Mental Health Recovery Narratives (MHRN) play a crucial role in the recovery paradigm within mental health policy and practice. However, an existing conceptual framework characterising MHRN lacks representation from Indian narratives thereby raising further questions regarding its suitability in the Indian mental health care system and practice.

The present article aims (1) to assess the overall applicability of the framework characterising MHRN, conceptualised by Llewellyn-Beardsley et al. and consisting of nine overarching dimensions vis-a-vis Indian narratives, and (2) to develop a typology characterising MHRN that can inform research, practice, and narrative-based interventions within the Indian context.

Nineteen Indian MHRN in the form of life memoirs were analysed deductively and inductively to assess the relevance of the dimensions and types of the existing MHRN framework.

Most of the components of the existing MHRN framework were found to be corresponding with the dimensions of recovery in the select Indian narratives. However, a few other components were identified in the indian memoirs, and were incorporated into a more comprehensive typology expanding the scope of the MHRN framework.

The refined typology provides evidence for research, practice, and narrative-based interventions within the Indian context. The implications for the Indian mental health care system and practice are also discussed.

Health-related quality of life (HRQoL) offers a framework for assessing the impact of health conditions and treatments on a patient's overall well-being. It also holds the potential to evaluate the effectiveness of hospital and health services. However, this approach lacks evidence to fully support its widespread adoption.

To explore current HRQoL practices and clinician attitudes toward standardising HRQoL instruments for service evaluation across a diverse range of in-scope community health services.

Semi-structured interviews were conducted with 20 senior clinicians from community health services. An interview guide was used, and interviews were recorded, transcribed, and analysed using content analysis to identify key themes and insights.

The average interview time was 20.1 min (SD = 4.6). While some HRQoL instruments were used, others had been discontinued due to limitations in relevance or effectiveness. Informal HRQoL assessments were commonly used alongside other instruments to gather broader insight into patient well-being. There was support for a holistic approach to service evaluation, emphasising comprehensive, contextually relevant assessments that are user-friendly and evidence-based. However, participants also raised several limitations to using HRQoL for service evaluation, such as the potential for misleading information, implementation difficulties, and risks to patient care. Participants identified 33 potential domains to be measured to demonstrate service success, with the most frequently cited being mental health, social connections, ability to perform daily activities, leisure pursuits, mobility and feeling supported.

Findings underscore the need for balanced and meaningful assessment instruments that accurately capture the full scope of patient well-being for evaluation purposes. No single HRQoL assessment instrument is likely to address the needs of services providing care for patients with complex and varied conditions. It is essential to use assessment instruments tailored to individual patient cohorts, resonating with clinicians and patients.

More than 1 in 8 people potentially live with a mental health disorder, yet fewer than half receive treatment. Poor mental health awareness may contribute to this treatment gap, and digital health technologies, like wearables and their associated phone- and web-based applications, have the potential to reduce the mental health awareness gap due to their ease of adoption, objective feedback, and high rate of engagement.

This study aimed to better understand the relationships between mental health and objective wearable-derived metrics.

We examined the longitudinal results of monthly mental health surveys (Patient Health Questionnaire-2, Generalized Anxiety Disorder 2-item, and Perceived Stress Scale) delivered over 13 months to 181,574 individuals wearing a device (WHOOP, Inc.) that measures sleep, cardiorespiratory parameters, and physical activity (up to 307,860 survey responses and 7,942,176 days of total wear time). Generalized linear mixed models, cross-lag analyses, and intrapersonal scaling were used to assess interpersonal and intrapersonal associations between wearable-derived metrics and mental health outcomes. Age, gender, BMI, and time of year were used as covariates in the models.

Interpersonal associations between wearable-derived metrics and mental health outcomes indicate that individuals with better sleep characteristics (ie, longer sleep durations and more consistent wake and sleep times), higher heart rate variabilities (HRV), lower resting heart rates (RHR), and higher levels of physical activity report lower levels of depression, anxiety, and stress. Intrapersonal associations between wearable-derived metrics and mental health outcomes displayed similar results as the between-person analyses, with higher HRVs, lower RHRs, and more physical activity generally coinciding with improved mental health outcomes. However, intrapersonal wearable-derived sleep metric associations diverged from the interpersonal association findings when specifically looking at sleep duration and depression, whereby increased sleep durations within an individual were associated with higher levels of depression. In interpersonal analyses, the largest association observed was between the Perceived Stress Scale scores and RHR, with a standardized coefficient of 0.09 (P<.001); in intrapersonal analyses, the largest association observed was between the Patient Health Questionnaire-2 scores and summated heart rate zones-a proxy for physical activity-with a standardized coefficient of -0.04 (P<.001). Cross-lagged models demonstrated that higher levels of reported stress preceded higher RHRs, respiratory rates, and sleep duration variabilities, as well as lower HRVs.

Overall, this investigation reveals that numerous physiological variables measured by wearables are associated with mental state in free-living environments. These findings underscore the potential of wearable-derived physiological and behavioral monitoring to serve as objective complements to traditional subjective assessments in mental health research and care. However, given the complex nature of mental health disorders, further research is needed to determine how these metrics can be effectively integrated into clinical practice.

Adolescence is a crucial period that can have lifelong effects on health. The COVID-19 pandemic's adverse effects on adolescent health, particularly the physical and mental well-being, have been emphasized in several World Health Organization (WHO) reports. Factors contributing to health disparities, including socioeconomic determinants, limited healthcare access, and psychosocial challenges, are identified. This article delves into the potential of yoga as a holistic wellness approach, presenting existing evidence on its benefits for adolescents. The mechanisms through which yoga addresses health inequalities are described by emphasizing its impact on physical well-being, mental health, and social connectivity. The implementation strategies for yoga programs, within school curricula and community-based initiatives, are outlined, focusing on cultural sensitivity, accessibility, and inclusivity. It also promotes the role of evidence-based interventions, including yoga, in cultivating resilient adolescent populations in society. Since yoga programs are also offered through telehealth platforms, there is an urgent need to explore the role of these online platforms in extending the reach of yoga, especially in promoting accessibility and inclusivity. The importance of accessibility and inclusivity, including physical and financial aspects, in yoga programs should be considered. Besides, cultural sensitivity is also crucial for effective healthcare promotion, emphasizing the need for tailored yoga interventions that respect diverse cultures. This article also identifies research gaps, offers future directions in studying yoga interventions for adolescents, and highlights the need for longitudinal studies and diverse intervention approaches. In essence, this article promotes a holistic approach to adolescent health, leveraging the benefits of yoga to foster equity and well-being for adolescents in present and future pandemics.

Adolescents Health Disparities, Yoga, Pandemic, COVID-19.

Despite persistently high rates of mental illness and suicide, receipt of treatment for mental health conditions remains low. In this context, it is important to quantify the number of inpatient psychiatric beds (IPBs), and to understand differences in the number of IPBs throughout the U.S, as these provide critical evaluation, medication, and stabilization services.

This study used nationally-representative data drawn from the 2011-2023 Centers for Medicare and Medicaid Services' Healthcare Cost Report Information System (HCRIS). From 2011-2023, while the total number of IPBs-in both psychiatric hospitals (PHs) and short-term acute care hospitals (STACHs)-did not change, the number IPBs within STACHs fell from 11.3 in 2011 to 9.06 in 2023. During this period, 846 counties (in which over 244 million individuals reside) experienced a decline in the rate of IPBs, while another 1,449 counties (in which 59 million individuals reside) never had IPBs. In regression models predicting the number of IPBs in STACHs and PHs, hospitals that received DSH payments (STACHs: IRR:1.93, 95% CI: 1.72, 2.15; PHs: IRR:1.40; 95% CI: 1.06, 1.84), had more full-time employees (STACHs: IRR:1.35, 95% CI: 1.31, 1.38; PHs: IRR:1.77; 95% CI: 1.75, 1.80) and were teaching STACHs (STACHs: IRR:1.78; 95% CI: 1.63, 1.95) had significantly more IPBs. In county-level regression models, counties with a lower percentage of Black residents (β: -21.15; 95% CI: -37.14, -5.16) had a significantly higher rate of IPBs. The absence of a causal design means we cannot assess the reasons behind changes in IPBs across time, and is a limitation of this study.

This study provides an overview of the availability of IPBs throughout the U.S, as well as the number of individuals without access to IPBs. Findings indicate a dearth of STACH-based IPBs, particularly in areas with a greater proportion of racial minority residents.

There is increasing interest in how sleep affects cognitive function; however, the combined impact of naps and night-time sleep on different cognitive domains is still not well understood. This study investigates the relationship between naps, night-time sleep, and cognitive function over time among middle-aged and older adults in China, as well as how this relationship may differ between rural and urban residents.

A total of 2,938 community residents aged 45 and older were selected from the China Health and Retirement Longitudinal Study (CHARLS, conducted in 2013, 2015, and 2018). The study examined the relationship between napping, night-time sleep, and cognitive function using fixed-effects analysis over a period of five years.

Sleeping 6-8 hours/ night and napping for less than 30 minutes/ day were associated with better cognitive function (β = 0.383, 95% CI: 0.198, 0.567) and memory (β = 0.304, 95% CI: 0.155, 0.451) across the entire sample. In contrast, sleeping more than 8 hours/ night and napping more than 90 minutes/ day were associated with poor mental status. Specifically, sleeping 6-8 hours/ night was significantly associated with better cognitive function (β = 0.501, 95% CI: 0.252, 0.750) and memory (β = 0.372, 95% CI: 0.173, 0.572) in rural respondents. Sleeping more than 8 hours/ night was associated with poorer mental status among urban respondents (β = -0.291, 95% CI: -0.551, -0.032). Rural respondents who napped less than 90 minutes/ day had improved cognitive function. Napping for more than 90 minutes/ day was significantly correlated with cognitive function and mental status, which was primarily observed among urban respondents.

Considerable differences were observed between rural and urban areas regarding the relationship between napping, night-time sleep, and cognitive function. When designing interventions to enhance cognitive function, it's essential to take into account cultural context, geographical factors, and individual differences.

The use of coercive measures such as seclusion and restraint in forensic mental healthcare settings is widespread but controversial. Efforts to reduce these measures require knowledge of patient-related risk factors. The present study aimed to identify and confirm factors related to seclusion and restraint that can be assessed upon admission among men and women admitted to forensic hospitals in Ontario, Canada. We included cross-sectional Ontario Mental Health Reporting System admission data for adult patients admitted to 10 forensic psychiatric hospitals between April 1, 2013, and March 31, 2023. We determined patient demographic, administrative, and clinical characteristics associated with seclusion and physical and manual restraint episodes during the first three days of admission. We conducted logistic Generalized Linear mixed Models (GLMM) to examine the association between the independent variables and restraint and seclusion while accounting for variability across facilities. Of 7635 patients, 30.2% (n = 2302) were secluded, and 3.7% (n = 286) were restrained within their first three days of admission. Secluded patients were more likely to be young adults, male, and scored higher on violence and aggression measures. Being admitted due to fitness-related reasons, lack of insight, medication non-adherence, higher scores on the mania scale and cognitive impairment further contributed to the higher odds of being secluded, whereas neurocognitive disorder diagnosis and elopement behavior were protective factors. Restrained patients were also more likely to be young adults, have a diagnosis of mood or anxiety, neurodevelopmental or personality disorder, and scored higher on violence and aggression measures. Fitness-related status, medication non-adherence, and cognitive impairment further contributed to this model of restraint. Indigenous self-identification and immigration status were not significant contributors to either model. Clinicians can assess indicators associated with seclusion and restraint when forensic patients are admitted to forensic hospitals or during the first three days of their stay, enabling effective targeting of those needs to reduce the use of coercive measures.

Sexual satisfaction is a key component of human sexuality and is often considered the final stage of the sexual response cycle. Menopause is a physiological phenomenon characterized by various physical, mental, and sexual changes. This qualitative study aimed to explain the concept of sexual satisfaction from the perspective of Iranian postmenopausal women. the study involved 22 married postmenopausal women aged 40-70 years conducted from April 8, 2023, to March 4, 2024, at health centers affiliated with Kerman University of Medical Sciences. Participants were selected through purposive sampling to maximize diversity. Data were collected via semi-structured interviews until saturation was reached and were analyzed following the Graneheim and Lundman method using MAXQDA software. The study identified 16 subcategories and seven main categories include: 1. Sociocultural and religious factors, 2. Individual and contextual characteristics, 3. Psychological factors, 4. Traces of dysfunctional married life, 5. Sexual satisfaction following positive sexual interactions, 6. Sexual helplessness in menopause, 7. Sexual values in menopause. Sexual satisfaction during menopause is a mental, dynamic, and interactive concept significantly influenced by an individual's perception of their sexual relationship experiences and marital life. Physiological changes during menopause can lead to feelings of sexual helplessness, which impacts sexual satisfaction. Postmenopausal women may find that intimacy and emotional closeness with a sexual partner have a more substantial effect on sexual satisfaction than physical acts. Healthcare providers should develop interventions tailored to the sexual health needs of postmenopausal women, considering cultural, psychological, and physiological factors. Additionally, enhancing access to sexual health education can empower these women to articulate their needs and improve their sexual satisfaction.

In clinical settings targeting alcohol use disorder (AUD), it is often unclear whether a treatment option may best suit a patient's clinical needs. Clinicians providing AUD treatment are often required to predict patients' responses to guide treatment decisions. Recently, machine learning approaches have been used as tools in precision medicine to help guide these clinical decisions. However, the extent of their clinical utility in populations undergoing treatment is largely unknown. Using data from four Phase 2 randomized clinical trials affiliated with the NIAAA Clinical Investigations Group and a Phase 3 trial sponsored by the NIAAA, we developed a machine learning model to predict treatment response phenotypes derived from clustering drinking rates at the end of treatment. Harmonized data included demographics and baseline data from biological and clinical assessments. Follow-up analyses were performed to characterize treatment response phenotypes. Three clusters corresponding to mild (M_SDU = 1.3), moderate (M_SDU = 6.70) and severe (M_SDU = 15.3) alcohol consumption were identified from end-of-treatment drinking data. Performance of the tree-based classifier using out-of-sample test data was 71% with baseline drinking included and 61% without. Exploratory analyses revealed participants clustered as mild drinkers showed reductions in drinking across treatment (M_Difference = -0.731, SE = 0.114, p < 0.001) whereas participants clustered as severe had escalation in use (M_Difference = 6.82, SE = 0.52, p < 0.001). Although males drank more than females at baseline (M_Difference = 1.46, SE = 0.287, p < 0.001), no significant differences in consumption emerged at the end of treatment. Findings from this work indicate that alcohol use derived from patterns of consumption at the end of treatment maps onto unique treatment response trajectories for mild and severe forms of AUD. Furthermore, the identified clusters revealed sex-specific differences in alcohol consumption patterns across different phases of treatment. Overall, this highlights the utility of computational methods for deriving clinically meaningful AUD-related phenotypes across multiple studies, each with different treatments and participant characteristics.

Rural communities in the United States (US) are disproportionately burdened with higher suicide rates than non-rural ones, facing structural and cultural barriers that make it less likely for suicidal individuals to obtain help. Community-based interventions have been called for to address the need for integrative approaches relevant to the rural landscape. To facilitate increased adaptation/implementation of rural suicide prevention programming, we conducted a scoping review of the literature to evaluate the state-of-the-science. Following PRISMA-ScR guidelines, we searched for and identified relevant peer-reviewed literature across four databases, using dual screening/extraction throughout. We extracted information on key article characteristics, program descriptions, and methodological approaches to identify trends, gaps, and emergent themes. 29 articles were included in this review. Studies predominantly focused on suicide prevention for youth, particularly amongst Indigenous communities, with papers also concentrating on medical settings and US veterans. While a wide range of intervention and evaluation approaches were employed, few studies measured clinical outcomes, utilized theoretical frameworks or official rural definitions, or used comprehensive prevention strategies. This review offers investigators a guide to the existing evidence base and growing patterns in the field of suicide prevention in rural US areas. Results highlight the dearth of literature on prevention programming in this much needed yet overlooked area of study. Future intervention research should consider using context-specific rural classifications, relevant clinical outcomes, and comprehensive theory-backed strategies embedded in their approach.