There is a need for a paradigm shift across mental health in primary care to improve the lives of millions of Europeans. To contribute to this paradigm shift, the European Forum for Primary Care (EFPC-MH) working group for Mental Health, produced a Position Paper for Primary Care Mental Health outlining 14 themes that needed prioritizing. These themes were developed and discussed interactively during the EFPC conferences between 2012 and 2019. The Position Paper on Mental Health gives direction to the necessary improvements over the next ten years. The themes vary from preferable healthcare model to the social determinants highlighting issues such as inequalities. The Statement of Mental Health in Primary Care will be established in cooperation with fellow organizations.

This first-of-its-kind national survey of 485 psychiatrists in nine states and the District of Columbia (DC) finds substantial evidence of clinicians being uninformed, misinformed, and misinforming patients of their gun rights regarding involuntary commitments and voluntary inpatient admissions. A significant percentage of psychiatrists (36.9%) did not understand that an involuntary civil commitment triggered the loss of gun rights, and the majority of psychiatrists in states with prohibitors on voluntary admissions (57%) and emergency holds (56%) were unaware that patients would lose gun rights upon voluntary admission or temporary commitment. Moreover, the survey found evidence that psychiatrists may use gun rights to negotiate “voluntary” commitments with patients: 15.9% of respondents reported telling patients they could preserve their gun rights by permitting themselves to be voluntarily admitted for treatment, in lieu of being involuntarily committed. The results raise questions of whether psychiatrists obtained full informed consent for voluntary patient admissions, and suggest that some medical providers in states with voluntary admission prohibitor laws may unwittingly deprive their patients of a constitutional right. The study calls into question the fairness of state prohibitor laws as policy, and — at minimum — indicates an urgent need for psychiatrist training on their state gun laws.

Having and building a romantic relationship is an important aspect of development in young adulthood. However, there are some challenges in relationships, including basic principle differences such as faith and culture that lead to fights and break-ups. Going through a break-up is not easy for some people and is considered to be one of the stress sources in people’s lives that often links to depression symptoms. It is crucial to focus on intervention aiming at the cognitive aspects, including negative thoughts and bias when dealing with depression, such as cognitive behavioural therapy (CBT). However, CBT in the Indonesian context, especially with religious and ethnic problems in a romantic relationship before marriage, is limited. This study aims to explore this by presenting the case of a 26-year-old Indonesian male with depressive episodes after a painful break-up due to religious and cultural differences. The previous history of childhood abuse and problems in social adjustment and communication had also worsened his conditions. CBT was used for treatment as he developed many negative thoughts about himself and had maladaptive beliefs about his conditions and his future. This case study report shows the effectiveness of CBT intervention in decreasing depression symptoms, such as sadness and the thought of being unworthy, as well as increasing self-confidence in facing difficulties.

This article provides an overview of current knowledge about the relationship between mental illness, violence, homicides, and suicides, with a view towards crafting sensible public policy options for reducing gun violence towards self or others. With this knowledge as a backdrop, the limitations of the federal National Instant Background Check System (NICS) as both over-inclusive and under-inclusive in identifying people with mental illness who pose potential risks are discussed. Finally, the article describes emerging approaches for identifying and removing firearms from persons who pose potential risks of gun violence towards self or others, including Extreme Risk Protection Orders (“Red Flag Laws“) and other options.

Quantitative models of psychopathology (i.e., HiTOP) propose that personality and psychopathology are intertwined, such that the various processes that characterize personality traits may be useful in describing and predicting manifestations of psychopathology. In the current study, we used data from the Human Connectome Project (N = 1050) to investigate neural activation following receipt of a reward during an fMRI task as one shared mechanism that may be related to the personality trait Extraversion (specifically its sub-component Agentic Extraversion) and internalizing psychopathology. We also conducted exploratory analyses on the links between neural activation following reward receipt and the other Five-Factor Model personality traits, as well as separate analyses by gender. No significant relations (p < .005) were observed between any personality trait or index of psychopathology and neural activation following reward receipt, and most effect sizes were null to very small in nature (i.e., r < |.05|). We conclude by discussing the appropriate interpretation of these null findings, and provide suggestions for future research that spans psychological and neurobiological levels of analysis.

Personality has been correlated with differences in cytokine expression, an indicator of peripheral inflammation; however, the associations between personality and central markers of inflammation have never been investigated in vivo in humans. Microglia are the resident macrophages of the central nervous system, and the first responders to tissue damage and brain insult. Microglial activation is associated with elevated expression of translocator protein 18kDa (TSPO), which can be imaged with positron emission tomography (PET) to quantify immune activation in the human brain. This study aimed to investigate the association between personality and TSPO expression across the psychosis spectrum. A total of 61 high-resolution [18F]FEPPA PET scans were conducted in 28 individuals at clinical high risk (CHR) for psychosis, 19 First-Episode Psychosis (FEP), and 14 healthy volunteers (HVs), and analyzed using a two-tissue compartment model and plasma input function to obtain a total volume of distribution (VT) as an index of brain TSPO expression (controlling for the rs6971 TSPO polymorphism). Personality was assessed using the Revised NEO Personality Inventory (NEO-PI-R). We found TSPO expression to be specifically associated with neuroticism. A positive association between TSPO expression and neuroticism was found in HVs, in contrast to a nonsignificant, negative association in CHR and significant negative association in FEP. The TSPO-associated neuroticism trait indicates an unexplored connection between neuroimmune activation and personality that varies across the psychosis spectrum.

Women suffer different forms of violence, both explicit and covert, due to gender asymmetry. This study analyzes the relationship between the internalization of norms assigned to the female gender understood as a form of covert social violence and the presence of anxiety and depression. 286 women were evaluated with the Inventory of Concealed Social Violence (IVISEM) to measure the internalization of gender norms, the Inventory of Situations and Responses to Anxiety (ISRA), to measure anxiety, and the Three-Dimensional Depression Questionnaire (CTD) to measure depression. In addition, the possible influence of some variables such as maternity, age and marital status on the internalization of norms and on the presence of emotional alterations is discussed. The findings showed the relationship between IVISEM factors and the seven health indicators measured. Age appeared as a modulating variable in relation to cognitive anxiety and depression and marital status is related to all depression factors. The results show that women's internalization of gender norms can be understood as hidden social violence, since it was associated with high scores in anxiety and depression.

Self-recognition is of great significance to our sense of self. To date, disturbances in the processing of visual self-recognition are well studied in people with schizophrenia, whereas relatively few studies have focused on the processing of self in other domains, such as auditory. An investigation of auditory self-recognition contributes to delineate changes related to self and the potential roots of the described psychopathological aspects connoting schizophrenia. By applying unimodal task and multisensory test, this study investigated auditory self-recognition in people with schizophrenia under unimodal and bimodal circumstances. Forty-six adults diagnosed with schizophrenia and thirty-two healthy controls were involved in this study. Results suggested that people with schizophrenia seemed to have significantly lower perceptual sensitivity in detecting self-voice, and also showed stricter judgment criteria in self-voice decision. Furthermore, in the presentation of stimuli that combined the stimulation of others’ faces with one’s own voice, people with schizophrenia mistakenly attributed the voices of others as their own. In conclusion, altered auditory self-recognition in people with schizophrenia was found.

Seeking help for mental health concerns is critical for improving wellbeing and preventing the development of mental health disorders, yet many adolescents with mental health problems fail to seek professional help. It is well established that young people with mental health problems face a variety of barriers to help-seeking; however, little is known about the ways in which these barriers interact to impact upon the help-seeking process. Guided by the reasoned action approach, this study investigated the predictive relationship between factors that influence help-seeking. Results revealed that mental health knowledge significantly predicted help-seeking intentions, while attitudes did not. Gender differences were identified for help source preferences. The current study contributes to knowledge on the relationship between key variables that influence the adolescent help-seeking process. Findings highlight the importance of mental health knowledge in predicting help-seeking intentions and provide support for interventions that focus on improving mental health literacy in adolescents.

Several studies have reported the factor structure of posttraumatic stress disorder (PTSD) using confirmatory factor analysis (CFA). The results show models with different number of factors, high correlations between factors, and symptoms that belong to different factors in different models without affecting the fit index. These elements could suppose the existence of considerable item cross-loading, the overlap of different factors or even the presence of a general factor that explains the items common source of variance. The aim is to provide new evidence regarding the factor structure of PTSD using CFA and exploratory structural equation modeling (ESEM). In a sample of 1,372 undergraduate students, we tested six different models using CFA and two models using ESEM and ESEM bifactor analysis. Trauma event and past-month PTSD symptoms were assessed with Life Events Checklist for DSM-5 (LEC–5) and PTSD Checklist for DSM-5 (PCL–5). All six tested CFA models showed good fit indexes (RMSEA = .051–.056, CFI = .969–.977, TLI = .965–.970), with high correlations between factors (M = .77, SD = .09 to M = .80, SD = .09). The ESEM models showed good fit indexes (RMSEA = .027–.036, CFI = .991–.996, TLI = .985–.992). These models confirmed the presence of cross-loadings on several items as well as loads on a general factor that explained 76.3% of the common variance. The results showed that most of the items do not meet the assumption of dimensional exclusivity, showing the need to expand the analysis strategies to study the symptomatic organization of PTSD.

This study aimed to explore the constructs related to teachers’ competence in immediately intervening in school bullying (CIISB) in order to develop a valid intervention process. In this study, 16 secondary school teachers in Taiwan with experience of dealing with school bullying were interviewed. In total, 26 interview transcripts were analysed. The results highlight two key constructs that are central to CIISB. The first is structuring prompt management of school bullying. This involves three phases: identifying the incident, stabilising the incident, and clarifying incidents as well as implementing incidental and intentional learning. The second construct is setting the appropriate atmosphere. This refers to teachers’ capacity to build a positive relationship with students by maintaining a calm, serious and fair attitude, and creating a positive atmosphere to implement an immediate intervention. The results suggest that teachers should master the above constructs of CIISB, thereby providing a suitable immediate intervention when school bullying occurs.

The purpose of this research was to examine the associations between self-esteem, perceived social competence, ostracism and loneliness among adolescent students. For the investigation of self-esteem and perceived social competence as key developmental constructs concerning negative experiences such as ostracism and loneliness, it is important to understand the experiences that may inhibit individual development in adolescence. Participants were 542 presecondary and secondary school students who completed the Rosenberg Self-Esteem Scale, the Perceived Social Competence Scale, the Ostracism Experience Scale for Adolescents, and the Loneliness Scale for Children. The data were analysed with Pearson moments correlation analysis and multiple regression analysis. Findings showed that: (1) self-esteem, perceived social competence, ostracism and loneliness were related to each other; (2) self-esteem and perceived social competence were negatively related to ostracism and loneliness; (3) ostracism had a positive relationship with loneliness and a negative impact on self-esteem; and (4) an increase in the level of perceived social competence predicted a decrease in the levels of ostracism and loneliness. The results were discussed in the light of relevant literature.