Suicide remains a global public health crisis, claiming over 800,000 lives each year and leaving millions more to struggle with attempts, ideation, or the ripple effect of loss. Traditional prevention strategies often focus on crisis intervention and identifying “warning signs,” but these approaches overlook the many who suffer in silence. Drawing on personal experience of suicide loss and a decade-long journey toward suicide literacy, the author argues for a reframing of suicide prevention. She challenges stigma-driven assumptions, underscores the power of honest storytelling, and introduces the concept of “preemptive, protective conversations” as a vital upstream prevention tool. By empowering ordinary people to become suicide prevention advocates equipped with knowledge, compassion, and a willingness to talk openly, we can build stronger connections, dismantle stigma, and create a broader societal safety net. Suicide is preventable, and each of us has a role to play in saving lives.

International students frequently report suicidal thoughts and behaviours, but often do not seek help. We evaluated the feasibility, acceptability, and preliminary effectiveness of an adapted version of safeTALK suicide prevention training for international students. Eight workshops were delivered in Melbourne, Australia (N = 128; 62.5% female, M age = 23.4). In this single-arm study, surveys were completed pre-, post-, and three months post-training, and 17 participants completed follow-up interviews. The training was rated as acceptable, helpful, and safe. Linear mixed models indicated increased confidence to intervene and stronger intentions to refer individuals to formal help sources, with improvements sustained at follow-up. Suicide stigma showed a small post-training reduction that was not sustained. Suicide literacy only improved three months post-training. Attrition limited inferences about long-term effects. Qualitative feedback supported the training’s value but highlighted the need for further cultural adaptation. Findings support adapted gatekeeper training as a promising strategy for suicide prevention among international students.

Drug use among young women has severe consequences for their mental health, increases their developmental vulnerability and highlights the global problem of drug addiction. The purpose of this study was to investigate the socioeconomic and psychological factors influencing drug use among young women in Khyber Pakhtunkhwa, Pakistan. The study used a qualitative research design. We collected data from 12 women aged 18–21 years via in-depth qualitative interviews conducted in Mardan and Peshawar from March to June 2022. Research shows that young women frequently use drugs due to peer pressure, emotional challenges and financial concerns, which significantly impact their lives. The study emphasizes the value of cultural intervention programs for young women, concentrating on the region’s mental health services, economic empowerment and gender-specific peer support networks.

Human immunodeficiency virus (HIV) and mental health have complex, bidirectional impacts. Integrated service delivery, especially in low- and middle-income countries (LMICs) where resources are most limited and the burden of HIV is heaviest, may help to improve both HIV and mental health outcomes. While the integration of mental health and HIV services has been studied in various settings, previous reviews on this topic have primarily focused on the integration processes rather than health outcomes. In this systematic review, we evaluated the effectiveness of interventions in LMICs that integrated mental health and HIV services. We searched PubMed, CINAHL, Sociological Abstracts, PsycINFO and EMBASE and conducted backward and forward citation searches. We included studies conducted in LMICs that evaluated the integration of services for HIV and mental health conditions using pre-post or multi-arm study designs, published in a peer-reviewed journal from January 2000 through January 2024. Studies on substance use services were excluded. Risk of bias for included studies was assessed using the Evidence Project tool. We summarized findings narratively, including both mental health-related and HIV-related outcomes. Eighteen studies with a total of 9,729 participants were included in the analysis, among which 17 studies were conducted in sub-Saharan Africa and 10 were randomized controlled trials. Seventeen studies used a task-sharing approach, where nonspecialists provided mental health interventions. The low follow-up rate and lack of random participant selection suggested the increased risk of bias in most studies. Overall, interventions that integrated mental health and HIV services provided greater improvement in recipients’ mental health symptoms (e.g., depression and post-traumatic stress disorder) than HIV services alone, often reducing symptom scores by more than 50%. While the evidence on HIV-related outcomes (e.g., antiretroviral therapy adherence, viral suppression and HIV stigma) was more limited, most studies that reported these outcomes showed positive effects of integrated interventions, especially community-based ones. These findings suggest the benefit of the interventions that integrate mental health and HIV services in LMICs, although further evaluations are warranted.

Psychosocial programs in low- and middle-income countries (LMIC) often omit cognitive strategies due to perceived difficulty for clients and lay providers. We evaluated the benefit of including “cognitive coping” in a brief, online intervention for conflict-affected Ukrainian veterans and family members with mild to moderate psychosocial distress. Participants were randomized to two treatment conditions based on the Common Elements Treatment Approach Psychosocial Program (CPSS). CPSS-Basic (CPSS-B) included a self-assessment, safety screening and psychoeducation. CPSS-Enhanced (CPSS-E) included these as well as cognitive coping. Distress, functional impairment, alcohol use, aggression, social disconnectedness and conflict resolution were assessed after one month. Participants also evaluated program accessibility, acceptability, appropriateness, feasibility and adoption. Of 1,177 study participants, 788 (67%) completed follow-up. Both conditions significantly improved distress, functional impairment, aggression and social disconnectedness; CPSS-E producing a greater reduction in distress than CPSS-B (ES: d = .22, p = .002). Implementation outcomes were positive across conditions, favoring CPSS-E for appropriateness (d = .48, 95% CI: .33, .62), feasibility (d = .15, 95% CI: .00, .29), adoption (d = .34, 95% CI: .19, .48) and acceptability (d = .29, 95% CI: .15, .44). Findings support the feasibility and added value of incorporating cognitive techniques into psychosocial programming in LMIC.

An increasing number of studies have sought to explore the applicability of scalable mental health interventions to bridge the adolescent mental health treatment gap. This study aimed to adapt the World Health Organization’s mental health intervention Early Adolescent Skills for Emotion (EASE) for urban communities in New York City (NYC). Following the mental health Cultural Adaptation and Contextualization for Implementation framework and in collaboration with three Brooklyn community-based organizations and the NYC Mayor’s Office of Community Mental Health, the intervention was intensively workshopped through eight weekly sessions with adolescents (n = 18) and caregivers (n = 12). Documentation of the process followed the Reporting Cultural Adaptation in Psychological Trials criteria. Surface adaptations involved revising the storybook to reflect key challenges faced by adolescents and caregivers of these communities, such as social media usage, economic stressors, and racial diversity. Deep adaptations addressed cultural concepts of distress by incorporating topics such as identity exploration, socioemotional learning, and the mind–body connection. Feedback from stakeholders indicated that the basic components of EASE are relevant for members in their communities, but additional changes would foster greater engagement and community building. These findings will inform upcoming program implementation across NYC and may guide adaptation work in other contexts.

While the links between extreme weather events and mental health have received growing attention, little is known about how climate change impacts adolescent mental health in low- and middle-income climate-affected settings. To address this gap, we conducted a multi-method qualitative study exploring how young adolescents (YAs) aged 10–14 years experience climate-related stressors across six regions in Kenya. Guided by the resource insecurity framework, we thematically analyzed Elder focus groups, YA walk-along interviews and YA participatory mapping workshops. Our findings revealed that food, water and sanitation insecurity contribute to psychological distress, including symptoms of depression and suicidality, and heighten concerns of community violence (e.g., assault, fighting). Water insecurity, particularly the time and distance required for collection, disrupted school attendance, while resource borrowing generated feelings of shame. Food insecurity and larger contexts of poverty were associated with substance use as a coping mechanism, which in turn contributed to school dropout, crime and gang involvement. Poverty also led some youth to run away from home. These findings highlight the urgent need for climate-informed mental health interventions that address co-occurring resource insecurities. To advance adolescent mental health and well-being in climate-affected settings, policy responses must be targeted and multilevel, engaging families, communities and institutions.

The mental health of Sri Lankan adolescents is of growing concern, given the decades of internal conflict and socio-political instability in Sri Lanka. This aims were to examine the prevalence and determinants of symptoms of common mental health problems (MHP) experienced by school-going adolescents in Sri Lanka. A cross-sectional survey was conducted among school-going adolescents in grades 10–12/13 from seven schools in Gampaha District, Sri Lanka. Depressive/psychological distress symptoms measured using the PHQ-9 /K10, were analysed using mean scale scoring. Psychosocial determinants were measured using JVQ/PBI/AESI/study-specific questions. Associations between MHPs and psychosocial determinants were examined using multiple linear regression models. 24.11% of 1,045 adolescents who completed the surveys reported clinically significant symptoms of depression, and 60.10% reported psychological distress. Higher age, being female, lesser physical activity, smoking, daily social media use, violent victimisation, not living with both birth parents, having ≥2 siblings, low maternal/paternal education, having an overprotective paternal figure, increased academic stress and rural living were associated with higher MHPs. We identified a high prevalence of MHPs among Sri Lankan adolescents, which was multifactorially determined. Modifiable risk factors addressed through public health policies, research and programmes, as well as less-modifiable risk factors addressed through national-level policy changes, are all essential to addressing mental health burdens in this population.

Understanding and responding to patient expectations is crucial for providing high-quality, person-centred mental healthcare, but remains underexplored in humanitarian settings. This study examines the preferences and experiences of Syrian mental health and psychosocial support (MHPSS) service users in Northwest Syria and Türkiye. We conducted structured interviews with 378 displaced Syrians (55% female, mean age: 31 years). Participants completed the Client Satisfaction Questionnaire-8 and responded to nine open-ended questions. An abductive qualitative content analysis guided by the World Health Organization’s health system responsiveness framework was used to interpret their accounts. Participants most frequently described the importance of time and understanding (62%), dignity (43%), confidentiality (36%) and continuity of care (31%), with notable variation by gender. Interpersonal aspects of care were crucial for building trust and sustaining service engagement. Service-level factors, such as adequate time with practitioners and integrated and coordinated care, ensured high-quality support in a context of ongoing conflict, displacement and poverty. These findings underscore the importance of embedding person-centred approaches in MHPSS service design and delivery. As efforts to rebuild Syria’s health system begin, prioritising service user experiences could improve the quality of care and restore health system trust and legitimacy.

This study aimed to adapt and validate the Mental Health Support Scale (MHSS) for Chile and Argentina, hypothesising that it would correlate positively with mental health literacy, negatively with stigma measures, and differ by mental health first aid (MHFA) training history. The MHSS involves the ‘Intended’ scale (assessing intended support) and the ‘Provided’ scale (evaluating actual help), capturing recommended and not-recommended actions. The scales were translated into Spanish, piloted with 17 adults to explore cultural relevance, and validated with 554 Chilean and Argentinian adults using concurrent measures of stigma, social distance and mental health literacy. Factor analysis of the MHSS-Intended identified a recommended factor (16 items) and a not-recommended factor (5 items). The recommended factor correlated positively with mental health literacy (r = 0.19) and negatively with weak-not-sick stigma (r = −0.16) and social distance (r = −0.16). Support scores significantly discriminated between participants with and without MHFA training (recommended d = 0.99, not-recommended d = 1.35) and within participants pre- and post-MHFA training (recommended d = 0.90, not recommend d = 0.47). Overall, the adapted MHSS demonstrates acceptable psychometric properties and is a promising tool for evaluating mental health first aid support in Chile and Argentina.

This study examined the role of coping resources – self-efficacy (problem-focused) and emotion regulation (emotion-focused) – in supporting mental health and social functioning among refugees in a transit setting in Indonesia. Using a latent profile analysis approach with 1,214 participants, three distinct coping profiles were identified: high coping resources, high emotion-focused coping resource, and low coping resources. Results showed that high coping resources were associated with better mental health and social functioning outcomes. Emotion-focused coping resources were more strongly associated with better mental health, while problem-focused coping resources were closely linked to social functioning. This study highlighted the importance of coping flexibility and offers practical implications for strength-based interventions in transit displacement settings.