Background: Individuals living with HIV often experience higher levels of depression compared to the general population. Community-based interventions can enhance socio-economic conditions and social support, potentially reducing stigma and discrimination and thereby improving mental well-being. This study assessed the effectiveness of the community-based antiretroviral therapy (ART) delivery (CAD) intervention in enhancing the mental health of stable individuals living with HIV in Cambodia.

Methods: A two-arm quasi-experimental study was conducted across 20 ART clinics in the capital and nine provinces from May 2021 to April 2023. The study compared the CAD intervention with the multi-month ART dispensing (MMD) model. Structured questionnaires were administered at baseline and endline, measuring depression symptoms with the Center for Epidemiologic Studies Depression Scale – 10 items (CES-D-10). Participants scoring ≥10 were classified as exhibiting depression symptoms. A difference-in-difference analysis evaluated the effectiveness of CAD on depression symptoms, with adjusted odds ratios (aOR) and 95% confidence intervals (CIs) calculated.

Results: Of the 4089 stable individuals living with HIV who participated in the baseline survey, 2040 were in the CAD group. Among them, 79.7% (n=1626) in the CAD group and 70.3% (n=1441) in the MMD group completed the endline survey. While depression symptoms rose in both groups, the increase was less pronounced in the CAD group (aOR=0.65, 95% CI: 0.50, 0.84). The CAD group had a 6.7 percentage point lower probability of depression symptoms compared to the MMD group. At baseline, the CAD group had a higher percentage of participants with depression symptoms (21.7% vs. 16.8% in MMD). By the endline, both groups showed an increase, but the CAD group (27.1%) experienced a smaller rise than the MMD group (28.9%).

Conclusions: The findings indicate a troubling trend of increasing depression symptoms among stable individuals living with HIV in both groups, likely exacerbated by the COVID-19 pandemic. However, the CAD intervention appeared to mitigate the rise in depression symptoms more effectively than the MMD model, suggesting its potential as a vital strategy in improving mental health outcomes among this vulnerable population.

While the impact of trauma exposure on health is well studied, less is known about the long-term effects of post-traumatic stress and the role of resilience resources on holistic well-being. Most research focuses on individual-level protective factors, with limited attention to systemic-level strengths, particularly in relation to broader indicators of positive functioning, such as subjective physical health and positive emotional states. These gaps are especially pronounced for Black and Latinx populations, where culturally relevant strengths and community resources remain understudied despite disproportionate trauma exposure.

This longitudinal study examined how resilience resources across multiple domains moderated the relationship between post-traumatic stress symptoms (PTSS), measured by the PCL-S (Weathers et al., 1993), and subjective well-being among Black and Latinx adults (n=306 43% Black American; 57% Puerto Rican 66% female; 34% male). We investigated whether PTSS (measured at mean age 36) predicted subjective physical (i.e., disturbed sleep, subjective health concerns; SHC) and emotional well-being (i.e., anger, happiness) in participants’ early 40s. We explored moderators across four domains: individual adaptation (i.e., active coping), relational resources (i.e., social support by friends), cultural strengths (i.e., ethnic/racial belonging), and community resources (i.e., access to safe neighborhood recreational space; ASRS).

PTSS was significantly associated with increased SHC (β=0.13, p<0.001), disturbed sleep (β=0.01, p<0.001), anger (β=0.03, p=0.005), and decreased happiness (β=-0.004, p=0.003). In adjusted analysis controlling for gender and race/ethnicity, active coping and ASRS weakened the relationship between PTSS and disturbed sleep (β=-0.01, p<0.001; β=-0.01, p=0.048) and PTSS and SHC (β=-0.14, p=0.001; β=-0.15, p=0.006). The effect of PTSS on anger (β=-0.04, p=0.033) and happiness (β=0.01, p=0.030) was attenuated by a greater sense of belonging. Social support from friends showed no significant moderation.

Findings suggest that active coping and access to safe recreational spaces contribute to subjective physical well-being, while a sense of cultural belonging enhances emotional well-being, reducing anger and increasing happiness, among those who have experienced PTSS. These differential patterns of risk and protection underscore the importance of considering a range of resilience-conferring characteristics and resources at different contextual levels when examining dimensions of well-being in the context of post-traumatic stress in Black and Puerto Rican adults.

Background: As concerns about mental health and substance use rise in the United States, many organizations want new or expanded education and resources for employee mental health and well-being. To help meet this need, Purdue Extension utilized federal grant funds to develop an introductory educational curriculum on mental well-being specific to workplaces, called Compassion & Resilience Education at Work or CREW.

Description: After conducting a needs assessment survey among employers throughout Indiana to gauge the needs, topics, and content gaps that this curriculum could address, a team of Purdue University professionals with various expertise worked together to create the curriculum content. The aim of CREW is to equip employees with tools to understand and address mental health and substance use concerns. The curriculum content is grounded in the following theories: Health Stigma and Discrimination Framework, Adult Learning Theory, and the Social Ecological Model (SEM). CREW consists of three content topics that Extension and other health education professionals can offer to workplaces: Work-Life Balance, Stress Management, and Stigma Reduction. Each session can be delivered virtually or in person, and as standalone one-hour sessions or as a series. The curriculum underwent both internal and external peer review. A team delivered pilots for each curriculum topic virtually and in person to test its delivery efficacy and to elicit feedback from participants and employers before making it available for use nationwide.

Lessons Learned: Workplaces across industries, especially smaller businesses and those in rural communities, demonstrate great interest for introductory workplace wellness education that includes mental health. Extension and health education professionals are well-suited to address these concerns, but several existing programs are too time-intensive or have daunting subject matter for adaptation into work environments. Extension professionals recognize these needs and barriers, but require training to build confidence and flexible programming options to address them effectively.

Recommendations/Implications: Though the initial reception and results of this research-based curriculum have been positive, additional efficacy evaluation and building its basis as evidence-based mental health education is warranted. Additionally, this program can foster cultural change in work environments to become more recovery friendly.

Background:
Boston Children’s Hospital’s Office of Community Health (OCH) invests in local organizations that support the health and social needs of children and families. In 2023, OCH launched the Metro South West Community Health initiative, serving Brockton, Framingham, Needham, Quincy, Randolph, Waltham, and Weymouth. The initiative funds 25 projects focused on community mental health and well-being. A key objective is to engage youth directly on issues impacting their mental health, thus leading to the creation of Alliance to Growth (AtG).

Description:
AtG engages high school-aged youth from the priority communities in a youth-centered environment. The program aims to amplify youth voice, teach advocacy skills, and gather youth perspective on supports needed in schools and communities. From 2023 to 2025, OCH hosted two AtG cohorts, engaging 22 youth from 11 organizations. Meeting topics are driven by youth participants, who identify needs across communities and request trainings to better support their own mental health and that of their peers. The current cohort also contributed to the hospital’s 2025 community health needs assessment and is planning a youth-led summit.

Lessons Learned:
Youth expressed a desire to build connections with peers and take ownership of the group, leading to the re-naming of the group and rotating meeting locations within their communities. Meetings prioritize youth input and ensure speakers reflect diverse backgrounds and experiences. Youth requested trainings on topics including Teen Mental Health First Aid, Healthy Social Media Habits, and Question, Persuade, Refer Suicide Prevention. Qualitative feedback activities were conducted during and at the end of each cohort. Youth reported feeling more empowered, educated, and confident in their ability to advocate for mental health. These findings will help improve future cohorts and inform the hospital’s community health strategies.

Implications:
AtG strengthened relationships with youth across geographically dispersed communities, creating a supportive network that enhances emotional well-being for individuals and communities. Youth have returned from previous cohorts, engaged in additional learning, and formed connections across communities. OCH will continue to incorporate youth-requested activities into future AtG cohorts; further enriching the program and empowering youth to address their mental and behavioral health in a safe, supportive environment.

Mental health is a global priority, fundamental to health and development of all nations. The contribution of mental disorders to global disease burden 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 suggested adoption of a community-based mental health care approach where the locus of services shifted from institutional care to local communities. Over the last five decades in India, diverse approaches of mental health care have emerged because of an interaction of the 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, the 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 low-and-middle income countries at large. This narrative review attempts to map and synthesize insights from community-based mental health interventions in India across diverse contexts. We searched peer reviewed journal articles and book chapters published in English language between years 2010-2023.

We present the synthesis of approaches used in 41 community-based mental health interventions where we unpack key intervention components and processes adopted in primary prevention and promotion; identification and case detection; treatment and care, and rehabilitation in the community. This review presents key learnings for the practitioners about the role of the ‘community’, the diversity and commonalities in the approaches across contexts, the role of various actors in service delivery and shared values guiding the conceptualization and implementation of community-based mental health interventions in India.

The United States faces increasing challenges in mental health care delivery, particularly in geographic areas with high ethnolinguistic fractionalization. These areas often experience both elevated prevalence rates of mental health disorders and significant mental health workforce shortages, highlighting the critical need for culturally competent care. Community-based interventions, while promising, frequently encounter barriers during implementation due to insufficient cultural adaptation and varying delivery effectiveness.

We introduce the concept of a 'cultural broker'—a vital yet understudied stakeholder who bridges the gap between evidence-based interventions and diverse communities. Drawing from Ronald Burt's (2005) social capital theory, cultural brokers are individuals who connect disconnected groups and translate mental health knowledge and practices across cultural contexts. Through a qualitative study of the Mental Health First Aid (MHFA) program organized by the American Muslim Health Professionals, we conducted focus groups with six trainers and semi-structured interviews with 25 trainees to examine how they navigate their roles as cultural brokers.

Data from the focus groups and interviews were coded for themes related to cultural brokerage and stigma resistance. Participants represented diverse backgrounds, providing insights into delivering culturally adapted mental health interventions. MHFA was selected for its structured approach to mental health literacy and community engagement, making it ideal for evaluating the impact of cultural brokers.

Our findings reveal that MHFA trainers, in particular, serve as active agents of change by challenging cultural stigma through specific strategies: incorporating Islamic perspectives on mental wellness; addressing intergenerational trauma; and creating culturally safe spaces for mental health discussions. Trainers consistently reported navigating dual identities—as both mental health advocates and cultural insiders—allowing them to effectively translate mental health concepts while maintaining cultural authenticity.

This research demonstrates how cultural brokers build community resilience through: (1) actively resisting stigma by using different cognitive frames, (2) fostering collective care through peer support networks, and (3) adapting evidence-based interventions to enhance their cultural relevance. These findings have important implications for scaling culturally adapted mental health interventions across diverse communities in the United States.

Background: Social isolation is a leading cause of mental illness and preventable death. To address these issues, the Resilient Connections program builds participant capacity to create need fulfilling relationships with friends, family, and the broader community. Delivered by community health workers (CHWs) in vulnerable communities, the innovative approach addresses disparities in access to mental health treatment and builds mental health workforce capacity. In delivering the program, CHWs develop skills in motivational interviewing and support group facilitation. The theory-driven program helps participants identity and express their emotions and psychological needs. From this foundation, participants learn several skills related to resolving conflict and achieving goals that promote emotional well-being. This study evaluates the program, examining changes over time in participant need fulfillment, anxiety, and depression.

Method: This longitudinal observational evaluation of the Resilient Connections program collected data from participants at baseline and 3-month follow-up. CHWs recruited participants in a predominantly low-income Spanish speaking neighborhood in El Paso, Texas through churches, community centers, and word of mouth. CHWs recruited 168 participants at baseline, with 108 (64%) completing the 3-month follow-up data collection. The interview assessed need fulfillment, anxiety, and depression. Regression models predicted change over time on these outcomes.

Results: Regression models indicate participants reported decreases in anxiety (Cohen’s d = -.54, 95% CI [-.73, -.34], p < .001) and depression (Cohen’s d = -.52, 95% CI [-.69, -.36], p < .001). Need fulfillment among participants increased from baseline to the 3-month follow-up (Cohen’s d = .33, 95% CI [.18, .47], p < .001).

Conclusions: Findings suggest Resilient Connections is a promising approach to mental health promotion. This innovative CHW delivered intervention may be able to extend the mental health workforce and serve as a population approach to mental health promotion.

Background: Deviant Place Theory suggests that individuals in high-risk environments face greater exposure to victimization, regardless of personal behaviors. In schools, unsafe or hostile environments may increase the risk of victimization, which in turn contributes to suicidal thoughts and behaviors (STB). This study applies latent class analysis (LCA) to identify school profiles of victimization and STBs, accounting for key sociodemographic factors.

Methods: Data were drawn from the 2023 Youth Risk Behavior Survey (YRBS), comprising 20103 adolescents. LCA identified victimization profiles using school-based indicators of bullying, physical fighting, racial discrimination, threats, and STBs. The best-fitting model was determined using AIC, BIC, and entropy. Multinomial regression examined associations between class membership, adjusting for age, sex, race/ethnicity, and sexual identity.

Results: LCA identified six distinct classes: Class 1 as “High suicide risk, high victimization, low deviance” with 5.0% representation; Class 2 as “Moderate suicide risk, high victimization, high deviance” with 0.8% representation; Class 3 as “high suicide risk, low victimization, low deviance” with 10.7% representation; Class 4 as “low suicide risk, moderate victimization, low deviance” with 16.2% representation; Class 5 as “low suicide risk, low victimization, low deviance” as 67.0% representation; and Class 6 as “low suicide risk, low victimization, high deviance” with 0.3% representation. Higher-risk classes were characterized by frequent bullying, physical aggression, discrimination, and students experiencing STBs. Sexual minority adolescents, younger aged adolescents, and racially/ethnically marginalized groups were disproportionately represented in high-risk classes.

Conclusions: These findings support Deviant Place Theory, highlighting environmental risks as key drivers of victimization and mental health disparities. School victimization is not evenly distributed and disproportionately affects vulnerable groups, reinforcing systemic inequities. Creating safer school environments and addressing structural risks may help reduce victimization and its mental health consequences. Future research should explore intersectional vulnerabilities and school-based interventions.

Background: Suicide and overdose are the leading causes of death in the first year after childbirth. Thus, identifying individuals at risk for maternal suicide is of clinical and public health importance. However, knowledge of risk factors for postpartum suicidal ideation (SI) is limited and has typically been examined among primarily white, socioeconomically privileged samples. Furthermore, stark health disparities exist and are worsening; Black, Indigenous, and People of Color (BIPOC) experience the highest rates of both perinatal SI and maternal mortality. The present study examined risk factors for postpartum SI among a diverse urban sample.

Methods: Data were derived from the electronic health records of 1,686 postpartum patients (47.9% white, 28.9% Black/African American, 21.5% publicly insured, 11.6% unemployed) at an urban obstetric clinic from 2021 to 2023. SI was assessed via endorsement of the Edinburgh Postnatal Depression Scale (EPDS) item #10. Bivariate analyses were used to compare demographic, psychological, obstetric, and neonatal characteristics among individuals with and without postpartum SI, and multivariable logistic regression was used to examine predictors of SI.

Results: SI was endorsed on 51 EPDS screens (3.1%). Endorsement of SI was significantly associated (p<.05) with public health insurance (34.7% vs. 21.1%), younger age (mean age 31.8 vs. 34.4 years), lifetime mood disorder diagnosis (17.6% vs. 7.6%), use of psychiatric medication (35.3% vs. 9.9%), preterm delivery (22.0% vs. 9.0%), lower birthweight infant (2988.1 vs. 3264.4 grams), and NICU admission (25.0% vs. 12.4%). In the final adjusted model, use of psychiatric medications (aOR=3.55, 95% CI:1.56-8.06, p=.003) remained significantly associated with SI, and preterm delivery (aOR=3.46, 95%CI:0.95-12.67, p=.060) was marginally significant.

Conclusions: Use of psychiatric medications at screening emerged as a significant predictor of postpartum SI among a diverse sample. Our findings also suggest that individuals who delivered prior to 37 weeks gestation could be at increased risk for postpartum SI; further research is needed to explore the mechanisms by which preterm delivery could lead to heightened postpartum distress. Clinically, routine mental health screenings in obstetric practice and holistic assessment of an individual’s personal stressors (e.g., socioeconomic, obstetric) play a critical role in the prevention of maternal suicide.

Introduction. Social isolation and loneliness are significant public health concerns, particularly for individuals with psychiatric disabilities. While prior research has established a link between social isolation and loneliness, the mechanisms underlying this relationship remain unclear. This study examines whether mattering—a psychological construct reflecting the perception of being important to others—mediates the relationship between social isolation and loneliness among adults with psychiatric disabilities.

Methods. Data were drawn from Wave 5 of the National Survey on Health and Disability (NSHD), which included 1,919 respondents. The analytical sample consisted of 181 individuals who identified their primary disability as a mental illness or psychiatric condition. Social isolation was measured using a six-item composite index, mattering was assessed using the General Mattering Scale (GMS), and loneliness was evaluated using the three-item UCLA Loneliness Scale. Mediation analysis was conducted using the Preacher and Hayes PROCESS macro in SAS, with 5,000 bootstrapped samples to test indirect effects.

Results. Social isolation was significantly associated with loneliness (b=0.30,p=0.0018). However, when mattering was included as a mediator, the direct effect of social isolation on loneliness became non-significant (b=0.05,p=0.5904), while mattering significantly predicted loneliness (b=−1.08,p<0.0001). The indirect effect was significant (95% CI: [0.1395, 0.3821]), indicating full mediation.

Conclusions. Mattering fully mediates the relationship between social isolation and loneliness among individuals with psychiatric disabilities. These findings suggest that interventions aimed at enhancing perceptions of mattering may help mitigate loneliness in this population.