Literature Collection

BACKGROUND: Mental health disorders, particularly anxiety and depression, disproportionately affect young adults, creating significant barriers to academic success. Access to mental health care remains a critical challenge in rural university settings. Nurse practitioner (NP)-led integrated care programs (ICPs) offer a potential solution by integrating behavioral health into primary care to provide timely, accessible, and holistic care. PURPOSE: This study examines the implementation and outcomes of a NP-led ICP aimed at addressing mental health challenges among college students in a rural university setting. METHODOLOGY: Over a 9-month period, 61 students participated in the ICP. The program used validated screening tools, including the 9-item Patient Health Questionnaire-9 (PHQ-9) and 7-item Generalized Anxiety Disorder (GAD-7), to assess and monitor depression and anxiety severity. Data on program outcomes were collected through these assessments, provider collaboration reviews, and satisfaction surveys. RESULTS: Participants demonstrated significant reductions in depression and anxiety severity, as measured by PHQ-9 and GAD-7 tools. Key findings included improved access to care, enhanced collaboration among providers, and high satisfaction rates among students and staff. However, challenges related to role clarity and the fit of behavioral health providers highlighted the need for targeted training and supervision. CONCLUSIONS: The study demonstrates that integrated care models can be successfully adapted to rural university environments, leading to improved mental health outcomes for college students. IMPLICATIONS: The findings support the broader application of ICPs in similar settings. Future work will focus on extending the program into surrounding communities to sustain and expand its impact.

Despite increasing rates of co-morbid depression and obesity, few interventions target both conditions simultaneously, particularly in men. The SHED-IT: Recharge trial, conducted in 125 men with depressive symptoms and overweight or obesity, tested the efficacy of a gender-tailored eHealth program with integrated mental health support. The aims of this study were to examine the perceptions of men who received the SHED-IT: Recharge intervention in relation to recruitment, satisfaction with the program, and suggestions to improve the program. Individual semi-structured interviews were conducted in a random sub-sample, stratified by baseline depression and weight status (n = 19, mean (SD) age 49.6 years (11.6), PHQ-9 score 9.0 (3.7), BMI 32.5 kg/m(2) (4.6)). Transcripts were analyzed using an inductive process by an independent qualitative researcher. Four themes emerged, namely, (i) specific circumstances determined men's motivation to enroll, (ii) unique opportunity to implement sustained physical and mental health changes compared to previous experiences, (iii) salience of the program elements, and (iv) further opportunities that build accountability could help maintain focus. Gender-tailored, self-directed lifestyle interventions incorporating mental health support are acceptable and satisfying for men experiencing depressive symptoms. These findings provide important insights for future self-guided lifestyle interventions for men with poor physical and mental health.