Background: The rapid evolution of large language models (LLMs), such as Bidirectional Encoder Representations from Transformers (BERT; Google) and GPT (OpenAI), has introduced significant advancements in natural language processing. These models are increasingly integrated into various applications, including mental health support. However, the credibility of LLMs in providing reliable and explainable mental health information and support remains underexplored. Objective: This scoping review systematically maps the factors influencing the credibility of LLMs in mental health support, including reliability, explainability, and ethical considerations. The review is expected to offer critical insights for practitioners, researchers, and policy makers, guiding future research and policy development. These findings will contribute to the responsible integration of LLMs into mental health care, with a focus on maintaining ethical standards and user trust. Methods: This review follows PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines and the Joanna Briggs Institute (JBI) methodology. Eligibility criteria include studies that apply transformer-based generative language models in mental health support, such as BERT and GPT. Sources include PsycINFO, MEDLINE via PubMed, Web of Science, IEEE Xplore, and ACM Digital Library. A systematic search of studies from 2019 onward will be conducted and updated until October 2024. Data will be synthesized qualitatively. The Population, Concept, and Context framework will guide the inclusion criteria. Two independent reviewers will screen and extract data, resolving discrepancies through discussion. Data will be synthesized and presented descriptively. Results: As of September 2024, this study is currently in progress, with the systematic search completed and the screening phase ongoing. We expect to complete data extraction by early November 2024 and synthesis by late November 2024. Conclusions: This scoping review will map the current evidence on the credibility of LLMs in mental health support. It will identify factors influencing the reliability, explainability, and ethical considerations of these models, providing insights for practitioners, researchers, policy makers, and users. These findings will fill a critical gap in the literature and inform future research, practice, and policy development, ensuring the responsible integration of LLMs in mental health services. International registered report identifier (irrid): DERR1-10.2196/62865.

Several systematic reviews support nature-based interventions (NBIs) as a mechanism of enhancing mental health and wellbeing. However, the available evidence for the effectiveness of these interventions is fragmentary and mixed. The heterogeneity of existing evidence and significant fragmentation of knowledge within the field make it difficult to draw firm conclusions regarding the effectiveness of NBIs. This can only limit the development of interventions to support personal and planetary wellbeing, potentially resulting in ineffective and ill-targeted investment decisions. These concerns have hindered the translation of research evidence into practice and guidelines are urgently required to assist researchers, practitioners and policymakers in developing interventions to promote environmental stewardship and meet the health needs of diverse communities. A higher-order or meta-level synthesis is required to make sense of this evidence. This umbrella review synthesises evidence on the barriers and enablers to nature-based interventions through a summative review of existing published systematic reviews and meta-analyses. A systematic search in PsycINFO, PubMed, Greenfile, Web of Science, Embase, Scopus, Academic Search Complete (EBSCO), Environment Complete (EBSCO), Cochrane Library, CINAHL, Health Policy Reference Centre and Google Scholar was performed. This is a mixed method review, and systematic reviews with both quantitative and qualitative data synthesis were included. 64 systematic reviews were included in the synthesis. The descriptive data, extracted from each study, forms an overview of the characteristics of available evidence on nature-based interventions. A narrative synthesis is used to present the potential factors influencing the outcomes of NBIs. The risk of bias of the systematic reviews was assessed using a 16-item Assessment of Multiple Systematic Reviews 2 (AMSTAR2) checklist. Directions for future research, potential quality needs and recommendations for future research, policymaking, and practice are discusssed.

Background: In the World Health Organization (WHO) geographical region of South-East Asia, the mental health burden of adolescents appears high. Addressing this burden requires development of mental health policies consistent with international standards to assist governance, resource allocation and delivery of mental healthcare effectively. The aim was to identify current national mental health policies/plans/programs/legislation in South-East Asia, assess compliance with international standards and review inclusion of adolescents in these documents. Methods: Searches were conducted on WHO MiNDbank, official government websites, Google and Google Scholar. Documents were compiled and screened, data were extracted and evaluated following WHO Guidelines on Monitoring and Evaluation of Mental Health Policies and Plans. Frequencies of checklist and sub scores were calculated. Data were narratively synthesised. Findings: Fourteen mental health policies/plans/programs/legislation from 8 countries met inclusion criteria. Maldivian and Bangladeshi documents complied the greatest with WHO guidelines. All 8 countries considered adolescents to some extent in their documents. Only Indian documents consulted child health groups during policy development. Intra/Inter sectoral collaboration with child health divisions was highlighted in documents from Sri Lanka, Bangladesh, India and Maldives. Interpretation: Most South-East Asian nations had developed separate national mental health governance documents. However, their incorporation of adolescent mental health is rare and compliance with international standards were inconsistent. Binding mental health legislation separate from health legislation; inclusion of adolescents; addressing resource constraints; and guidelines for mental health policy development catered to low-and-middle-income countries are all essential to address the complex mental health needs of South-East Asian adolescents.

Introduction Indigenous people experience a unique set of health inequalities and social determinants that can negatively affect their physical health, mental health and wellness. This critical state of affairs is compounded by the limited availability of culturally appropriate care services and treatments for the different groups. In response, increasing numbers of studies are turning their focus to art-based interventions and how these might benefit Indigenous lives. The proposed scoping review aims to map this growing field of research.Methods and analysis This scoping review is based on the Arksey and O'Malley methodological framework and the subsequent enhancements proposed by Levac et al. Academic databases and grey literature sources will be searched to identify appropriate studies for inclusion. The search strategies of all databases were tested on 25 April 2024. This will be followed by a two-step screening process to be conducted by two researchers and consisting of (1) a title and abstract review and (2) a full-text review. Data from the selected studies will be extracted, collated and charted to summarise all relevant interventions, their outcomes and key findings. An Indigenous research partner will be hired as a consultant, and the research will be further informed by other stakeholders.Ethics and dissemination This study is the first step in a research programme involving working with Indigenous artists to codesign a pilot art-based intervention aimed at improving mental health and wellness among Indigenous people. The scoping review will identify the specific components in documented art-based interventions that have proven beneficial to this group. Since it will draw exclusively on data from published and public sources, no ethics approval is required. The results will be disseminated through knowledge translation activities with Indigenous organisations and art therapy groups; a summary of the results will also be distributed through Indigenous networks.

Background: Despite the potential for improved population mental health and wellbeing, the integration of mental health digital interventions has been difficult to achieve. In this qualitative systematic review, we aimed to identify barriers and facilitators to the implementation of digital technologies in mental healthcare systems, and map these to an implementation framework to inform policy development. Methods: We searched Medline, Embase, Scopus, PsycInfo, Web of Science, and Google Scholar for primary research articles published between January 2010 and 2022. Studies were considered eligible if they reported barriers and/or facilitators to the integration of any digital mental healthcare technologies. Data were extracted using EPPI-Reviewer Web and analysed thematically via inductive and deductive cycles. Results: Of 12,525 references identified initially, 81 studies were included in the final analysis. Barriers and facilitators were grouped within an implementation (evidence-practice gap) framework across six domains, organised by four levels of mental healthcare systems. Broadly, implementation was hindered by the perception of digital technologies as impersonal tools that add additional burden of care onto both providers and patients, and change relational power asymmetries; an absence of resources; and regulatory complexities that impede access to universal coverage. Facilitators included person-cantered approaches that consider patients' intersectional features e.g., gender, class, disability, illness severity; evidence-based training for providers; collaboration among colleagues; appropriate investment in human and financial resources; and policy reforms that tackle universal access to digital health. Conclusion: It is important to consider the complex and interrelated nature of barriers across different domains and levels of the mental health system. To facilitate the equitable, sustainable, and long-term digital transition of mental health systems, policymakers should consider a systemic approach to collaboration between public and private sectors to inform evidence-based planning and strengthen mental health systems. Protocol registration: The protocol is registered on PROSPERO, CRD42021276838.

Background The existing body of research exploring minority stressors and their impact on the mental health of Lesbian, Gay, and Bisexual (LGB) students in China remains limited in scope and often restricted to specific geographic regions..Methods A combination of snowball and targeted sampling strategies was used to recruit lesbian, gay and bisexual students (N = 1,393) for a cross-sectional, online survey in China. Participants (Mage = 20.00 years; 60.23% assigned male at birth) were tasked with completing a comprehensive questionnaire designed to capture various dimensions, including gender expression, minority stressors (e.g., school bullying, internalized homophobia), social psychological resources (e.g., perceived social support), and mental health-related outcomes (e.g., depression, anxious and stress). Our analytical approach involved hierarchical multiple regression analyses, mediation and moderated mediation modeling to elucidate the intricate interplay among these factors.Results Our findings shed light on the pronounced mental health disparities afflicting LGB college students in China, with notable prevalence rates of depression (48.1%), anxiety (57.1%), and stress (37.5%). A significant positive correlation was observed between experiences of school-based victimization and internalized homophobia, which, in turn, exhibited a direct association with affective symptoms. School bullying was positive with internalized homophobia, which was positively associated with affective symptoms. In addition to unveiling the indirect effects of school bullying on affective symptoms, our study identified direct links in this complex relationship. Notably, the availability of social support emerged as a pivotal factor, serving as a moderator within the mediation model by mitigating the path from school-based victimization bullying to internalized homophobia (beta = -0.077, P = 0.040).Conclusions This study underscores the pervasive and concerning mental health disparities experienced by LGB college students in China. In response, institutions of higher learning should intensify anti-bullying initiatives tailored to LGB students and implement comprehensive gender education programs. Moreover, concerted efforts should be directed at enhancing the accessibility of social support resources for LGB college students, with the aim of cultivating and sustaining favorable psychological well-being.

Given the links between the built environment and loneliness, there is interest in using place-based approaches (addressing built environment characteristics and related socio-spatial factors) in local communities to tackle loneliness and mental health problems. However, few studies have described the effectiveness, acceptability, or potential harms of such interventions. This review aimed to synthesize the literature describing local community-based interventions that target place-based factors to address loneliness and mental health problems, informing the development of future public health approaches. We searched PsycINFO, Medline, and Embase using a structured search strategy to identify English-language studies evaluating the effectiveness, acceptability, and potential harms of place-based community interventions in addressing loneliness and mental health problems, both in general and clinical populations. Seven studies met the inclusion criteria, classified as evaluating provision of community facilities (such as clubhouses), active engagement in local green spaces, and housing regeneration. None were randomised trials. Quantitative and qualitative findings suggested promising effects and/or acceptability of six interventions, with minimal potential harms. There is a clear need for randomised trials or quasi-experimental studies of place-based interventions to describe their effectiveness in addressing loneliness and mental health problems, as well as complementary qualitative work investigating acceptability. This will inform future policy development.

Education actively helps us develop our well-being and health, but postgraduate students are at high risk of depression. The prevalence of depression symptoms varies from 6.2% to 84.7% among them, and its changes throughout the years remains unclear. The present study aimed to estimate the real prevalence of depression symptoms among postgraduate students and the changes from 1980 to 2020. Thirty-seven primary studies with 41 independent reports were included in the meta-analysis (none reports were in high-quality, three were medium-to-high quality, 20 were low-to-medium quality, and 18 were low-quality), involving 27,717 postgraduate students. The pooled prevalence of overall, mild, moderate, and severe depression symptoms was 34% (95% CI: 28-40, I-2 = 98.6%), 27% (95% CI: 22-32, I-2 = 85.8%), 13% (95% CI: 8-21, I-2 = 97.3%), and 8% (95% CI: 6-11, I-2 = 81.0%), respectively. Overall, the prevalence of depression symptoms remained relatively constant through the years following 1980 (overall: beta = -0.12, 95% CI: [-0.39, 0.15], p = 0.39; mild: beta = 0.24, 95% CI: [-0.02, 0.51], p = 0.07; moderate: beta = -0.24, 95% CI: [-0.75, 0.26], p = 0.34; severe: beta = 0.13, 95% CI: [-0.25, 0.51], p = 0.50). Doctoral students experienced more depressive symptoms than did master's students (43% vs. 27%; Q = 2.23, df = 1, p = 0.13), and studies utilising non-random sampling methods reported a higher prevalence of mild depression and lower moderate depression symptoms than those that used random sampling (overall: 34% vs. 29%; Q = 0.45, df = 1, p = 0.50; mild: 29% vs. 21%; Q = 1.69, df = 1, p = 0.19; moderate: 16% vs. 25%; Q = 1.79, df = 1, p = 0.18; severe: 8% vs. 9%; Q = 0.13, df = 1, p = 0.72) despite these differences was not statistically significant. The prevalence of depression symptoms was moderated by the measurements and the quality of primary studies. More than one-third of postgraduates reported depression symptoms, which indicates the susceptibility to mental health risk among postgraduates. School administrators, teachers, and students should take joint actions to prevent mental disorders of postgraduates from increasing in severity.

Extant literature illustrates a substantive impact on human health because of climate change. Despite this, discussions of the ethical and policymaking role of US health care's response to this problem are underdeveloped within peer-reviewed literature indexed in core medical databases. We conducted a systematic literature review in August 2017 at Vanderbilt University Medical Center of the following medical, business and policy databases to examine the state of inquiry on this topic: PubMed, CINAHL, PsychINFO, JAMA Network, Health Affairs, Business Source Complete, Greylit.org, LexisNexis Academic, Proquest Dissertations and Theses Global. An initial sample of n = 4434 rendered n = 75 articles precisely addressing this question following a two-tiered systematic examination of content. US medical professionals were most concerned by the health impacts of air pollution and respiratory complications, extreme weather events, and rising infectious/vector-borne diseases. They were least concerned by rising rates of migration and stresses to sanitation systems. Medical professionals took a broadly proactive stance to the issue, highlighting the need to implement education and advocacy strategies. Politics was the least pertinent motivation for climate change-related recommendations. Furthermore, partnerships between health care and public agencies were identified as holding the greatest potential for meaningful change. Mitigation approaches were slightly more common than adaptation approaches. We conclude that, while the enthusiasm of the medical community is commendable, efforts to address climate change in US health care are overly fractured, and lack the necessary expertise for efficaciousness.

Background: The interrelationships between research evidence and policy-making are complex. Different theoretical frameworks exist to explain general evidence-policy interactions. One largely unexplored element of these interrelationships is how evidence interrelates with, and influences, policy/political agenda-setting. This review aims to identify the elements and processes of theories, frameworks and models on interrelationships of research evidence and health policy-making, with a focus on actionability and agenda-setting in the context of mental health in low- and middle-income countries (LMICs). Methods: A systematic review of theories was conducted based on the BeHeMOTh search method, using a tested and refined search strategy. Nine electronic databases and other relevant sources were searched for peer-reviewed and grey literature. Two reviewers screened the abstracts, reviewed full-text articles, extracted data and performed quality assessments. Analysis was based on a thematic analysis. The included papers had to present an actionable theoretical framework/model on evidence and policy interrelationships, such as knowledge translation or evidence-based policy, specifically target the agenda-setting process, focus on mental health, be from LMICs and published in English. Results: From 236 publications included in the full text analysis, no studies fully complied with our inclusion criteria. Widening the focus by leaving out 'agenda-setting', we included ten studies, four of which had unique conceptual frameworks focusing on mental health and LMICs but not agenda-setting. The four analysed frameworks confirmed research gaps from LMICs and mental health, and a lack of focus on agenda-setting. Frameworks and models from other health and policy areas provide interesting conceptual approaches and lessons with regards to agenda-setting. Conclusion: Our systematic review identified frameworks on evidence and policy interrelations that differ in their elements and processes. No framework fulfilled all inclusion criteria. Four actionable frameworks are applicable to mental health and LMICs, but none specifically target agenda-setting. We have identified agenda-setting as a research theory gap in the context of mental health knowledge translation in LMICs. Frameworks from other health/policy areas could offer lessons on agenda-setting and new approaches for creating policy impact for mental health and to tackle the translational gap in LMICs.

Background: Youth with mental health disorders often experience challenges when transitioning into adult roles (e.g. independent living, work and community engagement). Health interventions that address the needs of youth with mental health disorders during these challenges in their development (i.e. developmental transitions) have not been reviewed in the literature. This scoping review examines the peer-reviewed research that describes evaluated interventions addressing developmental transitions for youth with mental health disorders. Methods: A search of four prominent health literature databases (CINAHL, Embase, MEDLINE and PsycINFO) was conducted to identify evaluated developmental transition interventions for adolescents and youth (12-25 years) with mental health disorders. Study selection and analysis were guided by a methodological framework for conducting scoping reviews. Selected studies were described, assessed for quality and collated based on ten dimensions from two notable conceptual frameworks in developmental transitions and disability. Results: Nine studies met the inclusion criteria. The interventions within these studies demonstrated five specialized and four multi-faceted programmes (i.e. multiple domains). All domains from the two conceptual frameworks were represented differently across studies. The sub-domains from these studies were most frequently related to vocational-focused interventions, least frequently related to social activities and living situation and did not explicitly map onto the sexuality sub-domain. Three multi-faceted interventions incorporated all domains and utilized each intervention approach. Study quality was rated for seven of the nine studies. Quantitative methodology for five of the seven studies was rated as higher quality. Conclusions: Evaluated interventions described in the transitions literature for youth with mental health disorders predominantly focus on vocational needs. The least studied areas were the personal and interpersonal domains. These domains were only incorporated within interventions addressing multiple domains of developmental transitions. These insights can be helpful in guiding evidence-based practice and policy development, as well as informing gaps for future research programmes.

Claims that women who have elective abortions will experience psychological distress have fueled much of the recent debate on abortion. It has been argued that the emotional sequelae of abortion may not occur until months or years after the event. Despite unclear evidence on such a phenomenon, adverse mental health outcomes of abortion have been used as a rationale for policy-making. We systematically searched for articles focused on the potential association between abortion and long-term mental health outcomes published between January 1, 1989 and August 1, 2008 and reviewed 21 studies that met the inclusion criteria. We rated the study quality based on methodological factors necessary to appropriately explore the research question. Studies were rated as Excellent (no studies), Very Good (4 studies), Fair (8 studies), Poor (8 studies), or Very Poor (1 study). A clear trend emerges from this systematic review: the highest quality studies had findings that were mostly neutral, suggesting few, if any, differences between women who had abortions and their respective comparison groups in terms of mental health sequelae. Conversely, studies with the most flawed methodology found negative mental health sequelae of abortion.