Does self-stigma reduce the probability of seeking mental health information?

Patient-reported experience measures (PREMs) in outpatient psychiatry - is there an association to perceived discrimination and devaluation?

Patient-Reported Experience Measures (PREMs) are gaining significance in the field of psychiatry, with patient satisfaction being a key measure. However, it is unclear if patient satisfaction in psychiatry is influenced by variables outside the treatment setting. This brief report thus examines the possible impact of perceived discrimination and devaluation (PDD) on patient satisfaction in the psychiatric outpatient setting. Data from 1,126 individuals who were undergoing or had recently completed treatment at 15 outpatient centers of the Psychiatric University Clinic in Basel, Switzerland, was analyzed. Patient satisfaction was assessed using the Münsterlingen Patient Satisfaction Questionnaire (MüPF), and perceived stigma was measured with the Perceived Discrimination Devaluation Scale. The results revealed a positive small effect size relationship between MüPF and PDD, suggesting that patients who perceived less stigma report higher treatment satisfaction. This relationship may affect most ratings, with the total MüPF score remaining relatively robust against this potential influence. Linear regression analysis indicated that a one-unit increase in PDD score could lead to a maximum change of 1.8 points on the 7-point Likert scale for the MüPF item correlating highest with PDD and 0.4 points on the total MüPF score. These findings highlight the importance of considering perceived stigma when evaluating patient satisfaction with psychiatric outpatient treatment. Future research should investigate associations between stigma, patient satisfaction, treatment outcome, as well as other external factors that may influence patient satisfaction in psychiatric settings.

Counteracting sexual and reproductive health misperceptions: Investigating the roles of stigma, misinformation exposure, and information overload

OBJECTIVE

Sexual and reproductive health (SRH) misperceptions constitute a critical precursor to undesired health outcomes for women. Drawing on the model of stigma management communication and exposure effects, we aimed to investigate the underlying processes of SRH misperceptions.

METHODS

A nationwide survey was conducted via quota sampling with Chinese women (N = 1000). Structural equation modeling with maximum likelihood estimation and 5000 bootstrapping resamples were used to test the hypotheses.

RESULTS

Stigma perceptions positively predicted information avoidance (β = 0.207, p < 0.001), which, in turn, was positively associated with misperceptions (β = 0.195, p < 0.001). Misinformation exposure significantly predicted misperceptions (β = 0.607, p < 0.001), and this relationship was mediated by information avoidance (β = 0.020, 95% CI [0.007, 0.040]). Moreover, information overload strengthened the relationship between misinformation exposure and information avoidance (β = 0.153, p < 0.001) as well as the relationship between misinformation exposure and misperceptions (β = 0.077, p = 0.006).

CONCLUSION

Stigma and misinformation exposure play prominent roles in the formation of SRH misperceptions. Information overload facilitates the misinformation-misperception transformation.

PRACTICE IMPLICATIONS

To counteract SRH misperceptions, health education should alleviate SRH stigma perceptions and strategically design messages to avoid information avoidance and overload.

Mental health problems and help-seeking behaviours of Syrian refugee adolescents: mediating role of self-stigma

BACKGROUND

Although common mental health problems have been widely studied with self-stigma, few studies have focused on the mediating effect of self-stigma in the relationship between mental health problems and help-seeking behaviours of refugee adolescents. Therefore, the purpose of the present study was to examine whether self-stigma mitigates the adverse effects of stress, anxiety, and depression symptoms on the help-seeking behaviours of Syrian adolescents living in Turkey.

METHODS

The participants of this study included 488 Syrian refugee adolescents (boys, 63.73%; girls, 3627%) living in Turkey. Participants completed the Depression Anxiety Stress Scale and General Help-Seeking Scale and Self-Stigma of Seeking Psychology Help Scale.

RESULTS

The findings revealed that stress (β = 0.19, p < 0.01), anxiety (β = 0.12, p < 0.05), and depression (β = 0.17, p < 0.01) had significant and positive predictive effects on self-stigma, but not on help-seeking behaviours. Also, self-stigma (β = -0.12, p < 0.01) had a significant negative predictive effect on help-seeking behaviours. With regard to the indirect effects, the findings showed that self-stigma fully mediated the associations between stress - help-seeking [effect = -0.05, 95% confidence interval (CI) -0.11 to -0.01], anxiety - help-seeking (effect = -0.04, 95% CI -0.09 to -0.01)], and depression - help-seeking (effect = -0.05, 95% CI -0.12 to -0.01).

CONCLUSIONS

Our findings highlight the potential negative effects of self-stigma on the help-seeking behaviours of Syrian refugee adolescents, both directly and indirectly. These results can be used to develop and implement effective and efficient interventions to address the unmet mental health needs of refugee adolescents.

Self-processing characteristics from first-person and third-person perspectives in individuals with social anxiety disorder: insights into negative bias

Background

As one of the most common psychological problems, social anxiety disorder (SAD) has lots of negative effects on the physical and mental development of individuals, such as decreasing the quality of interpersonal relationships, and even causing depression, suicidal ideation, etc., as well as leads individuals to generate mental illness stigma. The mental illness stigma that individuals perceive affects not only how they perceive themselves (first-person perspective) but also how they perceive others' appraisals of them (third-person perspective), which further exacerbates their anxiety symptoms.

Objective

The study aims to explore the self-processing characteristics of individuals with social anxiety disorder from the first-person perspective and the third-person perspective.

Methods

This study adopted the self-referential paradigm to conduct the recognition memory test on individuals with social anxiety disorder (30 participants in experiment 1) and individuals without social anxiety disorder (31 participants in experiment 2) in the two experiments.

Results

In experiment 1, the recognition rate of individuals with social anxiety disorder under the self-appraisals condition was significantly higher than that under the condition of appraisals on mothers; in the three conditions of self-appraisals, appraisals on mothers and mothers' reflected appraisals, the recognition rate of negative trait adjectives was significantly higher than that of positive trait adjectives. In experiment 2, there was no significant difference in recognition rate of individuals without social anxiety disorder under the three conditions, and the recognition rate of positive trait adjectives was significantly higher than that of negative trait adjectives under the three conditions.

Conclusion

Individuals with social anxiety disorder have a negative bias in self-processing and are more likely to focus on self-information, which is different from the self-positive bias of individuals without social anxiety disorder. This study can be beneficial to know the self-cognitive characteristics of individuals with social anxiety disorder, help them get rid of negative cognitive patterns, and remove the mental illness stigma.

Attitudes of Emergency Nurses toward Clients with Mental Illness: A Descriptive Correlational Study in a Nationwide U.S. Sample

Introduction: Individuals with mental illness often experience stigma from healthcare professionals, including emergency nurses. The purpose of this study was to identify personal and professional attributes of emergency nurses that may be related to their level of stigma toward people with mental illness in the U.S. Methods: Secondary analysis of a cross-sectional study to analyze emergency nurses' characteristics against their perceptions of stigma toward mental illness as measured by the Mental Illness: Clinicians' Attitudes Scale-4 (MICA v4). Data analyses consisted of descriptive statistics; stepwise linear regression; and analysis of the internal consistency of the MICA v4 in the current sample. Results: The mean MICA v4 scores for this sample were 53.4. The linear regression analysis revealed a significant model explaining 23.5% of the variance of MICA v4 scores (F[34] = 6.4, p < 0.001, R2 = 0.235). Many attributes were found to have a strong association with lower stigmatizing attitudes. Discussion: The results of this study indicated high levels of stigma toward individuals with mental illness. Findings from this study can inform nursing education and research, and ultimately improve the health outcomes of individuals with mental illness.

Assessing Underutilization of Mental Health Resources at a Historically Black College and University (HBCU)

Objective

In 2018, a survey was conducted with students on a Historically Black College and University (HBCU) campus that showed a significant lack of utilization of both on and off campus mental health resources. The primary outcome of this survey is to evaluate lack of utilization of mental health resources at an HBCU to effectively promote student mental wellness.

Methods

A short electronic survey was administered to students to assess underutilization.

Results

Subjects were predominately African American (60.24%) and female (85.53%). Of the 159 surveys completed, 13 responded they have used on campus mental health resources. Approximately 61.5% (8/13) are satisfied or very satisfied with the services. 29 responded they have used off campus mental health resources. Approximately 41.4% (12/29) are satisfied or very satisfied with the services. 62 (39%) responded that time constraint was a barrier faced in utilizing mental health resources. 60 (38%) responded that they did not feel that mental health resources were currently needed. 40 (25%) responded that they were not aware of mental health resources available. There is a significant association between classification and comfort level continuing to utilize mental health resources on or off campus (p = 0.02).

Conclusions

There are multiple barriers that have attributed to the underutilization of mental health resources. According to the results of this survey, the majority of students lacked time to utilize or denied need for any mental health resources. These results will allow for an opportunity to improve utilization of both on and off campus mental health resources.

Increasing resiliency and reducing mental illness stigma in post-secondary students: A meta-analytic evaluation of the inquiring mind program

Objective: Worsening student mental health, along with more complex mental illness presentation and increased access to campus mental health services, has led to a mental health "crisis" on campuses. One way to address student mental health needs may be through mental health programs which have been found to increase resiliency and help-seeking, and reduce stigma. Participants: The effectiveness of The Inquiring Mind (TIM), a mental health promotion and mental illness stigma reduction program, was examined in 810 students from 16 Canadian post-secondary institutions. Methods and Results: Using a meta-analytic approach, TIM improved resiliency and decreased stigmatizing attitudes from pre to post, with medium effect sizes (d > .50). Analyses with those that completed the follow-up (about one-third of the sample) showed that effects were mostly retained at three months. Other outcomes also point to the program's effectiveness. Conclusion: TIM appears to be an effective program for post-secondary students. However, additional research, including randomized control trials, is needed to address study limitations.

Barriers and facilitators affecting treatment uptake behaviours for patients with eating disorders: A systematic review synthesising patient, caregiver and clinician perspectives

OBJECTIVE

A significant treatment gap exists between persons affected by eating disorders (ED), and those engaging with treatment services. This systematic review aims to provide a thorough understanding of the barriers and facilitators affecting eating disorder treatment engagement, including a synthesis of the perspectives of patients, caregivers and healthcare professionals.

METHOD

This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were retrieved from three databases (PubMed, PsycInfo, Web of Science) and were screened and assessed independently by two raters. A thematic analysis was completed to determine the key barriers and facilitators reported by the included studies.

RESULTS

A total of 73 studies were included. From these studies, 12 barriers and 13 facilitators were identified. Patients reported stigma, shame and guilt as the most prominent barrier affecting their engagement with treatment services. Meanwhile, caregivers and healthcare professionals reported a lack of eating disorder knowledge of clinicians as the most important barrier. Positive social support was cited as the most prominent facilitator to promote help-seeking.

DISCUSSION

Patients, caregivers and healthcare professionals experience a variety of barriers and facilitators to treatment uptake for ED. Interventions addressing barriers and facilitators could increase treatment engagement, including anti-stigma campaigns and positive peer-support interventions.

Investıgatıon in to psychometric properties of self stigma scale by seeking psychological help in adolescent students

BACKGROUND

Stigmatization and help seeking are the one of the most important concepts of preventive interventions and mental health promotion in adolescent.

METHODS

This study is in descriptive, correlational and methodological design. The sample of the study consisted of 250 volunteer students studying in a total of six schools. The Self Stigma Scale in Seeking Psychological Help was used as a data collection tool. Data were evaluated with content validity index based on expert opinion, exploratory and confirmatory factor analysis, Cronbach's Alpha coefficient.

FINDINGS

Factor loadings explained 52% of the total variance in the two sub-dimensions. The KMO value was determined as 0.76 and the sample was found to be sufficient. The Cronbach's alpha coefficient of the entire scale was determined as.74. The alpha values of the sub-dimensions were determined as 0.76 and 0.74, respectively. In both exploratory and confirmatory factor analysis, all factor loads are >0.30. In confirmatory factor analysis, all fit indices were found to be >0.80 and the RMSEA value was determined as 0.067.

CONCLUSIONS

The results of the study revealed that it is a valid and reliable measurement tool that can be used to evaluate the level of self-stigma in seeking psychological help in adolescents.

PRACTICE IMPLICATIONS

It is recommended that scale will be a guide in protective and preventive studies for researchers and school nurses working with students.

Experiencing (Shared) Decision Making: Results from a Qualitative Study of People with Mental Illness and Their Family Members

(1) Background: There is a fundamental shift in healthcare toward shared decision making (SDM). This study explores SDM from the perspective of individuals affected by mental illness and their family members and investigates factors which promote and hinder the process. (2) Methods: We conducted N = 15 telephone interviews (n = 4 adults affected by mental illness, n = 5 family members, n = 6 both applicable, the majority reporting experiences with affective and anxiety disorders). Data were recorded, transcribed, and analyzed according to procedures established by Mayring. (3) Results: Individuals affected by mental illness and their family members have a strong desire to be involved in treatment decisions and to participate in finding a diagnosis. Often these stakeholders are denied the opportunity to participate; sometimes enabling behaviors impede participation. The stigmatization of mental illnesses is a major barrier. There are also structural barriers to SDM within the healthcare system. Peer support, self-help associations, and psychosocial counseling services are important to empowering individuals and promoting SDM. (4) Conclusions: SDM has the potential to improve the quality of mental healthcare. Barriers can be mitigated and new approaches for interventions in the psychiatric sector have been identified. This study has also shown the importance of understanding SDM as a process that should begin at the diagnostic phase.

Patients' acceptance of explanatory models for persistent somatic symptoms: A qualitative analysis within the HERMES study

OBJECTIVE

The aim of this qualitative study was to provide an in-depth analysis of participants' experiences with video-animated explanatory models developed within the three-arm randomized controlled HERMES study ('Helpful explanatory models for somatic symptoms') and suggestions for further intervention improvement.

METHODS

Semi-structured qualitative interviews were conducted with psychosomatic outpatients with persistent somatic symptoms (PSS) after they were randomized to view one of three psychoeducational videos on a tablet computer: a) an explanatory model without personalization or b) an explanatory model with personalization in the two experimental groups or c) PSS guidelines without an explanatory model in the control group. Qualitative interviews were audiotaped, transcribed and analyzed applying thematic analysis.

RESULTS

Seventy-five patients with PSS were allocated to the study arms, mean duration of interviews was 8.19 min (SD = 3.19, range 4.02-19.49 min). Although all participants gave positive feedback regardless of their allocated study arm, those in the explanatory model without and with personalization groups were especially likely to rate the psychoeducational interventions as helpful. Results highlighted previous illness course, symptom perceptions and patient characteristics as key factors related to patients' response to the video interventions and optimal personalization of the explanatory model.

CONCLUSION

The present study not only demonstrated the acceptance of all three psychoeducational interventions developed within the HERMES study, but also provided valuable insights into potential key factors that may increase their impact and potential starting points for tailored psychoeducation in patients with PSS.

Understanding and Fostering Mental Health and Well-Being among University Faculty: A Narrative Review

In recent years, there has been increasing recognition of mental health concerns in academia, with stress, burnout, anxiety, and depression being reported among faculty members. The demanding work environment, the need to balance personal and professional duties, and the constant pressure of productivity while navigating multiple tasks of teaching, research, mentorship, professional development, and service all impact the mental health and overall well-being of faculty. Higher education institutions have structurally changed as has the research landscape. These changes as well as faculty-specific and student-specific factors coupled to the effect of the COVID-19 pandemic have led to profound effects on the mental health of academics. This paper is a narrative review of the pertinent literature describing faculty mental health and well-being. It summarizes the available evidence on factors influencing faculty mental health and shows the prevalence of anxiety, depression, stress, and burnout among faculty from various academic fields and along the whole academic ladder. Using a suggested framework that collates the efforts of leaders and faculty, the paper concludes by exploring strategies that promote work-life balance among academics and suggesting effective interventions to improve their mental health outcomes.

The role of psychological distress, stigma and coping strategies on help-seeking intentions in a sample of Italian college students

BACKGROUND

Mental health issues are common among university students, but the latter are unlikely to seek professional help even when mental health services are available. Coping strategies, stigma and psychological distress are often considered as factors that can affect help-seeking intentions in university students.

METHODS

This study aimed to determine the role of coping strategies, stigma and psychological distress on the intentions to seek professional help for psychological problems. All students (N = 13,886) from an Italian medium-sized university were asked to participate in a multidimensional online survey and 3754 (27.1%) agreed to participate. A Structural Equation Modelling approach was applied to explore the simultaneous direct and indirect effects of distress, stigma and coping strategies on professional help-seeking intentions.

RESULTS

Results showed that students were not very likely to seek professional help and, through the Structural Equation Model, psychological distress was found to be positively correlated with coping strategies, which in turn was negatively associated with the stigma of seeking help. The latter was negatively associated with professional help-seeking intentions. These effects suggest that students with significant psychological distress use coping strategies to face the stigma of seeking help: the lower the stigma of seeking help, the higher the chance of developing intentions to seek professional help.

CONCLUSIONS

This study suggests the importance of implementing programs to encourage college students to seek help, including measures that foster a stigma-free environment, reduce psychological distress and promote the use of adaptive coping strategies. Interventions should be focused firstly on self-stigma and secondly on perceived stigma, taking into consideration the level of psychological distress and social stereotypes associated with mental disorders and help seeking behaviours. Programs about coping are also essential and should focus on promoting emotion-focused strategies and problem-focused strategies.

Self- and surrogate-seeking of information about mental health and illness in Germany

BACKGROUND

Seeking information on mental health issues - both for oneself and on behalf of others (so-called surrogate-seeking) - is a critical early step in dealing with mental illness and known to impede stigmatizing attitudes and foster help-seeking. Yet, knowledge about mental health tends to be insufficient worldwide. Therefore, it is necessary to better understand the search for mental health information and examine the factors that are positively associated with information-seeking.

METHOD

In a face-to-face survey in Germany (N = 1,522), we investigated the factors related to mental health information-seeking. The data was analyzed by means of a logistic regression model, in which we distinguished those searching information for themselves from so-called surrogate seekers, i.e., people who seek information on behalf of someone else.

RESULTS

Twenty-six percent of German adults in our sample have already searched for information on mental health, with the majority already having searched for information for others (73% of all seekers). Our findings indicate that individuals' proximity to people with mental health issues, including their own mental health treatment experience (Cramer's V = .429, p < .001), education (Cramer's V = .184, p < .001), and desire for social distance from the affected people (F [1, 1516] = 73.580, p < .001, η² = .046), play an important role in mental health information-seeking. The patterns of sociodemographic and proximity factors hereby differ between self-seekers and surrogate-seekers.

CONCLUSIONS

Our study provides insights into the public's mental health information orientation. The findings may particularly guide strategies to improve mental health awareness and fill knowledge gaps in supporting informed decision-making and reducing stigma. Surrogate seekers appear to be an important and distinctive target group for mental health information provision. Depending on whether one wants to promote surrogate- or self-seeking seekers, different target groups and determinants should be addressed.

A qualitative assessment of mental health literacy and help-seeking behaviors among male college students

Although the number of students receiving care from college counseling centers has increased, engaging male college students to seek help presents a unique challenge. This qualitative study explored mental health literacy and help-seeking behaviors among undergraduate college men. Semi-structured interviews (n = 26) based on three vignettes (anxiety, depression, stress) were employed to assess mental health literacy. Analysis revealed three general themes and associated sub-themes: (a) knowledge of signs and symptoms (physiological, behavioral, and emotional); (b) recommended help-seeking behaviors (do nothing, self-care, seek help); and (c) barriers to help-seeking (social stigma, self-stigma, masculinity). Findings present a triadic interplay between the person, help-seeking behavior, and environment. Future research should explore this dynamic relationship to inform interventions aimed at improving college male mental health help-seeking behavior.

Review: School-based mental health literacy interventions to promote help-seeking - a systematic review

BACKGROUND

School-based mental health literacy interventions aim to prevent mental disorders and promote mental wellbeing through improving the knowledge and understanding of mental health, mental disorders, and reducing stigma. Evidence suggests that good mental health literacy helps young people recognise mental health difficulties in themselves and in others, and seek help for mental health problems. Improved help-seeking can allow for early intervention, which prevents the progression of mental disorders and ultimately reduces the burden of mental disorders. The aim of this review is to identify and synthesise evidence on the effectiveness of school-based mental health literacy interventions in improving help-seeking outcomes.

METHODS

We searched MEDLINE, Embase, PsycINFO, ERIC, Child Development and Adolescent Studies, British Education Index and ASSIA (June 2020). Additional searches were conducted a year later to identify any new publications (June 2021). We included randomised controlled trials (RCTs) assessing the effectiveness or cost-effectiveness of school-based interventions to improve help-seeking outcomes for children and young people aged 4-18 years. Included studies were critically appraised.

RESULTS

We identified 11 studies investigating help-seeking outcomes of school-based mental health literacy interventions including a total of 7066 participants from 66 secondary schools. Overall, there is no strong evidence for the effectiveness of school-based mental health literacy interventions in improving help-seeking outcomes, including general attitudes towards help-seeking, personal intentions to seek help, knowledge of when and how to seek help for mental disorders, confidence to seek help, and actual help-seeking behaviours. None of the studies investigated the cost-effectiveness of the interventions.

CONCLUSION

The lack of standardised measures with established reliability and validity for help-seeking outcomes, and the incomprehensive consideration of the multi-faceted concepts of MH literacy and MH stigma have contributed to the scarcity of evidence for the effectiveness. Future research should focus on developing standardised measurement tools and including economic evaluations to understand pragmatic and financial aspects of school-based mental health literacy interventions.

Drivers of shared decision making in inpatient psychiatry: An exploratory survey of patients' and multi-disciplinary team members' perspectives

OBJECTIVE

To assess the prevalence and predictors of Shared Decision Making (SDM) in an adult, inpatient psychiatric setting.

METHOD

Multi-disciplinary clinician focus groups and patient pre-testing informed the development of a survey on 4 SDM and 11 factors hypothesized to interfere with SDM. The survey was administered to 89 adult inpatients (80% response rate) and their treatment team psychiatrists, nurses, and social workers (n = 338 ratings, 95% response rate). Group differences and predictors were estimated using t and F-tests.

RESULTS

Patients' mean SDM score (n = 64, standardized Cronbach alpha = 0.858) was 3.35 ± 1.13 (5 = highest agreement), and correlated with overall satisfaction with care (n = 61, r = 0.399, p = 0.001). Patients' disagreement with clinician's diagnosis (44% of patients) correlated with lower SDM ratings by patients (t = 2.55, df = 62, p = 0.013) and by clinicians (t = 2.99, df = 69, p = 0.004). Psychotic diagnoses were not a significant determining factor for SDM. Overall, clinicians rated SDM more favorably than patients (t = -5.43, df = 63, p < 0.001), with nurses and social workers rating SDM higher than physicians (p < 0.001).

CONCLUSIONS

Diagnostic agreement / disagreement is a key predictor of SDM for patients and clinicians, while presence of psychosis is not. SDM was rated higher by clinicians than patients. SDM ratings vary significantly between clinical disciplines.

Synthesis of the Evidence on What Works for Whom in Telemental Health: Rapid Realist Review

BACKGROUND

Telemental health (delivering mental health care via video calls, telephone calls, or SMS text messages) is becoming increasingly widespread. Telemental health appears to be useful and effective in providing care to some service users in some settings, especially during an emergency restricting face-to-face contact, such as the COVID-19 pandemic. However, important limitations have been reported, and telemental health implementation risks the reinforcement of pre-existing inequalities in service provision. If it is to be widely incorporated into routine care, a clear understanding is needed of when and for whom it is an acceptable and effective approach and when face-to-face care is needed.

OBJECTIVE

This rapid realist review aims to develop a theory about which telemental health approaches work (or do not work), for whom, in which contexts, and through what mechanisms.

METHODS

Rapid realist reviewing involves synthesizing relevant evidence and stakeholder expertise to allow timely development of context-mechanism-outcome (CMO) configurations in areas where evidence is urgently needed to inform policy and practice. The CMO configurations encapsulate theories about what works for whom and by what mechanisms. Sources included eligible papers from 2 previous systematic reviews conducted by our team on telemental health; an updated search using the strategy from these reviews; a call for relevant evidence, including "gray literature," to the public and key experts; and website searches of relevant voluntary and statutory organizations. CMO configurations formulated from these sources were iteratively refined, including through discussions with an expert reference group, including researchers with relevant lived experience and frontline clinicians, and consultation with experts focused on three priority groups: children and young people, users of inpatient and crisis care services, and digitally excluded groups.

RESULTS

A total of 108 scientific and gray literature sources were included. From our initial CMO configurations, we derived 30 overarching CMO configurations within four domains: connecting effectively; flexibility and personalization; safety, privacy, and confidentiality; and therapeutic quality and relationship. Reports and stakeholder input emphasized the importance of personal choice, privacy and safety, and therapeutic relationships in telemental health care. The review also identified particular service users likely to be disadvantaged by telemental health implementation and a need to ensure that face-to-face care of equivalent timeliness remains available. Mechanisms underlying the successful and unsuccessful application of telemental health are discussed.

CONCLUSIONS

Service user choice, privacy and safety, the ability to connect effectively, and fostering strong therapeutic relationships need to be prioritized in delivering telemental health care. Guidelines and strategies coproduced with service users and frontline staff are needed to optimize telemental health implementation in real-world settings.

TRIAL REGISTRATION

International Prospective Register of Systematic Reviews (PROSPERO); CRD42021260910; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021260910.

Effects of self-stereotype on older adults' self-integrity through the intervening effects of sense of coherence and empathy

Self-integrity plays a vital role in the psychological wellbeing of older adults. The present study investigated whether or not the confrontation with negative, self-stereotyped information leads to a deterioration of older adults' self-integrity. Additionally, the current study attempted to examine the mediating effects of sense of coherence and empathy on the relationship between self-stereotype and self-integrity. A total of 825 Chinese older adults aged 55 or above from Xi'an and Beijing were recruited as research participants. A self-stereotype scale, sense of coherence scale, interpersonal reactivity index and self-integrity scale were used. Results showed that self-stereotypes are negatively associated with sense of coherence, empathy and self-integrity. Furthermore, sense of coherence and empathy are positively associated with self-integrity and played important roles in mediating the relationship between self-stereotype and self-integrity. Findings of this study can contribute to an improved understanding of the mechanism of associations between self-stereotype and self-integrity in older adults. Lastly, results obtained can provide guidance for effectively improving older adults' self-integrity to limit the negative effects of self-stereotypes.

The mental health information needs of Chinese university students and their use of online resources: a holistic model

Purpose

This research aims to explore the nature of Chinese students' mental health information needs and to identify the online resources they use to meet those needs.

Design/methodology/approach

Data was collected from three Chinese research-oriented universities using semi-structured interviews and a survey. Twenty-five university students with varied backgrounds were selected for semi-structured interviews to explore the triggers and nature of their needs. Then, printed and online questionnaires were distributed to undergraduate and postgraduate students and 541 valid responses were processed for descriptive statistical analysis and variance analysis.

Findings

The following findings were incurred. First, the triggers of university students' mental health information needs mainly are mental health being in the news, personal interest in gaining mental health knowledge, mental health issues, required formal learning and preparation for mental health counselling. Second, eleven types of information are used, with an emphasis on employment pressure, study stress and self-understanding. Third, mental health information needs differ with mental health status and some social-demographic factors (including gender, urban or rural origin and educational stage). Fourth, information needs can be characterized as dynamic; complex and diverse but concentrated on a few types; ambiguous and hard for participants to define; private; stigmatized; self-dependent and substitutable. Fifth, Internet sources used to meet such needs are mainly search engines, Question and Answer platforms, public social media platforms. Finally, a model of mental health information needs was built based on the above findings to map the whole process from what triggers a need, to the content and characteristics of information need, and online resources used to meet those needs.

Practical implications

The paper provides suggestions for university mental health services in developing more tailored knowledge contents via effective delivery methods to meet diverse needs of student groups.

Originality/value

This research is novel in using empirical data to build a holistic model that captures the context and the nature of mental health information needs of university students.

Mental health stigma among college students: Test of an interactive online intervention

Objective: Young adults have low rates of help-seeking despite high rates of mental health problems, which relate to stigmatizing attitudes. Education as well as contact with people with mental health problems may improve stigmatization. The present pilot study tested the efficacy of an online interactive educational intervention that utilizes avatars depicting distressed individuals on stigmatizing attitudes toward mental illness and help-seeking. Participants and Methods: Eighty-five college student participants were assessed on self- and public-stigma as well as attitudes toward help-seeking and were randomly assigned to one of three conditions (intervention, control, post-test only). Results: Pre-post comparisons indicate that interactive programs may be an accessible and efficient means to reduce stigmatizing attitudes toward help-seeking among college students. Future studies should include follow-up assessments and measures of behavior and should consider individual differences. including personal mental health history.

The Stigma and Self-Stigma Scales for attitudes to mental health problems: Psychometric properties and its relationship to mental health problems and absenteeism

The Stigma and Self-Stigma scales (SASS) measure multiple aspects of stigmatic beliefs about mental health problems, including cognitive aspects of stigma towards others (Stigma to Others) and emotional stigma toward others (Social Distance), anticipated stigma by others, self-stigma, avoidant coping strategies, and help-seeking intentions, alongside an index of social desirability. The properties of the SASS were investigated by employees of a large UK government organization. With minor exceptions, each of the SASS scales had strong psychometric properties, good internal reliability, and test-retest reliability. Social Distance, Anticipated Stigma, Self-Stigma, and Avoidant Coping were all strongly associated with a lack of help-seeking for mental health problems. Similarly, Stigma to Others, Self-Stigma, and Avoidant Coping were all associated with current mental health problems. Finally, absenteeism from the workplace was found to be negatively related to Stigma to Others, and positively related to Avoidant Coping and Anticipated Stigma. In conclusion, the SASS was able to measure several different forms of stigma about mental health simultaneously in people both with and without a history of mental health problems. The SASS can be used to monitor changes in mental health attitudes outcomes following intervention programs to investigate stigmatic attitudes to mental health problems across different samples.

Mental Health of Czech University Psychology Students: Negative Mental Health Attitudes, Mental Health Shame and Self-Compassion

High rates of mental health problems are a growing concern in Czech higher education, negatively impacting students’ performance and wellbeing. Despite the serious nature of poor mental health, students often do not seek help because of negative attitudes and shame over mental health problems. Recent mental health research reports self-compassion is strongly associated with better mental health and reduced shame. However, relationships between those constructs remain to be evaluated among Czech students. This study aims to appraise the relationships between mental health problems, negative mental health attitudes, mental health shame, and self-compassion in this population. An opportunity sample of 119 psychology students from a Czech university completed questionnaires regarding these constructs. Correlation, regression, and path analyses were conducted. Mental health problems were positively associated with negative mental health attitudes and shame, and negatively associated with self-compassion. Self-compassion negatively predicted mental health problems, while negative attitudes and shame did not. Last, self-compassion fully mediated the negative attitudes-mental health problems relationship, and partially mediated the shame-mental health problems relationship. Findings suggest self-compassion is essential for mental health in Czech students and associated with negative mental health attitudes and mental health shame. Czech universities can benefit from incorporating self-compassion training into their curricula to protect students’ mental health.

Young People’s Coping Strategies When Dealing With Their Own and a Friend’s Symptoms of Poor Mental Health: A Qualitative Study

Young people struggle to seek help for their mental health, despite having different resources available. As the coping process is very complex, and elements such as trust and availability of resources have been said to influence it, this study aimed to understand how young people cope with their own or a friend’s symptoms of poor mental health. Eleven young people (13–15 years old) were interviewed. Thematic Analysis of the interviews showed that participants reported different coping strategies for dealing with their own hypothetical symptoms and those of a friend. Participants identified the social impact of experiencing symptoms of poor mental health and choice of resources as the main factors influencing their coping strategies. For their own symptoms, young people expressed concern about being judged and that they would only disclose to someone they trust. Participants would not disclose a friend’s symptoms because they did not want to break their trust. Finally, choice of resources was mainly influenced by the severity of symptoms being experienced, especially when it comes to asking for professional help. This study contributes to a better understanding of the different ways in which young people cope with their own symptoms and symptoms experienced by a friend.

Hide and seek – the role of personality, sense of coherence and experiential information in hidden information needs

Purpose

The aim of this study is to assess the impact of personality traits and sense of coherence (SOC) on concealing information needs out of shame. The study also investigates the link between concealed information needs and the use of experiential information for psychological wellbeing.

Design/methodology/approach

A Partial Least Square ‐ Structural Equation Modelling (PLS-SEM) approach is used to assess and analyse the proposed conceptual model, which is based on the responses of 412 upper secondary school students.

Findings

The findings reveal that personality traits not only have direct significant effects on concealing information needs but that their effects are also mediated by SOC. The positive relationship between concealed information needs and the use of experiential information is confirmed in the study.

Originality/value

This study is the first to show that personality and SOC influence concealing information needs. Two pathways are found. Firstly, negative emotionality and a low SOC lead to a heightened sense of shame. Secondly, introversion induces a more guarded behaviour. The study, moreover, quantitatively demonstrates a link between concealed information needs and the use of experiential information for psychological wellbeing.

Mental Health Information Seeking Online: A Google Trends Analysis of ADHD

Health information influences consumer decision making to seek, select, and utilize services. Online searching for mental health information is increasingly common, especially by adolescents and parents. We examined historical trends and factors that may influence population-level patterns in information seeking for attention-deficit/hyperactivity disorder (ADHD). We extracted Google Trends data from January 2004 to February 2020. Keywords included "ADHD," "ADHD treatment," "ADHD medication," and "ADHD therapy." We examined trends (systematic change over time) and seasonality (repeating pattern of change) via time-series analyses and graphics. We also used interrupted time-series analyses to examine the impact of celebrity and pharmaceutical events. Queries of "ADHD medication" increase, while queries for "ADHD therapy" remain relatively low despite a positive linear trend. Searches for "ADHD treatment" displayed a downward trend in more recent years. Analyses on seasonality revealed that holiday breaks coincided with a decrease in search interest, while post-break periods illustrated a rise, and the ADHD Awareness Month (October) coincided with a rise of public interest in all four search terms. Celebrity effects were more prominent in earlier years; the "Own It" pharmaceutical campaign may have increased ADHD awareness and the specificity of searches for "ADHD medication." The anonymous, accessible, and low-cost nature of seeking information online makes search engines like Google important sources of mental health information. Changing search patterns in response to seasonal, advocacy, and media events highlight internet-based opportunities for raising awareness and disseminating empirically supported information.

The Perceived Stigma Reduction Expressed by Young Adults in Response to Suicide Prevention Videos

Evidence indicates that stigma impedes an individual’s chance of seeking professional help for a mental health crisis. Commonly reported aggregate-level results for stigma-reduction efforts obfuscate how much stigma reduction is needed to incur a practically meaningful change within an individual, defined here as an attitudinal shift and openness towards seeking mental health for oneself and/or support for others. When basing conclusions and recommendations about stigma-reducing interventions on aggregate scales, it is unclear how much stigma reduction is needed to incur meaningful change within an individual. We explored the impact of reductions in stigma of help-seeking scores in response to an online suicide prevention video among young adults in the United States, using online surveys to collect qualitative and quantitative data. We compared mean changes in the stigma scores from pre- to post-test (video exposure) of 371 young U.S. adults using standard t-tests and individual level analysis. A separate thematic analysis of free-text responses was also conducted from a smaller, randomly-selected subgroup, capturing individuals’ attitudes towards help-seeking for mental health problems. Great attention was given to participants to ensure that they were in a campus setting where counseling services were available. Four main themes emerged: (1) small changes in stigma scores were associated with individual reports of meaningful reductions in their attitudes towards professional counseling; (2) increased empathy towards victims of suicide and other mental health problems sometimes indicated increased empathy for victims of suicide and decreased openness in professional help; (3) empathy towards victims sometimes took the form of increased scores and grief or sadness, possibly thwarting the potential for help-seeking; and (4) self-reports of decreased stigma were not always associated with increased openness towards help-seeking. Results also indicated that small stigma score charges, not meeting statistical significance, were often associated with increased openness towards seeking help. These findings, discovered using mixed-methods, contribute to the body of literature regarding stigma towards suicide and help-seeking by demonstrating deficits in the aggregate-only analysis of stigma-reducing interventions specifically aimed at suicide prevention. Such individuation in stigma experiences indicates that public education on how to reduce the stigma of help-seeking for suicide prevention needs to consider individual-level analyses for improving target populations. Recommendations for future research include additional studies prior to releasing suicide prevention videos to public forums where they may be seen by individuals without access to help.

Depression, stress and self-stigma towards seeking psychological help in veterinary students

Previous research indicates that the prevalence of depression among veterinarians and veterinary students is high. Although self-stigma in seeking psychological help is reportedly elevated in veterinary students, its impact on mental health has been largely unexplored. The aim of this study was to compare the levels of study-related stress, depression symptoms and self-stigma in veterinary students with those of non-veterinary students, and examine whether stress and self-stigma positively predicted depression symptoms in veterinary students. A total of 287 veterinary students and 317 non-veterinary students from Australian universities completed an online questionnaire measuring study-related stress, self-stigma and depression symptoms. Results showed that veterinary students reported significantly higher levels of stress and self-stigma than non-veterinary students, but there was no significant difference between veterinary and non-veterinary students in depression symptoms. Multiple regression analysis indicated that stress and self-stigma both predicted depression symptoms in veterinary students. These findings suggest that reducing stress and help-seeking self-stigma in veterinary students may be important in improving their wellbeing levels. These findings are important in developing a whole-of-career life course approach to understanding the professional and psychological experiences of veterinarians.

First-Person, Third-Person, or Bystander? Exploring the Persuasive Influence of Perspective in Mental Health Narratives

As evidence suggests that college students are particularly vulnerable to mental health distress and illness, guidance for designing messages that inspire help-seeking behavior is needed. The purpose of this study was to evaluate the influence of perspective of storytelling on health message involvement and persuasion. A controlled experiment (N= 430) compared the influence of online mental health narratives targeted to college students that featured a bystander perspective to those that used first- and third-person perspectives. Evidence suggests that the bystander perspective was more effective for producing persuasive outcomes, including mental health information recall and beliefs. Results also indicate that self-referencing mediated the effects of message involvement on outcomes across all message conditions. People with experience with mental illness became involved with and were influenced by mental health narratives in different ways.

Acceptability of an online relational intimacy and sexual enhancement (iRISE) intervention after breast cancer

The purpose of this study was to develop and evaluate an online relational intimacy and sexual enhancement (iRISE) intervention for couples experiencing sexual difficulties following breast cancer (BC). The acceptability of iRISE was evaluated using a single-arm, qualitative design, with 14 couples completing satisfaction surveys and posttreatment interviews. The intervention was found to be acceptable, as demonstrated by high satisfaction ratings and qualitative feedback regarding iRISE and its online delivery. Couples spoke about the helpfulness of iRISE and how the intervention improved their sexual relationship. The use of video conferencing (eTherapy) was widely accepted by participants, who highlighted several advantages of this modality. Overall, the results support the acceptability of this online psychosexual intervention for couples affected by BC. The empirical and theoretical basis for the design of iRISE along with findings from a qualitative analysis of couples' experiences of the intervention's helpfulness to them is discussed.

Helpful explanatory models for somatoform symptoms (HERMES): study protocol of a randomised mixed-methods pilot trial

INTRODUCTION

Persistent somatic symptoms (PSS) are common both in the general population and primary care. They are bothersome in terms of psychological and somatic symptom burden. Health professionals often struggle with communication, as there is a lack of scientifically supported explanatory models for PSS or a focus merely on somatic aspects of the complaints, which both frustrate patients' needs. The objective of the present study is therefore to develop a psychoeducational intervention based on a current evidence-based explanatory model, to examine its feasibility and form the basis for a large-scale randomised controlled trial.

METHODS AND ANALYSIS

In a randomised controlled mixed-methods pilot trial, 75 adult psychosomatic outpatients with PSS (duration of symptoms ≥6 months) and accompanying psychological (Somatic Symptom B-Criteria Scale total score ≥18) and somatic symptom burden (Patient Health Questionnaire-15 score >10) and no prior psychosomatic treatment will be eligible. Participants will be presented with either the explanatory model without (intervention group 1, n=25) or with elements of personalisation (intervention group 2, n=25). Participants in the control group (n=25) will receive information on current PSS guidelines. Participants will be blinded to group assignment and interventions will be shown on tablet computers at the outpatient clinic. After 1 month, qualitative follow-up telephone interviews will be conducted. As primary outcomes, mean changes in psychological and somatic symptom burden will quantitatively be compared between groups, respectively. Behavioural change mechanisms and feasibility of the three interventions will be evaluated using quantitative and qualitative measures.

ETHICS AND DISSEMINATION

Ethics approval has been granted by the medical ethics board of the Hamburg Medical Chamber (PV5653). Results from this study will be published in peer-reviewed journals and presented at national and international conferences.

TRIAL REGISTRATION NUMBER

DRKS00018803.

Addressing the Stigma Surrounding Serious Mental Illness in Adolescents: a Brief Intervention

Stigma in mental illness is a problem fueled by misrepresentation by the media and the assimilation of parent opinion, noted in those as young as six years old. Intervening in adolescence is critical given juxtaposition of increased judgement/fear of judgement and the onset of serious mental illness. This paper details the efforts of an intervention designed to specifically target the perception of dangerousness, social distancing, and use of stigmatizing language. A total of 124 high school freshman participated in the interactive presentation delivered over the course of a typical 40 min class period. An identical survey with a 5-point Likert scale was administered before and after to measure level of agreement with stigmatizing statements. Most participants reported prior exposure through the media (86.6%) and through conversations with family/friends (67.7%). Post intervention, improvement was seen in the perception of dangerousness (MD = 0.45, t = 4.435, p = <0.001), the need for social distancing (measure 1: MD = 0.148, t = 1.785, p = 0.039; measure 2: MD = 0.142, t = 1.773, p = 0.04), and understanding of the experience of those with serious mental illness (MD = 0.377, t = 3.378, p = <0.001). No significant difference was seen in terms of stigmatizing language use (MD = 0.114, t = 1.192, p = 0.118). This study supports the delivery of anti-stigma education to adolescents that avoids the biogenetic and contact approaches, embraces the continuum model of mental health, normalizes psychotic experiences, addresses dangerousness with data, identifies prominent figures with mental illness, and uses personalized statistics to demonstrate why this topic is of importance.

Mental health stigma among Middle Eastern adolescents: A protocol for a systematic review

WHAT IS KNOWN ON THE SUBJECT?: Four out of every five people with mental health disorders face stigma. Mental health and, consequently, mental health stigma are very common among youth living in the Middle East countries. Several studies have investigated mental health among adolescents in the Middle East, but studies on stigma are very scattered. There is no systematic review on stigma among adolescents with mental disorders across all the Middle East countries despite the common historical roots, similar cultural backgrounds, and recent widespread problems in the area. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper will aim to review and analyse the studies on stigma among adolescents with mental disorders in the Middle East countries, from different aspects such as the age rang, kind of stigma and risk factors of stigma. The study will cover studies on all kinds of stigma among Middle Eastern adolescents up to 18 years old published between 2000 and 2019. The study terms are generally focused on four categories: (a) kinds of Stigma, (b) Mental health problems, (c) Age range and (d) Region of study population. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Increasing understanding and awareness of different angles of mental health stigma among adolescents may be helpful for better coping with this challenge. Understanding the nature of stigma may give adolescents the ability of ignoring it and avoid starting self-stigma and/or stopping to seek help. ABSTRACT: Introduction Although many epidemiological and interventional investigations regarding improving mental health among youth in the Middle East have been performed, there is no systematic review specifically analysing the studies on stigma among adolescents with mental disorders (A-MDs) across all Middle East countries despite their common historical roots, similar cultural backgrounds, and recent widespread problems in the area. Purpose We will aim to systematically review and analyse the English language studies on stigma among A-MDs in the Middle East published between 2000 and 2019. Method The Web of Knowledge, Science Direct, PsycINFO and MEDLINE are electronic databases that will be included in this study. Furthermore, the bibliography lists of eligible articles will be manually searched for additional included articles. Descriptive statistics will be represented by mean score and standard deviation for continuous data and number/percentage for categorical data. Discussion This study may act as a resource for future studies attempting to assess and/or reduce stigma among children and adolescents with mental health issues specifically in the Middle East. Implications It is important for healthcare providers, including nursing professional, to improve their knowledge and vision towards stigma in their community. The outcomes of this study can be a shortcut reaching this information.

Perceived Effectiveness and Motivations for the Use of Web-Based Mental Health Programs: Qualitative Study

BACKGROUND

The prevalence of depression is high and has been stable despite increased treatment, research, and dissemination. People encounter barriers to seeking traditional mental health services, which could be mitigated by using web-based prevention methods.

OBJECTIVE

This study aims to understand what people at high risk for depression perceive as effective aspects of web-based mental health programs and what motivates people at high risk for depression to use web-based mental health programs.

METHODS

We conducted an inductive content analysis using telephone interview data from 77 participants at high risk for depression who were recruited from 2 randomized controlled trials (RCTs). Participants from the first RCT were working men who had been randomly assigned to 1 of the following 3 groups: control group, who had access to general depression information from a website called BroMatters; intervention group 1, who had access to the BroMatters website along with the associated BroHealth web-based mental health program; and intervention group 2, who had access to the BroMatters website, the BroHealth web-based mental health program, and telephone sessions with a life coach. Participants from the second RCT were men and women who had been assigned to the intervention group, who received access to the HardHat web-based mental health program, or the control group, who only received access to the HardHat web-based mental health program following completion of the RCT. Participants for this inductive content analysis study were recruited from the intervention groups in both RCTs. Two groups of participants (n=41 and n=20) were recruited from the BroHealth RCT, and a third group comprised 16 participants that were recruited from the HardHat RCT.

RESULTS

We generated four categories regarding the perceived effectiveness of web-based programs and five categories related to what motivates the use of web-based programs. Participants identified awareness, program medium and functionality, program content, and coaches as categories related to the effectiveness of the programs. Categories of motivators to use web-based programs included providing reminders or incentives, promotion of the programs, providing appropriate medium and functionality, appropriate content, and perceived need. The final category related to motivators reflects perceptions of participants who were either unsure about what motivates them or believed that there is no way to motivate use.

CONCLUSIONS

Conflicting evidence was obtained regarding the perceived effectiveness of aspects of the content and functionality of web-based programs. In general, web-based mental health programs were perceived to help increase mental health awareness, especially when it includes live access to a coach. However, the results also revealed that it is difficult to motivate people to begin using web-based mental health programs. Strategies that may motivate the use of such programs include perceived personal need, effective promotion, providing incentives and reminders, and improving functionality.

Recruiting breast cancer patients for mHealth research: Obstacles to clinic-based recruitment for a mobile phone app intervention study

BACKGROUND

Nearly half of newly diagnosed breast cancer patients will report clinically significant symptoms of depression and/or anxiety within the first year of diagnosis. Research on the trajectory of distress in cancer patients suggests that targeting patients early in the diagnostic pathway could be particularly impactful. Given the recent rise of smartphone adoption, apps are a convenient and accessible platform from which to deliver mental health support; however, little research has examined their potential impact among newly diagnosed cancer patients. One reason is likely due to the obstacles associated with in-clinic recruitment of newly diagnosed cancer patients for mHealth pilot studies.

METHODS

This article draws from our experiences of a recently completed pilot study to test a suite of mental health apps in newly diagnosed breast cancer patients. Recruitment strategies included in-clinic pamphlets, flyers, and direct communication with clinicians. Surgical oncologists and research staff members approached eligible patients after a medical appointment. Research team members met with patients to provide informed consent and review the study schedule.

RESULTS

Four domains of in-clinic recruitment challenges emerged: (a) coordination with clinic staff, (b) perceived burden among breast cancer patients, (c) limitations regarding the adoption and use of technology, and (d) availability of resources. Potential solutions are provided for each challenge.

CONCLUSION

Recruitment of newly diagnosed cancer patients is a major challenge to conducting mobile intervention studies for researchers on a pilot-study budget. To realize the impact of mobile interventions for the most vulnerable cancer patient populations, health researchers must address barriers to in-clinic recruitment to provide vital preliminary data in proposals of large-scale research projects.

Psychological distance reduces the effect of internalized stigma on mental health treatment decisions

Although stigma is a major barrier to treatment for those with mental health concerns, it is poorly understood when stigma is more or less influential in mental health treatment decisions. In the current work, we examined whether psychological distance - the removal of an event from direct experience - reduced the influence of internalized stigma on willingness to seek treatment. Specifically, we tested the hypothesis that psychological distance versus proximity (e.g., seeking treatment in three months vs. in two days, respectively) decreases the negative influence of stigma on willingness to seek treatment. We focused on a population for whom mental health treatment decisions are personally-relevant: individuals who had previously sought mental health treatment. Experiment 1 showed that the extent to which these individuals internalized (i.e., personally endorsed) stigma about mental illness predicted lower intentions to make an appointment with a mental health care provider for themselves (but not another person). Experiment 2 replicated this result using a different measure of psychological distance (temporal distance) and extended this finding to behavior (time spent reading mental health resources). Overall, this research demonstrated that internalized stigma disrupts mental health treatment-seeking intentions and behaviors when they are psychologically proximal, but not when they are distant. Potential applications of these results are discussed.

Post-Secondary Stress and Mental Well-Being: A Scoping Review of the Academic Literature

Post-secondary students have been identified as an at-risk population for chronic stress and poor mental health. We conducted a scoping review of the academic literature surrounding student stress and mental well-being as the first phase of research in the development of Canada’s National Standard for the Psychological Health and Safety of Post-Secondary Students. Major thematic findings included student stress, resilience through effective coping and help-seeking, and programs or strategies to improve campus mental health. Recommendations include a call for increased mental health promotion and mental illness prevention activities that are sensitive to diverse cultures, ethnicities, religions, and sexualities.

Burnout Stigma Inventory: Initial Development and Validation in Industry and Academia

Although burnout is a risk factor for various negative mental and physical outcomes, its prevention is hampered by the stigma associated with burnout. The current research therefore reports on the initial development and validation of a novel measure of perceived burnout stigma. Study 1 (n = 318) describes the construction and initial evaluation of scale items derived from established mental health stigma and burnout scales. Study 2 (n = 705) then replicated the burnout stigma factor structure established in the initial study. Additionally, it evaluates relationships between occupational and school burnout stigma and indicators of mental health. Hierarchical multiple regressions showed that burnout stigma accounted for variance in depression, anxiety, and stress over and beyond that of burnout. Study 3 (n = 682) extended these findings via cross-lagged and bidirectional models, demonstrating that burnout stigma predicted mental health indicators 6 weeks later. Study 4 (n = 717) supplemented earlier exploratory and confirmatory factor analyses using item response theory to further demonstrate that perceived burnout stigma is a unidimensional construct potentially applicable to both work and school settings. Overall, the current research resulted in an eight-item burnout stigma instrument (BSI-8) with excellent psychometric properties that predicts indicators of mental health.

An examination of help-seeking preferences via best-worst scaling

OBJECTIVE

This study utilized best-worst scaling and latent class analysis to assess mental health treatment preferences and identify subgroups of college student help seekers.

METHOD

College students (N = 504; age: M = 20.3, 79.2% female) completed assessments of mental health treatment preferences, self-stigma, and distress.

RESULTS

Students preferred utilizing friends and family, followed by professional mental health providers, self-help, keeping concerns to themselves, physicians, and lastly religious leaders. Latent class analyses identified four classes of respondents.

CONCLUSIONS

Subgroups of student help seekers include Formal Help Seekers who prefer professional mental health providers, Informal Help Seekers who prefer friends and family, Ambivalent Help Seekers who prefer family and friends but also keeping concerns to themselves, and Help Avoiders who prefer keeping concerns to themselves. Assessing treatment preferences among different student subgroups may constitute an initial step in identifying effective ways to address university-wide mental health concerns.

Event-related clinical distress in college students: Responses to the 2016 U.S. Presidential election

Objectives: College students have cited the 2016 U.S. presidential election as a significant source of stress. The current study examined the prevalence and demographic correlates of clinically significant election-related avoidance and intrusion symptoms among college students 2-3 months after the election. Participants: College students attending a large public university (N = 769; M_age = 19.19; 48.2% female; 58.4% White) were surveyed in January and February 2017. Methods: Participants completed a validated measure of clinically significant event-related distress symptoms (eg, intrusive thoughts, avoidance) and demographic questions. Results: One out of four students met criteria for clinically significant symptoms related to the election. Regression analyses suggested that sex, political party, religion, and perceived impact of the election on relationships were more useful predictors of stress symptoms than race or social class. Conclusions: The high level of event-related distress is concerning because elevated symptoms of event-related stress are predictive of future distress and subsequent PTSD diagnoses.