Psychiatric rehabilitation is a crucial aspect of recovery-oriented mental healthcare, yet it remains underdeveloped in Oman. This paper reviews the current state of rehabilitation services, identifying systemic gaps in in-patient, day care and community-based provisions. Services are fragmented, lacking adequate multidisciplinary integration, sufficient community rehabilitation and supported housing, which leads to prolonged hospital stays. Additionally, broader challenges such as stigma and limited intersectoral collaboration hinder service development. The paper suggests practical strategies to enhance rehabilitation services, including the establishment of multidisciplinary teams, expansion of community programmes, provision of supported accommodation and workforce training, all aligned with Oman Vision 2040 and the principles of recovery-oriented mental health care.

Despite the existence of effective public mental health (PMH) interventions, only a minority across the European region receive treatment for mental health conditions (MHCs). Even fewer receive interventions to prevent MHC-associated impacts, with negligible coverage of interventions to prevent MHCs, or promote mental well-being and resilience. Various reasons account for implementation failure which breaches the right to health and results in population scale preventable suffering, broad impacts and associated economic costs. Public mental health involves a population approach to improve coverage, outcomes and coordination of PMH interventions. Required actions to scale up PMH implementation include effectively making the case through assessment of PMH need, highlighting economic impacts of PMH implementation failure and improved coverage, and coordinated advocacy and leadership. Public mental health practice involves the use of PMH needs assessment to inform choice of interventions, policy development, and required coverage and resources for effective PMH intervention delivery by different sectors. This is supported by the collection of PMH-relevant data. Further actions to scale up PMH implementation include adopting human rights-based approaches and legislation, PMH training to different sectors and improved population PMH literacy, maximizing existing resources, settings-based and integrated approaches, use of digital technology, prioritizing interventions with large population impact, and implementation-focused research. Scaled up PMH implementation results in broad population impacts, achievement of a range of policy objectives, sustainable reduction in impacts of MHCs and promotion of mental well-being across the population of the European region. Associated economic savings also make PMH practice an essential part of sustainable economic development.

Young people (YP) face numerous challenges that can lead to mental health difficulties, yet mental health systems worldwide are often unprepared to support those affected. Club Synergy, a low-threshold, trauma-informed digital and face-to-face service for YP aged 14–25 with emotional and/or behavioural difficulties, was established in Georgia in 2019. This study examined the characteristics, clinical effectiveness and outcome predictors of YP presenting to Synergy. Quantitative data, including clinical outcome measures and treatment details, were collected pre- and post-treatment and at three-month follow-up over a 21-month period (November 2019–July 2021). Of 266 YP who completed treatment, most were female (66.9%; mean age 19.95, SD 3.13). Common presenting difficulties included emotional instability (77.1%), anxiety and restlessness (63.5%), interpersonal problems (53%) and low mood (48.5%). Among 144 who completed the ACEs measure, 57.6% reported four or more adverse childhood experiences. Most (67.7%) received transdiagnostic programmes; 74.1% of these completed the Emotional Regulation module (mean 7.18 sessions, SD 7.23). Significant reductions in depression and anxiety, and improved functioning, were observed post-treatment and at follow-up (p < 0.01). Quality-of-life gains were not sustained at follow-up (p = 0.14). Satisfaction was high (94.8%). Trauma-informed, transdiagnostic services grounded in a biopsychosocial model appear acceptable and potentially beneficial for YP at risk of or experiencing common mental health symptoms.

The National Health Service (NHS) 10-year health plan for England calls for transformational changes to service delivery, encompassing three fundamental ‘shifts’: hospital to community, analogue to digital and sickness to prevention. This editorial reflects on the plan, the three shifts and their implications for mental health service provision across the life course.

The developing field of infant mental health encompasses a young child’s capacity to form relationships, explore their environment and receive emotion regulation from their caregivers. Neural connections formed during these early years shape the foundation for future cognitive and emotional development and lifelong relational patterns. Without sufficient support, environmental stressors during this period can contribute to an increased lifelong risk for poor mental and physical health. This time of peak neuroplasticity also offers a unique opportunity for positive intervention, potentially altering developmental trajectories across the lifespan. Despite this, infant mental health is often overlooked in psychiatric care. This article highlights the relevance of infant mental health to all psychiatric specialties, outlines its importance to national public health initiatives and summarises the existing evidence base in support of specialist infant mental health services.

Childhood and adolescent obesity has emerged as one of the most pressing public health challenges worldwide. The persistence of excess weight from early life into adulthood together with its associated health consequences underscores the importance of effective prevention strategies. However, obesity in early life is driven by complex interactions between biological susceptibility, lifestyle behaviours, social determinants and obesogenic environments, making prevention particularly challenging. This review synthesises current evidence on childhood obesity prevention, critically examines the effectiveness of existing interventions and discusses key challenges and opportunities for improving their impact. Evidence indicates that preventive strategies can improve dietary habits, physical activity and other lifestyle behaviours, although their effects on anthropometric outcomes are generally modest. Interventions addressing multiple determinants and involving key settings such as families, schools and communities appear more likely to achieve meaningful and sustained effects. Translating evidence from controlled studies into effective, scalable real-world strategies remains a major challenge. Contextual factors, sustainability, stakeholder engagement and policy support play a critical role in determining intervention success. In this context, systems-oriented and participatory approaches offer promising opportunities to design coordinated, multilevel strategies. Future efforts should focus on early-life prevention, equity-oriented actions and the integration of scientific evidence into public policies to achieve sustainable population-level impact.

Late HIV diagnosis increases morbidity and mortality. In this retrospective cohort study on the national HIV register, we analysed risk factors for late HIV diagnosis among newly registered people living with HIV (PLWH) between 2008 and 2023, using the updated definition. Of 2683 PLWH registered, 1813 (67.6%) were newly diagnosed with CD4+ T-cell count available ≤90 days for 1572 (86.7%). Eighty-seven of the 609 (14.3%) individuals with CD4+ T-cell count <350/μL had recent infections and were reclassified as non-late. Of the newly diagnosed, 50.3% were diagnosed late. Multivariable analysis identified higher age as an independent risk factor for late diagnosis (adjusted OR 1.42 per ten years, 95% CI 1.30–1.56). Of the Finnish-born, females had lower odds than males (aOR 0.59, 95% CI 0.39–0.88). Asian-born (aOR 6.83, 95% CI 3.49–13.35) and African-born females (aOR 3.26, 95% CI 1.58–6.73) had significantly higher odds than Finnish-born females. In urban municipalities, men who have sex with men had lower odds than individuals with heterosexual transmission (aOR 0.55, 95% CI 0.40–0.76). Higher age was the most important factor for increasing the proportion of late diagnoses. We recommend enhanced testing and risk awareness for older adults and migrants from high-prevalence countries.

The recent study by Aron et al about lithium deficiency and the onset of Alzheimer’s disease provides a valuable explanatory framework for understanding how very small doses of lithium, delivered via environmental exposure, can exert neuroprotective effects. It also contains results which will need to be reconciled with foundational chemistry and existing evidence and which could be potentially misleading. The suggestion that lithium orotate (LiO) exhibits benefits relative to the more traditionally used lithium carbonate (LiC) requires further scrutiny in light of the following arguments: (a) no study has demonstrated the presence of stable LiO in physiological fluids; (b) acid–base chemistry predicts that LiO will be largely protonated in the stomach, causing it to dissociate and be absorbed as Li+; (c) experimental studies indicate that LiO and LiC have comparable pharmacokinetics after oral administration; and (d) previous research has shown that LiC also has neuroprotective effects, including at very low doses. Disproportionate focus on a specific lithium salt could have safety implications and may distract from answering fundamental questions about the effects of very low doses of lithium. More experiments are needed to provide evidence of a stable LiO complex in physiological fluids before this becomes the main form of lithium in future clinical trials.

Self-harm and suicide are major public health concerns and leading causes of mortality worldwide, highlighting a pressing need for policymakers to identify and implement cost-effective interventions. This systematic review (PROSPERO registration #CRD42023460339) followed the PRISMA guidelines and aimed to synthesize the available cost-effectiveness evidence for the prevention of self-harm and suicide. Systematic searches were performed in MEDLINE, Embase, PsycINFO, CINAHL, Econlit, and ProQuest to identify full economic evaluations and return-on-investment studies on preventive interventions for self-harm and suicide published up to January 15, 2026. Methodological quality was assessed using Drummond’s 10-item checklist, and findings were synthesized narratively. A total of 69 eligible studies evaluated 22 types of interventions: three universal, five selective, five indicated, and nine multi-level. Most studies were rated as high-quality (n = 61/69) and conducted in high-income countries (HICs) (n = 63/69), primarily assessing the cost-effectiveness of universal interventions like means restriction (n = 6), selective and indicated interventions like psychotherapy (n = 30), support services (n = 15), and medication (n = 5). Evidence consistently found that interventions for self-harm and suicide prevention were generally cost-effective or cost-saving. Strong evidence supported the cost-effectiveness of several universal (e.g. awareness training), selective (e.g. psychotherapy, support services), indicated (e.g. suicide risk screening, support services, psychotherapy for adults in HICs like Australia, US, Canada), and multi-level interventions. However, more economic evaluations are needed for interventions targeting older adults and children in all countries, especially in low- and middle-income countries, where evidence is lacking.

It is well-known that physical exercise brings a range of benefits for physical and mental health. This review specifically considers the impact of physical activity on mental health and focuses on the increasing knowledge of the neurobiological actions of exercise. It outlines the effects of stressors on physiology and, consequently, mental health and explores the concept of neuroplasticity. It assesses the wide-ranging evidence from animal and human studies consistent with exercise modulating neuroplasticity processes, such as stimulation of long-term potentiation, synaptic growth and neurogenesis. Mechanisms underpinning these effects are presented: stimulation of angiogenesis, production of neurotrophic factors, modulation of stress and inflammatory responses, metabolic adaptation and epigenetic modification. Finally, the relevance of the evidence base to clinical practice is considered. In particular, it is noted that discussion of these positive impacts of exercise on ‘brain health’ may increase motivation to participate in physical activity in some patients.