Mental Health and Prevention最新文献

India's mental health policies predominantly prioritize treatment and rehabilitation. While acknowledging the significance of youth well-being, the initiatives undertaken are fragmented, lacking comprehensive data on reach and utilization. Mounting evidence supports the preventability of mental illnesses, highlighting the cost-effectiveness of prevention initiatives, particularly within school-based programs. This paper aims to delineate a preventive framework centered on schools, employing the six-step OrigAMI (Origins of Adult Mental Illnesses) model. This model targets modifiable risk factors to stop the development of mental illnesses. Each step of this model is dissected and examined within the context of the school environment, elucidating the unique and influential role that educational institutions can undertake in preventive initiatives in India. In the initial step, the paper identifies modifiable risk factors in children and adolescents that can be addressed within the school environment. The second and third steps involve pinpointing the target demographic and utilizing data from comprehensive reviews of mental health initiatives. The fourth and fifth steps delineate the workforce structure, advocating for task shifting to non-specialists, engaging school stakeholders and parents, and establishing a systematic workforce framework. The final step delves into policy implications, exploring the potential to reduce the prevalence of mental illness by focusing on risk factors with a high Population Attributable Fraction. This section also contrasts the proposed approach in terms of expenditure against the current budget allocations. The paper culminates with a recommendation to integrate these preventive programs into existing healthcare policies, positioning schools as central to these prevention efforts. The integration of prevention programs into healthcare policies aims to reduce prevalence rates and alleviate the burden on the healthcare system.

The global economic burden of mental health disorders is substantial and continues to increase. To reverse this devastating trend, solutions are needed to not only treat but to prevent the emergence of mental health conditions negatively affecting an individual's health and their social and occupational functioning. Given that military personnel and their families experience a number of factors that may serve to elevate risk for mental health problems (e.g., separation from sources of social support, job-related stress and trauma exposure, combat), the US military has instituted a number of programs to prevent mental and behavioral disorders, which may provide benefit to civilian contexts. The present paper overviews military programs that seek to build individual resilience, utilize social support and peer support programs for preventing mental health problems, and emphasize the role of early identification and treatment for preventing worsening or continued distress. We propose these programs can be adapted for and implemented into civilian settings for mental health prevention. Parallels are drawn between military and civilian settings, with proposed recommendations and considerations for adaptation discussed. Civilian communities may benefit from the lessons learned from implementation in military settings to inform their own prevention strategies.

The workplace has been identified as a pertinent and sustainable setting for providing mental wellbeing support at scale, whilst overcoming the many barriers to accessing timely treatment through traditional healthcare pathways. Given the consequences of delayed treatment on exacerbation of symptoms and costs to both the employer and wider economy, there is a demand for preventative approaches to strengthen individuals’ protective characteristics (e.g., resilience, emotion regulation skills) against poor mental health outcomes. Following on from a feasibility phase, this study will evaluate the efficacy of the revised REST 2.0 intervention, an integrative digital psychological skills training intervention, on improving measures relating to wellbeing and organisational outputs. A multi-centre, mixed-method randomised waitlist controlled trial will be conducted with working individuals recruited from across the Midlands (England), who express an interest in learning coping skills to improve their resilience and wellbeing. Participants will be randomised to the intervention group or waitlist control group with no active treatment. REST 2.0 is an 8-week digital intervention based on integrated, evidence-based psychological approaches. Participants will complete outcome measures at pre-intervention, post-intervention and three months follow-up, with self-efficacy as the primary outcome measure. Secondary outcomes will explore changes (if any) in levels of wellbeing and organisational outputs. A mixed-method participant experiences assessment at post-intervention and follow-up will also explore in more depth usage of newly learnt skills and their impact. Ethical approval has been granted by the University of Warwick Biomedical and Research Ethics Committee and this trial is registered with the Open Science Framework.

Multilevel community-based interventions are considered the most efficient way to target diagnostic and treatment gaps concerning depression and to prevent suicidal behaviour. The 4-level intervention approach of the European Alliance against Depression (EAAD) combines the two partly overlapping aims of improving care for people with depression and preventing suicidal behavior. After forming a local stakeholder network in a certain region and a preparation phase, intervention activities start at four levels: i) Primary health care, ii) General public, iii) Community facilitators, iv) Affected individuals' and their relatives. This 4-level approach has been successfully adapted to different cultures and health care systems in more than 120 regions in and from outside of Europe. A systematic review recently has singled out this 4-level approach as the most promising community-based suicide preventive intervention worldwide. In this paper, the 4-level approach, it´s evidence base, and lessons learnt concerning implementation are presented.

Background

WazzUp Mama© is a remotely delivered web-based tailored intervention to prevent and reduce perinatal emotional distress. The intervention has a self-help character and generates personalized feedback.

Aim

To evaluate the effect of the WazzUp Mama© intervention in a perinatal population, comparing exposure and non-exposure.

Methods

We performed a 1:3 nested case-control study including 376 participants (94 cases/282 controls), matched on core maternal characteristics. Cases received the intervention WazzUp Mama© while controls did not. The two groups were compared for depression, anxiety, and coping style/strategy mean scores, for positive Whooley items and heightened depression and anxiety scores.

Results

The number of positive Whooley items, the above cut-off depression scores, depression, and anxiety mean scores showed statistically significant differences, in favor of the intervention group. Problem-focused, emotion-focused, and passive and active coping, using informational support, positive reframing, planning, acceptance, seeking emotional support, venting, self-blaming showed statistically significant differences in favor of the intervention group. Adjusting for covariates, the statistically significant differences between cases and controls remained for all emotional wellbeing scores and for emotion-focused- and avoidant coping, seeking emotional support, venting, acceptance, and self-blame in favor of the intervention group. A history of perinatal psychological problems showed to be a confounding factor.

Conclusion

WazzUp Mama© indicates to have a significant large positive effect in optimizing perinatal emotional wellbeing, and a significant small effect on coping styles and strategies. Those who received the intervention showed a significantly lower incidence of low mood and loss of interest or pleasure, lower levels of depression and anxiety, and maladaptive coping, and significantly higher levels of adaptive coping compared with the control group.

Background

The public cultivates thoughts, perceptions, and beliefs through media. Research has revealed that the media has a significant contribution to the publics’ negative perceptions and stigma surrounding Autism Spectrum Disorder (ASD). However, there are limited studies on the portrayal of ASD in Qatar's printed media.

Method

The current study explored the portrayal of ASD in six leading Qatari newspapers through retrospective content analysis of articles published between 27/08/2019 and 26/09/2020. Quantitative and qualitative data analysis methods were used to assess the extent and format of ASD-related articles as well as the discourse tone and thematic representation. Treatments were evaluated for their level of evidence through comparison with a combination of primary, secondary, and tertiary literature.

Results

A total of 178 ASD-related articles (88 in English and 90 in Arabic) were analyzed. The majority of these articles were displayed with minimal or no distinguishable features from articles about other topics, and placed in the middle of the newspaper or in the supplement section. Qualitative analysis revealed the presence of a stigmatizing tone in ASD articles written in both Arabic and English newspapers. Treatments reported were mostly evidence based, with some articles mentioning interventions without sufficient support from reputable guidelines.

Conclusions

There is much room for improvement in regards to portrayal of ASD in Qatari newspapers; in particular to emphasize on de-stigmatizing language, to promote reporting on the living experience of people with ASD, and to ensure accurate treatment-related information is provided.

Significant mental health problems affect one in five youth in the United States; in tandem with the child mental health epidemic, parents in the United States report high and rising rates of burnout and mental health challenges of their own. Multiple well-established theoretical perspectives demonstrate the high degree of interdependence between children's and their parents’ mental health, including intergenerational transmission, prenatal programming, attachment, and temperament and self-regulation theories. Drawing on these perspectives, we argue that a universal prevention approach that centers the development of psychopathology within the context of the parent-child dyad can promote resilience and arrest emerging mental health problems for children and their parents, during sensitive developmental windows (e.g., preconception through early childhood). Derived from this integrated theoretical framework, we review empirical support for the following targets to promote family resilience: screening for current and historical parent risk factors and resilience resources; strengthening healthy, reciprocal social ties; and supporting youth socioemotional skill acquisition. Our review of the literature highlights how improvements in these areas can have cascading benefits across development, for both parents and their children, as well as for future generations. We conclude with actionable, empirically-supported recommendations that can have profound impacts on these targets through changes in federal and state policies, community healthcare settings, and early childhood education and care programs. To achieve enduring, multigenerational impacts, societal and community-level policies, programs, and practices must interweave efforts to support child mental health with efforts to promote parent adjustment and wellbeing.

In this article we propose that nation-wide investment in mental and behavioral health (MBH) prevention efforts in public schools has the potential for powerful impact on developmental MBH in the United States (U.S.). We first provide an overview of the structure of public school systems in the U.S. Next, we apply the multi-tiered support system (MTSS) public health model to propose three key initiatives for optimal promotion of youth MBH through public schools in the U.S.: (a) universal access to high quality pre-kindergarten, (b) universal evidence-based social and emotional learning across all grades, and (c) universal MBH screening accompanied by tiered targeted and intensive support services. Within each proposed initiative, we summarize the evidence base and consider barriers and facilitators to implementation. We conclude that public schools in the U.S. represent an optimal place to promote children's and adolescents’ MBH in ways that prevent long-term mental and behavioral health problems.

High levels of mental wellbeing and low levels of mental ill-health across the population are good for individuals, good for communities, and good for the economy, and worth pursuing through a focus on promotion and prevention to complement existing efforts focused on treatment and cure. Success in promotion and prevention requires four things – giving a country's citizens the language and knowledge to motivate action, using a public health approach to positively change the balance of mental health risk and protective factors across the population, building the systems infrastructure to support action, and gaining and maintaining political commitment. This paper discusses each of these issues in turn and highlights the importance of taking a planned, coordinated, and systematic approach to promotion and prevention which is sustained over time.

Objective

Community sport can support mental health promotion and prevention initiatives. The aim was to establish the impact of a mental health literacy program (Tackle Your Feelings) delivered to Australian Rules Football clubs, on a range of mental health literacy measures.

Methods

A mixed-method approach was undertaken with four community sporting clubs allocated to treatment or control (n = 155). Study 1) involved linear mixedeffects modelling to determine if the intervention differed in effect to a waitlist control over time across five outcome measures. Study 2) determined if differences were sustained post-intervention. Study 3) analysed interview data to establish qualitative insights into impacts of the program.

Results

Longitudinal mixed-effects modelling found significant effects for confidence to support (p<.001), knowledge of resources to support mental health (p<.042) help seeking (p=.030), supportive club environment (p<.001), and program content knowledge (p<.001). Post-hoc analyses revealed a positive effect across measures and Study 2) found this was sustained for four months post-program. Qualitative data highlighted the value of this type of program but also where improvements could be made.

Conclusion

Findings highlight the potential value of community sport as a setting to support mental health promotion across a wide range of club members whilst demonstrating enhanced member perceptions of a sporting club environment to support mental health. Qualitative data highlighted opportunities to embed such programs across multiple layers of the sporting club context.