Supporting nursing degree apprentices: advice for higher education institutions and employers

A nursing degree apprenticeship offers an alternative route into nursing from the traditional preregistration nurse education programme by enabling apprentice employees to work and study at the same time. This route could address some of the issues associated with attrition from preregistration nurse education programmes, such as financial challenges. However, nursing degree apprentices may experience other challenges, for example suboptimal work-life-study balance and inadequate support from employers and higher education institutions (HEIs), resulting in dissatisfaction with or non-completion of their apprenticeship programme. This article examines some of the literature on apprenticeships and suggests ways in which employers, HEIs and nursing degree apprentices can work together to improve the apprenticeship experience.

Prevalence of fibromyalgia among university students and its impact on their health-related quality of life: a survey-based study from Egypt

BACKGROUND

University students are more likely to experience stress, anxiety, and depression. All these factors are regarded as psychological contributors to fibromyalgia syndrome (FMS).

AIM

To investigate the prevalence and determinants of FMS among university students and its impact on their health-related quality of life (HRQoL).

METHODS

This online survey-based study involved 2146 university students who were recruited from various faculties at several Egyptian universities. The participants' demographics, medical history, academic pursuits, and sleep data were collected. To identify the existence of FMS, the 2016 updates to the 2010/2011 FMS diagnostic criteria were used. Additionally, the participants completed the Short-Form Health Survey-36 (SF-36).

RESULTS

The mean age was 21.26 ± 2.015 years and 76% were females. Of 2146 students, 266 (12.4%) fulfilled the criteria of FMS. FMS group had a significantly lower age (p < 0.001) with predominant female gender (89.5% vs. 74.1%, p < 0.001), positive family history of FMS (8.6% vs. 3.7%, p < 0.001), previous history of traffic accident (10.2% vs. 6.8%, p = 0.045), lower level of physical activity (p = 0.002),higher time spent in study per week (p = 0.002), lower sleep time (p = 0.002), with frequent walk up (p < 0.001) and snoring (p < 0.001) during sleep. Regarding HRQoL, students with FMS had significantly lower scores than students without in all domains.

CONCLUSION

FMS is prevalent among Egyptian university students and is linked to female gender, positive family history, lower levels of physical activity, and more time spent studying each week. FMS has a negative impact on HRQoL. Therefore, early detection and treatment are recommended.

'We need to get paid for our value': Work-place experiences and role definitions of peer recovery specialists/community health workers

Despite growing research on peer recovery specialists and community health workers (CHWs) in fields such as substance use disorder (SUD) treatment and recovery support, their workplace experiences are little understood. Through semi-structured interviews with 21 CHWs and peer recovery specialists working within substance use disorder treatment and/or traditional health care settings, we identified six prevalent themes: Benefits/Pleasures of the Role; Reciprocity; Challenges; Duality of Lived Experience; Relationships with Medical Professionals and Supervisors; and Defining Metrics. These themes reveal a complex narrative of system failures, organizational hierarchies, and experiential realities in which shared experiences and personal connections with clients undergird both positive and negative aspects of the role. In the words of one study participant: "We have not taken a vow of poverty, we need to get paid for our value."

A bridge to recovery: an interpretative phenomenological analysis with peer support specialists in Singapore

Recovery-oriented mental health care approach is gaining acceptance in Asian countries, including Singapore. Following Western countries, Singapore started hiring peer support specialists (PSS) as part of mental healthcare services. The aim of this paper was to explore and understand how individual peer support specialists in Singapore perceive and make sense of their role given their unique perspective as both recipients and providers of mental healthcare treatment. Six PSS in Singapore were interviewed utilizing a semi-structured interview schedule. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis. Four superordinate themes were generated illustrating how PSS viewed their role: embracing and embodying recovery, balancing on a bridge, impossible without support, and helping to end stigma. Findings also illustrated participants' awareness of the nature of the job and the role of PSS as still in the infancy stage. They embraced a recovery-oriented mindset despite experiencing stigma from professionals and/or their social support. The need to understand familial attitudes towards the PSS role is discussed. The limitations, contributions to the research, and several areas for future research are also outlined.

Preparing undergraduate student paramedics to consider their mental health during clinical placement in Australia

INTRODUCTION

This article explores the impact of mental health issues on paramedics in Australia, particularly Post-Traumatic Stress Disorder, caused by their exposure to high levels of stress. The prevalence of Post-Traumatic Stress Disorder is higher among paramedics than any other occupation, and this could be a cause for concern, especially for undergraduate student paramedics. The article examines the need to build resilience among student paramedics to help them handle the trauma they may experience during clinical placement.

METHODS

This study conducted a two-step process to review literature and university handbooks to determine the level of education provided to paramedic students on Post-Traumatic Stress Disorder and resilience during clinical placement, due to the lack of research in this area. The first step involved a search for relevant articles, while the second step involved a search of the Australian Health Practitioner Regulation Agency website to identify paramedicine programs and a manual evaluation of each undergraduate pre-registration paramedicine curriculum in Australia.

RESULTS

This study conducted a systematic search of national and international literature and Australian undergraduate pre-registration paramedicine programs to identify any studies pertaining to the education of paramedic students in resilience and Post Traumatic Stress Disorder. The search found that only 15 (5.95 %) of the 252 reviewed subjects had reference to mental health, resilience or Post-Traumatic Stress Disorder, with only 4 (1.59 %) of them discussing these topics in preparation for clinical practice. The study highlights the lack of emphasis on student paramedic self-care as an essential underpinning for clinical placement preparation in the curriculum.

CONCLUSION

This literature review concludes that appropriate training and support, teaching resilience, and promoting self-care are crucial in preparing paramedic students for the emotional and psychological demands of their work. Equipping students with these tools and resources can improve their mental health and well-being and enhance their ability to provide high-quality care to patients. Promoting self-care as a core value in the profession is essential in creating a culture that supports paramedics in maintaining their own mental health and well-being.

Mental health literacy of undergraduate radiography students in Zimbabwe

INTRODUCTION

Assessing the Mental Health Literacy (MHL) of students is crucial in having an understanding of mental health knowledge gaps, stigma, wrong beliefs, risk factors, and treatment-seeking behaviour. The aim of this study was to use a validated scale to examine the MHL of radiography students at a tertiary institution in Harare, Zimbabwe.

METHODS

A cross-sectional descriptive survey was conducted to assess the MHL of radiography students at a tertiary institution in Harare, Zimbabwe, using a validated MHL scale. Individual t-tests and analysis of variance (ANOVA) tests were conducted for each variable to examine the differences between groups expected to differ in their MHL.

RESULTS

A total of 89 students were enrolled into the study. The overall mean MHL score was 96.62 (SD-9.55), with students less knowledgeable on environmental, social, familial, or biological factors that increase the risk of developing a mental illness. Gender had no statistically significant effect on the overall score, t(83) = -0.81, p = 0.42 [Males had mean score = 95.64, SD = 10.14; and Females had mean score = 97.35, SD = 9.12]]. However, there was a significant difference in recognition of disorders by gender, t(83) = -2.42, p = 0.02, with female students (M = 26.24, SD =2.68) scoring higher than male students (M =24.69, SD =3.21). In addition, students with a previous history of mental health disorders scored higher (M =26.86, SD = 2.19) than those with no previous history (M =25.47, SD =3.04), however the difference was not statistically significant.

CONCLUSION

The students in the current study demonstrated lower MHL compared to most studies in the literature. Students were less knowledgeable about environmental, social, familial, or biological factors that increase the risk of developing a mental illness. Furthermore, a correlation between MHL and mental health experience was demonstrated. The implication of these findings is that the curriculum ought to be developed to help undergraduate radiography students become more knowledgeable about mental health and comfortable seeking appropriate support.

Perceptions of learning and teaching human movement in physiotherapy: A systematic review and metasynthesis of qualitative studies

PURPOSE

Human movement is essential for health and well-being. Understanding human movement is pivotal in physiotherapy, but also an important element of physiotherapy education. This review identified, critically appraised, and synthesized the available evidence on learning and teaching human movement in physiotherapy as perceived by students, therapists, and instructors.

METHODS

The databases MEDLINE, CINAHL, ERIC, PsycINFO, MEDIC and FINNA, were searched. The search was conducted in March/April 2020 and updated in March 2022. The systematic review followed the JBI methodology for systematic reviews of qualitative evidence and was conducted in accordance with an a priori protocol.

RESULTS

The overall quality of the 17 included studies was scored low on ConQual but dependability and credibility were rated as moderate. Four synthesized findings aggregated from 17 categories and 147 findings described the perceived significance of 1) being present in movement, 2) movement quality, 3) movement transfer, and 4) contextual factors for the learning or teaching of human movement in physiotherapy.

CONCLUSION

The synthesized findings indicate that the perceived significance of contextual factors, movement quality and transfer, and being present in movement should be considered in all learning and teaching of movement in physiotherapy. However, the evidence of the review findings was evaluated as low-level, which should be considered when applying these results to physiotherapy education or practice.

Evaluation of a new online cognitive remediation therapy (CIRCuiTSTM ) training for mental health professionals

OBJECTIVE

Cognitive remediation (CR) improves cognition and aids recovery in people with psychosis. An active therapist provides increased benefit, but CR training for therapists is not routinely available, so CR has limited scalability. This study describes the development and evaluation of the first online CR therapist training programme.

METHODS

An online CR training, based on expert and novice therapist consultations, was developed, and then pilot tested with novice trainees and changes made to produce the evaluation version. Feasibility, acceptability, and training benefits were assessed in a group of naïve UK NHS mental health professionals. Training engagement with a group of clinicians who accessed the programme for professional development was compared to those who paid fees.

RESULTS

Most mental health professionals finished training and passed the knowledge test, indicating that training enhanced clinicians' knowledge. Fee-paying trainees had significantly faster completion times and a higher proportion finished in the recommended time. Those who were successful at passing the knowledge questionnaire had significantly fewer years in practice. The majority were satisfied with the programme, felt they had made considerable progress and that training would allow them to begin practicing CR, and would recommend the training to colleagues.

CONCLUSIONS

This online CR training programme was feasible, acceptable to participants and showed benefits for clinicians. It improved knowledge even in the most junior of staff who have had less time to develop clinical know-how.

Association between psychological distress and mental help-seeking intentions in international students of national university of Singapore: a mediation analysis of mental health literacy

BACKGROUND

International students encounter a wide range of challenges that can have a significant impact on their mental health. Seeking help is one of the primary means of managing mental health, and more attention is required. This study aimed to investigate the psychological distress(PD), mental health literacy(MHL), and mental help-seeking intentions(MHSI) in international students of National University of Singapore(NUS), to explore the correlation between the three and to verify the mediating role of MHL in PD and MHSI.

METHODS

This cross-sectional study was conducted between May and July 2023 using the Mental Help Seeking Intention Scale(MHSIS), Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder-7(GAD-7), and Mental Health Literacy Scale(MHLS). 281 international students(177 males, 104 females;) in NUS completed self-report questionnaires. SPSS 25.0 was applied to the data for descriptive analysis, Pearson correlation analysis and stepwise regression analysis. Mediation analysis fully for all potential confounding factors were conducted.

RESULTS

Significant correlations were found between PD, MHL and MHSI. MHLS- knowledge of how to seek professional information(MHLS- H) completely mediated the association of anxiety with MHSI[B=-0.271; 95% confidence interval(CI): (-0.067, 0.0037)]; MHLS- attitude that promote recognition or appropriate help-seeking behavior(stigma)(MHLS- H) partially mediated the association of PD with MHSI[B = 0.104, 95% CI: (0.008, 0.179)]; with mediating effects accounting for 100% and 24.847% of the total effect. In addition, demographic variables such as gender, years in Singapore and residence type mediated both the direct and indirect effect of the mediation model.

CONCLUSIONS

MHL mediated both the direct and indirect effects on the association between PD and MHSI, especially, the mediator of the MHLS- H and MHL-A. It means that MHSI in this population can be improved by increasing MHL and thus the PD. The findings suggest that, such as providing information about how to access to professional services and promoting disorder recognition to the international students, may help them develop their psychological well-being and good mental health care decisions.

Suicidal thoughts and behaviours among student nurses and midwives: A systematic review

AIM

To synthesize research investigating suicide, suicide attempts, self-harm and suicide ideation in nursing and midwifery students, a group of interest due to high rates of suicide among qualified nurses. Specific areas of interest for this review included prevalence, factors which may contribute to or mitigate risk and suicide prevention interventions.

DESIGN

A systematic review was conducted, and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed.

DATA SOURCES

Three electronic databases were searched, and additional articles identified using hand-searching. Studies were included if they examined suicide, suicide attempts, self-harm or suicide ideation in nursing or midwifery students.

REVIEW METHODS

Studies were deduplicated and assessed for inclusion. Data from included studies were extracted, quality of studies assessed and data synthesized, informed by study focus, design and assessed quality.

RESULTS

About 46 studies of largely moderate to low quality were identified. A high-quality study demonstrated increased risk of suicide in Swedish female nursing students, and increased risk of self-harm in nursing students of both sexes. Prevalence of suicide ideation did not appear to differ across course year, or between nursing students and students on other programmes. Psychiatric conditions, particularly depression, were associated with suicide ideation. Three studies related to suicide prevention interventions were identified. Integration of wellness initiatives into the curriculum and peer support were preferred interventions among nursing students and teaching staff.

CONCLUSIONS

To understand the extent of suicide and self-harm among nursing and midwifery students there is a need for further epidemiological research stratified by programme of study. To develop prevention interventions and initiatives for nursing students, high-quality longitudinal studies should examine characteristics associated with suicide and self-harm.

IMPACT

Current findings suggest interventions could include support for students experiencing mental health difficulties, foster peer support, and help develop wellness. No patient or public contribution.

The PhotoVoice method for collaborating with people with lived experience of mental health conditions to strengthen mental health services

There is a growing recognition of the benefits of collaborating with people with lived experience (PWLE) of mental health conditions in mental health research and implementation of services. Such collaboration has been effective in reducing mental health stigma and improving the quality of mental health care. Here, we describe using PhotoVoice as a collaborative method in which PWLE use visual narratives to tell their recovery stories for promoting social contact, debunking myths and reducing stigma. First, we outline the framework of this collaboration, drawing on theories from medical anthropology and social psychology and focusing on reducing mental health stigma among primary healthcare workers. Then, we describe the process using our learnings from implementing PhotoVoice in Nepal, Ethiopia and Uganda. We highlight collaboration in five key steps with associated considerations: (1) identifying PWLE for collaboration; (2) training in photography, distress management and presentation skills; (3) developing a photographic recovery story; (4) training healthcare workers using the PhotoVoice narratives; and (5) ongoing support of mental health systems strengthening in collaboration with PWLE. Then, we critically reflect on the process, highlighting the benefits and challenges to the participants and researchers, thereby paving the way for expanding collaborations with PWLE using the PhotoVoice method.

Intentions to Help People at Risk of Suicide and Associated Factors: A National Telephone Survey in Taiwan

OBJECTIVE

Many people at risk of suicide do not actively seek help. Suicide prevention efforts need to involve the general public to provide appropriate support to those in need. It is important to investigate the intention to help those at risk of suicide and the factors associated with helping intentions in the general population. We aimed to assess the intention to help people at risk and associated factors using a national representative sample.

METHOD

We conducted a national telephone survey of 1,087 Taiwanese adults and collected data regarding participants' socio-demographic characteristics, mental health status, helping intentions, misconceptions about suicide, and attitudes toward suicide and suicide prevention.

RESULTS

The prevalence of high intentions to help people at risk of suicide was 56.5%. Helping intentions did not differ by sex, educational level, employment status, marital status, or mental health status. Those with high helping intentions were younger, less likely to have misconceptions about suicide or agree that suicide is a personal choice, and more likely to believe that suicide is preventable and support suicide prevention measures.

CONCLUSIONS

Suicide prevention education programs aimed to enhance helping intentions may usefully target debunking misconceptions about suicide and cultivating positive attitudes toward suicide prevention.

Alcohol-related dementia

Dementia is one of the leading causes of death both in the UK and worldwide. Approximately 1 million people have been diagnosed with this condition in the UK. Although there are many types of dementia, this article will focus on alcohol-related dementia. Alcohol has become a leading cause of death in the 50-69-year age group in England, and with consumption rising rapidly, there is an increased risk that young and middle-aged people will develop alcohol-related dementia in the future. The aim of this article is to review the evidence base and discuss whether alcohol-related dementia is a sub-class of dementia or a separate entity.

What do we not know (yet) about recovery colleges? A study protocol on their (cost-)effectiveness, mechanisms of action, fidelity and positioning

BACKGROUND

Recovery Colleges (RCs) have spread across the globe as a new way of supporting people with mental vulnerabilities in their recovery journey. RCs focus on 'learning' rather than 'curing' and in that line facilitate a transition from being a passive, dependent patient/client to an active, empowered student learning to live life, despite vulnerabilities. Peer support and co-creation are central in RCs, as peers learn from each other by sharing personal experiences with mental vulnerabilities in an accessible, inspiring and stimulating atmosphere. The implementation of RCs is highly encouraged internationally, and as a result RCs and related self-help initiatives increasingly emerge. However, high-quality research on RCs is scarce and there is a call for thorough investigation of (cost-)effectiveness, mechanisms of action, cross-border fidelity and positioning of RCs. In response, this research project aims to fill these gaps.

METHODS

This research project entails (1) a prospective quasi-experimental effectiveness study and economic evaluation, (2) a multifaceted qualitative study to elaborate on the mechanisms of action of RCs for those involved (3) a study to develop a (Dutch) Fidelity Measure of Recovery Colleges, and (4) an organisational case study to describe the positioning of RCs in relation to other mental health care services and community-based initiatives. Following the ideals of co-creation and empowerment in RCs we conduct this research project in co-creation with RC students from Enik Recovery College in Utrecht, the Netherlands.

DISCUSSION

This research project will lead to one of the first longitudinal controlled quantitative evaluations of both cost-effectiveness and effectiveness of RC attendance in a broad sense (beyond attending courses alone). Moreover, we will gather data on a micro level (i.e., impact on RC students), meso level (i.e., organisational fidelity) and macro level (i.e., positioning in the care and support domain), capturing all important perspectives when scrutinizing the impact of complex systems. Finally, we will demonstrate the validity and value of embracing experiential knowledge in science as a complementary source of information, leading to a more profound understanding of what is researched.

TRIAL REGISTRATION

The prospective quasi-experimental study has been pre-registered at clinicaltrails.gov (#NCT05620212).

"What makes discovery college different?" a co-produced analysis of student experiences of discovery college

BACKGROUND

Recovery colleges are an education-based approach to supporting mental health recovery that incorporate the voice of both lived and living experience, and experience by training in their design, production, and delivery.

AIMS

To understand students' experiences of attending a youth-focused 'discovery college' course. Specifically, to see whether students were satisfied with the course, whether the learning goals of the courses were met, and what students felt makes discovery college different.

METHODS

A mixed methods design analysed quantitative data on students' ratings of the course and their learning goals. A co-produced thematic analysis, incorporating the voice of lived and living experience, was also conducted on students' responses to the question "what makes discovery college different?"

RESULTS

Overall, students rated their experience with the course very positively, and mostly met the learning goals of courses. The co-produced thematic analysis revealed students valued the incorporation of lived and living experience in courses, the lack of power imbalance between teachers and students, and felt it was a safe space to share and learn.

CONCLUSIONS

Findings support the delivery of the recovery college model within a youth setting, and highlights this as a useful initiative in engaging people from a range of perspectives in education about mental health.

Implementing mental health support teams in schools and colleges: the perspectives of programme implementers and service providers

Background: Between 2018 and 2025, a national implementation programme is funding more than 500 new mental health support teams (MHSTs) in England, to work in education settings to deliver evidence-based interventions to children with mild to moderate mental health problems and support emotional wellbeing for all pupils. A new role, education mental health practitioner (EMHP), has been created for the programme.Aims: A national evaluation explored the development, implementation and early progress of 58 MHSTs in the programme's first 25 'Trailblazer' sites. This paper reports the views and experiences of people involved in MHST design, implementation and service delivery at a local, regional and national level.Methods: Data are reported from in-depth interviews with staff in five Trailblazer sites (n = 71), and the programme's regional (n = 52) and national leads (n = 21).Results: Interviewees universally welcomed the creation of MHSTs, but there was a lack of clarity about their purpose, concerns that the standardised CBT interventions being offered were not working well for some children, and challenges retaining EMHPs.Conclusions: This study raises questions about MHSTs' service scope, what role they should play in addressing remaining gaps in mental health provision, and how EMHPs can develop the skills to work effectively with diverse groups.

Psychometric Properties of Psychosexual Functioning Survey Among Autistic and Non-autistic Adults: Adapting the Self-Report Teen Transition Inventory to the U.S. Context

Psychosexual functioning is an important aspect of human development and relationships. A previous study investigated psychosexual functioning of autistic adolescents using the Teen Transition Inventory (TTI), but there is a lack of comprehensive measurement of psychosexual functioning among autistic and non-autistic (NA) adults. To address this gap, the current study adapted the self-report TTI to the Psychosexual Functioning Survey (PSFS) and presented it to 131 autistic (n = 59) and NA adults (n = 72) in the U.S. Comparisons of psychometric properties between the original TTI and the PSFS are shared; the developmental relevancy among some items was changed, and the alphas indicated a difference in the content of certain scales. Differences emerged between autistic and NA adults in both the intra- and interpersonal domains of psychosexual functioning, but not in sexual and intimate behaviors. The findings suggest the persistence of differences from adolescence to adulthood between autistic and NA people and highlight the importance of understanding the unique experiences of adults in psychosexual functioning relative to diagnostic status.

Mental health symptoms and their associated factors among pharmacists in psychiatric hospitals during the early stage of the COVID-19 pandemic

As frontline workers, pharmacists often face significant work stress, especially in psychiatric settings. A multicenter cross-sectional design was conducted in 41 psychiatric hospitals. The Depression, Anxiety and Stress Scale-21 (DASS-21) was used to measure the mental health of 636 pharmacists. We also collected demographic data and work-related variables. The prevalence of depression, anxiety and stress was 20.60%, 22.96% and 8.96%, respectively. Multivariate logistic regression showed that several common factors were associated with depression, anxiety and stress, including professional identity (odds ratio [OR] = 0.132, 0.381 and 0.352) and verbal violence (OR = 2.068, 2.615 and 2.490). Those who were satisfied with their job were less likely to develop depression (OR = 0.234) or anxiety (OR = 0.328). We found specific factors associated with mental health. Older age (OR = 1.038) and perceived negative impact (OR = 2.398) of COVID-19 on medical work were associated with anxiety, and those with frontline experience with COVID-19 patients (OR = 2.306) were more likely to experience stress. More than one-fifth of pharmacists in psychiatric hospitals experienced symptoms of depression or anxiety during the pandemic, highlighting the need for policy change to improve workplace conditions and psychological well-being for this professional group.

Freely Available Training Videos for Suicide Prevention: Scoping Review

BACKGROUND

Freely available and asynchronous implementation supports can reduce the resource burden of evidence-based practice training to facilitate uptake. Freely available web-based training videos have proliferated, yet there have been no efforts to quantify their breadth, depth, and content for suicide prevention.

OBJECTIVE

This study presents results from a scoping review of freely available training videos for suicide prevention and describes a methodological framework for reviewing such videos.

METHODS

A scoping review of freely available training videos (≥2 minutes) for suicide prevention practices was conducted using 4 large video-sharing platforms: YouTube, Vimeo, Bing Video, and Google Video. Identified suicide prevention training videos (N=506) were reviewed and coded.

RESULTS

Most content was targeted toward gatekeepers or other lay providers (n=370) versus clinical providers (n=136). Videos most commonly provided content related to suicidal thoughts or behaviors (n=420). Many videos (n=274, 54.2%) included content designed for certain communities or organizations. Less than half (n=232, 45.8%) of training videos included formal clinical content pertaining to assessment or intervention for suicide prevention.

CONCLUSIONS

Results suggested an abundance of videos providing broad informational content (eg, "signs and symptoms of someone at risk for suicide") and a limited portion of videos with instructional content aimed at clinical providers delivering formal evidence-based assessments or interventions for suicide prevention. Development of resources to address identified gaps may be needed. Future work may leverage machine learning techniques to expedite the review process.

Medication-related problems identified by community pharmacists: a descriptive case study of two Australian populations

BACKGROUND

Medication-related problems (MRPs) contribute significantly to preventable patient harm and global healthcare expenditure. Vulnerable populations, including Indigenous Australians (please note that the use of the term 'Indigenous' in this paper includes all Aboriginal and Torres Strait Islander people and acknowledges their rich traditions and heterogenous cultures.) and people living with severe and persistent mental illness (SPMI), may be at increased risk of MRPs. Pharmacist-led medication reviews can identify MRPs for targeted action.

OBJECTIVE

To characterize MRPs identified and recommendations made by community pharmacists during medication reviews conducted with Indigenous Australians and people living with SPMI.

METHODS

Participants were recruited through two Australian trials testing the feasibility and/or effectiveness of novel community pharmacist-led interventions, the Indigenous Medication Review Service (IMeRSe) feasibility study (June 2018-July 2019) and Bridging the Gap between Physical and Mental Illness in Community Pharmacy (PharMIbridge) randomized controlled trial (September 2020-December 2021). Trained community pharmacists conducted medication reviews responsive to the cultural and health needs of participants. MRPs, MRP severity and pharmacist recommendations were documented and classified using an established classification system (DOCUMENT). MRP severity was assessed by pharmacists and an independent assessor. Data were analysed descriptively, and paired t-tests were used to compare severity ratings.

RESULTS

Pharmacists identified 795 MRPs with 411 participants across both trials (n = 255 IMeRSe, n = 156 PharMIbridge). Non-adherence to medication was the most common (n = 157, 25.1%) and second-most common (n = 25, 14.7%) MRP in IMeRSe and PharMIbridge, respectively. Undertreatment was the second-most common MRP in the sample of Indigenous Australians (n = 139, 22.2%), and reports of toxicity/adverse reactions were most common in people living with SPMI (n = 41, 24.1%). A change in pharmacotherapy was the most frequent recommendation made by pharmacists (40.2% and 55.0% in IMeRSe and PharMIbridge, respectively). Severity ratings varied, with the majority being 'Mild' or 'Moderate' in both groups. Significant differences were found in the severity rating assigned by trial pharmacists and the independent assessor.

CONCLUSIONS

Community pharmacists identified a range of MRPs experienced by two at-risk populations, most commonly non-adherence and toxicity or adverse reactions, when conducting medication reviews and proposed diverse strategies to manage these, frequently recommending a change in pharmacotherapy. These findings highlight the opportunity for more targeted approaches to identifying and managing MRPs in primary care and tailored community pharmacist-led interventions may be of value in this space.

TRAIL REGISTRATION

Australian and New Zealand Clinical Trial Registry records (IMeRSe ACTRN12618000188235 registered 06/02/2018 & PharMIbridge ACTRN12620000577910 registered 18/05/2020).

Predictors of Satisfaction and Value of Advanced Training for Mental Health Professionals in Wartime Ukraine

The full-scale escalation of Russia's war against Ukraine in 2022 created a surge of mental health issues, requiring urgent, evidence-based interventions to reduce trauma and mitigate stress. Reflecting recommendations from leading specialists in the field, Ukrainian mental health professionals sought to develop appropriate skills and knowledge for working in wartime through advanced training programs. This study aimed to investigate the experiences of Ukrainian mental health professionals having completed advanced training in mental health topics in wartime. A survey design was adopted, using the purposefully developed, and validated 'Wartime Learning Satisfaction Scale'. Regression analysis assessed the hypothesized contribution of four scales (Education, Educator, Learner, and War) to the perceived value of advanced training and learners' satisfaction. Respondents (n = 271) were trained in up to 30 courses (M = 4.27, SD = 3.03) lasting from two to over 120 h. Regression analysis revealed different predictors for satisfaction and value of the courses. Advanced training resulted in higher satisfaction with learning if it matched professional goals of mental health professionals and perceived higher value when relevant to societal demand, consistently constructed, practically useful, and not solely focusing on war-related issues. Respondents who completed all advanced training courses they were interested demonstrated significantly higher confidence in working in wartime. These findings are essential for effective mental health practice during wartime.

Impact of women's feedback on midwifery student learning: A thematic analysis of students' reflections

PROBLEM

Little is known about the educational impact of providing routine, online feedback from women on midwifery student learning and clinical practice.

BACKGROUND

Feedback on students' clinical performance has historically been provided by lecturers and clinical supervisors. Women's feedback is not routinely collected or evaluated for impact on student learning.

AIM

To evaluate the impact of women's feedback about continuity of care experiences with a midwifery student on learning and practice.

DESIGN

Descriptive, exploratory qualitative study.

METHODS

All second-and third-year Bachelor of Midwifery students undertaking clinical placement between February and June 2022 at one Australian university, submitted formative, guided written reflections on de-identified women's feedback they received through their ePortfolio. Data were analysed using reflexive thematic analysis.

FINDINGS

Forty-four of the 69 eligible students (64%) submitted reflections on feedback received. Three themes emerged: 1) Confidence boosting, 2) Deeply integrating Midwifery Metavalues, and 3) Enhancing commitment to continuity. Three subthemes: connection, future practice and advocacy were identified. Women's feedback positively impacts student learning and places the woman in the educational feedback loop.

CONCLUSION

This study is an international first evaluating the impact of feedback from women on midwifery students' learning. Students reported greater confidence in their clinical practice, a deeper understanding of their midwifery philosophy, and an intention to advocate for, and work in, midwifery continuity models after graduation. Routine feedback about women's experiences should be embedded into midwifery education programs.

The association of mental health literacy with mental well-being and help-seeking in young people: A systematic review and meta-analysis

PROBLEM

It is important to determine the relationship between mental health literacy (MHL), mental well-being and help seeking in young people in terms of guiding research and practices related to MHL.

ELIGIBILITY CRITERIA

A literature scan of the databases of Web of Science, PubMed, Science Direct, EBSCOhost CINAHL Complete, Cochrane Library, Springer Link, Scopus, Wiley Online Library, Ovid, Taylor & Francis and ProQuest Dissertations & Theses Global was conducted in May 2022 and April 2023 without any year limitations.

SAMPLE

A total of 12 studies with 4659 young people were included. Data synthesis was performed using Comprehensive Meta-Analysis (CMA) software. Pearson correlation coefficient (r) was used to calculate the effect size.

RESULTS

It was concluded that there was no correlation between MHL and mental well-being in young people (p > 0.05, r = 0.06, 95% CI = -0.05 to 0.16). A positive correlation was found between MHL with help seeking attitude (p < 0.01, r = 0.48, 95% CI = 0.30 to 0.63) and help-seeking intention (p < 0.01, r = 0.23, 95% CI = 0.12 to 0.34).

CONCLUSION

While there was a medium effect size between MHL and help seeking attitude in young people, there was a weak effect size between MHL and help seeking intention. No studies were found examining the relationship between MHL and help-seeking behavior in young people.

IMPLICATIONS

Nurses may provide support for young people in help seeking by giving education and counselling on MHL in schools and health institutions, and by creating reliable and easily accessible sources of information.

Yoga-Nidra as a mental health booster: A narrative review

Mental health disorders are treated with all the available advanced health techniques. The pioneers of Indian philosophy, sages, saints, and yogis, through their experiences and rational explanations, expressed the importance of yoga, and their treatment effects. Yoga-Nidra (YN), one of a particular forms of yoga, is described as a simple and precise way of dealing with mental disorders. The use of YN as an intervention has been reported to reduce anxiety, anger, depression, post-traumatic stress disorder (PTSD), and other different kinds of psycho-physiological abnormalities. In addition to the role of Yoga-Nidra as an intervention tool, it also brings relaxation to the mind and brain, mental catharsis, a positive attitude, self-improvement, and personality refinement. At the same time, YN contributes to boost concentration, memory, and other cognitive capacities, including attention, and thoughts. Because of its important therapeutic contribution to psychological well-being and mental health, it is currently used as a therapy and medical intervention. Yoga-Nidra and other yogic practices will play an important role in treating mental, physical, and psychological problems and improving cognitive abilities, and will help to connect with oneself.

Exploring the uses of yoga nidra: An integrative review

AIM

The purpose of this paper was to review and synthesize published research articles that have utilized yoga nidra as an intervention.

BACKGROUND

Yoga nidra is a form of guided meditation that has emerged in the literature in the past two decades as an intervention for a variety of medical conditions such as stress and mental health. It differs from traditional yoga, in that it does not require yoga poses. It is a noninvasive, cost-effective approach that is also easily accessible so it can be done in the privacy and comfort of the home.

DESIGN

The integrative review methodology by Whittemore and Knafl (2005) provided the framework for this review.

METHODS

The databases CINAHL, PubMed, SCOPUS, and PsycINFO were used to search for articles. Inclusion criteria consisted of journal articles in English with no limitations on dates of publication. Studies were excluded if any form of traditional yoga requiring poses was used as an intervention. Also excluded were all types of meditation that were not yoga nidra, systematic reviews, studies that utilized multiple intervention types (i.e., traditional yoga and yoga nidra), and commentaries/brief reports. Twenty-nine studies met the inclusion criteria. Quality appraisal was completed for each study.

RESULTS

The 29 studies that were reviewed consisted of 12 randomized controlled trials, 13 quasi-experimental studies, 3 mixed-methods studies, and 1 qualitative study. Outcome variables were categorized according to themes and results were systemically synthesized and reported by theme: (a) stress, (b) mood, (c) well-being, (d) psychologic dysfunction, (e) biomarkers, (f) sleep, and (g) miscellaneous.

CONCLUSION

Yoga nidra was found to be effective in most of these studies. However, there was some clinical heterogeneity in the sample populations and intervention session lengths, frequencies, and durations, making it difficult to draw conclusions about yoga nidra intervention based solely on the findings presented in this review. More studies are needed overall, particularly ones with larger sample sizes and stronger experimental designs.

CLINICAL RELEVANCE

Yoga nidra has the potential to be a useful, noninvasive, nonpharmacologic treatment or adjunct for a variety of conditions, particularly mental health.

Burnout and secondary traumatic stress in staff working with people with intellectual disabilities: The role of adverse childhood experiences, resilience and trauma-informed organisational climate

BACKGROUND

There has been extensive research into adverse childhood experiences (ACEs), however, less consideration has been given to the prevalence and impact of ACEs for staff working with people with intellectual disabilities.

METHOD

Participants were staff employed by agencies that care for people with intellectual disabilities. An online survey collected demographic information and measures of ACEs, resilience, trauma-informed organisational climate, burnout and secondary traumatic stress. Correlation, regression, mediation and moderation analyses were used.

RESULTS

81.7% of 109 participants had experienced at least one ACE. Burnout, secondary traumatic stress and resilience were greater in the present study than in comparable samples. Trauma-informed organisational climate significantly predicted burnout and secondary traumatic stress. Resilience significantly predicted burnout.

CONCLUSIONS

Staff working with people with intellectual disabilities are likely to have experienced ACEs. Working in a trauma-informed organisational climate and resilience may be effective avenues for reducing burnout and secondary traumatic stress.

Expanding Early Psychosis Care across a Large and Diverse State: Implementation Lessons Learned from Administrative Data and Clinical Team Leads in Texas

The U.S. is facing an unprecedented youth mental health crisis. Translating the findings from mental health intervention trials into large scale, accessible community-based services poses substantial challenges. Examination of state actions as a result of research-informed federal policy to improve youth access to quality mental healthcare is necessary. This mixed-methods study examines the implementation of evidence-informed multidisciplinary coordinated specialty care (CSC) for first-episode psychosis (FEP) services across Texas. The study explores CSC service model components, site location and participant characteristics, and implementation barriers. This cross-sectional study analyzes State of Texas public mental health administrative data from 2015 to 2020, including CSC site (n = 23) characteristics and CSC participant (n = 1682) demographics. Texas CSC site contracts were compared to OnTrackNY, a leading CSC model in the U.S. for CSC service element comparison. In-depth interviews with CSC Team Leads (n = 22) were analyzed to further understand CSC service elements and implementation barriers using qualitative content analysis. CSC was implemented across three waves in 2015, 2017, and 2019-serving 1682 participants and families. CSC sites were located in adult mental health programs; approximately one third of CSC participants were under 18 years. CSC implementation challenges reported by Team Leads included: staff role clarification, collaboration and turnover, community outreach and referrals, child and adult service billing issues, and adolescent and family engagement. Study findings have implications for large state-wide evidence-based practice implementation in transition-to-adulthood community mental health.

A psychosocial exploration of resistances to service user involvement in United Kingdom National Health Service (NHS) mental health services

Policy promotes the active participation of those with lived experience of mental health difficulties in UK NHS mental health services, from the level of collaborative care-planning to service delivery, leadership and development. However, research indicates different forms of resistance to the implementation of such service user involvement. This article reports the findings of a qualitative, interview-based study which used Foucauldian discourse analysis and psychoanalytic theory to understand how resistances are produced through the interplay of clinical mental health professionals' subjectivity and their organisational context. Service user involvement was found to highlight conflicts within clinicians' roles. Central to this conflict was an ambivalent relationship to the power associated with these roles. Power could protect professionals from work related stresses, but could also be used to dominate, silence and coerce service users in ways that conflicted with the core function of providing care. Whilst important, raising awareness of such conflict will arouse discomfort and resistance where psychological defences are challenged. A parallel is drawn with psychotherapeutic change, in which resistance must be understood and worked with as part of meaningful change.

Developing a Curriculum for Functional Neurological Disorder in Neurology Training: Questions and Answers

Functional neurologic disorder (FND) is a common condition for which neurology residents often receive little to no formal teaching. Using a question-and-answer format, this article puts forward a case for why an FND curriculum is needed and aims to provide guidance on possible curricular content including medical knowledge, clinical skills, communication, and team-based collaboration. The authors also discuss methods for teaching and evaluating this knowledge and associated clinical skills, linking this to current Accreditation Council for Graduate Medical Education neurology milestones. Finally, the authors consider how to better engage and energize neurology trainees around this underserved yet challenging patient population.

Optimization of a Transdiagnostic Mobile Emotion Regulation Intervention for University Students: Protocol for a Microrandomized Trial

BACKGROUND

Many university students experience mental health problems such as anxiety and depression. To support their mental health, a transdiagnostic mobile app intervention has been developed. The intervention provides short exercises rooted in various approaches (eg, positive psychology, mindfulness, self-compassion, and acceptance and commitment therapy) that aim to facilitate adaptive emotion regulation (ER) to help students cope with the various stressors they encounter during their time at university.

OBJECTIVE

The goals of this study are to investigate whether the intervention and its components function as intended and how participants engage with them. In addition, this study aims to monitor changes in distress symptoms and ER skills and identify relevant contextual factors that may moderate the intervention's impact.

METHODS

A sequential explanatory mixed methods design combining a microrandomized trial and semistructured interviews will be used. During the microrandomized trial, students (N=200) will be prompted via the mobile app twice a day for 3 weeks to evaluate their emotional states and complete a randomly assigned intervention (ie, an exercise supporting ER) or a control intervention (ie, a health information snippet). A subsample of participants (21/200, 10.5%) will participate in interviews exploring their user experience with the app and the completed exercises. The primary outcomes will be changes in emotional states and engagement with the intervention (ie, objective and subjective engagement). Objective engagement will be evaluated through log data (eg, exercise completion time). Subjective engagement will be evaluated through exercise likability and helpfulness ratings as well as user experience interviews. The secondary outcomes will include the distal outcomes of the intervention (ie, ER skills and distress symptoms). Finally, the contextual moderators of intervention effectiveness will be explored (eg, the time of day and momentary emotional states).

RESULTS

The study commenced on February 9, 2023, and the data collection was concluded on June 13, 2023. Of the 172 eligible participants, 161 (93.6%) decided to participate. Of these 161 participants, 137 (85.1%) completed the first phase of the study. A subsample of participants (18/172, 10.5%) participated in the user experience interviews. Currently, the data processing and analyses are being conducted.

CONCLUSIONS

This study will provide insight into the functioning of the intervention and identify areas for improvement. Furthermore, the findings will shed light on potential changes in the distal outcomes of the intervention (ie, ER skills and distress symptoms), which will be considered when designing a follow-up randomized controlled trial evaluating the full-scale effectiveness of this intervention. Finally, the results and data gathered will be used to design and train a recommendation algorithm that will be integrated into the app linking students to relevant content.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05576883; https://www.clinicaltrials.gov/study/NCT05576883.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/46603.

"A place without walls, only opportunities": personal accounts of attending Recovery Colleges in Norway

Introduction

Recovery colleges (RCs) are learning environments, first established in the UK, based on principles that support positive life changes and reduce stigma related to challenges with mental health and substance use problems. RCs offer courses based on co-production processes and are designed and delivered jointly by individuals with lived experience and professional experts. The courses are open to anyone, attracting people with a variety of life experiences. RCs are non-clinical environments that provide individuals with the identities of students and/or trainers as autonomous and independent agents. In this paper, we investigate experiences of being a part of a RC in Norway, either as a student and/or as a course trainer with lived experiences of mental health or substance use challenges. We ask the following research question: What kinds of personal and social processes are enabled by being part of a recovery college from the perspective of persons with experience-based competence?

Materials and methods

The study is qualitative and explorative based on 11 individual (N = 11) and two focus group interviews (N = 8). Participants were recruited from two of the first RCs in Norway between August 2021 and January 2022.

Results

Study participants describe how their involvement in a RC provided them with opportunities to assume new positions in their recovery process, both related to former institutional identities given in the course of treatment and related to the way they see themselves as people struggling with mental health and substances use challenges. Attending a RC represented significant transitions (1) from an institutional position as "sick" or as "what's on the paper" into a position as "a whole person"; (2) from being in in a position as a recipient of care to the position as actively responsible for life changes; (3) from seeing themselves as worthless to seeing themselves as persons with resources; (4) from being alone to being part of a fellowship. Participants describe being part of a RC as an invaluable addition to other kind of support or help.

Discussion

It is important to provide alternative arenas like RC for facilitating work with life changes, as an invaluable addition to regular services.

Work-related causes of mental health conditions and interventions for their improvement in workplaces

Mental health problems and disorders are common among working people and are costly for the affected individuals, employers, and whole of society. This discussion paper provides an overview of the current state of knowledge on the relationship between work and mental health to inform research, policy, and practice. We synthesise available evidence, examining both the role of working conditions in the development of mental disorders, and what can be done to protect and promote mental health in the workplace. We show that exposure to some working conditions is associated with an increased risk of the onset of depressive disorders, the most studied mental disorders. The causality of the association, however, is still debated. Causal inference should be supported by more research with stronger linkage to theory, better exposure assessment, better understanding of biopsychosocial mechanisms, use of innovative analytical methods, a life-course perspective, and better understanding of the role of context, including the role of societal structures in the development of mental disorders. There is growing evidence for the effectiveness of interventions to protect and promote mental health and wellbeing in the workplace; however, there is a disproportionate focus on interventions directed towards individual workers and illnesses, compared with interventions for improving working conditions and enhancing mental health. Moreover, research on work and mental health is mainly done in high-income countries, and often does not address workers in lower socioeconomic positions. Flexible and innovative approaches tailored to local conditions are needed in implementation research on workplace mental health to complement experimental studies. Improvements in translating workplace mental health research to policy and practice, such as through workplace-oriented concrete guidance for interventions, and by national policies and programmes focusing on the people most in need, could capitalise on the growing interest in workplace mental health, possibly yielding important mental health gains in working populations.

Recruitment of patients, carers and members of the public to advisory boards, groups and panels in public and patient involved health research: a scoping review

OBJECTIVES

The objectives of this scoping review are to: (1) identify the distribution of and context of the recruitment strategies used, (2) explore the facilitators, benefits, barriers and ethical issues of the identified recruitment strategies, (3) distinguish the varying terminology for involvement (ie, panels, boards, individual) and (4) determine if the individual recruitment strategies used were to address issues of representation or bias.

DESIGN

A scoping review.

SETTING

This scoping review follows the framework by Peters et al. Seven electronic databases were explored including Scopus, Medline, PubMed, Web of Science, CINAHL, Cochrane Library and PsycINFO (conducted July 2021). The search strategy was codeveloped among the research team, PPI research experts and a faculty librarian. Two independent reviewers screened articles by title and abstract and then at full text based on predetermined criteria.

PRIMARY AND SECONDARY OUTCOME MEASURES

Explore recruitment strategies used, facilitators, benefits, barriers and ethical issues of the identified recruitment strategies. Identify terminology for involvement. Explore recruitment strategies used to address issues of representation or bias.

RESULTS

The final sample was from 51 sources. A large portion of the extracted empirical literature had a clinical focus (37%, n=13) but was not a randomised control trial. The most common recruitment strategies used were human networks (78%, n=40), such as word of mouth, foundation affiliation, existing networks, clinics or personal contacts. Within the reviewed literature, there was a lack of discussion pertaining to facilitators, benefits, barriers and ethical considerations of recruitment strategies was apparent. Finally, 41% (n=21) of studies employed or proposed recruitment strategies or considerations to address issues of representation or bias.

CONCLUSION

We conclude with four key recommendations that researchers can use to better understand appropriate routes to meaningfully involve patients, carers and members of the public to cocreate the evidence informing their care.

The effect of cognitive behavioral therapy on stress and anxiety of mothers of girls with precocious puberty symptoms: a randomized controlled trial

INTRODUCTION

Precocious puberty in girls has been associated with an increased risk of stress and anxiety in their mothers. This study aimed to investigate the effect of cognitive behavioral therapy (CBT) on perceived stress and anxiety of mothers of girls with precocious puberty symptoms.

METHODS

This randomized controlled trial was conducted on 70 mothers of girls with precocious puberty symptoms in Tabriz-Iran, 2021. The participants were randomly assigned to CBT and control groups through blocked randomization. Group counseling was provided to the intervention group in eight sessions of 45-60 min weekly with 5 to 7 women. A booklet containing explanations about puberty was provided for the both groups. Data were collected using the questionnaires of socio-demographic characteristics, Spielberger State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and quality of life (SF-36). Independent t-test, ANCOVA, chi-square, and fisher's exact tests were used to compare the outcomes between the groups.

FINDINGS

After the intervention, based on ANCOVA test with adjusting the baseline values, mean scores of stress (mean difference (MD): -10.75; 95% confidence interval (95% CI): -11.77 to -9.72; P < 0.001), state anxiety (MD: -14.36; 95% CI: -15.7 to -12.7; P < 0.001) and trait anxiety (MD: -12.8; 95% CI: -14.4 to -11.1; P < 0.001) were significantly lower in CBT group compared to the control group. Also mean score of quality of life (MD: 9.82; 95% CI: -6.74 to -12.90; P < 0.001) was significantly higher in CBT group compared to the control group.

CONCLUSION

Based on the results, group CBT is effective in reducing stress and anxiety and improving the quality of life of mothers of girls with precocious puberty symptoms. However, more studies are required to make a definite conclusion in this field.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials (IRCT): IRCT20110826007418N6. Date of registration: 11/10/2021. URL: https://en.irct.ir/trial/57346 ; Date of first registration: 11/10/2021.

Barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease in Iran: a descriptive qualitative study

OBJECTIVES

Chronic obstructive pulmonary disease is a chronic disease with numerous complications. Therefore, its effective management depends on home-based pulmonary rehabilitation. The effectiveness of home-based pulmonary rehabilitation programmes in turn depends on patient adherence to them. The aim of this study was to explore the barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease.

DESIGN

Qualitative descriptive design.

SETTING

The lung care wards of Al-Zahra and Khorshid teaching hospitals and the comprehensive lung care clinic of Khorshid hospital, Isfahan, Iran.

PARTICIPANTS

Participants patients with chronic obstructive pulmonary disease (n=20), their family caregivers (n=15) and healthcare providers (n=14) recruited via purposive sampling.

RESULTS

The five main categories of the barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease were patient-related barriers, caregivers' caregiving burden, limited support for patients, healthcare providers' limited professional competence and ineffective home-based pulmonary rehabilitation planning.

CONCLUSION

Different and complex factors related to patients, families and healthcare providers can affect adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease. Healthcare authorities can use the findings of this study to develop strategies to support patients with chronic obstructive pulmonary disease and their family caregivers and thereby reduce the physical and mental complications of Chronic obstructive pulmonary disease.

PsyCARE study: assessing impact, cost-effectiveness, and transdiagnostic factors of the Italian ministry of health's "psychological bonus" policy

BACKGROUND

The prevalence of anxiety and depression disorders is surging worldwide, prompting a pressing demand for psychological interventions, especially in less severe cases. Responding to this need, the Italian government implemented the "Psychological Bonus" (PB) policy, allotting 25 million euros for mental health support. This policy entitles individuals to a minimum of four to twelve psychological sessions. In collaboration with the National Board of Italian Psychologists, our study assesses this policy's effectiveness. Indeed, the PsyCARE study aims to examine the utilization of the Psychological Bonus, evaluate its impact on adult and adolescent participants' psychological well-being through pre- and post-intervention assessments and six-month follow-up, and conduct a longitudinal cost-effectiveness analysis of this policy. A secondary aim is to investigate the influence of these interventions on transdiagnostic factors, including emotion regulation and epistemic trust.

METHODS

The study involves licensed psychotherapists and their patients, both adults and adolescents, benefiting from the Psychological Bonus. Data collection is underway and set to conclude in December 2023. Psychotherapists will provide diagnostic information and assess patient functioning. In addition, patients will be evaluated on mental health aspects such as clinical symptoms, emotion regulation, epistemic trust, and quality of life. We will employ linear mixed-effects models to analyze the outcomes, accounting for both fixed and random effects to capture the hierarchical structure of the data.

DISCUSSION

We anticipate the study's findings will highlight reduced psychological distress and improved quality of life for participants and demonstrate the Psychological Bonus policy's cost-effectiveness. The study will gather data on the role of specific versus nonspecific therapeutic factors in psychotherapy while adopting a patient-tailored approach to identify effective therapeutic elements and examine transdiagnostic factors. Overall, this study's findings will guide future measures within the Italian healthcare system, fostering a psychological health culture and providing valuable insights to the broader public.

STUDY REGISTRATION

https://osf.io/6zk2j.

A scoping review of the barriers and facilitators to accessing and utilising mental health services across regional, rural, and remote Australia

BACKGROUND

Inadequate healthcare access and utilisation are implicated in the mental health burden experienced by those living in regional, rural, and remote Australia. Facilitators that better enable access and utilisation are also reported in the literature. To date, a synthesis on both the barriers and facilitators to accessing and utilising mental health services within the rural Australian context has not been undertaken. This scoping review aims to (1) synthesise the barriers and facilitators to accessing and utilising mental health services in regional, rural, and remote Australia, as identified using the Modified Monash Model; and (2) better understand the relationship between barriers and facilitators and their geographical context.

METHODS

A systematic search of Medline Complete, EMBASE, PsycINFO, Scopus, and CINAHL was undertaken to identify peer-reviewed literature. Grey literature was collated from relevant websites. Study characteristics, including barriers and facilitators, and location were extracted. A descriptive synthesis of results was conducted.

RESULTS

Fifty-three articles were included in this scoping review. Prominent barriers to access and utilisation included: limited resources; system complexity and navigation; attitudinal and social matters; technological limitations; distance to services; insufficient culturally-sensitive practice; and lack of awareness. Facilitators included person-centred and collaborative care; technological facilitation; environment and ease of access; community supports; mental health literacy and culturally-sensitive practice. The variability of the included studies precluded the geographical analysis from being completed.

CONCLUSION

Both healthcare providers and service users considered a number of barriers and facilitators to mental health service access and utilisation in the regional, rural, and remote Australian context. Barriers and facilitators should be considered when re-designing services, particularly in light of the findings and recommendations from the Royal Commission into Victoria's Mental Health System, which may be relevant to other areas of Australia. Additional research generated from rural Australia is needed to better understand the geographical context in which specific barriers and facilitators occur.

Outcomes of psychological support skills training for cancer care staff: Skill acquisition, work engagement, mental wellbeing and burnout

OBJECTIVE

Psychological support skills training has the potential to improve both the ability of cancer staff to help their patients, and staff wellbeing. However, few recent studies have assessed both these outcomes or incorporated current developments in psychological skills training, such as deliberate practice, which includes the use of iterative, corrective feedback to identify and improve individualised skill deficits. No studies have evaluated the contribution that psychological skills training could make to cancer care staff wellbeing and expertise in the wake of the COVID-19 pandemic. This study aimed to evaluate staff skill acquisition and work-related wellbeing following psychological support skills training that applied deliberate practice principles.

METHOD

A 2-day training and monthly supervision was offered to 145 cancer care staff that focused on brief assessment and intervention skills for patients experiencing mental health problems after cancer diagnosis and treatment. Deliberate practice principles were used to focus training on skills practice and feedback, over technique description. Self-reported ability to perform key skills taught, staff mental wellbeing, work engagement, and burnout were assessed at baseline, 3-month and 8-month follow-up.

RESULTS

Significant improvements in skills, mental wellbeing, burnout and work engagement were reported at 8-month follow-up. Full engagement in both training sessions was predicted by poorer baseline mental wellbeing, more positive evaluation of initial training, supervision attendance, and shorter follow-up.

CONCLUSION

A 2-day psychological support skills training using deliberate practice principles may support improvement in staff skill, mental wellbeing, burnout and work engagement.

Teacher experience and students' mental well-being

INTRODUCTION

The purpose of this study is to investigate the relationship between homeroom teachers' experience and students' mental well-being, in addition to examining the underlying mechanisms that can explain the relationship.

METHODS

Secondary data from the Gyeonggi Education Panel Study was used. The analysis included 3002 fourth graders and 3090 first-year middle school students in Gyeonggi province in South Korea, and the quasi-random assignment of students into classrooms in South Korea was used. The level of students' mental well-being was used as an outcome, and homeroom teachers' experience was used as an independent variable. Students' perception of their homeroom teachers' teaching skills and teachers' self-perceived capacity for understanding students' behaviors were used for mechanism analyses.

RESULTS

Students assigned to homeroom teachers with less than 5 years of experience had lower mental well-being than those assigned to more experienced homeroom teachers. Mechanism analyses revealed that teachers who had more than 5 years of experience were more confident about understanding their students than those who had less than 5 years of experience.

CONCLUSIONS

Homeroom teachers' experience is highly associated with students' mental well-being. To promote students' mental well-being, deeper understanding of the relationship between teachers' experience and students' mental well-being is necessary.

Organisational and student characteristics, fidelity, funding models, and unit costs of recovery colleges in 28 countries: a cross-sectional survey

BACKGROUND

Recovery colleges were developed in England to support the recovery of individuals who have mental health symptoms or mental illness. They have been founded in many countries but there has been little international research on recovery colleges and no studies investigating their staffing, fidelity, or costs. We aimed to characterise recovery colleges internationally, to understand organisational and student characteristics, fidelity, and budget.

METHODS

In this cross-sectional study, we identified all countries in which recovery colleges exist. We repeated a cross-sectional survey done in England for recovery colleges in 28 countries. In both surveys, recovery colleges were defined as services that supported personal recovery, that were coproduced with students and staff, and where students learned collaboratively with trainers. Recovery college managers completed the survey. The survey included questions about organisational and student characteristics, fidelity to the RECOLLECT Fidelity Measure, funding models, and unit costs. Recovery colleges were grouped by country and continent and presented descriptively. We used regression models to explore continental differences in fidelity, using England as the reference group.

FINDINGS

We identified 221 recovery colleges operating across 28 countries, in five continents. Overall, 174 (79%) of 221 recovery colleges participated. Most recovery colleges scored highly on fidelity. Overall scores for fidelity (β=-2·88, 95% CI 4·44 to -1·32; p=0·0001), coproduction (odds ratio [OR] 0·10, 95% CI 0·03 to 0·33; p<0·0001), and being tailored to the student (OR 0·10, 0·02 to 0·39; p=0·0010), were lower for recovery colleges in Asia than in England. No other significant differences were identified between recovery colleges in England, and those in other continents where recovery colleges were present. 133 recovery colleges provided data on annual budgets, which ranged from €0 to €2 550 000, varying extensively within and between continents. From included data, all annual budgets reported by the college added up to €30 million, providing 19 864 courses for 55 161 students.

INTERPRETATION

Recovery colleges exist in many countries. There is an international consensus on key operating principles, especially equality and a commitment to recovery, and most recovery colleges achieve moderate to high fidelity to the original model, irrespective of the income band of their country. Cultural differences need to be considered in assessing coproduction and approaches to individualising support.

FUNDING

National Institute for Health and Care Research.

Evaluation of an online advanced suicide prevention training for pharmacists

BACKGROUND

With the pharmacist role extending internationally to include health promotion and harm reduction, pharmacists are well-suited to adopt a frontline role within suicide prevention efforts. To maximise their abilities to implement suicide prevention strategies, suicide prevention training is essential to improve pharmacists' knowledge of, attitudes towards, and confidence in pharmacy-based suicide prevention.

AIM

This study aimed to evaluate the impact of an online Advanced Suicide Prevention Training for Pharmacists and explore how participant feedback may direct training improvements.

METHOD

One hundred and fifty pharmacists in Tasmania, Australia, completed the training. Of these, 109 participants completed surveys pre-, post- and 6-months post-training to evaluate changes in suicide prevention knowledge, confidence, and attitudes, and explore participants' perceptions of the training.

RESULTS

Significant improvements were observed in suicide prevention attitudes (F(2, 20) = 4.12, p = 0.032, partial η2 = 0.292), and self-efficacy (F(2, 20) = 7.84, p = 0.003, partial η2 = 0.439), across the three timepoints, with improvements to knowledge and confidence evident between pre- and post-training (p < 0.05). Qualitative data reflected that the training was beneficial in aiding the identification and support of at-risk individuals, however barriers such as the pharmacy setting, personal discomfort, and perceptions of the pharmacist role were identified as impeding the implementation of suicide prevention within pharmacy practice.

CONCLUSION

Training is an effective means of improving pharmacists' suicide prevention knowledge, confidence, and attitudes. While personal barriers to suicide prevention improved, contextual and social barriers continue to impede pharmacists' implementation of suicide prevention in practice.

An Integrative Review on Psychiatric Intensive Care

Psychiatric intensive care units (PICUs) provide care and treatment when psychiatric symptoms and behaviors exceed general inpatient resources. This integrative review aimed to synthesize PICU research published over the past 5 years. A comprehensive search in MEDLINE, PsycINFO, PubMed and Scopus identified 47 recent articles on PICU care delivery, populations, environments, and models. Research continues describing patient demographics, and high rates of challenging behaviors, self-harm, and aggression continue being reported. Research on relatives was minimal. Patients describe restrictive practices incongruent with recovery philosophies, including controlling approaches and sensory deprivation. Some initiatives promote greater patient autonomy and responsibility in shaping recovery, yet full emancipatory integration remains limited within PICU environments. Multidisciplinary collaboration is needed to holistically advance patient-centered, equitable, and integrative PICU care. This review reveals the complex tensions between clinical risk management and emancipatory values in contemporary PICU settings. Ongoing reporting of controlling practices counters the recovery movement progressing in wider mental healthcare contexts. However, care innovations centered on patient empowerment and humane environments provide hope for continued evolution toward more liberation-focused PICU approaches that uphold both patient and provider perspectives.

The impact of expert by experience involvement in teaching in a DClinPsych programme; for trainees and experts by experience

INTRODUCTION

There is a growing acknowledgement of the value of creating partnerships between those delivering and those accessing health services. Less is known about this in the context of clinical psychology doctoral training programmes. This study explores the models of involvement of experts by experience (EbEs) in teaching on a DClinPsych course in England; the impact of this both for EbEs and trainee clinical psychologists and whether improvements are required to better meet their needs.

METHODS

An audit of current involvement was conducted by reviewing course records. Two survey questionnaires designed around commonly used frameworks of participation and reflective learning were completed by EbEs and trainees. Thematic Analysis was used to evaluate the written feedback from the surveys.

RESULTS

Records of current EbE involvement were found to be lacking in detail and sometimes missing. Key themes extrapolated from the surveys highlighted the importance of EbE involvement in supporting the wellbeing of EbEs and the learning experiences of trainees.

CONCLUSIONS

Recommendations with regard to the processes for future involvement of EbEs in teaching are put forward.

PATIENT OR PUBLIC CONTRIBUTION

A carer of a service user was consulted about the design of the participant information sheet, consent form and the survey questionnaire which was sent to the EbEs. A trainee clinical psychologist was also consulted to provide a trainee perspective on the above forms and the survey questionnaire that was sent to trainees. Further to this, the first author's supervisor identifies as a user of physical and mental health services and provided continued supervision and support regarding the direction of the study including the research questions, design, methodology and interpretation of results.

The role of pharmacists in supporting service users to optimise antipsychotic medication

Pharmacists have a contribution to make in improving optimising medication use for people on antipsychotic medication. The rates of prescribing antipsychotics have increased in England with an 18% rise from 2015 to 2020. People on antipsychotic medication are not treated as equal partners in conversations about their medications. This can leave people to make decisions about their antipsychotic medications without input from their prescribers which can have significant consequences for individuals. Involving people in the decision-making process, as experts on their own condition, has the potential to improve treatment outcomes. The evidence suggests that involving pharmacists in supporting people with serious mental illnesses will lead to improved clinical outcomes. Key areas for pharmacist involvement are providing information, education and counselling on antipsychotic medication and the side effects and reducing polypharmacy especially when antipsychotics are prescribed off license.

The engagement of psychology with complementary medicine: A critical integrative review

Amidst the global rise in complementary medicine (CM) use for mental health, a substantial number of clients consulting a psychologist also utilise at least one form of CM. Yet, how psychologists should engage with CM in their clinical practice (e.g., how to respond to a client disclosing CM use or enquiries regarding CM products or services for mental health) remains contested and unclear. In response, a systematic integrative review was conducted to examine empirical literature reporting on one or more aspects of the relationship between psychology (incorporating clinical practice, professional associations and academia) and CM, and how that relationship may relate to or inform psychologists' engagement with CM in their clinical practice. Twenty-seven peer-reviewed articles met the specific inclusion criteria and quality appraisal was employed. Analysis shows a substantial number of psychologists are engaging with, or are interested in engaging with, CM in their clinical practice. Analysis identified a dissonance between psychologists' engagement with CM in clinical practice and the limited engagement of the broader discipline of psychology with CM. Further research is required to understand these differing types of engagement with a view to helping inform relevant policy and practice guidelines, and ultimately assist psychologists in navigating CM in their clinical practice.

Effectiveness of an intervention to reduce stigma towards people with a mental disorder diagnosis in university students of healthcare careers

Students in healthcare careers present stigma towards people with psychiatric diagnoses, so the development of interventions to reduce it is essential. This study aimed to evaluate the effectiveness of an intervention to reduce stigma towards people diagnosed with mental disorders in healthcare students in Chile. A randomized clinical trial with a before and after measurement was carried out. The intervention was part of a compulsory course and combined educational and contact strategies. A total of 244 fourth-semester students of medicine, nursing, dentistry, obstetrics, psychology, and social work participated. The intervention was effective in reducing stigmatizing attitudes and the desire for social distance. For almost all variables, the magnitude of the stigma reduction depended on the initial level of stigma, not on the profession. The intervention had positive effects on all careers. In conclusion, incorporating a stigma reduction intervention into mandatory professional training, with the active participation of the teacher in charge and experts by experience, can be a valuable tool to promote humanized and non-stigmatizing treatment.

Co-designing psychosis simulated patient scenarios with mental health stakeholders for pharmacy curricula

BACKGROUND

Pharmacists need knowledge and confidence to support people living with mental illness. Evidence-based educational materials for pharmacy students to provide psychosis care is limited.

AIM

To co-design, content validate and pilot-test, with mental health stakeholders, simulated patient scenarios to educate and assess students in providing psychosis care.

METHOD

Mental health consumers were invited to co-design three simulated patient scenarios (first-episode psychosis, carer of someone living with schizophrenia, non-adherence to antipsychotics), guided by published and psychometrically-tested materials. A panel of mental health stakeholders participated in two rounds of content validation (RAND/UCLA appropriateness model). Round 1 involved individual survey completion to calculate item content validity index (I-CVI) for relevance/clarity, content validity ratio for essentiality and overall scale content validity index (S-CVI/Ave and S-CVI/UA) scores for each scenario. Scores analyses and feedback comments informed revisions. Round 2 involved a panel meeting to discuss revisions and finalise content. The scenarios were then pilot-tested with pharmacy students.

RESULTS

Two consumers participated in co-design, nine stakeholders in content validation. All items showed excellent content validity for relevance/clarity. Eleven items were revised for essentiality, discussed, then re-rated at the panel meeting for consensus. The scenarios were pilot-tested with pharmacy students (n = 15) and reported to be realistic and relevant to future practice, contributing to students' confidence in supporting people experiencing mental health symptoms or crises.

CONCLUSION

Partnering with mental health stakeholders has enabled co-design of authentic, content valid educational materials for pharmacy students to provide psychosis care, in preparation for future provision of mental health support.

Recovery college dropout: A qualitative study of external, relational and course-related dropout drivers in co-produced mental health care

Recovery colleges (RCs) are rapidly spreading across Western countries, and research indicates beneficial outcomes of this co-produced model of mental health care. Meanwhile, risks of adverse outcomes and RC dropout remain understudied. To address this research gap, we conducted qualitative interviews with 14 participants who dropped out of RC courses in Denmark. This article, adhering to the consolidated criteria for reporting qualitative research (COREQ), presents a typology of the main dropout drivers identified in our sample: external, relational and course-related. External drivers involve practical obstacles, for example some participants feared taking public transportation and lacked access to alternative means of travelling to the courses. Relational drivers entail distressing interactions with educators or peer students, for example some participants felt stigmatized or intimidated. Course-related drivers concern the content of the courses, for example some students considered the academic level too basic as their design did not take prior learning into account, while others experienced a sense of alienation because they were unable or unwilling to share the kind of personal experiences course assignments envisaged. In the discussion of our findings, we consider how different types of drivers call for different modes of responses. We discuss dilemmas related to the proposed responses for reducing or accepting RC dropout.

Important Considerations for ADHD 'Patient and Public' Involvement and Engagement in Research

In this letter, we summarise key points of learning from research projects on attention deficit hyperactivity disorder (ADHD) that have had patient and public involvement and engagement (PPIE) as a key part of the research process. We share learning from our experiences in delivering research working with PPIE groups with ADHD, as top tips for researchers. Our aim is to highlight the importance of including lived-experience in ADHD research, share learning and highlight some of the (potentially invisible) differences in functioning that someone with ADHD can experience in relation to attentional focus, organisation, and time management. Specifically, how these might impact working practices of PPIE groups that include people with ADHD.