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Australia has undergone significant youth mental health reform over the past 10 years, leading to numerous studies examining the effects of community-based mental health care programs for Australian youth. However, no synthesis of this literature currently exists. Therefore, this systematic review aimed to: (1) describe the types of community-based mental health programs that have been delivered to Australian youth in the past 10 years; and (2) examine their impact in improving young people’s mental health symptomology and psychosocial functioning. A systematic search of the peer-reviewed literature was conducted. Studies were included if they evaluated the extent to which such programs improved mental health symptomology (e.g., depression, anxiety, substance use) and/or psychosocial outcomes (e.g., social functioning, school engagement, employment) for Australian youth aged 10–25 years. Thirty-seven studies were included. Four types of community-based youth mental health care programs were identified: therapy (n = 16), case management (n = 9), integrated ‘one-stop-shop’ (n = 6) and lifestyle (n = 6) programs. The majority of therapeutic programs were effective in reducing mental health symptomology. Case management and integrated approaches consistently yielded significant improvements in both symptomology and psychosocial outcomes. Lifestyle programs were effective in alleviating depressive symptoms, but inconclusive for other outcomes. This review provides support for youth-friendly, systemic, multidisciplinary and integrated assertive outreach models of community mental health care to improve outcomes for young Australians experiencing mental health concerns. Several recommendations for future research are provided to strengthen the local evidence-base supporting community mental health programs to ultimately enhance young people’s life trajectory.

After-school community-based spaces are often recognized in political and educational discourse as institutions that \"save\" and \"rescue\" Black youth. Such rhetoric perpetuates an ethos of pathology that diminishes the agency of youth and their communities. Through ethnographic research with 20 youth workers at a college completion and youth development after-school program in the urban Northeast, findings indicate that tensions arise as youth workers strive to reimagine Black youth in humanizing ways despite pressures to frame them as broken and in need of fixing to compete for funding with charter schools. Data also reveal deep tensions in youth workers' experiences as they critique neoliberal reforms that shape their work; yet, at the same time, they are forced to hold students to markers of success defined by neoliberal ideals. These tensions result in youth workers downplaying the social, cultural, and emotional dimensions of their work.

A new paradigm is implicit within the constructivist and narrative methods for career intervention that have emerged in the 21st century. This article makes that general pattern explicit by ing its key elements from the specific instances that substantiate the new conceptual model. The paradigm for life design interventions constructs career through small stories, reconstructs the stories into a life portrait, and coconstructs intentions that advance the career story into a new episode.

Many families in developing countries do not have access to medical doctors and instead receive health care from informal providers. Das et al. used “mystery” patients (trained actors) to test whether a 9-month training program improved the quality of care delivered by informal providers in West Bengal (see the Perspective by Powell-Jackson). The patients did not identify themselves to the providers and were not told which providers had participated in the training program. The results of this blinded assessment showed that medical doctors delivered better care than informal providers but that the training program closed much of the gap. Science , this issue p. 80 ; see also p. 34 Training helped informal providers deliver better care for angina, diarrhea, and asthma. [Also see Perspective by Powell-Jackson ] Health care providers without formal medical qualifications provide more than 70% of all primary care in rural India. Training these informal providers may be one way to improve the quality of care where few alternatives exist. We report on a randomized controlled trial assessing a program that provided 72 sessions of training over 9 months to 152 informal providers (out of 304). Using standardized patients (“mystery clients”), we assessed clinical practice for three different conditions to which both providers and trainers were blinded during the intervention, representative of the range of conditions that these providers normally diagnose and treat. Training increased correct case management by 7.9 percentage points (14.2%) but did not affect the use of unnecessary medicines and antibiotics. At a program cost of $175 per trainee, our results suggest that multitopic medical training offers an effective short-run strategy to improve health care.

We report a randomized, wait-list controlled trial assessing the effects of school-wide positive behavior support (SWPBS). An effectiveness analysis was conducted with elementary schools in Hawaii and Illinois where training and technical assistance in SWPBS was provided by regular state personnel over a 3-year period. Results document that the training and technical assistance were functionally related to improved implementation of universal-level SWPBS practices. Improved use of SWPBS was functionally related to improvements in the perceived safety of the school setting and the proportion of third graders meeting or exceeding state reading assessment standards. Results also document that levels of office discipline referrals were comparatively low, but the absence of experimental control for this variable precludes inference about the impact of SWPBS. Implications for future research directions are offered.

Autistic adults in need of long-term services and supports spend months on waiting lists before receiving such services through Medicaid. Data from a state-wide survey of adults and their caregivers on a waiting list for autism waivers suggest that the majority have unmet needs for functional skills services (63.6%), employment or vocation services (62.1%), and mental and behavioral health services (52.8%). Almost a third require case management services (28.3%). Predictors of greater service need are African American race and the number of physical and behavioral health diagnoses. Predictors of greater service receipt were employment status, housing type, and school enrollment; there was lower service receipt for African American race, Hispanic ethnicity, over age 21 years, and college completion.

Background Artificial Intelligence is currently being applied in healthcare for diagnosis, decision-making and education. ChatGPT-4o, with its advanced language and problem-solving capabilities, offers an innovative alternative as a virtual standardised patient in clinical training. Intern physicians are expected to develop clinical case management skills such as problem-solving, clinical reasoning and crisis management. In this study, ChatGPT-4o’s served as virtual standardised patient and medical interns as physicians on clinical case management. This study aimed to evaluate intern physicians’ competencies in clinical case management; problem-solving, clinical reasoning, crisis management and explore the impact and potential of ChatGPT-4o as a viable tool for assessing these competencies. Methods This study used a simultaneous triangulation design, integrating quantitative and qualitative data. Conducted at Aydın Adnan Menderes University, with 21 sixth-year medical students, ChatGPT-4o simulated realistic patient interactions requiring competencies in clinical case management; problem-solving, clinical reasoning, crisis management. Data were gathered through self-assessment survey, semi-structured interviews, observations of the students and ChatGPT-4o during the process. Analyses included Pearson correlation, Chi-square, and Kruskal-Wallis tests, with content analysis conducted on qualitative data using MAXQDA software for coding. Results According to the findings, observation and self-assessment survey scores of intern physicians’ clinical case management skills were positively correlated. There was a significant gap between participants’ self-assessment and actual performance, indicating discrepancies in self-perceived versus real clinical competence. Participants reported feeling inadequate in their problem-solving and clinical reasoning competencies and experienced time pressure. They were satisfied with the Artificial Intelligence-powered standardised patient process and were willing to continue similar practices. Participants engaged with a uniform patient experience. Although participants were satisfied, the application process was sometimes negatively affected due to disconnection problems and language processing challenges. Conclusions ChatGPT-4o successfully simulated patient interactions, providing a controlled environment without risking harm to real patients for practicing clinical case management. Although some of the technological challenges limited effectiveness, it was useful, cost-effective and accessible. It is thought that intern physicians will be better supported in acquiring clinical management skills through varied clinical scenarios using this method. Clinical trial number Not applicable.

Objective This study sought to illuminate the barriers service providers experience in delivering healing services to enhance father and child well‐being. Background Manifestations of structural barriers, such as racism, mother‐centric practices, and disproportionate incarceration among Black and Brown fathers prevail. Little is known, however, about how providers describe barriers they encounter toward engaging fathers in services to equip them with the capacity to coparent effectively. Method A convenience sample of providers (n = 24) representing a diverse array of child and family service systems responded to questions from a semistructured interview guide. Thematic analyses were conducted to describe how providers engage with fathers and their perceptions of barriers related to their ability to engage them in services. Results Findings revealed three types of barriers, each representing a separate theme: micro (biases, colorblindness), societal (devaluation of fathers' role), and systemic (racism, mother‐centrism). Strategies to address barriers included implementing strengths‐based practices, creating spaces to engage in reflexivity, and investing in father‐centric programming. Most strategies involved modifying the micro context, conveying that future efforts should focus on developing procedures and policies that will enhance micro practices. Conclusion This study captured the experiences of change agents and healers working with fathers and families. Their experiences illuminate obstacles they must contend with at the micro, societal, and systemic levels of practice. Implications Providers indicated that fathers will not benefit from services unless organizations embrace father‐centric, strength‐based healing practices and allocate space to engage in reflexivity about biases and the impact of systemic racism.

Objective The goal was to explore low‐income, Black fathers' personal strengths and barriers to engaged fatherhood, healthy relationships, and economic stability. Background Fatherhood programs often rely on case management and education to promote positive fathering, healthy relationships, and economic stability. However, methods should be tailored to fit the strengths and needs of participating fathers. Low‐income, Black fathers face additional challenges related to systemic discrimination and structural violence that can hinder their success. To effectively serve this group, research is required to understand their relevant strengths and barriers. Methods Semistructured focus groups explored fathers' personal strengths and barriers specific to the three areas of interest with fatherhood program staff (n = 8) and enrolled fathers (n = 26). Thematic analysis was conducted then systematically vetted by community scholars (previously enrolled or graduated fathers). Results Fathering strengths included empathy, listening skills, and active family participation. Barriers included limited custody or access, individual constraints, and unmet social needs. Participants contextualized these findings with structural issues related to coparenting and the legal system (e.g., biased court systems). Men's relationship strengths included mutual respect and teamwork. Barriers included past trauma, lack of healthy relationship models, and relationship strain. Economic stability strengths included financial literacy and motivation to provide, whereas barriers included legal history, financial obligations, and limited resources. Conclusion These findings highlight key individual‐level strengths and barriers grounded in fathers' intersectional identities as predominantly low‐income, Black men. Implications Programs serving low‐income, Black fathers should consider tailoring their programming to the lived experiences of participants to navigate these critical barriers and amplify assets for success.

The Parents Empowering Parents (PEP) Initiative was launched by New York City's Administration for Children's Services in partnership with Rise, a parent-led advocacy organization, and two foster care agencies. PEP integrated parent advocates- parents with lived experience-into foster care units to support families toward reunification. This study explored PEP's role in fostering family-centered practices and culture change, highlighting its codesign process; collaborative approach; and individualized, traumainformed support as pathways to improved child welfare outcomes and systemic transformation.