Background: Among many deleterious effects on the well-being of children and youth, the COVID-19 pandemic contributed to a surge in youth mental health distress. This, coupled with pre-existing prolonged wait times for mental health care, highlighted the need for accessible community-based mental health supports. The Healthy Living Project (HELP) is a virtual lifestyle change support program aimed at promoting positive lifestyle changes and improved mental well-being among youth with mental distress. A pilot feasibility study explored youth engagement with HELP e-resources, and preliminary mental health and lifestyle measures over a 3-month period. Methods: Youth were enrolled in a 3-month pilot of the HELP e-resource. Feasibility metrics (recruitment, retention, and platform engagement) were documented, while exploratory self-reported data on emotional and behavioral difficulties, youth quality of life, sedentary behavior (screen time), sleep hygiene, and physical activity were assessed at baseline and 3 months. Results: Twenty-three youth (mean age 15.7 years, SD 1.7) completed baseline assessments and started the intervention, with ten participants retained by the end of the study. Compared with non-completers (n = 13), study completers (n = 10) tended to report higher quality of life and healthier habits (lower screen time, improved sleep hygiene, and higher activity). Ongoing access to HELP over 3 months was associated with suggestive trends toward improvement in emotional and behavioral difficulties and sleep hygiene. Engaged participants who received screen time education tended to report lower screen times as compared to unengaged counterparts. Conclusions: This study provides early insights into the implementation and acceptability of HELP e-resources among youth experiencing mental distress, with suggestive trends toward potential benefit. Low recruitment and high attrition preclude definitive conclusions, and the findings should be interpreted as exploratory. Lessons from this pilot will inform the design of a subsequent trial to more rigorously evaluate feasibility and the potential impact of HELP on youth with mental distress.

The COVID-19 pandemic intensified existing systemic inequities in educator mental health, particularly in rural and remote Indigenous communities. Educators faced sudden shifts to remote learning, limited access to technology, and challenges supporting students' well-being while adapting pedagogical practices.

This qualitative longitudinal, citizen science study explored culturally grounded digital engagement tools to support Indigenous educators' mental health during the pandemic in a prairie province of Canada. Eighteen educators from an on-reserve school participated in baseline focus groups in 2020 (n = 18) and follow-up discussions in 2021 (n = 6). Digital tools, including virtual focus groups and a custom mobile application, enabled inclusive participation despite geographic and pandemic-related barriers.

Thematic analysis using NVivo 12 revealed six baseline themes: emotional toll of lockdown, teaching challenges, student concerns, community support, school reopening barriers, and resilience strategies. Three follow-up themes emerged: sustained mental health impacts, adaptation to online teaching, and evolving coping strategies. Across both phases, 'Two-Eyed Seeing', integrating Indigenous and Western knowledge, supported mental well-being, culturally grounded teaching, and community resilience.

Findings highlight the need to strengthen digital access, provide culturally informed mental health supports, and deepen collaboration with Indigenous communities to better protect educator well-being during crises.

Culturally responsive and technology-enabled approaches are both feasible and meaningful for supporting Indigenous educators' mental health, thereby enabling more inclusive and resilient school health systems.

The Northern Territory (NT) experiences the highest rates of hospitalisations involving self-harm in Australia, especially amongst Aboriginal people. Given self-harm is a strong predictor of suicide risk, it is important to identify the distinct risk factors for a repeat hospitalisation involving self-harm amongst Aboriginal and non-Aboriginal people in the NT hospitalised for suicidal ideation and self-harm.

A retrospective cohort study was designed to follow-up patients with a first hospital admission involving suicidal ideation and/or self-harm between 1 July 2001 and 31 December 2013. Survival analysis techniques were used to estimate probability of and risk factors for repeat hospitalisation involving self-harm up to 31 December 2018 for Aboriginal and non-Aboriginal people separately.

The risk of repeat hospitalisation involving self-harm was higher (HR 1.39; 95% CI: 1.22-1.59) amongst Aboriginal (n = 2,304) than non-Aboriginal people (n = 2,087). Compared to suicidal ideation only at first hospital admission, a higher risk of repetition was observed for any self-harm method (aHR: 1.71; 95% CI: 1.37-2.12) amongst Aboriginal people and self-poisoning only (aHR: 1.45; 95% CI: 1.13-1.85) amongst non-Aboriginal people. Previous substance misuse was associated with a higher risk of repeat hospitalisation involving self-harm for Aboriginal (aHR: 1.7; 95% CI: 1.38-2.1) and non-Aboriginal (aHR: 1.6; 95% CI: 1.14-2.25) people. For non-Aboriginal people, several mental health diagnoses were associated with higher risks of repetition.

The distinct risk factors for repeat hospitalisation involving self-harm between Aboriginal and non-Aboriginal people emphasises the importance of comprehensive psychosocial assessment and culturally tailored clinical interventions and community-based solutions to properly understand and address risk factors for each group.

Post-Traumatic Stress Disorder (PTSD) remains under-detected in clinical settings, presenting opportunities for automated detection to identify at-risk patients. This study evaluates natural language processing approaches for binary PTSD classification from clinical interview transcripts using the DAIC-WOZ dataset, which contains semi-structured interviews with standardized psychological assessments. We compared embedding-based methods (SentenceBERT/LLaMA with logistic regression), general and mental health-specific transformer models (BERT/RoBERTa), and large language model prompting strategies (zero-shot/few-shot/chain-ofthought). SentenceBERT embeddings with logistic regression achieved the highest overall performance (AUPRC=0.758±0.128), outperforming domain-specific end-to-end fine-tuning models like Mental-RoBERTa (AUPRC=0.675±0.084 vs. RoBERTa-base 0.599±0.145). Few-shot prompting using DSM-5 criteria and two examples yielded competitive results (AUPRC=0.737). Performance varied significantly across symptom severity and comorbidity status with depression, with higher accuracy for severe PTSD cases and patients with comorbid depression. Our findings highlight the potential of embedding-based methods and LLMs for scalable screening while underscoring the need for improved detection of nuanced presentations.

Family Nurse Practitioner students often navigate graduate education while managing personal, professional, and emotional stressors. Many enter programs with histories of trauma, which may impair learning and performance in rigid, high-stakes academic environments. This pilot study explored the feasibility and perceived impact of implementing trauma-informed educational practices (TIEP) in an asynchronous Family Nurse Practitioner course using the Substance Abuse and Mental Health Services Administration's six principles to trauma-informed care as a framework. A mixed methods design was used with two consecutive student cohorts. Trauma-informed strategies were embedded into the course. Quantitative data were collected by pre-intervention and postintervention surveys. Qualitative feedback was obtained from open-ended responses and course evaluations. All students who completed the pre-intervention survey (n = 25) reported at least one adverse childhood experience, with over half citing trauma related to their nursing practice. Post-intervention surveys (n = 12) indicated high satisfaction with the trauma-informed course modifications. Thirty-three students provided qualitative feedback through the postintervention survey and course evaluations. Across data sources, students emphasized emotional safety, faculty connection, and the value of wellness reminders. Three themes emerged: (1) prioritizing wellness and emotional safety, (2) trauma is a daily lived reality for students, and (3) connection and communication. Findings suggest that TIEP can be feasibly integrated into asynchronous graduate Nurse Practitioner (NP) education and are well received by students. Although the study did not measure academic or clinical performance outcomes, TIEP aligns with the American Association of Colleges of Nursing Essentials for competency-based graduate education and supports ethical preparation for advanced practice.

Depression is a common mental disorder and a leading cause of disability, affecting approximately 280 million people worldwide. Its pathological mechanisms are closely linked to neurotransmitter homeostasis imbalance and neuroplasticity impairment. We aimed to systematically evaluate the clinical efficacy of virtual reality (VR) training in improving depression and to elucidate its dual-pathway regulatory mechanism involving neurotransmitter-plasticity interactions.

We systematically searched PubMed, Web of Science, CNKI, and ScienceDirect databases from their formation to May 2025 to identify randomised controlled trials (RCTs) assessing VR-based interventions. Given the significant heterogeneity across protocols, we conducted a narrative synthesis in accordance with the Synthesis Without Meta-analysis (SWiM) reporting guidelines rather than a quantitative meta-analysis. We assessed the quality of the included studies using the Physiotherapy Evidence Database (PEDro) scale.

Based on 16 studies, we found that VR training can significantly alleviate depressive symptoms through multimodal sensory stimulation and immersive interactions, as the included RCTs generally reported reductions in depression scale scores. Preliminary evidence from several studies also suggests a positive correlation between clinical efficacy and biomarkers of neural structure recovery and functional network synchronisation. However, due to high heterogeneity in intervention protocols, control group designs, and outcome measures, we were unable to provide a unified estimate of the VR training efficacy.

Evidence suggests that VR training may reverse the pathological cycle of depression through a synergistic dual pathway of neurotransmitter regulation and neuroplasticity enhancement, offering a novel strategy for precision intervention. Future research should optimise VR intervention protocols, explore synergistic effects with traditional therapies, and validate its long-term efficacy and safety in special populations.

PROSPERO: CRD420261300373.