Journal of Mental Health最新文献

Background: Black people in the United Kingdom disproportionately acquire long-term health conditions and are marginalised from the labour market compared with other groups. These conditions interact and reinforce high rates of unemployment among Black people with long-term health conditions.

Aims: To examine the efficacy, and experience, of employment support interventions in meeting the needs of Black service users in Britain.

Methods: A systematic literature search was conducted focusing on peer-reviewed literature featuring samples drawn from the United Kingdom.

Results: The literature search revealed a paucity of articles that include analysis of Black people's outcomes or experiences. Six articles met the selection criteria of the review, of which five focused on mental health impairments. No firm conclusions could be drawn from the systematic review; however, the evidence suggests that Black people are less likely than their White counterparts to secure competitive employment and that Individual Placement and Support (IPS) may be less effective for Black participants.

Conclusions: We argue for a greater focus on ethnic differences in employment support outcomes with an emphasis on how such services may remediate racial differences in employment outcomes. We conclude by foregrounding how structural racism may explain the dearth of empirical evidence in this review.

Background: Work-related stress negatively impacts employee wellbeing. Stress-management interventions that reduce workplace stress can be challenging. Immersive technologies, such as virtual reality (VR), may provide an alternative.

Aims: This systematic review aimed to evaluate feasibility, acceptability, and effectiveness of immersive technologies to promote workplace wellbeing (PROSPERO 268460).

Methods: Databases MEDLINE, Web of Science, PsycINFO and Embase were searched until 22^nd July 2021. Studies were included if they tested a workforce or were designed for a workplace. Effective Public Health Practice Project quality assessment tool (EPHPP) was used for quality ratings.

Results: There were 17 studies (N = 1270), published 2011-2021. Over half were conducted in Europe. Eight studies were controlled trials. Most studies involved brief, single sessions of immersive VR and provided evidence of feasibility, acceptability, and effectiveness when measuring wellbeing-related variables such as stress, relaxation, and restoration. VR environments included relaxation tasks such as meditation or breathing exercises, and nature-based stimuli, such as forests, beaches, and water. Studies tested office workers, healthcare professionals, social workers, teachers, and military personnel. EPHPP ratings were "strong" (N = 1), "moderate" (N = 13), and "weak" (N = 3).

Conclusions: VR relaxation appears helpful for workplaces. However, limited longer-term data, controlled trials, and naturalistic studies mean conclusions must be drawn cautiously.

Background: While employment generally promotes positive health and wellbeing, some jobs may be less salutogenic than others. Few studies have examined mental health across a range of broadly defined occupation types using a large population sample.

Aims: To examine the prevalence of mental health problems across a wide range of occupation types, and further examine the association of family demands, controlling for key social determinants and health-related factors.

Methods: We used linked administrative data from 2011 NI Census returns; NI Properties data; and Enhanced Prescribing Data (EPD) 2011/12. We examined self-reported mental health problems and receipt of psychotropic medication among 553,925 workers aged 25 and 59 years.

Results: Self-reported chronic mental ill health was more prevalent among workers in lower paid occupations, while "public- facing" occupations had the highest rates of medication. In fully adjusted models, informal caregivers were less likely to report mental health problems but more likely to be in receipt of psychotropic medication, as were lone parents. The association of family demands also varied across occupational groupings.

Conclusion: Future development of mental health at work plans should take cognisance of occupation specific mental health risk and wider family circumstances to support workers' mental wellbeing most effectively.

Background: Exercise protects against somatic comorbidities and positively affects cognitive function and psychiatric symptoms in patients with severe mental illness. In forensic psychiatry, exercise is a novel concept. Staff at inpatient care facilities may be important resources for successful intervention. Little is known about staff's knowledge, attitudes and behaviors regarding exercise in forensic psychiatric care.

Aims: To translate, culturally adapt and test the feasibility of the Exercise in Mental Health Questionnaire-Health Professionals Version (EMIQ-HP) in the Swedish context, and to use this EMIQ-HP-Swedish version to describe staff's knowledge, attitudes and behaviors regarding exercise.

Method: The EMIQ-HP was translated, culturally adapted, pilot-tested and thereafter used in a cross-sectional nationwide survey.

Results: Ten of 25 clinics and 239 health professionals (50.1%) participated. Two parts of the EMIQ-HP-Swedish version showed problems. Most participants considered exercise to be a low-risk treatment (92.4%) that is beneficial (99.2%). Training in exercise prescription was reported by 16.3%. Half of participants (52.7%) prescribed exercise and 50.0% of those undertook formal assessments prior to prescribing.

Conclusions: Creation of the EMIQ-HP-Swedish version was successful, despite some clarity problems. Exercise appears to be prescribed informally by non-experts in Swedish forensic psychiatric care and does not address treatment goals.

Background: The empirical literature on the lived experience of electroconvulsive therapy (ECT) is limited, divergent, and largely focused on the experiences of procedures, (adverse) effects, information provision, or decision-making.

Aims: This study aimed to investigate aspects related to the lived experience and meaning-making of people who have had ECT.

Method: In-depth interviews with 21 women (21-65 years old) were analyzed using interpretative phenomenological analysis (IPA).

Findings: A subgroup of nine participants described more negative experiences with ECT. A common factor for these participants was the experience of trauma that remained under-treated. The superordinate themes identified were a lack of trauma-based and recovery-oriented treatment. The rest of the sample (12) expressed more positive experiences with ECT.

Conclusions: This study suggests that exploring more broadly the impacts of ECT at the long term offers insights that can help design more person-centered services aligned to the needs of the treatment recipients. Educational modules for mental health care staff should include, besides knowledge on the methods' effectiveness, additional evidence about treatment recipients' subjective concerns and the relevance of trauma and recovery-oriented care models.

Background: Internet interventions for common mental disorders are widely available, effective, and economical, yet community uptake remains low. One consistently cited reason for not engaging in mental health interventions is lack of time.

Aims: This research examined whether lack of time as a rationale for not using online interventions reflects real time scarcity, and whether time availability impacts intention to use interventions.

Methods: A nationally representative sample (N = 1094, 51% women) reported their time use in activity categories for a typical week. Participants rated their acceptance and likelihood of use of mental health internet interventions, and completed mental health symptom, help-seeking and stigma measures.

Results: Amount of leisure time reported by participants was not associated with acceptance or likelihood of use of internet interventions for mental health. However, respondents who worked longer hours ranked time and effort factors as more influential in their intention to use internet-based mental health programs. Younger respondents and those with greater help-seeking attitudes reported higher acceptance of use.

Conclusion: These findings suggest lack of time is not a direct barrier to use of internet interventions, and that perceived time scarcity may be masking real barriers to uptake.

Background: Prior research on informal caregivers of people with schizophrenia (PWS) has primarily focused on parental caregivers. However, siblings also play an important role in the recovery process of PWS.

Aims: The aim of this study is to compare the coping profiles of family caregivers according to whether they are siblings or parents of the PWS.

Method: Parent and sibling caregivers (N = 181) completed the Family Coping Questionnaire (FCQ), which assessed their coping strategies.

Results: The results reveal that parents and siblings do not use the same coping strategies and styles. Three coping profiles were identified depending on the caregiver's relationship with the PWS. Most parents displayed an undifferentiated profile (96.7%), while siblings were more heterogeneously distributed among the undifferentiated profile (58.3%), problem-focused profile (37.5%), and emotion and social support-focused profile (4.2%).

Conclusions: These findings suggest that the coping capacities of family caregivers to deal with the illness of their sibling or child with schizophrenia are diverse and that it is important to differentiate among them. This would enable these caregivers to benefit from support that could be tailored to their specific needs.

Background: Individual Health Budget (IHB) is used for social and health integration and to facilitate processes of resource reorientation in healthcare. Despite its increased use in mental health settings, few studies investigated its effectiveness in severe mental disorders.

Methods: 383 IHB beneficiaries were recruited among Mental Health Departments users of the Italian region Friuli Venezia Giulia. Data involved sociodemographic and clinical variables, IHB type and scores of Health of the Nation Outcome Scale (HoNOS) at admission to IHB programme (T0), after 12 months (T1), and after 24 months (T2).

Results: The length and the mean number of hospitalisations and healthcare interventions decreased at T1. A significant scores' reduction from T0 to T1 evaluation was found in HoNOS total score (T-test (P) < 0.05) and in most of its items. An improvement throughout the whole evaluation period (T0 vs. T2) was found in 36% of the IHB beneficiaries, while more than 60% of them remained in the same HoNOS severity category.

Conclusions: Our results support the use of IHB in patients with severe mental problems, since it may contribute to an improvement in social and clinical functioning, consequently lowering the burden on MHDs.