The global health community has recognized that social determinants of health account for most of the inequities of health outcomes, including mental health outcomes, across and within countries. Strategies to overcome such inequities must focus on modifiable social factors. In this viewpoint, we argue for the preeminence of employment among social determinants of mental health for several reasons. People with mental health disabilities want to work, and a well-validated model of supported employment that is effective and cost-effective now exists. Employment leads to improvements in income, daily structure, self-esteem, social support, community integration and illness management, and people who are employed experience fewer emergencies and hospitalizations. Employment is empowering because people can use added income to activate their own choices regarding other social determinants. Supported employment actualizes the recovery paradigm: People who are employed in competitive jobs of their choice develop a meaningful functional life, increased self-esteem and new social supports. We provide examples of supported employment developments in diverse settings and discuss the implications of scaling up these services worldwide.

The current study aimed to test the association between environmental degradation, eco-anxiety and post-traumatic symptoms, and whether coping strategies mediate the association between these variables among a sample of Palestinian adults. The sample of our study consisted of 554 Palestinian adults, of whom 392 identified as female and 162 as male. Participants’ age ranged from 19 to 54 years old (M = 35.8, SD = 12.31). They were all recruited from online advertisements, e-mail campaigns and social media. The findings of our study revealed that post-traumatic stress symptoms positively correlated with environmental degradation, eco-anxiety and avoidant coping and negatively correlated with problem-focused coping and emotion-focused coping. Results of structural equation modeling revealed that coping strategies mediated the association between environmental degradation, echo-anxiety and post-traumatic stress symptoms. The findings of our study emphasize the need for tailored psychological support and coping strategies for individuals experiencing eco-anxiety and post-traumatic stress symptoms in the face of environmental challenges.

Evidence on the effectiveness and implementation of mental health and psychosocial support (MHPSS) interventions for men in humanitarian settings is limited. Moreover, engagement and retention of men in such interventions has been challenging. Adaptations may therefore be required to improve the appropriateness and acceptability of these interventions for men. This study conducted formative research and examined the feasibility of combining an MHPSS intervention, Self-Help Plus, with a brief intervention to reduce harmful alcohol use among refugee men in Uganda. We conducted a cluster randomized feasibility trial comparing the combined alcohol intervention and Self-Help Plus, Self-Help Plus alone and enhanced usual care. Participants were 168 South Sudanese refugee men in Rhino Settlement who reported moderate or high levels of psychological distress. Session attendance was adequate: all sessions had at least 69% of participants present. Participant outcome measures, including symptoms of psychological distress, functional impairment, self-defined problems, depressive symptoms, post-traumatic stress symptoms, overall substance use risk, substance specific risk (alcohol, cannabis, stimulants and sedatives) and well-being, were sensitive to change. A combined approach to addressing mental health and alcohol use appears feasible among men in refugee settings, but further research is needed to examine the effectiveness of combined interventions among men.

Studies indicate a high burden of mental health disorders among female sex workers (FSWs) in low- and middle-income countries (LMICs). Despite available data on suicidal ideation and suicide attempts among FSWs, little is known about suicide deaths in this hard-to-reach population. This study aims to examine the extent to which suicide is a cause of maternal mortality among FSWs, the contexts in which suicides occur, and the methods used. From January to October 2019, the Community Knowledge Approach method for identifying cause-specific deaths in communities was employed across eight LMICs (Angola, Brazil, the Democratic Republic of the Congo (DRC), India, Indonesia, Kenya, Nigeria, and South Africa). A total of one thousand two hundred eighty FSWs provided detailed reports on two thousand one hundred twelve FSW deaths in the preceding 5 years, including 288 (13.6%) suicides, 178 (61.8%) of which were maternal. Of these maternal suicides, 57.9% occurred during pregnancy (antepartum), 20.2% within two months of delivery (puerperium), and 21.9% in the 2–12 months following delivery (postpartum). The highest proportion of suicides occurred in Nigeria, Kenya, and DRC in sub-Saharan Africa. A total of 504 children lost their mothers to suicide. Further research is needed to identify interventions for suicide risk among FSW mothers.

This study investigates the stigma against people with mental illness in Bangladesh through in-depth interviews with 14 patients and 9 healthcare professionals, and 33 focus group discussions with people without mental illness. The research has delved into the understanding of different types of stigma against mental illness in the context of Bangladesh. The findings revealed four types of stigma which were categorized into four themes namely self-stigma, public stigma, professional, and institutional stigma. Patients had internalized negative attitudes, thereby discriminated toward themselves. The public discriminated against patients because of believing in prejudices against them. Other health professionals had negative conceptions toward patients, and they devalued mental health professionals (MHPs). A culture of negative attitude and belief had emerged in institutional settings which encouraged discrimination. Policymakers and healthcare professionals can use the findings to develop a mental health service by addressing the stigma. Mental health practitioners can assess the impact of stigma to improve the mental well-being of their patients. Students and workplace staff will benefit from intentional or unintentional discrimination in educational institutions and workplace settings by addressing the effects of stigma. Importantly, other health care providers will be aware of their thoughts against patients and MHPs.

Youth in sub-Saharan Africa (SSA) face limited access to professional mental health resources. A comprehensive assessment of the prevalence of mental disorders would build an understanding of the scope of the need.

We conducted systematic searches in PsycInfo, Pubmed, AfriBib and Africa Journals Online to identify prevalence rates for five disorders (anxiety, depression, conduct disorder, attention problems and post-traumatic stress) among SSA youth with a mean age of less than 19 years. We calculated a random-effects pooled prevalence for each disorder and assessed possible moderators.

The meta-analysis included 63 studies with 55,071 participants. We found the following pooled prevalence rates: 12.53% post-traumatic stress disorder (PTSD), 15.27% depression, 6.55% attention-deficit hyperactivity disorder, 11.78% anxiety and 9.76% conduct disorder. We found high heterogeneity across the studies, which may have resulted from differences in samples or measurement tools. Reported prevalence rates were not explained by the sample (i.e., special or general population), but whether the psychometric tool was validated for SSA youth affected the reported prevalence of PTSD and anxiety. In a meta-regression, prevalence rates were associated with the disorder type, with a higher prevalence of depression and PTSD. We found the mean age significantly moderated the prevalence in univariate meta-regression, with increased age correlated with greater prevalence.

Our findings suggest there is a need to explore reasons for varying prevalence rates further and to develop interventions that support youth mental health in SSA, particularly interventions for depression and PTSD. Limitations included a lack of standardization in psychometric tools and limited reporting on research methods, which influenced quality rating. Importantly, the search only considered studies published in English and was conducted 2 years ago. Although recent estimates reported slightly higher than our prevalence estimates, these reviews together highlight the prevalence and importance of youth mental health difficulties in SSA.

Evidence is scarce in terms of tracking the progress of implementation of mental healthcare plans and policies (MHPPs) in Europe, we aimed to map and analyze the content of MHPPs across the WHO European region.

We collected data from the WHO Mental Health Atlas 2011, 2017 and 2020 to map the development of MHPPs in the region. We contacted 53 key informants from each country in the European region to triangulate the data from WHO Mental Health Atlases and to obtain access to the national mental health plans and policies. We analyzed the content of MHPPs against the four major objectives of the WHO Comprehensive Mental Health Action Plan, and we also focused on the specificity and measurability of their targets.

The number and proportion of countries which have their own MHPPs has increased from 30 (52%) to 43 (91%) between 2011 and 2020. MHPPs are generally in line with the WHO policy, aiming to strengthen care in the community, expand mental health promotion and illness prevention activities, improve quality of care, increase intersectoral collaboration, build workforce and system capacity, and improve adherence to human rights. However, specific, and measurable targets as well as a description of concrete steps, responsibilities and funding sources are mostly missing. They often contain very little information systems, evidence and research, and mostly lack information on evaluating the implementation of MHPPs.

Progress has been made in terms of the development of MHPPs in the WHO Europe. However, MHPPs are often lacking operationalization and appropriate data collection for evaluation. This is then reflected in missing evaluation plans, which in turn leads to lessons not being learned. To enhance the potential for knowledge generation and demonstration of impact, MHPPs should be more specific and contain measurable targets with allocated responsibilities and funding as well as evaluation plans.

Adolescence is a critical developmental period marked by significant changes, increasing the risk of mental health problems such as anxiety and depression. Understanding how youth engage with mental health resources is essential. This study explored the role of interpersonal relationships—including peer-to-peer, adult-youth, parent, teacher and mentor relationships, and interactions with mental health professionals—in shaping youth mental health engagement and identified factors influencing these relationships. Using a phenomenological qualitative design, youth researchers (YRs) and youth advisors (YAs) were engaged throughout the research process. Semi-structured interviews were conducted with South African youth aged 14–24 years. The study highlighted the significance of peer relationships, particularly relatability, as key in youth mental health support. Family relationships had a mixed role, with factors like lack of mental health literacy, age differences, and cultural norms hindering effective communication and support. By understanding the dynamics of these relationships, this study emphasizes the need for targeted interventions that harness social support. Enhancing the quality of relationships and promoting positive social bonds can protect against mental health problems. Addressing gaps in support by recognizing and supporting peer-to-peer engagement is essential. Findings provide valuable insights for designing strategies to promote mental well-being among youth, particularly in resource-constrained settings.