1
|
Subu MA, Dias JM, Mottershead R, Ahmed FR, Narulita S, Maryuni M, Zakiyah Z, Nurbaeti I, Mohamed Al Marzouqi A, Al-Yateem N. Exploring mental health stigma among Indonesian healthcare students towards individuals with mental illnesses: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2327103. [PMID: 38465669 DOI: 10.1080/17482631.2024.2327103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/03/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND The social disapproval or stigma surrounding mental illness contributes to the postponement of individuals seeking assistance and frequently undermines therapeutic alliances between mental illness sufferers and health care professionals. AIMS This study explored perceptions and attitudes towards individuals with mental illness among college healthcare students in Indonesia. METHODS This study used a qualitative method. Twenty five students enrolled in six healthcare programs were interviewed using a semi structured format. The data analysis adopted a thematic analysis. RESULTS Our thematic analysis generated four main themes: (1) general perceptions of mental health and mental illness; (2) knowledge about mental illness; (3) mental health stigma; and (4) mental health stigma campaigns. CONCLUSIONS The participants exhibited positive perceptions of mentally ill people. Students understood mental health, and they exhibited positive attitudes toward mentally ill people. Some students have stigma and lack of confidence to assist those who have mental illness. Further efforts are required to acquaint students with mental health issues and facilitate their interaction with mentally ill individuals. Anti-stigma campaigns are required to combat the pervasive stigmatization of individuals with mental illness. It is recommended to conduct a more extensive study about the stigma that students encounter in relation to mentally ill individuals.
Collapse
Affiliation(s)
- Muhammad Arsyad Subu
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| | - Jacqueline Maria Dias
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
| | - Richard Mottershead
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
| | - Fatma Refaat Ahmed
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
| | - Sari Narulita
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| | - Maryuni Maryuni
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| | - Zakiyah Zakiyah
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| | - Irma Nurbaeti
- Faculty of Health Sciences, UIN Syarif Hidayatullah, Jakarta, Indonesia
| | - Alounoud Mohamed Al Marzouqi
- Department of Health Service Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nabeel Al-Yateem
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| |
Collapse
|
2
|
Goicolea I, Richter Sundberg L, Wiklund M, Gotfredsen A, Christianson M. Widening the scope of mental health with a 'youth centred' approach: a qualitative study involving health care professionals in Sweden's youth clinics. Int J Qual Stud Health Well-being 2024; 19:2348879. [PMID: 38700475 PMCID: PMC11073406 DOI: 10.1080/17482631.2024.2348879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
PURPOSE The aim of this study was to explore how health care providers at youth clinics (YCs) in Sweden engage with, focus on, and navigate across the mental health youth space, while upholding the core bedrock principle of "youth-centeredness". METHODS Qualitative interviews were conducted with 21 health care professionals working in three YCs located in three different regions of Sweden. Data were analysed using reflexive thematic analysis informed by the work of Braun and Clarke. RESULTS The three themes were: 1) "youth mission-at the core of the YCs" work and challenged by a stronger involvement in mental ill health'; 2) "YCs" unique and complementary role in the youth mental health system: a holistic perspective, team work, and a focus on normalization', and 3) "Caught between a rock and a hard place: to treat at a care level that is not optimal for the young users" needs or to refer within an unreliable system'. CONCLUSION This study reflects the individuality and key features of YCs, their widening roles within the mental health sphere, and the challenges faced in maintaining and expanding the characteristic "youth-centred" approach while expanding their work with mental health.
Collapse
Affiliation(s)
- Isabel Goicolea
- Department of Epidemiology and Global Health, Umeå International School of Public Health, Umeå University, Umeå, Sweden
| | | | - Maria Wiklund
- Department of Community medicine and rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | | | | |
Collapse
|
3
|
Yamashita Y, Yamamoto T. Effect of virtual reality self-counseling with the intimate other avatar. Sci Rep 2024; 14:15417. [PMID: 38965334 PMCID: PMC11224315 DOI: 10.1038/s41598-024-65661-6] [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: 09/26/2022] [Accepted: 06/21/2024] [Indexed: 07/06/2024] Open
Abstract
Virtual reality self-counseling (VR-SC) is considered an effective approach for addressing mental health problems. Previous studies have shown the effectiveness of VR-SC using Sigmund Freud's avatar as the counselor. However, considering that virtual reality (VR) enables embodied perspective-taking of another person, VR-SC using the avatar of a person who cares about the participant (an intimate person), such as a family member or friend, is considered effective because it could create warm attitudes toward the participants themselves. In this study, 60 undergraduate and graduate students were split into three conditions: VR-SC with intimate persons, VR-SC with Freud, and a control group. The intervention effects were then compared. The results showed that VR-SC with an intimate person was the most effective in improving anxiety symptoms. These results may be attributed to accepting and affirming oneself from the perspective of the intimate person's avatar and counseling oneself. This study is significant in that it is the first to conduct VR-SC with the avatar of an intimate person and compare the effects with Freud's avatar. More importantly, it showed that the same VR-SC method could have different effects depending on the avatar of the counseling partner.
Collapse
Affiliation(s)
- Yuko Yamashita
- Graduate School of Sciences and Technology for Innovation, Tokushima University, Tokushima, Japan.
- Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Tetsuya Yamamoto
- Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan
| |
Collapse
|
4
|
Schulte C, Sachser C, Rosner R, Ebert DD, Zarski AC. Feasibility of a trauma-focused internet- and mobile-based intervention for youth with posttraumatic stress symptoms. Eur J Psychotraumatol 2024; 15:2364469. [PMID: 38957142 PMCID: PMC11225631 DOI: 10.1080/20008066.2024.2364469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/28/2024] [Indexed: 07/04/2024] Open
Abstract
Background: Many youth with posttraumatic stress symptoms (PTSS) do not receive evidence-based care. Internet- and Mobile-Based Interventions (IMIs) comprising evidence-based trauma-focused components can address this gap, but research is scarce. Thus, we investigated the feasibility of a trauma-focused IMI for youth with PTSS.Methods: In a one-arm non-randomized prospective proof-of-concept study, 32 youths aged 15-21 years with clinically relevant PTSS (CATS ≥ 21) received access to a trauma-focused IMI with therapist guidance, comprising nine sessions on an eHealth platform accessible via web-browser. We used a feasibility framework assessing recruitment capability, sample characteristics, data collection, satisfaction, acceptability, study management abilities, safety aspects, and efficacy of the IMI in PTSS severity and related outcomes. Self-rated assessments took place pre-, mid-, post-intervention and at 3-month follow-up and clinician-rated assessments at baseline and post-intervention.Results: The sample mainly consisted of young adult females with interpersonal trauma and high PTSS levels (CATS, M = 31.63, SD = 7.64). The IMI sessions were found useful and comprehensible, whereas feasibility of trauma processing was perceived as difficult. Around one-third of participants (31%) completed the IMI's eight core sessions. The study completer analysis showed a significant reduction with large effects in self-rated PTSS at post-treatment [t(21) = 4.27; p < .001; d = 0.88] and follow-up [t(18) = 3.83; p = .001; d = 0.84], and clinician-rated PTSD severity at post-treatment [t(21) = 4.52; p < .001; d = 0.93]. The intention-to-treat analysis indicated significant reductions for PTSS at post-treatment and follow-up with large effect sizes (d = -0.97- -1.02). All participants experienced at least one negative effect, with the most common being the resurfacing of unpleasant memories (n = 17/22, 77%).Conclusion: The study reached highly burdened young adults. The IMI was accepted in terms of usefulness and comprehensibility but many youths did not complete all sessions. Exploration of strategies to improve adherence in trauma-focused IMIs for youth is warranted, alongside the evaluation of the IMI's efficacy in a subsequent randomized controlled trial.
Collapse
Affiliation(s)
- Christina Schulte
- Professorship Psychology and Digital Mental Health Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/ Psychotherapy, Ulm University, Ulm, Germany
- German Center for Mental Health (DZPG), partner Site Ulm, Ulm, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstaett-Ingolstadt, Eichstätt, Germany
| | - David Daniel Ebert
- Professorship Psychology and Digital Mental Health Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Anna-Carlotta Zarski
- Professorship Psychology and Digital Mental Health Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- Department of Clinical Psychology, Division of eHealth in Clinical Psychology, Philipps University of Marburg, Marburg, Germany
- German Center for Mental Health (DZPG), partner Site Ulm, Ulm, Germany
| |
Collapse
|
5
|
Hanano M, Rith-Najarian L, Gong-Guy E, Chavira D. Motivational Variables as Moderating Effects of a Web-Based Mental Health Program for University Students: Secondary Analysis of a Randomized Controlled Trial. JMIR Form Res 2024; 8:e56118. [PMID: 38959024 DOI: 10.2196/56118] [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: 01/17/2024] [Revised: 04/12/2024] [Accepted: 04/30/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Self-guided web-based interventions have the potential of addressing help-seeking barriers and symptoms common among university students, such as depression and anxiety. Unfortunately, self-guided interventions are also associated with less adherence, implicating motivation as a potential moderator for adherence and improvement for such interventions. Previous studies examining motivation as a moderator or predictor of improvement on web-based interventions have defined and measured motivation variably, producing conflicting results. OBJECTIVE This secondary analysis of data from a randomized controlled trial aimed to examine constructs of motivation as moderators of improvement for a self-guided 8-week web-based intervention in university students (N=1607). METHODS Tested moderators included internal motivation, external motivation, and confidence in treatment derived from the Treatment Motivation Questionnaire. The primary outcome was an improvement in depression and anxiety measured by the Depression Anxiety Stress Scale-21. RESULTS Piecewise linear mixed effects models showed that internal motivation significantly moderated symptom change for the intervention group (t1504=-2.94; P=.003) at average and high (+1 SD) motivation levels (t1507=-2.28; P=.02 and t1507=-4.05; P<.001, respectively). Significant results remained even after controlling for baseline severity. The results showed that confidence in treatment did not significantly moderate symptom change for the intervention group (t1504=1.44; P=.15). In this sample, only internal motivation was positively correlated with service initiation, intervention adherence, and intervention satisfaction. CONCLUSIONS The combination of a web-based intervention and high or moderate internal motivation resulted in greater improvement in the total Depression Anxiety Stress Scale-21 score. These findings highlight the importance of conceptually differentiating motivation-related constructs when examining moderators of improvement. The results suggest that the combination of a web-based intervention and high or moderate internal motivation results in greater improvement. These findings highlight the importance of conceptually differentiating motivation-related constructs when examining moderators of improvement. To better understand the moderating role of internal motivation, future research is encouraged to replicate these findings in diverse samples as well as to examine related constructs such as baseline severity and adherence. Understanding these characteristics informs treatment strategies to maximize adherence and improvement when developing web-based interventions as well as allows services to be targeted to individuals likely to benefit from such interventions. TRIAL REGISTRATION ClinicalTrials.gov NCT04361045; https://clinicaltrials.gov/study/NCT04361045.
Collapse
Affiliation(s)
- Maria Hanano
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Leslie Rith-Najarian
- University of California, Los Angeles, Los Angeles, CA, United States
- Strive Weekly, Los Angeles, CA, United States
| | | | - Denise Chavira
- University of California, Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
6
|
Lau N, Srinakarin K, Aalfs H, Zhao X, Palermo TM. TikTok and teen mental health: an analysis of user-generated content and engagement. J Pediatr Psychol 2024:jsae039. [PMID: 38950415 DOI: 10.1093/jpepsy/jsae039] [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] [Received: 01/06/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND TikTok is a social media mobile application that is widely used by adolescents, and has the potential to serve as a revolutionary platform for public and mental health discourse, education, and intervention. OBJECTIVE Our study aimed to describe the content and engagement metrics of the hashtag #teenmentalhealth on TikTok. METHODS In this study, we: (a) conducted a directed content analysis of the Top 100 TikTok videos tagged with #teenmentalhealth, and (b) collected data on video engagements (views, likes, saves, and shares) and computed view-based engagement rates. RESULTS The videos collectively garnered 144,320,591 views; 28,289,655 likes; 219,780 comments; 1,971,492 saves; and 478,696 shares. Most of the generated content were from teens and therapists. Engagement metrics revealed strong user engagement rates across user types. The most prevalent content categories represented across videos were personal experience, coping techniques or treatment, humor, interpersonal relationships, and health campaign. The content categories with the highest engagement rates were relatable media representation, health campaign, social isolation, and humor. Only a single video incorporated evidence-based treatment content. CONCLUSION TikTok facilitates communication and information dissemination on teen mental health. Future research should focus on improving the quality and credibility of digital content while maintaining engagement through creativity, self-expression, and relatability. Use of popular social media platforms and community-engaged research to disseminate evidence-based content may help bridge the translational research gap.
Collapse
Affiliation(s)
- Nancy Lau
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
| | - Kavin Srinakarin
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Homer Aalfs
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Xin Zhao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, United States
| |
Collapse
|
7
|
Park Y, Cho S, Lee YS, Roh S. Depression Literacy and Depressive Symptoms: The Mediating Role of Self-Rated Mental Health Among Korean Americans. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2024; 21:561-575. [PMID: 38721748 DOI: 10.1080/26408066.2024.2349529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVE Depression literacy (DL) is increasingly recognized as an important predictor of mental health outcomes, but there remains a noticeable lack of scientific inquiry focusing on Korean Americans in this area. In addition, women are known to be more susceptible to depression, potentially affecting their DL and depressive symptoms differently than men. This study aimed to explore two primary objectives: (1) the potential role of self-rated mental health (SRMH) in mediating the association between DL and depressive symptoms in this population, and (2) whether gender differences exist in the presence and magnitudes of these mediation effects. METHOD Data were drawn from a survey with 693 Korean Americans aged 18 and older residing in New York and New Jersey. The PROCESS macro was used to test the mediation effect of self-rated mental health on the relationship between depression literacy and depressive symptoms in men and women. RESULTS Self-rated mental health was found to mediate the relation between depression literacy and depressive symptoms in women but not in men. CONCLUSIONS Providing evidence-informed, culturally tailored and gender specific depression literacy education and programs for the KA communities may be an important strategy to reduce depressive symptoms in this group.
Collapse
Affiliation(s)
- Yeddi Park
- School of Education and Human Development, Fairfield University, Fairfield, Connecticut, USA
| | - Soyeon Cho
- Department of Human Services, New York City College of Technology/CUNY, Brooklyn, New York, USA
| | - Yeon-Shim Lee
- College of Health & Social Sciences, School of Social Work, San Francisco State University, San Francisco, California, USA
| | - Soonhee Roh
- Department of Social Work, University of South Dakota-Sioux Falls, Sioux Falls, South Dakota, USA
| |
Collapse
|
8
|
Armoon B, Mohammadi R, Griffiths MD. The Global Prevalence of Non-suicidal Self-injury, Suicide Behaviors, and Associated Risk Factors Among Runaway and Homeless Youth: A Meta-analysis. Community Ment Health J 2024; 60:919-944. [PMID: 38451378 DOI: 10.1007/s10597-024-01245-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/29/2024] [Indexed: 03/08/2024]
Abstract
A meta-analysis was performed to determine pooled prevalence of non-suicidal self-injury (NSSI), suicide behaviors (including ideation, attempts), and associated risk factors among runaway and homeless youth (RHY). The databases PubMed, Scopus, Web of Science, and Cochrane Library were searched for relevant studies published from January 1995 to May 2023. Initially, 8465 papers were screened, resulting in 69 included studies. The results showed that among RHY, lifetime prevalence rates were 42% for NSSI, 38% for suicidal ideation, and 27% for suicide attempts. Lifetime prevalence of NSSI and suicide behaviors was higher among adolescent minors (aged 12-17 years) compared to young adults (aged 18-24 years). Also, NSSI and suicide behaviors were associated with having a childhood history of physical and sexual abuse. Developing an impactful community-based suicide prevention campaign tailored for RHY appears warranted. Peer groups and mentorship programs would provide invaluable support for young individuals, as supportive friendships protect against NSSI.
Collapse
Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
| | - Rasool Mohammadi
- Social Determinants of Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| |
Collapse
|
9
|
Hempeler C, Schneider-Reuter L, Windel AS, Carlet J, Philipsen L, Juckel G, Gather J, Yeboah A, Faissner M. Intersectional Discrimination in Mental Health Care: A Systematic Review With Qualitative Evidence Synthesis. Psychiatr Serv 2024:appips20230252. [PMID: 38938095 DOI: 10.1176/appi.ps.20230252] [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: 06/29/2024]
Abstract
OBJECTIVE Discriminatory practices in mental health care undermine the right to health of marginalized service users. Intersectional approaches enable consideration of multiple forms of discrimination that occur simultaneously and remain invisible in single-axis analyses. The authors reviewed intersectionality-informed qualitative literature on discriminatory practices in mental health care to better understand the experiences of marginalized service users and their evaluation and navigation of mental health care. METHODS The authors searched EBSCO, PubMed, MEDLINE, and JSTOR for studies published January 1, 1989-December 14, 2022. Qualitative and mixed-methods studies were eligible if they used an intersectional approach to examine discrimination (experiences, mechanisms, and coping strategies) in mental health care settings from the perspective of service users and providers. A qualitative evidence synthesis with thematic analysis was performed. RESULTS Fifteen studies were included in the qualitative evidence synthesis. These studies represented the experiences of 383 service users and 114 providers. Most studies considered the intersections of mental illness with race, sexual and gender diversity, or both and were performed in the United States or Canada. Four themes were identified: the relevance of social identity in mental health care settings, knowledge-related concerns in mental health care, microaggressions in clinical practice, and service users' responses to discriminatory practices. CONCLUSIONS Discriminatory practices in mental health care lead to specific barriers to care for multiply marginalized service users. Universities and hospitals may improve care by building competencies in recognizing and preventing discrimination through institutionalized training.
Collapse
Affiliation(s)
- Christin Hempeler
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Lydia Schneider-Reuter
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Anne-Sophie Windel
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Jona Carlet
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Lea Philipsen
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Georg Juckel
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Jakov Gather
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Amma Yeboah
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Mirjam Faissner
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| |
Collapse
|
10
|
Byrne SJ, Swords L, Nixon E. Depression Literacy and Self-Reported Help-Giving Behaviour in Adolescents in Ireland. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01727-w. [PMID: 38916697 DOI: 10.1007/s10578-024-01727-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2024] [Indexed: 06/26/2024]
Abstract
This questionnaire-based study aimed to explore depression literacy (DL) and help-giving experiences in 12-18-year-old adolescents (N = 535, Mage = 14.9 years, 51.8% male) in Ireland. In response to a vignette depicting a character displaying symptoms of depression, 46.7% labelled these symptoms 'depression', with increasing age and empathy associated with increased likelihood of labelling as such. Almost all (92.1%) believed the character needed help, but the perceived helpfulness of potential responses varied. Over one-third (38.2%) indicated they knew someone who had displayed similar symptoms in the past year, with 85.2% of these reporting having helped this person. Reported help-giving responses included comforting the person, encouraging professional help-seeking, and informing an adult. The findings suggest adolescent DL can be best supported by developmentally-sensitive interventions that encourage empathy and the importance of engaging adults' assistance.
Collapse
Affiliation(s)
- Sadhbh J Byrne
- Department of Psychology, Maynooth University, Maynooth, Ireland.
- School of Psychology, Trinity College Dublin, Dublin, Ireland.
| | - Lorraine Swords
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Elizabeth Nixon
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
11
|
Wu J, Zhang R, Zhao L, Yin Y, Min J, Ge Y, Luo Y, Li P, Li L, Tong Y. Risk factors for subsequent suicidal acts among 12-25-year-old high-risk callers to a suicide prevention hotline in China: a longitudinal study. Child Adolesc Psychiatry Ment Health 2024; 18:73. [PMID: 38898519 PMCID: PMC11188529 DOI: 10.1186/s13034-024-00765-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 06/06/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND A few previous cross-sectional studies investigated correlated factors of suicidal ideation or suicide attempts among suicide prevention hotline callers; however, scarcely any evidence was from a longitudinal study. In addition, it is still unclear whether improvements in some suicide risk factors could reduce the occurrence of subsequent suicidal acts. This longitudinal study focusing on the risk factors for subsequent suicidal acts among adolescent and young adult callers with high suicide risk aims to fill this gap. METHODS This study recruited 12-25-year-old high-risk callers to a China nationwide suicide prevention hotline. Potential risk factors, including hopefulness, psychological distress, depression, history of suicide attempts, alcohol or substance misuse, and acute life events, were examined during the index calls, and improvements in hopefulness, psychological distress, and suicide intent were assessed before ending the index calls. The recruited callers were followed up 12 months after their index calls. The primary outcome was the occurrence of suicidal acts (suicide attempts or suicide death) during follow-up. Kaplan-Meier survival curves, log-rank tests, and Cox proportional hazards model were used. RESULTS During the follow-up period, 271 of 1656 high-risk adolescent and young adult callers attempted suicide, and seven callers died by suicide. After adjusting for demographic variables, low hopefulness (Hazard Ratio [HR] = 2.03, 95% Confidence Interval [CI]=[1.47, 2.80]) at the beginning of the index call was associated with a higher risk for subsequent suicidal acts, whereas improvements in psychological distress (HR = 0.61, 95%CI [0.41, 0.89]) and suicidal intent (HR = 0.56, 95%CI [0.38, 0.84]) during the index call reduced the risk of subsequent suicidal acts. In addition, alcohol or substance misuse (Model 2, HR = 1.65, 95%CI [1.11, 2.46]) and suicide attempt history(Model 1: one episode, HR = 1.96, 95%CI=[1.05, 3.66]; two or more episodes, HR = 2.81, 95%CI [1.59, 4.96]. Model 2: one episode, HR = 2.26, 95%CI [1.06, 4.82]; two or more episodes: HR = 3.28, 95%CI [1.63, 6.60]) were risk factors for subsequent suicidal acts. CONCLUSIONS While suicide prevention hotline operators deliver brief psychological interventions to high-risk adolescent and young adult callers, priority should be given to callers with low hopefulness and to the alleviation of callers' high psychological distress and suicide intent.
Collapse
Affiliation(s)
- Jianlan Wu
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Ruoyun Zhang
- Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, China
| | - Liting Zhao
- Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, China
| | - Yi Yin
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, China
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Jing Min
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Yiming Ge
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Yang Luo
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Peiyao Li
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Lingling Li
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Yongsheng Tong
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096.
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China.
| |
Collapse
|
12
|
Alinaitwe R, Elyanu PJ, Kanywa JB, Akena D. Use of computer-assisted self-interview in detection of and referral for depression among adolescents living with HIV at an urban HIV treatment clinic in Uganda: a quasi-experimental study. BMJ Paediatr Open 2024; 8:e002383. [PMID: 38886110 PMCID: PMC11184185 DOI: 10.1136/bmjpo-2023-002383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/22/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Depression is common among adolescents living with HIV (ALHIV) and impacts their quality of life. However, it is not routinely detected and treated due to a lack of screening tools, coupled with large numbers of clients in the HIV clinics and limited staff. Enabling adolescents to do a self-assessment for depression on a tablet computer could possibly improve the detection of depression in this population. We set out to assess the detection and referral of depression among ALHIV in care in Uganda. METHODS This was a quasi-experimental study design with a historical control at Baylor College of Medicine of Children's Foundation. We conducted a retrospective chart review of 425 adolescents covering a 3-month period and documented the proportion screened for depression and referred to the clinic counsellors. From July to September 2022, eligible adolescents aged 10-19 years who had assented and consented self-assessed for depression using a Patient Health Questionnaire-Adolescent on a tablet computer-assisted self-interview (CASI). Adolescents who screened positive had a prompt on the tablet computers referring them to the counsellor for mental healthcare. We compared the proportions of participants screened for depression and referred to counsellors from clinic chart review and on the CASI using paired t-tests. RESULTS Out of 425 medical records reviewed, 54% (231/425) were females and the median age was 15 years. Of the participants who self-assessed on the CASI, 52% (222/425) were males and the median age of all participants was 16 years. Self-assessment on the CASI increased the rate of detection of depression from 0% to 23.3%. Of those referred on the CASI, 15% accessed care at the referral point. CONCLUSION The use of CASI improves the rate of detection of depression among ALHIV; however, there is a need to address the barriers to effective referral for mental health services.
Collapse
Affiliation(s)
| | | | | | - Dickens Akena
- Makerere University College of Health Sciences, Kampala, Uganda
| |
Collapse
|
13
|
Klauber DG, Christensen SH, Fink-Jensen A, Pagsberg AK. I Didn't Want the Psychotic Thing to Get Out to Anyone at All: Adolescents with Early Onset Psychosis Managing Stigma. Cult Med Psychiatry 2024:10.1007/s11013-024-09859-3. [PMID: 38869653 DOI: 10.1007/s11013-024-09859-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 06/14/2024]
Abstract
The impact of stigmatisation on adults with mental illnesses has been thoroughly demonstrated. However, little is known about experiences of stigmatisation among adolescents with mental illness. Through semi-structured interviews with 34 Danish adolescents (14-19 years) diagnosed with psychosis, this study explores adolescents' experiences of psychosis stigma. On the basis of phenomenological analysis, we find that stigmatisation is widely experienced, and psychosis is generally regarded as more stigmatising than co-morbid mental illnesses. The participants engage in different strategies to manage possible stigma, especially strategies of (non-)disclosure. Disclosure is experienced as both therapeutic and normative, but also bears the risk of stigmatisation, and is therefore associated with numerous considerations. Being understood when disclosing is central to the participants, and lack of understanding from others is a continuous challenge. Nevertheless, participants experience benefits when feeling understood by people they confide in and can to a degree create the grounds for this through centralising aspects of their experiences of psychosis and mental illness. We argue that disclosure is both a stigma management strategy and a normative imperative, and that being understood or not is a challenge transcending stigma definitions.Clinical trial registration: Danish Health and Medicines Authority: 2612-4168. The Ethics Committee of Capital Region: H-3-2009-123. ClinicalTrials.gov: NCT01119014. Danish Data Protection Agency: 2009-41-3991.
Collapse
Affiliation(s)
- Dea Gowers Klauber
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Sofie Heidenheim Christensen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
| | - Anders Fink-Jensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
- Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology, University of Copenhagen, Nordre Ringvej 26-67, 2600, Glostrup, Denmark
- Psychiatric Center Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Anne Katrine Pagsberg
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| |
Collapse
|
14
|
Yang X, Hu J, Zhang B, Ding H, Hu D, Li H. The relationship between mental health literacy and professional psychological help-seeking behavior among Chinese college students: mediating roles of perceived social support and psychological help-seeking stigma. Front Psychol 2024; 15:1356435. [PMID: 38939229 PMCID: PMC11208703 DOI: 10.3389/fpsyg.2024.1356435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/27/2024] [Indexed: 06/29/2024] Open
Abstract
Introduction Mental health literacy is viewed as a significant factor that may facilitate an individual's pursuit of professional psychological assistance. However, it is important to explore further influencing factors that might underlie this association. This study, employing the framework of the Theory of Planned Behavior (TPB), aims to examine the relationship between mental health literacy and the behavior of seeking professional psychological help, with a focus on the potential mediating roles of perceived stigma and social support in this context. Methods We surveyed 911 college students in seven regions of China (406 males and 505 females, aged between 19 and 25 years old; M age = 19.65, SD = 1.41) utilizing self-report measures, including the Mental Health Literacy Questionnaire, Professional Psychological Help-Seeking Behavior Scale, Professional Psychological Help-Seeking Stigma Scale, and Perceived Social Support Scale. A chain mediation model was developed to analyze the interconnections between mental health literacy, stigma related to seeking psychological help, perceived social support, and professional psychological help-seeking behaviors. Results The mediation effect analysis indicates that: (1) mental health literacy significantly positively correlates with professional psychological help-seeking behaviors; (2) both perceived social support and professional psychological help-seeking stigma significantly mediate the relationship between mental health literacy and professional psychological help-seeking behavior; (3) perceived social support and the stigma associated with seeking professional psychological help play a chained mediating effect between mental health literacy and the behavior of seeking professional psychological help. Discussion This study found that mental health literacy indirectly facilitates professional psychological help-seeking behaviors by enhancing the perception of social support and reducing the stigma associated with seeking such help. These findings help in understanding how improving mental health literacy and perceived social support while reducing stigma can increase the likelihood of individuals seeking professional psychological assistance. The results are significant for enhancing the utilization of mental health services and implementing mental health education programs in universities.
Collapse
Affiliation(s)
- Xiao Yang
- Mental Health Education and Counseling Center, Hangzhou Normal University, Hangzhou, China
| | - Jun Hu
- School of Marxism, Hangzhou Normal University, Hangzhou, China
| | - Bingren Zhang
- Affiliated Hospital (School of Clinical Medicine), Hangzhou Normal University, Hangzhou, China
| | - Hua Ding
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Danying Hu
- Mental Health Education and Counseling Center, Ningbo Polytechnic, Ningbo, China
| | - Hangdong Li
- Mental Health Education and Counseling Center, China Jiliang University, Hangzhou, China
| |
Collapse
|
15
|
Wittevrongel E, Kessels R, Everaert G, Vrijens M, Danckaerts M, van Winkel R. A user perspective on youth mental health services: Increasing help-seeking behaviour requires addressing service preferences and attitudinal barriers. Early Interv Psychiatry 2024. [PMID: 38853403 DOI: 10.1111/eip.13584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/22/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
AIM Although the incidence of mental health problems is highest in young people, the majority do not seek help. Reducing the discrepancy between need for care and access to services requires an understanding of the user perspective, which is largely lacking. This study aimed to examine preferences for mental health service attributes and their relative importance among young people, as well as the potential impact on actual help-seeking intentions. METHODS Youth aged 16-24 years (N = 258) participated in a discrete choice experiment. In addition to choosing which service would suit their needs most out of two service options in nine choice sets, participants were asked whether they would consult the chosen service in the case of mental health problems. Demographic information was also collected, as well as their current mental health status, experience with and perceived barriers to care. Panel mixed logit models were estimated. RESULTS Young people's preferences were mostly driven by the attribute 'format', with a preference for individual rather than group therapy. Other attributes, in order of importance, were 'wait times' (short), 'cost' (low), 'healthcare professionals' expertise' (particular experience with working with youth aged 12 to 25 years), and 'location' (house in a city). However, a majority of young people would not consult the service they had indicated, mainly due to attitudinal barriers such as wanting to deal with problems on their own (self-reliance). CONCLUSIONS Addressing psychological barriers to access care should be a priority in mental health policies. Furthermore, entry point services, in particular, should be able to provide the option of individual treatment.
Collapse
Affiliation(s)
- Eline Wittevrongel
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Centre for Clinical Psychiatry, Leuven, Belgium
- KU Leuven, University Psychiatric Centre (UPC), Leuven, Belgium
| | - Roselinde Kessels
- Department of Data Analytics and Digitalization, Maastricht University, Maastricht, The Netherlands
- Department of Economics, University of Antwerp, Antwerp, Belgium
| | - Geert Everaert
- Neuro-Psychiatric Clinic Saint Joseph V.Z.W, Pittem, Belgium
| | - May Vrijens
- Asster Psychiatric Hospital, Sint-Truiden, Belgium
| | - Marina Danckaerts
- KU Leuven, University Psychiatric Centre (UPC), Leuven, Belgium
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Centre for Developmental Psychiatry, Leuven, Belgium
| | - Ruud van Winkel
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Centre for Clinical Psychiatry, Leuven, Belgium
- KU Leuven, University Psychiatric Centre (UPC), Leuven, Belgium
| |
Collapse
|
16
|
Glenn CR, Kalgren T, Dutta S, Kandlur R, Allison KK, Duan A, Eskin CK, Leets M, Gould MS. Evaluating the Experience of Teen-to-Teen Crisis Line Volunteers: A Pilot Study. Community Ment Health J 2024:10.1007/s10597-024-01298-z. [PMID: 38833081 DOI: 10.1007/s10597-024-01298-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 05/15/2024] [Indexed: 06/06/2024]
Abstract
Teen-to-teen (t2t) crisis lines are a special type of crisis service where youth volunteers help their peers. Although prior research has examined the experience of adult crisis line responders, no research has examined the experience of adolescents who do this work. In collaboration with two of the largest t2t lines in the U.S., this pilot study is the first examination of t2t crisis line work. Volunteers (ages 14-20) reported: their primary motivation for joining the crisis lines was to help others and give back to the community; responding to a range of peers' problems on the t2t crisis line, including high-risk suicide contacts; and a range of ways the crisis line work impacted their lives. Findings provide preliminary information about the experience of adolescents engaging in t2t crisis line work. Additional research is needed in larger and more diverse samples to understand the impact of crisis line work for youth.
Collapse
Affiliation(s)
- Catherine R Glenn
- Old Dominion University, Norfolk, VA, USA.
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA.
| | | | | | - Raksha Kandlur
- Old Dominion University, Norfolk, VA, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
| | | | - Annie Duan
- University of Rochester, Rochester, NY, USA
| | | | | | | |
Collapse
|
17
|
Perich T, Andriessen K. The impact of family history of mental illness on mental health help seeking in university students. J Ment Health 2024:1-7. [PMID: 38832569 DOI: 10.1080/09638237.2024.2361235] [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: 07/18/2023] [Accepted: 03/22/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND University students with a family history of mental illness may have an increased risk of developing mental health problems. AIMS The aim of the study was to assess differences in mental health help seeking among students with a family history of mental illness compared to those without a family history. METHODS A total of 1127 university students, aged 18 to 30 years, completed an online survey with questions about mental illness, family history of mental illness, help seeking, and psychological symptoms. RESULTS Students with a family history of mental illness were more likely to report clinically significant symptoms and more likely to use social media and online support programs. They reported similar rates of in-person help seeking. Those with more than one family member with a mental illness reported greater symptom severity, more use of online programs, and increased likelihood of prescription drug use than those with only one family member. CONCLUSIONS More research is needed to understand how to increase access to mental health care and to address barriers to help-seeking considering family history of mental illness. University students may not be accessing appropriate treatment and care as required, with the rates of in-person help-seeking being low overall.
Collapse
Affiliation(s)
- Tania Perich
- School of Psychology, Western Sydney University, Penrith, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
| |
Collapse
|
18
|
LeBlanc JA, Jones W, Harewood H. The lived experiences and perceptions of middle-aged adults in Dominica who have survived severe storms-a qualitative exploration. Front Psychiatry 2024; 15:1372971. [PMID: 38895038 PMCID: PMC11184466 DOI: 10.3389/fpsyt.2024.1372971] [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: 01/19/2024] [Accepted: 04/17/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction The Eastern Caribbean island of Dominica has experienced diverse negative effects from the North Atlantic hurricane season, including deadly storms like Hurricane Maria in 2017. Vulnerability is increased by geographic location, small island developing state (SIDS) status, and ecosystem characteristics. A variety of negative health effects including stress and anxiety are caused by powerful storms. The perspectives of middle-aged (the "sandwich generation") survivors in this post-storm milieu are understudied. Methods This phenomenological qualitative study describes the perceptions of middle-aged (35-55 years) Dominicans, purposively recruited with gatekeeper assistance from communities stratified according to four natural hazard vulnerability categories designated by the Climate Resilience Execution Agency for Dominica (CREAD), regarding their lived experiences in the context of severe storms. Data was collected between June and August 2022, using primarily Zoom-based semi-structured, individual interviews (12 of 13), guided by the principles of saturation and maximum variation. Verbatim interview transcripts were thematically analyzed with constant comparison using an ATLAS.ti-supported hybrid deductive-inductive coding frame. Reflexivity and contact summary sheets were used to minimize bias. Results Ten women and three men from diverse CREAD vulnerability and sociodemographic backgrounds were recruited. Data condensation yielded three organizing themes: (i) "The diverse health effects of severe storms", (ii) "Response to and recovery from severe storms", and (iii) "Preparedness and precaution for severe storms". These themes encapsulated the health impacts of severe storms on Dominicans and elucidated the role of facilitating and barricading resilience factors. Discussion Severe storms produced direct and indirect mental, social, and physical health impacts on middle-aged Dominicans, including anxiety and burnout. Participants used faith-based, tangible community-based support, and emotional mechanisms to cope with and demonstrate resilience. Better risk communication and early warning systems would improve population readiness. Persistent dispirited attitudes toward storm preparedness among some participants suggest the need for targeted methods to enhance community involvement in disaster planning, including traditional approaches like "coup-de-main" (self-help).
Collapse
Affiliation(s)
| | | | - Heather Harewood
- Faculty of Medical Sciences, The University of the West Indies, Bridgetown, Barbados
| |
Collapse
|
19
|
Murakami R, Kamikubo A, Morioka D, Kuroki H. Forensic analysis of suicide deaths: Comparing forensic information with public information and investigating factors contributing to psychiatric consultations. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2024; 3:e194. [PMID: 38868080 PMCID: PMC11114437 DOI: 10.1002/pcn5.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/26/2024] [Accepted: 04/04/2024] [Indexed: 06/14/2024]
Abstract
Aim This study aimed to examine the usefulness of forensic information on suicide deaths in Japan for epidemiological studies on suicide and determine the factors that lead people with suicidal ideation to seek psychiatric care prior to attempting suicide. Methods We focused on forensic information of 514 suicide deaths that occurred in Osaka City in 2019. First, to examine whether the data used in this study can be generalized to these cases, we compared the information on suicide deaths officially published by Osaka City with that used in this study, utilizing Pearson's χ 2 test. Next, the forensic data were analyzed using multivariate logistic regression analysis to confirm the relationship between demographic factors and the likelihood of having a history of psychiatric consultation before suicide. Results Both the official information and the data used in this study showed a higher number of males than females who died by suicide, with no significant differences in values between the data sets. Multivariate logistic regression analysis showed significant correlations. More females were associated with seeking a psychiatric consultation. However, those with regular jobs or students were more likely to avoid a psychiatric consultation. Conclusion The findings of this study provide insights into the phenomenon of suicide deaths by using a forensic perspective. The results of this study suggest that psychiatric consultation may be effective in reducing deaths by suicide. Forensic data should be incorporated into the formulation of suicide-prevention policies in Japan to conduct a more multifaceted analysis and improve suicide-prevention measures.
Collapse
Affiliation(s)
- Ryu Murakami
- Faculty of Emergency Medical ScienceMeiji University of Integrative MedicineNantanKyotoJapan
- Graduate School of Risk and Crisis ManagementChiba Institute of ScienceChibaJapan
| | - Atsushi Kamikubo
- Faculty of Emergency Medical ScienceMeiji University of Integrative MedicineNantanKyotoJapan
- Osaka Prefectural Medical Examiner's OfficeOsakaJapan
| | - Daigo Morioka
- Faculty of Emergency Medical ScienceMeiji University of Integrative MedicineNantanKyotoJapan
| | - Hisanaga Kuroki
- Graduate School of Risk and Crisis ManagementChiba Institute of ScienceChibaJapan
- Osaka Prefectural Medical Examiner's OfficeOsakaJapan
| |
Collapse
|
20
|
Helland Lindborg T, Kristensson Hallström I, Synnøve Litland A, Åvik Persson H. Adolescent boys' experiences of mental health and school health services - an interview study from Norway. BMC Public Health 2024; 24:1464. [PMID: 38822302 PMCID: PMC11143580 DOI: 10.1186/s12889-024-18952-6] [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: 06/22/2023] [Accepted: 05/24/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Mental health problems among adolescents is a global challenge. During the transition to adolescence, physiological, psychological, and social changes occur, leading to increased vulnerability. Thus, adolescent boys are less likely to seek help for mental health problems, which makes them an undetected group. The aim of this study was to gain a deeper understanding of adolescent boys' experiences of mental health and school health service. METHODS An inductive, qualitative design was chosen using three focus group interviews and three individual interviews. The study included 18 adolescent boys in 7th grade, in a school located in a medium-sized municipality in Norway. The interviews were analysed with qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed in this study. RESULTS The overall theme "barriers towards seeking help", and three categories- navigating stigma and privacy concerns; perceptions of self-responsibility; and lacking knowledge of mental health problems and help-seeking-described the adolescent boys experiences. The awareness and willingness to seek help were present, but there are barriers preventing the adolescent boys from acting on that willingness. CONCLUSIONS Lack of knowledge and a non-permissive culture for mental health problems among adolescents contributes to decreased help-seeking behaviour among adolescent boys. The school health service is the most related health service for adolescents and should focus on being available and strengthening empowerment and mental health literacy through the development and implementation of interventions to promote mental health.
Collapse
Affiliation(s)
- Tonje Helland Lindborg
- Department of Health and Caring Science, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | | | | | - Helene Åvik Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, Lund, SE, 221 00, Sweden.
| |
Collapse
|
21
|
Setia Lesmana MH, Chung MH. Mediating roles of perceived stigma and mental health literacy in the relationship between school climate and help-seeking behavior in Indonesian adolescents. PLoS One 2024; 19:e0298017. [PMID: 38820380 PMCID: PMC11142528 DOI: 10.1371/journal.pone.0298017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/17/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVE This study aimed to investigate whether perceived stigma and mental health literacy play mediating roles in the correlation between school climate and help-seeking behavior in Indonesian adolescents. METHODS We used cross-sectional study design that recruited 760 Indonesian adolescents of age 16-19 years. We used convenience sampling from July to September 2019. Bivariate analysis was used to investigate the association of demographic characteristics with help-seeking behavior. Mediation analysis was employed to explore the mediating roles of mental health literacy and perceived stigma on the relationship between school climate and help-seeking behavior. RESULTS Findings indicated that ethnicity, family income, and father's educational level were significantly associated (p < 0.05) with help-seeking behavior in Indonesian adolescents. Furthermore, perceived stigma and mental health literacy sequentially showed partial mediating roles in the relationship between school climate and help-seeking behavior (indirect effect: 0.004; 95% CI: 0.001, 0.010). Our mediating model indicated that a high level of school climate was associated with low perceived stigma (b = -0.11, p < 0.001) and high mental health literacy (b = 0.28, p < 0.001) and higher help-seeking behavior (b = 0.14, p < 0.001). CONCLUSION Our study discovered novel insight of help-seeking behavior mechanism among adolescent by serial mediation test. Supportive school climate is necessary to achieve adequate help-seeking behavior. In addition, taking into account of student's perceived stigma and mental health literacy in promoting help-seeking behavior is also important.
Collapse
Affiliation(s)
- Mohammad Hendra Setia Lesmana
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| |
Collapse
|
22
|
van Benthem P, van der Lans RM, Lamers A, Blanken P, Spijkerman R, Vermeiren RRJM, Hendriks VM. The working alliance inventory - short version: psychometric properties of the patient and therapist form in youth mental health and addiction care. BMC Psychol 2024; 12:319. [PMID: 38822423 PMCID: PMC11143678 DOI: 10.1186/s40359-024-01754-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/28/2024] [Indexed: 06/03/2024] Open
Abstract
The therapeutic alliance is considered to play an important role in youth treatment. The commonly used versions of the Working Alliance Inventory (WAI) are based on Bordin's three-dimensional alliance model. However, previous psychometric studies of the WAI did not find this three-dimensional structure in youth psychotherapy. These earlier findings may indicate different perceptions of the alliance by adolescent versus adult patients, but may also be due to methodological shortcomings. The current study aims to address previous study limitations by evaluating the factor structure of the short version of the WAI (WAI-S) in youth treatment in multilevel analysis to address the hierarchical structure of the alliance data. We examined the psychometric properties of the patient (n = 203) and therapist (n = 62) versions of the WAI-S in youth mental health and addiction care and tested four multilevel models of alliance at start of treatment and 2-month follow-up. Our results suggests a two-factor model for youth and a three-dimensional model for their therapist at both time points. Since this is the first study that finds a best fit for a two-dimensional construct of alliance in youth, more research is needed to clarify whether the differences in alliance dimensions are due to measurement differences between the WAI-S for youth and therapists or whether youth and their therapists truly differ in their perceptions of the concept of alliance.
Collapse
Affiliation(s)
- Patty van Benthem
- Parnassia Addiction Research Centre (PARC), Brijder Addiction Care, Zoutkeetsingel 40, The Hague, 2512 HN, The Netherlands.
- LUMC Curium, Leiden University Medical Center, Leiden, the Netherlands.
| | | | - A Lamers
- Opvoedpoli, Amsterdam, the Netherlands
| | - P Blanken
- Parnassia Addiction Research Centre (PARC), Brijder Addiction Care, Zoutkeetsingel 40, The Hague, 2512 HN, The Netherlands
| | - R Spijkerman
- Parnassia Addiction Research Centre (PARC), Brijder Addiction Care, Zoutkeetsingel 40, The Hague, 2512 HN, The Netherlands
| | - R R J M Vermeiren
- LUMC Curium, Leiden University Medical Center, Leiden, the Netherlands
| | - V M Hendriks
- Parnassia Addiction Research Centre (PARC), Brijder Addiction Care, Zoutkeetsingel 40, The Hague, 2512 HN, The Netherlands
- LUMC Curium, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
23
|
Mori Y, Sourander A, Mishina K, Ståhlberg T, Klomek AB, Kolaitis G, Kaneko H, Li L, Huong MN, Praharaj SK, Kyrrestad H, Lempinen L, Heinonen E. Unmet need for mental health care among adolescents in Asia and Europe. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02472-0. [PMID: 38819661 DOI: 10.1007/s00787-024-02472-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/18/2024] [Indexed: 06/01/2024]
Abstract
The unmet need for mental health care is a global concern. There is a lack of cross-cultural studies examining adolescent help-seeking behavior from both formal and informal sources, including both high-and lower-income countries. This study investigates mental health help-seeking behavior in eight Asian and European countries. Data from 13,184 adolescents aged 13-15 (51% girls) was analysed using mixed-effects logistic regression with school-wise random intercepts to compare countries and genders. Although a significant proportion of adolescents considered getting or sought informal help, formal help-seeking remained exceptionally low, especially in middle-income countries (< 1%), while it ranged from 2 to 7% in high-income countries. Among adolescents with high emotional and behavioral problems (scoring above the 90th percentile on the Strengths and Difficulties Questionnaire), 1-2% of those in middle-income countries and 6-25% of those in high-income countries sought formal help. Girls generally seek more help than boys. The study shows the most adolescents do not receive formal help for mental health problems. The unmet need gap is enormous, especially in lower-income countries. Informal sources of support, including relatives, peers, and teachers, play a crucial role, especially in lower-income countries.
Collapse
Affiliation(s)
- Yuko Mori
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, Turku, 20014, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Andre Sourander
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, Turku, 20014, Finland.
- INVEST Research Flagship Center, University of Turku, Turku, Finland.
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland.
| | - Kaisa Mishina
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, Turku, 20014, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Tiia Ståhlberg
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, Turku, 20014, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland
| | | | - Gerasimos Kolaitis
- Department of Child Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Hitoshi Kaneko
- Psychological Support and Research Center for Human Development, Nagoya University, Nagoya, Japan
| | - Liping Li
- School of Public Health, Shantou University Medical College, Shantou, China
| | - Mai Nguyen Huong
- Department of Psychiatry, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Samir Kumar Praharaj
- Department of Psychiatry, Kasturba Medical College, Manipal, India
- Manipal Academy of Higher Education, Manipal, India
| | - Henriette Kyrrestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lotta Lempinen
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, Turku, 20014, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Emmi Heinonen
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, Turku, 20014, Finland
| |
Collapse
|
24
|
Morey A, Samuel V, Williams M. Universal online self-help ACT interventions for youth: A systematic review. Behav Res Ther 2024; 180:104576. [PMID: 38852229 DOI: 10.1016/j.brat.2024.104576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
Previous reviews of online self-help have not exclusively focussed on universally delivered Acceptance and Commitment Therapy (ACT). This systematic review aimed to evaluate the effectiveness of universal online self-help ACT interventions for young people. Relevant databases were searched for studies examining ACT interventions that were delivered universally, online and as self-help (guided and unguided) to young people aged 10 to 25-years-old. Eleven studies met inclusion criteria. These were assessed for quality and findings summarised using a narrative synthesis. Outcomes on mental health, well-being and ACT processes were reviewed, and results across studies were mixed. Most studies found significant improvements in mental health and well-being outcomes following the ACT intervention; however less than half found improvements in ACT process measures. Subgroups, such as those with elevated mental health symptoms, had better outcomes. There were no changes in measures of psychological inflexibility. However, methodological issues limited the interpretation of findings. Heterogeneity between studies and methodological issues made it difficult for this review to draw conclusions regarding the effectiveness of universal online self-help ACT interventions for young people. Future research with consistent approaches is needed across these types of interventions to improve methodological rigour to determine whether these interventions are effective.
Collapse
Affiliation(s)
- Alex Morey
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.
| | - Victoria Samuel
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.
| | - Marc Williams
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.
| |
Collapse
|
25
|
Batterham PJ, Gulliver A, Heffernan C, Calear AL, Werner-Seidler A, Turner A, Farrer LM, Chatterton ML, Mihalopoulos C, Berk M. A Brief Workplace Training Program to Support Help-Seeking for Mental Ill-Health: Protocol for the Helipad Cluster Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e55529. [PMID: 38787608 PMCID: PMC11161717 DOI: 10.2196/55529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/25/2024] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Most people with mental health problems do not seek help, with delays of even decades in seeking professional help. Lack of engagement with professional mental health services can lead to poor outcomes and functional impairment. However, few effective interventions have been identified to improve help-seeking in adults, and those that exist are not widely implemented to deliver public health impact. Co-designing interventions with people with lived experience of mental ill-health and other relevant stakeholders is critical to increase the likelihood of uptake and engagement with these programs. OBJECTIVE This study aims to (1) test the effectiveness of a co-designed help-seeking program on increasing professional help-seeking intentions in employees in a workplace setting; (2) determine whether the program reduces mental illness stigma and improves help-seeking intentions and behavior, mental health literacy, mental health symptoms, and work and activity functioning relative to the control condition; (3) explore factors that facilitate broader implementation of the co-designed program; and (4) explore the cost-effectiveness of the co-designed program compared to the control condition over 6 months. METHODS A 2-arm cluster randomized controlled trial will be conducted (target sample: N=900 from 30 to 36 workplaces, with n=25 to 35 participants per workplace). The trial will compare the relative effectiveness of an enhanced interactive program (intervention condition) with a standard psychoeducation-alone program (active control condition) on the primary outcome of professional help-seeking intentions as measured by the General Help-Seeking Questionnaire. Secondary outcomes include the impact on mental illness stigma; mental health literacy; help-seeking attitudes and behavior; work and activity functioning; quality of life; and symptoms of mental ill-health including depression, anxiety, and general psychological distress. RESULTS Facilitators of and risks to the trial are identified and addressed in this protocol. Recruitment of workplaces is scheduled to commence in the first quarter of 2024. CONCLUSIONS If effective, the program has the potential to be ready for rapid dissemination throughout Australia, with the potential to increase appropriate and efficient service use across the spectrum of evidence-based services. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12623000270617p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385376. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/55529.
Collapse
Affiliation(s)
- Philip J Batterham
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | - Amelia Gulliver
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | - Cassandra Heffernan
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | - Alison L Calear
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | | | - Alyna Turner
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Louise M Farrer
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | - Mary Lou Chatterton
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Michael Berk
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
26
|
Gubi E, Hollander AC, Bäärnhielm S. "I had no idea there were psychiatric clinics for children": A qualitative study of how migrant parents reach Swedish mental health services for their children. Transcult Psychiatry 2024:13634615241250203. [PMID: 38780532 DOI: 10.1177/13634615241250203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Migrant children have repeatedly been shown to underutilize psychiatric services and to face barriers to care, yet few studies have examined the experience of migrant parents who are successful in their help-seeking efforts for their children's mental health. The aim of this study was to gain a deeper understanding of facilitators and obstacles to reaching care among migrant parents in contact with child psychiatric services. We explored how migrant parents in Stockholm, Sweden, experienced the process of reaching child mental health services. Participants were recruited from out-patient mental health clinics. Ten in-depth interviews were conducted; qualitative analysis of transcripts was undertaken using thematic content analysis. Parents described a desire to reach services but difficulties doing so on their own. We identified a strong dependence on referring agents, such as schools and child health centers, for parents to gain contact. Informants expressed a high degree of trust toward these agents. Contrary to previous studies, stigma was not described as an obstacle to help-seeking but was recognized by informants as a potential barrier to care had they not emigrated. Although participants in our study had differing educational backgrounds and residency times in Sweden, a common experience of reliance on others for reaching services was evident in the data. Our findings highlight the role of referring agents as bridging contacts between different welfare services. Understanding the specific local resources and services that are available to migrant parents, and strengthening these across different sectors, could potentially help reduce barriers to care.
Collapse
Affiliation(s)
- Ester Gubi
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Sofie Bäärnhielm
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet (KI) and Transcultural Centre, Stockholm Health Care Services, Stockholm, Sweden
| |
Collapse
|
27
|
Carlisle K, Kamstra P, Carlisle E, McCosker A, De Cotta T, Kilpatrick S, Steiner A, Kahl B, Farmer J. A qualitative exploration of online forums to support resilience of rural young people in Australia. Front Public Health 2024; 12:1335476. [PMID: 38841668 PMCID: PMC11150697 DOI: 10.3389/fpubh.2024.1335476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Prevention and early intervention are crucial strategies for improving young people's mental health and well-being. Building resilience is a key component of these strategies, especially among young individuals in rural areas who face well-documented mental health disparities. This study aimed to investigate how online mental health forums can contribute to enhancing individual resilience in young rural users. Methods A sample of forum posts (n = 1,000) made by Australian rural users (18-25 years) on an online peer support mental health forum were qualitatively analyzed. The analysis was guided by themes derived from the literature on indicators of rural resilience. Results Analysis of forum posts showed evidence of rural resilience in forum users. Online peer support forums offered a virtual space for individuals to establish social connections, experience a sense of belonging, share information, acquire knowledge, and offer mutual support. There were indications of increased self-efficacy among forum users, as they demonstrated their ability to implement strategies for better managing their mental health. Discussion These findings significantly contribute to our understanding of how online forums can enhance resilience factors that are beneficial for young people living in rural communities. In the context of prevention and early intervention, this study illustrates the intricate connections between forum design and user activity with resilience outcomes, providing valuable insights into the underlying causal mechanisms. Consequently, it emphasizes the importance of incorporating such digital interventions as integral components of mental health service ecosystems.
Collapse
Affiliation(s)
- Karen Carlisle
- College of Medicine and Dentistry, James Cook University, Douglas, QLD, Australia
| | | | - Emily Carlisle
- College of Medicine and Dentistry, James Cook University, Douglas, QLD, Australia
| | - Anthony McCosker
- Department of Media and Communications, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Tracy De Cotta
- Social Innovation Research Unit, Swinburne University of Technology, Melbourne, VIC, Australia
| | | | - Artur Steiner
- Glasgow Caledonian University, Yunus Centre, Glasgow, United Kingdom
| | | | - Jane Farmer
- Social Innovation Research Unit, Swinburne University of Technology, Melbourne, VIC, Australia
| |
Collapse
|
28
|
Bu D, Zhang CQ, Liu JD, Han Z, Wang X, Huang Z. Mental health literacy, mental health experiences and help-seeking behaviours of Chinese elite athletes: a qualitative study. Front Public Health 2024; 12:1391597. [PMID: 38813417 PMCID: PMC11133729 DOI: 10.3389/fpubh.2024.1391597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/15/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction Elite athletes' help-seeking on mental health might be influenced by their mental health literacy (MHL) and mental health experiences. The current study aimed to explore the MHL, experiences and help-seeking behaviours among elite athletes using a qualitative approach. Methods Face-to-face semi-structured interviews were conducted among 20 Chinese elite athletes, 12 coaches, and 5 team officials. Interview data was analyzed using content analysis. Results Seven main themes emerged from the analysis. The current study revealed that Chinese elite athletes suffered from various mental health issues and athletes' MHL levels, help-seeking attitudes and intentions, Chinese sports environments, and Chinese cultural background could impact their help-seeking behaviours. Conclusion Support for Chinese elite athletes' mental health and help-seeking requires improvement.
Collapse
Affiliation(s)
- Danran Bu
- School of Physical Education, Hubei University, Wuhan, China
| | - Chun-Qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Jing-Dong Liu
- Department of Physical Education, Sun Yat-sen University, Guangzhou, China
| | - Zhe Han
- Key Laboratory of General Administration of Sport of China, Hubei Institute of Sport Science, Wuhan, China
| | - Xiang Wang
- The Department of Sport, Physical Education and Health, Faculty of Social Science, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Zhijian Huang
- School of Physical Education, Hubei University, Wuhan, China
| |
Collapse
|
29
|
Danese A, Martsenkovskyi D, Remberk B, Khalil MY, Diggins E, Keiller E, Masood S, Awah I, Barbui C, Beer R, Calam R, Gagliato M, Jensen TK, Kostova Z, Leckman JF, Lewis SJ, Lorberg B, Myshakivska O, Pfeiffer E, Rosner R, Schleider JL, Shenderovich Y, Skokauskas N, Tolan PH, Caffo E, Sijbrandij M, Ougrin D, Leventhal BL, Weisz JR. Scoping Review: Digital Mental Health Interventions for Children and Adolescents Affected by War. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00243-0. [PMID: 38735431 DOI: 10.1016/j.jaac.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 02/19/2024] [Accepted: 02/23/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE More than 200 million children and adolescents live in countries affected by violent conflict, are likely to have complex mental health needs, and struggle to access traditional mental health services. Digital mental health interventions have the potential to overcome some of the barriers in accessing mental health support. We performed a scoping review to map existing digital mental health interventions relevant for children and adolescents affected by war, to examine the strength of the evidence base, and to inform the development of future interventions. METHOD Based on a pre-registered strategy, we systematically searched MEDLINE, Embase, Global Health, APA PsychInfo, and Google Scholar from the creation of each database to September 30, 2022, identifying k = 6,843 studies. Our systematic search was complemented by extensive consultation with experts from the GROW Network. RESULTS The systematic search identified 6 relevant studies: 1 study evaluating digital mental health interventions for children and adolescents affected by war, and 5 studies for those affected by disasters. Experts identified 35 interventions of possible relevance. The interventions spanned from universal prevention to specialist-guided treatment. Most interventions directly targeted young people and parents or carers/caregivers and were self-guided. A quarter of the interventions were tested through randomized controlled trials. Because most interventions were not culturally or linguistically adapted to relevant contexts, their implementation potential was unclear. CONCLUSION There is very limited evidence for the use of digital mental health interventions for children and adolescents affected by war at present. The review provides a framework to inform the development of new interventions. DIVERSITY & INCLUSION STATEMENT We actively worked to promote sex and gender balance in our author group. STUDY PREREGISTRATION INFORMATION Digital mental health interventions for children and young people affected by war: a scoping review; https://osf.io/; hrny9.
Collapse
Affiliation(s)
- Andrea Danese
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom.
| | - Dmytro Martsenkovskyi
- Bogomolets National Medical University, Kyiv, Ukraine; SI Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine, Kyiv, Ukraine; National Children's Specialized Hospital OHMATDYT, Kyiv, Ukraine
| | | | | | - Emma Diggins
- University of Leeds, Leeds, United Kingdom; Leeds Community Healthcare NHS Trust, Leeds, United Kingdom
| | - Eleanor Keiller
- Queen Mary University of London, London, UK; East London NHS Foundation Trust, London, United Kingdom
| | - Saba Masood
- Queen Mary University of London, London, UK; East London NHS Foundation Trust, London, United Kingdom
| | - Isang Awah
- University of Oxford, Oxford, United Kingdom
| | | | - Renée Beer
- EMDR Europe Association, Lausanne, Switzerland
| | - Rachel Calam
- University of Manchester, Manchester, United Kingdom
| | - Marcio Gagliato
- The Mental Health and Psychosocial Support Network - MHPSS.net; Fordham University, New York City, New York
| | - Tine K Jensen
- University of Oslo, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Zlatina Kostova
- University of Massachusetts Chan Medical School, Worcester, Massachusetts. Prof. Leckman is with
| | | | - Stephanie J Lewis
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Boris Lorberg
- University of Massachusetts Chan Medical School, Worcester, Massachusetts. Prof. Leckman is with
| | - Olha Myshakivska
- Institute of Psychiatry, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
| | | | - Rita Rosner
- Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| | | | - Yulia Shenderovich
- Cardiff University, Cardiff, United Kingdom; University of Oxford, Oxford, United Kingdom
| | | | | | - Ernesto Caffo
- University of Modena and Reggio Emilia, Italy; Foundation Child; and the Foundation SOS Il Telefono Azzurro ONLUS
| | | | - Dennis Ougrin
- Queen Mary University of London, London, UK; East London NHS Foundation Trust, London, United Kingdom
| | | | - John R Weisz
- Harvard University, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
30
|
Zhai F, Han F, Wang Q. The Impact of Coping Styles on the Mental Health of Outstanding Physical Education Students in Shanghai During the Normalization Epidemic: The Chain Mediation Role of Meaning in Life and Prosocial Behavior. Psychol Res Behav Manag 2024; 17:1935-1945. [PMID: 38737672 PMCID: PMC11088861 DOI: 10.2147/prbm.s458349] [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] [Received: 01/06/2024] [Accepted: 04/30/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose The continuous spread of the epidemic has inflicted serious harm upon individual's mental well-being, and effective coping mechanisms are associated with positive mental health outcomes. Prosocial behavior and a sense of meaning in life can enhance individuals' subjective well-being, which can subsequently positively impact their mental health. Thus, in the context of epidemic prevention and control, this study investigates the relationship between the meaning in life, prosocial behavior, and coping styles of outstanding physical education students and the impact on their mental health. Methods The study involved a questionnaire survey on 498 outstanding physical education students, consisting of 297 boys (mean age = 13.16) and 201 girls (mean age = 12.87 years). Subsequently, the data was analyzed using the mediating effect and Bootstrap tests. Results The coping style positively predicted the meaning in life (β=0.294) and prosocial behavior (β=0.293). Conversely, mental health was predicted in a negative direction (β=-0.494). Mental health negatively predicted prosocial behavior (β=-0.810), although prosocial behavior positively predicted meaning in life (β=0.644). Finally, prosocial behavior negatively predicted mental health (β=-0.513). Additionally, the interplay between prosocial behavior and meaning in life is established in terms of both the individual and chain mediating roles. Conclusion This study demonstrates that coping styles during a normalized epidemic prevention and control situation directly impact the mental health of Shanghai's outstanding physical education students. Additionally, these coping styles indirectly influence mental health through the mediating effects of meaning in life and prosocial behaviors. Furthermore, meaning in life and prosocial behaviors act as chain mediators in this relationship.
Collapse
Affiliation(s)
- Fang Zhai
- College of Physical Education, Yangzhou University, Yangzhou, Jiangsu, 225009, People’s Republic of China
| | - Fulei Han
- Kunshan No. 1 Vocational School in Jiangsu Province, Kunshan, Jiangsu, 215300, People’s Republic of China
| | - Qiulin Wang
- College of Physical Education, Yangzhou University, Yangzhou, Jiangsu, 225009, People’s Republic of China
| |
Collapse
|
31
|
Marmura H, Cozzi RRF, Blackburn H, Ortiz-Alvarez O. Adolescents Identify Modifiable Community-Level Barriers to Accessing Mental Health and Addiction Services in a Rural Canadian Town: A Survey Study. Pediatr Rep 2024; 16:353-367. [PMID: 38804374 PMCID: PMC11130897 DOI: 10.3390/pediatric16020031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/18/2024] [Accepted: 04/30/2024] [Indexed: 05/29/2024] Open
Abstract
Adolescents are particularly vulnerable to inadequate provision of mental health and addictions care, as services have been traditionally conceptualized to serve the needs of children or adults. Additionally, rural communities have been largely excluded from research investigating mental healthcare access and exhibit unique barriers that warrant targeted interventions. Finally, perspectives from the target population will be most important when understanding how to optimize adolescent mental health and addictions care. Therefore, the purpose of this study was to identify what adolescents in a rural town perceive as barriers to accessing mental health services. We conducted a cross-sectional survey study with high school students to generate ranked lists of the top perceived individual-level, community-level, and overall barriers. A total of 243 high school students responded to the survey. Perceived barriers were predominantly at the community level. Overall, the top barriers reported were a lack of awareness and education regarding mental health, resources, and the nature of treatment. Students who had previously accessed mental health services identified primary barriers related to mental health professionals, whereas students who had not accessed care reported fear and uncertainty as primary barriers. Modifiable community-level factors related to (1) mental health literacy and (2) mental healthcare professionals were identified by adolescents as the main perceived barriers to accessing mental health and addiction services in a rural town. The findings of this preliminary study should inform intervention strategies and further rigorous research for this traditionally underserved target population.
Collapse
Affiliation(s)
- Hana Marmura
- Faculty of Health Sciences, Western University, London, ON N6A 3K7, Canada;
| | - Regina R. F. Cozzi
- Biology Department, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada;
| | - Heather Blackburn
- Sexual Violence Prevention and Response Advocate Team, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada;
| | - Oliva Ortiz-Alvarez
- Women’s and Children’s Health, Saint Martha’s Regional Hospital, Antigonish, NS B2G 2G4, Canada
- Departments of Pediatrics and Family Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| |
Collapse
|
32
|
McPhail L, Thornicroft G, Gronholm PC. Help-seeking processes related to targeted school-based mental health services: systematic review. BMC Public Health 2024; 24:1217. [PMID: 38698391 PMCID: PMC11065683 DOI: 10.1186/s12889-024-18714-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND One in seven adolescents globally are affected by mental health conditions, yet only a minority receive professional help. School-based mental health services have been endorsed as an effective way to increase access to mental health support for people at risk, or currently presenting with mental health conditions, throughout adolescence. Despite this, low treatment utilisation prevails, therefore the aim of this review is to contribute insights into the processes related to adolescents' accessing and engaging with essential targeted mental health support within schools. METHODS This systematic review extracted qualitative, quantitative and mixed-methods data to determine what processes affect adolescents seeking help from targeted school-based mental health services (TSMS). Searches were conducted in EMBASE, Medline, PsycINFO, CINAHL, ERIC, Web of Science, in addition to manual searching and expert consultations. Data were synthesised following guidelines for thematic synthesis and narrative style synthesis. RESULTS The search resulted in 22 articles reflecting 16 studies with participant sample sizes ranging from n = 7 to n = 122. Three main themes were identified: 'access-related factors', 'concerns related to stigma', and 'the school setting'. These findings elucidate how help-seeking processes are variable and can be facilitated or hindered depending on the circumstance. We identified disparities with certain groups, such as those from low-socio economic or ethnic minority backgrounds, facing more acute challenges in seeking help. Help-seeking behaviours were notably influenced by concerns related to peers; an influence further accentuated by minority groups given the importance of social recognition. Conflicting academic schedules significantly contribute to characterising treatment barriers. CONCLUSIONS The findings of this review ought to guide the delivery and development of TSMS to facilitate access and promote help-seeking behaviours. Particularly, given the evidence gaps identified in the field, future studies should prioritise investigating TSMS in low- and middle-income settings and through quantitative methodologies. REGISTRATION The protocol for this systematic review was registered on PROSPERO (ID CRD42023406824).
Collapse
Affiliation(s)
- Lauren McPhail
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Petra C Gronholm
- Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
33
|
Tan J, Shi W, Yuan GF, Lowe SR, Liu J. Perceived barriers and influencing factors of psychological help-seeking amongst Chinese nurses exposed to COVID-19. J Res Nurs 2024; 29:203-213. [PMID: 38883255 PMCID: PMC11179599 DOI: 10.1177/17449871241236387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Abstract
Background The COVID-19 pandemic has caused psychological problems among nurses worldwide. However, their willingness to seek professional help is relatively low, due to perceived barriers that have remained unknown. Aims This study analysed the potential barriers and influencing factors of psychological help-seeking among nurses participating in community COVID-19 epidemic prevention work. Methods Five variables - depression, anxiety, post-traumatic stress syndrome, social support and mental health literacy - were measured from a sample of 667 nurses. Latent class analysis identified homogeneous classes about psychological help-seeking barriers and multinomial logistic regression identified factors associated with potential grouping outcomes. Results Three categories were identified: major barriers (N = 17, 2.5%), stigma and accessibility barriers (N = 132, 21.2%) and low barriers (N = 518, 76.4%). Mental health literacy was significantly correlated with the 'low barriers' class (OR = 0.953, B = -0.047, p = 0.03), whereas depression (OR = 1.091, B = 0.085, p = 0.011) had a slightly positive effect on being in the 'stigma and accessibility barriers' class. Conclusions During pandemics or other social health crises, nurses may experience psychological barriers to help seeking. Communities and hospitals should consider increasing the resources available for psychological counselling services, improving mental health awareness and literacy that may help reduce depression levels and promote mental health.
Collapse
Affiliation(s)
- Jiani Tan
- Research Student, Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Wei Shi
- Associate Professor, Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Guanzhe Frank Yuan
- Associate Professor, School of Education Science, Leshan Normal University, Leshan, China
| | - Sarah R Lowe
- Associate Professor, Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Jiahe Liu
- Research Student, School of Mathematics and Statistics, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
34
|
Alhumaidan NI, Alotaibi TA, Aloufi KS, Althobaiti AA, Althobaiti NSA, Althobaiti K, Almutiri WA, Alhaqbani K, Alboqami T, Albeheiri L, Alfaisal NF. Barriers to Seeking Mental Health Help in Saudi Arabia: A Systematic Review. Cureus 2024; 16:e60363. [PMID: 38883041 PMCID: PMC11178508 DOI: 10.7759/cureus.60363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
Globally, mental disorders have become a significant burden, affecting a substantial number of individuals. Accessing mental health services is crucial for effective treatment and improving outcomes. However, significant barriers to seeking health services can impede access and contribute to the treatment gap. This systematic review aims to identify and analyze the perceived barriers to seeking mental health services in Saudi Arabia. A comprehensive search was conducted among four databases (PubMed, Web of Science, ProQuest, and Science Direct) to identify relevant studies published between 2018 and 2023. Studies that investigated barriers that could prevent psychiatric patients from seeking mental health services in Saudi Arabia were included. Data extraction and synthesis were performed to identify common themes and barriers. The review included a total of six studies that examined barriers to seeking mental health services in Saudi Arabia. The identified barriers encompassed a range of factors, including stigma, lack of awareness, concerns about confidentiality, limited availability of services, negative attitudes toward professional help, and cultural and religious beliefs. The lack of knowledge, as well as the negative attitude toward mental health care, was a perceived barrier to help-seeking in most studies. Furthermore, stigma was consistently reported as a predominant barrier, preventing individuals from seeking mental health care. This systematic review highlights the barriers to seeking mental health services in Saudi Arabia. Addressing these barriers is essential for improving access to mental healthcare and reducing the treatment gap. Strategies should focus on destigmatization efforts, increasing awareness, ensuring confidentiality and privacy, providing culturally appropriate care, and addressing structural limitations. By implementing these strategies, healthcare systems can improve access to mental health care and the overall well-being of individuals experiencing mental disorders in Saudi Arabia.
Collapse
Affiliation(s)
- Norah I Alhumaidan
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | | | | | | | | | | | - Wijdan A Almutiri
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Khawlah Alhaqbani
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Tafe Alboqami
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Latifah Albeheiri
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Njoud F Alfaisal
- Family Medicine, King Abdullah bin Abdulaziz University Hospital, Riyadh, SAU
| |
Collapse
|
35
|
Amsalem D, Jankowski SE, Pagdon S, Markowitz JC, Martin A, Dixon LB. Stigma Reduction Via Brief Video Interventions: Comparing Presentations by an Actor Versus a Person With Lived Experience. Psychiatr Serv 2024; 75:485-488. [PMID: 38088037 DOI: 10.1176/appi.ps.20230215] [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: 05/02/2024]
Abstract
OBJECTIVE This study aimed to compare the efficacy of two brief video interventions in reducing mental health-related stigma: one featuring a person with lived experience of mental illness, the other featuring an actor guided by focus groups of individuals with lived experience. METHODS Participants (N=1,216) ages 18-30 were randomly assigned to an intervention group or a control group. The intervention groups viewed one of two 2-minute videos in which a young Black protagonist describes symptoms, struggles, and personal recovery related to schizophrenia. Five domains of stigma were assessed at baseline, postintervention, and a 30-day follow-up. RESULTS Stigma scores were lower across all five domains in both intervention groups (vs. control), and noninferiority analyses found no difference between the two videos (all p<0.001). CONCLUSIONS This study enhanced prior findings showing similar efficacy of the two videos and illustrated opportunities for people with mental illness to share their personal stories without public exposure.
Collapse
Affiliation(s)
- Doron Amsalem
- New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Dixon); Child Study Center and Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Samantha E Jankowski
- New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Dixon); Child Study Center and Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Shannon Pagdon
- New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Dixon); Child Study Center and Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - John C Markowitz
- New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Dixon); Child Study Center and Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Andrés Martin
- New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Dixon); Child Study Center and Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Lisa B Dixon
- New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Dixon); Child Study Center and Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut (Martin)
| |
Collapse
|
36
|
Moore K, Uriegas NA, Emerson DM, Winkelmann ZK, Harriell K, Torres-McGehee TM. Barriers To and Attitudes Toward Seeking Mental Health Services Among Collegiate Marching Band Artists. J Athl Train 2024; 59:506-513. [PMID: 38243734 PMCID: PMC11127682 DOI: 10.4085/1062-6050-0368.23] [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: 01/21/2024]
Abstract
CONTEXT Marching band (MB) artists experience stressors influencing their physical, mental, and emotional health warranting medical support, and they face challenges similar to those of other college students and athletes. Mental health illnesses exist in collegiate and MB settings, but barriers affect access to treatment. OBJECTIVES To examine MB artists' perceived barriers to and attitudes toward seeking care from mental health professionals. The secondary aim was to explore barriers to and attitudes about seeking mental health counseling between genders and history of pursuing mental health counseling. DESIGN Cross-sectional study. SETTING Online survey. PATIENTS OR OTHER PARTICIPANTS A total of 534 MB artists (women = 312, men = 222; age = 19.7 ± 1.4 years). MAIN OUTCOME MEASURE(S) Participants completed surveys on demographics and past medical history along with the Barriers to Help Seeking Checklist, the Attitudes Toward Seeking Professional Psychological Help-Short Form Scale (ATSPPH-SF), and the Mental Help Seeking Attitudes Scale (MHSAS). Descriptive statistics were calculated to assess demographic data. Cross-tabulations and χ2 statistics were used to evaluate individual barriers (Barriers to Help Seeking Checklist) between genders. Scales were scored 1 to 7 and 10 to 30 on the MHSAS and ATSPPH-SF, respectively. A 1-way analysis of variance measured differences in the total mean score on the ATSPPH-SF between genders. RESULTS The highest barrier reported was lack of time to seek services (69.1%; n = 369), followed by 47.6% (n = 254) for services not available during my free time. Average scores were 4.0 ± 0.4 on the MHSAS (indicating neutral attitudes toward seeking help) and 17.97 ± 5.48 on the ATSPPH-SF (indicating slightly positive attitudes to seeking help). No differences were seen for the total mean scores on the MHSAS and ATSPPH-SF between genders. CONCLUSIONS Marching band artists' barriers to and attitudes toward mental health care influenced their ability to seek care in times of need and demonstrated some similarities to those of collegiate athletes. Awareness of the obstacles MB artists face in receiving mental health care will assist health care providers in advocating for improved care in this setting.
Collapse
Affiliation(s)
- Kenya Moore
- Department of Exercise Science, University of South Carolina, Columbia
| | - Nancy A. Uriegas
- Department of Exercise Science, University of South Carolina, Columbia
| | - Dawn M. Emerson
- Department of Exercise Science, University of South Carolina, Columbia
| | | | - Kysha Harriell
- Department of Kinesiology & Sport Sciences, University of Miami, Coral Gables, FL
| | | |
Collapse
|
37
|
Guo S, Goldfeld S, Mundy L. Factors that impact mental health help-seeking in Australian adolescents: a life-course and socioecological perspective. Child Adolesc Ment Health 2024; 29:170-180. [PMID: 38494190 DOI: 10.1111/camh.12694] [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] [Accepted: 11/08/2023] [Indexed: 03/19/2024]
Abstract
BACKGROUND Help-seeking provides opportunities for early prevention and intervention of mental health problems. However, little is known about factors that impact help-seeking from a life-course and socioecological perspective. This study aimed to examine factors that impact adolescents' formal and informal help-seeking in three population groups: the whole population, adolescents with depressive symptoms and adolescents with anxiety symptoms. METHODS We drew on data from the Longitudinal Study of Australian Children birth cohort. Participants were followed from birth to 14-15 years. Based on previous literature and life-course and socioecological models, we measured a range of factors at individual and family, interpersonal and community levels at three time points (0-1 year, 4-5 years and 12-13 years). Outcomes at 14-15 years were help-seeking behaviours divided into three categories (formal help from health professionals, close informal help from friends and family members and broad informal help from other sources). Generalised linear models with logit-binomial links were used. RESULTS There were varying and common patterns of influencing factors across the three population groups and sources of help-seeking. In the whole population, five common factors (female, previous depressive or anxiety symptoms, discrimination and bully victimisation) were associated with all three sources of help-seeking. Among adolescents with depressive or anxiety symptoms, four common barriers to help-seeking were male adolescents, speaking a language other than English, having poor relationships with peers and less social support. CONCLUSION Both intrinsic and extrinsic barriers exist for adolescents' mental health help-seeking. There are priority groups of adolescents with mental health problems who are unlikely to seek support and warrant attention. There is a need for multisector collaborations to address barriers to mental health care and promote help-seeking among adolescents.
Collapse
Affiliation(s)
- Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Lisa Mundy
- Department of Pediatrics, University of Melbourne, Melbourne, Vic., Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
| |
Collapse
|
38
|
Shakya P, Sood M, Mathur R, Prajapati N, Patil V. Pathways to care and barriers in treatment among patients with Dissociative disorders. Asian J Psychiatr 2024; 95:104000. [PMID: 38507864 DOI: 10.1016/j.ajp.2024.104000] [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: 10/11/2023] [Revised: 03/02/2024] [Accepted: 03/06/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Dissociative disorder patients often present with sudden and embarrassing symptoms, and it is difficult for the patient and care giver to understand initially, recognize the need for help and reach for appropriate treatment timely. This can result in high risk of engaging in dangerous behaviors such as self-harm and suicidal acts, impaired global functioning, and poor quality of life. Knowledge about the types of barriers which are there in treatment seeking, can help in planning strategies for their removal and to facilitate the treatment process. METHODS Cross-sectional study among patients (n=133) with Dissociative disorders which were recruited from January 2023 to June 2023 in a tertiary care hospital. Pathways to care and barriers in treatment for Dissociative disorders were assessed by interviewing patients using semi-structured proforma. The Dissociative Experience Scale and World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0)) were used to assess disease severity and impact of illness on various domains of life respectively. Group comparison was made to assess differences in social- clinical profile of patients choosing different modalities of treatment. RESULTS 133 patients of Dissociative disorders with mean age 29.6±9.2, showed their first-choice of help seeking from general practitioner/ neurologist (40.6%), traditional faith healers (35.3%), psychiatrist (18.1%) and 5.2% preferred alternative treatments. This trend changed with 2nd and 3rd contact of help seeking with greater preference for psychiatrist in their 2nd (n=45, 33.8%) and 3rd (n=69, 51.8%) contact. The median duration of untreated illness was 56 weeks (IQR 24-182 weeks). Social-clinical profile of patients varied with their choice of treatment, having lower education level (P = 0.013), longer duration of untreated illness (p=0.003), more severity of symptoms (p=0.032) and greater disability scores(p=0.002) in patients whose first treatment choice was traditional faith healers. More than 70% patients faced availability barriers, stigma, unawareness about mental illness and influence of others in treatment of choice as barriers in initiating and continuing treatment. CONCLUSION Patients with Dissociative disorders seek treatment from a multitude of healthcare providers including traditional faith healers, general physicians, and alternative medicine practitioners before reaching psychiatrist and undergoes various barriers in treatment. There is need to implement necessary measures for sensitization and awareness about Dissociative disorders to prevent prolonged and undue delays in initiation of appropriate management.
Collapse
Affiliation(s)
- Pooja Shakya
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Mamta Sood
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Rahul Mathur
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Nisha Prajapati
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Vaibhav Patil
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| |
Collapse
|
39
|
Lynch L, Moorhead A, Long M, Hawthorne-Steele I. "If you don't actually care for somebody, how can you help them?": Exploring Young People's Core Needs in Mental Healthcare-Directions for Improving Service Provision. Community Ment Health J 2024; 60:796-812. [PMID: 38430285 PMCID: PMC11001725 DOI: 10.1007/s10597-024-01237-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/10/2024] [Indexed: 03/03/2024]
Abstract
Youth suicide and mental health are important issues of global concern that require timely and evidence-based interventions to increase quality of life and prevent deaths. Findings report that young people have lower mental health help-seeking rates, and there is a lack of qualitative research examining why. The aim of this research study was to further understanding on young people's core needs in mental healthcare based on actual experiences (PLE) of help-seeking with providers of mental health services. Constructivist Grounded Theory methods (Charmaz, 2014) informed this study design, and in-depth interviews and a focus group were conducted with 18 young people. The findings were presented across four sub-categories, which together describe the common factors, that are regarded as essential in youth mental healthcare provision. These include: 1. The services; 2. The helper; 3. The interventions, and 4. The impact of development. Critical discussion into young people's needs in mental healthcare was provided including the key service factors, approach and rapport with helpers, types of intervention and alignment with typical developmental capacity. This article provides guidance on how to improve, design, or reform service provision, and can be a useful resource for policy makers, service providers and practitioners. This study concluded that youth participation in the co-design of service provision is important as it can reduce health disparities and ensure that services provide relevant, respectful and suitable care that reflects the way in which young people experience mental health problems as well as the ways in which they want to be helped.
Collapse
Affiliation(s)
- Louise Lynch
- School of Communication and Media, Faculty of Arts, Humanities and Social Sciences, Ulster University, York Street, Belfast, Co. Antrim, BT15 1ED, Northern Ireland.
| | - Anne Moorhead
- School of Communication and Media, Institute for Nursing and Health Research, Ulster University, York Street, Belfast, Co. Antrim, BT15 1ED, Northern Ireland
| | - Maggie Long
- School of Communication and Media, Centre for Communication and Media Research, Faculty of Arts, Humanities and Social Science, Ulster University, York Street, Belfast, Co. Antrim, BT15 1ED, Northern Ireland
| | - Isobel Hawthorne-Steele
- School of Applied Social and Policy Sciences, Faculty of Arts, Humanities and Social Sciences, Ulster University, York Street, Belfast, Co. Antrim, BT15 1ED, Northern Ireland
| |
Collapse
|
40
|
Lemmer D, Moessner M, Arnaud N, Baumeister H, Mutter A, Klemm SL, König E, Plener P, Rummel-Kluge C, Thomasius R, Kaess M, Bauer S. The Impact of Video-Based Microinterventions on Attitudes Toward Mental Health and Help Seeking in Youth: Web-Based Randomized Controlled Trial. J Med Internet Res 2024; 26:e54478. [PMID: 38656779 PMCID: PMC11079770 DOI: 10.2196/54478] [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: 11/13/2023] [Revised: 12/22/2023] [Accepted: 03/08/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Mental health (MH) problems in youth are prevalent, burdening, and frequently persistent. Despite the existence of effective treatment, the uptake of professional help is low, particularly due to attitudinal barriers. OBJECTIVE This study evaluated the effectiveness and acceptability of 2 video-based microinterventions aimed at reducing barriers to MH treatment and increasing the likelihood of seeking professional help in young people. METHODS This study was entirely web based and open access. The interventions addressed 5 MH problems: generalized anxiety disorder, depression, bulimia, nonsuicidal self-injury, and problematic alcohol use. Intervention 1 aimed to destigmatize and improve MH literacy, whereas intervention 2 aimed to induce positive outcome expectancies regarding professional help seeking. Of the 2435 participants who commenced the study, a final sample of 1394 (57.25%) participants aged 14 to 29 years with complete data and sufficient durations of stay on the video pages were randomized in a fully automated manner to 1 of the 5 MH problems and 1 of 3 conditions (control, intervention 1, and intervention 2) in a permuted block design. After the presentation of a video vignette, no further videos were shown to the control group, whereas a second, short intervention video was presented to the intervention 1 and 2 groups. Intervention effects on self-reported potential professional help seeking (primary outcome), stigma, and attitudes toward help seeking were examined using analyses of covariance across and within the 5 MH problems. Furthermore, we assessed video acceptability. RESULTS No significant group effects on potential professional help seeking were found in the total sample (F2,1385=0.99; P=.37). However, the groups differed significantly with regard to stigma outcomes and the likelihood of seeking informal help (F2,1385=3.75; P=.02). Furthermore, separate analyses indicated substantial differences in intervention effects among the 5 MH problems. CONCLUSIONS Interventions to promote help seeking for MH problems may require disorder-specific approaches. The study results can inform future research and public health campaigns addressing adolescents and young adults. TRIAL REGISTRATION German Clinical Trials Register DRKS00023110; https://drks.de/search/de/trial/DRKS00023110.
Collapse
Affiliation(s)
- Diana Lemmer
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Nicolas Arnaud
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Agnes Mutter
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Sarah-Lena Klemm
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Elisa König
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Rainer Thomasius
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Stephanie Bauer
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
- German Center for Mental Health (DZPG), Partner site Mannheim/Heidelberg/Ulm, Heidelberg, Germany
| |
Collapse
|
41
|
Andersén MB, Revenäs Å, Lostelius PV, Olsson EMG, Bring A, Ring L. "It's about how you take in things with your brain" - young people's perspectives on mental health and help seeking: an interview study. BMC Public Health 2024; 24:1095. [PMID: 38643072 PMCID: PMC11031856 DOI: 10.1186/s12889-024-18617-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/16/2024] [Indexed: 04/22/2024] Open
Abstract
INTRODUCTION Poor mental health in young people has become a growing problem globally over the past decades. However, young people have also been shown to underutilize available healthcare resources. The World Health Organisation (WHO) has formulated guidelines for youth-friendly health services (YFHSs) to increase youth participation in healthcare. Still, little is known about how young people using these services perceive mental health, indicating a knowledge gap concerning the subjective evaluation of their mental health. AIM To investigate how young people visiting youth health clinics (YHC) perceive the concept of mental health and factors they view as central to maintaining mental health. METHODS In total 21 interviews were carried out, 16 in 2018, and 5 in 2023 to assure no changes in findings after the COVID-19 pandemic. Subjects were recruited during visits to youth health clinics (YHCs) in mid-Sweden and were aged 15-23 years. Recruitment strived to achieve heterogeneity in the sample concerning gender, sexual orientation, gender identity and age. Interviews were transcribed and analysed using qualitative content analysis. FINDINGS Findings of the analysis revealed two themes, "Mental health is helped and hindered by the surroundings" and "Mental health is difficult to understand and difficult to achieve". The participants described their health as highly dependent on their social surroundings, and that these are important to maintaining health but may also affect health negatively. They described mixed experiences of the health care services and mentioned prerequisites for seeking care for mental health problems such as accessibility and respect for their integrity, including the right to turn down offered treatment. The informants also viewed mental health as an ongoing undertaking that one must work for, and that it is sometimes difficult to know what constitutes mental health. They also expressed a need from healthcare services to enquire about their health, and to show an active interest in how they are doing. CONCLUSIONS Findings underline the need of young people's individual needs to be met in the healthcare system and their vulnerability to their social surroundings. Health status assessments in young people should consider social and individual factors to fully capture mental health.
Collapse
Affiliation(s)
- Mikael B Andersén
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
- Region Uppsala, Primary Care and Health, Uppsala, Sweden.
| | - Åsa Revenäs
- Centre for Clinical Research, Region Västmanland - Uppsala University, Västmanland Hospital Västerås, Västerås, Sweden
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Orthopedic clinic, Västmanland Hospital Västerås, Västerås, Sweden
| | - Petra V Lostelius
- Centre for Clinical Research, Region Västmanland - Uppsala University, Västmanland Hospital Västerås, Västerås, Sweden
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Clinic for Pain Rehabilitation Västmanland, Region Västmanland, Västerås, Sweden
| | - Erik M G Olsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Annika Bring
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Lena Ring
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Region Uppsala, Primary Care and Health, Uppsala, Sweden
| |
Collapse
|
42
|
Solbakken LE, Bergvik S, Wynn R. Breaking down barriers to mental healthcare access in prison: a qualitative interview study with incarcerated males in Norway. BMC Psychiatry 2024; 24:292. [PMID: 38632543 PMCID: PMC11025238 DOI: 10.1186/s12888-024-05736-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Mental health problems are highly prevalent in prison populations. Incarcerated persons generally come from disadvantaged backgrounds and are living under extraordinary conditions while in prison. Their healthcare needs are complex compared to the general population. Studies have found that incarcerated individuals are reluctant to seek help and that they experience challenges in accessing mental healthcare services. To some extent, seeking treatment depends on the degree of fit between potential users and health services, and actual use might be a better indication of accessibility than the fact that services are available. This study aimed to explore individual and systemic facilitators and barriers to accessing mental healthcare in a prison context. METHODS An analytical approach drawing on elements of constructivist Grounded theory was the methodological basis of this study. Fifteen male participants were recruited from three prisons in Northern Norway. Data was collected through in-depth interviews on topics such as help-seeking experiences, perceived access to services and availability of health information. RESULTS We found that distrust in the system, challenges with the referral routines, worries about negative consequences, and perceived limited access to mental healthcare were barriers to help-seeking among incarcerated individuals. How prison officers, and healthcare personnel respond to incarcerated persons reporting mental distress could also be critical for their future willingness to seek help. Providing information about mental health and available services, initiating outreaching mental health services, and integrating mental health interventions into treatment programs are examples of efforts that might reduce barriers to accessing services. CONCLUSIONS Facilitating access to mental health services is crucial to accommodate the mental health needs of those incarcerated. This study provides insights into the complex interplay of individual, social and systemic factors that may contribute to the utilization of mental health care among incarcerated persons. We suggest that correctional and healthcare systems review their practices to facilitate access to healthcare for people in prison.
Collapse
Affiliation(s)
- Line Elisabeth Solbakken
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, N-9038, Norway
- Division of Mental Health and Substance Use, University Hospital of North, Tromsø, Norway
| | - Svein Bergvik
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Rolf Wynn
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, N-9038, Norway.
- Department of Education, ICT and Learning, Østfold University College, Tromsø, Norway.
| |
Collapse
|
43
|
Gellatly R, Boustani M, Nair P, Mahajan R, Jambhale A, Sahu R, Chodankar B, Krishna M, Malik K, Mathur S, Becker K, Michelson D, Patel V, Chorpita B. Adolescent engagement in a stepped care, transdiagnostic mental health intervention delivered in Indian schools. DISCOVER PSYCHOLOGY 2024; 4:43. [PMID: 38686018 PMCID: PMC11057193 DOI: 10.1007/s44202-024-00154-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/12/2024] [Indexed: 05/02/2024]
Abstract
Given the relationship between poor engagement and worse treatment outcomes, improving engagement has been the focus of attention in recent years. Engagement is a particular challenge among minoritized and otherwise challenged youth, such as those from socioeconomically disadvantaged groups, including youth in low- and middle-income countries (LMICs), where they face lower levels of access to resources, including mental health treatment. The present study describes engagement challenges that arose in an uncontrolled pre-post evaluation of a school-based, modular, multi-problem, stepped-care intervention delivered in urban Indian communities. Specifically, the study aimed to (1) characterize barriers and facilitators of youth treatment engagement; and (2) evaluate treatment acceptability and fit of treatment from the youth perspective. Youth participants completed semi-structured interviews, which were transcribed and coded using thematic analysis. Participants described numerous facilitators to engagement (e.g., positive therapeutic relationship) and reported high overall satisfaction with the intervention, while also identifying barriers to engagement (e.g., concerns about confidentiality) and offering suggestions to increase fit and acceptability (e.g., more visually appealing treatment materials). Findings highlight ways in which engagement can be enhanced and implementation supports improved to maximize treatment effectiveness among minoritized and disadvantaged youth in LMICs. Supplementary Information The online version contains supplementary material available at 10.1007/s44202-024-00154-1.
Collapse
Affiliation(s)
- Resham Gellatly
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
| | | | | | | | | | | | | | | | - Kanika Malik
- PRIDE Project, Sangath, New Delhi India
- Jindal School of Psychology and Counselling, O.P. Jindal Global University, Sonipat, Haryana India
| | | | - Kimberly Becker
- Department of Psychology, University of South Carolina, Columbia, SC USA
| | - Daniel Michelson
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Vikram Patel
- PRIDE Project, Sangath, New Delhi India
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA USA
| | - Bruce Chorpita
- Department of Psychology, University of California, Los Angeles, CA USA
| |
Collapse
|
44
|
Blair M, Tweedlie L, Minnis H, Cronin I, Turner F. Online therapy with families - what can families tell us about how to do this well? A qualitative study assessing families' experience of remote Dyadic Developmental Psychotherapy compared to face-to-face therapy. PLoS One 2024; 19:e0301640. [PMID: 38626223 PMCID: PMC11020366 DOI: 10.1371/journal.pone.0301640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/19/2024] [Indexed: 04/18/2024] Open
Abstract
Dyadic Developmental Psychotherapy (DDP) is a family-based therapy for adopted children aiming to achieve secure attachment between the child and parent. Due to restrictions under the COVID-19 pandemic, delivery of DDP transitioned from face-to-face to online methods. This study aimed to explore families experience of online DDP compared to face-to-face DDP, looking at the advantages and disadvantages of remote delivery methods and the implications this has on future service delivery for clinicians. Semi-structured interviews with 6 families were conducted online. Analysis of transcripts using Interpretative Phenomenological Analysis (IPA) revealed four superordinate themes: environment and child engagement, non-verbal communication, travel and familiarity with remote interactions. Parents recognised the influence the physical and online environment had on their child's engagement levels, however, varied in their experience and hence preference of delivery method. All families emphasised the importance of non-verbal communication within DDP sessions and majority highlighted this may be lost online. For families who travelled to face-to-face DDP, car journeys provided a unique opportunity to decompress and reflect after sessions. For families where travel is unfeasible, online DDP was a lifeline, demonstrating the ability of remote therapy to widen access to specialist healthcare. Familiarity with online work emerged as a strong indicator of positive attitudes towards remote DDP, especially if the previous experience is positive and the child is confident using technology. Overall, families differed greatly in their experience of remote and face-to-face DDP indicating a new approach must be undertaken with each family beginning therapy, ensuring it is unique and individual to their needs.
Collapse
Affiliation(s)
- Monica Blair
- College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Leigh Tweedlie
- College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Helen Minnis
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Irene Cronin
- Academic Child and Mental Health Services, University of Glasgow, Glasgow, United Kingdom
| | - Fiona Turner
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| |
Collapse
|
45
|
Calear AL, Macleod E, Hoye AM, McCallum S, Morse A, Farrer LM, Batterham PJ. Pragmatic controlled trial of a school-based emotion literacy program for 8- to 10-year-old children: study protocol. BMC Psychiatry 2024; 24:275. [PMID: 38609882 PMCID: PMC11010293 DOI: 10.1186/s12888-024-05628-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/20/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Mental disorders are common in childhood, but many young people do not receive adequate professional support. Help-seeking interventions may bridge this treatment gap, however, there is limited research on interventions for primary-school children. This study aims to evaluate the effectiveness of an emotion literacy program at increasing literacy, reducing stigma, and promoting help-seeking in children aged 8-10 years. METHODS AND ANALYSIS A two-arm pragmatic cluster-controlled trial will compare Thriving Minds, an emotion literacy program for middle primary school children, to a wait-list control condition. Children aged 8-10 years will be recruited from approximately 12 schools (6 intervention schools/6 wait-list control) to participate in Thriving Minds via direct invitation by the program delivery service. Allocation to the intervention condition will be pragmatically, by school. Children will receive the intervention over two 50-minute sessions, across two weeks. Using story books and interactive discussion, the program aims to develop children's knowledge of their own and other's emotional experiences and emotion regulation strategies (self-care and help-seeking). The primary outcome is help-seeking intentions. Secondary outcomes include help-seeking knowledge, attitudes, and behaviours, emotion knowledge and attitudes, and stigma. Children will complete surveys at pre-intervention, post-intervention (one week after the program) and 12-week follow-up. Additional satisfaction data will be collected from teachers in intervention schools via surveys (post-intervention and 3-month follow-up) and semi-structured interviews (after follow-up), and selected children via focus groups (12-week follow-up). Analyses will compare changes in help-seeking intentions relative to the waitlist control condition using mixed-model repeated-measures analyses to account for clustering within schools. DISCUSSION With demonstrated effectiveness, this universal emotion literacy program for promoting help-seeking for mental health could be more widely delivered in Australian primary schools, providing a valuable new resource, contributing to the mental health of young people by improving help-seeking for early mental health difficulties. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry, ACTRN12623000910606 Registered on 24 August 2023.
Collapse
Affiliation(s)
- Alison L Calear
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australia.
| | - Emily Macleod
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Ashley M Hoye
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Sonia McCallum
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Alyssa Morse
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Louise M Farrer
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australia
| |
Collapse
|
46
|
Kaufman A, Nemeroff R. Motivation to change predicts college students' utilization of self-help resources. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38592799 DOI: 10.1080/07448481.2024.2334082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/11/2024] [Indexed: 04/11/2024]
Abstract
Background: Stress and mental health difficulties are common burdens on college students. College counseling centers have been overrun by demand. Thus, self-help interventions may offer a promising alternative to traditional college counseling services. Methods: The current study examined the influence of perceived stress, motivation to change, and self-efficacy beliefs on college students' use of self-help resources, to determine whether these factors would predict follow-up with self-help recommendations. Results: Results of stepwise linear regression models suggest that perceived stress and self-efficacy did not predict self-help resource utilization. Different types of self-help recommendations did not predict different levels of follow-up. However, motivation to change was a significant predictor college students' self-help resource use, and this variable was particularly important when self-help recommendations were less structured. Conclusions: These findings can help to predict which college students are likely to make use of self-help resources, and inform targeted individual treatment.
Collapse
Affiliation(s)
- Alyson Kaufman
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - Robin Nemeroff
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| |
Collapse
|
47
|
Grohmann E, Al-Addous A, Sander C, Dogan-Sander E, Baumann E, Angermeyer MC, Schomerus G. Changes in the ability to correctly identify schizophrenia and depression: results from general population surveys in Germany over 30 years. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02660-y. [PMID: 38583103 DOI: 10.1007/s00127-024-02660-y] [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: 10/10/2023] [Accepted: 03/10/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE This study aims to examine time trends in the ability to correctly identify schizophrenia and major depression within the German general population from 1990 to 2020, as an indicator of changing mental health literacy (MHL). Additionally, we investigated shifts in the use of stigmatizing language. METHODS Our analysis is based on four waves of representative population surveys in Germany in 1990/1993 (West Germany: N = 2044, East Germany: N = 1563), 2001 (N = 5025), 2011 (N = 2455), and 2020 (N = 3042) using identical methodology. Respondents were presented with an unlabelled case vignette describing a person who exhibited symptoms of either schizophrenia or major depression. Participants were then asked to name the problem described in the vignette using an open-ended question. RESULTS From 1990/1993 to 2020, correct identification of schizophrenia increased from 18% to 34% and from 27% to 46% for major depression. However, derogatory labels remained constant throughout all survey waves, particularly for schizophrenia (19% in 1990/1993 and 18% in 2020). For depression, more trivializing and potentially devaluing statements were recorded. CONCLUSION Despite the increasing use of psychiatric terminology among the general population, the persistence of derogatory labels suggests that improved MHL, reflected in higher recognition rates, may not automatically translate into a reduction in stigmatizing language. With depression, a normalization and trivialization of a severe illness could pose new challenges to people with major depression. Dedicated efforts to combat the stigma of severe mental illness are still needed.
Collapse
Affiliation(s)
- Elise Grohmann
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Centre, Leipzig, Germany.
| | - Amani Al-Addous
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Centre, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Centre, Leipzig, Germany
| | - Ezgi Dogan-Sander
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Centre, Leipzig, Germany
| | - Eva Baumann
- Department of Journalism and Communication Research, Hannover University of Music, Drama, and Media, Hannover, Germany
| | | | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Centre, Leipzig, Germany
| |
Collapse
|
48
|
Özkan E, Altuntaş O. Effects of online coping skills training on stress, anxiety and social problem solving in young people: A randomised controlled study. Int J Soc Psychiatry 2024:207640241239539. [PMID: 38563408 DOI: 10.1177/00207640241239539] [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: 04/04/2024]
Abstract
BACKGROUND Although most young people successfully manage the transition from childhood to adulthood, the speed and magnitude of these changes can cause stress that can exceed the coping abilities of many young people. Previous studies have suggested that adolescence is a vulnerable period for the development of psychiatric disorders; therefore, an adequate coping repertoire must be developed. AIMS Our aims were to develop and implement a coping skills training for young people and to evaluate the results of the training. Therefore, the components of the coping skills training programs in the existing literature were used. METHODS Young people from Turkey participated in this cluster randomised controlled trial (n = 89; mean age, 20.06 ± 1.44 years). Ten sessions of the coping skills training were applied in the study group (SG; n = 33), and one session was applied in the control group (CG; n = 56). To assess the effects of the coping skills training, all participants completed several psychological questionnaires (for stress, anxiety, coping and social problem-solving evaluations) at the beginning and end of the training. We performed an analysis of covariance (ANCOVA). In cases where ANCOVA assumptions could not be met, the efficacy of the intervention was determined using the mixed design/split-plot analysis of variance. RESULTS Compared with the CG, the SG had significantly reduced stress and anxiety levels and increased adaptive coping skills. Social problem-solving skills remained relatively similar between the groups. CONCLUSION Complete and correct implementation of coping skills training among the youth may contribute positively to the development of adaptive coping skills by reducing their stress and anxiety levels. This online coping skills training program allowed young people to directly experience their response to stress and offered opportunities to try and develop different coping strategies. Coping skills should be considered for successful stress and anxiety management in everyday life.
Collapse
Affiliation(s)
- Esma Özkan
- Department of Occupational Therapy, Faculty of Health Sciences, University of Health Sciences Türkiye, Ankara, Turkey
| | - Onur Altuntaş
- Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Türkiye
| |
Collapse
|
49
|
Amsalem D, Jankowski SE, Markowitz JC, Stroup TS, Dixon LB, Pope LG. Comparing brief video interventions to reduce public and self-stigma: Randomized control trial. Early Interv Psychiatry 2024. [PMID: 38565326 DOI: 10.1111/eip.13524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/16/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024]
Abstract
AIM Stigma is a major mental healthcare barrier. This study compares the efficacy of two types of brief video interventions, targeting public and self-stigma, in reducing public stigma towards people living with psychosis. We hypothesized both interventions would similarly reduce public stigma and outperform the control group. As a secondary analysis, we explored the effect of familiarity with a person living with serious mental illness (SMI). METHODS Participants (N = 1215) aged 18-35 recruited through crowdsourcing were assessed pre- and post-intervention and at 30-day follow-up regarding five public stigma domains: social distance, stereotyping, separateness, social restriction and perceived recovery. Both videos present individual narratives using different approaches: the self-stigma video was created through focus groups, while the public stigma video portrays a single person's journey. RESULTS A 3 × 3 analysis of variance (ANOVA) revealed a significant group-by-time interaction across all five stigma-related domains (p's < .001). Effect sizes (Cohen's d) ranged from 0.29 to 0.52 (baseline to post-intervention), and 0.18 to 0.45 (baseline to 30-day follow-up). The two video interventions did not significantly differ. Linear mixed modelling showed a significant difference between participants familiar and unfamiliar with people living with SMI for the public stigma video, with greater stigma reductions for unfamiliar participants. CONCLUSIONS This study corroborates previous findings on the positive influence of social contact-based interventions on youth mental health perceptions. Results provide insights into the relationship between public and self-stigma and the impact that familiarity with SMI may have on the efficacy of stigma reduction efforts further validation in diverse groups is needed.
Collapse
Affiliation(s)
- Doron Amsalem
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
| | - Samantha E Jankowski
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
| | - John C Markowitz
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
| | - T Scott Stroup
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
| | - Lisa B Dixon
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
| | - Leah G Pope
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
| |
Collapse
|
50
|
Renwick L, Pedley R, Johnson I, Bell V, Lovell K, Bee P, Brooks H. Mental health literacy in children and adolescents in low- and middle-income countries: a mixed studies systematic review and narrative synthesis. Eur Child Adolesc Psychiatry 2024; 33:961-985. [PMID: 35570227 PMCID: PMC11032284 DOI: 10.1007/s00787-022-01997-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 04/23/2022] [Indexed: 12/12/2022]
Abstract
Mental illnesses are the leading cause of disease burden among children and young people (CYP) globally. Low- and middle-income countries (LMIC) are disproportionately affected. Enhancing mental health literacy (MHL) is one way to combat low levels of help-seeking and effective treatment receipt. We aimed to synthesis evidence about knowledge, beliefs and attitudes of CYP in LMICs about mental illnesses, their treatments and outcomes, evaluating factors that can enhance or impede help-seeking to inform context-specific and developmentally appropriate understandings of MHL. Eight bibliographic databases were searched from inception to July 2020: PsycInfo, EMBASE, Medline (OVID), Scopus, ASSIA (ProQuest), SSCI, SCI (Web of Science) CINAHL PLUS, Social Sciences full text (EBSCO). 58 papers (41 quantitative, 13 qualitative, 4 mixed methods) representing 52 separate studies comprising 36,429 participants with a mean age of 15.3 [10.4-17.4], were appraised and synthesized using narrative synthesis methods. Low levels of recognition and knowledge about mental health problems and illnesses, pervasive levels of stigma and low confidence in professional healthcare services, even when considered a valid treatment option were dominant themes. CYP cited the value of traditional healers and social networks for seeking help. Several important areas were under-researched including the link between specific stigma types and active help-seeking and research is needed to understand more fully the interplay between knowledge, beliefs and attitudes across varied cultural settings. Greater exploration of social networks and the value of collaboration with traditional healers is consistent with promising, yet understudied, areas of community-based MHL interventions combining education and social contact.
Collapse
Affiliation(s)
- Laoise Renwick
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Rebecca Pedley
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Isobel Johnson
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Vicky Bell
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Helen Brooks
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| |
Collapse
|