A large proportion of applicants for asylum in the UK are housed in contingency hotels while awaiting the outcome of their claim. As the prevalence of severe mental illness (SMI) among asylum seekers is estimated to be around 61%, a measurable impact on mental health services local to these hotels might be expected.

To evaluate the proportion of asylum seekers on the caseload of a crisis mental health team serving an area with a high concentration of contingency hotels, and to briefly explore the care needs of this population.

Retrospective cross-sectional analysis of all referrals to the Hounslow Crisis Assessment and Home Treatment Team (HCAHTT) in London, UK, between 1 April and 30 September 2023.

Of the 718 referrals to HCAHTT, 536 were taken on the caseload, of whom 9 were asylum seekers. No difference was found in the proportion of asylum seekers on the caseload compared with the general population. Asylum seekers were often moved at short notice, over half required an interpreter and all 9 had a history of trauma.

Asylum seekers housed in Hounslow are not over-represented on the HCAHTT caseload compared with the general population. Given that higher rates of SMI in the asylum seeker population are well-established, this result is more likely to be due to systemic factors than to represent an unusually low rate of asylum seekers experiencing SMI. Asylum seekers tended to require interpretation services and have high rates of reported trauma. Continuity of care is affected by the asylum accommodation process. Better active outreach to vulnerable populations to raise awareness of services might be required.

Depression and anxiety are widespread globally, with significant treatment gaps in low-resource settings. In Pakistan, where prevalence is high and specialists are scarce, brief psychological interventions by trained lay counsellors show promise. DIALOG+ is a novel technology-assisted, solution-focused approach for leveraging resource-oriented approaches in routine community mental health treatment.

To explore the feasibility and acceptability of using DIALOG+ for community-based treatment of common mental disorders delivered by non-specialist lay counsellors in a low-resource setting (trial registration: ISRCTN14528579).

An open, uncontrolled trial in community settings in Karachi, Pakistan, was conducted with 40 patients with depression and anxiety visiting two primary care clinics between June 2019 and February 2020. Patients were enrolled for monthly sessions delivered over 6 months by lay counsellors. Subjective quality of life along with symptoms of depression and anxiety were measured at baseline and endline (following the 6-month intervention) on the Manchester Short Assessment of Quality of Life (MANSA) and Aga Khan University Anxiety and Depression Scale (AKUADS). Changes in measures were evaluated before and after the intervention using a t-test analysis. Post-intervention, in-depth interviews were held with patients and lay counsellors to gather insights into their experience of the intervention.

In total, 146 DIALOG+ sessions were conducted with 40 patients. At the 6-month post-intervention assessment, 33 patients showed improved subjective quality of life and reduced self-reported depression and anxiety scores. Patients reported that the intervention helped strengthen the therapeutic relationship with their lay counsellors, helped them track their progress through therapy and enhanced their self-management of negative emotions and behaviours.

Structured communication can help strengthen lay counsellors’ ability to improve therapeutic outcomes of people with common mental disorders in resource-constrained community settings. Future clinical trials are recommended to further evaluate the long-term impact of the DIALOG+ intervention on mental health outcomes.

Patients with psychosis face an elevated risk of cardiovascular mortality and are more likely to disengage from care. While antipsychotics are essential for treatment, they further increase this risk. Despite this, Ghana lacks a national policy for monitoring cardiovascular risk factors in individuals on antipsychotics.

To evaluate disengagement in care and weight changes among newly diagnosed psychotic patients at Accra Psychiatric Hospital, and to inform clinical practice.

A retrospective review of medical records was conducted for patients newly diagnosed with non-affective psychotic disorders between June 2022 and May 2023. Patients were reviewed for 6 months, with assessments at baseline, 3 months and 6 months. Outcomes included antipsychotic prescription patterns, dropout rates, cardiovascular disease monitoring and weight changes. Descriptive statistics, multinomial logistic regression and linear mixed-effects models were used for analysis.

The number of patients disengaged from care within the first month was 53.1%, and within 6 months 75.5%; 62.8% received olanzapine at baseline. Weight gain was exponential, with 40% experiencing clinically significant weight gain at 3 months, increasing to 58% at 6 months. Less than 50% of patients had their blood sugar and lipid profiles checked before starting antipsychotics. Higher baseline weight was associated with increased weight over time (β = 0.96, t = 80, P < 0.001, 95% CI 0.93, 0.98).

High disengagement rates, low cardiovascular disease monitoring and exponential weight gain were observed. Targeted interventions, robust monitoring protocols and further research are needed to improve patient outcomes.