Literature Collection

BACKGROUND: There is an increased risk of mood changes in perimenopause, and evidence that patients and GPs may overlook this association. Evidence also shows that GPs have a lack of confidence in managing perimenopausal symptoms. AIM: To examine clinical consultations for patients in the perimenopausal age range who were presenting with mental health symptoms, and the experiences of GPs providing care to such patients. DESIGN & SETTING: A qualitative study was undertaken in one integrated care system in south-west England. It involved 18 women aged 45-55 years, who had consulted with their GP about a mental health symptom in the previous 6 months, and 11 GPs. METHOD: Participants were recruited between February 2023 and August 2023. Data were collected through semi-structured interviews, and thematic analysis was used to identify recurring patterns and key insights regarding consultation practices, patient-GP communication, and gaps in education and training. RESULTS: Women either did not recognise perimenopause or were uncertain whether it contributed to their mental health symptoms, and felt inhibited or embarrassed about raising the issue. GPs reported using variable approaches to asking about perimenopausal symptoms and acknowledged that there were gaps in their training. Time constraints and the stigma surrounding menopause further hindered consultations. CONCLUSION: Addressing mental health symptoms during perimenopause requires a proactive and informed approach in primary care. Improved GP training on menopause, coupled with patient education to increase awareness and confidence, could improve consultations and the management of mental health symptoms experienced during perimenopause.

BACKGROUND: Supporting children and young people (≤24 years) who have experienced adverse childhood experiences (ACEs) is challenging due to limited access to specialized mental health services and systemic barriers that hinder continuity of mental health care. OBJECTIVE: This qualitative evidence synthesis investigated the pathways and continuum of mental health care among children and young people experiencing ACEs and mental health challenges. METHODS: Articles were identified through searches of electronic databases and manual searches of reference lists. The candidacy framework guided our thematic synthesis, focusing on how young people access, navigate, and remain engaged in mental health care. RESULTS: Twenty-one studies evaluated the health seeking practices for young people with ACEs. Many children and young people with ACEs do not seek treatment, and others discontinue care due to distress or alienation. Early help-seeking was often delayed due to low awareness, fear of disclosure, and parental reluctance. Access to services was limited by fragmented systems, logistical and financial barriers, and lack of information. Engagement was undermined by emotional discomfort, cultural or language barriers, re-traumatization risks, and negative provider attitudes, while sustained use depended on trust, culturally appropriate care, and service continuity. As a coping, many young people turned to informal support from peers, teachers, and online resources when formal services were inaccessible. Structural challenges, including insufficient training, weak referral pathways, and limited resources, further undermined continuity of care. CONCLUSIONS: Recognizing informal and alternative pathways, combined with integrated, contextually adapted, cross-sectoral care models, can help address unmet mental health needs of children and young people with ACEs globally.

Mental health conditions are up to 2 to 3 times more common across a woman's lifespan depending on the condition, making it important to screen for these conditions and be aware of key treatment differences compared to men. Medication choices should take into account a woman's reproductive potential.

To explore the receipt of mental health education, assessment, and referrals, and mental health service use among individuals with vestibular disorders. Patients with vestibular disorders living in the US, Australia, Canada, and the UK were surveyed through social media forums. Questionnaires assessed demographics, anxiety (Generalized Anxiety Disorder-7), depression (Center for Epidemiological Studies Depression-10), dizziness (Dizziness Handicap Inventory), and type of professional providing mental health education, assessment, referral, and treatment. The 226 participants were largely White (90%), educated (67% holding an associate's degree or higher) women (88%) with an average age of 45 who self-identified as having chronic vestibular symptoms (78%), as opposed to episodic ones (22%). Fifty-two percent reported never receiving verbal education, written education (69%), mental health assessment (54%), or referral (72%). Participants were more likely to receive mental health treatment in the past if they had received verbal resources and/or referrals from clinicians. The majority of patients with vestibular disorders report that medical professionals have not provided education, mental health assessment, or a mental health referral.