1
|
Mamede T, Lordêlo P. Mental health in the virtual world: Are we ready for the metaverse era? World J Methodol 2024; 14:95064. [DOI: 10.5662/wjm.v14.i4.95064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 06/14/2024] [Accepted: 06/28/2024] [Indexed: 07/26/2024] Open
Abstract
The advent of the metaverse, including virtual reality, augmented reality, and artificial intelligence, is an undeniable issue that health care scientists need to update. It influences all fields of knowledge, interpersonal relationships, and health. Regarding mental health since the post-coronavirus disease 2019 pandemic, it is necessary to consider and understand the potential, possibilities, weaknesses, and consequences arising from and provided by this new scenario. Due to the increasing need for mental health monitoring and care, mental health treatments require in-depth training and preparation to achieve the maximum use of the metaverse advantages and possibilities. Currently, very little is known about the effectiveness of remote mental health treatment, but it is certainly suggested that accessibility and the characteristics associated with the use of metaverse technologies may represent new horizons for accessibility and approach tools, as long as more studies are carried out and more evidence is collected to develop accurate guidelines, safe training, solve ethical concerns, and overcome limitations.
Collapse
Affiliation(s)
- Tuffy Mamede
- Post Graduation in Medicine and Human Health, Bahiana School of Medicine and Public Health, Salvador 40290-000, Brazil
| | - Patrícia Lordêlo
- Pelvic Floor Care Center and Postgraduate, Patricia Lordelo Institute, Bahiana School of Medicine and Public Health, Salvador 40290-000, Brazil
| |
Collapse
|
2
|
Goicolea I, Richter Sundberg L, Wiklund M, Gotfredsen A, Christianson M. Widening the scope of mental health with a 'youth centred' approach: a qualitative study involving health care professionals in Sweden's youth clinics. Int J Qual Stud Health Well-being 2024; 19:2348879. [PMID: 38700475 PMCID: PMC11073406 DOI: 10.1080/17482631.2024.2348879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
PURPOSE The aim of this study was to explore how health care providers at youth clinics (YCs) in Sweden engage with, focus on, and navigate across the mental health youth space, while upholding the core bedrock principle of "youth-centeredness". METHODS Qualitative interviews were conducted with 21 health care professionals working in three YCs located in three different regions of Sweden. Data were analysed using reflexive thematic analysis informed by the work of Braun and Clarke. RESULTS The three themes were: 1) "youth mission-at the core of the YCs" work and challenged by a stronger involvement in mental ill health'; 2) "YCs" unique and complementary role in the youth mental health system: a holistic perspective, team work, and a focus on normalization', and 3) "Caught between a rock and a hard place: to treat at a care level that is not optimal for the young users" needs or to refer within an unreliable system'. CONCLUSION This study reflects the individuality and key features of YCs, their widening roles within the mental health sphere, and the challenges faced in maintaining and expanding the characteristic "youth-centred" approach while expanding their work with mental health.
Collapse
Affiliation(s)
- Isabel Goicolea
- Department of Epidemiology and Global Health, Umeå International School of Public Health, Umeå University, Umeå, Sweden
| | | | - Maria Wiklund
- Department of Community medicine and rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | | | | |
Collapse
|
3
|
Chen MY, He F, Rao WW, Qi Y, Rao SY, Ho TI, Su Z, Cheung T, Smith RD, Ng CH, Zheng Y, Xiang YT. The network structures of mental and behavioral problems among children and adolescents in China using propensity score matching: A comparison between one-child and multi-child families based on a nationwide survey. J Affect Disord 2024; 360:206-213. [PMID: 38797390 DOI: 10.1016/j.jad.2024.05.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Exploring networks of mental and behavioral problems in children and adolescents may identify differences between one-child and multi-child families. This study compared the network structures of mental and behavioral problems in children and adolescents in one-child families versus multi-child families based on a nationwide survey. METHODS Propensity score matching (PSM) was used to match children and adolescents from one-child families with those from multi-child families. Mental and behavioral problems were assessed using the Achenbach's Child Behavior Checklist (CBCL) with eight syndromal subscales. In the network analysis, strength centrality index was used to estimate central symptoms, and case-dropping bootstrap method was used to assess network stability. RESULTS The study included 39,648 children and adolescents (19,824 from one-child families and 19,824 from multi-child families). Children and adolescents from multi-child families exhibited different network structure and higher global strength compared to those from one-child families. In one-child families, the most central symptoms were "Social problems", "Anxious/depressed" and "Withdrawn/depressed", while in multi-child families, the most central symptoms were "Social problems", "Rule-breaking behavior" and "Anxious/depressed". CONCLUSION Differences in mental and behavioral problems among children and adolescents between one-child and multi-child families were found. To address these problems, interventions targeting "Social problems" and "Anxious/depressed" symptoms should be developed for children and adolescents in both one-child and multi-child families, while other interventions targeting "Withdrawn/depressed" and "Rule-breaking behavior" symptoms could be useful for those in one-child and multi-child families, respectively.
Collapse
Affiliation(s)
- Meng-Yi Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Fan He
- Advanced Innovation Center for Human Brain Protection, Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Wen-Wang Rao
- Department of Preventive Medicine,Shantou University Medical College, Shantou, Guandong province, China
| | - Yanjie Qi
- Advanced Innovation Center for Human Brain Protection, Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Shu-Ying Rao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Tin-Ian Ho
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Robert D Smith
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia.
| | - Yi Zheng
- Advanced Innovation Center for Human Brain Protection, Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
| |
Collapse
|
4
|
Landman B, Khoury E, Cohen A, Trebossen V, Michel A, Lefebvre A, Delorme R. Acceptance of a French e-Mental Health Information Website (CléPsy) for Families: A Web-Based Survey. JMIR Pediatr Parent 2024; 7:e50978. [PMID: 39149926 DOI: 10.2196/50978] [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: 07/18/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 08/17/2024] Open
Abstract
Background Childhood mental health issues concern a large amount of children worldwide and represent a major public health challenge. The lack of knowledge among parents and caregivers in this area hinders effective management. Empowering families enhances their ability to address their children's difficulties, boosts health literacy, and promotes positive changes. However, seeking reliable mental health information remains challenging due to fear, stigma, and mistrust of the sources of information. Objective This study evaluates the acceptance of a website, CléPsy, designed to provide reliable information and practical tools for families concerned about child mental health and parenting. Methods This study examines user characteristics and assesses ease of use, usefulness, trustworthiness, and attitude toward using the website. Platform users were given access to a self-administered questionnaire by means of mailing lists, social networks, and posters between May and July 2022. Results Findings indicate that the wide majority of the 317 responders agreed or somewhat agreed that the website made discussions about mental health easier with professionals (n=264, 83.3%) or with their relatives (n=260, 82.1%). According to the ANOVA, there was a significant effect between educational level and perceived trust (F6=3.03; P=.007) and between frequency of use and perceived usefulness (F2=4.85; P=.008). Conclusions The study underlines the importance of user experience and design in web-based health information dissemination and emphasizes the need for accessible and evidence-based information. Although the study has limitations, it provides preliminary support for the acceptability and usefulness of the website. Future efforts should focus on inclusive co-construction with users and addressing the information needs of families from diverse cultural and educational backgrounds.
Collapse
Affiliation(s)
- Benjamin Landman
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Assistance Publique - Hopitaux de Paris, 48 Boulevard Serurier, Paris, 75019, France, 33 185552762
- Paris University, Paris, France
| | - Elie Khoury
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Assistance Publique - Hopitaux de Paris, 48 Boulevard Serurier, Paris, 75019, France, 33 185552762
- Paris University, Paris, France
| | - Alicia Cohen
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Assistance Publique - Hopitaux de Paris, 48 Boulevard Serurier, Paris, 75019, France, 33 185552762
- Paris University, Paris, France
| | - Vincent Trebossen
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Assistance Publique - Hopitaux de Paris, 48 Boulevard Serurier, Paris, 75019, France, 33 185552762
- Paris University, Paris, France
| | - Alexandre Michel
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Assistance Publique - Hopitaux de Paris, 48 Boulevard Serurier, Paris, 75019, France, 33 185552762
- Paris University, Paris, France
| | - Aline Lefebvre
- Centre Hospitalier Spécialisée Fondation Vallee, Gentilly, France
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Assistance Publique - Hopitaux de Paris, 48 Boulevard Serurier, Paris, 75019, France, 33 185552762
- Paris University, Paris, France
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
| |
Collapse
|
5
|
Smith SN, Almirall D, Choi SY, Andrews C, Koschmann E, Rusch A, Bilek E, Lane A, Abelson JL, Eisenberg D, Himle JA, Liebrecht C, Kilbourne AM. Student mental health outcomes of a clustered SMART for developing an adaptive implementation strategy to support school-based CBT delivery. J Affect Disord 2024:S0165-0327(24)01265-5. [PMID: 39151756 DOI: 10.1016/j.jad.2024.08.048] [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: 03/12/2024] [Revised: 08/07/2024] [Accepted: 08/11/2024] [Indexed: 08/19/2024]
Abstract
PURPOSE Most youth experiencing anxiety/depression lack access to evidence-based mental health practices (EBPs). School-delivered care improves access, and various support can help school professionals (SPs; school social workers, counselors) deliver EBPs, like Cognitive Behavioral Therapy (CBT). Understanding implementation strategies' impact on downstream mental health outcomes is crucial to scaling up EBPs to address the treatment gap, but it has rarely been assessed. METHODS This paper compares implementation strategies' impact on change in student outcomes, collected as exploratory outcomes from a type III hybrid implementation-effectiveness trial. A clustered, sequential, multiple-assignment randomized trial design was used, which embedded four implementation supports that differentially sequence three implementation strategies, Replicating Effective Programs (REP), Coaching, and Facilitation. Prior to the first randomization, N = 169 SPs from 94 Michigan high schools each identified up to 10 students whom they believed could benefit from CBT and facilitated student survey completion. Changes in students' depression (Patient Health Questionnaire-9, modified for teens) and anxiety symptoms (Generalized Anxiety Disorder-7) over 10 months were compared across the four sequences of implementation support using a generalization of a marginal, weighted least squares approach developed for a clustered SMARTs. RESULTS Small, non-clinically significant reductions in symptoms over the study period were found. Pairwise comparisons found no significant differences in symptom change across the four implementation strategies. The difference in the estimated mean PHQ-9 T/GAD-7 scores between the least and the most intensive strategies (REP vs. REP+Coaching+Facilitation) was 1.04 (95%CI = -0.95, 3.04) for depression and 0.82 (95%CI = -0.89, 2.52) for anxiety. DISCUSSION No difference in symptom change was found across the four implementation strategies. Multiple forms of implementation support may be useful for improving student mental health outcomes. TRIAL REGISTRATION NCT03541317-Registered on 29 May 2018 on ClinicalTrials.gov PRS.
Collapse
Affiliation(s)
- Shawna N Smith
- Department of Health Management and Policy, School of Public Health, University of Michigan, USA; Department of Psychiatry, Michigan Medicine, University of Michigan, USA.
| | - Daniel Almirall
- Survey Research Center, Institute of Social Research, University of Michigan, USA; Department of Statistics, University of Michigan, USA
| | - Seo Youn Choi
- Department of Health Management and Policy, School of Public Health, University of Michigan, USA
| | - Carolyn Andrews
- Department of Health Management and Policy, School of Public Health, University of Michigan, USA
| | | | - Amy Rusch
- Department of Health Management and Policy, School of Public Health, University of Michigan, USA
| | - Emily Bilek
- Department of Psychiatry, Michigan Medicine, University of Michigan, USA
| | - Annalise Lane
- Department of Health Management and Policy, School of Public Health, University of Michigan, USA
| | - James L Abelson
- Department of Psychiatry, Michigan Medicine, University of Michigan, USA
| | | | - Joseph A Himle
- Department of Psychiatry, Michigan Medicine, University of Michigan, USA; School of Social Work, University of Michigan, USA
| | - Celeste Liebrecht
- Department of Learning Health Sciences, Michigan Medicine, University of Michigan, USA
| | - Amy M Kilbourne
- Department of Learning Health Sciences, Michigan Medicine, University of Michigan, USA; Quality Enhancement Research Initiative (QUERI), US Department of Veterans Affairs, USA
| |
Collapse
|
6
|
Siegel P, Peterson BS. Advancing the treatment of anxiety disorders in transition-age youth: a review of the therapeutic effects of unconscious exposure. J Child Psychol Psychiatry 2024. [PMID: 39128857 DOI: 10.1111/jcpp.14037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND The real-world effectiveness of exposure-based therapies for youth depends on the willingness and ability of young people to tolerate confronting their fears, which can be experienced as highly aversive and create problems with treatment engagement and acceptance. Recently, neuroscientific research on the nonconscious basis of fear has been translated into novel exposure interventions that bypass conscious processing of feared stimuli and that thus do not cause phobic youth to experience distress. We present a review of these unconscious exposure interventions. METHODS A PRISMA-based search yielded 20 controlled experiments based on three paradigms that tested if fear-related responses could be reduced without conscious awareness in highly phobic, transition-age youth: 14 randomized controlled trials (RCTs), 5 fMRI studies (1 was also an RCT), 4 psychophysiological studies (3 were also RCTs), and 1 ERP study. We conducted meta-analyses of outcomes where feasible. RESULTS Unconscious exposure interventions significantly (1) reduced avoidance behavior (range of Cohen's d = 0.51-0.95) and self-reported fear (d = 0.45-1.25) during in vivo exposure to the feared situation; (2) reduced neurobiological indicators of fear (d = 0.54-0.62) and concomitant physiological arousal (d = 0.55-0.64); (3) activated neural systems supporting fear regulation more strongly than visible exposure to the same stimuli (d = 1.2-1.5); (4) activated regions supporting fear regulation that mediated the reduction of avoidance behavior (d = 0.70); (5) evoked ERPs suggesting encoding of extinction memories (d = 2.13); and (6) had these effects without inducing autonomic arousal or subjective fear. CONCLUSIONS Unconscious exposure interventions significantly reduce a variety of symptomatic behaviors with mostly moderate effect sizes in transition-age youth with specific phobias. fMRI and physiological findings establish a neurophysiological basis for this efficacy, and suggest it occurs through extinction learning. Unconscious exposure was well tolerated, entirely unassociated with drop out, and is highly scalable for clinical practice. However, a number of limitations must be addressed to assess potential clinical impacts, including combining unconscious exposure with exposure therapy to boost treatment acceptance and efficacy.
Collapse
Affiliation(s)
- Paul Siegel
- Department of Psychology, Purchase College, State University of New York, Purchase, NY, USA
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Bradley S Peterson
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Psychiatry, Children's Hospital Los Angeles, Institute for the Developing Mind, Los Angeles, CA, USA
| |
Collapse
|
7
|
Hirsig A, Häfeli XA, Schmidt SJ. Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial. Trials 2024; 25:530. [PMID: 39118136 PMCID: PMC11308397 DOI: 10.1186/s13063-024-08241-3] [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: 04/11/2024] [Accepted: 06/10/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Most mental disorders have their onset in adolescence. Preventive interventions during this period are important; however, help-seeking behavior is generally poor in this age group resulting in low treatment rates. Internet interventions are expected to be an effective, low-threshold, and scalable approach to overcome barriers to help-seeking, particularly for individuals experiencing subclinical symptoms. Internet-delivered indicated prevention seems promising as it targets individuals with minimal symptoms of mental disorders who might need care but are not help-seeking yet. Previous indicated prevention-approaches have mainly targeted specific risk-syndromes. However, this contradicts the increasing recognition of emerging psychopathology as a complex system characterized by co-occurrence and rapid shifts of subclinical symptoms cutting across diagnostic categories. Therefore, this study will investigate the efficacy, mediators, moderators, and core symptomatic changes of a transdiagnostic Internet-delivered indicated prevention program (EMPATIA program) for adolescents. METHODS This randomized controlled trial (RCT) will be conducted in a general population sample (planned n = 152) of adolescents aged 12-18 years with subclinical symptoms but without any current or past mental disorder. Participants will be randomly assigned to the EMPATIA program or a care as usual (CAU) control condition. The 8-week guided EMPATIA program encompasses 8 modules targeting the following transdiagnostic mechanisms: repetitive negative thinking, self-perfectionism, emotion regulation, intolerance of uncertainty, rejection sensitivity, and behavioral avoidance. Participants will be asked to answer online self-report questionnaires at baseline, after 8 weeks, and at 6-, 9-, and 12-month follow-up. Diagnostic telephone interviews will be conducted at baseline and at 12-month follow-up. Additionally, intervention-specific constructs (motivation, alliance, negative effects, satisfaction, adherence) will be assessed during and after the EMPATIA program. The level of self-reported general psychopathology post-intervention is the primary outcome. DISCUSSION Results will be discussed considering the potential of Internet interventions as a scalable, low-threshold option for indicated prevention in adolescents experiencing subclinical symptoms. The EMPATIA program introduces a novel Internet prevention program targeting six transdiagnostic mechanisms associated with various mental health outcomes. Thereby, this trial pursues a very timely and important topic because it may contribute to narrow the current care gap for adolescents, to prevent mental health problems and related negative consequences, and to promote mental health in the long-term. TRIAL REGISTRATION The trial was approved by Swissmedic (Registration Number: 10001035, 08/22/2022) and the Ethics Committee of Bern (Registration Number: 2022-D0036, 08/22/2022). The trial was registered at ClinicalTrials.gov NCT05934019 on 07-03-2023.
Collapse
Affiliation(s)
- Anja Hirsig
- Division of Clinical Child and Adolescent Psychology, University of Bern, Fabrikstrasse 8, Bern, 3012, Switzerland.
| | - Xenia Anna Häfeli
- Division of Clinical Child and Adolescent Psychology, University of Bern, Fabrikstrasse 8, Bern, 3012, Switzerland
| | - Stefanie Julia Schmidt
- Division of Clinical Child and Adolescent Psychology, University of Bern, Fabrikstrasse 8, Bern, 3012, Switzerland
| |
Collapse
|
8
|
McGovern R, Balogun-Katung A, Artis B, Bareham B, Spencer L, Alderson H, Brown E, Brown J, Lingam R, McArdle P, Newham JJ, Wojciechowska A, Rankin J, Redgate S, Thomason P, Kaner E. The Effectiveness of Preventative Interventions to Reduce Mental Health Problems in at-risk Children and Young People: A Systematic Review of Reviews. JOURNAL OF PREVENTION (2022) 2024; 45:651-684. [PMID: 38884876 PMCID: PMC11271346 DOI: 10.1007/s10935-024-00785-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/18/2024]
Abstract
Mental health problems are the leading cause of childhood disability worldwide, resulting in poor outcomes for children and young people that persist into adulthood. It is essential that those young people most at risk of developing mental health problems receive effective preventative interventions. Whilst there have been a number of systematic reviews which have examined the effectiveness of secondary prevention interventions for specific groups of children and young people, or to address identified mental health concerns, no review has engaged with the breadth of this literature. We conducted a systematic review of systematic reviews to map this complex field of secondary preventative interventions and identify effective interventions to prevent mental health problems in children and adolescents aged 3-17 years. The review protocol was registered on PROSPERO. We searched five electronic databases from inception to February 2023. The certainty of the evidence was appraised using the AMSTAR 2. We included 49 unique systematic reviews each including between 2 and 249 (mean 34) unique studies; the majority of which were reviews which included only or mostly randomised controlled trials (70%). The reviews examined selective interventions (defined as interventions which are delivered to sub-group populations of young people at increased risk of mental health problems) (n = 22), indicated interventions (defined as interventions which target young people who are found to have pre-clinical symptoms) (n = 15) or a synthesis of both (n = 12). The certainty of the evidence in the reviews was rated as high, (n = 12) moderate (n = 5), low (n = 9) and critically low (n = 23). We found evidence to support both selective and indicated interventions in a range of populations and settings, with most of this evidence available for children and young people in their mid-years (6-10 years) and early adolescence (11-13 years). There was a large body of evidence suggesting that resilience enhancing, cognitive behaviour therapy-based and psychoeducational interventions for children who experience adversity, or those with subclinical externalising problems may offer promise. Early selective interventions for a subpopulation of children and young people who have experienced adversity which combines risk reduction and resilience enhancing approaches directed at children and their families may be effective at reducing mental health problems.
Collapse
Affiliation(s)
- R McGovern
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - A Balogun-Katung
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - B Artis
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - B Bareham
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - L Spencer
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - H Alderson
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - E Brown
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - J Brown
- Children's Social Care, Newcastle City Council, Newcastle upon Tyne, UK
| | - R Lingam
- Population Child Health Research Group, School of Women and Children's Health, University New South Wales, Sydney, Australia
| | - P McArdle
- Child and Adolescent Mental Health Services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J J Newham
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - A Wojciechowska
- Disabilities Integrated Team at the Tees, Esk and Wear Valleys, NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J Rankin
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - S Redgate
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - P Thomason
- Children's Social Care, Gateshead Council, Tyne and Wear, UK
| | - E Kaner
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| |
Collapse
|
9
|
Muwonge JJ, Dalman C, Burström B, de Leon AP, Galanti MR, Jablonska B, Hollander AC. Are the estimated needs for mental health care among adolescents from different socioeconomic backgrounds met equally in Sweden? A longitudinal survey-registry linkage study. Eur Child Adolesc Psychiatry 2024; 33:2581-2591. [PMID: 38157010 PMCID: PMC11272712 DOI: 10.1007/s00787-023-02341-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024]
Abstract
Evidence of inequality in the utilisation of mental health care (MHC) by adolescents in Nordic countries is mixed. This study aims to investigate if there are socioeconomic differences in the utilisation of MHC, while accounting for adolescents' mental health status. We analysed a cohort of 3517 adolescents, followed from 7 to 9th grade (ages 13-16), to examine the association between parental socioeconomic position (SEP: education and disposable income), adolescents' estimated needs, and the utilisation of MHC (defined as visits to secondary psychiatric care or receipt of psychotropic medication). Logistic and negative binomial regression models, with mental health status as moderator, were used to predict utilisation during each grade. Lower SEP predicted higher odds of utilising MHC in adolescents with no/mild symptoms (e.g., odds ratio, OR = 1.33, 95% CI 1.04-1.72, lower vs highest education), but not in those with moderate-to-severe symptoms (estimates close to one and non-significant). This pattern was largely explained by treatment of attention deficit hyperactivity disorder/autism spectrum disorders (ADHD/ASD) in boys. For girls with severe symptoms, lower SEP predicted reduced odds of utilising MHC for other mental disorders (OR = 0.48, 95% CI 0.25-0.92, lower education), and fewer outpatient visits when in contact with such care, although non-significant (incidence rate ratio, IRR = 0.51, 95% CI 0.25-1.05, lowest vs highest income). Our findings suggest a more equitable use of MHC for treating ADHD/ASD, but not other mental disorders such as depression and anxiety, particularly among girls.
Collapse
Affiliation(s)
- Joseph Jr Muwonge
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden.
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.
| | - Christina Dalman
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Bo Burström
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Antonio Ponce de Leon
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | - Beata Jablonska
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | |
Collapse
|
10
|
Mathews F, Ford TJ, White S, Ukoumunne OC, Newlove-Delgado T. Children and young people's reported contact with professional services for mental health concerns: a secondary data analysis. Eur Child Adolesc Psychiatry 2024; 33:2647-2655. [PMID: 38172370 PMCID: PMC11272805 DOI: 10.1007/s00787-023-02328-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024]
Abstract
Children and young people's mental health services have been under increasing pressure following COVID-19. Understanding, for which channels help is sought from, will highlight services needing support. This study aims to explore the professional services that parents of children, and young people get help from when they have a concern for the child's/their mental health. Secondary analysis of data is taken from Mental Health of Children and Young People in England Survey, 2017. 7608 reports of mental health-related contact with professional services from parents of 5-16 year-olds and self-reports from young people aged 17-19 were available. Service contact was reported by Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnosis, age, gender and ethnicity. Less than two-thirds of children and young people with a DSM-V diagnosis (63.5% (95% CI 58.6-68.1) aged 5-10, and 64.0% (95% CI 59.4-68.4) aged 11-16) reported contact with any professional services. The figure was lower for those aged 17-19; 50.1% (95% CI 42.8-58.2), p = 0.005. Children and young people aged 5-16 from Black (11.7%; 95% CI 2.4-41.4), Asian (55.1%; 95% CI 34.7-73.9) and Mixed (46.0%; 95% CI 32.4-60.3) ethnic groups reported less contact with professional services compared to those from the White group (66.9%; 95% CI 63.5-70.2). Patterns of service access during the three main educational stages aid with understanding service need during childhood. These lower levels of reported service access for young people aged 17-19 with a DSM-V diagnosis and those in ethnic minority groups demand further investigation.
Collapse
Affiliation(s)
| | - Tamsin Jane Ford
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Simon White
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Obioha Chukwunyere Ukoumunne
- Department of Health and Community Sciences, Faculty of Health and Life Sciences, NIHR Applied Research Collaboration South West Peninsula, University of Exeter, Exeter, UK
| | | |
Collapse
|
11
|
Ashworth E, McCarthy M, Wynne S, Robinson J, McKay S, Lane S, Richardson G, Boardman N, Henderson K, Crosbie V, Humphrey N, York S, Michail M, Hart D, Clacy D, Jalota M, Saini P. Study protocol for the Multimodal Approach to Preventing Suicide in Schools (MAPSS) project: A regionally based feasibility trial of an integrated response to suicide risk among UK secondary school pupils. PLoS One 2024; 19:e0302873. [PMID: 39058694 PMCID: PMC11280149 DOI: 10.1371/journal.pone.0302873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/30/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Suicide is the leading cause of death of children and young people under 35 in the UK, and suicide rates are rising in this age group. Schools are considered an appropriate and logical setting for youth suicide prevention activities, with universal, selective, and indicated approaches all demonstrating efficacy. Given that international best practice recommends suicide prevention programmes combine these approaches, and that to date this has not been done in school settings in the UK, this study aims to evaluate the feasibility of delivering a suicide prevention programme incorporating universal, selective, and indicated components in UK schools. METHODS This study is a feasibility cluster-randomised controlled trial (RCT) of an adapted version of the Multimodal Approach to Preventing Suicide in Schools (MAPSS) programme. The programme, initially developed in Australia, involves delivering universal psychoeducation to all pupils, screening them for suicide risk, and delivering Internet-based Cognitive Behavioural Therapy (Reframe IT-UK) to those students identified as being at high-risk for suicide. The programme will be trialled in six secondary schools in Northwest England and will target Year 10 students (14- and 15-year-olds). The primary aims are to assess: 1) the acceptability and safety of delivering MAPSS in a school setting in the UK; 2) the social validity of the MAPSS programme; and 3) the feasibility of delivering a large-scale, appropriately powered, cluster-RCT and economic evaluation of this intervention in the future. Secondary aims are to assess changes over time in mental health and wellbeing outcomes. DISCUSSION This study is the first to evaluate a suicide prevention programme comprising universal, selective, and indicated components in UK schools. If the programme is found to be feasible, it could be more widely tested in schools and may ultimately lead to reduced rates of suicide and suicidal behaviour in young people.
Collapse
Affiliation(s)
- Emma Ashworth
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Molly McCarthy
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Sio Wynne
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Jo Robinson
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Samuel McKay
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Steven Lane
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Gerry Richardson
- Centre for Health Economics, University of York, York, United Kingdom
| | - Neil Boardman
- Champs Public Health Collaborative, Cheshire and Merseyside, United Kingdom
| | | | - Vivienne Crosbie
- Child and Adolescent Mental Health Services, Alder Hey Children’s NHS Foundation Trust, Liverpool, United Kingdom
| | - Neil Humphrey
- Manchester Institute of Education, University of Manchester, Manchester, United Kingdom
| | - Sian York
- Calderstones School, Liverpool, United Kingdom
| | - Maria Michail
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Damian Hart
- Merseyside Youth Association, Liverpool, United Kingdom
| | | | | | - Pooja Saini
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| |
Collapse
|
12
|
David OA, Tomoiagă C, Fodor LA. The MoodWheel app: validation and factor structure of a new tool for the assessment of mood based on the experience sampling method. THE JOURNAL OF GENERAL PSYCHOLOGY 2024:1-17. [PMID: 39028550 DOI: 10.1080/00221309.2024.2378284] [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: 02/22/2024] [Accepted: 06/25/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND The MoodWheel app is a newly developed tool that uses experience sampling method (ESM) for assessing negative and positive emotions, based on the circumplex model of emotions and the binary model of distress, and including behavioral and heart rate (HR) measurement via photoplethysmography and the possibility to personalize the application with additional measures. Aims: This study was designed to assess the factorial structure, reliability and validity of the MoodWheel (MW) application for evaluating emotions in children, adolescents. METHODS A sample of 490 children and adolescents were recruited from the schools. Internal consistency was assessed via Cronbach's alpha test. Concurrent validity was assessed by evaluating the correlations between MW and Profile of Emotional Distress scale (PED) scores, in terms of functional/dysfunctional negative and positive emotions. RESULTS Results obtained show that MW has good to excellent internal consistency and test-retest reliability, while the convergent validity was also adequate. Moreover, we found support for the organization of the MW based on the binary model of distress, given the predictive value found for the irrational and rational beliefs. CONCLUSIONS The MW application is a useful and easy to use tool that can be used for the accurate measurement of emotions, which will be complimented in future with additional behavioral parameters to provide a comprehensive and dynamic assessment.
Collapse
|
13
|
Baldofski S, Scheider J, Kohls E, Klemm SL, Koenig J, Bauer S, Moessner M, Kaess M, Eschenbeck H, Lehner L, Becker K, Krämer J, Diestelkamp S, Thomasius R, Rummel-Kluge C. Intentions and barriers to help-seeking in adolescents and young adults differing in depression severity: cross-sectional results from a school-based mental health project. Child Adolesc Psychiatry Ment Health 2024; 18:84. [PMID: 39010111 PMCID: PMC11251315 DOI: 10.1186/s13034-024-00775-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 07/01/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Mental health problems, such as depression, have a high prevalence in young people. However, the majority of youths suffering from depression do not seek professional help. This study aimed to compare help-seeking behavior, intentions and perceived barriers between youthswith different levels of depressive symptoms. METHODS This cross-sectional study is part of a large-scale, multi-center project. Participants were n = 9509 youths who were recruited in German schools and completed a baseline screening questionnaire. Based on their depressive symptoms, youths were allocated to the following three subgroups: (a) without depressive symptoms, (b) with subclinical symptoms, (c) with clinical symptoms (measured by PHQ-A). Quantitative analyses compared previous help-seeking behavior, help-seeking intentions and perceived barriers (Barriers questionnaire) between these subgroups. An additional exploratory qualitative content analysis examined text answers on other perceived barriers to help-seeking. RESULTS Participants were mostly female (n = 5575, 58.6%) and 12 to 24 years old (M = 15.09, SD 2.37). Participants with different levels of depressive symptoms differed significantly in help-seeking behavior, intentions and perceived barriers. Specifically, participants with clinical depressive symptoms reported more previous help-seeking, but lower intentions to seek help compared to participants without symptoms (all p < 0.05). Participants with subclinical depressive symptoms reported a similar frequency of previous help-seeking, but higher intentions to seek help compared to participants without symptoms (all p < 0.05). Perception of barriers was different across subgroups: participants with clinical and subclinical depressive symptoms perceived the majority of barriers such as stigma, difficulties in accessibility, and family-related barriers as more relevant than participants without depressive symptoms. Across all subgroups, participants frequently mentioned intrapersonal reasons, a high need for autonomy, and a lack of mental health literacy as barriers to help-seeking. CONCLUSIONS Youths with higher levels of depressive symptoms are more reluctant to seek professional help and perceive higher barriers. This underlines the need for effective and low-threshold interventions to tackle barriers, increase help-seeking, and lower depressive symptoms in adolescents and young adults differing in depression severity. TRIAL REGISTRATION DRKS00014685.
Collapse
Affiliation(s)
- Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Jelena Scheider
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig University, Leipzig, Germany
| | - Sarah-Lena Klemm
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stephanie Bauer
- Centre for Psychosocial Medicine, Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Mental Health (DZPG), partner site Mannheim/Heidelberg/Ulm, Mannheim, Germany
| | - Markus Moessner
- Centre for Psychosocial Medicine, Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Heike Eschenbeck
- Department of Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Laya Lehner
- Department of Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Marburg, Germany
| | - Jennifer Krämer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the Philipps-University Marburg, Marburg, Germany
| | - Silke Diestelkamp
- German Center for Addiction Research in Childhood and Adolescence, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Rainer Thomasius
- German Center for Addiction Research in Childhood and Adolescence, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany.
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig University, Leipzig, Germany.
| |
Collapse
|
14
|
Sheikh A, Payne-Cook C, Lisk S, Carter B, Brown JSL. Why do young men not seek help for affective mental health issues? A systematic review of perceived barriers and facilitators among adolescent boys and young men. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02520-9. [PMID: 39004687 DOI: 10.1007/s00787-024-02520-9] [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: 08/30/2023] [Accepted: 07/01/2024] [Indexed: 07/16/2024]
Abstract
Men are less likely to seek help for their mental health than women, but less is known about the specific patterns of help-seeking in adolescent boys and young men. This is concerning as adolescent boys and young men have high suicide rates but a low take-up of services. It is therefore of particular importance that the access needs of this group are understood. This review sought to identify the barriers and facilitators faced by adolescent boys and young men in help-seeking for affective mental health disorders. A search of the PubMed, APA PsycInfo, and Cochrane databases identified 3961 articles, of which 12 met the inclusion criteria. Six of the studies were qualitative, five were quantitative and one used mixed methods. Two authors independently extracted data and assessed the quality of the articles. Five key themes were identified, including the impact of social norms, with the subthemes of conformity to masculine norms and self-stigma, limited availability of information about mental health, and 'male-friendly' mental health literacy campaigns. Other themes referred to the help-seeking preferences of adolescent boys and young men, in terms of informal or formal and online or offline help-seeking. Some of the factors were well-researched (e.g., conformity to masculine norms as a barrier) whereas other factors (e.g., self-compassion as a facilitator) were less researched. These barriers and facilitators need to be considered in the development of future strategies to improve the help-seeking behaviour of adolescent boys and young men.
Collapse
Affiliation(s)
| | | | - Stephen Lisk
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - June S L Brown
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| |
Collapse
|
15
|
Ho TQA, Engel L, Melvin G, Le LKD, Le HND, Mihalopoulos C. Young People's Barriers and Facilitators of Engagement with Web-Based Mental Health Interventions for Anxiety and Depression: A Qualitative Study. THE PATIENT 2024:10.1007/s40271-024-00707-5. [PMID: 39002094 DOI: 10.1007/s40271-024-00707-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND The prevalence of anxiety and depressive symptoms in young people have increased in many countries around the world. Web-based mental health interventions (or W-MHIs) have the potential to reduce anxiety and depression symptoms for young people. Although W-MHIs have become more widely used by young people since the coronavirus disease 2019 (COVID-19) pandemic, real-world engagement in these W-MHIs has remained low compared with engagement reported in research studies. Moreover, there are limited studies examining factors influencing engagement with W-MHIs in the post-COVID-19 pandemic years. OBJECTIVE This study aims to explore barriers and facilitators of engagement with W-MHIs for anxiety and depression among young people. METHOD Seventeen semi-structured interviews and one focus group with three participants were conducted online via Zoom between February and March 2023. Participants were young people aged 18-25 years who had self-reported experience of anxiety and/or depression in the past 6 months, lived in Australia, and considered using W-MHIs to manage their anxiety and/or depression symptoms. Inductive thematic analysis was performed to understand the key barriers and facilitators of young people's engagement with W-MHIs. RESULTS Both individual- and intervention-related factors influenced young people's engagement with W-MHIs. Facilitators of engagement included personal trust and beliefs in W-MHIs, ability to contact a health professional, programme suitability (e.g., affordability, content aligning with user needs), programme usability (e.g., user interface), and accessibility of the online platform. Barriers included concerns about online security, lack of human interaction and immediate responses from health professionals (if any), and negative experience with mental health programmes. Participants expressed greater willingness to pay if they could contact health professionals during the programme. CONCLUSION Better promotion strategies for mental health and W-MHI awareness are needed to increase the perceived importance and priority of mental health interventions among young people. Young people should be involved in the W-MHI co-design to enhance the programme suitability and usability for young people, fostering their engagement with W-MHIs.
Collapse
Affiliation(s)
- Thi Quynh Anh Ho
- Deakin University, Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Lidia Engel
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Glenn Melvin
- School of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Long Khanh-Dao Le
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ha N D Le
- Deakin University, Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
16
|
Saunders E, Pevie NW, Bedford S, Gosselin J, Harris N, Rash JA. Moms in motion: Predicting healthcare utilization patterns among mothers in Newfoundland and Labrador. PLoS One 2024; 19:e0304815. [PMID: 38980863 PMCID: PMC11233017 DOI: 10.1371/journal.pone.0304815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 05/18/2024] [Indexed: 07/11/2024] Open
Abstract
Mothers have a significant influence on family dynamics, child development, and access to family services. There is a lack of literature on the typical Canadian maternal experience and its influence on access to services for mothers despite recognizing the importance of mothers. A cross-sectional study was conducted to address this research gap that employed Andersen's Behavioral Model of Health Service Use in conjunction with a feminist lens. A total of 1,082 mothers who resided in Newfoundland and Labrador (NL) participated in a province-wide survey in 2017 and reported on their wellbeing, family life, and healthcare utilization. Stepwise binomial logistic regressions and linear regressions were used to predict initiation and continued service utilization within the preceding 12 months, respectively. Mothers who participated in this survey were older, and were more likely to be in a relationship than those in the Canadian census, while no difference was observed in annual income. Approximately half of mothers accessed services for themselves over the previous 12-months, with the overwhelming majority accessing services for their children. Medical services were the most likely to be utilized, and mental health and behavioural services were the most likely services to be needed, but not available. Sociodemographic (e.g., age, education attainment), familial relationships and role satisfaction, health need, and health practices predicted maternal initiation and continued use of services, with a larger number of variables influencing maternal service initiation as compared to continuous use of services. Sociodemographic (e.g., maternal age, community population), maternal social support, health need, and maternal health practices predicted maternal access of at least one child service while family relationships, health need, and maternal health practices predicted maternal use of a range of child services conditional on initial access. These results can support the provincial health system to better support access to care by acknowledging the interdependent nature of maternal and child health care utilization. They also highlight the importance of equitable healthcare access in rural locations. Results are discussed in terms of their clinical relevance to health policy.
Collapse
Affiliation(s)
- Emily Saunders
- Department of Psychology, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Noah W. Pevie
- Department of Psychology, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Shannon Bedford
- Department of Psychology, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Julie Gosselin
- Department of Psychology, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Nick Harris
- Department of Psychology, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Joshua A. Rash
- Department of Psychology, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| |
Collapse
|
17
|
Turuba R, Cormier W, Zimmerman R, Ow N, Zenone M, Quintana Y, Jenkins E, Ben-David S, Raimundo A, Marcon AR, Mathias S, Henderson J, Barbic S. Exploring How Youth Use TikTok for Mental Health Information in British Columbia: Semistructured Interview Study With Youth. JMIR INFODEMIOLOGY 2024; 4:e53233. [PMID: 38967966 PMCID: PMC11259762 DOI: 10.2196/53233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 04/27/2024] [Accepted: 05/26/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND TikTok (ByteDance) experienced a surge in popularity during the COVID-19 pandemic as a way for people to interact with others, share experiences and thoughts related to the pandemic, and cope with ongoing mental health challenges. However, few studies have explored how youth use TikTok to learn about mental health. OBJECTIVE This study aims to understand how youth used TikTok during the COVID-19 pandemic to learn about mental health and mental health support. METHODS Semistructured interviews were conducted with 21 youths (aged 12-24 years) living in British Columbia, Canada, who had accessed TikTok for mental health information during the COVID-19 pandemic. Interviews were audio-recorded, transcribed verbatim, coded, and analyzed using an inductive, data-driven approach. RESULTS A total of 3 overarching themes were identified describing youth's experiences. The first theme centered on how TikTok gave youth easy access to mental health information and support, which was particularly helpful during the COVID-19 pandemic to curb the effects of social isolation and the additional challenges of accessing mental health services. The second theme described how the platform provided youth with connection, as it gave youth a safe space to talk about mental health and allowed them to feel seen by others going through similar experiences. This helped normalize and destigmatize conversations about mental health and brought awareness to various mental health conditions. Finally, the last theme focused on how this information led to action, such as trying different coping strategies, discussing mental health with peers and family, accessing mental health services, and advocating for themselves during medical appointments. Across the 3 themes, youth expressed having to be mindful of bias and misinformation, highlighting the barriers to identifying and reporting misinformation and providing individualized advice on the platform. CONCLUSIONS Findings suggest that TikTok can be a useful tool to increase mental health awareness, reduce stigma, and encourage youth to learn and address their mental health challenges while providing a source of peer connection and support. Simultaneously, TikTok can adversely impact mental health through repetitive exposure to mentally distressing content and misleading diagnosis and treatment information. Regulations against harmful content are needed to mitigate these risks and make TikTok safer for youth. Efforts should also be made to increase media and health literacy among youth so that they can better assess the information they consume online.
Collapse
Affiliation(s)
- Roxanne Turuba
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Foundry, Providence Health Care, Vancouver, BC, Canada
| | - Willow Cormier
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Rae Zimmerman
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Nikki Ow
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Marco Zenone
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Health Law Institute, University of Alberta, Edmonton, AB, Canada
| | - Yuri Quintana
- Division of Clinical Informatics, Beth Israel Deaconess Medical Centre, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Homewood Research Institute, Guelph, ON, Canada
| | - Emily Jenkins
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Shelly Ben-David
- School of Social Work, University of British Columbia, Vancouver, BC, Canada
| | | | | | - Steve Mathias
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Foundry, Providence Health Care, Vancouver, BC, Canada
- Centre for Advancing Health Outcomes, Vancouver, BC, Canada
| | - Jo Henderson
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Youth Wellness Hubs Ontario, Toronto, ON, Canada
| | - Skye Barbic
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Foundry, Providence Health Care, Vancouver, BC, Canada
- Centre for Advancing Health Outcomes, Vancouver, BC, Canada
| |
Collapse
|
18
|
Verhoog S, Eijgermans DGM, Fang Y, Bramer WM, Raat H, Jansen W. Contextual determinants associated with children's and adolescents' mental health care utilization: a systematic review. Eur Child Adolesc Psychiatry 2024; 33:2051-2065. [PMID: 36129544 PMCID: PMC9490713 DOI: 10.1007/s00787-022-02077-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 08/31/2022] [Indexed: 11/19/2022]
Abstract
Determinants at the contextual level are important for children's and adolescents' mental health care utilization, as this is the level where policy makers and care providers can intervene to improve access to and provision of care. The objective of this review was to summarize the evidence on contextual determinants associated with mental health care utilization in children and adolescents. A systematic literature search in five electronic databases was conducted in August 2021 and retrieved 6439 unique records. Based on eight inclusion criteria, 74 studies were included. Most studies were rated as high quality (79.7%) and adjusted for mental health problems (66.2%). The determinants that were identified were categorized into four levels: organizational, community, public policy or macro-environmental. There was evidence of a positive association between mental health care utilization and having access to a school-based health center, region of residence, living in an urban area, living in an area with high accessibility of mental health care, living in an area with high socio-economic status, having a mental health parity law, a mental health screening program, fee-for-service plan (compared to managed care plan), extension of health insurance coverage and collaboration between organizations providing care. For the other 35 determinants, only limited evidence was available. To conclude, this systematic review identifies ten contextual determinants of children's and adolescents' mental health care utilization, which can be influenced by policymakers and care providers. Implications and future directions for research are discussedPROSPERO ID: CRD42021276033.
Collapse
Affiliation(s)
- S Verhoog
- Department of Public Health, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
| | - D G M Eijgermans
- Department of Public Health, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Y Fang
- Department of Public Health, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
| | - W M Bramer
- Medical Library, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - H Raat
- Department of Public Health, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
| | - W Jansen
- Department of Public Health, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands.
- Department of Social Development, City of Rotterdam, Rotterdam, the Netherlands.
| |
Collapse
|
19
|
Willing L, Schreiber J. Using Advocacy to Address the Crisis of Children's Mental Health. Child Adolesc Psychiatr Clin N Am 2024; 33:319-330. [PMID: 38823806 DOI: 10.1016/j.chc.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
Children and youth in the United States are experiencing a mental health crisis that predates the COVID-19 pandemic. Child and adolescent psychiatrists have the knowledge and skillset to advocate for improving the pediatric mental health care system at the local, state, and federal levels. Child psychiatrists can use their knowledge and expertise to advocate legislatively or through regulatory advocacy to improve access to mental health care for youth. Further, including advocacy education in psychiatry and child psychiatry graduate medical education would help empower child psychiatrists to make an impact through their advocacy efforts.
Collapse
Affiliation(s)
- Laura Willing
- Children's National Hospital and George Washington University School of Medicine, 6833 4th Street NW Washington, DC 20012, USA.
| | - Justin Schreiber
- University of Pittsburgh Medical Center, Western Psychiatric Hospital, UPMC Children's Hospital of Pittsburgh, Lawrenceville Medical Building, 4117 Penn Avenue, 3rd Floor- 3111, Pittsburgh, PA 15224, USA
| |
Collapse
|
20
|
Nyashanu T, Scheibe A, Visser M. 'I went for rehab many times and it never worked, but the harm reduction process has given me renewed hope'. Perceptions on the effectiveness of harm reduction and community-based opioid substitution therapy. Health Promot J Austr 2024; 35:653-661. [PMID: 37605794 DOI: 10.1002/hpja.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/23/2023] Open
Abstract
ISSUE ADDRESSED The accessibility of opioid substitution therapy (OST), one of the recommended treatments for opioid dependence, remains low. This study sought to explore the perceived effectiveness of OST from the perspectives of peer outreach workers and OST clients in a community-based harm reduction programme. METHODS The research was done within the Community-Oriented Substance Use Programme (COSUP) in Tshwane, South Africa. Fifteen peer educators (13 males and 2 females) took part in two focus group discussions. Thereafter, there were semi-structured interviews in which 15 OST clients (11 males and 4 females) participated. A convenience cross-sectional study was used. Interviews were audio-recorded. Using thematic analysis, themes were examined to evaluate how OST and the harm reduction approach were perceived to contribute to the improved health status of people with opioid dependence. RESULTS Peer outreach workers and COSUP clients significantly endorsed OST as an effective treatment for opioid dependence. Participants perceived greater effectiveness of OST compared to abstinence-centred inpatient rehabilitation programmes. However, there were sentiments that more community education on OST was needed to motivate people with opioid dependence to access services and to address misconceptions about OST. CONCLUSIONS There is a lack of multi-level and multi-sectoral engagement of various stakeholders in opioid dependence services, needed to accelerate utilisation of OST services. SO WHAT?: The research unpacks the need for an integrated approach to service use optimisation, and the need to evaluate the role that increased awareness and community education on harm reduction strategies can play in enhancing the utilisation of OST services.
Collapse
Affiliation(s)
- Tichaenzana Nyashanu
- Department of Psychology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Andrew Scheibe
- Community Oriented Primary Care Research Unit, Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Maretha Visser
- Department of Psychology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
21
|
Brown J, James K, Lisk S, Shearer J, Byford S, Stallard P, Deighton J, Saunders D, Yarrum J, Fonagy P, Weaver T, Sclare I, Day C, Evans C, Carter B. Clinical effectiveness and cost-effectiveness of a brief accessible cognitive behavioural therapy programme for stress in school-aged adolescents (BESST): a cluster randomised controlled trial in the UK. Lancet Psychiatry 2024; 11:504-515. [PMID: 38759665 DOI: 10.1016/s2215-0366(24)00101-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Depression and anxiety are increasingly prevalent in adolescents. The Brief Educational Workshops in Secondary Schools Trial investigated the effectiveness of a brief accessible stress workshop programme for 16-18-year-olds. We aimed to investigate the clinical effectiveness and cost-effectiveness of the DISCOVER cognitive behavioural therapy (CBT) workshop on symptoms of depression in 16-18-year-olds at 6 months compared with treatment-as-usual. METHODS We conducted a multicentre, cluster randomised controlled trial in UK schools or colleges with sixth forms to evaluate clinical effectiveness and cost-effectiveness of a brief CBT workshop (DISCOVER) compared with treatment-as-usual. We planned to enrol 60 schools and 900 adolescents, using a self-referral system to recruit participants. Schools were randomised in a 1:1 ratio for participants to receive either the DISCOVER workshop or treatment-as-usual, stratified by site and balanced on school size and index of multiple deprivation. Participants were included if they were 16-18 years old, attending for the full school year, seeking help for stress, and fluent in English and able to provide written informed consent. The outcome assessors, senior health economist, senior statistician, and chief investigator were masked. People with lived experience were involved in the study. The primary outcome was depression symptoms measured with the Mood and Feelings Questionnaire (MFQ) at 6-month follow-up, in the intention-to-treat population of all participants with full covariate data. The trial was registered with the ISRCTN registry (ISRCTN90912799). FINDINGS 111 schools were invited to participate in the study, seven were deemed ineligible, and 47 did not provide consent. Between Oct 4, 2021, and Nov 10, 2022, 933 students at 57 schools were screened for eligibility, seven were not eligible for inclusion, and 26 did not attend the baseline meeting and assessment, resulting in 900 adolescents participating in the study. The DISCOVER group included 443 participants (295 [67%] female and 136 [31%] male) and the treatment-as-usual group included 457 participants (346 [76%] female and 92 [20%] male). 468 (52%) of the 900 participants were White, and the overall age of the participants was 17·2 years (SD 0·6). 873 (97%) adolescents were followed up in the intention-to-treat population. The primary intention-to-treat analysis (n=854) found an adjusted mean difference in MFQ of -2·06 (95% CI -3·35 to -0·76; Cohen's d=-0·17; p=0·0019) at the 6-month follow-up, indicating a clinical improvement in the DISCOVER group. The probability that DISCOVER is cost- effective compared with treatment-as-usual ranged from 61% to 78% at a £20 000 to £30 000 per quality-adjusted life-year threshold. Nine adverse events (two of which were classified as serious) were reported in the DISCOVER group and 14 (two of which were classified as serious) were reported in the treatment-as-usual group. INTERPRETATION Our findings indicate that the DISCOVER intervention is modestly clinically effective and economically viable and could be a promising early intervention in schools. Given the importance of addressing mental health needs early in this adolescent population, additional research is warranted to explore this intervention. FUNDING National Institute for Health and Care Research Health Technology Assessment Programme.
Collapse
Affiliation(s)
- June Brown
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Kirsty James
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; King's Clinical Trials Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stephen Lisk
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James Shearer
- Health Service & Population Research Department, King's College London, London, UK
| | - Sarah Byford
- Health Service & Population Research Department, King's College London, London, UK
| | | | - Jessica Deighton
- Anna Freud National Centre for Children and Families, London, UK
| | - David Saunders
- Faculty of Health and Society, University of Northampton, Northampton, UK
| | - Jynna Yarrum
- Faculty of Health and Society, University of Northampton, Northampton, UK
| | - Peter Fonagy
- Anna Freud National Centre for Children and Families, London, UK; Department of Clinical Educational and Health Psychology, University College London, London, UK
| | - Timothy Weaver
- Faculty of Health, Social Care & Education, Middlesex University, London, UK
| | - Irene Sclare
- Southwark CAMHS Clinical Academic Group, South London & Maudsley NHS Foundation Trust, London, UK
| | - Crispin Day
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Claire Evans
- Anna Freud National Centre for Children and Families, London, UK
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; King's Clinical Trials Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
22
|
Armoon B, Mohammadi R, Griffiths MD. The Global Prevalence of Non-suicidal Self-injury, Suicide Behaviors, and Associated Risk Factors Among Runaway and Homeless Youth: A Meta-analysis. Community Ment Health J 2024; 60:919-944. [PMID: 38451378 DOI: 10.1007/s10597-024-01245-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/29/2024] [Indexed: 03/08/2024]
Abstract
A meta-analysis was performed to determine pooled prevalence of non-suicidal self-injury (NSSI), suicide behaviors (including ideation, attempts), and associated risk factors among runaway and homeless youth (RHY). The databases PubMed, Scopus, Web of Science, and Cochrane Library were searched for relevant studies published from January 1995 to May 2023. Initially, 8465 papers were screened, resulting in 69 included studies. The results showed that among RHY, lifetime prevalence rates were 42% for NSSI, 38% for suicidal ideation, and 27% for suicide attempts. Lifetime prevalence of NSSI and suicide behaviors was higher among adolescent minors (aged 12-17 years) compared to young adults (aged 18-24 years). Also, NSSI and suicide behaviors were associated with having a childhood history of physical and sexual abuse. Developing an impactful community-based suicide prevention campaign tailored for RHY appears warranted. Peer groups and mentorship programs would provide invaluable support for young individuals, as supportive friendships protect against NSSI.
Collapse
Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
| | - Rasool Mohammadi
- Social Determinants of Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| |
Collapse
|
23
|
Rao WW, He F, Qi Y, Lok GKI, Jackson T, Zheng Y, Xiang YT. Mental health among school children and adolescents in China: A comparison of one-child and multiple-children families from a nationwide survey. Asian J Psychiatr 2024; 100:104130. [PMID: 39083955 DOI: 10.1016/j.ajp.2024.104130] [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: 11/23/2023] [Revised: 04/05/2024] [Accepted: 05/25/2024] [Indexed: 08/02/2024]
Abstract
The influence of China's "one-child" policy on the mental health of children and adolescents is still unclear. This study examined the associations between number of children and children's mental health using data from the national school children and adolescents survey of China. Mental health was measured using the Achenbach's Child Behavior Checklist (CBCL). Linear regression models were used to explore the relationship between number of children per family and children's mental health. A total of 64,017 students were enrolled, with 68.60 % from one-child families. Compared with children from one-child families, those from multiple-children families had significantly higher scores on the total CBLC and each of its subscales (all P<0.001). Analyses suggested children from multiple-child families have a higher risk of mental health problems (total problems on the CBCL: adjusted B=2.217, 95 %CI=1.883-2.550, P<0.001). Regular mental health assessments should be implemented and effective interventions should be developed for those in need.
Collapse
Affiliation(s)
- Wen-Wang Rao
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Fan He
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yanjie Qi
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Grace Ka In Lok
- Macao Polytechnic University, Peking University Health Science Center, Macao Polytechnic University Nursing Academy, Macao SAR, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Yi Zheng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Science, University of Macau, Macao SAR, China.
| |
Collapse
|
24
|
Dadswell A, Bungay H, Acton F, Walshe N. Branching out: mobilizing community assets to support the mental health and wellbeing of children in primary schools. Front Public Health 2024; 12:1386181. [PMID: 39005988 PMCID: PMC11239542 DOI: 10.3389/fpubh.2024.1386181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/12/2024] [Indexed: 07/16/2024] Open
Abstract
Introduction Mobilizing existing creative, cultural and community assets is seen as a crucial pathway to improving public health. Schools have been identified as key institutional community assets and arts-in-nature practice has been shown to promote children's mental health. The 'Branching Out' research investigated how an established arts-in-nature practice called 'Artscaping' could be scaled up through the mobilization of community assets including school staff and local volunteers to reach more children in primary schools. Methods The Branching Out model was piloted in six primary schools across Cambridgeshire with 'Community Artscapers' delivering 1.5-h Artscaping sessions with children outdoors for 8 weeks. Interviews were conducted with 11 Community Artscapers (six school staff and five volunteers) and four school leaders reflecting on their experiences of the Branching Out model and the data was subject to a reflexive thematic analysis. Results The findings presented here discuss themes relating to mobilizing community assets, including framing the opportunity, recruiting and sustaining volunteers, training and supporting Community Artscapers, and tensions in roles and responsibilities. They also cover impacts for the children, including mental health provision, freedom in creativity and being outside, personal development, emotional impacts, and social connection, as well as impacts for the Community Artscapers, including making a difference, emotional wellbeing, personal and professional development, and connection and community. Discussion These findings are considered in terms of their alignment with public health policy drivers and the potential for the Branching Out model to become replicable and self-sustaining across schools to promote children's mental health as a public health intervention.
Collapse
Affiliation(s)
- Anna Dadswell
- School of Allied Health and Social Care, Faculty of Health, Medicine and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Hilary Bungay
- School of Allied Health and Social Care, Faculty of Health, Medicine and Social Care, Anglia Ruskin University, Cambridge, United Kingdom
| | - Faye Acton
- Veterans and Families Institute, Faculty of Health, Medicine and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Nicola Walshe
- Institute of Education, Faculty of Education and Society, University College London, London, United Kingdom
| |
Collapse
|
25
|
El Masri R, Chaar S, Elias J, Meksassi B, Ali R, Roberts B, Brown FL, Asmar MK, McKee M, El Chammay R, Singh NS. Barriers, facilitators and proposed solutions to equitable mental health financing and service delivery for the Lebanese populations and displaced Syrians in Lebanon: Findings from a qualitative study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003318. [PMID: 38941293 PMCID: PMC11213328 DOI: 10.1371/journal.pgph.0003318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/15/2024] [Indexed: 06/30/2024]
Abstract
Forcibly displaced populations experience an increased burden of mental illness. Scaling up mental health (MH) services places new resource demands on health systems in crises-affected settings and raises questions about how to provide equitable MH services for refugee and host populations. Our study investigates barriers, facilitators, and proposed solutions to MH financing and access for Lebanese populations and Syrian refugees in Lebanon, a protracted crisis setting. We collected qualitative data via 73 interviews and 3 focus group discussions. Participants were purposively selected from: (i) national, United Nations and NGO stakeholders; (ii) frontline MH service providers; (iii) insurance company representatives; (iv) Lebanese and Syrian adults and parents of children aged 12-17 years using MH services. Data were analysed using inductive and deductive approaches. Our results highlight challenges facing Lebanon's system of financing MH care in the face of ongoing multiple crises, including inequitable coverage, dependence on external humanitarian funds, and risks associated with short-term funding and their impact on sustainability of services. The built environment presents additional challenges to individuals trying to navigate, access and use existing MH services, and the social environment and service provider factors enable or hinder individuals accessing MH care. Registered Syrian refugees have better financial coverage to secondary MH care than Lebanese populations. However, given the economic crisis, both populations are facing similar challenges in paying for and accessing MH care at primary health care (PHC) level. Multiple crises in Lebanon have exacerbated challenges in financing MH care, dependence on external humanitarian funds, and risks and sustainability issues associated with short-term funding. Urgent reforms are needed to Lebanon's health financing system, working with government and external donors to equitably and efficiently finance and scale up MH care with a focus on PHC, and to reduce inequities in MH service coverage between Lebanese and Syrian refugee populations.
Collapse
Affiliation(s)
- Rozane El Masri
- Research and Development Department, War Child Holland, Beirut, Lebanon
| | - Sandy Chaar
- Research and Development Department, War Child Holland, Beirut, Lebanon
| | - Joseph Elias
- Research and Development Department, War Child Holland, Beirut, Lebanon
| | - Bassel Meksassi
- Research and Development Department, War Child Holland, Beirut, Lebanon
| | - Rayane Ali
- Research and Development Department, War Child Holland, Beirut, Lebanon
| | - Bayard Roberts
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Felicity L. Brown
- Research and Development Department, War Child Holland, Beirut, Lebanon
| | | | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rabih El Chammay
- Department of Psychiatry, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
- National Mental Health Programme, Ministry of Public Health, Beirut, Lebanon
| | - Neha S. Singh
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
26
|
Giosan C, Pană A, Cosmoiu A, Chira AM, Toma AM, Papasteri CC, Nedelcea C, Popoviciu C. Mental health literacy and academic performance (MHLAP) in high school students: a randomized clinical trial protocol. Trials 2024; 25:419. [PMID: 38937769 PMCID: PMC11212191 DOI: 10.1186/s13063-024-08270-y] [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: 03/31/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Mental health literacy is a promising avenue of intervention for addressing the development of psychopathology, as well as its associated consequences, such as a decrease in academic performance. The current study aims to test the effectiveness of such an intervention in high school students, focusing on two main formats of delivery: (1) automated and (2) blended. METHODS To achieve this aim, a randomized clinical trial with direct comparisons at three time points between three conditions (automated, blended, and waitlist) was designed. Power analyses yielded a necessary sample size of 264 high school students. The participants will be selected from Romanian high schools. DISCUSSION The current study aims to contribute to the mental health literacy literature by testing the effectiveness of an educational intervention concerning mental health in terms of its benefits for reducing psychopathology and increasing academic performance. The success of such an intervention bears important implications for addressing mental health in the educational system. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT06217744, version 1, 22 January 2024.
Collapse
|
27
|
Rudolphi JM, Berg RL. Stress, Mental Health, and Risk-Taking: Associations among a Sample of Agricultural Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:830. [PMID: 39063407 PMCID: PMC11276652 DOI: 10.3390/ijerph21070830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/07/2024] [Accepted: 06/22/2024] [Indexed: 07/28/2024]
Abstract
Farm stress and mental health research has largely focused on adult producers, even though youths live and work on farms. The purpose of this study is to describe the stress and mental health experience of agricultural youths and describe participation in risk-taking behaviors. Farm families in the U.S. were invited to participate in an online survey that inquired about farm economics, stress (ASQ-S), mental health (PHQ-A and SCARED), parenting, social support, and risk-taking behaviors during the summers in 2021 and 2022. This analysis is limited to adolescent respondents (N = 298). Just over 70% of the farm adolescent sample met the criteria for at least mild symptoms of depression (PHQ-A score ≥ 5). Among anxiety disorders, 62.8% of the farm adolescent sample met the criteria for probable panic disorder, and 70.5% met the criteria for probable separation anxiety disorder. Adolescents reported the most stress around future uncertainty and school performance. The stress scores were significantly associated with more symptoms of depression. Over a quarter (27.7%) of the participants reported carrying a weapon at least 1 day in the past month, and 22.5% reported carrying a weapon on school property at least 1 day in the past month. Violence-related risk-taking behaviors were also associated with increased symptoms of depression. The results underscore the need for community- and school-based stress and mental health interventions in rural and agricultural communities.
Collapse
Affiliation(s)
- Josie M. Rudolphi
- Department of Agricultural and Biological Engineering, University of Illinois Urbana, Champaign, IL 60801, USA
| | - Richard L. Berg
- Office of Research Computing and Analytics, Marshfield Clinic Research Institute, Marshfield, WI 54449, USA
| |
Collapse
|
28
|
Santa K, Dixon C, Ganga RN, Trainor G, Smith G, Furfie V, Brown H. Facilitating Access to Mental Health Services: A Stakeholder-Driven Improvement of the Children and Young People (CYP) as One Referral Platform. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:784. [PMID: 38929030 PMCID: PMC11203779 DOI: 10.3390/ijerph21060784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
(1) Background: Pre-pandemic, child and adolescent mental health service (CAMHS) referrals were paper based in Liverpool and Sefton (England, United Kingdom), causing delays in waiting times. The "CYP as One" online mental health referral platform was co-created to overcome these challenges. (2) Methods: This study aims to improve "CYP as One" accessibility and usability and, subsequently, support CAMHS to improve waiting times. The current study utilised the Living Lab approach. We conducted content analysis on completed online referrals extracted from the "CYP as One" platform. These findings were supplemented by seven online focus groups, with 16-19-year-old young people, parents of children under 16, and health service providers. Thematic analysis was conducted on all data. (3) Results: The thematic analysis returned seven themes, namely (i) "CYP as One" vs. Traditional Referrals, (ii) Gender and Language Dynamics, (iii) Digital Empathy in Action, (iv) the Influence of the Provider Perspective, (v) Age and Social Sensitivity, (vi) Enhancing Access to Information, and (vii) Boosting Admin and Clinical Efficiency. (4) Conclusions: Digital content that seeks to replace in-person referrals can provide adequate support to children and young people who have faced difficulties accessing mental health services.
Collapse
Affiliation(s)
- Kristof Santa
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | - Chloe Dixon
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | - Rafaela Neiva Ganga
- Liverpool Business School, Faculty of Business and Law, Liverpool John Moores University, Liverpool L1 2TZ, UK
| | - Gemma Trainor
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | - Grahame Smith
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | | | - Holly Brown
- Alder Hey Children’s Hospital, Liverpool L14 5AB, UK
| |
Collapse
|
29
|
López del Hoyo Y, Elices M, Garcia-Campayo J. Mental health in the virtual world: Challenges and opportunities in the metaverse era. World J Clin Cases 2024; 12:2939-2945. [PMID: 38898837 PMCID: PMC11185398 DOI: 10.12998/wjcc.v12.i17.2939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/24/2024] [Accepted: 02/29/2024] [Indexed: 06/04/2024] Open
Abstract
Current rates of mental illness are worrisome. Mental illness mainly affects females and younger age groups. The use of the internet to deliver mental health care has been growing since 2020 and includes the implementation of novel mental health treatments using virtual reality, augmented reality, and artificial intelligence. A new three dimensional digital environment, known as the metaverse, has emerged as the next version of the Internet. Artificial intelligence, augmented reality, and virtual reality will create fully immersive, experiential, and interactive online environments in the metaverse. People will use a unique avatar to do anything they do in their "real" lives, including seeking and receiving mental health care. In this opinion review, we reflect on how the metaverse could reshape how we deliver mental health treatment, its opportunities, and its challenges.
Collapse
Affiliation(s)
| | - Matilde Elices
- Mental Health Research Group, Hospital del Mar Medical Research Institute, Barcelona 08003, Spain
| | - Javier Garcia-Campayo
- Department of Psychiatry, Miguel Servet Hospital, Aragon Institute for Health Research, University of Zaragoza, Zaragoza 50009, Spain
| |
Collapse
|
30
|
Yang X, Hu J, Zhang B, Ding H, Hu D, Li H. The relationship between mental health literacy and professional psychological help-seeking behavior among Chinese college students: mediating roles of perceived social support and psychological help-seeking stigma. Front Psychol 2024; 15:1356435. [PMID: 38939229 PMCID: PMC11208703 DOI: 10.3389/fpsyg.2024.1356435] [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: 12/15/2023] [Accepted: 05/27/2024] [Indexed: 06/29/2024] Open
Abstract
Introduction Mental health literacy is viewed as a significant factor that may facilitate an individual's pursuit of professional psychological assistance. However, it is important to explore further influencing factors that might underlie this association. This study, employing the framework of the Theory of Planned Behavior (TPB), aims to examine the relationship between mental health literacy and the behavior of seeking professional psychological help, with a focus on the potential mediating roles of perceived stigma and social support in this context. Methods We surveyed 911 college students in seven regions of China (406 males and 505 females, aged between 19 and 25 years old; M age = 19.65, SD = 1.41) utilizing self-report measures, including the Mental Health Literacy Questionnaire, Professional Psychological Help-Seeking Behavior Scale, Professional Psychological Help-Seeking Stigma Scale, and Perceived Social Support Scale. A chain mediation model was developed to analyze the interconnections between mental health literacy, stigma related to seeking psychological help, perceived social support, and professional psychological help-seeking behaviors. Results The mediation effect analysis indicates that: (1) mental health literacy significantly positively correlates with professional psychological help-seeking behaviors; (2) both perceived social support and professional psychological help-seeking stigma significantly mediate the relationship between mental health literacy and professional psychological help-seeking behavior; (3) perceived social support and the stigma associated with seeking professional psychological help play a chained mediating effect between mental health literacy and the behavior of seeking professional psychological help. Discussion This study found that mental health literacy indirectly facilitates professional psychological help-seeking behaviors by enhancing the perception of social support and reducing the stigma associated with seeking such help. These findings help in understanding how improving mental health literacy and perceived social support while reducing stigma can increase the likelihood of individuals seeking professional psychological assistance. The results are significant for enhancing the utilization of mental health services and implementing mental health education programs in universities.
Collapse
Affiliation(s)
- Xiao Yang
- Mental Health Education and Counseling Center, Hangzhou Normal University, Hangzhou, China
| | - Jun Hu
- School of Marxism, Hangzhou Normal University, Hangzhou, China
| | - Bingren Zhang
- Affiliated Hospital (School of Clinical Medicine), Hangzhou Normal University, Hangzhou, China
| | - Hua Ding
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Danying Hu
- Mental Health Education and Counseling Center, Ningbo Polytechnic, Ningbo, China
| | - Hangdong Li
- Mental Health Education and Counseling Center, China Jiliang University, Hangzhou, China
| |
Collapse
|
31
|
Chen X, Chen J, Zhao X, Mu R, Tan H, Yu Z. Issues and Solutions in Psychiatric Clinical Trial with Case Studies. Neuropsychiatr Dis Treat 2024; 20:1191-1200. [PMID: 38855383 PMCID: PMC11162181 DOI: 10.2147/ndt.s454813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/22/2024] [Indexed: 06/11/2024] Open
Abstract
The coronavirus disease-2019 pandemic resulted in a major increase in depression and anxiety disorders worldwide, which increased the demand for mental health services. However, clinical interventions for treating mental disorders are currently insufficient to meet this growing demand. There is an urgent need to conduct scientific and standardized clinical research that are consistent with the features of mental disorders in order to deliver more effective and safer therapies in the clinic. Our study aimed to expose the challenges, complexities of study design, ethical issues, sample selection, and efficacy evaluation in clinical research for mental disorders. The reliance on subjective symptom presentation and rating scales for diagnosing mental diseases was discovered, emphasizing the lack of clear biological standards, which hampers the construction of rigorous research criteria. We underlined the possibility of psychotherapy in efficacy evaluation alongside medication treatment, proposing for a multidisciplinary approach comprising psychiatrists, neuroscientists, and statisticians. To comprehend mental disorders progression, we recommend the development of artificial intelligence integrated evaluation tools, the use of precise biomarkers, and the strengthening of longitudinal designs. In addition, we advocate for international collaboration to diversity samples and increase the dependability of findings, with the goal of improving clinical research quality in mental disorders through sample representativeness, accurate medical history gathering, and adherence to ethical principles.
Collapse
Affiliation(s)
- Xiaochen Chen
- Clinical Research Institute & School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Jun Chen
- Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Xue Zhao
- Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Rongji Mu
- Clinical Research Institute & School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Hongsheng Tan
- Clinical Research Institute & School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Zhangsheng Yu
- Clinical Research Institute & School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| |
Collapse
|
32
|
Abo-Rass F, Nakash O, Gelaye B, Khatib A, AboJabel H. Determinants of intentions to seek formal mental health help among Palestinian adolescents in Israel. Int J Soc Psychiatry 2024; 70:720-729. [PMID: 38312061 DOI: 10.1177/00207640231224658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
BACKGROUND Mental health challenges are widespread among adolescents undergoing significant physical, emotional, social, and academic changes. However, rates of formal help-seeking remain low, particularly among those from ethnic minorities. AIMS This study investigated the determinants of intentions to seek formal mental health help among Palestinian adolescents in Israel, focusing on mental health literacy (MHL) and trust in formal sources of information. METHODS A total of 178 adolescents (Mage = 16.24 ± 1.24 years, 61.8% female) completed measures assessing intention for formal help-seeking, psychological distress, MHL, trust in formal sources of information, sociodemographic, and clinical characteristics. RESULTS Findings revealed low levels of intention to seek formal help and psychological distress, alongside average or above-average levels on all MHL dimensions and trust in formal sources for information. Our analysis identified socioeconomic status (β = .17, p < .05), psychological distress (β = .18, p < .05), trust in formal sources of information (β = .28, p < .001), and two MHL dimensions: knowledge of where to seek information (β = .25, p < .01) and attitudes that promote recognition or appropriate help-seeking behavior (β = .16, p < .05) - as the main determinants of intention for formal help-seeking. CONCLUSIONS This study underscores the critical role of trust in formal sources of information and MHL in seeking formal help among adolescents from ethnic minorities. Interventions aiming to improve access to mental health-related information, address and enhance attitudes, and foster trust in formal professionals and institutions may contribute to an increased tendency for formal mental health help-seeking among this population and others.
Collapse
Affiliation(s)
- Fareeda Abo-Rass
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ora Nakash
- School for Social Work, Smith College, Northampton, MA, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Anwar Khatib
- Department of Social Work, Zefat Academic College, Israel
- Department of Community Mental Health, University of Haifa, Israel
| | - Hanan AboJabel
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel
| |
Collapse
|
33
|
Hurley J, Longbottom P, Bennett B, Yoxall J, Hutchinson M, Foley KR, Happell B, Parkes J, Currey K. Workforce strategies to address children's mental health and behavioural needs in rural, regional and remote areas: A scoping review. Aust J Rural Health 2024; 32:462-474. [PMID: 38572866 DOI: 10.1111/ajr.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/22/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Children living in rural, regional and remote locations experience challenges to receiving services for mental illness and challenging behaviours. Additionally, there is a lack of clarity about the workforce characteristics to address the needs of this population. OBJECTIVE To scope the literature on the rural, regional and remote child mental health and behavioural workforce and identify barriers and enabling mechanisms to mental health service provision. DESIGN A scoping review utilising the Joanna Briggs Institute methodology. A database search was undertaken using Medline, CINAHL, PsycINFO, ProQuest and Scopus to identify papers published 2010-2023. Research articles reporting data on mental health workforce characteristics for children aged under 12 years, in rural, regional or remote locations were reviewed for inclusion. FINDINGS Seven hundred and fifty-four papers were imported into Covidence with 22 studies being retained. Retained studies confirmed that providing services to meet the needs of children's mental health is an international challenge. DISCUSSION The thematic analysis of the review findings highlighted four workforce strategies to potentially mitigate some of these challenges. These were: (1) The use of telehealth for clinical services and workforce upskilling; (2) Role shifting where non mental health professionals assumed mental health workforce roles; (3) Service structure strategies, and (4) Indigenous and rural cultural factors. CONCLUSION A range of potential strategies exists to better meet the needs of children with mental health and behavioural issues. Adapting these to specific community contexts through co-design and production may enhance their efficacy.
Collapse
Affiliation(s)
- John Hurley
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Paula Longbottom
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Bindi Bennett
- Federation University, Ballarat, Victoria, Australia
| | - Jacqui Yoxall
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Marie Hutchinson
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Kitty-Rose Foley
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Brenda Happell
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Jill Parkes
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Kate Currey
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| |
Collapse
|
34
|
Moyes A, McGough S, Wynaden D. An Untenable Burden: Exploring Experiences of Secondary School Nurses Who Encounter Young People with Mental Health Problems. J Sch Nurs 2024; 40:305-315. [PMID: 35313759 DOI: 10.1177/10598405221088957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
School nurses have reported stress and worry caring for young people experiencing mental health problems, but why this occurs and how they respond has not been well-explored. In this study researchers generated a substantive theory of the experiences of secondary school nurses who encountered young people with mental health problems using the original method of grounded theory. Thirty-one Western Australian school nurse participants reported that students presented with complex mental and social health needs that were not easily resolved. This was conceptualized as an untenable burden. Participants countered this by engaging in the three-stage process of tactical prioritizing. During an initial period of strategic assimilation into the school and broader community, participants referred students to external service providers. This was frequently inadequate, and participants found themselves grappling with unmet student mental health needs. Participants responded by implementing nursing strategies for optimizing outcomes in the lives of young people, while simultaneously engaging in managing self to support their own well-being.
Collapse
Affiliation(s)
- Anita Moyes
- Edith Cowan University, Joondalup, Perth, Western Australia, Australia
| | | | | |
Collapse
|
35
|
Fisher AP, Patronick J, Moscato EL, Gerhardt CA, Treble-Barna A, Radonovich K, Wade SL. Barriers to Care and Perceived Need for Mental Health Services Among Adolescent and Emerging Adult Survivors of Pediatric Brain Tumors. J Adolesc Young Adult Oncol 2024; 13:469-480. [PMID: 38100322 PMCID: PMC11296316 DOI: 10.1089/jayao.2023.0119] [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] [Indexed: 12/17/2023] Open
Abstract
Purpose: Pediatric brain tumor survivors (PBTS) commonly experience mental health challenges, which can be exacerbated during adolescence and emerging adulthood (AEA). We examined survivors and caregivers' perceived need for mental health services and barriers to receiving mental health care. Methods: Families completed surveys to assess perceived need for mental health services, socioemotional impairment, and barriers to mental health services. Survivors were between 13 and 25 years of age and were at least 5 years from diagnosis. Results: Sixty-nine caregiver-PBTS dyads participated, as well as 18 survivors and 20 caregivers who participated individually. Approximately half of survivors were male (n = 57, 52.3%), 85% (n = 93) were White, and their average age was 19.31. Most caregivers (n = 63, 70.8%) and survivors (n = 55, 63.2%) endorsed need for services for the survivors. Adolescents endorsed more barriers related to perceived helpfulness, t(18) = 2.3, p = 0.03, d = 0.54, and effects of services, t(18) = 3.8, p < 0.001, d = 0.88, than their caregivers. Emerging adults, t(34) = 2.4, p = 0.02, d = 0.41, endorsed more content barriers than their caregivers.. Discussion: Both survivors and their caregivers reported obstacles to accessing mental health services such as perceived lack of need, concerns regarding the effectiveness and usefulness of services, and limited knowledge about the content of services. Psychoeducation and psychosocial screening can support families in understanding survivors' need for mental health services.
Collapse
Affiliation(s)
- Allison P. Fisher
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jamie Patronick
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Emily L. Moscato
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Cynthia A. Gerhardt
- Department of Pediatrics and Psychology, The Abigail Wexner Research Institute, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Amery Treble-Barna
- Neurodevelopmental Center, WVU Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA
| | - Krestin Radonovich
- Physical Medicine and Rehabilitation and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shari L. Wade
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| |
Collapse
|
36
|
Ahmed SM, Saber AF, Naif AA, Hamad AH, Ahmed SK, Abdullah AY, Qurbani K, Hussein S. Exploring Young Adults' Reluctance to Engage With Psychiatric Hospitals in Erbil, Iraq: Identifying Barriers to Psychiatric Care. Cureus 2024; 16:e62164. [PMID: 38993398 PMCID: PMC11238745 DOI: 10.7759/cureus.62164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND AND AIM In Erbil, Iraq, the reluctance of young adults to engage with psychiatric services is influenced by a complex array of barriers, including stigma-related, attitudinal, and instrumental factors that hinder effective mental healthcare access. This study aimed to identify these specific barriers to accessing psychiatric care among young adults in Erbil. MATERIALS AND METHODS The study utilized a cross-sectional online survey conducted between April 5th and May 1st, 2024. Data collection was carried out through purposive sampling and involved a comprehensive questionnaire. Electronic informed consent was obtained from all participants before they started the survey, which collected demographic data and utilized the Barriers to Access to Care Evaluation (BACE v3) tool. Statistical analysis was conducted using SPSS version 27 (IBM Corp., Armonk, NY). Descriptive statistics (frequency and percentage) were used for categorical data, while the mean and standard deviation characterized continuous variables. Chi-square tests, including Fisher's exact test and odds ratio (OR), were used to analyze categorical data, with a significance level set at p < 0.05. RESULTS A total of 407 participants were enrolled in the study. The study highlighted several barriers to mental health care. Stigma-related barriers were significant, with participants fearing being seen as weak (mean score = 2.14, SD = 0.96) and concerns about being labeled "crazy" (mean score = 1.80, SD = 1.19). Regarding attitudinal barriers, there was a notable preference for dealing with issues independently (mean score = 2.04, SD = 0.98) and a tendency toward resolving problems without professional help (mean score = 1.88, SD = 0.98). Additionally, instrumental barriers were identified, including the rare availability of culturally diverse mental health professionals (mean score = 1.78, SD = 1.09) and practical difficulties such as arranging transportation to appointments (mean score = 0.61, SD = 0.87). CONCLUSION The study demonstrated that young adults in Erbil face significant stigma and attitudinal and instrumental barriers to accessing psychiatric care. In response to these findings, it is recommended for the government to prioritize mental health awareness, actively destigmatize mental health issues, and improve service accessibility to foster a supportive care environment. Additionally, mental health professionals and educational institutions should collaborate to provide targeted support programs and resources for young adults.
Collapse
Affiliation(s)
- Sangar M Ahmed
- Department of Public Health, College of Health Sciences, Hawler Medical University, Erbil, IRQ
- Department of Nursing, Faculty of Nursing, Tishk International University, Erbil, IRQ
| | - Abdulmalik F Saber
- Department of Psychiatric and Mental Health Nursing, College of Nursing, Hawler Medical University, Erbil, IRQ
| | - Ahmed A Naif
- Department of Psychiatric and Mental Health Nursing, College of Nursing, Hawler Medical University, Erbil, IRQ
| | - Abdulqader H Hamad
- Department of Psychiatric and Mental Health Nursing, College of Nursing, Hawler Medical University, Erbil, IRQ
| | - Sirwan K Ahmed
- College of Nursing, University of Raparin, Sulaymaniyah, IRQ
| | - Ammar Y Abdullah
- Department of Psychiatric and Mental Health Nursing, College of Nursing, Hawler Medical University, Erbil, IRQ
| | - Karzan Qurbani
- Department of Biology, University of Raparin, Sulaymaniyah, IRQ
| | - Safin Hussein
- Department of Biology, University of Raparin, Sulaymaniyah, IRQ
| |
Collapse
|
37
|
Causier C, Johns L, Radez J, Hassan H, Maughan D, Waite F. Experiences of Help-Seeking for Severe Mental Health Problems in Young Pakistani Women: A Preliminary Qualitative Study. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2024; 55:429-443. [PMID: 38766627 PMCID: PMC11101305 DOI: 10.1177/00220221241236944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Almost three quarters of mental illnesses start by the age of 25, yet youth (18-25-year-olds) are often underrepresented in U.K. services. This is particularly true for those of ethnic minorities. In this study, we aimed to understand how young Pakistani women and their parents make decisions to seek help for severe mental health problems, and the barriers and facilitators to accessing professional help. Young Pakistani women with experience of severe mental health problems and their parents were recruited from a community sample. Semi-structured interviews were conducted with six young people and two parents. Data were analyzed using reflexive thematic analysis. Pakistani culture and its interplay with British culture strongly influenced the decisions and ability of young Pakistani women and their parents to help-seek, largely through the role of stigma. Low mental health literacy, stigma, and a lack of culturally informed services were identified as the most common barriers to accessing care. These barriers fed into the internalized stigma these young women experienced which, through fear of damaged reputation and personal prejudices, posed further barriers to seeking help. Participants highlighted recommendations for both individual-level (e.g., increased education and awareness) and service-level (e.g., greater choice over care) change to facilitate accessibility of professional help. Young Pakistani women face multiple culturally related challenges to accessing care for severe mental health problems at both the individual- and service-level. Novel suggestions to address these challenges, such as including youth peer support workers in services, may facilitate more inclusive and accessible services.
Collapse
Affiliation(s)
- Chiara Causier
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| | - Louise Johns
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| | - Jerica Radez
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| | - Hibah Hassan
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| | | | - Felicity Waite
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| |
Collapse
|
38
|
Calear AL, Morse AR, Christensen H, McCallum S, Werner-Seidler A, Alexander R, Batterham PJ. Evaluating suicide attitudes and suicide literacy in adolescents. J Ment Health 2024; 33:312-319. [PMID: 37605447 DOI: 10.1080/09638237.2023.2245883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/05/2023] [Accepted: 07/08/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Two of the most common modifiable barriers to help-seeking for mental health problems during adolescence are stigma and poor mental health literacy. However, relatively little is known about stigma as it relates to suicide, and knowledge about suicidality in this age group. AIMS To assess levels of suicide literacy and suicide attitudes in an adolescent sample, and to identify correlates of these constructs. METHODS Data were drawn from the pre-intervention survey of the Sources of Strength Australia Project. A total of 1019 adolescents aged between 11 and 17 years participated. Suicide literacy and attitudes were measured alongside potential correlates including psychological distress, suicidal ideation, mastery, previous exposure to suicidal thinking and behaviour, and demographics. RESULTS Participants more strongly endorsed attitudes attributing suicide to isolation/depression, compared to attitudes glorifying or stigmatising suicide. Gaps in knowledge about suicide included the risk factors, signs and symptoms. Key correlates of suicide attitudes and literacy included age, gender and cultural background. CONCLUSION Findings highlight the need for further education activities in schools and public awareness campaigns that address the gaps in suicide knowledge and attitudes. Such activities would assist in the identification of suicide risk among young people and improve help-seeking in this population.
Collapse
Affiliation(s)
- Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Alyssa R Morse
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Sonia McCallum
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | | | - Rebecca Alexander
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| |
Collapse
|
39
|
Fleury MJ, Armoon B. Profiles of Permanent Supportive Housing Residents Related to Their Housing Conditions, Service Use, and Associated Sociodemographic and Clinical Characteristics. Psychiatr Q 2024; 95:203-219. [PMID: 38584240 DOI: 10.1007/s11126-024-10071-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/09/2024]
Abstract
As permanent supportive housing (PSH) is the main strategy promoted to reduce homelessness, understanding how PSH resident profiles may be differentiated is crucial to the optimization of PSH implementation - and a subject that hasn't been studied yet. This study identified PSH resident profiles based on their housing conditions and service use, associated with their sociodemographic and clinical characteristics. In 2020-2021, 308 PSH residents from Quebec (Canada) were interviewed, with K-means cluster analysis produced to identify profiles and subsequent analyses to compare profiles and PSH resident characteristics. Of the three profiles identified, Profiles 1 and 2 (70% of sample) showed moderate or poor housing, neighborhood, and health conditions, and moderate or high unmet care needs and service use. Besides their "moderate" conditions, Profile 1 residents (52%) reported being in PSH for more than two years and being less educated. With the "worst" conditions and high service use, Profile 2 (18%) included younger individuals, while Profile 3 (30%) showed the "best" conditions and integrated individuals with more protective determinants (e.g., few in foster care, homelessness at older age, more self-esteem), with a majority living in single-site PSH and reporting higher satisfaction with support and community-based services. Profiles 1 and 2 may be provided with more psychosocial, crisis, harm reduction, and empowerment interventions, and peer helper support. Profile 2 may benefit from more intensive and integrated care, and better housing conditions. Continuous PSH may be sustained for Profile 3, with regular monitoring of service satisfaction and met needs.
Collapse
Affiliation(s)
- Marie-Josée Fleury
- Department of Psychiatry, McGill University, Montréal, Québec, Canada.
- Douglas Hospital Research Centre, Montréal, Québec, Canada.
| | - Bahram Armoon
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Douglas Hospital Research Centre, Montréal, Québec, Canada
| |
Collapse
|
40
|
Laurenzi CA, du Toit S, Mawoyo T, Luitel NP, Jordans MJ, Pradhan I, van der Westhuizen C, Melendez-Torres G, Hawkins J, Moore G, Evans R, Lund C, Ross DA, Lai J, Servili C, Tomlinson M, Skeen S. Development of a school-based programme for mental health promotion and prevention among adolescents in Nepal and South Africa. SSM - MENTAL HEALTH 2024; 5:100289. [PMID: 38910844 PMCID: PMC11188151 DOI: 10.1016/j.ssmmh.2023.100289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 06/25/2024] Open
Abstract
Introduction Adolescence is a critical time for mental health promotion and prevention and establishing healthy behaviours. Implementing universal, school-based psychosocial interventions can improve short- and long-term health trajectories for adolescents. While these interventions may offer important opportunities for fostering skills and relationships, few school-based interventions have been developed for and tested in low- and middle-income countries (LMICs) where adolescent mental health needs may be significant and under-served. This manuscript details the development of a multi-component, universal school-based intervention, Health Action in ScHools for a Thriving Adolescent Generation (HASHTAG), for adolescents aged 12-15 years in Nepal and South Africa. Methods and results We describe HASHTAG's development over four phases, combining methods and results as each phase was iteratively conducted between 2018 and 2021. Phase 1 included a systematic review and components analysis, building from WHO guidelines for adolescent mental health. Seven components were strongly supported by the evidence: emotional regulation, stress management, mindfulness, problem-solving, interpersonal skills, assertiveness training, and alcohol and drug education. Phase 2 encompassed site selection, theory of change development, and formative research engagements; research teams in each site engaged adolescents and key adult stakeholders to identify priorities for intervention. Stakeholders voiced preferences for external facilitators and key content and delivery for intervention sessions. These findings informed Phase 3, a draft manual of HASHTAG, including a whole-school component, called Thriving Environment in Schools, and a classroom-based, six-session component, Thrive Together. In Phase 4, participants engaged in consultative workshops to review and contextualise content by country, preparing HASHTAG for implementation in a feasibility trial. Minor adaptations were made in Nepal, including using school nurses and adjusting take-home materials; both country's workshops identified practical considerations for implementing activities. Conclusions HASHTAG was designed around core evidence-based components to increase translatability across LMICs, while enabling country-specific tailoring to enhance feasibility. Future research will test whether this multi-component, whole-school approach can improve adolescent mental health.
Collapse
Affiliation(s)
- Christina A. Laurenzi
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Stefani du Toit
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Tatenda Mawoyo
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Nagendra P. Luitel
- Research Department, Transcultural Psychosocial Organization Nepal, Baluwatar, Kathmandu, Nepal
| | - Mark J.D. Jordans
- Research Department, Transcultural Psychosocial Organization Nepal, Baluwatar, Kathmandu, Nepal
- Center for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Indira Pradhan
- Research Department, Transcultural Psychosocial Organization Nepal, Baluwatar, Kathmandu, Nepal
| | - Claire van der Westhuizen
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, South Africa
| | - G.J. Melendez-Torres
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
- University of Exeter, Exeter, United Kingdom
| | - Jemma Hawkins
- DECIPHer (Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement), Cardiff University, Cardiff, Wales, United Kingdom
| | - Graham Moore
- DECIPHer (Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement), Cardiff University, Cardiff, Wales, United Kingdom
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, Wales, United Kingdom
| | - Rhiannon Evans
- DECIPHer (Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement), Cardiff University, Cardiff, Wales, United Kingdom
| | - Crick Lund
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, South Africa
- Center for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - David A. Ross
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | | | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
- School of Nursing and Midwifery, Queens University, Belfast, Northern Ireland, United Kingdom
| | - Sarah Skeen
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| |
Collapse
|
41
|
González-Sanguino C, Rodríguez-Medina J, Redondo-Pacheco J, Betegón E, Valdivieso-León L, Irurtia MJ. An exploratory cross-sectional study on Mental health literacy of Spanish adolescents. BMC Public Health 2024; 24:1469. [PMID: 38822283 PMCID: PMC11143666 DOI: 10.1186/s12889-024-18933-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/23/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Mental health literacy (MHL) is especially important for young people, but comprehensive studies on MHL in adolescents are limited, with no nationwide studies in Spain. This research aims to study MHL among Spanish adolescents and its relationship with sociodemographic factors. METHODS An exploratory study is carried out using stratified random sampling in Spanish adolescents (N = 1000), aged 12-16 years and balanced in terms of gender, age and territorial distribution. Data collection took place in October and November 2023 through online surveys using the CAWI methodology. Sociodemographic variables, contact with mental health and the Spanish version of the Mental Health Literacy Questionnaire (MHLq-E), a self-administered instrument of 32 Likert-type items (1-5) that assesses the dimensions of help-seeking skills, knowledge about causes and symptoms, and stigma, were evaluated. Descriptive and multivariate analyses of variance (MANOVA) were conducted. RESULTS In general, adequate levels of literacy were observed, although some aspects related to help-seeking towards teachers, stigmatising attitudes towards people of low economic status and knowledge of severe mental health problems could be improved. The results show contact with previous mental health problems as a key variable for stigma and knowledge about symptomatology together with age. Likewise, gender and family educational level were found to be related to the ability to seek professional help. CONCLUSION This study provides information on levels of MHL among Spanish adolescents and highlights significant socio-demographic variables. These findings pave the way for interventions aimed at improving adolescents' understanding, attitudes and skills to manage mental health problems, making possible to adapt content and focus on specific groups, thus increasing its effectiveness.
Collapse
Affiliation(s)
| | | | | | - Elena Betegón
- Department of Personality, Evaluation and Psychological Treatment, University of Salamanca, Salamanca, Spain
| | | | | |
Collapse
|
42
|
Mori Y, Sourander A, Mishina K, Ståhlberg T, Klomek AB, Kolaitis G, Kaneko H, Li L, Huong MN, Praharaj SK, Kyrrestad H, Lempinen L, Heinonen E. Unmet need for mental health care among adolescents in Asia and Europe. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02472-0. [PMID: 38819661 DOI: 10.1007/s00787-024-02472-0] [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: 10/25/2023] [Accepted: 05/18/2024] [Indexed: 06/01/2024]
Abstract
The unmet need for mental health care is a global concern. There is a lack of cross-cultural studies examining adolescent help-seeking behavior from both formal and informal sources, including both high-and lower-income countries. This study investigates mental health help-seeking behavior in eight Asian and European countries. Data from 13,184 adolescents aged 13-15 (51% girls) was analysed using mixed-effects logistic regression with school-wise random intercepts to compare countries and genders. Although a significant proportion of adolescents considered getting or sought informal help, formal help-seeking remained exceptionally low, especially in middle-income countries (< 1%), while it ranged from 2 to 7% in high-income countries. Among adolescents with high emotional and behavioral problems (scoring above the 90th percentile on the Strengths and Difficulties Questionnaire), 1-2% of those in middle-income countries and 6-25% of those in high-income countries sought formal help. Girls generally seek more help than boys. The study shows the most adolescents do not receive formal help for mental health problems. The unmet need gap is enormous, especially in lower-income countries. Informal sources of support, including relatives, peers, and teachers, play a crucial role, especially in lower-income countries.
Collapse
Affiliation(s)
- Yuko Mori
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, Turku, 20014, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Andre Sourander
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, Turku, 20014, Finland.
- INVEST Research Flagship Center, University of Turku, Turku, Finland.
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland.
| | - Kaisa Mishina
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, Turku, 20014, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Tiia Ståhlberg
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, Turku, 20014, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland
| | | | - Gerasimos Kolaitis
- Department of Child Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Hitoshi Kaneko
- Psychological Support and Research Center for Human Development, Nagoya University, Nagoya, Japan
| | - Liping Li
- School of Public Health, Shantou University Medical College, Shantou, China
| | - Mai Nguyen Huong
- Department of Psychiatry, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Samir Kumar Praharaj
- Department of Psychiatry, Kasturba Medical College, Manipal, India
- Manipal Academy of Higher Education, Manipal, India
| | - Henriette Kyrrestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lotta Lempinen
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, Turku, 20014, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Emmi Heinonen
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, Turku, 20014, Finland
| |
Collapse
|
43
|
Morey A, Samuel V, Williams M. Universal online self-help ACT interventions for youth: A systematic review. Behav Res Ther 2024; 180:104576. [PMID: 38852229 DOI: 10.1016/j.brat.2024.104576] [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: 11/03/2023] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
Previous reviews of online self-help have not exclusively focussed on universally delivered Acceptance and Commitment Therapy (ACT). This systematic review aimed to evaluate the effectiveness of universal online self-help ACT interventions for young people. Relevant databases were searched for studies examining ACT interventions that were delivered universally, online and as self-help (guided and unguided) to young people aged 10 to 25-years-old. Eleven studies met inclusion criteria. These were assessed for quality and findings summarised using a narrative synthesis. Outcomes on mental health, well-being and ACT processes were reviewed, and results across studies were mixed. Most studies found significant improvements in mental health and well-being outcomes following the ACT intervention; however less than half found improvements in ACT process measures. Subgroups, such as those with elevated mental health symptoms, had better outcomes. There were no changes in measures of psychological inflexibility. However, methodological issues limited the interpretation of findings. Heterogeneity between studies and methodological issues made it difficult for this review to draw conclusions regarding the effectiveness of universal online self-help ACT interventions for young people. Future research with consistent approaches is needed across these types of interventions to improve methodological rigour to determine whether these interventions are effective.
Collapse
Affiliation(s)
- Alex Morey
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.
| | - Victoria Samuel
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.
| | - Marc Williams
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.
| |
Collapse
|
44
|
Ivanova MY, Hall A, Weinberger S, Buckingham SL, Copeland WE, Crockett P, Dainer-Best J, D'Alberto C, Dewey L, Foret D, Galano M, Goodrich L, Holly L, Lane NE, Leahy M, Lerner M, Marsh J, McGinnis EW, Paiva-Salisbury M, Shaw JS, Swift P, Tinker R, Hudziak JJ. A Pilot Randomized Controlled Trial of the Family Assessment and Feedback Intervention (FAFI): Effects on Mental Health Literacy and Attitudinal Engagement with Health Supports and Services. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01707-0. [PMID: 38796676 DOI: 10.1007/s10578-024-01707-0] [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] [Accepted: 04/15/2024] [Indexed: 05/28/2024]
Abstract
This randomized controlled trial tested the Family Assessment and Feedback Intervention (FAFI), a new intervention to enhance family engagement with emotional and behavioral health services. The FAFI is a guided conversation with families about results of their multidimensional assessment that is set in the context of motivational enhancement. It differs from other assessment-with-feedback interventions by extending the focus of assessment beyond the target child to parents and the family environment, addressing parental emotional and behavioral problems and competencies, spanning a broad range of children's and parents' strengths and difficulties, and being generalizable to many settings and practitioners. Participants were 81 families in primary care pediatrics. The FAFI was associated with a significant increase in parental mental health literacy and with an increase in parental attitudinal engagement with health supports and services that closely approached statistical significance (p = .052), while controlling for children's age and gender and family socioeconomic status.
Collapse
Affiliation(s)
- Masha Y Ivanova
- Department of Psychiatry, University of Vermont, Burlington, VT, USA.
| | - Allison Hall
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | | | - Sara L Buckingham
- Department of Psychology, University of Alaska Anchorage, Anchorage, AK, USA
| | | | - Phoenix Crockett
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | | | - Casey D'Alberto
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Lauren Dewey
- Department of Psychological Sciences, University of Vermont, Burlington, VT, USA
| | - DeShan Foret
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Maria Galano
- Department of Psychological and Brain Sciences, University of Massachusetts at Amherst, Amherst, MA, USA
| | - Lisa Goodrich
- University of Vermont Medical Center, Burlington, VT, USA
| | - Lindsay Holly
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Nalini Emily Lane
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Maureen Leahy
- University of Vermont Medical Center, Burlington, VT, USA
| | - Mathew Lerner
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jasmine Marsh
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Ellen W McGinnis
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | | | - Judith S Shaw
- Department of Pediatrics, University of Vermont, Burlington, VT, USA
| | - Pamela Swift
- Department of Pediatrics, University of Vermont, Burlington, VT, USA
| | - Rebekah Tinker
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - James J Hudziak
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| |
Collapse
|
45
|
Gubi E, Hollander AC, Bäärnhielm S. "I had no idea there were psychiatric clinics for children": A qualitative study of how migrant parents reach Swedish mental health services for their children. Transcult Psychiatry 2024:13634615241250203. [PMID: 38780532 DOI: 10.1177/13634615241250203] [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: 05/25/2024]
Abstract
Migrant children have repeatedly been shown to underutilize psychiatric services and to face barriers to care, yet few studies have examined the experience of migrant parents who are successful in their help-seeking efforts for their children's mental health. The aim of this study was to gain a deeper understanding of facilitators and obstacles to reaching care among migrant parents in contact with child psychiatric services. We explored how migrant parents in Stockholm, Sweden, experienced the process of reaching child mental health services. Participants were recruited from out-patient mental health clinics. Ten in-depth interviews were conducted; qualitative analysis of transcripts was undertaken using thematic content analysis. Parents described a desire to reach services but difficulties doing so on their own. We identified a strong dependence on referring agents, such as schools and child health centers, for parents to gain contact. Informants expressed a high degree of trust toward these agents. Contrary to previous studies, stigma was not described as an obstacle to help-seeking but was recognized by informants as a potential barrier to care had they not emigrated. Although participants in our study had differing educational backgrounds and residency times in Sweden, a common experience of reliance on others for reaching services was evident in the data. Our findings highlight the role of referring agents as bridging contacts between different welfare services. Understanding the specific local resources and services that are available to migrant parents, and strengthening these across different sectors, could potentially help reduce barriers to care.
Collapse
Affiliation(s)
- Ester Gubi
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Sofie Bäärnhielm
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet (KI) and Transcultural Centre, Stockholm Health Care Services, Stockholm, Sweden
| |
Collapse
|
46
|
Carlisle K, Kamstra P, Carlisle E, McCosker A, De Cotta T, Kilpatrick S, Steiner A, Kahl B, Farmer J. A qualitative exploration of online forums to support resilience of rural young people in Australia. Front Public Health 2024; 12:1335476. [PMID: 38841668 PMCID: PMC11150697 DOI: 10.3389/fpubh.2024.1335476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Prevention and early intervention are crucial strategies for improving young people's mental health and well-being. Building resilience is a key component of these strategies, especially among young individuals in rural areas who face well-documented mental health disparities. This study aimed to investigate how online mental health forums can contribute to enhancing individual resilience in young rural users. Methods A sample of forum posts (n = 1,000) made by Australian rural users (18-25 years) on an online peer support mental health forum were qualitatively analyzed. The analysis was guided by themes derived from the literature on indicators of rural resilience. Results Analysis of forum posts showed evidence of rural resilience in forum users. Online peer support forums offered a virtual space for individuals to establish social connections, experience a sense of belonging, share information, acquire knowledge, and offer mutual support. There were indications of increased self-efficacy among forum users, as they demonstrated their ability to implement strategies for better managing their mental health. Discussion These findings significantly contribute to our understanding of how online forums can enhance resilience factors that are beneficial for young people living in rural communities. In the context of prevention and early intervention, this study illustrates the intricate connections between forum design and user activity with resilience outcomes, providing valuable insights into the underlying causal mechanisms. Consequently, it emphasizes the importance of incorporating such digital interventions as integral components of mental health service ecosystems.
Collapse
Affiliation(s)
- Karen Carlisle
- College of Medicine and Dentistry, James Cook University, Douglas, QLD, Australia
| | | | - Emily Carlisle
- College of Medicine and Dentistry, James Cook University, Douglas, QLD, Australia
| | - Anthony McCosker
- Department of Media and Communications, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Tracy De Cotta
- Social Innovation Research Unit, Swinburne University of Technology, Melbourne, VIC, Australia
| | | | - Artur Steiner
- Glasgow Caledonian University, Yunus Centre, Glasgow, United Kingdom
| | | | - Jane Farmer
- Social Innovation Research Unit, Swinburne University of Technology, Melbourne, VIC, Australia
| |
Collapse
|
47
|
Hornstein S, Scharfenberger J, Lueken U, Wundrack R, Hilbert K. Predicting recurrent chat contact in a psychological intervention for the youth using natural language processing. NPJ Digit Med 2024; 7:132. [PMID: 38762694 PMCID: PMC11102489 DOI: 10.1038/s41746-024-01121-9] [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: 10/03/2023] [Accepted: 04/23/2024] [Indexed: 05/20/2024] Open
Abstract
Chat-based counseling hotlines emerged as a promising low-threshold intervention for youth mental health. However, despite the resulting availability of large text corpora, little work has investigated Natural Language Processing (NLP) applications within this setting. Therefore, this preregistered approach (OSF: XA4PN) utilizes a sample of approximately 19,000 children and young adults that received a chat consultation from a 24/7 crisis service in Germany. Around 800,000 messages were used to predict whether chatters would contact the service again, as this would allow the provision of or redirection to additional treatment. We trained an XGBoost Classifier on the words of the anonymized conversations, using repeated cross-validation and bayesian optimization for hyperparameter search. The best model was able to achieve an AUROC score of 0.68 (p < 0.01) on the previously unseen 3942 newest consultations. A shapely-based explainability approach revealed that words indicating younger age or female gender and terms related to self-harm and suicidal thoughts were associated with a higher chance of recontacting. We conclude that NLP-based predictions of recurrent contact are a promising path toward personalized care at chat hotlines.
Collapse
Affiliation(s)
- Silvan Hornstein
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany.
| | | | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
- German Center for Mental Health (DZPG), partner site Berlin/Potsdam, Potsdam, Germany
| | - Richard Wundrack
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
| | - Kevin Hilbert
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
| |
Collapse
|
48
|
McPhail L, Thornicroft G, Gronholm PC. Help-seeking processes related to targeted school-based mental health services: systematic review. BMC Public Health 2024; 24:1217. [PMID: 38698391 PMCID: PMC11065683 DOI: 10.1186/s12889-024-18714-4] [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: 01/16/2024] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND One in seven adolescents globally are affected by mental health conditions, yet only a minority receive professional help. School-based mental health services have been endorsed as an effective way to increase access to mental health support for people at risk, or currently presenting with mental health conditions, throughout adolescence. Despite this, low treatment utilisation prevails, therefore the aim of this review is to contribute insights into the processes related to adolescents' accessing and engaging with essential targeted mental health support within schools. METHODS This systematic review extracted qualitative, quantitative and mixed-methods data to determine what processes affect adolescents seeking help from targeted school-based mental health services (TSMS). Searches were conducted in EMBASE, Medline, PsycINFO, CINAHL, ERIC, Web of Science, in addition to manual searching and expert consultations. Data were synthesised following guidelines for thematic synthesis and narrative style synthesis. RESULTS The search resulted in 22 articles reflecting 16 studies with participant sample sizes ranging from n = 7 to n = 122. Three main themes were identified: 'access-related factors', 'concerns related to stigma', and 'the school setting'. These findings elucidate how help-seeking processes are variable and can be facilitated or hindered depending on the circumstance. We identified disparities with certain groups, such as those from low-socio economic or ethnic minority backgrounds, facing more acute challenges in seeking help. Help-seeking behaviours were notably influenced by concerns related to peers; an influence further accentuated by minority groups given the importance of social recognition. Conflicting academic schedules significantly contribute to characterising treatment barriers. CONCLUSIONS The findings of this review ought to guide the delivery and development of TSMS to facilitate access and promote help-seeking behaviours. Particularly, given the evidence gaps identified in the field, future studies should prioritise investigating TSMS in low- and middle-income settings and through quantitative methodologies. REGISTRATION The protocol for this systematic review was registered on PROSPERO (ID CRD42023406824).
Collapse
Affiliation(s)
- Lauren McPhail
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Petra C Gronholm
- Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
49
|
Muller JL, Tomlin L, March S, Jackson B, Budden T, Law KH, Dimmock JA. Understanding parent perspectives on engagement with online youth-focused mental health programs. Psychol Health 2024; 39:613-630. [PMID: 35758102 DOI: 10.1080/08870446.2022.2090561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/12/2022] [Accepted: 06/11/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Online youth-focused health programs often include parent modules-that equip parents with skills to assist their child in improving their health-alongside youth-specific content. BRAVE Self-Help, an evidence-based program designed for children and teenagers with early signs of anxiety, is a popular Australian program that includes six parent modules. Despite its popularity and proven efficacy, BRAVE Self-Help shares the same challenge as many online self-help programs-that of low participant engagement. Using parents registered in BRAVE Self-Help as 'information rich' participants, we explored (a) factors that influenced parent engagement in online health programs, and (b) their recommendations for enhancing parent engagement. DESIGN AND OUTCOME MEASURE We conducted semi-structured interviews with 14 parents registered in BRAVE Self-Help. Data were analysed through reflexive thematic analysis. RESULTS Social-, family- and program-related factors drove parents' program engagement and recommendations. Social sub-themes related to the benefits of professional and community support in promoting more engagement. Family sub-themes included difficulties with program engagement due to competing priorities, perceptions that condition severity influenced engagement, and feelings that previously-acquired health knowledge reduced motivation to engage. Program sub-themes included perceived usefulness and ease-of-use. CONCLUSION Program designers could target support systems, include flexible delivery options, and use iterative design processes to enhance parent engagement.
Collapse
Affiliation(s)
- Jessica L Muller
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Luke Tomlin
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
| | - Sonja March
- School of Psychology and Counselling and Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Timothy Budden
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
| | - Kwok Hong Law
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - James A Dimmock
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| |
Collapse
|
50
|
Broersen M, Creemers DHM, Frieswijk N, Vermulst AA, Kroon H. Effects of Youth Flexible Assertive Community Treatment: outcomes of an 18-month observational study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:745-758. [PMID: 37280465 PMCID: PMC11087363 DOI: 10.1007/s00127-023-02508-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 05/25/2023] [Indexed: 06/08/2023]
Abstract
PURPOSE This Multicenter Youth Flexible ACT Study examined the effect of Youth Flexible Assertive Community Treatment on symptomatic, social, and personal recovery outcomes of adolescents dealing with multifaceted psychiatric and social care needs who do not readily engage in regular office-based mental health services. METHODS Newly admitted clients (n = 199) aged 12-24 years from 16 Youth Flexible ACT teams participated in this observational prospective cohort study. Client and practitioner questionnaires were administered every 6 months, up to 18 months. Latent growth curve analyses were conducted to examine changes in symptomatic, social, and personal recovery outcomes throughout Flexible ACT. RESULTS Our analyses of client-reported outcomes showed a decrease in overall psychosocial difficulties, depressive symptoms, and subclinical psychosis symptoms. Moreover, outcomes showed improved social interaction with peers, quality of life, and feelings of empowerment and fewer contacts with the police/legal system. In addition, analyses of clinician-reported outcomes showed a decrease in problems related to family life, peer relationships, school/work attendance, emotional symptoms, and attentional problems. Problems related to personal finance, school and work status, substance misuse, disruptive and aggressive behavior, self-injury, and self-care and independence remained unchanged. CONCLUSION Our results showed that clients participating in Youth Flexible ACT improved in symptomatic, social, and personal recovery outcomes over 18 months. With its integrated approach and personalized care, this service delivery model is promising for adolescents unable to engage successfully in regular (office based) mental health support services.
Collapse
Affiliation(s)
- Marieke Broersen
- GGZ Oost Brabant, Oss, The Netherlands.
- Tranzo-Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
| | | | | | | | - Hans Kroon
- Tranzo-Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Trimbos Institute, Utrecht, The Netherlands
| |
Collapse
|