Making cities mental health friendly for adolescents and young adults.

Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health1,2. Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities3. Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories4. We invited a multidisciplinary, global group of researchers, practitioners, advocates and young people to complete sequential surveys to identify and prioritize the characteristics of a mental health-friendly city for young people. Here we show a set of ranked characteristic statements, grouped by personal, interpersonal, community, organizational, policy and environmental domains of intervention. Life skills for personal development, valuing and accepting young people's ideas and choices, providing safe public space for social connection, employment and job security, centring youth input in urban planning and design, and addressing adverse social determinants were priorities by domain. We report the adversities that COVID-19 generated and link relevant actions to these data. Our findings highlight the need for intersectoral, multilevel intervention and for inclusive, equitable, participatory design of cities that support youth mental health.

Experience with the use of the DIALOG+ intervention in patients with severe mental illness in outpatient services in Colombia.

INTRODUCTION: Severe mental disorders can cause significant and lasting distress for patients and their families and generate high costs through the need for care and loss of productivity. This study tests DIALOG+, an app-based intervention to make routine patient-clinician meetings therapeutically effective. It combines a structured evaluation of patient satisfaction with a solution-focused approach. METHODS: We conducted a qualitative study, based on a controlled clinical trial, in which 9 psychiatrists and 18 patients used DIALOG+ monthly over a six-month period. Semi-structured interviews were used to explore the experiences of participants and analysed in an inductive thematic analysis focusing on the feasibility and effects of the intervention in the Colombian context. RESULTS: Experiences were grouped into five overall themes: a) impact of the intervention on the consultation and the doctor-patient relationship; b) impact on patients and in promoting change; c) use of the supporting app, and d) adaptability of the intervention to the Colombian healthcare system. CONCLUSIONS: DIALOG+ was positively valued by most of the participants. Participants felt that it was beneficial to the routine consultation, improved communication and empowered patients to take a leading role in their care. More work is required to identify the patient groups that most benefit from DIALOG+, and to adjust it, particularly to fit brief consultation times, so that it can be rolled out successfully in the Colombian healthcare system.

Implementación de una intervención multifamiliar para niños con problemas conductuales y emocionales en una población semirrural / Implementation of a Multi-Family Intervention for Children With Behavioural and Emotional Problems in a Semi-Rural Population

RESUMEN Objetivo: Determinar la factibilidad de implementar una intervención grupal multifamiliar, basada en la comunidad, en una población semirrural en Aranzazu, en el norte de Caldas, Colombia. Métodos: Estudio cualitativo. Se tomó una muestra de conveniencia de 10 familias con ninos con alteraciones afectivas y conductuales, previamente identificados mediante la Child Beha-vior Checklist (CBCL). Se adaptó a la cultura y a las necesidades de las familias el modelo de Psicoterapia Psicoeducativa Multifamiliar (MF-PEP). Resultados: Se describen los contenidos de las sesiones, los temas y las experiencias que fueron más significativos para los ninos y sus familias. Conclusiones: La adecuación al contexto cultural de la intervención multifamiliar tuvo una muy buena aceptación de los participantes, tanto cuidadores como ninos y terapeutas.

ABSTRACT Objective: To determine the feasibility of implementing a community-based, multi-family Multiple psychotherapy group intervention in a semi-rural population in Aranzazu, northern Caldas, Colombia. Family Affective symptoms Methods: Qualitative study. A convenience sample was taken of 10 families with children Child with affective and behavioural disorders, previously identified by the Child Behaviour Check-Community list (CBCL). The Multifamily Psychoeducational Psychotherapy (MF-PEP) model was adapted to the culture and needs of the families. Results: The contents of the sessions and the topics and experiences that were most significant for the children and their families are described. Conclusions: The adaptation to the cultural context of the multi-family intervention had a very good acceptability by all participants: caregivers, children and therapists.