Brief, low-intensity interventions may hold untapped promise for bolstering maternal health in low-resource contexts. The current study used propensity score matching (PSM) to evaluate uptake and differential effectiveness of two low-intensity digital perinatal health (PH) support programs in Lima, Peru. Pregnant women (N = 251) were assigned to one of two conditions (PH vs. trauma-focused PH [TF-PH]) and received weekly psychoeducational content via WhatsApp from a lay paraprofessional for 5 weeks. Conditions were not randomly assigned; PSM was used to improve causal inference of the condition. Women were interviewed before participation (T1), immediately following treatment (T2) and at 3 (T3) and 12 months postpartum (T4). Intimate partner violence had strong negative effects on women’s mental health, multisystem resilience and parenting, and single mothers reported higher levels of depression and posttraumatic stress symptoms than did partnered women. Intervention uptake was high, with 77% of women participating in all sessions. There were no significant differences between treatment groups over time, but effect sizes indicated a slight advantage of the TF-PH condition in addressing depression symptoms (dr = −0.29) and multisystem resilience (dr = 0.39). Study findings suggest that brief interventions may be well-received and that trauma-focused supports may also confer additional benefits for addressing depression and resilience.

The ENHANCE non-inferiority trial that took place in a deprived setting in Pakistan demonstrated that a technology-assisted digital adaptation of the Technology Assisted Thinking Healthy Programme (THP-TAP) was no different than the face-to-face THP in improving symptoms of perinatal depression. The present study examines the mechanisms through which THP-TAP improved symptoms of perinatal depression (or not) compared to the face-to-face THP.

We applied a counterfactual-based approach to mediation – particularly interventional effects – to decompose the total effect of the THP-TAP intervention on symptoms of perinatal depression into the following pre-specified indirect effects: number of sessions attended; behavioural activation; perceived social support; problem-solving and cognitive-restructuring skills; and peer empathy. Mediators were assessed at 3 months post-partum, and depressive symptoms were measured at 6 months using the Patient Health Questionnaire-9 (PHQ-9).

Perceived social support in THP-TAP arm mediated an improvement in symptoms of perinatal depression compared to the standard face-to-face THP group (adjusted mean difference in PHQ-9 scores attributable to perceived social support in the technology-assisted digital adaptation of the THP group compared to the World Health Organisation THP group: −0.072, bias-corrected 95% confidence interval: −0.170, −0.018). There was no difference to support the indirect effects for all other mediators.

Even in the absence of treatment superiority, our findings suggest that levels of perceived social support were an important feature of the THP-TAP intervention, which resulted in improved symptoms of perinatal depression. From a practical perspective, these findings highlight the importance of social connectedness as a mechanism of change, demonstrating that peer-delivered digital psychosocial interventions can successfully cultivate this relational component.

During the perinatal period, women in low- and middle-income countries experience high rates of common mental disorders (CMDs). We aimed to estimate CMD prevalence at 6 and 12 months postpartum in Rahim Yar Khan (RYK), Pakistan, and identify factors associated with postpartum mental health. We conducted secondary analysis of a longitudinal birth cohort study, which was nested within the control arm of a community-based, cluster-randomized trial that enrolled pregnant women in their third trimester (n = 2,122). Mental health was assessed using the Self-Reporting Questionnaire. Factors associated with postpartum mental health were explored using mixed-effects linear regression, and associations between preconception, antenatal and postpartum CMDs were assessed using robust Poisson regression. The prevalence of CMDs was 16% and 17% at 6 and 12 months postpartum, respectively. Women who reported that their husbands were unhappy had poorer postpartum mental health, whereas high social support was associated with improved postpartum mental health. History of antenatal CMDs was associated with increased risk of CMDs at 6 and 12 months postpartum (adjusted risk ratio = 2.60 and 1.90, 95% confidence interval: 1.69–4.01 and 1.40–2.58, respectively). Mothers with identified risk factors may benefit from targeted mental health support during the perinatal period.

This study focuses on the national and subnational estimation of prevalence, incidence, disability-adjusted life years (DALYs) related to self-harm and suicide mortality in Iran. These indicators of disease burden were analyzed over the period from 1990 to 2021, with stratifications based on sex, age and geographic location. Additionally, the percentage change observed between 1990 and 2021 was documented. The age-standardized prevalence rate (per 100,000) of self-harm decreased from 173.92 (95% UI: 146.13–208.75) in 1990 to 131.2 (95% UI: 110.55–156.67) in 2021, reflecting a percentage change of −0.25% over the period. In terms of self-harm prevalence in 2021, males had a higher rate (137.62 per 100,000) compared to females (124.82 per 100,000). The findings of the current study revealed that, despite significant challenges such as demographic shifts, economic instability and the impacts of war, the trends in self-harm incidents and suicide mortality rates in Iran have generally been on the decline. Additionally, it was observed that suicide-related deaths were more prevalent among males when compared to females. However, when examining self-harm behaviors over previous decades, these acts appeared to be more frequent among females.

The aim of the present study was to develop short and very short forms of the Children’s Test Anxiety Scale (CTAS) using the ant colony optimization (ACO) algorithm. The item selection algorithm for the short form was applied to Sample 1 (N = 570), and the best-fitting short form was identified based on validity and reliability evidence. These analyses were then replicated with Sample 2 (N = 825) to confirm the findings. Children’s Perceived Academic Self-Efficacy Scale used for convergent validity. Also measurement invariance tested by gender. Additionally, a very short form of the scale (CTAS-VS) was developed using a subset of the same sample. Across all three studies, consistent results were found in terms of model fit, factor structure and validity. Overall, findings suggest that both the 14-item short form (CTAS-S) and the 3-item very short form (CTAS-VS), developed via the ACO algorithm, possess strong psychometric properties.

Mental illness-related stigma acts as a critical barrier to care by fostering shame, fear of judgment and discrimination, which deters individuals from seeking help, delays treatment and worsens outcomes. This study aimed to investigate the forms, drivers and consequences of mental health-related stigma on help-seeking behavior. A cross-sectional study was conducted from November 2020 to March 2021. Data were collected from 419 participants using structured questionnaires, guided by the Health Stigma and Discrimination Framework and the Attitudes Towards Seeking Professional Psychological Help Scale for validation. Data were analyzed using Statistical Package for the Social Sciences version 22, employing descriptive statistics, chi-square tests and multinomial logistic regression. The average age of participants was 34.5 years. Findings revealed alarmingly high stigma: economic (76.8–80.2%), social (77.1–81.2%) and psychological (71.9–82.8%). Key drivers included stereotypes of dangerousness (58.7%) and systemic healthcare discrimination (65.6%). Multinomial regression confirmed that all stigma forms significantly reduced help-seeking odds. Structural barriers (odds ratio [OR] = 0.48) and internalized shame (OR = 0.53) were the strongest deterrents, with a multiplicative effect for combined economic and psychological stigma (OR = 0.41). This complex, multilayered barrier, driven by socio-cultural beliefs and structural failures, necessitates urgent, multifaceted interventions targeting public education, policy and self-stigma to improve mental health equity in rural Ghana.

Mental health symptoms pose a significant vulnerability to stressful life events among currently married women, adversely impacting their overall well-being and quality of life. This study explores the spatial patterns and factors associated with anxiety, depressive symptoms and the co-occurrence of both symptoms among currently married women of reproductive age in Bangladesh. This study utilised data from 13,372 (weighted) currently married women aged 15–49 years in the Bangladesh Demographic and Health Survey (BDHS) 2022, which used a cross-sectional design. Multivariable logistic regression models determined the associated factors. Additionally, spatial distribution and hotspot analysis were conducted using ArcGIS version 10.8. The weighted prevalence of moderate to severe anxiety, depressive symptoms and co-occurrence of anxiety and depressive (CAD) symptoms among currently married women of reproductive age was 4.1% (95% confidence interval [CI]: 3.8%, 4.5%), 4.8% (95% CI: 4.7%, 5.4%) and 2.2% (95% CI: 2.1%, 2.6%), respectively. Clustering of anxiety symptoms (Moran’s I = 0.063, p < 0.001), depressive symptoms (I = 0.091, p < 0.001) and CAD symptoms (I = 0.082, p < 0.001) were observed, with hotspots in Rangpur, Sylhet and Chittagong regions. Logistics regression analysis shows that currently married women who were living in the Barishal, Khulna, Rangpur and Sylhet regions, who belong to households with a higher wealth index, who experienced high levels of intimate partner violence (IPV), have completed high school, who are sexually inactive and whose husbands are unemployed, were more likely to experience CAD symptoms. Additionally, currently married women of reproductive age, whose age was 25–34 years, who are labourers, whose pregnancies are terminated and who have ≥5 children ever born, are at a higher risk of having anxiety symptoms. Besides, currently married women aged 25–34 years and 35–44 years, who are underweight, were more likely to have depressive symptoms. The findings highlight a significant regional disparity in the burden of anxiety, depressive and CAD symptoms among currently married women of reproductive age in Bangladesh. These findings can help design site-specific programmes and actions for women in the hot spot areas of Rangpur, Sylhet and Chittagong.

International migrant workers (IMWs) may face insecure work and housing, limited access to healthcare and increased risk of psychological problems. Two scalable, evidence-based interventions to support individuals experiencing psychological distress are Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). This study aimed to explore IMWs’ problems, daily functioning and help-seeking behaviour, to inform cultural adaptation of the DWM/PM+ stepped-care intervention in the Netherlands. Following the Design, Implementation, Monitoring, and Evaluation (DIME) model, we conducted various qualitative interviews and a focus group discussion with IMWs (n = 30) and professionals (n = 18). Data were analysed thematically, and findings informed adaptations. Participants described problems related to work, housing, administration, finances, healthcare access and the COVID-19 pandemic. Daily routines focused on practical needs. Help-seeking was hindered by stigma, fear of job loss, low trust and reliance on informal or cross-border healthcare. Based on these results, the intervention was adapted to the needs of Polish IMWs in the Netherlands, regarding content and examples, which were tailored to their context; the intervention was offered remotely and collaboration with employers was avoided. These findings highlight the structural vulnerabilities of IMWs and demonstrate how qualitative insights can guide the cultural adaptation of a psychological intervention.

Urban refugees in low- and middle-income countries (LMICs) often face housing insecurity, undermining their ability to achieve self-reliance and well-being. Few studies have evaluated the impact of housing interventions in these contexts. This study offers preliminary evidence on the effectiveness of a 9-month rental assistance program targeting female-headed Venezuelan migrant households in Colombia. Using pre-post data from 517 participants, we assessed changes over time in household-level self-reliance, domains of self-reliance, subjective well-being and perceived agency. We also employed ordinary least squares regression and fixed-effects models to estimate changes in self-reliance and the relationship between self-reliance, psychosocial and housing outcomes. Our analysis found significant improvements in overall self-reliance, well-being and agency after controlling for observed individual and household characteristics. Increases were observed across almost all domains of self-reliance. Fixed-effects models also found that subjective well-being, perceived agency and select housing conditions were positively associated with self-reliance. Rental support appears to promote both material and psychosocial recovery for displaced households by alleviating financial stress and enabling forward-looking behaviors. However, the impact of housing quality dimensions varies, and the sustainability of outcomes remains uncertain. Future evaluations should incorporate longitudinal designs and control groups to inform holistic refugee housing strategies.