More than 116 million people in Africa live with mental health conditions. However, many African countries lack the infrastructure, training and workforce to effectively manage psychiatric emergencies. This has led to overuse of controversial practices such as physical and chemical restraint and involuntary seclusion, often violating patient rights. We conducted a scoping review of restraint and seclusion practices and their impacts in African clinical settings using the PubMed, Embase, CINAHL, PsycInfo and ProQuest databases. Titles/abstracts and full texts were reviewed for inclusion using the Covidence platform, and 29 studies were included in the final extraction. Restraint and/or seclusion were employed to manage aggression, enable involuntary treatment or prevent self-harm. Patients found restraint and seclusion to be dehumanizing, a cause of posttraumatic stress and a barrier to future help-seeking. Healthcare workers described inadequate training, overuse of restraint and seclusion, injuries and emotional distress after employing these treatments. Further research, intervention development and policy reform are urgently needed to promote humane and patient-centered psychiatric care, including verbal de-escalation training, in underresourced healthcare systems.

We aimed to compare the concordance between the Montreal Cognitive Assessment (MoCA) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), as cognitive screening tools to detect mild cognitive impairment (MCI) in a South African adult community sample (N = 370).

The MoCA showed acceptable internal consistency, agreement with the RBANS and good criterion-related validity. The MoCA demonstrated fair performance, compared to the RBANS, for predicting MCI, with AUCs of 0.711 (English) and 0782 (Afrikaans). Using the recommended cut-off score of 26/30, the MoCA showed high sensitivity but low specificity. Sensitivity and specificity were optimal when the cut-off scores were lowered to 25/30 (English) and 24/30 (Afrikaans). MoCA scores were significantly associated with language, sex, age and education.

While these findings demonstrate applicability of the MoCA in screening for and identifying mild cognitive difficulty in this population, our findings suggest that modifications are needed to improve differentiating between normal aging and MCI. Until a culturally adapted version of the MoCA is developed and validated for this population we suggest lowering the cut-off score to 25/30 (English) and 24/30 (Afrikaans) to reduce false positive NCD diagnoses. Demographic factors (age, sex, language and education) also need to be considered.

This study aimed to perform a cross-country validation of the Arabic version of the World Health Organization 5-item (WHO-5) Well-Being Index, in terms of factor structure, composite reliability, cross-gender measurement invariance and concurrent validity. We carried out a cross-sectional, web-based study on a total of 3,247 young adults (aged 18–35 years) from six Arab countries (Tunisia, Lebanon, Egypt, Jordan, Morocco and Kuwait). Confirmatory Factor Analysis showed that the one-factor model demonstrated acceptable fit across all six countries. In addition, the Arabic WHO-5 Well-Being Index yielded high reliability coefficients in samples from each country (McDonald’s ω and Cronbach’s α = .92–.96), across genders (ω = .95 in men and .94 in women) and age groups (ω = .94/α = .94 in participants aged ≤25 years and ω =.96/α =.96 in those aged ≥26 years). Multi-group analyses demonstrated that configural, metric and scalar invariance were supported across gender, countries and age groups. Regarding concurrent validity, WHO-5 Well-being scores were strongly and significantly inversely correlated with depression, anxiety, stress, suicidal ideation and insomnia severity. This study provides a brief, valid and reliable Arabic version of the WHO-5 Well-Being Index that can be applied cross-nationally among Arabic-speaking young adult populations for screening and research purposes.

Adolescents may not necessarily have a specific mental health challenge to seek information on mental health. They may be genuinely curious on how to better understand these issues, especially when mental health is being discussed in school, among peers and with parents. The purpose of this study was to examine the frequency and factors associated with online information seeking about mental health among adolescents. A total of 702 high school students from Belgrade, Serbia, participated in the study and filled in an anonymous questionnaire about sociodemographics, digital behaviors and the Electronic Health Literacy Scale (eHEALS). The prevalence of seeking information about mental health in our study sample was 23.5% (165/702). The multivariate model showed that having a lower school performance, lower eHEALS score and browsing health blogs, social media and websites run by physicians and health institutions were independently associated with online information seeking about mental health. Additionally, searching for online information about psychoactive substances, bullying and medications was independently associated with online information seeking about mental health among adolescents. Adolescents are familiar with a variety of sources of online health information, but choose specific online platforms to read about mental health. These platforms could be utilized to promote mental well-being in high schools.

Women in the perinatal phase are at an increased risk of experiencing mental health problems, but in low and middle-income countries such as India, perinatal mental health (PMH) care provision is often scarce. This situational analysis presents the formative findings of the SMARThealth Pregnancy and Mental Health (PRAMH) project (Votruba et al. 2023). It investigates the nature and availability of maternal mental health policies, legislation, systems and services, as well as relevant context and community in India on a national, state (Haryana and Telangana) and district (Faridabad and Siddipet) level. A desktop, scoping review and informal interviews with mental health experts were conducted. Socio-demographic and maternal health indicators vary between Haryana and Telangana. No specific national PMH policy or plan is available. General mental health services exist at a district level within Siddipet and Faridabad, but no specific PMH services have been identified.

The Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) was developed by the World Health Organization as a key tool for delivering evidence-based mental healthcare in non-specialized settings. The mhGAP-IG requires contextualization and adaptation to ensure local relevance. However, evidence on adapting the Child and Adolescent Mental Disorders (CMH) module of the mhGAP-IG is limited. This study contextualized and adapted the 2016 mhGAP-IG CMH module through two workshops with local mental health experts and stakeholders, preceded by six in-depth interviews exploring the child and adolescent mental health contexts in Nairobi and Kilifi. Data were analysed in NVivo-Lumivero© software. Interviews with mental health stakeholders revealed significant challenges in both counties, including a shortage of mental health specialists, frequent medication stockouts, stigma and inadequate resources. Key adaptations to the module included using locally acceptable terms (e.g., replacing ‘failure to thrive’ with ‘suboptimal growth’); expanding training to five days; adding the mhGAP-IG Essential Care and Practice module to address culturally sensitive communication in mental healthcare provision; streamlining referral pathways; and incorporating aspects of self-harm/suicide and substance use linked to the CMH module content. Contextualizing the CMH module is crucial for effective implementation, but sustaining impact will require addressing systemic barriers beyond capacity-building.

Pension systems play a crucial role in providing economic security and supporting well-being in later life. However, as governments implement reforms to ensure financial sustainability—such as raising the retirement age, reducing benefits, and shifting to defined-contribution schemes—these measures often overlook their psychological and social consequences. Pension insecurity has been linked to heightened stress, anxiety, and depression, as well as increased social isolation, particularly among vulnerable populations, including those in physically demanding jobs, low-income workers, and individuals with existing health conditions. Despite clear evidence of these effects, mainstream pension reform discourse prioritises fiscal concerns over social and mental health implications. This article examines pension reform through the Human Rights–Public Health Pension Framework (HRPHPF), integrating legal, public health, and policy perspectives to assess its impact on mental well-being. It situates pension rights within international human rights law, explores the psychological risks associated with pension insecurity, and advocates for a human rights-based approach to pension policymaking. The article calls for integrating mental health impact assessments into pension reforms to prevent adverse outcomes and ensure that policies promote dignity, social inclusion, and economic security in old age. A more balanced approach is necessary to align financial sustainability with broader well-being and human rights principles.

This study investigates the epidemiology of adolescent suicide in India, addressing the limited research on the subject. Data on adolescent suicide (14–17 years) by sex and state were obtained from the National Crimes Records Bureau for 2014–2019, which included acquiring unpublished data from 2016 to 2019. Crude suicide rates for the period 2014–2019 were calculated by sex and state. Rate ratios (RRs) by sex and state were also calculated to assess changes over time, comparing suicide rates from 2017–2019 to 2014–2016. Female adolescent suicide rates, which ranged between 9.04 and 8.10 per 100,000 population, were consistently higher than male adolescent suicide rates, which ranged between 8.47 and 6.24 per 100,000 population. Compared to the first half of the study period (2014–2016), adolescent suicide rates significantly increased between 2017 and 2019 among less developed states (RRs = 1.06, 95% uncertainty interval [UI] = 1.03–1.09) and among females in these states (RRs = 1.09, 95% UI = 1.05–1.14). Male suicide rates aligned with global averages, while female rates were two to six times higher than in high-income and Southeast Asian countries. Findings highlight the urgent need for comprehensive surveillance and targeted suicide prevention strategies to address this critical public health issue.

Mental health is a global priority, fundamental to the health and development of all nations. The contribution of mental disorders to the global burden of disease is widely recognized; however, a significant care gap exists, particularly in the context of low-and middle-income countries. In India, for instance, there are 0.3 psychiatrists per 1,00,000 population. To address this severe shortage of mental health professionals and resources globally, the World Health Organization has suggested the adoption of a community-based mental health care approach, where the locus of services shifts from institutional care to local communities. Over the last five decades in India, diverse approaches to mental health care have emerged because of the interaction of dominant discourses on community-based mental health care with various socio-cultural contexts. In addition to the government-run mental health program and programs run by medical colleges, civil society organizations have increasingly contributed to this space. Although studies have assessed individual interventions, there exists a need to map these interventions and synthesize the approaches for service delivery to inform public health practice in India and in low-and middle-income countries at large. This narrative review attempts to map and synthesize insights from community-based mental health interventions in India implemented across diverse contexts. We searched peer-reviewed journal articles and book chapters published in the English language between 2010 and 2023. We present the synthesis of approaches used in 41 community-based mental health interventions, where we unpack key intervention components and processes adopted for primary prevention and promotion; identification and case detection; treatment and care, and rehabilitation in the community. This review presents key recommendations for practitioners about the role of community, the diversity and commonalities in various approaches across contexts, the roles of various actors in service delivery, and the shared values guiding the conceptualization and implementation of community-based mental health interventions in India.

Adverse childhood experiences (ACEs) are widely associated with mental health disorders, such as depression, post-traumatic stress disorder (PTSD), and suicidality. Resilience plays a role in mediation and moderation of these associations, yet there is limited data from Kenya on this. This cross-sectional study examined the role of resilience in the relationship between ACEs and mental health outcomes among 1,972 participants aged 14–25 years in the Nairobi Metropolitan area. Participants completed the Trauma and Distress Scale (ACEs), Patient Health Questionnaire-9 (depression), Columbia-Suicide Severity Rating Scale (suicidality), Harvard Trauma Questionnaire (PTSD), and Adult Resilience Measure-Revised (resilience). Analyses of moderation and mediation using Hayes Process Macro indicated that resilience moderated the association between ACEs with PTSD and depression, with minimal effect on suicidality. It also moderated specific associations, including emotional/physical neglect on ideation, physical abuse on lifetime behavior (p = 0.0479), and total ACEs on recent behavior (p = 0.0514). Resilience also partially mediated the effects of ACEs on PTSD and depression, and fully mediated suicidality for specific ACE domains (emotional neglect, physical neglect, and physical abuse on suicidal ideation and all ACEs on recent suicidal behaviors). Building resilience mitigates the effects of ACEs on depression, PTSD, and suicidality among Kenyan youth.

This study addresses the mental health needs of refugees and migrants in the Netherlands, highlighting the urgent public health challenges they face. Unique psychosocial hurdles, exacerbated by cultural dislocation, language barriers and systemic inequalities, hinder their access to quality mental healthcare. This study explores how coloniality intersects with mental healthcare access, using a decolonial framework to challenge stereotypes and assumptions that marginalize migrant voices. Through semi-structured interviews with migrants and language service providers, this research reveals the complexities of navigating the mental healthcare system. Findings reveal that temporality, professionalism and language barriers are key issues in migrants’ mental healthcare journeys. We advocate for systemic changes that prioritize migrant perspectives. Ultimately, this study aims to inform policy and practice to enhance mental health services for migrant populations in the Netherlands and contribute to the broader dialogue on decolonization in mental health.

Negative symptoms in schizophrenia are critical to functional outcomes but remain difficult to assess reliably. The Brief Negative Symptom Scale (BNSS) was developed to address these challenges, though no validation exists in Romanian-speaking populations. To validate the BNSS in a Romanian clinical sample, explore its psychometric properties and compare BNSS-based and PANSS-based classifications of severe negative symptoms. Forty-seven inpatients with schizophrenia were assessed using Romanian versions of the BNSS, PANSS, CDSS and AIMS. Psychometric analyses included internal consistency, inter-rater reliability, factor analysis and correlation-based validity. Two classification schemes, moderate–severe negative symptoms, measured by BNSS (BNSS-MS), and predominant negative symptoms, measured by PANSS (PANSS-PNS), were compared. The BNSS showed excellent internal consistency (α = .94) and inter-rater reliability (ICC = .98). A five-factor structure was confirmed. BNSS total scores correlated strongly with PANSS negative (ρ = .90), but not with positive, depressive, or motor symptoms. Blunted affect emerged as the most prominent subscale. The BNSS-MS group captured more severe cases than PANSS-PNS and showed greater symptom burden and higher distress scores. The Romanian BNSS is valid and sensitive for detecting negative symptoms, outperforming PANSS in identifying clinically significant subgroups.