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Beukema L, Tullius JM, Korevaar L, Hofstra J, Reijneveld SA, de Winter AF. Promoting Mental Health Help-Seeking Behaviors by Mental Health Literacy Interventions in Secondary Education? Needs and Perspectives of Adolescents and Educational Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11889. [PMID: 36231190 PMCID: PMC9565342 DOI: 10.3390/ijerph191911889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Mental health literacy (MHL) interventions in secondary schools may help to improve competencies that adolescents require to stay mentally healthy and seek help if mental health problems arise. These MHL interventions should be tailored to the needs of adolescents and educational professionals (EPs) to reach sustainable implementation and long-term effectiveness. However, evidence is lacking on these needs. Thus, our aim was to explore their experiences with, and perspectives on, mental health help seeking and needs regarding MHL interventions. We performed online focus group discussions and interviews with adolescents (n = 21; 13-19 years) and EPs (n = 12) and analyzed the data using directed content analysis. We identified three themes related to mental health help seeking: (1) Limited MHL competencies of adolescents, (2) Limited competencies of EP to provide mental health support, and (3) Limited mental health promotion in the school environment. We further identified three themes regarding MHL interventions: (1) Addressing basic mental health knowledge and skills, (2) Interactive and easily accessible, and (3) Sustainable implementation. Improving the MHL competencies of adolescents and EPs, and creating a mental health-literate school environment can promote adolescents' mental health help seeking. Our findings highlight the importance of developing MHL interventions that are tailored to both adolescents' and EPs needs.
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Affiliation(s)
- Lindy Beukema
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1/FA10, 9713 AV Groningen, The Netherlands
| | - Janne M. Tullius
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1/FA10, 9713 AV Groningen, The Netherlands
| | - Lies Korevaar
- Research and Innovation Centre for Rehabilitation, Hanze University of Applied Sciences, 9747 AA Groningen, The Netherlands
| | - Jacomijn Hofstra
- Research and Innovation Centre for Rehabilitation, Hanze University of Applied Sciences, 9747 AA Groningen, The Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1/FA10, 9713 AV Groningen, The Netherlands
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1/FA10, 9713 AV Groningen, The Netherlands
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Kaminer Y, Chan G, Burke R. Barriers for recruitment to treatment of youths with co-occurring substance use disorders and depression. Am J Addict 2022; 31:463-469. [PMID: 35762189 PMCID: PMC9463095 DOI: 10.1111/ajad.13307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/23/2022] [Accepted: 06/12/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Recruitment challenges for treatment trials of adolescents with substance use disorder (SUD) and co-occurring depression (COD) have not been reported. The objective is to examine whether recruitment and engagement during the pretreatment assessment phase differ between adolescents in a SUD-COD versus SUD-only treatment study. METHODS A similar recruitment approach compared five-stage progressions in the pretreatment phase between a SUD-only (n = 252) and SUD-COD (n = 212) study. We examined the "gradient" of recruitment and retention along four stages after referral/inquiries; (a) screening for eligibility by phone, (b) meeting eligibility in an interview, (c) completion of baseline assessment, and (d) participation in the first psychotherapy session of each study. RESULTS Compared to SUD-only, the retention of adolescents with SUD-COD was significantly poorer from referral/inquiry to all subsequent stages. In particular, the odds ratio and 95% confidence interval from referral/inquiry to screening for eligibility by phone, meeting eligibility in an interview, completion of baseline assessment, and participation in the first psychotherapy session were all less than one. Male attrition rates were slightly higher than females but were not statistically significant. DISCUSSION AND CONCLUSIONS A high proportion of referred adolescents did not meet the study criteria. This indicates a need to examine (1) potential strategies for overcoming recruitment challenges in adolescents and their engagement in the pretreatment phase for studies of COD and (2) baseline variables for predictors and moderators for adequately powered studies. SCIENTIFIC SIGNIFICANCE This is the first study to assess recruitment challenges for adolescents with COD.
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Affiliation(s)
- Yifrah Kaminer
- University of Connecticut School of Medicine, Farmington, Connecticut
| | - Grace Chan
- University of Connecticut School of Medicine, Farmington, Connecticut
| | - Rebecca Burke
- University of Connecticut School of Medicine, Farmington, Connecticut
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Hagström J, Woodford J, von Essen A, Lähteenmäki P, von Essen L. Opt-out rates and reasons for non-participation in a single-arm feasibility trial (ENGAGE) of a guided internet-administered CBT-based intervention for parents of children treated for cancer: a nested cross-sectional survey. BMJ Open 2022; 12:e056758. [PMID: 35365530 PMCID: PMC8977820 DOI: 10.1136/bmjopen-2021-056758] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Difficulties with recruitment into clinical trials are common. An opt-out recruitment strategy, whereby potential participants can decline further contact about a study (opt-out), and non-responders are contacted, may facilitate participation. Primary objectives examined opt-out and consent rates, mode and time point of opt-out, and sociodemographic characteristics of those who opted out versus those who chose to participate in a single-arm feasibility trial (ENGAGE) of a guided, internet-administered, cognitive-behavioural therapy-based intervention for parents of children treated for cancer. Secondary objectives examined reasons for non-participation. DESIGN A cross-sectional survey nested within the ENGAGE feasibility trial. SETTING The intervention was delivered from Uppsala University, with parents located throughout Sweden. PARTICIPANTS Potential participants were recruited 3 months-5 years following their child ending treatment for cancer and were identified via their personal identification number (via the Swedish Childhood Cancer Registry and Swedish Tax Agency) and invited via postal invitation packs and could opt out via post, online, telephone or email. Those who did not opt out or consent, within 4 weeks, received up to five telephone calls and/or one postal reminder. RESULTS Of 509 invited, 164 (32.2%) opted out, 78 (47.6%) via post, 53 (32.3%) via telephone, 24 (14.6%) online, and 6 (3.7%) via email, 88 (53.7%) opted out after at least one telephone call and/or postal reminder. There was a trend for parents with lower educational levels to opt out. No need of psychological support, lack of time, and no interest in internet-administered self-help were frequently reported reasons for non-participation. CONCLUSIONS Results emphasise the importance of using different opt-out modes and suggest future research should consider how to widen study participation for parents with lower education levels. Self-identifying a need for psychological support and the acceptability of internet-administered self-help are important factors for participation and should be considered in future research to increase recruitment. TRIAL REGISTRATION NUMBER ISRCTN57233429.
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Affiliation(s)
- Josefin Hagström
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Agnes von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Päivi Lähteenmäki
- Department of Paediatrics and Adolescent Medicine, TYKS Turku University Hospital, Turku, Finland
- Pediatric Oncology and Pediatric Surgery, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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4
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Eijgermans DGM, Raat H, Jansen PW, Blok E, Hillegers MHJ, Jansen W. Teacher-reported emotional and behavioural problems and ethnic background associated with children's psychosocial care use: a longitudinal population-based study. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-021-01937-w. [PMID: 35006343 DOI: 10.1007/s00787-021-01937-w] [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] [Received: 05/07/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022]
Abstract
Approximately, 15% of children in Western countries suffer from emotional and behavioural problems. However, not all children receive the psychosocial care they need, especially children with a non-Western background experience an unmet need for care. This might be because parents of non-Western children report a lower need for care than parents of Western children, unrelated to the actual need. This study examined the association between teacher-reported problems and psychosocial care use, independent of mother-reported problems. Further, the role of ethnic background in this association was investigated. The study sample of 9-year-old children was retrieved from the Generation R Study (N = 3084), a prospective, population-based cohort of children born in Rotterdam, the Netherlands. Teacher- and mother-reported problems were measured via questionnaire when the children were 6/7 years old. Psychosocial care use was mother-reported at the research centre when children were 9 years old (8.1%). Hierarchical logistic regressions showed significant positive associations between teacher-reported total, externalising and internalising problems and later psychosocial care use. These associations were independent of mother-reported problems. Children with a non-Western background used less care, but ethnic background did not moderate the association between teacher-reported problems and care use. Our findings suggest that teachers might have an important role, next to parents, in the identification of problems and children's access to care. This may be particularly important for non-Western children, as they use less psychosocial care than Western children, despite other research showing that they generally display higher levels of problems. Directions for future research and implications are discussed.
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Affiliation(s)
- D G M Eijgermans
- The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - H Raat
- Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - P W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - E Blok
- The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - M H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - W Jansen
- Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. .,Department of Social Development, City of Rotterdam, P. O. Box 70032, 3000 LP, Rotterdam, The Netherlands.
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5
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Michaud PA, Visser A, Vervoort JPM, Kocken P, Reijneveld SA, Jansen DEMC. Availability and accessibility of primary mental health services for adolescents: an overview of national recommendations and services in EU. Eur J Public Health 2020; 30:1127-1133. [PMID: 32820338 DOI: 10.1093/eurpub/ckaa102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mental health problems in adolescence can profoundly jeopardize adolescent current and future health and functioning. We aimed to describe existing recommendations and services regarding the delivery of primary mental health care for adolescents in 31 European countries. METHODS Data on the availability and accessibility of primary mental health services were collected, as part of the Horizon 2020-funded project Models of Child Health Appraised. One expert from each country answered a closed items questionnaire during years 2017-18. RESULTS All 31 participating countries had some policy or recommendations regarding the availability and accessibility of primary mental health services for adolescents, but their focus and implementation varied largely between and within countries. Only half of the participating countries had recommendations on screening adolescents for mental health issues and burdens. Merely a quarter of the countries had ambulatory facilities targeting specifically adolescents throughout the whole country. Just over half had some kind of suicide prevention programs. Same-day access to primary care in case of -health emergencies was possible in 21 countries, but often not throughout the whole country. Nineteen countries had strategies securing accessible mental health care for vulnerable adolescents. CONCLUSIONS Overall, around half of European countries had strategies securing access to various primary mental health care for adolescents. They frequently did not guarantee care over the whole country and often tackled a limited number of situations. EU countries should widen the range of policies and recommendations governing the delivery of mental health care to adolescents and monitor their implementation.
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Affiliation(s)
| | - Annemieke Visser
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Paul Kocken
- Department of Child Health, TNO Leiden, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Erasmus School of Social and Behavioural Sciences, Rotterdam, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Child Health, TNO Leiden, The Netherlands
| | - Danielle E M C Jansen
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Nanninga M, Jansen DEMC, Knorth EJ, Reijneveld SA. Enrolment of children in psychosocial care: problems upon entry, care received, and outcomes achieved. Eur Child Adolesc Psychiatry 2018; 27:625-635. [PMID: 29119299 PMCID: PMC5945729 DOI: 10.1007/s00787-017-1048-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/13/2017] [Indexed: 11/29/2022]
Abstract
Psychosocial care systems have been designed so that specific problems are treated by specific care types. There is insufficient evidence as to which problem types are actually presented to the various care types. This study assessed types and severity of problems among children and adolescents upon enrolment in psychosocial care, compared to children not enrolled; also outcomes after 3 and 12 months, overall and per care type. We obtained data on a cohort of 1382 Dutch children aged 4-18 years (response rate 56.6%), included upon enrolment in psychosocial care, and on 443 not-enrolled children (response rate 70.3%), all from one region. Results showed that enrolled children had more problems than children not enrolled in care. In child and adolescent mental healthcare (CAMH), relatively many children had internalizing problems, and in child and adolescent social care (CASC) relatively many children had externalizing, parenting, family and multiple problems. Regardless of the type of problem, care duration in preventive child healthcare (PCH) was relatively short; and in CASC and CAMH longer. After 3 and 12 months, rates of problem solution were highest in PCH. These rates were also substantial among children not in care. To conclude, our findings show that the system of psychosocial care functions as intended regarding the distribution of problems across care types. Extended demarcation of clients by problem type and severity towards type and contents of care may further improve the system.
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Affiliation(s)
- Marieke Nanninga
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1/FA10, 9713 AV, Groningen, The Netherlands.
| | - Danielle E. M. C. Jansen
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1/FA10, 9713 AV Groningen, The Netherlands ,Department of Sociology and Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Groningen, The Netherlands
| | - Erik J. Knorth
- Department of Special Needs Education and Youth Care, University of Groningen, Groningen, The Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1/FA10, 9713 AV Groningen, The Netherlands
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Alakortes J, Kovaniemi S, Carter AS, Bloigu R, Moilanen IK, Ebeling HE. Do child healthcare professionals and parents recognize social-emotional and behavioral problems in 1-year-old infants? Eur Child Adolesc Psychiatry 2017; 26:481-495. [PMID: 27770294 DOI: 10.1007/s00787-016-0909-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 10/11/2016] [Indexed: 11/28/2022]
Abstract
Growing evidence supports the existence of clinically significant social-emotional/behavioral (SEB) problems among as young as 1-year-old infants. However, a substantial proportion of early SEB problems remain unidentified during contacts with child healthcare professionals. In this study, child healthcare nurse (CHCN; N = 1008) and parental (N = 518) reports about SEB worries were gathered, along with the maternal and paternal Brief Infant-Toddler Social and Emotional Assessment (BITSEA) ratings, for 12-month-old infants randomly recruited through Finnish child health centers. Only 1.4-1.8 % of CHCNs, 3.9 % of mothers, and 3.2 % of fathers reported of being worried about the assessed child's SEB development. When the CHCNs' and parental reports were combined, 7.7 % (33/428) of the infants assessed each by all three adults had one (7.0 %), two (0.7 %) or three (0 %) worry reports. Even the combination of the CHCN's and parental worry reports identified only 7.0-13.8 % of the infants with the maternal and/or paternal BITSEA Problem or Competence rating in the of-concern range. Identified associations across the three informants' worry reports, parental BITSEA ratings and sociodemographic factors are discussed in the paper. Routine and frequent use of developmentally appropriate screening measures, such as the BITSEA, might enhance identification and intervening of early SEB problems in preventive child healthcare by guiding both professionals and parents to pay more attention to substantial aspects of young children's SEB development and encouraging them to discuss possible problems and worries.
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Affiliation(s)
- Jaana Alakortes
- PEDEGO Research Unit, Clinic of Child Psychiatry, University of Oulu, P.O. Box 26, 90029, Oulu, Finland. .,Clinic of Child Psychiatry, Oulu University Hospital, P.O. Box 26, 90029, Oulu, Finland.
| | - Susanna Kovaniemi
- PEDEGO Research Unit, Clinic of Child Psychiatry, University of Oulu, P.O. Box 26, 90029, Oulu, Finland.,Clinic of Child Psychiatry, Oulu University Hospital, P.O. Box 26, 90029, Oulu, Finland
| | - Alice S Carter
- Department of Psychology, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA
| | - Risto Bloigu
- Medical Informatics and Statistics Research Group, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Irma K Moilanen
- PEDEGO Research Unit, Clinic of Child Psychiatry, University of Oulu, P.O. Box 26, 90029, Oulu, Finland.,Clinic of Child Psychiatry, Oulu University Hospital, P.O. Box 26, 90029, Oulu, Finland
| | - Hanna E Ebeling
- PEDEGO Research Unit, Clinic of Child Psychiatry, University of Oulu, P.O. Box 26, 90029, Oulu, Finland.,Clinic of Child Psychiatry, Oulu University Hospital, P.O. Box 26, 90029, Oulu, Finland
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Churchill RD. Young People: Understanding the Links Between Satisfaction With Services and Their Health Outcomes in Primary Care. J Adolesc Health 2017; 60:358-359. [PMID: 28340869 DOI: 10.1016/j.jadohealth.2017.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 01/25/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Richard D Churchill
- Division of Primary Care, University of Nottingham Medical School, Nottingham, England
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