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Grazier KL, Smith JE, Song J, Smiley ML. Integration of depression and primary care: barriers to adoption. J Prim Care Community Health 2013; 5:67-73. [PMID: 23799678 DOI: 10.1177/2150131913491290] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Despite the prevailing consensus as to its value, the adoption of integrated care models is not widespread. Thus, the objective of this article it to examine the barriers to the adoption of depression and primary care models in the United States. METHODS A literature search focused on peer-reviewed journal literature in Medline and PsycInfo. The search strategy focused on barriers to integrated mental health care services in primary care, and was based on previously existing searches. The search included: MeSH terms combined with targeted keywords; iterative citation searches in Scopus; searches for grey literature (literature not traditionally indexed by commercial publishers) in Google and organization websites, examination of reference lists, and discussions with researchers. FINDINGS Integration of depression care and primary care faces multiple barriers. Patients and families face numerous barriers, linked inextricably to create challenges not easily remedied by any one party, including the following: vulnerable populations with special needs, patient and family factors, medical and mental health comorbidities, provider supply and culture, financing and costs, and organizational issues. CONCLUSIONS An analysis of barriers impeding integration of depression and primary care presents information for future implementation of services.
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1402
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Younes N, Chee CC, Turbelin C, Hanslik T, Passerieux C, Melchior M. Particular difficulties faced by GPs with young adults who will attempt suicide: a cross-sectional study. BMC FAMILY PRACTICE 2013; 14:68. [PMID: 23706018 PMCID: PMC3674947 DOI: 10.1186/1471-2296-14-68] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 05/17/2013] [Indexed: 12/14/2022]
Abstract
Background Suicide is a major public health problem in young people. General Practitioners (GPs) play a central role in suicide prevention. However data about how physicians deal with suicidal youths are lacking. This study aims to compare young adult suicide attempters (from 18 to 39 years old) with older adults in a primary care setting. Methods A cross-sectional study was carried. All suicide attempts (N=270) reported to the French Sentinel surveillance System from 2009 to 2011 were considered. We conducted comparison of data on the last GP’s consultation and GPs’ management in the last three months between young adults and older adults. Results In comparison with older adults, young adults consulted their GP less frequently in the month preceding the suicidal attempt (40.9 vs. 64.6%, p=.01). During the last consultation prior to the suicidal attempt, they expressed suicidal ideas less frequently (11.3 vs. 21.9%, p=.03). In the year preceding the suicidal attempt, GPs identified depression significantly less often (42.0 vs. 63.4%, p=.001). In the preceding three months, GPs realized significantly less interventions: less psychological support (37.5 vs. 53.0%, p=.02), prescribed less antidepressants (28.6 vs. 54.8%, p<.0001) or psychotropic drugs (39.1 vs. 52.9%, p=.03) and made fewer attempts to refer to a mental health specialist (33.3 vs. 45.5%, p=.05). Conclusion With young adults who subsequently attempt suicide, GPs face particular difficulties compared to older adults, as a significant proportion of young adults were not seen in the previous six months, as GPs identified less depressions in the preceding year and were less active in managing in the preceding three months. Medical training and continuing medical education should include better instruction on challenges relative to addressing suicide risk in this particular population.
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Affiliation(s)
- Nadia Younes
- EA 40-47 Université Versailles Saint-Quentin-en-Yvelines, Versailles F-7800, France.
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1403
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Yap MBH, Reavley N, Jorm AF. Where would young people seek help for mental disorders and what stops them? Findings from an Australian national survey. J Affect Disord 2013; 147:255-61. [PMID: 23228570 DOI: 10.1016/j.jad.2012.11.014] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 11/12/2012] [Accepted: 11/12/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND In order to improve help seeking by young people for mental illness, a better understanding is required of their help-seeking intentions and barriers to their help seeking from various different sources and for different disorders. METHODS Young people's help-seeking intentions and perceived barriers to help seeking were assessed by a national telephone survey of 3021 youths aged 15-25 years. Respondents were presented with a vignette of a young person portraying depression, depression with suicidal thoughts, depression with alcohol abuse, post-traumatic stress disorder, social phobia, or psychosis. RESULTS Embarrassment or shyness was the most frequently mentioned barrier to seeking help from most sources. However, different barriers featured prominently depending on the disorder and the helper. Age, sex, and knowing a family member or friend who had received professional help for mental illness predicted some barriers. LIMITATIONS Help-seeking intentions and barriers were assessed with reference to a vignette character and may not reflect actual experience or behaviors. CONCLUSIONS Findings can facilitate the targeting of future efforts to improve young people's help seeking for mental disorders by highlighting the barriers that are more relevant for specific disorders, sources of help and personal characteristics.
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Affiliation(s)
- Marie Bee Hui Yap
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia.
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1404
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Magin P, Holliday S, Dunlop A, Ewald B, Dunbabin J, Henry J, Goode S, Baker F. Discomfort sharing the general practice waiting room with mentally ill patients: a cross-sectional study. Fam Pract 2013; 30:190-6. [PMID: 23024372 DOI: 10.1093/fampra/cms058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Most mental illness is managed in general practice rather than specialist psychiatric settings. Management of mental illness in general practice is advocated as being less stigmatizing than psychiatric settings. Thus, other patients' discomfort with sharing the waiting room with the mentally ill may be problematic. OBJECTIVES To examine prevalence and associations of discomfort of general practice waiting room patients with fellow patients with mental illness and the implications for practices of these attitudes. We sought attitudes reflecting social distance, a core element of stigmatization. METHODS A cross-sectional waiting room questionnaire-based study in 15 Australian general practices. Outcome measures were discomfort sharing a waiting room with patients with mental illness, likelihood of changing GP practice if that practice provided specialized care for patients with mental illness, and the perception that general practice is a setting where patients with mental illness should be treated. RESULTS Of 1134 participants (response rate 78.5%), 29.7% and 12.2%, respectively, reported they would be uncomfortable sharing a waiting room with a patient with schizophrenia or severe depression/anxiety. Only 29.9% and 48.8%, respectively, felt that general practice was an appropriate location for treatment of schizophrenia or severe depression/anxiety. Ten per cent would change their current practice if it provided specialized care for mentally ill patients. CONCLUSIONS This desire of general practice patients for social distance from fellow patients with mental illness may have implications for both the GPs with a particular interest in mental disorders and the care-seeking and access to care of patients with mental illness.
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Affiliation(s)
- Parker Magin
- Discipline of General Practice, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
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1405
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1406
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Buechter R, Pieper D, Ueffing E, Zschorlich B. Interventions to reduce experiences of stigma and discrimination of people with mental illness and their caregivers. Hippokratia 2013. [DOI: 10.1002/14651858.cd010400] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Roland Buechter
- Institute for Quality and Efficiency in Health Care (IQWiG); Health Information Department; Im Mediapark 8 Koeln Germany 50670
| | - Dawid Pieper
- Witten/Herdecke University; Institute for research in operative medicine (IFOM); Ostmerheimer Strasse 200 Haus 38 Koeln NRW Germany 51109
| | - Erin Ueffing
- The Ottawa Hospital - General Campus; Canadian Cochrane Centre; 501 Smyth Road, Box 711 Room 1234 Ottawa Ontario Canada K1H 8L6
| | - Beate Zschorlich
- Institute for Quality and Efficiency in Health Care (IQWiG); Health Information Department; Im Mediapark 8 Koeln Germany 50670
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1407
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Fergusson DM, Boden JM, Horwood LJ. Nine-year follow-up of a home-visitation program: a randomized trial. Pediatrics 2013; 131:297-303. [PMID: 23359575 DOI: 10.1542/peds.2012-1612] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate the extent to which a home-visitation program (Early Start) had benefits for child abuse, child behavior, and parental- and family-level benefits to the 9-year follow-up. METHODS A randomized controlled trial in which 220 families receiving Early Start were contrasted with a control series of 223 families not receiving the program. Families were enrolled in the program for up to 5 years. Outcomes were assessed at 6 months, annually from 1 year to 6 years, and at 9 years after trial entry. RESULTS Comparisons between the Early Start and control series showed that families in the Early Start program showed significant (P < .05) benefits in reduced risk of hospital attendance for unintentional injury, lower risk of parent-reported harsh punishment, lower levels of physical punishment, higher parenting competence scores, and more positive child behavioral adjustment scores. Effect sizes (Cohen's "d") ranged from 0.13 to 0.29 (median = 0.25). There were no significant differences (all P values > .05) between the Early Start and control series on a range of measures of parental behavior and family outcomes, including maternal depression, parental substance use, intimate partner violence, adverse economic outcomes, and life stress. CONCLUSIONS The Early Start program was associated with small to moderate benefits in a range of areas relating to child abuse, physical punishment, child behavior, and parenting competence. There was little evidence to suggest that the Early Start program had benefits that extended to the level of parents or family overall.
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Affiliation(s)
- David M Fergusson
- Christchurch Health & Development Study, University of Otago, Christchurch School of Medicine & Health Sciences, PO Box 4345, Christchurch, New Zealand.
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1408
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Lewis SF. Examining changes in substance use and conduct problems among treatment-seeking adolescents. Child Adolesc Ment Health 2013; 18:33-38. [PMID: 32847262 DOI: 10.1111/j.1475-3588.2012.00657.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Outdoor behavioral healthcare (OBH) treatment offers an alternative to parents of youth who are treatment-resistant or avoidant. METHOD The current study evaluated OBH therapeutic outcomes. The sample was 190 adolescents (Mage = 15.69) presenting for treatment between 2006 and 2008. To be eligible, participants had to be between the ages of 13 and 17 years and be admitted to one of the three OBH programs for mental health intervention. Primary study hypotheses were that OBH treatment would be associated with a reduction in psychiatric symptomatology from baseline to post-treatment and second, that the OBH intervention would be associated with the maintenance of the hypothesized treatment gains. RESULTS AND CONCLUSIONS Findings were consistent with hypotheses, suggesting that youth demonstrated significant symptomatic reductions and maintained these improvements over a 12-month follow-up period.
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Affiliation(s)
- Sarah F Lewis
- Center for Research, Assessment, and Treatment Efficacy (CReATE), P.O. Box 2062, Asheville, NC, 28802-2062, USA
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1409
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Zou H, Li Z, Nolan M, Wang H, Hu L. Self-management among Chinese people with schizophrenia and their caregivers: a qualitative study. Arch Psychiatr Nurs 2013; 27:42-53. [PMID: 23352024 DOI: 10.1016/j.apnu.2012.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 10/18/2012] [Accepted: 10/20/2012] [Indexed: 01/08/2023]
Abstract
This study explores the practice of self-management in Chinese people with schizophrenia and their caregivers. Twenty-one patients and 14 caregivers were interviewed. Four themes were identified, reflecting the practice of self-management from both the patients' and caregivers' perspective: managing medication, monitoring and dealing with symptoms, maintaining social relations, and seeking health information and maintaining medical appointments. In general, self-management practices among Chinese people with schizophrenia were not optimal. This study highlights the importance of developing and implementing family-based self-management programs for Chinese people with schizophrenia and their family in order to enhance their self-management abilities and improve care outcomes.
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Affiliation(s)
- Haiou Zou
- Peking Union Medical College, School of Nursing Beijing, P. R. China
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1410
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Gren-Landell M, Aho N, Carlsson E, Jones A, Svedin CG. Posttraumatic stress symptoms and mental health services utilization in adolescents with social anxiety disorder and experiences of victimization. Eur Child Adolesc Psychiatry 2013; 22:177-84. [PMID: 23099817 PMCID: PMC3586047 DOI: 10.1007/s00787-012-0336-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 09/29/2012] [Indexed: 11/28/2022]
Abstract
Recent findings from studies on adults show similarities between social anxiety disorder (SAD) and posttraumatic stress in the form of recurrent memories and intrusive and distressing images of earlier aversive events. Further, treatment models for SAD in adults have been successfully developed by using transdiagnostic knowledge on posttraumatic stress symptoms (PTSS). Studies on adolescents are though missing. The present study aimed at exploring the association between PTSS and SAD in Swedish adolescents. A second aim was to study mental health services utilization in relation to these conditions. A total of 5,960 high-school students participated and reported on SAD, life time victimization, PTSS and mental health service utilization. Socially anxious adolescents reported significantly higher levels of PTSS than adolescents not reporting SAD and this difference was seen in victimized as well as non-victimized subjects. Contact with a school counselor was the most common mental health service utilization in subjects with SAD and those with elevated PTSS. In the prediction of contact with a CAP-clinic, significant odds ratios were found for a condition of SAD and elevated PTSS (OR = 4.88, 95% CI = 3.53-6.73) but not for SAD only. Screening of PTSS in adolescents with SAD is recommended. The service of school counselors is important in detecting and helping young people with SAD and elevated PTSS. Clinical studies on SAD and PTSS in adolescents could aid in modifying treatment models for SAD.
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Affiliation(s)
- Malin Gren-Landell
- The Child and Adolescent Psychiatric Clinic, The University Hospital of Linköping, S-581 85, Linköping, Sweden.
| | - Nikolas Aho
- The Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Elisabeth Carlsson
- Department of Behavioural Sciences and Learning, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden
| | - Annica Jones
- Department of Behavioural Sciences and Learning, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden
| | - Carl Göran Svedin
- The Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
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1411
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Czyz EK, Horwitz AG, Eisenberg D, Kramer A, King CA. Self-reported barriers to professional help seeking among college students at elevated risk for suicide. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2013; 61:398-406. [PMID: 24010494 PMCID: PMC3788673 DOI: 10.1080/07448481.2013.820731] [Citation(s) in RCA: 182] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVES This study sought to describe self-reported barriers to professional help seeking among college students who are at elevated suicide risk and determine if these barriers vary by demographic and clinical characteristics. PARTICIPANTS Participants were 165 non-treatment seekers recruited as part of a Web-based treatment linkage intervention for college students at elevated suicide risk (from September 2010 through December 2011). METHODS Data were collected using Web-based questionnaires. Two coders coded students' responses to an open-ended question about reasons for not seeking professional help. RESULTS The most commonly reported barriers included perception that treatment is not needed (66%), lack of time (26.8%), and preference for self-management (18%). Stigma was mentioned by only 12% of students. There were notable differences based on gender, race, and severity of depression and alcohol abuse. CONCLUSIONS Efforts aimed at reaching students at elevated risk for suicidal behavior should be particularly sensitive to these commonly described barriers.
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Affiliation(s)
- Ewa K Czyz
- a Department of Psychiatry and University of Michigan Depression Center, University of Michigan , Ann Arbor , Michigan
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1412
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Priorities for young adults when accessing UK primary care: literature review. Prim Health Care Res Dev 2012; 14:341-9. [PMID: 23092551 DOI: 10.1017/s1463423612000497] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
This literature review focuses on what matters to young adults when they access primary care services in the United Kingdom. Patients' access to and experience of primary care services differs across age groups. Existing research has largely focused on the needs and experiences of children, adolescents, and adults. There is some evidence to suggest the views of young adults (aged 18-25 years) that may differ from the views of other age groups, and research has not previously reported specifically on the views of this group of the population. The literature was reviewed to identify the views and priorities of young UK adults regarding primary healthcare provision, and furthermore, to identify those related topics that would benefit from further research. Relevant academic publications and grey literature published from 2000 onwards was reviewed and synthesised. We identified and reported emerging themes that were of importance to young adults in respect of the UK primary care provision. A total of 19 papers met our inclusion criteria. Young adults access primary care services less frequently than other age groups; this may be because of their experience of primary care throughout childhood and adolescence. Five aspects of primary care provision emerged as being of importance to young adults--the accessibility and availability of services, the confidentiality of health-related information, issues relating to communication with healthcare professionals, continuity of care, and behaviours and attitudes expressed towards young adults by healthcare professionals. There is a lack of focus of current research on the expectations, needs, and primary healthcare experiences of young adults. Young adults may hold views that are distinct from other age groups. Further research is needed to better understand the needs of a young adult population as their needs may impact the future use of services.
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1413
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Del Mauro JM, Jackson Williams D. Children and Adolescents’ Attitudes Toward Seeking Help From Professional Mental Health Providers. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2012. [DOI: 10.1007/s10447-012-9172-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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1414
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Gulliver A, Griffiths KM, Christensen H. Barriers and facilitators to mental health help-seeking for young elite athletes: a qualitative study. BMC Psychiatry 2012; 12:157. [PMID: 23009161 PMCID: PMC3514142 DOI: 10.1186/1471-244x-12-157] [Citation(s) in RCA: 215] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 09/18/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Adolescents and young adults experience a high level of mental disorders, yet tend not to seek help. Research indicates that there are many barriers and facilitators to help-seeking for young people in the general community. However there are limited data available for young elite athletes. This study aims to determine what young elite athletes perceive as the barriers and facilitators to help-seeking for common mental health problems. METHODS Fifteen elite athletes aged 16-23 years each participated in one of three focus group discussions. In addition to written data, verbal responses were audio taped, transcribed and thematically analysed. RESULTS Participants' written and verbal data suggested that stigma was the most important perceived barrier to seeking help for young elite athletes. Other notable barriers were a lack of mental health literacy, and negative past experiences of help-seeking. Facilitators to help-seeking were encouragement from others, having an established relationship with a provider, pleasant previous interactions with providers, the positive attitudes of others, especially their coach, and access to the internet. CONCLUSIONS Intervention strategies for improving help-seeking in young elite athletes should focus on reducing stigma, increasing mental health literacy, and improving relations with potential providers.
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Affiliation(s)
- Amelia Gulliver
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Kathleen M Griffiths
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Helen Christensen
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
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1415
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Jordan J, McKenna H, Keeney S, Cutcliffe J, Stevenson C, Slater P, McGowan I. Providing meaningful care: learning from the experiences of suicidal young men. QUALITATIVE HEALTH RESEARCH 2012; 22:1207-1219. [PMID: 22785623 DOI: 10.1177/1049732312450367] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Little is known about young suicidal men's preferences for care. Using a broad interpretive approach, we interviewed 36 formerly suicidal young men in a study addressing the development and provision of mental health services. Our analysis yielded three core categories: widening access and bolstering proactive outreach, on becoming a man, and equipping young men for future challenges. Collectively, these categories suggest key features and processes of appropriate service configuration and clinical care: (a) services that reach out proactively serve to encourage young men's initial and ongoing engagement; (b) care delivered over the long term ensures a necessary focus on a meaningful future life; (c) mental health professionals (MHPs) are centrally involved alongside significant others, including those with personal experience of suicide; and (d) the development of a vital interpersonal connection is based on MHPs actively communicating their empathy, open-mindedness, and interest in a young man's unique biography.
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1416
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Morthorst B, Krogh J, Erlangsen A, Alberdi F, Nordentoft M. Effect of assertive outreach after suicide attempt in the AID (assertive intervention for deliberate self harm) trial: randomised controlled trial. BMJ 2012; 345:e4972. [PMID: 22915730 PMCID: PMC3425442 DOI: 10.1136/bmj.e4972] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE To assess whether an assertive outreach intervention after suicide attempt could reduce the frequency of subsequent suicidal acts, compared with standard treatment. DESIGN Randomised, parallel group, superiority trial with blinded outcome assessment. SETTING Outpatient intervention at one location at Copenhagen University Hospital, Denmark. PARTICIPANTS Patients older than 12 years admitted to regional hospitals in Copenhagen with a suicide attempt within the past 14 days. We excluded patients diagnosed with schizophrenia spectrum disorders and patients living in institutions. INTERVENTION Case management through assertive outreach that provided crisis intervention and flexible problem solving. This approach incorporated motivational support and actively assisted patients to scheduled appointments to improve adherence with after-treatment as an add on to standard treatment. MAIN OUTCOME Repeated suicide attempt and death by suicide, recorded in medical records and death register at 1-year follow-up. RESULTS 243 patients were included. During 12 months of follow-up, 20/123 (16%) patients in the intervention group had been registered in hospital records with subsequent suicide attempt, compared with 13/120 (11%) in the control group (odds ratio 1.60, 95% confidence interval 0.76 to 3.38; P=0.22). By contrast, self reported data on new events showed 11/95 (12%) in the intervention group versus 13/74 (18%) in the control group (0.61, 0.26 to 1.46; P=0.27). By imputing missing data on the selfreported outcomes, we estimated 15/123 (12%) events in the intervention group and 23/120 (19%) in the control group (0.69, 0.34 to 1.43; P=0.32). CONCLUSION Assertive outreach showed no significant effect on subsequent suicide attempt. The difference in rates of events between register data and self reported data could indicate detection bias. TRIAL REGISTRATION ClinicalTrials.gov NCT00700089.
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Affiliation(s)
- Britt Morthorst
- Research Unit, Mental Health Centre Copenhagen, Faculty of Health Sciences, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.
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1417
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Ross AM, Hart LM, Jorm AF, Kelly CM, Kitchener BA. Development of key messages for adolescents on providing basic mental health first aid to peers: a Delphi consensus study. Early Interv Psychiatry 2012; 6:229-38. [PMID: 22240091 DOI: 10.1111/j.1751-7893.2011.00331.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Most young people fail to receive professional treatment for mental disorders; however, they do indicate a preference for sharing problems with peers. This article describes key messages about knowledge and actions to form the basis of a basic mental health first aid (MHFA) course for adolescents to increase recognition of and help seeking for mental health problems by teaching the best knowledge and helping actions a young person can undertake to support a peer with a mental health problem. METHODS The Delphi method was used to achieve consensus among Australian and Canadian youth mental health experts regarding the importance of statements that describe helping actions a young person can take, and information they should have, to support a friend with a mental health problem. There were two expert panels, one consisting of 36 youth mental health consumer advocates and the other of 97 Youth MHFA instructors. Panellists rated each statement according to how appropriate it would be as a basic mental health first aid message for both a junior adolescent (12-15 years) and a senior adolescent (16-18 years). RESULTS Out of 98 statements, 78 were endorsed as key basic MHFA messages for junior adolescents and 81 were endorsed for senior adolescents. CONCLUSION The study has identified key messages for adolescents on how they can help a peer. These messages will form the basis of the curriculum for an MHFA course for adolescents, which will aim to facilitate early recognition of and help seeking for mental health problems in adolescents.
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Affiliation(s)
- Anna M Ross
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
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1418
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Gulliver A, Griffiths KM, Christensen H, Brewer JL. A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry 2012; 12:81. [PMID: 22799879 PMCID: PMC3464688 DOI: 10.1186/1471-244x-12-81] [Citation(s) in RCA: 172] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Accepted: 05/01/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Depression and anxiety are treatable disorders, yet many people do not seek professional help. Interventions designed to improve help-seeking attitudes and increase help-seeking intentions and behaviour have been evaluated in recent times. However, there have been no systematic reviews of the efficacy or effectiveness of these interventions in promoting help-seeking. Therefore, this paper reports a systematic review of published randomised controlled trials targeting help-seeking attitudes, intentions or behaviours for depression, anxiety, and general psychological distress. METHODS Studies were identified through searches of PubMed, PsycInfo, and the Cochrane database in November 2011. Studies were included if they included a randomised controlled trial of at least one intervention targeting help-seeking for depression or anxiety or general psychological distress, and contained extractable data on help-seeking attitudes or intentions or behaviour. Studies were excluded if they focused on problems or conditions other than the target (e.g., substance use, eating disorder). RESULTS Six published studies of randomised controlled trials investigating eight different interventions for help-seeking were identified. The majority of trials targeted young adults. Mental health literacy content was effective (d = .12 to .53) in improving help-seeking attitudes in the majority of studies at post-intervention, but had no effect on help-seeking behaviour (d = -.01, .02). There was less evidence for other intervention types such as efforts to destigmatise or provide help-seeking source information. CONCLUSIONS Mental health literacy interventions are a promising method for promoting positive help-seeking attitudes, but there is no evidence that it leads to help-seeking behaviour. Further research investigating the effects of interventions on attitudes, intentions, and behaviour is required.
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Affiliation(s)
- Amelia Gulliver
- Centre for Mental Health Research, The Australian National University, Canberra, Australia.
| | - Kathleen M Griffiths
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Helen Christensen
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Jacqueline L Brewer
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
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1419
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Gulliver A, Griffiths KM, Christensen H, Mackinnon A, Calear AL, Parsons A, Bennett K, Batterham PJ, Stanimirovic R. Internet-based interventions to promote mental health help-seeking in elite athletes: an exploratory randomized controlled trial. J Med Internet Res 2012; 14:e69. [PMID: 22743352 PMCID: PMC3414855 DOI: 10.2196/jmir.1864] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 11/04/2011] [Accepted: 02/06/2012] [Indexed: 01/16/2023] Open
Abstract
Background Mental disorders are more common in young adults than at any other life stage. Despite this, young people have low rates of seeking professional help for mental health problems. Young elite athletes have less positive attitudes toward seeking help than nonathletes and thus may be particularly unlikely to seek help. Interventions aimed at increasing help-seeking in young elite athletes are warranted. Objective To test the feasibility and efficacy of three Internet-based interventions designed to increase mental health help-seeking attitudes, intentions, and behavior in young elite athletes compared with a control condition. Methods We conducted a randomized controlled trial (RCT) of three brief fully automated Internet-based mental health help-seeking interventions with 59 young elite athletes recruited online in a closed trial in Australia. The interventions consisted of a mental health literacy and destigmatization condition, a feedback condition providing symptom levels, and a minimal content condition comprising a list of help-seeking resources, compared with a control condition (no intervention). We measured help-seeking attitudes, intentions and behavior using self-assessed surveys. Participation was open to elite athletes regardless of their mental health status or risk of mental illness. Results Of 120 athletes initially agreeing to participate, 59 (49%) submitted a preintervention or postintervention survey, or both, and were included in the present study. Adherence was satisfactory, with 48 (81%) participants visiting both weeks of assigned intervention material. None of the interventions yielded a significant increase in help-seeking attitudes, intentions, or behavior relative to control. However, at postintervention, there was a trend toward a greater increase in help-seeking behavior from formal sources for the mental health literacy/destigmatization condition compared with control (P = .06). This intervention was also associated with increased depression literacy (P = .003, P = .005) and anxiety literacy (P = .002, P = .001) relative to control at postintervention and 3-month follow-up, respectively, and a reduction in depression stigma relative to control at postintervention (P = .01, P = .12) and anxiety stigma at 3-month follow-up (P = .18, P = .02). The feedback and help-seeking list interventions did not improve depression or anxiety literacy or decrease stigmatizing attitudes to these conditions. However, the study findings should be treated with caution. Due to recruitment challenges, the achieved sample size fell significantly short of the target size and the study was underpowered. Accordingly, the results should be considered as providing preliminary pilot data only. Conclusions This is the first RCT of an Internet-based mental health help-seeking intervention for young elite athletes. The results suggest that brief mental health literacy and destigmatization improves knowledge and may decrease stigma but does not increase help-seeking. However, since the trial was underpowered, a larger trial is warranted. Trial Registration 2009/373 (www.clinicaltrials.gov ID: NCT00940732), cited at http://www.webcitation.org/5ymsRLy9r.
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Affiliation(s)
- Amelia Gulliver
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia.
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1420
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Clement S, Brohan E, Jeffery D, Henderson C, Hatch SL, Thornicroft G. Development and psychometric properties the Barriers to Access to Care Evaluation scale (BACE) related to people with mental ill health. BMC Psychiatry 2012; 12:36. [PMID: 22546012 PMCID: PMC3379935 DOI: 10.1186/1471-244x-12-36] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 04/30/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many people with mental illness do not seek or delay seeking care. This study aimed to develop, and provide an initial validation of, a comprehensive measure for assessing barriers to access to mental health care including a 'treatment stigma' subscale, and to present preliminary evidence about the prevalence of barriers experienced by adults currently or recently using secondary mental health services in the UK. METHODS The Barriers to Access to Care Evaluation scale (BACE) was developed from items in existing scales, systematic item reduction, and feedback from an expert group. It was completed in an online survey by 117 individuals aged 18 and over who had received care from secondary mental health services in the past 12 months. Internal consistency, test-retest reliability, convergent validity (correlation of treatment stigma subscale with the Stigma Scale for Receiving Psychological Help (SSRPH) and with the Internalised Stigma of Mental Illness Scale (ISMI)), respondent opinion and readability were assessed. RESULTS The BACE items were found to have acceptable test-retest reliability as all but one of the items exceeded the criterion for moderate agreement. The treatment stigma subscale had acceptable test-retest-reliability and good internal consistency. As hypothesised the subscale was significantly positively correlated with the SSRPH and the ISMI demonstrating convergent validity. The developmental process ensured content validity. Respondents gave the BACE a median rating of 8 on the 10-point quality scale. Readability scores indicated the measure can be understood by the average 11 to 12 year-old. The most highly endorsed barrier was 'concern that it might harm my chances when applying for jobs'. The scale was finalised into a 30-item measure with a 12-item treatment stigma subscale. CONCLUSIONS There is preliminary evidence demonstrating the reliability, validity and acceptability of the BACE. It can be used to ascertain key barriers to access to mental health care which may help to identify potential interventions to increase care seeking and service use. Further research is needed to establish its factor analytic structure and population norms.
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Affiliation(s)
- Sarah Clement
- Health Service and Population Research Department, Institute of Psychiatry, King’s College London, De Crespigny Park, London, SE5 8AF, UK
| | - Elaine Brohan
- Health Service and Population Research Department, Institute of Psychiatry, King’s College London, De Crespigny Park, London, SE5 8AF, UK
| | - Debra Jeffery
- Health Service and Population Research Department, Institute of Psychiatry, King’s College London, De Crespigny Park, London, SE5 8AF, UK
| | - Claire Henderson
- Health Service and Population Research Department, Institute of Psychiatry, King’s College London, De Crespigny Park, London, SE5 8AF, UK
| | - Stephani L Hatch
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK
| | - Graham Thornicroft
- Health Service and Population Research Department, Institute of Psychiatry, King’s College London, De Crespigny Park, London, SE5 8AF, UK
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1421
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Schauman O, Mansell W. Processes underlying ambivalence in help‐seeking: The loss of valued control model. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2012. [DOI: 10.1111/j.1468-2850.2012.01277.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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1422
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D'Avanzo B, Barbato A, Erzegovesi S, Lampertico L, Rapisarda F, Valsecchi L. Formal and informal help-seeking for mental health problems. A survey of preferences of italian students. Clin Pract Epidemiol Ment Health 2012; 8:47-51. [PMID: 22715343 PMCID: PMC3377873 DOI: 10.2174/1745017901208010047] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 02/17/2012] [Accepted: 02/26/2012] [Indexed: 11/22/2022]
Abstract
Help-seeking preferences for mental health are a crucial aspect to design strategies to support adolescents in an emotionally delicate life phase. Informal help-seeking is usually preferred but little was published about preferences in different cultures, and it is not clear whether informal and formal help are mutually exclusive or whether they are part of the same overall propensity to help-seeking. In a survey of 710 students in Milan, Italy, help-seeking propensity measured through an Italian version of the General Help-Seeking Questionnaire was high, similar in males and females (mean total score 3.8, DS 0.9); few (9%) tended not to seek help. The most-preferred source of help was a friend, then father or mother, partner, psychologist and psychiatrist. 355 students (55%) reported high propensity to seek both informal and formal help; 33 (5%) would only seek formal help. Help-seeking should be promoted in itself, rather than indicating professionals and professional settings as primary sources of help.
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Affiliation(s)
- Barbara D'Avanzo
- Mario Negri Institute for Pharmacological Research, Via La Masa 19 - 20156 Milan, Italy
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1423
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Wallerblad A, Möller J, Forsell Y. Care-Seeking Pattern among Persons with Depression and Anxiety: A Population-Based Study in Sweden. INTERNATIONAL JOURNAL OF FAMILY MEDICINE 2012; 2012:895425. [PMID: 22655197 PMCID: PMC3357962 DOI: 10.1155/2012/895425] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 02/29/2012] [Indexed: 06/01/2023]
Abstract
Background. In primary care, a vast majority of patients affected with depression and anxiety present with somatic symptoms. Detection rate of psychiatric symptoms is low, and knowledge of factors influencing care seeking in persons affected by depressive and anxiety disorders on a population level is limited. Objective. This study aims to describe if persons, affected by depression and anxiety disorders, seek care and which type of care they seek as well as factors associated with care seeking. Method. Data derives from a longitudinal population-based study of mental health conducted in the Stockholm County in 1998-2010 and the present study includes 8387 subjects. Definitions of anxiety and depressive disorders were made according to DSM-IV criteria, including research criteria, using validated diagnostic scales. 2026 persons (24%) fulfilled the criteria for any depressive or anxiety disorder. Results. Forty-seven percent of those affected by depression and/or anxiety had been seeking care for psychological symptoms within the last year. A major finding was that seeking care for psychological symptoms was associated with having treatment for somatic problems. Conclusions. As a general practitioner, it is of great importance to increase awareness of mild mental illness, especially among groups that might be less expected to be affected.
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Affiliation(s)
- Anna Wallerblad
- Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Norrbacka Plan 7, 17176 Stockholm, Sweden
| | - Jette Möller
- Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Norrbacka Plan 7, 17176 Stockholm, Sweden
| | - Yvonne Forsell
- Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Norrbacka Plan 7, 17176 Stockholm, Sweden
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1424
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1425
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Rickwood D, Bradford S. The role of self-help in the treatment of mild anxiety disorders in young people: an evidence-based review. Psychol Res Behav Manag 2012; 5:25-36. [PMID: 22427736 PMCID: PMC3304342 DOI: 10.2147/prbm.s23357] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Anxiety disorders are the most common mental health problems experienced by young people, and even mild anxiety can significantly limit social, emotional, and cognitive development into adulthood. It is, therefore, essential that anxiety is treated as early and effectively as possible. Young people are unlikely, however, to seek professional treatment for their problems, increasing their chance of serious long-term problems such as impaired peer relations and low self-esteem. The barriers young people face to accessing services are well documented, and self-help resources may provide an alternative option to respond to early manifestations of anxiety disorders. This article reviews the potential benefits of self-help treatments for anxiety and the evidence for their effectiveness. Despite using inclusive review criteria, only six relevant studies were found. The results of these studies show that there is some evidence for the use of self-help interventions for anxiety in young people, but like the research with adult populations, the overall quality of the studies is poor and there is need for further and more rigorous research.
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Affiliation(s)
- Debra Rickwood
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
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1426
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Yap MBH, Reavley NJ, Jorm AF. Intentions and helpfulness beliefs about first aid responses for young people with mental disorders: findings from two Australian national surveys of youth. J Affect Disord 2012; 136:430-42. [PMID: 22137764 DOI: 10.1016/j.jad.2011.11.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 11/07/2011] [Accepted: 11/07/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND Youths are important sources of first aid for people close to them who are experiencing mental health problems, but their skills are not optimal. A better understanding of predictors of young people's first aid intentions and beliefs will facilitate future efforts to improve their mental health first aid skills. METHODS Young people's first aid intentions and beliefs were assessed by a national telephone survey of 3746 Australian youth aged 12-25 years in 2006. A similar survey was repeated in 2011 with 3021 youths aged 15-25 years. In both surveys, youths were presented with a vignette portraying depression, psychosis, social phobia, or depression with alcohol misuse in a young person. The 2011 survey also included depression with suicidal thoughts and post-traumatic stress disorder. Respondents reported on any past-year experience of mental health problems and treatment, exposure to beyondblue and mental health information at school or work. RESULTS The potential value of encouraging professional treatment was not universally recognized, although young people were mostly aware of and reported the intention to take supportive actions. Respondent age, sex, experience of mental health problems, type of mental disorder, and exposure to mental health information at school, work, or beyondblue all predicted some intentions and beliefs. Some improvements in beliefs were observed between surveys. LIMITATIONS Actual first aid actions and their helpfulness were not measured. CONCLUSIONS Future efforts should target adolescents, males and those with recent mental health problems who had not received help. Beyondblue and school and work settings may be promising avenues for these efforts.
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Affiliation(s)
- Marie Bee Hui Yap
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia.
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1427
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Moessner M, Bauer S. Online counselling for eating disorders: reaching an underserved population? J Ment Health 2012; 21:336-45. [PMID: 22251091 DOI: 10.3109/09638237.2011.643512] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND A substantial proportion of individuals suffering from eating disorders (ED) seek help late and many never access treatment. Internet-based services may have the potential to reach these underserved individuals by providing low-intense support and facilitating access to regular healthcare. METHOD Two hundred and thirty-eight individuals who used a counselling service for ED via email and/or moderated forums were surveyed. Acceptance of the service, users' satisfaction, utilization of other services, and attitudes towards Internet-based interventions were assessed. RESULTS Participants reported substantial ED symptoms (67.4% reported bingeing, 42.2% self-induced vomiting, and 18.0% a body mass index below 17.5). Both forum and email counselling were rated very positively. More than half of the participants (57.3%) stated that this was the first time they ever accessed professional help. Half of these reported that they engaged in additional services after registering for the online program and most of them stated that they would have not done so without the online service. DISCUSSION The Internet-based service proved well-accepted in the target group. It reaches a substantial percentage of individuals with ED-related impairment that would have stayed without any professional support otherwise. The service also facilitated access to the regular healthcare system for a subgroup of participants.
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Affiliation(s)
- Markus Moessner
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany.
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1428
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Bagnell AL, Santor DA. Building mental health literacy: opportunities and resources for clinicians. Child Adolesc Psychiatr Clin N Am 2012; 21:1-9, vii. [PMID: 22137807 DOI: 10.1016/j.chc.2011.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Youth mental health is increasingly recognized as a key concern with significant impact on youth and society. School is the one setting where professionals are consistently available to monitor how children are functioning and learning and intervene and support. School psychiatry has expanded beyond individual mental health problems to school-wide and community issues including school violence, sexual harassment, bullying, substance abuse, discrimination, and discipline. This article describes the importance of mental health literacy in health outcomes and research in school-based mental health programs to better position the clinician to advocate at the individual and/or system level.
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Affiliation(s)
- Alexa L Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
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1429
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Optimistic bias in help-seeking intentions and behaviors for depressive symptoms. ACTA ACUST UNITED AC 2012; 83:430-9. [DOI: 10.4992/jjpsy.83.430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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1430
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Bussing R, Koro-Ljungberg M, Noguchi K, Mason D, Mayerson G, Garvan CW. Willingness to use ADHD treatments: a mixed methods study of perceptions by adolescents, parents, health professionals and teachers. Soc Sci Med 2012; 74:92-100. [PMID: 22133584 PMCID: PMC3253014 DOI: 10.1016/j.socscimed.2011.10.009] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 08/17/2011] [Accepted: 10/05/2011] [Indexed: 12/17/2022]
Abstract
Little is known about factors that influence willingness to engage in treatment for attention deficit/hyperactivity disorder (ADHD). From 2007 to 2008, in the context of a longitudinal study assessing ADHD detection and service use in the United States, we simultaneously elicited ADHD treatment perceptions from four stakeholder groups: adolescents, parents, health care professionals and teachers. We assessed their willingness to use ADHD interventions and views of potential undesirable effects of two pharmacological (short- and long-acting ADHD medications) and three psychosocial (ADHD education, behavior therapy, and counseling) treatments. In multiple regression analysis, willingness was found to be significantly related to respondent type (lower for adolescents than adults), feeling knowledgeable, and considering treatments acceptable and helpful, but not significantly associated with stigma/embarrassment, respondent race, gender and socioeconomic status. Because conceptual models of undesirable effects are underdeveloped, we used grounded theory method to analyze open-ended survey responses to the question: "What other undesirable effects are you concerned about?" We identified general negative treatment perceptions (dislike, burden, perceived ineffectiveness) and specific undesirable effect expectations (physiological and psychological side effects, stigma and future dependence on drugs or therapies) for pharmacological and psychosocial treatments. In summary, findings indicate significant discrepancies between teens' and adults' willingness to use common ADHD interventions, with low teen willingness for any treatments. Results highlight the need to develop better treatment engagement practices for adolescents with ADHD.
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Affiliation(s)
- Regina Bussing
- Department of Psychiatry, University of Florida, Gainesville, FL 32610, United States.
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1431
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Reavley NJ, Jorm AF. Recognition of mental disorders and beliefs about treatment and outcome: findings from an Australian national survey of mental health literacy and stigma. Aust N Z J Psychiatry 2011; 45:947-56. [PMID: 21995330 DOI: 10.3109/00048674.2011.621060] [Citation(s) in RCA: 145] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of the study was to carry out a national survey in order to assess recognition and beliefs about treatment for affective disorders, anxiety disorders and schizophrenia/psychosis. METHOD In 2011, telephone interviews were carried out with 6019 Australians aged 15 or over. Participants were presented with a case vignette describing either depression, depression with suicidal thoughts, early schizophrenia, chronic schizophrenia, social phobia or post-traumatic stress disorder (PTSD). Questions were asked about what was wrong with the person, the likely helpfulness of a broad range of interventions and the likely outcomes for the person with and without appropriate treatment. RESULTS Rates of recognition of depression were relatively high, with almost 75% of respondents using the correct label. Rates of recognition for the schizophrenia vignettes and PTSD were similar, with around one third of respondents using the correct labels. Only 9.2% of respondents were able to correctly label social phobia. Respondents gave the highest helpfulness ratings to GPs, counsellors, antidepressants, antipsychotics (for schizophrenia) and lifestyle interventions such as physical activity, relaxation and getting out more. Respondents were generally optimistic about recovery following treatment, although relapse was seen as likely. CONCLUSIONS While Australians' beliefs about effective medications and interventions for mental disorders have moved closer to those of health professionals since surveys conducted in 1995 and 2003/4, there is still potential for mental health literacy gains in the areas of recognition and treatment beliefs for mental disorders. This is particularly the case for schizophrenia and anxiety disorders, which are less well recognized and, in the case of social phobia, generally perceived as having less need for professional help.
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Affiliation(s)
- Nicola J Reavley
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia.
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1432
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Allgaier AK, Schiller Y, Schulte-Körne G. Wissens- und Einstellungsänderungen zu Depression im Jugendalter. KINDHEIT UND ENTWICKLUNG 2011. [DOI: 10.1026/0942-5403/a000062] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Es bestehen nach wie vor Wissenslücken und Stigmata bei Jugendlichen bezüglich Depression und Suizidalität. Erste internationale Initiativen für Jugendliche zeigen, dass bereits niederschwellige Maßnahmen zu einer signifikanten Wissenszunahme und Einstellungsänderung führen können. Evaluationsstudien zu depressionsspezifischen Aufklärungsmaterialien im Jugendalter fehlen jedoch bislang. Um diese Lücke zu schließen, wurde eine Aufklärungsbroschüre zu Depression für Jugendliche mit dem Ziel entwickelt, spezifisches Wissen zu vermitteln und Vorurteile abzubauen. An einer Stichprobe von 156 Schülern der neunten Jahrgangsstufe wurde die Broschüre in einer Prä-Post-Erhebung evaluiert. Nach Korrektur für multiples Testen zeigten sich für 32 der 50 Fragebogenitems signifikante Veränderungen bezüglich Wissen und Einstellungen. Besonders deutliche Effekte wurden in den Kategorien „Symptome“ und „Antidepressiva“ erreicht. Die größten Verbesserungen wiesen Gymnasiasten auf, gefolgt von Real- und Hauptschülern. Die Akzeptanz der Aufklärungsbroschüre wurde anhand der Kategorien „Gestaltung“, „Inhalt“ und „Nutzen“ erfasst. Die Jugendlichen beurteilten die Broschüre in allen Kategorien positiv und vergaben als Gesamtbewertung die Schulnote „gut“.
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Affiliation(s)
- Antje-Kathrin Allgaier
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie Klinikum der Ludwig-Maximilians-Universität München
| | - Yvonne Schiller
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie Klinikum der Ludwig-Maximilians-Universität München
| | - Gerd Schulte-Körne
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie Klinikum der Ludwig-Maximilians-Universität München
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1433
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Reavley NJ, Jorm AF. Young people's recognition of mental disorders and beliefs about treatment and outcome: findings from an Australian national survey. Aust N Z J Psychiatry 2011; 45:890-8. [PMID: 21942746 DOI: 10.3109/00048674.2011.614215] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of the study was to carry out a national survey in order to assess young people's recognition and beliefs about treatment for depression, anxiety disorders and schizophrenia/psychosis. METHOD In 2011, telephone interviews were carried out with 3021 Australians aged between 15 and 25 years. Participants were presented with a case vignette describing either depression, depression with suicidal thoughts, depression with alcohol misuse, psychosis/schizophrenia, social phobia or post-traumatic stress disorder (PTSD). Questions were asked about what was wrong with the person, help-seeking intentions and the likely helpfulness of a broad range of interventions. RESULTS Rates of recognition of depression were relatively high, with almost 75% of respondents using the correct label. Rates of recognition for the psychosis (schizophrenia) and PTSD vignettes were similar, with around one third of respondents using the correct labels. Only 3% of respondents were able to correctly label social phobia. Intentions to seek help were highest for depression with suicidal thoughts and lowest for social phobia, with family members nominated the most likely sources of help across all vignettes. CONCLUSIONS Most young people believe in the importance of seeking professional help and they have good recognition of depression. However, there is still potential for young people's mental health literacy to improve in the areas of recognition and treatment beliefs for all the mental disorders covered in this survey, particularly social phobia which has very low recognition rates and a lower perceived need for treatment.
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Affiliation(s)
- Nicola J Reavley
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria 3052, Australia.
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1434
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Christensen H, Reynolds J, Griffiths KM. The use of e-health applications for anxiety and depression in young people: challenges and solutions. Early Interv Psychiatry 2011; 5 Suppl 1:58-62. [PMID: 21208393 DOI: 10.1111/j.1751-7893.2010.00242.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM E-health applications are effective. However, challenges to their uptake amongst youth need to be investigated. This paper aims to explore the barriers to the use of these programs by young people and the methods by which these barriers might be overcome. METHODS Qualitative review of research literature. RESULTS Barriers to the use of these programs included the difficulty in engaging young people in their use, perceptions that the programs have low adherence, and clinician concerns about their value, effectiveness and safety. Evidence to date suggests that more research is needed to understand the reasons more young people do not engage with them. However, adherence rates are reasonable when properly benchmarked and the applications can be appropriately implemented in clinical and educational settings. CONCLUSIONS Optimal methods for implementing these applications will require further targeted research.
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Affiliation(s)
- Helen Christensen
- Centre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia.
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