Comment

Wastewater analysis can quantify the pharmaceuticals used to treat mental health disorders, providing data for policy development. This Comment highlights the potential of such wastewater-based epidemiology to enhance the estimation of treated mental health disorders at the community level.

We launched the ENIGMA-Neuroendocrinology working group with the aim to address knowledge gaps about the role of sex hormones in the brain, which lead to prevalent sex- and gender-based health disparities in biomedical research. We approach this by adopting a lifespan perspective to explore the interplay of hormonal dynamics and mental health in the brain.

The COVID-19 pandemic caused unprecedented developmental disruptions to children and young people. Here we address its long-term impact on children and young people, relay their views on important issues for mental health in the context of the pandemic and provide recommendations for future research priorities.

A deficit-oriented approach to describing living with schizophrenia obscures the challenges affected individuals face in being understood by others. Though symptoms of the illness complicate the development of a robust narrative self, patients still seek meaningful dialogue, and provider attitudes and practices can foster this narrative voice.

Clinical staging could be an actionable concept for behavioral and psychological symptoms of dementia (BPSD), providing clinicians with tools to navigate choices of treatment, acceptability of side effects and suitable care settings. This would pave the way for more research into tailored interventions that are much needed in high-stage BPSD.

This article explores debates in psychiatry about generalism and subspecialization, illustrating the potential benefits and issues of each in the context of service delivery and education founded on the biopsychosocial model. Recommendations are given to respond to varying global dynamics and support moves toward patient-centred care.

Intergenerational trauma, passed down through generations, is a significant concern for refugees and their descendants. Millions of people are forcibly displaced worldwide, with profound effects on mental and physical health. Refugees face many challenges, from acculturation to legal uncertainties, leading to a range of emotional struggles.

Deciding between treatments in depression relies on trial-and-error following the stepped-care approach (escalating to more intensive treatments after treatment failures). Recent research is focused on biomarkers and precision psychiatry; however, we argue that stratified psychiatry could be a practical alternative for individuals with mental health disorders.

Early evidence suggests psychedelics could help alleviate end-of-life anxiety and depression. Yet there has been little study or discussion of their integration into hospice and palliative care settings, where patients often have complex comorbidities and medication regimens. The authors discuss relevant clinical challenges and approaches.

This Comment proposes to increase knowledge of the effects of urbanicity on brain and mental health by linking existing human spatial data with macroenvironmental and regional socioeconomic data. It introduces hypothesis-free models to capture the data and model life in the city and suggests refinements for future studies into conditions that will soon affect the majority of the earth’s population.

This Comment highlights the intertwined nature of mental and brain health and disease. Common genetic, environmental and lifestyle factors contribute to psychiatric and neurological disorders, which partially share neurocognitive and pathophysiological mechanisms. A call for a more dimensional, interdisciplinary approach can accelerate the development of robust approaches to research, prevention and intervention.

Utilizing an everyday citizenship approach in forensic psychiatric care, by recognizing the agentive actions and relational interactions in mundane activities and caregiving communications, could substantially enhance and advance care practices.

Men often experience mental health issues in silence. This Comment considers the many manifestations of silence in men’s mental illness, which serve to reduce subjective wellbeing and social/occupational functioning amid elevating suicide risk.

Cases of mild or transient distress in young people are increasingly viewed as problems that require medical intervention. As CAMHS clinicians, we argue that this overmedicalization undermines the value of social support within the family and community, and funding cuts to nonmedical support services have only compounded the problem.

LGBTQIA+ older adults are under-represented in Alzheimer’s disease and mental health research. Here we highlight the current research evidence, social and policy influences, and ways healthcare and research professionals can improve equity in research and healthcare.

Climate change and ecological emergencies threaten life on Earth. This creates a distress that is in danger of being pathologized and dismissed. We examine how such feelings are rational and underpinned by instinctive compassion for the environment and each other. We must respond by supporting people to act with their full potential, amidst systemic and government failures.

Sex and gender play an important role in mental health. Clinical and preclinical research for novel treatments need to take this serious matter under consideration. The development of safe and effective treatments for specific populations can be achieved only with enhanced and targeted funding that will generate robust and reliable data.

Climate change is affecting mental health in all communities, especially in young people. It is critical that we consider how to support young people affected by climate change anxiety and the possibilities of looking forward to supporting them.

In this Comment, Patwary et al. discuss the mental health needs of the Turkey–Syria earthquake survivors from an internal point of view, providing suggestions on what could be done for short- and long-term mental health improvement.