Mental Health and Prevention最新文献

Background

Spondyloarthritis (SpA) can considerably impact mental health, quality of life, and well-being via the occurrence of anxiety or depressive symptoms. A higher psychological resilience can protect patients from the distress that comes with the disease and aid in the successful adjustment to the illness. Understanding resilience and identifying the associated factors can help us offer early interventions to SpA patients. The aim of this work was to explore psychological resilience and coping strategies in patients with SpA and to investigate associated factors.

Design

This review adhered to EQUATOR guidelines: The PRISMA 2020 guidelines for reporting systematic reviews and meta-analyses. Four electronic databases were searched (Pubmed, Cochrane, Web of Science, Scopus). Studies reporting results of resilience or coping strategies in SpA were screened.

Results

Our literature search retrieved 21 studies, sixteen cross-sectional and five longitudinal studies. The total number of patients was 3,324: 1768 ankylosing spondylitis (AS), 1,768 psoriatic arthritis (PsA), and 1,223 axial spondyloarthritis (axSpa). Among the included studies, three reports involved a control group. Four studies investigated resilience among SpA patients and revealed high resilience scores. Seventeen studies examined coping strategies utilized by patients in response to their disease. Coping strategies varied across studies. Of the 17 studies, six reports showed a predominance of active and adaptative coping strategies. Six studies revealed a tendency to use cognitive coping strategies and five reports noted the use of evasive and maladaptative coping strategies. Higher disease activity, higher pain levels, and functional impairment were associated with low levels of resilience and passive coping strategies. Higher resilience and active coping were associated with lower risk of anxiety and depression. Among the four reports that investigated coping over time, three showed that coping strategies were stable.

Conclusion

SpA patients displayed high levels of resilience. Coping strategies varied across studies. This present review emphasized the importance of psychological interventions in routine clinical practice to support patients.

Patient and public contribution

No patient or public contribution

Objective

Early substance use has been linked to various adverse outcomes and escalates quickly during adolescence. Delaying the onset of substance use among adolescents is a primary public priority as it is associated with severe effects. The objective of the study is to develop and determine the effectiveness of a School-based Substance Abuse Prevention Programme (SSPP) on awareness, attitude, peer pressure, and life skills towards preventing substance abuse among adolescents.

Method

Phase I of the study is a qualitative approach, where a focus group discussion (FGD) will be conducted among different stakeholders to explore their perceptions regarding the prevention of substance use among adolescents. The anticipated sample size is 38. Thematic analysis will be done by using ATLAS.ti software. The inputs given by the stakeholders will be incorporated in developing the intervention (SSPP). Phase II is a cluster randomized controlled trial. A minimum of 210 adolescents (105 each in the intervention and control groups) between the age group of 13 to 15 years from 8^th and 9^th grade will be recruited for the study. In this study, the school will be the cluster and will be randomly assigned either to an intervention or control arm. The data will be collected at pre, post, 3-month, and 6-month intervals. The ethical approval was obtained from the Nepal Health Research Council Committee, Nepal (NHRC 276/2023). The trial was also registered under the Clinical Trial Registry of USA-Clinical Trials.gov (CTRI 06004726/2023/08/22/). Descriptive and inferential statistics will be used to analyze the data.

Expected results

Implementation of the SSPP module will improve the awareness, attitude, peer pressure, and life skills of adolescents toward preventing substance use behavior. Overall, the study aims to achieve Sustainable Development Goal (SDG) 3.5- ‘Good Health and Well-being; strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.’

Conclusion

The present study protocol will help to develop a unique training module (SSPP) focused on preventing substance use behaviour among adolescents in Nepal.

Background

The Indian rural population is recognised as one of the vulnerable segments of the society in terms of reporting suicide. Inconsistencies in the reporting of suicide impede the real suicide case, that in turn hinders efforts to prevent suicide. There are differences in suicide motives in rural areas due to the clear cultural and social borders, that could affect reporting. Very few studies have examined these psychological and sociocultural variables in rural context. Thus, the main goal of the current investigation is to comprehend these aspects and recommend strategies accordingly.

Method

The present study employed in-depth interviewing using focus group discussions on a sample of 93 participants. Through purposive sampling 12 areas were shortlisted from four districts from Bihar State, India. Only those areas were selected, where suicide had occurred in the last one year. All the twelve discussions were finally transcribed and using the thematic analysis approach qualitative data were analysed.

Results

Three themes appeared followed by their subthemes. First theme was apprehensions and fears and the subtheme emerged were society's reaction towards suicide and legal procedure. Second theme was religious belief related to suicide and the subthemes were, soul wandering, unfulfilled desire of the soul, and life after death. Third theme was females were more underreported and subtheme emerged i.e., protecting the honor of the family, and laws related to women social issues.

Conclusion

Findings of this study suggest that psychosocial and cultural factors serve as barrier in reporting and hinders suicide prevention process. This finding indicates that formulating multisectoral approach in reducing community attitude and stigma of rural population towards suicide.

The American Rescue Plan Act of 2021 expanded the Child Tax Credits (CTC) by increasing the maximum amount of credit, making the credit fully refundable, and providing advanced monthly credit payments from July to December 2021. We evaluated the impact of the expanded CTC in 2021 on mental health of home renters compared to homeowners within the income range eligible for maximum credit. The study included nationally representative data from the 2019–2022 Behavioral Risk Factor Surveillance System. Outcomes were the number of days not in good mental health in the past 30 days, and an indicator for having 14 or more such days. The study employed regression models examining mental health changes of adults before and after the CTC expansion by number of children (which determines the overall CTC payment). We find that the CTC expansion was associated with improved mental health among renters. A $100 monthly CTC payment was associated with 0.096 fewer days not in good mental health among renters in the past 30, with associations concentrated in the last quarter of 2021. There was little evidence of associations of CTC payments with mental health among homeowners. The findings suggest that cash support programs such as the CTC are associated with improved mental health of adults in low-income renting households.

Symptoms of depression and anxiety have increased dramatically among Aotearoa New Zealand (Aotearoa) youth over the last decade, with widening inequities for Māori (Indigenous population). Increased access to quality timely treatment is essential, but not sufficient to reduce population rates of mental distress. Social determinants and other risk factors which increase the chances of mental health problems are cumulative, interact and are unequally distributed. Most of these risk factors are preventable. In this paper we present a framework for improving youth mental health in Aotearoa building on global evidence, ‘Te Mauri’ (an Aotearoa prevention model) and young people's perspectives. This centres equity in order to address disparities and to improve mental health for all. The six key elements for action are: embedding and enacting te Tiriti o Waitangi (founding treaty of New Zealand which protects the rights of Māori and all peoples); ensuring human rights-based, consumer-driven, and culturally safe approaches; fostering leadership and multisectoral collaboration; addressing modifiable determinants of mental health; ensuring early access to services; and embedding research and evaluation. This evidence-based framework is responsive to the unique needs of youth in Aotearoa and can inform efforts in other diverse nations to improve youth mental health and reduce the lifelong human and economic impacts of mental ill-health.

Background

Mental ill health is persistent and pervasive in universities, with calls for setting-level change to improve mental health and wellbeing. However, rather than addressing setting-level factors, most research evaluates individual-level change, and most previous reviews privilege quantitative studies. Research on setting-level change remains limited and under-synthesised.

Aims

This review addressed three questions: (i) what are the domains of setting-level change evaluated for mental health impacts in universities? (ii) what are the quantified effects of setting-level changes in universities upon student and staff mental health and wellbeing? and (iii) what are the perspectives of students and staff with respect to setting-level changes in universities?

Methods

A systematic mixed studies review was conducted. APA PsycINFO, MEDLINE via Ovid, and Web of Science were searched twice – on 19 December 2022 and 20 January 2023 – with 3,643 records returned. Peer-reviewed journal articles reporting qualitative, quantitative, and mixed-methods studies on mental health outcomes, perspectives, and experiences arising from setting-level changes in universities were included. Included studies were critically appraised using the Mixed Methods Appraisal Tool.

Findings

Sixteen studies, reported in 18 articles, were included. All studies evaluated setting-level changes in relation to students’ mental health and wellbeing; none focused on staff. Two domains of setting-level change were identified: (i) learning and teaching, and (ii) student-focused policy. Studies varied in design and methodological quality.

Conclusions

Most setting-level changes modify how students are taught. Further research should prioritise impacts upon staff, employ rigorous study designs, and include comprehensive review of the grey literature.

Background

Youth in low-resource settings such as Pakistan have high levels of unmet mental health needs. Mental health stigma and sparse resources are key barriers to accessing help.

Aim

To capture end-users’ and trainers’ perspectives of youth mental health awareness in Pakistan informed by the Train-the-Trainer framework.

Method

A qualitative research design was adopted, utilizing focus group discussions to hear the voices of those engaged in the study. Following the facilitation of four youth mental health awareness events in disadvantaged communities, five focus groups were conducted with 29 participants, i.e., mothers (n = 7 and n = 3), youth (n = 3 female and n = 7 male), and trainers (n = 9). Data were integrated and analysed through framework thematic analysis, which is a codebook approach to thematic analysis.

Results

Three themes related to perceived individual, community and implementation enablers and challenges. Trainers, mothers and youth reported undergoing parallel processes of personal growth. Communities were viewed as sources of both stigma and solutions, through engagement and addressing contextual issues such as gender.

Conclusion

Participants in community youth mental health awareness welcomed the opportunity to acquire and transfer new knowledge, but also identified required supports to engage and actively involve communities in Majority World Countries.

Background

Organised sport and recreation have the potential to promote physical, psychological and social health and wellbeing for individuals and communities. However, for Indigenous people, experiences of sport and recreation may be tempered by a lack of cultural safety and racism. This systematic review sought to synthesise qualitative findings on experiences of sport and recreation amongst Indigenous peoples in Australia, Aotearoa New Zealand, the United States, and Canada.

Method

Following the Johanna Briggs Institute (JBI) guidelines for systematic review and meta-aggregation, a three-phase search strategy was employed. Studies were reviewed against the inclusion criteria by three reviewers. Characteristics of included studies, including methods and theoretical approach were summarised; studies were critically appraised using two tools; and findings of all studies were synthesised to identify over-arching themes.

Results

Following identification and screening, 27 articles met the inclusion criteria, including 11 from Canada, 10 from Australia, five from New Zealand and one from the United States. Methodological characteristics were summarised. Through meta-aggregation, five themes were described: barriers and facilitators to engagement; physical health benefits; racism and discrimination; social and emotional wellbeing; and community spirit.

Conclusions

These findings may assist sport and recreation administrators and leaders to provide culturally safe sport and recreation environments for Indigenous people and communities participating in sport and recreation. Specifically, for Indigenous peoples to enjoy the holistic benefits of sport and recreation participation, racism and discrimination need to be addressed.

Background

For young living in rural areas around the world, suicide is a leading cause of death, stressing the need to understand characteristics of programs aiming to impact suicide and related behaviours.

Aim

A systematic literature review aimed to synthesise the evidence and explore characteristics of programs seeking to impact suicidal behaviours (rates, attempts, ideation) for young people in rural areas.

Method

Data sources: Electronic databases EMBASE, Medline, PsycINFO and Scopus. Study eligibility criteria, participants, and interventions: Studies measuring suicide-related outcomes (rates, attempts, ideation) for youth (people aged 12–25 years) in rural areas worldwide, published 1 January 2000 to 6 June 2023. Study appraisal and synthesis: Data were thematically analysed, exploring intervention characteristics. Mixed Methods Appraisal Tool assessed study quality.

Results

Eleven (11) studies met the selection criteria. Studies impacting suicides and attempts were often multiple strategies, multi-layered, combining universal, selective, and indicated programs, implemented across systems and settings, including public-health psychoeducation, referral mechanisms, crisis lines, postvention, peer support, outreach, means restriction, mindfulness, and gatekeeper training. Psychoeducation and mindfulness contributed to decreased suicidal ideation. Community-level partners were central to efforts, including working groups, networks, Indigenous people, people with lived experience, volunteers, and peers.

Conclusions

Varied programs have capacity to reduce suicide rates and related behaviours among young people in rural areas, with communities and schools as crucial settings. Programs implemented across levels show promise at reducing the number of young people who end their lives by suicide or attempt to do so, demonstrating a need for program evaluations and continued, long-term outcome monitoring.

Background

A reactive approach is typically taken when addressing and intervening with mental health problems rather than a proactive or preventative one, yet preventative approaches can also reduce mental ill-health. This study protocol aims to evaluate the feasibility of recruiting general practice patients into a randomised feasibility study where they will receive either mental health treatment as usual or a brief psychological intervention for preventing the deterioration of mental health and promoting emotional wellbeing.

Methods

This is a two-arm RCT, where participants will be randomised to either: treatment-as-usual within GP; or treatment-as-usual within GP plus a mental health prevention and promotion intervention. Sixty patients, aged 16+ from GP surgeries, with mild to moderate mental health difficulties as indicated by the PHQ9 and GAD7 will be recruited. Data on engagement with the intervention will be summarised using descriptive statistics. Regression models will be fitted, using the 12-week post-intervention follow-up data as the outcome variable and age, gender, trial arm and the corresponding baseline data as covariates. Cost-effectiveness will be investigated in an explorative way. Descriptive statistics will be used to analyse participant's resource use and HRQoL. Qualitative data will understand factors that facilitate or challenge the successful implementation of interventions and a process evaluation will provide insight into the intervention's mechanisms of action.

Discussion

The research team will progress from a feasibility RCT to a larger definitive RCT and disseminate widely across stakeholders (clinical, academic, service users, caregivers, Integrated Care Board (ICB) colleagues), ensuring accessibility in collaboration with the PPI committee.