Despite growing research on disaster-related health impacts, pregnant individuals remain understudied. This study explores the sociodemographic characteristics of pregnant women affected by Hurricane Harvey.

A cross-sectional analysis of 4,951 pregnant individuals (511 directly impacted) was conducted to identify predictors of disrupted healthcare, financial loss, and mental health outcomes.

Social and structural vulnerabilities significantly influenced disaster impact. Pregnant individuals who were foreign-born racial/ethnic minorities (16.7% non-Latinx Black, 10.2% Latinx vs. 8.3% non-Latinx White), low-income (13.0% vs. 8.0%), less educated (12.5% vs. 7.6%), reliant on public healthcare (81% vs. 33.5%), or with limited maternity care access (11.4% vs. 54.8%) were disproportionately affected (all p < 0.001). Conversely, post-disaster anxiety was more common among U.S.-born (14.8% vs. 8.0%), college-educated (19.0% vs. 9.8%), and higher-income individuals (21.2% vs. 7.9%) (all p < 0.01).

Disadvantaged pregnant populations face greater disruption during disasters, while those with fewer vulnerabilities may experience more prolonged anxiety.

Autistic people have high levels of mental ill-health and an increased risk of suicide across the lifespan. Yet autistic people report difficulties communicating with healthcare professionals and accessing a range of healthcare services. At the same time, mental healthcare workers in other countries are reporting links between confidence when working with autistic patients and the degree of autism knowledge and training they can access.

We sought to examine what factors helped or hindered Irish mental healthcare colleagues when working with autistic healthcare service users. An online survey using quantitative and qualitative metrics was circulated among psychiatrists who are members of the College of Psychiatrists of Ireland, both in training and at consultant level, from April 2021 to April 2022.

Knowledge of autism was high among psychiatrists (n = 140), but self-efficacy scores were variable, particularly in relation to care pathways. Self-efficacy was better among psychiatrists with caseloads of children and youth or individuals with co-occurring intellectual disabilities. Three key qualitative themes emerged relating to capacity and training of mental health professionals, ways to improve mental health services provision for autistic individuals and also the critical need for co-creation and neurodiversity affirmative care.

The study highlighted critical systemic and professional challenges in providing mental health care to autistic people in Ireland. We provide recommendations for reducing these challenges and for enabling the development of inclusive, evidenced-based care to autistic individuals.

We studied the relation between individual and neighborhood socioeconomic characteristics and the probability of:

• – new long-duration antidepressant treatment;

• – early antidepressant discontinuation.

We followed two cohorts of inhabitants of Marseille (aged 18–64 years) covered by the National Health Insurance Fund (NHIF) for 2.5 years. In the first cohort (316,412 individuals in 2008), we studied new long-duration antidepressant treatments (≥ 4 antidepressants prescription claims within 6 months after the index claim, and none in the 6 months before). The second cohort was restricted to the 14,518 individuals with a new episode of antidepressant treatment prescribed by a private GP in 2008–2009 to study early treatment discontinuation: < 4 antidepressant prescription claims in the 6 months following the index claim. We developed a deprivation index at the neighborhood level (census block) and used multivariate multilevel logistic models adjusted for consultations with GPs and psychiatrists. In the second cohort, analyses were further adjusted on GPs characteristics.

First cohort: the probability of new long-duration antidepressant treatments was negatively associated with both individual low income and neighborhood deprivation. Second cohort: low income, and prescribers’ clientele composition (high proportion of disadvantaged patients) were independently associated with an increased risk of early discontinuation. A significant interaction was found between low income and gender.

Our results add further evidence supporting the existence of inequalities in antidepressant treatment at both the individual, GP and neighborhood levels, and that these inequalities occur principally during the processes of care. Inequalities in antidepressant continuation are more pronounced among women. Further research is warranted to improve our understanding of their mechanisms.