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Reuman L, Thompson-Hollands J. Family accommodation in PTSD: Proposed considerations and distinctions from the established transdiagnostic literature. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2023; 30:453-464. [PMID: 38390036 PMCID: PMC10881198 DOI: 10.1111/cpsp.12375] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/07/2020] [Indexed: 11/29/2022]
Abstract
Accommodation is widely documented and studied among internalizing disorders; however, the conceptualization and study of accommodation in the context of posttraumatic stress disorder (PTSD) is relatively nascent. PTSD entails many diagnostic criteria-including exposure to a distinct Criterion A event, emotional numbing, and anger-that may uniquely influence accommodation and merit special consideration. Our aim was to review the impact of accommodation in PTSD, compare and contrast accommodation in PTSD to other disorders with a strong empirical evidence base regarding accommodation, and highlight considerations unique to PTSD and associated implications for accommodation. We conclude by providing considerations for future research and practice.
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Affiliation(s)
- Lillian Reuman
- VA Boston Healthcare System, National Center for PTSD, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Johanna Thompson-Hollands
- VA Boston Healthcare System, National Center for PTSD, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
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2
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Berry K, Allsopp K, Gaskin F, Price O. Staff support for workplace trauma: a freedom of information act request survey for NHS trusts providing mental health care in England. J Ment Health 2023:1-5. [PMID: 37933756 DOI: 10.1080/09638237.2023.2278094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/16/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Workplace trauma in mental health settings is defined as exposure to verbal and physical aggression, witnessing self-harm or hearing about patients' histories of abuse. Support for workplace trauma is important for staff well-being, staff retention and ultimately patient care. Assessing the extent and adequacy of staff support for workplace trauma in mental health settings is important in identifying areas of need and good practice. AIM To determine what staff support systems are in place for workplace trauma in mental health services across England. METHODS Freedom of Information Act requests were sent to all 57 National Health Service Trusts providing mental health care in England to identify policies on the support to mental health staff after traumatic incidents that they have experienced in the course of their clinical duties. RESULTS Fifty-five Trusts provided usable data. Only half provided evidence of a psychologically informed incident response that went beyond a fact-finding exercise and only a fifth of Trusts used an established model for the response process. A small proportion of policies acknowledged workplace traumas related to staff discrimination on the basis of protected characteristics. CONCLUSION There is insufficient attention to supporting mental health staff with the effects of workplace trauma.
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Affiliation(s)
- Katherine Berry
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Complex Trauma and Resilience Research Unit, Department of Research and Innovation, Manchester Academic Health Sciences Centre, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Kate Allsopp
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Complex Trauma and Resilience Research Unit, Department of Research and Innovation, Manchester Academic Health Sciences Centre, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Fay Gaskin
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Owen Price
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
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Morabito DM, Schmidt NB. Efficacy of a brief web-based tonic immobility psychoeducation intervention among trauma-exposed adults: A randomized clinical trial. J Trauma Stress 2023; 36:896-906. [PMID: 37467150 DOI: 10.1002/jts.22955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/21/2023] [Accepted: 05/06/2023] [Indexed: 07/21/2023]
Abstract
Tonic immobility (TI) is a defensive response that may occur during traumatic events. Although TI is adaptive in certain circumstances, it has been shown to contribute to increased trauma-related symptoms and poorer recovery. However, current frontline treatments for posttraumatic stress disorder (PTSD) have not focused significant attention on the experience of TI. Thus, the aim of this study was to develop and test the impact of a brief TI-focused psychoeducation (TIP) intervention on posttraumatic cognitions and PTSD symptoms relative to a health education control intervention. The sample included 46 adults with elevated PTSD symptoms who endorsed prior TI episodes. After providing informed consent, participants were randomly assigned to either the active or control intervention and completed self-report questionnaires including the tonic immobility questionnaire (TIQ-R), Life Events Checklist for DSM-5 (LEC-5), Posttraumatic Stress Checklist for DSM-5 (PCL-5), Posttraumatic Cognitions Inventory (PTCI), and Positive and Negative Affect Schedule (PANAS) at baseline, 1-week, and 1-month follow-up assessments. Results from linear mixed effects models indicated that participants in the TIP condition reported significantly larger reductions in posttraumatic cognitions and PTSD symptoms at 1-week, ds = 0.48 and 0.84, respectively, and 1-month, ds = 0.67 and 0.74. The findings suggest that TIP is a promising intervention that may be used to reduce posttraumatic cognitions and PTSD symptoms associated with TI. Given the ease of access, TIP could be used as a standalone intervention or as an add-on to existing evidence-based treatments for PTSD.
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Affiliation(s)
- Danielle M Morabito
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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4
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Tsantila F, Coppens E, De Witte H, Arensman E, Amann B, Cerga-Pashoja A, Corcoran P, Creswell-Smith J, Cully G, Toth MD, Greiner B, Griffin E, Hegerl U, Holland C, Leduc C, Leduc M, Ni Dhalaigh D, O'Brien C, Paterson C, Purebl G, Reich H, Ross V, Rugulies R, Sanches S, Thompson K, Van Audenhove C. Outcome assessment of a complex mental health intervention in the workplace. Results from the MENTUPP pilot study. Int Arch Occup Environ Health 2023; 96:1149-1165. [PMID: 37452149 PMCID: PMC10504212 DOI: 10.1007/s00420-023-01996-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Multicomponent interventions are recommendable to achieve the greatest mental health benefits, but are difficult to evaluate due to their complexity. Defining long-term outcomes, arising from a Theory of Change (ToC) and testing them in a pilot phase, is a useful approach to plan a comprehensive and meaningful evaluation later on. This article reports on the pilot results of an outcome evaluation of a complex mental health intervention and examines whether appropriate evaluation measures and indicators have been selected ahead of a clustered randomised control trial (cRCT). METHODS The MENTUPP pilot is an evidence-based intervention for Small and Medium Enterprises (SMEs) active in three work sectors and nine countries. Based on our ToC, we selected the MENTUPP long-term outcomes, which are reported in this article, are measured with seven validated scales assessing mental wellbeing, burnout, depression, anxiety, stigma towards depression and anxiety, absenteeism and presenteeism. The pilot MENTUPP intervention assessment took place at baseline and at 6 months follow-up. RESULTS In total, 25 SMEs were recruited in the MENTUPP pilot and 346 participants completed the validated scales at baseline and 96 at follow-up. Three long-term outcomes significantly improved at follow-up (p < 0.05): mental wellbeing, symptoms of anxiety, and personal stigmatising attitudes towards depression and anxiety. CONCLUSIONS The results of this outcome evaluation suggest that MENTUPP has the potential to strengthen employees' wellbeing and decrease anxiety symptoms and stigmatising attitudes. Additionally, this study demonstrates the utility of conducting pilot workplace interventions to assess whether appropriate measures and indicators have been selected. Based on the results, the intervention and the evaluation strategy have been optimised.
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Affiliation(s)
- Fotini Tsantila
- Centre for Care Research and Consultancy, LUCAS, KU Leuven, Louvain, Belgium.
| | - Evelien Coppens
- Centre for Care Research and Consultancy, LUCAS, KU Leuven, Louvain, Belgium
| | - Hans De Witte
- Research Group Work, Organisational and Personnel Psychology (WOPP-O2L), KU Leuven, Louvain, Belgium
- Optentia Research Unit, Vaal Campus, North-West University, Vanderbijlpark, South Africa
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Benedikt Amann
- Centre Fòrum Research Unit, Hospital del Mar Research Institute, Parc de Salut Mar, Barcelona, Spain
- Mental Health Institute Hospital del Mar, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
- Universitat Pompeu Fab, Barcelona, Spain
| | - Arlinda Cerga-Pashoja
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Paul Corcoran
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Grace Cully
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Monika Ditta Toth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Birgit Greiner
- School of Public Health, University College Cork, Cork, Ireland
| | - Eve Griffin
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Ulrich Hegerl
- European Alliance against Depression e.V., Leipzig, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt Am Main, Germany
| | - Carolyn Holland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Mallorie Leduc
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Cliodhna O'Brien
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Charlotte Paterson
- University of Stirling, Nursing, Midwifery and Allied Health Professionals Research Unit, Stirling, Scotland, UK
| | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Hanna Reich
- German Depression Foundation, Leipzig, Germany
- Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sarita Sanches
- Phrenos Center of Expertise for Severe mental illness, Utrecht, The Netherlands
- Altrecht Mental Health Care, Utrecht, The Netherlands
| | | | - Chantal Van Audenhove
- Centre for Care Research and Consultancy, LUCAS, KU Leuven, Louvain, Belgium
- Academic Center for General Practice, KU Leuven, Louvain, Belgium
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5
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Ramírez-Vielma R, Vaccari P, Cova F, Saldivia S, Vielma-Aguilera A, Grandón P. Interventions to reduce the stigma of mental health at work: a narrative review. PSICOLOGIA-REFLEXAO E CRITICA 2023; 36:14. [PMID: 37213032 DOI: 10.1186/s41155-023-00255-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/07/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND While there are reviews of the literature on mental health stigma reduction programs, very few have focused on the workplace. OBJECTIVE We sought to identify, describe and compare the main characteristics of the interventions to reduce the stigma towards mental health at work. METHOD The search of original articles (2007 to 2022) was carried out in the Web of Science Core Collection and Scopus databases, selecting 25 articles from the key terms: 1. Stigma, 2. Workplace, 3. Anti-stigma intervention/program, 4. Mental health. RESULTS These interventions can be effective in changing the knowledge, attitudes, and behaviors of workers towards people with mental health problems, although further verification of these results is needed as they are limited to date. DISCUSSION AND CONCLUSION Interventions to reduce stigma in the workplace could create more supportive work environments by reducing negative attitudes and discrimination and improving awareness of mental disorders.
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Affiliation(s)
- Raúl Ramírez-Vielma
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Barrio Universitario S/N, Concepción, Chile
| | - Pamela Vaccari
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Barrio Universitario S/N, Concepción, Chile
| | - Félix Cova
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Barrio Universitario S/N, Concepción, Chile
| | - Sandra Saldivia
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Alexis Vielma-Aguilera
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Pamela Grandón
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Barrio Universitario S/N, Concepción, Chile.
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Bogaers R, Geuze E, van Weeghel J, Leijten F, van de Mheen D, Greenberg N, Rozema AD, Brouwers E. Mental health issues and illness and substance use disorder (non-)disclosure to a supervisor: a cross-sectional study on beliefs, attitudes and needs of military personnel. BMJ Open 2023; 13:e063125. [PMID: 37045564 PMCID: PMC10105997 DOI: 10.1136/bmjopen-2022-063125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES Research suggests that military personnel frequently delay disclosing mental health issues and illness (MHI), including substance use disorder, to supervisors. This delay causes missed opportunities for support and workplace accommodations which may help to avoid adverse occupational outcomes. The current study aims to examine disclosure-related beliefs, attitudes and needs, to create a better understanding of personnel's disclosure decision making. DESIGN A cross-sectional questionnaire study among military personnel with and without MHI. Beliefs, attitudes and needs regarding the (non-)disclosure decision to a supervisor were examined, including factors associated with (non-)disclosure intentions and decisions. Descriptive and regression (logistic and ordinal) analyses were performed. SETTING The study took place within the Dutch military. PARTICIPANTS Military personnel with MHI (n=324) and without MHI (n=554) were participated in this study. OUTCOME MEASURE (Non-)disclosure intentions and decisions. RESULTS Common beliefs and attitudes pro non-disclosure were the preference to solve one's own problems (68.3%), the preference for privacy (58.9%) and a variety of stigma-related concerns. Common beliefs and attitudes pro disclosure were that personnel wanted to be their true authentic selves (93.3%) and the desire to act responsibly towards work colleagues (84.5%). The most reported need for future disclosure (96.8%) was having a supervisor who shows an understanding for MHI. The following factors were associated both with non-disclosure intentions and decisions: higher preference for privacy (OR (95% CI))=(1.99 (1.50 to 2.65)intention, 2.05 (1.12 to 3.76)decision) and self-management (OR (95% CI))=(1.64 (1.20 to 2.23)intention, 1.79 (1.00 to 3.20)decision), higher stigma-related concerns (OR (95% CI))=(1.76 (1.12 to 2.77)intention, 2.21 (1.02 to 4.79)decision) and lower quality of supervisor-employee relationship (OR (95% CI))=(0.25 (0.15 to 0.42)intention, 0.47 (0.25 to 0.87)decision). CONCLUSION To facilitate (early-)disclosure to a supervisor, creating opportunities for workplace support, interventions should focus on decreasing stigma and discrimination and align with personnels' preference for self-management. Furthermore, training is needed for supervisors on how to recognise, and effectively communicate with, personnel with MHI. Focus should also be on improving supervisor-employee relationships.
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Affiliation(s)
- Rebecca Bogaers
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg University, Tilburg School of Social and Behavioral Sciences, Tilburg, The Netherlands
- Brain Research and Innovation Centre, Dutch Ministry of Defence, Utrecht, The Netherlands
| | - Elbert Geuze
- Brain Research and Innovation Centre, Dutch Ministry of Defence, Utrecht, The Netherlands
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jaap van Weeghel
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg University, Tilburg School of Social and Behavioral Sciences, Tilburg, The Netherlands
| | - Fenna Leijten
- Directorate-General of Policy, Directorate of Strategy and Knowledge, Dutch Ministry of Defence, Den Haag, The Netherlands
| | - D van de Mheen
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg University, Tilburg School of Social and Behavioral Sciences, Tilburg, The Netherlands
| | - N Greenberg
- King's Centre for Military Health Research, King's College London, London, UK
| | - A D Rozema
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg University, Tilburg School of Social and Behavioral Sciences, Tilburg, The Netherlands
| | - Evelien Brouwers
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg University, Tilburg School of Social and Behavioral Sciences, Tilburg, The Netherlands
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Ryan CM, Innes CS, Kannis-Dymand L, Mason J, Lovell GP. An efficacy trial of a brief group based, single session intervention delivered through Australian community sport clubs to reduce mental illness stigma and increase help-seeking intention. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2023. [DOI: 10.1080/21507686.2023.2193751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Affiliation(s)
| | - Campbell S Innes
- School of Health, University of Sunshine Coast, Maroochydore, Queensland, Australia
| | - Lee Kannis-Dymand
- School of Health, University of Sunshine Coast, Maroochydore, Queensland, Australia
| | - Jonathon Mason
- School of Psychology, Counselling and Psychotherapy, Cairnmillar Institute, Melbourne, Victoria, Australia
| | - Geoff P Lovell
- School of Health, University of Sunshine Coast, Maroochydore, Queensland, Australia
- Kaplan Open Learning, Leeds, UK
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8
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Clapp JD, Sowers AF, Freng SA, Elmi LM, Kaya RA, Bachtel AR. Public beliefs about trauma and its consequences: Profiles and correlates of stigma. Front Psychol 2023; 13:992574. [PMID: 36687984 PMCID: PMC9846146 DOI: 10.3389/fpsyg.2022.992574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
Public stereotypes about trauma exposure and its likely consequences have the potential to influence levels of support extended to survivors in the larger community. The current project sought to examine unique profiles of stereotype endorsement both within and across participants sampled from distinct populations. Trauma-related stereotypes involving symptom course, dangerousness, employability, social functioning, predictability, character, and treatment need were examined in undergraduate (N 1 = 404; N 2 = 502) and MTurk (N 3 = 364) samples. Sympathizing [low overall endorsement], Fearful [high overall endorsement], Pejorative [high endorsement + moralizing beliefs], Safety-Focused [intermediate endorsement + dangerousness], and Performance-Focused [intermediate endorsement + employability] groups were replicated in latent profile models across all samples. Stereotype profiles demonstrated hypothesized associations with general perspectives of mental illness although support for consistent relations with respondent characteristics (e.g., sex; personal exposure to trauma; reported exposure in friends/family) was limited. Data suggest that trauma stereotypes are endorsed at high frequencies in the general community and conform to systematic patterns of prejudice that may be overlooked in more global assessments of stigma.
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Graham K, Murphy D, Hendrikx LJ. Exploring Barriers to Mental Health Treatment in the Female Veteran Population: A Qualitative Study. JOURNAL OF VETERANS STUDIES 2022. [DOI: 10.21061/jvs.v8i3.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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10
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Clary KL, Campbell C, Chiu C. Qualitatively Exploring Mental Health Attitude Changes among Emerging Adult Motivational Interviewing after One Motivational Enhanced Interview. CLINICAL SOCIAL WORK JOURNAL 2022; 50:445-457. [PMID: 35493776 PMCID: PMC9028893 DOI: 10.1007/s10615-022-00837-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/25/2022] [Indexed: 05/30/2023]
Abstract
UNLABELLED Emerging adult military members and veterans (MMV) are experiencing many transitions (e.g., adulthood, military). The sum of these changes can cause stress, anxiety, and mental health challenges. Stigma of mental health and treatment exists, and military populations are often not seeking or engaging in appropriate care. Recent research emphasizes the need to uncover mental health attitudes and self-stigma barriers regarding help seeking. We evaluated the impact of a single motivational-interviewing enhanced interview with 26 MMV, all who reported high risk substance use. In 75-minute interviews with the primary focus of discussing their experiences regarding mental health, substance use, and identity development, the interviewer incorporated motivational interviewing strategies (e.g., affirmations, complex reflections). Participants shared their developmental experiences, stressors transitioning, and barriers and stigma around mental health treatment. Participants completed a survey which included a variety of standardized measures and open-ended questions two weeks before and after the interview. Qualitative follow-up data via open ended questions shows the session was well received by participants as they could share their stories, think critically about their military experiences, and brainstorm solutions for mental health care. We conclude that using individual, confidential interviews to discuss sensitive topics for data collection with MMV is an area to continue developing. Conducting qualitative research with motivational interviewing strategies has the potential to be twofold: advance scholarship and inform practitioners, but also serve as a therapeutic platform for some participants. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10615-022-00837-z.
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Affiliation(s)
- Kelly Lynn Clary
- School of Social Work, Texas State University, 601 University Drive; Encino Hall, 78666 San Marcos, TX United States
| | - Corey Campbell
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, United States
| | - Chungyi Chiu
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, United States
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11
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Gast M, Lehmann J, Schwarz E, Hirning C, Hoelzer M, Guendel H, Balint EM. A Single-Day Training for Managers Reduces Cognitive Stigma Regarding Mental Health Problems: A Randomized Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074139. [PMID: 35409821 PMCID: PMC8998400 DOI: 10.3390/ijerph19074139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/04/2022]
Abstract
Background: Mental illnesses have received increasing attention in the work context in recent years, yet they are still often accompanied by stigma. One starting point for stigma reduction is interventions in the workplace. The present study evaluated a one-day workshop for managers in a large company. Method: Enrolled managers (n = 70) were randomly assigned to the intervention group and the waiting control group. The training included a theoretical section on mental and stress-related diseases as well as the interplay between work and health, group work on personal stress experience, theoretical input on dealing with mentally ill employees, and a group discussion on this topic along with case studies. Both groups completed the following questionnaires at baseline and three months after training: Effort–Reward Imbalance Questionnaire, Patient Health Questionnaire, Mental Health Knowledge Schedule, Social Distance Scale, and the Irritation Scale. Results: Compared to the waiting group, the intervention group showed a significant improvement in the Mental Health Knowledge Schedule (U = 417.00, p = 0.040) and an increase in the Irritation Scale (U = 371.50 p = 0.011). All other scales remained unchanged. Conclusion: The content and duration of the training were adequate to reduce cognitive stigma towards mental illness. However, the present approach was not sufficient for an improvement in the subjective stress level of the participating managers.
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Affiliation(s)
- Michael Gast
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, 89081 Ulm, Germany; (M.G.); (J.L.); (E.S.); (C.H.); (E.M.B.)
| | - Janina Lehmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, 89081 Ulm, Germany; (M.G.); (J.L.); (E.S.); (C.H.); (E.M.B.)
| | - Elena Schwarz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, 89081 Ulm, Germany; (M.G.); (J.L.); (E.S.); (C.H.); (E.M.B.)
| | - Christian Hirning
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, 89081 Ulm, Germany; (M.G.); (J.L.); (E.S.); (C.H.); (E.M.B.)
| | | | - Harald Guendel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, 89081 Ulm, Germany; (M.G.); (J.L.); (E.S.); (C.H.); (E.M.B.)
- Correspondence: ; Tel.: +49-731-500-61801
| | - Elisabeth Maria Balint
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, 89081 Ulm, Germany; (M.G.); (J.L.); (E.S.); (C.H.); (E.M.B.)
- Privatklinik Meiringen, 3860 Meiringen, Switzerland
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12
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Auth NM, Booker MJ, Wild J, Riley R. Mental health and help seeking among trauma-exposed emergency service staff: a qualitative evidence synthesis. BMJ Open 2022; 12:e047814. [PMID: 35110304 PMCID: PMC8811562 DOI: 10.1136/bmjopen-2020-047814] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To identify factors and contexts that may contribute to mental health and recovery from psychological difficulties for emergency service workers (ESWs) exposed to occupational trauma, and barriers and facilitators to help-seeking behaviour among trauma-exposed ESWs. BACKGROUND ESWs are at greater risk of stressor-related psychopathology than the general population. Exposure to occupational stressors and trauma contribute to the observed rates of post-trauma psychopathology in this occupational group with implications for workforce sustainability. Types of organisational interventions offered to trauma-exposed ESWs are inconsistent across the UK, with uncertainty around how to engage staff. DESIGN Four databases (OVID MEDLINE, EMBASE, PsycINFO and SCOPUS) were systematically searched from 1 January 1980 to March 2020, with citation tracking and reference chaining. A modified Critical Appraisal Skills Programme tool and quality appraisal prompts were used to identify fatally flawed studies. Qualitative studies of trauma-exposure in front-line ESWs were included, and data were extracted using a customised extraction table. Included studies were analysed using thematic synthesis. RESULTS A qualitative evidence synthesis was conducted with 24 qualitative studies meeting inclusion criteria, as defined by the PerSPEcTiF framework. Fourteen descriptive themes emerged from this review, categorised into two overarching constructs: (1) factors contributing to mental health (such as the need for downtime, peer support and reassurance) and (2) factors influencing help-seeking behaviour (such as stigma, the content/form/mandatory nature of interventions, and mental health literacy issues including emotional awareness and education). CONCLUSION ESWs reported disconnect between the organisations' cultural positioning on trauma-related mental health, the reality of undertaking the role and the perceived applicability and usefulness of trauma interventions. Following traumatic exposure, ESWs identify benefitting from recovery time and informal support from trusted colleagues. A culture which encourages help seeking and open dialogue around mental health may reduce stigma and improve recovery from mental ill health associated with trauma exposure.
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Affiliation(s)
| | | | - Jennifer Wild
- Experimental Psychology, University of Oxford, Oxford, UK
| | - Ruth Riley
- Social and Community Medicine, University of Bristol, Bristol, UK
- Department of Applied Health Research, University of Birmingham, Birmingham, UK
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Brouzos A, Vatkali E, Mavridis D, Vassilopoulos SP, Baourda VC. Psychoeducation for Adults with Post-Traumatic Stress Symptomatology: A Systematic Review and Meta-Analysis. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2021. [DOI: 10.1007/s10879-021-09526-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Harden L, Jones N, Whelan C, Phillips A, Simms A, Greenberg N. A systematic review of psychological training or interventions given to UK military personnel prior to deployment. BMJ Mil Health 2020; 167:63-69. [PMID: 33109732 DOI: 10.1136/bmjmilitary-2019-001296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Predeployment stress management/mental health training is routinely delivered in an effort to mitigate potential adverse psychological effects. Little is known about the effectiveness of such interventions. METHODS A systematic literature review explored research outcomes related to this subject, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. An electronic database search using key terms identified studies published between January 2007 and March 2019. Comprehensive inclusion/exclusion criteria were applied and study quality was appraised by two reviewers using 12 criteria adapted from the Critical Appraisal Skills Programme (CASP) checklist. Papers were excluded if they were allocated CASP scores ≤10 out of 24. RESULTS 2003 references were identified; 15 papers fulfilled inclusion criteria and quality threshold requirements. Included studies were randomised controlled trial design (n=8), quasi-experimental (n=5), case report (n=1) and cross-sectional (n=1). Duration of follow-up assessment varied from immediately postintervention to 24 months. The included studies were heterogeneous so clear recommendations relating to predeployment training for military personnel could not be made. Although somewhat disparate, predeployment interventions shared the aim of promoting prior to, during and after deployment health and well-being. Social benefits such as improved cohesion and improved stress management skills were identified in some studies, although substantial mental health and well-being benefits were not found. CONCLUSIONS Evidence for the effectiveness of predeployment psychological interventions is scant. Every attempt should be made to use methods and measures to facilitate comparisons across studies, to attempt a longer follow-up timescale and to clarify key trainer characteristics.
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Affiliation(s)
- Larissa Harden
- Academic Department of Military Mental Health, King's College London, London, UK
| | - N Jones
- Academic Department of Military Mental Health, King's College London, London, UK
| | - C Whelan
- Academic Department of Military Mental Health, King's College London, London, UK
| | - A Phillips
- Academic Department of Military Mental Health, King's College London, London, UK
| | - A Simms
- Academic Department of Military Mental Health, King's College London, London, UK
| | - N Greenberg
- King's Centre for Military Health Research, King's College London, London, UK
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15
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Aikins DE, Pietrzak RH, Geraci JC, Benham T, Morrissey P, Southwick SM. Beyond stigma: Understanding the "inclined abstainers" in military behavioral health-care utilization. MILITARY PSYCHOLOGY 2020; 32:419-427. [PMID: 38536308 PMCID: PMC10013392 DOI: 10.1080/08995605.2020.1784822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 06/15/2020] [Indexed: 10/23/2022]
Abstract
Low treatment utilization in Soldiers with combat-related Posttraumatic Stress Disorder (PTSD) is an ongoing issue. The critical concern is to better understand factors which prohibit a Soldier with PTSD who wants help from seeking treatment (an "inclined abstainer"). A total of 537 Active Duty Soldiers on a US Army post completed a brief survey comprising psychometrically validated measures of stigma, behavioral health treatment beliefs, resilience, PTSD symptoms, and treatment intentions. Health-care records were prospectively tracked for 12 months to determine the relation between survey answers and treatment utilization. Sixty-three percent of those who acknowledged having a mental health-related problem did not seek help within a one-year period. Greater severity of PTSD symptoms was associated with an increased likelihood of behavioral health engagement. Soldiers that were classified as "inclined abstainers" were also more likely to endorse negative beliefs about psychotherapy and report higher levels of resilience as compared to "inclined actors." These results suggest that a treatment model of PTSD emphasizing self-efficacy and self-reliance, while addressing negative beliefs about psychotherapy, may help promote engagement of behavioral health services among Active Duty Soldiers.
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Affiliation(s)
- Deane E. Aikins
- Department of Psychiatry, VA Detroit Healthcare System, Detroit, Michigan
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University, Detroit, Wayne
| | - Robert H. Pietrzak
- National Center for PTSD Behavioral Neuroscience Division, West Haven, Connecticut
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Joseph C. Geraci
- Behavioral Health MEDDAC, United States Army
- Resilience Center for Veterans & Families, Teachers College, Columbia University, New York
| | - Todd Benham
- Behavioral Health MEDDAC, United States Army
| | | | - Steven M. Southwick
- National Center for PTSD Behavioral Neuroscience Division, West Haven, Connecticut
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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Hom MA, de Terte I, Bennett C, Joiner TE. Resilience and attitudes toward help-seeking as correlates of psychological well-being among a sample of New Zealand Defence Force personnel. MILITARY PSYCHOLOGY 2020; 32:329-340. [PMID: 38536362 PMCID: PMC10013528 DOI: 10.1080/08995605.2020.1754148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Abstract
Research is needed to examine factors that contribute to psychological well-being among military service members. This study examined associations between various indices of psychological well-being, resilience, and help-seeking stigma among New Zealand Defence Force (NZDF) personnel (N = 2,805). Participants completed self-report measures of psychological well-being, resilience, help-seeking stigma, and past-year help-seeking behaviors. Greater resilience and a lower degree of help-seeking stigma were each significantly associated with better psychological well-being (i.e., greater psychological flourishing, less psychological distress, and better overall mental health). Though effects were relatively small, engagement in help-seeking behaviors moderated the relationship between (1) greater resilience and less psychological distress and (2) greater resilience and better overall mental health, such that these relationships were stronger among those who had sought help for their mental health in the past year. Findings suggest that greater resilience and less mental health help-seeking stigma may independently contribute to better psychological well-being among NZDF personnel; thus, enhancing resilience and reducing help-seeking stigma may serve to promote psychological well-being in this population. Improving resilience among NZDF personnel who seek help, in particular, may contribute to better psychological well-being. However, longitudinal research among service members is needed to establish a temporal relationship between these constructs.
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Affiliation(s)
- Melanie A. Hom
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Ian de Terte
- School of Psychology, Massey University, Palmerston North, New Zealand
| | - Clare Bennett
- Defense Health Directorate, New Zealand Defence Force, Wellington, New Zealand
| | - Thomas E. Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida
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Gu RP, Liu XR, Ye XF. Attitudes and perceived barriers to mental healthcare in the People's Liberation Army Navy: study from a navy base. BMJ Mil Health 2020; 168:331-336. [PMID: 32430460 PMCID: PMC9554070 DOI: 10.1136/bmjmilitary-2019-001396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/21/2020] [Accepted: 04/26/2020] [Indexed: 11/30/2022]
Abstract
Introduction The People’s Liberation Army (PLA, China) Navy is increasingly conducting military operations other than war overseas. Factors such as confrontations with pirates, special environments and long sailing times have resulted in mental health problems. However, the navy’s actual utilisation of mental health services is low. This study examined members’ rate of willingness to seek help and the factors that act as barriers to willingness to seek mental health services in the PLA Navy. Methods This cross-sectional study was conducted at the Zhoushan Base, operated by the East Sea Fleet, between March 2019 and April 2019. We distributed a 12-item questionnaire to examine participants’ attitudes and perceived barriers to mental healthcare. We recruited 676 navy personnel. Participants’ willingness to seek help if they had mental health problems was also assessed. Results The response rate was 99%. A total of 88.44% of the sample reported being willing to seek help. Univariate analysis suggested that those not willing to seek help were more likely to agree with the items, ‘Mental healthcare does not work’ and ‘My unit leadership might treat me differently’ and all organisational barriers, and they were more likely to have concerns about ‘embarrassment’ and ‘being weak’ than those willing to seek help. After controlling for demographic characteristics, binary logistic regression analyses confirmed that a lack of knowledge regarding the location of mental health clinics and being perceived as weak were the main factors preventing participants’ willingness from seeking help. Conclusions Extensive efforts to decrease organisational barriers and stigma towards mental healthcare should be a priority for researchers and policymakers to improve the usage of mental health services. Psychoeducation aimed at de-stigmatising mental health problems should be delivered and the accessibility and availability of mental health services should be increased.
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Affiliation(s)
- Ren-Ping Gu
- Faculty of Military Health Service, Second Military Medical University, Shanghai, China
| | - X R Liu
- Faculty of Military Health Service, Second Military Medical University, Shanghai, China
| | - X F Ye
- Faculty of Military Health Service, Second Military Medical University, Shanghai, China
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Forsyth A, Lysaght R, Aiken A, Cramm H. Wilderness Adventure Program May Help Combat Perceptions of Stigma Among Veterans. ECOPSYCHOLOGY 2020. [DOI: 10.1089/eco.2019.0031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Ashleigh Forsyth
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Rosemary Lysaght
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Alice Aiken
- Faculty of Health, Dalhousie University, Halifax, Canada
| | - Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
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Crone DM, Sarkar M, Curran T, Baker CM, Hill D, Loughren EA, Dickson T, Parker A. Mental health first aid for the UK Armed Forces. Health Promot Int 2020; 35:132-139. [DOI: 10.1093/heapro/day112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Education programmes in mental health literacy can address stigma and misunderstanding of mental health. This study investigated self-rated differences in knowledge, attitudes and confidence around mental health issues following participation in a bespoke Mental Health First Aid (MHFA) training course for the Armed Forces. The mixed methods approach comprised quantitative surveys and qualitative interviews. A survey, administered immediately post-training (n = 602) and again at 10-months post-attendance (n = 120), asked participants to rate their knowledge, attitudes and confidence around mental health issues pre- and post-training. Quantitative findings revealed a significant increase in knowledge, positive attitudes and confidence from the post-training survey which was sustained at 10-months follow-up.Semi-structured telephone interviews (n = 13) were conducted at follow-up, 6-months post-attendance. Qualitative findings revealed that participation facilitated an ‘ambassador’ type role for participants. This study is the first to have investigated the effect of MHFA in an Armed Forces community. Findings show participants perceived the training to increase knowledge regarding mental health and to enhance confidence and aptitude for identifying and supporting people with mental health problems. Results suggest that such an intervention can provide support for personnel, veterans and their families, regarding mental health in Armed Forces communities.
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Affiliation(s)
- Diane M Crone
- School of Health and Social Care, University of Gloucestershire, Cheltenham, UK
| | - Mustafa Sarkar
- Department of Sport Science, Nottingham Trent University, Nottingham, UK
| | | | - Colin M Baker
- School of Health and Social Care, University of Gloucestershire, Cheltenham, UK
| | - Denise Hill
- College of Engineering, Swansea University, UK
| | | | - Tabitha Dickson
- School of Health and Social Care, University of Gloucestershire, Gloucester, UK
| | - Andrew Parker
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
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20
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C'de Baca J, Castillo D, DeBeer B, Qualls C. Rationale and design of an efficacy study of Group Prolonged Exposure for PTSD. Contemp Clin Trials Commun 2020; 17:100509. [PMID: 31989057 PMCID: PMC6970140 DOI: 10.1016/j.conctc.2019.100509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 11/27/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Among health problems in the Veteran population, the most common is posttraumatic stress disorder (PTSD) and its effect on the quality of life. Prolonged Exposure therapy, based on emotional processing theory, is a first-line treatment for reducing PTSD symptom severity when delivered in an individual format, and its efficacy is well established. The primary objective of this study is to establish the efficacy of prolonged exposure delivered in a small 3-person group modality. Quality of life should improve with decreases in PTSD symptoms such as sleep disturbance, irritability, and hypervigilance. Stigma is associated with hesitation in seeking treatment and treatment dropout. A secondary objective is to measure the effect of group treatment on reducing the stigma surrounding PTSD. METHODS/DESIGN This study is a randomized controlled trial testing the efficacy of Group Prolonged Exposure (PE) for reducing PTSD symptom severity and improving quality of life in male Afghanistan and Iraq Veterans. All participants are randomly assigned to receive Group PE or Group Present-Centered Therapy (PCT) for 10-weekly, 90-min sessions. Group PE focuses on processing trauma memories, while the goal of Group PCT is improved psychosocial functioning through management of current stressors. The primary outcome is improvement in CAPS-5 PTSD symptom severity scores and quality of life measures (WHO-QOL and SF-36) from pre-treatment to post-treatment, 3-months post-treatment, and 6-months post-treatment. A secondary outcome is reductions in perceived self-stigma of mental illness based on the Stigma Scale at baseline and follow-up points. This study is designed to expand access to this first-line treatment for PTSD by delivering PE in a small group modality while conforming to the individual PE protocol, with group treatment reducing perceived stigma of mental illness.
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Affiliation(s)
- Janet C'de Baca
- New Mexico VA Health Care System VISN 22, Behavioral Health Care Line (116), 1501 San Pedro SE, Albuquerque, NM, 87108, USA
| | - Diane Castillo
- VA VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Drive, 151-C, Waco, TX, 76711, USA
| | - Bryann DeBeer
- VA VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Drive, 151-C, Waco, TX, 76711, USA.,Texas A&M University Health Science Center, Temple, TX, USA
| | - Clifford Qualls
- Mathematics and Statistics, University of New Mexico, Albuquerque, NM, USA.,Biostatistician, Biomedical Research Institute of New Mexico, Albuquerque, NM, USA
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Brooks SK, Dunn R, Amlôt R, Rubin GJ, Greenberg N. Protecting the psychological wellbeing of staff exposed to disaster or emergency at work: a qualitative study. BMC Psychol 2019; 7:78. [PMID: 31823824 PMCID: PMC6905092 DOI: 10.1186/s40359-019-0360-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background Disasters are becoming more prevalent across the world and people are frequently exposed to them as part of their occupational groups. It is important for organisations to understand how best to support employees who have experienced a trauma such as a disaster. The purpose of this study was to explore employees’ perceptions of workplace support and help-seeking in the context of a disaster. Methods Forty employees in England took part in semi-structured interviews. Thematic analysis was used to extract recurring themes from the data. Results Participants reported both positive and negative psychological outcomes of experiencing a disaster or emergency at work. Most had little training in how to prepare for, and cope with, the psychological impact. They perceived stigma around mental health and treatment for psychological issues which often made them reluctant to seek help. Many reported that the psychological support available in the workplace was insufficient and tended to be reactive rather than proactive. Interpersonal relationships at work were viewed as being important sources of support, particularly support from managers. Participants suggested that psychosocial training in the workplace could be beneficial in providing education about mental health, encouraging supportive workplace relationships, and developing listening skills and empathy. Conclusions Organisations can take steps to reduce the psychological impact of disasters on employees. This could be done through provision of training workshops incorporating mental health education to reduce stigma, and team-building exercises to encourage supportive workplace relationships.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK.
| | - Rebecca Dunn
- Department of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK
| | - Richard Amlôt
- Public Health England, Emergency Response Department Science & Technology, Health Protection Directorate, Porton Down, Salisbury, Wilts, SP4 0JG, UK
| | - G James Rubin
- Department of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK
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Krzemieniecki A, Gabriel KI. Stigmatization of posttraumatic stress disorder is altered by PTSD Knowledge and the precipitating trauma of the sufferer. J Ment Health 2019; 30:447-453. [PMID: 31662009 DOI: 10.1080/09638237.2019.1677870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Reducing stigma could improve well-being and decrease discrimination toward persons with mental illness. AIM The current study investigated the impact of posttraumatic stress disorder (PTSD) knowledge and the characteristics of a person suffering from PTSD symptoms on stigmatization. METHOD University students (n = 560) read one of twelve vignettes describing someone with PTSD symptoms who varied by gender, military status, and precipitating trauma. Then, participants rated their own responses to the person in the vignette (i.e. personal stigma), their perception of how others would respond (i.e. perceived stigma), and their comfort with the person in different social settings (i.e. social distance) followed by a PTSD Knowledge Questionnaire. RESULTS PTSD knowledge was associated with decreased personal stigma and increased willingness to socialize with individuals in the vignettes. The precipitating trauma of the person in the vignette influenced perceived stigma ratings, lowering perceived stigma for those who had experienced a rape as opposed to a car accident. Neither the gender nor military status of the person in the vignette affected stigmatization. CONCLUSIONS The current findings underscore the importance of mental health education in reducing stigma and indicate that the type of precipitating trauma affects attitudes toward those with PTSD symptoms.
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Affiliation(s)
- Anna Krzemieniecki
- Master of Science in Experimental Psychology Program, Central Washington University, Ellensburg, WA, USA
| | - Kara I Gabriel
- Department of Psychology, Central Washington University, Ellensburg, WA, USA
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Agarwal B, Brooks SK, Greenberg N. The Role of Peer Support in Managing Occupational Stress: A Qualitative Study of the Sustaining Resilience at Work Intervention. Workplace Health Saf 2019; 68:57-64. [PMID: 31538851 DOI: 10.1177/2165079919873934] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Peer support at work may support psychological resilience by enhancing coping skills and providing social support. The current study aimed to examine how a workplace peer support program, "Sustaining Resilience at Work" (StRaW), may support employee mental health from the perspective of the trained peer supporter. Method: Nine individuals from various public and private organizations who had completed StRaW peer supporter training participated in semi-structured interviews to explore their views on the StRaW program. Data were analyzed using inductive thematic analysis. Findings: Three main themes emerged: the impact of workplace stressors on employee mental health, the impact of StRaW, and feedback on StRaW. The results suggested positive effects of StRaW training on practitioners' ability to support colleagues and maintain their own psychological well-being. Discussion/Application to Practice: Our results indicated that peer support programs in the workplace may improve employees' well-being and relationships between employees. As such, occupational health professionals should recommend that their organizations invest in these types of programs to improve organizational resilience. They should encourage employees they consider to be capable of supporting their colleagues to undergo this training as evidence suggests this is beneficial to the trained employees' own well-being, rather than making them feel burdened or under pressure. Occupational health professionals should also view such programs as useful ways of improving attitudes toward mental health within their organizations.
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Predictors of Consent to Treatment and Premature Termination of Treatment in a Sample of Veterans With Military-Related PTSD. J Nerv Ment Dis 2019; 207:300-306. [PMID: 30865074 DOI: 10.1097/nmd.0000000000000966] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study examined different variables as predictors of treatment entry and treatment dropout among veterans with military-related posttraumatic stress disorder (PTSD). First, we examined predictors of treatment entry versus refusal of treatment. Among the veterans who started therapy, we examined predictors of treatment completion. Symptom severity of PTSD, depression, and anxiety at baseline were measured. Daily functioning at baseline was also measured. Results indicate that the younger the veterans were, the more likely they were to refuse treatment. Dropout from treatment was also predicted by younger age at referral, as well as by past treatment, higher number of years of education, and higher depression levels at baseline. Two conclusions can be drawn from the results. First, it may be beneficial to increase awareness of treatment options for PTSD among younger veterans as this may increase treatment consent rates. Second, to reduce treatment dropout in veteran patients with PTSD, therapists should take into consideration both past treatment and baseline depression levels as risk factors for dropout.
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Niegocki KL, Ægisdóttir S. College Students' Coping and Psychological Help-Seeking Attitudes and Intentions. ACTA ACUST UNITED AC 2019. [DOI: 10.17744/mehc.41.2.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The relationship between college students' coping and psychological help-seeking attitudes and intentions was examined. Seven hundred and nineteen students participated (180 men, 537 women, and two individuals who did not indicate their gender). Questionnaires were completed online and included the Brief COPE and Beliefs About Psychological Services scales. It was found that for students with previous counseling experience, coping by means of greater use of support seeking and less use of avoidant coping strategies was associated with greater intent to seek psychological help, greater stigma tolerance, and greater belief in psychologists' expertness. Problem-focused coping was unrelated to psychological help-seeking attitudes and intentions among these students. For students without previous counseling experience, coping by means of greater use of support seeking (emotional support, instrumental support, and venting), greater use of problem-focused coping (active coping, positive reframing, religion, and planning), and less use of avoidant coping strategies (denial, substance use, behavioral disengagement, and self-blame) was associated with greater stigma tolerance and greater belief in psychologists' expertness. For these students, coping behaviors were not related to intentions to seek counseling.
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Impact of Veteran Status and Timing of PTSD Diagnosis on Criminal Justice Outcomes. Healthcare (Basel) 2018; 6:healthcare6030080. [PMID: 30002284 PMCID: PMC6164822 DOI: 10.3390/healthcare6030080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/06/2018] [Accepted: 07/10/2018] [Indexed: 11/17/2022] Open
Abstract
Previous research has demonstrated that jurors show a bias towards treatment for veterans with post-traumatic stress disorder (PTSD). The present research examines this bias when jurors are faced with cases of potential malingering, in which the defendant’s claim of PTSD is a perceived attempt to escape legal punishments. Trial vignettes, in which veteran status and PTSD diagnosis timing were manipulated, were used to explore this phenomenon. It was found that veterans who received their diagnosis after being arrested were found guilty more often, and were diverted to treatment less often, than those who were diagnosed before an arrest. This has critical implications for mental healthcare in that it is crucial to properly diagnose and treat people before they find themselves in court. Further, the negative outcomes in court demonstrate one of the severe social impacts of untreated or late-diagnosed PTSD.
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Osório C, Jones N, Jones E, Robbins I, Wessely S, Greenberg N. Response to Letter to the Editor: Confounding by Symptomatic Mefloquine Exposure in Military Studies of Post-Traumatic Stress Disorder. Behav Med 2018; 44:173-174. [PMID: 28506186 DOI: 10.1080/08964289.2017.1330497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
SummaryThe psychiatric problems of combat returnees are a topical and important issue given the ongoing conflicts in Iraq and Afghanistan. Despite the media prominence afforded to post-traumatic stress disorder, the most common disorders in the UK armed forces post-deployment are depression, alcohol misuse and anxiety disorders. Although the majority of service personnel do well after leaving military life, a minority who leave with psychiatric problems appear to be at risk of social exclusion and ongoing ill health. Reserve veterans are at greater risk as they do not have access to the usual support networks of the regular military. Steps to improve the knowledge and expertise of primary care services about veterans' mental health issues and increasing the availability of treatment options are important and are underway.
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Sage CAM, Brooks SK, Greenberg N. Factors associated with Type II trauma in occupational groups working with traumatised children: a systematic review. J Ment Health 2017; 27:457-467. [PMID: 28898109 DOI: 10.1080/09638237.2017.1370630] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND There is evidence that "Type II trauma" (TTT) - repeated exposure to traumatic events - can lead to the development of post-traumatic stress disorder (PTSD). TTT frequently occurs in occupational groups working with children who are themselves victims of trauma. AIM To conduct a systematic review identifying risk factors for/protective factors against TTT-associated mental ill-health in employees working with traumatised children and explore how this type of work impacts upon social functioning. METHOD Databases were searched for relevant studies and supplemented by hand searches. RESULTS 836 papers were found and 13 were included in the review. The key themes identified were coping mechanisms; social support; personality; demographics; occupational support; work-related stressors; traumatic exposure; organisational satisfaction; training/experience and impact on life. CONCLUSION Unhelpful coping strategies (e.g. denial) appeared to increase the risk of TTT. Training and strong support may be protective and work-related stressors (e.g. excessive workload) appeared detrimental. Despite some positive impacts of the work (e.g. becoming more appreciative of life) many negative impacts were identified, demonstrating the importance of minimising risk factors and maximising protective factors for staff at risk of TTT.
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Affiliation(s)
- Clara A M Sage
- a Department of Psychological Medicine , King's College London , London , United Kingdom
| | - Samantha K Brooks
- a Department of Psychological Medicine , King's College London , London , United Kingdom
| | - Neil Greenberg
- a Department of Psychological Medicine , King's College London , London , United Kingdom
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Hanisch SE, Birner UW, Oberhauser C, Nowak D, Sabariego C. Development and Evaluation of Digital Game-Based Training for Managers to Promote Employee Mental Health and Reduce Mental Illness Stigma at Work: Quasi-Experimental Study of Program Effectiveness. JMIR Ment Health 2017; 4:e31. [PMID: 28778839 PMCID: PMC5562929 DOI: 10.2196/mental.7600] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/30/2017] [Accepted: 07/14/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To counteract the negative impact of mental health problems on business, organizations are increasingly investing in mental health intervention measures. However, those services are often underused, which, to a great extent, can be attributed to fear of stigmatization. Nevertheless, so far only a few workplace interventions have specifically targeted stigma, and evidence on their effectiveness is limited. OBJECTIVE The objective of this study was to develop and evaluate a digital game-based training program for managers to promote employee mental health and reduce mental illness stigma at work. METHODS We describe the empirical development of Leadership Training in Mental Health Promotion (LMHP), a digital game-based training program for leaders. A 1-group pre-post design and a 3-month follow-up were used for training evaluation. We applied multilevel growth models to investigate change over time in the dependent variables knowledge, attitudes, self-efficacy, and intentions to promote employee mental health in 48 managers of a global enterprise in the United Kingdom. Participants were mainly male (44/48, 92%) and ranged in age from 32 to 58 (mean 46.0, SD 7.2) years. RESULTS We found a positive impact of the Web-based training program on managers' knowledge of mental health and mental illness (P<.001), on attitudes toward people with mental health problems (P<.01), and on their self-efficacy to deal with mental health situations at work (P<.001), with the exception of intentions to promote employee mental health, which was initially high. CONCLUSIONS Results provide first evidence of the effectiveness of LMHP to positively affect managers' skills to promote employee mental health at work. Furthermore, the high rate of participation in LMHP (48/54, 89%) supports the use of digital game-based interventions to increase user engagement and user experience in mental health programs at work.
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Affiliation(s)
- Sabine Elisabeth Hanisch
- Department of Medical Informatics, Biometry and Epidemiology, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Ulrich Walter Birner
- HR EHS, Department of Psychosocial Health and Well-being, Siemens AG, Munich, Germany
| | - Cornelia Oberhauser
- Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, WHO Collaborating Centre for Occupational Health, Clinic of Ludwig-Maximilians-University Munich, Munich, Germany
| | - Carla Sabariego
- Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University Munich, Munich, Germany
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Guay S, Tremblay N, Goncalves J, Bilodeau H, Geoffrion S. Effects of a peer support programme for youth social services employees experiencing potentially traumatic events: a protocol for a prospective cohort study. BMJ Open 2017; 7:e014405. [PMID: 28647721 PMCID: PMC5623380 DOI: 10.1136/bmjopen-2016-014405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 02/13/2017] [Accepted: 03/24/2017] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The use of peer support programmes to help workers experiencing potentially traumatic events (PTE) has increased in high-risk organisations in the last decades. However, the scientific evidence of its effectiveness is still very limited. This paper aims to describe the protocol of a prospective cohort study that assesses the efficacy of a peer support programme among youth social services employees exposed to a PTE at work on psychological well-being, work functioning and needs of support. METHODS AND ANALYSIS This is a mixed-methods prospective study that will examine workers' evolution four times over a 12-month period in Canada. This study involves: (1) quantitative data obtained through self-administrated questionnaires among 222 workers, and (2) qualitative in-depth interviews with a subsample of 45 workers. This study will compare findings from a cohort who received the support of a peer following a PTE (peer support-experimental protocol) as part of the experimental protocol of the Montreal Youth Social Services-University Institute (MYSS-UI), the second group of workers did not ask for the peer support (no peer support-experimental protocol) but was part of MYSS-UI, and the third group received standard organisational support from the Monteregie Youth Social Services (MYSS) (standard organisational protocol). ETHICS AND DISSEMINATION The protocol and informed consent form complied with the ethics guidelines of the MYSS-UI. The Research Ethics Board of MYSS-UI and MYSS reviewed and accepted the protocol as required. The results of the study will be published in peer-reviewed journals, presented at research and general public conferences, disseminated via a public report for the institute that funded the project and for all workers. Results of this study will influence decision making regarding intervention policies following PTE and peer support interventions may be expanded throughout the youth social services in Canada and worldwide.
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Affiliation(s)
- Stephane Guay
- École de criminologie, Université de Montréal, Montreal, Quebec, Canada
- Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Montreal, Quebec, Canada
| | - Nicole Tremblay
- Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Montreal, Quebec, Canada
| | - Jane Goncalves
- Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Montreal, Quebec, Canada
| | - Henriette Bilodeau
- Département d'organisation et ressources humaines, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Steve Geoffrion
- Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Montreal, Quebec, Canada
- École de psychoéducation, Université de Montréal, Montreal, Quebec, Canada
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Wainwright V, McDonnell S, Lennox C, Shaw J, Senior J. Treatment Barriers and Support for Male Ex-Armed Forces Personnel in Prison: Professional and Service User Perspectives. QUALITATIVE HEALTH RESEARCH 2017; 27:759-769. [PMID: 26984365 DOI: 10.1177/1049732316636846] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Ex-armed forces personnel represent a potentially vulnerable group within the prison population. To provide support to this group, we need to understand their needs and help-seeking behavior. A focus group with professionals and semi-structured interviews with service users explored perspectives of the treatment barriers faced by this group and their support needs. Data were analyzed using constant comparison methods, and four primary themes were identified. The findings suggest ex-armed forces personnel consider prison an opportunity to access support but find it difficult to ask for help. Staff having an awareness of military issues was thought to encourage help-seeking, but the variability of provision across prison establishments was considered a barrier. Resettlement was a prominent concern, and access to support when preparing for, and after, release was felt by all participants to be important. Implications for the provision of support in prison are discussed along with recommendations for practice.
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Affiliation(s)
| | | | | | - Jenny Shaw
- 1 University of Manchester, Manchester, UK
- 2 Lancashire Care NHS Foundation Trust, Preston, UK
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Harik JM, Matteo RA, Hermann BA, Hamblen JL. What people with PTSD symptoms do (and do not) know about PTSD: A national survey. Depress Anxiety 2017; 34:374-382. [PMID: 27787928 DOI: 10.1002/da.22558] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 08/30/2016] [Accepted: 09/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND If people do not recognize posttraumatic stress disorder (PTSD) symptoms, they may not realize they are suffering from the disorder. Likewise, if people do not know that effective treatments exist, they may be unlikely to seek care. This study examined what people with PTSD symptoms know about PTSD and its treatment. We hypothesized that military service and prior receipt of PTSD treatment would be associated with greater PTSD knowledge. METHODS We conducted an online survey assessing knowledge in three domains: trauma, PTSD symptoms, and effective PTSD treatments. Participants were 301 adults (50% veterans) who were drawn from a national research panel and screened positive for PTSD. RESULTS When asked to identify items from a list, participants had better recognition for traumatic events (M = 72.2% of items correct) and PTSD symptoms (M = 62.3%) than for effective PTSD treatments (M = 37.9%). Across domains, participants often identified false items as true. Most participants thought divorce was a trauma that could cause PTSD, that drug addiction was a PTSD symptom, and that support groups are effective PTSD treatments. Prior receipt of PTSD treatment was associated with better symptom recognition (b = .86, P = .003). Being a military veteran was associated with better trauma recognition (b = .56, P = .025), but poorer treatment recognition (b = -.65, P = .034). CONCLUSIONS People with PTSD symptoms lack knowledge about the disorder, especially regarding effective treatments. Public education about PTSD is needed so that people recognize when to seek care and which treatments to choose.
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Affiliation(s)
- Juliette M Harik
- National Center for PTSD, White River Junction, VT, USA.,Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | | - Barbara A Hermann
- National Center for PTSD, White River Junction, VT, USA.,Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Jessica L Hamblen
- National Center for PTSD, White River Junction, VT, USA.,Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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Brooks SK, Dunn R, Amlôt R, Rubin GJ, Greenberg N. Social and occupational factors associated with psychological wellbeing among occupational groups affected by disaster: a systematic review. J Ment Health 2017. [DOI: 10.1080/09638237.2017.1294732] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Samantha K. Brooks
- King’s College London, Department of Psychological Medicine, London, UK and
| | - Rebecca Dunn
- King’s College London, Department of Psychological Medicine, London, UK and
| | - Richard Amlôt
- Public Health England, Emergency Response Department Science & Technology, Health Protection Directorate, Wilts, UK
| | - G. James Rubin
- King’s College London, Department of Psychological Medicine, London, UK and
| | - Neil Greenberg
- King’s College London, Department of Psychological Medicine, London, UK and
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Bunnell BE, Davidson TM, Hamblen JL, Cook DL, Grubaugh AL, Lozano BE, Tuerk PW, Ruggiero KJ. Protocol for the evaluation of a digital storytelling approach to address stigma and improve readiness to seek services among veterans. Pilot Feasibility Stud 2017; 3:7. [PMID: 28239485 PMCID: PMC5314584 DOI: 10.1186/s40814-017-0121-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 01/02/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research suggests that at least 10% of veterans returning from Iraq and Afghanistan meet criteria for posttraumatic stress disorder (PTSD) related to their military experiences. National dissemination initiatives have increased veterans' access to best-practice interventions. However, treatment-seeking remains low among veterans with PTSD, often due to perceived stigma and other associated barriers. The National Center for PTSD recently developed and launched AboutFace, a digital storytelling (DST) resource designed to help veterans recognize PTSD and motivate them to seek evidence-based treatment. The Ralph H. Johnson Veterans Affairs Medical Center (VAMC) and the National Center for PTSD have partnered to conduct pilot work to evaluate veterans' reactions to AboutFace to set the stage for a large-scale study to examine whether AboutFace effectively reduces stigma and improves attitudes toward treatment-seeking among veterans. If effective, this DST approach may serve as a valuable national model for a variety of treatment-seeking populations. METHODS During the first phase of the pilot, in-person usability assessments of AboutFace will be conducted via semi-structured interviews with 20 veterans. Audio recordings of interviews will undergo transcription and coding. A report of the results of qualitative analyses of these interviews will be provided to the National Center for PTSD and will inform revisions to the site. In the second phase of the pilot, 60 veterans referred to a specialized PTSD clinic will be recruited to demonstrate and refine the methodology that we propose to use in a larger randomized controlled trial evaluation of AboutFace. Veterans will be randomly assigned to receive AboutFace plus standard education vs. standard education alone. Baseline and 2-week telephone assessments will be conducted with participating veterans to measure stigma, attitudes toward seeking mental health services, and treatment access/engagement. DISCUSSION The feedback we receive in this pilot will be used to strengthen the quality of the DST website in preparation for a large-scale evaluation. Future work will involve evaluation of reach and impact of the site relative to stigma, attitudes toward seeking mental health service, and utilization of care. If AboutFace is found to increase access to care, this finding would have broad and significant implications for overcoming barriers to care for veterans and other populations with stigmatized conditions. TRIAL REGISTRATION Clinicaltrials.gov, NCT02486692.
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Affiliation(s)
- Brian E. Bunnell
- Ralph H. Johnson VAMC, Charleston, SC USA
- Department of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St., MSC 160, Charleston, SC 29425 USA
| | - Tatiana M. Davidson
- Ralph H. Johnson VAMC, Charleston, SC USA
- Department of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St., MSC 160, Charleston, SC 29425 USA
| | - Jessica L. Hamblen
- VA National Center for PTSD, White River Junction, VT USA
- Geisel School of Medicine at Dartmouth, Hanover, NH USA
| | - Danna L. Cook
- Ralph H. Johnson VAMC, Charleston, SC USA
- Department of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St., MSC 160, Charleston, SC 29425 USA
| | - Anouk L. Grubaugh
- Ralph H. Johnson VAMC, Charleston, SC USA
- Department of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St., MSC 160, Charleston, SC 29425 USA
| | - Brian E. Lozano
- Ralph H. Johnson VAMC, Charleston, SC USA
- Department of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St., MSC 160, Charleston, SC 29425 USA
| | - Peter W. Tuerk
- Ralph H. Johnson VAMC, Charleston, SC USA
- Department of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St., MSC 160, Charleston, SC 29425 USA
| | - Kenneth J. Ruggiero
- Ralph H. Johnson VAMC, Charleston, SC USA
- Department of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St., MSC 160, Charleston, SC 29425 USA
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Hom MA, Stanley IH, Schneider ME, Joiner TE. A systematic review of help-seeking and mental health service utilization among military service members. Clin Psychol Rev 2017; 53:59-78. [PMID: 28214634 DOI: 10.1016/j.cpr.2017.01.008] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 11/10/2016] [Accepted: 01/24/2017] [Indexed: 11/20/2022]
Abstract
Research has demonstrated that military service members are at elevated risk for a range of psychiatric problems, and mental health services use is a conduit to symptom reduction and remission. Nonetheless, there is a notable underutilization of mental health services in this population. This systematic review aimed to identify and critically examine: (1) rates of service use; (2) barriers and facilitators to care; and (3) programs and interventions designed to enhance willingness to seek care and increase help-seeking behaviors among current military personnel (e.g., active duty, National Guard, Reserve). Overall, 111 peer-reviewed articles were identified for inclusion. Across studies, the rate of past-year service use among service members with mental health problems during the same time frame was 29.3% based on weighted averages. Studies identified common barriers to care (e.g., concerns regarding stigma, career impact) and facilitators to care (e.g., positive attitudes toward treatment, family/friend support, military leadership support) among this population. Although programs (e.g., screening, gatekeeper training) have been developed to reduce these barriers, leverage facilitators, and encourage service use, further research is needed to empirically test the effectiveness of these interventions in increasing rates of service utilization. Critical areas for future research on treatment engagement among this high-risk population are discussed.
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Affiliation(s)
- Melanie A Hom
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, United States.
| | - Ian H Stanley
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, United States
| | - Matthew E Schneider
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, United States
| | - Thomas E Joiner
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, United States
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Jones N, Burdett H, Green K, Greenberg N. Trauma Risk Management (TRiM): Promoting Help Seeking for Mental Health Problems Among Combat-Exposed U.K. Military Personnel. Psychiatry 2017; 80:236-251. [PMID: 29087252 DOI: 10.1080/00332747.2017.1286894] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Trauma Risk Management (TRiM) is a peer-led, occupational mental health support process that aims to identify and assist U.K. military personnel with persistent mental ill health related to potentially traumatic events (PTEs). This study compared help seeking, mental disorder symptoms, and alcohol use between TRiM recipients and personnel experiencing similar combat events who did not receive TRiM; an unexposed group provided context. METHODS Records of TRiM activity during a U.K. military deployment in Afghanistan were linked to contemporaneous survey data assessing mental health and combat experiences. The resulting deployment data set was amalgamated with mental health, alcohol use, and help-seeking data collected within 12 weeks of homecoming and again one to two years later. Mental health and help-seeking outcomes were compared between a nonexposed, non-TRiM sample (n = 161), an exposed, non-TRiM sample (n = 149), and an exposed, TRiM-recipient sample (n = 328) using logistic regression analyses. RESULTS At follow-up, TRiM recipients were significantly more likely to seek help from mental health services than exposed, non-TRiM personnel. At baseline, TRiM recipients had significantly greater adjusted odds of reporting possible posttraumatic stress disorder (PTSD) symptoms than exposed non-TRiM personnel; the difference was not significant at follow-up. TRiM recipients were significantly more likely to report persistent mental disorder and alcohol misuse caseness over the follow-up period. CONCLUSIONS TRiM recipients were significantly more likely to seek help from mental health services than a similar PTE-exposed group that did not receive TRiM; however, TRiM recipients experienced more persistent mental ill-health symptoms and hazardous alcohol use over the period of follow-up despite seeking help.
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Whitworth JD. The Role of Psychoeducation in Trauma Recovery: Recommendations for Content and Delivery. ACTA ACUST UNITED AC 2016; 13:442-51. [PMID: 27120103 DOI: 10.1080/23761407.2016.1166852] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Providing trauma psychoeducation remains a highly popular intervention despite the fact that little remains known about how effective such information provision is for improving participant outcomes. In this article the author outlines recommendations that can be identified from available research on how to provide psychoeducation for trauma recovery. The author also describes suggested content areas and material to include in this psychoeducation, highlighting the importance of conducting trauma psychoeducation in a culturally-sensitive, human-centered, and relationship-focused manner which emphasizes the value of building resiliency in response to trauma.
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Affiliation(s)
- James D Whitworth
- a School of Education and Social Services, Saint Leo University , St. Leo , Florida , USA
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Brooks SK, Dunn R, Amlôt R, Greenberg N, Rubin GJ. Social and occupational factors associated with psychological distress and disorder among disaster responders: a systematic review. BMC Psychol 2016; 4:18. [PMID: 27114240 PMCID: PMC4845476 DOI: 10.1186/s40359-016-0120-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND When disasters occur, there are many different occupational groups involved in rescue, recovery and support efforts. This study aimed to conduct a systematic literature review to identify social and occupational factors affecting the psychological impact of disasters on responders. METHODS Four electronic literature databases (MEDLINE®, Embase, PsycINFO® and Web of Science) were searched and hand searches of reference lists were carried out. Papers were screened against specific inclusion criteria (e.g. published in peer-reviewed journal in English; included a quantitative measure of wellbeing; participants were disaster responders). Data was extracted from relevant papers and thematic analysis was used to develop a list of key factors affecting the wellbeing of disaster responders. RESULTS Eighteen thousand five papers were found and 111 included in the review. The psychological impact of disasters on responders appeared associated with pre-disaster factors (occupational factors; specialised training and preparedness; life events and health), during-disaster factors (exposure; duration on site and arrival time; emotional involvement; peri-traumatic distress/dissociation; role-related stressors; perceptions of safety, threat and risk; harm to self or close others; social support; professional support) and post-disaster factors (professional support; impact on life; life events; media; coping strategies). CONCLUSIONS There are steps that can be taken at all stages of a disaster (before, during and after) which may minimise risks to responders and enhance resilience. Preparedness (for the demands of the role and the potential psychological impact) and support (particularly from the organisation) are essential. The findings of this review could potentially be used to develop training workshops for professionals involved in disaster response.
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Affiliation(s)
- Samantha K Brooks
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, UK.
| | - Rebecca Dunn
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, UK
| | - Richard Amlôt
- Public Health England, Emergency Response Department Science and Technology, Health Protection and Medical Directorate, Porton Down, Salisbury, Wilts, SP4 0JG, UK
| | - Neil Greenberg
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, UK
| | - G James Rubin
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, UK
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Wu L. US media representation of post-traumatic stress disorder: a comparative study of regional newspapers and national newspapers. J Ment Health 2016; 26:225-231. [PMID: 27053417 DOI: 10.3109/09638237.2016.1167849] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND News media play an important role in introducing and defining PTSD-related issues to the general public as well as framing their social importance and analyzing solutions for policymakers. AIMS Compare how coverage of PTSD by larger papers serving general audiences differed from smaller papers catering to communities likely to be affected by the issue. METHOD A content analysis of frames and subtopics about PTSD in all newspaper articles published by selected national newspapers and regional newspapers between the year of 2003 and 2014 (N = 426). RESULTS National newspapers engaged in higher-level policy discussion with greater frequency than regional newspapers, while regional newspapers were more likely to publish stories highlighting the impact of PTSD on individuals and local communities. Furthermore, coverage by regional newspapers used significantly more episodic frames than thematic frames. CONCLUSION Both national and regional newspapers increased the amount of coverage on PTSD significantly after the beginning of the Iraq War in 2003. National newspapers and regional newspapers shared similarities in recognizing dominant issues with PTSD but varied in the way of presenting the topics to the public.
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Affiliation(s)
- Lu Wu
- a School of Media and Journalism , University of North Carolina at Chapel Hill , Chapel Hill, NC , USA
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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: 606] [Impact Index Per Article: 75.8] [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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Wainwright V, Shaw J, McDonnell S, Lennox C, Senior J. Ex-armed forces personnel in prison: Where do we stand? CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2016; 26:1-5. [PMID: 26849634 DOI: 10.1002/cbm.1985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 10/13/2015] [Indexed: 06/05/2023]
Affiliation(s)
| | - Jenny Shaw
- The University of Manchester, Manchester, UK
- Lancashire Care NHS Foundation Trust, Preston, UK
| | | | | | - Jane Senior
- The University of Manchester, Manchester, UK
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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: 180] [Impact Index Per Article: 22.5] [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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Pless Kaiser A, Seligowski A, Spiro III A, Chopra M. Health status and treatment-seeking stigma in older adults with trauma and posttraumatic stress disorder. ACTA ACUST UNITED AC 2016; 53:391-402. [DOI: 10.1682/jrrd.2015.03.0039] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 07/31/2015] [Indexed: 11/05/2022]
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The Trauma Risk Management Approach to Post-Traumatic Stress Disorder in the British Military: Masculinity, Biopolitics and Depoliticisation. FEMINIST REVIEW 2015. [DOI: 10.1057/fr.2015.23] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This paper discusses the political implications of the British military's Trauma Risk Management (TRiM) approach to personnel suffering from combat-related mental debilities such as post-traumatic stress disorder. Drawing on narratives that emerged from qualitative interviews with trained TRiM practitioners and military welfare workers, I tease out some of the assumptions and beliefs about mental health and mental illness that underpin this mental health intervention programme. I explore TRiM as a biopolitical strategy targeted towards the construction of a particular conceptualisation of mental wellness and militarised masculine personhood. As a biopolitical strategy, I argue that TRiM plays an important role in the construction of ideas around mental well-being and mental frailty that best enable the operation of military power in the contemporary British context. I discuss the narrative of transformation in militarised models of masculinity that emerge from discussions of TRiM, and highlight the important political function that this plays in enabling and legitimating militarism. Finally, I draw attention to the ways in which the focus on individual and cultural factors, rather than war as the primary cause of difficulties for servicemen experiencing psychological distress, functions to neutralise the potential trouble that could be instigated for the British military by the bodies of servicemen psychologically damaged by their experiences of conflict.
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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: 180] [Impact Index Per Article: 20.0] [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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Sage CAM, Brooks SK, Jones N, Greenberg N. Attitudes towards mental health and help-seeking in railway workers. Occup Med (Lond) 2015; 66:118-21. [DOI: 10.1093/occmed/kqv165] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Adler AB, Britt TW, Riviere LA, Kim PY, Thomas JL. Longitudinal determinants of mental health treatment-seeking by US soldiers. Br J Psychiatry 2015; 207:346-50. [PMID: 25858176 DOI: 10.1192/bjp.bp.114.146506] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 10/07/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Studies with members of the armed forces have found a gap between reports of mental health symptoms and treatment-seeking. AIMS To assess the impact of attitudes on treatment-seeking behaviours in soldiers returning from a combat deployment. METHOD A sample of 529 US soldiers were surveyed 4 months (time 1) and 12 months (time 2) post-deployment. Mental health symptoms and treatment-seeking attitudes were assessed at time 1; reported mental healthcare visits were assessed at time 2. RESULTS Factor analysis of the total time 1 sample revealed four attitude factors: professional concerns, practical barriers, preference for self-management and positive attitudes about treatment. For the subset of 160 soldiers reporting a mental health problem at time 1, and controlling for mental health symptom severity, self-management inversely predicted treatment-seeking; positive attitudes were positively related. CONCLUSIONS Results demonstrate the importance of broadening the conceptualisation of barriers and facilitators of mental healthcare beyond stigma. Techniques and delivery models emphasising self-care may help increase soldiers' interest in using mental health services.
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Affiliation(s)
- Amy B Adler
- Amy B. Adler, PhD, Military Psychiatry Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland; Thomas W. Britt, PhD, Department of Psychology, Clemson University, Clemson, South Carolina; Lyndon A. Riviere, PhD, Paul Y. Kim, MA, Walter Reed Army Institute of Research, Department of Military Psychiatry, Silver Spring, Maryland, USA; Jeffrey L. Thomas, PhD, US Army Medical Research Unit - Europe, Walter Reed Army Institute of Research, Sembach/Heuberg, Germany
| | - Thomas W Britt
- Amy B. Adler, PhD, Military Psychiatry Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland; Thomas W. Britt, PhD, Department of Psychology, Clemson University, Clemson, South Carolina; Lyndon A. Riviere, PhD, Paul Y. Kim, MA, Walter Reed Army Institute of Research, Department of Military Psychiatry, Silver Spring, Maryland, USA; Jeffrey L. Thomas, PhD, US Army Medical Research Unit - Europe, Walter Reed Army Institute of Research, Sembach/Heuberg, Germany
| | - Lyndon A Riviere
- Amy B. Adler, PhD, Military Psychiatry Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland; Thomas W. Britt, PhD, Department of Psychology, Clemson University, Clemson, South Carolina; Lyndon A. Riviere, PhD, Paul Y. Kim, MA, Walter Reed Army Institute of Research, Department of Military Psychiatry, Silver Spring, Maryland, USA; Jeffrey L. Thomas, PhD, US Army Medical Research Unit - Europe, Walter Reed Army Institute of Research, Sembach/Heuberg, Germany
| | - Paul Y Kim
- Amy B. Adler, PhD, Military Psychiatry Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland; Thomas W. Britt, PhD, Department of Psychology, Clemson University, Clemson, South Carolina; Lyndon A. Riviere, PhD, Paul Y. Kim, MA, Walter Reed Army Institute of Research, Department of Military Psychiatry, Silver Spring, Maryland, USA; Jeffrey L. Thomas, PhD, US Army Medical Research Unit - Europe, Walter Reed Army Institute of Research, Sembach/Heuberg, Germany
| | - Jeffrey L Thomas
- Amy B. Adler, PhD, Military Psychiatry Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland; Thomas W. Britt, PhD, Department of Psychology, Clemson University, Clemson, South Carolina; Lyndon A. Riviere, PhD, Paul Y. Kim, MA, Walter Reed Army Institute of Research, Department of Military Psychiatry, Silver Spring, Maryland, USA; Jeffrey L. Thomas, PhD, US Army Medical Research Unit - Europe, Walter Reed Army Institute of Research, Sembach/Heuberg, Germany
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Whybrow D, Jones N, Greenberg N. Promoting organizational well-being: a comprehensive review of Trauma Risk Management. Occup Med (Lond) 2015; 65:331-6. [PMID: 25883216 DOI: 10.1093/occmed/kqv024] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Trauma Risk Management (TRiM) is a peer support system developed within the British Armed Forces. It aims to ensure that trauma-exposed personnel are properly supported and encouraged to seek timely help should they develop mental health problems that fail to resolve spontaneously. AIMS To summarize current knowledge about TRiM and make recommendations for further research. METHODS A search of PsychINFO, CINAHL and PubMed identified 13 published papers. RESULTS TRiM outcomes were represented in different ways within the relevant studies suggesting that TRiM may have effects additional to those that it seeks to achieve. For example, a randomized controlled trial demonstrated that TRiM had a specific positive occupational effect and did no harm; a qualitative study suggested that TRiM enhanced liaison between mental health workers and line managers and a service evaluation suggested that it reduced sickness absence. In general, the process appears to enhance trauma-exposed personnel's reliance on peer support and TRiM was reportedly acceptable and sustainable. CONCLUSIONS Evidence suggests that TRiM's utility has moved beyond the military to other organizations where personnel risk occupational traumatic exposure. Further research would help to understand how TRiM is perceived by line managers and how it functions within the trauma-prone populations.
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Affiliation(s)
- D Whybrow
- Academic Department of Military Mental Health, King's College London, Weston Education Centre, London SE5 9RJ, UK,
| | - N Jones
- Academic Department of Military Mental Health, King's College London, Weston Education Centre, London SE5 9RJ, UK
| | - N Greenberg
- Department of Psychological Medicine, King's College London, Weston Education Centre, London SE5 9RJ, UK
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Schreiber M, McEnany GP. Stigma, American military personnel and mental health care: challenges from Iraq and Afghanistan. J Ment Health 2015; 24:54-9. [DOI: 10.3109/09638237.2014.971147] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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