Background: Smoking prevalence is disproportionately high among individuals with mental disorders, who also show reduced cessation success, suggesting that current cessation interventions may not fully address their specific needs. A barrier to smoking cessation is the fear that quitting may worsen mental health, yet little is known about how individuals with mental disorders experience guideline-conform cessation treatments, which may address such concerns. Objective: This qualitative study explored the perspectives of smoking individuals with comorbid mental disorders who participated in a standardized, manual-based, cognitive behavioral smoking cessation program to identify targets for optimizing guideline-conform interventions for this population, spanning treatment engagement, perceived challenges, and facilitators within this context. Methods: Semistructured interviews were conducted with 11 participants representing diverse cessation trajectories (sustained abstinence, relapse, and no quit attempt) 6 months after treatment completion. Data were analyzed using reflexive thematic analysis. Results: Three overarching themes were identified. First, participants described smoking cessation as a multidimensional, processual experience extending beyond behavioral change to encompass psychological and social dimensions, characterized by nonlinearity, adaptive meaning-making, and improvements in self-efficacy despite transient strain during early abstinence. Second, smoking was experienced as a functionally embedded practice serving affective, habitual, and social functions, with motivation emerging as dynamic and relationally sustained rather than stable. Third, treatment engagement was shaped by motivational states and contextual circumstances, with participants offering favorable evaluations of the structured intervention alongside recommendations for greater individualization and flexibility. Notably, mental health–related concerns about cessation largely persisted despite predominantly positive or neutral mental health outcomes, a pattern consistent with cognitive immunization processes. Conclusions: Guideline-conform smoking cessation treatment appears feasible and largely well-received by individuals with comorbid mental disorders. The findings highlight the need for targeted psychoeducation to address persistent misconceptions about the mental health risks of cessation, as well as individualized, context-sensitive treatment adaptations, including greater flexibility in session structure, motivational support beyond the active treatment phase, and explicit attention to the social and functional embeddedness of smoking, to improve cessation outcomes in this high-risk population. Trial Registration: ISCRTN ISRCTN12859609; https://www.isrctn.com/ISRCTN12859609
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Background: Self-harm, including suicidal thoughts, self-injurious behavior, and disordered eating, is a major public health concern among adolescents and young adults. Youth increasingly encounter self-harm–related content online, including websites that explicitly encourage harmful behaviors. Although exposure to such content has been linked to poorer mental health, most research is cross-sectional and has not examined longitudinal exposure trajectories. Whether persistent exposure represents a distinct digital risk pattern remains unclear. Objective: This study examined longitudinal trajectories and correlates of exposure to self-harm–encouraging websites over 1 year and tested whether persistent exposure was associated with subsequent suicidal ideation, self-injury, and disordered eating. Methods: We analyzed data from 2197 US youth aged 13 to 22 years who completed waves 2 and 4 of Project Lift Up, a national longitudinal cohort study. Website exposure was categorized into 4 trajectories: none, desist (wave 2 only), new (wave 4 only), and persistent (both waves). Categories reflected reported exposure at the 2 assessment waves rather than the frequency or continuity of website use between assessments. Logistic regression models estimated associations between exposure trajectory and wave 4 suicidal ideation, self-injury, and disordered eating, restricting analyses to participants without the respective outcome at wave 2. Models were adjusted for demographics and wave 2 depression or anxiety symptoms and other mental health indicators. Results: Overall, 26.5% (583/2197) reported exposure to self-harm–encouraging websites at wave 2, and 18.5% (407/2197) reported persistent exposure. Privacy concerns, embarrassment, curiosity, and lack of offline support were associated with greater odds of persistence (adjusted odds ratios [aORs] 1.84‐3.23), whereas accidental exposure was associated with lower odds of persistence (aOR 0.28, 95% CI 0.19‐0.41). Compared with no exposure, persistent exposure was associated with higher odds of suicidal ideation (aOR 1.88, 95% CI 1.24‐2.86; =.003), self-injury (aOR 3.14, 95% CI 2.05‐4.80; <.001), and disordered eating (aOR 2.46, 95% CI 1.54‐3.93; <.001). Adjusted predicted probabilities showed a graded pattern, with persistent exposure associated with the highest predicted probabilities (suicidal ideation: 33.4% vs 21.3%; self-injury: 25.7% vs 10.2%; disordered eating: 11.7% vs 5.3%). New exposure was associated with increased odds of self-injury (aOR 2.32, 95% CI 1.30‐4.15; =.004) but was not significantly associated with suicidal ideation or disordered eating. The desist trajectory was not significantly associated with outcomes. Conclusions: Persistent exposure to self-harm–encouraging websites may represent a distinct digital risk pattern associated with higher subsequent odds of suicidal ideation, self-injury, and disordered eating. Assessing patterns of repeated website exposure and youths’ motivations for seeking this content—not merely whether exposure occurred—may improve the identification of youth at heightened risk and inform digital prevention and clinical intervention strategies.
A friend once told me approvingly that someone she knew had talked his schizophrenic adult son into having a vasectomy. Though I read “talked into” as “coerced,” I didn’t say anything.
Oh my god, I thought instead, maybe I shouldn’t be a mother. I’d had a break with reality after stopping my antipsychotic 10 years before, frustrated with weight gain. I had returned to taking medication and my mental health had stabilized long before this conversation. But I was now pursuing pregnancy.
BackgroundIntegrated youth mental healthcare is an approach that has evolved in response to the global escalation of young people’s poor mental health, and the failure of current mental health systems and models to improve this situation. Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) young people have disproportionately high rates of poor mental health compared with their cisgender, heterosexual peers, but there is a dearth of research examining how best to integrate mental healthcare for LGBTQ+ youth.AimTo identify differences in the discursive construction of LGBTQ+ identity, youth, and mental health between LGBTQ+-specific youth mental health services and mainstream services and how these differences may facilitate or limit the integration of mental healthcare.MethodsWe conducted a qualitative secondary analysis using Foucauldian discourse analysis, a method that centralises power and knowledge, to examine the discourses used to construct LGBTQ+ identity, youth, and mental health across four different mental health services. Using epistemic injustice as a theoretical framework, we analysed interviews with LGBTQ+ young people and staff (n = 30).ResultsMainstream discourses of LGBTQ+ youth mental health concentrate on risks, trauma, and harm, and reinforce a passive, pathologised, and patronised subject position for LGBTQ+ youth. In contrast, we identified three counter-discourses in LGBTQ+-specific mental health services: Knowing and telling, Resisting pathology, and Capability. These counter-discourses allowed for wider, transformative possibilities for LGBTQ+ youth subjectivities and mental wellbeing.DiscussionExisting models of integrated youth mental healthcare privilege a clinical, developmental, and universal approach that does not consider justice or the oppressive power systems implicated in LGBTQ+ young people’s mental healthcare. Without addressing in/justice, there will remain fundamental irreconcilable differences that will forfeit effective and inclusive systems of mental healthcare for LGBTQ+ young people.
Background: Many adolescents experience elevated stress and anxiety; yet, access to effective psychological support is limited. Brief digital mental health interventions, such as slow breathing (SB) and detached mindfulness (DM), offer a potentially scalable approach to promoting emotion regulation in daily life. Objective: This study aimed to investigate whether 1 week of daily practice with a SB or DM intervention reduced stress, anxiety, and negative metacognitive beliefs in youth, and explored participants’ experiences to inform the development of accessible, youth-tailored digital interventions. Methods: A mixed method approach was used, including quantitative and qualitative data. A total of 147 university students between 16 and 19 years old were randomly allocated to the DM (n=49), SB (n=49), or passive control group (n=49). Participants who were allocated to DM or SB practiced the intervention for 1 week. Stress, anxiety, and negative metacognitive beliefs were assessed at pre- and postintervention using self-report questionnaires. The quantitative data were analyzed with linear mixed-effects models, and we explored daily changes in intervention effect. After posttest, participants were invited to focus groups to evaluate their experience with the interventions (n=37). The qualitative data were analyzed with a content analysis. Results: Our results showed that a week-long DM intervention significantly reduced stress compared with the control condition. No other differences emerged for the main outcomes on pre- and postmeasurements. However, in the SB group, higher perceived usability was associated with greater reductions in stress. Qualitative findings showed that both interventions were viewed as calming, easy to use, and acceptable, while also highlighting challenges such as maintaining motivation and integrating the exercises into daily routines. Conclusions: This study provides early formative evidence that brief digital interventions such as SB and DM are feasible and usable, with preliminary indication that DM intervention may support short-term stress reduction. Future research should focus on enhancing motivation and sustained engagement to maximize the effectiveness of digital mental health tools for late adolescents. Trial Registration: OSF Registries osf.io/vu56y; https://osf.io/vu56y/overview
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Lower bone density in the spine is linked with poorer cognitive function, in research findings that could be of particular importance for postmenopausal women.
The study, in Radiology, suggests that chest computed tomography (CT) scans could help identify people with accelerated brain aging who might be at risk of dementia.
The deep-learning analysis found that bone density in the thoracic vertebrae of the spine was associated with both functional and imaging measures of age-related brain degeneration at a later stage.
Nonetheless, the researchers caution that their results do not mean osteoporosis causes dementia.
“This study is not about cause and effect, but rather the observation of a metabolic syndrome that may cause both bone and brain degeneration,” said researcher Shadpour Demehri, MD, from Johns Hopkins university in Baltimore, Maryland.
“The co-occurrence observed in the study may reflect shared metabolic drivers of aging, including insulin resistance, dyslipidemia, and menopausal change, rather than a direct bone-to-brain effect.”
The study is the first longitudinal secondary analysis linking baseline vertebral bone mineral density to changes in white matter structure, white matter hyperintensity progression, and cognition.
It included 715 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent noncontrast chest CT scans together with MRI and cognitive besting.
Longitudinal data on white matter hyperintensities and fractional anisotropy were available for 408 and 405 of these individuals, respectively.
Imaging and clinical assessments revealed that lower baseline thoracic vertebral volumetric bone mineral density (vBMD) was associated with white matter injury and faster decline in global cognition, particularly among people with diabetes.
Lower baseline vBMD was associated with a faster decline in global cognitive performance, with this link seen in specific brain regions.
Specifically, lower vBMD was associated with faster accumulation of white matter hyperintensities in the corpus callosum, which is associated with executive functioning, working memory, and attention.
It also correlated with faster fractional anisotropy decline in the anterior limb of the internal capsule, which is involved in executive function as well.
“Identifying individuals, particularly postmenopausal women, with low vBMD may help flag those at risk for parallel skeletal and neurologic decline, allowing earlier screening and shared risk-factor management,” reported lead researcher Sara Momtazmanesh, MD, also from Johns Hopkins, and co-workers.
They summarized: “These findings support the potential value of deep learning–enabled opportunistic vBMD assessment on chest CT for risk stratification beyond skeletal outcomes.”
By Ananya Meenakshi, 2026 Youth Mental Health Academy Intern, Child Mind Institute
How the Stavros Niarchos Foundation (SNF) Global Center’s second annual Global Summit on Youth Mental Health is advancing opportunities for young people and experts to exchange perspectives and shape priorities together.
Intergenerational dialogue is an excellent way for different generations to learn from each other’s experience; each generation can share their knowledge to develop helpful solutions.
Around the world, instances of conflict and political instability have often led to serious consequences. The potential for peace is more likely to be achieved if there is a higher level of collaboration and understanding between generations. Intergenerational dialogue, therefore, can be an effective way to address trauma and foster resilience.
Jennifer Matibi, Member of the Global Youth Advisory Council and the SNF Global Center (left) and Jason Bantjes SNF Global Center Scientific Lead in South Africa and Director at the South African Medical Research Council
To ensure intergenerational dialogue is beneficial, it is important to be respectful, mindful of everyone’s roles, adapt to changing needs, and set mutual expectations. The SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute’s Global Youth Advisory Council (GYAC) members are excited to further engage in shared learning and brainstorming during the second annual Global Summit on Youth Mental Health in New York, September 21-24.
“Young people’s lives are structured much more differently than Greece’s older generations, who may have had their path laid out for them,” explains Faidra Kaberidi, a GYAC member from Greece. “The biggest challenge today is that the unlimited opportunities available to us can be overstimulating, and older generations might not understand the difficulty of having to choose.”
These unlimited opportunities, she adds, include lifestyle choices like style, sexuality, gender, personality, and so forth.
“Though being given these opportunities is not negative, it can be challenging for young people to explore and discover themselves in a sea of endless opportunities,” says Kaberidi.
As we pull back the curtain, the summit is multigenerational exchange in action — giving youth an open space to discuss issues, develop their skills, and create solutions.
The event will take place at the Child Mind Institute’s New York headquarters under the theme, “Redefining Mental Health Care: Youth Perspectives in a Changing World.” It will feature three diverse sessions including panel discussions, breakout sessions, and a youth-moderated Q&A with global experts. The sessions will cover three categories:
“Meeting Young People Where They Are” will focus on topics such as school systems and digital spaces.
“What Do Young People Care About” is set to expand into climate change, economic instability, and political polarization.
“Setting Young People Up for the Future” looks at preparing young people to take care of their mental health in our modern world.
To ensure challenges are being solved efficiently, intergenerational dialogue must therefore be established. Both parties have valuable knowledge to contribute to the bettering of our society. The youth summit successfully implements these progressive values and facilitates the inclusion of cross-generational conversations.
By laying the path for both groups to speak and listen to each other, we are supporting the advancement towards a desired, exceptional future.
BackgroundSerious mental illness imposes a substantial burden. Pharmacologic treatments remain only partially effective and are associated with significant side effects, highlighting the need for novel treatment approaches. Ketogenic metabolic therapy (KMT) is emerging as an intervention for serious mental illness, with a growing evidence base and strong patient interest. A critical barrier to KMT implementation is the lack of health care professional (HCP) competence and readiness to discuss KMT with patients with serious mental illness. Existing training does not adequately address HCP competence in presenting KMT as a treatment option. This study describes the pilot-testing of “Live It, Launch It” (LI-LI), the first KMT training program designed to build self-reported competence to discuss KMT in psychiatric care for HCPs.MethodsLI-LI combines a 4-hour asynchronous educational course on KMT with a 4-week experiential group KMT intervention during which participants adhered to a ketogenic diet. LI-LI aimed to improve self-reported competence to utilize KMT and perceived ability to engage in shared decision-making with patients about incorporating KMT into their treatment plan.ResultsForty HCPs participated in the education course: 10 psychiatrists, 10 psychiatric pharmacists, 8 psychologists/therapists, and 12 other HCPs (e.g., nurse practitioners, physician assistants). Twenty-five initiated the diet intervention. Baseline competence scores (visual analog scale 0-100) were low, M(SE) = 17.40 (2.68), increasing to M(SE) = 68.08 (2.47) after education (d = 2.88, p <0.0001), and to M(SE) = 86.62 (1.82) post-diet (d = 1.08), with a very large whole-study effect (d = 3.49, p < 0.0001). Shared decision-making scores at baseline were M(SE) = 53.64 (2.89), increasing to M(SE) = 83.35 (1.83) after the educational course (d = 1.74, p <0.0001), and to M(SE) = 91.23 (2.05) after the diet phase (d = 0.73, p = 0.009), with a very large whole-study effect (d = 2.53, p < 0.0001). Feedback indicated that lived experience with KMT was helpful for implementation-readiness.DiscussionThe educational course on KMT was associated with increased self-reported competence and perceived shared decision-making in HCPs, and this was enhanced with combined education and lived experience. Implementation of this approach could accelerate KMT into clinical care. Results should be interpreted with caution as this was a small uncontrolled study with self-reported main outcomes.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT07116226, identifier NCT07116226.
By Emma Beckwith, 2026 Youth Mental Health Academy Intern, Child Mind Institute
As mental health care, education, and research for youth advances, it is important to remember that in order to best serve young people, we must listen to their lived experience. They know better than anyone what conversations and changes need to happen to improve child and adolescent mental health care around the world. Therefore, they must be included in this discussion as co-creators and leaders of transformation.
Building on the momentum of last year’s inaugural Global Summit on Youth Mental Health, the Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health at the Child Mind Institute will host the second edition of the annual event on September 21-24 in New York City.
Anna Laura Praxedes, Director, Young Peacebuilders (left) with Felipe Neto, Founder of the Felipe Neto Institute, and João Pedro Schroder, Member of the SNF Global Center Youth Council in Brazil, during the inaugural Global Summit on Youth Mental Health in New York, 2025
Led by the SNF Global Center’s Global Youth Advisory Council (GYAC), the event is set to unite young people from around the world to discuss the issues impacting their mental health. Additionally, clinicians, researchers, and policymakers will participate in various sessions. The hope is that youth and adult experts can work together to enact necessary changes in child and adolescent mental health care.
The GYAC, consisting of members from the Global Center’s Child and Adolescent Mental Health Initiatives (CAMHI) in Greece, Brazil, and South Africa, took on a leading role in organizing the summit. In every step of the process, they have had input on what they want the summit to look like, new features they want to include, the key topics that will be discussed, as well as the theme for this year’s summit: “Redefining Mental Health Care: Youth Perspectives in a Changing World.” They will also serve as moderators of discussion panels, with each GYAC member leading conversations on topics they feel passionate about.
“Nothing About Us Without Us”
The youth are the present and future and deserve to be the lead contributors in this work. This year, the summit aims to center their voices through three thematic sessions:
“Meeting Young People Where They Are” will examine how to make school systems safer places for identity expression and mental health education. And they’ll discuss how to make digital spaces safer, including ways to communicate the impact online spaces have on mental wellness to young people.
“What Young People Care About” will consist of breakout sessions where, in small groups, young people will discuss the modern youth experience in how topics such as climate change, economic instability, and political polarization affect their mental health.
“Setting Young People Up for the Future” will include a Q&A with experts where youth can learn how to take care of their mental wellness in a changing world.
During last year’s summit, young participants came together to document key takeaways and actionable items for implementation and global change through a published youth-led report. This year, the goal is to increase youth involvement even more, with more youth attendees, speakers, and leaders. After all, this event isn’t just for the betterment of youth and adolescent mental health, but a space for people around the world who have a shared passion and care about this issue to connect and unify in order to enact positive change.
As a young person myself, what I would like to see come out of this year’s summit is action. The event is already an amazing starting point, where both young people and adults have shown their care for improving child and adolescent mental health. Now, we need to take actionable steps to implement the changes needed as voiced by youth, so that the talk doesn’t just stay within the event but becomes a reality. While there is no doubt that it will take time, I have hope that with the continuation of these annual summits, more global experts, changemakers, policymakers, clinicians, researchers, and caretakers will take what they’ve learned into their spaces of work to enact real change.
As Nelly Serdari, a member of the Youth Engagement Scheme (YES) with CAMHI in Greece, stated at last year’s summit, “The only way that we can try to break down barriers is if older generations try to get on our level.”
Now, it is up to the adults to break down the barriers that we youth cannot.
