Association of mental health related quality of life and other factors with treatment seeking for substance use disorders: A comparison of SUDs rooted in legal, partially legal, and illegal substances.

The association of subjective mental health-related quality of life (MHRQOL) and treatment use among people experiencing common substance use disorders (SUDs) is not known. Furthermore, the association of a given substance's legal status with treatment use has not been studied. This work aims determine the association of MHRQOL with SUD treatment use, and how substance legal status modulates this relationship. Our analysis used nationally-representative data from the NESARC-III database of those experiencing past-year SUDs (n = 5,808) to compare rates of treatment use and its correlates among three groups: those with illicit substance use disorders (ISUDs); those with partially legal substance use disorders, i.e., cannabis use disorder (CUD); and those with fully legal substance use disorders, i.e., alcohol use disorder (AUD). Survey-weighted multiple regression analysis was used to assess the association of MHRQOL with likelihood of treatment use among these three groups, both unadjusted and adjusted for sociodemographic, behavioral, and diagnostic factors. Adults with past-year ISUDs were significantly more likely to use treatment than those with CUD and AUD. Among those with ISUDs, MHRQOL had no significant association with likelihood of treatment use. Those with past-year CUD saw significant negative association of MHRQOL with treatment use in unadjusted analysis, but not after controlling for diagnostic and other behavioral health factors. Those with past-year AUD had significant negative association of MHRQOL with treatment use in both unadjusted and adjusted analysis. If legalization and decriminalization continue, there may be a greater need for effective public education and harm reduction services to address this changing SUD landscape.

Detention of children and adolescents under mental health legislation: a scoping review of prevalence, risk factors, and legal frameworks.

BACKGROUND: For individuals with severe mental illness, involuntary assessment and/or treatment (hereafter detention) can be a necessary intervention to support recovery and may even be lifesaving. Despite this, little is known about how often these interventions are used for children and adolescents. METHODS: This global scoping review set out to: (1) map the current evidence around mental health detentions of children and adolescents (< 18 years); (2) identify the clinical, sociodemographic, and behavioural factors associated with detention; and (3) document the views of professionals and young people on the implementation of mental health legislation. RESULTS: After searching databases of peer-reviewed literature and citation chaining, 42 articles from 15 jurisdictions were included. About one fifth of psychiatric admissions in national register data were detentions, however trends were only available for a few high-income Western countries. The circumstances justifying detention and the criteria authorising detention varied between studies, with a mix of clinical factors and observed behaviours reported as the reason(s) warranting/precipitating a detention. Particular groups were more likely to experience detention, such as children and adolescents from minority ethnic communities and those with a documented history of abuse. There was a notable absence of qualitative research exploring the views of professionals or children and adolescents on detention. CONCLUSION: Further research is needed to explore the impact of detention on those aged < 18 years, including national register-based studies and qualitative studies. This is particularly relevant in nations currently undergoing legislative reform.

Collateral Consequences for Third-Party Interviewees in Forensic Contexts.

Collateral interviews can be an integral source of third-party information used in a range of forensic mental health assessments. Although family members and spouses often have the most knowledge about the evaluee, research suggests that they may also experience distress related to the legal proceedings. This article discusses the nature and purpose of collateral interviewing with close collateral contacts, comparing collateral interviews with direct interviews with evaluees. The secondary consequences of having a justice-involved family member are considered, including the possibility of vicarious trauma. Finally, the responsibilities of evaluators are considered, especially in the context of trauma-informed principles applied to collateral interviewing. Recommendations regarding consent, the use of empathy, and feedback to collateral are provided.

Effects of ethnic density on the risk of compulsory psychiatric admission for individuals attending secondary care mental health services: evidence from a large-scale study in England.

BACKGROUND: Black, Asian and minority ethnicity groups may experience better health outcomes when living in areas of high own-group ethnic density - the so-called 'ethnic density' hypothesis. We tested this hypothesis for the treatment outcome of compulsory admission. METHODS: Data from the 2010-2011 Mental Health Minimum Dataset (N = 1 053 617) was linked to the 2011 Census and 2010 Index of Multiple Deprivation. Own-group ethnic density was calculated by dividing the number of residents per ethnic group for each lower layer super output area (LSOA) in the Census by the LSOA total population. Multilevel modelling estimated the effect of own-group ethnic density on the risk of compulsory admission by ethnic group (White British, White other, Black, Asian and mixed), accounting for patient characteristics (age and gender), area-level deprivation and population density. RESULTS: Asian and White British patients experienced a reduced risk of compulsory admission when living in the areas of high own-group ethnic density [odds ratios (OR) 0.97, 95% credible interval (CI) 0.95-0.99 and 0.94, 95% CI 0.93-0.95, respectively], whereas White minority patients were at increased risk when living in neighbourhoods of higher own-group ethnic concentration (OR 1.18, 95% CI 1.11-1.26). Higher levels of own-group ethnic density were associated with an increased risk of compulsory admission for mixed-ethnicity patients, but only when deprivation and population density were excluded from the model. Neighbourhood-level concentration of own-group ethnicity for Black patients did not influence the risk of compulsory admission. CONCLUSIONS: We found only minimal support for the ethnic density hypothesis for the treatment outcome of compulsory admission to under the Mental Health Act.

[Clinical and regulatory challenges of forced hospitalization in Chile under the new Mental Health Law]. / Desafíos clínicos y normativos de la internación forzada en Chile, en virtud de la nueva Ley de Salud Mental.

Forced hospitalization is a common practice in psychiatry. It involves limiting the patient's freedom of movement in a clinical context without expressing informed consent, causing stress to the family and support network. Thus, forced hospitalization may cause violations, disturbances, or threats to the human rights of a vulnerable population. Considering this clinical reality, the present study seeks to analyze the current law on this subject in Chile compared to the international human rights guidelines. The analysis included a review of legal documents and referenced scientific articles. The new law No. 21,331 establishes a more demanding standard for the origin of forced internment, shortening the distance concerning the human rights guidelines regarding intellectual disability. The incoming development of the regulations mandated by the law could fill in the gaps in several situations that may arise and clarify fuzzy points. The key stakeholders' participation level will be critical in this matter.

Información, narrativas y vivencias de los equipos de salud del Hospital Vilardebó ante la nueva Ley de Salud Mental No 19529 / Information, narratives and experiences of the health teams of the Hospital Vilardebó before the new Law of Mental Health N.o 19.529

La nueva Ley de Salud Mental N.o 19.529 promueve el cierre paulatino de los establecimientos asilares y monovalentes en todo el país. Dentro del sector público se encuentra el Hospital Vilardebó. En esta investigación se exploraron los significados que los equipos de salud de dicho hospital construyen sobre la implementación de la Ley N.o 19.529. Para esto se diseñó un estudio descriptivo. A partir de un muestreo teórico estratificado, la población quedó conformada por 69 personas con formación en medicina general, psiquiatría, psicología, trabajo social y enfermería. A través de un cuestionario autoadministrado, se indagó la información sobre la nueva ley, el reconocimiento de cambios institucionales, la modificación de las prácticas laborales, y los afectos movilizados. De los resultados se destaca un manejo heterogéneo de la información sobre la nueva normativa. Se advierte, asimismo, un proceso de transición institucional donde se observan narrativas contradictorias sobre los cambios en curso.

The new Mental Health Law N 19.529 promotes gradual closure of asylums and monovalent institutions throughout the country. Hospital Vilardebó is the public health psychiatric hospital. This research explores the meanings that health teams assign to this law's implemen tation by means of a descriptive study. Based on a theoretical stratified sample, 69 workers with training in general medicine, psychiatry, psychology, social work and nursing answered a self-administered questionnaire regarding the new law, institutional and work practice changes, and affects involved. The results highlight a heterogeneous handling of information on new regulations. Likewise, an institutional transitional process is noted, with contradictory narratives regarding ongoing changes.

La otra llave, la poética propia de los cortometrajes de ficción / The other key, the poetics of short fiction films

Este escrito es un extracto de la Tesis Final de la Licenciatura de Medios Audiovisuales de la UNTDF del autor, en la que se expusieron los resultados de una indagación académica sobre las especificidades del formato cinematográfico denominado "cortometraje", estudiando aquellos aspectos que hacen que el mismo sea un producto audiovisual autónomo respecto del largometraje. El trabajo también comprendió una Memoria Crítica sobre el proceso de creación, producción y realización de una obra audiovisual del autor, un corto de ficción denominado La otra llave, que aquí se comenta y comparte

This paper is an extract from the author's Final Thesis of the UNTDF Audiovisual Media Degree, in which the results of an academic investigation on the specificities of the cinematographic format called "short film" were presented, studying those aspects that make the itself be an autonomous audiovisual product with respect to the feature film. The work also included a Critical Report on the process of creation, production and production of an audiovisual work by the author, a short fiction called The Other Key, which is commented and shared here

Cannabis use and suicidal ideation among youth: Can we democratize school policies using digital citizen science?

BACKGROUND: School policies and programs are important in preventing Cannabis use among youth. This study uses an innovative digital citizen science approach to determine the association between Cannabis use and suicidal ideation among youth while investigating how school health policies mediate this association. METHODS: The study engaged 818 youth (aged 13-18 years) and 27 educators as citizen scientists via their own smartphones. Youths responded to time-triggered validated surveys and ecological momentary assessments to report on a complex set of health behaviours and outcomes. Similarly, educators' reported on substance misuse and mental health school policies and programs. Multivariable logistic regression modeling and mediation analyses were employed. RESULTS: 412 youth provided data on substance misuse and suicidal ideation. Cannabis use and other factors such as bullying, other illicit drug use, and youth who identified as females or other gender were associated with increased suicidal ideation. However, school policies and programs for substance misuse prevention did not mediate the association between Cannabis use and suicidal ideation. CONCLUSIONS: In the digital age, it is critical to reimagine the role of schools in health policy interventions. Digital citizen science not only provides an opportunity to democratize school policymaking and implementation processes, but also provides a voice to vulnerable youth.

Ley 21331: nuevos desafíos de la Ley del reconocimiento y protección de los derechos de las personas en la atención de salud mental / Law 21331: new challenges of the law of recognition and protection of people's rights in mental health care

Since the dawn of the Republic, the question regarding the diagnosis, management and treatment of mental illnesses has been an unresolved issue to this day. Since before the time of the colony, at the time of the conquest, mental illnesses abounded, both in the Mapuche population - autochthonous indigenous - and in the Spanish. The presence in the river basins of heavy metals and minerals toxic for human consumption, as was originally the Mapocho River, whose waters were not drinkable and were only used for crops adopted from the Inca culture, were consumed by the population of the Spanish conquerors, who manifested various types of mental disorders, either due to the consumption of polluted water and the neurological damage that it caused them, the high levels of stress due to the same occupation and the isolation in which they found themselves and the diseases venereal that they carried, which they progressively transmitted to the aboriginal population. (1) On the other hand, the Mapuche population had magical-ritual treatments and methods to treat these and other diseases based on herbalism, phytotherapy and rituals (2) for the evil of melancholy (depression), anxiety disorders, panic attacks and schizophrenia. (3) Centuries later, when medicine and hard science are presented in society giving way to the scientific method, key people make their appearance within mental health studies, who made their way into the national and world panorama, and who, despite the dark past and the tortuous evolution of this branch of medicine, stand out figures who were pioneers and who gave rise to a reality that today continues in constant development and debate. Today mental health is an issue on the table, and Law 21331, promulgated on April 23, 2021 (4) is a response to changes in the perception that society currently has of the concept of disease, which is contrasted to the thinking and management that existed for years, decades and centuries ago around mental health

Desde los albores de la República, la cuestión referente al diagnóstico, manejo y tratamiento de las enfermedades mentales ha sido un tema sin resolver hasta nuestros días. Desde antes del tiempo de la colonia, en la época de la conquista, las enfermedades mentales abundaban, tanto en la población mapuche -indígena autóctona- como en la española. La presencia en las cuencas fluviales de metales pesados y minerales tóxicos para el consumo humano, como fue en su origen el río Mapocho, cuyas aguas no eran bebestibles y solo se utilizaban para los cultivos adoptados de la cultura inca, fueron consumidas por la población de los conquistadores españoles, los cuales manifestaron diversos tipos de trastornos mentales, ya fuese por el consumo de aguas contaminadas y el daño neurológico que les provocaba, los altos niveles de estrés debido a la misma ocupación y al aislamiento en el que se encontraban y las enfermedades venéreas que portaban, las cuales transmitieron progresivamente a la población aborigen. (1) Por otra parte, la población mapuche tenía tratamientos y métodos mágico-rituales para tratar estas y otras enfermedades basados en la herbolaria, la fitoterapia y los rituales (2) para el mal de la melancolía (depresión), trastornos ansiosos, crisis de pánico y la esquizofrenia.(3) Siglos más tarde, cuando la medicina y la ciencia dura se presentan en sociedad dando paso al método científico, hacen su aparición personas clave dentro de los estudios en salud mental, quienes se abrieron camino dentro del panorama nacional y mundial, y que, pese al pasado oscuro y a la evolución tortuosa de esta rama de la medicina, se destacan figuras que fueron pioneras y que dieron pie a una realidad que hoy en día continúa en constante desarrollo y debate. Hoy la salud mental es un tema sobre la mesa, y la Ley 21331, promulgada el 23 de abril del año 2021 (4) es una respuesta a los cambios en la percepción que la sociedad actualmente tiene frente al concepto de enfermedad, que se contrasta al pensamiento y manejo que durante años, décadas y siglos atrás existió en torno a la salud mental