Pub Date : 2023-08-11DOI: 10.1108/mhrj-07-2022-0052
John G. Mills, Lee Cumbers, S. Williams, Henry Titley-Wall
Purpose Adolescence and young adulthood are recognised as critical time for developing mental health literacy (MHL). The purpose of this study is to analyse the effectiveness of current MHL interventions to guide the future development of MHL intervention strategies. Design/methodology/approach A meta-analysis adopting the PRISMA framework for systematically reviewing the literature was adopted. Three authors independently reviewed studies and extrapolated key data for analysis. A robust random-effects model with adjustments for small study biases was conducted to establish the effect sizes of all included MHL interventions. Moderator analysis was conducted to examine the effects of intervention length in MHL. Findings A total of 11 intervention studies were identified and analysed, resulting in a medium to large pooled effect size of 0.62 (95% CI: 0.28; 0.96). Moderator analysis found that short interventions had an estimated standard mean difference (SMD) effect size of 0.9220 (95% CI: −1.1555; 2.9995). This was greater than the medium length interventions, with an estimated SMD effect size of 0.4967 (95% CI: 0.0452; 0.9483), and long interventions, with an estimated SMD effect size of 0.5628 (95% CI: −0.2726; 1.3983). As a result, MHL interventions are proficient in improving young adults’ MHL, with shorter interventions (45–50 min) having the largest effect size. This study highlights several inconsistencies in methodological rigour and reporting from studies in this area, which future research should look to address. Originality/value To date, MHL review studies have often focused their attention on a specific domain, most notably education and school-based setting. To the best of the authors’ knowledge, no reviews have conducted a meta-analysis across contexts and domains with a specific focus on MHL intervention strategies for young adults.
{"title":"The effectiveness of mental health literacy interventions in young people: a meta-analysis","authors":"John G. Mills, Lee Cumbers, S. Williams, Henry Titley-Wall","doi":"10.1108/mhrj-07-2022-0052","DOIUrl":"https://doi.org/10.1108/mhrj-07-2022-0052","url":null,"abstract":"\u0000Purpose\u0000Adolescence and young adulthood are recognised as critical time for developing mental health literacy (MHL). The purpose of this study is to analyse the effectiveness of current MHL interventions to guide the future development of MHL intervention strategies.\u0000\u0000\u0000Design/methodology/approach\u0000A meta-analysis adopting the PRISMA framework for systematically reviewing the literature was adopted. Three authors independently reviewed studies and extrapolated key data for analysis. A robust random-effects model with adjustments for small study biases was conducted to establish the effect sizes of all included MHL interventions. Moderator analysis was conducted to examine the effects of intervention length in MHL.\u0000\u0000\u0000Findings\u0000A total of 11 intervention studies were identified and analysed, resulting in a medium to large pooled effect size of 0.62 (95% CI: 0.28; 0.96). Moderator analysis found that short interventions had an estimated standard mean difference (SMD) effect size of 0.9220 (95% CI: −1.1555; 2.9995). This was greater than the medium length interventions, with an estimated SMD effect size of 0.4967 (95% CI: 0.0452; 0.9483), and long interventions, with an estimated SMD effect size of 0.5628 (95% CI: −0.2726; 1.3983). As a result, MHL interventions are proficient in improving young adults’ MHL, with shorter interventions (45–50 min) having the largest effect size. This study highlights several inconsistencies in methodological rigour and reporting from studies in this area, which future research should look to address.\u0000\u0000\u0000Originality/value\u0000To date, MHL review studies have often focused their attention on a specific domain, most notably education and school-based setting. To the best of the authors’ knowledge, no reviews have conducted a meta-analysis across contexts and domains with a specific focus on MHL intervention strategies for young adults.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44216291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-25DOI: 10.1108/mhrj-08-2022-0058
Antaine Stíobhairt, Nicole Cassidy, Niamh Clarke, S. Guerin
Purpose This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented practice and related professional practice issues. Design/methodology/approach A qualitative hermeneutic phenomenological study was conducted from a social constructivist perspective. Semi-structured interviews with 17 psychologists were analysed using reflexive thematic analysis. Findings Twenty-four themes were identified, which were clustered into four overarching themes. Participants viewed themselves and psychology in Ireland more broadly as peripheral to seclusion. They believed that seclusion possessed no inherent therapeutic value but viewed it as an uncomfortable and multi-faceted reality. Participants regarded seclusion and recovery as largely inconsistent and difficult to reconcile, and they perceived systemic factors, which had a pervasive negative impact on seclusion and recovery in practice. Practical implications The findings highlight the perceived complexity of seclusion and its interface with recovery, and the need to conscientiously balance conflicting priorities that cannot be easily reconciled to ensure ethical practice. The findings suggest psychologists are well-suited to participate in local and national discussions on using seclusion in recovery-oriented practice. Originality/value This study offers a unique insight into psychologists’ perceptions of seclusion and considers the implications of these views. Participants’ nuanced views suggest that psychologists can make valuable contributions to local and national discussions on these topics.
{"title":"Seclusion in the context of recovery-oriented practice: the perspectives and experiences of psychologists in Ireland","authors":"Antaine Stíobhairt, Nicole Cassidy, Niamh Clarke, S. Guerin","doi":"10.1108/mhrj-08-2022-0058","DOIUrl":"https://doi.org/10.1108/mhrj-08-2022-0058","url":null,"abstract":"\u0000Purpose\u0000This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented practice and related professional practice issues.\u0000\u0000\u0000Design/methodology/approach\u0000A qualitative hermeneutic phenomenological study was conducted from a social constructivist perspective. Semi-structured interviews with 17 psychologists were analysed using reflexive thematic analysis.\u0000\u0000\u0000Findings\u0000Twenty-four themes were identified, which were clustered into four overarching themes. Participants viewed themselves and psychology in Ireland more broadly as peripheral to seclusion. They believed that seclusion possessed no inherent therapeutic value but viewed it as an uncomfortable and multi-faceted reality. Participants regarded seclusion and recovery as largely inconsistent and difficult to reconcile, and they perceived systemic factors, which had a pervasive negative impact on seclusion and recovery in practice.\u0000\u0000\u0000Practical implications\u0000The findings highlight the perceived complexity of seclusion and its interface with recovery, and the need to conscientiously balance conflicting priorities that cannot be easily reconciled to ensure ethical practice. The findings suggest psychologists are well-suited to participate in local and national discussions on using seclusion in recovery-oriented practice.\u0000\u0000\u0000Originality/value\u0000This study offers a unique insight into psychologists’ perceptions of seclusion and considers the implications of these views. Participants’ nuanced views suggest that psychologists can make valuable contributions to local and national discussions on these topics.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":"1 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41424312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-20DOI: 10.1108/mhrj-03-2023-0014
Peta Temple
Purpose The purpose of this paper is to explore the historic policy context and social implications of the diagnosis of personality disorder and also consider formulation-based and trauma-informed understandings of distress. Design/methodology/approach Ongoing changes to (and splits between) medical understandings of what is being labelled as personality disorder have eroded the label’s cultural capital, adding weight to lived-experience-led calls to Drop the Disorder (Watson, 2019). This paper explores the impact and implications of the historic policy and practice context through a lived experience lens. Findings Such diversity of views in the lived experience and medical communities on personality disorder has allowed alternatives to diagnostically informed understandings of distress (such as formulation-based and trauma-informed approaches) to gain traction with practitioners (Bloom and Farragher, 2013; Johnstone and Boyle, 2020). The broader assimilation of these alternative perspectives into dominant medical ideology is evidenced by the fact that the Royal College of Psychiatrists (RCP) is now also exploring alternatives to diagnosis (2023). This suggests even more change ahead for how we understand people and their relationships with trauma and distress. Research limitations/implications This paper discusses UK policy and does not include broader global policies. Practical implications This paper would be helpful for any student interested in where the ideas that underpin personality disorder diagnosis stemmed from and why so many lived experience practitioners and experts by profession question the diagnosis' legitimacy. Social implications As the RCP is now considering alternatives to diagnosis, it is even more critical that practitioners are aware of the competing narratives surrounding this contested diagnosis – as the author believes this will promote more compassionate, trauma-informed working practices. Originality/value This is the author’s own work and includes not only the RCP position change but also directly quotes Professor Tyrer (who wrote the International Classification of Diseases 11), giving his views on the changed RCP position, as he recently presented at a conference here in Cornwall. The author is a part of Lighthouse peer support group and wrote this paper as preparation for a Participatory Action Research project they are planning, where they will evaluate the Sanctuary Approach with their membership to create a lived experience-designed trauma-informed charter. Before starting that work, the author wanted to better understand the historic policy context and created this paper to fill that need.
{"title":"Personality disorder: no longer a diagnosis?","authors":"Peta Temple","doi":"10.1108/mhrj-03-2023-0014","DOIUrl":"https://doi.org/10.1108/mhrj-03-2023-0014","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to explore the historic policy context and social implications of the diagnosis of personality disorder and also consider formulation-based and trauma-informed understandings of distress.\u0000\u0000\u0000Design/methodology/approach\u0000Ongoing changes to (and splits between) medical understandings of what is being labelled as personality disorder have eroded the label’s cultural capital, adding weight to lived-experience-led calls to Drop the Disorder (Watson, 2019). This paper explores the impact and implications of the historic policy and practice context through a lived experience lens.\u0000\u0000\u0000Findings\u0000Such diversity of views in the lived experience and medical communities on personality disorder has allowed alternatives to diagnostically informed understandings of distress (such as formulation-based and trauma-informed approaches) to gain traction with practitioners (Bloom and Farragher, 2013; Johnstone and Boyle, 2020). The broader assimilation of these alternative perspectives into dominant medical ideology is evidenced by the fact that the Royal College of Psychiatrists (RCP) is now also exploring alternatives to diagnosis (2023). This suggests even more change ahead for how we understand people and their relationships with trauma and distress.\u0000\u0000\u0000Research limitations/implications\u0000This paper discusses UK policy and does not include broader global policies.\u0000\u0000\u0000Practical implications\u0000This paper would be helpful for any student interested in where the ideas that underpin personality disorder diagnosis stemmed from and why so many lived experience practitioners and experts by profession question the diagnosis' legitimacy.\u0000\u0000\u0000Social implications\u0000As the RCP is now considering alternatives to diagnosis, it is even more critical that practitioners are aware of the competing narratives surrounding this contested diagnosis – as the author believes this will promote more compassionate, trauma-informed working practices.\u0000\u0000\u0000Originality/value\u0000This is the author’s own work and includes not only the RCP position change but also directly quotes Professor Tyrer (who wrote the International Classification of Diseases 11), giving his views on the changed RCP position, as he recently presented at a conference here in Cornwall. The author is a part of Lighthouse peer support group and wrote this paper as preparation for a Participatory Action Research project they are planning, where they will evaluate the Sanctuary Approach with their membership to create a lived experience-designed trauma-informed charter. Before starting that work, the author wanted to better understand the historic policy context and created this paper to fill that need.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43507545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-16DOI: 10.1108/mhrj-05-2022-0031
Ketan Sonigra, Lucy McIvor, J. Payne-Gill, Tim Smith, A. Beck
Purpose There is a proportion of psychiatric service users whose needs are not met by existing models of care. This can lead to a reliance on acute and crisis services. These service users may be considered high intensity users (HIUs). The purpose of this research is to evaluate the Crisis Plus model, an intervention designed to better support HIUs in the community and reduce dependency on acute and crisis services. Design/methodology/approach Forty-seven HIUs were involved in Crisis Plus. The core intervention of Crisis Plus was an Anticipatory Management Plan (AMP), produced in collaboration with service users, their families and their care coordinators. AMPs were shared with relevant services and attached to electronic patient notes to ensure a uniform, psychologically informed approach to care. Findings HIU service use was compared pre and post-AMP. On average, number of inpatient admissions, number of days spent on the ward, accepted psychiatric liaison referrals and accepted home treatment team (HTT) referrals decreased significantly. Practical implications Crisis Plus has taken a collaborative, proactive approach to engage HIUs, their families and the services that care for them. Crisis interventions that emphasise collaborative working and service user agency are key. Originality/value The provision of dedicated psychological support to HIUs and their professional and personal network is crucial to reduce reliance on acute and crisis care. Crisis Plus is unique in that it instigates co-production and active consultation with HIUs and services to improve clinical outcomes, in addition to reducing NHS expenditure.
{"title":"A preliminary evaluation of Crisis Plus: a model for working with frequent users of psychiatric crisis and inpatient services","authors":"Ketan Sonigra, Lucy McIvor, J. Payne-Gill, Tim Smith, A. Beck","doi":"10.1108/mhrj-05-2022-0031","DOIUrl":"https://doi.org/10.1108/mhrj-05-2022-0031","url":null,"abstract":"\u0000Purpose\u0000There is a proportion of psychiatric service users whose needs are not met by existing models of care. This can lead to a reliance on acute and crisis services. These service users may be considered high intensity users (HIUs). The purpose of this research is to evaluate the Crisis Plus model, an intervention designed to better support HIUs in the community and reduce dependency on acute and crisis services.\u0000\u0000\u0000Design/methodology/approach\u0000Forty-seven HIUs were involved in Crisis Plus. The core intervention of Crisis Plus was an Anticipatory Management Plan (AMP), produced in collaboration with service users, their families and their care coordinators. AMPs were shared with relevant services and attached to electronic patient notes to ensure a uniform, psychologically informed approach to care.\u0000\u0000\u0000Findings\u0000HIU service use was compared pre and post-AMP. On average, number of inpatient admissions, number of days spent on the ward, accepted psychiatric liaison referrals and accepted home treatment team (HTT) referrals decreased significantly.\u0000\u0000\u0000Practical implications\u0000Crisis Plus has taken a collaborative, proactive approach to engage HIUs, their families and the services that care for them. Crisis interventions that emphasise collaborative working and service user agency are key.\u0000\u0000\u0000Originality/value\u0000The provision of dedicated psychological support to HIUs and their professional and personal network is crucial to reduce reliance on acute and crisis care. Crisis Plus is unique in that it instigates co-production and active consultation with HIUs and services to improve clinical outcomes, in addition to reducing NHS expenditure.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43063678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-06DOI: 10.1108/mhrj-07-2022-0045
J. Meggs, S. Young, A. Mckeown
Purpose Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition with community prevalence globally of 2%–7% (M = 5%; Sayal et al., 2018). Clinicians are routinely encouraged to explain to children and young people the benefits of a healthy lifestyle, including exercise (NICE NG87, 2018). Exercise has been proposed as a safe and low-cost adjunctive approach for ADHD and is reported to be accompanied by positive effects on several aspects of executive functioning (EF). The purpose of this narrative review was to synthesise the contemporary randomised control trial (RCT) studies that examine the effect of sport, physical activity and movement on EF in children and adolescents with ADHD. Design/methodology/approach A narrative review approach with a systematic literature search using PRISMA guidelines for screening and selecting relevant systematic reviews was used. The final review included four peer-review systematic reviews (>2019). Findings The results identified four RCT meta-analyses and findings showed that children and adolescents with lower baseline cognitive performance demonstrated greater improvements in functioning after physical activity interventions, particularly for tasks with higher executive function demands, where baseline performance reaches an optimal level. Findings suggest that 10–20 min of acute moderate-high-intensity exercise interventions (cycling/running) appeared to have positive effects on indices of inhibitory control. Preliminary evidence suggests that as little as 5 min of jumping exercises improved inhibitory control. Sixty to eighty minutes of moderately intense, repeated (chronic) exercise appeared to demonstrate the greatest beneficial impact on selective attention. Originality/value To the best of the authors’ knowledge, this review is the first to present the extant literature on the effect of physical activity and sport on symptoms of young people with ADHD. It presents evidence to suggest that exercise with progressively increasing cognitive demands may have positive effects for children with ADHD, specifically in terms of improving cognitive flexibility. Further large-scale clinical trials are needed to confirm the positive effects of physical exercise on cognitive functioning in children with ADHD.
目的注意缺陷多动障碍(ADHD)是一种常见的神经发育疾病，全球社区患病率为2%-7% (M = 5%;Sayal et al.， 2018)。临床医生经常被鼓励向儿童和年轻人解释健康生活方式的好处，包括锻炼(NICE NG87, 2018年)。运动被认为是一种安全、低成本的ADHD辅助治疗方法，据报道，运动对执行功能(EF)的几个方面都有积极的影响。本叙述性综述的目的是综合当代随机对照试验(RCT)研究，这些研究考察了运动、体育活动和运动对患有ADHD的儿童和青少年EF的影响。设计/方法学/方法采用叙述性综述法，采用PRISMA指南进行系统文献检索，筛选和选择相关的系统综述。最终评审包括四次同行评审系统评审(>2019)。结果确定了四项随机对照试验荟萃分析，结果表明，基线认知能力较低的儿童和青少年在体育活动干预后表现出更大的功能改善，特别是在执行功能要求较高的任务中，基线表现达到最佳水平。研究结果表明，10-20分钟的急性中高强度运动干预(骑车/跑步)似乎对抑制控制指标有积极影响。初步证据表明，只需5分钟的跳跃练习就能改善抑制控制。60到80分钟中等强度的、重复的(慢性)运动似乎对选择性注意力有最大的有益影响。原创性/价值据作者所知，这篇综述是第一个介绍体力活动和运动对青少年多动症症状影响的现有文献。它提供的证据表明，逐渐增加认知需求的运动可能对多动症儿童有积极影响，特别是在提高认知灵活性方面。需要进一步的大规模临床试验来证实体育锻炼对多动症儿童认知功能的积极影响。
{"title":"A narrative review of the effect of sport and exercise on ADHD symptomatology in children and adolescents with ADHD","authors":"J. Meggs, S. Young, A. Mckeown","doi":"10.1108/mhrj-07-2022-0045","DOIUrl":"https://doi.org/10.1108/mhrj-07-2022-0045","url":null,"abstract":"\u0000Purpose\u0000Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition with community prevalence globally of 2%–7% (M = 5%; Sayal et al., 2018). Clinicians are routinely encouraged to explain to children and young people the benefits of a healthy lifestyle, including exercise (NICE NG87, 2018). Exercise has been proposed as a safe and low-cost adjunctive approach for ADHD and is reported to be accompanied by positive effects on several aspects of executive functioning (EF). The purpose of this narrative review was to synthesise the contemporary randomised control trial (RCT) studies that examine the effect of sport, physical activity and movement on EF in children and adolescents with ADHD.\u0000\u0000\u0000Design/methodology/approach\u0000A narrative review approach with a systematic literature search using PRISMA guidelines for screening and selecting relevant systematic reviews was used. The final review included four peer-review systematic reviews (>2019).\u0000\u0000\u0000Findings\u0000The results identified four RCT meta-analyses and findings showed that children and adolescents with lower baseline cognitive performance demonstrated greater improvements in functioning after physical activity interventions, particularly for tasks with higher executive function demands, where baseline performance reaches an optimal level. Findings suggest that 10–20 min of acute moderate-high-intensity exercise interventions (cycling/running) appeared to have positive effects on indices of inhibitory control. Preliminary evidence suggests that as little as 5 min of jumping exercises improved inhibitory control. Sixty to eighty minutes of moderately intense, repeated (chronic) exercise appeared to demonstrate the greatest beneficial impact on selective attention.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, this review is the first to present the extant literature on the effect of physical activity and sport on symptoms of young people with ADHD. It presents evidence to suggest that exercise with progressively increasing cognitive demands may have positive effects for children with ADHD, specifically in terms of improving cognitive flexibility. Further large-scale clinical trials are needed to confirm the positive effects of physical exercise on cognitive functioning in children with ADHD.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47677957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.1108/mhrj-11-2022-0068
Chris Griffiths, Ksenija da Silva, Harmony Jiang, K. Walker, David Smart, A. Zafar, Sarah Deeks, S. Galvin, Taz Shah
Purpose This study aims to evaluate the effect of Alpha-Stim Anxiety, Insomnia and Depression (AID) cranial electrotherapy stimulation (CES) on anxiety, depression and health-related quality of life for primary care social prescribing service patients with anxiety symptoms. Design/methodology/approach Open-label patient cohort design with no control group. A total of 33 adult patients (average age 42 years) completed six weeks of Alpha-Stim AID use. Pre- and post-intervention assessment with participant self-report measures: Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7) and European Quality of Life Five Dimension (EQ-5D-5L). Findings Reliable improvement and remission rates, respectively, were 53.39% and 33.3% for GAD-7; 46.7% and 29.5% for PHQ-9. There was a significant improvement in GAD-7 and PHQ-9 with large effect sizes. EQ-5D-5L results showed significant improvements in health-related quality of life. Perceived quality of life increased by 0.17 on the health index score, with the intervention adding 1.68 quality-adjusted life years (QALYs). Practical implications Alpha-Stim AID can be delivered through a primary health-care social prescribing service and most patients will use as prescribed and complete treatment course. Alpha-Stim AID CES may be an effective anxiety and depression treatment for people with anxiety symptoms. The widespread roll-out of Alpha-Stim AID in health-care systems should be considered. Originality/value To the best of the authors’ knowledge, this is the first study to respond to the UK’s National Institute for Health and Care (NICE) request for the collection of real-world data to understand better Alpha-Stim AID in relation to people’s treatment uptake, response rates and treatment completion rates (NICE, 2021).
{"title":"Alpha-Stim AID cranial electrotherapy stimulation (CES) anxiety treatment: anxiety, depression and health-related quality-of-life outcomes in primary health-care social prescribing services","authors":"Chris Griffiths, Ksenija da Silva, Harmony Jiang, K. Walker, David Smart, A. Zafar, Sarah Deeks, S. Galvin, Taz Shah","doi":"10.1108/mhrj-11-2022-0068","DOIUrl":"https://doi.org/10.1108/mhrj-11-2022-0068","url":null,"abstract":"\u0000Purpose\u0000This study aims to evaluate the effect of Alpha-Stim Anxiety, Insomnia and Depression (AID) cranial electrotherapy stimulation (CES) on anxiety, depression and health-related quality of life for primary care social prescribing service patients with anxiety symptoms.\u0000\u0000\u0000Design/methodology/approach\u0000Open-label patient cohort design with no control group. A total of 33 adult patients (average age 42 years) completed six weeks of Alpha-Stim AID use. Pre- and post-intervention assessment with participant self-report measures: Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7) and European Quality of Life Five Dimension (EQ-5D-5L).\u0000\u0000\u0000Findings\u0000Reliable improvement and remission rates, respectively, were 53.39% and 33.3% for GAD-7; 46.7% and 29.5% for PHQ-9. There was a significant improvement in GAD-7 and PHQ-9 with large effect sizes. EQ-5D-5L results showed significant improvements in health-related quality of life. Perceived quality of life increased by 0.17 on the health index score, with the intervention adding 1.68 quality-adjusted life years (QALYs).\u0000\u0000\u0000Practical implications\u0000Alpha-Stim AID can be delivered through a primary health-care social prescribing service and most patients will use as prescribed and complete treatment course. Alpha-Stim AID CES may be an effective anxiety and depression treatment for people with anxiety symptoms. The widespread roll-out of Alpha-Stim AID in health-care systems should be considered.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, this is the first study to respond to the UK’s National Institute for Health and Care (NICE) request for the collection of real-world data to understand better Alpha-Stim AID in relation to people’s treatment uptake, response rates and treatment completion rates (NICE, 2021).\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49199519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-16DOI: 10.1108/mhrj-06-2022-0038
J. Goodwin, L. Behan
Purpose People who experience mental illness often demonstrate limited help-seeking behaviours. There is evidence to suggest that media content can influence negative attitudes towards mental illness; less is known about how media impacts help-seeking behaviours. The purpose of this study is to identify if media plays a role in people’s decisions to seek help for their mental health. Design/methodology/approach The databases Academic Search Complete, CINAHL Plus with Full Text, MEDLINE, APA PsycArticles, APA PsycInfo, Social Sciences Full Text [H.W. Wilson] and Soc Index were systemically searched for papers in the English language that investigated the link between media and help-seeking for mental illness. Findings Sixteen studies met eligibility criteria. There was some evidence to suggest that various forms of media – including video and online resources – can positively influence help-seeking for mental health. Print media had some limited effect on help-seeking behaviours but was weaker in comparison to other forms of media. There was no evidence to suggest that media discourages people from seeking help. Originality/value This review identified that, given the heterogeneity of the included papers, and the limited evidence available, there is a need for more focused research to determine how media impacts mental health-related help-seeking behaviours.
目的经历精神疾病的人往往表现出有限的求助行为。有证据表明，媒体内容会影响人们对精神疾病的负面态度；人们对媒体如何影响求助行为知之甚少。这项研究的目的是确定媒体是否在人们寻求心理健康帮助的决定中发挥作用。设计/方法/方法在数据库Academic Search Complete、CINAHL Plus with Full Text、MEDLINE、APA PsycArticles、APA PsycInfo、Social Sciences Full Text[H.W.W.W.Wilson]和Soc Index中系统搜索英文论文，调查媒体与精神疾病求助之间的联系。发现16项研究符合资格标准。有证据表明，包括视频和在线资源在内的各种形式的媒体可以对寻求心理健康帮助产生积极影响。印刷媒体对求助行为的影响有限，但与其他形式的媒体相比较弱。没有证据表明媒体不鼓励人们寻求帮助。原创性/价值这篇综述发现，鉴于所收录论文的异质性和可用证据的有限性，有必要进行更集中的研究，以确定媒体如何影响心理健康求助行为。
{"title":"Does media content have an impact on help-seeking behaviors for mental illness? A systematic review","authors":"J. Goodwin, L. Behan","doi":"10.1108/mhrj-06-2022-0038","DOIUrl":"https://doi.org/10.1108/mhrj-06-2022-0038","url":null,"abstract":"\u0000Purpose\u0000People who experience mental illness often demonstrate limited help-seeking behaviours. There is evidence to suggest that media content can influence negative attitudes towards mental illness; less is known about how media impacts help-seeking behaviours. The purpose of this study is to identify if media plays a role in people’s decisions to seek help for their mental health.\u0000\u0000\u0000Design/methodology/approach\u0000The databases Academic Search Complete, CINAHL Plus with Full Text, MEDLINE, APA PsycArticles, APA PsycInfo, Social Sciences Full Text [H.W. Wilson] and Soc Index were systemically searched for papers in the English language that investigated the link between media and help-seeking for mental illness.\u0000\u0000\u0000Findings\u0000Sixteen studies met eligibility criteria. There was some evidence to suggest that various forms of media – including video and online resources – can positively influence help-seeking for mental health. Print media had some limited effect on help-seeking behaviours but was weaker in comparison to other forms of media. There was no evidence to suggest that media discourages people from seeking help.\u0000\u0000\u0000Originality/value\u0000This review identified that, given the heterogeneity of the included papers, and the limited evidence available, there is a need for more focused research to determine how media impacts mental health-related help-seeking behaviours.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49114583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-16DOI: 10.1108/mhrj-08-2022-0055
F. Rocca, T. Schröder, S. Regel
Purpose Lengthy and complex routes to specialist care may negatively affect clinical profiles of trauma survivors accessing mental health services. The purpose of this study was to describe the characteristics and referral pathways of a cohort of clients accepted by a specialist trauma service in England; and investigate the associations between referral pathways and clients’ clinical profiles, namely, pre-treatment levels of post-traumatic stress, depression, anxiety, stress and post-traumatic growth. Design/methodology/approach Data on 117 consecutive, accepted referrals were extracted from clients’ clinical records. Information on demographics, trauma histories, clinical presentations and referral pathways was synthesised through summary statistics. Correlational analyses were conducted to test associations with pre-treatment scores. Findings Clients accessing the service were highly complex and mostly experienced prolonged, interpersonal trauma. Pathways to the service varied, but 50% of the sample had at least four “steps” in their referral histories and seven previous clinical contacts. The average time between trauma and specialist referral was 16.34 years. The number of referral steps positively, significatively and moderately correlated with anxiety and stress at pre-treatment. Research limitations/implications Limitations include issues around collecting past referral information, the small sample size for clients with available pre-treatment data and the lack of post-treatment scores. Originality/value This evaluation provides an informative overview of the characteristics and referral pathways of clients accessing a specialist trauma service. It also offers preliminary insights on the relationship between clients’ routes into the service and their clinical profiles. Practice, commissioning and research implications are discussed.
{"title":"Evaluating referral pathways to a specialist trauma service","authors":"F. Rocca, T. Schröder, S. Regel","doi":"10.1108/mhrj-08-2022-0055","DOIUrl":"https://doi.org/10.1108/mhrj-08-2022-0055","url":null,"abstract":"\u0000Purpose\u0000Lengthy and complex routes to specialist care may negatively affect clinical profiles of trauma survivors accessing mental health services. The purpose of this study was to describe the characteristics and referral pathways of a cohort of clients accepted by a specialist trauma service in England; and investigate the associations between referral pathways and clients’ clinical profiles, namely, pre-treatment levels of post-traumatic stress, depression, anxiety, stress and post-traumatic growth.\u0000\u0000\u0000Design/methodology/approach\u0000Data on 117 consecutive, accepted referrals were extracted from clients’ clinical records. Information on demographics, trauma histories, clinical presentations and referral pathways was synthesised through summary statistics. Correlational analyses were conducted to test associations with pre-treatment scores.\u0000\u0000\u0000Findings\u0000Clients accessing the service were highly complex and mostly experienced prolonged, interpersonal trauma. Pathways to the service varied, but 50% of the sample had at least four “steps” in their referral histories and seven previous clinical contacts. The average time between trauma and specialist referral was 16.34 years. The number of referral steps positively, significatively and moderately correlated with anxiety and stress at pre-treatment.\u0000\u0000\u0000Research limitations/implications\u0000Limitations include issues around collecting past referral information, the small sample size for clients with available pre-treatment data and the lack of post-treatment scores.\u0000\u0000\u0000Originality/value\u0000This evaluation provides an informative overview of the characteristics and referral pathways of clients accessing a specialist trauma service. It also offers preliminary insights on the relationship between clients’ routes into the service and their clinical profiles. Practice, commissioning and research implications are discussed.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42446274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-08DOI: 10.1108/mhrj-09-2022-0059
K. Fenton, Katherine Kidd, A. Lord
Purpose The purpose of this study is to assess if the new community-enhanced rehabilitation team reduced anxiety and readmissions in service users discharged from an inpatient rehabilitation setting. Design/methodology/approach The study used both qualitative and quantitative methodology. Service user’s anxiety level was measured before being discharged and at the end of the Community Enhanced Rehabilitation Team (CERT) transition intervention. Six service users were interviewed to gain further understanding of their experiences of anxiety. Findings Findings showed the anxiety score was significantly lower (M = 1.5, 95% CI [0.051,2.99], t(20) = 2.159, p = 0.043) following the CERT intervention (M = 8.6, SD = 6.4) compared to before (M = 10.1, SD = 7.0). No service user receiving the CERT intervention was readmitted to hospital within 12 weeks of discharge from the inpatient setting, compared to three service users (15% of those discharged) who were discharged to other community services. Research limitations/implications Community rehabilitation pathways would benefit from having interventions to aid patient transitions from inpatient to the community. The National Health Service (NHS) trusts develop community rehabilitation teams as recommended by the National Institute for Health and Care Excellence (NICE), and they should consider including transitional support as part of their model. Practical implications It is recommended that as NHS trusts design and implement community mental health teams, they should consider including transition support as part of their model. Social implications People with severe and enduring mental health difficulties who have been in an inpatient rehabilitation setting would benefit from community transitional support. This study suggests that such support helps reduce anxiety and readmission. Originality/value Community rehabilitation teams are currently being developed across the NHS as part of the NHS long-term plan. These teams are new, and as such, there is a dearth of information regarding their effectiveness. To the best of the authors’ knowledge, this is one of the first studies to evaluate outcomes in these new teams.
{"title":"Reducing anxiety and hospital readmission in the early weeks following discharge from inpatient rehabilitation: the new community enhanced rehabilitation team","authors":"K. Fenton, Katherine Kidd, A. Lord","doi":"10.1108/mhrj-09-2022-0059","DOIUrl":"https://doi.org/10.1108/mhrj-09-2022-0059","url":null,"abstract":"\u0000Purpose\u0000The purpose of this study is to assess if the new community-enhanced rehabilitation team reduced anxiety and readmissions in service users discharged from an inpatient rehabilitation setting.\u0000\u0000\u0000Design/methodology/approach\u0000The study used both qualitative and quantitative methodology. Service user’s anxiety level was measured before being discharged and at the end of the Community Enhanced Rehabilitation Team (CERT) transition intervention. Six service users were interviewed to gain further understanding of their experiences of anxiety.\u0000\u0000\u0000Findings\u0000Findings showed the anxiety score was significantly lower (M = 1.5, 95% CI [0.051,2.99], t(20) = 2.159, p = 0.043) following the CERT intervention (M = 8.6, SD = 6.4) compared to before (M = 10.1, SD = 7.0). No service user receiving the CERT intervention was readmitted to hospital within 12 weeks of discharge from the inpatient setting, compared to three service users (15% of those discharged) who were discharged to other community services.\u0000\u0000\u0000Research limitations/implications\u0000Community rehabilitation pathways would benefit from having interventions to aid patient transitions from inpatient to the community. The National Health Service (NHS) trusts develop community rehabilitation teams as recommended by the National Institute for Health and Care Excellence (NICE), and they should consider including transitional support as part of their model.\u0000\u0000\u0000Practical implications\u0000It is recommended that as NHS trusts design and implement community mental health teams, they should consider including transition support as part of their model.\u0000\u0000\u0000Social implications\u0000People with severe and enduring mental health difficulties who have been in an inpatient rehabilitation setting would benefit from community transitional support. This study suggests that such support helps reduce anxiety and readmission.\u0000\u0000\u0000Originality/value\u0000Community rehabilitation teams are currently being developed across the NHS as part of the NHS long-term plan. These teams are new, and as such, there is a dearth of information regarding their effectiveness. To the best of the authors’ knowledge, this is one of the first studies to evaluate outcomes in these new teams.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44751927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-25DOI: 10.1108/mhrj-01-2023-0004
Hala Bucheeri, Afsana Faheem
Purpose This study aims to explore whether the cultural competency training in Improving Access to Psychological Therapies (IAPT) services is sufficient to equip Psychological Wellbeing Practitioners (PWP) to support Black, Asian and Minority Ethnic (BAME) service users. Design/methodology/approach A qualitative design was adopted using semi-structured interviews with six PWP participants. Reflexive thematic analysis using Braun and Clarke’s (2006) six-step process was used in data analysis. Findings Three themes revealed evaluations of PWP training, factors supporting PWPs’ cultural competency and points of improvement for PWP training. The training briefly and superficially covered cultural competency content; however, it encouraged PWPs to explore potential personal and cultural biases in therapy. PWP training can also be improved by providing more culturally relevant resources and involving BAME service users. Research limitations/implications A small sample size (N = 6) was used, impacting the findings’ generalizability. Practical implications PWP training does not sufficiently equip PWPs to support BAME service users. PWPs’ reflection of their own ethnic identity and personal experiences, when combined with training, can improve cultural competency. IAPT training should focus on cultural awareness, knowledge and skills to enhance therapeutic experience. Moreover, PWPs should reflect on their identity, personal biases and experiences when working with diverse communities. Originality/value This is one of the few qualitative studies evaluating the cultural competencies of PWPs in IAPT.
目的本研究旨在探讨提高心理治疗服务可及性的文化能力训练是否足以让心理健康从业者(PWP)为黑人、亚裔和少数族裔(BAME)服务使用者提供支持。设计/方法/方法采用定性设计，对六名PWP参与者进行了半结构化访谈。数据分析采用Braun and Clarke(2006)的六步法进行反身性主题分析。调查结果三个主题包括对工务人员培训的评估、支持工务人员文化能力的因素和工务人员培训的改进要点。培训对文化能力内容的覆盖比较简单、肤浅;然而，它鼓励残疾人在治疗中探索潜在的个人和文化偏见。通过提供更多与文化相关的资源和让BAME服务用户参与进来，也可以改善工务计划的培训。研究局限性/意义由于样本量小(N = 6)，影响了研究结果的普遍性。实际意义spwp培训不能充分装备pwp来支持BAME服务用户。工兵对自身种族认同和个人经历的反思，与培训相结合，可以提高他们的文化能力。IAPT培训应注重文化意识、知识和技能，以提高治疗体验。此外，工兵在与不同社区合作时，应反思自己的身份、个人偏见和经历。原创性/价值这是为数不多的定性研究之一，评估了IAPT中pwp的文化能力。
{"title":"Psychological wellbeing practitioners’ experiences of improving access to psychological therapies (IAPT) services cultural competency training","authors":"Hala Bucheeri, Afsana Faheem","doi":"10.1108/mhrj-01-2023-0004","DOIUrl":"https://doi.org/10.1108/mhrj-01-2023-0004","url":null,"abstract":"\u0000Purpose\u0000This study aims to explore whether the cultural competency training in Improving Access to Psychological Therapies (IAPT) services is sufficient to equip Psychological Wellbeing Practitioners (PWP) to support Black, Asian and Minority Ethnic (BAME) service users.\u0000\u0000\u0000Design/methodology/approach\u0000A qualitative design was adopted using semi-structured interviews with six PWP participants. Reflexive thematic analysis using Braun and Clarke’s (2006) six-step process was used in data analysis.\u0000\u0000\u0000Findings\u0000Three themes revealed evaluations of PWP training, factors supporting PWPs’ cultural competency and points of improvement for PWP training. The training briefly and superficially covered cultural competency content; however, it encouraged PWPs to explore potential personal and cultural biases in therapy. PWP training can also be improved by providing more culturally relevant resources and involving BAME service users.\u0000\u0000\u0000Research limitations/implications\u0000A small sample size (N = 6) was used, impacting the findings’ generalizability.\u0000\u0000\u0000Practical implications\u0000PWP training does not sufficiently equip PWPs to support BAME service users. PWPs’ reflection of their own ethnic identity and personal experiences, when combined with training, can improve cultural competency. IAPT training should focus on cultural awareness, knowledge and skills to enhance therapeutic experience. Moreover, PWPs should reflect on their identity, personal biases and experiences when working with diverse communities.\u0000\u0000\u0000Originality/value\u0000This is one of the few qualitative studies evaluating the cultural competencies of PWPs in IAPT.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42666940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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