Community health workers (CHWs) are trained lay individuals embedded within and trusted by their communities who help address health system gaps across diverse settings. While CHW models are well established in low- and middle-income countries, their integration in high-income countries with universal healthcare systems remains limited and inconsistent and has not yet been comprehensively synthesised.

To map available evidence on the integration of CHWs in high-income countries with universal healthcare systems, including Canada. Specifically, it examined the tools, strategies, training approaches, organisational features, policies, frameworks and programmes supporting CHW integration and summarised their key characteristics and reported or anticipated outcomes.

We included all relevant studies and grey literature on the integration of CHWs into high-income countries with universal healthcare systems. It encompassed all types of CHWs, or similar roles, defined as trained laypersons providing health-related services, with full-text articles available in any language.

Medline (Ovid), Embase (Elsevier), Scopus (Elsevier), CINAHL (EBSCO), PsycINFO (EBSCO), Academic Search Premier (EBSCO), Business Source Complete (EBSCO), ProQuest Dissertations and Theses Global from inception until 31 December 2025.

All identified records from the selected databases and supplementary sources were imported into the online review management platform Covidence, where duplicates were removed. The review followed JBI methodology and was reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Findings were organised using the Lévesque conceptual framework of access to healthcare.

A total of 27 514 records were retrieved from all databases. After removal of duplicates, 16 538 records were screened, 352 full-text articles were assessed for eligibility and 23 studies were included in the review. The included literature described diverse CHW and related peer-based interventions spanning consultation and co-design, education and training, workforce integration and service delivery models. A substantial proportion of studies focused on peer-based roles, particularly within mental health settings. Findings highlighted the importance of organisational readiness, role clarity and collaborative, person-centred approaches in supporting integration. Reported outcomes included improved service access, care experiences and perceived quality; however, evidence varied across settings and outcomes.

Guided by the Lévesque framework, CHW and related peer workforce integration was associated with improved healthcare access, particularly through enhanced approachability, acceptability, continuity, collaboration and person-centred, recovery-oriented approaches. However, evidence was predominantly focused on supply-side dimensions of access, while affordability and other demand-side dimensions were underreported. Persistent structural barriers, including stigma, role ambiguity, inconsistent training and funding instability, limited sustainability, underscoring the need for supportive organisational structures, clear roles and aligned policy and funding mechanisms.

Graves' disease (GD) is an autoimmune thyroid disease, mainly affecting women of working age. The hyperthyroidism in GD is characterised by physical symptoms (tachycardia, weight loss, sweating and tremors) as well as cognitive and psychological problems that have a major impact on the daily lives of patients. Mental symptoms are particularly distressing, with patients expressing a desire for more communication and support for the mental aspects of their care. The aim of this study was to explore the experience of healthcare professionals (HCPs) when providing care and treatment to patients with GD.

A qualitative study based on interviews conducted digitally or face to face was performed with data evaluated according to Graneheim and Lundman's qualitative content analysis.

The study was conducted within specialised care at the secondary level in a Swedish healthcare context.

12 HCPs (6 physicians and 6 registered nurses) with experience in providing care and treatment for patients with GD were interviewed.

The study highlighted shortcomings in the care of patients with GD, emphasising that GD is more complex than many other endocrine conditions due to its cognitive and psychological impact. Several obstacles hindered the ability to meet patient needs, including limited time, an organisational structure that is not adapted to the nature of GD, insufficient resources and a lack of interdisciplinary cooperation. HCPs acknowledged that patients often had needs that exceeded what the current system allowed them to address, which led to frustration and affected the work environment. There was a strong and shared desire among HCPs for changes that could improve the quality of care for this patient group.

Optimal care for patients with GD requires treatment tailored to the specific needs of each patient supported by organisational approaches that acknowledge the complexity of the condition, addressing both physical and psychological aspects. A way to achieve this is by enabling sufficient time for patient-HCP interaction, improving continuity of care and strengthening interdisciplinary collaboration. Key implications for practice include targeted training in the psychosocial aspects of GD and the integration of a contact registered nurse with specialised knowledge in thyroid diseases, which may improve both care quality and the HCP work environment.

To examine the association between interpersonal and impersonal stressful and potentially traumatic life events (SLEs/PTEs) and satisfaction with life (SWL), and to assess the extent to which this relationship is mediated by mental distress, somatic health and social factors.

Cross-sectional study.

Population-based study in Tromsø, Norway.

A total of 21 069 adults aged ≥40 years from the seventh wave of the Tromsø Study (mean age 57.3 years).

SWL measured using the Satisfaction With Life Scale-3.

Linear regression analyses and structural equation modelling (SEM) were used to examine associations between SLEs/PTEs and SWL and to assess direct and indirect effects via mental distress, somatic health, cohabitation status, perceived social support and self-reliance.

Both interpersonal (B = -0.11, p<0.001) and impersonal SLEs/PTEs (B = -0.05, p<0.001) were significantly associated with lower SWL. SEM analyses indicated that SLEs/PTEs had both direct negative effects on SWL (interpersonal SLE/PTE: B = -0.15, p<0.001, impersonal SLE/PTE: B = -0.06, p<0.001) and indirect effects through mental distress, somatic health, living with a partner, having friends to confide in and self-reliance.

Exposure to SLEs/PTEs is associated with reduced life satisfaction, with both direct and indirect pathways via mental and somatic health and social support. Interpersonal SLEs/PTEs appear to have a stronger negative impact on SWL than impersonal events.

Body image has been highlighted by young people as a significant concern; however, there is limited research on the impact of appearance ideals and negative body image. The aim was to undertake a national community survey exploring body dissatisfaction and related factors in young Australians.

1550 Australians aged 12-18 (M = 16.02, SD = 1.53) completed an online survey.

One quarter of participants were mostly or completely dissatisfied with how their body looks and 90% reported some level of concern about their body image. Further, participants' feelings about their bodies stopped them from engaging in a range of life activities, such as spending time with friends and family. Approximately two thirds of participants reported being teased about their body.

The findings suggest that body image is a salient concern for young people and has notable impacts on quality of life, emphasising the importance of implementing body image-related programs for young people.

Although combining long-acting injectable antipsychotics (LAIs) with psychosocial treatments for schizophrenia is important, psychiatrists' attitudes toward this approach remain underexplored. We investigated Japanese psychiatrists' perceptions of combining atypical LAIs with psychosocial interventions.

An anonymous cross-sectional web-based survey was administered to 1038 mid-career Japanese psychiatrists, of whom 69 provided complete responses. Participants' general attitude toward recommending atypical LAIs was dichotomized as positive or negative/neutral, and they rated on a 4-point scale the usefulness of combining atypical LAIs with five psychosocial interventions: (1) psychosocial treatment (e.g., psychoeducation), (2) day/night care, (3) community care, (4) financial/employment support, and (5) housing support.

Thirty-nine respondents held a positive attitude toward recommending atypical LAIs, whereas 30 held a negative/neutral attitude. A positive attitude was significantly associated with perceiving the combination as useful for psychosocial treatment (p = 0.038), financial/employment support (p = 0.015), and housing support (p = 0.041), but not for day/night care (p = 0.090) or community care (p = 0.079). Free-text rationales most commonly cited improved adherence and relapse prevention, enhanced illness insight, and synergistic effects as reasons for valuing the combination.

This exploratory study suggests that mid-career Japanese psychiatrists, particularly those with a favorable attitude toward atypical LAIs, perceive the combination of LAIs with psychosocial support not merely as an adherence tool but as a synergistic strategy promoting broader functional recovery. Because respondents represent a small, predominantly male, self-selected sample, the generalizability of the findings is limited.

Psychosis is a frequent and disabling non-motor complication of Parkinson's disease (PD). Reported prevalence varies widely, and data in Brazilian cohorts remain scarce.

To estimate the prevalence of PD-associated psychosis (PDP) in a Brazilian cohort and to describe its sociodemographic and clinical profile.

We conducted a cross-sectional study in a Brazilian movement disorders outpatient clinic between May and December of 2022. Adult patients with idiopathic PD defined by the United Kingdom's Parkinson's Disease Society Brain Bank criteria were consecutively evaluated. Sociodemographic and clinical variables were collected. Psychosis was assessed using the diagnosis criteria proposed by the National Institute of Neurological Disorders and Stroke and the National Institute of Mental Health (NINDS/NIMH) and graded with the Movement Disorders Society's Unified PD Rating Scale (MDS-UPDRS). Cognitive screening was performed using the Mini-Mental State Examination (MMSE), and disease severity was assessed with the modified Hoehn & Yahr scale (mH&Y). Neuropsychiatric symptoms were evaluated with the Neuropsychiatric Inventory Questionnaire (NPI-Q). Descriptive analyses and exploratory univariate comparisons were performed.

In total, 75 patients were included. The median age was 68 years (IQR: 59.5-74.5), and the mean age at PD onset was 56.0 ±  9.8 years. Median disease duration was 10 years (IQR: 6-14.5). Most patients were male (54.7%) and self-identified as Mixed-race (48.6%) or Black (31.1%). According to the mH&Y scale, 82.7% had mild-to-moderate disease. Furthermore, PDP was diagnosed in 18 patients (24%) according to NINDS/NIMH criteria. Minor phenomena and hallucinations were the most frequent psychotic manifestations, each occurring in 72.2% of PDP cases.

In this Brazilian cohort, PDP had a prevalence of 24%. These findings reinforce that psychosis is a frequent non-motor manifestation of PD and highlight the importance of systematic clinical screening in routine care.

Intermittent and uncontrolled loss of urine is common among children but requires medical attention when it persists beyond age 5 years. Mostly functional in origin, urinary incontinence is caused by a complex inter-relationship of biopsychosocial factors, and evidence shows that mental health problems and adverse childhood experiences (ACEs) are common in children and adolescents with urinary incontinence. Mental health problems and ACEs (including abuse, neglect, and household dysfunction) could be both causes and consequences of paediatric urinary incontinence, but research is needed to understand causal pathways. Treatment guidelines increasingly recognise the need to integrate assessment of psychosocial factors and mental health support into clinical care pathways for children affected by urinary incontinence. Parental and societal beliefs, cultural norms, availability of sanitation facilities, economic constraints, and policy-level gaps affect the management of paediatric urinary incontinence. Early assessment and treatment are needed to prevent urinary incontinence from becoming chronic and negatively impacting on children's quality of life, wellbeing, and education.

Functional seizures (FS) present substantial diagnostic and treatment challenges, particularly for Veterans with multiple medical and psychiatric comorbidities including post traumatic stress disorder, mood disorders and traumatic brain injury. To more effectively care for Veterans with FS and neuropsychiatric comorbidities, the US Department of Veterans Affairs (VA) neurology program office developed an interdisciplinary Mind Brain Program (MBP) to bridge the gap between neurology and mental health care for Veterans. In the context of expandeding MBP program development targeting Veterans with FS and complex comorbidities, this quality improvement project explored Veterans' lived experiences navigating FS diagnosis and treatment to identify opportunities for enhancing seizure care. Between April and July 2024, we conducted semi-structured interviews with 19 participants: 10 Veterans and 9 care partners. Using rapid qualitative analysis, we coded data into predefined themes to identify opportunities for improving care. Three major themes were identified within the predefined framework, with emergent subthemes. First, diagnostic challenges included clinicians' limited FS knowledge resulting in delayed video-EEG monitoring, and patient stigma, delaying diagnostic clarity. Second, limited access to specialty care was shaped by geographical barriers, lack of local expertise, scheduling difficulties, and reliance on community care referrals. Third, communication gaps within and between VA and community clinicians contributed to fragmented care, duplicated testing, and increased care partner burden. Findings are limited by a small sample from a single health system and by reliance on interview notes. Despite these limitation, findings highlight opportunities to improve FS care through standardized diagnostic pathways, enhanced clinician and patient education, strengthened communication within and between VA and community, and formal inclusion of care partners. These results can inform ongoing efforts to optimize FS care across the VA system.

Delivering face-to-face psychological interventions for cannabis use disorder (CUD) in early intervention services (EIS) for psychosis is often limited by structural barriers. App-based interventions may help overcome these limitations, though studies in non-psychosis populations report low engagement and retention. This study evaluated the feasibility of conducting an efficacy randomized controlled trial (RCT) of iCanChange (iCC), a novel app-based psychological intervention for CUD, and explored preliminary effects on cannabis use and related outcomes. We conducted a pilot RCT across 6 EIS programs in Canada, with 101 young adults aged 18-35 years with first-episode psychosis and CUD. They were randomized to modified EIS plus iCC (n = 51) or EIS only (n = 50). The intervention lasted 12 weeks with assessments at baseline and weeks 6, 12 (primary endpoint), and 24. Primary feasibility outcomes were intervention acceptability, defined as iCC completion (>50% of participants completing >50% modules), and trial retention, defined as >50% of participants retained at week 12. Secondary outcomes included cannabis use quantity and frequency, participant satisfaction, and app use metrics. Exploratory outcomes included cannabis-related outcomes, psychotic symptoms, and life satisfaction. Retention at week 12 was 84% in the intervention group and 86% in the control group, while iCC completion rate was 49% in intent-to-treat and 54% in per-protocol analyses. Preliminary signals of improvement in the intervention group were observed regarding cannabis use frequency, cannabis-related problems, dependence severity, and coping self-efficacy. Results demonstrate strong retention, supporting the feasibility of an efficacy trial while highlighting the need to enhance app engagement in youth with psychosis.

Internalising symptoms including depression, anxiety and somatic symptoms in adolescence are common. They can be transient, but they can also persist and progress to major depressive disorder (MDD) Polygenic risk scores for major depression (MD-PGS) may help identify which symptomatic adolescents are at greatest risk of later disorder. In a mega-analysis of two longitudinal population-based cohorts from Brisbane, Australia, we investigated whether polygenic liability to depression improves risk stratification among adolescents with elevated internalising symptoms. Internalising symptoms were assessed at age 14, lifetime MDD was assessed in young adulthood using the Composite International Diagnostic Interview, and MD-PGS were generated using summary statistics from the latest Psychiatric Genomics Consortium major depression genome-wide association study, excluding Australian cohorts. Analyses focused on comparisons between individuals in the top decile of risk and those in the remaining 90% of each cohort. A total of 302 cases with lifetime MDD and 1693 controls were included. Compared with adolescents outside the highest decile of internalising symptoms, those in the top decile at age 14 had a more than two-fold increased odds of lifetime MDD (OR = 2.56, 95% CI 1.92-3.49, p = 5.4 × 10^-10). Individuals in the top decile of MD-PGS also showed increased odds of lifetime MDD compared with the remaining 90% (OR = 3.45, 95% CI 2.53-4.71, p = 4.4 × 10^-¹⁵). Adolescents who were simultaneously in the top decile of both internalising symptoms and MD-PGS had an approximately eight-fold increased odds of lifetime MDD compared with individuals outside the top decile for both risk factors (OR = 8.58, 95% CI 4.04-18.26, p = 1.2 × 10^-⁵). These findings indicate that polygenic risk scores for depression may have particular clinical utility for stratifying risk among adolescents already presenting with elevated internalising symptoms, identifying a subgroup at very high risk for later major depressive disorder.