Eco-anxiety is an emerging mental health concern among adolescents, particularly in regions affected by climate-related disasters. Following the 2023 wildfires in Canada’s Northwest Territories (NWT), this study examined associations between wildfire exposure severity, socio-ecological factors, and eco-anxiety among adolescents in the NWT. We conducted a cross-sectional survey with 290 adolescents aged 13–18 years across NWT secondary schools during the 2023–2024 school year. Structural equation modelling examined pathways linking social factors (gender, sexual orientation, Indigenous identity), living conditions (rural residence, caregiver status), structural conditions (food insecurity, wildfire exposure severity) and eco-anxiety. Self-esteem was examined as a moderator. Participants had a mean age of 13.7 years; most identifyied as Indigenous and lived in rural communities. Greater wildfire exposure severity and food insecurity were associated with higher eco-anxiety. Girls, LGBQ+ youth and rural youth reported higher eco-anxiety. Indigenous identity was indirectly associated with eco-anxiety through food insecurity and wildfire exposure severity. Higher self-esteem was associated with lower eco-anxiety and buffered the relationship between wildfire exposure and eco-anxiety. Findings suggest that eco-anxiety among NWT adolescents is shaped by climate-related disruption and social conditions. Interventions can address psychosocial resources and material conditions to support NWT youth mental health following climate-related disasters such as wildfires.

Bipolar disorder (BD) is associated with substantial disability and caregiver burden. In Pakistan, prevalence is unusually high, and limited mental health services place families at the center of care. Cultural and religious beliefs strongly shape how the illness is recognized, understood and managed. This study explored how individuals living with BD and their caregivers understand and navigate the illness within this context. Semi-structured interviews were conducted with 12 adults diagnosed with BD (type I or II) and 12 caregivers recruited through a national registry. Open-ended questions explored illness understanding, caregiving challenges, cultural influences and preferences for family intervention. Interviews were conducted in Roman Urdu, audio-recorded, transcribed verbatim and analyzed using Braun and Clarke’s reflexive thematic analysis. Purposive and snowball sampling ensured diversity in gender, socioeconomic status and residence. Patients described blended biomedical and cultural explanations of BD, symptom-related disruption, treatment barriers, stigma and coping through routines and religious practices. Caregivers reported confusion at illness onset, financial and emotional burden, inconsistent support and the need to navigate biomedical and spiritual care pathways. Both groups emphasized the need for accessible, family-inclusive interventions. The findings support development of culturally tailored, scalable and faith-sensitive family interventions.

This study investigated factors influencing insect phobia among older adults in Iran and Malaysia using a quasi-experimental design with individual and group-based teaching models. The study included 151 older adults (82 Iranians, 69 Malaysians). Baseline and post-intervention scores were analyzed using paired t-tests, MANOVA, regression analysis, path analysis and a neural network model. Malaysians scored higher on EVI: Disgusting Pre (mean = 8.03 vs. Iranian mean = 7.46, p < 0.05) but showed greater reductions post-intervention (mean difference = 1.03 vs. Iranian mean difference = 0.63, p < 0.01). OAEAS scores decreased more among Malaysians (mean difference = 14.45 vs. Iranian mean difference = 15.08, p < 0.05). Males reported higher fear and disgust levels than females (p < 0.05). Pet ownership reduced phobic responses (p < 0.05), while chronic conditions heightened baseline scores but limited reductions over time. Group-based interventions were more effective for Malaysians, while individual-based approaches worked better for Iranians. The neural network model explained 82% of EVI variance and 79% of OAEAS variance. Culturally tailored interventions effectively reduce insect phobia among older adults. Future research should explore longitudinal effects and broader cultural contexts.

The objective of this study is to explore public sector clinicians’ perspectives on factors associated with relapse in schizophrenia within a South African context, focusing on structural, social and environmental contributors beyond treatment non-adherence. Three focus groups were conducted with 14 public-sector clinicians (psychiatrists, medical officers, psychiatric registrars and psychiatric nurses) with ≥5 years’ experience in schizophrenia care. Data were analysed using reflexive thematic analysis to identify themes relating to relapse risk. Clinicians consistently described medication non-adherence, often the immediate trigger for relapse, as emerging from interrelated health system and socio-structural constraints, including poverty, unemployment, unsafe communities, fragmented services and stigma. Limited access to newer-generation antipsychotics, medication stockouts, early discharges due to bed shortages and scarce post-discharge rehabilitation compounded relapse risk. Family support was frequently undermined by financial strain and competing demands, while crime and gang violence discouraged clinic attendance. Stigma within both communities and healthcare settings reduced trust and engagement. In this lower-middle-income country context, relapse prevention depends on integrated strategies that combine clinical management with interventions addressing structural and social determinants. Policy priorities include strengthening primary-level mental healthcare, ensuring medication supply continuity, expanding supervised care and vocational programmes, implementing stigma-reduction initiatives and fostering intersectoral collaboration to address safety and spatial inequities in service provision.

Harmful and hazardous alcohol use poses significant health risks globally. Brief interventions (BIs) have shown promise in reducing hazardous alcohol use, but fidelity to the protocol needs to be ensured, especially in low- and middle-income countries like Tanzania. Our study aimed to evaluate the psychometric properties of the Tanzanian-Swahili version of the BI adherence scale (BAS) adapted to Tanzanian culture. A psychometric evaluation of the BAS was conducted as part of the “Punguza Pombe Kwa Afya Yako” intervention. Translation and adaptation of the BAS were supervised by a committee of experts at Kilimanjaro Christian Medical Centre in Moshi. Data analyses included exploratory structural equation modeling and confirmatory factor analysis to assess construct validity. Reliability was evaluated using internal consistency measures. Translation and adaptation of the BAS yielded a final Tanzanian-Swahili version, featuring modifications to align with the Tanzanian context. The internal structure evaluation favored a three-factor solution, as the model demonstrated slightly superior internal consistency and fit. This study developed the first validated Swahili version of BAS in Tanzania. It is evaluated to be a reliable instrument to assess healthcare providers’ adherence to BI. The use of BI and BAS should be included in the standard clinical practices.

Common perinatal mental health conditions are especially prevalent in low- and middle-income countries (LMICs) and are associated with numerous adverse effects. While complex interventions have been developed and tested, there has been limited exploration of how these interventions can be implemented and sustained at scale. This scoping review aims to explore the strategies discussed for scaling, spreading and sustaining complex perinatal mental health interventions in LMICs. We conducted a systematic search in APA PsycINFO, Cinahl, Medline (EBSCOhost), Embase, MIDIRS (Ovid Online) and ProQuest for reports published between January 2010 and November 2023, using search terms related to scaling innovations, perinatal mental health and LMICs. We also conducted a grey literature search using the websites of organisations that focus on maternal mental health. We identified 42 information sources. Using thematic synthesis, scale, spread and sustainability strategies regarding workforce diversity, integration of health services, tool and method development, adaptation, training, supervision and support and stakeholder engagement were identified. The study identified persistent gaps in the literature around how interventions move beyond early adaptation and implementation phases. These included the need for more consistency and shared understanding around terminology and increased interdisciplinary collaboration, especially drawing on fields such as implementation science. The findings from this review open new avenues for research and policy on expanding perinatal mental health interventions in LMICs, with an emphasis on long-term sustainability and interdisciplinary perspectives.

Firearm suicide among adolescents in the United States has increased in recent years, with Black and Latino youth experiencing disproportionately rising rates. Although firearm violence and mental health disparities have received growing attention, the structural conditions that shape racial inequities in firearm suicide risk remain insufficiently examined. This overview applies an intersectional and structural lens to analyze how systemic inequities including residential segregation, concentrated disadvantage, punitive school discipline practices, underinvestment in mental health infrastructure and commercial determinants of firearm availability contribute to differential suicide risk. Drawing on interdisciplinary literature and recent epidemiologic data, the manuscript maps the causal pathways through which structural racism and institutional inequities shape exposure to community violence, access to culturally responsive care, crisis response practices and household firearm environments. It further examines how these mechanisms interact with gender and lethal means availability to amplify disparities in suicide mortality. The analysis underscores the importance of multilevel, upstream interventions that address structural inequities, strengthen community-based supports and reduce access to lethal means. By reframing firearm suicide as a structurally patterned outcome rather than an individual-level phenomenon, this work advances a socio-ecological understanding of adolescent suicide prevention with implications for structural reform and suicide prevention policy.

This study explores the complex interplay between academic, social and cultural pressures and the mental health of female university students in Pakistan. Operating within a collectivist society, these students face unique challenges, including high academic expectations, financial constraints and rigid gender roles, which significantly increase their vulnerability to psychological distress, anxiety and depression. Despite the high prevalence of these issues, help-seeking behaviours remain markedly low. This research investigates the formidable barriers to seeking professional psychological support, focusing on the potent influence of pervasive social stigma, fear of reputational damage and a widespread lack of mental health literacy. Cultural norms that prioritize family honour and misinterpret emotional suffering as personal weakness further compound these obstacles, often leading to silence and isolation. Utilizing a qualitative approach, this paper highlights the critical need for culturally sensitive, university-based mental health interventions. Recommendations include establishing accessible on-campus counselling services, implementing de-stigmatization awareness campaigns and integrating mental health education into the academic curriculum to foster a more supportive environment and encourage proactive help-seeking among this demographic.

This article presents the findings from a qualitative study that explored the impact of humanitarian shelter programming on the well-being of Ukrainians who suffered damage to their homes following the full-scale Russian invasion in the Kharkiv region in eastern Ukraine. The impact of humanitarian interventions on mental health is neglected in the global mental health literature. Findings suggest that shelter repairs alone are important to participants’ sense of well-being, because home means ‘everything’ for them and is a focal point for their lives. Homemaking support and internal repairs are signposted as relevant to their well-being. Focus on their lived experience also highlights the importance of understanding the historical and socio-economic context to understand participants’ decisions to stay in or return to their damaged homes amid continued conflict. Beyond mental well-being, home is a site of food security. Family, friends, neighbours and communities are also highlighted as important sources of support that significantly contribute to their well-being. Mobile communication is an important means to stay connected to their loved ones. Findings also suggest that the mental health and psychosocial support in conflict settings should focus on community revitalisation and collaboration with other humanitarian sectors.

Young migrants encounter heightened challenges as the intersection of their youth and migrant identities magnifies the influence of risk factors for suicide. Social media offers a platform for young migrants to express emotions, seek support and connect with others, often anonymously. However, how they communicate about self-harm and suicide online remains underexplored. This qualitative study involved 17 online interviews with young migrants aged 15–25 years. Transcribed data were coded and thematically explored using Braun and Clarke’s reflexive thematic analysis methodology. Four key themes were identified: (1) Exposed and isolated: The emotional toll of viewing self-harm and suicide-related content on young migrants; (2) Connected but at-risk: The dual role of social media in migrant belonging; (3) Digital belonging across borders: Benefits and strains of staying connected; and (4) Helpful and harmful: The dual nature of support on social media. Social media has a complex impact on young migrants, offering both protective and harmful effects. While exposure to distressing or discriminatory content may exacerbate feelings of isolation and disconnection, social media can also promote belonging, cultural understanding and resilience. It also provides accessible support, though poor-quality advice and stigma may deter help-seeking. These insights can inform culturally responsive mental health interventions.

Despite the widely use and multiple validations of the EURO-D scale, its factor structure is still under debate. Exploratory Graph Analysis (EGA), a novel network psychometric method, offers a promising approach to examining dimensionality. Methodology: 45,390 participants (mean age = 71.27, 57.4% women) from 26 European countries. The sample was randomly split into a derivation sample (n = 22,823) and a cross-validation sample (n = 22,567). EGA was applied to the derivation sample to determine the structure of the EURO-D scale, utilizing two estimation methods: Graphical Least Absolute Shrinkage and Selection Operator (GLASSO) and Triangulated Maximally Filtered Graph (TMFG). The identified factor structures were then tested via Confirmatory Factor Analysis (CFA) in the cross-validation sample for model fit. Results: EGA consistently revealed a two-factor structure with minor differences in the placement of suicidality and fatigue items across estimation methods. CFA results confirmed an adequate model fit for both solutions. Conclusion: This study combines exploratory (EGA) and confirmatory (CFA) approaches, supporting a two-factor structure for the EU-RO-D scale with alternative placements for fatigue and suicidality items. Results are discussed in contrast to previous studies reporting two and three-factor solutions with different assignments of these items.

Schizophrenia (SCZ) and alcohol use disorder (AUD) are associated with physical decline and motor dysfunction, but objective wearable-based motor assessments remain underutilized in psychiatric research. This study compared handgrip strength (HGS) and gait features between healthy controls (HCs) and individuals with SCZ or AUD using wearable sensors. A total of 434 participants (HCs: n = 210; AUD: n = 80; SCZ: n = 144) completed instrumented Timed Up and Go, walking, and HGS tests. Fifteen motor features were extracted and analyzed using multivariable linear regression adjusted for age, sex, and BMI. Five features—HGS, relative HGS (rHGS), walk quality index, symmetry index, and mid-turning phase duration—significantly differentiated one or both diagnostic groups from HCs. In AUD, rHGS showed moderate associations with multiple gait parameters, consistent with more widespread motor dysfunction. In SCZ, these associations were weaker, suggesting reduced coupling between upper- and lower-limb motor function. Both groups showed reduced HGS and gait alterations, but with distinct coordination patterns. These findings support wearable-based grip and gait metrics as scalable and objective motor functional markers in SCZ and AUD.