Compounding vulnerabilities: victimization and discrimination is associated with COVID-19 disruptions to HIV-related care among gay, bisexual, and other men and transgender and nonbinary people who have sex with men in Kazakhstan

Operational status of mental health, substance use, and problem gambling services: A system-level snapshot two years into the COVID-19 pandemic

BACKGROUND

The aim of this paper is to provide a system-level snapshot of the operational status of mental health, substance use, and problem gambling services 2 years into the pandemic in Ontario, Canada, with a specific focus on services that target individuals experiencing vulnerable circumstances (e.g., homelessness and legal issues).

METHODS

We examined data from 6038 publicly funded community services that provide mental health, substance use, and problem gambling services in Ontario. We used descriptive statistics to describe counts and percentages by service type and specialisation of service delivery. We generated cross-tabulations to analyse the relationship between the service status and service type for each target population group.

RESULTS

As of March 2022, 38.4% (n = 2321) of services were fully operational, including 36.0% (n = 1492) of mental health, 44.1% (n = 1037) of substance use, and 23.4% (n = 78) of problem gambling services. These service disruptions were also apparent among services tailored to sexual/gender identity (women/girls, men/boys, 2SLGBTQQIA + individuals), individuals with legal issues, with acquired brain injury, and those experiencing homelessness.

CONCLUSION

Accessible community-based mental health, substance use and problem gambling services are critical supports, particularly for communities that have historically contended with higher needs and greater barriers to care relative to the general population. We discuss the public health implications of the findings for the ongoing pandemic response and future emergency preparedness planning for community-based mental health, substance use and problem gambling services.

Analysis of the Mediation Effects of Adverse Mental Health Outcomes in HIV-Infected Women of Childbearing Age from Multiple Perspectives Including Discrimination Perception

Objective

To Analysis of the mediation effects of adverse mental health outcomes in HIV-infected women of childbearing age from multiple perspectives including discrimination perception, social capital, and other factors.

Methods

A cross-sectional survey was conducted among 553 people in Xinjiang region of China using Survey scale. AMOS was used to identify factors that influenced the "discrimination perception/mental resilience/social capital-depression-poor mental health outcomes" pathway.

Results

A total of 44.85% and 42.13% of the study participants had anxiety and depression symptoms, as perceived discrimination increased, the higher the level of depression in HIV-infected women of childbearing age. Correlation coefficient among depression with poor mental health outcomes was also significant. Psychological resilience, social capital and depression have mediating effects on perceived discrimination and poor mental health outcomes, discrimination perception had an indirect effect on depression through social capital and an indirect effect on adverse mental health outcomes through depression and psychological resilience. The modified model has a good fitting effect.

Conclusion

Discrimination perception was shown to affect adverse mental health outcomes by impacting mental resilience, depression, and social capital. The findings suggest the need for measures to reduce adverse mental health outcomes by decreasing discrimination perception, increasing social capital, and enhancing psychological resilience.