Mental Health and Prevention最新文献

The global burden of mental disorders is increasing, in line with the shift from communicable to chronic non-communicable diseases. Mental disorders affect the functioning of individuals, resulting not only in enormous emotional suffering and diminished quality of life, but also in stigma and discrimination. This burden extends to the community and society, with far-reaching economic and social consequences. Even under optimal conditions, treatment alone will never be sufficient to reduce the global burden of mental disorders, so a shift in focus from treatment to prevention of mental disorders should be promoted at the central level in the form of legislation, policy formulation and resource allocation. Universal and selective prevention programs should be prioritized nationally, as they aim to change the risk profile of the entire population and specifically target populations at risk for mental disorders, respectively. In this article, we review the key risk factors for mental disorders and the measures that can be taken at the national level to prevent them, taking into due consideration that prevention efforts can vary based on the audience they are addressing, level of intensity they are providing, and the life phase they target. By adopting a human rights perspective and placing the social determinants of health at the center of our narrative, we maintain that improving mental health cannot be achieved by strengthening health services alone. Coordination across government departments is needed to implement multi-level public health interventions across a wide range of settings, programs, and policies. Focusing on children's mental health and addressing poverty, gender inequality and social discrimination should be absolute priorities for national mental health policies and plans.

Background

Male engagement with public health programming, especially around stigmatised issues, is often low, which may have adverse health outcomes. Eyethu, a behavioural intervention delivered using soccer to reduce multiple risks associated with HIV and substance use among young men, was shown in a randomised trial to be ineffective. This study explored the trial's null findings to identify considerations for future male-targeted programming tackling multiple risks concurrently. We explored trial participants’ perceptions of factors influencing engagement and effectiveness.

Methods

The descriptive, qualitative sub-study was nested within the RCT, conducted in two peri-urban townships outside Cape Town. Data was collected post-intervention, in November-December 2020. In-depth interviews, at a single timepoint, were conducted with individuals (n = 30) who had participated in the RCT. Data were analysed using thematic analysis.

Results

Three major themes emerged from the data: 1) participants’ positive perceptions of the programme's impact, despite the trial's null results; 2) reflections on the intervention's mechanisms, related to its impact on group cohesion, and 3) perceptions of contextual factors influencing intervention engagement and effectiveness.

Conclusion

Behavioural interventions that are embedded in communities and utilise sport to influence health-related outcomes have the potential to expand knowledge, foster social capital, and offer platforms for positive, meaningful connections for young men exposed to multiple adversities. However, these programmes need to be sustained over time to effectively enable behaviour change to take hold and be sustained when implemented with other environmental constraints.

India accounts for nearly 18 % of the global population but approximately 28 % of global suicides. Similar to many countries around the world, suicide in India is known to result from a complex interplay of social, economic, and personal factors. To address this important issue, India released its first national suicide prevention strategy in 2022. The strategy follows the WHO-recommended model of a multisectoral approach to suicide prevention, incorporating a mix of primary prevention interventions (focusing on whole populations), secondary prevention interventions (targeting 'high-risk' individuals), and tertiary prevention interventions (aimed at individuals affected by suicide). This paper delves into the details of these primary, secondary, and tertiary prevention interventions and explores how they apply to the Indian context, while arguing for the need to prioritize primary prevention interventions, at least in the short term, to reduce suicides.

Suicide stigma among adolescents is a critical public health concern with far-reaching implications for mental well-being and suicide prevention efforts. This study examines the relationships between age, mental health stigma, traditional beliefs, and suicide stigma among middle school students in the Greater Accra Region of Ghana. A sample of 742 students participated in the study, completing measures assessing mental health stigma, traditional beliefs, and suicide stigma. The results revealed significant positive correlations between suicide stigma and mental health stigma as well as suicide stigma and traditional beliefs. Additionally, a significant positive correlation was found between traditional beliefs and mental health stigma. Multiple linear regression analysis indicated that age, sex, mental health stigma, and traditional beliefs were significantly associated with suicide stigma scores. Mental health stigma and traditional beliefs remained significantly associated with suicide stigma after controlling for other factors. These findings highlight the complex interplay between age, mental health stigma, traditional beliefs, and suicide stigma among Ghanaian adolescents. The implications of the study emphasize the importance of targeted interventions that address mental health stigma, challenge traditional beliefs, and promote supportive environments for adolescents.

Mental health promotion is an essential strategy for improving population mental health and wellbeing and preventing poor mental health. This paper outlines the case for governments to invest in promoting population mental health and wellbeing by adopting a mental health promotion approach.

Drawing on a synthesis of the international evidence, findings are presented on effective mental health promotion interventions that can be feasibly implemented across the life course in everyday settings and that have the potential to be scaled-up at a country level. Based on a review of 111 meta-analyses and 57 systematic reviews, both universal and targeted interventions are identified, that have been shown to enhance good mental health, reduce the risk of mental ill-health, and advance population health and wellbeing. The implications of the findings for policy and practice are outlined.

The policy structures and processes that are needed to support the delivery of evidence-based strategies at a population level are considered, including investing in the systems and capacity to ensure their sustained implementation. In particular, the need for policy models to support intersectoral action at a whole-of-government and whole-of-society level is outlined.

Mental disorders are prevalent and associated with a substantial burden of disease. Effective prevention at a population level is crucial in alleviating this burden. Here, we argue that without coordinated action on the social determinants of health, it is difficult to envisage meaningful progress on preventing mental disorders at a population level. We highlight the importance and opportunity of a developmental life course approach to the prevention of mental disorders. This approach recognises that upstream, distal factors that occur early in life act as fundamental causes of mental health, and that varying targets and interventions may be needed at different stages across the lifespan. We draw on a well-established framework for disease prevention – immunisation schedules – to embed action on social determinants of health into a national framework for the prevention of mental disorders. We call for a substantial shift to meaningful, multi-disciplinary co-production with policymakers across sectors, educators, researchers, clinicians, minorities, First Nations groups, people with lived experience and young people, to produce widespread, sustainable solutions to preventing mental disorders.

Background

Emotion regulation plays an important role in an individual's psychological and social functions. The Difficulties in Emotion Regulation Scale – Short Form (DERS-SF) has been chosen to investigate its psychometric properties.

Objective

To develop the Thai version of the scale and examine construct validity, internal consistency, concurrent validity, criterion-related validity, and floor and ceiling effects of the scale.

Design

A cross-sectional survey design

Participants

400 undergraduate students were recruited and completed a self-report online questionnaire including a demographic form, the Thai version of DERS-SF, and The Depression Anxiety Stress Scale.

Methods

The Thai version of DERS-SF was developed following the Beaton translation process. Confirmatory factor analyses, Cronbach's alpha, Pearson's correlations, and T-test were used.

Results

The Thai version of the DERS-SF without Awareness provided a good fit with good internal consistency (Cronbach's α = 0.88). The scale presented a moderate correlation with depression (r = 0.58), anxiety (r = 0.57), and stress (r = 0.67) (all p < 0.05). Students who reported higher scores on the scale tended to experience inadequate income (t-test = 2.82 p < 0.01), mental illness history (t-test = -2.73 p < 0.05), and stressful life-event in the past six months (t-test = -3.95 p < 0.001). Eight items of the scale presented the floor effect while one item had a ceiling effect.

Conclusion

The Thai version of the DERS-SF without Awareness exhibited good psychometric properties. The scale would be useful for future research and clinical work to assess emotion regulation among Thai university students.

Background

Indonesia's population have experienced social restriction and economic downturn during the COVID-19 pandemic which raised questions on how this predicament is associated with mental wellbeing.

Aims

To examine the association between social isolation and economic shock with an individual's mental health condition during the COVID-19 pandemic in Indonesia.

Methods

Phone survey was conducted with 1,082 respondents who were mobile phone users and within the age range of 15–65 years old in the country. The relation between isolation and economic downturn with perceived mental health indicators were analyzed by comparing the distribution of respondents’ response using Chi-squared test. In addition, a logistic regression was performed to analyse their association.

Results

While social isolation (decreased frequency of social gathering and increased spare time) during the COVID-19 pandemic were associated with several indicators of negative mental health, social restrictions were solely related to work-related stress. Financial strain was linked to a decrease in perceived mental health (all indicators), but job loss was only correlated with helpless feelings, and lower job status was unrelated to perceived mental health indicators.

Conclusions

Significant portion of respondents reported deterioration in mental health conditions during the COVID-19 pandemic, predicted partly by isolation and financial strain. This finding highlights the need for public health measures to address mental health crises during the pandemic, particularly to those affected by isolation and economic downturn.