Campaigns to enhance public awareness and attitudes towards mental health problems have been a feature of mental health policy and practice for several decades. In Australia, Beyond Blue, an independent, not-for-profit organisation which was launched in 2000, marked a turning point in the national approach to improving population mental health. From the outset, it prioritised a systemic approach including national awareness campaigns, support for consumers and carers, early intervention, primary care reform and investment in research.

Over the past 25 years, Australia has seen substantial improvements in mental health literacy, stigma and help-seeking. To explore Beyond Blue’s contribution, we drew on nationally representative surveys of mental health literacy, stigma and service use. Analyses of surveys from the mid-2000s showed that respondents in states with greater exposure to Beyond Blue had higher awareness, better recognition of depression and more accurate treatment beliefs. Later studies confirmed that engagement with Beyond Blue was associated with higher mental health literacy, including among young people. National surveys have also shown significant reductions in stigma towards people with depression, changes not observed in other countries. Longitudinal data suggest that engaging with Beyond Blue predicts lower stigma and greater help-seeking over time.

National Surveys of Mental Health and Wellbeing have shown steady increases in professional help-seeking and perceived need for support since the late 1990s. While there are multiple reasons for this, recent national survey data link engagement with Beyond Blue to increased contact with health professionals and informal supports.

Globally, Beyond Blue is unique in its long-term, multi-pronged approach to improving population mental health. Its sustained focus and demonstrated impact on mental health literacy, stigma and help-seeking for depression and anxiety remain largely unmatched among comparable national initiatives.

Refugees bear the highest burden of mental health issues; however, they often underuse available mental health services. Interventions aimed at those with diagnosed conditions frequently do little to prevent the onset of disorders. Problem Management Plus for Immigrants (PMP-I) is a prevention intervention adapted from the World Health Organization’s Problem Management Plus (PMP). PMP-I includes psychoeducation, problem-solving, behavioural activation, social support and networking, and mind-body exercises. This pilot randomized controlled trial (RCT) aimed to evaluate the impact of PMP-I on mental, social and emotional well-being outcomes among Bhutanese refugees resettled in Massachusetts.

Bhutanese individuals aged 18 or older who had resettled in Massachusetts and scored ≤14 on the Patient Health Questionnaire-9 (PHQ-9) were randomly assigned to two groups: PMP-I (n = 58 families) and a talk programme with a community support services pamphlet (n = 58 families). Trained community interventionists delivered five sessions of PMP-I to intervention participants in their family settings. Primary outcomes included scores on measures of stress (Cohen Perceived Stress Scale-10), and anxiety and depression (Hopkins Symptoms Checklist-25), assessed at baseline, 6-week and 3-month post-intervention. Secondary outcomes included hair cortisol, coping, coping self-efficacy, social support, social network, family conflict resolution and family satisfaction. Linear mixed-effects models were used to analyse differences in changes in outcomes between the intervention and control groups, adjusting for baseline scores on the primary outcomes, as well as age, duration of residence, marital status and history of chronic diseases.

All 232 participants recruited (116 families) were retained throughout the project. The intervention group evidenced a significantly greater decrease than the control group at both 6-week and 3-month post-intervention assessments on the primary outcomes of stress, anxiety, and depressive symptom scores. Similarly, the intervention group demonstrated significantly higher scores at both the 6-week and 3-month periods after the intervention compared to the control group on measures of coping, family conflict resolution, self-efficacy, family satisfaction and social networking with large effect sizes (Cohen’s d > 0.8, p < .01). Hair cortisol concentrations did not differ significantly between the intervention and control groups at either baseline or 3-month post-intervention.

The PMP-I improved the mental, social and emotional well-being of Bhutanese adults (PHQ-9 score ≤ 14) resettled in Massachusetts. Peer-delivered, family-centred PMP-I offers a significant public health benefit; however, a large-scale, RCT involving diverse refugee groups is necessary to replicate its success nationwide and beyond.

Childhood maltreatment has been associated with increased risk of cognitive impairment in later life, but little is known about whether distinct joint trajectories of social isolation and depression across midlife predict this risk.

Using a prospective cohort design with documented childhood maltreatment and matched controls (N = 1196) followed from ages 0 to 11 into late midlife, we modelled joint trajectories of social isolation and depression (ages 29–47) using group-based trajectory modelling (GBTM) and examined their associations with cognitive impairment with no dementia (CIND) at age 59 through modified Poisson regression, controlling for risk factors related to neurodegenerative outcomes (i.e., hypertension, diabetes, obesity, limited physical activity, hearing impairment, smoking, excessive alcohol consumption and traumatic brain injury).

GBTM identified four groups: ‘Not isolated or depressed’ (67.7%), ‘Moderately isolated’ (11.7%), ‘Moderately depressed’ (16.5%) and ‘Chronically isolated and depressed’ (4.1%). Using the ‘Not isolated or depressed’ group as the reference category, membership in the highest-risk trajectory (‘Chronically isolated and depressed’) was associated with a 41.5% higher risk of CIND, whereas the ‘Moderately isolated’ and ‘Moderately depressed’ groups did not differ significantly from the reference group. Black non-Hispanic participants and those with documented childhood maltreatment histories had 32.8% and 21.2% higher risk of CIND, respectively, and each additional year of education was associated with a 4.9% reduction in CIND risk.

Sustained co-occurring social isolation and depression from early to mid-adulthood predicted increased risk of CIND independent of established risk factors, highlighting prolonged social and emotional difficulties as modifiable targets for late midlife cognitive health.

Patient-reported outcome measures (PROMs) are central to person-centred mental healthcare, yet evidence from large-scale digital implementation in routine psychiatry is limited.

To describe demographic characteristics and PROMs outcomes in out-patient mental health services across a multicentre Spanish network, and to analyse associations between PROMs and adherence, medication side-effects, self-harm and suicide attempts.

A multicentre, cross-sectional study included adults attending out-patient mental health clinics (October 2023–March 2025) and who participated in a digital PROMs (e-PROMs) program. Validated Spanish versions of the World Health Organization-Five Well Being Index (WHO-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Alcohol Use Disorders Identification Test (AUDIT-C), Drug Abuse Screening Test-10 (DAST-10) and Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) scales were deployed via a patient web portal and integrated into the electronic health record. Associations were examined using univariate tests and multivariate logistic regression.

Of 73 140 referred patients, 7925 (10.9%) completed PROMs (median age 48 years; 68.8% women). Well-being was low (WHO-5 median 36). Moderately severe–severe depression affected 38.5%, severe anxiety 30.9% and post-traumatic stress disorder (PTSD) risk 42.4%. Substance misuse risk was identified in 7.2% and hazardous drinking in 14.7%. Women reported lower well-being (p < 0.001) and higher severe depression (40.6 v. 34.0%, p < 0.001), severe anxiety (33.1 v. 26.0%, p = 0.003) and PTSD risk (45.2 v. 36.1%, p = 0.002). Men had higher substance misuse (9.7 v. 6.0%, p = 0.033) and hazardous drinking (16.3 v. 14.0%, p = 0.034).

In multivariate models, the strongest predictors of self-harm (odds ratio >2) included severe depression (odds ratio 4.52, p < 0.001), substance misuse (odds ratio 2.38, p < 0.001), PTSD risk (odds ratio 2.29, p < 0.001) and moderate depression (odds ratio 2.27, p < 0.001). The strongest predictors of suicide attempts included all grades of depression (p < 0.001), PTSD risk (odds ratio 2.39, p < 0.001) and substance misuse (odds ratio 2.37, p < 0.001). Risk of alcohol abuse (odds ratio 0.60, p < 0.001) and substance misuse (odds ratio 0.73, p = 0.003) predicted non-adherence.

Large-scale digital PROMs collection is feasible and clinically informative. PROMs strongly predicted self-harm, suicidality and adherence, supporting their use for early risk detection and measurement-based psychiatric care.

Post-stroke depression (PSD) is the most common neuropsychological complication in stroke survivors. While psychological interventions are promising non-pharmacological treatments, the most effective intervention type, as well as their mid- to long-term efficacy and effectiveness across PSD severity levels, remains unclear. This study aims to compare the efficacy of psychological interventions for PSD, focusing on overall effectiveness, mid- to long-term efficacy, and effectiveness across PSD severity levels.

We systematically searched seven databases for randomized controlled trials (RCTs) of psychological interventions targeting depression in stroke survivors. The primary outcome was depression symptom reduction. Post-intervention, mid- to long-term data were analyzed. A frequentist network meta-analysis (NMA) with random effects was conducted in Stata 17.0. Subgroup analyses by PSD severity were performed.

Thirty-eight RCTs involving 3106 participants were included. Post-intervention, third-wave therapies (Hedges’ g = −1.08, 95% CI: −1.62 to −0.55) significantly improved PSD compared to treatment as usual. At mid- to long-term follow-up, third-wave therapies (Hedges’ g = −0.82, 95% CI: −1.25 to −0.39) maintained significant effects. Relaxation therapy significantly ameliorated mild PSD (Hedges’ g = −0.77, 95% CI: −1.27 to −0.27); for moderate-to-severe PSD, no significant effects were observed.

Third-wave therapies are potentially effective for PSD, showing sustained mid- to long-term benefits. Relaxation therapy seems to be most effective for mild PSD, while no significant effects were observed for moderate-to-severe PSD. However, the NMA showed high heterogeneity and generally low to very low evidence certainty for most comparisons, the findings should be interpreted with caution.

Diabetes and mental health problems are closely linked, yet evidence examining this relationship among international labour migrants in the Gulf region is limited. Labour migrants are exposed to distinct occupational and psychosocial stressors that may increase vulnerability to depression and anxiety, particularly in the context of chronic diseases such as diabetes.

This study examined the prevalence and correlates of depressive and anxiety symptoms among male migrant workers with type 2 diabetes attending out-patient services in Qatar.

A clinic-based, cross-sectional study was conducted among adult male migrants receiving care at endocrinology out-patient clinics in Qatar. Symptoms of depression and anxiety were assessed using Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7. Sociodemographic and clinical variables were collected using structured questionnaires and electronic medical records. Associations between clinical and sociodemographic factors and mental health outcomes were examined using chi-square tests and logistic regression analyses.

A total of 339 participants were included, predominantly of South Asian origin. Clinically significant depressive symptoms were identified in 21.3% of participants, with 14.8% reporting clinically significant anxiety symptoms. Depression severity was significantly associated with diabetes treatment modality and past psychiatric history. Anxiety severity was significantly associated with ethnicity and past psychiatric history. In multivariate analysis, past psychiatric illness independently predicted anxiety symptoms (odds ratio 6.24, 95% CI: 1.91–20.38, p = 0.002). No significant associations were observed between mental health outcomes and glycaemic control or duration of diabetes.

Lower-skilled male labour migrants with diabetes experience a substantial burden of depressive and anxiety symptoms, highlighting a clinically important but often overlooked dimension of diabetes care in this population. Past psychiatric illness and more complex diabetes treatment regimens were associated with poorer mental health outcomes. These findings support the need for integration of mental health assessment and targeted support within routine diabetes services for migrant worker populations.

The prevalence and burden of depression are increasing among young people. Despite this, relatively few treatments specifically target this critical developmental period, and under-addressed mental health difficulties in youth often have lifelong consequences. Social isolation is commonly reported by young adults and is both a risk and maintenance factor for depression. There is a need for accessible, engaging interventions that can reduce depressive symptoms and improve social connectedness.

Building on evidence of the therapeutic potential of social dance-based activities for depression, this randomized controlled trial evaluated the efficacy of an 8-week salsa dance intervention for young adults (aged 18–24 years) with mild to moderately severe depressive symptoms. 121 participants were randomly assigned to either a salsa intervention or a waitlist control. Participants completed the Patient Health Questionnaire (PHQ-9), a validated measure of depressive symptoms, and additional mental health measures at baseline, during, and after the intervention.

Participants in the salsa dance condition showed a significantly greater reduction in depressive symptoms than the waitlist control, with a −2.45 PHQ-9 point between-group difference, exceeding the criterion for clinical significance. Both groups reported improvements in social anxiety, generalized anxiety, loneliness, and daily happiness, but salsa participants had significantly greater reductions in social anxiety and greater improvements in daily happiness.

These findings support the value of social dance as a novel, accessible intervention for reducing depressive symptoms. Implementing such programs within a suite of wellbeing-oriented interventions for young people could provide cost-effective mental health benefits.

Mindfulness-based cognitive therapy (MBCT) was developed for relapse prevention in people with remitted depression but is increasingly used for those with difficult-to-treat depression (DTD). A key question regarding this broader application is whether ongoing depressive symptoms constrain therapeutic responsiveness or disrupt MBCT’s proposed mechanism, decentering. We explored whether baseline depressive severity moderates clinical outcomes, whether changes in decentering mediate treatment effects, and whether this mediation varies by baseline severity.

Secondary moderation, mediation, and moderated mediation analyses were conducted using data from the RESPOND randomized trial (N = 234), comparing MBCT plus treatment as usual (TAU) with TAU alone in adults not remitted after high-intensity psychological therapy. Depressive symptoms (PHQ-9) and decentering (Experiences Questionnaire) were assessed at baseline, post-treatment (10 weeks), and follow-up (34 weeks). Analyses were conducted using structural equation modelling.

Higher baseline severity predicted greater symptom improvement across both groups. Treatment-related increases in decentering partially mediated the effect of MBCT on depressive symptoms at follow-up. Although baseline severity did not moderate the treatment effect, it moderated the indirect effect, with decentering more strongly associated with symptom reduction among those with higher baseline depression. Severity did not moderate the acquisition of decentering skills.

Concerns that more severe depressive symptoms limit the effectiveness of MBCT were not supported. MBCT’s core mechanism remained operative under substantial symptom burden, with clinical impact amplified at higher severity. These findings reduce key uncertainties regarding the application of MBCT in DTD and support its use across a broad range of symptom severity.