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Lyzwinski L, Mcdonald S, Zwicker J, Tough S. Digital and Hybrid Pediatric and Youth Mental Health Program Implementation Challenges During the Pandemic: Literature Review With a Knowledge Translation and Theoretical Lens Analysis. JMIR Pediatr Parent 2024; 7:e55100. [PMID: 38916946 PMCID: PMC11234057 DOI: 10.2196/55100] [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: 12/02/2023] [Revised: 03/20/2024] [Accepted: 03/26/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND The pandemic brought unprecedented challenges for child and youth mental health. There was a rise in depression, anxiety, and symptoms of suicidal ideation. OBJECTIVE The aims of this knowledge synthesis were to gain a deeper understanding of what types of mental health knowledge translation (KT) programs, mental health first aid training, and positive psychology interventions were developed and evaluated for youth mental health. METHODS We undertook a literature review of PubMed and MEDLINE for relevant studies on youth mental health including digital and hybrid programs undertaken during the pandemic (2020-2022). RESULTS A total of 60 studies were included in this review. A few KT programs were identified that engaged with a wide range of stakeholders during the pandemic, and a few were informed by KT theories. Key challenges during the implementation of mental health programs for youth included lack of access to technology and privacy concerns. Hybrid web-based and face-to-face KT and mental health care were recommended. Providers required adequate training in using telehealth and space. CONCLUSIONS There is an opportunity to reduce the barriers to implementing tele-mental health in youth by providing adequate technological access, Wi-Fi and stationary internet connectivity, and privacy protection. Staff gained new knowledge and training from the pandemic experience of using telehealth, which will serve as a useful foundation for the future. Future research should aim to maximize the benefits of hybrid models of tele-mental health and face-to-face sessions while working on minimizing the potential barriers that were identified. In addition, future programs could consider combining mental health first aid training with hybrid digital and face-to-face mental health program delivery along with mindfulness and resilience building in a unified model of care, knowledge dissemination, and implementation.
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Affiliation(s)
- Lynnette Lyzwinski
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- The School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Sheila Mcdonald
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Jennifer Zwicker
- The School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Suzanne Tough
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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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.
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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
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Closson K, Zharima C, Kuchena TM, Dietrich JJ, Ogilvie G, Raj A, Beksinska M, Kaida A. Relationship impacts of the COVID-19 pandemic and lockdown restrictions on young women and men in Durban and Soweto, South Africa. CULTURE, HEALTH & SEXUALITY 2024; 26:734-746. [PMID: 37584715 DOI: 10.1080/13691058.2023.2243300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023]
Abstract
To deepen our understanding of the impact of the COVID-19 pandemic on intimate and/or sexual relationships, we conducted a qualitative study among 26 South African women and men aged 21-30 years in Durban and Soweto between September 2020 and March 2021. Overall, 13 women and 12 men who had been in an intimate and/or sexual relationship since the start of the COVID-19 pandemic were asked about the impact of COVID-19 on their relationships with their current or most recent primary partners. Data were analysed using reflexive thematic analysis. The three most common impacts of the COVID-19 pandemic on relationships were on (i) communication and connection; (ii) strained relationships; and (iii) job and economic loss. Both women and men discussed how COVID-19-related lockdowns provided opportunities to foster better communication, connection and support to one another. However, too little or too much time together strained relationships. Finally, income loss among young men meant that some young women became the primary income earner, changing relationship power dynamics. Findings highlight the importance of young people's relationships and the need for action to support young people in building positive relationships in challenging times.
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Affiliation(s)
- Kalysha Closson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Campion Zharima
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - T Michelle Kuchena
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Janan J Dietrich
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Gina Ogilvie
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Anita Raj
- Center on Gender Equity and Health, University of CA, San Diego, CA, US
- Newcomb Institute, Tulane University, New Orleans, LA, US
| | - Mags Beksinska
- Maternal, Adolescent and Child Health Research Unit, University of the Witwatersrand, Durban, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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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.
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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
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Klymkiw DF, Day DM, Henderson JL, Hawke LD. What do justice-involved youth want from integrated youth services? A conjoint analysis. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2024; 33:18-32. [PMID: 38449724 PMCID: PMC10914151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/09/2023] [Indexed: 03/08/2024]
Abstract
Background Many youth in the criminal justice system are affected by mental health and/or substance use (MHS) challenges, yet only a minority receive treatment. One way to increase access to MHS care is integrated youth services (IYS), a community-based model of service delivery where youth can access evidence-based treatment for their MHS problems and other wellbeing needs, in one location. However, it is unknown what IYS services justice-involved youth prioritize. Objective This study explored what components of IYS justice-involved youth deem to be the most important in meeting their MHS service needs, in comparison with non-justice-involved youth, by conducting a secondary analysis of data gathered from a larger Ontario-wide study. Method Using a conjoint analysis, n = 55 justice-involved youth, and n = 188 non-justice-involved youth, completed thirteen choice tasks representing different combinations of IYS. Results Both justice-involved and non-justice-involved youth exhibited preferences for a broad range of core health services, including mental health services, substance misuse counseling, medication management, and physical or sexual health services. They also preferred a broad range of additional support services, in addition to fast access to care in a community setting that specializes in mental health services, with the incorporation of e-health services. Justice-involved youth prioritized working with a trained peer support worker to learn life skills and help them with the services they need. The importance of youth playing a leadership role in making decisions within IYS organizations was also a distinguishing preference among justice-involved youth. Conclusions Tailoring IYS to meet the service preferences of justice-involved youth may enhance service utilization, potentially leading to better outcomes for justice-involved youth and their communities.
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Affiliation(s)
- Deanna F Klymkiw
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario
| | - David M Day
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario
| | - J L Henderson
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | - Lisa D Hawke
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
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Berardi C, Antonini M, Jordan Z, Wechtler H, Paolucci F, Hinwood M. Barriers and facilitators to the implementation of digital technologies in mental health systems: a qualitative systematic review to inform a policy framework. BMC Health Serv Res 2024; 24:243. [PMID: 38408938 PMCID: PMC10898174 DOI: 10.1186/s12913-023-10536-1] [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: 02/04/2023] [Accepted: 12/28/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Despite the potential for improved population mental health and wellbeing, the integration of mental health digital interventions has been difficult to achieve. In this qualitative systematic review, we aimed to identify barriers and facilitators to the implementation of digital technologies in mental healthcare systems, and map these to an implementation framework to inform policy development. METHODS We searched Medline, Embase, Scopus, PsycInfo, Web of Science, and Google Scholar for primary research articles published between January 2010 and 2022. Studies were considered eligible if they reported barriers and/or facilitators to the integration of any digital mental healthcare technologies. Data were extracted using EPPI-Reviewer Web and analysed thematically via inductive and deductive cycles. RESULTS Of 12,525 references identified initially, 81 studies were included in the final analysis. Barriers and facilitators were grouped within an implementation (evidence-practice gap) framework across six domains, organised by four levels of mental healthcare systems. Broadly, implementation was hindered by the perception of digital technologies as impersonal tools that add additional burden of care onto both providers and patients, and change relational power asymmetries; an absence of resources; and regulatory complexities that impede access to universal coverage. Facilitators included person-cantered approaches that consider patients' intersectional features e.g., gender, class, disability, illness severity; evidence-based training for providers; collaboration among colleagues; appropriate investment in human and financial resources; and policy reforms that tackle universal access to digital health. CONCLUSION It is important to consider the complex and interrelated nature of barriers across different domains and levels of the mental health system. To facilitate the equitable, sustainable, and long-term digital transition of mental health systems, policymakers should consider a systemic approach to collaboration between public and private sectors to inform evidence-based planning and strengthen mental health systems. PROTOCOL REGISTRATION The protocol is registered on PROSPERO, CRD42021276838.
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Affiliation(s)
- Chiara Berardi
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia.
| | - Marcello Antonini
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Department of Health Policy, London School of Economics and Political Science, London, WC2A 2AE, UK
| | - Zephanie Jordan
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia
| | - Heidi Wechtler
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia
| | - Francesco Paolucci
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia
| | - Madeleine Hinwood
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Emezue CN, Karnik NS, Sabri B, Anakwe A, Bishop-Royse JC, Dan-Irabor D, Froilan AP, Dunlap A, Li Q, Julion W. Mental Telehealth Utilization Patterns Among High School Students from Racial and Ethnic Minority Backgrounds Affected by Violence and Substance Use. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01936-y. [PMID: 38366279 DOI: 10.1007/s40615-024-01936-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/18/2024] [Accepted: 01/31/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Recent data show high school students from racial and ethnic minority (REM) backgrounds in the United States confront a twofold challenge, marked by the highest rates of firearm-related homicides since 1994 and increased youth substance use. The pandemic increased online and telehealth usage opportunities for at-risk REM youth. Therefore, this study investigated (1) the frequency and prevalence of co-occurring youth violence and substance use among REM adolescents, (2) racial/ethnic, age, and natal sex (as gender data was not collected) differences in patterns and trends in co-occurring youth violence and substance use among REM adolescents, and (3) the relationship between these syndemic issues and REM adolescent mental telehealth use during the pandemic. METHODS Data was sourced from a nationally representative sample of U.S. 9th-12th students (n = 3241) who completed the CDC's 2021 Adolescent and Behavioral Experiences Survey (ABES). Using univariate (frequency distribution), bivariate (Pearson's chi-squared test), and multivariate logistic regression models, we examined seven violence victimization outcomes, four violence perpetration outcomes, two family violence outcomes, and six substance use outcomes and their associations with telehealth use for mental health (dependent variable) among REM adolescents. RESULTS This sample was primarily female (50.7%), Black or African American (48.3%), Hispanic or Latinx (20.6%), and identified as straight or heterosexual (69.5%). The study found significant sex-based differences in violence perpetration/victimization, substance use, and telehealth use for mental health. In general, mental telehealth use was significantly associated with substance use among REM adolescents (cigarette smoking, vaping, alcohol, marijuana, prescription meds, and illicit drug use) (p-value = .001). Mental telehealth use was also significantly associated with all peer and family violence outcomes (p < 0.001). Controlling for covariates, gun carrying was associated with 4.8 times higher odds of using mental telehealth. Students in a physical fight or carrying a weapon (gun, knife, or club) on school property had 2.45 times and 8.09 times the odds of utilizing mental telehealth. Bullied students were 2.5 times more likely to use mental telehealth (p-value < 0.05). Illicit drug use (cocaine, heroin, methamphetamines, and ecstasy) was associated with a higher likelihood of mental telehealth use (AOR = 1.3, p-value = .05). CONCLUSION Our results suggest crucial insights for shaping violence and substance use prevention strategies, with implications for the future of online and telehealth behavioral services. Mental telehealth help-seeking emerges as a crucial avenue for supporting adolescents affected by violence and substance use, especially when they face obstacles to accessing traditional services. It can work in tandem with in-person services to address these challenges.
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Affiliation(s)
- Chuka N Emezue
- Department of Women, Children, and Family Nursing, College of Nursing, Rush University Medical Center, Chicago, USA.
| | - Niranjan S Karnik
- Department of Psychiatry, Institute for Juvenile Research (IJR), University of Illinois Chicago, Chicago, USA
| | - Bushra Sabri
- Johns Hopkins University, School of Nursing, Baltimore, USA
| | - Adaobi Anakwe
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | | | - Dale Dan-Irabor
- School of Humanities and Social Sciences, University of Missouri Kansas City - Volker Campus, Kansas City, USA
| | - Andrew Paul Froilan
- Faculty Practice and Department of Women, Children, and Family Nursing, Rush University Medical Center, Chicago, USA
| | - Aaron Dunlap
- Department of Women, Children, and Family Nursing, College of Nursing, Rush University Medical Center, Chicago, USA
| | - Qing Li
- University of Mississippi Medical Center, School of Nursing, Jackson, USA
| | - Wrenetha Julion
- Department of Women, Children, and Family Nursing, College of Nursing, Rush University Medical Center, Chicago, USA
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Mazurka R, Vallis EH, Chen L, Freeman K, Langley R, Ross B, Arora S, Kahn M, Howard C, Liu D, Cumby J, Brennan ML, Hickcox SE, Bagnell AL, Propper L, Pavlova B, Uher R. Preferences for virtual versus in-person mental and physical healthcare in Canada: a descriptive study from a cohort of youth and their parents enriched for severe mental illness. BMJ Paediatr Open 2024; 8:e002197. [PMID: 38191204 PMCID: PMC10806455 DOI: 10.1136/bmjpo-2023-002197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/21/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Virtual care may improve access to healthcare and may be well suited to digitally connected youth, but experts caution that privacy and technology barriers could perpetuate access inequities. Success of virtual care will depend on its alignment with patient preferences. However, information on preferences for virtual and in-person healthcare is missing, especially for youth. We sought to quantify preferences for and barriers to virtual versus in-person mental and physical healthcare in youth and their parents, including in vulnerable segments of the population such as families with a parent with severe mental illness (SMI). METHODS Participants were 219 youth and 326 parents from the Families Overcoming Risks and Building Opportunities for Wellbeing cohort from Canada, of which 61% of youth had at least one parent with SMI. Participants were interviewed about healthcare preferences and access to privacy/technology between October 2021 and December 2022. RESULTS Overall, youth reported a preference for in-person mental (66.6%) and physical healthcare (74.7%) versus virtual care or no preference, and to a somewhat lesser degree, so did their parents (48.0% and 53.9%). Half of participants reported privacy/technology barriers to virtual care, with privacy being the most common barrier. Preferences and barriers varied as a function of parent SMI status, socioeconomic status and rural residence. CONCLUSIONS The majority of youth and parents in this study prefer in-person healthcare, and the preference is stronger in youth and in vulnerable segments of the population. Lack of privacy may be a greater barrier to virtual care than access to technology.
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Affiliation(s)
- Raegan Mazurka
- Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Emily Howes Vallis
- Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Lucy Chen
- Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Ross Langley
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Briana Ross
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Swasti Arora
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Mica Kahn
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Cynthia Howard
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Dara Liu
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Jill Cumby
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | | | - Samuel E Hickcox
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
- Office of Addictions and Mental Health, Government of Nova Scotia, Halifax, Nova Scotia, Canada
| | - Alexa L Bagnell
- Dalhousie University, Halifax, Nova Scotia, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Lukas Propper
- Dalhousie University, Halifax, Nova Scotia, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Barbara Pavlova
- Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Rudolf Uher
- Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
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Zhao X, Schueller SM, Kim J, Stadnick NA, Eikey E, Schneider M, Zheng K, Mukamel DB, Sorkin DH. Real-World Adoption of Mental Health Support Among Adolescents: Cross-Sectional Analysis of the California Health Interview Survey. J Pediatr Psychol 2023:jsad082. [PMID: 37978854 DOI: 10.1093/jpepsy/jsad082] [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: 05/18/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE We aim to examine: (a) the extent to which patterns of adoption of counseling services and digital mental health interventions (DMHIs) shifted in recent years (2019-2021); (b) the impact of distress on adoption of mental health support; and (c) reasons related to adolescents' low adoption of DMHIs when experiencing distress. METHODS Data were from three cohorts of adolescents aged 12-17 years (n = 847 in 2019; n = 1,365 in 2020; n = 1,169 in 2021) recruited as part of the California Health Interview Survey. We estimated logistic regression models to examine the likelihood of using mental health support as a function of psychological distress, sociodemographic characteristics, and cohorts. We also analyzed adolescents' self-reported reasons for not trying DMHIs as a function of distress. RESULTS The proportion of adolescents reporting elevated psychological distress (∼50%) was higher than those adopting counseling services (<20%) or DMHIs (<10%). A higher level of distress was associated with a greater likelihood of receiving counseling (OR = 1.15), and using DMHIs to connect with a professional (Odds ratio (OR) = 1.11) and for self-help (OR = 1.17). Among those experiencing high distress, adolescents' top reason for not adopting an online tool was a lack of perceived need (19.2%). CONCLUSION Adolescents' main barriers to DMHI adoption included a lack of perceived need, which may be explained by a lack of mental health literacy. Thoughtful marketing and dissemination efforts are needed to increase mental health awareness and normalize adoption of counseling services and DMHIs.
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Affiliation(s)
- Xin Zhao
- Department of General Internal Medicine, University of California, Irvine, USA
| | - Stephen M Schueller
- Department of Psychological Science, University of California, Irvine, USA
- Department of Informatics, University of California, Irvine, USA
| | - Jeongmi Kim
- Department of General Internal Medicine, University of California, Irvine, USA
| | - Nicole A Stadnick
- Department of Psychiatry, University of California San Diego, USA
- Altman Clinical and Translational Research Institute, Dissemination and Implementation Science Center, University of California San Diego, USA
- Child and Adolescent Services Research Center, USA
| | - Elizabeth Eikey
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, USA
- The Design Lab, University of California San Diego, USA
| | | | - Kai Zheng
- Department of Informatics, University of California, Irvine, USA
| | - Dana B Mukamel
- Department of General Internal Medicine, University of California, Irvine, USA
| | - Dara H Sorkin
- Department of General Internal Medicine, University of California, Irvine, USA
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10
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Messias E, Ugarte L, Azasu E, White AJ. A Tsunami of Concern: The Lasting Impacts of COVID Isolation and School Closures on Youth Mental Health. MISSOURI MEDICINE 2023; 120:328-332. [PMID: 37841568 PMCID: PMC10569389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Affiliation(s)
- Erick Messias
- Samuel W. Fordyce Professor and Chair, Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Leticia Ugarte
- Assistant Professor, Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Enoch Azasu
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Andrew J White
- Robert W. Wilmott Endowed Professor, Chair, Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri
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McClure EA, Baker N, Walters KJ, Tomko RL, Carpenter MJ, Bradley E, Squeglia LM, Gray KM. Monitoring Cigarette Smoking and Relapse in Young Adults With and Without Remote Biochemical Verification: Randomized Brief Cessation Study. JMIR Form Res 2023; 7:e47662. [PMID: 37498643 PMCID: PMC10415950 DOI: 10.2196/47662] [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: 03/28/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Technological advancements to study young adult smoking, relapse, and to deliver interventions remotely offer conceptual appeal, but the incorporation of technological enhancement must demonstrate benefit over traditional methods without adversely affecting outcomes. Further, integrating remote biochemical verification of smoking and abstinence may yield value in the confirmation of self-reported smoking, in addition to ecologically valid, real-time assessments. OBJECTIVE The goal of this study was to evaluate the impact of remote biochemical verification on 24-hour self-reported smoking and biochemical verification agreement, retention, compliance with remote sessions, and abstinence during a brief, 5-week cessation attempt and relapse monitoring phase. METHODS Participants (N=39; aged 18-25 years; mean age 21.6, SD 2.1 years; n=22, 56% male; n=29, 74% White) who smoked cigarettes daily engaged in a 5-week cessation and monitoring study (including a 48-hour quit attempt and provision of tobacco treatment in the form of nicotine replacement therapy, brief cessation counseling, and financial incentives for abstinence during the 2-day quit attempt only). Smoking (cigarettes per day) was self-reported through ecological momentary assessment (EMA) procedures, and participants were randomized to either (1) the inclusion of remote biochemical verification (EMA + remote carbon monoxide [rCO]) 2× per day or (2) in-person, weekly CO (wCO). Groups were compared on the following outcomes: (1) agreement in self-reported smoking and breath carbon monoxide (CO) at common study time points, (2) EMA session compliance, (3) retention in study procedures, and (4) abstinence from smoking during the 2-day quit attempt and at the end of the 5-week study. RESULTS No significant differences were demonstrated between the rCO group and the wCO (weekly in-person study visit) group on agreement between 24-hour self-reported smoking and breath CO (moderate to poor), compliance with remote sessions, or retention, though these outcomes numerically favored the wCO group. Abstinence was numerically higher in the wCO group after the 2-day quit attempt and significantly different at the end of treatment (day 35), favoring the wCO group. CONCLUSIONS Though study results should be interpreted with caution given the small sample size, findings suggest that the inclusion of rCO breath added to EMA compared to EMA with weekly, in-person CO collection in young adults did not yield benefit and may have even adversely affected outcomes. Our results suggest that technological advancements may improve data accuracy through objective measurement but may also introduce barriers and burdens and could result in higher rates of missing data. The inclusion of technology to inform smoking cessation research and intervention delivery among young adults should consider (1) the research question and necessity of biochemical verification and then (2) how to seamlessly incorporate monitoring into personalized and dynamic systems to avoid the added burden and detrimental effects to compliance and honesty in self-report.
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Affiliation(s)
- Erin A McClure
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
| | - Nathaniel Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Kyle J Walters
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
| | - Elizabeth Bradley
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
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Wesołowski A, Skawińska J, Soroko E. "Let me tell you what I think about online psychological help." A thematic analysis of voluntary opinions collected at the onset of the COVID-19 pandemic. Front Psychol 2023; 14:1141856. [PMID: 37529307 PMCID: PMC10389662 DOI: 10.3389/fpsyg.2023.1141856] [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: 01/10/2023] [Accepted: 05/22/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction The COVID-19 pandemic shifted many aspects of life from face-to-face to an online form, including psychological help. Many people had to face the choice of adjourning contact with a psychologist or shifting it to the Internet. This study aimed to develop an understanding of attitudes and opinions toward relatively new phenomenon in Poland - online psychological help. Method Seventy two (N=72) statements about relationship between COVID-19 pandemic and online psychological help from (potential) patients were included in this research. The statements were collected from a community sample via open-ended question for volunteers added to an online survey conducted regarding an existing project. The statements were exclusively written responses to the following question: If you want to provide us with something about the relationships between the COVID-19 pandemic and online help/psychotherapy, please let us know below. By reason of exploratory character of our study and general phenomenological philosophical approach and constructionist approach, a thematic analysis method was used to analyze the data. Results The analysis led us to identify three general themes with sub-themes that refer to meaningful aspects of online psychological help: 1. Online psychological help situates in the shadow of face-to-face help, 1.1. It frustrates the needs, especially the need for psychological contact, 1.2. It contributes to negative emotions, 1.3. It is sometimes better than the face-to-face help; 2. Online psychological help is a solution during the COVID-19 pandemic, 2.1. It provides a sense of continuity during lockdown, 2.2. It is a means to adapt to exceptional circumstances, 3. The concerns about the credibility and effectiveness of online psychological help. Discussion The results show (potential) patients' attitudes (including emotions, thoughts, and concerns) toward online psychological help. The perspective presented here could be beneficial to professionals. A better understanding of client/patient attitudes will allow for more accurate customization of the online help and sensitize psychologists to the emotions that may occur about online psychological help. It could also be beneficial for patients to understand how other people would feel about online psychological help and develop ones' own self-awareness of the attitudes toward online psychological help.
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13
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Montreuil M, Camden C, Genest C, Gilbert E, Laberge-Perrault E, Piché G, Rassy J, Bogossian A, Gendron-Cloutier L, Barbo G. Children and adolescents' mental health in pandemics and confinement: A scoping review of vulnerability factors and repercussions. J Child Health Care 2023:13674935231165554. [PMID: 37146991 PMCID: PMC10164454 DOI: 10.1177/13674935231165554] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Children and adolescents are a population at particular risk of experiencing adverse mental health repercussions related to pandemics. To understand vulnerability factors and repercussions of pandemics and related sanitary measures on children and adolescents' mental health, we performed a scoping review to examine and synthesize literature. In total, 66 articles were included. Results present: (1) factors that increase vulnerability to adverse mental health repercussions (e.g., having a pre-existing mental health condition, social isolation, low socio-economic status, parental distress, and overexposure to media content) and (2) specific mental health repercussions (e.g., anxiety, fear, depression, and externalizing behaviors). Addressing concerns underlined in this review could contribute to preventing further negative mental health repercussions of pandemics for children and adolescents and better prepare governments and professionals to address these highly challenging situations. Recommendations for practice include enhancing healthcare professionals' awareness about possible detrimental repercussions pandemics and sanitary measures have on children and adolescents' mental health, assessing changes for those with pre-existing mental health conditions, allocating funding for telehealth research, and providing greater support to healthcare providers.
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Affiliation(s)
| | - Chantal Camden
- School of rehabilitation, Université de Sherbrooke (Universite de Sherbrooke), Sherbrooke QC, Canada
| | - Christine Genest
- School of Nursing, Université de Montréal (Universite de Montreal), Montreal, QC, Canada
| | - Elsa Gilbert
- Department of Health Sciences, Université du Québec à Rimouski, Lévis (Universite du Quebec a Rimouski, Levis), Lévis, QC, Canada
| | | | - Geneviève Piché
- Department of Psychology and Psychoeducation, Université du Québec en Outaouais, Saint-Jérôme (Universite du Quebec en Outaouais, Saint-Jerome), Saint-Jérôme, QC, Canada
| | - Jessica Rassy
- School of rehabilitation, Université de Sherbrooke (Universite de Sherbrooke), Sherbrooke QC, Canada
| | - Aline Bogossian
- School of Nursing, Université de Montréal (Universite de Montreal), Montreal, QC, Canada
| | | | - Geneveave Barbo
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
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14
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DiGiovanni LK, Lim AC, Kosyluk K, Loecher N, Lewald DL, Rodriguez CA, Sanders LJ. Novel Application of Dot Survey Methodology at a Youth Health Clinic: A Pilot Study. J Adolesc Health 2023; 72:616-622. [PMID: 36543632 DOI: 10.1016/j.jadohealth.2022.10.029] [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: 04/05/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE We tested a novel dot survey methodology at our clinic that provides sexual health services to youth ages 13 to 24. We conducted two interactive dot surveys to assess their feasibility and acceptability while gaining insight into patients' attitudes about mental health. METHODS We adapted a dot survey approach to assess youths' familiarity with mental health and attitudes toward related services. We also assessed their attitudes toward participating in this survey method. All patients with scheduled appointments were eligible to participate. Participants used dot stickers to indicate their responses on survey posters displayed in the waiting room. RESULTS Three hundred patients participated between June and September 2021 (150 participants/survey). About 95% of participants liked seeing others' responses to the dot surveys, and over 70% reported that the surveys made them think more about mental health. Over 90% would participate in future dot surveys at the clinic. Survey items with the most consensus among participants included that 74.5% "really agree" youth face barriers to accessing mental health services (n = 141, mean = 4.61, standard deviation = 0.79) and 87.1% "really agree" primary care providers should ask youth about their mental health (n = 139, mean = 4.81, standard deviation = 0.59). DISCUSSION The dot surveys were effective at assessing patients' attitudes about mental health and feasible to conduct in our waiting room. Results confirmed that this survey method was well received among patients. Dot surveys can be adapted by other clinical settings to engage youth regarding their health-related attitudes.
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Affiliation(s)
- Lauren K DiGiovanni
- Department of Pediatrics, University of South Florida Health, Morsani College of Medicine, Tampa, Florida
| | - Andrew C Lim
- Department of Pediatrics, University of South Florida Health, Morsani College of Medicine, Tampa, Florida
| | - Kristin Kosyluk
- Department of Mental Health Law & Policy, University of South Florida, Tampa, Florida
| | - Nele Loecher
- Department of Mental Health Law & Policy, University of South Florida, Tampa, Florida
| | | | - Carina A Rodriguez
- Department of Pediatrics, University of South Florida Health, Morsani College of Medicine, Tampa, Florida
| | - Lisa J Sanders
- Department of Pediatrics, University of South Florida Health, Morsani College of Medicine, Tampa, Florida.
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15
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Kourgiantakis T, Markoulakis R, Lee E, Hussain A, Lau C, Ashcroft R, Goldstein AL, Kodeeswaran S, Williams CC, Levitt A. Access to mental health and addiction services for youth and their families in Ontario: perspectives of parents, youth, and service providers. Int J Ment Health Syst 2023; 17:4. [PMID: 36918893 PMCID: PMC10011786 DOI: 10.1186/s13033-023-00572-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 01/31/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Canadian youth (aged 16-24) have the highest rates of mental health and addiction concerns across all age groups and the most unmet health care needs. There are many structural barriers that contribute to the unmet mental health care needs of youth including lack of available and appropriate services, high costs, long wait times, fragmented and siloed services, lack of smooth transition between child and adult services, stigma, racism, and discrimination, as well as lack of culturally appropriate treatments. Levesque et al. (2013) developed a framework to better understand health care access and this framework conceptualizes accessibility across five dimensions: (1) approachability, (2) availability, (3) affordability, (4) appropriateness, and (5) acceptability. The purpose of this study was to explore access to addiction and mental health services for youth in Ontario, Canada from the perspectives of youth, parents, and service providers. METHODS This qualitative study was a university-community partnership exploring the experiences of youth with mental health concerns and their families from the perspectives of youth, caregivers, and service providers. We conducted semi-structured interviews and used thematic analysis to analyze data. RESULTS The study involved 25 participants (n = 11 parents, n = 4 youth, n = 10 service providers). We identified six themes related to structural barriers impacting access to youth mental health and services: (1) "The biggest barrier in accessing mental health support is where to look," (2) "There's always going to be a waitlist," (3) "I have to have money to be healthy," (4) "They weren't really listening to my issues," (5) "Having more of a welcoming and inclusive system," and (6) "Health laws aren't doing what they need to do." CONCLUSION Our study identified five structural barriers that map onto the Levesque et al. healthcare access conceptual framework and a sixth structural barrier that is not adequately captured by this model which focuses on policies, procedures, and laws. The findings have implications for policies and service provisions, and underline the urgent need for a mental health strategy that will increase access to care, improve mental health in youth, decrease burden on parents, and reduce inequities in mental health policies and services.
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Affiliation(s)
- Toula Kourgiantakis
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada.
| | - Roula Markoulakis
- Family Navigation Project, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Eunjung Lee
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Amina Hussain
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Carrie Lau
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Rachelle Ashcroft
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Abby L Goldstein
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, Toronto, ON, Canada
| | - Sugy Kodeeswaran
- Family Navigation Project, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Charmaine C Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Anthony Levitt
- Family Navigation Project, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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16
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Monarque M, Sabetti J, Ferrari M. Digital interventions for substance use disorders in young people: rapid review. Subst Abuse Treat Prev Policy 2023; 18:13. [PMID: 36805783 PMCID: PMC9937742 DOI: 10.1186/s13011-023-00518-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/26/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Young people are disproportionately more likely than other age groups to use substances. The rise in substance use and related harms, including overdose, during the Covid-19 pandemic has created a critical need for more innovative and accessible substance use interventions. Digital interventions have shown effectiveness and can provide more engaging, less stigmatizing, and accessible interventions that meet the needs of young people. This review provides an overview of recent literature on the nature of recently published digital interventions for young people in terms of technologies used, substances targeted, intended outcomes and theoretical or therapeutic models employed. METHODS Rapid review methodology was used to identify and assess the literature on digital interventions for young people. An initial keyword search was conducted using MEDLINE the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database (HTA) and PROSPERO for the years 2015-2020, and later updated to December 2021. Following a title/abstract and full-text screening of articles, and consensus decision on study inclusion, the data extraction process proceeded using an extraction grid developed for the study. Data synthesis relied on an adapted conceptual framework by Stockings, et al. that involved a three-level treatment spectrum for youth substance use (prevention, early intervention, and treatment) for any type of substance. RESULTS In total, the review identified 43 articles describing 39 different digital interventions. Most were early interventions (n = 28), followed by prevention interventions (n = 6) and treatment interventions (n = 5). The identified digital technologies included web-based (n = 14), game-based (n = 10), mobile-based (n = 7), and computer-based (n = 5) technologies, and virtual reality (n = 3). Most interventions targeted alcohol use (n = 20) followed by tobacco/nicotine (n = 5), cannabis (n = 2), opioids (n = 2), ketamine (1) and multiple, or any substances (n = 9). Most interventions used a personalized or normative feedback approach and aimed to effect behaviour change as the intended outcome. Interestingly, a harm reduction approach guided only one of the 39 interventions. CONCLUSIONS While web-based interventions represented the most common type of technology, more recently developed immersive and interactive technologies such as virtual reality and game-based interventions call for further exploration. Digital interventions focused mainly on alcohol use, reflecting less concern for tobacco, cannabis, co-occurring substance use, and illicit drug use. Specifically, the recent exacerbation in the opioid crisis throughout North American underlines the urgent need for more prevention-oriented digital interventions for opioid use. The uptake of digital interventions among youth also depends on the incorporation of harm reduction approaches.
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Affiliation(s)
- Marika Monarque
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Judith Sabetti
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Manuela Ferrari
- Douglas Mental Health University Institute, Montreal, QC, Canada.
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
- Douglas Hospital Research Centre, 6875 Boulevard LaSalle, Perry C3 E-3102, QC H4H 1R3, Montreal, Canada.
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17
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Telehealth Use in Pediatric Care during the COVID-19 Pandemic: A Qualitative Study on the Perspectives of Caregivers. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020311. [PMID: 36832439 PMCID: PMC9955717 DOI: 10.3390/children10020311] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/08/2023]
Abstract
This qualitative study surveyed caregivers regarding their perspectives on the benefits of, challenges with, and suggestions for improving telehealth during the COVID-19 pandemic. Caregivers who had the responsibility for caring for at least one child aged under 18 years of age in Genesee County, MI, participated. The caregivers were biological parents, stepparents, foster parents, adoptive parents, and guardians. A total of 105 caregivers completed a survey with open-ended questions via Qualtrics. Two independent coders developed themes based on the responses using grounded theory. Participants were primarily biological parents and non-Hispanic White and African Americans. According to the participants, the benefits of telehealth included prevention of exposure to the COVID-19 virus, quality communication with physicians, savings in travel time, and cost-effective methods to receive care. The challenges included a lack of in-person interaction, fear of compromised confidentiality, and the potential for misdiagnosis. Suggestions for improvement by caregivers included increasing access to telehealth for poorer families, offering a media educational campaign to promote telehealth use, and creating a universal platform to share patient information. Future studies may test the effectiveness of interventions such as those suggested by caregivers in this study to improve telehealth.
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18
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Coulaud PJ, Jesson J, Bolduc N, Ferlatte O, Jenkins E, Bertrand K, Salway T, Jauffret-Roustide M, Knight R. Young Adults' Mental Health and Unmet Service Needs in the Context of the COVID-19 Pandemic Across Canada and France. Community Ment Health J 2023; 59:222-232. [PMID: 35763148 PMCID: PMC9243891 DOI: 10.1007/s10597-022-01000-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/10/2022] [Indexed: 01/25/2023]
Abstract
While young adults experienced mental health challenges during the COVID-19 pandemic, little is known about how their mental health needs were subsequently met through access to mental health services (MHS). From October to December 2020, we conducted an online survey of young adults (18-29 years) living in Canada and France to investigate factors associated with unmet MHS needs. Of the 3222 participants expressing a need to access MHS (50.7% of the total sample), 58.2% in Canada and 74.8% in France reported unmet MHS needs. In both countries, those who identified as men and those who lost income due to COVID-19, were more likely to report unmet MHS needs. In Canada, participants from Quebec, those living in rural areas, and those who experienced ethno-racial discrimination had higher odds of reporting such unmet needs. Urgent investments are needed to improve access to MHS for young adults during and after the COVID-19 pandemic.
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Affiliation(s)
- Pierre-Julien Coulaud
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
- Department of Medicine, University of British Columbia, 317-2194 Health Sciences Mall (Woodward Instructional Resource Centre), Vancouver, BC, V6T 1Z3, Canada.
| | - Julie Jesson
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Naseeb Bolduc
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Olivier Ferlatte
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- École de Santé Publique de l'Université de Montréal, 7101 Avenue du Parc, Montreal, QC, H3N 1X9, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 1560 Rue Sherbrooke E, Montreal, H2L 4M1, Canada
| | - Emily Jenkins
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Karine Bertrand
- Department of Community Health Science, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC, J1H 5H3, Canada
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
- British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada
- Centre for Gender and Sexual Health Equity, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Marie Jauffret-Roustide
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Centre d'Étude des Mouvements Sociaux (EHESS/CNRS UMR8044/INSERM U1276), 54 Boulevard Raspail, 75006, Paris, France
- Baldy Center on Law and Social Policy, Buffalo University, 511 O'Brian Hall Buffalo, New York, 14260, USA
| | - Rod Knight
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Department of Medicine, University of British Columbia, 317-2194 Health Sciences Mall (Woodward Instructional Resource Centre), Vancouver, BC, V6T 1Z3, Canada
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19
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Sheikhan NY, Henderson JL, Halsall T, Daley M, Brownell S, Shah J, Iyer SN, Hawke LD. Stigma as a barrier to early intervention among youth seeking mental health services in Ontario, Canada: a qualitative study. BMC Health Serv Res 2023; 23:86. [PMID: 36703119 PMCID: PMC9877499 DOI: 10.1186/s12913-023-09075-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/16/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Stigma associated with mental health challenges is a major barrier to service seeking among youth. Understanding how stigma impacts service-seeking decisions from the perspectives of youth remains underexplored. Such research is necessary to inform effective stigma reduction. OBJECTIVE This study aims to understand how stigma influences service seeking among youth with mental health challenges. METHODS Qualitative inquiry was taken using youth engagement, underpinned by pragmatism. Data were collected via 4 virtual focus groups with 22 purposively selected youth participants with lived experience of mental health challenges in Ontario, Canada. Focus group guides were developed collaboratively among research team members, including youth co-researchers. Data were analyzed inductively using reflexive thematic analysis. RESULTS Three main themes were constructed from the data: point of entry into the system, being biomedicalized or trivialized, and paving the way for non-stigmatizing services. Initial contact with the mental healthcare system was seen to be affected by stigma, causing participants to delay contact or be refused services if they do not fit with an expected profile. Participants described a constant negotiation between feeling 'sick enough' and 'not sick enough' to receive services. Once participants accessed services, they perceived the biomedicalization or trivialization of their challenges to be driven by stigma. Lastly, participants reflected on changes needed to reduce stigma's effects on seeking and obtaining services. CONCLUSION A constant negotiation between being 'sick enough' or 'not sick enough' is a key component of stigma from the perspectives of youth. This tension influences youth decisions about whether to seek services, but also service provider decisions about whether to offer services. Building awareness around the invisibility of mental health challenges and the continuum of wellness to illness may help to break down stigma's impact as a barrier to service seeking. Early intervention models of care that propose services across the spectrum of challenges may prevent the sense of stigma that deters youth from accessing and continuing to access services.
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Affiliation(s)
- Natasha Y. Sheikhan
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
| | - Jo L. Henderson
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
| | - Tanya Halsall
- grid.28046.380000 0001 2182 2255University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Mardi Daley
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
| | - Samantha Brownell
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
| | - Jai Shah
- grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1 Canada
| | - Srividya N. Iyer
- grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1 Canada
| | - Lisa D. Hawke
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
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Allan J, Thompson A. Experiences of Young People and Their Carers with a Rural Mobile Mental Health Support Service: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1774. [PMID: 36767141 PMCID: PMC9914613 DOI: 10.3390/ijerph20031774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
Mental health difficulties during teenage years are common. They are also a risk factor for later mental and physical health problems. Rural young people are at a greater risk for mental health difficulties and have less access to services than their urban counterparts. The purpose of this study was to explore the experiences of young people and their carers with mental health support provided by a rural mobile service, and to identify access enablers from the perspective of the service users. A qualitative descriptive approach was used to analyse twelve interviews with current service users and eight interviews with family members of young people who had accessed the service. Three main themes were identified: (a) access and flexibility, (b) the qualities and strategies of the clinicians, and (c) experiences of change. The mobile service was perceived to be effective in producing a positive change in mental health, relationships, and the attainment of life goals. Key enablers to access included the flexibility of the mobile service, the variety of service delivery modes and therapeutic methods offered, the ease of access facilitated by the location in schools, and the autonomy of young people in how they chose to utilise the service. This study provides information about what is important to rural young people and their families in the provision of mental health services. The findings have implications for changing the way services are organized and operated. Healthcare policies and services could support a user-led model design that incorporates access and use-enablers and removes barriers to rural mental health support.
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Affiliation(s)
- Julaine Allan
- Rural Health Research Institute, Charles Sturt University, Orange, NSW 2800, Australia
| | - Anna Thompson
- School of Rural Health, Faculty of Medicine and Health, University of Sydney, Orange, NSW 2800, Australia
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21
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Kodjebacheva GD, Culinski T, Kawser B, Amin S. Satisfaction with pediatric telehealth according to the opinions of children and adolescents during the COVID-19 pandemic: A literature review. Front Public Health 2023; 11:1145486. [PMID: 37089475 PMCID: PMC10118045 DOI: 10.3389/fpubh.2023.1145486] [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: 01/16/2023] [Accepted: 03/16/2023] [Indexed: 04/25/2023] Open
Abstract
Objective To review satisfaction with telehealth among children and adolescents based on their own opinions during the COVID-19 pandemic. Methods In the PubMed, CINAHL, PsycINFO, and Embase databases, we searched for peer-reviewed studies in English on satisfaction with telehealth among children and adolescents (rather than parents). Both observational studies and interventions were eligible. The review was categorized as a mini review because it focused on the limited time frame of the COVID-19 pandemic. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Reviewers extracted information from each study and assessed risk of bias. Results A total of 14 studies were eligible. Studies were conducted in Australia, Canada, Italy, Israel, Poland, South Korea, the United Kingdom, and the United States. They focused on a variety of health conditions. Two of the 14 studies were interventions. Participants expressed high satisfaction with video and telephone visits and home telemonitoring while also preferring a combination of in-person visits and telehealth services. Factors associated with higher satisfaction with telehealth included greater distance from the medical center, older age, and lower anxiety when using telehealth. In qualitative studies, preferred telehealth features among participants included: a stable Internet connection and anonymity and privacy during telehealth visits. Conclusion Telehealth services received favorable satisfaction ratings by children and adolescents. Randomized-controlled trials on the effectiveness of pediatric telehealth services compared to non-telehealth services may assess improvements in satisfaction and health outcomes.
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Affiliation(s)
- Gergana Damianova Kodjebacheva
- College of Health Sciences, University of Michigan-Flint, Flint, MI, United States
- Institute for Healthcare Policy and Innovation, University of Michigan-Ann Arbor, Ann Arbor, MI, United States
- *Correspondence: Gergana Damianova Kodjebacheva
| | - Taylor Culinski
- College of Health Sciences, University of Michigan-Flint, Flint, MI, United States
- Department of Behavioral Sciences, College of Arts and Sciences, University of Michigan-Flint, Flint, MI, United States
| | - Bushra Kawser
- College of Health Sciences, University of Michigan-Flint, Flint, MI, United States
| | - Saman Amin
- College of Health Sciences, University of Michigan-Flint, Flint, MI, United States
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22
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Olateju A, Cervantes M, Dowshen N, Kuhns LM, Dhar CP. Acceptability of Telemedicine Among Parents of Adolescent Patients in an Adolescent Clinic: Cross-sectional Survey Study. JMIR Pediatr Parent 2022; 5:e39704. [PMID: 36542447 PMCID: PMC9813812 DOI: 10.2196/39704] [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: 05/18/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Since the beginning of the COVID-19 pandemic, new literature has described the perceptions of adolescent patients on the use of telemedicine for their health care, but less attention has been devoted to parents' and caregivers' perspectives on telemedicine usage for their adolescents. Parents' perspectives are important, as they undoubtedly influence how children learn to make decisions about their health care. OBJECTIVE This study describes the level of acceptability (measured based on accessibility and satisfaction) expressed by caregivers of adolescent patients with regard to telemedicine visits in an urban adolescent medicine practice. METHODS A cross-sectional survey was sent electronically to parents and guardians of patients aged <18 years who completed outpatient telemedicine visits to an adolescent medicine practice in Chicago, Illinois, from March 2020 to February 2021. The questions focused on accessibility and satisfaction. The data were analyzed to describe response frequencies. RESULTS Among a sample of 71 survey respondents, the vast majority reported that telemedicine was very easy to use (58/71, 82%) and was at least as convenient as in-person visits (70/71, 99%). Over 90% of respondents reported that their adolescents' needs were addressed (69/69, 100%) and that they were at least as comfortable with the level of privacy and the confidential conversations between their adolescents and medical providers in telemedicine visits (65/71, 92%) as they were with those in in-person visits. CONCLUSIONS Our findings suggest that parents and guardians find telemedicine to be an acceptable way for their children and adolescents to receive appropriate health care.
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Affiliation(s)
- Adetola Olateju
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Marbella Cervantes
- Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Nadia Dowshen
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Craig-Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Lisa M Kuhns
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Cherie Priya Dhar
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
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23
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Fiala-Baumann B, Ploner H, Witzmann D, Jesser A. Säuglings‑, Kinder- und Jugendlichen- (SKJ) Psychotherapien während der Covid-19 Pandemie: Ergebnisse einer Studie unter psychodynamischen Psychotherapeut*innen in Österreich. PSYCHOTHERAPIE FORUM 2022. [PMCID: PMC9746562 DOI: 10.1007/s00729-022-00213-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Zusammenfassung
Fragestellung
Diese explorative Studie untersucht die Situation der Säuglings‑, Kinder- und Jugendlichen- (SKJ) Psychotherapien während der Covid-19 Pandemie in Österreich.
Methodik
23 psychodynamisch arbeitende Psychotherapeut*innen nahmen an einer Online-Umfrage teil, die quantitative und qualitative Daten generierte. Offene Fragen zu subjektiv wahrgenommenen Veränderungen wurden mithilfe der qualitativen Inhaltsanalyse ausgewertet.
Ergebnisse
Insgesamt sank die Anzahl an Psychotherapien insbesondere bei den Säuglings- und Kleinkind-Psychotherapien. Die Zahl der Kinder und Jugendlichen-Psychotherapien nahm zunächst ab, stieg nach dem ersten Lockdown aber an. Große Nachfrage wurde zuletzt vor allem bei Jugendlichenpsychotherapien wahrgenommen. Anpassungsleistungen an sich ändernde Bedingungen und Settings erforderten große Flexibilität der Psychotherapeut*innen, die mit Fortschreiten der Pandemie zunehmend an ihre Belastungsgrenzen kamen. Befragte beobachteten eine Zunahme an Symptomen sowie einen gestiegenen Bedarf an Eltern- und Vernetzungsarbeit mit Institutionen.
Schlussfolgerungen
Tele-Psychotherapie kann vor allem mit jüngeren Kindern Präsenztherapie nicht ersetzen. Ergebnisse deuten auf eine Unterversorgung dieser Zielgruppe hin. Dies, sowie die beobachtete Zunahme an Symptomen bei älteren Kindern und Jugendlichen, ist gesellschaftspolitisch und gesundheitsökonomisch ein großes Thema und erfordert dringend einen weiteren Ausbau der Versorgungsnetzwerke.
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Affiliation(s)
| | | | | | - Andrea Jesser
- Wissenschaftliche Arbeitsgruppe, D.O.T. – Die offene Tür, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Österreich
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24
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Heinrich L, Hernandez AK, Laurie AR. Telehealth Considerations for the Adolescent Patient. Prim Care 2022; 49:597-607. [DOI: 10.1016/j.pop.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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25
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Impact Potpourri: A Multimethod Survey Study on Youth Substance Use During COVID-19. CANADIAN JOURNAL OF ADDICTION 2022; 13:46-55. [PMID: 36452036 PMCID: PMC9677386 DOI: 10.1097/cxa.0000000000000158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Given the important implications of youth substance use, it is essential to document and describe changes in substance use during the coronavirus disease 2019 pandemic. METHODS This multimethod survey study examines the impacts of the coronavirus disease 2019 pandemic on youth substance use among 149 Canadian youth who were using substances at a mid-pandemic period. Participants were 21.9 years of age on average (SD=2.2), including 99 girls/young women, 42 boys/young men, and 8 transgender or nonbinary individuals. The majority were Caucasian and born in Canada. Qualitative and quantitative findings are reported, with thematic analysis combined with descriptive and inferential statistical analyses. RESULTS Qualitatively, many youth reported increases or shifts in their substance use over the course of the pandemic. Youth reported using substances with limited numbers of peers, with family, or alone. Many reported using substances out of boredom and to cope. While legal substances remained highly accessible, illegal substances were reported to be more difficult to acquire and less trustworthy. Spending had increased. Quantitative findings suggested alcohol use has decreased, but other substance use has remained stable in the sample as a whole, although for each substance, some youth reported increases. DISCUSSION Despite minimal quantitative change, qualitative findings show that some youth increased their use of some substances during the pandemic, decreased others, changed their motivation to use, and decreased in safety behaviors. Youth-serving organizations should be aware of individual differences, the changing context of substance use, and the potential long-term impacts.
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26
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Schlief M, Saunders KRK, Appleton R, Barnett P, Vera San Juan N, Foye U, Olive RR, Machin K, Shah P, Chipp B, Lyons N, Tamworth C, Persaud K, Badhan M, Black CA, Sin J, Riches S, Graham T, Greening J, Pirani F, Griffiths R, Jeynes T, McCabe R, Lloyd-Evans B, Simpson A, Needle JJ, Trevillion K, Johnson S. Synthesis of the Evidence on What Works for Whom in Telemental Health: Rapid Realist Review. Interact J Med Res 2022; 11:e38239. [PMID: 35767691 PMCID: PMC9524537 DOI: 10.2196/38239] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/20/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Telemental health (delivering mental health care via video calls, telephone calls, or SMS text messages) is becoming increasingly widespread. Telemental health appears to be useful and effective in providing care to some service users in some settings, especially during an emergency restricting face-to-face contact, such as the COVID-19 pandemic. However, important limitations have been reported, and telemental health implementation risks the reinforcement of pre-existing inequalities in service provision. If it is to be widely incorporated into routine care, a clear understanding is needed of when and for whom it is an acceptable and effective approach and when face-to-face care is needed. OBJECTIVE This rapid realist review aims to develop a theory about which telemental health approaches work (or do not work), for whom, in which contexts, and through what mechanisms. METHODS Rapid realist reviewing involves synthesizing relevant evidence and stakeholder expertise to allow timely development of context-mechanism-outcome (CMO) configurations in areas where evidence is urgently needed to inform policy and practice. The CMO configurations encapsulate theories about what works for whom and by what mechanisms. Sources included eligible papers from 2 previous systematic reviews conducted by our team on telemental health; an updated search using the strategy from these reviews; a call for relevant evidence, including "gray literature," to the public and key experts; and website searches of relevant voluntary and statutory organizations. CMO configurations formulated from these sources were iteratively refined, including through discussions with an expert reference group, including researchers with relevant lived experience and frontline clinicians, and consultation with experts focused on three priority groups: children and young people, users of inpatient and crisis care services, and digitally excluded groups. RESULTS A total of 108 scientific and gray literature sources were included. From our initial CMO configurations, we derived 30 overarching CMO configurations within four domains: connecting effectively; flexibility and personalization; safety, privacy, and confidentiality; and therapeutic quality and relationship. Reports and stakeholder input emphasized the importance of personal choice, privacy and safety, and therapeutic relationships in telemental health care. The review also identified particular service users likely to be disadvantaged by telemental health implementation and a need to ensure that face-to-face care of equivalent timeliness remains available. Mechanisms underlying the successful and unsuccessful application of telemental health are discussed. CONCLUSIONS Service user choice, privacy and safety, the ability to connect effectively, and fostering strong therapeutic relationships need to be prioritized in delivering telemental health care. Guidelines and strategies coproduced with service users and frontline staff are needed to optimize telemental health implementation in real-world settings. TRIAL REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO); CRD42021260910; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021260910.
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Affiliation(s)
- Merle Schlief
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Katherine R K Saunders
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rebecca Appleton
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Phoebe Barnett
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Norha Vera San Juan
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Una Foye
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rachel Rowan Olive
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Karen Machin
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Prisha Shah
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Beverley Chipp
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Natasha Lyons
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Camilla Tamworth
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Karen Persaud
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Monika Badhan
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Carrie-Ann Black
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jacqueline Sin
- Centre for Mental Health Research, City, University of London, London, United Kingdom
| | - Simon Riches
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Tom Graham
- Centre for Anxiety Disorders & Trauma, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jeremy Greening
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Farida Pirani
- Psychological Medicine & Older Adult Directorate, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Raza Griffiths
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Tamar Jeynes
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Rose McCabe
- Centre for Mental Health Research, City, University of London, London, United Kingdom
| | - Brynmor Lloyd-Evans
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Alan Simpson
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Justin J Needle
- Centre for Health Services Research, City, University of London, London, United Kingdom
| | - Kylee Trevillion
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Sonia Johnson
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
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27
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Ceniti AK, Abdelmoemin WR, Ho K, Kang Y, Placenza F, Laframboise R, Bhat V, Foster JA, Frey BN, Lam RW, Milev R, Rotzinger S, Soares CN, Uher R, Kennedy SH. "One Degree of Separation": A Mixed-Methods Evaluation of Canadian Mental Health Care User and Provider Experiences With Remote Care During COVID-19. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:712-722. [PMID: 34986035 PMCID: PMC9445628 DOI: 10.1177/07067437211070656] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The COVID-19 pandemic has contributed to a shift from in-person to remote mental health care. While remote care methods have long existed, their widespread use is unprecedented. There is little research about mental health care user and provider experiences with this transition, and no published studies to date have compared satisfaction between these groups. METHODS Canadian mental health care users (n = 332) and providers (n = 107) completed an online self-report survey from October 2020 to February 2021 hosted by the Canadian Biomarker Integration Network in Depression. Using a mixed-methods approach, participants were asked about their use of remote care, including satisfaction, barriers to use, helpful and unhelpful factors, and suggestions for improvement. RESULTS Overall, 59% to 63% of health care users and 59% of health care providers were satisfied with remote care. Users reported the greatest satisfaction with the convenience of remote care, while providers were most satisfied with the speed of provision of care; all groups were least satisfied with therapeutic rapport. Health care providers were less satisfied with the user-friendliness of remote care (P < 0.001) than users, while health care users were less satisfied than providers with continuity of care (P < 0.001). The use of a video-based platform was associated with remote care satisfaction among health care users (P < 0.02), and qualitative responses support the importance of visual cues in maintaining therapeutic rapport remotely. The majority of users (55%) and providers (87%) reported a likelihood of using remote care after the pandemic. CONCLUSIONS Remote mental health care is generally accepted by both users and providers, and the majority would consider using remote care following the pandemic. Suggestions for improvement include greater use of video, increased attention to body language and eye contact, consistency with in-person care, as well as increased provider training and administrative support.
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Affiliation(s)
- Amanda K Ceniti
- Arthur Sommer Rotenberg Suicide & Depression Studies Program, 10071St. Michael's Hospital, Toronto, Canada.,Centre for Depression and Suicide Studies, 10071St. Michael's Hospital, Toronto, Canada.,Institute of Medical Science, 7938University of Toronto, Toronto, Canada
| | - Wegdan R Abdelmoemin
- Centre for Depression and Suicide Studies, 10071St. Michael's Hospital, Toronto, Canada
| | - Keith Ho
- Centre for Depression and Suicide Studies, 10071St. Michael's Hospital, Toronto, Canada.,Centre for Mental Health, 7989University Health Network, Toronto, Canada
| | - Yudi Kang
- Centre for Mental Health, 7989University Health Network, Toronto, Canada
| | - Franca Placenza
- Centre for Mental Health, 7989University Health Network, Toronto, Canada
| | - Rachel Laframboise
- Centre for Mental Health, 7989University Health Network, Toronto, Canada
| | - Venkat Bhat
- Arthur Sommer Rotenberg Suicide & Depression Studies Program, 10071St. Michael's Hospital, Toronto, Canada.,Centre for Depression and Suicide Studies, 10071St. Michael's Hospital, Toronto, Canada.,Institute of Medical Science, 7938University of Toronto, Toronto, Canada.,Centre for Mental Health, 7989University Health Network, Toronto, Canada.,Department of Psychiatry, 7938University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute, 10071St. Michael's Hospital, Toronto, Canada
| | - Jane A Foster
- Centre for Mental Health, 7989University Health Network, Toronto, Canada.,Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Canada.,Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Raymond W Lam
- Department of Psychiatry, 8166University of British Columbia, Vancouver, Canada
| | - Roumen Milev
- Departments of Psychiatry and Psychology, 4257Queen's University, Kingston, Canada.,Providence Care, Kingston, ON, Canada
| | - Susan Rotzinger
- Arthur Sommer Rotenberg Suicide & Depression Studies Program, 10071St. Michael's Hospital, Toronto, Canada.,Centre for Depression and Suicide Studies, 10071St. Michael's Hospital, Toronto, Canada.,Centre for Mental Health, 7989University Health Network, Toronto, Canada.,Department of Psychiatry, 7938University of Toronto, Toronto, Canada
| | - Claudio N Soares
- Departments of Psychiatry and Psychology, 4257Queen's University, Kingston, Canada.,Providence Care, Kingston, ON, Canada
| | - Rudolf Uher
- Department of Psychiatry, 3688Dalhousie University, Halifax, Canada
| | - Sidney H Kennedy
- Arthur Sommer Rotenberg Suicide & Depression Studies Program, 10071St. Michael's Hospital, Toronto, Canada.,Centre for Depression and Suicide Studies, 10071St. Michael's Hospital, Toronto, Canada.,Institute of Medical Science, 7938University of Toronto, Toronto, Canada.,Centre for Mental Health, 7989University Health Network, Toronto, Canada.,Department of Psychiatry, 7938University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute, 10071St. Michael's Hospital, Toronto, Canada
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28
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Ferrari M, Allan S, Arnold C, Eleftheriadis D, Alvarez-Jimenez M, Gumley A, Gleeson JF. Digital Interventions for Psychological Well-Being in University Students: A Systematic Review and Meta-Analysis (Preprint). J Med Internet Res 2022; 24:e39686. [PMID: 36169988 PMCID: PMC9557766 DOI: 10.2196/39686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background Life at university provides important opportunities for personal growth; however, this developmental phase also coincides with the peak period of risk for the onset of mental health disorders. In addition, specific university lifestyle factors, including impaired sleep and academic and financial stress, are known to exacerbate psychological distress in students. As a result, university students have been identified as a vulnerable population who often experience significant barriers to accessing psychological treatment. Digital psychological interventions are emerging as a promising solution for this population, but their effectiveness remains unclear. Objective This systematic review and meta-analysis aimed to assess digital interventions targeting psychological well-being among university students. Methods Database searches were conducted on December 2, 2021, via Embase, MEDLINE, PsycINFO, and Web of Science. Results A total of 13 eligible studies were identified, 10 (77%) of which were included in the meta-analysis. Mean pre-post effect sizes indicated that such interventions led to small and significant improvement in psychological well-being (Hedges g=0.32, 95% CI 0.23-0.4; P<.001). These effects remained, albeit smaller, when studies that included a wait-list control group were excluded (Hedges g=0.22, 95% CI 0.08-0.35; P=.002). An analysis of acceptance and commitment therapy approaches revealed small and significant effects (k=6; Hedges g=0.35, 95% CI 0.25-0.45; P<.001). Conclusions Digital psychological interventions hold considerable promise for university students, although features that optimize service delivery and outcomes require further assessment. Trial Registration PROSPERO CRD42020196654; https:/www.crd.york.ac.uk/prospero/display_record.php?RecordID=196654
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Affiliation(s)
- Madeleine Ferrari
- Healthy Brain and Mind Research Centre, Australian Catholic University, Sydney, Australia
| | - Stephanie Allan
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Chelsea Arnold
- Healthy Brain and Mind Research Centre, Australian Catholic University, Melbourne, Australia
| | - Dina Eleftheriadis
- Healthy Brain and Mind Research Centre, Australian Catholic University, Melbourne, Australia
| | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - Andrew Gumley
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - John F Gleeson
- Healthy Brain and Mind Research Centre, Australian Catholic University, Melbourne, Australia
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29
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Hämäläinen T, Kaipainen K, Keinonen K, Lappalainen P, Puolakanaho A, Lappalainen R, Kiuru N. The Roles of Adherence and Usage Activity in Adolescents' Intervention Gains During Brief Guided Online Acceptance and Commitment Therapy. J Cogn Psychother 2022; 37:JCP-2021-0038.R1. [PMID: 35470151 DOI: 10.1891/jcp-2021-0038] [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: 11/25/2022]
Abstract
OBJECTIVE This study investigated the roles of adherence and usage activity in adolescents' (n = 161) gains during a 5-week web intervention program based on acceptance and commitment therapy (ACT). METHOD Program adherence was calculated as adherence percentage in relation to intended usage, whereas completion percentage, usage time, and usage weeks were used as indicators for usage activity. Subjective well-being was measured by self-reported life satisfaction and stress before and after the intervention. RESULTS First, regression analysis results showed that higher adherence predicted an increase in life satisfaction during intervention. Second, three subgroups of adolescents were identified using K-means cluster analysis in regard to adherence, usage activity and intervention gains: (1) "Adhered, committed users with relatively large intervention gains" (35%), (2) "Less committed users with no intervention gains" (42%), and (3) "Non-committed users with no intervention gains" (23%). The results showed that the highest gains from the Youth Compass intervention program are most likely obtained when the program is used as intended in its design. In addition, time investment and engagement in doing exercises seem as important as filling the minimum adherence criterion. CONCLUSIONS The results support the feasibility of ACT-based web intervention programs in promoting adolescent well-being, although more attention should be paid to motivating adolescents to commit to them and invest enough time in them.
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Affiliation(s)
- Tetta Hämäläinen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland
| | - Kirsikka Kaipainen
- Faculty Information of Technology and Communication Sciences, Tampere University, Finland
| | - Katariina Keinonen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland
| | - Päivi Lappalainen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland
| | - Anne Puolakanaho
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland
| | - Raimo Lappalainen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland
| | - Noona Kiuru
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland
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Abstract
PURPOSE OF REVIEW To review the literature on the trends in substance use among youth during the coronavirus SARS-CoV-2 (COVID-19) pandemic. RECENT FINDINGS The pandemic has given rise to concerns about the mental health and social well-being of youth, including its potential to increase or exacerbate substance use behaviors. This systematic review identified and included 49 studies of use across alcohol, cannabis, tobacco, e-cigarettes/vaping, and other drugs, and unspecified substances. The majority of studies across all categories of youth substance use reported reductions in prevalence, except in the case of other drugs and unspecified drug and substance use, which included three studies that reported an increase in use and three studies that reported decrease in use. Overall, the results of this review suggest that the prevalence of youth substance use has largely declined during the pandemic. Youth substance use in the post-pandemic years will require monitoring and continued surveillance.
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Haslinger M, Weindl D, Peper-Bösenkopf J, Haiderer M, Singer V, Zajec K. Psychosoziale Versorgung von Kindern und Jugendlichen im ersten Corona-Lock-Down unter Zuhilfenahme von Telefon und Online-Tools. Möglichkeiten und Grenzen. PSYCHOTHERAPIE FORUM 2021. [PMCID: PMC8647625 DOI: 10.1007/s00729-021-00184-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Die vorliegende Studie widmet sich der Analyse einer Befragung von 20 Fachkräften des Gesundheits- und Sozialbereichs, die während des ersten „Lock-Downs“ aufgrund der Covid-19-Pandemie zur Sicherstellung der psychosozialen Versorgung von Kindern und Jugendlichen Telefon und Onlinemedien benutzten. Veränderte Rahmenbedingungen, das Fehlen des persönlichen Kontakts sowie Auswirkungen auf die Behandlung (u. a. Beziehung, Inhalt, Methodik) wurden als negative Aspekte der distanzierten Behandlung beschrieben. Eine Veränderung der Privatsphäre sowie des Settings wurden sowohl als Vor- als auch Nachteil betrachtet. Als positiv wurden insbesondere Kontinuität, Flexibilität und Anonymität hervorgehoben.
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Hawke LD, Szatmari P, Cleverley K, Courtney D, Cheung A, Voineskos AN, Henderson J. Youth in a pandemic: a longitudinal examination of youth mental health and substance use concerns during COVID-19. BMJ Open 2021; 11:e049209. [PMID: 34716160 PMCID: PMC8561825 DOI: 10.1136/bmjopen-2021-049209] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE This study analyses longitudinal data to understand how youth mental health and substance use are evolving over the course of the COVID-19 pandemic, which is critical to adjusting mental health response strategies. SETTING Participants were recruited from among existing participants in studies conducted in an urban academic hospital in Ontario, Canada. PARTICIPANTS A total of 619 youth aged 14-28 years participated in the study (62.7% girls/young women; 61.4% Caucasian). MEASURES Data on mood, substance use and COVID-19-related worries were collected over four time points, that is, every 2 months beginning in the early stages of the pandemic in April 2020. Latent class analyses were conducted on the longitudinal data to identify distinct groups of youth who have different trajectory profiles of pandemic impact on their mood, substance use and COVID-19-related worries. RESULTS For the majority of participants, mood concerns increased early in the pandemic, declined over Canada's summer months and subsequently increased in autumn. Among the youth with the highest level of mood symptoms at the beginning of the pandemic, increases in mental health concerns were sustained. Substance use remained relatively stable over the course of the pandemic. COVID-19-related worries, however, followed a trajectory similar to that of mood symptoms. Girls/young women, youth living in urban or suburban areas, in larger households, and with poorer baseline mental and physical health are the most vulnerable to mental health concerns and worries during the pandemic. CONCLUSIONS Youth mental health symptom levels and concerns are evolving over the course of the COVID-19 pandemic, in line with the evolution of the pandemic itself, and longitudinal monitoring is therefore required. It is also essential that we engage directly with youth to cocreate pandemic response strategies and mental health service adaptations to best meet the needs of young people.
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Affiliation(s)
- Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kristin Cleverley
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Darren Courtney
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Amy Cheung
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Joanna Henderson
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Palinkas LA, De Leon J, Salinas E, Chu S, Hunter K, Marshall TM, Tadehara E, Strnad CM, Purtle J, Horwitz SM, McKay MM, Hoagwood KE. Impact of the COVID-19 Pandemic on Child and Adolescent Mental Health Policy and Practice Implementation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189622. [PMID: 34574547 PMCID: PMC8467758 DOI: 10.3390/ijerph18189622] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022]
Abstract
Background: The impact of the 2019 coronavirus pandemic on the mental health of millions worldwide has been well documented, but its impact on prevention and treatment of mental and behavioral health conditions is less clear. The COVID-19 pandemic also created numerous challenges and opportunities to implement health care policies and programs under conditions that are fundamentally different from what has been considered to be usual care. Methods: We conducted a qualitative study to determine the impact of the COVID-19 pandemic on implementation of evidence-based policy and practice by State Mental Health Authorities (SMHA) for prevention and treatment of mental health problems in children and adolescents. Semi-structured interviews were conducted with 29 SMHA representatives of 21 randomly selected states stratified by coronavirus positivity rate and rate of unmet services need. Data analysis with SMHA stakeholders used procedures embedded in the Rapid Assessment Procedure—Informed Community Ethnography methodology. Results: The need for services increased during the pandemic due primarily to family stress and separation from peers. States reporting an increase in demand had high coronavirus positivity and high unmet services need. The greatest impacts were reduced out-of-home services and increased use of telehealth. Barriers to telehealth services included limited access to internet and technology, family preference for face-to-face services, lack of privacy, difficulty using with young children and youth in need of substance use treatment, finding a Health Insurance Portability and Accountability Act (HIPAA)-compliant platform, training providers and clients, and reimbursement challenges. Policy changes to enable reimbursement, internet access, training, and provider licensing resulted in substantially fewer appointment cancellations or no-shows, greater family engagement, reduction in travel time, increased access for people living in remote locations, and increased provider communication and collaboration. States with high rates of coronavirus positivity and high rates of unmet need were most likely to continue use of telehealth post-pandemic. Despite these challenges, states reported successful implementation of policies designed to facilitate virtual services delivery with likely long-term changes in practice. Conclusions: Policy implementation during the pandemic provided important lessons for planning and preparedness for future public health emergencies. Successful policy implementation requires ongoing collaboration among policy makers and with providers.
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Affiliation(s)
- Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA; (J.D.L.); (E.S.); (S.C.)
- Correspondence: ; Tel.: +1-858-922-7265; Fax: +1-213-740-0789
| | - Jessenia De Leon
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA; (J.D.L.); (E.S.); (S.C.)
| | - Erika Salinas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA; (J.D.L.); (E.S.); (S.C.)
| | - Sonali Chu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA; (J.D.L.); (E.S.); (S.C.)
| | - Katharine Hunter
- Office of Child and Family Services, Virginia Department of Behavioral Health and Developmental Services, Richmond, VA 23218, USA;
| | - Timothy M. Marshall
- Office of Community Mental Health, Connecticut Department of Children and Families, Hartford, CT 06103, USA;
| | - Eric Tadehara
- Utah Department of Human Services, Substance Abuse and Mental Health, Salt Lake City, UT 84116, USA;
| | - Christopher M. Strnad
- Office of Children’s Behavioral Health, Department of Children, Youth and Families, Providence, RI 02903, USA;
| | - Jonathan Purtle
- Department of Health Management & Policy, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA;
| | - Sarah McCue Horwitz
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY 10016, USA; (S.M.H.); (K.E.H.)
| | - Mary M. McKay
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63130, USA;
| | - Kimberly E. Hoagwood
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY 10016, USA; (S.M.H.); (K.E.H.)
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