporary structural-level oppressions, injustices, and inequities.

This study aimed to explore how individuals with complex multimorbidity perceive and experience the management of their health in everyday life and healthcare encounters.

Patients with two or more health conditions may be challenging for general practitioners (GPs) who must provide adequate treatment(-s) in a healthcare system structured mainly around single-disease models. For patients, the lived experience of this multimorbidity can be demanding, as it often involves managing multiple appointments, medications, and medical advice alongside everyday life. This situation may be particularly challenging for patients who live with multiple physical and mental health conditions.

Semi-structured individual interviews with eight individuals with complex multimorbidity living in Denmark. Analysis was guided by thematic analysis.

The analysis resulted in two main themes. First, 'Multiple diagnoses - not multimorbidity' describes how the participants did not expect overall continuity across diagnoses but appreciated recognition of the cumulative burden of multimorbidity. They expected continuity within each speciality and developed agentic strategies to achieve this. Some were successful; others were not. Second, 'Managing treatment and illness in everyday life' describes how the participants navigated tensions between medical recommendations and personal priorities as they deliberately pursued valued activities at the expense of their long- or short-term health. A professional lifeline, was a significant support for the participant. This person was often the GP. These findings underscore the active role of patients and the GP's role in recognizing their resources to develop patient-centred care that is responsive to and realistic for the individual patient.

To examine the associations between various hurricane-related exposures and psychiatric and substance use disorders among Puerto Rican adults following Hurricane Maria and to identify disaster-related exposures that may contribute to psychiatric morbidity in hurricane- and typhoon-prone settings.

Hurricane-related exposures were grouped into personal, property, utility/resource losses, and unsanitary/hazardous exposures. Logistic regression models were run to examine the associations between the number of hurricane-related exposures and disorders.

Each additional hurricane-related exposure was associated with a 1.1 percentage-point increase in the probability of any mood disorder (P < 0.001), a 1.3 percentage-point increase in the probability of any anxiety disorder (P < 0.001), and a 2.0 percentage-point increase in the probability of any disorder (P < 0.001). Each additional utility/resource loss exposure was associated with a 2.3 percentage-point increase in the probability of any anxiety disorder (P = 0.001). Each additional unsanitary/hazardous exposure was associated with a 1.9 percentage-point increase in the probability of any mood disorder (P = 0.017). Findings varied when individual disorders were examined. No associations were found between exposures and substance use disorders.

Utility/resource losses and unsanitary/hazardous conditions emerged as important correlates of post-disaster psychiatric disorders, suggesting that these often-overlooked exposures should be incorporated into disaster assessments and recovery planning.

BackgroundAccess to high-quality and timely dementia diagnoses varies between rural and urban location.ObjectiveWe examined rural-urban disparities in key indicators for high-quality and timely diagnoses of mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia in Australia.Methods3648 patients with all-cause MCI or AD dementia were geographically classified into major cities (75.7%), inner (15.8%) and outer (8.4%) regional areas. We used regression analyses to assess rural-urban disparities in completion of key diagnostic investigations and diagnostic wait times.ResultsParticipants in inner regional areas were more likely (odds ratio [OR] = 1.55; 95% confidence interval [CI] = 1.14, 2.13; p = 0.006) to have had more basic diagnostic investigations completed (including core blood tests, cognitive assessments, functional assessments, structural neuroimaging) compared to those in major cities. However, participants in inner regional (OR = 0.37; 95% CI = 0.28, 0.48; p < 0.001) and outer regional (OR = 0.32; 95% CI = 0.21, 0.48; p < 0.001) areas were less likely to have functional neuroimaging completed. Median wait times for an initial appointment following referral to a memory clinic were up to 28 days longer for rural compared to urban participants (Inner regional: Beta (median) = 12.91; 95% CI = 5.15, 20.69; p = 0.001; Outer regional: Beta (median) = 27.50; 95% CI = 18.80, 36.20; p < 0.001), whereas median wait times from initial appointment to diagnosis were up to 47 days shorter in rural compared to urban residents (Inner regional: Beta (median) = -46.83; 95% CI = -52.35, -41.32; p < 0.001; Outer regional: Beta (median) = -44.42; 95% CI = -50.35, -38.49; p < 0.001).ConclusionsFindings suggest disparities in access to advanced diagnostic investigations and timely initial appointments in rural Australia, and increased need for enhanced workforce and diagnostic infrastructure in these areas.

Food insecurity is associated with poorer health status and reduced access to cancer treatments. This systematic review aimed to examine the association of food insecurity with health outcomes and treatment complications in cancer survivors.

A comprehensive search was conducted across 5 electronic databases through July 5, 2025: PubMed, CINAHL, MEDLINE, Scopus, and PsycINFO. Studies were included if they met the following criteria: (a) a primary study examining food insecurity in cancer survivors aged ≥18; (b) examined outcomes related to health-related quality of life, mental health status, medication/treatment adherence, postoperative complications, or mortality rate; and (c) reported results in English. Studies were excluded if they were review articles, qualitative studies, or editorials/conference papers. The Joanna Briggs Institute critical appraisal tools were used to assess the risks of bias.

Twenty-one studies, identified from 878 references, met the inclusion criteria. Thirteen studies reported status issues, including physical, behavioral, and mental health problems, as well as quality-of-life outcomes. Few studies indicated that cancer survivors with food insecurity had significantly higher length of stay, 90-day readmission rates, or a greater likelihood of postoperative ileus. Evidence from 5 studies indicated that food insecurity was linked to a higher risk of mortality. Two studies reported associations between food insecurity and treatment adherence, specifically prescription medication use and the postponement of follow-up care.

Nurses should regularly screen cancer patients for food insecurity to facilitate prompt referral to interdisciplinary support. Future research should evaluate interventions and their effects on clinical outcomes and treatment adherence.PROSPERO Protocol Registration:CRD420251083222.

(1) To map experiences of accessing and adhering to community-based aphasia therapy and establish priorities for improvement, based on lived experience. (2) To identify design principles for the experience-based co-design (EBCD) of a mobile health self-management application.

EBCD and human-centred design. Experience gathering and prioritisation (stages 1-3) with people with aphasia (n = 13), significant others (n = 8), and health professionals (n = 10) in interviews and focus groups. Experiences were analysed thematically to identify unmet needs and touchpoints. Priorities were established using the nominal group technique and mapped to technology design principles.

Five touchpoints were identified: (1) The great divide; (2) Too many roadblocks; (3) Getting enough therapy that's right for me; (4) A need to see progress; (5) Finding new ways to bridge the therapy gap. Priorities were synthesised into seven themes and mapped to five design principles: (1) connects the person with aphasia with their speech pathologist, significant others, and community; (2) links goals-therapy-outcomes; (3) shows progress visually; (4) supports information finding and sharing; and (5) is customisable and accessible.

A customisable mHealth solution that facilitates connections and information finding, links goals, therapy, and outcomes, and tracks progress over time, may support aphasia self-management.

Volunteer firefighters face occupational exposures that increase risks for cardiovascular disease, respiratory illness, mental health conditions, and cancer. Although the National Fire Protection Association (NFPA) recommends regular, comprehensive occupational health screenings, the standard lacks a clear protocol and implementation is voluntary; therefore adherence to these recommendations among volunteer firefighters remains unclear. This study examined occupational health screening behaviors and perceived barriers among volunteer firefighters in Texas.

An online, cross-sectional survey was conducted from August-September 2024 to assess demographics, occupational health screening behaviors, and perceived barriers. Multiple logistic regression was used to identify factors associated with frequently reported barriers.FindingsThree hundred and twenty-six volunteer firefighters completed the survey. Only 86 (26.4%) volunteer firefighters reported that th:ey currently receive an annual occupational health screening. The barriers most frequently reported were cost, followed by lack of knowledge about screening locations, lack of insurance, medical providers, and time constraints. Full-time employment, rurality, older age, and higher levels of education were associated with reporting barriers at a statistically significant level. Older age and insurance status were also associated with significantly lower odds for other barriers.

Despite NFPA recommendations, most volunteer firefighters do not receive regular occupational health screenings, highlighting a significant gap between national standards and practice. Addressing structural and access-related barriers is essential to improve screening uptake among volunteer firefighters.Applications to Practice:These findings highlight an urgent need for targeted interventions to address barriers to occupational health screenings and work toward improving the health and longevity of volunteer firefighters.

There has been an increase in the prevalence of mental health problems in young people worldwide for over a decade. Population-based longitudinal studies can help show why this has occurred and whether it will continue throughout life for the present cohort of young people. This in turn will guide the policy response. We discuss two recent articles published in Australian and New Zealand Journal of Psychiatry which highlight the value of longitudinal studies in understanding the causal structure of mental health problems. Australia and New Zealand have a rich tradition of longitudinal studies dating to the 1970s, with some studies now enrolling offspring of the original cohorts. Advances in methods, computing technology and the availability of linked administrative data will make these studies even more valuable in future. The studies will need to evolve to capture shifting environmental factors, such as the digital environment. To get the most value from these studies, there needs to be secure long-term investment by central funding agencies and support for vibrant collaboration networks between the studies.

Psychotropic prescribing in youth is increasingly debated through concerns regarding both overmedicalisation and unmet mental health need. Rising rates are often interpreted as evidence of overprescribing, yet clinicians often operate in under-resourced services, with long waiting lists and limited access to psychological therapies. This paper argues that the key issue is not whether prescribing rates are too high, but whether prescribing is proportionate to clinical need. Drawing on international and recent Irish CAMHS prescribing data, we propose a "Goldilocks model" of psychotropic prescribing in youth, in which optimal prescribing lies on a continuum between the extremes of under- and over-prescribing. This position is shaped by evidence, patient factors, and service context. While psychotropics have an important evidence-based role within child psychiatry, safe and effective use depends on accurate assessment, appropriate monitoring, and access to multidisciplinary and psychosocial supports. Achieving proportionate prescribing therefore requires systems capable of supporting evidence-informed, ethically grounded, and developmentally informed care, ensuring treatment is neither too much nor too little, but ultimately "just right."

AI is increasingly being integrated into mental health support, with applications spanning chatbots, large language models, digital therapeutics and clinical decision-support systems. Although these technologies have demonstrated potential to improve access to care and support clinical practice, their implications for psychiatric mental health nursing (PMHN) remain insufficiently synthesized. This scoping review aimed to examine how AI is being applied in mental health care and to synthesize its implications for psychiatric mental health nursing practice and related nursing-relevant outcomes. A scoping review was conducted following established scoping review methodology and reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Searches were conducted across four databases for studies published between January 2022 and May 2026. A total of 42 sources of evidence met the inclusion criteria. Five overarching themes were identified: (1) AI-based psychosocial interventions and mental health care delivery; (2) suicide prevention and risk management; (3) therapeutic relationships and human-centred care; (4) ethics, safety and governance; and (5) nursing readiness, education and professional transformation. AI applications were associated with improved accessibility of mental health support, enhanced symptom management and more efficient risk assessment. However, concerns regarding privacy, algorithmic bias, transparency and the preservation of therapeutic relationships were consistently reported. AI demonstrates considerable potential to support care delivery, suicide prevention and clinical decision-making, yet raises important ethical, relational and professional challenges. AI should be viewed as a complementary tool that supports rather than replaces psychiatric mental health nursing practice. Educational programmes should strengthen AI literacy, digital ethics and critical appraisal skills to support safe and person-centred AI integration.