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Hess RS, Pearrow M, Hazel CE, Sander JB, Wille AM. Enhancing the Behavioral and Mental Health Services Within School-Based Contexts. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2017. [DOI: 10.1080/15377903.2017.1317151] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Robyn S. Hess
- Department of School Psychology, University of Northern Colorado, Greeley, Colorado, USA
| | - Melissa Pearrow
- Department of Counseling and School Psychology, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Cynthia E. Hazel
- Department of Teaching and Learning Sciences and Child, Family, and School Psychology, University of Denver, Denver, Colorado, USA
| | - Janay B. Sander
- Educational Psychology, Ball State University, Muncie, Indiana, USA
| | - Alice M. Wille
- Department of School Psychology, University of Northern Colorado, Greeley, Colorado, USA
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102
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Svensson B, Hansson L. Mental health first aid for the elderly: A pilot study of a training program adapted for helping elderly people. Aging Ment Health 2017; 21:595-601. [PMID: 26829477 DOI: 10.1080/13607863.2015.1135873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Epidemiological studies have shown a high prevalence of mental illness among the elderly. Clinical data however indicate both insufficient detection and treatment of illnesses. Suggested barriers to treatment include conceptions that mental health symptoms belong to normal aging and lack of competence among staff in elderly care in detecting mental illness. A Mental Health First Aid (MHFA) training program for the elderly was developed and provided to staff in elderly care. The aim of this study was to investigate changes in knowledge in mental illness, confidence in helping a person, readiness to give help and attitudes towards persons with mental illness. METHOD Single group pre-test-post-test design. RESULTS The study group included staff in elderly care from different places in Sweden (n = 139). Significant improvements in knowledge, confidence in helping an elderly person with mental illness and attitudes towards persons with mental illness are shown. Skills acquired during the course have been practiced during the follow-up. CONCLUSIONS The adaption of MHFA training for staff working in elderly care gives promising results. Improvements in self-reported confidence in giving help, attitudes towards persons with mental illness and actual help given to persons with mental illness are shown. However, the study design allows no firm conclusions and a randomized controlled trail is needed to investigate the effectiveness of the program. Outcomes should include if the detection and treatment of mental illness among the elderly actually improved.
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Affiliation(s)
- Bengt Svensson
- a Department of Health Sciences , Lund University , Lund , Sweden
| | - Lars Hansson
- a Department of Health Sciences , Lund University , Lund , Sweden
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103
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Patalay P, Gondek D, Moltrecht B, Giese L, Curtin C, Stanković M, Savka N. Mental health provision in schools: approaches and interventions in 10 European countries. Glob Ment Health (Camb) 2017; 4:e10. [PMID: 28596911 PMCID: PMC5454766 DOI: 10.1017/gmh.2017.6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 02/17/2017] [Accepted: 03/20/2017] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The role of schools in providing community-based support for children's mental health and well-being is widely accepted and encouraged. Research has mainly focused on designing and evaluating specific interventions and there is little data available regarding what provision is available, the focus and priorities of schools and the professionals involved in providing this support. The current study presents these data from schools in 10 European countries. METHODS Online survey of 1466 schools in France, Germany, Ireland, Netherlands, Poland, Serbia, Spain, Sweden, UK and Ukraine. The participating countries were chosen based on their geographical spread, diversity of political and economic systems, and convenience in terms of access to the research group and presence of collaborators. RESULTS Schools reported having more universal provision than targeted provision and there was greater reported focus on children who already have difficulties compared with prevention of problems and promotion of student well-being. The most common interventions implemented related to social and emotional skills development and anti-bullying programmes. Learning and educational support professionals were present in many schools with fewer schools reporting involvement of a clinical specialist. Responses varied by country with 7.4-33.5% between-country variation across study outcomes. Secondary schools reported less support for parents and more for staff compared with primary schools, with private schools also indicating more staff support. Schools in rural locations reported less student support and professionals involved than schools in urban locations. CONCLUSION The current study provides up-to-date and cross-country insight into the approaches, priorities and provision available for mental health support in schools; highlighting what schools prioritise in providing mental health support and where coverage of provision is lacking.
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Affiliation(s)
- P. Patalay
- University College London, London, UK
- University of Liverpool, Liverpool, UK
| | - D. Gondek
- University College London, London, UK
| | - B. Moltrecht
- Maastricht University, Maastricht, The Netherlands
| | - L. Giese
- University of Glasgow, Glasgow, UK
- Lund University, Lund, Sweden
| | - C. Curtin
- University of Limerick, Limerick, Ireland
| | - M. Stanković
- University of Niš, Niš, Serbia
- University of Sarajevo, Sarajevo, Bosnia & Herzegovina
| | - N. Savka
- University of Warsaw, Warsaw, Poland
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104
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Booth A, Scantlebury A, Hughes-Morley A, Mitchell N, Wright K, Scott W, McDaid C. Mental health training programmes for non-mental health trained professionals coming into contact with people with mental ill health: a systematic review of effectiveness. BMC Psychiatry 2017; 17:196. [PMID: 28545425 PMCID: PMC5445268 DOI: 10.1186/s12888-017-1356-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 05/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The police and others in occupations where they come into close contact with people experiencing/with mental ill health, often have to manage difficult and complex situations. Training is needed to equip them to recognise and assist when someone has a mental health issue or learning/intellectual disability. We undertook a systematic review of the effectiveness of training programmes aimed at increasing knowledge, changing behaviour and/or attitudes of the trainees with regard to mental ill health, mental vulnerability, and learning disabilities. METHODS Databases searched from 1995 onwards included: ASSIA, Cochrane Central Register of Controlled Clinical Trials (CENTRAL), Criminal Justice Abstracts, Embase, ERIC, MEDLINE, PsycINFO, Social Science Citation Index. Courses, training, or learning packages aimed at helping police officers and others who interact with the public in a similar way to deal with people with mental health problems were included. Primary outcomes were change in practice and change in outcomes for the groups of people the trainees come into contact with. Systematic reviews, randomised controlled trials (RCTs) and non- randomised controlled trials (non-RCTs) were included and quality assessed. In addition non-comparative evaluations of training for police in England were included. RESULTS From 8578 search results, 19 studies met the inclusion criteria: one systematic review, 12 RCTs, three prospective non-RCTs, and three non-comparative studies. The training interventions identified included broad mental health awareness training and packages addressing a variety of specific mental health issues or conditions. Trainees included police officers, teachers and other public sector workers. Some short term positive changes in behaviour were identified for trainees, but for the people the trainees came into contact with there was little or no evidence of benefit. CONCLUSIONS A variety of training programmes exist for non-mental health professionals who come into contact with people who have mental health issues. There may be some short term change in behaviour for the trainees, but longer term follow up is needed. Research evaluating training for UK police officers is needed in which a number of methodological issues need to be addressed. TRIAL REGISTRATION Protocol registration number: PROSPERO: CRD42015015981 .
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Affiliation(s)
- Alison Booth
- York Trials Unit, Department of Health Sciences, Faculty of Science, University of York, Helslington, York, YO10 5DD, UK.
| | - Arabella Scantlebury
- 0000 0004 1936 9668grid.5685.eYork Trials Unit, Department of Health Sciences, Faculty of Science, University of York, Helslington, York YO10 5DD UK
| | - Adwoa Hughes-Morley
- 0000 0004 1936 9668grid.5685.eYork Trials Unit, Department of Health Sciences, Faculty of Science, University of York, Helslington, York YO10 5DD UK
| | - Natasha Mitchell
- 0000 0004 1936 9668grid.5685.eYork Trials Unit, Department of Health Sciences, Faculty of Science, University of York, Helslington, York YO10 5DD UK
| | - Kath Wright
- 0000 0004 1936 9668grid.5685.eCentre for Reviews and Dissemination, University of York, Helslington, York UK
| | | | - Catriona McDaid
- 0000 0004 1936 9668grid.5685.eYork Trials Unit, Department of Health Sciences, Faculty of Science, University of York, Helslington, York YO10 5DD UK
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105
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Green JG, Keenan JK, Guzmán J, Vinnes S, Holt M, Comer JS. Teacher perspectives on indicators of adolescent social and emotional problems. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2017; 2:96-110. [PMID: 30775446 PMCID: PMC6377196 DOI: 10.1080/23794925.2017.1313099] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Teachers are a primary source of referral to mental health services for children and adolescents. However, studies find that students identified by teachers differ from those identified by standardized screening scales. This suggests possible discrepancies in conceptualizations of student emotional and behavioral challenges. The current article describes results of a study that explores how teachers conceptualize the emotional and behavioral challenges of adolescents. Middle and high school teachers across the U.S. were identified using a stratified random sampling process and recruited for participation. Twenty-nine teachers (26% of those recruited) were interviewed and asked to describe markers that indicated to them that a student was experiencing emotional and behavioral challenges. Themes in teacher responses were identified and coded. Teachers identified multiple, diverse markers that they perceived were indicators of emotional and behavioral challenges among their students. Markers described by teachers were compared to those typically measured by standardized screening scales. Discrepancies between markers identified by teachers and screening scales are highlighted as potential areas for professional development and enhanced school-based intervention efforts. These findings underscore the importance of integrating teacher perspectives in understanding the referral process for students.
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106
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Burns S, Crawford G, Hallett J, Hunt K, Chih HJ, Tilley PM. What's wrong with John? a randomised controlled trial of Mental Health First Aid (MHFA) training with nursing students. BMC Psychiatry 2017; 17:111. [PMID: 28335758 PMCID: PMC5364573 DOI: 10.1186/s12888-017-1278-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 03/18/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The prevalence of mental health problems have been found to be higher among university students compared to their non-student peers. Nursing students in particular face a range of additional stressors which may impact their undergraduate performance and their careers. Mental Health First Aid (MHFA) aims to increase mental health literacy and to reduce stigma and may positively impact on the student population. This paper describes a MHFA randomised controlled trial targeting nursing students at a large Australian university. This study aimed to measure the impact of the MHFA course on mental health literacy, mental health first aid intentions, confidence in helping someone with a mental health problem and stigmatising attitudes including social distance. METHODS Participants were first year nursing students (n = 181) randomly allocated to the intervention (n = 92) or control (n = 89) group. Intervention group participants received the standardised MHFA course for nursing students. Online self-report questionnaires were completed at three time intervals: baseline (one week prior to the intervention: T1) (n = 140), post intervention (T2) (n = 120), and two months post intervention (T3) (n = 109). Measures included demographics, mental health knowledge, recognition of depression, confidence in helping, mental health first aid intentions and stigmatising attitudes including social distance. Repeated measures ANOVA was computed to measure if the impact of time (T1, T2, T3) and group (intervention and control) on the outcome variables. RESULTS There was a significant improvement among intervention compared to control group participants across the three time periods for knowledge scores (p < 0.001), confidence in helping (p < 0.001), mental health first aid intentions (p < 0.001), total personal stigma (p < 0.05), personal dangerous/unpredictable stigma (p < 0.05) and social distance (p < 0.05) scores. CONCLUSION MHFA is useful training to embed in university courses and has the potential to enhance mental health literacy and reduce stigmatising attitudes and social distance. While this course has particular salience for nursing and other health science students, there are broader benefits to the general university population that should be considered and opportunities accordingly explored for all students to complete the course. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12614000861651 . Retrospectively registered 11 August 2014.
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Affiliation(s)
- Sharyn Burns
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Gemma Crawford
- 0000 0004 0375 4078grid.1032.0Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
| | - Jonathan Hallett
- 0000 0004 0375 4078grid.1032.0Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
| | - Kristen Hunt
- 0000 0004 0375 4078grid.1032.0Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
| | - Hui Jun Chih
- 0000 0004 0375 4078grid.1032.0School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - P.J. Matt Tilley
- 0000 0004 0375 4078grid.1032.0Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
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107
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Mental health training for secondary school teachers in Haiti: a mixed methods, prospective, formative research study of feasibility, acceptability, and effectiveness in knowledge acquisition. Glob Ment Health (Camb) 2017; 4:e4. [PMID: 28596905 PMCID: PMC5454794 DOI: 10.1017/gmh.2016.29] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/13/2016] [Accepted: 12/02/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Engagement and training of educators in student mental health holds promise for promoting access to care as a task sharing strategy but has not been well-studied in low-income regions. METHODS We used a prospective and convergent mixed methods design to evaluate a customized school mental health 2½ day training for teachers in rural Haiti (n = 22) as the initial component of formative research developing a school-based intervention to promote student mental health. Training prepared teachers to respond to student mental health needs by providing psychoeducational and practical support to facilitate access to care. We examined level of participation and evaluated feasibility, acceptability, and perceived effectiveness by calculating mean scores on self-report Likert-style items eliciting participant experience. We examined effectiveness of the training on improving mental health knowledge and attitudes by comparing mean scores on an assessment administered pre- and post-training. Finally, we examined self-report written open-ended responses and focus group discussion (FGD) interview data bearing on perceived feasibility, acceptability, and effectiveness to contextualize participant ratings of training and to identify recommendations for enhancing the utility of mental health training locally for educators. RESULTS Mean scores of knowledge and attitudes significantly improved between the pre-test and post-tests; e.g., knowledge improved from 58% correct at baseline to 68% correct on the second post-test (p = 0.039). Mean ratings of the training were favorable across all categories and FGD data demonstrated widespread participant endorsement of training acceptability and effectiveness; participants recommended extending the duration and number of training sessions. CONCLUSIONS Findings support feasibility, acceptability, and a limited scope of effectiveness of brief mental health training for secondary school teachers in Haiti. Further development of approaches to engage teachers in promoting school mental health through training is warranted.
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108
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Haddad M, Llewellyn-Jones S, Yarnold S, Simpson A. Improving the physical health of people with severe mental illness in a low secure forensic unit: An uncontrolled evaluation study of staff training and physical health care plans. Int J Ment Health Nurs 2016; 25:554-565. [PMID: 27443217 DOI: 10.1111/inm.12246] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 03/31/2016] [Accepted: 05/03/2016] [Indexed: 01/05/2023]
Abstract
The life expectancy of people with severe mental illnesses is substantially reduced, and monitoring and screening for physical health problems is a key part of addressing this health inequality. Inpatient admission presents a window of opportunity for this health-care activity. The present study was conducted in a forensic mental health unit in England. A personal physical health plan incorporating clearly-presented and easily-understood values and targets for health status in different domains was developed. Alongside this, a brief physical education session was delivered to health-care staff (n = 63). Printed learning materials and pedometers and paper tape measures were also provided. The impact was evaluated by a single-group pretest post-test design; follow-up measures were 4 months' post-intervention. The feasibility and acceptability of personal health plans and associated resources were examined by free-text questionnaire responses. Fifty-seven staff provided measures of attitudes and knowledge before training and implementation of the physical health plans. Matched-pairs analysis indicated a modest but statistically-significant improvement in staff knowledge scores and attitudes to involvement in physical health care. Qualitative feedback indicated limited uptake of the care plans and perceived need for additional support for better adoption of this initiative. Inpatient admission is a key setting for assessing physical health and promoting improved management of health problems. Staff training and purpose-designed personalized care plans hold potential to improve practice and outcomes in this area, but further support for such innovations appears necessary for their uptake in inpatient mental health settings.
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Affiliation(s)
- Mark Haddad
- Centre for Mental Health Research, School of Health Sciences, City University London.,East London National Health Service Foundation Trust, London, UK
| | | | - Steve Yarnold
- East London National Health Service Foundation Trust, London, UK
| | - Alan Simpson
- Centre for Mental Health Research, School of Health Sciences, City University London.,East London National Health Service Foundation Trust, London, UK
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109
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Kidger J, Evans R, Tilling K, Hollingworth W, Campbell R, Ford T, Murphy S, Araya R, Morris R, Kadir B, Moure Fernandez A, Bell S, Harding S, Brockman R, Grey J, Gunnell D. Protocol for a cluster randomised controlled trial of an intervention to improve the mental health support and training available to secondary school teachers - the WISE (Wellbeing in Secondary Education) study. BMC Public Health 2016; 16:1089. [PMID: 27756268 PMCID: PMC5070146 DOI: 10.1186/s12889-016-3756-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 10/08/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Teachers are reported to be at increased risk of common mental health disorders compared to other occupations. Failure to support teachers adequately may lead to serious long-term mental disorders, poor performance at work (presenteeism), sickness absence and health-related exit from the profession. It also jeopardises student mental health, as distressed staff struggle to develop supportive relationships with students, and such relationships are protective against student depression. A number of school-based trials have attempted to improve student mental health, but these have mostly focused on classroom based approaches and have failed to establish effectiveness. Only a few studies have introduced training for teachers in supporting students, and none to date have included a focus on improving teacher mental health. This paper sets out the protocol (version 4.4 20/07/16) for a study aiming to address this gap. METHODS Cluster randomised controlled trial with secondary schools as the unit of randomisation. Intervention schools will receive: i) Mental Health First Aid (MHFA) training for a group of staff nominated by their colleagues, after which they will set up a confidential peer support service for colleagues ii) training in MHFA for schools and colleges for a further group of teachers, which will equip them to more effectively support student mental health iii) a short mental health awareness raising session and promotion of the peer support service for all teachers. Comparison schools will continue with usual practice. The primary outcome is teacher wellbeing measured using the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS). Secondary outcomes are teacher depression, absence and presenteeism, and student wellbeing, mental health difficulties, attendance and attainment. Measures will be taken at baseline, one year follow up (teachers only) and two year follow up. Economic and process evaluations will be embedded within the study. DISCUSSION This study will establish the effectiveness and cost-effectiveness of an intervention that supports secondary school teachers' wellbeing and mental health, and improves their skills in supporting students. It will also provide information regarding intervention implementation and sustainability. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number: ISRCTN95909211 registered 24/03/16.
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Affiliation(s)
- Judi Kidger
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Rhiannon Evans
- DECIPHer, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD UK
| | - Kate Tilling
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - William Hollingworth
- Bristol Randomised Trials Collaboration, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Rona Campbell
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Tamsin Ford
- University of Exeter Medical School, South Cloisters, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Simon Murphy
- DECIPHer, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD UK
| | - Ricardo Araya
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Richard Morris
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Bryar Kadir
- Bristol Randomised Trials Collaboration, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Aida Moure Fernandez
- Bristol Randomised Trials Collaboration, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Sarah Bell
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Sarah Harding
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Rowan Brockman
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Jill Grey
- DECIPHer, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD UK
| | - David Gunnell
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
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Kidger J, Stone T, Tilling K, Brockman R, Campbell R, Ford T, Hollingworth W, King M, Araya R, Gunnell D. A pilot cluster randomised controlled trial of a support and training intervention to improve the mental health of secondary school teachers and students - the WISE (Wellbeing in Secondary Education) study. BMC Public Health 2016; 16:1060. [PMID: 27716226 PMCID: PMC5053067 DOI: 10.1186/s12889-016-3737-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 09/30/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Secondary school teachers are at heightened risk of psychological distress, which can lead to poor work performance, poor quality teacher-student relationships and mental illness. A pilot cluster randomised controlled trial (RCT) - the WISE study - evaluated the feasibility of a full-scale RCT of an intervention to support school staff's own mental health, and train them in supporting student mental health. METHODS Six schools were randomised to an intervention or control group. In the intervention schools i) 8-9 staff received Mental Health First Aid (MHFA) training and became staff peer supporters, and ii) youth MHFA training was offered to the wider staff body. Control schools continued with usual practice. We used thematic qualitative data analysis and regression modelling to ascertain the feasibility, acceptability and potential usefulness of the intervention. RESULTS Thirteen training observations, 14 staff focus groups and 6 staff interviews were completed, and 438 staff (43.5 %) and 1,862 (56.3 %) students (years 8 and 9) completed questionnaires at baseline and one year later. MHFA training was considered relevant for schools, and trainees gained in knowledge, confidence in helping others, and awareness regarding their own mental health. Suggestions for reducing the length of the training and focusing on helping strategies were made. A peer support service was established in all intervention schools and was perceived to be helpful in supporting individuals in difficulty - for example through listening, and signposting to other services - and raising the profile of mental health at a whole school level. Barriers to use included lack of knowledge about the service, concerns about confidentiality and a preference for accessing support from pre-existing networks. CONCLUSIONS The WISE intervention is feasible and acceptable to schools. Results support the development of a full-scale cluster RCT, if steps are taken to improve response rates and implement the suggested improvements to the intervention. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number: ISRCTN13255300 retrospectively registered 28/09/16.
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Affiliation(s)
- Judi Kidger
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Tracey Stone
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
- National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care in the West (NIHR CLAHRC West), 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT UK
| | - Kate Tilling
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Rowan Brockman
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Rona Campbell
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Tamsin Ford
- University of Exeter Medical School, South Cloisters, St Luke’s Campus, Exeter, EX1 2LU UK
| | - William Hollingworth
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
| | - Michael King
- Division of Psychiatry (Faculty of Brain Sciences), University College London, 6th Floor, Maple House, 149, Tottenham Court Road, London, W1T 7NF UK
| | - Ricardo Araya
- Ricardo Araya, Professor of Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - David Gunnell
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS UK
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Effectiveness of MH-Guru, a brief online mental health program for the workplace: A randomised controlled trial. Internet Interv 2016; 6:29-39. [PMID: 30135812 PMCID: PMC6096203 DOI: 10.1016/j.invent.2016.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 09/09/2016] [Accepted: 09/12/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Depression and anxiety interfere with an individual's quality of life and result in substantial economic costs to the workplace through lost productivity. The internet offers an unparalleled opportunity for the large scale, cost-effective delivery of mental health awareness and destigmatisation programs in the workplace. However, to date high quality assessments of the effectiveness of such workplace programs have been confined to health professional settings. The current study reports the effectiveness of Mental Health Guru (MH-Guru), a two-module online mental health workplace induction program. METHODS A total of 507 employees from a large multi-departmental government workplace were randomised to a 2-week online depression and anxiety educational program (Mental Health Guru; MH-Guru), or a Wait List Control condition. Participants completed online surveys at baseline, 1 week post-intervention and at 6-month follow-up. Primary outcome measures included depression and anxiety literacy, personal stigma about depression and anxiety, and help seeking intentions for anxiety and depression at post-test. Secondary measures included help-seeking attitudes and self-reported help seeking behaviour. Satisfaction measures were also collected. RESULTS Dropout at post intervention was 26.7% and 21.0% for the MH-Guru and Control conditions respectively. Relative to Control, MH-Guru participants showed significantly greater improvements in depression and anxiety literacy at post intervention. Between group standardized effect sizes at post-test and 6-months were 0.78 and 0.81 for depression literacy and 0.80 and 0.79 for anxiety literacy. Compared to the Control participants, the MH-Guru group also showed significantly greater reductions in depression and anxiety personal stigma. Between group effect sizes in stigma for depression were - 0.56 and - 0.47 at post-test and 6-months respectively and - 0.42 at both time points for anxiety. The MH-Guru intervention was not associated with a differentially greater increase in anxiety or depression help-seeking intentions or improvement in help seeking attitudes compared to the Control group. However, self-reported help-seeking behaviour was significantly greater in the MH-Guru group at post-test. In addition, the MH-Guru group showed greater intentions to seek help for depression from the Internet at 6-month follow-up. Satisfaction items suggested that the program was acceptable to employees. CONCLUSIONS Brief online programs such as MH-Guru have the potential to play an important role in increasing mental health awareness and decreasing stigmatizing attitudes in the workplace, and by extension the general community.
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Lubman DI, Berridge BJ, Blee F, Jorm AF, Wilson CJ, Allen NB, McKay-Brown L, Proimos J, Cheetham A, Wolfe R. A school-based health promotion programme to increase help-seeking for substance use and mental health problems: study protocol for a randomised controlled trial. Trials 2016; 17:393. [PMID: 27502480 PMCID: PMC4976510 DOI: 10.1186/s13063-016-1510-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 07/06/2016] [Indexed: 12/02/2022] Open
Abstract
Background Adolescence is a high-risk time for the development of mental health and substance use problems. However, fewer than one in four 16–24 year-olds with a current disorder access health services, with those experiencing a substance use disorder being the least likely to seek professional help. Research indicates that young people are keeping their problems to themselves or alternatively, turning to peers or trusted adults in their lives for help. These help-seeking preferences highlight the need to build the mental health literacy of adolescents, to ensure that they know when and how to assist themselves and their peers to access support. The MAKINGtheLINK intervention aims to introduce these skills to adolescents within a classroom environment. Methods/design This is a cluster randomised controlled trial (RCT) with schools as clusters and individual students as participants from 22 secondary schools in Victoria, Australia. Schools will be randomly assigned to either the MAKINGtheLINK intervention group or the waitlist control group. All students will complete a self-report questionnaire at baseline, immediately post intervention and 6 and 12 months post baseline. The primary outcome to be assessed is increased help-seeking behaviour (from both formal and informal sources) for alcohol and mental health issues, measured at 12 months post baseline. Discussion The findings from this research will provide evidence on the effectiveness of the MAKINGtheLINK intervention for teaching school students how to overcome prominent barriers associated with seeking help, as well as how to effectively support their peers. If deemed effective, the MAKINGtheLINK programme will be the first evidence-informed resource that is able to address critical gaps in the knowledge and behaviour of adolescents in relation to help-seeking. It could, therefore, be a valuable resource that could be readily implemented by classroom teachers. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12613000235707. Registered on 27 February 2013. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1510-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dan I Lubman
- Turning Point, Eastern Health, 54-62 Gertrude St, Fitzroy, VIC, 3065, Australia. .,Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.
| | - Bonita J Berridge
- Turning Point, Eastern Health, 54-62 Gertrude St, Fitzroy, VIC, 3065, Australia.,Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Fiona Blee
- Turning Point, Eastern Health, 54-62 Gertrude St, Fitzroy, VIC, 3065, Australia.,Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Anthony F Jorm
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Coralie J Wilson
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia.,Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.,Department of Psychology, University of Oregon, Eugene, OR, USA
| | - Lisa McKay-Brown
- Victorian Department of Education and Early Childhood Development, Travancore School, Travancore, VIC, Australia.,Melbourne Graduate School of Education, The University of Melbourne, Parkvilleᅟ, VIC, Australia
| | - Jenny Proimos
- Victorian Department of Education and Early Childhood Development, Melbourne, VIC, Australia
| | - Ali Cheetham
- Turning Point, Eastern Health, 54-62 Gertrude St, Fitzroy, VIC, 3065, Australia.,Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
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113
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Marzano L, Smith M, Long M, Kisby C, Hawton K. Police and Suicide Prevention. CRISIS 2016; 37:194-204. [DOI: 10.1027/0227-5910/a000381] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Abstract. Background: Police officers are frequently the first responders to individuals in crisis, but generally receive little training for this role. We developed and evaluated training in suicide awareness and prevention for frontline rail police in the UK. Aims: To investigate the impact of training on officers’ suicide prevention attitudes, confidence, and knowledge. Method: Fifty-three participants completed a brief questionnaire before and after undertaking training. In addition, two focus groups were conducted with 10 officers to explore in greater depth their views and experiences of the training program and the perceived impact on practice. Results: Baseline levels of suicide prevention attitudes, confidence, and knowledge were mixed but mostly positive and improved significantly after training. Such improvements were seemingly maintained over time, but there was insufficient power to test this statistically. Feedback on the course was generally excellent, notwithstanding some criticisms and suggestions for improvement. Conclusion: Training in suicide prevention appears to have been well received and to have had a beneficial impact on officers’ attitudes, confidence, and knowledge. Further research is needed to assess its longer-term effects on police attitudes, skills, and interactions with suicidal individuals, and to establish its relative effectiveness in the context of multilevel interventions.
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Affiliation(s)
- Lisa Marzano
- Psychology Department, Middlesex University, London, UK
| | | | | | | | - Keith Hawton
- Centre for Suicide Research, University of Oxford, UK
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114
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Petersen I, Evans-Lacko S, Semrau M, Barry MM, Chisholm D, Gronholm P, Egbe CO, Thornicroft G. Promotion, prevention and protection: interventions at the population- and community-levels for mental, neurological and substance use disorders in low- and middle-income countries. Int J Ment Health Syst 2016; 10:30. [PMID: 27069506 PMCID: PMC4827227 DOI: 10.1186/s13033-016-0060-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 03/23/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In addition to services within the health system, interventions at the population and community levels are also important for the promotion of mental health, primary prevention of mental, neurological and substance use (MNS) disorders, identification and case detection of MNS disorders; and to a lesser degree treatment, care and rehabilitation. This study aims to identify "best practice" and "good practice" interventions that can feasibly be delivered at these population- and community-levels in low- and middle-income countries (LMICs), to aid the identification of resource efficiencies and allocation in LMICs. METHODS A narrative review was conducted given the wide range of relevant interventions. Expert consensus was used to identify "best practice" at the population-level on the basis of existing quasi-experimental natural experiments and cost effectiveness, with small scale emerging and promising evidence comprising "good practice". At the community-level, using expert consensus, the ACE (Assessing Cost-Effectiveness in Prevention Project) grading system was used to differentiate "best practice" interventions with sufficient evidence from "good practice" interventions with limited but promising evidence. RESULTS At the population-level, laws and regulations to control alcohol demand and restrict access to lethal means of suicide were considered "best practice". Child protection laws, improved control of neurocysticercosis and mass awareness campaigns were identified as "good practice". At the community level, socio-emotional learning programmes in schools and parenting programmes during infancy were identified as "best practice". The following were all identified as "good practice": Integrating mental health promotion strategies into workplace occupational health and safety policies; mental health information and awareness programmes as well as detection of MNS disorders in schools; early child enrichment/preschool educational programs and parenting programs for children aged 2-14 years; gender equity and/or economic empowerment programs for vulnerable groups; training of gatekeepers to identify people with MNS disorders in the community; and training non-specialist community members at a neighbourhood level to assist with community-based support and rehabilitation of people with mental disorders. CONCLUSION Interventions provided at the population- and community-levels have an important role to play in promoting mental health, preventing the onset, and protecting those with MNS disorders. The importance of inter-sectoral engagement and the need for further research on interventions at these levels in LMICs is highlighted.
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Affiliation(s)
- Inge Petersen
- Centre for Rural Health, School of Nursing and Public Health and School of Applied Human Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Sara Evans-Lacko
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Maya Semrau
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Margaret M Barry
- World Health Organization Collaborating Centre for Health Promotion Research, National University of Ireland Galway, Galway, Ireland
| | - Dan Chisholm
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Petra Gronholm
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Catherine O Egbe
- School of Applied Human Sciences, University of KwaZulu Natal, Durban, South Africa ; Center for Tobacco Control Research and Education, University of California, San Francisco, USA
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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115
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Bovopoulos N, LaMontagne A, Martin A, Jorm A. Delivering mental health first aid training in Australian workplaces: exploring instructors’ experiences. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2016. [DOI: 10.1080/14623730.2015.1122658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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116
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Thornicroft G, Mehta N, Clement S, Evans-Lacko S, Doherty M, Rose D, Koschorke M, Shidhaye R, O'Reilly C, Henderson C. Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet 2016; 387:1123-1132. [PMID: 26410341 DOI: 10.1016/s0140-6736(15)00298-6] [Citation(s) in RCA: 623] [Impact Index Per Article: 77.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Stigma and discrimination in relation to mental illnesses have been described as having worse consequences than the conditions themselves. Most medical literature in this area of research has been descriptive and has focused on attitudes towards people with mental illness rather than on interventions to reduce stigma. In this narrative Review, we summarise what is known globally from published systematic reviews and primary data on effective interventions intended to reduce mental-illness-related stigma or discrimination. The main findings emerging from this narrative overview are that: (1) at the population level there is a fairly consistent pattern of short-term benefits for positive attitude change, and some lesser evidence for knowledge improvement; (2) for people with mental illness, some group-level anti-stigma inventions show promise and merit further assessment; (3) for specific target groups, such as students, social-contact-based interventions usually achieve short-term (but less clearly long-term) attitudinal improvements, and less often produce knowledge gains; (4) this is a heterogeneous field of study with few strong study designs with large sample sizes; (5) research from low-income and middle-income countries is conspicuous by its relative absence; (6) caution needs to be exercised in not overgeneralising lessons from one target group to another; (7) there is a clear need for studies with longer-term follow-up to assess whether initial gains are sustained or attenuated, and whether booster doses of the intervention are needed to maintain progress; (8) few studies in any part of the world have focused on either the service user's perspective of stigma and discrimination or on the behaviour domain of behavioural change, either by people with or without mental illness in the complex processes of stigmatisation. We found that social contact is the most effective type of intervention to improve stigma-related knowledge and attitudes in the short term. However, the evidence for longer-term benefit of such social contact to reduce stigma is weak. In view of the magnitude of challenges that result from mental health stigma and discrimination, a concerted effort is needed to fund methodologically strong research that will provide robust evidence to support decisions on investment in interventions to reduce stigma.
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Affiliation(s)
- Graham Thornicroft
- Centre for Global Mental Health, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Nisha Mehta
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Sarah Clement
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Sara Evans-Lacko
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Mary Doherty
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Diana Rose
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Mirja Koschorke
- Centre for Global Mental Health, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Rahul Shidhaye
- Centre for Mental Health, Public Health Foundation of India, Delhi, India
| | - Claire O'Reilly
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia
| | - Claire Henderson
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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117
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LaMontagne AD, Milner AJ, Allisey AF, Page KM, Reavley NJ, Martin A, Tchernitskaia I, Noblet AJ, Purnell LJ, Witt K, Keegel TG, Smith PM. An integrated workplace mental health intervention in a policing context: Protocol for a cluster randomised control trial. BMC Psychiatry 2016; 16:49. [PMID: 26920745 PMCID: PMC4769504 DOI: 10.1186/s12888-016-0741-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 02/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In this paper, we present the protocol for a cluster-randomised trial to evaluate the implementation and effectiveness of a workplace mental health intervention in the state-wide police department of the south-eastern Australian state of Victoria. n. The primary aims of the intervention are to improve psychosocial working conditions and mental health literacy, and secondarily to improve mental health and organisational outcomes. METHODS/DESIGN The intervention was designed collaboratively with Victoria Police based on a mixed methods pilot study, and combines multi-session leadership coaching for the senior officers within stations (e.g., Sergeants, Senior Sergeants) with tailored mental health literacy training for lower and upper ranks. Intervention effectiveness will be evaluated using a two-arm cluster-randomised trial design, with 12 police stations randomly assigned to the intervention and 12 to the non-intervention/usual care control condition. Data will be collected from all police members in each station (estimated at >20 per station). Psychosocial working conditions (e.g., supervisory support, job control, job demands), mental health literacy (e.g., knowledge, confidence in assisting someone who may have a mental health problem), and mental health will be assessed using validated measures. Organisational outcomes will include organisational depression disclosure norms, organisational cynicism, and station-level sickness absence rates. The trial will be conducted following CONSORT guidelines. Identifying data will not be collected in order to protect participant privacy and to optimise participation, hence changes in primary and secondary outcomes will be assessed using a two-sample t-test comparing summary measures by arm, with weighting by cluster size. DISCUSSION This intervention is novel in its integration of stressor-reduction and mental health literacy-enhancing strategies. Effectiveness will be rigorously evaluated, and if positive results are observed, the intervention will be adapted across Victoria Police (total employees ~16,500) as well as possibly in other policing contexts, both nationally and internationally. TRIAL REGISTRATION Current Controlled Trials: ISRCTN82041334. Registered 24th July, 2014.
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Affiliation(s)
- Anthony D LaMontagne
- Centre for Population Health Research, School of Health & Social Development, Deakin University, Geelong, VIC, 3220, Australia.
| | - Allison J Milner
- Centre for Population Health Research, School of Health & Social Development, Deakin University, Geelong, VIC, 3220, Australia.
| | - Amanda F Allisey
- Faculty of Business and Law, Deakin Business School, Deakin University, Geelong, 3220, VIC, Australia.
| | - Kathryn M Page
- Centre for Population Health Research, School of Health & Social Development, Deakin University, Geelong, VIC, 3220, Australia.
| | - Nicola J Reavley
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Melbourne, VIC, Australia.
| | - Angela Martin
- Tasmanian School of Business and Economics, University of Tasmania, Sandy Bay Campus, Hobart, TAS, Australia.
| | - Irina Tchernitskaia
- Centre for Population Health Research, School of Health & Social Development, Deakin University, Geelong, VIC, 3220, Australia.
| | - Andrew J Noblet
- Faculty of Business and Law, Deakin Business School, Deakin University, Geelong, 3220, VIC, Australia.
| | - Lauren J Purnell
- Centre for Population Health Research, School of Health & Social Development, Deakin University, Geelong, VIC, 3220, Australia.
| | - Katrina Witt
- Centre for Population Health Research, School of Health & Social Development, Deakin University, Geelong, VIC, 3220, Australia.
| | - Tessa G Keegel
- College of Science, Health and Engineering, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
| | - Peter M Smith
- Monash Centre for Occupational & Environmental Health, School of Public Health & Preventive Medicine, Alfred Hospital, Monash University, Melbourne, VIC, Australia.
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118
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Talbot JA, Ziller EC, Szlosek DA. Mental Health First Aid in Rural Communities: Appropriateness and Outcomes. J Rural Health 2016; 33:82-91. [DOI: 10.1111/jrh.12173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Jean A. Talbot
- Maine Rural Health Research Center, Muskie School of Public Service; Cutler Institute for Health and Social Policy, University of Southern Maine; Portland Maine
| | - Erika C. Ziller
- Maine Rural Health Research Center, Muskie School of Public Service; Cutler Institute for Health and Social Policy, University of Southern Maine; Portland Maine
| | - Donald A. Szlosek
- Maine Rural Health Research Center, Muskie School of Public Service; Cutler Institute for Health and Social Policy, University of Southern Maine; Portland Maine
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119
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Hanisch SE, Twomey CD, Szeto ACH, Birner UW, Nowak D, Sabariego C. The effectiveness of interventions targeting the stigma of mental illness at the workplace: a systematic review. BMC Psychiatry 2016; 16:1. [PMID: 26739960 PMCID: PMC4704270 DOI: 10.1186/s12888-015-0706-4] [Citation(s) in RCA: 191] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 12/21/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The majority of people experiencing mental-health problems do not seek help, and the stigma of mental illness is considered a major barrier to seeking appropriate treatment. More targeted interventions (e.g. at the workplace) seem to be a promising and necessary supplement to public campaigns, but little is known about their effectiveness. The aim of this systematic review is to provide an overview of the evidence on the effectiveness of interventions targeting the stigma of mental illness at the workplace. METHODS Sixteen studies were included after the literature review. The effectiveness of anti-stigma interventions at the workplace was assessed by examining changes in: (1) knowledge of mental disorders and their treatment and recognition of signs/symptoms of mental illness, (2) attitudes towards people with mental-health problems, and (3) supportive behavior. RESULTS The results indicate that anti-stigma interventions at the workplace can lead to improved employee knowledge and supportive behavior towards people with mental-health problems. The effects of interventions on employees' attitudes were mixed, but generally positive. The quality of evidence varied across studies. CONCLUSIONS This highlights the need for more rigorous, higher-quality evaluations conducted with more diverse samples of the working population. Future research should explore to what extent changes in employees' knowledge, attitudes, and supportive behavior lead to affected individuals seeking help earlier. Such investigations are likely to inform important stakeholders about the potential benefits of current workplace anti-stigma interventions and provide guidance for the development and implementation of effective future interventions.
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Affiliation(s)
- Sabine E Hanisch
- Institute for Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilian University, Marchioninistr. 17, 81377, Munich, Germany.
| | - Conal D Twomey
- School of Psychology, University of Southampton, SO17 1BJ, Southampton, UK.
| | - Andrew C H Szeto
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.
| | - Ulrich W Birner
- Siemens AG, Human Resources, Department of Psychosocial Health and Well-being, Otto-Hahn-Ring 6, 81739, Munich, Germany.
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, WHO Collaborating Centre for Occupational Health, Clinic of the Ludwig-Maximilian University, Ziemsenstr. 1, 80336, Munich, Germany.
| | - Carla Sabariego
- Institute for Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilian University, Marchioninistr. 17, 81377, Munich, Germany.
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Oral R, Ramirez M, Coohey C, Nakada S, Walz A, Kuntz A, Benoit J, Peek-Asa C. Adverse childhood experiences and trauma informed care: the future of health care. Pediatr Res 2016; 79:227-33. [PMID: 26460523 DOI: 10.1038/pr.2015.197] [Citation(s) in RCA: 239] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 08/23/2015] [Indexed: 11/09/2022]
Abstract
Adverse childhood experiences (ACEs) are related to short- and long-term negative physical and mental health consequences among children and adults. Studies of the last three decades on ACEs and traumatic stress have emphasized their impact and the importance of preventing and addressing trauma across all service systems utilizing universal systemic approaches. Current developments on the implementation of trauma informed care (TIC) in a variety of service systems call for the surveillance of trauma, resiliency, functional capacity, and health impact of ACEs. Despite such efforts in adult medical care, early identification of childhood trauma in children still remains a significant public health need. This article reviews childhood adversity and traumatic toxic stress, presents epidemiologic data on the prevalence of ACEs and their physical and mental health impacts, and discusses intervention modalities for prevention.
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Affiliation(s)
- Resmiye Oral
- Department of Pediatrics, University of Iowa, Iowa City, Iowa
| | - Marizen Ramirez
- College of Public Health, University of Iowa, Iowa City, Iowa
| | - Carol Coohey
- School of Social Work, University of Iowa, Iowa City, Iowa
| | | | - Amy Walz
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Angela Kuntz
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Jenna Benoit
- Department of Pediatrics, University of Iowa, Iowa City, Iowa
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Kutcher S, Wei Y, Morgan C. Successful Application of a Canadian Mental Health Curriculum Resource by Usual Classroom Teachers in Significantly and Sustainably Improving Student Mental Health Literacy. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2015; 60:580-6. [PMID: 26720827 PMCID: PMC4679167 DOI: 10.1177/070674371506001209] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 06/01/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate whether the significant and substantive findings from a previous study of youth mental health literacy (MHL) could be replicated using the same methods in another population. METHOD We examined the impact of a curriculum resource, the Mental Health and High School Curriculum Guide (The Guide), taught by usual classroom teachers on students' knowledge and attitudes related to mental health and mental illness in Canadian secondary schools. Survey data were collected before, immediately after, and 2 months after implementation of The Guide by teachers in usual classroom teaching. We conducted paired-sample t tests and calculated the Cohen d value to determine outcomes and impact of the curriculum resource application. RESULTS One hundred fourteen students were matched for analysis of knowledge data and 112 students were matched for analysis of attitude data at pre-intervention, post-intervention, and 2-month follow-up time periods. Following classroom exposure to the curriculum resource, students' knowledge scores increased significantly and substantively, compared with baseline (P < 0.001, d = 1.11), and this was maintained at 2-month follow-up (P < 0.001, d = 0.91). Similar findings for attitude improvement were found (P < 0.001, d = 0.66), and this improvement was maintained at 2-month follow-up (P < 0.001, d = 0.52). CONCLUSIONS These findings corroborate those from a previous study conducted in a different location. Taken together these results suggest a simple but effective approach to improving MHL in young people by embedding a classroom resource, delivered by usual classroom teachers in usual school settings.
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Affiliation(s)
- Stan Kutcher
- Psychiatrist, Department of Psychiatry, Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia
| | - Yifeng Wei
- Research Associate and School Mental Health Lead, Sun Life Financial Chair in Adolescent Mental Health Team, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia
| | - Catherine Morgan
- Research Assistant, Sun Life Financial Chair in Adolescent Mental Health Team, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia
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Mehta N, Clement S, Marcus E, Stona AC, Bezborodovs N, Evans-Lacko S, Palacios J, Docherty M, Barley E, Rose D, Koschorke M, Shidhaye R, Henderson C, Thornicroft G. Evidence for effective interventions to reduce mental health-related stigma and discrimination in the medium and long term: systematic review. Br J Psychiatry 2015; 207:377-84. [PMID: 26527664 PMCID: PMC4629070 DOI: 10.1192/bjp.bp.114.151944] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 01/04/2015] [Accepted: 02/27/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Most research on interventions to counter stigma and discrimination has focused on short-term outcomes and has been conducted in high-income settings. AIMS To synthesise what is known globally about effective interventions to reduce mental illness-based stigma and discrimination, in relation first to effectiveness in the medium and long term (minimum 4 weeks), and second to interventions in low- and middle-income countries (LMICs). METHOD We searched six databases from 1980 to 2013 and conducted a multi-language Google search for quantitative studies addressing the research questions. Effect sizes were calculated from eligible studies where possible, and narrative syntheses conducted. Subgroup analysis compared interventions with and without social contact. RESULTS Eighty studies (n = 422 653) were included in the review. For studies with medium or long-term follow-up (72, of which 21 had calculable effect sizes) median standardised mean differences were 0.54 for knowledge and -0.26 for stigmatising attitudes. Those containing social contact (direct or indirect) were not more effective than those without. The 11 LMIC studies were all from middle-income countries. Effect sizes were rarely calculable for behavioural outcomes or in LMIC studies. CONCLUSIONS There is modest evidence for the effectiveness of anti-stigma interventions beyond 4 weeks follow-up in terms of increasing knowledge and reducing stigmatising attitudes. Evidence does not support the view that social contact is the more effective type of intervention for improving attitudes in the medium to long term. Methodologically strong research is needed on which to base decisions on investment in stigma-reducing interventions.
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Affiliation(s)
- N Mehta
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - S Clement
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - E Marcus
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - A-C Stona
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - N Bezborodovs
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - S Evans-Lacko
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - J Palacios
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - M Docherty
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - E Barley
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - D Rose
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - M Koschorke
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - R Shidhaye
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - C Henderson
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - G Thornicroft
- Nisha Mehta, MBBS, Sarah Clement, PhD, Elena Marcus, MSc, Anne-Claire Stona, BSc, Nikita Bezborodovs, MD, Sara Evans-Lacko, PhD, Jorge Palacios, PhD, Mary Docherty, MRCPsych, Elizabeth Barley, PhD, Diana Rose, PhD, Mirja Koschorke, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Rahul Shidhaye, PhD, Centre for Mental Health, Public Health Foundation of India, Delhi, India; Claire Henderson, PhD, Graham Thornicroft, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Milner A, Witt K, Burnside L, Wilson C, LaMontagne AD. Contact & connect--an intervention to reduce depression stigma and symptoms in construction workers: protocol for a randomised controlled trial. BMC Public Health 2015; 15:1062. [PMID: 26475500 PMCID: PMC4609134 DOI: 10.1186/s12889-015-2394-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 09/30/2015] [Indexed: 11/10/2022] Open
Abstract
Background Males employed in the construction industry have high rates of suicide. Although reasons underpinning this risk are multifaceted, poor help-seeking and stigma are represent major contributors. Males in the construction industry are also exposed to other risk factors for mental ill health and suicide, including unemployment. Sigma-reducing interventions that are accessible and attractive to recently unemployed males in the construction industry could therefore improve help-seeking, and address depression and suicidal behaviour in this population. Methods/Design Contact&Connect will use a parallel individual randomized design to evaluate the effectiveness of a multimedia-based intervention aimed at reducing stigma. The intervention consists of a package of 12 brief contact interventions (BCIs) delivered over a six month period. BCIs will direct participants to informational programs and microsites. Content will address three major themes: debunking depression myths and stereotypes, normalisation, and empowerment. Target enrolment is 630 (315 in each arm), each to be followed for 12 months. Eligible participants will be males, between 30 and 64 years, unemployed at the time of recruitment, registered with Incolink (a social welfare trustee company for unemployed members of the construction industry), and own a smart phone with enabled internet connectivity. Discussion At present, there are no programs that have been shown to be effective in reducing stigma in the blue-collar male population. Contact&Connect promises to provide a tailored, efficient, and scalable approach to reducing stigma, depressive symptoms and suicidality among unemployed males. Trial registration Australian New Zealand Clinical Trials Register ACTRN12615000792527 (date of registration: 30 July, 2015). Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2394-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Allison Milner
- Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Burwood, VIC, Australia. .,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Katrina Witt
- Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Burwood, VIC, Australia
| | | | | | - Anthony D LaMontagne
- Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Burwood, VIC, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Ojio Y, Yonehara H, Taneichi S, Yamasaki S, Ando S, Togo F, Nishida A, Sasaki T. Effects of school-based mental health literacy education for secondary school students to be delivered by school teachers: A preliminary study. Psychiatry Clin Neurosci 2015; 69:572-9. [PMID: 25975933 DOI: 10.1111/pcn.12320] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 04/13/2015] [Accepted: 05/13/2015] [Indexed: 11/28/2022]
Abstract
AIMS Improving knowledge and beliefs about mental health (or mental health literacy [MHL]) may promote appropriate help-seeking by adolescents who are suffering from mental health problems. We developed a concise, school-staff-led MHL program and examined its effects. METHODS The participants comprised 118 grade-9 students (61 boys and 57 girls). The program consisted of two 50-min sessions, and was given by a schoolteacher. The effects of the program were evaluated before, immediately after and 3 months after the program, using a self-report questionnaire. RESULTS Knowledge of mental health/illnesses and desirable behavior for help-seeking were significantly improved immediately after (post-test, P < 0.001, and P < 0.001, respectively) and 3 months after the program (3-month follow up, P < 0.001 and P < 0.001, respectively), compared with the test before the delivery of the program (pre-test, Wilcoxon signed rank test). Proportions of the correct diagnoses of vignette cases of major depression and schizophrenia were significantly (P < 0.001) elevated from 38.3% and 19.1% (pre-test) to 94.7% and 93.6% (post-test), and 91.5% and 86.2% (3-month follow up). Intentions to seek help and to provide peers with help with mental health problems were also significantly (P < 0.001) elevated at post-test and at 3 months compared with the pre-test. CONCLUSIONS A concise, school-staff-led program may have a significant effect on the improvement of MHL in secondary school students.
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Affiliation(s)
- Yasutaka Ojio
- Department of Physical and Health Education, The University of Tokyo, Tokyo, Japan
| | - Hiromi Yonehara
- Secondary School attached to the Faculty of Education, The University of Tokyo, Tokyo, Japan
| | - Setsuko Taneichi
- Department of Physical and Health Education, The University of Tokyo, Tokyo, Japan
| | - Syudo Yamasaki
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shuntaro Ando
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Fumiharu Togo
- Department of Physical and Health Education, The University of Tokyo, Tokyo, Japan
| | - Atsushi Nishida
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Tsukasa Sasaki
- Department of Physical and Health Education, The University of Tokyo, Tokyo, Japan
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125
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Wong EC, Collins RL, Cerully JL. Reviewing the Evidence Base for Mental Health First Aid: Is There Support for Its Use with Key Target Populations in California? RAND HEALTH QUARTERLY 2015; 5:19. [PMID: 28083372 PMCID: PMC5158252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This article reviews the current state of evidence for Mental Health First Aid's effectiveness in key target populations, to help the California Mental Health Services Authority's planning for future prevention and early intervention activities.
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126
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Fernandez A, Moreno-Peral P, Zabaleta-del-Olmo E, Bellon JA, Aranda-Regules JM, Luciano JV, Serrano-Blanco A, Rubio-Valera M. Is there a case for mental health promotion in the primary care setting? A systematic review. Prev Med 2015; 76 Suppl:S5-11. [PMID: 25475684 DOI: 10.1016/j.ypmed.2014.11.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 11/11/2014] [Accepted: 11/24/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of mental health promotion (MHP) interventions by primary health care professionals in the adult population. METHODS Systematic review of literature in English and Spanish for randomized controlled trials (RCTs) and observational studies evaluating the impact of interventions carried out by primary care professionals explicitly to promote and improve the overall mental health of adult patients. PubMed, PsycINFO, and Web of Science were independently searched by two investigators to identify all MHP articles from inception to October 2013 (no restrictions). RESULTS We retrieved 4262 records and excluded 4230 by a review of title and abstract. Of 32 full-text articles assessed, 3 RCTs were selected (2 in USA, 1 in UK); two focused on the mental health of parents whose children have behavioral problems, the other on older people with disabilities. One study reported a MHP intervention that improved participants' mental health at 6-month follow-up. All studies had low-moderate quality (2 of 5 points) on the Jadad Scale. CONCLUSION There is a lack of implementation and/or evaluation of mental health promotion activities conducted by primary care professionals. More research is needed to clearly understand the benefits of promoting mental health in this setting.
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Affiliation(s)
- Ana Fernandez
- Centre for Disability Research and Policy/Brain and Mind Research Institute, Faculty of Health Sciences, University of Sydney, Australia; Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Network for Prevention and Health Promotion in Primary Care (RedIAPP, ISCIII), Spain; Department of Pharmacology and Therapeutic Chemistry, School of Pharmacy, Universitat de Barcelona, Spain.
| | - Patricia Moreno-Peral
- Network for Prevention and Health Promotion in Primary Care (RedIAPP, ISCIII), Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Investigación del Distrito de Atención Primaria de Málaga, Spain
| | - Edurne Zabaleta-del-Olmo
- Network for Prevention and Health Promotion in Primary Care (RedIAPP, ISCIII), Spain; Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Juan Angel Bellon
- Network for Prevention and Health Promotion in Primary Care (RedIAPP, ISCIII), Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Investigación del Distrito de Atención Primaria de Málaga, Spain; Centro de Salud El Palo, Distrito de Atención Primaria Málaga-Guadalohorce, Departamento de Medicina Preventiva, Universidad de Málaga, Spain
| | - Jose Manuel Aranda-Regules
- Network for Prevention and Health Promotion in Primary Care (RedIAPP, ISCIII), Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Investigación del Distrito de Atención Primaria de Málaga, Spain; Centro de Salud San Andrés Torcal, Distrito Sanitario Málaga-Guadalhorce, Servicio Andaluz de Salud, Málaga, Spain
| | - Juan Vicente Luciano
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Network for Prevention and Health Promotion in Primary Care (RedIAPP, ISCIII), Spain; Open University of Catalonia, Barcelona, Spain
| | - Antoni Serrano-Blanco
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Network for Prevention and Health Promotion in Primary Care (RedIAPP, ISCIII), Spain
| | - Maria Rubio-Valera
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Network for Prevention and Health Promotion in Primary Care (RedIAPP, ISCIII), Spain; Open University of Catalonia, Barcelona, Spain
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Experiences of a Mental Health First Aid training program in Sweden: a descriptive qualitative study. Community Ment Health J 2015; 51:497-503. [PMID: 25663123 DOI: 10.1007/s10597-015-9840-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 02/04/2015] [Indexed: 10/24/2022]
Abstract
Restricted mental health literacy and stigma are barriers to treatment of mental disorders. A Mental Health First Aid training program was tested for implementation in Sweden among employees in the public sector. The aim of the present qualitative study was to explore participants' experiences of the program in more depth, in conjunction with a randomized controlled study. Twenty four persons participated in a total of six focus groups 6-8 months after program participation. Data were analyzed using content analysis. The analysis resulted in five categories illustrating the participants' experiences of the course: increased awareness, knowledge and understanding; influence on attitude and approach; tool box and confidence; feedback on content and layout; and tangible examples of applied knowledge. The most central finding is the fruitfulness of the program's practical focus and use, the increased confidence and inclination to act following program participation, and the importance of experienced instructors.
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128
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Lucksted A, Mendenhall AN, Frauenholtz SI, Aakre JM. Experiences of graduates of the Mental Health First Aid-USA course. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2015. [DOI: 10.1080/14623730.2015.1013670] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bond KS, Jorm AF, Kitchener BA, Reavley NJ. Mental health first aid training for Australian medical and nursing students: an evaluation study. BMC Psychol 2015; 3:11. [PMID: 25914827 PMCID: PMC4399395 DOI: 10.1186/s40359-015-0069-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 03/26/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The role and demands of studying nursing and medicine involve specific stressors that may contribute to an increased risk for mental health problems. Stigma is a barrier to help-seeking for mental health problems in nursing and medical students, making these students vulnerable to negative outcomes including higher failure rates and discontinuation of study. Mental Health First Aid (MHFA) is a potential intervention to increase the likelihood that medical and nursing students will support their peers to seek help for mental health problems. This study aimed to evaluate the effectiveness of a tailored MHFA course for nursing and medical students. METHODS Nursing and medical students self-selected into either a face-to-face or online tailored MHFA course. Four hundred and thirty-four nursing and medical students completed pre- and post-course surveys measuring mental health first aid intentions, mental health literacy, confidence in providing help, stigmatising attitudes and satisfaction with the course. RESULTS The results of the study showed that both the online and face-to-face courses improved the quality of first aid intentions towards a person experiencing depression, and increased mental health literacy and confidence in providing help. The training also decreased stigmatizing attitudes and desire for social distance from a person with depression. CONCLUSION Both online and face-to-face tailored MHFA courses have the potential to improve outcomes for students with mental health problems, and may benefit the students in their future professional careers.
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Affiliation(s)
- Kathy S Bond
- />Mental Health First Aid Australia, Level 6/369 Royal Parade, Parkville, VIC 3052 Australia
| | - Anthony F Jorm
- />Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 4/207 Bouverie St., Parkville, VIC 3010 Australia
| | - Betty A Kitchener
- />Mental Health First Aid Australia, Level 6/369 Royal Parade, Parkville, VIC 3052 Australia
- />School of Psychology, Deakin University, Geelong, Victoria Australia
| | - Nicola J Reavley
- />Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 4/207 Bouverie St., Parkville, VIC 3010 Australia
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School mental health. SCHOOL MENTAL HEALTH 2015. [DOI: 10.1017/cbo9781107284241.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Cossu G, Cantone E, Pintus M, Cadoni M, Pisano A, Otten R, Kuijpers R, Pintus E, Sancassiani F, Moro MF, Holzinger A, Mereu A, Preti A, Carta MG. Integrating children with psychiatric disorders in the classroom: a systematic review. Clin Pract Epidemiol Ment Health 2015; 11:41-57. [PMID: 25834627 PMCID: PMC4378069 DOI: 10.2174/1745017901511010041] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/07/2014] [Accepted: 10/22/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND The school setting may be the optimal context for early screening of and intervention on child mental health problems, because of its large reach and intertwinement with various participants (child, teacher, parent, other community services). But this setting also exposes children to the risk of stigma, peer rejection and social exclusion. This systematic literature review investigates the efficacy of mental health interventions addressed to children and adolescents in school settings, and it evaluates which programs explicitly take into account social inclusion indicators. METHOD Only randomized controlled trials conducted on clinical populations of students and carried out in school settings were selected: 27 studies overall. Most studies applied group Cognitive Behavioural Therapy or Interpersonal Psychotherapy. RESULTS Findings were suggestive of the effectiveness of school-based intervention programs in reducing symptoms of most mental disorders. Some evidence was found about the idea that effective studies on clinical populations may promote the social inclusion of children with an ongoing mental disorder and avoid the risk of being highly stigmatized. CONCLUSION School programs are still needed that implement standardized models with verifiable and evidence-based practices involving the whole school community.
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Affiliation(s)
- Giulia Cossu
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Elisa Cantone
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Mirra Pintus
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Michela Cadoni
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Anna Pisano
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Roy Otten
- Radboud University Nijmegen, The Nederlands
| | | | - Elisa Pintus
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Federica Sancassiani
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Maria Francesca Moro
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Anita Holzinger
- Medical University of Vienna, Clinical Institute of Pathology, Austria
| | - Alessandra Mereu
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Antonio Preti
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
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Crawford G, Burns SK, Chih HJ, Hunt K, Tilley PJM, Hallett J, Coleman K, Smith S. Mental health first aid training for nursing students: a protocol for a pragmatic randomised controlled trial in a large university. BMC Psychiatry 2015; 15:26. [PMID: 25886615 PMCID: PMC4337104 DOI: 10.1186/s12888-015-0403-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 02/02/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The impact of mental health problems and disorders in Australia is significant. Mental health problems often start early and disproportionately affect young people. Poor adolescent mental health can predict educational achievement at school and educational and occupational attainment in adulthood. Many young people attend higher education and have been found to experience a range of mental health issues. The university setting therefore presents a unique opportunity to trial interventions to reduce the burden of mental health problems. Mental Health First Aid (MHFA) aims to train participants to recognise symptoms of mental health problems and assist an individual who may be experiencing a mental health crisis. Training nursing students in MHFA may increase mental health literacy and decrease stigma in the student population. This paper presents a protocol for a trial to examine the efficacy of the MHFA training for students studying nursing at a large university in Perth, Western Australia. METHODS/DESIGN This randomised controlled trial will follow the CONSORT guidelines. Participants will be randomly allocated to the intervention group (receiving a MHFA training course comprising two face to face 6.5 hour sessions run over two days during the intervention period) or a waitlisted control group (not receiving MHFA training during the study). The source population will be undergraduate nursing students at a large university located in Perth, Western Australia. Efficacy of the MHFA training will be assessed by following the intention-to-treat principle and repeated measures analysis. DISCUSSION Given the known burden of mental health disorders among student populations, it is important universities consider effective strategies to address mental health issues. Providing MHFA training to students offers the advantage of increasing mental health literacy, among the student population. Further, students trained in MHFA are likely to utilise these skills in the broader community, when they graduate to the workforce. It is anticipated that this trial will demonstrate the scalability of MHFA in the university environment for pre-service nurses and that implementation of MHFA courses, with comprehensive evaluation, could yield positive improvements in the mental health literacy amongst this target group as well as other tertiary student groups. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12614000861651 .
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Affiliation(s)
- Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Sharyn K Burns
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Hui Jun Chih
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Kristen Hunt
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - P J Matt Tilley
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Jonathan Hallett
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Kim Coleman
- School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Sonya Smith
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
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Improving Malawian teachers' mental health knowledge and attitudes: an integrated school mental health literacy approach. Glob Ment Health (Camb) 2015; 2:e1. [PMID: 28596850 PMCID: PMC4964842 DOI: 10.1017/gmh.2014.8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mental health literacy is foundational for mental health promotion, prevention, stigma reduction and care. Integrated school mental health literacy interventions may offer an effective and sustainable approach to enhancing mental health literacy for educators and students globally. METHODS Through a Grand Challenges Canada funded initiative called 'An Integrated Approach to Addressing the Issue of Youth Depression in Malawi and Tanzania', we culturally adapted a previously demonstrated effective Canadian school mental health curriculum resource (the Guide) for use in Malawi, the African Guide: Malawi version (AGMv), and evaluated its impact on enhancing mental health literacy for educators (teachers and youth club leaders) in 35 schools and 15 out-of-school youth clubs in the central region of Malawi. The pre- and post-test study designs were used to assess mental health literacy - knowledge and attitudes - of 218 educators before and immediately following completion of a 3-day training programme on the use of the AGMv. RESULTS Results demonstrated a highly significant and substantial improvement in knowledge (p < 0.0001, d = 1.16) and attitudes (p < 0.0001, d = 0.79) pertaining to mental health literacy in study participants. There were no significant differences in outcomes related to sex or location. CONCLUSIONS These positive results suggest that an approach that integrates mental health literacy into the existing school curriculum may be an effective, significant and sustainable method of enhancing mental health literacy for educators in Malawi. If these results are further found to be sustained over time, and demonstrated to be effective when extended to students, then this model may be a useful and widely applicable method for improving mental health literacy among both educators and students across Africa.
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Martínez V, Espinosa D, Zitko P, Marín R, Schilling S, Schwerter C, Rojas G. Effectiveness of the workshop "adolescent depression: what can schools do?". Front Psychiatry 2015; 6:67. [PMID: 26005423 PMCID: PMC4424900 DOI: 10.3389/fpsyt.2015.00067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 04/20/2015] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Adolescent depression is associated with serious consequences. School staff is in a unique position to screen and refer adolescents with depression in a timely manner, and can collaborate with healthcare teams to assist in the proper management of the disease. The objective of this paper is to describe the results of a workshop that aims to improve the knowledge of adolescent depression among school staff. MATERIALS AND METHODS This was a single-arm trial with a pre-post design. Six workshops were conducted in four cities in Chile. Each workshop lasted 4 h. Participatory methodology was used. A 26-item knowledge questionnaire about adolescent depression, with the alternatives "I agree," "I disagree," and "I don't know," was administered to the participants, before and after the workshop. RESULTS A total of 152 people participated in the trial. Of these, 74.3% were female, and 44.7% were school psychologists, 25.0%, teachers, 17.8%, school counselors, and 5.3%, social workers. On average, there were 69.6% (SD 21.3) correct responses on the initial test, and 91.8% (SD 8.0) on the final test. All items had an increase of correct answers and a decrease of "don't know" answers. There were notable increases of correct responses on statements dealing with myths: "Antidepressants for the treatment of depression in adolescents must be avoided because they produce dependence" (59-96%), and "Depression in adolescence is better defined as a weakness of character than as a disease" (75-95%). School psychologists scored higher than the other participants on the questionnaire both before and after the workshop. CONCLUSION The workshop: "Adolescent depression: What can schools do?" can improve school staff knowledge of this topic, especially aiding to dispel myths regarding the disease and its treatment. This can help bring about timely case detection and improved collaboration with health team for proper handling of adolescent depression.
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Affiliation(s)
- Vania Martínez
- Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente (CEMERA), Facultad de Medicina, Universidad de Chile , Santiago , Chile ; Millennium Institute for Research in Depression and Personality , Santiago , Chile
| | - Daniel Espinosa
- Millennium Institute for Research in Depression and Personality , Santiago , Chile
| | - Pedro Zitko
- Unidad de Estudios Asistenciales, Complejo Asistencial Barros Luco , Santiago , Chile ; Facultad de Medicina, Universidad Diego Portales , Santiago , Chile ; School of Medicine, Facultad de Medicina, Universidad de Chile , Santiago , Chile
| | - Rigoberto Marín
- School of Medicine, Facultad de Medicina, Universidad de Chile , Santiago , Chile
| | - Sara Schilling
- School of Public Health, Facultad de Medicina, Universidad de Chile , Santiago , Chile
| | - Camila Schwerter
- School of Medicine, Facultad de Medicina, Universidad de Chile , Santiago , Chile
| | - Graciela Rojas
- Millennium Institute for Research in Depression and Personality , Santiago , Chile ; Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile , Santiago , Chile
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Wynaden D, McAllister M, Tohotoa J, Al Omari O, Heslop K, Duggan R, Murray S, Happell B, Byrne L. The silence of mental health issues within university environments: a quantitative study. Arch Psychiatr Nurs 2014; 28:339-44. [PMID: 25439976 DOI: 10.1016/j.apnu.2014.08.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 08/20/2014] [Indexed: 11/15/2022]
Abstract
A descriptive study was used to examine the attitudes and experiences of staff and students towards mental health problems. Staff completed the "Attitude towards mental illness survey", and students who self-identified having a mental health problem completed the "Stigma scale". Using an online collection process, data from 270 staff and 201 students showed that the "silence" surrounding mental health problems permeates the university environment and impacts on help seeking behaviors, the provision of support and on the recovery and wellbeing of affected individuals. Universities must decrease stigma and foster social inclusion to build self-esteem in people who have mental health problems.
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Affiliation(s)
- Dianne Wynaden
- School of Nursing and Midwifery, Curtin University, GPO Box U 1987, Perth, Western Australia, Australia.
| | | | - Jenny Tohotoa
- School of Nursing and Midwifery, Curtin University, GPO Box U 1987, Perth, Western Australia, Australia.
| | - Omar Al Omari
- School of Nursing and Midwifery, Jerash University, Jordan, Jerash, Amman, Jerash, Jordan.
| | - Karen Heslop
- School of Nursing and Midwifery, Curtin University, GPO Box U 1987, Perth, Western Australia, Australia.
| | - Ravani Duggan
- School of Nursing and Midwifery, Curtin University, GPO Box U 1987, Perth, Western Australia, Australia.
| | - Sean Murray
- Curtin University, GPO Box U 1987, Perth, Western Australia, Australia.
| | - Brenda Happell
- Central Queensland University Rockhampton, North Rockhampton, Queensland, Australia.
| | - Louise Byrne
- School of Nursing and Midwifery, Central Queensland University Rockhampton, North Rockhampton, Queensland, Australia.
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Doyle K, Hungerford C. Adapting evidence-based interventions to accommodate cultural differences: where does this leave effectiveness? Issues Ment Health Nurs 2014; 35:739-44. [PMID: 25259636 DOI: 10.3109/01612840.2014.901452] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Evidence-based interventions are an essential part of delivering contemporary mental health services. Many such interventions, however, are developed with and for mainstream population groups. Practitioners and researchers alike will often adapt tools, practices, processes or programmes to meet the needs of culturally diverse populations groups, but wonder if and how such adaptations will affect outcomes. This paper considers the processes by which evidence-based interventions can be adapted by health professionals in any context; and includes an example of a successful cultural adaptation to an evidence-based intervention. The successful implementation of the Aboriginal Mental Health First Aid programme in Australia illustrates the potential for adapted interventions to support improvements in the health outcomes of people from culturally diverse backgrounds. The paper concludes by outlining the steps mental health professionals can take when adapting evidence-based interventions for use in their own workplace settings.
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Affiliation(s)
- Kerrie Doyle
- Disciplines of Nursing and Midwifery, Faculty of Health, University of Canberra, Canberra, Australia
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Hadlaczky G, Hökby S, Mkrtchian A, Carli V, Wasserman D. Mental Health First Aid is an effective public health intervention for improving knowledge, attitudes, and behaviour: a meta-analysis. Int Rev Psychiatry 2014; 26:467-75. [PMID: 25137113 DOI: 10.3109/09540261.2014.924910] [Citation(s) in RCA: 199] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Mental Health First Aid (MHFA) is a standardized, psychoeducational programme developed to empower the public to approach, support and refer individuals in distress by improving course participants' knowledge, attitudes and behaviours related to mental ill-health. The present paper aims to synthesize published evaluations of the MHFA programme in a meta-analysis to estimate its effects and potential as a public mental health awareness-increasing strategy. Fifteen relevant papers were identified through a systematic literature search. Standardized effect sizes were calculated for three different outcome measures: change in knowledge, attitudes, and helping behaviours. The results of the meta-analysis for these outcomes yielded a mean effect size of Glass's Δ = 0.56 (95% CI = 0.38 - 0.74; p < 0.001), 0.28 (95% CI = 0.22 - 0.35; p < 0.001) and 0.25 (95% CI = 0.12 - 0.38; p < 0.001), respectively. Results were homogenous, and moderator analyses suggested no systematic bias or differences in results related to study design (with or without control group) or 'publication quality' (journal impact factor). The results demonstrate that MHFA increases participants' knowledge regarding mental health, decreases their negative attitudes, and increases supportive behaviours toward individuals with mental health problems. The MHFA programme appears recommendable for public health action.
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Affiliation(s)
- Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet , Stockholm , Sweden
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139
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Svensson B, Hansson L. Effectiveness of mental health first aid training in Sweden. A randomized controlled trial with a six-month and two-year follow-up. PLoS One 2014; 9:e100911. [PMID: 24964164 PMCID: PMC4071003 DOI: 10.1371/journal.pone.0100911] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 06/01/2014] [Indexed: 11/18/2022] Open
Abstract
Background According to a recent report from the European Brain Council and the European Colleague of Neuropsychopharmacology the one year prevalence of some kind of mental disorder is around 27% among the adult population in Europe. Research has shown a lack of mental health literacy in the population in general and it is thus important to find ways to improve the public's knowledge and skills to provide first hand support to people with mental disorders. Mental Health First Aid (MHFA) is a training program that has shown positive changes in knowledge and helping behavior. This study investigates if MHFA training in a Swedish context provides a sustained improvement in knowledge about mental disorders, a better ability to be helpful in contacts with people who are ill and if it changes attitudes in a positive direction. Methods and Findings The introduction of the training program was made in accordance with the constructor's instructions. Participants were mainly public sector employees from a county in the west of Sweden. The study was a randomized controlled trial with an experiment group (n = 199) and a control group (n = 207) placed on a waiting list during a 6-month follow-up. A two-year follow-up was conducted for participants (n = 155) from both the intervention and waiting list group who had completed the training and during the follow-up been in contact with persons with mental disorders. The intervention group improved in knowledge as well as in confidence in providing help for someone in need. The two-year follow-up showed that the improvements were to a great extent maintained. Conclusions Mental Health First Aid might raise the level of awareness of mental disorders and have an influence on the number of people who can receive professional treatment for their problems.
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Affiliation(s)
- Bengt Svensson
- Department of Health Sciences, Lund University, Lund, Sweden
- * E-mail:
| | - Lars Hansson
- Department of Health Sciences, Lund University, Lund, Sweden
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140
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Griffiths KM, Carron-Arthur B, Parsons A, Reid R. Effectiveness of programs for reducing the stigma associated with mental disorders. A meta-analysis of randomized controlled trials. World Psychiatry 2014; 13:161-75. [PMID: 24890069 PMCID: PMC4102289 DOI: 10.1002/wps.20129] [Citation(s) in RCA: 238] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The stigma associated with mental disorders is a global public health problem. Programs to combat it must be informed by the best available evidence. To this end, a meta-analysis was undertaken to investigate the effectiveness of existing programs. A systematic search of PubMed, PsycINFO and Cochrane databases yielded 34 relevant papers, comprising 33 randomized controlled trials. Twenty-seven papers (26 trials) contained data that could be incorporated into a quantitative analysis. Of these trials, 19 targeted personal stigma or social distance (6,318 participants), six addressed perceived stigma (3,042 participants) and three self-stigma (238 participants). Interventions targeting personal stigma or social distance yielded small but significant reductions in stigma across all mental disorders combined (d=0.28, 95% CI: 0.17-0.39, p<0.001) as well as for depression (d=0.36, 95% CI: 0.10-0.60, p<0.01), psychosis (d=0.20, 95% CI: 0.06-0.34, p<0.01) and generic mental illness (d=0.30, 95% CI: 0.10-0.50, p<0.01). Educational interventions were effective in reducing personal stigma (d=0.33, 95% CI: 0.19-0.42, p<0.001) as were interventions incorporating consumer contact (d=0.47, 95% CI: 0.17-0.78, p<0.001), although there were insufficient studies to demonstrate an effect for consumer contact alone. Internet programs were at least as effective in reducing personal stigma as face-to-face delivery. There was no evidence that stigma interventions were effective in reducing perceived or self-stigma. In conclusion, there is an evidence base to inform the roll out of programs for improving personal stigma among members of the community. However, there is a need to investigate methods for improving the effectiveness of these programs and to develop interventions that are effective in reducing perceived and internalized stigma.
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Affiliation(s)
- Kathleen M Griffiths
- Centre for Mental Health Research, Australian National University, Acton, Canberra, ACT 0200, Australia
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141
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Workplace mental health: developing an integrated intervention approach. BMC Psychiatry 2014; 14:131. [PMID: 24884425 PMCID: PMC4024273 DOI: 10.1186/1471-244x-14-131] [Citation(s) in RCA: 157] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 03/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health problems are prevalent and costly in working populations. Workplace interventions to address common mental health problems have evolved relatively independently along three main threads or disciplinary traditions: medicine, public health, and psychology. In this Debate piece, we argue that these three threads need to be integrated to optimise the prevention of mental health problems in working populations. DISCUSSION To realise the greatest population mental health benefits, workplace mental health intervention needs to comprehensively 1) protect mental health by reducing work-related risk factors for mental health problems; 2) promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities; and 3) address mental health problems among working people regardless of cause. We outline the evidence supporting such an integrated intervention approach and consider the research agenda and policy developments needed to move towards this goal, and propose the notion of integrated workplace mental health literacy. SUMMARY An integrated approach to workplace mental health combines the strengths of medicine, public health, and psychology, and has the potential to optimise both the prevention and management of mental health problems in the workplace.
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142
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Gratwick-Sarll K, Bentley C. Improving eating disorders mental health literacy: a preliminary evaluation of the "Should I say something?" workshop. Eat Disord 2014; 22:405-19. [PMID: 24964314 DOI: 10.1080/10640266.2014.925764] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A repeated measures, uncontrolled, preliminary evaluation of a single 3-hour workshop-"Should I Say Something?"-aimed at improving eating disorders mental health literacy, was conducted in a sample of 177 university undergraduates. Following participation in the workshop, significant increases in eating disorder recognition and knowledge, and significant decreases in stigmatizing attitudes, were reported by participants. Moreover, 85% of participants reported that they provided assistance to someone whom they suspected had a mental health condition, including an eating disorder, during the 3-month follow-up period. This study provides preliminary evidence that "Should I Say Something?" may be effective in improving the mental health literacy of young people.
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Affiliation(s)
- Kassandra Gratwick-Sarll
- a Research School of Psychology , Australian National University , Canberra , Australian Capital Territory , Australia
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143
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Mendenhall AN, Jackson SC. Instructor insights into delivery of Mental Health First Aid USA: A case study of mental health promotion across one state. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2013. [DOI: 10.1080/14623730.2013.853420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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144
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Al-Obaidi AK, Nelson BD, Al Badawi G, Hicks MHR, Guarino AJ. Child mental health and service needs in Iraq: beliefs and attitudes of primary school teachers. Child Adolesc Ment Health 2013; 18:171-179. [PMID: 32847249 DOI: 10.1111/j.1475-3588.2012.00670.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To survey Iraqi primary school teachers' beliefs and attitudes about mental health and behavioural problems of children. METHODS From 10 primary schools in Baghdad, 148 teachers were surveyed using a closed-response questionnaire to assess beliefs and attitudes regarding students' mental health and behavioural problems, needs, resources and limitations to teaching. RESULTS Disruptive behaviours were rated as main problems by the largest proportions of teachers. In-service training on 'identifying students with social, emotional, or behavioural problems' and 'effective behaviour management' was rated very important by 70% of teachers. Most teachers received no training on mental health during their teaching career. There was low reported availability of a wide range of school-based mental health resources. CONCLUSIONS Teachers in Iraq report substantial mental health and behavioural problems in primary school children and identify high unmet need for school-based mental health programmes and training.
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Affiliation(s)
- Abdul Kareem Al-Obaidi
- Institute of International Education (IIE), 5 W, 37th St. # 12, New York, NY 10018, USA.,Psychiatry, Al Mustansyria Medical College, Baghdad, Iraq
| | - Brett D Nelson
- Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, Harvard Humanitarian Initiative: Director, Children in Conflict and Crisis, MA, USA
| | | | - Madelyn Hsiao-Rei Hicks
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
| | - Anthony J Guarino
- Centre for Interprofessional Studies and Innovation MGH, Institute of Health Professions, Boston, MA, USA
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Shepherd J, Dewhirst S, Pickett K, Byrne J, Speller V, Grace M, Almond P, Hartwell D, Roderick P. Factors facilitating and constraining the delivery of effective teacher training to promote health and well-being in schools: a survey of current practice and systematic review. PUBLIC HEALTH RESEARCH 2013. [DOI: 10.3310/phr01020] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundSchools are an important setting for health promotion and teachers have an integral role to play in promoting children and young people’s health and well-being. Adequate initial teacher training (ITT) and continuing professional development in health is therefore important.ObjectivesTo conduct a survey of initial teacher training providers in England and a systematic review of effectiveness to assess how health and well-being is covered on courses, and to identify barriers and facilitators to effective training.MethodsMethods included an online questionnaire survey with a sample of 220 ITT course managers in England; interviews with a purposive sample of 19 of the course managers responding to the questionnaire; and a two-stage systematic review comprising a descriptive map of the characteristics of international research studies of health teacher training and a detailed synthesis of a subset of studies specifically on pre-service training. Databases (including MEDLINE, EMBASE, The Campbell Library and PsycINFO) were searched from the period of database inception up to May 2011.ResultsThe overall response rate for the survey was 34%. The majority (89%) of respondents agreed that it was either important or very important to cover health within the ITT curriculum. The most commonly covered topics on courses wereEvery Child Matters(100%), child protection (100%), emotional health (99%) and antibullying (97%). Fewer course managers reported covering healthy eating (63%), sex and relationships (62%), drugs (56%), alcohol (41%) and smoking (34%). Many interviewees expressed a holistic view of education and believed that health was important in the ITT curriculum. However, there was variability in how health was addressed across and within institutions. Trainee teachers' experience of addressing child health on school placement was also variable. Facilitators to covering health included interests and backgrounds of ITT staff; staff health-related professional experience; availability of health expertise from external agencies; supportive government policy frameworks; and interprofessional and interdepartmental working. The main barriers were limited curriculum time; health being perceived to be a lower priority than other aspects of training; health no longer a high government priority in education; and lack of funding. A total of 170 studies met the eligibility criteria for the descriptive map. The majority covered teacher training in relation to sexual and reproductive health, drugs and alcohol or mental and emotional health. A total of 21 publications (20 studies) were prioritised for the synthesis. All were evaluations of health training for pre-service teachers, and just under half were from the UK. Twelve studies reported outcomes (impact of training on teachers, but not pupils), many of which were single cohort before-and-after studies. Sixteen studies reported processes. Following training there were some increases in trainee teachers' factual knowledge of health and a general increase in their confidence to address health issues. In general, training was acceptable and well received by trainees. Evidence suggested that effective training should include practical experience and skills and be personally relevant and take into account individual needs. Barriers to health training identified from the studies included lack of time, balancing breadth and depth, and variation in training provision.ConclusionsAmong those surveyed there appears to be general support for health and well-being in ITT. However, further research on the longer-term impact of ITT around health and well-being is needed, particularly in the early career period. The main limitation of this research was the low response rate (34%) to the survey.Study registrationPROSPERO number CRD42012001977.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- J Shepherd
- Southampton Health Technology Assessments Centre (SHTAC), Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Dewhirst
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - K Pickett
- Southampton Health Technology Assessments Centre (SHTAC), Faculty of Medicine, University of Southampton, Southampton, UK
| | - J Byrne
- Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK
| | - V Speller
- Health Development Consulting Ltd, Waterlooville, UK
| | - M Grace
- Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK
| | - P Almond
- Faculty of Health and Social Care, Anglia Ruskin University, Cambridge, UK
| | - D Hartwell
- Southampton Health Technology Assessments Centre (SHTAC), Faculty of Medicine, University of Southampton, Southampton, UK
| | - P Roderick
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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146
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Clement S, Lassman F, Barley E, Evans-Lacko S, Williams P, Yamaguchi S, Slade M, Rüsch N, Thornicroft G. Mass media interventions for reducing mental health-related stigma. Cochrane Database Syst Rev 2013; 2013:CD009453. [PMID: 23881731 PMCID: PMC9773732 DOI: 10.1002/14651858.cd009453.pub2] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Mental health-related stigma is widespread and has major adverse effects on the lives of people with mental health problems. Its two major components are discrimination (being treated unfairly) and prejudice (stigmatising attitudes). Anti-stigma initiatives often include mass media interventions, and such interventions can be expensive. It is important to know if mass media interventions are effective. OBJECTIVES To assess the effects of mass media interventions on reducing stigma (discrimination and prejudice) related to mental ill health compared to inactive controls, and to make comparisons of effectiveness based on the nature of the intervention (e.g. number of mass media components), the content of the intervention (e.g. type of primary message), and the type of media (e.g. print, internet). SEARCH METHODS We searched eleven databases: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 7, 2011); MEDLINE (OvidSP),1966 to 15 August 2011; EMBASE (OvidSP),1947 to 15 August 2011; PsycINFO (OvidSP), 1806 to 15 August 2011; CINAHL (EBSCOhost) 1981 to 16 August 2011; ERIC (CSA), 1966 to 16 August 2011; Social Science Citation Index (ISI), 1956 to 16 August 2011; OpenSIGLE (http://www.opengrey.eu/), 1980 to 18 August 2012; Worldcat Dissertations and Theses (OCLC), 1978 to 18 August 2011; metaRegister of Controlled Trials (http://www.controlled-trials.com/mrct/mrct_about.asp), 1973 to 18 August 2011; and Ichushi (OCLC), 1903 to 11 November 2011. We checked references from articles and reviews, and citations from included studies. We also searched conference abstracts and websites, and contacted researchers. SELECTION CRITERIA Randomised controlled trials (RCTs), cluster RCTs or interrupted time series studies of mass media interventions compared to inactive controls in members of the general public or any of its constituent groups (excluding studies in which all participants were people with mental health problems), with mental health as a subject of the intervention and discrimination or prejudice outcome measures. DATA COLLECTION AND ANALYSIS Two authors independently extracted data and assessed the risk of bias of included studies. We contacted study authors for missing information. Information about adverse effects was collected from study reports. Primary outcomes were discrimination and prejudice, and secondary outcomes were knowledge, cost, reach, recall, and awareness of interventions, duration/sustainability of media effects, audience reactions to media content, and unforeseen adverse effects. We calculated standardised mean differences and odds ratios. We conducted a primarily narrative synthesis due to the heterogeneity of included studies. Subgroup analyses were undertaken to examine the effects of the nature, content and type of mass media intervention. MAIN RESULTS We included 22 studies involving 4490 participants. All were randomised trials (3 were cluster RCTs), and 19 of the 22 studies had analysable outcome data. Seventeen of the studies had student populations. Most of the studies were at unclear or high risk of bias for all forms of bias except detection bias.Findings from the five trials with discrimination outcomes (n = 1196) were mixed, with effects showing a reduction, increase or consistent with no evidence of effect. The median standardised mean difference (SMD) for the three trials (n = 394) with continuous outcomes was -0.25, with SMDs ranging from -0.85 (95% confidence interval (CI) -1.39 to -0.31) to -0.17 (95% CI -0.53 to 0.20). Odds ratios (OR) for the two studies (n = 802) with dichotomous discrimination outcomes showed no evidence of effect: results were 1.30 (95% CI 0.53 to 3.19) and 1.19 (95% CI 0.85 to 1.65).The 19 trials (n = 3176) with prejudice outcomes had median SMDs favouring the intervention, at the three following time periods: -0.38 (immediate), -0.38 (1 week to 2 months) and -0.49 (6 to 9 months). SMDs for prejudice outcomes across all studies ranged from -2.94 (95% CI -3.52 to -2.37) to 2.40 (95% CI 0.62 to 4.18). The median SMDs indicate that mass media interventions may have a small to medium effect in decreasing prejudice, and are equivalent to reducing the level of prejudice from that associated with schizophrenia to that associated with major depression.The studies were very heterogeneous, statistically, in their populations, interventions and outcomes, and only two meta-analyses within two subgroups were warranted. Data on secondary outcomes were sparse. Cost data were provided on request for three studies (n = 416), were highly variable, and did not address cost-effectiveness. Two studies (n = 455) contained statements about adverse effects and neither reported finding any. AUTHORS' CONCLUSIONS Mass media interventions may reduce prejudice, but there is insufficient evidence to determine their effects on discrimination. Very little is known about costs, adverse effects or other outcomes. Our review found few studies in middle- and low-income countries, or with employers or health professionals as the target group, and none targeted at children or adolescents. The findings are limited by the quality of the evidence, which was low for the primary outcomes for discrimination and prejudice, low for adverse effects and very low for costs. More research is required to establish the effects of mass media interventions on discrimination, to better understand which types of mass media intervention work best, to provide evidence about cost-effectiveness, and to fill evidence gaps about types of mass media not covered in this review. Such research should use robust methods, report data more consistently with reporting guidelines and be less reliant on student populations.
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Affiliation(s)
- Sarah Clement
- Health Service and Population ResearchDepartment, King’s College London, Institute of Psychiatry, London, UK.
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147
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Klineberg E, Kelly MJ, Stansfeld SA, Bhui KS. How do adolescents talk about self-harm: a qualitative study of disclosure in an ethnically diverse urban population in England. BMC Public Health 2013; 13:572. [PMID: 23758739 PMCID: PMC3685521 DOI: 10.1186/1471-2458-13-572] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 05/18/2013] [Indexed: 11/21/2022] Open
Abstract
Background Self-harm is prevalent in adolescence. It is often a behaviour without verbal expression, seeking relief from a distressed state of mind. As most adolescents who self-harm do not seek help, the nature of adolescent self-harm and reasons for not disclosing it are a public health concern. This study aims to increase understanding about how adolescents in the community speak about self-harm; exploring their attitudes towards and experiences of disclosure and help-seeking. Methods This study involved 30 qualitative individual interviews with ethnically diverse adolescents aged 15–16 years (24 females, 6 males), investigating their views on coping with stress, self-harm and help-seeking, within their own social context in multicultural East London. Ten participants had never self-harmed, nine had self-harmed on one occasion and 11 had self-harmed repeatedly. Verbatim accounts were transcribed and subjected to content and thematic analysis using a framework approach. Results Self-harm was described as a complex and varied behaviour. Most participants who had self-harmed expressed reluctance to talk about it and many had difficulty understanding self-harm in others. Some participants normalised self-harm and did not wish to accept offers of help, particularly if their self-harm had been secretive and ‘discovered’, leading to their referral to more formal help from others. Disclosure was viewed more positively with hindsight by some participants who had received help. If help was sought, adolescents desired respect, and for their problems, feelings and opinions to be noticed and considered alongside receiving treatment for injuries. Mixed responses to disclosure from peers, family and initial sources of help may influence subsequent behaviour and deter presentation to services. Conclusions This study provides insight into the subjective experience of self-harm, disclosure and help-seeking from a young, ethnically diverse community sample. Accounts highlighted the value of examining self-harm in the context of each adolescent’s day-to-day life. These accounts emphasised the need for support from others and increasing awareness about appropriate responses to adolescent self-harm and accessible sources of help for adolescents.
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Affiliation(s)
- Emily Klineberg
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Barts& The London School of Medicine and Dentistry, London, UK.
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148
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Morawska A, Fletcher R, Pope S, Heathwood E, Anderson E, McAuliffe C. Evaluation of mental health first aid training in a diverse community setting. Int J Ment Health Nurs 2013; 22:85-92. [PMID: 22783922 DOI: 10.1111/j.1447-0349.2012.00844.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mental health first aid (MHFA) training has been disseminated in the community and has yielded positive outcomes in terms of increasing help-seeking behaviour and mental health literacy. However, there has been limited research investigating the effectiveness of this programme in multicultural communities. Given the increasing levels of multiculturalism in many countries, as well as the large number of barriers presented to these groups when trying to seek help for mental illnesses, the present study aimed to investigate the effectiveness of MHFA in these settings. A total of 458 participants, who were recruited from multicultural organizations, participated in a series of MHFA training courses. Participants completed questionnaires pre and post the training course, and 6-month follow-up interviews were conducted with a subsample of participants. Findings suggested that MHFA training increased participant recognition of mental illnesses, concordance with primary care physicians about treatments, confidence in providing first aid, actual help provided to others, and a reduction in stigmatizing attitudes. A 6-month follow up also yielded positive long-term effects of MHFA. The results have implications for further dissemination and the use of MHFA in diverse communities. In addition, the results highlight the need for mental health training in health-care service providers.
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Affiliation(s)
- Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Australia.
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149
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Wade D, Varker T, Coates S, Fitzpatrick T, Shann C, Creamer M. A mental health training program for community members following a natural disaster. DISASTER HEALTH 2013; 1:9-12. [PMID: 28228982 PMCID: PMC5314877 DOI: 10.4161/dish.22658] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 10/23/2012] [Accepted: 10/24/2012] [Indexed: 11/22/2022]
Abstract
This study reports data on a disaster mental health training program to enhance the capacity of lay people from disaster-affected communities, to provide assistance to others following a bushfire disaster. Local facilitators conducted training sessions which were actively promoted within communities. Participants were asked to complete an anonymous pre- and post-training survey to obtain data on the impact and quality of the training program. Responses from 462 (80%) of 577 people who attended 39 sessions showed substantial and significant increases in key competencies including confidence in their abilities to detect difficulties coping in others and to provide assistance. The quality of the program and materials were rated highly. The findings of the evaluation provide support for the program as a beneficial, acceptable and feasible community-level intervention following disaster.
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Affiliation(s)
- Darryl Wade
- Australian Centre for Posttraumatic Mental Health; East Melbourne, Victoria AUSTRALIA; Department of Psychiatry; University of Melbourne; Parkville, Victoria AUSTRALIA
| | - Tracey Varker
- Australian Centre for Posttraumatic Mental Health; East Melbourne, Victoria AUSTRALIA; Department of Psychiatry; University of Melbourne; Parkville, Victoria AUSTRALIA
| | | | | | - Clare Shann
- beyondblue: the national depression initiative
| | - Mark Creamer
- Department of Psychiatry; University of Melbourne; Parkville, Victoria AUSTRALIA
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150
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Jorm AF, Reavley NJ, Ross AM. Belief in the dangerousness of people with mental disorders: a review. Aust N Z J Psychiatry 2012; 46:1029-45. [PMID: 22422995 DOI: 10.1177/0004867412442406] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The scientific literature on stigma has been confused because there are multiple components of stigma with different correlates. In order to help make sense of this confusion, the present review focuses on research on one of the most commonly measured components - belief in dangerousness. METHOD AND RESULTS The review examines: measurement of belief in dangerousness; prevalence of belief in dangerousness; characteristics of people who believe in dangerousness; experiences associated with belief in dangerousness; characteristics of people that elicit belief in dangerousness; the effects of psychiatric labelling; the effects of causal explanations; interventions to reduce belief in dangerousness; and effects on help-seeking. CONCLUSION It is concluded that future research needs to focus on rigorous evaluation of interventions to reduce belief in dangerousness and the impact of this belief on people affected by mental disorders.
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Affiliation(s)
- Anthony F Jorm
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Australia.
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