Journal of Mental Health最新文献

Background: Actively engaging clients in managing their health and care is crucial for person-centered mental healthcare. Self-monitoring tools such as the Experience Sampling Method (ESM) can help individuals collect information about their mental health and daily activities on their smartphones and share this with their clinicians.

Aims: This qualitative paper examines how ESM self-monitoring might enhance self-insight, self-management, self-efficacy, therapeutic alliance, and shared decision-making and this way facilitate the activation of clients in mental healthcare.

Methods: Twelve clinicians and 24 clients participated in the IMPROVE study. After using the IMPROVE ESM self-monitoring tool, seven clinicians and 11 clients were interviewed, and a thematic analysis examined participants' experiences of changes in processes related to client activation.

Results: Clients reported improvements in self-awareness, self-insight, and self-management. Only a few participants experienced enhanced self-efficacy, improved therapeutic alliances, and more client involvement. Self-awareness was mainly boosted via smartphone self-monitoring, while collaborative data interpretation between clients and clinicians was crucial for unlocking insights about clients' mental health and creating actionable therapy goals.

Conclusion: Our findings suggest that using ESM self-monitoring tools can help facilitate the activation of clients in mental healthcare. Future research should develop best practice guidelines for integrating these tools into clinical care.

Background: Adolescents with depression are at heightened risk of suicide, with a distinct sex difference in suicidal behaviour observed. This study explores the sex-specific factors influencing suicide attempts among Chinese adolescents with depression.

Methods: Data were collected from 2343 depressed adolescents across 14 hospitals in 9 provinces through self-report questionnaires. The survey was conducted between December 2020 and December 2023. Thirty-six potential risk factors were selected from validated measures of psychological, sociodemographic, and social stress domains. The dataset was split by sex, and SMOTE was applied to address class imbalance. Logistic regression, elastic net regression, random forest, XGBoost, and neural networks were used to model the data, evaluated by accuracy, precision, recall, and F1 score. The optimal model was employed for SHapley Additive exPlanations (SHAP) analysis to identify key factors influencing suicide attempts.

Results: The Random Forest model exhibited the best performance for both sexes (AUC: females 0.720, males 0.736). Non-suicidal self-injury and depression were significant predictors for both sexes. Among females, factors like difficulty identifying emotions and physical abuse had a stronger impact, while resilience and hopelessness were more predictive for males.

Conclusions: The study highlights sex differences in suicide attempt predictors, emphasizing the need for sex-specific prevention strategies.

Background: There is a focus globally on reducing restrictive practices in mental healthcare. However, we know little about how service users experience restrictive practices generally.

Aim: To explore and synthesise experiences of restrictive practices in adult inpatients mental health settings and to report on the depth and breadth of the literature. Methods. CINAHL, PsycINFO, Scopus, MEDLINE and Embase were searched. Qualitative studies exploring the service user experience of restrictive practices were included and analysed using meta-ethnographic synthesis.

Results: Twenty-seven papers were included. Restrictive practices are experienced negatively by service users, who feel punished and powerless when the therapeutic relationship is weak, and communication is lacking. The third-order constructs were: (1) anti-therapeutic and dehumanising, (2) a vicious cycle, (3) an abuse of power and (4) the critical role of support and communication (subthemes: (i) the impact of communication and (ii) how support and communication can minimise negative impacts).

Conclusions: Participants suggest that increasing supportive communication and detailing the decision making for using restrictive practices, would reduce feelings of coercion and increase trust in staff. Future research into the experience of restrictive practice should aim to capture the experience of informal restrictive practices such as locked doors and coercive language.

Prsima/prospero statement: The review has been conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA; see Supplemental Materials Table S1) and the Meta-Ethnography Reporting Guidelines (eMERGE; see Supplemental Materials Table S2). The protocol was registered on PROSPERO (registration number: CRD42023399272; URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023399272).

Background: Survivors of intimate partner violence (IPV) are at an increased risk of developing mental health conditions.

Aims: To examine the perspectives and perceptions of mental health professionals on their provision of mental healthcare to IPV survivors and to hear the lived experiences of IPV survivors regarding their use of mental health services in Portugal.

Methods: An online survey was conducted to gather data on the experiences of IPV survivors who had or had not accessed mental health services in Portugal. Additionally, two focus groups involving 17 mental health professionals were held. Audio recordings were transcribed verbatim, and the data were thematically analysed using MAXQDA software.

Results: Both IPV survivors and mental health professionals frequently acknowledged the critical role of mental health support in the recovery process for individuals who experienced IPV. However, professionals often lack sufficient specialised knowledge to address the complexities of IPV, potentially leaving survivors' mental healthcare needs inadequately met.

Conclusions: Comprehensive approaches are required, including trauma- and violence-informed care, multi-disciplinary collaboration, and inter-sectoral efforts. Further research is essential to investigate the nuances of mental health service utilisation by IPV survivors and to identify the most effective interventions for this population across diverse geographical and cultural settings.

Background: Media portrayals inform understandings of mental illness; yet little research has investigated representations of characters with psychosis in fictional television programming.

Aims: This study examined the valence and trends regarding representations of people with psychosis in popular fictional television programing in the United States, one of the most influential markets in the world.

Methods: A content analysis was conducted of the 50 most-watched American primetime fictional television shows from 2011 to 2021. Two raters independently coded characters in three domains pertaining to: demographics, life-status, and - most importantly - character framing. The Cochran-Armitage and Jonckheere-Terpstra tests were used to determine potential changes over time.

Results: Regarding valence, characterizations were more positive than negative. Trend analysis revealed few changes regarding demographic or life status variables, but a different picture emerged with the character framing variables. Over the course of the decade, characters with psychosis were progressively less likely to be depicted as formerly incarcerated, engaging in criminal activity, and as villains, and more likely to be portrayed as victims, protagonists, attractive, and having a positive effect on society.

Conclusion: The study findings are encouraging although additional efforts are needed to ensure media representations accurately reflect the demographic characteristics of people living with psychosis.

Background: Informal caring is an increasingly common phenomenon. Experiences of mental health caring are not well-researched, and few studies focus on experiences of family carers supporting individuals with a Borderline Personality Disorder (BPD) diagnosis.

Aims: This research explores lived experiences of people in caring roles for family members diagnosed with BPD.

Methods: Seventy-two participants who identified as carers to a loved one diagnosed with BPD completed an online qualitative survey. Six of these participants took part in follow-up interviews, and three completed a follow-up survey. Survey responses and interviews were compiled and analysed using reflexive thematic analysis.

Results: Two main themes were developed. "Labour of Love" involved experiences of burden and strain, and "Self as Secondary" incorporated feeling unheard and obliged to censor one's own behaviours.

Conclusions: Overall, this research broadens awareness of how a mental health diagnosis and a diagnosis of BPD specifically can have a broader, systemic impact on not only the individuals diagnosed, but their families and those providing support to them, and suggests that provision of support by healthcare providers to carers is necessary.

Background: African-descended groups with psychosis have poorer clinical outcomes and more negative pathways to care than White-British groups. It is therefore important to investigate potential contributing factors to this disparity.

Aims: To explore the relationships between beliefs about schizophrenia and attitudes towards accessing help from mental health services in an African-descended UK-based sample with psychosis.

Method: Thirty-four participants with self-reported experiences of psychosis completed the Illness Perception Questionnaire for Schizophrenia and the Inventory of Attitudes towards Seeking Help from Services.

Results: Beliefs about coherence of symptoms and treatment control were the only significant individual predictors of attitudes towards accessing help from mental health services subscales.

Conclusions: Implications of the findings include the use of culturally-appropriate educational resources and the generation of culturally-informed, collaborative psychological formulations to help guide to guide treatment choice.

Objectives: Digitally native university students face challenges to their well-being and up to a third develop mental health problems. "Whitu: seven ways in seven days" is an app based on positive psychology, cognitive behaviour therapy (CBT) and psychoeducation principles.

Methods: Ninety-first year university students (45 per arm) participated in a randomised controlled trial of Whitu against a university self-help website ("Be Well"). Primary outcomes were changes in well-being on the World Health Organisation 5-item well-being index (WHO-5) and the short Warwick-Edinburgh mental well-being scale (SWEMWBS). Secondary outcomes were changes in depression, anxiety, self-compassion, stress, sleep and self-reported acceptability of the app.

Results: At 4 weeks (primary endpoint), participants in the intervention group experienced significantly higher mental well-being (mean difference: 2.53 (95%CI: 0.53, 4.52); p = 0.013) and significantly lower depression (-4.23 (-8.32, -0.15); p = 0.042), compared to controls. Emotional well-being was greater in the intervention group at 3 months (12.23 (3.93, 20.54; p = 0.004). Other outcomes were similar between groups. User feedback was positive, with 88% saying they would recommend the app to a friend.

Conclusions: Whitu is an acceptable, effective, scalable and multi-modal means of improving some aspects of well-being and mental health among university students.

Trial registration: This study was registered with the Australian New Zealand Clinical Trials Network Registry: ACTRN12622000053729.

Background: Perceived social cohesion (PSC) is a protective factor for mental health. Yet, evidence on social mechanisms influencing mental health is scarce.

Aims: We examined the moderating role of PSC between parental stressors and depressive symptoms before and during the COVID-19 pandemic.

Methods: We performed a multilevel moderated linear regression analysis using German Socio-Economic Panel (G-SOEP) data to investigate the interaction of PSC in 2018 and in 2020 with parental stressors (having pre-school-aged child(-ren), concerns about COVID-19 infection, financial insecurity, working from home, changes at work) and depressive symptoms (PHQ-4) in 2020 and 2021.

Results: 3,112 observations from 1,621 participants were included in the regression analyses. The parental stressors had mostly negative, although not always significant effects on PHQ-4. Both PSC measures positively moderated the association between experienced financial insecurity and PHQ-4. PCS 2020 positively moderated the association between the stressors "not working from home" and "being unemployed in 2020 or 2021" compared to "having no changes at work" for those employed. It negatively moderated the association between "having some concerns about infection" and PHQ-4.

Conclusions: PSC can act as a buffer for parental mental health. Social cohesion should be promoted in public health interventions, especially during pandemics or disasters.