Trauma can contribute to lasting psychological, behavioral, and physiological effects that extend across generations. Intergenerational trauma refers to trauma-related effects observed in children of exposed parents, while transgenerational trauma describes effects observed in later generations without direct exposure. Proposed mechanisms involve interacting biological and psychosocial processes, including stress-responsive regulatory systems, epigenetic variation, and caregiving environments. This review synthesizes evidence on epigenetic changes associated with acute, chronic, and complex traumatic exposures and their relevance to multi-generational outcomes. Studies published between 1990 and 2025 were identified through PubMed and Google Scholar and evaluated for reported epigenetic findings, caregiving patterns, and offspring health outcomes. Across trauma contexts, reported epigenetic variation most consistently involves pathways related to stress-response regulation, immune-inflammatory signaling, neurodevelopment, metabolic processes, and developmental programming. Patterns across exposure types suggest that acute events are most often associated with stress-related and inflammatory signaling that may influence developmental programming, whereas chronic and complex trauma reflect cumulative physiological adaptation involving broader alterations in stress-regulatory, metabolic, and neurodevelopmental systems. Offspring outcomes most consistently include increased vulnerability to anxiety, depressive symptoms, stress-related disorders, and certain chronic medical conditions, often described alongside shifts in caregiving behaviors and psychosocial environments that may shape developmental vulnerability. Interpretation of the current literature is limited by small sample sizes, varying definitions of trauma, and limited multi-generational cohorts. Overall, current evidence supports a model in which trauma-related outcomes across generations reflect interacting biological and caregiving processes, highlighting the importance of integrated molecular and psychosocial frameworks for prevention and intervention.
Internet addiction in adolescents with suicidal ideation: the role of self-esteem and school connectedness
BackgroundInternet addiction (IA) has become a growing concern, particularly among adolescents, due to its adverse effects on mental health, physical well-being, and future development. Adolescents with suicidal ideation (SI) are particularly vulnerable to IA, which may be associated with a higher risk of engaging in suicidal behaviors. However, the relationship and underlying mechanisms between SI and IA remain unclear. This study, grounded in the cognitive-behavioral model of pathological internet use, investigates the relationship and explores the roles of self-esteem (mediator) and school connectedness (moderator) in this association.MethodsIn this cross-sectional study, 462 Chinese adolescents with SI (79.0% female) were recruited from psychiatric outpatient clinics between June 2024 and September 2025. Validated instruments measured SI, self-esteem, school connectedness, and IA. Structural equation modeling with bootstrapping procedures was used to test the mediation effect of self-esteem on the relationship between SI and IA. The moderating role of school connectedness was examined using PROCESS Model 8.ResultsSI was positively associated with IA (β = 0.224, p < 0.001). SI was negatively associated with self-esteem (β = -0.464, p < 0.001), and self-esteem was further negatively associated with IA (β = -0.448, p < 0.001). Self-esteem partially mediated the relationship between SI and IA, with an indirect effect of 0.208 (95% CI: 0.154-0.271). School connectedness significantly moderated the direct association between SI and IA (β = -0.005, p = 0.001), but did not moderate the association between SI and the mediator, self-esteem (β = 0.004, p = 0.202).ConclusionThis study identifies a significant positive association between SI and IA among adolescents with SI, with self-esteem partially mediating this link. Furthermore, school connectedness showed a very weak buffering effect on the direct association between SI and IA, and it does not moderate the association between SI and self-esteem. These findings enhance our understanding of the mechanisms underlying IA in this vulnerable population and suggest potential targets for interventions.
The Role of Disulfide Bonds in the GluN1 Subunit in the Early Trafficking and Functional Properties of GluN1/GluN2 and GluN1/GluN3 NMDA Receptors
N-Methyl-
Closing the Gap in Autism Genetics: Population-Specific Variants and the Imperative for Global Inclusion
Autism spectrum disorder (ASD) is a highly heritable neurodevelopmental condition with an exceptionally complex and heterogeneous genetic architecture, encompassing both polygenic common variants and rare, high-impact variants. Over the past decade, large-scale sequencing studies in Europe and North America have identified hundreds of ASD risk genes and substantially advanced biological insight. However, the global distribution of ASD genomic research remains profoundly imbalanced, with most non-European ancestry populations severely underrepresented.
World Mental Health Day Statement
Ottawa – October 10, 2025
As someone who has worked in countries affected by conflict and humanitarian crises, I’ve learned that physical displacement is only part of the story. The mental and emotional toll defines the other half of that experience, and often for much longer.
This World Mental Health Day focuses on mental health in humanitarian emergencies. It asks us to consider not just the scale of the challenge, but the strength of the response possible when communities lead the way.
There is no single solution to the mental health impacts of humanitarian crises. But what I’ve witnessed, both internationally and here on Turtle Island, is that the most meaningful support often comes from within affected communities themselves.
Whether it’s refugees organizing healing circles in displacement camps, neighbours checking in on one another after a wildfire, or volunteers trained to provide peer support—these acts of care are not just helpful. They are essential. They save lives.
Right now, the world feels heavy. The growing phenomenon of eco-anxiety, combined with escalating crises of famine, war, and displacement, can make hope feel out of reach. We see the numbers—123 million people forcibly displaced worldwide—and it can be overwhelming.
But I’ve also seen what happens when we share that weight by leaning on one another. This is equally true for humanitarian aid workers, who are responding to unprecedented numbers of conflicts and urgencies at home and around the globe.
As the World Health Organization reminds us, “Humanitarian workers face extreme stress and are often directly affected by the crisis they respond to.”
As a member of this community, I know that sustaining an effective humanitarian response means meeting the needs of those providing comfort and care, whether through peer support, workplace health programs, or Mental Health First Aid. Here at home, programs like The Working Mind – First Responder are helping to create a culture of care for those we call on in crisis.
The way we heal—whether we’re first responders or community workers, volunteers or refugees—is through community. It’s in the everyday ways we show up for one another: listening without judgment, making space for grief and fear, and recognizing that asking for help is an act of courage.
On this World Mental Health Day, let’s all find the courage to lean on each other.
Lili-Anna Pereša C.Q.
President & CEO
Mental Health Commission of Canada
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Canada Gets its First National Guidance on AI for Mental and Substance Use Health
Ottawa (ONTARIO) – In a first-of-its-kind initiative, national guidance for using artificial intelligence (AI) in the mental and substance use health field is being developed through a partnership between the Canadian Centre on Substance Use and Addiction (CCSA) and the Mental Health Commission of Canada.
AI is increasingly being used for healthcare triage, service navigation, service delivery, and communication, but developers and users have no guidelines specific to mental or substance use health to support its effective and safe use. The recently published E-Mental Health Strategy for Canada highlights the need for safety in this field.
The new National Guidance for Artificial Intelligence Use in Mental Health and Substance Use Health Care will provide guidance, tools, and resources to help practitioners, organizations, and health leaders in efficiently evaluating and implementing AI-enabled mental health and substance use health care services and solutions. It will also support people with lived or living experience of mental health or substance use health concerns in making informed choices about these technologies, while helping technology companies design and improve such solutions to meet the needs of those who use them.
“People are excited about what AI can bring, but the saying ‘break it then fix it’ can take on new dangers when what is at risk is people’s lives. This guidance will allow innovators to move fast while working to ensure it’s done safely and in a way that increases impact and access,” says CCSA CEO Dr. Alexander Caudarella.
The Mental Health Commission of Canada President and CEO Lili-Anna Pereša adds, “Technology can be a powerful ally in transforming mental health care, but innovation must be matched with responsibility. Communities are the best problem-solvers. By working together with developers, providers, and people with lived experience, we’re creating guidance that ensures AI enhances care safely and meaningfully.”
The National Guidance team will share its early findings at several upcoming conferences, including the World Psychiatric Association’s World Congress of Psychiatry, the Canadian Centre on Substance Use and Addiction’s Issues of Substance conference, and the eMental Health International Collaborative (eMHIC) Congress.
In Canada, mental health and substance use health needs are highly common, yet many people continue to face significant barriers to care, including limited access, stigma, financial costs, and lack of tailored treatment options.
The National Guidance for Artificial Intelligence Use with Mental Health and Substance Use Health is expected to launch in 2026/2027.
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About CCSA:
CCSA was created by Parliament to provide national leadership to address substance use in Canada. A trusted counsel, we provide national guidance to decision makers by harnessing the power of research, curating knowledge and bringing together diverse perspectives. CCSA activities and products are made possible through a financial contribution from Health Canada. The views of CCSA do not necessarily represent the views of Health Canada.
About The Mental Health Commission of Canada:
The Commission leads the development and dissemination of innovative programs and tools to support the mental health and wellness of people in Canada. Through its unique mandate from the Government of Canada, the Commission supports federal, provincial, and territorial governments as well as organizations in the implementation of sound public policy. The Commission’s current mandate aims to deliver on priority areas identified in the Mental Health Strategy for Canada in alignment with the delivery of its strategic plan.
Media contacts:
Canadian Centre on Substance Use and Addiction
Christine LeBlanc, Senior Strategic Communications Advisor
613-898-6343 | cleblanc@ccsa.ca
Mental Health Commission of Canada
media@mentalhealthcommission.ca
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Beyond Survival: Addressing the Mental Health Crisis Among the World’s Displaced
By Karla Thorpe, Vice President, Programs and Priorities, Mental Health Commission of Canada.
The statistics are staggering, but they represent real human lives: 117 million people worldwide have been forcibly displaced from their homes due to war, famine, and other horrific conditions. To put this in perspective, that’s four times the number displaced during the Second World War. At this year’s International Association for Suicide Prevention conference, experts gathered to address a critical question: How do we support the mental health of those who have lost everything?
The Scale of the Crisis
The numbers tell only part of the story. Two-thirds of asylum seekers find refuge not in wealthy nations like Canada, but in low and middle-income countries that often lack the resources to meet their overwhelming needs. These displaced populations face a perfect storm of challenges: shrinking settlement options, limited support services, and a desperate shortage of culturally appropriate care.
For many refugees, the trauma doesn’t end when they reach safety. Prolonged exposure to violence, separation from loved ones, and the uncertainty of displacement create conditions where suicidal thoughts and behaviours become tragically common. Yet we lack comprehensive data on suicide within displacement camps, partly because refugees often fear that reporting mental health struggles could jeopardize their immigration prospects or those of their families.
Understanding Complex Needs
The mental health challenges facing refugees extend far beyond clinical symptoms. Families torn apart by circumstance may find themselves scattered across different camps or even different countries. The trauma manifests differently across demographics and cultures, requiring nuanced responses rather than one-size-fits-all solutions.
Men often struggle most with feelings of powerlessness, finding healing through employment opportunities that restore their sense of purpose and ability to provide for their families. Women face distinct vulnerabilities, including protection from violence while trying to create stability and hope for their children. Children, who make up approximately 40% of all refugees, grapple with profound losses: family members, security, and often their childhood itself.
It bears repeating what should be obvious but sometimes gets lost in clinical discussions: even the most sophisticated mental health interventions fail without access to basic necessities like food, water, and medicine.
Despite overwhelming challenges, the conference revealed inspiring examples of both systematic programs and grassroots innovations making real differences in refugees’ lives.
Structured Interventions
Throughout the conference, we heard about promising practices being implemented systematically across different countries and innovative, grassroots initiatives being spontaneously enacted to respond to specific local needs. The World Health Organization’s “Problem Management Plus” program trains refugee volunteers to deliver brief cognitive behavioural therapy interventions, creating a sustainable model that builds community capacity while addressing immediate needs.
Similarly, the “Contact and Safety Planning” (CASP) program offers a cost-effective approach: screening to identify those at highest suicide risk, then working directly with these individuals to develop personalized safety plans.
Community-Led Solutions
The most enheartening stories emerged from refugees themselves. Across displacement sites, people are organizing healing and listening circles for those sharing common experiences or challenges. Religious leaders, teachers, and sports coaches are stepping up to support overstretched health professionals. Women are training other women in low-intensity interventions to help those who cannot access care, conducting check-ins via WhatsApp, and providing peer support through text messages.
These organic solutions represent more than resourcefulness; they embody a fundamental truth that conference speakers repeatedly emphasized: refugees are resilient, understand their own needs, and possess valuable insights about healing and recovery.
Redefining Support
A central theme emerged throughout the discussions: supporting refugee mental health requires a power shift from traditional top-down service delivery. Effective interventions must be co-designed with refugee populations, ensuring cultural relevance and community buy-in. Many of the most impactful programs are also surprisingly low-cost, challenging assumptions about resource-intensive treatment models.
But perhaps the most important insight that stuck with me concerns our fundamental approach. After experiencing profound inhumanity throughout their journeys, refugees encounter a critical moment when receiving support: our response can either compound their dehumanization or offer compassion, care, and genuine connection. In a world that has shown them cruelty, our interactions become opportunities to demonstrate that humanity still exists.
Lessons for Canada
How can Canada apply these international insights to strengthen our own refugee support systems?
Stability as Foundation: Following tremendous upheaval and uncertainty, refugees need predictability. Offering permanent status rather than temporary measures provides crucial emotional stability during recovery.
Eliminating Barriers: We must address inequitable access to services, including waiting periods for health coverage that leave vulnerable populations without essential care during critical adjustment periods.
Shifting Public Narrative: Public education campaigns should help Canadians understand the global humanitarian crisis and reframe refugees not as burdens, but as resilient individuals deserving of support and capable of tremendous contributions to our communities.
A Call for Compassion
The refugee mental health crisis demands more than policy responses; it requires a fundamental commitment to recognizing the humanity in every displaced person. As we’ve learned from innovative programs worldwide, the most effective interventions often spring from refugees themselves, given proper support and respect for their expertise about their own experiences.
Globally, we can and must do better. The question isn’t whether we have the resources to support 117 million displaced people; it’s whether we have the collective will to demonstrate that compassion and human dignity remain powerful forces in our world.
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Hertfordshire Community NHS Trust to roll out AI-scribing
Hertfordshire Community NHS Trust is rolling out ambient voice technology following a pilot in community and mental health services.
Development of the Healthy Women Intervention to Increase Women’s Engagement in Medication Treatment for Opioid Use Disorder: Mixed Methods, User-Centered Design Approach
Background: Rates of opioid use disorder (OUD) have increased among women over the past 2 decades. Medication treatment for opioid use disorder (MOUD) is effective but underused. Gender-specific treatments for women have been associated with improved substance use outcomes. However, these treatments have not specifically targeted women’s engagement in MOUD, and the impact of existing gender-specific treatments is restricted by in-person delivery. Objective: The aim of this study was to develop a digital intervention to feasibly deliver gender-specific care that addresses the individualized needs of women with OUD to increase engagement in MOUD. Methods: A mixed methods, user-centered design approach was used to inform the development of a digital intervention. In phase 1, qualitative interviews were conducted with women with lived experience of OUD (n=20) and providers who treat women with OUD (n=8). Interviews were recorded, transcribed, and coded for themes. In addition, a larger sample of treatment providers (n=55) completed an online survey to further inform the content of the digital intervention. Phase 2 consisted of designing, beta-testing (n=5), and refining the intervention. Results: The age of women with lived experience ranged from 21 to 59 (mean 38.5, SD 9.4) years; 63% (5/8) of providers interviewed were female participants. The qualitative interview data from women with lived experience and providers were grouped into 6 thematic categories: 3 treatment-related (1) barriers to treatment, (2) facilitators to successful recovery, and (3) important issues to address in treatment, and 3 technology-related (4) positives of using technology as part of treatment, (5) suggested technology features, and (6) barriers to using technology. Across the treatment-related categories, several themes touched on women-specific factors including family responsibilities, abusive partners, stigma, and motivation for treatment (eg, pregnancy). The technology-related categories provided information for designing the features of the intervention, as well as revealing barriers to technology use, which could be helpful in developing implementation strategies. Provider survey participants were primarily female participants (40/55, 73%), with a mean age of 42.5 (SD 12.5) years. Survey data provided additional information on barriers to treatment and suggested technology features. Based on these data and preliminary work, the intervention was created. Minor edits to content and visual design were made in the beta-testing phase. The final version includes a web-based component with 6 topic modules and a mobile component. Topics in the web-based component are presented through infographics, text, videos, and interactive questions. The mobile component includes daily motivational messages, skills practice activities (2/wk), weekly check-ins, and resources (always available). Conclusions: Important themes and suggested features from women with lived experience and providers were incorporated into a digital intervention for women with OUD. Data on feasibility, satisfaction, and engagement with the intervention are currently being collected in phase 3, a pilot randomized controlled trial.
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Help-Seeking in the Age of AI: Cross-Sectional Survey of the Use and Perceptions of AI-Based Mental Health Support Among US Adults
<strong>Background:</strong> Anecdotal evidence suggests that an increasing number of people are turning to generative artificial intelligence (GenAI) tools or artificial intelligence (AI)-assisted chatbots to discuss and manage mental health concerns. However, systematic data on the use and perception of such tools remain scarce. <strong>Objective:</strong> This study aimed to examine how young and middle-aged adults in the United States use GenAI and AI-assisted mental health chatbots as mental health resources and assess their preferences for these tools relative to human mental health professionals. <strong>Methods:</strong> An anonymous online survey was conducted in October 2025 among US adults in a commercial online panel sample of US adults aged 18-49 years (N=1805). Respondents were asked about the sources they typically turn to when facing mental health concerns, their frequency of using GenAI tools or chatbots for mental health support, and whether the frequency of seeing human mental health professionals had changed since they started using AI tools for mental health support. Attitudes toward AI-based mental health support were assessed and compared with attitudes toward human mental health professionals. <strong>Results:</strong> In this sample, of the 1805 respondents, 638 (35.2%) reported using AI tools at least once a week in a typical week for mental health support, and 99 (5.5%) were classified as “heavy users” who reported regularly spending hours discussing their mental health concerns through AI. However, nearly 60% of respondents reported that they would turn first to family (1078/1805) and friends (1046/1805) when facing mental health concerns. Respondents who screened positive for moderate to severe depressive or anxiety symptoms were more likely to use AI-based mental health support compared to those without these symptoms (adjusted odds ratio 1.71, 95% CI 1.36-2.15) and those with suicidal ideation were more likely to be heavy AI users (adjusted odds ratio 2.42, 95% CI 1.49-3.95). Among those who had ever seen a human mental health professional (n=511), 28.4% (145/511) reported a perceived decline in visit frequency to human mental health professionals since they started using AI tools for the same purpose. Participants expressed more favorable attitudes toward human mental health professionals than toward AI-based tools. However, among heavy AI users, perceptions of AI-based mental health support and human counseling were nearly equivalent in positivity. <strong>Conclusions:</strong> AI appears to be an important component of the mental health help-seeking landscape among respondents in this sample. Although most respondents still preferred human professionals, a subset reported relying on AI tools for comparable support. Ongoing monitoring and ethical guidelines are needed to ensure that AI technologies expand access to care while being safely and effectively integrated into the broader continuum of mental health services.
