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Authors: Mark Ferguson, Joanne K. Garrett, Barbara Tschirren, Benedict W. Wheeler, Alexander G. C. Vaux, Cornelia Guell, Jolyon M. Medlock, Camille Bonneaud, Timothy J. Taylor, Gesche M. Huebner

Source: PLOS Climate. DOI: 10.1371/journal.pclm.0001016. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Bhawana Subedi, Kalpana Bhattarai, Brandon A. Kohrt, Claire Henderson, Elaine Brohan, Graham Thornicroft, Ioannis Bakolis, Maya Semrau, Nicole Votruba, Petra C. Gronholm, Uta Ouali, Dristy Gurung

Mental health-related stigma is a barrier to access to mental health services. This mixed-methods pre-post pilot feasibility study aimed to adapt and pilot-test a multi-level anti-stigma intervention across three levels of the health system to assess its feasibility and potential to reduce mental health-related stigma in Nepal. Contact-based interventions integrating people with lived experience in mental health and stigma training packages were adapted and implemented, targeting female community health volunteers (n = 19), primary healthcare workers (n = 9), and psychiatrists and psychiatric nurses (n = 9). Stigma-related knowledge, attitudes, and competency were measured pre- and post-training with follow-up at 3 and 6 months. Qualitative interviews were conducted with 43 participants across levels. In INDIGO Local, knowledge score increased from 20.43 (95% CI: 20.0-20.9) at pre-training to 25.11 (95% CI: 23.83-26.17) at six months. In INDIGO Primary, the intended behavior increased from 16.67 (95% CI: 14.73-19.27) at pre-training to 18.88 (95% CI: 17.69-20.31) at post-training, while SDS mean score decreased from 39.26 to 20.62. The PCP’s helpful behavior increased, and harmful behavior decreased. The knowledge and OSCE mean score in INDIGO READ-MH increased from 12.67 (95% CI: 10.36 -14.97) at baseline to 14.67 (95% CI: 13.28-16.05) at the post-training and from 2 (95% CI: 1.62-2.38) at pre-training to 9 (95% CI: 7.56-10.44) at post- training, respectively. The ASTAD subscale increased at three months, except for motivation and work satisfaction, which decreased at post-training. Qualitative data highlighted the positive attitudinal shift following the interventions, with strong emphasis on PWLE involvement. Overall, the providers perceived the training as feasible and appropriate within Nepal’s health system. However, whilst they reported more positive perceptions towards persons with mental health conditions following the interventions, they also identified barriers to effective mental health care, such as insufficient availability of medicines, limited human resources, or separate counseling rooms.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000638. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Orrin D. Ware

Substance use disorders may arise when individuals use substances to cope with adverse mental health symptoms. Conversely, mental health symptoms can develop because of substance use, a category of conditions called substance-induced disorders. This study used two United States-based datasets, the Mental Health Client-Level Data and the Treatment Episode Data Set Admissions, to summarize the number of cases with “alcohol-induced disorders” and “substance-induced disorders” from both mental health and substance use disorder treatment programs from 2013 to 2022. The primary study aim was to identify the percentage of cases with alcohol-induced disorders or substance-induced disorders in these treatment settings. Among all mental health disorder treatment cases, those with an alcohol or substance-induced disorder totaled N = 439,932, making up 0.7% of total cases over the analytic period. During the same period, alcohol or substance-induced disorders totaled N = 459,817, accounting for approximately 2.7% of all substance use disorder treatment cases. The majority (79%) of cases with an alcohol-induced disorder in substance use disorder treatment were identified as reporting alcohol use, with 68% having alcohol listed as their primary substance. Heroin and other opiates and synthetics accounted for the primary substance among 28.8% of cases with a substance-induced disorder in the substance use disorder treatment data. Approximately 1 in 3 cases with an alcohol-induced disorder and 1 in 4 cases with a substance-induced disorder had a depressive disorder diagnosis in mental health treatment. When considering the primary diagnosis, approximately 1 in 4 cases with an alcohol-induced disorder and 15% of cases with a substance-induced disorder had a depressive disorder as the primary diagnosis in mental health treatment. Substance-induced disorders are a significant public health concern, and more research is needed to better understand the clinical needs of this population.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000706. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Cristian Montenegro, Felipe Szabzon, Sofía Bowen, Delia da Mosto

Psychiatric deinstitutionalisation (PDI) has re-emerged as an important concern in global mental health in response to the persistence of long-term institutionalisation and human rights abuses in institutions. However, contemporary responses continue to frame reform largely in managerial and technocratic terms, prioritising service coverage, bed reductions, workforce expansion, and scalability. We argue that this framing narrows the meaning of reform and its capacity to address the institutional, political, and social conditions through which psychiatric care is organised. Drawing on critical perspectives on PDI and experiences from South America, we show how PDI has developed through distinct relationships between institutional transformation, democratisation, social mobilisation, and citizenship. These trajectories illuminate contemporary dilemmas such as transinstitutionalisation, fragmented systems of care, and the persistence of segregationist and custodial logics within community settings. We propose three lenses for re-engaging with PDI as an ongoing political and ethical project: attending to context and history, decentring dominant geographies of reform, and foregrounding lived experience. Together, these lenses shift attention towards the sites where reform is actually produced—across research, policy, training, activism, and governance— and highlight the contribution of South American experiences to ongoing debates on institutional transformation.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000699. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Daniella Myriam Pierre, Rehana Rasul, Reichling St. Sauveur, Kelly Celestin, Vanessa Rouzier, Erline Hilaire, Marie Marcelle Deschamps, Jean William Pape, Lily D. Yan, Anju Ogyu, Catherine Bennett, Margaret L. McNairy, Rodney Sufra, Denis Nash

Cardiovascular disease (CVD) is the leading cause of mortality in low- and middle-income countries, and depression remains an underexplored CVD risk factor in Haiti. We assessed the association between depressive symptoms (DS) and prevalent CVD in urban Haiti and examined sex differences using a cross-sectional analysis of enrollment data from the Haiti Cardiovascular Disease Cohort (adults ≥18 years; March 2019–August 2021). DS were measured using the Patient Health Questionnaire-9 and categorized as none–mild (<10) versus moderate–severe (≥10). Prevalent CVD (angina, myocardial infarction, transient ischemic attack or stroke and heart failure) was adjudicated using epidemiologic definitions aligned with international cohorts. Prevalence ratios (PRs) were estimated using generalized estimating equation Poisson models with a log link, adjusting for age, sex, education, income, food insecurity, smoking, alcohol use, physical activity, stress, and ody Mass Index; effect modification by sex was assessed on multiplicative and additive scales. Among 2,995 participants (mean age 41.9 years; 58.0% female), 16.2% had moderate–severe DS, with higher prevalence in females (22.0%) than males (8.5%). CVD prevalence was higher among those with moderate–severe DS than none–mild DS in both sexes (males: 21.5% vs. 10.6%; females: 23.3% vs. 15.3%). Moderate–severe DS were independently associated with higher CVD prevalence (adjusted PR = 1.36; 95% CI: 1.08–1.71). Sex-stratified estimates were 1.38 (95% CI: 1.06–1.78) for females and 1.25 (95% CI: 0.75–1.99) for males; evidence for additive interaction by sex was limited (RERI = 0.07, 95% CI: −0.74 to 0.88). DS were independently associated with higher CVD prevalence in urban Haiti, with a consistently stronger pattern among women, although formal tests of effect modification was not statistically significant. Integrating depression screening into CVD prevention may help address the growing burden of both conditions in resource-limited settings. Prospective studies are needed to clarify the underlying mechanisms and causal pathways.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000693. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Giulia Vivaldi, Emeka Chukwusa, Nick Bridge, Michael Smythe, Ioannis Bakolis, Lisa Page, Rhiannon Thompson, Matthew White, Andrea Mechelli

The United Kingdom (UK) Government’s recent 10 Year Health Plan for England aims to fix a “broken” and increasingly unaffordable health system through a shift from sickness to prevention, hospital to community, and analogue to digital, with a focus on mental as well as physical health. However, the 171-page strategy for a healthy nation does not contain a single reference to nature or biodiversity. We review the significant benefits of nature and biodiversity to health and outline how these benefits can and should be incorporated into the 10 Year Health Plan. We provide examples of effective approaches and techniques, describe challenges to implementation, and propose potential solutions. We focus on mental health, although many benefits will also apply to physical health. Harnessing nature and biodiversity could play a substantial role in supporting the UK’s revised goals, particularly preventing illness and enhancing treatment at the community level.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000647. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Simon Busch-Moreno, Xiao Fu, Etienne B. Roesch

The relationship between income and mental health is well-established yet complex, as both can be confounded by age, gender, and other demographic factors. To clarify these dynamics, this study examines the effects of age and income on symptoms of depression and generalised anxiety across female and male genders during the COVID-19 pandemic in the UK. Data from Wave-1 and Wave-6 of the COVID-19 Psychological Research Consortium (C19PRC) study were analysed using Bayesian hierarchical ordered-logistic mediation models. Results showed that older age was linked to less depression and anxiety in both genders. Higher income was linked to better mental health in males in both waves. For females, however, higher income was only weakly linked to more symptoms early in the pandemic, but by Wave‑6, it had become a substantially protective factor for their mental health. Additionally, males reported better mental health than females across most income groups, except at the lowest income group, where both genders experienced comparable distress. Using robust inferential statistical models, our findings explain the nuanced relationships between socioeconomic factors and mental health across genders during a public health crisis. This evidence can inform targeted mental health policies and economic support programs for future emergencies.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000691. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Carlos Muleya, Rosemary N. Likwa, Peter J. Chipimo, Jacqueline J. Folotiya, Ngosa Mwiya, Lweendo Mapiki, Asarf Sibuchi, Godfrey Chulu, Caitlin Baumhart, Cassidy W. Claassen, Naeem Dalal, Loyd B. Mulenga

Adolescents and young people living with HIV (AYPLHIV) experience substantial mental health and psychosocial challenges, yet information on youth-responsive service availability is often limited for routine planning. We mapped mental health and psychosocial support services in Lusaka and Shibuyunji districts of Zambia and assessed alignment with AYPLHIV antiretroviral therapy (ART) program burden using treatment current (TX-CURR) ages 15–24 data. We conducted a cross-sectional mapping survey (10–21 February 2025) of facilities providing any mental health/psychosocial service to characterize service modalities, operating days, eligibility/consent requirements, privacy infrastructure, and ownership. We linked mapped facilities to ART sites and September 2024 TX-CURR using standardized facility names and districts, and calculated burden-weighted coverage among linked sites. As of September 2024, 16,550 AYPLHIV (15–24) were on ART across 87 sites, with 97.7% of burden in Lusaka. We mapped 88 facilities (73 Lusaka; 15 Shibuyunji); 58.0% were government-owned and 40.9% privately owned. Counseling was widely available (97.7%), whereas group therapy (31.8%), medication (37.5%), and medical supervision [observed medication] (38.6%) were less common; medication was frequently referral-based. Weekend availability was reported by 60.2% and parental/guardian consent requirements by 28.4%. Routine data readiness was higher in Lusaka than Shibuyunji (93.2% vs 66.7%; OR 6.8, 95% CI 1.7–27.7; p = 0.011). Forty-seven facilities were linked to ART sites representing 11,194 AYPLHIV: burden-weighted coverage was 40.7% for weekend services, 47.2% for referral medication, and 23.0% for a composite package (weekend availability + on-site counseling + referral medication). AYPLHIV burden is concentrated in Lusaka, but key access features (weekend options, privacy) and biomedical support beyond counseling often depend on referral pathways and are not consistently aligned with high-burden sites. Strengthening youth-friendly service organization, referral functionality, and routine monitoring at high-burden sites may improve equitable access to mental health and psychosocial support.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000610. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Liz Willetts

Freshwater biodiversity is vital to Sustainable Development Goal (SDG) 6 and to human health and wellbeing. Unrealized opportunities exist to strengthen awareness of freshwater biodiversity and health interlinkages and enhance their uptake into national implementation under the Ramsar Convention on Wetlands as well as under public health and water, sanitation, and hygiene systems. This article aims to identify and mobilize integrated thinking and action on freshwater biodiversity and health during the Ramsar triennium 2025–2028. The article analyzes the 15th meeting of the contracted parties to the wetlands Convention in July 2025 (COP15) and its outcomes in the context of the many global water governance meetings taking place in 2026 and 2027. It considers the role of the Ramsar Convention in achieving planetary health through a) COP15 decisions, b) stronger socioecological framing to wetland character, and c) improved coordination with the health sector in national reporting and proceedings of wetland governance. An analysis of national reports tracking the 2008 Changwon Declaration on Human Health and Wellbeing as well as reports on implementation in the 2021–2024 triennium reveal several areas for de-siloing and sharpening health sector engagement in the Ramsar Convention. The article, arguing that these actions also support achievement of SDG 6, proposes a new planetary health vision of SDG 6 for the post-2030 development agenda. In conclusion, a range of basic coordination actions that could be taken to support and translate COP15 resolutions across the public health and WASH sectors during the 2025–2028 triennium are outlined.

Source: PLOS Water. DOI: 10.1371/journal.pwat.0000594. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.