Alternative crisis response programs have emerged nationwide in response to the need for social service and not law enforcement responses to mental health calls. The Community Assistance and Life Liaison (CALL) program in St. Petersburg, Florida, is one such initiative. Pairs of trained bachelor's level professionals ("community navigators") are dispatched to nonviolent crisis calls (e.g., mental health and substance use issues, neighborhood disputes, disorderly youth) instead of police. Following a quantitative first-phase evaluation of CALL, the present study represents the second-phase evaluation that focuses on implementation processes, impact, and acceptability. In-depth qualitative interviews were conducted with 23 informants from three key groups (CALL leadership and team members, police and 911 staff, and community members). Six prominent themes emerged from the thematic analysis: support and initial buy-in; tension between safety and accessibility; fidelity and purposeful delivery; police referral/reduced burden; community awareness; and equity implications. A main tension involved ensuring the safety of navigators by adhering to stringent vetting of calls for nonviolence and ensuring that high-risk individuals most in need of resources could still access CALL's services. Police officers varied in their opinions of workload reductions and 911 call takers reported the program increased the impact of their work. Community members who came into contact with CALL endorsed having positive experiences overall. Finally, Black community leaders viewed CALL as a positive meaningful step toward culturally responsive services and requested further data on its equitable implementation. Recommendations from this study are provided to inform future or existing programs on processes that optimize acceptability and increase accessibility. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Non-adherence to cardiovascular disease (CVD) treatments leads to suboptimal health outcomes and increased healthcare and societal costs. We assessed the long-term effects of adherence to CVD and diabetes medications using population data and microsimulation modelling.

We developed a CVD microsimulation model using individual participant data from the SIDIAP database (2012-2021) for 152,117 adults who received new prescriptions for antihypertensive, lipid-lowering, oral glucose-lowering or antiplatelet treatments in Catalonia between January 2012 and December 2013. Model inputs included demographic and clinical characteristics, medication adherence and cardiovascular events. Costs (€, 2025) and treatment effects were sourced from the literature, and utilities were estimated using national population-based surveys. Model validity was assessed by comparing simulated and observed cumulative incidences over 8 years. The model simulated life-years (LYs), quality-adjusted life-years (QALYs) and healthcare and societal costs under three scenarios: non-adherent, observed adherence and full adherence. We estimated the maximum per-patient cost at which adherence-enhancing interventions would remain cost-effective.

Simulated cumulative incidences of cardiovascular events and all-cause death closely matched observed data. Improved adherence increased survival by 0.19-0.58 years and QALYs by 0.25-0.70, while increasing lifetime healthcare costs by €2,431-€8,093 per patient. The additional cost per QALY ranged from €8,946 to €12,614 per QALY, indicating that improving adherence is likely to be a cost-effective if achieved at additional cost of up to €4,041 to €10,098 per patient.

Long-term extrapolation of real-world data using microsimulation modelling shows that optimising adherence to CVD and diabetes medications can enhance health outcomes cost-effectively.

Patients who survive prolonged stays in intensive care units (ICUs) often face lasting physical, psychological, cognitive, and social impairments. The aim of this study was to explore the challenges experienced after ICU discharge and the coping strategies employed.

Eleven semi-structured qualitative interviews were conducted with former patients who had undergone continuous or intermittent invasive mechanical ventilation for at least 7 days. Participants from a Swiss university hospital were interviewed 7-13 months after ICU discharge. Data were analysed using reflexive thematic analysis, following the interpretive descriptive approach.

Six central themes emerged: (i) no longer being the same person; (ii) the social environment as both a help and a burden; (iii) dealing with gaps in memory; (iv) noticing their own progress; (v) navigating setbacks and finding motivation; and (vi) what cannot be understood or changed. Each theme reflected both challenges and coping. Participants reported physical, mental, cognitive, and social challenges, and coping strategies included problem-focused and emotion-focused coping and cognitive reappraisal.

Recovery after prolonged ICU stays involves challenges across all health domains. Patients apply diverse coping strategies, indicating that one-size-fits-all follow-up programs may not be adequate. Aspects of recovery, such as social support, may be experienced as either a resource or a burden, depending on individual circumstances.

Follow-up care should be flexible and individualised and should support the recognition of small improvements. Family members play a key role in recovery but may require guidance in understanding patients' support needs.

Clinical prediction models use individual-level patient data to inform clinical decisions across medicine. However, few are currently used in psychiatry. Here, we examine the opportunities and challenges presented by the new generation of clinical prediction models in psychiatry and consider what it would mean for a model to be 'good enough' for clinical use.

Auditory verbal hallucinations, or hearing voices, occur across various mental health conditions and can vary widely in distress and content. Understanding the factors that influence these experiences is essential for effective therapy. Schema therapy, particularly its concept of schema modes, offers a framework to explore how emotional states and coping strategies shape the nature and distress of voice hearing. Despite this, there is limited research on the relationship between schema modes and voice-hearing experiences. This study aimed to address this gap by developing a schema mode profile for transdiagnostic voice hearers, and investigating whether schema modes predict voice-related distress and positive or negative voice-related content. The study included 76 voice hearers who completed assessments of their voices and schema modes. The schema mode scores in voice hearers were generally elevated compared to nonclinical and Axis I populations (e.g., those with anxiety or depressive disorders) and closely mirrored those of Axis II populations (e.g., personality disorders). The greatest elevations compared to Axis I patients were observed in the Vulnerable Child, Impulsive Child, Detached Protector, Bully and Attack and Punitive Parent modes. Regression analyses showed that Vulnerable Child mode significantly predicted greater voice-related distress. For negative voice content, both the Vulnerable Child and Detached Self-Soother modes were associated with an increased negativity. For positive voice content, the Happy Child and Enraged Child modes were positive predictors, while the Detached Self-Soother was negatively associated with positive voice experiences. These findings suggest schema modes may play a role in voice-hearing experiences, offering promising avenues for schema therapy interventions and future research.

The overconsumption of sodium contributes to a wide range of detrimental health conditions. Thus, it is imperative to gain a better understanding of the neural mechanisms driving sodium appetite. Here, we combined neuroanatomic, transgenic, behavioural and chemogenetic approaches to investigate the role of bed nucleus of stria terminalis (BNST) enkephalin neurons (BNST^ENK) in sodium appetite in male and female pENK-Cre mice. Our results demonstrate that Gi-mediated signalling onto BNST^ENK neurons regulates salt consumption following sodium depletion, but does not impact upon taste preference when replete. Further, Gi-mediated signalling onto BNST^ENK neurons had no effect on deprivation-induced food or water intake, or anxiety-like behavior. Using Cre-dependent retrograde trans-synaptic tracing and anterograde AAV tracing we show connectivity between BNST^ENK neurons with the extended amygdala, thalamus and hypothalamus. In summary, we have identified that BNST^ENK neurons are integral to a needs-based salt appetite and demonstrate the broader connectivity of these neurons providing a roadmap for future circuit interventions.Significance Statement We identify a functional role for BNST^ENK neurons in a needs-based salt appetite following sodium depletion. Further, we map the upstream and downstream connectivity of BNST^ENK neurons to provide a roadmap for future investigations into the broader circuitry underpinning salt appetite.

This study investigated the incidence of stressors and psychological resilience among medical students within the framework of AI-assisted (artificial intelligence-assisted) learning, with the objective of informing evidence-based treatments for the enhancement of resilience. A cross-sectional study utilizing random sampling was performed among 994 medical students from three medical colleges in East China in 2025.The data were analyzed utilizing SPSS version 27.0.The findings indicated that the psychological resilience ratings of medical students were markedly inferior to the national youth average. Resilience had a positive correlation with the utilization of AI applications and a negative correlation with various stressors, demonstrating differing magnitudes and directions of influence. The academic year, academic ranking, family income, only-child status, and gender significantly influenced the outcomes. Path analysis indicated that stress perception partially moderated the association between AI-assisted learning and resilience. These findings offer new empirical data regarding the pathways connecting AI-assisted learning experiences to psychological resilience and underscore the varying impacts of different stressors and individual backgrounds. The study provides practical insights for creating stress-categorization management systems and enhancing intelligent technology applications to promote mental health in medical education.

Overgeneral autobiographical memory (OGM), a tendency to retrieve events from memory that did not occur at a specific time, is a transdiagnostic mechanism in psychopathology. However, its specific role in obsessive-compulsive disorder (OCD) remains unknown. This study aimed to examine the presence and cue-valence specificity of OGM in OCD, investigate its associations with executive function subcomponents, and explore how OGM and executive dysfunction individually and interactively predict OCD symptom severity.

A total of 112 OCD patients and 101 healthy controls completed the Autobiographical Memory Test to assess OGM, N-back task for working memory, task-switching paradigm for cognitive flexibility, stop signal task for inhibitory control, and Yale-Brown Obsessive-Compulsive Scale for OCD symptom severity. Group comparisons and regression analyses were conducted.

After controlling for depression and anxiety, the OCD group exhibited significantly greater OGM for negative and positive cues compared to controls (ps < 0.001), while showing comparable specificity for neutral cues. Among executive function subcomponents in the OCD group, cognitive flexibility demonstrated the strongest prediction of OGM (β = 0.488, p < .001), followed by working memory (β = 0.362, p = .001), but inhibitory control had no significant correlation with OGM. Furthermore, OGM predicted OCD symptom severity (β = 0.415, p < .001). Cognitive flexibility deficits moderated the relationship between OGM and OCD symptom severity (β = -0.232, p = .039).

OGM in OCD is characterized by specificity to emotional-valence cues, which is linked closely to impaired cognitive flexibility and relates to greater OCD symptom severity. These findings identify OGM and its interaction with cognitive flexibility as key targets for therapeutic intervention in OCD.