Unmet depression information needs in the community

Validity and reliability of the Depression Information Needs Scale among the Iranian general population

Introduction

The prevalence of depression in the community is high. Therefore, it is necessary to examine the information needs on depression in the community. This cross-sectional study aimed to translate and evaluate the psychometric properties of the Depression Information Needs Scale (DINS) among the general population.

Methods

The translation and assessment of the validity and reliability of the DINS were conducted from February 2022 to May 2023 in Gonabad, Iran. The inclusion criteria in this study were individuals 18 years or older, those living in Gonabad for 1 year or more, and participants who provided written informed consent. Sample sizes of 546 and 629 were used for the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. The reliability of the DINS was examined using three methods: McDonald's omega coefficient, test-retest reliability, and Cronbach's alpha coefficient.

Results

Most participants were women, had a bachelor's degree, and were married. The values of 0.959 for scale content validity index averaging (S-CVI/Ave) and 0.817 for content validity ratio (CVR) were calculated. In the EFA section, four factors with eigenvalues greater than 1 were extracted and explained 63.861% of the variance. Only two items were not placed in related or acceptable factors and were deleted. Finally, based on the results of the goodness-of-fit indexes (e.g., RMSEA = 0.074, CFI = 0.944, NFI = 0.930, and GFI = 0.911), the scale was approved with 18 items and 4 factors: lived experience (4 items), general (facts about depression) (6 items), research and policies (4 items), and specific treatments (4 items). For all the DINS items, the McDonald's omega coefficient, Cronbach's alpha coefficient, and Intraclass Correlation Coefficient (ICC) were 0.953, 0.950, and 0.957, respectively.

Conclusion

The Persian version of the DINS was validated with 18 items and 4 factors, and this scale can be used to assess depression information needs in the general public and specific groups.

Do anxiety websites have the answers people are looking for?

OBJECTIVES AND METHODS: A wealth of online anxiety information exists but much of it is not evidence-based or well-balanced. This study evaluated anxiety websites (N = 20) on readability, quality, usability, visual design, and content.

RESULTS

Overall, websites were of reasonable quality but only half were considered understandable according to the PEMAT usability scale (70% cutoff value). The average reading level across websites was 11.2 (SMOG), which is higher than NIH recommended grade 6-7 level. Websites had variable design features and a trending association suggested websites with better design come up earlier in search results. The number of topics covered varied across websites and most did not adequately cover all topics of interest. Most websites included information about psychological and self-help treatments, how treatment works, and what treatment entails. The Top 5 websites were: (1) Anxiety BC, (2) ADAA, (3) Mind, (4) Beyond Blue, and (5) Web MD.

CONCLUSIONS

This is the first study to evaluate existing anxiety information websites based on the dimensions described above and their relationship to Google search results.

PRACTICE IMPLICATIONS

This study highlights the importance of considering several dimensions in developing mental health resources and provides direction for strategies to improve existing websites and/or develop new resources.

Mental health service use among those with depression: an exploration using Andersen's Behavioral Model of Health Service Use

BACKGROUND

Despite positive effects on prognosis, less than half of the people diagnosed with depression access mental health services. Knowledge of what promotes such service use is limited. There is dispute about whether the receipt of mental illness related information encourages or discourages service use among those with depression. Accurate service use models are needed to inform programs designed to facilitate service use by those who would benefit most. We examine the appropriateness of Andersen's Behavioral Model of Health Service Use in this context.

METHOD

Data from 451 adults identified through the Australian National Survey of Mental Health and Wellbeing as meeting International Classification of Diseases Ten (ICD-10) criteria for depression were used.

RESULTS

Confirmatory factor analysis failed to verify Andersen's model. Thus, an empirically derived service use model was developed using exploratory factor analysis and then structural equation modelling. Mental health need was the strongest predictor of service use and the model suggested the importance of social connectedness in promoting service use. Participants who had received helpful mental illness information were significantly more likely to have accessed mental health services than those who had not.

LIMITATIONS

The cross-sectional design and lack of replication preclude definitive conclusions CONCLUSION: Andersen's model is a useful starting point for the exploration of service use among people with depression. It is necessary, however, to develop specific models for this population.

Internet use by patients with bipolar disorder: Results from an international multisite survey

There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with a diagnosis of bipolar disorder in 17 countries completed a paper-based, anonymous survey. 81% of the patients used the Internet, a percentage similar to the general public. Older age, less education, and challenges in country telecommunications infrastructure and demographics decreased the odds of using the Internet. About 78% of the Internet users looked online for information on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage of patients with bipolar disorder who use the Internet is about the same as the general public. Other information sources remain important.

How a concerned family member, friend or member of the public can help someone with gambling problems: a Delphi consensus study

Background

Gambling is an enjoyable recreational pursuit for many people. However, for some it can lead to significant harms. The Delphi expert consensus method was used to develop guidelines for how a concerned family member, friend or member of the public can recognise the signs of gambling problems and support a person to change their gambling.

Methods

A systematic review of websites, books and journal articles was conducted to develop a questionnaire containing items about the knowledge, skills and actions needed for supporting a person with gambling problems. These items were rated over three rounds by two international expert panels comprising people with a lived experience of gambling problems and professionals who treat people with gambling problems or research gambling problems.

Results

A total of 66 experts (34 with lived experience and 32 professionals) rated 412 helping statements according to whether they thought the statements should be included in these guidelines. There were 234 helping statements that were endorsed by at least 80 % of members of both of the expert panels. These endorsed statements were used to develop the guidelines.

Conclusion

Two groups of experts were able to reach substantial consensus on how someone can recognise the signs of gambling problems and support a person to change.

Electronic supplementary material

The online version of this article (doi:10.1186/s40359-016-0110-y) contains supplementary material, which is available to authorized users.

How People with Depression Receive and Perceive Mental Illness Information: Findings from the Australian National Survey of Mental Health and Wellbeing

Despite the recognised importance of accurate mental illness information in help-seeking and improving recovery, little is known about the dissemination of such information to people with depression. With a view to informing effective communication to those most in need, we explored the extent to which mental illness information is received by people with depression, its perceived helpfulness and we characterise those who do not receive such information. Using data from the Australian National Survey of Mental Health and Wellbeing we observed that mental illness information was received by 54.7 % of those with depression. Most (76.7 %) found it helpful. Pamphlets were the most frequently cited source of information. People who did not receive information were less educated, unlikely to have accessed mental health services and unlikely to believe they had mental health needs. Targeted information campaigns which shape perceptions of need in relation to depression have the potential to reduce the resultant disease burden.

A questions-based investigation of consumer mental-health information

Despite the wealth of mental-health information available online to consumers, research has shown that the mental-health information needs of consumers are not being met. This study contributes to that research by soliciting consumer questions directly, categorizing them, analyzing their form, and assessing the extent to which they can be answered from a trusted and vetted source of online information, namely the website of the US National Institute of Mental Health (NIMH). As an alternative to surveys and analyses of online activity, this study shows how consumer questions provide new insight into what consumers do not know and how they express their information needs. The study crowdsourced 100 consumer questions through Amazon Inc.'s Mechanical Turk. Categorization of the questions shows broad agreement with earlier studies in terms of the content of consumer questions. It also suggests that consumers' grasp of mental health issues may be low compared to other health topics. The majority of the questions (74%) were simple in form, with the remainder being multi-part, multifaceted or narrative. Even simple-form questions could, however, have complex interpretations. Fifty four questions were submitted to the search box at the NIMH website. For 32 questions, no answer could be found in the top one to three documents returned. Inadequacies in the search and retrieval technology deployed at websites account for some of the failure to find answers. The nature of consumer questions in mental health also plays a role. A question that has a false presupposition is less likely to have an answer in trusted and vetted sources of information. Consumer questions are also expressed with a degree of specificity that makes the retrieval of relevant information difficult. The significance of this study is that it shows what an analysis of consumer mental-health questions can tell us about consumer information needs and it provides new insight into the difficulties facing consumers looking for answers to their questions in online resources.

Clinical Practice Models for the Use of E-Mental Health Resources in Primary Health Care by Health Professionals and Peer Workers: A Conceptual Framework

BACKGROUND

Research into e-mental health technologies has developed rapidly in the last 15 years. Applications such as Internet-delivered cognitive behavioral therapy interventions have accumulated considerable evidence of efficacy and some evidence of effectiveness. These programs have achieved similar outcomes to face-to-face therapy, while requiring much less clinician time. There is now burgeoning interest in integrating e-mental health resources with the broader mental health delivery system, particularly in primary care. The Australian government has supported the development and deployment of e-mental health resources, including websites that provide information, peer-to-peer support, automated self-help, and guided interventions. An ambitious national project has been commissioned to promote key resources to clinicians, to provide training in their use, and to evaluate the impact of promotion and training upon clinical practice. Previous initiatives have trained clinicians to use a single e-mental health program or a suite of related programs. In contrast, the current initiative will support community-based service providers to access a diverse array of resources developed and provided by many different groups.

OBJECTIVE

The objective of this paper was to develop a conceptual framework to support the use of e-mental health resources in routine primary health care. In particular, models of clinical practice are required to guide the use of the resources by diverse service providers and to inform professional training, promotional, and evaluation activities.

METHODS

Information about service providers' use of e-mental health resources was synthesized from a nonsystematic overview of published literature and the authors' experience of training primary care service providers.

RESULTS

Five emerging clinical practice models are proposed: (1) promotion; (2) case management; (3) coaching; (4) symptom-focused treatment; and (5) comprehensive therapy. We also consider the service provider skills required for each model and the ways that e-mental health resources might be used by general practice doctors and nurses, pharmacists, psychologists, social workers, occupational therapists, counselors, and peer workers.

CONCLUSIONS

The models proposed in the current paper provide a conceptual framework for policy-makers, researchers and clinicians interested in integrating e-mental health resources into primary care. Research is needed to establish the safety and effectiveness of the models in routine care and the best ways to support their implementation.