Understanding Australian university students’ mental health help‐seeking: An empirical and theoretical investigation

Spiritual Connectivity Intervention for Individuals with Depressive Symptoms: A Randomized Control Trial

Depression is one of the most prevalent mental disorders worldwide. This study examined the effect of a spiritual connectivity intervention on individuals with depression in a randomized waitlist-controlled trial. Fifty-seven participants with mild or moderate depressive symptoms were randomly assigned to either the intervention group (n = 28) or the waitlist control group (n = 29). The intervention comprised eight weekly sessions focusing on divine connection, forgiveness and freedom, suffering and transcendence, hope, gratitude, and relapse prevention. The outcome measures included depressive symptoms, anxiety, hope, meaning in life, self-esteem, and social support. Participants completed self-administered questionnaires at baseline (week 0), post-intervention (week 8), and 3-month follow-up (week 20). Repeated-measures ANOVA and one-way ANCOVA were used to compare the within-group and between-group differences in the changes in outcome variables. Participants in the intervention group showed significant improvements in depression, anxiety, spiritual experience, hope, self-esteem, and perceived social support after the intervention. Effect size statistics showed small to large differences (Cohen's d, 0.308 to -1.452). Moreover, 85.71% of participants in the intervention group also experienced clinically significant reductions in PHQ-9 scores from baseline to immediate post-intervention. This study highlights the effectiveness of a low-cost, accessible intervention suitable for community implementation by clergy and faith-based organizations.

Student intentions to engage instructors in mental health-related conversations: An application of the theory of planned behavior

OBJECTIVE

Considering that college students experience mental health issues and college counseling centers are overwhelmed, this study identifies instructors as a potential mental health resource for students. This study utilizes the theory of planned behavior to investigate the relationship between students' attitudes, injunctive and descriptive norms, perceived behavioral control, and their intentions to engage their instructors in mental health conversations.

PARTICIPANTS

Participants were 311 undergraduate students at a small, private university in Southern California.

METHODS

Participants were recruited through a Communication subject pool and completed an online survey about engaging instructors in these conversations.

RESULTS

Results of a regression analysis indicate that all theoretical constructs positively predict students' intentions to discuss mental health with an instructor.

CONCLUSIONS

By providing insight into students' intentions to utilize instructors as mental health resources on campus, these findings yield practical implications for better preparing universities and their faculty to engage in students' mental health.

Faith-Based Spiritual Intervention for Persons with Depression: Preliminary Evidence from a Pilot Study

Depression is a common, depleting, and potentially life-threatening disorder. This pilot study examined the feasibility and applicability, reported preliminary evidence for effectiveness, and explored the potential healing mechanisms of a faith-based spiritual intervention for people with depression. The intervention consisted of six weekly sessions focused on restoring a connection with the divine, forgiveness and freedom, suffering and transcendence, hope, gratitude, and relapse prevention. Seven adults with mild or moderate depressive symptoms were recruited. A qualitative evaluation was conducted via focus group discussions, and rating scales were administered at baseline, after the intervention, and at the 3-month follow-up. The mean difference scores of the treatment's effect over time were analyzed using Friedman's ANOVA. The themes identified by the focus group included the meaning of the spiritual intervention, the effect of involvement in a spiritual group, and the therapeutic components. The results indicated a significant decrease in the mean scores for depression (PHQ-9) after intervention and at the 3-month follow-up. Participants expressed their improvement in terms of increased knowledge about depression, enhanced coping mechanisms, and improved self-esteem. The preliminary evidence suggested that the faith-based spiritual intervention was effective in reducing depressive symptoms and also helped participants develop a greater sense of connection with themselves, others, and their environment.

Pilot randomised controlled trial of a remotely delivered online intervention for adolescent mental health problems in India: lessons learned about low acceptability and feasibility during the COVID-19 pandemic

BACKGROUND

'POD Adventures' is a gamified problem-solving intervention delivered via smartphone app, and supported by non-specialist counsellors for a target population of secondary school students in India during the COVID-19 pandemic.

AIMS

To evaluate the feasibility and acceptability of undertaking a randomised controlled trial of POD Adventures when delivered online with telephone support from counsellors.

METHOD

We conducted a parallel, two-arm, individually randomised pilot-controlled trial with 11 secondary schools in Goa, India. Participants received either the POD Adventures intervention delivered over 4 weeks or usual care comprising information about local mental health services and national helplines. Outcomes were assessed at two timepoints: baseline and 6 weeks post-randomisation.

RESULTS

Seventy-nine classroom sensitisation sessions reaching a total of 1575 students were conducted. Ninety-two self-initiated study referrals (5.8%) were received, but only 11 participants enrolled in the study. No intervention arm participants completed the intervention. Outcomes at 6 weeks were not available for intervention arm participants (n = 5), and only four control arm participants completed outcomes. No qualitative interviews or participant satisfaction measures were completed because participants could not be reached by the study team.

CONCLUSIONS

Despite modifications to address barriers arising from COVID-19 restrictions, online delivery was not feasible in the study context. Low recruitment and missing feasibility and acceptability data make it difficult to draw conclusions about intervention engagement and indicative clinical outcomes. Prior findings showing high uptake, adherence and engagement with POD Adventures when delivered in a school-based context suggest that an online study and delivery posed the biggest barriers to study participation and engagement.

Design of Psychological Well-Being Education Environment Scheme Based on Deep Learning Theory

This paper discusses the structure of psychological well-being education programmes in higher education institutions based on an analysis of the connotation and characteristics of deep learning theory, as well as the background of today's talent training requirements, the psychological traits of contemporary students, and the practical requirements of the teaching reform of psychological well-being education courses in higher education institutions. A model for evaluating the psychological well-being of college students based on BPNN is presented in this paper, which also addresses the current severe shortage of full-time psychological counsellors. Additionally, the traditional BPNN is optimised by GA, and the resulting NN can better achieve the desired effect, demonstrating the viability of BPNN. It enables the psychological well-being of college students to be self-diagnosed online and significantly lessens the workload of psychological counselling institutions in higher education. According to the experimental findings, the optimised algorithm's accuracy can reach 92.47 percent, and it is considered to be reliable. This study not only offers a novel approach to nonlinear data processing, but also paves the way for variable screening in the presence of an ambiguous structure. Additionally, in a limited sense, it offers insightful research for psychological education in higher education institutions.

Explaining adults' mental health help-seeking through the lens of the theory of planned behavior: a scoping review

BACKGROUND

Despite evidence-based efficacy, mental health services are underutilized due to low rates of help-seeking, leaving unmet mental health needs a global concern. The Theory of Planned Behavior (TPB) has been applied to understand the help-seeking process and in the development of behavior change interventions. The aim of this scoping review was to map the literature on the TPB as applied to mental health help-seeking in adults aged >18 years.

METHODS

This scoping review was conducted based on the methodology presented by Arksey and O'Malley (2005). Six databases (CINAHL, PsycINFO, MEDLINE, ProQuest Health and Medicine, ProQuest Dissertations and Theses, Web of Science) and two grey literature sources (OpenGrey, Google Scholar) were systematically searched in February 2018 and updated in March 2020. Studies that explicitly discussed the TPB in the context of mental health help-seeking were initially selected; only studies that explored formal help-seeking for mental health problems and were published in English were retained. Data were extracted using Microsoft Excel.

RESULTS

Initially, 8898 records were identified. Of these, 49 met the selection criteria and were included: 32 were journal articles and 17 were theses. Forty-three papers reported on non-intervention studies and seven articles reported on TPB-based interventions. Most studies (n = 39) identified predictors of help-seeking intentions. Attitudes and perceived behavioral control were significant predictors of intentions in 35 and 34 studies, respectively. Subjective norms were a significant predictor of intentions in 23 studies. Few studies aimed to predict help-seeking behavior (n = 8). Intentions and perceived behavioral control were significant predictors of behavior in seven and six studies, respectively. Only six TPB-based interventions were identified, all used digital technology to influence help-seeking, with mixed results.

CONCLUSIONS

The present scoping review identified a considerable evidence base on the TPB for predicting mental health help-seeking intentions. Attitudes and perceived behavioral control were frequently found to be significant predictors of help-seeking intentions. Knowledge on the TPB for predicting mental health help-seeking behavior, and on TPB-based interventions, is limited. Thus, the role of the TPB in developing help-seeking interventions remains unclear. Recommendations are presented to address such research gaps and inform policy and practice.

Intention to seek professional and non-professional emotional help among Jewish young adults in Israel

Young adulthood is a major and significant stage in life encompassing various life transitions which may increase the risk of developing emotional crises. Receiving mental health treatment and turning to nonprofessional resources for support can ease such emotional burdens. However, many of those in need of such help do not turn to professional services and, rather, tend to rely on themselves. The aim of this study was to examine the contribution of attitudes towards seeking professional emotional help, self-stigma, anticipated risk, anticipated utility, and social support to the intention to seek professional and nonprofessional emotional help among Jewish young adults in Israel. Participants included 282 Jewish Israeli young adults aged 18-30, recruited in person or online. They filled out a self-report questionnaire, between March and June 2017, regarding intention to seek professional and non-professional emotional help, attitudes towards seeking professional emotional help, self-stigma towards seeking professional emotional help, anticipated risk and anticipated utility of self-disclosure when seeking professional help, perceived social support and sociodemographic questions. A path analysis model was used to analyse the data. Intention to seek professional help was positively associated with positive attitudes towards seeking professional emotional help and anticipated utility and negatively with self-stigma and social support. Intention to seek nonprofessional help was positively associated with anticipated utility and social support and negatively with anticipated risk. In addition, indirect effects were found between religious affiliation and previous mental health treatment, and intention to seek professional help, through the mediating effects of attitudes and anticipated utility. Interventions for increasing intention to seek professional and nonprofessional support are important and should include reference to attitudes, anticipated utility, anticipated risk and self-stigma, and should promote mutual support and highlight the importance of support from close ones. In addition, a model for predicting intention to seek non-professional help should be developed.

Barriers to Seeking Mental Help and Interventions to Remove Them in Medical School during the COVID-19 Pandemic: Perspectives of Students

Medical students are at increased risk for psychological morbidity but the majority of those with mental health problems do not seek professional care. We aimed to uncover the viewpoints of medical students regarding barriers and facilitators to using university mental health services and their attitudes and preferences towards online counselling. Four semi-structured focus groups were conducted (n = 26, mean age = 21.8, ±1.88, 73% males). After reaching data saturation, interviews were audio-recorded, transcribed and content-analysed by two independent coders. Intrapersonal barriers emerged to be perceived low risk, excessive self-reliance, lack of belief in the effectiveness of service, lack of openness. Interpersonal factors were the following: assumed long waiting list, insufficient provision of service information, fear of exposure, and not being familiar with the counsellor and the process. Extrapersonal barriers such as insurance problems, the number of available sessions, adverse sociocultural attitudes, fear of stigmatisation were identified. Students suggested that the university should provide psychoeducation and routine screening, apply social marketing and stigma reduction campaigns, improve information flow, and offer not only personal but also online video counselling to target removing these barriers. The results provide a reference for the redesign of mental health services to facilitate their access by students. Implications and limitations are discussed.

Students' Mental Health, Well-Being, and Loneliness during the COVID-19 Pandemic: A Cross-National Study

During the COVID-19 pandemic, much research has been devoted to assessing mental health in a variety of populations. Students in higher education appear to be particularly vulnerable to experiencing reduced mental health. The purpose of the study was to assess whether higher education students experienced poorer mental health compared to the general population and examine the factors associated with students' mental health during the COVID-19 pandemic. A cross-national sample of students (n = 354) and non-students (n = 3120) participated in a survey in October/November 2020. Mental health outcomes among students and non-students were compared with independent t-tests. Multiple linear regression analysis and general linear estimation were used to assess the impact of student status on mental health outcomes while adjusting for sociodemographic factors. Students reported poorer mental health than non-students. The difference in mental health between students and non-students was bigger for participants aged 30 years or older. More social media use was associated with poorer mental health outcomes. In conclusion, students had poorer mental health than the wider population. Aspects of life as a student, beyond what can be attributed to life stage, appears to increase mental health problems.

How I cope at university: Self-directed stress management strategies of Australian students

Universities across the world remain under-resourced and frequently unequipped to provide the required support to the increasing demand of students experiencing mental health problems. While there is a considerable amount of research focusing on university student stress levels, interventions to address them, and coping strategies adopted by students, little research has reported on the strategies students choose to manage their stress and how that relates to their self-identified sources of stress as well as to what universities are offering to support their mental health and wellbeing. The present study provides a contribution in this direction, reporting on a study that surveyed over 3200 students from three large Australian metropolitan universities and interviewed three groups of university staff who provide student wellbeing services. Results highlight differences between what students and staff perceive as main sources of stress and best strategies to address them. In addition, students recommend task-oriented, pro-active coping strategies more often to their peers than engage in them themselves. The findings of the study further reinforce the need to develop an understanding of student coping strategies with a lens considerate of students' perspectives and preferences to authentically support their wellbeing, better informing planning and service delivery.

Lower help-seeking intentions mediate subsequent depressive symptoms among adolescents with high autistic traits: a population-based cohort study

Adolescents with high autistic traits are at increased risk of depression. Despite the importance of seeking help for early intervention, evidence on help-seeking intentions amongst this population is scarce. Using a population-based cohort in Japan, we examined adolescents' help-seeking intentions and preferences by the level of autistic traits and tested its mediating role on the association between high autistic traits and depressive symptoms. At age 12, we measured parent-rated autistic traits using the short version of the Autism Spectrum Quotient and classified the adolescents into two groups (≥ 6 as AQhigh, < 6 as AQlow); help-seeking intentions and preferences were assessed through a depression vignette. At age 14, depressive symptoms were self-rated using the Short Mood and Feelings Questionnaire. Hypothesised associations between autistic traits and help-seeking intentions or depressive symptoms were tested applying multivariable regression modelling, while mediation was tested with structural equation modelling. Of the 2505 adolescent participants, 200 (8%) were classified as AQhigh. In both groups, the main source of help-seeking was their family; however, 40% of the AQhigh group reported having no help-seeking intentions compared to 27% in the AQlow. The AQhigh group was at increased risk of not having help-seeking intentions (OR 1.84, 95% CI 1.35-2.50) and higher depressive symptoms (b coefficient 1.06, 0.33-1.79). Help-seeking intentions mediated 18% of the association mentioned above. Interventions to promote help-seeking intentions among adolescents with high autistic traits could reduce their subsequent depressive symptoms. Ideally, such interventions should be provided prior to adolescence and with the involvement of their parents.

'Having come to university my care was very much in my hands': exploration of university students' perceptions of health care needs and services using the common-sense model of self-regulation

The health care needs and service experiences of higher education students require more research attention, given the increase in students who have a long-term illness, medical condition, or disability ("condition"). It is also important to consider the experiences of rising numbers of international students. This exploratory qualitative study used face-to-face interviews and the common-sense model of self-regulation to investigate students' perceptions and coping behaviours, in a higher education institution in the UK. Thematic analysis was used to analyse the data. Twenty students who self-identified as having a condition were interviewed. This study adds depth to the understanding of the connections between students' health-related experiences and their personal, academic, and post-graduation aspirations and the support needs of students, including international students. To optimise institutional support, innovations in partnerships with local care organisations and within the university, staff training about conditions, peer mentorship, and information outreach especially to international students, should be considered.