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Andersen NK, Smith CL, Gao CX, Filia K, Simmons M, Chinnery G, Killackey E, Thompson A, Brown E. Vocational functioning in young people accessing services for first-episode psychosis and ultra-high risk of psychosis: A longitudinal naturalistic cohort study. Aust N Z J Psychiatry 2024; 58:875-884. [PMID: 39075845 PMCID: PMC11420578 DOI: 10.1177/00048674241261778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
AIMS Young people with first-episode psychosis (FEP) or at ultra-high risk (UHR) of psychosis often have lower vocational engagement than their peers. This study examines the effect of treatment in early intervention for psychosis services in Australia on engagement in education and employment. METHODS This is a naturalistic sample of young people aged 12-25 with FEP (n = 1574) and UHR (n = 1515), accessing treatment in the headspace Early Psychosis (hEP) programme. Engagement in education and employment was assessed at baseline and every 90 days in treatment. Mixed effects logistic regression were used to analyse changes over time. RESULTS On entering the hEP programme, approximately 49% of the young people with FEP and 28% of the young people at UHR status identified as Not in Education, Employment or Training (NEET). The odds of being NEET were reduced by 27% (95% confidence interval = [14, 39]) for every 6 months treatment for the FEP group, but no change in NEET status was observed in the UHR group. In both groups, absence from daily activities was significantly reduced during time in treatment. CONCLUSION While there are methodological challenges analysing real-world non-control group cohort data, the findings indicate positive effects of the hEP programme on vocational and daily activity engagement for young people with FEP and at UHR status. A large proportion of the young people still identified as NEET after receiving treatment services, suggesting further refinement to ensure targeted and consistent vocational support throughout care.
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Affiliation(s)
- Naja Kirstine Andersen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Catherine L Smith
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Caroline X Gao
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Kate Filia
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Magenta Simmons
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | | | - Eoin Killackey
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Andrew Thompson
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Ellie Brown
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, Sydney, NSW, Australia
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Hao J, Tiles-Sar N, Habtewold TD, Liemburg EJ, Bruggeman R, van der Meer L, Alizadeh BZ. Shaping tomorrow's support: baseline clinical characteristics predict later social functioning and quality of life in schizophrenia spectrum disorder. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02630-4. [PMID: 38456932 DOI: 10.1007/s00127-024-02630-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/28/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE We aimed to explore the multidimensional nature of social inclusion (mSI) among patients diagnosed with schizophrenia spectrum disorder (SSD), and to identify the predictors of 3-year mSI and the mSI prediction using traditional and data-driven approaches. METHODS We used the baseline and 3-year follow-up data of 1119 patients from the Genetic Risk and Outcome in Psychosis (GROUP) cohort in the Netherlands. The outcome mSI was defined as clusters derived from combined analyses of thirteen subscales from the Social Functioning Scale and the brief version of World Health Organization Quality of Life questionnaires through K-means clustering. Prediction models were built through multinomial logistic regression (ModelMLR) and random forest (ModelRF), internally validated via bootstrapping and compared by accuracy and the discriminability of mSI subgroups. RESULTS We identified five mSI subgroups: "very low (social functioning)/very low (quality of life)" (8.58%), "low/low" (12.87%), "high/low" (49.24%), "medium/high" (18.05%), and "high/high" (11.26%). The mSI was robustly predicted by a genetic predisposition for SSD, premorbid adjustment, positive, negative, and depressive symptoms, number of met needs, and baseline satisfaction with the environment and social life. The ModelRF (61.61% [54.90%, 68.01%]; P =0.013) was cautiously considered outperform the ModelMLR (59.16% [55.75%, 62.58%]; P =0.994). CONCLUSION We introduced and distinguished meaningful subgroups of mSI, which were modestly predictable from baseline clinical characteristics. A possibility for early prediction of mSI at the clinical stage may unlock the potential for faster and more impactful social support that is specifically tailored to the unique characteristics of the mSI subgroup to which a given patient belongs.
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Affiliation(s)
- Jiasi Hao
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - Natalia Tiles-Sar
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
- Department of Psychiatry, University Medical Centre Groningen, University Centre for Psychiatry, Rob Giel Research Centre, University of Groningen, Groningen, The Netherlands
| | - Tesfa Dejenie Habtewold
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Edith J Liemburg
- Department of Psychiatry, University Medical Centre Groningen, University Centre for Psychiatry, Rob Giel Research Centre, University of Groningen, Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, University Medical Centre Groningen, University Centre for Psychiatry, Rob Giel Research Centre, University of Groningen, Groningen, The Netherlands
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands
| | - Lisette van der Meer
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands
| | - Behrooz Z Alizadeh
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
- Department of Psychiatry, University Medical Centre Groningen, University Centre for Psychiatry, Rob Giel Research Centre, University of Groningen, Groningen, The Netherlands.
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3
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García E, Ares-Lavalle G, Borelli M, Fernández MA, Agrest M, Ardila-Gómez S. [Attitudes of neighbors about the treatment and community life of people with severe mental health disorders in Argentina]. CAD SAUDE PUBLICA 2023; 39:e00083123. [PMID: 37851727 PMCID: PMC10581681 DOI: 10.1590/0102-311xes083123] [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: 05/08/2023] [Revised: 06/28/2023] [Accepted: 08/23/2023] [Indexed: 10/20/2023] Open
Abstract
A psychiatric reform is underway in Latin America and the Caribbean. Specifically in Argentina, a model of community mental health is being built, and prolonged psychiatric hospitalizations are still taking place, especially in neuropsychiatric hospitals. Therefore, it is necessary to closely monitor the psychiatric reform. One of the possible ways to monitor the reform is by analyzing society's attitudes towards prolonged psychiatric hospitalization as a mean of mental health treatment. Thus, an analytical observational study was conducted at the Buenos Aires Province, Argentina, in 2021, to analyze the behavior of neighbors of people who had prolonged psychiatric hospitalizations and who received housing support. Questionnaires were applied to neighbors and non-neighbors, addressing the behaviors toward prolonged psychiatric hospitalization as a mean of treatment, social distance toward people who were hospitalized, as well as specific interviews with key informants from neighborhoods where people with severe mental health disorders and who receive housing support live. Based on the answers of neighbors and non-neighbors, no statistically significant differences were identified in behaviors toward prolonged psychiatric hospitalization as a mean of treatment, nor for social distance in relation to people who were hospitalized. Key informants conditioned their assessment of prolonged hospitalization and valued the role of support teams in making community life viable.
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Affiliation(s)
- Elena García
- Centro de Salud Mental Comunitaria E. Pichón Riviere, La Plata, Argentina
| | | | - Mariana Borelli
- Hospital José A. Estéves, Ministerio de Salud, Temperley, Argentina
| | - Marina A Fernández
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Martín Agrest
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
- Proyecto Suma, Buenos Aires, Argentina
| | - Sara Ardila-Gómez
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
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4
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Ashdown-Franks G, Sabiston CM, Stubbs B, Atkinson M, Quirk H, Bullas A, Haake S. parkrun participation, impact and perceived social inclusion among runners/walkers and volunteers with mental health conditions. PSYCHOL HEALTH MED 2023; 28:2621-2634. [PMID: 36881438 DOI: 10.1080/13548506.2023.2185643] [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: 08/31/2022] [Accepted: 02/22/2023] [Indexed: 03/08/2023]
Abstract
Engagement in recreation can positively impact the physical and mental health of those experiencing mental health challenges; however, the impact of engaging in other aspects of such recreation, such as volunteering, remain largely unexplored in this population. Volunteering is known to have a wealth of health and wellbeing benefits among the general population; therefore, the impact of recreational-based volunteering for those with mental health conditions deserves to be explored. The current study sought to examine the health, social and wellbeing impacts of parkrun engagement among runners and volunteers living with a mental health condition. Participants with a mental health condition (N = 1661, M(SD)age = 43.4 (12.8) years, 66% female) completed self-reported questionnaires. A MANOVA was conducted to examine the differences in health and wellbeing impacts between those who run/walk vs. those who run/walk and volunteer, while chi-square analyses examined variables of perceived social inclusion. Findings suggest that there was a statistically significant multivariate effect of participation type on perceived parkrun impact (F (10, 1470) = 7.13; p < 0.001; Wilk's Λ = 0.954, partial η2 = 0.046). It was also found that for those who run/walk and volunteer, compared to those who only run/walk, parkrun made them more feel part of a community (56% v 29% respectively, X2(1) = 116.70, p < 0.001) and facilitated them meeting new people (60% v 24% respectively, X2 (1) = 206.67, p < 0.001). These results suggest that the health, wellbeing, and social inclusion benefits of parkrun participation are different for those who run and volunteer, compared to those who only run. These findings may have public health implications and clinical implications for mental health treatment, as they convey that it is not simply the physical engagement in recreation that may play a role in one's recovery, but also the volunteer aspect.
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Affiliation(s)
- Garcia Ashdown-Franks
- Department of Kinesiology, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Catherine M Sabiston
- Department of Kinesiology, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Michael Atkinson
- Department of Kinesiology, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Helen Quirk
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alice Bullas
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Steve Haake
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
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5
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Kassam A, Beder M, Sediqzadah S, Levy M, Ritts M, Maher J, Kirwan N, Law S. Impact of COVID-19 on the lives of people with severe mental illness-front-line community psychiatry workers observation from a provincial survey of assertive community treatment teams in Ontario, Canada. Int J Ment Health Syst 2023; 17:18. [PMID: 37328776 DOI: 10.1186/s13033-023-00585-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/23/2023] [Indexed: 06/18/2023] Open
Abstract
Using an online survey distributed to members of the provincial organization that represents the 88 Assertive Community Treatment (ACT) and Flexible ACT teams in Ontario, Canada, this descriptive study relied on the unique vantage points and observations of the front-line community psychiatry workers who maintained contact with patients through outreach and telecommunication during the height of COVID-19. The patients who suffer from serious mental illness (SMI) were uniquely affected by COVID-19 due to the changes, reduction or shut down of many essential clinical and community support services. Thematic and quantitative analyses of the workers' observations highlighted 6 main areas of note, including significant social isolation and loneliness, clinical course deterioration and life disruption, increased hospital and ER use, police and legal contacts, and substance abuse and related deaths. There were also encouraging signs of positive adaptations in terms of independence and resilience. Reflections of these impacts and potential ameliorating approaches are further discussed.
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Affiliation(s)
- Aly Kassam
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Michaela Beder
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Saadia Sediqzadah
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Matthew Levy
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Madeleine Ritts
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - John Maher
- Canadian Mental Health Association, Barrie and Ontario Association of ACT and FACT, Barrie, ON, Canada
| | - Nicole Kirwan
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Samuel Law
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada.
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6
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Miley K, Meyer-Kalos P, Ma S, Bond DJ, Kummerfeld E, Vinogradov S. Causal pathways to social and occupational functioning in the first episode of schizophrenia: uncovering unmet treatment needs. Psychol Med 2023; 53:2041-2049. [PMID: 37310333 PMCID: PMC10106305 DOI: 10.1017/s0033291721003780] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND We aimed to identify unmet treatment needs for improving social and occupational functioning in early schizophrenia using a data-driven causal discovery analysis. METHODS Demographic, clinical, and psychosocial measures were obtained for 276 participants from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) trial at baseline and 6-months, along with measures of social and occupational functioning from the Quality of Life Scale. The Greedy Fast Causal Inference algorithm was used to learn a partial ancestral graph modeling causal relationships across baseline variables and 6-month functioning. Effect sizes were estimated using a structural equation model. Results were validated in an independent dataset (N = 187). RESULTS In the data-generated model, greater baseline socio-affective capacity was a cause of greater baseline motivation [Effect size (ES) = 0.77], and motivation was a cause of greater baseline social and occupational functioning (ES = 1.5 and 0.96, respectively), which in turn were causes of their own 6-month outcomes. Six-month motivation was also identified as a cause of occupational functioning (ES = 0.92). Cognitive impairment and duration of untreated psychosis were not direct causes of functioning at either timepoint. The graph for the validation dataset was less determinate, but otherwise supported the findings. CONCLUSIONS In our data-generated model, baseline socio-affective capacity and motivation are the most direct causes of occupational and social functioning 6 months after entering treatment in early schizophrenia. These findings indicate that socio-affective abilities and motivation are specific high-impact treatment needs that must be addressed in order to promote optimal social and occupational recovery.
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Affiliation(s)
- Kathleen Miley
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Piper Meyer-Kalos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Sisi Ma
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - David J. Bond
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Erich Kummerfeld
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
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7
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Flock L, King SR, Williams J, Finlay E, Smikle H, Benito M, Benton-Stace F, Brown J, Mann-Daraz AJ, Hart L, Mclean K, Prucnal Z, Barry L, Lynes R, Toy M, Valentine K, Slattery S, Aldridge-Waddon L. Working Together to Find a Voice: Recommendations for Voice Healthcare Based on Expert-By-Experience and Practitioner Consensus. J Voice 2023:S0892-1997(23)00083-8. [PMID: 36959052 DOI: 10.1016/j.jvoice.2023.02.023] [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: 01/31/2023] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVES Voice care services aim to provide effective and meaningful voice care. Current practice guidance recommends a multidisciplinary voice care approach, supported by the evidence-base and practitioner experience. However, unlike other areas of physical and mental health, current voice care guidance does not explicitly include the voices of experts-by-experience, meaning those who have lived experience of voice difficulties. The perspectives of those working within nonclinical voice professions, such as vocal coaches, are also often omitted. There is therefore a need for updated practice guidance which prioritizes expert-by-experience and nonclinical perspectives. METHODS Vocal Health Education hosted a consensus meeting in London, UK. The meeting was coproduced with experts-by-experience, and attendees included those with lived experience of voice difficulties and practitioners across a range of disciplines within voice care. The content of the meeting was synthesized into themes and associated recommendations were drafted and agreed to by all attendees. RESULTS The consensus statement offers practical advice to those working in voice care. Recommendations are offered for multidisciplinary and biopsychosocial voice care, with a focus on person-centered practice and the valuing of lived experience. Through discussion, consensus was reached regarding recommendations for voice care assessment and treatment, practitioner approach, psychosocial considerations, and service design. The need for greater expert-by-experience involvement, coproduction, and co-construction was emphasized throughout. CONCLUSIONS This report emphasizes the voices of those with lived experience. It highlights ways of updating or improving current care, with the aim of informing clinical practice as well as research and service development. The consensus statement is the first in voice care to include experts-by-experience at the center of its recommendations, underlining the need for more coproduced and co-constructed research and practice within voice healthcare.
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Affiliation(s)
- Lydia Flock
- Vocal Manual Therapy, Oxford Vocal Massage, Oxford, UK; Voice Care Centre, Voice Care Centre, London, UK
| | - Stephen R King
- Voice Care Centre, Voice Care Centre, London, UK; Vocal Health Education, Vocal Health Education, London, UK
| | - Jenevora Williams
- Voice Care Centre, Voice Care Centre, London, UK; Vocal Health Education, Vocal Health Education, London, UK
| | - Emma Finlay
- Independent Researcher, VHE Meeting, London, UK
| | - Hannah Smikle
- Vocal Coaching, Hannah Smikle-Vocal Performance Coaching, Stockport, UK
| | | | | | - Jenna Brown
- Voice Study Centre, Voice Study Centre, Suffolk, UK
| | | | - Lydia Hart
- Voice Care Centre, Voice Care Centre, London, UK; Speech and Language Therapy, Frimley Health NHS Foundation Trust, Berkshire, UK
| | - Keesha Mclean
- Cairns Voice Studio and Cairns Voice Care, Cairns Voice Studio and Cairns Voice Care, Cairns, Australia
| | | | | | | | - Mel Toy
- Mel Toy Music, Mel Toy Music, London, UK
| | - Kate Valentine
- Voice Care Centre, Voice Care Centre, London, UK; Valentine Voice Care, Valentine Voice Care, Seaford/Glasgow/London, UK
| | - Sam Slattery
- Grace Bay Medical, Grace Bay Medical, Grace Bay, Turks and Caicos Islands
| | - Luke Aldridge-Waddon
- Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, Oxford, UK.
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8
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Hunt X, Shakespeare T, Vilyte G, Melendez-Torres GJ, Henry J, Bradshaw M, Naidoo S, Mbuyamba R, Aljassem S, Suubi E, Aljasem N, Makhetha M, Bantjes J. Effectiveness of Social Inclusion Interventions for Anxiety and Depression among Adolescents: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1895. [PMID: 36767261 PMCID: PMC9914997 DOI: 10.3390/ijerph20031895] [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: 12/14/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Adolescents who are socially excluded are at increased risk of mental health problems such as depression and anxiety. Promoting social inclusion could be an effective strategy for preventing and treating adolescent depression and anxiety. METHODS We conducted a systematic review of intervention studies which aimed to prevent or treat adolescent depression and/or anxiety by promoting social inclusion. Throughout the review we engaged a youth advisory group of 13 young people (aged 21-24) from Uganda, Turkey, Syria, South Africa, and Egypt. RESULTS We identified 12 studies relevant to our review. The interventions tested use a range of different strategies to increase social inclusion and reduce depression and anxiety, including social skills training, psychoeducation, teaching life skills training, and cash transfers. Pooled standardised mean differences (SMDs) based on random-effects models showed medium-to-large benefits of interventions on improving depression and anxiety symptoms (n = 8; SMD = -0.62; 95% CI, -1.23 to -0.01, p < 0.05). CONCLUSION Although there are not many studies, those which have been done show promising results that strongly suggest that social inclusion could be an important component of programmes to promote adolescent mental health.
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Affiliation(s)
- Xanthe Hunt
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
| | - Tom Shakespeare
- International Centre for Evidence on Disability, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Gabriele Vilyte
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
| | | | - Junita Henry
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
| | - Melissa Bradshaw
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
| | - Selvan Naidoo
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
| | - Rachel Mbuyamba
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
| | - Shahd Aljassem
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
| | - Esta Suubi
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
| | - Nawar Aljasem
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
| | - Moroesi Makhetha
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
| | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
- Alcohol, Tabaco and Other Drug Research Unit, South African Medical Research Unit, Cape Town 7505, South Africa
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9
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Psychometric properties of a brief, self-report measure of social inclusion: the F-SIM16. Epidemiol Psychiatr Sci 2022; 31:e8. [PMID: 35060845 PMCID: PMC8786614 DOI: 10.1017/s2045796021000755] [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] [Indexed: 11/07/2022] Open
Abstract
AIMS A disproportionate number of people with mental ill-health experience social exclusion. Appropriate measurement tools are required to progress opportunities to improve social inclusion. We have developed a novel measure, the Filia Social Inclusion Measure (F-SIM). Here we aimed to present a more concise, easy-to-use form, while retaining its measurement integrity by (i) refining the F-SIM using traditional and contemporary item-reduction techniques; and (ii) testing the psychometric properties of the reduced measure. METHODS Five hundred and six participants completed the F-SIM, younger and older groups of people with serious mental illness (including psychosis, mood, anxiety disorders) and same-aged community counterparts. The F-SIM was completed at baseline and 2-week follow-up, alongside other measures (including social inclusion, loneliness). The F-SIM was refined using multidimensional scaling network analysis, confirmatory factor analysis and item response theory. The psychometric evaluation included assessment of dimensionality, internal consistency, test-retest reliability, discriminant ability and construct validity. RESULTS The F-SIM was reduced from 135-items to 16; with 4-items in each domain of housing and neighbourhood, finances, employment and education and social participation and relationships. Psychometric properties were sound, including strong internal consistency within domains (all α > 0.85) and excellent overall (α = 0.92). Test-retest reliability was also high (γ = 0.90). Differences between groups were observed; clinical subgroups consistently reported lower levels of social inclusion compared to community counterparts. CONCLUSIONS The F-SIM16 is a sound, reliable, brief self-report measure of social inclusion suitable for use in clinical and research settings. It has the potential to evaluate the effectiveness of interventions, and aid in fostering targeted and personalised needs-based care.
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10
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Filia KM, Cotton SM, Watson AE, Jayasinghe A, Kerr M, Fitzgerald PB. Understanding the Barriers and Facilitators to Employment for People with Bipolar Disorder. Psychiatr Q 2021; 92:1565-1579. [PMID: 34097245 DOI: 10.1007/s11126-021-09931-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2021] [Indexed: 11/30/2022]
Abstract
People with Bipolar Disorder (BD) consistently report a desire for employment; however, this is not reflected in employment figures. Individuals' perceptions of barriers to employment, along with endorsement of facilitators to employment remain under-investigated. We aimed to address this limitation by: (i) first examining differences in employed versus unemployed individuals (demographic, clinical, functioning); then (ii) identifying barriers and/or facilitators to employment, perception of same, and subsequent impact on employment. We assessed demographics, functioning, and illness-related characteristics in 35 participants with BD (19 employed, 16 unemployed). Participants were asked to indicate perception of common barriers and facilitators to employment. Groups did not differ regarding demographic or clinical variables. High levels of absenteeism, termination of last role and commonly perceived barriers were attributed to mental ill-health. 93.3% of unemployed participants reportedly desired employment, and more perceived barriers were observed in the unemployed group. Identified facilitators included increased support and flexible work strategies. A comprehensive understanding of perceptions of limiting and helpful factors related to employment for people with BD was obtained. These findings have implications for service provision, encouraging targeted discussion, and tailored treatment approaches to individual's unique perceptions of factors related to employment.
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Affiliation(s)
- K M Filia
- Orygen; Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia. .,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.
| | - S M Cotton
- Orygen; Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - A E Watson
- Orygen; Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - A Jayasinghe
- Orygen; Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.,School of Psychology, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - M Kerr
- Orygen; Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - P B Fitzgerald
- Department of Psychiatry, Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash University, 888 Toorak Road, Camberwell, VIC, 3124, Australia
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11
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Lindstrom G, Sofija E, Riley T. "Getting better at getting better": How Sharing Mental Health Stories Can Shape Young People's Wellbeing. Community Ment Health J 2021; 57:1604-1613. [PMID: 33580469 DOI: 10.1007/s10597-021-00786-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/29/2021] [Indexed: 10/22/2022]
Abstract
Sharing lived-experience of mental ill-health is increasingly recognised as a promising youth mental health intervention. batyr is a preventative mental health organization that trains young people to share their story of mental ill-health safely through a speaker development program. This qualitative study aimed to understand how the role of batyr speakers shapes individual wellbeing, help-seeking behaviour, and stigma as well as how young people talk about mental health within their social circles. Data was collected using in-depth semi-structured interviews with 18 batyr speakers (age 18-35 years). Thematic analysis revealed five themes: Getting better at getting better, Growing towards self-acceptance, Breaking the wall by talking about mental health, Increasing connectedness and Reaching out for support. The participants reported overall improved wellbeing, as a result of increased confidence, greater self-awareness, and an increased ability to talk safely about their mental illness. Findings suggested that the program led to a reduction of self-stigma and stigma.
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Affiliation(s)
- Genesis Lindstrom
- School of Medicine, Griffith University, Parklands drive, Southport, QLD 4222, Australia.
| | - Ernesta Sofija
- School of Medicine, Griffith University, Parklands drive, Southport, QLD 4222, Australia
| | - Tom Riley
- batyr, The Dax Centre, Kenneth Myer Building, 30 Royal Parade, Parkville, VIC 3010, Australia
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12
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Vaingankar JA, Teh WL, Roystonn K, Goh J, Zhang YJ, Satghare P, Shahwan S, Chong SA, Verma S, Tan ZL, Tay B, Maniam Y, Subramaniam M. Roles, Facilitators and Challenges of Employment Support Specialists Assisting Young People with Mental Health Conditions. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:405-418. [PMID: 33090356 PMCID: PMC8172398 DOI: 10.1007/s10926-020-09930-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Purpose The present study aimed to understand the roles, effective strategies and facilitators, and challenges of employment support specialists (ESS) in assisting young people with mental health conditions (MHCs) gain and sustain employment in Singapore. Methods An interpretative qualitative design using an inductive approach was adopted for this study. Using a semi-structured interview guide, in-depth interviews were conducted with twenty ESS employed with mental health service providers or other community-based centers. Verbatim transcripts of the interviews were thematically analyzed using inductive methods. ESS were broadly classified as "any professionals providing employment-related support to people with MHCs". Results Majority of the ESS were employed at a tertiary psychiatric institute. Participants included vocational and occupational specialists, case managers and other clinical professionals. Three key themes emerged from the data: (i) descriptions of roles undertaken by the ESS depicting a wide range of services and requisite skillsets; (ii) facilitators that benefit young people with MHCs' in terms of job placement, for example, ESS' attitudes and attributes, and their clients' disposition; and (iii) challenges that deter effective job placements, such as factors pertaining to the ESS themselves, their clients, and clients' employers. Under this theme, ESS also proposed ways to improve employment opportunities of people with MHCs. Conclusions This study provided insight into a range of tasks performed and challenges faced by ESS in Singapore while assisting their clients. There is a need to address ESS' challenges and expectations in order to enhance their efficiency and aid reintegration of young people with MHCs into the workforce and the society.
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Affiliation(s)
- Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janrius Goh
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Yun Jue Zhang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Pratika Satghare
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Zhuan Liang Tan
- Sector Strategy Group, National Council of Social Service, 170 Ghim Moh Road #01-02, Singapore, 279621, Singapore
| | - Benjamin Tay
- Sector Strategy Group, National Council of Social Service, 170 Ghim Moh Road #01-02, Singapore, 279621, Singapore
| | - Yogeswary Maniam
- Department of Psychosis, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
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Chiang YC, Chu M, Zhao Y, Li X, Li A, Lee CY, Hsueh SC, Zhang S. Influence of Subjective/Objective Status and Possible Pathways of Young Migrants' Life Satisfaction and Psychological Distress in China. Front Psychol 2021; 12:612317. [PMID: 34122214 PMCID: PMC8187866 DOI: 10.3389/fpsyg.2021.612317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 05/03/2021] [Indexed: 01/07/2023] Open
Abstract
Young migrants have been the major migrant labor force in urban China. But they may be more vulnerable in quality of life and mental health than other groups, due to their personal characteristic and some social/community policies or management measures. It highlights the need to focus on psychological wellbeing and probe driving and reinforcing factors that influence their mental health. This study aimed to investigate the influence of subjective/objective status and possible pathways of young migrants' life satisfaction and psychological distress. Data on 9838 young migrants in the China Migrants Dynamic Survey were analyzed by LISREL 8.8. A total of 94.03% migrated for jobs or business. Subjective status, including subjective socioeconomic status, social adaptation, and psychological integration, had positive effects on life satisfaction, whereas social adaptation and psychological integration negatively affected psychological distress. Objective status, including objective socioeconomic status and health insurance, had adverse effects on life satisfaction, whereas they positively affected psychological distress. Social participation and city belonging had only significant positive mediating roles on life satisfaction. It is essential to increase social adaptation and decrease integration stress according to younger internal migrants' practical needs. It is also necessary to enhance community/social resources and activities in the context of developing sustainability in the community to assist in mental health promotion.
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Affiliation(s)
- Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Meijie Chu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Yuchen Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Xian Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - An Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Chun-Yang Lee
- School of International Business, Xiamen University Tan Kah Kee College, Zhangzhou, China
| | - Shao-Chieh Hsueh
- Institute of Economics, School of Economics and Wang Yanan Institute for Studies in Economics, Xiamen University, Xiamen, China
| | - Shuoxun Zhang
- Department of Finance at School of Economics and Wang Yanan Institute for Studies in Economics, Xiamen University, Xiamen, China
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14
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Affiliation(s)
- Martin Guha
- Kings College London Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Ben Channon
- Head of Wellbeing, Assael Architecture Ltd, London, UK
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15
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Gardner A, Cotton S, O'Donoghue B, Killackey E, Norton P, Filia K. Group differences in social inclusion between young adults aged 18 to 25 with serious mental illness and same-aged peers from the general community. Int J Soc Psychiatry 2019; 65:631-642. [PMID: 31402736 DOI: 10.1177/0020764019868749] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIMS Young adults with serious mental illness (SMI) are thought to be socially excluded. However, psychometric measures of social inclusion have not been employed to examine group differences relative to peers from the general community. The aim of this study was to employ such a measure to determine differences in social inclusion between young adults with SMI and peers from the general community. METHODS A cross-sectional hierarchical logistic regression was conducted to identify which dimensions and individual indicators from the Filia Social Inclusion Measure (F-SIM) discriminated between n = 152 young adults aged 18-25 from the general community (M = 21.36, SD = 2.16) and n = 159 young adults aged 18-25 with SMI (M = 21.13, SD = 2.21). RESULTS Group membership was accounted for by Interpersonal Connections (Nagelkerke R2 = .32), Vocational & Financial Security (Nagelkerke R2 = .32) and Healthy Independent Lifestyle (Nagelkerke R2 = .08) dimensions of the F-SIM. Relative to young adults from the general community, those with SMI were five times less likely to feel they had friends who would call on them in a crisis, odds ratio (OR) = .19 (95%CI = .04, .53), p = .04, almost five times more likely to live with their parents, OR = 4.79 (95%CI = 1.98,11.15), p = .004, almost four times less likely to have worked/studied any time over the past 12 months, OR = .27 (95%CI = .11,.64), p < .001, and three-and-a-half times more likely to report unstable accommodation, OR = 3.58 (95%CI = 1.14, 11.15), p = .03. CONCLUSION Young adults with SMI are socially excluded relative to peers from the general community in terms of interpersonal connections, vocational engagement, autonomy/independence and housing stability. In addition to the well-established focus on vocational engagement, interventions to improve social inclusion in this population must promote reciprocity within social relationships and healthy autonomy/independence (including stable housing).
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Affiliation(s)
- Andrew Gardner
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Sue Cotton
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Brian O'Donoghue
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Eóin Killackey
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Peter Norton
- 2 School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Kate Filia
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
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16
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Filia KM, Jackson HJ, Cotton SM, Killackey EJ. Developing and testing the F-SIM, a measure of social inclusion for people with mental illness. Psychiatry Res 2019; 279:1-8. [PMID: 31276963 DOI: 10.1016/j.psychres.2019.06.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/25/2019] [Accepted: 06/25/2019] [Indexed: 11/18/2022]
Abstract
Social inclusion is an important contributor to good mental health and greater mental health outcomes for people with psychiatric disorders. A psychometrically-sound measure of social inclusion is required to facilitate progress in this area. The aim here was to report on preliminary findings from a novel, user-friendly measure of social inclusion that comprehensively assesses the construct. Preliminary testing of the Filia Social Inclusion Measure (F-SIM) was conducted with ninety participants (30 consumers; 30 family members/carers; 30 community members). Participants completed the self-report measure and a usability questionnaire. Preliminary findings demonstrated poorer social inclusion for people with mental illness compared to those without, with differences seen in each of five domains (housing and services, social functioning, occupational functioning, finances and health). Differences were also seen regarding family members or carers, with consistently poorer social inclusion than general community members observed. Participants reported the F-SIM as easy to use, and considered it to measure social inclusion well, indicating good face validity. The F-SIM demonstrates an ability to differentiate between groups. Implications for use and suggestions for future research are detailed. Following further psychometric assessment, the F-SIM will have wide applicability in clinical and research settings.
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Affiliation(s)
- Kate M Filia
- Orygen, the National Centre of Excellence in Youth Mental Health, Locked Bag 10, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, 35 Poplar Road, Parkville, Victoria 3052, Australia.
| | - Henry J Jackson
- Melbourne School of Psychological Sciences, University of Melbourne, 12th floor, Redmond Barry Building, Parkville Campus, Parkville, Victoria 3010, Australia
| | - Sue M Cotton
- Orygen, the National Centre of Excellence in Youth Mental Health, Locked Bag 10, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, 35 Poplar Road, Parkville, Victoria 3052, Australia
| | - Eoin J Killackey
- Orygen, the National Centre of Excellence in Youth Mental Health, Locked Bag 10, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, 35 Poplar Road, Parkville, Victoria 3052, Australia
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