Monitoring positive mental health and its determinants in Canada: the development of the Positive Mental Health Surveillance Indicator Framework

Mental health status according to the dual-factor model in Swedish adolescents: A cross sectional study highlighting associations with stress, resilience, social status and gender

In this cross-sectional study, we aimed to I) investigate the dual-factor model of mental health by forming and describing four participant groups and II) examine associations between mental health status and background factors, school-related factors, stress, and resilience among adolescents in a community population in Sweden. Data were collected through a survey completed by 2,208 students in lower and upper secondary school on the Swedish island of Gotland. After missing data were removed, a total of 1,833 participants were included in the study. The survey included the Mental Health Continuum Short Form (MHC-SF) for the assessment of mental well-being and the Strengths and Difficulties Questionnaire (SDQ) for the assessment of mental health problems. These two measures were combined into a dual-factor model, forming four mental health status subgroups: Vulnerable (47.5%), Complete mental health (36.2%), Troubled (13.9%), and Symptomatic but content (2.5%). Associations between these groups were explored regarding background factors, school-related factors, stress, and resilience through chi-squared tests and logistic regressions. Girls (OR: 1.88) and participants with high stress levels (OR: 2.23) had elevated odds for Vulnerable mental health status, whereas higher resilience (OR: 0.87) and subjective social status in school (OR: 0.76) were factors associated with reduced odds for this mental health status classification. Female gender (OR: 5.02) was also associated with Troubled mental health status. Similarly, a high level of stress (ORs: 4.08 and 11.36) was associated with Symptomatic but content and Troubled mental health status, and participants with higher levels of resilience had decreased odds for being classified into these groups (ORs: 0.88 and 0.81). The findings highlight the importance of interventions to increase resilience, reduce stress, and address stereotypic gender norms as well as social status hierarchies to support adolescents' mental health.

Assessing the Effectiveness of ChatGPT in Delivering Mental Health Support: A Qualitative Study

Background

Artificial Intelligence (AI) applications are widely researched for their potential in effectively improving the healthcare operations and disease management. However, the research trend shows that these applications also have significant negative implications on the service delivery.

Purpose

To assess the use of ChatGPT for mental health support.

Methods

Due to the novelty and unfamiliarity of the ChatGPT technology, a quasi-experimental design was chosen for this study. Outpatients from a public hospital were included in the sample. A two-week experiment followed by semi-structured interviews was conducted in which participants used ChatGPT for mental health support. Semi-structured interviews were conducted with 24 individuals with mental health conditions.

Results

Eight positive factors (psychoeducation, emotional support, goal setting and motivation, referral and resource information, self-assessment and monitoring, cognitive behavioral therapy, crisis interventions, and psychotherapeutic exercises) and four negative factors (ethical and legal considerations, accuracy and reliability, limited assessment capabilities, and cultural and linguistic considerations) were associated with the use of ChatGPT for mental health support.

Conclusion

It is important to carefully consider the ethical, reliability, accuracy, and legal challenges and develop appropriate strategies to mitigate them in order to ensure safe and effective use of AI-based applications like ChatGPT in mental health support.

Loneliness and sense of community are not two sides of the same coin: Identifying different determinants using the 2019 Nova Scotia Quality of Life data

The purpose of this study was to explore the relative importance of lifestyle factors and living conditions when predicting loneliness and sense of community (SOC) in a representative sample of 12,871 participants from Nova Scotia collected in 2019. Using multiple regression and measures of relative importance based on the Lindeman, Merenda and Gold (lmg) method, we identified which variables are most important to predicting measures of loneliness and SOC. Twenty-two predictors accounted for 46% of the variance in SOC and the top 10 predictors accounted for 36% of the variance: satisfaction with quality of the natural environment in the neighborhood (ri = 0.09), life satisfaction (ri = 0.05), number of neighbors one can rely on (ri = 0.05), confidence in institutions (ri = 0.05), feeling better off due to government policy or programming (ri = 0.04), feeling safe walking in neighborhood after dark (ri = 0.03), mental health (ri = 0.02), number of friends one can rely on (ri = 0.02), volunteering (ri = 0.02), and perceptions of time adequacy (ri = 0.02). Only six of these variables were also the top predictors of loneliness. These results show that both community- and individual-level variables are substantial predictors of social well-being. The effect sizes differ between models, which suggests that there may be important predictors of loneliness that we have not accounted for. This study may inform community-level programming and policy that seeks to promote social well-being for individuals and their communities.

Investigating associations between emotional and behavioral problems, self-esteem, and parental attachment among adolescents: A cross-sectional study in Indonesia

Background

Emotional and Behavioral Problems (EBPs) are prevalent among adolescents, and adolescents' capacity for adaptation can be influenced by their interactions with their parents, environment, and self-esteem. This link has not been systematically examined among adolescents in West Sumatra, Indonesia. This study aimed to assess the association of parental attachment and self-esteem with EBPs in adolescents.

Methods

A cross-sectional study was conducted from July to November 2022 in Padang West Sumatra, Indonesia. In total, 854 students from public senior high school 4 Padang were involved in this study and completed questionnaires on demographics, EBPs, parental attachment, and self-esteem. There was a total of five subscales for EBPs, which included emotional problems, conduct problems, hyperactivity, peer problems and prosocial. Additionally, there were three subscales for parental attachment, which included the mother's attachment, father's attachment, and peer attachment. Spearman's correlation, independent-sample t-tests, ANOVA and multiple linear regression analysis were employed to examine factors associated with EBPs.

Results

This study showed that father's attachment (r = -0.191, p < 0.001), mother's attachment (r = -0.241, p < 0.001), and self-esteem (r = -0.437, p < 0.001) were negatively correlated with EBPs. The linear regression analysis showed EBPs was associated with father's education, father's communication, father's alienation, mother's alienation, and self-esteem. All predictors of overall EBPs among adolescents were able to explain 31 % of the variance in EBPs.

Conclusion

High self-esteem and a strong parental attachment have positive outcomes in terms of mental health in adolescents. Thus, increasing adolescent self-esteem and establishing a warm parent attachment can be the main target in providing interventions for Indonesian adolescents with EBPs.

AI-Powered Mental Health Virtual Assistants' Acceptance: An Empirical Study on Influencing Factors Among Generations X, Y, and Z

STUDY PURPOSE

This study aims to analyze various influencing factors among generations X (Gen X), Y (Gen Y), and Z (Gen Z) of artificial intelligence (AI)-powered mental health virtual assistants.

METHODS

A cross-sectional survey design was adopted in this study. The study sample consisted of outpatients diagnosed with various mental health illnesses, such as anxiety, depression, schizophrenia, and behavioral disorders. A survey questionnaire was designed based on the factors (performance expectancy, effort expectancy, social influence, facilitating conditions, and behavioural intention) identified from the unified theory of acceptance and use of the technology model. Ethical approval was received from the Ethics Committee at Imam Abdulrahman Bin Faisal University, Saudi Arabia.

RESULTS

A total of 506 patients participated in the study, with over 80% having moderate to high experience in using mental health AI assistants. The ANOVA results for performance expectancy (PE), effort expectancy (EE), social influence (SI), facilitating conditions (FC), and behavioral intentions (BI) indicate that there are statistically significant differences (p < 0.05) between the Gen X, Gen Y, and Gen Z participants.

CONCLUSION

The findings underscore the significance of considering generational differences in attitudes and perceptions, with Gen Y and Gen Z demonstrating more positive attitudes and stronger intentions to use AI mental health virtual assistants, while Gen X appears to be more cautious.

Mixed Signals in Child and Adolescent Mental Health and Well-Being Indicators in the United States: A Call for Improvements to Population Health Monitoring

Policy Points Social indicators of young peoples' conditions and circumstances, such as high school graduation, food insecurity, and smoking, are improving even as subjective indicators of mental health and well-being have been worsening. This divergence suggests policies targeting the social indicators may not have improved overall mental health and well-being. There are several plausible reasons for this seeming contradiction. Available data suggest the culpability of one or several common exposures poorly captured by existing social indicators. Resolving this disconnect requires significant investments in population-level data systems to support a more holistic, child-centric, and up-to-date understanding of young people's lives.

Factors associated with stress impacting academic success among post-secondary students: A systematic review

Objective: To synthesize peer-reviewed primary research exploring factors associated with perceived stress impacting post-secondary students' academic success. Methods: A systematic review identified research conducted in North America, Europe, and Australia in the last ten years across 12 databases. Results: Of the 6,214 references screened, 14 English articles published between 2011 and 2018 were deemed relevant. Subsequent analysis characterized articles by study design, location, population, factors with a statistically significant relationship with both perceived stress and academic success, and future research directions. Findings reveal a complex relationship among overlapping factors associated with perceived stress on academic success at both the intrapersonal (eg, academic, demographic, psychological, attitudinal, and behavioral characteristics) and interpersonal levels (eg, social capital). Conclusions: Further research should measure the association of the identified factors to inform areas where resources could be targeted within post-secondary institutions to prevent stress from unduly impacting students' educational outcomes.

[Public mental health from an international perspective: from "shifting the curve" to inclusion of vulnerable populations]

In recent years, efforts in the field of public mental health have increased that seek to promote mental health and mental health literacy at population level and yield advances in the prevention, treatment and care of mental health conditions. This paper provides an overview of contemporary conceptualisations of indicators and determinants of public mental health as well as population-based intervention strategies from an international perspective. Current conceptual and methodological challenges of so-called high-risk, whole-population and vulnerable population strategies are critically discussed. Future efforts in research, policy and practice need to address fundamental causes of social and health inequalities, drawing on all societal fields, to contribute to improving population mental health.

Advancing socioecological mental health promotion intervention: A mixed methods exploration of Phase 1 Agenda Gap findings

Introduction

Protecting and promoting the mental health of youth under 30 years of age is a priority, globally. Yet investment in mental health promotion, which seeks to strengthen the determinants of positive mental health and wellbeing, remains limited relative to prevention, treatment, and recovery. The aim of this paper is to contribute empirical evidence to guide innovation in youth mental health promotion, detailing the early outcomes of Agenda Gap, an intervention centering youth-led policy advocacy to influence positive mental health for individuals, families, communities and society.

Methods

Leveraging a convergent mixed methods design, this study draws on data from n = 18 youth (ages 15 to 17) in British Columbia, Canada, who contributed to pre- and post-intervention surveys and post-intervention qualitative interviews following their participation in Agenda Gap from 2020-2021. These data are supplemented by qualitative interviews with n = 4 policy and other adult allies. Quantitative and qualitative data were analyzed in parallel, using descriptive statistics and reflexive thematic analysis, and then merged for interpretation.

Results

Quantitative findings suggest Agenda Gap contributes to improvements in mental health promotion literacy as well as several core positive mental health constructs, such as peer and adult attachment and critical consciousness. However, these findings also point to the need for further scale development, as many of the available measures lack sensitivity to change and are unable to distinguish between higher and lower levels of the underlying construct. Qualitative findings provided nuanced insights into the shifts that resulted from Agenda Gap at the individual, family, and community level, including reconceptualization of mental health, expanded social awareness and agency, and increased capacity for influencing systems change to promote positive mental health and wellbeing.

Discussion

Together, these findings illustrate the promise and utility of mental health promotion for generating positive mental health impacts across socioecological domains. Using Agenda Gap as an exemplar, this study underscores that mental health promotion programming can contribute to gains in positive mental health for individual intervention participants whilst also enhancing collective capacity to advance mental health and equity, particularly through policy advocacy and responsive action on the social and structural determinants of mental health.

The Key Role of Psychosocial Competencies in Evidence-Based Youth Mental Health Promotion: Academic Support in Consolidating a National Strategy in France

Psychosocial competencies, also known as psychosocial skills or life skills, are essential for the prevention and promotion of mental health. Since the beginning of this century, psychosocial competencies have been defined as the ability to develop positive mental health. Most individual or social mental health protection programs are related to psychosocial competencies. A majority of evidence-based programs that develop mental health explicitly aim at developing psychosocial competencies, either exclusively or with complementary approaches. Many of these programs have demonstrated their effectiveness, with lasting effects on reduced anxiety and depression symptoms, violent and risky behaviors, and improved well-being and academic success. Based on international meta-analyses and on 20 years of French national and local experiences, a national strategy to develop psychosocial competencies was launched in France in 2021 for all children from 3 to 25 years old. Two reports on evidence-based psychosocial competence development were published in 2022 by the national agency for public health-Santé publique France (Public Health France)-to support this deployment strategy and develop a common evidence-based culture in health and education. This article presents the French national strategy as an example of a means of increasing evidence-based mental health promotion while discussing the importance of cultural adaptation of such programs.

Conceptualising public mental health: development of a conceptual framework for public mental health

Background

Numerous determinants have been linked to public mental health; however, they have not been brought together in a comprehensive conceptual framework. The goal of this work was to bring together academic research, practitioner expertise, and public perspectives to create a public mental health conceptual framework.

Methods

The development process proceeded in four stages. First, we identified a comprehensive list of potential determinants through a state-of-the-art academic literature review, grey literature review, and created mind maps created by peer researchers. Next, we conducted in-person workshops, consultations, and an online survey with academics, practitioners, policy makers, and members of the public to review the potential determinants, nominate additional determinants, and prioritise determinants by importance for understanding public mental health. This iterative process resulted in the final list of determinants contained in the framework. We then conducted rapid reviews to define each determinant and to identify key research, interventions, and resources. Finally, we worked with a design team to visualise the conceptual framework as an online tool and printable infographic.

Results

We found substantial overlap between sources reflecting a shared understanding of the key drivers of public mental health. The unique determinants that emerged from each data source highlighted the importance of using multiple sources to create a comprehensive model. 72 potential determinants were prioritised through stakeholder consultations, resulting in a final list of 55 determinants and organised into four levels: individual, family, community, and structural.

Conclusions

This is the most complete conceptual framework for public mental health to date, bringing together academic research, policy and practitioner views, and lived experience perspectives. The co-production processes and tools we used provides a template for researchers looking to include multiple perspectives in their research.

The conceptual framework draws together current knowledge on each determinant, but also highlights areas where further research is needed to better understand the relationship between each factor and mental health, which can inform the research agenda. This online tool and infographic can be used by practitioners to identify interventions for promoting mental health, and by the general public as a resource to increase awareness of the broad factors which shape public mental health.

Building engagement to support adoption of community-based substance use prevention initiatives

BACKGROUND

System-level approaches that target social determinants of health are promising strategies to support substance use prevention, holistic youth development and wellbeing. Yet, the youth services system is largely based on individual-focused programs that do not adequately account for social determinants of health and place the responsibility for wellness on the individual. There is a need to understand how to enhance adoption of complex system-level approaches that support comprehensive youth development. The Icelandic Prevention Model (IPM) represents a collaborative initiative that takes an ecological, system-level approach to prevent substance use and promote wellness in youth. This research was designed to examine key stakeholder perceptions to better understand social motivations and contextual complexities that influence stakeholder support to garner community-level adoption of the IPM in a rural Canadian community.

METHODS

This research applies a case study approach using qualitative interviews to explore strategies to support uptake in the early stages of IPM adoption associated with developing community buy-in and acceptance. A thematic analysis was applied using QSR NVivo.

RESULTS

Nine interviews were conducted with community partners leading the implementation of the IPM. Three over-arching themes emerged from the data: 1) Motivating influences 2) Strategies to develop buy-in, and 3) Resistance to the adoption of the IPM. Findings reflect issues that affect behaviour change in system transformation in general as well as upstream prevention and the IPM, in particular.

CONCLUSIONS

The findings from this research describe critical insight derived from implementing community-driven initiatives that are designed to support health promotion. It contributes new scientific knowledge related to implementation of complex system-level innovations and practical information that is useful for communities interested in implementing the IPM or following similar approaches to prevent substance use.

Investigating the association between sleep and aspects of mental health in children: findings from the Canadian Health Survey on Children and Youth

INTRODUCTION

Sufficient sleep and good quality sleep are crucial aspects of children's healthy development. While previous research has suggested associations between sleep and positive mental health, few studies have been conducted in Canadian children.

METHODS

This study used data from the 2019 Canadian Health Survey on Children and Youth. Parents of children aged 5 to 11 years (N = 16 170) reported on their children's sleep habits and mental health. Descriptive statistics were used to calculate means and percentages for sleep and mental health indicators. Logistic regression was used to compare mental health outcomes by meeting sleep duration recommendations (9-11 hours of sleep vs. < 9 or > 11 hours of sleep), sleep quality (difficulties getting to sleep) and having enforced rules for bedtime.

RESULTS

Overall, 86.2% of children aged 5 to 11 years met sleep duration recommendations (9-11 hours of sleep), 90.0% had high sleep quality and 83.1% had enforced rules for bedtime. While 83.0% of children had high general mental health, mental health diagnoses were reported for 9.5% of children, and 15.8% of children required or received mental health care. High sleep quality was consistently associated with better mental health, enforced rules for bedtime were associated with some negative mental health outcomes and meeting sleep duration recommendations tended not to be associated with mental health outcomes.

CONCLUSION

Sleep quality was strongly associated with mental health among children in this study. Future research should explore longitudinal associations between sleep and mental health in Canadian children.

„Shifting the Curve“: Neue Entwicklungen und Herausforderungen im Bereich der Public Mental Health

In der nationalen und internationalen Forschung nimmt das noch relativ junge Fach der Public Mental Health einen immer wichtigeren Stellenwert ein. Allerdings bleibt eine zentrale Herausforderung, dieses Fach in seiner Interdisziplinarität abzubilden und den Diskurs im Spannungsfeld von Public Health, psychiatrischer Epidemiologie, psychischer Gesundheitsförderung, Prävention und Versorgungsforschung zu führen, um sein innovatives Potenzial vollständig auszuschöpfen. In diesem Spannungsfeld stellen sich eine Reihe von grundsätzlichen konzeptionellen und methodischen Fragen, die in diesem Essay unter Bezugnahme auf die Populationsstrategie von Geoffrey Rose exemplarisch auch hinsichtlich fundamentaler Ursachen von sozialen und gesundheitlichen Ungleichheiten erörtert und adressiert werden sollen, mit dem letztendlichen Ziel, die Grundlage zur Erfassung und Veränderung von psychischer Gesundheit auf Populationsebene zu verbessern.

Conceptualising public mental health: development of a conceptual framework for public mental health

BACKGROUND

Numerous determinants have been linked to public mental health; however, they have not been brought together in a comprehensive conceptual framework. The goal of this work was to bring together academic research, practitioner expertise, and public perspectives to create a public mental health conceptual framework.

METHODS

The development process proceeded in four stages. First, we identified a comprehensive list of potential determinants through a state-of-the-art academic literature review, grey literature review, and created mind maps created by peer researchers. Next, we conducted in-person workshops, consultations, and an online survey with academics, practitioners, policy makers, and members of the public to review the potential determinants, nominate additional determinants, and prioritise determinants by importance for understanding public mental health. This iterative process resulted in the final list of determinants contained in the framework. We then conducted rapid reviews to define each determinant and to identify key research, interventions, and resources. Finally, we worked with a design team to visualise the conceptual framework as an online tool and printable infographic.

RESULTS

We found substantial overlap between sources reflecting a shared understanding of the key drivers of public mental health. The unique determinants that emerged from each data source highlighted the importance of using multiple sources to create a comprehensive model. 72 potential determinants were prioritised through stakeholder consultations, resulting in a final list of 55 determinants and organised into four levels: individual, family, community, and structural.

CONCLUSIONS

This is the most complete conceptual framework for public mental health to date, bringing together academic research, policy and practitioner views, and lived experience perspectives. The co-production processes and tools we used provides a template for researchers looking to include multiple perspectives in their research. The conceptual framework draws together current knowledge on each determinant, but also highlights areas where further research is needed to better understand the relationship between each factor and mental health, which can inform the research agenda. This online tool and infographic can be used by practitioners to identify interventions for promoting mental health, and by the general public as a resource to increase awareness of the broad factors which shape public mental health.

Household food insecurity, sense of community belonging, and access to a regular medical doctor as mediators in the relationship between mood and/or anxiety disorders and self-rated general health in Canada between 2011 and 2016: a serial cross-sectional analysis

OBJECTIVE

To assess whether (household) food insecurity, access to a regular medical doctor, and sense of community belonging mediate the relationship between mood and/or anxiety disorders and self-rated general health.

METHODS

We used six annual cycles of the Canadian Community Health Survey, including Canadian adults aged 18-59 years, between 2011 and 2016. Mediation models, adjusted for key determinants of health, were based on a series of weighted logistic regression models. The Sobel products of coefficients approach was used to estimate the indirect effect, and bootstrapping to estimate uncertainty.

RESULTS

The annual (weighted) prevalence of mood and/or anxiety disorders increased from 11.3% (2011) to 13.2% (2016). Across the 6 years, 23.9-27.7% of individuals with mood and/or anxiety disorders reported fair/poor self-rated health as compared with 4.9-6.5% of those without mood and/or anxiety disorders (p<0.001). Similarly, the 7.2-8.9% of the population reporting fair/poor self-rated health were disproportionately represented among individuals reporting food insecurity (21.1-26.2%, p<0.001) and a weak sense of community belonging (10.0-12.2%, p<0.001). A significantly lower prevalence of poor self-rated health was observed among respondents reporting having access to a regular medical doctor in 2012, 2015, and 2016. In 2016, sense of community belonging and food insecurity significantly mediated the effect of mood and/or anxiety disorders on self-rated general health. Access to a regular medical doctor did not mediate this relationship.

CONCLUSION

Efficient policies that address food insecurity and sense of community belonging are needed to decrease the mental health burden and improve health satisfaction of Canadians.

Strategic Assessment of Neighbourhood Environmental Impacts on Mental Health in the Lisbon Region (Portugal): A Strategic Focus and Assessment Framework at the Local Level

Scientific evidence shows that each place/environment generates specific conditions with associated impacts on the mental health and well-being of the population. A holistic, multilevel and integrated environmental approach to mental health enhances the understanding of this phenomena, supporting the local decision-making processes to improve spatial planning of neighbourhood environments. The aim of this study is to develop a strategic assessment framework, based on four municipalities in the Lisbon Region (Portugal), that explores policy and planning initiatives capable of generating favourable neighbourhood environmental conditions for mental health while also detecting risks. Using baseline results of significant statistical associations between individuals’ perceptions of their neighbourhood environment and their mental health in the Lisbon Region, a Strategic Focus on Environmental and Mental Health Assessment framework (SEmHA) was built, by applying the methodology “Strategic Thinking for Sustainability” in Strategic Environmental Assessment, developed by Partidário in 2012. Taking into account the promotion of the population’s mental health, four critical decision factors of neighbourhood environments were identified: (1) public space quality (e.g., improving sense of place), (2) physical environment quality (e.g., low levels of noise exposure), (3) professional qualification and creation of economic activities (e.g., attracting new economic activities), and (4) services and facilities (e.g., improving access to health and education services). The proposed strategic focus and assessment framework contributes to ensuring that interventions in neighbourhood environments truly achieve community mental health benefits and reduce inequalities, thus helping policy makers to assess impacts at the local level.

A systematic scoping review of community-based interventions for the prevention of mental ill-health and the promotion of mental health in older adults in the UK

BACKGROUND

Mental health concerns in older adults are common, with increasing age-related risks to physical health, mobility and social isolation. Community-based approaches are a key focus of public health strategy in the UK, and may reduce the impact of these risks, protecting mental health and promoting wellbeing. We conducted a review of UK community-based interventions to understand the types of intervention studied and mental health/wellbeing impacts reported.

METHOD

We conducted a scoping review of the literature, systematically searching six electronic databases (2000-2020) to identify academic studies of any non-clinical community intervention to improve mental health or wellbeing outcomes for older adults. Data were extracted, grouped by population targeted, intervention type, and outcomes reported, and synthesised according to a framework categorising community actions targeting older adults.

RESULTS

In total, 1,131 full-text articles were assessed for eligibility and 54 included in the final synthesis. Example interventions included: link workers; telephone helplines; befriending; digital support services; group social activities. These were grouped into: connector services, gateway services/approaches, direct interventions and systems approaches. These interventions aimed to address key risk factors: loneliness, social isolation, being a caregiver and living with long-term health conditions. Outcome measurement varied greatly, confounding strong evidence in favour of particular intervention types.

CONCLUSION

The literature is wide-ranging in focus and methodology. Greater specificity and consistency in outcome measurement are required to evidence effectiveness - no single category of intervention yet stands out as 'promising'. More robust evidence on the active components of interventions to promote older adult's mental health is required.

Establishing a Mental Health Surveillance in Germany: Development of a framework concept and indicator set

In the course of the recognition of mental health as an essential component of population health, the Robert Koch Institute has begun developing a Mental Health Surveillance (MHS) system for Germany. MHS aims to continuously report data for relevant mental health indicators, thus creating a basis for evidence-based planning and evaluation of public health measures. In order to develop a set of indicators for the adult population, potential indicators were identified through a systematic literature review and selected in a consensus process by international and national experts and stakeholders. The final set comprises 60 indicators which, together, represent a multidimensional public health framework for mental health across four fields of action. For the fifth field of action 'Mental health promotion and prevention' indicators still need to be developed. The methodology piloted proved to be practicable. Strengths and limitations will be discussed regarding the search and definition of indicators, the scope of the indicator set as well as the participatory decision-making process. Next steps in setting up the MHS will be the operationalisation of the single indicators and their extension to also cover children and adolescents. Given assured data availability, the MHS will contribute to broadening our knowledge on population mental health, supporting a targeted promotion of mental health and reducing the disease burden in persons with mental disorders.

Positive mental health and perceived change in mental health among adults in Canada during the second wave of the COVID-19 pandemic

INTRODUCTION

Canadian surveys from spring/summer 2020 suggest the prevalence of some positive mental health (PMH) outcomes have declined compared to pre-pandemic levels. However, less is known about the state of PMH during the second wave of the COVID-19 pandemic.

METHODS

We compared adults' self-rated mental health (SRMH), community belonging and life satisfaction in Fall 2020 versus 2019 in the overall population and across sociodemographic characteristics using cross-sectional data from the Survey on COVID-19 and Mental Health (September-December, 2020) and the 2019 Canadian Community Health Survey. We also conducted regression analyses to examine which sociodemographic factors were associated with reporting in Fall 2020 that one's mental health was about the same or better compared to before the pandemic.

RESULTS

Fewer adults reported high SRMH in Fall 2020 (59.95%) than in 2019 (66.71%) and fewer reported high community belonging in Fall 2020 (63.64%) than in 2019 (68.42%). Rated from 0 (very dissatisfied) to 10 (very satisfied), average life satisfaction was lower in Fall 2020 (7.19) than in 2019 (8.08). Females, those aged under 65 years, those living in a population centre, and those absent from work due to COVID-19 had lower odds of reporting that their mental health was about the same or better in Fall 2020.

CONCLUSION

The PMH of adults was lower during the pandemic's second wave. However, the majority of individuals still reported high SRMH and community belonging. The findings identify certain sociodemographic groups whose mental health appears to have been more negatively impacted by the pandemic. Continued surveillance is important in ensuring mental health builds back better and stronger in Canada after the pandemic.

Indicators for Public Mental Health: A Scoping Review

Background: To monitor population mental health, the identification of relevant indicators is pivotal. This scoping review provides a comprehensive overview of current indicators representing the various fields of public mental health core topics. It was conducted as a first step to build up a Mental Health Surveillance for Germany.

Methods: We conducted a systematic MEDLINE search via PubMed. This search was supplemented by an extensive examination of the websites of relevant national as well as international institutions in the context of public mental health and an additional internet search via Google. To structure the data, an expert-based focus group identified superordinate topics most relevant to public mental health to which the identified indicators could be assigned to. Finally, the indicator set was screened for duplicates and appropriate content to arrive at a final set.

Results: Within the various search strategies, we identified 13.811 records. Of these records, a total of 365 records were processed for indicator extraction. The extracted indicators were then assigned to 14 topics most relevant to public mental health as identified by the expert-based focus group. After the exclusion of duplicates and those indicators not meeting criteria of specificity and target group, the final set consisted of 192 indicators.

Conclusion: The presented indicator set provides guidance in the field of current concepts in public mental health monitoring. As a comprehensive compilation, it may serve as basis for future surveillance efforts, which can be adjusted and condensed depending on the particular monitoring focus. Our work provides insights into established indicators included in former surveillance work as well as recent, not yet included indicators reflecting current developments in the field. Since our compilation mainly concludes indicators related to mental health in adults, it should be complemented with indicators specific to children and adolescents. Furthermore, our review revealed that indicators on mental health promotion and prevention are underrepresented in current literature of public mental health and should hence be focused on within future research and surveillance.

The 5Cs of Positive Youth Development, Purpose in Life, Hope, and Well-Being Among Emerging Adults in Malaysia

A substantial body of evidence supports Lerner and colleagues' 5Cs model of positive youth development (PYD) in the United States (U.S.). Nonetheless, it remains unclear whether the 5Cs can be used to identify positive development in the under-researched Asian contexts, such as Malaysia. Thus, this study examined the 5Cs of PYD (competence, confidence, character, connection, and caring) and their importance to purpose in life, hope, and well-being in a sample of emerging adult undergraduate university students in Malaysia. Data were collected from 400 participants from 15 Malaysian universities (132 males, 268 females; ages ranged from 18 to 26 years old, M = 22). A hierarchical multiple regression analysis indicated that two of the 5Cs of PYD (confidence and connection) as well as hope were important to explaining variation in well-being. The findings imply that there are strong links between PYD, especially confidence and connection, and well-being, while purpose in life and hope were indirectly related to the 2Cs (confidence and connection) of PYD and well-being. Therefore, mental health professionals are encouraged to review and redefine their treatment design to include confidence, connection, purpose in life and hope when working with Malaysian emerging adult university students.

Exploration of Factors Affecting Post-Secondary Students' Stress and Academic Success: Application of the Socio-Ecological Model for Health Promotion

OVERVIEW

There has been an increase in the frequency and severity of stress experienced by Canadian post-secondary students, which has adverse implications on their academic success. This work applied the socio-ecological model for health promotion to explore the contextual factors that influence this relationship at the individual, interpersonal, institutional, community, and public policy levels.

METHODS

Using a qualitative, phenomenological approach, we conducted 38 semi-structured interviews with undergraduate students and on-campus staff who provide services to this population at a post-secondary institution in Southwestern Ontario, Canada. Thematic analysis inductively identified overarching themes among participants' perspectives.

RESULTS

Several positive and negative factors were identified at each socio-ecological model level, demonstrating the complex interplay of demographic, psychological, emotional, social, physical, and academic factors impacting students' academic stress.

CONCLUSIONS

A lack of communication and knowledge seems to underlie many factors, highlighting the need to strengthen communication strategies to promote awareness, accessibility, and availability of services and programs on campus. Results also pointed to focusing on proactive, resilience-focused, upstream mental health promotion efforts at post-secondary institutions to reduce stress and improve academic success. This knowledge can help Canadian campuses better address students' needs.

Determinants of psychological and social well-being among youth in Canada: investigating associations with sociodemographic factors, psychosocial context and substance use

INTRODUCTION

Positive mental health is an essential part of youth's healthy development. For instance, positive mental health is associated with greater self-reported physical health, closer relationships and fewer conduct problems in youth. As positive mental health promotion is a public health priority, examining its potential determinants is important.

METHODS

We analyzed data from students in Grades 7-12 (secondary I-V in Quebec), from nine Canadian provinces, who participated in the 2016/2017 Canadian Student Tobacco, Alcohol and Drugs Survey. Psychological and social well-being (PSWB) was assessed using the Children's Intrinsic Needs Satisfaction Scale (CINSS). We conducted linear regression analyses to determine associations of sociodemographic, psychosocial and substance use variables with overall CINSS scores (n = 37 897).

RESULTS

In general, youth in Canada reported fairly high PSWB. After adjusting for all included variables, being in a higher grade, being bullied, bullying others, reporting more behavioural problems and using cigarettes, e-cigarettes or cannabis at least once in the past 30 days were associated with lower overall CINSS scores for both male and female students. Reporting more prosocial behaviours was associated with higher overall scores for both sexes.

CONCLUSION

A number of sociodemographic, psychosocial and substance use factors are associated with PSWB among youth in Canada. Prospective longitudinal and intervention studies could examine whether changes in these potential risk/protective factors are accompanied by changes in positive mental health.

Association of Birth Order With Mental Health Problems, Self-Esteem, Resilience, and Happiness Among Children: Results From A-CHILD Study

Objective: This study aimed to investigate the association of birth order with mental health problems, self-esteem, resilience, and happiness among children aged 9-10 years. Methods: This was a cross-sectional study using data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study, which was a population-based study of children in fourth grade in public schools in Adachi City, Tokyo, Japan in 2018 (N = 3,744). Parent-rated Strengths and Difficulties Questionnaire (SDQ) and self-rated resilience, happiness, and self-esteem score were used to assess child mental health. Multiple regression analysis for continuous outcomes and logistic regression for dichotomous outcomes were used to examine the association of birth order with mental health problems, resilience, happiness, and self-esteem. The analysis was controlled for child sex, mother's age, mother's education, caregiver's depressive symptoms, household income, and living with grandparents. Results: Last-borns showed the lowest total difficulties score in the SDQ, while only children showed the highest (p < 0.001). The highest prosocial behaviors score was found among last-borns (p < 0.001). Resilience score was also highest among last-borns, followed by first-borns, middle-borns, and only children. The lowest happiness score was found among middle-borns. Self-esteem score did not differ by sibling types. These associations were similar in the adjusted model and dichotomized outcomes model. Conclusions: Differential impacts of birth order on child mental health, for both positive and negative sides, were found. Further research is warranted to elucidate the mechanism of the association between birth order and the development of behavior problems and the positive aspects such as resilience, happiness, and self-esteem among children.

Measurement Invariance of the Flourishing Scale among a Large Sample of Canadian Adolescents

Our aim was to examine measurement invariance of the Flourishing Scale (FS)—a concise measure of psychological wellbeing—across two study samples and by population characteristics among Canadian adolescents. Data were retrieved from 74,501 Canadian secondary school students in Year 7 (2018–2019) of the COMPASS Study and from the original validation of the FS (n = 689). We assessed measurement invariance using a confirmatory factor analysis in which increasingly stringent equality constraints were specified for model parameters between the following groups: study sample (i.e., adolescents vs. adults), gender, grade, and ethno-racial identity. In all models, full measurement invariance of the FS across all sub-groups was demonstrated. Our findings support the validity of the FS for measuring psychological wellbeing among Canadian adolescents in secondary school. Observed differences in FS score among subgroups therefore represent true differences in wellbeing rather than artifacts of differential interpretation.

Positive Mental Health and Self-Care in Patients with Chronic Physical Health Problems: Implications for Evidence-based Practice

BACKGROUND

The capacity for self-care and positive mental health (PMH) has an influence on well-being and on one's approach to chronic illness.

PURPOSE

The aim was to determine the level of PMH and self-care agency as well as the relations among sociodemographic variables, PMH, and the level of self-care among patients with chronic physical health problems. We also examined correlations between PMH and self-care agency.

METHODS

A descriptive, cross-sectional correlational study was conducted with a sample of 209 patients at a primary care center. The instruments used were the Positive Mental Health Questionnaire and the Appraisal of Self-Care Agency scale. The STROBE statement was used.

RESULTS

Significant differences were found in the PMH factors in relation to sociodemographic variables and health conditions. Suffering one or more chronic diseases was associated negatively, and significantly, with the capacity for self-care. The four most prevalent chronic health problems in the sample were hypertension, hypercholesterolemia, obesity, and diabetes mellitus.

LINKING EVIDENCE TO ACTION

In people with chronic physical health problems, there is a positive relationship between PMH and self-care capacity. An increase in the possibility of caring for oneself saw an increase in PMH; conversely, an increase in PMH brought with it an increased capacity for self-care as well. Therefore, if actions are taken to increase PMH, the capacity for self-care will also increase.

An update on positive mental health among adults in Canada

This At-a-glance presents updated estimates for the Positive Mental Health Surveillance Indicator Framework for adults aged 18 years and older. Using data from the 2015 and 2017 Canadian Community Health Survey, we calculated the prevalence of positive mental health and associated determinants. Estimates for positive mental health outcomes for adults ranged from 68.1% to 87.1%. We also explored the associations between sociodemographic factors and positive mental health among adults in Canada. Our findings suggest sociodemographic differences in odds of self-rated mental health, happiness, life satisfaction, and psychological and social well-being.

An update on positive mental health among youth in Canada

The Positive Mental Health Surveillance Indicator Framework (PMHSIF) provides estimates of positive mental health outcomes and associated risk and protective factors for youth aged 12 to 17 years in Canada. This study explored the relationship between sociodemographic factors and psychological and social well-being among youth in Canada using data from the Canadian Student Tobacco, Alcohol and Drugs Survey 2016-2017. Grade and province were significantly associated with psychological and social well-being.

Social and Behavioral Predictors of Adolescents' Positive Attitude towards Life and Self

Positive attitude is an important cognitive component of optimism. Although optimism has been widely studied in adolescents’ health, there is limited knowledge about social and behavioral determinants of their positive attitude. The aim of this study was to identify the main predictors of a positive attitude towards life and self in adolescence. Data were collected in 2010 from 2562 Polish adolescents, aged 15 to 17 years old, within the Health Behavior in School-Aged Children survey. A positive attitude was measured using the 4-item Positive Attitude Scale (PAS). Univariate analysis of variance was conducted and then hierarchical linear regression models adjusted for gender, age and family affluence were estimated. The mean PAS score was 13.25 (SD = 3.74), on the scale ranged 0–20. Eight out of 18 variables were included in the final model, which explained 25.1% of PAS variability. Communication in the family and with peers, as well as neighborhood social capital showed the strongest impact on positive attitude in adolescents. Physical activity, eating breakfast and school performance were also found to be important predictors. The results of the study highlight the need to include the development of interpersonal competences, promoting physical activity and supporting school performance, in adolescents’ mental health promotion programs, particularly in girls.

The effectiveness of positive mental health programs in adults: A systematic review

A systematic review was conducted. So, electronic database including CINAHL, Embase, MEDLINE, Pubmed, Scopus and Cochrane-Central were explored in January 2017 and in October 2017. The aim of this systematic review is to identify, appraise and synthesize the best evidence for the effectiveness of programmes of positive mental health in adults. Mental health is regarded as an ideal functioning state of the human being, which emphasizes the relevance of promoting the person's qualities in the optimization of their potential. Mental health is not inert and definitive but a dynamic and variable state. Studies were reviewed and data extracted by two independent reviewers using Joanna Briggs Institute standardized critical appraisal and data extraction instruments. Six studies met the inclusion criteria for the analysis. However, a meta-analysis could not be performed. The results suggest that positive mental health programmes improve adults' mental condition, although there is neither evidence of content formalization nor of programme sessions criteria. The review findings indicate that interventions promoting positive mental health of young adults can be implemented effectively in community settings with various programmes and results.

Utilisation et enjeux des données clinico-administratives dans le domaine de la santé mentale et de la dépendance

Les banques de données clinico-administratives sont des outils clés pour la prise de décision publique en santé. Pour soutenir la gestion des services, plusieurs banques sont disponibles s’intéressant aux besoins des populations et aux ressources disponibles, tout en intégrant des indicateurs de performance. Depuis les années 2000, des efforts considérables ont été menés afin de consolider les données et développer des outils visant à mieux surveiller l’état de santé des populations ou la performance du système sociosanitaire. Dans le cadre du congrès annuel de l’Association francophone pour le savoir (ACFAS), qui s’est tenu à l’Université McGill en 2017, un colloque a été organisé pour débattre de leur exploitation en santé mentale et en dépendance. Le colloque a intégré une discussion d’experts qui se sont entretenus afin d’identifier les principales banques clinico-administratives, l’ampleur de leur utilisation, leurs limites et les solutions à développer pour les optimiser afin de mieux soutenir la gestion des services. Cet article vise à résumer le contenu de ces discussions. Bien que les banques comportent des forces importantes, dont un potentiel élevé de généralisation de l’information, elles présentent des limites se rapportant surtout à leur capacité à répondre aux besoins, à des enjeux de qualité et de validation, ainsi que d’accessibilité. Diverses recommandations ont été émises pour améliorer leur gestion et optimiser leur impact, dont leur conservation et traitement dans un organisme autonome et hautement accessible, et un changement sociétal de culture favorisant l’évaluation de la performance afin d’améliorer les pratiques et de mieux monitorer les résultats de santé.

Key steps for a mental health and addictions performance measurement framework for Canada

To inform the development of a pan-Canadian Mental Health and Addictions (MHA) performance measurement framework, we undertook a rapid review of the recent Performance Measurement (PM) literature and solicited input from 20 MHA policy and measurement experts. Six key steps for framework development were identified: recognizing and acknowledging key issues, developing shared language and understanding of key concepts, defining overall scope, defining framework dimension/domains, selecting indicators and using systematic engagement and consultation processes with stakeholders. Subject matter experts underscored the need for a comprehensive engagement process which would honour multiple stakeholder viewpoints and attend to key issues in the codesign of features of the PM framework. Findings from this analysis may be used to inform a comprehensive stakeholder consultation process for the development of a pan-Canadian PM framework for MHA.

Validation of the Children's Intrinsic Needs Satisfaction Scale among Canadian youth: psychometric properties, criterion-related validity and multitrait multimethod confirmatory factor analysis

INTRODUCTION

Based on self-determination theory, the Children's Intrinsic Needs Satisfaction Scale (CINSS) measures autonomy, competence and relatedness at school, home and with peers. The factor structure and criterion-related validity of the CINSS in the Canadian youth population are tested using data from the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS).

METHODS

Data from the 2014/2015 CSTADS were analyzed for evidence of convergent and discriminant validity and for method variance. A multitrait multimethod (MTMM) confirmatory factor analysis (CFA) was conducted to account for the conceptual structure of the measure. Criterion-related validity was demonstrated through correlations between related constructs, prosocial behaviours and behavioural problems, and the CINSS subscale scores. Mean differences on CINSS subscale scores between those who reported and did not report being bullied or bullying others were also examined.

RESULTS

Correlation analyses demonstrated that, in general, correlations were higher between concept/context item pairs and lowest between items measuring different concepts and contexts. Cronbach's alpha for concept and context subscales were high: α = 0.77 for autonomy, α = 0.85 for competence and α = 0.79 for relatedness. A MTMM CFA demonstrated that the model fit the data well, with no modifications. Criterion-related validity was demonstrated through correlations between CINSS subscales and related concepts or mean differences on CINSS subscales between groups.

CONCLUSION

The CINSS demonstrates good internal consistency, factorial validity and criterion-related validity in this sample of Canadian students. The measurement of positive mental health among Canadian youth is central to surveillance efforts which will help inform mental health promotion activities across Canada.

Developing key performance indicators for guaranteeing right to health and access to medical service for persons with disabilities in Korea: Using a modified Delphi

Recently, the Act on Guarantee of Right to Health and Access to Medical Service for Persons with Disabilities was implemented to legally define the health care system for persons with disabilities (PWDs) and the guarantee of access to medical care in Korea. This study aimed to develop specific goals and performance indicators to establish a system to guarantee right to health and access to medical service for PWDs. The first procedure was the establishment of the performance indicators, and the second was the content validity verification of the established performance indicators. To establish the performance indicators, we used the policy indicators of the government to improve the health of the Korean people. The indicators that needed to be newly developed were established based on literature review and expert consultation. Three Delphi surveys were conducted to verify the content validity of the established performance indicators. The content validity index (CVI) was obtained for the importance and possibility of the performance indicators. The indicators using the existing policy indicators are “proportion of public health centers” and “rate of health checkup of PWDs,” and newly developed indicators are “establishment of facilities for PWDs in health care facilities (buildings and personnel)” and “diagnosis of autism spectrum disorder in early childhood (average age and awareness).” The final performance indicators consist of a total of six areas, 22 sub-areas, and 40 individual indicators. The final performance indicators in this study can be used as basic data for continuously identifying the health status of PWDs in Korea and establishing the national policy for their health promotion. This study is also expected to serve as a framework to guarantee the right to health and access to medical service for PWDs rather than simply containing declarative content.

Priorities of positive mental health promotion in the Iranian community: a qualitative study

BACKGROUND

Positive Mental Health (PMH) enables people to cope with the common stresses of life and adversity to achieve their full potential and humanity. In many communities, promoting PMH via prioritized interventions has been considered as a key component of public health policies to optimize mental well-being.

OBJECTIVE

To set the priorities of interventional programs of Iranian PMH promotion according to the World Health Organization (WHO) Priority Public Health Condition (PPHC) analytical framework.

METHODS

This qualitative study was implemented in 2017 in Tehran, Iran and had two main phases. In a qualitative needs-assessment phase, needs of the community's PMH were collected through eight focus group discussions with a general population aged 30 to 60 years-old. In a priority-setting phase, the priorities of PMH were extracted through an expert panel consisting of mental health professionals and policy makers. Data gathering was implemented based on purposeful sampling according to inclusion criteria. Data were analyzed based on directional content analysis using Dedoose software version 7.6.6.

RESULTS

Fifty-one people and ten mental health professionals and policymakers participated in this study. The process of data analyzing, categorized PMH needs in 4 main categories, 15 subcategories and 46 codes. The four categories were financial security, social security, healthy lifestyle and promoting psychological factors. In the expert panel, first, the indicators of PMH priority setting were determined and then based on the priority public health condition analytical framework of the World Health Organization, the most important of PMH priority in each level was indicated as "creating job positions" in socioeconomic level, "providing proper working conditions" in differential exposure, "promoting practical life skills training" in the differential vulnerability, "easy and affordable access to mental health services" in differential healthcare outcome.

CONCLUSION

Appropriate policymaking and regulation at national level regarding employment, promoting working conditions, and reducing unemployment, promote community PMH as well as expanding accessible and affordable mental health services in the national healthcare system and empowering the community through providing practical life skill courses.

Prevalence and correlates of positive mental health in Chinese adolescents

BACKGROUND

Studies investigating the prevalence of positive mental health and its correlates are still scarce compared to the studies on mental disorders, although there is growing interest of assessing positive mental health in adolescents. So far, no other study examining the prevalence and determinants of positive mental health in Chinese adolescents has been found. The purpose of this study was to assess the prevalence and correlates of positive mental health in Chinese adolescents.

METHODS

This cross-sectional study used a questionnaire including Mental Health Continuum-Short Form (MHC-SF) and items regarding multiple aspects of adolescent life. The sample involved a total of 5399 students from grade 8 and 10 in Weifang, China. Multivariate Logistic regression analyses were performed to evaluate the associations between potential indicators regarding socio-economic situations, life style, social support and school life and positive mental health and calculate odds ratios and 95% confidence intervals.

RESULTS

More than half (57.4%) of the participants were diagnosed as flourishing. The correlated factors of positive mental health in regression models included gender, perceived family economy, the occurrence of sibling(s), satisfaction of self-appearance, physical activity, sleep quality, stress, social trust, desire to learn, support from teachers and parents as well as whether being bullied at school (OR ranging from 1.23 to 2.75). The Hosmer-Lemeshow p-value for the final regression model (0.45) indicated adequate model fit.

CONCLUSION

This study gives the first overview on prevalence and correlates of positive mental health in Chinese adolescents. The prevalence of positive mental health in Chinese adolescents is higher than reported in most of the previous studies also using MHC-SF. Our findings suggest that adolescents with advantageous socio-economic situations, life style, social support and school life are experiencing better positive mental health than others.

Positive Mental Health Surveillance Indicator Framework: Quick Stats, Youth (12 to 17 years of age), Canada, 2017 Edition

Positive mental health is a state of well-being that allows people to feel, think and act in ways that enhance the ability to enjoy life and deal with challenges.1 The Positive Mental Health Surveillance Indicator Framework (“the Framework”) provides comprehensive, high quality information on the outcomes and risk and protective factors associated with positive mental health across four domains (individual, family, community and society), to support research and policy development. The release of the Framework for youth aged 12 to 17 years is the second in a series; the Framework for adults aged 18 years and older was released in early 2016.2 The Framework was developed in consultation with stakeholders working in mental health surveillance, programs and policy. The details of the development of the Frameworks across the life course, for adults, youth and children, can be found in the paper “Monitoring positive mental health and its determinants.”3 More data on positive mental health can be found online using the Public Health Agency of Canada’s interactive data tool, “Infobase.”4

Status report -- Childhood overweight and obesity in Canada: an integrative assessment

INTRODUCTION

Obesity is a complex risk factor for chronic disease that is associated with a number of socioecological determinants. In this status report, we provide an overview of the socioecological framework that is now guiding our ongoing surveillance efforts in the area of childhood overweight and obesity. This framework considers individual risk and protective factors (sociodemographic, lifestyle, psychosocial and early-life) through the lens of the life stage, levels of influence and environments in which these factors play a role.

METHODS

Using data from the Canadian Community Health Survey and the Canadian Health Measures Survey, univariate and bivariate analyses were used to report on behavioural, psychosocial, and early life factors associated with excess weight among Canadian children.

RESULTS

Estimates of early-life (e.g. breastfeeding), behavioural (e.g. physical activity), and psychosocial factors (e.g. sense of community) are presented as they relate to age group, sex, income adequacy and weight status.

CONCLUSION

Building upon our recent reporting on trends in and sociodemographic factors associated with childhood obesity in Canada, this work illustrates the remaining risk and protective factors shown in our surveillance framework. This analysis supports the shift towards a holistic appraisal of determinants related to healthy weights.

Reliability and validity of the Positive Mental Health Questionnaire in a sample of Spanish university students

WHAT IS KNOWN ON THE SUBJECT?: In general, the current studies of positive mental health use questionnaires or parts thereof. However, while these questionnaires evaluate aspects of positive mental health, they fail to measure the construct itself. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: The widespread use and the lack of specific questionnaires for evaluating the positive mental health construct justify the need to measure the robustness of the Positive Mental Health Questionnaire. Also six factors are proposed to measure positive mental health. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The availability of a good questionnaire to measure positive mental health in university students is useful not only to promote mental health but also to strengthen the curricula of future professionals.

ABSTRACT

Introduction Nursing has a relevant role in managing mental health. It is important to identify and thereafter to enhance positive aspects of mental health among university nursing students. Aim The aim of the present study was to analyse the psychometric properties of the Positive Mental Health Questionnaire (PMHQ) in terms of reliability and validity using confirmatory factor analysis in a sample of university students. Method A cross-sectional study was carried out in a sample of 1091 students at 4 nursing schools in Catalonia, Spain. The reliability of the PMHQ was measured by means of Cronbach's alpha coefficient, and the test-retest stability was measured with the intraclass correlation coefficient (ICC). Confirmatory factor analysis was used to determine the validity of the factorial structure. Results Cronbach's alpha coefficient was satisfactory (>0.70) for four of the six subscales or dimensions and ranged from 0.54 to 0.79. ICC analysis was satisfactory for the six subscales or dimensions. The hypothesis was confirmed in the analysis of the correlations between subclasses and the overall scale, with the strongest correlations being found between the majority of the subscales and the overall scale. Confirmatory factor analysis showed that the model proposed for the factors fit the data satisfactorily. Discussion This scale is a valid and reliable instrument for evaluating positive mental health in university students. Implications for Practice A good questionnaire to measure positive mental health in university students is useful not only to promote mental health but also to strengthen the curricula of future professionals.

Correlates of well-being among Canadians with mood and/or anxiety disorders

INTRODUCTION

Our objective was to examine variables associated with well-being as measured by high self-rated mental health (SRMH) and life satisfaction (LS), among Canadian adults (aged 18+) living with a mood and/or an anxiety disorder.

METHODS

We used nationally representative data from the 2014 Survey on Living with Chronic Diseases in Canada-Mood and Anxiety Disorders Component (SLCDC-MA) to describe the association between well-being and self-management behaviours (physical activity, sleep and meditation) as well as perceived stress, coping and social support. We used multivariate logistic regression to model the relationship between these factors and measures of well-being.

RESULTS

Approximately one in three individuals with mood and/or anxiety disorders reported high SRMH. The logistic regression models demonstrated that several characteristics such as being older, and reporting higher self-rated general health, fewer functional limitations, lower levels of perceived life stress, higher levels of perceived coping and higher levels of perceived social support were associated with higher levels of wellbeing. Self-management behaviours (including starting physical activity, meditation, adopting good sleep habits and attaining a certain number of hours of nightly sleep) were not significantly associated with measures of well-being in our multivariate model.

CONCLUSION

Canadian adults with mood and/or anxiety disorders who reported lower levels of perceived stress and higher levels of social support and coping were more likely to report high levels of well-being. This study contributes evidence from a representative population-based sample indicating well-being is achievable, even in the presence of a mood and/or an anxiety disorder.

Individual- and Relationship-Level Factors Related to Better Mental Health Outcomes following Child Abuse: Results from a Nationally Representative Canadian Sample

OBJECTIVE

Child abuse can have devastating mental health consequences. Fortunately, not all individuals exposed to child abuse will suffer from poor mental health. Understanding what factors are related to good mental health following child abuse can provide evidence to inform prevention of impairment. Our objectives were to 1) describe the prevalence of good, moderate, and poor mental health among respondents with and without a child abuse history; 2) examine the relationships between child abuse and good, moderate, and poor mental health outcomes; 3) examine the relationships between individual- and relationship-level factors and better mental health outcomes; and 4) determine if individual- and relationship-level factors moderate the relationship between child abuse and mental health.

METHOD

Data were from the nationally representative 2012 Canadian Community Health Survey: Mental Health ( n = 23,395; household response rate = 79.8%; 18 years and older). Good, moderate, and poor mental health was assessed using current functioning and well-being, past-year mental disorders, and past-year suicidal ideation.

RESULTS

Only 56.3% of respondents with a child abuse history report good mental health compared to 72.4% of those without a child abuse history. Individual- and relationship-level factors associated with better mental health included higher education and income, physical activity, good coping skills to handle problems and daily demands, and supportive relationships that foster attachment, guidance, reliable alliance, social integration, and reassurance of worth.

CONCLUSIONS

This study identifies several individual- and relationship-level factors that could be targeted for intervention strategies aimed at improving mental health outcomes following child abuse.

Tobacco consumption and positive mental health: an epidemiological study from a positive psychology perspective

Background

Positive mental health (PMH) is much more than the absence of mental illnesses. For example, PMH explains that to be happy or resilient can drive us to live a full life, giving us a perception of well-being and robustness against everyday problems. Moreover, PMH can help people to avoid risky behaviours like tobacco consumption (TC). Our hypothesis was that PMH is negatively associated with TC, and this association differs across rural, urban and migrant populations.

Methods

A cross-sectional study was conducted using the PERU MIGRANT Study’s dataset, including rural population from the Peruvian highlands (n = 201), urban population from the capital city Lima (n = 199) and migrants who were born in highlands but had to migrated because of terrorism (n = 589). We used an adapted version of the 12-item Global Health Questionnaire to measure PMH. The outcome was TC, measured as lifetime and recent TC. Log-Poisson robust regression, performed with a Maximum Likelihood method, was used to estimate crude prevalence ratios (PR) and 95 % confidence intervals (95%CI), adjusted by sex, age, family income and education which were the confounders. The modelling procedure included the use of LR Test, Akaike information criteria (AIC) and Bayesian information criteria (BIC).

Results

Cumulative occurrence of tobacco use (lifetime TC) was 61.7 % in the rural group, 78 % in the urban group and 76.2 % in rural-to-urban migrants. Recent TC was 35.3 % in the rural group, 30.7 % in the urban group and 20.5 % in rural-to-urban migrants. After adjusting for confounders, there was evidence of a negative association between PMH and lifetime TC in the rural group (PR = 0.93; 95%CI: 0.87–0.99), and a positive association between PMH and recent TC in migrants (PR = 1.1; 95%CI: 1.0–1.3).

Conclusions

PMH was negatively associated with TC in rural participants only. Urbans exhibited just a similar trend, while migrants exhibited the opposite one. This evidence represents the first step in the route of knowing the potential of PMH for fighting against TC. For rural populations, this study supplies new information that could support decisions about prevention programmes and psychotherapy for smoking cessation. However, more research in the topic is needed.

Electronic supplementary material

The online version of this article (doi:10.1186/s40359-016-0130-7) contains supplementary material, which is available to authorized users.