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Looi JC, Allison S, Bastiampillai T, Kisely S, Maguire PA, Woon LSC, Anderson K, Malhi GS. Deprescribing antidepressants for depression - what is the evidence for and against? Australas Psychiatry 2024:10398562241282377. [PMID: 39240731 DOI: 10.1177/10398562241282377] [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: 09/08/2024]
Abstract
OBJECTIVE Recent guidelines suggest that the overall quantity and duration of antidepressant prescriptions should be reduced. In this paper, we comment on the evidence both for and against this view. METHODS We critically review the arguments proposed by proponents of antidepressant deprescribing in the context of the evidence-base for the treatment of depression. RESULTS Proponents of deprescribing do not address the substantive issues of whether inappropriate prescribing has been demonstrated, and when prescribing is needed. Their arguments for deprescribing are rebutted in this context. CONCLUSIONS Whether or not to deprescribe antidepressant medication needs to take into consideration the risk-benefit profile of the decision, the responsibility for which needs to be shared and based on the context of the patient's depression, their preferences, experiences and perspectives.
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Affiliation(s)
- Jeffrey Cl Looi
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra, ACT, Australia; Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
| | - Stephen Allison
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Tarun Bastiampillai
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia; Department of Psychiatry, Monash University, Clayton, VIC, Australia
| | - Steve Kisely
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; School of Medicine, The University of Queensland, Brisbane, QLD, Australia; Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia; Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Paul A Maguire
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra, ACT, Australia
| | - Luke S-C Woon
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra, ACT, Australia; Department of Psychiatry, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Katrina Anderson
- Academic Unit of General Practice, The Australian National University School of Medicine and Psychology, Canberra, ACT, Australia
| | - Gin S Malhi
- Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; CADE Clinic and Mood-T, Royal North Shore Hospital, St. Leonards, NSW, Australia; Department of Psychiatry, University of Oxford, Oxford, UK and Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK
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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] [MESH Headings] [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.
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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.
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McGinty EE, Alegria M, Beidas RS, Braithwaite J, Kola L, Leslie DL, Moise N, Mueller B, Pincus HA, Shidhaye R, Simon K, Singer SJ, Stuart EA, Eisenberg MD. The Lancet Psychiatry Commission: transforming mental health implementation research. Lancet Psychiatry 2024; 11:368-396. [PMID: 38552663 DOI: 10.1016/s2215-0366(24)00040-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 04/19/2024]
Affiliation(s)
| | - Margarita Alegria
- Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Rinad S Beidas
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Lola Kola
- College of Medicine, University of Ibadan, Ibadan, Nigeria; Kings College London, London, UK
| | | | | | | | | | - Rahul Shidhaye
- Pravara Institute of Medical Sciences University, Loni, India; Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | | | - Sara J Singer
- Stanford University School of Medicine, Stanford, CA, USA
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Baumann SE, Kameg BN, Wiltrout CT, Murdoch D, Pelcher L, Burke JG. Visualizing Mental Health Through the Lens of Pittsburgh Youth: A Collaborative Filmmaking Study During COVID-19. Health Promot Pract 2024; 25:368-382. [PMID: 36546679 PMCID: PMC9791059 DOI: 10.1177/15248399221141688] [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] [Indexed: 12/24/2022]
Abstract
Youth mental health has been significantly impacted by COVID-19, with concerns of rising anxiety-related and depressive symptoms and reduced quality of life. This study provides a nuanced understanding of mental health stressors and supports in the lives of youth during the pandemic. Using Collaborative Filmmaking, an embodied, visual, and participatory research method, participants in Pittsburgh, Pennsylvania, were trained to create, analyze, and screen films about mental health. The films elucidated numerous stressors impacting youth mental health, including educational stressors (e.g., academic pressure and relationships with teachers), personal and social stressors (e.g., social and cultural expectations), and current events (e.g., the election and the political system). Supports included individual level supports (e.g., hobbies, self-care, spending time outdoors), and interpersonal level supports (e.g., family and socializing). Several themes were discussed as both stressors and supports, such as family, COVID-19, and social media. Overall, educational stressors are major contributors to adverse mental health symptoms among youth, which have been magnified by the COVID-19 pandemic. Youth discussions of the importance of self-care and engaging in healthy hobbies demonstrated strong awareness about maintaining mental health, though structural-level recommendations are still needed to improve youth mental health. Screening the Collaborative Films with the public illuminated several additional opportunities for action, including structural and social actions (e.g., changing policies and social norms around mental health). Given the structural nature of the stressors mentioned by participants, systemic changes as well as policy level action and programming are needed to address the intersectional nature of current mental health concerns among youth.
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Affiliation(s)
- Sara E. Baumann
- University of Pittsburgh School of
Public Health, Pittsburgh, PA, USA
| | - Brayden N. Kameg
- University of Pittsburgh School of
Public Health, Pittsburgh, PA, USA
| | | | | | - Lindsay Pelcher
- University of Pittsburgh School of
Public Health, Pittsburgh, PA, USA
| | - Jessica G. Burke
- University of Pittsburgh School of
Public Health, Pittsburgh, PA, USA
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5
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Stecher C, Cloonan S, Domino ME. The Economics of Treatment for Depression. Annu Rev Public Health 2024; 45:527-551. [PMID: 38100648 DOI: 10.1146/annurev-publhealth-061022-040533] [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: 12/17/2023]
Abstract
The global prevalence of depression has risen over the past three decades across all socioeconomic groups and geographic regions, with a particularly rapid increase in prevalence among adolescents (aged 12-17 years) in the United States. Depression imposes large health, economic, and societal costs, including reduced life span and quality of life, medical costs, and reduced educational attainment and workplace productivity. A wide range of treatment modalities for depression are available, but socioeconomic disparities in treatment access are driven by treatment costs, lack of culturally tailored options, stigma, and provider shortages, among other barriers. This review highlights the need for comparative research to better understand treatments' relative efficacy, cost-effectiveness, scalability, and potential heterogeneity in efficacy across socioeconomic groups and country and cultural contexts. To address the growing burden of depression, mental health policy could consider reducing restrictions on the supply of providers, implementing digital interventions, reducing stigma, and promoting healthy lifestyles.
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Affiliation(s)
- Chad Stecher
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA;
- The Center for Health Information and Research, Arizona State University, Phoenix, Arizona, USA
| | - Sara Cloonan
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Marisa Elena Domino
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA;
- The Center for Health Information and Research, Arizona State University, Phoenix, Arizona, USA
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Purtle J, Stadnick NA, Wynecoop M, Walker SC, Bruns EJ, Aarons GA. A Tale of Two Taxes: Implementation of Earmarked Taxes for Behavioral Health Services in California and Washington State. Psychiatr Serv 2024; 75:410-418. [PMID: 37933132 PMCID: PMC11139541 DOI: 10.1176/appi.ps.20230257] [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] [Indexed: 11/08/2023]
Abstract
OBJECTIVE The authors sought to characterize perceptions of the impacts, attributes, and support for taxes earmarked for behavioral health services and to compare perceptions of the taxes among professionals in California and Washington, two states differing in earmarked tax designs. METHODS Surveys were completed by 155 public agency and community organization professionals involved in tax implementation in California (N=87) and Washington State (N=68) during 2022-2023 (29% response rate). Respondents indicated their perceptions of the taxes' impacts, attributes, and support. Responses were summed as aggregate scores and were also analyzed as individual items. Bivariate analyses were used to compare responses of professionals in California versus Washington State. RESULTS Earmarked taxes were generally regarded positively. Of the respondents, >80% strongly agreed that the taxes increased funding for services and were helpful, and only 10% strongly agreed that the taxes decreased behavioral health funding from other sources. Substantially more respondents in California than in Washington State strongly agreed that taxes' reporting requirements were complicated (45% vs. 5%, p<0.001) and that the taxes increased unjustified scrutiny of services or systems (33% vs. 2%, p<0.001). However, more respondents in California than in Washington State also strongly agreed that the taxes increased public awareness about behavioral health (56% vs. 15%, p<0.001) and decreased behavioral health stigma (47% vs. 14%, p<0.001). CONCLUSIONS Perceptions of the strengths and weaknesses of taxes earmarked for behavioral health services may vary by design features of the tax. Such features include stigma-reduction initiatives and tax spending and reporting requirements.
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Affiliation(s)
- Jonathan Purtle
- Global Center for Implementation Science, Department of Public Health Policy and Management, New York University School of Global Public Health, New York City (Purtle, Wynecoop); Dissemination and Implementation Science Center, Department of Psychiatry, Altman Clinical and Translational Research Institute, University of California, San Diego, La Jolla (Stadnick, Aarons); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Walker, Bruns)
| | - Nicole A Stadnick
- Global Center for Implementation Science, Department of Public Health Policy and Management, New York University School of Global Public Health, New York City (Purtle, Wynecoop); Dissemination and Implementation Science Center, Department of Psychiatry, Altman Clinical and Translational Research Institute, University of California, San Diego, La Jolla (Stadnick, Aarons); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Walker, Bruns)
| | - Megan Wynecoop
- Global Center for Implementation Science, Department of Public Health Policy and Management, New York University School of Global Public Health, New York City (Purtle, Wynecoop); Dissemination and Implementation Science Center, Department of Psychiatry, Altman Clinical and Translational Research Institute, University of California, San Diego, La Jolla (Stadnick, Aarons); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Walker, Bruns)
| | - Sarah C Walker
- Global Center for Implementation Science, Department of Public Health Policy and Management, New York University School of Global Public Health, New York City (Purtle, Wynecoop); Dissemination and Implementation Science Center, Department of Psychiatry, Altman Clinical and Translational Research Institute, University of California, San Diego, La Jolla (Stadnick, Aarons); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Walker, Bruns)
| | - Eric J Bruns
- Global Center for Implementation Science, Department of Public Health Policy and Management, New York University School of Global Public Health, New York City (Purtle, Wynecoop); Dissemination and Implementation Science Center, Department of Psychiatry, Altman Clinical and Translational Research Institute, University of California, San Diego, La Jolla (Stadnick, Aarons); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Walker, Bruns)
| | - Gregory A Aarons
- Global Center for Implementation Science, Department of Public Health Policy and Management, New York University School of Global Public Health, New York City (Purtle, Wynecoop); Dissemination and Implementation Science Center, Department of Psychiatry, Altman Clinical and Translational Research Institute, University of California, San Diego, La Jolla (Stadnick, Aarons); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Walker, Bruns)
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7
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Wong VWH, Yiu EKL, Ng CH, Sarris J, Ho FYY. Unraveling the associations between unhealthy lifestyle behaviors and mental health in the general adult Chinese population: A cross-sectional study. J Affect Disord 2024; 349:583-595. [PMID: 38176449 DOI: 10.1016/j.jad.2023.12.079] [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: 07/08/2023] [Revised: 11/24/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND This study examined the cumulative risk of unhealthy lifestyle behaviors and the associations between overall lifestyle and common mental disorders (CMDs), insomnia, stress, health-related quality of life (HRQOL), and functional impairment. Additionally, the treatment preferences for managing CMDs and insomnia were examined. METHODS A survey was conducted on 1487 Chinese Hong Kong adults, assessing their lifestyle behaviors (i.e., diet and nutrition, substance use, physical activity, stress management, restorative sleep, social support, and environmental exposures), mental health-related outcomes, and treatment preferences via a vignette. RESULTS The findings revealed significant additive relationships between the number of 'worse' lifestyle domains and the risk of all outcomes. A healthier overall lifestyle was significantly associated with reduced risks of all outcomes (AORs = 0.88 to 0.93). Having healthier practices in diet and nutrition, substance use, stress management, restorative sleep, and social support domains were significantly associated with lower risks of all outcomes (AORs = 0.93 to 0.98), except that substance use was not significantly associated with stress. Physical activity was inversely associated with only depressive symptoms (AOR = 0.98), anxiety symptoms (AOR = 0.99), and stress (AOR = 0.99). Environmental exposures were not significantly associated with functional impairment but with all other outcomes (AORs = 0.98 to 0.99). Besides, lifestyle interventions (55 %) were significantly more preferred for managing CMDs and insomnia relative to psychotherapy (35.4 %) and pharmacotherapy (9.6 %). CONCLUSIONS Our findings underscore the importance of considering lifestyle factors when managing CMDs, insomnia, stress, HRQOL, and functional impairment, with a particular emphasis on adopting a multicomponent treatment approach.
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Affiliation(s)
| | - Eric Kwok-Lun Yiu
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Jerome Sarris
- Western Sydney University, NICM Health Research Institute, Westmead, NSW, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong.
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Fanali A, Giorgi F, Tramonti F. Thick description and systems thinking: Reiterating the importance of a biopsychosocial approach to mental health. J Eval Clin Pract 2024; 30:309-315. [PMID: 36444133 DOI: 10.1111/jep.13800] [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: 06/09/2022] [Revised: 11/10/2022] [Accepted: 11/20/2022] [Indexed: 11/30/2022]
Abstract
STUDY AIMS The article aims at reiterating the importance of a biopsychosocial approach to mental health, taking stock of the critiques that have been raised and moving forward throughout a reconsideration of the theoretical background of systems thinking and emphasizing the relevance of the concept of thick description for the promotion of an adequate reflection on methodology and case formulation. LITERATURE REVIEW It is our opinion that the biopsychosocial approach is still a powerful framework for making sense of the growing data collected in the different fields related to mental health and for designing proper treatment plans. A crucial challenge for mental health is that of surpassing the dichotomies and ideological disputes that still contaminate the field with detrimental effects on the advancement of knowledge and on the integration and continuity of different kind of interventions. CONCLUSIONS The time is ripe for building bridges among neuroscience, humanities and social sciences, and this can only happen within the umbrella of a biopsychosocial perspective reinstated into its systems thinking background.
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Affiliation(s)
| | - Franco Giorgi
- Department of Neuroscience, University of Pisa, Pisa, Italy
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Lovero KL, Kemp CG, Wagenaar BH, Giusto A, Greene MC, Powell BJ, Proctor EK. Application of the Expert Recommendations for Implementing Change (ERIC) compilation of strategies to health intervention implementation in low- and middle-income countries: a systematic review. Implement Sci 2023; 18:56. [PMID: 37904218 PMCID: PMC10617067 DOI: 10.1186/s13012-023-01310-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/02/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND The Expert Recommendations for Implementing Change (ERIC) project developed a compilation of implementation strategies that are intended to standardize reporting and evaluation. Little is known about the application of ERIC in low- and middle-income countries (LMICs). We systematically reviewed the literature on the use and specification of ERIC strategies for health intervention implementation in LMICs to identify gaps and inform future research. METHODS We searched peer-reviewed articles published through March 2023 in any language that (1) were conducted in an LMIC and (2) cited seminal ERIC articles or (3) mentioned ERIC in the title or abstract. Two co-authors independently screened all titles, abstracts, and full-text articles, then abstracted study, intervention, and implementation strategy characteristics of included studies. RESULTS The final sample included 60 studies describing research from all world regions, with over 30% published in the final year of our review period. Most studies took place in healthcare settings (n = 52, 86.7%), while 11 (18.2%) took place in community settings and four (6.7%) at the policy level. Across studies, 548 distinct implementation strategies were identified with a median of six strategies (range 1-46 strategies) included in each study. Most studies (n = 32, 53.3%) explicitly matched implementation strategies used for the ERIC compilation. Among those that did, 64 (87.3%) of the 73 ERIC strategies were represented. Many of the strategies not cited included those that target systems- or policy-level barriers. Nearly 85% of strategies included some component of strategy specification, though most only included specification of their action (75.2%), actor (57.3%), and action target (60.8%). A minority of studies employed randomized trials or high-quality quasi-experimental designs; only one study evaluated implementation strategy effectiveness. CONCLUSIONS While ERIC use in LMICs is rapidly growing, its application has not been consistent nor commonly used to test strategy effectiveness. Research in LMICs must better specify strategies and evaluate their impact on outcomes. Moreover, strategies that are tested need to be better specified, so they may be compared across contexts. Finally, strategies targeting policy-, systems-, and community-level determinants should be further explored. TRIAL REGISTRATION PROSPERO, CRD42021268374.
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Affiliation(s)
- Kathryn L Lovero
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Christopher G Kemp
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bradley H Wagenaar
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Ali Giusto
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, USA
| | - M Claire Greene
- Program On Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Byron J Powell
- Brown School, Center for Mental Health Services Research, Washington University in St. Louis, St. Louis, MO, USA
- Center for Dissemination & Implementation, Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA
- Division of Infectious Diseases, John T. Milliken Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Enola K Proctor
- Brown School, Center for Mental Health Services Research, Washington University in St. Louis, St. Louis, MO, USA
- Center for Dissemination & Implementation, Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA
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10
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Yin C, Gao R, Ni X. Intention of Psychological Counseling, Attitude Toward Seeking Psychological Help, and Shame Among Vocational College Students: A Cross-Sectional Survey. ALPHA PSYCHIATRY 2023; 24:186-192. [PMID: 38105784 PMCID: PMC10724798 DOI: 10.5152/alphapsychiatry.2023.231235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/06/2023] [Indexed: 12/19/2023]
Abstract
Objective The aim of this study was to explore the psychological counseling intention of college students, the attitude of seeking psychological help, and the related factors of shame so as to promote the psychological health of college students. Methods In 4 comprehensive colleges with sound psychological counseling centers, students of different grades were selected and divided into an active help-seeking group (n = 216) and a help-refusal group (n = 270). Students' shame behaviors were evaluated using the Self-Stigma of Seeking Help (SSOSH) scale and Self-Stigma Scale (SSS). The intention of psychological counseling was measured by the General Help-Seeking Questionnaire. The Inventory of Attitudes Toward Seeking Mental Health Services was used to evaluate the psychological status. Data from the above scales were compared through the t-test. Additionally, multiple linear regression analysis was performed to explore the impact of shame on the intention of psychological counseling. Results The study found that the active help-seeking group scored lower on SSOSH scale compared to those in the help-refusal group (total score: 41.2 ± 9.1 vs. 37.9 ± 8.7, P = .0017). Meanwhile, the help-refusal group had higher scores on the shame dimension of the SSS (16.2 ± 3.9 vs. 5.3 ± 1.1, P = .00085). After adjusting for age, gender, and other variables, multiple linear regression analysis indicated a negative correlation between shame and intention of psychological help and counseling, revealing a significant impact of shame on professional psychological counseling (P < .05). Conclusion Our study findings suggest that shame has a negative impact on the intention of seeking psychological help and counseling among college students, highlighting the importance of addressing shame-related factors to promote psychological health and encourage the utilization of professional psychological counseling services.
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Affiliation(s)
- Changchun Yin
- General Education College, Hainan Vocational and Technical College, Haikou, Hainan, China
| | - Ru Gao
- General Education College, Hainan Vocational and Technical College, Haikou, Hainan, China
| | - Xiaomin Ni
- General Education College, Hainan Vocational and Technical College, Haikou, Hainan, China
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11
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Graham E, Gariépy G, Orpana H. System dynamics models of depression at the population level: a scoping review. Health Res Policy Syst 2023; 21:50. [PMID: 37312087 DOI: 10.1186/s12961-023-00995-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 05/12/2023] [Indexed: 06/15/2023] Open
Abstract
AIMS Depression is a disease driven by dynamic processes both at the individual- and system-level. System dynamics (SD) models are a useful tool to capture this complexity, project the future prevalence of depression and understand the potential impact of interventions and policies. SD models have been used to model infectious and chronic disease, but rarely applied to mental health. This scoping review aimed to identify population-based SD models of depression and report on their modelling strategies and applications to policy and decision-making to inform research in this emergent field. METHODS We searched articles in MEDLINE, Embase, PsychInfo, Scopus, MedXriv, and abstracts from the System Dynamics Society from inception to October 20, 2021 for studies of population-level SD models of depression. We extracted data on model purpose, elements of SD models, results, and interventions, and assessed the quality of reporting. RESULTS We identified 1899 records and found four studies that met the inclusion criteria. Studies used SD models to assess various system-level processes and interventions, including the impact of antidepressant use on population-level depression in Canada; the impact of recall error on lifetime estimates of depression in the USA; smoking-related outcomes among adults with and without depression in the USA; and the impact of increasing depression incidence and counselling rates on depression in Zimbabwe. Studies included diverse stocks and flows for depression severity, recurrence, and remittance, but all models included flows for incidence and recurrence of depression. Feedback loops were also present in all models. Three studies provided sufficient information for replicability. CONCLUSIONS The review highlights the usefulness of SD models to model the dynamics of population-level depression and inform policy and decision-making. These results can help guide future applications of SD models to depression at the population-level.
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Affiliation(s)
- Eva Graham
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Geneviève Gariépy
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
- Montreal Mental Health University Institute Research Center, Montreal, Canada
| | - Heather Orpana
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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12
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PURTLE JONATHAN, WYNECOOP MEGAN, CRANE MARGARETE, STADNICK NICOLEA. Earmarked Taxes for Mental Health Services in the United States: A Local and State Legal Mapping Study. Milbank Q 2023; 101:457-485. [PMID: 37070393 PMCID: PMC10262390 DOI: 10.1111/1468-0009.12643] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/09/2023] [Accepted: 03/23/2023] [Indexed: 04/19/2023] Open
Abstract
Policy Points Local governments are increasingly adopting policies that earmark taxes for mental health services, and approximately 30% of the US population lives in a jurisdiction with such a policy. Policies earmarking taxes for mental health services are heterogenous in their design, spending requirements, and oversight. In many jurisdictions, the annual per capita revenue generated by these taxes exceeds that of some major federal funding sources for mental health. CONTEXT State and local governments have been adopting taxes that earmark (i.e., dedicate) revenue for mental health. However, this emergent financing model has not been systematically assessed. We sought to identify all jurisdictions in the United States with policies earmarking taxes for mental health services and characterize attributes of these taxes. METHODS A legal mapping study was conducted. Literature reviews and 11 key informant interviews informed search strings. We then searched legal databases (HeinOnline, Cheetah tax repository) and municipal data sources. We collected information on the year the tax went into effect, passage by ballot initiative (yes/no), tax base, tax rate, and revenue generated annually (gross and per capita). FINDINGS We identified 207 policies earmarking taxes for mental health services (95.7% local, 4.3% state, 95.7% passed via ballot initiative). Property taxes (73.9%) and sales taxes/fees (25.1%) were most common. There was substantial heterogeneity in tax design, spending requirements, and oversight. Approximately 30% of the US population lives in a jurisdiction with a tax earmarked for mental health, and these taxes generate over $3.57 billion annually. The median per capita annual revenue generated by these taxes was $18.59 (range = $0.04-$197.09). Per capita annual revenue exceeded $25.00 in 63 jurisdictions (about five times annual per capita spending for mental health provided by the US Substance Abuse and Mental Health Services Administration). CONCLUSIONS Policies earmarking taxes for mental health services are diverse in design and are an increasingly common local financing strategy. The revenue generated by these taxes is substantial in many jurisdictions.
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Affiliation(s)
- JONATHAN PURTLE
- Global Center for Implementation ScienceNew York University School of Global Public Health
| | | | | | - NICOLE A. STADNICK
- ACTRI Dissemination and Implementation Science CenterUniversity of California San Diego
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Castro Ribeiro T, Sobregrau Sangrà P, García Pagès E, Badiella L, López-Barbeito B, Aguiló S, Aguiló J. Assessing effectiveness of heart rate variability biofeedback to mitigate mental health symptoms: a pilot study. Front Physiol 2023; 14:1147260. [PMID: 37234414 PMCID: PMC10206049 DOI: 10.3389/fphys.2023.1147260] [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: 01/18/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
Introduction: The increasing burden on mental health has become a worldwide concern especially due to its substantial negative social and economic impact. The implementation of prevention actions and psychological interventions is crucial to mitigate these consequences, and evidence supporting its effectiveness would facilitate a more assertive response. Heart rate variability biofeedback (HRV-BF) has been proposed as a potential intervention to improve mental wellbeing through mechanisms in autonomic functioning. The aim of this study is to propose and evaluate the validity of an objective procedure to assess the effectiveness of a HRV-BF protocol in mitigating mental health symptoms in a sample of frontline HCWs (healthcare workers) who worked in the COVID-19 pandemic. Methods: A prospective experimental study applying a HRV-BF protocol was conducted with 21 frontline healthcare workers in 5 weekly sessions. For PRE-POST intervention comparisons, two different approaches were used to evaluate mental health status: applying (a) gold-standard psychometric questionnaires and (b) electrophysiological multiparametric models for chronic and acute stress assessment. Results: After HRV-BF intervention, psychometric questionnaires showed a reduction in mental health symptoms and stress perception. The electrophysiological multiparametric also showed a reduction in chronic stress levels, while the acute stress levels were similar in PRE and POST conditions. A significant reduction in respiratory rate and an increase in some heart rate variability parameters, such as SDNN, LFn, and LF/HF ratio, were also observed after intervention. Conclusion: Our findings suggest that a 5-session HRV-BF protocol is an effective intervention for reducing stress and other mental health symptoms among frontline HCWs who worked during the COVID-19 pandemic. The electrophysiological multiparametric models provide relevant information about the current mental health state, being useful for objectively evaluating the effectiveness of stress-reducing interventions. Further research could replicate the proposed procedure to confirm its feasibility for different samples and specific interventions.
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Affiliation(s)
- Thais Castro Ribeiro
- Biomedical Research Network Center in Biogineering, Biomaterial and Nanomedicine (CIBER-BBN), Madrid, Spain
- Department of Microelectronics and Electronic Systems, Autonomous University of Barcelona, Barcelona, Spain
| | - Pau Sobregrau Sangrà
- Clínic Foundation for Biomedical Research, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Esther García Pagès
- Department of Microelectronics and Electronic Systems, Autonomous University of Barcelona, Barcelona, Spain
| | - Llorenç Badiella
- Applied Statistics Service, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Sira Aguiló
- Emergency Department, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Jordi Aguiló
- Biomedical Research Network Center in Biogineering, Biomaterial and Nanomedicine (CIBER-BBN), Madrid, Spain
- Department of Microelectronics and Electronic Systems, Autonomous University of Barcelona, Barcelona, Spain
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Zatzick D, Palinkas L, Chambers DA, Whiteside L, Moloney K, Engstrom A, Prater L, Russo J, Wang J, Abu K, Iles-Shih M, Bulger E. Integrating pragmatic and implementation science randomized clinical trial approaches: a PRagmatic Explanatory Continuum Indicator Summary-2 (PRECIS-2) analysis. Trials 2023; 24:288. [PMID: 37085877 PMCID: PMC10122352 DOI: 10.1186/s13063-023-07313-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/17/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Over the past two decades, pragmatic and implementation science clinical trial research methods have advanced substantially. Pragmatic and implementation studies have natural areas of overlap, particularly relating to the goal of using clinical trial data to leverage health care system policy changes. Few investigations have addressed pragmatic and implementation science randomized trial methods development while also considering policy impact. METHODS The investigation used the PRagmatic Explanatory Continuum Indicator Summary-2 (PRECIS-2) and PRECIS-2-Provider Strategies (PRECIS-2-PS) tools to evaluate the design of two multisite randomized clinical trials that targeted patient-level effectiveness outcomes, provider-level practice changes and health care system policy. Seven raters received PRECIS-2 training and applied the tools in the coding of the two trials. Descriptive statistics were produced for both trials, and PRECIS-2 wheel diagrams were constructed. Interrater agreement was assessed with the Intraclass Correlation (ICC) and Kappa statistics. The Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE) qualitative approach was applied to understanding integrative themes derived from the PRECIS-2 ratings and an end-of-study policy summit. RESULTS The ICCs for the composite ratings across the patient and provider-focused PRECIS-2 domains ranged from 0.77 to 0.87, and the Kappa values ranged from 0.25 to 0.37, reflecting overall fair-to-good interrater agreement for both trials. All four PRECIS-2 wheels were rated more pragmatic than explanatory, with composite mean and median scores ≥ 4. Across trials, the primary intent-to-treat analysis domain was consistently rated most pragmatic (mean = 5.0, SD = 0), while the follow-up/data collection domain was rated most explanatory (mean range = 3.14-3.43, SD range = 0.49-0.69). RAPICE field notes identified themes related to potential PRECIS-2 training improvements, as well as policy themes related to using trial data to inform US trauma care system practice change; the policy themes were not captured by the PRECIS-2 ratings. CONCLUSIONS The investigation documents that the PRECIS-2 and PRECIS-2-PS can be simultaneously used to feasibly and reliably characterize clinical trials with patient and provider-level targets. The integration of pragmatic and implementation science clinical trial research methods can be furthered by using common metrics such as the PRECIS-2 and PRECIS-2-PS. Future study could focus on clinical trial policy research methods development. TRIAL REGISTRATION DO-SBIS ClinicalTrials.gov NCT00607620. registered on January 29, 2008. TSOS ClinicalTrials.gov NCT02655354, registered on July 27, 2015.
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Affiliation(s)
- Douglas Zatzick
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA.
| | - Lawrence Palinkas
- Department of Children, Youth, and Families, California School of Social Work, University of Southern, Los Angeles, CA, USA
| | - David A Chambers
- Implementation Science, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Lauren Whiteside
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, USA
| | - Kathleen Moloney
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA
| | - Allison Engstrom
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA
| | - Laura Prater
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA
| | - Joan Russo
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA
| | - Jin Wang
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA
| | - Khadija Abu
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA
| | - Matt Iles-Shih
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA
| | - Eileen Bulger
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, USA
- Department of Surgery, University of Washington School of Medicine, Seattle, USA
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McGINTY BETH. The Future of Public Mental Health: Challenges and Opportunities. Milbank Q 2023; 101:532-551. [PMID: 37096616 PMCID: PMC10126977 DOI: 10.1111/1468-0009.12622] [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: 04/26/2022] [Revised: 09/30/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points Social policies such as policies advancing universal childcare to expand Medicaid coverage of home- and community-based care for seniors and people with disabilities and for universal preschool are the types of policies needed to address social determinants of poor mental health. Population-based global budgeting approaches like accountable care and total cost of care models have the potential to improve population mental health by incentivizing health systems to control costs while simultaneously improving outcomes for the populations they serve. Policies expanding reimbursement for services delivered by peer support specialists are needed. People with lived experience of mental illness are uniquely well suited to helping their peers navigate treatment and other support services.
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Aggarwal R, Balon R, Morreale MK, Guerrero APS, Beresin EV, Louie AK, Coverdale J, Brenner AM. Is It Time to Rethink Psychiatry Residency Training? Part I: Overview. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:117-119. [PMID: 36689094 PMCID: PMC9869309 DOI: 10.1007/s40596-023-01741-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
| | | | | | | | | | | | | | - Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Lyne J, Connellan L, Ceannt R, O'Connor K, Shelley E. Public mental health: a psychiatry and public health perspective. Ir J Psychol Med 2023; 40:84-88. [PMID: 34839854 DOI: 10.1017/ipm.2021.77] [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: 11/06/2022]
Abstract
Mental health issues are fast becoming one of society's greatest health challenges with evidence of higher levels of illness and strain on psychiatric services. The reasons for this trend of increasing mental health problems across the population are complex and there is an urgent need to research and deliver effective public mental health strategies. In this perspective piece we argue that psychiatrists and public health physicians have unique knowledge and perspectives on population mental health. The development of interdisciplinary initiatives and training posts would result in clinicians with expertise to drive forward public mental health strategies. Focused and sustained advocacy and collaboration are necessary for prioritisation of public mental health on policymakers' agendas.
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Affiliation(s)
- J Lyne
- Royal College of Surgeons in Ireland, Dublin, Ireland
- Health Service Executive, Newcastle Hospital, Greystones, Wicklow, Ireland
| | - L Connellan
- Health Service Executive, Newcastle Hospital, Greystones, Wicklow, Ireland
| | - R Ceannt
- Department of Public Health East, Health Service Executive, Dr. Steeven's Hospital, Dublin, Ireland
| | - K O'Connor
- RISE, Early Intervention in Psychosis Service & Home Based Treatment Team, South Lee Mental Health Services, Cork, Ireland
| | - E Shelley
- Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Public Health East, Health Service Executive, Dr. Steeven's Hospital, Dublin, Ireland
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Jenkins E, Daly Z, McAuliffe C, McGuinness L, Richardson C, Hill TG, Goodyear T, Lind C, Barbic S, Rivers R, Haines-Saah R. Advancing socioecological mental health promotion intervention: A mixed methods exploration of Phase 1 Agenda Gap findings. Front Public Health 2023; 11:1066440. [PMID: 36875387 PMCID: PMC9978376 DOI: 10.3389/fpubh.2023.1066440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction Protecting and promoting the mental health of youth under 30 years of age is a priority, globally. Yet investment in mental health promotion, which seeks to strengthen the determinants of positive mental health and wellbeing, remains limited relative to prevention, treatment, and recovery. The aim of this paper is to contribute empirical evidence to guide innovation in youth mental health promotion, detailing the early outcomes of Agenda Gap, an intervention centering youth-led policy advocacy to influence positive mental health for individuals, families, communities and society. Methods Leveraging a convergent mixed methods design, this study draws on data from n = 18 youth (ages 15 to 17) in British Columbia, Canada, who contributed to pre- and post-intervention surveys and post-intervention qualitative interviews following their participation in Agenda Gap from 2020-2021. These data are supplemented by qualitative interviews with n = 4 policy and other adult allies. Quantitative and qualitative data were analyzed in parallel, using descriptive statistics and reflexive thematic analysis, and then merged for interpretation. Results Quantitative findings suggest Agenda Gap contributes to improvements in mental health promotion literacy as well as several core positive mental health constructs, such as peer and adult attachment and critical consciousness. However, these findings also point to the need for further scale development, as many of the available measures lack sensitivity to change and are unable to distinguish between higher and lower levels of the underlying construct. Qualitative findings provided nuanced insights into the shifts that resulted from Agenda Gap at the individual, family, and community level, including reconceptualization of mental health, expanded social awareness and agency, and increased capacity for influencing systems change to promote positive mental health and wellbeing. Discussion Together, these findings illustrate the promise and utility of mental health promotion for generating positive mental health impacts across socioecological domains. Using Agenda Gap as an exemplar, this study underscores that mental health promotion programming can contribute to gains in positive mental health for individual intervention participants whilst also enhancing collective capacity to advance mental health and equity, particularly through policy advocacy and responsive action on the social and structural determinants of mental health.
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Affiliation(s)
- Emily Jenkins
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Zachary Daly
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Corey McAuliffe
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Liza McGuinness
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Chris Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Taylor G. Hill
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Trevor Goodyear
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Candace Lind
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Skye Barbic
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Foundry, Vancouver, BC, Canada
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Pilar M, Purtle J, Powell BJ, Mazzucca S, Eyler AA, Brownson RC. An Examination of Factors Affecting State Legislators' Support for Parity Laws for Different Mental Illnesses. Community Ment Health J 2023; 59:122-131. [PMID: 35689717 PMCID: PMC9188272 DOI: 10.1007/s10597-022-00991-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/24/2022] [Indexed: 01/09/2023]
Abstract
Mental health parity legislation can improve mental health outcomes. U.S. state legislators determine whether state parity laws are adopted, making it critical to assess factors affecting policy support. This study examines the prevalence and demographic correlates of legislators' support for state parity laws for four mental illnesses- major depression disorder, post-traumatic stress disorder (PTSD), schizophrenia, and anorexia/bulimia. Using a 2017 cross-sectional survey of 475 U.S. legislators, we conducted bivariate analyses and multivariate logistic regression. Support for parity was highest for schizophrenia (57%), PTSD (55%), and major depression (53%) and lowest for anorexia/bulimia (40%). Support for parity was generally higher among females, more liberal legislators, legislators in the Northeast region of the country, and those who had previously sought treatment for mental illness. These findings highlight the importance of better disseminating evidence about anorexia/bulimia and can inform dissemination efforts about mental health parity laws to state legislators.
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Affiliation(s)
- Meagan Pilar
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA.
- Department of Infectious Diseases, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, 63110, USA.
| | - Jonathan Purtle
- Department of Public Health Policy & Management, Global Center for Implementation Science, New York University School of Global Public Health, New York University, 708 Broadway, New York, NY, 10003, USA
| | - Byron J Powell
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
- Division of Infectious Diseases, John T. Milliken Department of Medicine, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Stephanie Mazzucca
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Amy A Eyler
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, 63130, USA
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Adjorlolo S. Seeking and receiving help for mental health services among pregnant women in Ghana. PLoS One 2023; 18:e0280496. [PMID: 36867597 PMCID: PMC9983869 DOI: 10.1371/journal.pone.0280496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 01/02/2023] [Indexed: 03/04/2023] Open
Abstract
OBJECTIVE The heightened vulnerability of women to mental health issues during the period of pregnancy implies that seeking and receiving support for mental health services is a crucial factor in improving the emotional and mental well-being of pregnant women. The current study investigates the prevalence and correlates of seeking and receiving help for mental health services initiated by pregnant women and health professionals during pregnancy. DESIGN Using a cross-sectional design and self-report questionnaires, data were collected from 702 pregnant women in the first, second and third trimesters from four health facilities in the Greater Accra region of Ghana. Data were analyzed using descriptive and inferential statistics. RESULTS It was observed that 18.9% of pregnant women self-initiated help-seeking for mental health services whereas 64.8% reported that health professionals asked about their mental well-being, of which 67.7% were offered mental health support by health professionals. Diagnosis of medical conditions in pregnancy (i.e., hypertension and diabetes), partner abuse, low social support, sleep difficulty and suicidal ideation significantly predicted the initiation of help-seeking for mental health services by pregnant women. Fear of vaginal delivery and COVID-19 concerns predicted the provision of mental health support to pregnant women by health professionals. CONCLUSION The low prevalence of individual-initiated help-seeking implies that health professionals have a high responsibility of supporting pregnant women achieve their mental health needs.
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Affiliation(s)
- Samuel Adjorlolo
- Department of Mental Health Nursing, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Legon Accra, Ghana
- * E-mail:
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Last BS, Johnson C, Dallard N, Fernandez-Marcote S, Zinny A, Jackson K, Cliggitt L, Rudd BN, Mills C, Beidas RS. Implementing trauma-focused cognitive behavioral therapy in Philadelphia: A 10-year evaluation. IMPLEMENTATION RESEARCH AND PRACTICE 2023; 4:26334895231199467. [PMID: 37790185 PMCID: PMC10496473 DOI: 10.1177/26334895231199467] [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] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Background: In 2012, Philadelphia's Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) developed an initiative to implement an evidence-based treatment for posttraumatic stress disorder (PTSD), trauma-focused cognitive behavioral therapy (TF-CBT), across the city's behavioral health system. This report evaluates the initiative's 10-year implementation and effectiveness outcomes. Method: The Exploration, Preparation, Implementation, and Sustainment framework guided our implementation evaluation. The implementation outcomes include adoption, reach, and sustainment; these were obtained during regular evaluation data collection from publicly funded behavioral health agencies participating in the TF-CBT initiative. We analyze effectiveness outcomes (i.e., changes in PTSD symptoms) from a subset of patients receiving TF-CBT, which were collected in 6-month intervals by our research team between 2013 and 2021. Results: From 2012 to 2021, DBHIDS trained 478 clinicians in TF-CBT across 20 behavioral health agencies. During this time, 23,401 youths were screened for potentially traumatic events and PTSD symptoms, and 7,550 youths received TF-CBT. Through the TF-CBT initiative, the city expanded the network of TF-CBT providers from 3 to 20 agencies. DBHIDS sustained this network by maintaining the participation of 16 behavioral health agencies over the course of a decade. The subset of 202 youths who were evaluated to assess TF-CBT effectiveness was drawn from 94 therapists and 20 agencies across Philadelphia. All participating youths completed a baseline assessment, and 151 (75%) completed at least one follow-up assessment. Linear mixed-effects models accounting for observations nested within participants and nested within clinicians found that treatment significantly reduced PTSD symptoms. Conclusion: Between 2012 and 2021, DBHIDS successfully implemented and sustained TF-CBT across the city's behavioral health system. Adoption, reach, and sustainment of TF-CBT were high. Despite the considerable adverse experiences faced by youths seeking treatment in Philadelphia's behavioral health system, TF-CBT was effective. Future directions to improve TF-CBT implementation in the next iteration of the initiative are described.
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Affiliation(s)
- Briana S. Last
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Christina Johnson
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Natalie Dallard
- Community Behavioral Health, Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA
| | - Sara Fernandez-Marcote
- Community Behavioral Health, Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA
| | - Arturo Zinny
- Community Behavioral Health, Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA
- Center for Nonviolence and Social Justice, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Kamilah Jackson
- Community Behavioral Health, Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA
- Talawa International Consultants, Philadelphia, PA, USA
| | - Lauren Cliggitt
- Hall-Mercer Community Mental Health Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brittany N. Rudd
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Chynna Mills
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Rinad S. Beidas
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Purtle J, Nelson KL, Lê-Scherban F, Gollust SE. Unintended consequences of disseminating behavioral health evidence to policymakers: Results from a survey-based experiment. IMPLEMENTATION RESEARCH AND PRACTICE 2023; 4:26334895231172807. [PMID: 37790180 PMCID: PMC10170598 DOI: 10.1177/26334895231172807] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Background Communication research demonstrates that messages often have unintended consequences, but this work has received limited attention in implementation science. This dissemination experiment sought to determine whether state-tailored policy briefs about the behavioral health consequences of adverse childhood experiences (ACEs), compared to national policy briefs on the topic, increased state legislators'/staffers' perceptions of the policy brief relevance and parental blame for the consequences of ACEs, and whether effects differed between Democrats and Republicans. Method A preregistered, web-based survey experiment with U.S. state legislators/staffers was conducted in 2021 (n = 133). Respondents were randomized to view a policy brief about the behavioral health consequences of ACEs that included state-tailored data (intervention condition) or national data (control condition) and then answered survey questions. Dependent variables were perceived policy brief relevance and parental blame for the consequences of ACEs. Results The mean policy brief relevance score was 4.1% higher in the intervention than in the control condition (p = .24), but the mean parental blame score was 16.5% higher (p = .02). When outcomes were dichotomized, 61.2% of respondents in the intervention condition rated parents as "very much to blame" for the consequences of ACEs compared to 37.1% in the control condition (p = .01). When the sample was stratified by political affiliation, the effect of the state-tailored policy brief on parental blame was larger in magnitude among Democrats and not significant among Republicans. The intervention policy brief increased the mean parental blame score by 22.8% among Democrats relative to the control policy brief (p = .007) and doubled the proportion rating parents as "very much to blame" (52.2% vs. 26.1%, p = .03). Conclusions Despite limited statistical power, state-tailored policy briefs significantly increased state legislators'/staffers' perceptions of parental blame for the behavioral health consequences of ACEs, relative to a policy brief with national data. Unintended messaging effects warrant greater attention in dissemination research and practice.
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Affiliation(s)
- Jonathan Purtle
- Department of Public Health Policy & Management, New York University School of Global Public Health, Global Center for Implementation Science, New York, NY, USA
| | | | - Félice Lê-Scherban
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Sarah E. Gollust
- Division of Health Policy & Management, University of Minnesota School of Public Health, Minneapolis, MN, USA
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Cresswell-Smith J, Kauppinen T, Laaksoharju T, Rotko T, Solin P, Suvisaari J, Wahlbeck K, Tamminen N. Mental Health and Mental Wellbeing Impact Assessment Frameworks-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13985. [PMID: 36360865 PMCID: PMC9653904 DOI: 10.3390/ijerph192113985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/14/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
Mental health is largely shaped by the daily environments in which people live their lives, with positive components of mental health emphasising the importance of feeling good and functioning effectively. Promoting mental health relies on broad-based actions over multiple sectors, which can be difficult to measure. Different types of Impact Assessment (IA) frameworks allow for a structured approach to evaluating policy actions on different levels. A systematic review was performed exploring existing IA frameworks relating to mental health and mental wellbeing and how they have been used. A total of 145 records were identified from the databases, from which 9 articles were included in the review, with a further 6 studies included via reference list and citation chaining. Five different mental-health-related IA frameworks were found to be implemented in a variety of settings, mostly in relation to evaluating community actions. A Narrative Synthesis summarised key themes from the 15 included articles. Findings highlight the need for participatory approaches in IA, which have the dual purpose of informing the IA evaluation and advocating for the need to include mental health in policy development. However, it is important to ensure that IA frameworks are user-friendly, designed to be used by laypeople in a variety of sectors and that IA frameworks are operational in terms of time and monetary resources.
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Affiliation(s)
| | - Tapani Kauppinen
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | | | - Tuulia Rotko
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Pia Solin
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Jaana Suvisaari
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | | | - Nina Tamminen
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
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Hoffmann JA, Alegría M, Alvarez K, Anosike A, Shah PP, Simon KM, Lee LK. Disparities in Pediatric Mental and Behavioral Health Conditions. Pediatrics 2022; 150:e2022058227. [PMID: 36106466 PMCID: PMC9800023 DOI: 10.1542/peds.2022-058227] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 12/31/2022] Open
Abstract
Mental and behavioral health conditions are common among children and adolescents in the United States. The purpose of this state-of the-art review article is to describe inequities in mental and behavioral health care access and outcomes for children and adolescents, characterize mechanisms behind the inequities, and discuss strategies to decrease them. Understanding the mechanisms underlying these inequities is essential to inform strategies to mitigate these health disparities. Half of United States children with a treatable mental health disorder do not receive treatment from a mental health professional. Children and adolescents in racial, ethnic, sexual, sex, and other minority groups experience inequities in access to care and disparities in outcomes for mental and behavioral health conditions. Suicide rates are nearly twice as high in Black compared to White boys 5 to 11 years old and have been increasing disproportionately among adolescent Black girls 12 to 17 years old. Children identifying as a sexual minority have >3 times increased odds of attempting suicide compared to heterosexual peers. Adverse experiences of children living as part of a minority group, including racism and discrimination, have immediate and lasting effects on mental health. Poverty and an uneven geographic distribution of resources also contribute to inequities in access and disparities in outcomes for mental and behavioral health conditions. Strategies to address inequities in mental and behavioral health among United States children include investing in a diverse workforce of mental health professionals, improving access to school-based services, ensuring equitable access to telehealth, and conducting quality improvement with rigorous attention to equity.
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Affiliation(s)
- Jennifer A. Hoffmann
- . Division of Emergency Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine; Chicago, IL
| | - Margarita Alegría
- . Disparities Research Unit, Massachusetts General Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Kiara Alvarez
- . Disparities Research Unit, Massachusetts General Hospital, Department of Medicine, Harvard Medical School, Boston, MA
| | - Amara Anosike
- . Office of Government Relations, Boston Children’s Hospital, Boston, MA
| | | | - Kevin M. Simon
- . Adolescent Substance use and Addiction Program, Boston Children’s Hospital, Boston, Massachusetts; Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts; Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Lois K. Lee
- . Division of Emergency Medicine, Boston Children’s Hospital, Boston, MA
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Hughes MC, Spana E, Cada D. Developing a Needs Assessment Process to Address Gaps in a Local System of Care. Community Ment Health J 2022; 58:1329-1337. [PMID: 35072911 PMCID: PMC8785380 DOI: 10.1007/s10597-022-00940-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 01/08/2022] [Indexed: 12/03/2022]
Abstract
Early diagnosis and access to behavioral health services can improve the health outcomes for young children suffering from mental illness. Often, children and their families' behavioral health needs are not met due to a broken local system of care. Developing a deep understanding of the situation by exploring all stakeholders' needs across a community in conjunction with a comprehensive review of the existing scientific literature prepared one rural midwestern county to build a better local system of care. This study's unique aspects include visual mapping using art in focus groups and close collaboration between a public mental health board, academic faculty, student researchers, local behavioral health organizations, and schools. Major themes found about the existing barriers were dysfunctional patterns in families, lack of resources, reliance on the school system, and lack of access to healthcare professionals. Other communities can use this approach as a model for a local needs assessment.
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Affiliation(s)
- M Courtney Hughes
- School of Health Studies, Northern Illinois University, Wirtz Hall 209, DeKalb, IL, 60115, USA.
| | - Ethan Spana
- School of Health Studies, Northern Illinois University, Wirtz Hall 209, DeKalb, IL, 60115, USA
| | - Deanna Cada
- DeKalb County Community Mental Health Board, 2500 N Annie Glidden Rd, DeKalb, IL, 60115, USA
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26
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Cresswell‐Smith J, Mäkikärki N, Appelqvist‐Schmidlechner K, Wahlbeck K. Finding the right words: Articulating the value of mental health promotion. A focus group study. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:2857-2874. [PMID: 35050498 PMCID: PMC9541557 DOI: 10.1002/jcop.22801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 11/24/2021] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
The Lapinlahti Hospital initiative in Helsinki has transformed a disused psychiatric hospital into an open site for mental health promotion. The current study uses qualitative methods to explore how the initiative may promote population mental health. The phenomenological study comprised of data from 7 focus group including 28 participants. Resulting data were thematically analysed to articulate how the initiative supports mental wellbeing in different ways. Mental health benefits were categorized into three themes; mental health value, civil values and common values which were comprised of nine subthemes; paradigm shift, social inclusion, personal meaning, regeneration, ambience, stigma, sustainability, democracy and environment. Mental health promotion emphasises the impact of daily environments in which people live their lives. Results from this study support the use of broad based actions which promote different components of mental wellbeing simultaneously. Psychiatric hospitals may offer historically meaningful sites for such actions.
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Affiliation(s)
- Johanna Cresswell‐Smith
- Equality Unit, Mental Health TeamFinnish Institute for Health and Welfare (THL)HelsinkiFinland
| | | | | | - Kristian Wahlbeck
- Mieli, Mental Health FinlandFinnish Institute for Health and Welfare (THL)HelsinkiFinland
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27
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Jenkins EK, Slemon A, Richardson C, Pumarino J, McAuliffe C, Thomson KC, Goodyear T, Daly Z, McGuinness L, Gadermann A. Mental Health Inequities Amid the COVID-19 Pandemic: Findings From Three Rounds of a Cross-Sectional Monitoring Survey of Canadian Adults. Int J Public Health 2022; 67:1604685. [PMID: 35936999 PMCID: PMC9349347 DOI: 10.3389/ijph.2022.1604685] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 06/10/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives: Adverse mental health impacts of the COVID-19 pandemic are well documented; however, there remains limited data detailing trends in mental health at different points in time and across population sub-groups most impacted. This paper draws on data from three rounds of a nationally representative cross-sectional monitoring survey to characterize the mental health impacts of COVID-19 on adults living in Canada (N = 9,061). Methods: Descriptive statistics were used to examine the mental health impacts of the pandemic using a range of self-reported measures. Multivariate logistic regression models were then used to quantify the independent risks of experiencing adverse mental health outcomes for priority population sub-groups, adjusting for age, gender, and survey round. Results: Data illustrate significant disparities in the mental health consequences of the pandemic, with inequitable impacts for sub-groups who experience structural vulnerability related to pre-existing mental health conditions, disability, LGBTQ2+ identity, and Indigenous identity. Conclusion: There is immediate need for population-based approaches to support mental health in Canada and globally. Approaches should attend to the root causes of mental health inequities through promotion and prevention, in addition to treatment.
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Affiliation(s)
- Emily K. Jenkins
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
- *Correspondence: Emily K. Jenkins,
| | - Allie Slemon
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Chris Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Javiera Pumarino
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Corey McAuliffe
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Kimberly C. Thomson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Trevor Goodyear
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Zachary Daly
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Liza McGuinness
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Anne Gadermann
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Kim J. Exploring a counselling frame based on buddhist ontological soteriology, rooted in the four noble truths. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2022. [DOI: 10.1080/21507686.2022.2104888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Jeongil Kim
- Autism & Developmental Disabilities, Director, Lotus Flowers Children Center, Nam-gu, Korea (ROK)
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29
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Innovations in Psychotherapy. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:318-319. [PMID: 37205023 PMCID: PMC10172525 DOI: 10.1176/appi.focus.22020008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Bridger E, Nettle D. Public perceptions of the effectiveness of income provision on reducing psychological distress. JOURNAL OF PUBLIC MENTAL HEALTH 2022. [DOI: 10.1108/jpmh-04-2022-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to understand public perceptions of the role of income for improving mental health, since public perceptions shape political decision-making. Socioeconomic determinants such as poverty cause a great deal of mental ill-health, yet it is not clear whether the general public believes this to be true. Lay understandings of health often overemphasize the roles of individual habits and medical treatments and underappreciate the importance of socioeconomic determinants.
Design/methodology/approach
UK adults (n = 622) rated effectiveness of three interventions for reducing psychological distress: medication, psychotherapy, and providing sufficient income to cover necessities via a basic income. We manipulated whether participants rated effectiveness for an identified individual vs. the population in general. Participants also indicated their support for the introduction of the basic income scheme.
Findings
Increasing income was rated highly effective for reducing psychological distress. Effectiveness ratings for income provision were as high as those for psychotherapy, and higher than those for medication. There was also an interaction with framing: in the population framing, income provision was rated more effective than either of the other two interventions. There were high levels of support for introducing a universal basic income scheme in this population.
Originality/value
UK adults anticipate that income provision would be highly effective at reducing psychological distress, as or more effective than increasing access to psychotherapy or medication. Policymakers can assume that the public will be receptive to arguments for mental health interventions that tackle broader socioeconomic determinants, especially when these are framed in population terms.
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31
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Newson JJ, Pastukh V, Thiagarajan TC. Assessment of Population Well-being With the Mental Health Quotient: Validation Study. JMIR Ment Health 2022; 9:e34105. [PMID: 35442210 PMCID: PMC9069309 DOI: 10.2196/34105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Mental Health Quotient (MHQ) is an anonymous web-based assessment of mental health and well-being that comprehensively covers symptoms across 10 major psychiatric disorders, as well as positive elements of mental function. It uses a novel life impact scale and provides a score to the individual that places them on a spectrum from Distressed to Thriving along with a personal report that offers self-care recommendations. Since April 2020, the MHQ has been freely deployed as part of the Mental Health Million Project. OBJECTIVE This paper demonstrates the reliability and validity of the MHQ, including the construct validity of the life impact scale, sample and test-retest reliability of the assessment, and criterion validation of the MHQ with respect to clinical burden and productivity loss. METHODS Data were taken from the Mental Health Million open-access database (N=179,238) and included responses from English-speaking adults (aged≥18 years) from the United States, Canada, the United Kingdom, Ireland, Australia, New Zealand, South Africa, Singapore, India, and Nigeria collected during 2021. To assess sample reliability, random demographically matched samples (each 11,033/179,238, 6.16%) were compared within the same 6-month period. Test-retest reliability was determined using the subset of individuals who had taken the assessment twice ≥3 days apart (1907/179,238, 1.06%). To assess the construct validity of the life impact scale, additional questions were asked about the frequency and severity of an example symptom (feelings of sadness, distress, or hopelessness; 4247/179,238, 2.37%). To assess criterion validity, elements rated as having a highly negative life impact by a respondent (equivalent to experiencing the symptom ≥5 days a week) were mapped to clinical diagnostic criteria to calculate the clinical burden (174,618/179,238, 97.42%). In addition, MHQ scores were compared with the number of workdays missed or with reduced productivity in the past month (7625/179,238, 4.25%). RESULTS Distinct samples collected during the same period had indistinguishable MHQ distributions and MHQ scores were correlated with r=0.84 between retakes within an 8- to 120-day period. Life impact ratings were correlated with frequency and severity of symptoms, with a clear linear relationship (R2>0.99). Furthermore, the aggregate MHQ scores were systematically related to both clinical burden and productivity. At one end of the scale, 89.08% (8986/10,087) of those in the Distressed category mapped to one or more disorders and had an average productivity loss of 15.2 (SD 11.2; SEM [standard error of measurement] 0.5) days per month. In contrast, at the other end of the scale, 0% (1/24,365) of those in the Thriving category mapped to any of the 10 disorders and had an average productivity loss of 1.3 (SD 3.6; SEM 0.1) days per month. CONCLUSIONS The MHQ is a valid and reliable assessment of mental health and well-being when delivered anonymously on the web.
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Purtle J, Nelson KL, Henson RM, Horwitz SM, McKay MM, Hoagwood KE. Policy Makers' Priorities for Addressing Youth Substance Use and Factors That Influence Priorities. Psychiatr Serv 2022; 73:388-395. [PMID: 34384231 PMCID: PMC9704547 DOI: 10.1176/appi.ps.202000919] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Understanding public policy makers' priorities for addressing youth substance use and the factors that influence these priorities can inform the dissemination and implementation of strategies that promote evidence-based decision making. This study characterized the priorities of policy makers in substance use agencies of U.S. states and counties for addressing youth substance use, the factors that influenced these priorities, and the differences in priorities and influences between state and county policy makers. METHODS In 2020, a total of 122 substance use agency policy makers from 35 states completed a Web-based survey (response rate=22%). Respondents rated the priority of 14 issues related to youth substance use and the extent to which nine factors influenced these priorities. Data were analyzed as dichotomous and continuous variables and for state and county policy makers together and separately. RESULTS The highest priorities for youth substance use were social determinants of substance use (87%), adverse childhood experiences and childhood trauma (85%), and increasing access to school-based substance use programs (82%). The lowest priorities were increasing access to naloxone for youths (49%), increasing access to medications for opioid use disorder among youths (49%), and deimplementing non-evidence-based youth substance use programs (41%). The factors that most influenced priorities were budget issues (80%) and state legislature (69%), federal (67%), and governor priorities (65%). Issues related to program implementation and deimplementation were significantly higher priorities for state than for county policy makers. CONCLUSIONS These findings can inform the tailoring of dissemination and implementation strategies to account for the inner- and outer-setting contexts of substance use agencies.
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Affiliation(s)
- Jonathan Purtle
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia (Purtle, Nelson, Henson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Brown School at Washington University in St. Louis, St. Louis (McKay)
| | - Katherine L Nelson
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia (Purtle, Nelson, Henson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Brown School at Washington University in St. Louis, St. Louis (McKay)
| | - Rosie Mae Henson
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia (Purtle, Nelson, Henson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Brown School at Washington University in St. Louis, St. Louis (McKay)
| | - Sarah McCue Horwitz
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia (Purtle, Nelson, Henson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Brown School at Washington University in St. Louis, St. Louis (McKay)
| | - Mary M McKay
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia (Purtle, Nelson, Henson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Brown School at Washington University in St. Louis, St. Louis (McKay)
| | - Kimberly E Hoagwood
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia (Purtle, Nelson, Henson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Brown School at Washington University in St. Louis, St. Louis (McKay)
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33
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Appiah R. A look back, a path forward: Revisiting the mental health and well-being research and practice models and priorities in sub-Saharan Africa. NEW IDEAS IN PSYCHOLOGY 2022. [DOI: 10.1016/j.newideapsych.2022.100931] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Purtle J, Nelson KL, Horwitz SM, Palinkas LA, McKay MM, Hoagwood KE. Impacts of COVID-19 on Mental Health Safety Net Services for Youths: A National Survey of Agency Officials. Psychiatr Serv 2022; 73:381-387. [PMID: 34320821 PMCID: PMC8799776 DOI: 10.1176/appi.ps.202100176] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Mental health agencies provide critical safety net services for youths. No research has assessed impacts of the COVID-19 pandemic on services these agencies provide or youths they serve. This study sought to characterize agency officials' perceptions of the pandemic's impacts on youths and challenges to providing youth services during the pandemic and to examine associations between these challenges and impacts. METHODS Surveys were completed in September-October 2020 by 159 state or county mental health agency officials from 46 states. Respondents used 7-point scales (higher rating indicated more severe impact or challenge) to rate the pandemic's impact on youth mental health issues, general service challenges, and telepsychiatry service challenges across patient, provider, and financing domains. Multiple linear regression models estimated associations between service challenges (independent variables) and pandemic impacts (dependent variables). RESULTS Most agency officials perceived the pandemic as having disproportionately negative mental health impacts on socially disadvantaged youths (serious impact, 72%; mean rating=5.85). Only 15% (mean=4.29) perceived the pandemic as having a seriously negative impact on receipt of needed youth services. Serious service challenges were related to youths' lack of reliable equipment or Internet access for telepsychiatry services (serious challenge, 59%; mean=5.47) and the inability to provide some services remotely (serious challenge, 42%, mean=4.72). In regression models, the inability to provide some services remotely was significantly (p≤0.01) associated with three of five pandemic impacts. CONCLUSIONS Officials perceived the COVID-19 pandemic as exacerbating youth mental health disparities but as not having a dramatic impact on receipt of needed services.
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Affiliation(s)
- Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Palinkas); Brown School, Washington University in St. Louis, St. Louis (McKay)
| | - Katherine L Nelson
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Palinkas); Brown School, Washington University in St. Louis, St. Louis (McKay)
| | - Sarah McCue Horwitz
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Palinkas); Brown School, Washington University in St. Louis, St. Louis (McKay)
| | - Lawrence A Palinkas
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Palinkas); Brown School, Washington University in St. Louis, St. Louis (McKay)
| | - Mary M McKay
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Palinkas); Brown School, Washington University in St. Louis, St. Louis (McKay)
| | - Kimberly E Hoagwood
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Palinkas); Brown School, Washington University in St. Louis, St. Louis (McKay)
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May D, Fullilove R. Depression, HIV, and COVID-19: A Deadly Trifecta. Public Health Rep 2022; 137:420-424. [PMID: 35137644 PMCID: PMC9109531 DOI: 10.1177/00333549221074389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- David May
- Department of Counseling and
Clinical Psychology, Teachers College, Columbia University, New York, NY,
USA,David May, MA, Columbia University,
Teachers College, Department of Counseling and Clinical Psychology,
525 West 120th St, New York, NY 10027, USA.
| | - Robert Fullilove
- Department of Sociomedical
Sciences, Columbia University Mailman School of Public Health, New York, NY,
USA
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Pilar M, Jost E, Walsh-Bailey C, Powell BJ, Mazzucca S, Eyler A, Purtle J, Allen P, Brownson RC. Quantitative measures used in empirical evaluations of mental health policy implementation: A systematic review. IMPLEMENTATION RESEARCH AND PRACTICE 2022; 3:26334895221141116. [PMID: 37091091 PMCID: PMC9924289 DOI: 10.1177/26334895221141116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Mental health is a critical component of wellness. Public policies present an opportunity for large-scale mental health impact, but policy implementation is complex and can vary significantly across contexts, making it crucial to evaluate implementation. The objective of this study was to (1) identify quantitative measurement tools used to evaluate the implementation of public mental health policies; (2) describe implementation determinants and outcomes assessed in the measures; and (3) assess the pragmatic and psychometric quality of identified measures. Method Guided by the Consolidated Framework for Implementation Research, Policy Implementation Determinants Framework, and Implementation Outcomes Framework, we conducted a systematic review of peer-reviewed journal articles published in 1995-2020. Data extracted included study characteristics, measure development and testing, implementation determinants and outcomes, and measure quality using the Psychometric and Pragmatic Evidence Rating Scale. Results We identified 34 tools from 25 articles, which were designed for mental health policies or used to evaluate constructs that impact implementation. Many measures lacked information regarding measurement development and testing. The most assessed implementation determinants were readiness for implementation, which encompassed training (n = 20, 57%) and other resources (n = 12, 34%), actor relationships/networks (n = 15, 43%), and organizational culture and climate (n = 11, 31%). Fidelity was the most prevalent implementation outcome (n = 9, 26%), followed by penetration (n = 8, 23%) and acceptability (n = 7, 20%). Apart from internal consistency and sample norms, psychometric properties were frequently unreported. Most measures were accessible and brief, though minimal information was provided regarding interpreting scores, handling missing data, or training needed to administer tools. Conclusions This work contributes to the nascent field of policy-focused implementation science by providing an overview of existing measurement tools used to evaluate mental health policy implementation and recommendations for measure development and refinement. To advance this field, more valid, reliable, and pragmatic measures are needed to evaluate policy implementation and close the policy-to-practice gap. Plain Language Summary Mental health is a critical component of wellness, and public policies present an opportunity to improve mental health on a large scale. Policy implementation is complex because it involves action by multiple entities at several levels of society. Policy implementation is also challenging because it can be impacted by many factors, such as political will, stakeholder relationships, and resources available for implementation. Because of these factors, implementation can vary between locations, such as states or countries. It is crucial to evaluate policy implementation, thus we conducted a systematic review to identify and evaluate the quality of measurement tools used in mental health policy implementation studies. Our search and screening procedures resulted in 34 measurement tools. We rated their quality to determine if these tools were practical to use and would yield consistent (i.e., reliable) and accurate (i.e., valid) data. These tools most frequently assessed whether implementing organizations complied with policy mandates and whether organizations had the training and other resources required to implement a policy. Though many were relatively brief and available at little-to-no cost, these findings highlight that more reliable, valid, and practical measurement tools are needed to assess and inform mental health policy implementation. Findings from this review can guide future efforts to select or develop policy implementation measures.
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Affiliation(s)
- Meagan Pilar
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
- Department of Infectious Diseases, Washington University School of Medicine,
Washington University in St. Louis, St. Louis, MO, USA
| | - Eliot Jost
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Callie Walsh-Bailey
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Byron J. Powell
- Center for Mental Health Services Research, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
- Division of Infectious Diseases, John T. Milliken Department of
Medicine, Washington University School of Medicine, Washington University in St.
Louis, St. Louis, MO, USA
| | - Stephanie Mazzucca
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Amy Eyler
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Jonathan Purtle
- Department of Public Health Policy & Management, New York
University School of Global Public Health, Global Center for Implementation Science, New York University, New York, NY, USA
| | - Peg Allen
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Ross C. Brownson
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
- Department of Surgery (Division of Public Health Sciences) and Alvin
J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St.
Louis, St. Louis, MO, USA
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Przybylko G, Morton D, Morton J, Renfrew M. The Influence of Gender and Age on the Outcomes of and Adherence to a Digital Interdisciplinary Mental Health Promotion Intervention in an Australasian Nonclinical Setting: Cohort Study. JMIR Ment Health 2021; 8:e29866. [PMID: 34762058 PMCID: PMC8663468 DOI: 10.2196/29866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 06/21/2021] [Accepted: 10/03/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The global prevalence of mental health disorders is at a crisis point, particularly in the wake of COVID-19, prompting calls for the development of digital interdisciplinary mental health promotion interventions (MHPIs) for nonclinical cohorts. However, the influence of gender and age on the outcomes of and adherence to MHPIs is not well understood. OBJECTIVE The aim of this study was to determine the influence of gender and age on the outcomes of and adherence to a 10-week digital interdisciplinary MHPI that integrates strategies from positive psychology and lifestyle medicine and utilizes persuasive systems design (PSD) principles in a nonclinical setting. METHODS This study involved 488 participants who completed the digital interdisciplinary MHPI. Participants completed a pre and postintervention questionnaire that used: (1) the "mental health" and "vitality" subscales from the Short Form 36 (SF-36) Health Survey; (2) the Depression, Anxiety and Stress Scale (DASS-21); and (3) Satisfaction With Life Scale (SWL). Adherence to the digital interdisciplinary MHPI was measured by the number of educational videos the participants viewed and the extent to which they engaged in experiential challenge activities offered as part of the program. RESULTS On average, the participants (N=488; mean age 47.1 years, SD 14.1; 77.5% women) demonstrated statistically significant improvements in all mental health and well-being outcome measures, and a significant gender and age interaction was observed. Women tended to experience greater improvements than men in the mental health and well-being measures, and older men experienced greater improvements than younger men in the mental health and vitality subscales. Multiple analysis of variance results of the adherence measures indicated a significant difference for age but not gender. No statistically significant interaction between gender and age was observed for adherence measures. CONCLUSIONS Digital interdisciplinary MHPIs that utilize PSD principles can improve the mental health and well-being of nonclinical cohorts, regardless of gender or age. Hence, there may be a benefit in utilizing PSD principles to develop universal MHPIs such as that employed in this study, which can be used across gender and age groups. Future research should examine which PSD principles optimize universal digital interdisciplinary MHPIs. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12619000993190; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377889 and Australian New Zealand Clinical Trials Registry ACTRN12619001009101; http://www.anzctr.org.au/ACTRN12619001009101.aspx.
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Affiliation(s)
- Geraldine Przybylko
- Lifestyle Medicine and Health Research Centre, Avondale University, Cooranbong, Australia
| | - Darren Morton
- Lifestyle Medicine and Health Research Centre, Avondale University, Cooranbong, Australia
| | - Jason Morton
- Faculty of Education, Business and Science, Avondale University, Cooranbong, Australia
| | - Melanie Renfrew
- Lifestyle Medicine and Health Research Centre, Avondale University, Cooranbong, Australia
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Denary W, Fenelon A, Schlesinger P, Purtle J, Blankenship KM, Keene DE. Does rental assistance improve mental health? Insights from a longitudinal cohort study. Soc Sci Med 2021; 282:114100. [PMID: 34144434 PMCID: PMC8299474 DOI: 10.1016/j.socscimed.2021.114100] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 02/06/2023]
Abstract
Almost half of renters in the United States are rent-burdened, meaning that they pay more than 30% of their income toward housing costs. Rental assistance through programs administered by the U.S. Department of Housing and Urban Development, alleviates these financial strains for around 5 million households. However, due to budgetary constraints, fewer than one in four eligible households actually receive this assistance and waitlists average two years nationally. Using longitudinal data from a cohort of 400 low-income adults living in New Haven, CT, this paper investigates how access to rental assistance affects mental health through two analytical methods that address selection into rental assistance. First, we performed a cross-sectional analysis to identify how psychological distress differs among those receiving and those on a waitlist for rental assistance. Second, we used a within-person fixed-effects analysis to compare changes in individuals following entry into rental assistance. We find that those receiving rental assistance report significantly less psychological distress than those on waiting lists and that transitions into rental assistance are associated with statistically non-significant decreases in psychological distress. Our findings suggest that expanding rental assistance may be one potential step toward improving the mental health of low-income individuals in the United States.
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Affiliation(s)
- Whitney Denary
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA.
| | - Andrew Fenelon
- School of Public Policy and Department of Sociology and Criminology, Penn State University, University Park, PA, USA
| | - Penelope Schlesinger
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Jonathan Purtle
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | | | - Danya E Keene
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Ortega Vega M, Attoe C, Iannelli H, Saunders A, Cross S. Current perspectives on public mental health training provision: a scoping review. JOURNAL OF PUBLIC MENTAL HEALTH 2021. [DOI: 10.1108/jpmh-11-2020-0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Public mental health training can effectively support well-being at a population level. The application of this type of training is increasingly prevalent, however, training evaluation is currently limited and inconsistent. This paper aims to summarise the characteristics of public mental health training available in England, presents key quality criteria for this training and identifies gaps in training provision.
Design/methodology/approach
This paper uses a pragmatic mixed-methods approach including database and Google Searches, focus groups and survey methods. The data analysis included a structured data extraction template for the training availability scoping and thematic analysis of the survey and focus groups.
Findings
This paper identifies a total of 74 training courses targeting workplace employees, young people and the general population. Most courses were delivered face-to-face (54), followed by e-learning (16) and blended modalities (4). This paper derives four core quality principles, focussing on the training approach, key features of training, trainer attributes and evaluation. There were no significant gaps in training provision, although areas for future development included consistency in public mental health terminology, systems and populations requiring additional training and the logistics of training delivery, etc.
Originality/value
The results contribute to the evidence base of interventions that are currently available, supporting the efforts to evaluate the impact of training provision in this area. This paper provides a novel approach to assessing training quality and discuss areas for development and innovation in this field.
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Przybylko G, Morton DP, Renfrew ME. Addressing the COVID-19 Mental Health Crisis: A Perspective on Using Interdisciplinary Universal Interventions. Front Psychol 2021; 12:644337. [PMID: 33927669 PMCID: PMC8076681 DOI: 10.3389/fpsyg.2021.644337] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/12/2021] [Indexed: 12/14/2022] Open
Abstract
Mental health is reaching a crisis point due to the ramifications of COVID-19. In an attempt to curb the spread of the virus and circumvent health systems from being overwhelmed, governments have imposed regulations such as lockdown restrictions and home confinement. These restrictions, while effective for infection control, have contributed to poorer lifestyle behaviors. Currently, Positive Psychology and Lifestyle Medicine are two distinct but complimentary disciplines that offer an array of evidence-based approaches for promoting mental health and well-being across a universal population. However, these strategies for improving mental health are typically used in isolation. This perspective calls for a new paradigm shift to create and rollout well-designed interdisciplinary universal multicomponent mental health interventions that integrates the benefits of both disciplines, and uses innovative digital mental health solutions to achieve scalability and accessibility within the limitations and beyond the COVID-19 lockdown and restrictions.
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Affiliation(s)
- Geraldine Przybylko
- Lifestyle Medicine and Health Research Centre, Avondale University College, Cooranbong, NSW, Australia
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41
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Hoagwood KE, Purtle J, Spandorfer J, Peth-Pierce R, Horwitz SM. Aligning dissemination and implementation science with health policies to improve children's mental health. AMERICAN PSYCHOLOGIST 2020; 75:1130-1145. [PMID: 33252950 PMCID: PMC8034490 DOI: 10.1037/amp0000706] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The prevalence of mental health problems among children (ages 0-21) in the United States remains unacceptably high and, post-COVID-19, is expected to increase dramatically. Decades of psychological knowledge about effective treatments should inform the delivery of better services. Dissemination and implementation (D&I) science has been heralded as a solution to the persistent problem of poor quality services and has, to some extent, improved our understanding of the contexts of delivery systems that implement effective practices. However, there are few studies demonstrating clear, population-level impacts of psychological interventions on children. Momentum is growing among communities, cities, states, and some federal agencies to build "health in all policies" to address broad familial, social, and economic factors known to affect children's healthy development and mental health. These health policy initiatives offer a rare opportunity to repurpose D&I science, shifting it from a primary focus on evidence-based practice implementation, to a focus on policy development and implementation to support child and family health and well-being. This shift is critical as states develop policy responses to address the health and mental health impacts of the COVID-19 pandemic on already-vulnerable families. We provide a typology for building research on D&I and children's mental health policy. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | - Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University
| | - Julia Spandorfer
- Department of Child and Adolescent Psychiatry, New York University Langone Health
| | | | - Sarah McCue Horwitz
- Department of Child and Adolescent Psychiatry, New York University Langone Health
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Purtle J, Nelson KL, Bruns EJ, Hoagwood KE. Dissemination Strategies to Accelerate the Policy Impact of Children's Mental Health Services Research. Psychiatr Serv 2020; 71:1170-1178. [PMID: 32517640 PMCID: PMC9721469 DOI: 10.1176/appi.ps.201900527] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The United States is in the midst of a children's mental health crisis, with rates of depression, anxiety, and suicide increasing precipitously. Evidence produced by children's mental health services research can help address this crisis by informing public policy decisions about service delivery, system design, and investments in the social determinants of mental health. Unfortunately, the policy impact of children's mental health services research is limited because evidence often fails to reach policy makers, be responsive to their needs, resonate with their worldview, or reflect the contexts in which they make decisions. Dissemination strategies-defined as the development and targeted distribution of messages and materials about research evidence pertaining to a specific issue or intervention-can help address these challenges. Yet, limited integrated guidance exists to inform the design of such strategies. This article addresses this need by synthesizing the results of empirical studies to provide guidance about how to enhance the dissemination of children's mental health services research to policy makers. The article provides four recommendations about the content of policy maker-focused dissemination materials, discusses how strategic framing and message tailoring can increase the chances that evidence is persuasive to policy makers, and highlights strategies to ensure that evidence reaches policy makers.
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Affiliation(s)
- Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Bruns); Department of Child and Adolescent Psychiatry, New York University Langone School of Medicine, New York (Hoagwood)
| | - Katherine L Nelson
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Bruns); Department of Child and Adolescent Psychiatry, New York University Langone School of Medicine, New York (Hoagwood)
| | - Eric J Bruns
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Bruns); Department of Child and Adolescent Psychiatry, New York University Langone School of Medicine, New York (Hoagwood)
| | - Kimberly E Hoagwood
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Bruns); Department of Child and Adolescent Psychiatry, New York University Langone School of Medicine, New York (Hoagwood)
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Nelson KL. Associations Between Cross-Sector Partnerships and Local Health Department Participation in Population-Based Activities to Prevent Mental Health Conditions. Am J Public Health 2020; 110:S225-S231. [PMID: 32663080 DOI: 10.2105/ajph.2020.305646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To describe partnerships between US local health departments (LHDs) and community organizations and assess the relationship between the types of activities performed in these partnerships and LHD engagement in population-based activities to prevent mental health conditions.Methods. Data were derived from 457 LHDs that responded to module 1 of the 2016 Profile Study conducted by the National Association of County and City Health Officials. These data were used to assess the presence of partnerships with community organizations and examine associations between the types of activities performed in such partnerships and LHDs' participation in population-based activities to prevent mental health conditions.Results. LHDs had higher odds of participating in population-based activities to prevent mental health conditions if they shared personnel or resources or had written agreements with mental health or substance use disorder providers, held regularly scheduled meetings with hospitals, or shared personnel or resources with community health centers. Odds were reduced if they exchanged information with community health centers or shared personnel or resources with faith-based organizations.Conclusions. This study offers an improved understanding of how the types of activities performed in cross-sector partnerships affect LHDs' participation in population-based activities to prevent mental health conditions, which is important as public policies, programs, and funding initiatives continue to encourage cross-sector partnership building.
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Affiliation(s)
- Katherine L Nelson
- Katherine L. Nelson is a doctoral candidate with the Department of Health Management and Policy and the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA
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Rudd BN, Beidas RS. Digital Mental Health: The Answer to the Global Mental Health Crisis? JMIR Ment Health 2020; 7:e18472. [PMID: 32484445 PMCID: PMC7298632 DOI: 10.2196/18472] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/27/2020] [Accepted: 03/28/2020] [Indexed: 02/06/2023] Open
Abstract
Digital mental health interventions are often touted as the solution to the global mental health crisis. However, moving mental health care from the hands of professionals and into digital apps may further isolate individuals who need human connection the most. In this commentary, we argue that people, our society's greatest resource, are as ubiquitous as technology. Thus, we argue that research focused on using technology to support all people in delivering mental health prevention and intervention deserves greater attention in the coming decade.
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Affiliation(s)
- Brittany N Rudd
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States.,Center for Mental Health, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Penn Implementation Science Center, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States
| | - Rinad S Beidas
- Center for Mental Health, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Penn Implementation Science Center, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States.,Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Sharwood LN, Wiseman T, Tseris E, Curtis K, Vaikuntam B, Craig A, Young J. Pre-existing mental disorder, clinical profile, inpatient services and costs in people hospitalised following traumatic spinal injury: a whole population record linkage study. Inj Prev 2020; 27:injuryprev-2019-043567. [PMID: 32414771 DOI: 10.1136/injuryprev-2019-043567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/06/2020] [Accepted: 04/19/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Risk of traumatic injury is increased in individuals with mental illness, substance use disorder and dual diagnosis (mental disorders); these conditions will pre-exist among individuals hospitalised with acute traumatic spinal injury (TSI). Although early intervention can improve outcomes for people who experience mental disorders or TSI, the incidence, management and cost of this often complex comorbid health profile is not sufficiently understood. In a whole population cohort of patients hospitalised with acute TSI, we aimed to describe the prevalence of pre-existing mental disorders and compare differences in injury epidemiology, costs and inpatient allied health service access. METHODS Record linkage study of all hospitalised cases of TSI between June 2013 and June 2016 in New South Wales, Australia. TSI was defined by specific International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes. Mental disorder status was considered as pre-existing where specific ICD-10-AM codes were recorded in incident admissions. RESULTS 13 489 individuals sustained acute TSI during this study. 13.11%, 6.06% and 1.82% had pre-existing mental illness, substance use disorder and dual diagnosis, respectively. Individuals with mental disorder were older (p<0.001), more likely to have had a fall or self-harmed (p<0.001), experienced almost twice the length of stay and inpatient complications, and increased injury severity compared with individuals without mental disorder (p<0.001). CONCLUSION Individuals hospitalised for TSI with pre-existing mental disorder have greater likelihood of increased injury severity and more complex, costly acute care admissions compared with individuals without mental disorder. Care pathway optimisation including prevention of hospital-acquired complications for people with pre-existing mental disorders hospitalised for TSI is warranted.
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Affiliation(s)
- Lisa Nicole Sharwood
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Faculty of Engineering and Risk, University of Technology Sydney, Sydney, NSW, Australia
| | - Taneal Wiseman
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Health and Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Emma Tseris
- Faculty of Arts and Social Sciences, Sydney School of Education and Social work, University of Sydney, Sydney, New South Wales, Australia
| | - Kate Curtis
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Health and Medicine, The University of Sydney, Sydney, New South Wales, Australia
- Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
- The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Bharat Vaikuntam
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ashley Craig
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jesse Young
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- National Drug Research Institute, Curtin University, Perth, WA, Australia
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