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The State of Mental Health Services: Challenges, Trends and Achievements

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 6197

Special Issue Editor


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Guest Editor
Clinical Psychology PhD Program, Albizu University, San Juan Campus, San Juan, PR 00901, USA
Interests: trauma; digital mental health; implementation and dissemination science; community-based participatory research; health disparities and cultural adaptation of evidence-based interventions

Special Issue Information

Dear Colleagues,

The landscape of mental health services has changed worldwide since the onset of the COVID-19 pandemic. During the COVID-19 outbreak, mental services were disrupted, halted or rapidly transitioned to some form or combination of digital mental health and in-person care. Researchers and providers are concerned that the next public health crisis will be a mental-health pandemic. 

Even prior to the spread of the COVID-19, mental illnesses were among the leading causes of the global-health burden. The Global Burden of Diseases, Injuries and Factors Study [1] ranked depression and anxiety as the most disabling mental illnesses and among the top 25 causes of burden worldwide. The global prevalence of mental health illnesses reached a record high during the COVID-19 outbreak [2], contributing to an additional 53.2 million and 76.2 million global cases of major depressive disorder and anxiety disorders, respectively [3]. Due to the increased prevalence of mental illnesses, the rapid advancement and uptake of digital mental health, and an ever-pervasive need to serve traditionally underserved populations, researchers, providers and community leaders face opportunities and challenges to improve and increase access to mental health services. Simultaneously, new trends and achievements in mental-health care have emerged to address the increasing mental health needs of all populations worldwide. 

This Special Issue of the International Journal of Environmental Research and Public Health focuses on the current state of the provision of mental health services. Papers emphasizing digital mental health are welcome for this issue. A variety of manuscript types will be accepted for this Special Issue, including original research papers, reviews, case reports, position papers, brief reports and commentaries. The keywords listed below provide an outline of some potential areas of interest. 

References

  1. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020, 396, 1204–1222.
  2. World Health Organization: Mental Health and COVID-19: Early evidence of the pandemic’s impact: Scientific brief, 2 March 2022. Available online: https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Mental_health-2022.1 (accessed on 15 April 2022).
  3. Santomauro, D. F., Herrera, A. M. M., Shadid, J., Zheng, P., Ashbaugh, C., Pigott, D. M., Abbafati. C., Adolph, C., Amlag, J.O., Aravkin, G.J., etc. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet 2021, 398, 1700–1712. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02143-7/fulltext?mkt_tok=ODUwLVRBQS01MTEAAAGADlbu-Ek7vpDg5pIJb3l5OxIuUaatGcthN3L8jeTndIW_IIK1W2gKuWIHP-VImOioNQ_5PUDQJ6HhyFdkiRxbHB-eW7_58AbtXVU0-uefK9-P#%20.

Dr. Andel V. Nicasio
Guest Editor

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Keywords

  • mental health care
  • mental health services
  • mental health services research
  • community mental health services
  • implementation
  • dissemination
  • best practices
  • digital metal health
  • evidence-based interventions
  • brief interventions

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Published Papers (3 papers)

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Research

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14 pages, 686 KiB  
Article
A Conceptual Framework for Empowerment of Psychiatric Nurses Caring for Children with Mental Health Challenges
by Rorisang Mary Machailo, Magdalena Petronella Koen and Molekodi Jacob Matsipane
Int. J. Environ. Res. Public Health 2025, 22(3), 396; https://doi.org/10.3390/ijerph22030396 - 7 Mar 2025
Viewed by 616
Abstract
There are scanty empirical and theoretical studies focusing specifically on the implementation models for the care of psychiatric nurses caring for children. Staff contribution in the process of putting clinically relevant actions into practice contributes to effective implementation, increased acceptance, and commitment. These [...] Read more.
There are scanty empirical and theoretical studies focusing specifically on the implementation models for the care of psychiatric nurses caring for children. Staff contribution in the process of putting clinically relevant actions into practice contributes to effective implementation, increased acceptance, and commitment. These practises can be used to improve mental health care services of children at different levels. The aim is to deepen an understanding of the perspective of care for children with mental health challenges. A qualitative, exploratory, and descriptive design was used to allow for innovative thoughts to restructure the practice of child psychiatric nursing and is based on the Practice-Orientated Theory of Dickoff. A positive focus on aspects that facilitate care for children with mental health problems is informed by the data collected. A suite of services that include practice environment, trainings, and practical assistance is feasible to support psychiatric nurses. This framework implies that psychiatric nurses need professional competence to understand the context of the environment. Psychiatric nurses need to move beyond engagement to demonstrate how they help children with psychiatric challenges and to enable the development of psychiatric nursing practice through international collaboration. Full article
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16 pages, 1203 KiB  
Article
Understanding Mental Health Impact of COVID-19 on Puerto Rican Youth: Influence of Parental Stress
by Gabriela M. Martínez-Seda, María C. Vélez-Pastrana and Andel Nicasio-Infante
Int. J. Environ. Res. Public Health 2024, 21(12), 1564; https://doi.org/10.3390/ijerph21121564 - 26 Nov 2024
Viewed by 799
Abstract
The COVID-19 pandemic disrupted all areas of society. The socioemotional effects of isolation, financial instability, and educational and employment uncertainty are anticipated to have a ripple effect on the mental health of parents and children, which has not yet been studied in the [...] Read more.
The COVID-19 pandemic disrupted all areas of society. The socioemotional effects of isolation, financial instability, and educational and employment uncertainty are anticipated to have a ripple effect on the mental health of parents and children, which has not yet been studied in the Puerto Rican context. To examine the impact of COVID-19 on Puerto Rican families, we used a cross-sectional, correlational research design that studied the following: (a) Adverse experiences (AE) related to the COVID-19 pandemic reported by parents; (b) Parental stress; (c) Parental psychopathology: (d) The mental health of their children. We hypothesized that AEs have direct and indirect effects on child mental health, which are mediated by parental mental health and stress. One hundred and thirty-five parents with children aged 4 to 18 years completed an anonymous online survey from March to May 2022. Results show that COVID-19 AEs have significant direct and indirect effects on child mental health, which are mediated by parental stress and parental psychopathology. We observed medium-to-large effect sizes in the associations between child mental health and COVID-19 AEs, which are mediated by parental stress and psychopathology. Children’s mental health symptoms worsen as parental stress and parental psychopathology increase in the context of COVID-19 AEs. Full article
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Review

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10 pages, 293 KiB  
Review
Compound Crises: The Impact of Emergencies and Disasters on Mental Health Services in Puerto Rico
by Fernando I. Rivera, Sara Belligoni, Veronica Arroyo Rodriguez, Sophia Chapdelaine, Varun Nannuri and Ashley Steen Burgos
Int. J. Environ. Res. Public Health 2024, 21(10), 1273; https://doi.org/10.3390/ijerph21101273 - 25 Sep 2024
Cited by 2 | Viewed by 3259
Abstract
Background: Mental health in Puerto Rico is a complex and multifaceted issue that has been shaped by the island’s unique history, culture, and political status. Recent challenges, including disasters, economic hardships, and political turmoil, have significantly affected the mental well-being of the population, [...] Read more.
Background: Mental health in Puerto Rico is a complex and multifaceted issue that has been shaped by the island’s unique history, culture, and political status. Recent challenges, including disasters, economic hardships, and political turmoil, have significantly affected the mental well-being of the population, coupled with the limitations in the accessibility of mental health services. Thus, Puerto Rico has fewer mental health professionals per capita than any other state or territory in the United States. Objective: This comprehensive review examines the impact of disasters on mental health and mental health services in Puerto Rico. Given the exodus of Puerto Ricans from the island, this review also provides an overview of mental health resources available on the island, as well as in the continental United States. This review identifies efforts to address mental health issues, with the intent of gaining a proper understanding of the available mental health services, key trends, as well as observable challenges and achievements within the mental health landscape of the Puerto Rican population. Design: A comprehensive search using the PRIMO database of the University of Central Florida (UCF) library database was conducted, focusing on key terms related to disasters and mental healthcare and services in Puerto Rico. The inclusion criteria encompassed studies on Puerto Rican individuals, both those who remained on the island and those who migrated post-disaster, addressing the mental health outcomes and services for adults and children. We included peer-reviewed articles published from 2005 onwards in English and/or Spanish, examining the impact of disasters on mental health, accessibility of services, and/or trauma-related consequences. Results: In this scoping review, we identified 39 studies addressing the mental health profile of Puerto Ricans, identifying significant gaps in service availability and accessibility and the impact of environmental disasters on mental health. The findings indicate a severe shortage of mental health services in Puerto Rico, exacerbated by disasters such as Hurricanes Irma and Maria, the earthquakes of late 2019 and early 2020 that followed, and the COVID-19 pandemic, resulting in substantial delays in accessing care, and limited insurance coverage, particularly in rural regions. Despite these challenges, efforts to improve mental health services have included substantial federal funding and community initiative aimed at enhancing care availability and infrastructure. Limitations include the use of a single database, language restrictions, and potential variability in data extraction and synthesis. Conclusions: This scoping review highlights the significant impact of disasters on mental health in Puerto Rico and the challenges in accessing mental health services exacerbated by disasters. Despite efforts, significant gaps in mental healthcare and services persist, emphasizing the need for more rigorous research and improvements in infrastructure and workforce to enhance mental health outcomes for Puerto Ricans both on the island and in the continental United States. Full article
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