1
|
Dykstra VW, Willoughby T, Evans AD. A Latent Profile Analysis of Lie-Telling to Parents and Friends during Adolescence. J Youth Adolesc 2023; 52:2559-2577. [PMID: 37632583 DOI: 10.1007/s10964-023-01834-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/26/2023] [Indexed: 08/28/2023]
Abstract
Adolescence has been suggested to be a time of heightened lie-telling. The current study used a latent profile analysis to examine unique patterns of lie-telling for lies told to parents and friends during adolescence as well as whether adjustment indicators (relationship quality, depressive symptoms, social anxiety, externalizing problems) could be used to predict group membership. These patterns were examined among 828 10- to 16- year-olds (Mage = 12.39, SD = 1.69, 49.9% male). In both relationships, 5-profile solutions emerged; most adolescents reported very infrequent lie-telling, while a small portion (less than 5%) told high rates of lies. Adjustment indicators predicted group membership. Depressive symptoms, social anxiety, parent relationship quality, and externalizing problems predicted group membership for lying to parents. Depressive symptoms and social anxiety predicted group membership for lying to friends. The findings indicate that high rates of lie-telling found in previous research may be driven by a small number of prolific lie-tellers.
Collapse
Affiliation(s)
- Victoria W Dykstra
- Psychology Department, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada.
| | - Teena Willoughby
- Psychology Department, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| | - Angela D Evans
- Psychology Department, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| |
Collapse
|
2
|
Wang Q, Zhang W, An S. A systematic review and meta-analysis of Internet-based self-help interventions for mental health among adolescents and college students. Internet Interv 2023; 34:100690. [PMID: 38023965 PMCID: PMC10654252 DOI: 10.1016/j.invent.2023.100690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/24/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose This meta-analysis aims to evaluate the impact of Internet-based self-help interventions on the mental health of adolescents and college students. Methods We conducted a systematic review of randomized controlled trials (RCTs) that investigated Internet-based self-help interventions aiming to mitigate mental health symptoms such as anxiety and depression, as well as managing high levels of stress, among adolescents and college students. Our search spanned databases including Web of Science, PubMed, Cochrane Library, and Embase, up until November 1st, 2022. It is essential to emphasize that our focus was the evaluation of symptoms (continuous outcomes), rather than the diagnosis of specific mental disorders. The meta-analysis was performed using the R version 4.3.1. The effect size measure was the standardized mean difference (SMD), and random-effects models were used to pool data from eligible RCTs. Subgroup analyses were carried out to examine variations in intervention effects based on factors such as sample type, intervention modality, guidance type, and intervention duration. Results The meta-analysis was based on 25 comparisons involving a total of 4480 participants. In comparison to the control group (n = 2125), participants receiving interventions (n = 2355) reported significant reductions in symptoms of anxiety, depression, and stress, along with a significant improvement in quality of life. Specifically, for depression, we observed moderate intervention effects (SMD = -0.42, 95 % CI: -0.56, -0.27), and a similar pattern was seen for quality of life (SMD = 0.36, 95%CI: 0.22, 0.49). Small intervention effects were found for anxiety (SMD = -0.35, 95 % CI [-0.48, -0.22]) and stress (SMD = -0.35, 95 % CI [-0.51, -0.20]). Given significant heterogeneity, subgroup analyses were conducted for anxiety and depression, considering factors such as sample type, intervention method, and intervention duration. Notably, college students experienced more significant benefits in both anxiety and depression alleviation compared to adolescents. Longer interventions (>8 weeks) were particularly effective in reducing anxiety and depression. Additionally, third-wave cognitive-behavioral therapy (CBT) showed pronounced intervention effects in both outcome measures, while the presence of guidance did not notably influence results. Conclusion This meta-analysis underscores the positive impact of Internet-based self-help programs in alleviating the symptoms of psychological disorders among adolescents and college students. However, it is crucial to acknowledge that the available evidence exhibits inconsistencies and limitations. Therefore, further research utilizing rigorous methodologies is necessary to verify and broaden the findings of this meta-analysis.
Collapse
Affiliation(s)
- Qing Wang
- Nanjing Normal University, School of Education Science, Jiangsu, Nanjing 210000, PR China
| | - Weixin Zhang
- Department of Traditional Chinese Medical Orthopedic Surgery, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, PR China
| | - Senbo An
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, PR China
| |
Collapse
|
3
|
Cliffe B, Peck A, Shafique J, Hards E, Loades ME. Psychological therapists' perceptions of adolescent depression and its treatment: A mixed methods online survey. Clin Child Psychol Psychiatry 2023; 28:580-594. [PMID: 35635010 PMCID: PMC10018054 DOI: 10.1177/13591045221104570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Challenges to implementating interventions for adolescent depression exist. Exploring the perceptions of key stakeholders in the treatment of adolescent depression is essential for improving implementation . This study aimed to explore psychological therapists' perceptions of, and experiences treating, adolescent depression to identify future avenues for exploration. METHOD Data were collected opportunistically via a survey integrated within an e-learning package about adolescent depression. RESULTS Participants believed that adolescent depression was characterised by adolescents' lack of understanding, isolation, and a lack of hope and knowledge. Participants overcame engagement barriers by building trust. Following the e-learning, participants expressed increased understanding of the risk factors associated with adolescent depression and of assessment using different measures. Several key areas for future research to explore were identified and discussed, including (1) whether clinicians of different modalities or at different career stages have difference perceptions, (2) how to meaningfully engage adolescents in treatment and (3) how to train clinicians on different modalities so patients have a choice over their treatment. CONCLUSION This study demonstrates the value of knowledge gained from understanding psychological therapists' perceptions and illustrates how this can contribute to the improved treatment of adolescent depression.
Collapse
Affiliation(s)
- Bethany Cliffe
- Department of Health,
University
of Bath, Bath, UK
- Bethany Cliffe, Wessex House, Department
for Health, University of Bath, Claverton Down, Bath, BA2 7AY, England.
| | - Amelia Peck
- Department of Psychology,
University
of Bath, Bath, UK
| | | | - Emily Hards
- Department of Psychology,
University
of Bath, Bath, UK
| | | |
Collapse
|
4
|
Brodar KE, Leite RO, Jaramillo M, Marchetti D, Davis E, Sanchez J, Saab PG, Delamater AM, La Greca AM. Psychosocial screening in a pediatric diabetes clinic: Adolescents' and mothers' perspectives. Pediatr Diabetes 2022; 23:1101-1112. [PMID: 35752873 DOI: 10.1111/pedi.13385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/17/2022] [Accepted: 06/23/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Adolescents with type 1 diabetes (T1D) frequently experience psychosocial concerns, and mental health screening is becoming increasingly common in routine diabetes care. However, little is known about what adolescents or their caregivers think about the role of mental health screening and intervention within the context of comprehensive diabetes care, or how their diabetes care providers should be involved in navigating mental health concerns. This study used qualitative methods to obtain the perspectives of adolescents with T1D and their caregivers regarding these issues. METHODS Participants were 13 adolescents with T1D (ages 12-19 years; M = 15.1 years; 53.8% female; 61.5% Hispanic/Latinx White) and 13 mothers, recruited from an outpatient pediatric endocrinology clinic in South Florida, who participated in semi-structured interviews via video teleconference. Thematic content analysis was used to evaluate participants' responses. RESULTS Adolescents and their mothers reported positive experiences with the clinic's psychosocial screening procedures and appreciated meeting with the psychology team during visits. They wanted the clinic to offer more opportunities for peer support. Mothers highlighted barriers to seeking mental health care outside of the clinic and the importance of mental health professionals understanding diabetes. Mothers also wanted the clinic to offer more on-site therapeutic services. DISCUSSION Study participants valued psychosocial screening and supported addressing mental health as a routine part of diabetes comprehensive care.
Collapse
Affiliation(s)
- Kaitlyn E Brodar
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Rafael O Leite
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Manuela Jaramillo
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Daniella Marchetti
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Eileen Davis
- Mailman Center for Child Development, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Janine Sanchez
- Mailman Center for Child Development, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Patrice G Saab
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Alan M Delamater
- Mailman Center for Child Development, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Annette M La Greca
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| |
Collapse
|
5
|
Gómez-Restrepo C, Marroquín-Rivera A, Calvo-Valderrama MG, Ospina-Pinillos L, Stanislaus Sureshkumar D, Bird VJ. Stakeholder perspectives on a patient-centred intervention (DIALOG+) for adolescents with common mental disorders in Colombia: A qualitative study. PLoS One 2022; 17:e0272066. [PMID: 35951610 PMCID: PMC9371287 DOI: 10.1371/journal.pone.0272066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/12/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Patient and stakeholders’ involvement in the development of mental health interventions is a central part of the research process as end-user’s input can improve the design of patient-centered interventions. This is particularly important when developing interventions directed towards improving the mental health of children and adolescents. The rising prevalence of mental health disorders in this population requires special attention and the development of interventions that include them as active participants is crucial.
Objective
Our aim is to explore the perspectives and opinions of adolescents, parents, educators/youth workers, and clinicians regarding the appeal and usability of an existing patient-centered digital intervention (DIALOG+), which aims to improve quality of life.
Methods
As part of a broader study aiming to adapt and test DIALOG+, we conducted Online Focus Groups (OFGs) with adults and adolescents in two cities in Colombia. The existing DIALOG+ intervention was introduced to participants, followed by a structured discussion regarding the opinions and views of stakeholders. A framework approach was used to identify the main themes followed by content analysis to aid adaptation.
Results
We conducted 10 OFGs with a total of 45 participants. A positive feature highlighted by all groups was the innovation of including a digital intervention in a traditional medical visit. Additionally, participants considered that the active role that adolescents have when using the intervention empowers them. Barriers identified included concerns from clinicians related to the time required during consultations and confusion with terminology. Furthermore, additional domains that are particularly relevant for the adolescent population were suggested.
Conclusions
Data obtained suggest that overall, the DIALOG+ intervention and supporting app are seen as innovative and appealing to adolescents as well as adult stakeholders. However, concerns raised about the availability of time to apply the intervention, the app interface and the language and terminology require modification.
Collapse
Affiliation(s)
- Carlos Gómez-Restrepo
- Departments of Clinical Epidemiology and Biostatistics, and Psychiatry and Mental Health, Faculty of Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotà D.C, Colombia
| | - Arturo Marroquín-Rivera
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotà D.C, Colombia
| | | | - Laura Ospina-Pinillos
- Department of Psychiatry and Mental Health, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotà D.C, Colombia
| | - Diliniya Stanislaus Sureshkumar
- Unit for Social and Community Psychiatry, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Victoria Jane Bird
- Unit for Social and Community Psychiatry, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- * E-mail:
| |
Collapse
|
6
|
Stiles-Shields C, Batts KR, Reyes KM, Archer J, Crosby S, Draxler JM, Lennan N, Held P. Digital Screening and Automated Resource Identification System to Address COVID-19-Related Behavioral Health Disparities: Feasibility Study. JMIR Form Res 2022; 6:e38162. [PMID: 35696607 PMCID: PMC9221976 DOI: 10.2196/38162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/03/2022] [Accepted: 06/05/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Digital mental health (DMH) tools use technology (eg, websites and mobile apps) to conveniently deliver mental health resources to users in real time, reducing access barriers. Underserved communities facing health care provider shortages and limited mental health resources may benefit from DMH tools, as these tools can help improve access to resources. OBJECTIVE This study described the development and feasibility evaluation of the Emotional Needs Evaluation and Resource Guide for You (ENERGY) System, a DMH tool to meet the mental health and resource needs of youth and their families developed in the context of the COVID-19 pandemic. The ENERGY System offers a brief assessment of resource needs; problem-solving capabilities; and symptoms of depression, anxiety, trauma, and alcohol and substance use followed by automated, personalized feedback based on the participant's responses. METHODS Individuals aged ≥15 years were recruited through community partners, community events, targeted electronic health record messages, and social media. Participants completed screening questions to establish eligibility, entered demographic information, and completed the ENERGY System assessment. Based on the participant's responses, the ENERGY System immediately delivered digital resources tailored to their identified areas of need (eg, relaxation). A subset of participants also voluntarily completed the following: COVID-19 Exposure and Family Impact Survey (CEFIS) or COVID-19 Exposure and Family Impact Survey Adolescent and Young Adult Version (CEFIS-AYA); resource needs assessment; and feedback on their experience using the ENERGY System. If resource needs (eg, housing and food insecurity) were endorsed, lists of local resources were provided. RESULTS A total of 212 individuals accessed the ENERGY System link, of which 96 (45.3%) completed the screening tool and 86 (40.6%) received resources. Participant responses on the mental health screening questions triggered on average 2.04 (SD 1.94) intervention domains. Behavioral Activation/Increasing Activities was the most frequently launched intervention domain (56%, 54/96), and domains related to alcohol or substance use were the least frequent (4%, 4/96). The most frequently requested support areas were finances (33%, 32/96), transportation (26%, 25/96), and food (24%, 23/96). The CEFIS and CEFIS-AYA indicated higher than average impacts from the pandemic (ie, average scores >2.5). Participants were satisfied with the ENERGY System overall (65%, 39/60) as well as the length of time it took to answer the questions (90%, 54/60), which they found easy to answer (87%, 52/60). CONCLUSIONS This study provided initial support for the feasibility of the ENERGY System, a DMH tool capable of screening for resource and mental health needs and providing automated, personalized, and free resources and techniques to meet the identified needs. Future studies should seek direct feedback from community members to further improve the ENERGY System and its dissemination to encourage use.
Collapse
Affiliation(s)
- Colleen Stiles-Shields
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Kathryn R Batts
- Community Health Research Division, RTI International, Research Triangle Park, NC, United States
| | - Karen M Reyes
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Joseph Archer
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
- University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Sharad Crosby
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
- Institute for Translational Medicine, University of Chicago, Chicago, IL, United States
| | - Janel M Draxler
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Nia Lennan
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Philip Held
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| |
Collapse
|
7
|
Viksveen P, Bjønness SE, Cardenas NE, Game JR, Berg SH, Salamonsen A, Storm M, Aase K. User involvement in adolescents' mental healthcare: a systematic review. Eur Child Adolesc Psychiatry 2022; 31:1765-1788. [PMID: 34089383 PMCID: PMC9666298 DOI: 10.1007/s00787-021-01818-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/31/2021] [Indexed: 12/29/2022]
Abstract
More than one out of ten adolescents suffer from mental illness at any given time. Still, there is limited knowledge about their involvement in mental healthcare. Adolescents have the right to be involved in decisions affecting their healthcare, but limited research focuses on their engagement and decision-making. Therefore, this systematic review aims to explore the existing experiences with, the effectiveness of, and safety issues associated with user involvement for adolescents' mental healthcare at the individual and organizational level. A systematic literature review on user involvement in adolescents' mental healthcare was carried out. A protocol pre-determined the eligibility criteria and search strategies, and established guidelines were used for data extraction, critical appraisal, and reporting of results. Quantitative studies were analysed individually due to heterogeneity of the studies, while qualitative studies were analysed using thematic synthesis. A total of 31 studies were included in the review. The experiences with user involvement were reported in 24 studies with three themes at the individual level: unilateral clinician control versus collaborative relationship, capacity and support for active involvement, the right to be involved; and two themes at the organizational level: involvement outcomes relevant to adolescents' needs, conditions for optimal involvement. The effectiveness of user involvement was reported in seven studies documenting fragmented evidence related to different support structures to facilitate adolescents' involvement. The safety associated with user involvement was not reported in any studies, yet a few examples related to potential risks associated with involvement of adolescents in decision-making and as consultants were mentioned.
Collapse
Affiliation(s)
- Petter Viksveen
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
| | - Stig Erlend Bjønness
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
- Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway.
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Nicole Elizabeth Cardenas
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Faculty of Health Sciences, University of Aberdeen, Aberdeen, Scotland
| | - Julia Rose Game
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Faculty of Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Siv Hilde Berg
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
| | - Anita Salamonsen
- Regional Centre for Child and Youth Mental Health and Child Welfare - North (RKBU North), Faculty of Health Sciences, UiT The Arctic University of Norway, Langnes, P.O. Box 6050, Tromsø, Norway
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Karina Aase
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
| |
Collapse
|
8
|
Bolton CA, Thompson H, Spring JA, Frick MH. Innovative Play-Based Strategies for Teletherapy. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2021. [DOI: 10.1080/15401383.2021.2011814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
9
|
Stuckey H, Hivner EA, Kraschnewski JL, Molinari AM, Costigan HJ, Sekhar DL. "I wouldn't even know what to do," Adolescent and Parent Perspectives on Identifying, Understanding, and Seeking Help for Adolescent Depression. Psychiatr Q 2021; 92:1459-1472. [PMID: 33909227 PMCID: PMC8542576 DOI: 10.1007/s11126-021-09918-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2021] [Indexed: 11/27/2022]
Abstract
Within the context of a randomized clinical trial (RCT) of school-based depression screening, the study objective was to understand parent and adolescent perspectives on school-based depression screening and barriers to help-seeking for adolescent depression. From May-Nov. 2019, separate focus groups were held with adolescents (8 groups, n = 52) and parents (6 groups, n = 36). Two coders individually coded 20% of transcripts to establish interrater reliability (adolescent k = 0.76 and parent k = 0.80). Remaining transcripts were then separately coded and reviewed to develop three themes: (1) Both recognized depression as a serious issue that needed to be addressed in schools, but had confidentiality and communication concerns; (2) Both parents and adolescents believed the majority of adolescents would seek help with depression from friends more than any other source; and (3) Neither adolescents nor parents could clearly describe steps to take if their peers (adolescents) or adolescents (parents) were depressed. We intend to address identified barriers and concerns in the context of the larger RCT.
Collapse
Affiliation(s)
- Heather Stuckey
- Department of Medicine, Penn State College of Medicine, Hershey, PA, 17033, USA
| | - Elizabeth A Hivner
- Department of Pediatrics, Penn State College of Medicine, 500 University Drive, HS83, Hershey, PA, 17033, USA
| | | | - Alissa M Molinari
- Department of Pediatrics, Penn State College of Medicine, 500 University Drive, HS83, Hershey, PA, 17033, USA.
- Penn State PRO Wellness, Penn State College of Medicine, Mail Code A145, 90 Hope Drive, Suite 1103, Hershey, PA, 17033, USA.
| | - Heather J Costigan
- Department of Pediatrics, Penn State College of Medicine, 500 University Drive, HS83, Hershey, PA, 17033, USA
| | - Deepa L Sekhar
- Department of Pediatrics, Penn State College of Medicine, 500 University Drive, HS83, Hershey, PA, 17033, USA
| |
Collapse
|
10
|
Suffoletto B, Goldstein T, Brent D. A Text Message Intervention for Adolescents With Depression and Their Parents or Caregivers to Overcome Cognitive Barriers to Mental Health Treatment Initiation: Focus Groups and Pilot Trial. JMIR Form Res 2021; 5:e30580. [PMID: 34751665 PMCID: PMC8663469 DOI: 10.2196/30580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/12/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Many adolescents with depression do not pursue mental health treatment following a health care provider referral. We developed a theory-based automated SMS text message intervention (Text to Connect [T2C]) that attempts to reduce cognitive barriers to the initiation of mental health care. OBJECTIVE In this two-phase study, we seek to first understand the potential of T2C and then test its engagement, usability, and potential efficacy among adolescents with depression and their parents or caregivers. METHODS In phase 1, we conducted focus groups with adolescents with depression (n=9) and their parents or caregivers (n=9) separately, and transcripts were examined to determine themes. In phase 2, we conducted an open trial of T2C comprising adolescents with depression referred to mental health care (n=43) and their parents or caregivers (n=28). We assessed usability by examining program engagement, usability ratings, and qualitative feedback at the 4-week follow-up. We also assessed potential effectiveness by examining changes in perceived barriers to treatment and mental health care initiation from baseline to 4 weeks. RESULTS In phase 1, we found that the themes supported the T2C approach. In phase 2, we observed high engagement with daily negative affect check-ins, high usability ratings, and decreased self-reported barriers to mental health treatment over time among adolescents. Overall, 52% (22/42) of the adolescents who completed follow-up reported that they had attended an appointment with a mental health care specialist. Of the 20 adolescents who had not attended a mental health care appointment, 5% (1/20) reported that it was scheduled for a future date, 10% (2/20) reported that the primary care site did not have the ability to help them schedule a mental health care appointment, and 15% (3/20) reported that they were no longer interested in receiving mental health care. CONCLUSIONS The findings from this study suggest that T2C is acceptable to adolescents with depression and most parents or caregivers; it is used at high rates; and it may be helpful to reduce cognitive barriers to mental health care initiation.
Collapse
Affiliation(s)
- Brian Suffoletto
- Department of Emergency Medicine, Stanford University, Palo Alto, CA, United States
| | - Tina Goldstein
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - David Brent
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| |
Collapse
|
11
|
Paduca A, Arnaut O, Beschieru E, Lundmark PO, Bruenech JR. Shared decision making and patients satisfaction with strabismus care-a pilot study. BMC Med Inform Decis Mak 2021; 21:109. [PMID: 33771137 PMCID: PMC7995717 DOI: 10.1186/s12911-021-01469-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Strabismus is a complex disease that has various treatment approaches each with its own advantages and drawbacks. In this context, shared decisions making (SDM) is a communication process with the provider sharing all the relevant treatment alternatives, all the benefits, and risks of each procedure, while the patient shares all the preferences and values regarding his/her choices. In that way, SDM is a bidirectional process that goes beyond the typical informed consent. Therefore, it is known a little of the extent to which SDM influences the satisfaction with the treatment outcome along with strabismus patients. To study this correlation, an SDM-Q-9 questionnaire was provided within surgical consultations where treatment decisions were made; the SDM-Q-9 aims to assess the relationship between the post-operative patient's satisfaction and their SMD score. METHODS The study is considered a prospective observational pilot study. Eligible patients were adult patients diagnosed with strabismus, who had multiple treatment options, were given at the right of choice without being driven into a physician's preference. Ninety-three strabismus patients were asked to fill out the SDM-Q-9 questionnaire related to their perception of SDM during the entire period of strabismus treatment. After the treatment, patients were asked to rate their satisfaction level with the surgical outcome as excellent, good, fair, and poor. Descriptive statistics and the linear regression statistical tests (Spearman, Mann Whitney U, and Kriskal-Wallis) were used as analysis tools. RESULTS The average age of the participants was 24, where 50.6% were women. The mean SDM-Q-9 score among patients was 32 (IQR = 3). The postoperative patient satisfaction was rated as being excellent by 16 (17.2%) patients, good by 38 (40.9%), fair by 32 (34.4%), and poor by 7 patients (7.5%). Data analysis by linear regression statistical tests showed a positive correlation between the SDM-Q-9 score and the patient satisfaction related to the surgery outcome (B = 0.005, p < 0.001). Criteria in assessing patients' satisfaction were age, gender, and strabismus type. A positive correlation between SDM and real satisfaction (r = 0.834, p < 0.01) was found with age, and no significant relationship was found while taking into consideration the responder's gender and the strabismus type. CONCLUSIONS Assessing patient satisfaction after choosing a treatment for strabismus method helped us evaluate the gaps in constructive dialogue that would lead to a positive outcome for both patient and clinician. The correlation between the SDM process and the patients' satisfaction with surgery outcome, adjusted by age, has been established. These findings can serve as a springboard to further communicative improvements related to the SDM process and between patients and physicians, thereby consequently leading to patients' satisfaction raise in strabismus care. The study underlines the importance of further analysis and validation of on-ground interactions among the adolescent and adult patients and the clinicians across the strabismus management trajectory. A multicentral study and its validation will follow.
Collapse
Affiliation(s)
- Ala Paduca
- Faculty of Health and Social Science, South Eastern University Norway, Kongsberg, Norway. .,Ophthalmology Department, Universitatea de Stat de Medicina si Farmacie "Nicolae Testemitanu″, Chişinău, Republic of Moldova.
| | - Oleg Arnaut
- Department of Human Physiology and Biophysics, Universitatea de Stat de Medicina si Farmacie "Nicolae Testemitanu", Chişinău, Republic of Moldova
| | - Eugeniu Beschieru
- Department of Surgery No.1 "N. Anestiadi", Universitatea de Stat de Medicina si Farmacie "Nicolae Testemitanu", Chişinău, Republic of Moldova
| | - Per Olof Lundmark
- Faculty of Health and Social Science, South Eastern University Norway, Kongsberg, Norway
| | - Jan Richard Bruenech
- Faculty of Health and Social Science, South Eastern University Norway, Kongsberg, Norway
| |
Collapse
|
12
|
Subu MA, Wati DF, Al-Yateem N, Netrida N, Priscilla V, Maria Dias J, Slewa-Younan S, Edwin Nurdin A. ‘Family stigma’ among family members of people with mental illness in Indonesia: A grounded theory approach. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2021. [DOI: 10.1080/00207411.2021.1891363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Muhammad Arsyad Subu
- Department of Nursing, College of Health Sciences, University of Sharjah, United Arab Emirates
- Universitas Binawan, Jakarta, Indonesia
| | | | - Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, United Arab Emirates
| | | | | | - Jacqueline Maria Dias
- Department of Nursing, College of Health Sciences, University of Sharjah, United Arab Emirates
| | | | | |
Collapse
|
13
|
Syan A, Lam JYY, Huang CGL, Smith MSM, Darnay K, Hawke LD, Henderson J. The Wellness Quest: A health literacy and self-advocacy tool developed by youth for youth mental health. Health Expect 2021; 24:659-669. [PMID: 33636052 PMCID: PMC8077157 DOI: 10.1111/hex.13214] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/19/2021] [Accepted: 01/23/2021] [Indexed: 11/27/2022] Open
Abstract
Background Less than 20% of youth who experience mental health difficulties access and receive appropriate treatment. This is exacerbated by barriers such as stigma, confidentiality concerns and lack of mental health literacy. A youth team developed the Wellness Quest: a health literacy tool to enable help‐seeking youth to advocate for themselves. Objective To evaluate the content, presentation and utility of the Wellness Quest tool among youth. Participants Participants aged 14 to 26. Methods A youth research team conducted five focus groups and one online survey to evaluate the Wellness Quest tool. Thematic analysis was used to analyse the qualitative data, and descriptive statistics were used to explore the survey results. Main results Overall evaluations of the Wellness Quest were positive: participants felt it would be useful during their mental health help‐seeking journey. Participants expressed the need for information about services for specific populations, such as Indigenous, immigrants, refugees and 2SLGBTQ + youth. They expressed that the tool should be available in complementary online and print versions. Discussion Improving mental health literacy may improve mental health by enabling youth and those who support them to recognize and respond to signs of distress and understanding where and how to get help. The Wellness Quest tool may equip youth with the knowledge to make informed decisions and advocate for their own mental health, thereby facilitating help‐seeking among youth. Patient or public contribution Youth as service users led all stages of the project, from designing and conducting the study and analysing the data to writing the manuscript.
Collapse
Affiliation(s)
- Asavari Syan
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Janice Y Y Lam
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | | | | | - Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Joanna Henderson
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| |
Collapse
|
14
|
Sekhar DL, Gebremariam A, Waxmonsky JG, Walker-Harding LR, Stuckey H, Batra E, Rosen P, Kraschnewski JL, Clark SJ. Parent Views on School-Based Depression Screening: Findings From a National Survey. J Adolesc Health 2021; 68:403-406. [PMID: 33032930 PMCID: PMC8385551 DOI: 10.1016/j.jadohealth.2020.08.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/18/2020] [Accepted: 08/21/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study explored parent views on school involvement in screening and identification of adolescent depression. METHODS This was a cross-sectional Internet-based survey with the C.S. Mott Children's Hospital National Poll on Children's Health. Of 2,004 parents (63.4% response rate), 770 had a middle/high school student and were eligible for this module. Poststratification weights were generated by survey vendor Ipsos. Descriptive and bivariate results were calculated; multinomial logistic regression models controlled for parent sex, race/ethnicity, education, employment status, and school level. RESULTS Parent respondents were 54.8% female, 57.5% white, 64.3% above a high school education, and 79.7% employed; 76.2% were answering based on a high school student. Most parents supported school-based depression screens starting in sixth (46.7%) or seventh (15.1%) grades, although 15.9% responded no screening should be done. Among parent respondents, 93.2% wished to be informed of a positive screen. Regression analysis found parents of middle school students were 4.18 times more likely to prefer sixth versus 9th to 12th grade to start screening. CONCLUSIONS Most parents support middle school depression screening but overwhelmingly wished to be informed of a positive result. Guidelines for maintaining adolescent confidentiality in a school-based depression screening program will require careful consideration.
Collapse
Affiliation(s)
- Deepa L. Sekhar
- Department of Pediatrics, Penn State College of Medicine, 500 University Drive, HS83, Hershey, PA 17033, United States
| | - Acham Gebremariam
- University of Michigan, Susan B. Meister Child Health Evaluation and Research Center, Ann Arbor, MI
| | | | | | - Heather Stuckey
- Department of Medicine, Penn State College of Medicine, Hershey, PA
| | - Erich Batra
- Department of Pediatrics, Penn State College of Medicine, 500 University Drive, HS83, Hershey, PA 17033, United States,Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA
| | - Perri Rosen
- Garrett Lee Smith Youth Suicide Prevention Grant, Harrisburg, PA
| | - Jennifer L. Kraschnewski
- Department of Pediatrics, Penn State College of Medicine, 500 University Drive, HS83, Hershey, PA 17033, United States,Department of Medicine, Penn State College of Medicine, Hershey, PA,Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Sarah J. Clark
- University of Michigan, Susan B. Meister Child Health Evaluation and Research Center, Ann Arbor, MI
| |
Collapse
|
15
|
Radez J, Reardon T, Creswell C, Lawrence PJ, Evdoka-Burton G, Waite P. Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies. Eur Child Adolesc Psychiatry 2021; 30:183-211. [PMID: 31965309 PMCID: PMC7932953 DOI: 10.1007/s00787-019-01469-4] [Citation(s) in RCA: 243] [Impact Index Per Article: 81.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 12/31/2019] [Indexed: 11/28/2022]
Abstract
Mental health disorders in children and adolescents are highly prevalent yet undertreated. A detailed understanding of the reasons for not seeking or accessing help as perceived by young people is crucial to address this gap. We conducted a systematic review (PROSPERO 42018088591) of quantitative and qualitative studies reporting barriers and facilitators to children and adolescents seeking and accessing professional help for mental health problems. We identified 53 eligible studies; 22 provided quantitative data, 30 provided qualitative data, and one provided both. Four main barrier/facilitator themes were identified. Almost all studies (96%) reported barriers related to young people's individual factors, such as limited mental health knowledge and broader perceptions of help-seeking. The second most commonly (92%) reported theme related to social factors, for example, perceived social stigma and embarrassment. The third theme captured young people's perceptions of the therapeutic relationship with professionals (68%) including perceived confidentiality and the ability to trust an unknown person. The fourth theme related to systemic and structural barriers and facilitators (58%), such as financial costs associated with mental health services, logistical barriers, and the availability of professional help. The findings highlight the complex array of internal and external factors that determine whether young people seek and access help for mental health difficulties. In addition to making effective support more available, targeted evidence-based interventions are required to reduce perceived public stigma and improve young people's knowledge of mental health problems and available support, including what to expect from professionals and services.
Collapse
Affiliation(s)
- Jerica Radez
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Tessa Reardon
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK. .,Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.
| | - Cathy Creswell
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | | | - Georgina Evdoka-Burton
- Slough Community Mental Health Team, Berkshire Healthcare NHS Foundation Trust, Slough, UK
| | - Polly Waite
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK ,Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| |
Collapse
|
16
|
Marotti J, Thackeray L, Midgley N. Teenage Boys in Therapy: A Qualitative Study of Male Adolescents’ Experiences of Short-Term Psychoanalytic Psychotherapy. ACTA ACUST UNITED AC 2020. [DOI: 10.1080/15289168.2020.1832836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
17
|
Terrizzi DA, Khan HA, Paulson A, Abuwalla Z, Solis N, Bolotin M, Burke B, Toner E, de Forest SA, Lee M, Goodwin B, Fogel J, Gladstone TRG, Van Voorhees BW. Understanding Adolescent Expressions of Sadness: A Qualitative Exploration. Res Theory Nurs Pract 2020; 34:321-339. [PMID: 33199406 DOI: 10.1891/rtnp-d-19-00103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Primary care providers are positioned to identify adolescents at risk for depression and prevent major depressive disorder. To identify subthreshold depression, we examined the language adolescents use to describe their symptoms. METHODS Adolescents ages 13-18 with elevated levels on the Center for Epidemiologic Studies Depression (CES-D) scale and/or a history of depression who were part of a large randomized clinical trial to prevent depressive disorder were included. We used content analysis to analyze transcripts of semi-structured interviews. RESULTS Saturation was reached at 37 interviews. Adolescents self-identified as African American (N = 15), Hispanic (N = 10), and White (N = 21). Three domains were revealed; external sources of stress, adolescent expressions of sadness, and seeking help and care. Within these domains, 12 distinct themes emerged contextualizing these domains. No variations in the expression of the themes identified for subthreshold depression were found between the three ethno-cultural groups. IMPLICATIONS FOR PRACTICE Our study identifies, in adolescents' own words, how adolescents with subthreshold depression express feelings and cope with symptoms, and may guide primary care providers to recognize subthreshold depression early. These findings are a step toward filling the gap in the empirical literature needed to improve identification of adolescents at risk for depression in nonspecialist settings.
Collapse
Affiliation(s)
- Daniela A Terrizzi
- Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Huma A Khan
- Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Allison Paulson
- Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Zach Abuwalla
- Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Nitza Solis
- Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Megan Bolotin
- Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Brendan Burke
- Department of Pediatrics, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Emma Toner
- Massachusetts General Hospital, Boston, Massachusetts
| | - Sarah A de Forest
- Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Miae Lee
- Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Brady Goodwin
- Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Joshua Fogel
- Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois.,Department of Business Management, Brooklyn College, Brooklyn, New York
| | - Tracy R G Gladstone
- The Robert S. and Grace W. Stone Primary Prevention Initiatives, Wellesley Centers for Women, Wellesley College, Wellesley, Massachusetts
| | - Benjamin W Van Voorhees
- Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| |
Collapse
|
18
|
Stopped, Delayed or Discouraged: What Are the Barriers for Adolescents Fully Engaging in the Mental Health System? Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00135-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
19
|
Waid J, Kelly M. Supporting family engagement with child and adolescent mental health services: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1333-1342. [PMID: 31951087 DOI: 10.1111/hsc.12947] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/19/2019] [Accepted: 01/06/2020] [Indexed: 05/10/2023]
Abstract
A key challenge facing the mental health field is connecting children and families to services when symptoms first appear. Multiple barriers inhibit timely access to treatment, and interventions to resolve barriers to care are not common among health and social care organisations. To address this research-to-practice gap this study undertook a scoping review of the empirical literature aimed at identifying key factors in the social ecology of families which influence family engagement with child and adolescent mental health services, then identifying and describing models of intervention designed to help facilitate access to care. Forty studies published between 1 January 2000 and 28 February 2019 were reviewed. Key factors associated with child and adolescent mental health service engagement included family attitudes towards mental illness and help seeking, the flexibility and availability of needed services, community attitudes and stigma surrounding mental illness and mental health treatment, and the degree of coordination and integration across systems of health and social care. Models of intervention to facilitate engagement with mental health services included family outreach, telephone and digital health strategies, and integrated care approaches. Empirical support is strongest for family outreach and integrated care, although telephone and digital health strategies are underexplored with children and families and a potentially promising avenue for future research. To support family engagement with child and adolescent mental health services health and social care organisations should be prepared to identify barriers in their local practice settings and integrate efficacious engagement approaches into their continuum of available services.
Collapse
Affiliation(s)
- Jeffrey Waid
- School of Social Work, University of Minnesota - Twin Cities, Paul, MN, USA
| | - Meredith Kelly
- School of Social Work, University of Minnesota - Twin Cities, Paul, MN, USA
| |
Collapse
|
20
|
Schraeder K, Dimitropoulos G, McBrien K, Li JY, Samuel S. Perspectives from primary health care providers on their roles for supporting adolescents and young adults transitioning from pediatric services. BMC FAMILY PRACTICE 2020; 21:140. [PMID: 32660598 PMCID: PMC7359255 DOI: 10.1186/s12875-020-01189-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 06/12/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Transitioning from pediatric care to adult-oriented care at age 18 (the age of transfer in most countries and jurisdictions) is a complex process for adolescents and young adults affected by chronic physical health and/or mental health conditions. The role of primary health care (PHC) providers for this population is poorly understood. Perspectives from these providers, such as family physicians and other members of the primary care team, have not been explored in depth. METHODS A total of 18 participants (e.g., family physicians, social workers, nurses) were recruited from 6 Primary Care Networks in Calgary, Alberta, Canada. Semi-structured individual interviews were conducted, and transcribed verbatim. A qualitative description approach was used to analyze the data, and included thematic analysis. RESULTS Five distinct, yet overlapping, roles of primary health care providers for adolescents and young adults transitioning to adult care resulted from our analysis: (1) being the "common thread" (continuous accessible care); (2) caring for the "whole patient" (comprehensive care); (3) "knowing families" (family-partnered care); (4) "empowering" adolescents and young adults to develop "personal responsibility" (developmentally-appropriate care); and (5) "quarterbacking" care (coordination of specialist and/or community-based care). Participants identified potential benefits of these roles for adolescents and young adults transitioning to adult care, and barriers in practice (e.g., lack of time, having minimal involvement in pediatric care). CONCLUSIONS Input from family physicians, who follow their patients across the lifespan and provide the majority of primary care in Canada, are critical for informing and refining recommended transition practices. Our findings provide insights, from PHC providers themselves, to bolster the rationale for primary care involvement during transitions from pediatric specialty and community-based care for AYAs. Solutions to overcome barriers for integrating primary care and specialty care for adolescents and young adults need to be identified, and tested, with input from key stakeholders.
Collapse
Affiliation(s)
- Kyleigh Schraeder
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 28 Oki Drive, Calgary, Alberta, Canada.
| | - Gina Dimitropoulos
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
- Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada
| | - Kerry McBrien
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jessica Yijia Li
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 28 Oki Drive, Calgary, Alberta, Canada
| | - Susan Samuel
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 28 Oki Drive, Calgary, Alberta, Canada
| |
Collapse
|
21
|
Gaziel M, Hasson-Ohayon I, Morag-Yaffe M, Schapir L, Zalsman G, Shoval G. Insight and Satisfaction with Life Among Adolescents with Mental Disorders: Assessing Associations with Self-Stigma and Parental Insight. Eur Psychiatry 2020; 30:329-33. [DOI: 10.1016/j.eurpsy.2014.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 08/18/2014] [Accepted: 08/20/2014] [Indexed: 11/29/2022] Open
Abstract
AbstractObjective:The purpose of the current study was to assess the associations of illness perception-related variables with satisfaction with life (SwL) among adolescents with mental disorders.Methods:Insight into mental disorder (SAI-E), Internalized stigma of mental illness (ISMI) and Multidimensional Students’ Life Satisfaction Scale (MSLSS) were administrated to 30 adolescent patients. Adapted version for parents of the SAI-E was also administrated to 37 of their parents.Results:Significant positive correlations were found between insight into the illness, self-stigma and parental insight. Insight and self-stigma were significantly negatively related to the total score of SwL and few of its dimensions while parental insight was significantly associated only with the SwL dimensions of school and self. Regression models revealed main negative effects of insight and self-stigma on SwL and no interaction effect.Conclusions:The possible independent contribution of insight and self-stigma to SwL should be addressed in interventions designed for family and adolescents coping with mental illness. Special attention should be given to the possible negative implications that insight possesses. In lack of support of the moderation role of self-stigma, reported in studies among adults with mental illness, future studies should trace other variables in order to further understand the insight paradox among adolescents.
Collapse
|
22
|
Hughes S, Colbert R, Baugh A. Valuing whole complex lives: Young adults' experiences of recovery-related principles in mental healthcare in the United States. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:357-365. [PMID: 31578768 PMCID: PMC7027744 DOI: 10.1111/hsc.12867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/14/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
One in five young adults (aged 18-25 years) in the United States experiences a past year mental disorder, commonly including depression or anxiety. Yet, 1.5 million each year do not receive needed mental health services and are unlikely, in general, to seek formal mental healthcare. We aimed to inform the development of a novel programme for young adult mental health by first eliciting their positive and negative prior experiences with mental health providers. Four focus groups with 19 young adults (aged 19-26 years) recruited from the community and with moderate to severe depression and/or anxiety were conducted in 2018 in a western US state. Participants' prior experiences with services/providers were elicited along six pre-defined recovery-related concepts: feeling listened to and validated, inclusivity, full information and consent, hope and optimism, connectedness, and change. Focus groups were audio-recorded, transcribed verbatim and uploaded into NVivo version 12 software. Two independent coders used deductive thematic analysis to identify patterned responses. Feeling listened to and validated appeared as a cornerstone of other recovery concepts. Participants discussed past negative experiences with psychiatrists and regret for being put on medications in their teenage years without information or options. Hope and optimism were low because of a general focus by professionals to address immediate symptom-based issues, rather than on improving their overall lives. Service providers' focus on medication-taking, and other one-size-fits-all tools, was interpreted as lacking a sincere desire to help. Young adults were particularly sensitive to inauthentic interactions and superficial strategies, which left them craving care that incorporated their whole lives, acknowledged biopsychosocial interconnections and prioritised improving their lives over 'feeling better' in a given moment. Mental health providers should consider developing programmes that shift focus away from an exclusively medical understanding of distress and towards holistic, educational or relational approaches that value body, mind, self-exploration and authentic connection.
Collapse
Affiliation(s)
- Shannon Hughes
- School of Social WorkColorado State UniversityFort CollinsColorado
- Department of Community and Behavioral HealthColorado School of Public HealthFort CollinsColorado
| | | | - Ashley Baugh
- Children's Immunodeficiency ProgramChildren's HospitalAuroraColorado
| |
Collapse
|
23
|
McMillan SS, Wilson B, Stapleton H, Wheeler AJ. Young people's experiences with mental health medication: A narrative review of the qualitative literature. J Ment Health 2020; 31:281-295. [PMID: 32031034 DOI: 10.1080/09638237.2020.1714000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: With the growing prevalence of mental illness in young people, healthcare professionals require an understanding of the social and psychological implications of medication use in this population.Aim: To characterize the qualitative literature regarding the perceptions and experiences of young people taking medication for mental illness.Methods: A narrative review of qualitative studies involving young people (13-24 years) taking any medication as treatment for a mental illness. The Medication Experience Model guided analysis of quotes related to medication use.Results: Of the 27 included studies, the majority involved participants with depression and utilized interviews. Young people reported a wide range of mental health medication experiences, both negative and positive, which could influence medication acceptance. Lack of autonomy and the influence of family members were challenges faced by this population.Conclusions: Young people reported that medications had affected them in various ways across multiple dimensions. Lack of involvement in decision-making and a loss of autonomy were of particular relevance to young people, issues which should also be of interest to healthcare professionals.
Collapse
Affiliation(s)
- Sara S McMillan
- School of Pharmacy and Pharmacology, Quality Use of Medicines Network, Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - Bethany Wilson
- School of Pharmacy and Pharmacology, Griffith University, Southport, Queensland, Australia
| | - Helen Stapleton
- School of Human Services and Social Work, Griffith University, Nathan, Queensland, Australia
| | - Amanda J Wheeler
- School of Human Services and Social Work, Quality Use of Medicines Network, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| |
Collapse
|
24
|
Bjønness S, Viksveen P, Johannessen JO, Storm M. User participation and shared decision-making in adolescent mental healthcare: a qualitative study of healthcare professionals' perspectives. Child Adolesc Psychiatry Ment Health 2020; 14:2. [PMID: 31988656 PMCID: PMC6969458 DOI: 10.1186/s13034-020-0310-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/07/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Most mental health problems occur in adolescence. There is increasing recognition of user participation and shared decision-making in adolescents' mental healthcare. However, research in this field of clinical practice is still sparse. The objective of this study was to explore healthcare professionals' perspectives on user participation, and opportunities for shared decision-making in Child and Adolescent Mental Health Service (CAMHS) inpatient units. METHODS Healthcare professionals at CAMHS inpatient units participated in three focus group interviews. Fifteen participants with experience with user participation and shared decision-making were recruited from five hospitals in Norway. RESULTS Five themes emerged: (1) involvement before admission; (2) sufficient time to feel safe; (3) individualized therapy; (4) access to meetings where decisions are made; and (5) changing professionals' attitudes and practices. CONCLUSION User participation and shared decision-making require changes in workplace culture, and routines that allow for individualized mental health services that are adapted to adolescents' needs. This calls for a flexible approach that challenges clinical pathways and short-stay hospital policies. The results of this study may inform further work on strengthening user participation and the implementation of shared decision-making.Trial registration Norwegian Regional Committees for Medical and Health Research Ethics, reference number 2017/1195.
Collapse
Affiliation(s)
- Stig Bjønness
- Centre for Resilience in Healthcare (SHARE), Department for Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway
| | - Petter Viksveen
- Centre for Resilience in Healthcare (SHARE), Department for Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Jan Olav Johannessen
- Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway
- Department for Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Marianne Storm
- Department for Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| |
Collapse
|
25
|
A Longitudinal Examination of the Relation Between Lie-Telling, Secrecy, Parent–Child Relationship Quality, and Depressive Symptoms in Late-Childhood and Adolescence. J Youth Adolesc 2020; 49:438-448. [DOI: 10.1007/s10964-019-01183-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022]
|
26
|
Radovic A, Odenthal K, Flores AT, Miller E, Stein BD. Prescribing Technology to Increase Uptake of Depression Treatment in Primary Care: A Pre-implementation Focus Group Study of SOVA (Supporting Our Valued Adolescents). J Clin Psychol Med Settings 2019; 27:766-782. [PMID: 31630347 DOI: 10.1007/s10880-019-09669-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Supporting Our Valued Adolescents (SOVA) is a web-based technology intervention designed to increase depression and anxiety treatment uptake by adolescents in the context of an anonymous peer community with an accompanying website for parents. With a goal of informing the design of a hybrid effectiveness-implementation randomized controlled trial, we conducted a pre-implementation study in two primary care practices to guide implementation strategy development. We conducted focus groups with primary care providers (PCPs) at three different timepoints with PCPs (14 total) from two community practices. A baseline survey was administered using Evidence-Based Practice Attitude Scale (EBPAS) and Physician Belief Scale (PBS). Subsequently, during each focus group, PCPs listened to a relevant presentation after which a facilitated discussion was audio recorded and transcribed. After timepoint 1, a codebook based on Consolidated Framework for Intervention Research (CFIR) and qualitative description were used to summarize findings and inform implementation strategies that were then adapted based on PCP feedback from timepoint 2. PCPs were provided with resources to implement SOVA over 5 months and then a third focus group was conducted to gather their feedback. Based on EBPAS and PBS, PCPs are willing to try new evidence-based practices and have positive feelings about taking care of psychosocial problems with some concerns about increased burden. During focus groups, PCPs expressed SOVA has a relative advantage and intuitive appeal, especially due to its potential to overcome stigma and reach adolescents and parents who may not want to talk about mental health concerns with their PCP. PCPs informed various implementation strategies (e.g., advertising to reach a wider audience than the target population; physical patient reminders). During timepoint 3, however, they shared they had a difficult time utilizing these despite their intention. PCPs requested use of champions and others to nudge them and priming of families with advertising, so that the PCP would not be required to initiate recommendation of the intervention, but only offer their strong endorsement when prompted. The process of conducting a pre-implementation study in primary care settings may assist with piloting potential implementation strategies and understanding barriers to their use.Trial registration NCT03318666.
Collapse
Affiliation(s)
- Ana Radovic
- Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, PA, 15213, USA.
| | - Kayla Odenthal
- Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, PA, 15213, USA
| | - Ana T Flores
- Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, PA, 15213, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, PA, 15213, USA
| | - Bradley D Stein
- RAND Corporation, 4570 Fifth Avenue #600, Pittsburgh, PA, USA.,Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| |
Collapse
|
27
|
Wright B, Lau AS, Brookman-Frazee L. Factors Associated With Caregiver Attendance in Implementation of Multiple Evidence-Based Practices in Youth Mental Health Services. Psychiatr Serv 2019; 70:808-815. [PMID: 31159663 PMCID: PMC6718317 DOI: 10.1176/appi.ps.201800443] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The implementation of evidence-based practices (EBPs) in community mental health settings for youths has consistently yielded weakened effects compared with controlled trials. There is a need to feasibly measure the quality of large-scale implementation efforts to inform improvement targets. This study used therapist-reported caregiver attendance in treatment sessions as a quality indicator in the community implementation of EBPs. METHODS Data were collected from therapists practicing in agencies contracted to provide publicly funded children's mental health services following a system-driven implementation of multiple EBPs. Community therapists (N=101) provided information about youth clients (N=267) and psychotherapy sessions (N=685). Multivariable binomial logistic regressions were conducted to examine associations between caregiver attendance and therapist factors (e.g., licensure status, education), youth factors (e.g., gender, age), and the type of EBP delivered. RESULTS Caregiver attendance occurred in 42% of sessions. The following factors were associated with increased odds of caregiver attendance: younger client age, male sex of client, externalizing presenting problem, and delivery of an EBP that prescribes caregiver attendance at all sessions. Caregiver attendance at sessions targeting trauma or externalizing disorders appeared to explain the differences between boys and girls in levels of caregiver engagement. CONCLUSIONS Overall, the patterns of actual caregiver attendance appeared consistent with empirically informed practice parameters for involvement of caregivers in treatment. Still, the rates of caregiver attendance in externalizing-focused sessions were suboptimal, and the gender difference in these rates-which clearly disfavored girls-suggests targeted areas for quality improvement. Potential reasons for these quality gaps are discussed.
Collapse
Affiliation(s)
- Blanche Wright
- Department of Psychology, University of California, Los Angeles (Wright, Lau); Child and Adolescent Services Research Center, Department of Psychiatry, University of California, San Diego (Brookman-Frazee)
| | - Anna S Lau
- Department of Psychology, University of California, Los Angeles (Wright, Lau); Child and Adolescent Services Research Center, Department of Psychiatry, University of California, San Diego (Brookman-Frazee)
| | - Lauren Brookman-Frazee
- Department of Psychology, University of California, Los Angeles (Wright, Lau); Child and Adolescent Services Research Center, Department of Psychiatry, University of California, San Diego (Brookman-Frazee)
| |
Collapse
|
28
|
Singh S, Zaki RA, Farid NDN. A systematic review of depression literacy: Knowledge, help-seeking and stigmatising attitudes among adolescents. J Adolesc 2019; 74:154-172. [DOI: 10.1016/j.adolescence.2019.06.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/14/2019] [Accepted: 06/07/2019] [Indexed: 01/11/2023]
|
29
|
Bosco N, Giaccherini S, Meringolo P. A gender perspective about young people's seeking help. J Prev Interv Community 2019; 48:132-146. [PMID: 31215327 DOI: 10.1080/10852352.2019.1624353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This article is focused on young people's perceptions about psychological help seeking for mental health issues. Males and females perspectives are investigated in order to detect if there are gender differences in seeking help when psychological problems are arising. Stigma seems to interfere with the decisional process of seeking professional help because of the feelings of shame, sense of inadequacy, and personal failure. These feelings are particularly perceived by young people, who may avoid professional help in order to preserve a positive self-image, with significant gender differences. Proposed studies, involving University of Florence, Public Mental Health Service and High School have been realized with qualitative and quantitative methods, aimed at exploring males and females' perceptions about seeking help. Results show that young males ask for help those they trust (friends and parents), and adopt self-reliance as preferred strategy, while females seem to have more confidence in mental health professionals.
Collapse
Affiliation(s)
- Nicolina Bosco
- Department of Education, Psychology University of Florence, Florence, Italy
| | | | - Patrizia Meringolo
- Department of Education, Psychology University of Florence, Florence, Italy
| |
Collapse
|
30
|
Carson NJ, Mullin B, Sanchez MJ, Lu F, Yang K, Menezes M, Cook BL. Identification of suicidal behavior among psychiatrically hospitalized adolescents using natural language processing and machine learning of electronic health records. PLoS One 2019; 14:e0211116. [PMID: 30779800 PMCID: PMC6380543 DOI: 10.1371/journal.pone.0211116] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 01/09/2019] [Indexed: 01/01/2023] Open
Abstract
Objective The rapid proliferation of machine learning research using electronic health records to classify healthcare outcomes offers an opportunity to address the pressing public health problem of adolescent suicidal behavior. We describe the development and evaluation of a machine learning algorithm using natural language processing of electronic health records to identify suicidal behavior among psychiatrically hospitalized adolescents. Methods Adolescents hospitalized on a psychiatric inpatient unit in a community health system in the northeastern United States were surveyed for history of suicide attempt in the past 12 months. A total of 73 respondents had electronic health records available prior to the index psychiatric admission. Unstructured clinical notes were downloaded from the year preceding the index inpatient admission. Natural language processing identified phrases from the notes associated with the suicide attempt outcome. We enriched this group of phrases with a clinically focused list of terms representing known risk and protective factors for suicide attempt in adolescents. We then applied the random forest machine learning algorithm to develop a classification model. The model performance was evaluated using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. Results The final model had a sensitivity of 0.83, specificity of 0.22, AUC of 0.68, a PPV of 0.42, NPV of 0.67, and an accuracy of 0.47. The terms mostly highly associated with suicide attempt clustered around terms related to suicide, family members, psychiatric disorders, and psychotropic medications. Conclusion This analysis demonstrates modest success of a natural language processing and machine learning approach to identifying suicide attempt among a small sample of hospitalized adolescents in a psychiatric setting.
Collapse
Affiliation(s)
- Nicholas J Carson
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States of America.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| | - Brian Mullin
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States of America
| | - Maria Jose Sanchez
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States of America.,Prevention and Community Health Department, Milken School of Public Health, George Washington University, Washington, D.C., United States of America
| | - Frederick Lu
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States of America
| | - Kelly Yang
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States of America.,Department of Psychiatry, Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Michelle Menezes
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States of America.,University of Virginia, Charlottesville, VA, United States of America
| | - Benjamin Lê Cook
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States of America.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| |
Collapse
|
31
|
Maroun RA, Thackeray LA, Midgley N. Meaning and medication: a thematic analysis of depressed adolescents' views and experiences of SSRI antidepressants alongside psychological therapies. BMC Psychiatry 2018; 18:374. [PMID: 30486802 PMCID: PMC6263068 DOI: 10.1186/s12888-018-1961-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is a key period of risk for the emergence of Major Depressive Disorder (MDD). The prescription of selective serotonin re-uptake inhibitors (SSRIs) for the treatment of depression in adolescents is an issue of worldwide controversy, and evidence regarding their safety and efficacy is inconclusive. In the UK, NICE guidelines have recently recommended offering SSRIs to adolescents alongside psychological therapy or on their own if therapy is refused. Thus, SSRIs are increasingly becoming a major component of treatment for adolescents. This study qualitatively explored adolescents' views and experiences of SSRIs within their accounts of engaging in a psychological therapy for depression, particularly focusing on meanings they attached to medication-use. METHODS The qualitative study reports data from semi-structured interviews conducted 12-months post-treatment with 12 adolescents who were clinically referred and treated for depression as part of the IMPACT trial. The interviews were analysed using Thematic Analysis. RESULTS Four themes were identified: 'a perceived threat to autonomy', 'a sign of severity', 'a support, not a solution', and 'an ongoing process of trial and error'. CONCLUSIONS This study highlights the value of bringing adolescents' voices into the broader debate on the use of antidepressants in their age group and in the development of future guidelines. Future implications for research and clinical practice are discussed.
Collapse
Affiliation(s)
- Rita A. Maroun
- Faculty of Brain and Language Sciences, University College London, London, UK
- Anna Freud National Centre for Children and Families (AFNCCF), London, UK
| | - Lisa A. Thackeray
- Faculty of Brain and Language Sciences, University College London, London, UK
- Anna Freud National Centre for Children and Families (AFNCCF), London, UK
| | - Nick Midgley
- The Child Attachment and Psychological Therapies Research Unit (ChAPTRe), University College London and Anna Freud National Centre for Children and Families, London, UK
| |
Collapse
|
32
|
Ho GWK, Bressington D, Leung SF, Lam KKC, Leung AYM, Molassiotis A, Ligot J, Ranoco C, Sophal C, Valimaki M. Depression literacy and health-seeking attitudes in the Western Pacific region: a mixed-methods study. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1039-1049. [PMID: 29860568 DOI: 10.1007/s00127-018-1538-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/28/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE Depression literacy refers to the ability to recognize depression and make informed decisions about its treatment. To date, relatively little research has been done to examine depression literacy in the Western Pacific region. Given the pervasiveness of depression and the need to enhance mental health care in this region, it is important to gain a better understanding of depression literacy and health-seeking behaviors in this part of the world. METHODS This mixed-methods study utilized a convergent parallel design to examine depression literacy and the associated health-seeking attitudes among urban adults from three countries-Cambodia, Philippines, and Fiji. A total of 455 adults completed a quantitative survey on depression knowledge, attitudes, and professional help seeking. Separately, 56 interviewees from 6 focus groups provided qualitative data on their impression and knowledge of depression and mental illness within the context of their local communities. RESULTS Overall, results showed that depression knowledge was comparatively lower in this region. Controlling for differences across countries, higher knowledge was significantly associated with more positive attitudes towards mental illness (B = - 0.28, p = 0.025) and professional help seeking (B = 0.20, p < 0.001). Financial stability, such as employment, was also a salient factor for help seeking. CONCLUSIONS This study was the first to provide a baseline understanding on depression literacy and highlights the need to increase public knowledge on depression in the Western Pacific. Culturally congruent recommendations on enhancing depression literacy in this region, such as anti-stigma campaigns, use of financial incentives, and family-based approach in health education, are discussed.
Collapse
Affiliation(s)
- Grace W K Ho
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
| | - D Bressington
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - S F Leung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - K K C Lam
- Center for Health, Social Care Research, Kingston University and St. George's, University of London, London, UK
| | - A Y M Leung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - A Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - J Ligot
- WHO Headquarters, Geneva, Switzerland
| | - C Ranoco
- College of Nursing, University of Santo Tomas, Manila, Philippines
| | - C Sophal
- Department of Mental Health and Substance Abuse, Ministry of Health, Phnom Penh, Cambodia
| | - M Valimaki
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| |
Collapse
|
33
|
Overlap and distinction between measures of insight and self-stigma. Psychiatry Res 2018; 266:47-64. [PMID: 29807315 DOI: 10.1016/j.psychres.2018.05.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 04/15/2018] [Accepted: 05/13/2018] [Indexed: 11/22/2022]
Abstract
Multiple studies on insight into one's illness and self-stigma among patients with serious mental illness and their relatives have shown that these constructs are related to one another and that they affect outcome. However, a critical exploration of the items used to assess both constructs raises questions with regard to the possible overlapping and centrality of items. The current study used five different samples to explore the possible overlap and distinction between insight and self-stigma, and to identify central items, via network analyses and principal component factor analysis. Findings from the network analyses showed overlap between insight and self-stigma exist with a relatively clearer observational distinction between the constructs among the two parent samples in comparison to the patient samples. Principal component factor analysis constrained to two factors showed that a relatively high percentage of items were not loaded on either factor, and in a few datasets, several insight items were loaded on the self-stigma scale and vice versa. The author discusses implications for research and calls for rethinking the way insight is assessed. Clinical implications are also discussed in reference to central items of social isolation, future worries and stereotype endorsement among the different study groups.
Collapse
|
34
|
Nichols L, Ryan R, Connor C, Birchwood M, Marshall T. Derivation of a prediction model for a diagnosis of depression in young adults: a matched case-control study using electronic primary care records. Early Interv Psychiatry 2018; 12:444-455. [PMID: 27027490 DOI: 10.1111/eip.12332] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 02/18/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Approximately 80 000 children and young people in the UK suffer from depression, but many are untreated because of poor identification of early warning signs and risk factors. AIMS This study aimed to derive and to investigate discrimination characteristics of a prediction model for a first recorded diagnosis of depression in young people aged 15-24 years. METHOD This study used a matched case-control method using electronic primary care records. Stepwise conditional logistic regression modelling investigated 42 potential predictors including symptoms, co-morbidities, social factors and drug and alcohol misuse. RESULTS Of the socio-economic and symptomatic predictors identified, the strongest associations were with depression symptoms and other psychological conditions. School problems and social services involvement were prominent predictors in men aged 15-18 years, work stress in women aged 19-24 years. CONCLUSION Our model is a first step in the development of a predictive model identifying early warning signs of depression in young people in primary care.
Collapse
Affiliation(s)
- Linda Nichols
- Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Ronan Ryan
- Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Charlotte Connor
- Centre for Mental Health, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Max Birchwood
- WMS - Mental Health and Wellbeing, University of Warwick, Coventry, UK
| | - Tom Marshall
- Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
35
|
Efficacy of an Internet-based depression intervention to improve rates of treatment in adolescent mothers. Arch Womens Ment Health 2018; 21:273-285. [PMID: 29260321 PMCID: PMC5943152 DOI: 10.1007/s00737-017-0804-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 12/08/2017] [Indexed: 12/23/2022]
Abstract
Approximately 400,000 adolescents give birth in the USA annually. Although one-half experience depressive symptoms, less than 25% comply with referrals for depression evaluation and treatment. The current study tested the effectiveness of an Internet-based depression intervention on seeking depression treatment. Based upon the theory of planned behavior (TPB), the intervention included vignettes, questions and answers, and resources. Before the intervention, immediately after the intervention, and 2 weeks later the adolescent mothers (n = 151) answered questions related to TPB variables and depression treatment. Data were compared to adolescent mothers (n = 138) in the control group. Data were collected in community organizations or home visits for the control group. Adolescent mothers in the intervention group answered questions and completed the intervention from a computer of their choice. The adolescents were primarily African American (89.2%), less than high school educated (51.7%), had given birth in last year (97.1%), with a mean age 18.2 years. The intervention led to significant changes in attitude, perceived control, intention to seek mental health treatment, and actually seeking depression treatment. Untreated postpartum depression dramatically impacts a mother's relationship with her child, her functioning at work and school, health care-seeking behaviors, mothering skills, and her development as well as the development of her child. An Internet-based depression intervention is an inexpensive method to increase rates of depression treatment.
Collapse
|
36
|
Chapman L, Edbrooke-Childs J, Martin K, Webber H, Craven MP, Hollis C, Deighton J, Law R, Fonagy P, Wolpert M. A Mobile Phone App to Support Young People in Making Shared Decisions in Therapy (Power Up): Study Protocol. JMIR Res Protoc 2017; 6:e206. [PMID: 29084708 PMCID: PMC5684513 DOI: 10.2196/resprot.7694] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/11/2017] [Accepted: 07/21/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Evidence suggests that young people want to be active participants in their care and involved in decisions about their treatment. However, there is a lack of digital shared decision-making tools available to support young people in child and adolescent mental health services (CAMHS). OBJECTIVE The primary aim of this paper is to present the protocol of a feasibility trial for Power Up, a mobile phone app to empower young people in CAMHS to make their voices heard and participate in decisions around their care. METHODS In the development phase, 30 young people, parents, and clinicians will take part in interviews and focus groups to elicit opinions on an early version of the app. In the feasibility testing phase, 60 young people from across 7 to 10 London CAMHS sites will take part in a trial looking at the feasibility and acceptability of measuring the impact of Power Up on shared decision making. RESULTS Data collection for the development phase ended in December 2016. Data collection for the feasibility testing phase will end in December 2017. CONCLUSIONS Findings will inform the planning of a cluster controlled trial and contribute to the development and implementation of a shared decision-making app to be integrated into CAMHS. TRIAL REGISTRATION ISRCTN77194423; http://www.isrctn.com/ISRCTN77194423 (Archived by WebCite at http://www.webcitation.org/6td6MINP0). ClinicalTrials.gov NCT02987608; https://clinicaltrials.gov/ct2/show/NCT02987608 (Archived by WebCite at http://www.webcitation.org/6td6PNBZM).
Collapse
Affiliation(s)
- Louise Chapman
- Evidence Based Practice Unit, University College London and the Anna Freud National Centre for Children and Familes, London, United Kingdom
| | - Julian Edbrooke-Childs
- Evidence Based Practice Unit, University College London and the Anna Freud National Centre for Children and Familes, London, United Kingdom
| | - Kate Martin
- Common Room Consulting Ltd, London, United Kingdom
| | | | - Michael P Craven
- NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, United Kingdom
- Bioengineering Research Group, Faculty of Engineering, University of Nottingham, Nottingham, United Kingdom
| | - Chris Hollis
- NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, United Kingdom
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Jessica Deighton
- Evidence Based Practice Unit, University College London and the Anna Freud National Centre for Children and Familes, London, United Kingdom
| | - Roslyn Law
- University College London and the Anna Freud National Centre for Children and Familes, London, United Kingdom
| | - Peter Fonagy
- University College London and the Anna Freud National Centre for Children and Familes, London, United Kingdom
| | - Miranda Wolpert
- Evidence Based Practice Unit, University College London and the Anna Freud National Centre for Children and Familes, London, United Kingdom
| |
Collapse
|
37
|
Integrating Mindfulness into Mixed Martial Arts Training to Enhance Academic, Social, and Emotional Outcomes for At-Risk High School Students: a Qualitative Exploration. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s40688-017-0142-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
38
|
Boyd RC, Butler L, Benton TD. Understanding Adolescents’ Experiences with Depression and Behavioral Health Treatment. J Behav Health Serv Res 2017; 45:105-111. [DOI: 10.1007/s11414-017-9558-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
39
|
Georgakakou-Koutsonikou N, Williams JM. Children and young people's conceptualizations of depression: a systematic review and narrative meta-synthesis. Child Care Health Dev 2017; 43:161-181. [PMID: 28090667 DOI: 10.1111/cch.12439] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 08/29/2016] [Accepted: 11/19/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is an increasing research interest in conceptualizations of mental illness, examined in association with help-seeking, stigma and treatment preferences. A recent focus on young people's concepts has been identified, with depression being one of the most examined conditions. METHODS The purpose of this systematic review is to synthesize evidence on children and adolescents' conceptualizations of depression, adopting the model of illness representations. The review further aims to examine developmental trends, gender differences and the role of experience. A systematic review and narrative meta-synthesis were conducted, reviewing 36 studies identified through a systematic search of six databases in March 2016. RESULTS Thirty-six quantitative and qualitative studies were included. Half of the young people are able to recognize depression, and recognition increases when symptoms are more severe (e.g. suicidality). Young people are able to name a variety of causes for depression. Mental health professionals are considered the appropriate source of help by half of the young people, followed by family and peers. However, stigma constitutes a major barrier to help-seeking. There are developmental trends and gender differences in young people's conceptualization of depression, while experience with depression is associated with a broader conceptualization. CONCLUSIONS Young people's concepts of depression resemble aspects of adult conceptualizations, however are sometimes incomplete. Further research on younger children and clinical populations is needed. Research on young people's conceptualizations informs both clinical practice and mental health literacy interventions.
Collapse
Affiliation(s)
- N Georgakakou-Koutsonikou
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - J M Williams
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
40
|
Woodgate RL, Sigurdson C, Demczuk L, Tennent P, Wallis B, Wener P. The meanings young people assign to living with mental illness and their experiences in managing their health and lives: a systematic review of qualitative evidence. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2017; 15:276-401. [PMID: 28178021 DOI: 10.11124/jbisrir-2016003283] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND It is estimated that less than 25% of young people in need of treatment for mental illness receive specialized services, and even fewer receive a diagnosis by their doctor. These findings are troubling given that living with a mental illness can have a significant impact on a young person's life, the lives of his/her family members, the young person's community and society generally. OBJECTIVE The objective of this systematic review was to synthesize the best available qualitative evidence on the meanings young people assign to living with mental illness and their experiences in managing their health and lives. INCLUSION CRITERIA The current review considered both interpretive and critical research studies that drew on the experiences of young people with mental illness. SEARCH STRATEGY The search for published studies included the following databases: MEDLINE, CINAHL, Social Sciences Full Text, PsycINFO, Social Work Abstracts, Sociological Abstracts, Embase, Social Services Abstracts, Child Development and Adolescent Studies, Scopus, Web of Science and Academic Search Complete. The search for unpublished studies included conference proceedings and ProQuest Dissertations and Theses Database. METHODOLOGICAL QUALITY Each paper was assessed independently by two reviewers for methodological quality. The Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) was used to appraise the methodological quality of the articles. DATA EXTRACTION Qualitative data were extracted from papers included in the review using the standardized data extraction tool from JBI-QARI. DATA SYNTHESIS JBI-QARI was used to pool findings based on their similarity of meaning and developed into four synthesized findings. RESULTS Fifty-four research papers generated 304 study findings that were aggregated into nine categories. The nine categories were further aggregated into four synthesis statements: (1) A different way of being, (2) Getting through the difficult times, (3) Yearning for acceptance and (4) Room for improvement. CONCLUSION Young people with mental illness experienced a range of feelings and thoughts that at times left them feeling uncomfortable in their body and world. Rejection by family and friends was a common fear. The changes experienced by young people required them to use a variety of strategies that were both negative and positive. The challenges young people faced in seeking and receiving care reinforce that there is a need for improvement in mental health services for youth living with mental illness.
Collapse
Affiliation(s)
- Roberta L Woodgate
- 1College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada 2Applied Health Sciences PhD Program, University of Manitoba, Winnipeg, Manitoba, Canada 3Elizabeth Dafoe Library, University of Manitoba, Winnipeg, Manitoba, Canada 4College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada 5University of Manitoba, Winnipeg, Manitoba, Canada and the Queen's Collaboration for Health Care Quality: a Joanna Briggs Institute Center of Excellence, Kingston, Ontario, Canada
| | | | | | | | | | | |
Collapse
|
41
|
Kendal S, Kirk S, Elvey R, Catchpole R, Pryjmachuk S. How a moderated online discussion forum facilitates support for young people with eating disorders. Health Expect 2017; 20:98-111. [PMID: 26725547 PMCID: PMC5217921 DOI: 10.1111/hex.12439] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2015] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Young people with eating disorders are at risk of harm to their social, emotional and physical development and life chances. Although they can be reluctant to seek help, they may access social media for information, advice or support. The relationship between social media and youth well-being is an emotive subject, but not clearly understood. This qualitative study aimed to explore how young people used a youth-orientated, moderated, online, eating disorders discussion forum, run by an eating disorders charity. METHODS We applied a netnographic approach involving downloading and thematically analysing over 400 messages posted August-November 2012. RESULTS Data analysis generated five themes: Taking on the role of mentor; the online discussion forum as a safe space; Friendship within the online forum; Flexible help; and Peer support for recovery and relapse prevention. Forum moderation may have influenced the forum culture. DISCUSSION Our findings are consistent with literature about youth preferences for mental health self-care support. A young person's decision to use this discussion forum can be construed as pro-active self-care. A moderated online discussion forum can make a positive contribution to support for youth with eating disorders, countering negative media perceptions of online groups. CONCLUSION This study adds to knowledge about how young people access support via social media. Online discussion forums can be safe and acceptable spaces for youth to access help. Further research could provide insights into the impact of forum moderation.
Collapse
Affiliation(s)
- Sarah Kendal
- School of Human and Health SciencesUniversity of HuddersfieldHuddersfieldUK
| | - Sue Kirk
- School of Nursing Midwifery and Social WorkUniversity of ManchesterManchesterUK
| | - Rebecca Elvey
- Centre for Primary CareUniversity of ManchesterManchesterUK
| | | | - Steven Pryjmachuk
- School of Nursing Midwifery and Social WorkUniversity of ManchesterManchesterUK
| |
Collapse
|
42
|
Radovic A, Vona PL, Santostefano AM, Ciaravino S, Miller E, Stein BD. Smartphone Applications for Mental Health. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2017; 19:465-70. [PMID: 27428034 DOI: 10.1089/cyber.2015.0619] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Many adolescents and adults do not seek treatment for mental health symptoms. Smartphone applications (apps) may assist individuals with mental health concerns in alleviating symptoms or increasing understanding. This study seeks to characterize apps readily available to smartphone users seeking mental health information and/or support. Ten key terms were searched in the Apple iTunes and Google Play stores: mental health, depression, anxiety, schizophrenia, bipolar, trauma, trauma in schools, post traumatic stress disorder (PTSD), child trauma, and bullying. A content analysis of the first 20 application descriptions retrieved per category was conducted. Out of 300 nonduplicate applications, 208 (70%) were relevant to search topic, mental health or stress. The most common purported purpose for the apps was symptom relief (41%; n = 85) and general mental health education (18%; n = 37). The most frequently mentioned approaches to improving mental health were those that may benefit only milder symptoms such as relaxation (21%; n = 43). Most app descriptions did not include information to substantiate stated effectiveness of the application (59%; n = 123) and had no mention of privacy or security (89%; n = 185). Due to uncertainty of the helpfulness of readily available mental health applications, clinicians working with mental health patients should inquire about and provide guidance on application use, and patients should have access to ways to assess the potential utility of these applications. Strategic policy and research developments are likely needed to equip patients with applications for mental health, which are patient centered and evidence based.
Collapse
Affiliation(s)
- Ana Radovic
- 1 Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.,2 Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Pamela L Vona
- 3 School of Social Work, University of Southern California , Los Angeles, California
| | | | - Samantha Ciaravino
- 1 Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.,2 Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Elizabeth Miller
- 1 Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.,2 Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | | |
Collapse
|
43
|
Gondek D, Edbrooke-Childs J, Velikonja T, Chapman L, Saunders F, Hayes D, Wolpert M. Facilitators and Barriers to Person-centred Care in Child and Young People Mental Health Services: A Systematic Review. Clin Psychol Psychother 2016; 24:870-886. [DOI: 10.1002/cpp.2052] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 09/26/2016] [Accepted: 09/27/2016] [Indexed: 01/15/2023]
Affiliation(s)
- Dawid Gondek
- Evidence Based Practice Unit, UCL and Anna Freud Centre; London UK
| | | | - Tjasa Velikonja
- Evidence Based Practice Unit, UCL and Anna Freud Centre; London UK
| | - Louise Chapman
- Evidence Based Practice Unit, UCL and Anna Freud Centre; London UK
| | | | - Daniel Hayes
- Evidence Based Practice Unit, UCL and Anna Freud Centre; London UK
| | - Miranda Wolpert
- Evidence Based Practice Unit, UCL and Anna Freud Centre; London UK
| |
Collapse
|
44
|
Genuis SK, Bronstein J. Looking for “normal”: Sense making in the context of health disruption. J Assoc Inf Sci Technol 2016. [DOI: 10.1002/asi.23715] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shelagh K. Genuis
- School of Public Health; University of Alberta; 3-094 ECHA, 11405 87 Avenue Edmonton AB T6G 1C9 Canada
| | - Jenny Bronstein
- Department of Information Science; Bar-Ilan University; Ramat Gan 52900 Israel
| |
Collapse
|
45
|
Dey M, Reavley NJ, Jorm AF. Young people's difficulty in talking to others about mental health problems: An analysis of time trends in Switzerland. Psychiatry Res 2016; 237:159-65. [PMID: 26826898 DOI: 10.1016/j.psychres.2016.01.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 09/29/2015] [Accepted: 01/21/2016] [Indexed: 11/28/2022]
Abstract
The article aimed to analyse time trends regarding young people's willingness to talk about mental health problems. Data on 16,774 participants (16-20-year olds) of the 'Swiss Multicentre Adolescent Survey on Health' (SMASH) were analysed. The survey was conducted in 1992/93 and in 2002. Logistic regression analyses were conducted to identify predictors associated with the self-reported willingness of youth to talk about mental health problems with adults (other than parents), friends or no one. Socio-demographic characteristics were used as covariates. These analyses were first carried out for the total sample and, in a second step, stratified by suicidality of the participants. The percentage of participants who would talk about mental health problems with adults or friends increased between 1992/93 and 2002, while the percentage of those who would not talk about such problems decreased. This pattern was confirmed in the stratified analyses (i.e., for suicidal and non-suicidal individuals). Hence, Swiss youth seem to have less difficulty in talking with others about mental health problems than previous cohorts. This trend towards increased disclosure may have implications for claims that the prevalence of mental health problems has increased in recent decades.
Collapse
Affiliation(s)
- Michelle Dey
- Population Mental Health Group, University of Melbourne, Melbourne, Australia.
| | - Nicola Jane Reavley
- Population Mental Health Group, University of Melbourne, Melbourne, Australia
| | | |
Collapse
|
46
|
Hasson-Ohayon I, Kravetz S, Lysaker PH. The Special Challenges of Psychotherapy with Persons with Psychosis: Intersubjective Metacognitive Model of Agreement and Shared Meaning. Clin Psychol Psychother 2016; 24:428-440. [PMID: 26987691 DOI: 10.1002/cpp.2012] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 12/15/2015] [Accepted: 02/16/2016] [Indexed: 01/28/2023]
Abstract
Agreement between client and therapist is an essential part of the therapeutic alliance. While there are general challenges to the creation of agreement and shared meaning in all psychotherapies, there are specific challenges while working with persons with psychosis. These challenges include the different narratives of the client and the therapist with regard to their roles and the description of the condition or problem, as well as possible stigmatic views and theoretical bias. Here we present a metacognitive intersubjective model as a framework for the understanding and resolutions of these challenges. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE Goal consensus, agreement and shared meaning are essential for a collaborative process and positive outcome in psychotherapy. Challenges to psychotherapy with persons with psychosis include the different narratives of the client and the therapist with regard to their roles and the description of the condition or problem, as well as possible stigmatic views and theoretical bias. In the intersubjective exchange, the concepts of metacognition and empathy can act as a framework for navigating between the possible challenges and the desired shared meaning and agreement.
Collapse
Affiliation(s)
| | - Shlomo Kravetz
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Paul H Lysaker
- Department of Psychiatry, Roudebush VA Medical Center and the Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
47
|
Sampasa-Kanyinga H, Lewis RF. Frequent Use of Social Networking Sites Is Associated with Poor Psychological Functioning Among Children and Adolescents. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2016; 18:380-5. [PMID: 26167836 DOI: 10.1089/cyber.2015.0055] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Social networking sites (SNSs) have gained substantial popularity among youth in recent years. However, the relationship between the use of these Web-based platforms and mental health problems in children and adolescents is unclear. This study investigated the association between time spent on SNSs and unmet need for mental health support, poor self-rated mental health, and reports of psychological distress and suicidal ideation in a representative sample of middle and high school children in Ottawa, Canada. Data for this study were based on 753 students (55% female; Mage=14.1 years) in grades 7-12 derived from the 2013 Ontario Student Drug Use and Health Survey. Multinomial logistic regression was used to examine the associations between mental health variables and time spent using SNSs. Overall, 25.2% of students reported using SNSs for more than 2 hours every day, 54.3% reported using SNSs for 2 hours or less every day, and 20.5% reported infrequent or no use of SNSs. Students who reported unmet need for mental health support were more likely to report using SNSs for more than 2 hours every day than those with no identified unmet need for mental health support. Daily SNS use of more than 2 hours was also independently associated with poor self-rating of mental health and experiences of high levels of psychological distress and suicidal ideation. The findings suggest that students with poor mental health may be greater users of SNSs. These results indicate an opportunity to enhance the presence of health service providers on SNSs in order to provide support to youth.
Collapse
Affiliation(s)
| | - Rosamund F Lewis
- Department of Epidemiology, Ottawa Public Health , Ottawa, Canada
| |
Collapse
|
48
|
Radovic A, Reynolds K, McCauley HL, Sucato GS, Stein BD, Miller E. Parents' Role in Adolescent Depression Care: Primary Care Provider Perspectives. J Pediatr 2015; 167:911-8. [PMID: 26143382 PMCID: PMC4586359 DOI: 10.1016/j.jpeds.2015.05.049] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 04/09/2015] [Accepted: 05/26/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To understand how primary care providers (PCPs) perceive barriers to adolescent depression care to inform strategies to increase treatment engagement. STUDY DESIGN We conducted semistructured interviews with 15 PCPs recruited from community pediatric offices with access to integrated behavioral health services (ie, low system-level barriers to care) who participated in a larger study on treating adolescent depression. Interviews addressed PCP perceptions of barriers to adolescents' uptake of care for depression. Interviews were audiorecorded, transcribed, and coded for key themes. RESULTS Although PCPs mentioned several adolescent barriers to care, they thought parents played a critical role in assisting adolescents in accessing mental health services. Important aspects of the parental role in accessing treatment included transportation, financial support, and social support. PCPs perceived that parental unwillingness to accept the depression diagnosis, family dysfunction, and trauma were common barriers. PCPs contrasted this with examples of good family support they believed would enable adolescents to attend follow-up appointments and have a "life coach" at home to help monitor for side effects and watch for increased suicidality when starting antidepressants. CONCLUSIONS In this PCP population, which had enhanced access to mental health specialists, PCPs primarily reported attitudinal barriers to adolescent depression treatment, focusing mainly on perceived parent barriers. The results of these qualitative interviews provide a framework for understanding PCP perceptions of parental barriers to care, identifying that addressing complex parental barriers to care may be important for future interventions.
Collapse
Affiliation(s)
- Ana Radovic
- Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine,Department of Pediatrics, University of Pittsburgh School of Medicine
| | - Kerry Reynolds
- RAND Corporation, University of Pittsburgh School of Medicine
| | - Heather L. McCauley
- Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine,Department of Pediatrics, University of Pittsburgh School of Medicine
| | - Gina S. Sucato
- Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine,Department of Pediatrics, University of Pittsburgh School of Medicine,Group Health, University of Pittsburgh School of Medicine
| | - Bradley D. Stein
- RAND Corporation, University of Pittsburgh School of Medicine,Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Elizabeth Miller
- Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine,Department of Pediatrics, University of Pittsburgh School of Medicine
| |
Collapse
|
49
|
Hargreaves DS, Elliott MN, Viner RM, Richmond TK, Schuster MA. Unmet Health Care Need in US Adolescents and Adult Health Outcomes. Pediatrics 2015; 136:513-20. [PMID: 26283778 DOI: 10.1542/peds.2015-0237] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Adolescence is a formative period when health care services have a unique opportunity to influence later health outcomes. Unmet health care need in adolescence is known to be associated with poor contemporaneous health outcomes; it is unknown whether it predicts poor adult health outcomes. METHODS We used nationally representative data from 14 800 subjects who participated in Wave I (mean age: 15.9 years [1994/1995]) and Wave IV (mean age: 29.6 years [2008]) of the National Longitudinal Study of Adolescent to Adult Health. Logistic regression models were used to estimate the association between unmet health care need in adolescence and 5 self-reported measures of adult health (fair/poor general health, functional impairment, time off work/school, depressive symptoms, and suicidal ideation). Models were adjusted for baseline health, insurance category, age, gender, race/ethnicity, household income, and parental education. RESULTS Unmet health care need was reported by 19.2% of adolescents and predicted worse adult health: fair/poor general health (adjusted odds ratio [aOR]: 1.27 [95% confidence interval (CI): 1.00-1.60]); functional impairment (aOR: 1.52 [95% CI: 1.23-1.87]); depressive symptoms (aOR: 1.36 [95% CI: 1.13-1.64]); and suicidal ideation (aOR: 1.30 [95% CI: 1.03-1.68]). There was no significant association between unmet health care need and time off work/school (aOR: 1.13 [95% CI: 0.93-1.36]). Cost barriers accounted for only 14.8% of unmet health care need. The reason for unmet need was not significantly related to the likelihood of poor adult health outcomes. CONCLUSIONS Reported unmet health care need in adolescence is common and is an independent predictor of poor adult health. Strategies to reduce unmet adolescent need should address health engagement and care quality, as well as cost barriers to accessing services.
Collapse
Affiliation(s)
- Dougal S Hargreaves
- Division of General Pediatrics, Department of Medicine, and Population, Policy and Practice Programme, UCL Institute of Child Health, London, United Kingdom;
| | | | - Russell M Viner
- Population, Policy and Practice Programme, UCL Institute of Child Health, London, United Kingdom
| | - Tracy K Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Mark A Schuster
- Division of General Pediatrics, Department of Medicine, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
50
|
Joshi SV, Hartley SN, Kessler M, Barstead M. School-based suicide prevention: content, process, and the role of trusted adults and peers. Child Adolesc Psychiatr Clin N Am 2015; 24:353-70. [PMID: 25773329 DOI: 10.1016/j.chc.2014.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Suicide is a leading cause of preventable death in youth, and numerous curricula and other prevention and intervention programs have been developed in the last 15 years. Comprehensive suicide prevention planning should include the 4 components of health promotion, prevention/education, intervention, and postvention. School-based suicide prevention and mental health education programs have become more common as an efficient and cost-effective way to reach youth. Process considerations that are based on the principles of therapeutic engagement with patients and families can provide mental health professionals with strategies that can assist education professionals, students, and the larger school community simultaneously.
Collapse
Affiliation(s)
- Shashank V Joshi
- Lucile Packard Children's Hospital at Stanford University, Palo Alto, CA, USA.
| | - Samantha N Hartley
- School Mental Health Team, Lucile Packard Children's Hospital at Stanford University, 401 Quarry Road, Stanford, CA 94305, USA
| | - Moira Kessler
- Lucile Packard Children's Hospital at Stanford University, Palo Alto, CA, USA
| | - Maura Barstead
- Lucile Packard Children's Hospital at Stanford University, Palo Alto, CA, USA
| |
Collapse
|