51
|
Aldrich RS, Cerel J, Drapeau CW. Suicide knowledge and intention to intervene: college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:182-189. [PMID: 33759712 DOI: 10.1080/07448481.2021.1885413] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 03/19/2020] [Accepted: 01/31/2021] [Indexed: 06/12/2023]
Abstract
Objective: The revised Willingness to Intervene against Suicide questionnaire and the Expanded Revised Facts on Suicide Quiz were employed to examine the relationship between college students' knowledge about suicide and intention to intervene. Participants: College students (n = 515) participated, a majority being women and Caucasian. Methods: Participants completed an online survey. Data were analyzed in SPSS. Results: College students have poor knowledge of suicide facts; however, this low level of accurate knowledge was not associated with intention to intervene with a suicidal person. Attitudes, subjective norms, perceived behavioral control, sex, and no previous suicide attempt were all significant predictors of intention to intervene. Conclusions: These results challenge the notion that one must be well-informed in order to intend to take action.
Collapse
Affiliation(s)
- Rosalie S Aldrich
- Department of Communication Studies, Indiana University East, Richmond, Indiana, USA
| | - Julie Cerel
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
| | | |
Collapse
|
52
|
Osborne D, De Boer K, Meyer D, Nedeljkovic M. Raising Suicide in Medical Appointments-Barriers and Facilitators Experienced by Young Adults and GPs: A Mixed-Methods Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:822. [PMID: 36613144 PMCID: PMC9820164 DOI: 10.3390/ijerph20010822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
The aim of this review was to understand the barriers and facilitators facing GPs and young adults in raising and addressing suicide in medical appointments. A mixed-methods systematic review was conducted of qualitative and quantitative studies. The focus was papers that explored barriers and facilitators experienced by young adults aged 18 to 26, and GPs working in primary care environments. Nine studies met the inclusion criteria. Four studies provided information on young adults' views, four on GPs, and one considered both GP and young adults' viewpoints. Nine barrier and seven facilitator themes were identified. Unique to this review was the recognition that young adults want GPs to initiate the conversation about suicide. They see this as a GP's responsibility. This review further confirmed that GPs lack the confidence and skills to assess suicide risk in young adults. Both findings combined could explain previous results for reduced identification of suicide risk in this cohort. GP training needs considerable focus on addressing skill deficiencies and improving GP confidence to assess suicide risk. However, introducing suicide risk screening in primary care for young adults should be a priority as this will overcome the need for young adults to voluntarily disclose thoughts of suicide.
Collapse
Affiliation(s)
- Debra Osborne
- Centre for Mental Health, Swinburne University of Technology, P.O. Box 218, Hawthorn, VIC 3122, Australia
| | | | | | | |
Collapse
|
53
|
DeBate R, Gatto A, Rafal G, Bleck J. A qualitative assessment of mental health literacy and help-seeking behaviors among male college students. DISCOVER MENTAL HEALTH 2022; 2:23. [PMID: 37861733 PMCID: PMC10501103 DOI: 10.1007/s44192-022-00028-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/20/2022] [Indexed: 10/21/2023]
Abstract
Although the number of students receiving care from college counseling centers has increased, engaging male college students to seek help presents a unique challenge. This qualitative study explored mental health literacy and help-seeking behaviors among undergraduate college men. Semi-structured interviews (n = 26) based on three vignettes (anxiety, depression, stress) were employed to assess mental health literacy. Analysis revealed three general themes and associated sub-themes: (a) knowledge of signs and symptoms (physiological, behavioral, and emotional); (b) recommended help-seeking behaviors (do nothing, self-care, seek help); and (c) barriers to help-seeking (social stigma, self-stigma, masculinity). Findings present a triadic interplay between the person, help-seeking behavior, and environment. Future research should explore this dynamic relationship to inform interventions aimed at improving college male mental health help-seeking behavior.
Collapse
Affiliation(s)
- Rita DeBate
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL 33612 USA
| | - Amy Gatto
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL 33612 USA
| | - Gregor Rafal
- Colorado Department of Public Health and Environment, 4300 Cherry Creek Dr. S, Denver, CO 80246 USA
| | - Jennifer Bleck
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL 33612 USA
| |
Collapse
|
54
|
Mason A, Johnstone G, Riordan BC, Lie C, Rapsey C, Treharne GJ, Jang K, Collings SC, Scarf D. Understanding Aotearoa New Zealand University Students Intentions to Seek Help If Experiencing Mental Distress: A Comparison of Naturalistic and Interventional Findings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15836. [PMID: 36497912 PMCID: PMC9738961 DOI: 10.3390/ijerph192315836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/19/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
University students globally are consistently identified as a vulnerable group for mental distress and suicide. Despite this, students report low engagement in help-seeking behaviours. This series of studies aimed to assess barriers to help-seeking for students and the impact of an intervention that sought to increase support-seeking intentions. In Study 1, 373 undergraduate psychology students completed items related to depression, anxiety, suicidal ideation, stigma, and help-seeking intentions. In Study 2, 133 undergraduate psychology students were randomly allocated into one of three intervention groups (control, infographic, video) and completed measures as used in Study 1. Despite experiencing clinically relevant symptoms and recent suicidal ideation, students in Study 1 tended to report low intentionality to seek help, citing perceptions that their distress was not serious enough or a desire to handle their issues independently. In Study 2, an infographic about different support services increased student's intentions to access support services and reduced their perception that their issues were not serious enough. Overall, Aotearoa New Zealand students endorsed similar barriers to help-seeking as students in other countries. Importantly, we demonstrated that a simple infographic intervention reduced perceptions regarding these common barriers and may increase students' knowledge about when to seek help.
Collapse
Affiliation(s)
- Andre Mason
- Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Grace Johnstone
- Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Benjamin C. Riordan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC 3086, Australia
| | - Celia Lie
- Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Charlene Rapsey
- Department of Psychological Medicine, University of Otago, Dunedin 9016, New Zealand
| | - Gareth J. Treharne
- Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Kyungho Jang
- Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Sunny C. Collings
- Faculty of Health, Victoria University, Wellington 6012, New Zealand
| | - Damian Scarf
- Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| |
Collapse
|
55
|
Ma KKY, Burn AM, Anderson JK. Review: School-based mental health literacy interventions to promote help-seeking - a systematic review. Child Adolesc Ment Health 2022. [PMID: 36377083 DOI: 10.1111/camh.12609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND School-based mental health literacy interventions aim to prevent mental disorders and promote mental wellbeing through improving the knowledge and understanding of mental health, mental disorders, and reducing stigma. Evidence suggests that good mental health literacy helps young people recognise mental health difficulties in themselves and in others, and seek help for mental health problems. Improved help-seeking can allow for early intervention, which prevents the progression of mental disorders and ultimately reduces the burden of mental disorders. The aim of this review is to identify and synthesise evidence on the effectiveness of school-based mental health literacy interventions in improving help-seeking outcomes. METHODS We searched MEDLINE, Embase, PsycINFO, ERIC, Child Development and Adolescent Studies, British Education Index and ASSIA (June 2020). Additional searches were conducted a year later to identify any new publications (June 2021). We included randomised controlled trials (RCTs) assessing the effectiveness or cost-effectiveness of school-based interventions to improve help-seeking outcomes for children and young people aged 4-18 years. Included studies were critically appraised. RESULTS We identified 11 studies investigating help-seeking outcomes of school-based mental health literacy interventions including a total of 7066 participants from 66 secondary schools. Overall, there is no strong evidence for the effectiveness of school-based mental health literacy interventions in improving help-seeking outcomes, including general attitudes towards help-seeking, personal intentions to seek help, knowledge of when and how to seek help for mental disorders, confidence to seek help, and actual help-seeking behaviours. None of the studies investigated the cost-effectiveness of the interventions. CONCLUSION The lack of standardised measures with established reliability and validity for help-seeking outcomes, and the incomprehensive consideration of the multi-faceted concepts of MH literacy and MH stigma have contributed to the scarcity of evidence for the effectiveness. Future research should focus on developing standardised measurement tools and including economic evaluations to understand pragmatic and financial aspects of school-based mental health literacy interventions.
Collapse
Affiliation(s)
| | - Anne-Marie Burn
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | |
Collapse
|
56
|
Anzai T, Kikuchi K, Fukui K, Ito Y, Takahashi K. Have restrictions on human mobility impacted suicide rates during the COVID-19 pandemic in Japan? Psychiatry Res 2022; 317:114898. [PMID: 36265193 PMCID: PMC9548340 DOI: 10.1016/j.psychres.2022.114898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/06/2022] [Accepted: 10/08/2022] [Indexed: 01/05/2023]
Abstract
During the COVID-19 pandemic in Japan, various measures have been implemented to prevent the spread of infection, including restrictions on human mobility. A dynamic fluctuation in the number of suicides has been observed during this period. The question is whether the increase/decrease in suicides during the pandemic is related to changes in human mobility. To answer the same, we estimated incidence rate ratios (IRR) of suicide for changes in human mobility using the relative number of suicides by month from March 2020 to September 2021, based on the same months in 2019 as reference. The IRR of suicide during the pandemic were significantly lower in the months when mobility decreased-in both the previous and current month-than in the months when mobility was stable; the IRR of suicide were statistically higher in the months with increased mobility compared with the stable months. The burden from a decrease in one's mobility, which might lead to an increase in suicide, may not occur immediately, as seen in the delayed effects of unemployment. It may be important to investigate people's mental health and stress levels after pandemic restrictions were relaxed. The findings may help practitioners and families consider the timing of intervention.
Collapse
Affiliation(s)
- Tatsuhiko Anzai
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Kohtaro Kikuchi
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; Japanese Red Cross Musashino Hospital, 1-26-1 Kyonan-cho, Musashino, Tokyo 180-8610, Japan
| | - Keisuke Fukui
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, HigashiHiroshima, Hiroshima 739-8527, Japan
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan
| | - Kunihiko Takahashi
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| |
Collapse
|
57
|
Sullivan SR, Myhre K, Mitchell EL, Monahan M, Khazanov G, Spears AP, Gromatsky M, Walsh S, Goodman A, Jager-Hyman S, Green KL, Brown GK, Stanley B, Goodman M. Suicide and Telehealth Treatments: A PRISMA Scoping Review. Arch Suicide Res 2022; 26:1794-1814. [PMID: 35137677 DOI: 10.1080/13811118.2022.2028207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND This PRISMA scoping review explored worldwide research on the delivery of suicide-specific interventions through an exclusive telehealth modality. Research over telehealth modalities with suicidal individuals highlights the importance of facilitating participants' access to treatments despite location and circumstances (e.g., rural, expenses related to appointments, etc.). AIM The review sought evidence of outcomes of trials or projects in which both the patient and therapist attended sessions conjointly and openly discussed suicide over a telehealth modality (e.g., phone, zoom). METHOD To explore this topic the authors searched for research trials and quality improvement projects using Ovid Medline, Ovid Embase, Ovid PsycINFO, EBSCO Social Services Abstracts, and Web of Science on 3/3/2021. RESULTS Nine different articles were included that each spanned distinct treatments, with eight being research studies and one being a quality improvement project. LIMITATIONS Publications featuring ongoing or upcoming research in which complete study results were not available did not meet inclusion criteria for this review. CONCLUSION Several important research gaps were identified. While this approach has been largely understudied, exclusive telehealth delivery of suicide-specific interventions has great potential for the prevention of suicidality, especially in the era of COVID-19 and beyond.
Collapse
|
58
|
Hubbard AK, Anderson JR. Understanding barriers to couples therapy. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:1147-1162. [PMID: 35315112 DOI: 10.1111/jmft.12589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 08/18/2021] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
What prevents couples from entering therapy? Given that the rate of couple help-seeking is low, we need a better understanding of barriers to couple help-seeking. To expand our understanding of these barriers, we asked almost 300 people who expressed an interest in couples therapy, to clarify what kept them from seeking help. A content analysis of participant's responses found six distinctive categories: cost of treatment, logistics, the modality of treatment, trustworthiness, relational factors, and a clear therapeutic process. Additionally, some responses suggested that stigma and concerns around the emotional work involved deterred couples from seeking help. This expanded understanding of barriers to couples therapy can assist both researchers and clinicians address them in more intentional ways.
Collapse
Affiliation(s)
- Aimee K Hubbard
- Kansas City Relationship Institute, Independence, Missouri, USA
| | - Jared R Anderson
- Department of Applied Human Sciences, Kansas State University, Manhattan, Kansas, USA
| |
Collapse
|
59
|
Lui JC, Sagar-Ouriaghli I, Brown JSL. Barriers and facilitators to help-seeking for common mental disorders among university students: a systematic review. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-9. [PMID: 36084266 DOI: 10.1080/07448481.2022.2119859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 08/13/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Objectives: Common mental disorders affect high proportions of university students. This systematic review aims to summarize the barriers and facilitators to help-seeking for depression and anxiety among university students and provide evidence to improve mental health services. Methods: EMBASE, MEDLINE, and PsycINFO were searched for eligible papers. Inclusion criteria: (1) published between 1990 and 2021, (2) written in English, (3) had qualitative or quantitative methodology, (4) involved university students, (5) students had depression or anxiety, (6) students were explicitly asked about barriers and facilitators, (7) >60% of study population had mental illness. Results: Ten studies were included into this review. The most common barriers were self-reliance, stigma, and poor mental health literacy. Good mental health literacy and social encouragement were significant facilitators. Conclusions: Universities could encourage help-seeking by targeting stigma and increasing mental health literacy. Future research could explore the role of self-reliance in help-seeking and identify more facilitators.
Collapse
Affiliation(s)
- Joyce Claresta Lui
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Ilyas Sagar-Ouriaghli
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - June S L Brown
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, United Kingdom
| |
Collapse
|
60
|
Richard J, Rebinsky R, Suresh R, Kubic S, Carter A, Cunningham JEA, Ker A, Williams K, Sorin M. Scoping review to evaluate the effects of peer support on the mental health of young adults. BMJ Open 2022; 12:e061336. [PMID: 35926986 PMCID: PMC9358944 DOI: 10.1136/bmjopen-2022-061336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/19/2022] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES Young adults report disproportionality greater mental health problems compared with the rest of the population with numerous barriers preventing them from seeking help. Peer support, defined as a form of social-emotional support offered by an individual with a shared lived experience, has been reported as being effective in improving a variety of mental health outcomes in differing populations. The objective of this scoping review is to provide an overview of the literature investigating the impact of peer support on the mental health of young adults. DESIGN A scoping review methodology was used to identify relevant peer-reviewed articles in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across six databases and Google/Google Scholar. Overall, 17 eligible studies met the inclusion criteria and were included in the review. RESULTS Overall, studies suggest that peer support is associated with improvements in mental health including greater happiness, self-esteem and effective coping, and reductions in depression, loneliness and anxiety. This effect appears to be present among university students, non-student young adults and ethnic/sexual minorities. Both individual and group peer support appear to be beneficial for mental health with positive effects also being present for those providing the support. CONCLUSIONS Peer support appears to be a promising avenue towards improving the mental health of young adults, with lower barriers to accessing these services when compared with traditional mental health services. The importance of training peer supporters and the differential impact of peer support based on the method of delivery should be investigated in future research.
Collapse
Affiliation(s)
- Jérémie Richard
- Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Canadian Peer Support Network, Montreal, Quebec, Canada
| | - Reid Rebinsky
- Canadian Peer Support Network, Montreal, Quebec, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Rahul Suresh
- Canadian Peer Support Network, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Serena Kubic
- Canadian Peer Support Network, Montreal, Quebec, Canada
| | - Adam Carter
- Canadian Peer Support Network, Montreal, Quebec, Canada
| | - Jasmyn E A Cunningham
- Canadian Peer Support Network, Montreal, Quebec, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Amy Ker
- Canadian Peer Support Network, Montreal, Quebec, Canada
| | | | - Mark Sorin
- Canadian Peer Support Network, Montreal, Quebec, Canada
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
61
|
Tureluren E, Claes L, Andriessen K. Help-seeking behavior in bereaved university and college students: Associations with grief, mental health distress, and personal growth. Front Psychol 2022; 13:963839. [PMID: 35992443 PMCID: PMC9381721 DOI: 10.3389/fpsyg.2022.963839] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022] Open
Abstract
Many students have experienced the death of a loved one, which increases their risk of grief and mental health problems. Formal and social support can contribute to better coping skills and personal growth in bereaved students. The purpose of this study was to examine the support that students received or wanted to receive and its relation to students’ mental health. We also looked at students’ needs when receiving support and barriers in seeking formal and social support. Participants (N = 666) completed an online survey consisting of questions about their sociodemographic characteristics, the support they received or wanted to receive, and support needs and barriers in seeking support. The survey also included three scales assessing grief, mental health distress, and personal growth. First, we analyzed the data descriptively. Next, we used MANCOVA to examine whether students who did or did not receive or wanted more support differed in terms of their grief, mental health distress, or personal growth. About 30% of students needed more support and experienced more grief and mental health distress than students who had their support needs met. Students who received support experienced more personal growth and grief than students who did not receive support. Students indicated a need for feeling acknowledged and safe. Feeling like a burden to others and perceiving their problems as not serious enough to warrant support were common barriers to seeking support. Our results indicate that support should be provided actively to students after the death of a loved one, and support being available on an ongoing basis.
Collapse
Affiliation(s)
- Emilie Tureluren
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences, University Antwerp, Antwerp, Belgium
| | - Karl Andriessen
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
- *Correspondence: Karl Andriessen,
| |
Collapse
|
62
|
Bornheimer LA, Czyz E, Koo HJ, Li Verdugo J, Eisenberg D, Zheng K, Pistorello J, Albucher RC, Coryell W, Favorite T, King CA. Suicide risk profiles and barriers to professional help-seeking among college students with elevated risk for suicide. J Psychiatr Res 2022; 152:305-312. [PMID: 35772258 PMCID: PMC10653046 DOI: 10.1016/j.jpsychires.2022.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/20/2022] [Accepted: 06/10/2022] [Indexed: 11/23/2022]
Abstract
Suicide is the second leading cause of death among college students, yet many students with elevated suicide risk do not seek professional help. This study identified suicide risk profiles among college students and examined these in relation to students' perceived barriers to professional help-seeking. Data were obtained from college students (n = 1689) identified to be at elevated risk for suicide based at four US universities. Latent class analysis was performed to determine risk profiles, followed by examinations of differences in help-seeking barriers by profile groupings. Results revealed three student groupings: (1) moderate internalizing and externalizing symptoms (with low alcohol misuse), (2) highest internalizing and externalizing symptoms (with highest social disconnection), and (3) lowest internalizing symptoms and low externalizing (with highest social connection and alcohol misuse). Group 1 included the youngest and most racially and sexually diverse students, Group 2 endorsed the most help-seeking barriers, and Group 3 endorsed the fewest barriers. Group 2 is especially concerning, considering the severe clinical characteristics, high number of barriers, and low connectedness to others for potential support. Understanding these differences across risk and barrier profiles is an important step towards developing tailored approaches to increase mental health care in college populations.
Collapse
Affiliation(s)
- Lindsay A Bornheimer
- University of Michigan, School of Social Work, USA; University of Michigan, Department of Psychiatry, USA; University of Michigan Depression Center, USA; University of Michigan, Injury Prevention Center, USA.
| | - Ewa Czyz
- University of Michigan, Department of Psychiatry, USA
| | - Hyun Jung Koo
- University of Michigan, Department of Psychiatry, USA
| | | | - Daniel Eisenberg
- University of California, Los Angeles, Fielding School of Public Health, USA
| | - Kai Zheng
- University of California, Irvine, Donald Bren School of Information and Computer Sciences, USA
| | | | - Ronald C Albucher
- Stanford University, Department of Psychiatry, Counseling and Psychological Services, USA
| | | | - Todd Favorite
- University of Michigan, Mary A. Rackham Institute, USA
| | - Cheryl A King
- University of Michigan, Department of Psychiatry, USA; University of Michigan Depression Center, USA; University of Michigan, Injury Prevention Center, USA; University of Michigan, Department of Psychology, USA
| |
Collapse
|
63
|
Chaudhuri JD. An initial preparation for human cadaveric dissection ameliorates the associated mental distress in students. ANATOMICAL SCIENCES EDUCATION 2022; 15:910-927. [PMID: 34143562 DOI: 10.1002/ase.2112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 06/12/2023]
Abstract
It is universally recognized that cadaveric dissection is an essential part of anatomy training. However, it has been reported to induce mental distress in some students and impair their intrinsic motivation (IM) to study. One of the postulated reasons for this behavior is the lack of adequate information and preparation of students for cadaveric dissection. Therefore, it is hypothesized that providing relevant information prior to cadaveric dissection will ameliorate the mental distress, enhance the IM of students, and improve their academic performance. A cohort of occupational therapy students enrolled in an anatomy course were psychologically prepared for cadaveric dissection. Students were provided with a curated list of YouTube videos and peer-reviewed journal articles related to cadaveric dissection prior to the commencement of the anatomy course. All students were also required to attend an oral presentation immediately before commencing dissection. The control group included students who had not been provided with any resources in preparation for cadaveric dissection. Compared to the control group, students who had been prepared demonstrated better quality of cadaveric dissection, improved academic performance, reported less mental distress and greater IM. Moreover, students reported the oral presentation to be most relevant and journal articles to be least useful in their preparation. Therefore, this is an effective approach in the amelioration of mental distress and improvement of performance in anatomy students. Consequently, this study represents a paradigm shift in the pedagogy of anatomy, and could represent a vital element in the evolution of a revitalized anatomy curriculum.
Collapse
Affiliation(s)
- Joydeep Dutta Chaudhuri
- School of Occupational Therapy, College of Health Sciences, Husson University, Bangor, Maine, USA
| |
Collapse
|
64
|
Blair SA, Brockmann AN, Arroyo KM, Carpenter CA, Ross KM. Awareness, Acceptability, and Perceived Effectiveness of Text-Based Therapy Among Graduate Students: Cross-sectional Study. JMIR Mhealth Uhealth 2022; 10:e34102. [PMID: 35797098 PMCID: PMC9305396 DOI: 10.2196/34102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/25/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Research has suggested that there is a mental health crisis occurring among graduate students in the United States. Moreover, many students go without effective treatment owing to the limited availability of mental and behavioral health resources on college campuses. Text-based therapy may represent a viable method for increasing access to mental health support for graduate students, but little is known regarding its acceptability in this population.
Objective
The purpose of this study was to assess how graduate students perceive text-based therapy and their likelihood of seeking out this form of therapy.
Methods
In total, 265 graduate students completed a cross-sectional web-based survey that included multiple-choice and open-ended questions assessing their perceptions of text-based therapy and the likelihood of seeking out this form of therapy. Chi-square tests, ANOVAs, and nonparametric Wilcoxon signed-rank tests were used to examine differences in multiple-choice questions. The constant comparative method was used for qualitative analyses of the open-ended question responses.
Results
Participants (n=265) were predominately non-Hispanic White (166/265, 62.6%) and female (167/265, 63%) with a mean age of 28.3 (SD 5.1) years. Over half of the participants (139/265, 52.5%) were not aware that text-based therapy existed; however, 65.3% (173/265) reported that they would consider using text-based services, if available. In comparison to face-to-face therapy, participants reported being less likely to seek out text-based therapy and perceived it as less effective (P<.001). Qualitative results indicated that participants were concerned about the ability to effectively communicate and build rapport through text-based therapy and thought that this modality may be more effective for some mental and behavioral health concerns than others. Moreover, participants noted that text-based therapy would be best implemented as a way to supplement, rather than replace, face-to-face services.
Conclusions
Altogether, the results of this study suggest that text-based therapy holds the potential to increase access to and use of mental and behavioral health services; however, graduate students remain concerned about its effectiveness and the optimal methods of implementation. Future research should investigate how therapeutic processes (eg, effective communication and rapport-building) can be facilitated in digital environments and how text-based therapy could be best implemented to supplement and extend, rather than replace, face-to-face services.
Collapse
Affiliation(s)
- Samari A Blair
- College of Medicine, University of Florida, Gainesville, FL, United States
- Social and Behavioral Sciences Program, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Andrea N Brockmann
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Kelsey M Arroyo
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Chelsea A Carpenter
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Kathryn M Ross
- Social and Behavioral Sciences Program, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| |
Collapse
|
65
|
Anosike C, Anene-Okeke CG, Ayogu EE, Oshigbo MC. Prevalence of depression and anxiety, and attitudes toward seeking help among first-year pharmacy, medical, and nursing students at a Nigerian university. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:720-728. [PMID: 35809901 DOI: 10.1016/j.cptl.2022.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 03/01/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The first year of university study tends to be particularly challenging and exhausting, especially for students in health sciences. This study aimed to explore the prevalence of anxiety and depression among first-year pharmacy, medicine, and nursing students at a Nigerian university as well as their attitudes toward seeking professional support. METHODS This study was a cross-sectional descriptive survey among all first-year pharmacy, medicine, and nursing students. Paper-based self-administered questionnaires were used, and they included the Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Attitudes Toward Seeking Professional Psychological Help Scale. Descriptive statistics, Chi-square test, and Pearson correlation were used for data analysis. RESULTS The study included 522 students (89% response rate). The prevalence of depression among participants was 71.8%, while the prevalence of anxiety was 61.7%. Only 24.9% of the participants expressed willingness to seek professional psychological help. Attitudes toward getting professional care was inversely related to the prevalence of depression (r = -0.155, P = .01) and anxiety (r = -0.098, P = .05). Age, smoking, alcohol intake, and dietary habits were associated with the occurrence of depression and anxiety. No demographic variables were related to the participants' attitudes toward seeking professional care. CONCLUSIONS Depression and anxiety symptoms were very common among health science freshmen. However, the vast majority of students were unwilling to seek help. Students' attitudes toward seeking treatment are influenced by the prevalence of depression and anxiety. Therefore, educational interventions on mental health promotion are recommended.
Collapse
Affiliation(s)
- Chibueze Anosike
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, 410001, Enugu State, Nigeria.
| | - Chigozie G Anene-Okeke
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, 410001, Enugu State, Nigeria.
| | - Ebere E Ayogu
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, 410001, Enugu State, Nigeria.
| | - Mariagorathy C Oshigbo
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, 410001, Enugu State, Nigeria.
| |
Collapse
|
66
|
Koulouri T, Macredie RD, Olakitan D. Chatbots to Support Young Adults’ Mental Health: an Exploratory Study of Acceptability. ACM T INTERACT INTEL 2022. [DOI: 10.1145/3485874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Despite the prevalence of mental health conditions, stigma, lack of awareness and limited resources impede access to care, creating a need to improve mental health support. The recent surge in scientific and commercial interest in conversational agents and their potential to improve diagnosis and treatment seems a potentially fruitful area in this respect, particularly for young adults who widely use such systems in other contexts. Yet, there is little research that considers the acceptability of conversational agents in mental health. This study, therefore, presents three research activities that explore whether conversational agents and, in particular, chatbots can be an acceptable solution in mental healthcare for young adults. First, a survey of young adults (in a university setting) provides an understanding of the landscape of mental health in this age group and of their views around mental health technology, including chatbots. Second, a literature review synthesises current evidence relating to the acceptability of mental health conversational agents and points to future research priorities. Third, interviews with counsellors who work with young adults, supported by a chatbot prototype and user-centred design techniques, reveal the perceived benefits and potential roles of mental health chatbots from the perspective of mental health professionals, while suggesting preconditions for the acceptability of the technology. Taken together, these research activities: provide evidence that chatbots are an acceptable solution to offering mental health support for young adults; identify specific challenges relating to both the technology and environment; and argue for the application of user-centred approaches during development of mental health chatbots and more systematic and rigorous evaluations of the resulting solutions.
Collapse
|
67
|
Franzoi IG, Sauta MD, Carnevale G, Granieri A. Student Counseling Centers in Europe: A Retrospective Analysis. Front Psychol 2022; 13:894423. [PMID: 35529546 PMCID: PMC9072741 DOI: 10.3389/fpsyg.2022.894423] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 12/20/2022] Open
Abstract
Objective Tertiary education can be stressful for many young people, who consistently report high levels of distress. The issue has major implications for campus health services and mental health policymaking more widely. The present study proposes to map student counseling services in Europe. Methods The sample of institutions was sourced, using standardized data extraction, from the European Tertiary Education Register (ETER). Then, each institution's website was analyzed for information about the availability of student counseling centers and the services provided. Data extracted from the ETER database were: ETER ID, national identifier, institution name, English institution name, number of students, legal status (in English), institution category (in English), and institutional website. Data extracted from institutions' websites concerned the availability of students' psychological centers and the services provided. Analyses were carried out using the SPSS Statistics software package (IBM Corp., Armonk, NY, United States), version 26. Results Overall, it was found that most institutions do not provide mental health counseling services for their students. Institutions of medium dimensions showed a higher probability of reporting students' psychological centers than small institutions. Moreover, private institutions and public institutions were more likely to report having such centers, while private government-dependent institutions were less likely. Universities of applied sciences and universities were more likely to report having them, while other institutions were less likely. Regarding provision according to geographic area, compared to Northern Europe, every other European region was less likely to report featuring such centers. Most institutions reported offering counseling, career counseling, or not otherwise specified psychological services, but only a small number reported providing services such as psychotherapy, psychiatric services, or counseling for learning-specific disabilities. Conclusion It is critically important to catalog European data on student counseling centers and services, to encourage tertiary education institutions to invest in such services as key sites for mental health promotion. Indeed, professionally trained staff and the possibility of long-term treatment options would go a long way in supporting students who might not otherwise have access to treatment.
Collapse
|
68
|
Visvalingam S, McHardy HL, Norder SJ, Magson NR, Norberg MM. A mixed methods study of an online intervention to reduce perfectionism. CURRENT PSYCHOLOGY 2022; 42:1-16. [PMID: 35400979 PMCID: PMC8978490 DOI: 10.1007/s12144-022-02953-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 11/03/2022]
Abstract
Perfectionism is linked to a variety of mental health conditions in university students. Guided by the Perfectionism Social Disconnection Model, the purpose of the current mixed methods feasibility study was to evaluate the acceptability and potential effectiveness of a brief online intervention designed to reduce the negative consequences of perfectionism in university students. Seventy university students (83.9% female; M age = 19) reporting moderate to extreme levels of perfectionism completed the two hour 'Intentional Imperfection Program' (IIP). The IIP includes techniques to increase mindfulness, compassion for self and others, distress tolerance, and social skills. Participants completed self-report measures at baseline and at a two-week follow-up. Quantitative data showed statistically significant small to moderate reductions in self-oriented perfectionism (d = -0.48, p < .001), socially-prescribed perfectionism (d = 0.40, p < .001), hostility (r = 0.53, p < .001), rejection sensitivity (d = 0.37, p < .001), depression (r = -0.47, p < .001), and anxiety (r = -0.33, p = .010) and a small increase in perceived social support (r = -0.29, p = .023). Thematic analyses of qualitative data indicated that participants found the IIP feasible, enjoyable, and useful. A brief online intervention may be a feasible way of reducing the negative consequences of perfectionism among university students. A randomised control trial is warranted to further evaluate the efficacy of the IIP. This research was registered with the Australian New Zealand Clinical Trials Registry (no. ACTRN12620000574943).
Collapse
Affiliation(s)
- Shanara Visvalingam
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Building 4 First Walk, Room 714, Sydney, NSW 2109 Australia
| | - Hannah L. McHardy
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Building 4 First Walk, Room 714, Sydney, NSW 2109 Australia
| | - Susanne J. Norder
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Building 4 First Walk, Room 714, Sydney, NSW 2109 Australia
| | - Natasha R. Magson
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Building 4 First Walk, Room 714, Sydney, NSW 2109 Australia
| | - Melissa M. Norberg
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Building 4 First Walk, Room 714, Sydney, NSW 2109 Australia
| |
Collapse
|
69
|
Tucker RP, Haydel R, Zielinski M, Niederkrotenthaler T. Storytelling of suicide attempt recovery and its relationship with mental health treatment-seeking attitudes and behaviors: An experimental study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:801-809. [PMID: 32529929 DOI: 10.1080/07448481.2020.1767110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveThis experimental study investigated if watching a brief video detailing an individual's recovery following a suicide attempt increased college student mental health treatment-seeking attitudes and resource engagement more than viewing a psychoeducational video about suicide. Participants: Undergraduate student participants (N = 218) completed the study online. Methods: Participants were randomized to see either the storytelling or one of two narrated psychoeducation videos and complete self-report measures following video viewing. Results: Video condition as well as its interaction with levels of identification with the storyteller/video narrator generally did not predict treatment-seeking attitudes as hypothesized. A small but not statistically significant effect for immediate resource engagement was seen as those in the storytelling condition interacted with online suicide prevention more than those in one of the psychoeducation conditions. Conclusions: These results suggest that brief viewing of storytelling about lived experience with suicide may have minimal impact on treatment-seeking propensity in college students.
Collapse
Affiliation(s)
- Raymond P Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
- Department of Psychiatry, Louisiana State University Health Sciences Center, Baton Rouge, Louisiana, USA
| | - Rachel Haydel
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Mark Zielinski
- Department of Psychiatry, Louisiana State University Health Sciences Center, Baton Rouge, Louisiana, USA
| | - Thomas Niederkrotenthaler
- Medical University of Vienna, Center for Public Health, Department of Social and Preventive Medicine, Unit Suicide Research & Mental Health Promotion, Vienna, Austria
| |
Collapse
|
70
|
Hong V, Busby DR, O'Chel S, King CA. University students presenting for psychiatric emergency services: Socio-demographic and clinical factors related to service utilization and suicide risk. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:773-782. [PMID: 32529919 DOI: 10.1080/07448481.2020.1764004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/19/2020] [Accepted: 04/26/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveGiven increases in mental health utilization among college and university students, this study examines clinical and socio-demographic characteristics in students presenting to psychiatric emergency services. Participants: University students (N = 725; Mage = 22 years, SD = 4.0; 67% White) visiting psychiatric emergency services at a large academic health system between July 1, 2012 and June 30, 2016. Methods: A retrospective review of students' electronic medical records, which included responses to the Columbia-Suicide Severity Rating Scale, was conducted. Results: Levels of suicide risk varied by students' self-identified race. Nonwhite students were more likely to endorse a suicide attempt in the past week and less likely to be taking psychiatric medications than White students. International students were more likely to report a lifetime history of multiple attempts. Conclusions: Disparities related to college student psychiatric emergencies warrant specific attention to specific racial/ethnic groups and international students to reduce and manage mental health crises.
Collapse
Affiliation(s)
- Victor Hong
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Danielle R Busby
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Stefaney O'Chel
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Cheryl A King
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
71
|
Kruzan KP, Meyerhoff J, Nguyen T, Mohr DC, Reddy M, Kornfield R. "I Wanted to See How Bad it Was": Online Self-screening as a Critical Transition Point Among Young Adults with Common Mental Health Conditions. PROCEEDINGS OF THE SIGCHI CONFERENCE ON HUMAN FACTORS IN COMPUTING SYSTEMS. CHI CONFERENCE 2022; 2022:328. [PMID: 35531062 PMCID: PMC9075814 DOI: 10.1145/3491102.3501976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Young adults have high rates of mental health conditions, yet they are the age group least likely to seek traditional treatment. They do, however, seek information about their mental health online, including by filling out online mental health screeners. To better understand online self-screening, and its role in help-seeking, we conducted focus groups with 50 young adults who voluntarily completed a mental health screener hosted on an advocacy website. We explored (1) catalysts for taking the screener, (2) anticipated outcomes, (3) reactions to the results, and (4) desired next steps. For many participants, the screener results validated their lived experiences of symptoms, but they were nevertheless unsure how to use the information to improve their mental health moving forward. Our findings suggest that online screeners can serve as a transition point in young people's mental health journeys. We discuss design implications for online screeners, post-screener feedback, and digital interventions broadly.
Collapse
Affiliation(s)
| | | | | | | | - Madhu Reddy
- University of California-Irvine, Irvine, California, USA
| | | |
Collapse
|
72
|
Kim J, Phillips JG, Ogeil RP. Nowhere else to go: Help seeking online and maladaptive decisional styles. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2021.107103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
73
|
Engagement With Personalized Feedback for Emotional Distress Among College Students at Elevated Suicide Risk. Behav Ther 2022; 53:365-375. [PMID: 35227410 PMCID: PMC8894794 DOI: 10.1016/j.beth.2021.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/06/2021] [Accepted: 10/09/2021] [Indexed: 11/21/2022]
Abstract
Depression and suicidal ideation have substantially increased among college students, yet many students with clinically significant symptoms do not perceive their distress as warranting mental health services. Personalized feedback (PF) interventions deliver objective data, often electronically, comparing an individual's reported symptoms or behaviors to a group norm. Several studies have shown promise for PF interventions in the context of mood and depression, yet little is known regarding how, and for whom, mood-focused PF interventions might be best deployed. The primary aim of this study was to examine the sociodemographic, clinical, and treatment-seeking factors associated with reviewing PF reports on emotional distress among college students (N = 1,673) screening positive for elevated suicide risk and not receiving mental health treatment. Results indicated that PF engagement was greatest among those with higher depression scores, and those reporting privacy/stigma concerns as barriers to treatment. Sexual minority students were more likely to review their PF than heterosexual students. Taken together, PF interventions may be a useful tool for engaging those with greater clinical acuity, and those hesitant to seek in-person care. Further research is warranted to examine the circumstances in which PF interventions might be used in isolation, or as part of a multitiered intervention strategy.
Collapse
|
74
|
Kwan C, Wong C, Chen Z, Yip PSF. Youth Bullying and Suicide: Risk and Protective Factor Profiles for Bullies, Victims, Bully-Victims and the Uninvolved. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052828. [PMID: 35270521 PMCID: PMC8910292 DOI: 10.3390/ijerph19052828] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 02/01/2023]
Abstract
Bullying is closely associated with suicide. This study validates mixed evidence on whether young bullies, victims, bully-victims, and those uninvolved in bullying differ in suicidality, risk, protective factor profiles, and predictors of suicide. A total of 2004 Hong Kong adolescents and young adults completed the Hong Kong Online Survey on Youth Mental Health and Internet Usage in 2018. Bullies, victims, and bully victims, as opposed to the uninvolved, were found to possess higher tendencies of suicidal thoughts and behaviors. They had more distinct rather than overlapping risk and protective factor profiles yet shared psychological distress and diagnosis of a psychiatric disorder as common predictors of suicide. The results indicate that suicide screening assessments and training to detect common suicide predictors can benefit youngsters regardless of their bullying involvement. From the discussion, group-specific interventions include restorative justice approaches to promote reintegration and help-seeking among bullies, peer, and professional support programs geared towards lowering victim isolation and equipping gatekeepers such as teachers with skills to connect with both bullies and victims.
Collapse
Affiliation(s)
- Ching Kwan
- HKJC Centre for Suicide Research and Prevention, Hong Kong 999077, China; (C.K.); (C.W.)
| | - Clifford Wong
- HKJC Centre for Suicide Research and Prevention, Hong Kong 999077, China; (C.K.); (C.W.)
| | - Zhansheng Chen
- Department of Psychology, University of Hong Kong, Hong Kong 999077, China;
| | - Paul S. F. Yip
- HKJC Centre for Suicide Research and Prevention, Hong Kong 999077, China; (C.K.); (C.W.)
- Correspondence: ; Tel.: +852-2831-5232
| |
Collapse
|
75
|
Goodwin J, Savage E, O’Donovan A. “I Personally Wouldn’t Know Where to Go”: Adolescents’ Perceptions of Mental Health Services. JOURNAL OF ADOLESCENT RESEARCH 2022. [DOI: 10.1177/07435584221076056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to explore perceptions of mental health services from the perspectives of adolescents with no prior service experience. Thirty students in the Transition Year (fourth year) of secondary school participated in this study: 22 females and 8 males, aged 15 to 16. There was equal distribution across rural and urban settings. Participants had no prior experience of accessing mental health services. Data were collected in secondary school settings in the Republic of Ireland. An interpretive description approach guided this study. Data were collected through individual interviews. To complement interviews, participants drew images of mental health care environments and mental health staff members; drawings were not subjected to analysis. Data (participant interviews) were analyzed using qualitative content analysis. Three themes were identified. Participants suggested that “mental health services” differed from “psychiatric services,” with the latter term perceived more negatively. Uncertainty about how to access these services was voiced. Considering the vulnerability of adolescents to the experience of mental distress, education around mental health services is warranted. It is expected that provision of education in this area would enhance service delivery, improve adolescents’ help-seeking behaviors for mental distress, and reduce stigma.
Collapse
|
76
|
Amanvermez Y, Zhao R, Cuijpers P, de Wit LM, Ebert DD, Kessler RC, Bruffaerts R, Karyotaki E. Effects of self-guided stress management interventions in college students: A systematic review and meta-analysis. Internet Interv 2022; 28:100503. [PMID: 35242591 PMCID: PMC8861419 DOI: 10.1016/j.invent.2022.100503] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND College students face several sources of stress. Self-guided stress management interventions offer an excellent opportunity for scaling up evidence-based interventions for self-management of these stresses. However, little is known about the overall effects of these interventions. Increasing this understanding is essential because self-guided stress management interventions might be a cost-effective and acceptable way of providing help to this important segment of the population during a critical life course stage. METHODS We carried out a systematic literature search of bibliographical databases (PubMed, PsycINFO, Embase, and Cochrane Library) for randomized controlled trials (RCTs) of self-guided stress management interventions published up through April 2020. We conducted two separate meta-analyses for perceived stress, depression, and anxiety. The first included interventions for general college student samples. The second included studies for students with high levels of perceived stress. RESULTS The first meta-analysis included 26 studies with 29 intervention-control comparisons based on a total of 4468 students. The pooled effect size was small but statistically significant (g = 0.19; 95% CI [0.10, 0.29]; p < 0.001). Results showed moderate heterogeneity across studies [I 2 = 48%; 95% CI (19, 66%)]. The second meta-analysis, included four studies based on a total of 491 students with high levels of stress. The pooled effect size was small but statistically significant (g = 0.34; 95% CI [0.16, 0.52]; p < 0.001). Results showed no heterogeneity across studies (I 2 = 0%; 95% CI [0, 79%]), but risk of bias was substantial. DISCUSSION Our results suggest that self-guided stress management programs may be effective when compared to control conditions, but with small average effects. These programs might be a useful element of a multi-component intervention system. Given the psychological barriers to treatment that exist among many college students, self-help interventions might be a good first step in facilitating subsequent help-seeking among students reluctant to engage in other types of treatment. More studies should be conducted to investigate these interventions, sample specifications, mediating effects, and individual-level heterogeneity of effects.
Collapse
Affiliation(s)
- Yagmur Amanvermez
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands,Corresponding author at: Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, 1081 BT Amsterdam, the Netherlands.
| | - Ruiying Zhao
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Leonore M. de Wit
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - David D. Ebert
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| |
Collapse
|
77
|
Shannonhouse L, Hill M, Hightower J. Trauma exposure, suicidality, and reporting in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:331-334. [PMID: 32723223 DOI: 10.1080/07448481.2020.1752695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 02/05/2020] [Accepted: 03/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Researchers explored the link between individual trauma history, lifetime suicide risk, and reporting of suicidal ideation in undergraduate students. PARTICIPANTS A sample of 372 undergraduate students (130 males and 242 females) at two institutions completed measures of their personal trauma histories and suicidality in the Fall of 2017. METHODS Categories of suicidality from the Suicide Behavior Questionnaire were reported, along with odds ratios from multivariate associations of traumatic events with lifetime suicidality. RESULTS Suicidality is prevalent in college students. Traumas, such as rape, which are endemic to the college experience are significant risk factors for suicidality. Students reported reaching out for help when suicidal. CONCLUSIONS Awareness of trauma history will give a more comprehensive understanding of suicide risk among college students. Additionally, suicide safety programs may consider a broad scope for campus preparedness in order to support the large number of students with suicidal ideation that seek help.
Collapse
Affiliation(s)
- Laura Shannonhouse
- Counseling and Psychological Services, Georgia State University, Atlanta, GA, USA
| | - Michele Hill
- Psychological Science, University of North Georgia, Dahlonega, GA, USA
| | - Jennifer Hightower
- Educational Psychology and Counseling, University of Tennessee, Knoxville, TN, USA
| |
Collapse
|
78
|
King CA, Eisenberg D, Pistorello J, Coryell W, Albucher RC, Favorite T, Horwitz A, Bonar EE, Epstein D, Zheng K. Electronic bridge to mental health for college students: A randomized controlled intervention trial. J Consult Clin Psychol 2022; 90:172-183. [PMID: 35099205 PMCID: PMC11443499 DOI: 10.1037/ccp0000709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Suicide is the second leading cause of death among college students in the United States, and the percentage of students reporting suicidal thoughts is increasing. Nevertheless, many students at risk do not seek mental health (MH) services. This randomized controlled trial (RCT) examined the efficacy of Electronic Bridge to Mental Health for College Students (eBridge) for increasing at-risk students' linkage to MH services. METHOD Students from four universities were recruited via email; 40,347 (22.6%) completed the online suicide risk screen; and 3,363 (8.3%) met criteria for randomization based on suicide risk factors and lack of current treatment (62.2% female, 35.0% male, 2.8% transgender/nonbinary; 73.2% White, 7.0% Black, 19.9% Asian, 11.7% other; 12.4% Hispanic, 76.2% undergraduate). These students were randomized to eBridge [personalized feedback (PF) with option of online counseling] or Control (PF). The primary outcome was linkage to MH services within 6 months. RESULTS Among students assigned to eBridge, 355 students (21.0%) posted ≥1 message, and 168 (10.0%) posted ≥2 messages to the counselor. In intent-to-treat analyses, there was no eBridge effect on obtaining MH services. However, within the eBridge group, students who posted ≥1 message were significantly more likely to link to MH services. CONCLUSIONS eBridge shows promise for reaching a relatively small subset of college students at risk for suicide; however, engagement in eBridge was low. This study underscores the urgent need for more effective strategies to engage young adults in online mental health interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
Affiliation(s)
- Cheryl A. King
- Department of Psychiatry, University of Michigan
- University of Michigan Depression Center
- Injury Prevention Center, University of Michigan
| | | | | | | | | | | | - Adam Horwitz
- Department of Psychiatry, University of Michigan
| | - Erin E. Bonar
- Department of Psychiatry, University of Michigan
- Injury Prevention Center, University of Michigan
- Addiction Center, University of Michigan
| | | | - Kai Zheng
- Donald Bren School of Information and Computer Sciences, University of California, Irvine
| |
Collapse
|
79
|
Virk P, Arora R, Burt H, Gadermann A, Barbic S, Nelson M, Davidson J, Cornish P, Doan Q. HEARTSMAP-U: Adapting a Psychosocial Self-Screening and Resource Navigation Support Tool for Use by Post-secondary Students. Front Psychiatry 2022; 13:812965. [PMID: 35280181 PMCID: PMC8908908 DOI: 10.3389/fpsyt.2022.812965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/24/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Mental health challenges are highly prevalent in the post-secondary educational setting. Screening instruments have been shown to improve early detection and intervention. However, these tools often focus on specific diagnosable conditions, are not always designed with students in mind, and lack resource navigational support. OBJECTIVE The aim of this study was to describe the adaptation of existing psychosocial assessment (HEARTSMAP) tools into a version that is fit-for-purpose for post-secondary students, called HEARTSMAP-U. METHODS We underwent a three-phase, multi-method tool adaptation process. First, a diverse study team proposed a preliminary version of HEARTSMAP-U and its conceptual framework. Second, we conducted a cross-sectional expert review study with Canadian mental health professionals (N = 28), to evaluate the clinical validity of tool content. Third, we conducted an iterative series of six focus groups with diverse post-secondary students (N = 54), to refine tool content and language, and ensure comprehensibility and relevance to end-users. RESULTS The adaptation process resulted in the HEARTSMAP-U self-assessment and resource navigational support tool, which evaluates psychosocial challenges across 10 sections. In Phase two, clinician experts expressed that HEARTSMAP-U's content aligned with their own professional experiences working with students. In Phase three, students identified multiple opportunities to improve the tool's end-user relevance by calling for more "common language," such as including examples, definitions, and avoiding technical jargon. CONCLUSIONS The HEARTSMAP-U tool is well-positioned for further studies of its quantitative psychometric properties and clinical utility in the post-secondary educational setting.
Collapse
Affiliation(s)
- Punit Virk
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Ravia Arora
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Heather Burt
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Anne Gadermann
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, Providence Health, Vancouver, BC, Canada
| | - Skye Barbic
- Centre for Health Evaluation and Outcome Sciences, Providence Health, Vancouver, BC, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Marna Nelson
- Student Health Service, University of British Columbia, Vancouver, BC, Canada
| | - Jana Davidson
- BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Peter Cornish
- Student Counselling Services, University of California, Berkeley, Berkeley, CA, United States
| | - Quynh Doan
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Division of Emergency Medicine, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
80
|
Karyotaki E, Klein AM, Ciharova M, Bolinski F, Krijnen L, de Koning L, de Wit L, van der Heijde CM, Ebert DD, Riper H, Batelaan N, Vonk P, Auerbach RP, Kessler RC, Bruffaerts R, Struijs S, Wiers RW, Cuijpers P. Guided internet-based transdiagnostic individually tailored Cognitive Behavioral Therapy for symptoms of depression and/or anxiety in college students: A randomized controlled trial. Behav Res Ther 2022; 150:104028. [DOI: 10.1016/j.brat.2021.104028] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 12/17/2021] [Accepted: 12/27/2021] [Indexed: 12/22/2022]
|
81
|
Milbourn B, Black MH, Afsharnejad B, Snyman Z, Baker-Young E, Thompson C, McGarry S, Scott M, Clifford R, Zimmermann F, Kacic V, Hasking P, Romanos M, Bölte S, Girdler S. The "Talk-to-Me" MOOC intervention for suicide prevention and mental health education among tertiary students: Protocol of a multi-site cross-over randomised controlled trial. Contemp Clin Trials 2021; 112:106645. [PMID: 34861409 DOI: 10.1016/j.cct.2021.106645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/22/2021] [Accepted: 11/27/2021] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Mental health problems are common among tertiary education students, with concerning levels of suicide ideation frequently observed in this population. There is a need for evidence-based mental health education and suicide prevention programs designed to meet the specific needs of these students. The "Talk-to-Me" Mass Open Online Course (MOOC) is a strengths-based mental health education program underpinned by a six-phase model for managing a suicidal crisis. METHODS To evaluate the efficacy of the "Talk-to-Me" MOOC in improving student knowledge of appropriate responses to suicide crisis via a randomised control trial (RCT) comparing tertiary education health science and education students attending the program to a waitlist control group. Overall, 170 will be screened and randomly allocated to either the "Talk-to-Me" MOOC or a waitlist control group, with data collection occurring at three-time points (baseline, 10-weeks and 24-weeks from baseline) over one year. The primary outcome will be participants' knowledge and responses to suicidal statements as measured by the Suicide Intervention Response Inventory. Secondary outcomes will be knowledge of mental health and coping skills as well as the overall utility of the program. CONCLUSIONS This pragmatic RCT will demonstrate the efficacy of the "Talk-to-Me" MOOC in improving the students' ability to respond to suicidal and mental health concerns compared to the waitlist group. This design will enable rigorous evaluation of the "Talk-to-Me" MOOC, contributing to a greater understanding of the online-delivered safe-paced suicide prevention programs for tertiary students. Australian New Zealand Clinical Trials Registry (ANZCTR): #12619000630112.
Collapse
Affiliation(s)
- Ben Milbourn
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Melissa H Black
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Bahareh Afsharnejad
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Zelma Snyman
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Ellie Baker-Young
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Craig Thompson
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Sarah McGarry
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Melissa Scott
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Rhonda Clifford
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia.
| | - Frank Zimmermann
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Klinikum Aschaffenburg Hospital for Child and Adolescent Psychiatry and Psychotherapy, Germany
| | - Viktor Kacic
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Klinikum Aschaffenburg Hospital for Child and Adolescent Psychiatry and Psychotherapy, Germany.
| | | | - Marcel Romanos
- University Hospital Würzburg, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany.
| | - Sven Bölte
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Sonya Girdler
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| |
Collapse
|
82
|
Keller EM, Owens GP. Understanding help-seeking in rural counties: A serial mediation analysis. J Clin Psychol 2021; 78:857-876. [PMID: 34614200 DOI: 10.1002/jclp.23260] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Rural areas in the Southern United States are characterized by certain cultural values that may delay or prevent mental health service utilization. The present study examined a four-stage chain of serial mediation where higher levels of general self-reliance would be related to greater levels of public stigma, which would in turn be related to higher levels of self-stigma, followed by greater self-reliance about managing mental health problems, and finally, more negative attitudes toward seeking help from psychologists. METHOD Community members who lived in rural counties in the Southern United States (N = 783) completed measures of these constructs online. RESULTS Mediation analyses supported a direct association between general self-reliance and attitudes toward help-seeking that was explained in serial by higher levels of public stigma, self-stigma, and mental health self-reliance. CONCLUSIONS Clinical implications for rural practitioners are suggested including instilling policy changes, increasing provider visibility, and addressing barriers in therapy.
Collapse
Affiliation(s)
- Emily M Keller
- University of Tennessee, Department of the Psychology, Knoxville, Tennessee, USA
| | - Gina P Owens
- University of Tennessee, Department of the Psychology, Knoxville, Tennessee, USA
| |
Collapse
|
83
|
Felter CE, Cicone J, Mathis L, Smith DL. Identifying and Addressing Social Determinants of Learning During the COVID-19 Pandemic. Phys Ther 2021; 101:6365142. [PMID: 34499180 PMCID: PMC8499936 DOI: 10.1093/ptj/pzab210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/02/2021] [Accepted: 07/25/2021] [Indexed: 11/22/2022]
Abstract
UNLABELLED The COVID-19 pandemic has negatively impacted the health of people from communities of color and people of limited socioeconomic means in a disproportionate way due to social determinants of health (SDoH). The Centers for Disease Control defines SDoH as the "conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes." A related construct, social determinants of learning (SDoL), includes contextual conditions and variables that impact students' ability to optimally participate in their education, including academic and clinical development. SDoL directly impact students' ability to participate in the educational process. During the COVID-19 pandemic, students struggling with SDoH and, by extension SDoL, may be more likely to have sick family members, caregiving responsibilities, food and housing insecurity, and obligations to supplement lost family wages. SDoL are also influenced by individual experiences within and outside of the classroom. Beyond bringing this matter to the attention of our profession, especially clinical and academic educators, we must take action to reach and support students who are at higher academic risk due to the SDoL. The purpose of this paper is to (1) define SDoL, (2) explain how SDoL are impacting doctor of physical therapy and physical therapist assistant students, and (3) discuss actions that physical therapists and physical therapist assistants can take to mitigate the effects of SDoL on current doctor of physical therapy and physical therapist assistant students. IMPACT This Perspective is one of the first explorations of how SDoL affect physical therapy students during the pandemic and provides concrete suggestions on how educators in both academic and clinical settings can help students succeed when they are negatively affected by SDoL.
Collapse
Affiliation(s)
- Cara E Felter
- Address all correspondence to Cara Felter, , 100 Penn St., Suite 240 C, Baltimore, MD 21201
| | - Jonathan Cicone
- Cecil College, Department of Health and Human Sciences, Physical Therapist Assistant Program
| | - Lindsey Mathis
- University of Maryland School of Medicine, Department of Physical Therapy and Rehabilitation Science
| | - Deanna L Smith
- Cecil College, Department of Health and Human Sciences, Physical Therapist Assistant Program
| |
Collapse
|
84
|
Wong K, Chan CS, Chan M, Wong C, Cheng Q, Xiong C, Yip P. Who seeks help online? Comparing online and offline help-seeking preferences amongst youths with suicidal ideation. J Affect Disord 2021; 292:21-29. [PMID: 34087633 DOI: 10.1016/j.jad.2021.05.056] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 05/16/2021] [Accepted: 05/23/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Research consistently report an inverse relationship between suicide risk and help-seeking. The increasingly available internet-based support potentially offers an attractive alternative to traditional forms of assistance. The study compared the characteristics of suicidal youths in Hong Kong and their online and offline help-seeking behaviours. METHODS Participants (N = 1214, age-range = 15-24 years) responded to the anonymous 2018 Hong Kong Online Survey on Youth Mental Health and Internet Usage. Respondents with suicidal thoughts were classified into those who sought help online and offline, or online only ("online-help"); those who sought help offline only ("offline-help"); and those who never sought help ("no-help"). They responded to questions concerning mental health, perception towards online support, internet use, help sources, and demographic information. RESULTS The online-help group differed significantly from other groups, with greater suicidal ideation, distress, risk behaviours, and spent more time online for non-work-related purposes. Their perceived benefits of online support include anonymity, avoiding embarrassment, and social support. They are more likely to seek help from a combination of informal and formal sources. LIMITATIONS No data on whether participants sought help online or offline first, and their current treatment status is available. Our study adopted conveniences sampling, and few respondents have sought help online exclusively. CONCLUSION Online support offers an alternate way of engaging at-risk youths. Future clinical practice should consider online platforms as a complement, rather than a replacement, of offline platforms.
Collapse
Affiliation(s)
- Kelly Wong
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong
| | - Christian S Chan
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong; Department of Psychology, University of Hong Kong, Hong Kong
| | - Milton Chan
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong
| | - Clifford Wong
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong
| | - Qijin Cheng
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong; Department of Social Work, Chinese University of Hong Kong, Hong Kong
| | - Cynthia Xiong
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong
| | - Paul Yip
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, University of Hong Kong, Hong Kong.
| |
Collapse
|
85
|
Keefner TP, Stenvig T. Rethinking Suicide Risk With a New Generation of Suicide Theories. Res Theory Nurs Pract 2021; 34:389-408. [PMID: 33199410 DOI: 10.1891/rtnp-d-19-00128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Suicide is a global concern to nurses and other health-care providers. However, deaths by suicide are only part of the spectrum of suicide, as suicidal thinking and behaviors may precede a suicide attempt. Theoretical models are used infrequently in research to explain how the individual progresses from suicidal ideation to a suicide attempt. Thus, there is a critical need to advance the study of suicide with useful theoretical models to describe and explain processes whereby suicidal thoughts transition to attempts and to suicide. PURPOSE This article provides a conceptual discussion and scoping review comparing historical and contemporary ideation-to-action theories of suicide. METHOD Systematic reviews and meta-analyses from three databases (CINAHL, JSTOR, and PsychINFO) were reviewed to find literature describing suicide theories. RESULTS Historically, theory applications have limited capacity to differentiate between those individuals with suicidal ideations and those who attempt suicide. Newer theories, grounded in the ideation-to-action framework, propose distinct processes explaining what moves an individual from suicidal ideations toward suicidal behaviors. IMPLICATIONS FOR PRACTICE The ideation-to-action theories can guide health-care providers' assessment of at-risk individuals beyond merely asking about suicidal thinking. CONCLUSION The new generation of suicide theories suggest that suicidal ideations are only one component of risk. The common factor in ideation-to-action theories that distinguishes ideators from attempters is the acquired capability for suicide.
Collapse
Affiliation(s)
- Tamara P Keefner
- College of Nursing, South Dakota State University, Brookings, South Dakota
| | - Thomas Stenvig
- College of Nursing, South Dakota State University, Brookings, South Dakota
| |
Collapse
|
86
|
Kim HC. Mediating effect of stigma on the relationship between mental health literacy and help-seeking attitudes among university students in South Korea. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2021. [DOI: 10.1080/00207411.2021.1965397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Hee Chul Kim
- Department of Social Welfare, Hallym University, Chuncheon, Republic of Korea
| |
Collapse
|
87
|
Castro-Ramirez F, Al-Suwaidi M, Garcia P, Rankin O, Ricard JR, Nock MK. Racism and Poverty are Barriers to the Treatment of Youth Mental Health Concerns. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2021; 50:534-546. [PMID: 34339320 DOI: 10.1080/15374416.2021.1941058] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Traditional studies of treatment moderators have focused largely on psychological factors such as clinical severity. Racial and economic inequity exert large effects on youth mental health, on treatment efficacy, and on the likelihood of receiving treatment altogether. Yet, these factors are studied less often by clinical psychological scientists. METHOD We conducted a narrative review of literature on racial and economic inequities and their impact on youth mental health. RESULTS First, systemic problems such as racism and poverty increase the risk of developing complex health issues and decrease the likelihood of benefiting from treatment. Second, attitudinal barriers, such as mistrust associated with treatments provided by researchers and government agencies, decrease the likelihood that minoritized groups will engage with or benefit from evidence-based treatments. Third, minoritized and underserved communities are especially unlikely to receive evidence-based treatment. CONCLUSION Clinical psychological science has unique insights that can help address systemic inequities that can decrease treatment efficacy for youth mental health treatment. Psychological scientists can help eliminate disparities in accessing evidence-based treatment and help end violent policies in underserved minoritized communities by at the very least (1) building and supporting scalable community-based treatments as well as (2) publicly advocating for an end to violent policies that impose negative social costs.
Collapse
Affiliation(s)
| | | | | | | | | | - Matthew K Nock
- Department of Psychology, Harvard University.,Department of Psychiatry, Massachusetts General Hospital.,Mental Health Research Program, Franciscan Children's
| |
Collapse
|
88
|
Sander LB, Lemor ML, Van der Sloot RJA, De Jaegere E, Büscher R, Messner EM, Baumeister H, Terhorst Y. A Systematic Evaluation of Mobile Health Applications for the Prevention of Suicidal Behavior or Non-suicidal Self-injury. Front Digit Health 2021; 3:689692. [PMID: 34713162 PMCID: PMC8521855 DOI: 10.3389/fdgth.2021.689692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/22/2021] [Indexed: 12/12/2022] Open
Abstract
People with suicidal ideation and non-suicidal self-injury (NSSI) behavior face numerous barriers to help-seeking, which worsened during the COVID-19 pandemic. Mobile health applications (MHA) are discussed as one solution to improve healthcare. However, the commercial app markets are growing unregulated and rapidly, leading to an inscrutable market. This study evaluates the quality, features, functions, and prevention strategies of MHA for people with suicidal ideation and NSSI. An automatic search engine identified MHA for suicidal behavior and NSSI in the European commercial app stores. MHA quality and general characteristics were assessed using the Mobile Application Rating Scale (MARS). MHA of high quality (top 25%) were examined in detail and checked for consistency with established suicide prevention strategies. Of 10,274 identified apps, 179 MHA met the predefined inclusion criteria. Average MHA quality was moderate (M = 3.56, SD = 0.40). Most MHA provided emergency contact, but lacked security features. High-quality MHA were broadly consistent with the best-practice guidelines. The search revealed apps containing potentially harmful and triggering content, and no randomized controlled trial of any included MHA was found. Despite a large heterogeneity in the quality of MHA, high-quality MHA for suicidal behavior and NSSI are available in European commercial app stores. However, a lack of a scientific evidence base poses potential threats to users.
Collapse
Affiliation(s)
- Lasse B. Sander
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Marie-Luise Lemor
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Racine J. A. Van der Sloot
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Eva De Jaegere
- Department of Head and Skin, Flemish Centre of Expertise in Suicide Prevention, Ghent University, Ghent, Belgium
| | - Rebekka Büscher
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Eva-Maria Messner
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| |
Collapse
|
89
|
Patrick ME, Lyden GR, Morrell N, Mehus CJ, Gunlicks-Stoessel M, Lee CM, King CA, Bonar EE, Nahum-Shani I, Almirall D, Larimer ME, Vock DM. Main outcomes of M-bridge: A sequential multiple assignment randomized trial (SMART) for developing an adaptive preventive intervention for college drinking. J Consult Clin Psychol 2021; 89:601-614. [PMID: 34383533 DOI: 10.1037/ccp0000663] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: The goal was to develop a universal and resource-efficient adaptive preventive intervention (API) for incoming first-year students as a bridge to indicated interventions to address alcohol-related risks. The aims were to examine: (a) API versus assessment-only control, (b) the different APIs (i.e., 4 intervention sequences) embedded in the study design, and (c) moderators of intervention effects on binge drinking. Method: A sequential multiple assignment randomized trial (SMART) included two randomizations: timing (summer before vs. first semester) of universal personalized normative feedback and biweekly self-monitoring and, for heavy drinkers, bridging strategy (resource email vs. health coaching invitation). Participants (N = 891, 62.4% female, 76.8% White) were surveyed at the end of first and second semesters. The primary outcome was binge drinking frequency (4+/5+ drinks for females/males); secondary outcomes were alcohol consequences and health services utilization. Results: API (vs. control) was not significantly associated with outcomes. There were no differences between embedded APIs. Among heavy drinkers, the resource email (vs. health coach invitation) led to greater health services utilization. Moderator analyses suggested students intending to pledge into Greek life benefited more from any API (vs. control; 42% smaller increase from precollege in binge drinking frequency). Conclusions: Although overall effects were not significant, students at high risk (i.e., entering fraternities/sororities) did benefit more from the intervention. Furthermore, the resource email was effective for heavier drinkers. A technology-based strategy to deliver targeted resource-light interventions for heavy drinkers may be effective for reducing binge drinking during the transition to college. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Megan E Patrick
- Survey Research Center, Institute for Social Research, University of Michigan
| | | | - Nicole Morrell
- Center for Applied Research and Educational Improvement, College of Education and Human Development, University of Minnesota
| | - Christopher J Mehus
- Center for Applied Research and Educational Improvement, College of Education and Human Development, University of Minnesota
| | | | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington
| | | | | | - Inbal Nahum-Shani
- Survey Research Center, Institute for Social Research, University of Michigan
| | - Daniel Almirall
- Survey Research Center, Institute for Social Research, University of Michigan
| | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington
| | - David M Vock
- Division of Biostatistics, University of Minnesota
| |
Collapse
|
90
|
Barnett P, Arundell LL, Matthews H, Saunders R, Pilling S. 'Five hours to sort out your life': qualitative study of the experiences of university students who access mental health support. BJPsych Open 2021; 7:e118. [PMID: 36043691 PMCID: PMC8269927 DOI: 10.1192/bjo.2021.947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Previous qualitative research suggests that university students feel that current service provision does not meet their needs. Exploring the reasons for this may help to promote service change, encourage the uptake of care, improve outcomes and increase satisfaction within university services. AIMS This study aimed to improve the understanding of how students experience the process of accessing and using mental health support, barriers and facilitators to treatment, and how students would adapt provision to improve experiences. METHOD Semi-structured interviews were conducted with 16 full-time students who had used mental health services at university. Data were analysed using thematic analysis. RESULTS Five higher-order themes were identified: personalisation and informed choice, simplifying the process, feeling abandoned ignored or invisible, stigma, and superiority of private and external services. Sixteen subthemes were identified within these themes. CONCLUSIONS Findings indicate that access to mental health support should be simplified, with collaboration across university and external health and care services, to prevent students feeling lost or abandoned when seeking care. An inclusive approach to support access and provision of services for all presentations of mental health problems should be developed.
Collapse
Affiliation(s)
- Phoebe Barnett
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational, and Health Psychology, University College London, UK
| | - Laura-Louise Arundell
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational, and Health Psychology, University College London, UK; and National Collaborating Centre for Mental Health, Royal College of Psychiatrists, UK
| | | | - Rob Saunders
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational, and Health Psychology, University College London, UK
| | - Stephen Pilling
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational, and Health Psychology, University College London, UK; National Collaborating Centre for Mental Health, Royal College of Psychiatrists, UK; and Camden and Islington NHS Foundation Trust, UK
| |
Collapse
|
91
|
Systematic review and narrative synthesis of suicide prevention in high-schools and universities: a research agenda for evidence-based practice. BMC Public Health 2021; 21:1116. [PMID: 34112141 PMCID: PMC8194002 DOI: 10.1186/s12889-021-11124-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 05/24/2021] [Indexed: 11/20/2022] Open
Abstract
Background Youth suicide prevention in high-schools and universities is a public health priority. Our aim was to propose a research agenda to advance evidence-based suicide prevention in high-schools and universities by synthesizing and critically reviewing the research focus and methodologies used in existing intervention studies. Methods Fourteen databases were systematically searched to identify studies which evaluate suicide prevention interventions delivered on high-school or university campuses, with before and after measures. Data from included studies (n = 43) were extracted to identify what, where, how and for whom interventions have been tested. Narrative synthesis was used to critically evaluate research focus and methodology. Study quality was assessed. Results Research has focused primarily on selective interventions, with less attention on indicated and universal interventions. Most evidence comes from North America and high-income countries. The target of interventions has been: non-fatal suicidal behaviour; confidence and ability of staff/students to intervene in a suicidal crisis; suicide-related knowledge and attitudes; and suicide-related stigma. No studies included suicide deaths as an outcome, evaluated eco-systemic interventions, explored how context influences implementation, used multisite study designs, or focused explicitly on LGBTQ+ youth. Two studies evaluated digital interventions. Quality of the majority of studies was compromised by lack of methodological rigour, small samples, and moderate/high risk of bias. Interventions often assume the existence of an external well-functioning referral pathway, which may not be true in low-resource settings. Conclusion To advance evidence-based suicide prevention in educational settings we need to: conduct more high-quality clinical and pragmatic trials; promote research in low- and middle-income countries; test targeted interventions for vulnerable populations (like LGBTQ+ youth), evaluate interventions where death by suicide is the primary outcome; include translational studies and use implementation science to promote intervention uptake; evaluate the potential use of digital and eco-systemic interventions; and conduct multisite studies in diverse cultural settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11124-w.
Collapse
|
92
|
Szlyk HS, Tan J, Lengnick-Hall R. Innovating Technology-Enhanced Interventions for Youth Suicide: Insights for Measuring Implementation Outcomes. Front Psychol 2021; 12:657303. [PMID: 34149543 PMCID: PMC8210584 DOI: 10.3389/fpsyg.2021.657303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/29/2021] [Indexed: 11/30/2022] Open
Abstract
Technology is one medium to increase youth engagement, especially among underserved and minority groups, in suicide preventive interventions. Technology can be used to supplement or adjunct an in-person intervention, guide an in-person intervention, or be the stand-alone (automated) component of the intervention. This range in technological use is now called the continuum of behavioral intervention technologies (BITs). Overall, suicide intervention researchers do not use this terminology to categorize how the role of technology differs across technology-enhanced youth interventions. There is growing recognition that technology-enhanced interventions will not create substantial public health impact without an understanding of the individual (youth, families, and providers), mezzo (clinics and health systems of care), and contextual factors (society, culture, community) that are associated with their implementation. Implementation science is the study of methods to promote uptake of evidence-based practices and policies into the broader health care system. In this review, we incorporate work from implementation science and BIT implementation to illustrate how the study of technology-enhanced interventions for youth suicide can be advanced by specifying the role of technology and measuring implementation outcomes.
Collapse
Affiliation(s)
- Hannah S. Szlyk
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Jia Tan
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, United States
| | - Rebecca Lengnick-Hall
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, United States
| |
Collapse
|
93
|
Online Peer Counseling for Suicidal Ideation: Participant Characteristics and Reasons for Using or Refusing This Service. PSYCH 2021. [DOI: 10.3390/psych3020007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
[U25] is a German online-peer-counseling service for adolescents with suicidal ideation, who typically do not seek or receive adequate counseling. We conducted an online survey in order to compare persons who receive online counseling by [U25] compared to those who are visitors of [U25] websites but do not (yet) receive counseling. Via online survey, all visitors to the [U25] websites were invited to fill in a questionnaire on sociodemographic data, utilization reasons, and barriers. Our final sample consisted of n = 318 counseling clients, n = 1127 persons who have not yet sought help but intend to do so (“prospective clients”), and n = 444 persons who do not consider [U25] counseling for themselves (“refusers”). Clients were more often female and showed positive attitudes toward online counseling. Low perceived need for counseling was the most frequent barrier reported by the refusers, whereas fear of stigma and practical barriers were rarely reported; younger and male refusers reported needing to write down one’s problems as a barrier more often. Self-selection might reduce generalizability of our results. Online counseling can facilitate receiving psychosocial support for young persons with suicidal ideation, particularly if barriers are addressed.
Collapse
|
94
|
Busby DR, Zheng K, Eisenberg D, Albucher RC, Favorite T, Coryell W, Pistorello J, King CA. Black college students at elevated risk for suicide: Barriers to mental health service utilization. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:308-314. [PMID: 31662044 DOI: 10.1080/07448481.2019.1674316] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 06/06/2019] [Accepted: 09/23/2019] [Indexed: 06/10/2023]
Abstract
To examine differences between Black students who do and do not screen positive for suicide risk; to describe barriers to mental health service utilization (MHSU) among participants with a positive screen and no current MHSU and; to determine if barriers vary by student characteristics. Participants: 1,559 Black students (66% female), ages 18 years and older (M = 21 years, SD = 2.61) recruited from September 2015 to October 2017 across four universities. Method: Participants completed an online survey assessing demographics, suicide risk, MHSU, and barriers to MHSU. Results: Seventeen percent of students screened positive for risk; 66% of these students were not receiving MHS. Students who screened positive were female and younger. Perceived problem severity (74%) was reported most frequently. Conclusions: Efforts to improve MHSU among Black college students at risk for suicide should address students' awareness of treatable MH problems and time concerns.
Collapse
Affiliation(s)
- Danielle R Busby
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Kai Zheng
- Department of Informatics, University of California, Irvine, California, USA
| | - Daniel Eisenberg
- School of Public Health, Health Management and Policy, University of Michigan, Ann Arbor, Michigan, USA
| | - Ronald C Albucher
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Todd Favorite
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - William Coryell
- Department of Psychiatry, University of Iowa, Iowa City, Iowa, USA
| | | | - Cheryl A King
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
95
|
Newman MG, Jacobson NC, Rackoff GN, Bell MJ, Taylor CB. A randomized controlled trial of a smartphone-based application for the treatment of anxiety. Psychother Res 2021; 31:443-454. [PMID: 32662323 PMCID: PMC7855205 DOI: 10.1080/10503307.2020.1790688] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 06/24/2020] [Indexed: 12/15/2022] Open
Abstract
AbstractIntroduction: Generalized anxiety disorder (GAD) is prevalent among college students. Smartphone-based interventions may be a low-cost treatment method. Method: College students with self-reported GAD were randomized to receive smartphone-based guided self-help (n = 50), or no treatment (n = 50). Post-treatment and six-month follow-up outcomes included the Depression Anxiety Stress Scales-Short Form Stress Subscale (DASS Stress), the Penn State Worry Questionnaire (PSWQ-11), and the State-Trait Anxiety Inventory-Trait (STAI-T), as well as diagnostic status assessed by the GAD-Questionnaire, 4th edition. Results: From pre- to post-treatment, participants who received guided self-help (vs. no treatment) experienced significantly greater reductions on the DASS Stress (d = -0.408) and a greater probability of remission from GAD (d = -0.445). There was no significant between-group difference in change on the PSWQ-11 (d = -0.208) or STAI-T (d = -0.114). From post to six-month follow-up there was no significant loss of gains on DASS Stress scores (d = -0.141) and of those who had remitted, 78.6% remained remitted. Yet rates of remitted participants no longer differed significantly between conditions at follow-up (d = -0.229). Conclusion: Smartphone-based interventions may be efficacious in treating some aspects of GAD. Methods for improving symptom reduction and long-term outcome are discussed.
Collapse
Affiliation(s)
- Michelle G Newman
- Department of Psychology, the Pennsylvania State University, University Park, PA, USA
| | - Nicholas C Jacobson
- Department of Psychology, the Pennsylvania State University, University Park, PA, USA
- Department of Biomedical Data Science and Psychiatry, Dartmouth College, Hanover, NH, USA
| | - Gavin N Rackoff
- Department of Psychology, the Pennsylvania State University, University Park, PA, USA
| | - Megan Jones Bell
- Headspace, Inc., San Francisco, CA, USA
- Department of Psychiatry, Stanford University, Stanford, CA, USA
| | - C Barr Taylor
- Department of Psychiatry, Stanford University, Stanford, CA, USA
- Center for m2Health, Palo Alto University, Palo Alto, CA, USA
| |
Collapse
|
96
|
Harrer M, Apolinário-Hagen J, Fritsche L, Salewski C, Zarski AC, Lehr D, Baumeister H, Cuijpers P, Ebert DD. Effect of an internet- and app-based stress intervention compared to online psychoeducation in university students with depressive symptoms: Results of a randomized controlled trial. Internet Interv 2021; 24:100374. [PMID: 33718001 PMCID: PMC7932886 DOI: 10.1016/j.invent.2021.100374] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 01/18/2021] [Accepted: 02/08/2021] [Indexed: 02/07/2023] Open
Abstract
Depression is highly prevalent among university students. Internet-based interventions have been found to be effective in addressing depressive symptoms, but it is open if this also applies to interventions directed at academic stress. It is also largely unclear if the techniques employed in such programs provide significant additional benefits when controlling for non-specific intervention effects. A sample of N = 200 students with elevated levels of depression (CES-D ≥ 16) of a large distance-learning university were randomly assigned to either an Internet- and App-based stress intervention group (IG; n = 100) or an active control group (CG; n = 100) receiving an Internet-based psychoeducational program of equal length. Self-report data was assessed at baseline, post-treatment (7 weeks) and three-month follow-up. The primary outcome was depression (CES-D) post-treatment. Secondary outcomes included mental health outcomes, modifiable risk factors, and academic outcomes. We found significant between-group effects on depressive symptom severity (d = 0.36; 95% CI: 0.08-0.64), as well as behavioral activation (d = 0.61; 95% CI: 0.30-0.91), perceived stress (d = 0.45; 95% CI: 0.18-0.73), anxiety (d = 0.35; 95% CI: 0.03-0.67) and other secondary outcomes post-treatment. Effects on depression were sustained at three-month follow-up. Response rates for depressive symptoms were significantly higher in the IG (26%) than the CG (14%) at post-test (χ 2=4.5, p = 0.04), but not at three-month follow-up (p = 0.454). We also found significant effects on relevant academic outcomes, including work impairment (follow-up; d = 0.36), work output (post-treatment; d = 0.27) and work cutback (follow-up; d = 0.36). The intervention was more effective for depressive symptoms compared to the CG, and so controlling for unspecific intervention effects. This suggests that specific techniques of the intervention may provide significant additional benefits on depressive symptoms. Trial registration: German Clinical Trial Registration (DRKS): DRKS00011800 (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011800).
Collapse
Affiliation(s)
- Mathias Harrer
- Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Jennifer Apolinário-Hagen
- Institute of Occupational, Social and Environmental Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Lara Fritsche
- Department of Health Psychology, Institute for Psychology, University of Hagen, Hagen, Germany
| | - Christel Salewski
- Department of Health Psychology, Institute for Psychology, University of Hagen, Hagen, Germany
| | - Anna-Carlotta Zarski
- Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Dirk Lehr
- Division of Online Health Trainings, Innovation Incubator, Leuphana University, Lüneburg, Germany
| | - Harald Baumeister
- Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Pim Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David Daniel Ebert
- Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
97
|
Linden B, Boyes R, Stuart H. Cross-sectional trend analysis of the NCHA II survey data on Canadian post-secondary student mental health and wellbeing from 2013 to 2019. BMC Public Health 2021; 21:590. [PMID: 33765965 PMCID: PMC7992810 DOI: 10.1186/s12889-021-10622-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 03/14/2021] [Indexed: 11/19/2022] Open
Abstract
Background Canadian post-secondary students are considered to be at risk for chronic stress and languishing mental health, but there has been no longitudinal analysis of the available population-level data. The purpose of this study was to examine trends in the overall and sex-specific prevalence of self-reported stress, distress, mental illness, and help seeking behaviours among Canadian post-secondary students over the past several years. Methods Using the 2013, 2016, and 2019 iterations of the National College Health Assessment II Canadian Reference data, we conducted a trend analysis for each variable of interest, stratified by sex. The significance and magnitude of the changes were modelled using cumulative linked ordinal regression models and log binomial regression models. Results With few exceptions, we observed significant increases over time in the proportion of students reporting symptoms of psychological distress, mental illness diagnoses, and help seeking for mental health related challenges. Female students reported a higher level of stress than male students, with a statistically significant increase in the stress level reported by female students observed over time. In all cases, larger proportions of female students were observed compared to male students, with the proportion of female students who self-reported mental illness diagnoses nearly doubling that of males. Conclusions Our analysis indicated that the proportion of students self-reporting mental health related challenges, including stress, psychological distress, and diagnosed mental illnesses increased between the 2013, 2016 and 2019 iterations of the NCHA II conducted among Canadian post-secondary students. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10622-1.
Collapse
Affiliation(s)
- Brooke Linden
- Health Services and Policy Research Institute, Queen's University, Abramsky Hall, 21 Arch Street, Kingston, ON, K7L 3N6, Canada.
| | - Randall Boyes
- Department of Public Health Sciences, Queen's University, Abramsky Hall, 21 Arch Street, Kingston, ON, K7L 3N6, Canada
| | - Heather Stuart
- Department of Public Health Sciences, Queen's University, Abramsky Hall, 21 Arch Street, Kingston, ON, K7L 3N6, Canada
| |
Collapse
|
98
|
Langley EL, Clark G, Murray C, Wootton BM. The utility of the health belief model variables in predicting help-seeking intention for depressive symptoms. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1080/00050067.2021.1893598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Emma L. Langley
- School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, Australia
| | - Gavin Clark
- School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, Australia
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | - Clara Murray
- School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, Australia
| | - Bethany M. Wootton
- Discipline of Psychology, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| |
Collapse
|
99
|
Almanasef M. Mental Health Literacy and Help-Seeking Behaviours Among Undergraduate Pharmacy Students in Abha, Saudi Arabia. Risk Manag Healthc Policy 2021; 14:1281-1286. [PMID: 33790673 PMCID: PMC8006949 DOI: 10.2147/rmhp.s289211] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/08/2021] [Indexed: 02/03/2023] Open
Abstract
Background The serious mental health problems experienced by university students could have a negative impact on their long-term mental, social and physical health as well as their academic achievements. The ability to recognise a condition, and knowledge about mental health issues and sources of help, are among the factors influencing help-seeking behaviour in young individuals. This study was conducted to examine the mental health literacy among undergraduate pharmacy students and to assess whether mental health literacy is linked to a stronger intention to seek help. Methods This prospective cross-sectional study used an online self-administered questionnaire. A total of 271 pharmacy students at King Khalid University completed the questionnaire and agreed to participate in the study. Results The mental health literacy in the current study (M=112.53) was found to be lower than that reported in international research using the MHLS. Students with no history of mental health issues scored significantly higher in help-seeking behaviours from informal sources (M=23.65, SD=6.88) than those with a previous history (M=19.03, SD=7.58), F (1, 269)=11.76, p=0.001. The study revealed a significant positive correlation between mental health literacy and help-seeking behaviours r(271)=0.26, p<0.01. Conclusion This study demonstrates that there is a positive correlation between mental health literacy and help-seeking behaviours. Implementing appropriate interventions could be a key priority in improving the mental health literacy and help-seeking behaviour of students.
Collapse
Affiliation(s)
- Mona Almanasef
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| |
Collapse
|
100
|
Abstract
Suicide is a preventable health problem. Multiple definitions and inconsistent use of the term suicidality can result in failure to properly recognize suicide risk and behavior and confuses suicide research. Clarification of the suicidality concept is needed to facilitate the care for individuals at risk for suicide. Using Rodgers' evolutionary concept analysis method, this analysis describes the breadth and scope of the suicidality concept. Findings indicate suicidality covers a spectrum of suicidal risk and levels of emotional suffering and intent. The analysis does not draw definite conclusions, but outlines a direction for further research.
Collapse
Affiliation(s)
- Tamara Pike Keefner
- Nursing, South Dakota State University - College of Nursing, Rapid City, South Dakota, USA
| | - Thomas Stenvig
- Graduate Nursing, South Dakota State University - College of Nursing, Brookings, Rapid City, South Dakota, USA
| |
Collapse
|