From promise to practice: artificial intelligence in mental health care in the MENA region

Mental health disorders represent a growing burden across the Middle East and North Africa (MENA) region, where depression and anxiety are highly prevalent amid conflict, displacement, and socioeconomic strain, affecting up to 40 percent of adults, yet treatment gaps remain at 80-95% due to provider shortages, financial strain, and cultural barriers. In this context, artificial intelligence (AI), in the form of large language models (LLMs) and specialized psychotherapy chatbots, may offer a scalable adjunct to help address these gaps through anonymous screening, predictive risk modeling, psychoeducation, and brief interventions. This narrative review examines current evidence of AI-driven conversational tools in mental health with a specific focus on their application, acceptance, and limitations within the MENA region. To do so, A structured search of MEDLINE and Embase (2000–2026) identified studies on conversational AI in mental health, prioritizing evidence from the MENA region and supplemented by relevant global literature. Overall, findings suggest that while these tools offer high accessibility and user engagement, particularly for low-intensity support, their effectiveness is limited by linguistic and cultural mismatches, including Arabic diglossia and poor alignment with locally grounded expressions of distress. At the same time, user acceptance reflects a paradox in which stigma and privacy concerns drive reliance on anonymous AI tools while simultaneously limiting trust in their clinical reliability, reinforcing a preference for hybrid models with human oversight. Taken together, these findings indicate that current systems remain insufficiently adapted to the MENA context, underscoring the need for culturally grounded, dialect-sensitive, and clinically supervised approaches to ensure safe and effective integration.

Beyond Theory of Mind: mentalization as a relational and developmental framework for autism

Autistic individuals and those around them often navigate social and emotional situations in which behaviors, intentions, and affects are difficult to interpret. Supporting mentalizing processes within child–caregiver interactions may help address these challenges; however, a broader conceptual shift is needed, moving beyond a narrow deficit-based perspective toward understanding mentalization as a multidimensional, relational, and developmental process. By shifting the focus from individual deficits to child–caregiver meaning-making processes, this framework may help clarify assessment and intervention targets and inform future research on psychopathological vulnerability in autism. This targeted narrative mini-review therefore aimed to summarize preliminary evidence suggests that other-related mentalizing may show greater difficulties than self-related mentalizing, although this hypothesis requires further replication. Findings also highlight caregiver mentalization, particularly parental reflective functioning, as a key relational process shaping how children’s behavior is interpreted, regulated, and responded to over time. In this light, preliminary intervention studies suggest that mentalization-based and mentalization-informed approaches may improve parental reflective functioning, cognitive reappraisal, self-efficacy, and inferential style, with potential indirect benefits for children’s emotional outcomes. We therefore propose a relational-developmental framework in which mentalization is conceptualized as a shared and dynamic process of meaning-making under conditions of social and emotional ambiguity. Adopting an individual, relational and developmentally informed perspective may contribute to the development of more precise assessment models, more targeted interventions, and a deeper understanding of mental health vulnerability in autism.

Development and Formative Evaluation of a Narrative-Based Serious Game for Pregnancy Education: Mixed Methods Study

Background: Serious games are increasingly used in professional health education and maternal health promotion. However, most pregnancy-related digital interventions target specific behaviors and do not provide a comprehensive, longitudinal simulation of the pregnancy journey that incorporates psychosocial and administrative aspects. Objective: This study aimed to develop and evaluate a narrative-based serious game that simulates the chronological course of pregnancy and to assess its perceived educational usefulness, accessibility, and user acceptance across multiple platforms. Methods: We developed a 9-chapter interactive serious game covering pregnancy recognition, partner communication, public health consultation, mid-pregnancy and late-pregnancy checkups, and home preparation for childbirth. The game was collaboratively created by a pediatrician, 6 medical students, and a student illustrator using a low-cost visual novel engine (TyranoBuilder). It was released in April 2025 on iOS, Android, and Steam. A voluntary, anonymous postgame survey was conducted between April 2025 and January 2026. Descriptive statistics were used to summarize survey responses and platform analytics. This study was approved by the Ethics Committee of Shinshu University Hospital. Results: A total of 65 users completed the postgame questionnaire. Most respondents were aged 10 to 19 years (38/65, 58.5%) and female (55/65, 84.6%). Nearly half of the participants (30/65, 46.2%) completed the game within 1 hour. Gameplay evaluation scores (5-point Likert scale; 3=neutral or appropriate) were balanced: game length (mean 3.37, SD 0.96), difficulty (mean 2.84, SD 0.85), and interactivity (mean 3.31, SD 1.10). Educational outcomes were rated highly (5-point Likert scale; higher=more favorable): reduced anxiety (mean 3.84, SD 0.96), perceived educational usefulness (mean 3.98, SD 1.02), perceived knowledge acquisition (mean 4.06, SD 1.06), story empathy (mean 3.80, SD 1.11), and overall satisfaction (mean 4.05, SD 1.04). Across all platforms, the game achieved 925 cumulative downloads. iOS and Android downloads were predominantly from Japan, whereas Steam downloads were geographically diverse. Of the 21 Steam reviews, 20 (95.2%) were positive. Conclusions: A serious pregnancy education game developed through a low-cost clinician-student collaborative model demonstrated high perceived educational usefulness, balanced gameplay characteristics, and broad user acceptance, including substantial engagement among teenagers and international users. Narrative-based serious games represent an accessible and scalable approach to maternal health education. Further research using more rigorous evaluation designs is warranted to assess long-term educational and behavioral impacts.
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Maintaining Emotional Boundaries as a Parent

Parents often emphasize to children the importance of respecting others’ boundaries — don’t tickle another kid if they say they don’t like it, for example. Don’t kiss someone unless they welcome it. But within the family, we can fail to notice our own difficulty setting and respecting boundaries with our children, especially emotional boundaries.

What are emotional boundaries

Emotional boundaries refer to an individual’s sense of autonomy and ability to control how they think, feel, and engage with others. Those boundaries are crossed either when you try to control someone else’s thoughts or feelings or they try to control yours.   

Difficulty setting your own and respecting others’ emotional boundaries often comes from a place of care and concern. Parents are usually concerned that their child is not going to make safe choices or are trying to protect their child from distressing emotions. But the intrusion can have a negative impact on children’s emotional development as well as parents’ mental health, especially when it’s done repeatedly. Everyone has boundaries, even parents, and it’s important for kids to learn that.  

How parents overstep their child’s emotional boundaries

Parents can inadvertently encroach on their child’s right to their own thoughts and feelings through:

  • Over-involvement in children’s academic and social life: Your child has a whole life outside the home, and it can be anxiety-provoking to trust them to manage their homework, advocate for themselves with teachers, and navigate conflicts with peers. It can alleviate your anxiety to get involved, but that can feel highly intrusive to your child. For example, if your kid feels snubbed by a friend, you might feel the urge to contact that friend’s parent to try to smooth things over. However, over-involvement in these tasks can prevent your kid from developing the skills they need to manage challenging situations successfully and can impact their confidence in their ability to cope independently.
  • Overconcern to protect your child’s safety: Fears that something negative will happen to your child are understandable, but aggressive monitoring can backfire. This can include strict control over the ingredients in your teen’s food, the information they consume online, or what activities they do. This may temporarily alleviate anxiety about the child’s health and safety but it can lead to resentment and rebellion. 
  • Ignoring or rejecting children’s requests for privacy: It is normal for children and adolescents to want more privacy as they mature, from showering alone to keeping a private diary.Unless your child engages in an activity that suggests they are being unsafe, it is important to trust your child and let them decide what to share with you.
  • Sharing private information without the child’s permission: Parents telling anecdotes about their children, much to their kids’ embarrassment, is hardly new. However, that sharing now includes photographs and videos posted on social media that is broadcast far beyond close friends.It is important to include your child in decisions about what information is shared with others (excluding, of course, medical professionals). When in doubt, consider what information you would feel comfortable with them sharing about you.
  • Telling children what is or isn’t acceptable to value, think, or feel: Many parents, in an effort to help their child feel better, say things like, “Don’t worry about that” or “You can’t think that way.” These seemingly innocuous phrases can come across as attempts to control how the child feels. We can forget that kids are real people just like adults. And if they’re mad or upset about something, they want to be able to feel those feelings, not be told that that their feelings are wrong.

How parents fail to set their own emotional boundaries

Letting kids change your own values, thoughts, and feelings can also be unhealthy. Here are some common ways in which parents fail to set their own boundaries:

  • Allowing your child’s thoughts and feelings to influence your own too much:  Your child may act like it will be the end of the world if they don’t get into the right college. If their anxiety becomes your anxiety, then it’s going to be very hard for you to encourage your kid to have fun on the weekend or to go to bed with work left undone. What they need you to do is validate their feelings but challenge those worry thoughts and help them to relax.
  • Implying that your child is responsible for how you feel:  As a parent, your child’s well-being is your priority, and your emotional state is affected by your child’s behavior. But phrases like, “You are making me crazy” or “I cannot cope with one more word from you” unintentionally suggest that the child has control over your feelings. It’s not healthy for children to feel that they are responsible for your well-being.
  • Depending on your child for emotional support: If you’re a parent under stress and you’re not getting support elsewhere, it makes sense that you’re going to vent to a child. It’s not necessarily meant to burden a kid with financial stressors or relationship drama, and the child might be a sympathetic ear. But it blurs the boundaries between the parent role and the kid role, and that often causes difficulties for the kid in accepting parental authority in other domains. If they see themselves as equals in terms of emotional support, then they might think, why can you tell me what to do?
  • Sharing age-inappropriate information: Many children want to be treated as older than they are (at least in certain ways). So they might requestinformation about finances, romantic relationships, or family stressors that are inappropriate for their age. Although it can be tempting to share, it is not helpful long-term. It may alleviate the child’s current anxiety (and stop the nagging), but it will impair their ability to respect boundaries as well as interfere with them just being a kid.
  • Difficulty saying no: If you’re exhausted, the last thing you want is an argument. One way to avoid an argument is to say yes to your kid’s requests to buy a toy, stay up 15 more minutes, or have a different dinner. If you have boundaries around what you will spend, how much sleep you need, or what you will cook, you are still a good parent. Sticking to your limits teaches your child to accept other people’s boundaries without whining or threats. 
  • Allowing your child to treat you unkindly: Many parents allow their children to treat them in ways they would never tolerate from another person. This includes calling the parent mean or profane names, hitting them, or disregarding their needs (for money, sleep, leisure time, etc.).  Allowing this kind of behavior prevents the child from learning how to respect boundaries and tolerate the emotions they experience when they face them.

Factors that contribute to boundary concerns

There are specific circumstances that can make it difficult for a parent to know where the appropriate boundaries are. They include a child’s late development, psychiatric challenges, and history of unsafe choices. For example, a child may have delays in language, executive functioning, or social or emotional skills. These things can make it challenging to determine how involved you need to be in your child’s daily life and how much independence they can handle.

  • Poor risk assessment and impulsivity: Many disorders can impact children’s ability to think clearly, regulate emotionally, and act safely. For example, a teen experiencing a manic episode may overestimate their abilities, underestimate risk, and act impulsively. Or a child with ADHD might hard to control on crowded city streets or in restaurants, so you avoid taking them out or letting them do activities on their own with friends.  
  • Lack of confidence: Anxious children may underestimate their abilities and request continued support past when they are capable of independence. For example, a socially anxious child may ask their parent to order for them at a restaurant or keep track of their homework assignments.  When a parent accommodates these requests, it confirms their belief that they still need help.
  • Executive functioning deficits: Children who struggle with executive functioning may need more scaffolding to complete daily self-care tasks than other kids their age. This can look like parents providing frequent reminders of assignments, events, or even hygiene tasks — as well as cleaning their room for them long past when an child with ADHD should be doing it themselves. Consider how you can scaffold the skills (packing their bookbag!) without doing tasks for them, and gradually remove the supports over time.
  • History of not successfully navigating tasks: A child’s history of poorly handling a responsibility (safe use of technology, completion of homework, brushing their teeth) often reduces parents’ confidence in the child’s abilities and increases their inclination to step in. Although extra supervision and support may be needed initially, it is important to reassess your child’s abilities over time as they can learn and grow if you let them!

How to get better at boundaries

Once you have recognized the challenges in respecting your child’s boundaries and protecting your own, the next step is to figure out what those boundaries are.

  • Identify your boundaries: What things are most important to support your child’s growing independence and sense of autonomy? What boundaries do you need to set to protect your own mental health? Consider what level of involvement you want to have in their academics, friendships, emotion regulation, and appearance and what you want to disclose to them about your own relationship, emotions, or work.  
  • Practice setting these boundaries: It is much easier to set a boundary when you are not forced to make the choice with a child’s puppy dog eyes looking at you. Rehearsing how you will say no, decline to share certain information, or respond to an anxiety-provoking situation can prepare you to respond more effectively and in line with your values in a moment of conflict.
  • Share your reasons for boundaries: Children can be quick to interpret lack of boundaries as “more caring,” but being consistent in language around why boundaries are being set can help prevent this. When setting a boundary, it is helpful to couch it in care. For example, “I care about you enjoying your childhood, so I do not feel comfortable sharing with you about our family’s finances.”

When kids want more independence than you are sure they are ready to handle, identifying steps toward their goal can be effective. Giving them opportunities to show maturity, with success at one step leading to more responsibility, can help you trust your child with greater independence. What can your kids show you that will help you feel confident in their ability to manage their emotions themselves or make well thought-out decisions?

Kids also need to recognize that they sometimes overestimate their own abilities, that there are times they have not assessed risk accurately and still need their parents. It is important to teach your child that you should be alerted if they are experiencing something that is unsafe or concerning (such as a friend talking about suicide or sharing an inappropriate photo). Discussions with your kid can sort out how to work toward new milestones and help everybody feel confident that they have the skills to do it.

Modeling a healthy respect for boundaries will set your child up to establish their own and respect others’ boundaries throughout their life.

Frequently Asked Questions

What are emotional boundaries between parents and children?

Emotional boundaries are the limits that protect each person’s right to their own thoughts, feelings, values, and decisions. In families, healthy boundaries allow children to develop independence while helping parents avoid taking responsibility for emotions or choices that belong to their child.

Why are emotional boundaries important in parenting?

Healthy emotional boundaries support children’s confidence, autonomy, and ability to solve problems on their own. They also protect parents’ well-being by preventing them from becoming overly responsible for their child’s feelings, worries, or decisions.

What are signs a parent is overstepping a child’s emotional boundaries?

Common signs include getting overly involved in a child’s friendships or school life, refusing age-appropriate privacy, sharing personal information without permission, or telling a child what they should think or feel. While these behaviors often come from a place of love and concern, they can undermine a child’s confidence and independence.

How can parents determine appropriate emotional boundaries?

Parents can start by considering where their child is developmentally and what level of support versus independence is appropriate. A good guideline is to provide enough structure to keep children safe while gradually giving them more responsibility and privacy as they demonstrate readiness.

The post Maintaining Emotional Boundaries as a Parent appeared first on Child Mind Institute.

The ECHO study: compassion-focused therapy for young voice hearers and their caregivers. A pilot study

BackgroundVoice hearing can occur in healthy people without a trigger, be caused by a traumatic event, or occur as part of a psychiatric disorder. There are still many gaps in our understanding of voice hearing, and research in this field can be challenging, maybe because it is associated with shame and stigma. Those who experience distress by voice hearing could benefit from a treatment, aimed directly at that. The ECHO manualized treatment is based on the principles of compassion-focused therapy (CFT).MethodsTreatment will take place on several different psychiatric hospitals in the Region of Southern Denmark. Treatment consists of a 10-session, manualized CFT for voice hearing. Caregivers participate in half of the sessions, and a recording of the voice content is made, which the caregivers are encouraged to listen to. The study is designed as a prospective single-arm pre–post intervention study using a mirror-image approach, in which participants serve as their own controls over time. The intervention group consists of (N = 60) voice-hearing adolescents aged 13–18 years. Additionally, a clinical comparison group (who also receive the intervention) of (N = 20) individuals aged 18–20 years with first-episode schizophrenia and voice hearing is included for descriptive and exploratory analyses. Data are collected 3 months prior to CFT treatment, immediately before the start of treatment, immediately after treatment is completed, and at 1 month follow-up. Data will be centered around social cognition, perceived social safeness, social connectedness, general well being, auditory hallucinations and compassion.DiscussionThe ECHO study addresses the wellbeing and thriving of an overlooked group of young people. The results of this study will provide information about who the voice hearers are, what challenges they face, and how they perceive them. The results will also provide information about the feasibility and efficacy of the treatment manual and, thus, its potential further implementability. Caregivers participate in half of the sessions, to facilitate a common language about mental states and voice hearing. To support their understanding, a recording of the voice content is made and the caregivers are encouraged to listen to it. We suggest that when caregivers understand the young voice hearers’ experiences, they can adjust their expectations and approach accordingly. We also suggest that by sharing the voice content, the young voice hearer will feel less isolated.Study protocol registrationhttps://clinicaltrials.gov/study/NCT07314515, identifier NCT07314515.

Autistic- and attention-deficit/hyperactivity disorder-like traits: differential associations with burnout, depression and anxiety, and empathy among Japanese junior residents

IntroductionBurnout, depression, and anxiety are major concerns among physicians because they affect individual well-being, patient care, and healthcare systems. Neurodevelopmental traits, including autistic-like traits (ALTs) and attention-deficit/hyperactivity disorder (ADHD)-like traits (ADHLTs), may increase vulnerability to psychological distress. However, little is known about how these traits relate to burnout, depression and anxiety, and empathy among junior residents.MethodsIn this cross-sectional study, 148 junior residents from two teaching hospitals in Japan completed validated measures of ALTs (21-item Japanese version of the Autism-Spectrum Quotient), ADHLTs (Adult ADHD Self-Report Scale Screener), burnout (Maslach Burnout Inventory), depression and anxiety (Hospital Anxiety and Depression Scale), physician–patient empathy (Jefferson Scale of Physician Empathy), and psychological flexibility and inflexibility processes (Valuing Questionnaire, Cognitive Fusion Questionnaire-7, and Work-related Acceptance and Action Questionnaire). Associations were examined using multivariable logistic and linear regression analyses. Exploratory statistical mediation analyses using structural equation modeling examined indirect associations through psychological flexibility and inflexibility processes.ResultsThe prevalence of ALTs and ADHLTs was 23.6% for each trait. ALTs were associated with lower personal accomplishment, a burnout dimension; higher depression and anxiety; and lower physician–patient empathy. ADHLTs were associated with greater emotional exhaustion, another burnout dimension. In exploratory statistical mediation analyses, progress toward values, a core process of psychological flexibility, showed a significant indirect association between ALTs and personal accomplishment, and the direct association was attenuated and no longer statistically significant after including the process variables. Significant indirect associations through progress toward values were also observed for the associations of ALT with depression and anxiety and empathy. Cognitive fusion, a core process of psychological inflexibility, showed a significant indirect association between ADHLTs and emotional exhaustion. Overall, neurodevelopmental traits were associated with distinct patterns of psychological functioning, suggesting variability in both vulnerability and adaptive processes.DiscussionNeurodevelopmental traits such as ALTs and ADHLTs were significantly associated with burnout dimensions, depression and anxiety, and physician–patient empathy among junior residents. Psychological flexibility and inflexibility processes, particularly progress toward values and cognitive fusion, may be relevant to these associations. Process-based support strategies may warrant further investigation for residents with elevated neurodevelopmental traits.Clinical trial registrationhttps://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R00005, identifier UMIN000046897.

Millions of People in Canada Are Finding AI-Enabled Support for Mental Health Effective Amid Ongoing Questions Around Trust.

(OTTAWA) July 8, 2026 — New polling shows approximately six million people in Canada used AI-enabled tools for mental health support in the past year and most find them effective. Today, the Mental Health Commission of Canada (the Commission), in partnership with Mental Health Research Canada (MHRC) and Pollara Strategic Insights, releases the first nationally representative data on how people in Canada engage with digitally supported mental health tools, including AI and virtual care, across every province and demographic.

Quick Facts:

  • 1 in 7 people in Canada used AI mental health tools in the past year
  • Three out of four who used AI and virtual mental health services found them effective for their well-being
  • Only 14 % trust AI tools, just 2% trust them completely
  • 40 % of AI users said they were more likely to seek professional care
  • Nearly half (45%) who accessed mental health care did so virtually, in whole or in part

WHY IT MATTERS

People in Canada are turning to AI as a convenient way to access mental health support.  AI-enabled tools may offer greater convenience and accessibility. Among those surveyed, AI is being used because it is:

  • Free or low-cost; 46% of AI users cite this as the reason they use it during a time when financial stress is itself a cause for anxiety.
  • Always available; 44% of AI users cite 24/7 access.
  • Immediate and convenient; it can be used from anywhere without travelling or waiting for an appointment. For someone in rural Canada, it saves time and travel costs.
  • Seemingly private; 39 % of AI service users cite private, anonymous support as a reason for use, while privacy and data protection remain key public concerns.

AI is most used for general well-being (42%), companionship (36%), and mild-to-moderate stress (36%), and 40% of AI users said they were more likely to seek professional care.

WHO IS USING IT AND HOW MUCH DO THEY TRUST IT?

Use is higher among people in Canada under 35 (27%; 29% among men aged 25–34), newcomers to Canada (28%), racialized people in Canada (23%), and 2SLGBTQI+ communities (20%), populations that may experience greater barriers to traditional care.

Overall, trust remains low, particularly for AI-enabled tools, where only 2% of people in Canada trust them completely. People in Canada over 55 show the lowest adoption and trust.

VIRTUAL CARE: EFFECTIVE AND MORE TRUSTED BUT FALLS SHORT OF IN-PERSON SERVICES

45% of people in Canada who used mental health services in the past year did so virtually, with 75% reporting positive outcomes. However, nearly 1 in 3 prefer a hybrid model that combines virtual and in-person services. The data signals what people in Canada need: well-designed tools for safer digital mental health care that they can trust.

THE COMMISSION OFFERS GUIDANCE FOR THE DIGITAL MENTAL HEALTH ERA

The Commission is Canada’s trusted resource for safe digital mental health — assessing apps and tools, setting evidence-based standards, and leading the national conversation on guidance for AI in mental health and substance use health care.

As virtual services and AI-enabled tools continue to expand rapidly across the mental health landscape, there is a growing need for evidence-based insight into how people in Canada engage with, understand, and perceive them. The Commission partnered with MHRC to leverage their ongoing national polling initiative and provide timely insights into usage, attitudes, and concerns related to e-mental health and AI.

The polling is clear: people in Canada want to close the gap between availability and trust. The Commission is working with the Canadian Centre on Substance Use and Addiction and collaborators, provincial governments, technology developers, and health system partners to establish guidance for AI.

“Six million people in Canada have already used AI for mental health support and most found it convenient and effective for their well-being. It is critical that AI is safe and equitable to increase public trust and reduce harms.” – Lili-Anna Pereša, President and Chief Executive Officer, Mental Health Commission of Canada

“The people turning to digitally-supported mental health tools are often those facing some of the greatest barriers to care. Making sure these tools are safe, effective, evidence-based and human-centred is a matter of equity. Ongoing research is essential to understanding where they help and where safeguards are needed.”– Akela Peoples, Chief Executive Officer, Mental Health Research Canada

About Mental Health Commission of Canada
As an independent, not-for-profit with charitable status, the Commission collaborates with leading experts and organizations nationally and internationally, including with people with lived and living experience, to develop national guidelines, standards and strategies, promote innovation and best practices, reduce stigma, increase mental health literacy, and support all levels of government to improve mental health outcomes for everyone living in Canada.  The Commission is Canada’s trusted resource for digital mental health best practices with the e-Mental Health Strategy for Canada, app assessment, e-modules for e-mental health implementation, and AI guidance for mental health and substance use health.

About Mental Health Research Canada
As an independent national charity, MHRC works hard to enable a future where mental health in Canada is transformed using evidence, data and stakeholder engagement. We unite researchers, communities, and people with lived experience to bridge gaps in care through national population polling, rapid data reporting, and partnerships that inform policy to improve outcomes. Learn more at www.mhrc.ca

About the Polling
Conducted by Pollara Strategic Insights in partnership with Mental Health Research Canada and the Mental Health Commission of Canada, this national poll (n=3,519) is the first representative data on AI use for mental health in Canada. Full findings: https://mentalhealthcommission.ca/AI-polling-report

About the Funding
The views in this report solely represent the views of the Mental Health Commission of Canada. Production of this report is made possible through financial contribution from Health Canada.

Media Contact
Heather Bakken, Pendulum Group
email: heather@pendulumgroup.ca 
cell: 613-406-5432

The post Millions of People in Canada Are Finding AI-Enabled Support for Mental Health Effective Amid Ongoing Questions Around Trust. appeared first on Mental Health Commission of Canada.

Technology-Enhanced Peer Support for Depression in Older Adults: Single-Arm Mixed Methods Feasibility Study

<strong>Background:</strong> Depression in late life is often compounded by social isolation and barriers to care. There is limited study of technology-enhanced peer support for depression among older adults. <strong>Objective:</strong> This study aimed to assess the feasibility and acceptability of a technology-enhanced peer support intervention to decrease depression among older adults. <strong>Methods:</strong> We used a mixed methods pilot study among adults aged 50 years and older with depression who received a peer support intervention called Peers+. The intervention consisted of 8 weekly video chats and unidirectional texts focused on increasing depression self-care and coping. Data obtained from screening, baseline, postintervention, and 3-month follow-up were used in the analysis to assess preliminary outcomes of the intervention. Mixed effects longitudinal models were used to assess change in depression, and qualitative data were collected and analyzed to identify key themes related to participant experiences. <strong>Results:</strong> A total of 34 older adults with a mean age of 67 (SD 9.57) years participated in the study, and 82.4% (28/34) of participants finished all 8 intervention meetings. Depressive symptoms declined over the course of the study of 35 weeks (<i>F</i><sub>1, 88.8</sub>=26.0; <i>β</i>=–.14, 95% CI –0.20 to 0.09; <i>P</i>&lt;.001). Emotional well-being (<i>β</i>=.48, 95% CI 0.26-0.70; <i>P</i>&lt;.001), social functioning (<i>β</i>=.71, 95% CI 0.33-1.09; <i>P</i>&lt;.001), self-efficacy (<i>β</i>=2.29, 95% CI 0.83-3.75; <i>P</i>&lt;.001), and coping (<i>β</i>=2.90, 95% CI 0.24-5.55; <i>P</i>&lt;.001) improved throughout the study period. Participants perceived supportive texts as reinforcing trust between peer coaches, using coping strategies, increasing social connection, and providing accountability for improving self-care. Peer coaches and older adults needed technology support for participation in the study. <strong>Conclusions:</strong> This study demonstrated the feasibility and acceptability of a peer support intervention enhanced by video chats and texts, delivered by older adult peer coaches to an ethnically diverse group of older adults with depression. Study findings indicate that ongoing and accessible technology support contributed to older adult participation and engagement.

Mental health stigma among nursing students: current status and intervention strategies— an integrative review

ObjectiveAims to synthesize the current evidence on the prevalence of mental health stigma among nursing students and to summarize the interventions that have been developed and evaluated to reduce such stigma.MethodsA comprehensive search was conducted across PubMed, CINAHL, and Web of Science databases for peer-reviewed studies published in English between January 2018 and June 2024.ResultsA total of 25 studies were included. The prevalence of mental health stigma among nursing students was found to be moderate to high. Stigma manifested in various forms, including negative attitudes toward patients, internalized shame, and public stigma directed at nursing students themselves. Interventions such as mental health training, empathy enhancement programs, and clinical internships demonstrated varying degrees of effectiveness in reducing stigma, with multi-component interventions showing the most promise.ConclusionMental health stigma among nursing students is a persistent and multifaceted issue that requires targeted strategies to address. Enhancing mental health education, increasing clinical exposure, and implementing comprehensive intervention programs are essential steps to reduce stigma and support the development of compassionate, skilled nursing professionals.