The gap between mental health conditions and care uptake remains a global challenge, despite the availability of effective and affordable treatments. This gap is driven by demand-side barriers, such as lack of mental health literacy (MHL), stigma, etc., that hinder help-seeking. In this systematic review, we critically appraise interventions aimed at promoting help-seeking for mental health conditions. The review protocol was prospectively registered with PROSPERO (registration number CRD42021273843). A systematic search was conducted across MEDLINE, PsycINFO, Embase, Global Health, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Central Register of Controlled Trials (CENTRAL). Only RCTs published after 2016, testing interventions with the aim of improving help-seeking behaviors, intentions and attitudes for any mental health conditions, were included. Due to the heterogeneity of outcomes and measures used in the studies, a narrative synthesis was conducted to examine the evidence. Fifty-four studies met the inclusion criteria. Our review confirms that MHL or psychoeducation, motivational interviewing (MI) and social contact interventions effectively improve help-seeking attitudes (n = 10), intentions (n = 17) and behaviors (n = 16). Multi-component MHL and MI-based strategies enhance help-seeking behaviors, while social contact online interventions enhance intentions. MHL/psychoeducation was effective across all outcomes, particularly when combined with other strategies. Despite a rise in help-seeking research, many studies lacked standardized frameworks, making cross-intervention comparisons difficult. Future work should align with theoretical models of help-seeking and explore mechanisms of change to better understand the link between intentions, attitudes and behaviors.

About 10 million people worldwide chew khat daily. Chronic khat use is a public health problem associated with physical and psychological impacts, such as mental health disorders and social consequences. The use of khat is increasing dramatically in Ethiopia among the young population. There are controversies over the legal status and health effects related to the consumption of khat. Despite the existing controversies, the problem is increasing with its detrimental impact. Policymakers need to enforce education campaigns aimed at awareness creation on the impact of khat use. It is important to consider legally restricting the availability and use of khat in vulnerable populations, such as children under 18 years, individuals with mental disorders and pregnant women, as well as in settings such as hospitals and schools.

Suicidal ideation and trauma exposure are significant health challenges worldwide, and their interaction increases their burden on individuals and communities. However, limited research has been devoted to these conditions in low- and middle-income countries, where the majority of the burden of these disorders exists. Additionally, unique cultural factors that may contribute to differential relationships in these symptoms and disorders make this an important area to explore. This study examines relationships between the number and types of adverse exposures, PTSD symptoms and severity, depression and suicidal ideation in a sample of Cambodian women with experiences of trauma using logistic and linear regressions. Overall, PTSD severity significantly contributes to suicidal ideation, with hyperarousal symptoms playing a particularly influential role in this association. Further, adverse experiences, including physical abuse and parental mental health problems, contributed significantly to increased suicidal ideation. Lastly, depression severity partially mediates the relationship between PTSD severity and suicidal ideation. These results illustrate the significant role of PTSD in the experience of suicidal ideation, particularly within regions like Cambodia with high trauma loads. These findings point to psychological constructs that may be especially important to include in suicidality screening tools and to target within prevention and intervention efforts.

Mental health conditions, including anxiety disorders, are a major cause of morbidity across Sub-Saharan Africa. There are scarce mental health resources and providers in Madagascar, which substantiates a need for clear and accessible assessment tools for assessing mental health conditions. Yet, before this study, there were no validated scales to measure anxiety disorder symptoms in Madagascar. We assessed the psychometric properties of the culturally adapted 10-item Hopkins Symptom Checklist (HSCL-10-SW) anxiety subscale in the Bay of Ranobe region, in southwestern Madagascar. The study participants were part of the ongoing HIARA cohort study. The HSCL-10-SW includes the original HSCL-10 anxiety subscale in addition to three culturally relevant items that were derived through qualitative research: irritability, lost in thoughts/overthinking and forgetfulness. We administered the HSCL-10-SW to 809 participants (41.2% males) aged 16 years (mean age 36.9) and above in October 2023. Our exploratory factor analysis supported a two-factor structure: Fear Anxiety and Cognitive-Somatic Anxiety. We found discriminant validity between Fear anxiety and Depression factors. Although the HSCL-10-SW demonstrated acceptable psychometric validity, we suggest that additional qualitative studies should be conducted to explore the local conceptualization of anxiety disorders in southwestern Madagascar.

Chronic stress can lead to physical and mental health conditions. This study aimed to identify the different stress profiles and stress relief methods among Filipinos living in the Philippines using latent class analysis. A secondary analysis of a cross-sectional study was employed in this study. The stressors and stress-relief practices among Filipinos were investigated using the I-HEART-FILIPINOS data set. Latent class analysis was used to identify the different profiles of stress causes and management methods among 1,196 Filipinos residing in the Philippines, specifically the Northern Luzon area. Four stress-related profiles were identified: (1) low financial stress relieved by eating and exercise; (2) work-related stress relieved by self-care; (3) familial and economic turmoil relieved by eating, exercise and prayer; (4) high financial stress relieved by staying at home and remaining indoors. The four-class solution explained 58% of the variation in the data through classification. Disparities were observed between classes in terms of emotional distress and sociodemographic variables, implying how sociocultural factors could affect stress presentation and management in Filipinos. The findings of this study inform the development of stress management interventions specifically designed to address the needs of underserved populations in the Philippines and neighboring countries to improve overall health.

The study evaluated a training programme adapted from the WHO mhGAP to enhance suicide prevention knowledge, attitudes, and confidence among 436 Community Health Workers (CHWs) in India. A pre–post intervention design assessed outcomes at four time points using a structured questionnaire, analysed via repeated-measures ANOVA. Mean knowledge scores increased from 6.32 ± 0.14 at baseline to 11.12 ± 0.12 post-training, then levelled off at 10.10 ± 0.14 and 10.10 ± 0.13 at 6 and 12 months, respectively; similarly, mean confidence scores increased from 4.96 ± 0.11 to 7.84 ± 0.11, remaining at 7.28 ± 0.10 and 7.44 ± 0.10 at the same time points. Mean attitude scores changed slightly from 41.00 ± 0.38 to 42.72 ± 0.43 over 12 months, indicating increased negative attitudes. Knowledge and confidence scores across time points were statistically significant (p < 0.05); however, this was not observed for attitude scores. Improvements were associated with CHW cadre and educational status. Post-training, CHWs demonstrated sustained improvements in knowledge and confidence for identifying, referring, and managing suicidal behaviour over 12 months, with those having lower baseline scores improving uniformly following the programme.

Mental health disorders are prevalent among adolescents and evidence suggests that stigma, poor mental health literacy (MHL) and access are key barriers to help-seeking for mental health difficulties in adolescence and throughout life. The study purpose is to assess existing mental health knowledge, stigma and help-seeking behaviour among adolescents in Uganda. A total of 889 secondary school students in Kampala completed standardised self-report questionnaires. The results reveal low-to-moderate levels of mental health knowledge (MAKS, range 12–60, M = 16.35, SD = 5.18, AMHLQ, range 33–138, M = 64.01, SD = 12.98), stigma (RIBS, range 4–20, M = 12.30, SD = 3.52) and prejudice towards people with mental illness (PPMI-TR, range 133–19, M = 73.85, SD = 13.38). Knowledge correlated with stigma (r = 0.166 and r = 0.135, p < 0.01), and with one’s capacity to assess own mental health (SELF-I range 5–25, M = 12.34, SD = 4.4). Adolescents are open to seek help from mental health professionals but reluctant to seek it from most accessible help sources like schoolteachers. The findings provide insights for future mental health-promoting and anti-stigma interventions for adolescents.

Individuals from refugee backgrounds may experience higher rates of mental and physical health problems compared to the general population, yet the interdependence of these outcomes within couples remains poorly understood. This study aims to understand the relationship between post-traumatic stress disorder (PTSD), socio-economic status and self-rated general health (SRGH) among couples from refugee backgrounds living in Australia. Couples were nested within dyads using multi-level frameworks and mixed-effects logistic regression (n = 436 dyads). In respondents with likely PTSD, 61% of their partners were also likely to have PTSD compared to only 26% of partners in refugees with unlikely PTSD. After controlling for socio-economic factors, respondents with likely PTSD were significantly less likely to rate their health as ‘excellent/very good’ (OR = 0.20), compared to those with unlikely PTSD. Partners with likely PTSD were also less likely to rate their health as ‘excellent/very good’ (OR = 0.54). Individuals who were older, female, born in the Middle East, experienced less community support or more economic stressors were at greater risk of poorer SRGH. PTSD and SRGH had an interdependent effect within couples from refugee backgrounds. Familial and psychosocial contexts must be considered when developing health promotion and policies for refugee communities.

The role of Law enforcement agencies (LEA) is significant in suicide prevention efforts as first responders. Nevertheless, no published study to date has systematically compiled the body of knowledge about suicide prevention efforts involving LEA. The current scoping review aims to methodically map and examine the peer-reviewed literature and grey literature on the role of LEA in suicide prevention. Electronic searches of the databases like Medline, PsycINFO, Google Scholar, Web of Science, Scopus, CINAHL and Google were conducted using a comprehensive search strategy to identify relevant resources. Grey literature was searched searches were undertaken on relevant databases and, as well as government and organisational websites. The reporting of the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. The inclusion criteria comprised research articles, reports, and guidelines/policy documents on the role of law enforcement agencies (LEAs) in suicide prevention. Studies on prevalence, custodial settings, non-English publications, and reviews were excluded. Inclusion criteria comprised research articles, reports and guidelines/policy documents focusing on law enforcement’s role in suicide prevention. Studies focusing solely on prevalence or epidemiology, studies confined strictly to custodial settings, publications not in English and systematic reviews or meta-analyses were excluded. Out of 3,327 records screened, the full texts of 82 resources were included in the review. All the resources identified were categorised between peer-reviewed literature and grey literature. Resources were thematically categorised based on functional roles into- I. Strategic and System-Embedded Roles of LEA, II. Capacity Building and Training Oriented Engagements, III. Surveillance Reporting and Data Systems Role, IV. Community Facing and Preventive Engagement, and V. Means Restriction and Environmental Prevention Roles. The chronological development of the resources was inconsistent. Most resources were from high-income countries, focusing on the evaluation of training, capacity building programmes, surveillance initiatives and the exploration of varied roles of LEA across custodial, community and crisis settings and other interdisciplinary collaborations. Notably, the resources show increased disparity in quantity and research methodological approaches across geographies. The review highlights substantial heterogeneity and a limited resource base from low- and middle-income countries on the role of LEA in suicide prevention, with a dearth of structured, evidence-based, scalable models in these settings. These gaps point to an urgent need for locally relevant and cross-sectoral models that position law enforcement as integral partners in suicide prevention efforts, especially where these agencies play a major role as first responders.

Evidence on the association between self-esteem and suicide risk (SR) among adolescents in Latin America is limited. To address this gap, we examined this association in secondary school students from northern Peru. We performed an analytical cross-sectional study based on secondary data collected in 2022 from 1,314 adolescents attending 5 secondary schools. SR was assessed using the Plutchik Suicide Risk Scale, while self-esteem was measured with the Rosenberg Self-Esteem Scale. Prevalence ratios (PRs) and corresponding 95% confidence intervals (CIs) were calculated through Poisson regression with robust variance, both in crude and adjusted models. The study population comprised 54.2% males, with the majority (69%) in middle adolescence. Low self-esteem was identified in 44.7% of participants, while 29.4% presented average self-esteem. Overall, 33.3% of adolescents reported SR (95% CI: 30.8–36.0). In crude analyses, both average and low self-esteem were associated with a higher prevalence of SR compared with high self-esteem (PR = 2.30 and PR = 4.11, respectively). In adjusted models, average self-esteem was associated with a 42% higher prevalence (PR = 1.42) and low self-esteem with a 67% higher prevalence (PR = 1.67). One in three adolescents presented an SR, underscoring the need to integrate school- and community-based programs that promote self-esteem within suicide prevention.

Loneliness is a public health concern influenced by environmental contexts. Among youth, it manifests differently at school and home, yet research in low-resource settings is limited. This study examined patterns of loneliness and how economic and sociodemographic factors correlate with it in school and home environments among Kenyan youths in the Nairobi Metropolitan Area. A cross-sectional study was conducted with 1,972 youths aged 14–25 years using a self-administered questionnaires. Analyses included paired t-tests, ANOVA and generalized estimating equations (GEEs). Among participants with complete paired data (n = 1,166), loneliness was significantly higher at school (M =23.15) than at home (M = 21.53). Females reported higher loneliness than males (school: p=.011; home: p<.001). Education level and marital status were significantly related to loneliness at home (p<.001 and p=.022) but not at school. Loneliness at home was higher among the poorest households compared to middle-class households (mean difference =2.556, p=.048). GEE models confirmed these patterns and indicated that employment status influenced differences in loneliness between home and school settings. School settings were linked with higher loneliness, while home loneliness varied by socioeconomic and demographic factors, underscoring the need for targeted interventions addressing environmental and social determinants of youth loneliness.