Scoping review to evaluate the effects of peer support on the mental health of young adults

Key Considerations in Integrating a Peer Support Model Within Psychiatric Emergency Services at a Canadian Pediatric Emergency Department: A Qualitative Study

Difficulties accessing primary care and community-based mental health supports has contributed to youth (aged < 18 years) with mental health concerns presenting to Emergency Departments (EDs). Peer support services in community-based mental health settings are associated with improved outcomes; research exploring this in pediatric EDs is lacking. Determine feasibility and acceptability of integrating peer support services into a pediatric ED. 13 peer support workers (PSWs) and 30 mental health providers and stakeholders participated in interviews or focus groups. Using codebook thematic analysis, recommendations for integration were identified. Key recommendations were: clear conceptualization of youth and family peer support, effective communication pathways between the multidisciplinary team and PSWs, provision of training for ED staff to ensure workplace readiness for peer support, and consistent support for PSWs. Integration of peer support into pediatric EDs offers a feasible and acceptable way to support youth experiencing mental health crises.

Social Determinants, Mental Well-Being, and Disrupted Life Transitions Among Young Adults with Disabling Mental Health Conditions

This study sought to understand how young adults (age 18-25) with histories of mental health disorders are coping with disrupted transitions to adulthood during the COVID-19 pandemic. A cross-sectional web survey was conducted in March-June 2021 of 967 US young adults with pre-pandemic psychiatric disability to assess their current psychiatric status, interrupted transitions, and associations with social determinants including income, community participation, and social context. Mental health was assessed with the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and PTSD Checklist-Civilian Version. Social determinants were identified with the Epidemic-Pandemic Impacts Inventory. Interrupted transitions were measured with the Young Adult Disrupted Transitions Assessment. Multivariable logistic regression models predicted four types of transition disruptions and associations with current mental health, social determinants, and demographic factors. Disruptions were reported by 81.1% including interrupted education completion (38.3%), employment careers (37.6%), residential independence (27.7%), and intimate partner relationships (22.9%). Many screened positive for major depressive disorder (81.7%), PTSD (85.5%), or GAD (58.6%). Disruption in establishing intimate partner relationships was associated with depression, anxiety, and PTSD. Interrupted residential independence was associated with anxiety. Interrupted education completion was associated with PTSD. Interrupted employment was associated with anxiety. Social determinants significant in these models included social connections, community participation, income, and racial/ethnic identification. Results illuminate ways that current mental health and social determinants affect transition interruptions during the pandemic. Findings suggest the need for interdisciplinary approaches, integrated models of care, and assistance accessing treatment, rehabilitation, and community support services from adult service systems.

Emotional and cognitive responses to romantic breakups in adolescents and young adults: the role of rumination and coping mechanisms in life impact

Background

Romantic breakups can significantly impact the psychological well-being of young adults, affecting emotional, physical, and social domains. This study examines the roles of rumination and coping strategies in shaping adjustment to breakup-related distress, specifically focusing on Italian adolescents and young adults.

Methods

A sample of 560 participants aged 17 to 22 who had recently experienced a romantic breakup completed questionnaires assessing rumination, coping strategies, and perceived impacts on life domains such as academic performance, family relationships, physical health, and emotional well-being. Correlation, regression, and mediation analyses were conducted to explore the relationships between rumination, coping strategies, and adjustment outcomes.

Results

Rumination emerged as a significant predictor of negative outcomes in academic performance and physical health. Avoidance coping mediated the relationship between rumination and emotional well-being, suggesting that individuals who ruminate are more likely to adopt avoidance strategies, leading to greater emotional distress. Conversely, adaptive strategies like Positive Attitude and Problem Solving were associated with better adjustment, predicting improved academic performance and healthier family relationships.

Conclusions

The findings underscore the importance of addressing rumination and avoidance coping in interventions aimed at supporting young adults post-breakup. Encouraging adaptive coping strategies, such as Positive Attitude and Problem Solving, could enhance resilience and mitigate the negative effects of relationship dissolution. This study contributes to a better understanding of coping processes in a culturally specific context, highlighting potential avenues for fostering resilience in youth facing emotional challenges.

Do We Need to Re-Think Transition to Take a More Comprehensive Approach to Supporting Young People to Navigate Complex Journeys to Adulthood?

This discussion paper draws on a range of personal and other published research articles to respond to calls for a re-conceptualization of the concept of Transition. Acknowledging the roots of the concept in developmental and health psychology, the article briefly considers application to fields of practice in formal and informal education, health, social care, counseling, and psychotherapy that underpin approaches to supporting young people to navigate the journey to adulthood. UK service provision is discussed to consider why linear developmental approaches may be problematic, alongside recent calls for a re-conceptualization of what we mean by Transition to successfully understand, support, and enable complex journeys to young adulthood. The paper concludes by proposing a holistic, non-linear bio-ecological systems approach within which it is possible to integrate globally evolving research, pathways, models, and interventions. The approach will be of interest to an international readership because principles can be adapted to respond to shared and country-specific challenges, developments, and models of service provision as we approach the second quarter of the twenty-first century.

Perceived teacher support and student engagement among higher education students - a systematic literature review

BACKGROUND

Research on student engagement has garnered significant interest from educators and practitioners because of its direct impact on academic success and achievement. Engaged students tend to perform better academically and exhibit fewer undesirable study behaviors, thereby enhancing academic outcomes.

OBJECTIVE

This systematic literature review consolidates research on the impact of perceived teacher support on student engagement in higher education. This study emphasizes the association between teacher support in improving students' academic performance, motivation, and retention. Furthermore, the review explores key theoretical frameworks, such as self-determination theory and social cognitive theory, alongside methodological tools such as measurement instruments and statistical analyses. The goal is to equip psychologists and educational researchers with insights into the relevant frameworks, tools, and methods for advancing future studies within the context of higher education.

METHODS

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We conducted a comprehensive search for academic studies published in English within databases such as APA PsycNet, Scopus, ERIC, EBSCOHost, ProQuest, and PubMed to identify eligible studies published between 2014 and 2024.

RESULTS

A review of 13 selected articles revealed that both students' personal characteristics and school environment factors mediate and moderate the relationship between perceived teacher support and student engagement. The students' personal characteristics factors include self-efficacy, the fulfillment of psychological needs, and motivation, whereas school environment factors involve the learning environment and the quality of teacher-student and peer relationships. Our findings show a lack of studies prior to 2020, with most research conducted in China and limited contributions from Malaysia and Vietnam. The reviewed articles predominantly used cross-sectional quantitative designs and self-report questionnaires, employing statistical methods like path analysis and structural equation modeling. Theoretical frameworks on student engagement mostly followed Fredricks et al.'s model, while teacher support theories varied, with three main patterns identified: direct influence, mediation through basic psychological needs, and social cognitive perspectives. This review emphasizes the crucial role of teacher support in enhancing student engagement in higher education and urges further exploration in this under-researched area.

CONCLUSION

In conclusion, this review underscores the significant role of teacher support in enhancing student engagement in higher education. It highlights key theoretical frameworks and research methodologies, offering valuable insights for future studies aimed at advancing teacher support and student engagement in this context.

Effects of intra-class peer mentorship intervention programme on the academic performances of academically underperforming medical students in Nigeria

BACKGROUND

A significant gap exists in understanding the effectiveness of intra-class (same-class) level peer mentorship programmes designed to enhance academic performance, well-being, and student involvement among underperforming medical students. This study assessed the effectiveness of intra-class (same-class) peer mentorship programme on the academic performances, subjective well-being and school engagement of academically underperforming medical students in Nigeria.

METHODS

This was a quasi-experimental research consisting of the pretest-posttest control design at Nnamdi Azikiwe University, Awka, Nigeria. Preclinical medical students from same class level were categorised into three groups: 7 academically underperforming students (mentees) scoring below 45% on the continuous assessment test (CAT), 12 mentors scoring 70% or above, and 30 controls scoring between 50% and 70%. Participants completed the Subjective Vitality Scale (SVS) and the self-University Student Engagement Inventory (USEI) before and after the 6-month programme, led by an experienced educationist. A post-programme CAT assessed academic performance, and quantitative data were analysed using paired-samples t-tests to evaluate changes in academic performance, SVS and USEI. The dimensions of students' subjective vitality and the school engagement were considered in the analysis.

RESULTS

A total of 49 students were included in the study, with 7 (14.3%) in the mentee group, 12 (24.3%) in the mentor group and 30 (61.2%) in the control group. The same-class peer mentorship intervention led to a significant improvement in CAT scores for the mentee group, with their median score rising from 40.0 to 70.0% (p = 0.003), while the control group's median slightly decreased. The mentee group's SVS (p = 0.722) and USEI (p = 0.388) scores non-significantly improved post-intervention. However, specific USEI items revealed significant post-intervention improvements in mentees' classroom engagement or increased participation in discussions (p = 0.001) and enjoyment of school (p = 0.031). SVS items showed non-significant differences between groups post-intervention.

CONCLUSION

The same-class peer mentorship intervention significantly improved CAT scores among academically underperforming medical students, with modest gains in SVS and USEI scores. While overall vitality and engagement changes were not significant, classroom engagement improved. These findings support intra-class peer mentorship in medical education.

A novel approach to peer support for academic researchers

BACKGROUND

Academic researchers experience high levels of stress, isolation and loneliness, which compromise their well-being. There is a particular need to address these issues amongst early career and postgraduate research staff. 'Spaces for Listening' is an initiative to increase active listening and provide peer support.

AIMS

To assess the feasibility, acceptability and potential impacts of Spaces for Listening in an academic setting.

METHODS

Early career and postgraduate researchers from a large university in the UK were invited to attend 'Academic Spaces for Listening' (ASfL). Five ASfL sessions (including in-person and Chinese language) were held. A mixed-methods study using online survey and in-depth interviews was conducted. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed using principles of thematic analysis. The qualitative and quantitative findings were integrated at the interpretation phase.

RESULTS

A total of 25 participants attended an ASfL session, 22 of them completed the survey and 6 participants participated in semi-structured interviews. Participants were very satisfied with the session content (68%, n = 15), organization (68%, n = 15) and delivery (68%, n = 15). Four themes were identified from qualitative analysis: (i) the 'Academic Spaces for Listening' (ASfL) experience; (2) impact of ASfL; (3) potential challenges of ASfL and (4) ASfL in the future. Interpersonal connectedness was an important outcome for participants during the session. Participants showed interest in the future of ASfL.

CONCLUSIONS

Implementing Spaces for Listening in an academic setting is feasible and was well received by participants. The initiative may fill a gap in the social interactions amongst academic researchers.

Persuasive design principle of social support in digital interventions targeting mental health symptoms: a systematic review and meta-analysis

OBJECTIVE

This systematic review and meta-analysis evaluates the available evidence on efficacy of social support strategies, as defined by the persuasive system design framework, in internet-based and mobile-based interventions (IMI) targeting mental health.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

PubMed, Embase, PsycINFO and the Cochrane Central Register of Controlled Trials.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Randomised controlled trials comparing IMI implementing a social support strategy for mental health symptoms to various control conditions. Publications up to June 2023 (date of search 6 June 2023) were considered.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers screened and extracted data in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias was assessed with the Risk of Bias Tool V.2.0. Data were pooled based on a random-effects model.

RESULTS

After screening 6484 records, a total of 45 studies met our inclusion criteria. At 96%, social support was predominantly implemented through the strategy of social facilitation, by which users recognising others using the intervention (eg, discussion forum). IMI implementing social support strategies showed moderate effect sizes of Hedges' g=-0.34 (95% CI -0.47 to -0.21, p<0.001) in comparison to different control conditions. Heterogeneity was considerable (I2=73.6%; 95% CI 64.8 to 80.3). Subgroup analyses revealed a significant influence of targeted psychological condition (p<0.001), type of social support (p<0.001) and control condition (p<0.001). In k=11 component studies (ie, comparison to a disentangled version of the same intervention), IMI with social support strategies were not significantly more effective in comparison to the same IMI without social support (Hedges' g=-0.08 (95% CI -0.22 to 0.05, p=0.19, I2=0%). 64% (k=7) of component studies reported higher adherence rates in IMI with social support.

CONCLUSIONS

Based on a small number of component studies, implementing social support strategies in IMI that target mental health symptoms has no significant incremental benefit on effectiveness. To draw more robust conclusions, the potential of other social support strategies besides social facilitation should be exploited in future component studies.

PROSPERO REGISTRATION NUMBER

CRD42020222810.

New graduate nurses' perspectives on well-being and transitioning into the workforce

BACKGROUND

The COVID-19 pandemic profoundly impacted nurses' well-being and the transition of new nurses into the workplace. The National Academy of Medicine and American Nurses Foundation has announced the need to prioritize well-being research.

PURPOSE

To explore new nurses' perspectives related to factors that influenced their well-being and transition to practice.

METHODS

New graduate nurses (1-2years post graduation) in Hawaii were invited to participate in a qualitative study, September 2023.

DISCUSSION

Participants (N = 25) were predominantly female (84%), Asian (80%), and had 1year of experience (76%). Participants described the effect of the pandemic on their well-being, individual factors they needed to develop, external factors that were barriers or facilitators, and considerations for future interventions to support well-being and transition to practice.

CONCLUSION

The findings highlighted components of interventions needed in the academic and professional setting to support new nurses' successful and sustained transition to the workplace.

Adolescent depressive symptoms and memory performance in young adulthood: Testing critical period, accumulation, and pathway models using a sibling comparison design

RATIONALE

Despite the existing literature connecting depressive symptoms with cognitive function in adulthood, there is limited knowledge about the longitudinal association between depressive symptoms in adolescence and memory function in adulthood, as well as the mechanisms underlying this relationship.

OBJECTIVES

This study aims to determine whether depressive symptoms in adolescence are associated with memory function in young adulthood. To explore the underlying mechanisms of this association, it employs a life course approach, testing the critical period, accumulation, and pathway models.

METHODS

Utilizing data from the sibling sample of the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study employed sibling fixed effects models to control for unobserved heterogeneity at the family level. To test various life course models, the analysis incorporated adult depressive symptoms, as well as an array of behavioral, psychosocial, and educational mechanism variables.

RESULTS

Sibling fixed effects estimates indicated a longitudinal association between depressive symptoms in adolescence and memory function in young adulthood (b = -0.084, p < 0.01). Depressive symptoms in adulthood neither explained nor intensified this association. Mediation analysis revealed that educational attainment modestly accounted for about 11% of the relationship between adolescent depressive symptoms and adult memory function. Combined, these findings lend support to the life course approach, with a specific focus on the critical period model.

CONCLUSIONS

This study's findings suggest that depressive symptoms in adolescence are an independent risk factor for memory function in adulthood. The empirical support for the critical period model underscores the importance of implementing early intervention programs and targeted strategies to support adolescents experiencing depressive symptoms.

Peer-led intervention for individuals with major depression: study protocol for a randomized controlled trial (SUPEERMood)

BACKGROUND

Major Depressive Disorder (MDD) is one of the most disabling mental health problems worldwide. The Recovery Model emphasizes peer support to empower individuals with MDD, improve self-management, and patients' quality of life. Despite the demonstrated efficacy of peer-led interventions, further research is needed due to methodological limitations and variability in interventions across studies. Therefore, the objective of this trial is to evaluate the effectiveness of an adjuvant peer-led intervention for the reduction of depressive symptoms in individuals diagnosed with MDD attended in primary care mental health units.

METHODS

A controlled, parallel, randomized clinical trial will be conducted. The intervention group (n = 35) will receive 6 weeks of peer-led sessions based on a peer support program drive whilst supervised by nurses, while the control group (n = 35) will use a mobile Health (mHealth) application for emotional wellness based on CBT for 6 weeks. Measurements will be collected at baseline, at 6 weeks, at 6 and 12 months after the intervention to evaluate post-intervention effects. The primary outcome is the reduction of depressive symptoms through the Beck Depression Inventory (BDI-II) after the intervention. Secondary outcomes will involve measures such as adherence to psychiatric treatment, quality of life, adherence to mediterranean diet, alcohol consumption and physical activity.

DISCUSSION

We hypothesize that this peer-led intervention, in contrast to the mHealth, will show improvement in BDI-II score reduction of 6 points after six weeks, 6 and 12 months. Standardized peer-led programs can benefit patients and professionals in terms of efficacy and feasibility of clinical treatment of depression, healthy habits, self-care and quality of life. In addition, they can provide recovery and relapse reduction, improved psychosocial support, minimization of intensive care use, and support for patient autonomy through self-management.

TRIAL REGISTRATION

The trial protocol is prospectively registered with ClinicalTrials.gov under protocol registration number NCT06398561. Date of registration: May 01, 2024. Recruitment is ongoing.

Peer social support moderates the impact of ethnoracial discrimination on mental health among young sexual minority men of color

Few studies have examined developmentally relevant sources of resilience, such as peer social support, among young sexual minority men (SMM) of color experiencing discrimination and mental health distress. To address this gap in the literature, we examined the role of peer social support in the association between discrimination and mental health distress in a sample of young SMM of color. Ninety-four cisgender young SMM of color (aged 16-29) were recruited through community-based organizations in the New York City metropolitan area as part of an effectiveness trial of a tailored Motivational Interviewing intervention. Participants completed a baseline survey that included measures of school/workplace ethnoracial discrimination, sexual orientation discrimination, peer social support, and symptoms of anxiety and depression. Results of multivariable models indicated some evidence of the stress-buffering effects of peer social support. School/workplace ethnoracial discrimination was negatively associated with symptoms of anxiety (B = -0.12, SE = 0.03, p < 0.001) and depression (B = 0.44, SE = 0.15, p = 0.005) among young SMM of color with lower levels of peer social support. Peer social support did not moderate the association between sexual orientation discrimination and either depression or anxiety. Findings provide some evidence of the protective role of peer social support. We discuss the implications of the results for practice with young SMM of color with mental health distress.

Co-Producing Paws on Campus: A Psychoeducational Dog-Facilitated Programme for University Students Experiencing Mental Health Difficulties

Declining student mental health is a global public health issue. Campus-based animal-assisted interventions (AAIs) are popular and effective interventions to prevent and alleviate symptoms. How to design, implement and evaluate evidence-based, student-centred interventions that enjoy sustained stakeholder buy-in and support is less known. This paper presents the procedures and results of a three-stage co-production method and the resulting curriculum of a novel AAI aimed at university students experiencing serious mental health problems. Stage 1 shaped the focus and structure of the intervention based on online student surveying (N = 204) and consultations with stakeholders (N = 10), including representatives of Student Well-being Services leadership, veterinarians, animal welfare charities and Therapets volunteers. In Stage 2, we conducted co-production workshops with post-graduate students (N = 6), developing the curriculum based on Stage 1 insights. In Stage 3, through iterative prototyping and student feedback (N = 22) the Paws on Campus programme was finalised, resulting in a series of four, one-hour themed sessions: (1) Thoughts and Feelings, (2) Well-being and Welfare, (3) Care and Compassion and (4) Problem Solving and Help Seeking. We describe the co-production method and resulting programme characteristics and provide considerations for others interested in developing effective and sustainable AAIs for their respective populations and contexts.

Effect of group online-based peer support intervention on psychological distress of adolescent and young adult cancer patients: a randomized controlled trial

PURPOSE

Adolescent and young adult (AYA) cancer patients, aged between 15 to 39 years old, suffer from long-term psychological distress, confronting low self-efficacy and various psychological problems. This study constructs a group online-based peer support intervention combined with offline activities to explore its impact on the psychological distress of AYA cancer patients.

METHODS

A randomized, two-arm clinical trial was conducted in which 90 AYA cancer patients were recruited. The control group (N = 45) received conventional psychological care and treatment, and the experimental group (N = 45) received 8 weeks of an online peer support intervention. Outcome measures included psychological distress (Distress Thermometer, DT), anxiety and depression (Hospital Anxiety and Depression Scale, HADS), perceived peer support (Cancer Peer Support Scales, CaPSS), and readiness for return to work (Readiness to Return-To-Work Scale, RRTW).

RESULTS

Eight-week peer support intervention was effective in improving psychological distress, anxiety, and depressive symptoms in the experimental group with statistically significant differences (P < 0.05). Time affected psychological distress, anxiety, and depressive symptoms in AYA cancer patients (P < 0.05), and there was an interaction with intervention factors (P < 0.05). The intervention has a positive effect on relieving the psychological status of AYA cancer patients. For readiness for return to work, the experimental group was in the preparation for the action-behavioral stage immediately, 1 month and 3 months after the end of the intervention (P < 0.01), supporting AYA cancer patients who have not returned to work to maintain optimal return-to-work readiness.

CONCLUSIONS

The group online-based peer support intervention is popular and has good scientificity, effectiveness, and practical significance for AYA cancer patients.

TRIAL REGISTRATION

This study was registered at clinicaltrials.gov. (ChiCTR2100053091, registered on 10 November 2021).

Examining the experiences of student peer support workers delivering care within post-secondary institutions

Objective: Despite experiencing exacerbation of mental health issues, post-secondary students may not seek help due to perceived stigma, overreliance on the self, or preference for nonprofessional supports - including peer support. This study aimed to understand peer support workers' (PSWs) perspectives regarding providing support for mental health concerns in post-secondary institutions. Methods: 41 PSWs were recruited from two post-secondary institutions. 17 semi-structured interviews and three focus groups were conducted. Themes were identified using a qualitative descriptive approach. Results: Three themes emerged: (1) diverse presentations and approaches to operationalizing peer support for mental health issues on campus exist; (2) peer support has core ingredients; (3) reasons why students access peer support extend beyond mental health crisis. Conclusions: An inclusive peer support approach to mental health is needed for post-secondary students. Considerations for implementation hinge on providing standardized, foundational training to prepare PSWs for the complex mental health issues that present across services.

Young adults' experiences of using a young person's mental health peer support app: A qualitative interview study

Evidence suggests that digital peer support can be valuable for individuals struggling with their wellbeing, particularly those who do not feel able to or do not want to engage with other services. The current study explores the experience of young adults engaging with a digital peer support smartphone app. Interviews were conducted with 11 young adults aged 18-25. Reflexive thematic analysis was used and five themes were developed from the data: 1) Finding comfort in familiar and friendly digital spaces; 2) Developing coping and support skills through digital peer support; 3) The value of shared experiences; 4) Needing to 'pull your weight' but being scared of causing harm; 5) The limits of digital peer support. We found that participants valued the sense of community and feelings of relief and validation elicited from sharing relatable experiences with peers. They also believed they had developed skills in supporting themselves and others both within and external to the app. However, it was mainly perceived as a space for venting and may not succeed in delivering benefits beyond this, such as in reducing symptoms of poor mental health or helping people get to the root of issues. Moreover, participants reported a pressure to respond and anxieties around exacerbating someone's difficult feelings. Providing training and supervision to peers to help them feel confident and safe when supporting others may help to further the benefits of peer support, and a greater emphasis on boundaries within digital peer support may alleviate some anxieties and pressure.

Optimizing and Predicting Antidepressant Efficacy in Patients with Major Depressive Disorder Using Multi-Omics Analysis and the Opade AI Prediction Tools

According to the World Health Organization (WHO), major depressive disorder (MDD) is the fourth leading cause of disability worldwide and the second most common disease after cardiovascular events. Approximately 280 million people live with MDD, with incidence varying by age and gender (female to male ratio of approximately 2:1). Although a variety of antidepressants are available for the different forms of MDD, there is still a high degree of individual variability in response and tolerability. Given the complexity and clinical heterogeneity of these disorders, a shift from "canonical treatment" to personalized medicine with improved patient stratification is needed. OPADE is a non-profit study that researches biomarkers in MDD to tailor personalized drug treatments, integrating genetics, epigenetics, microbiome, immune response, and clinical data for analysis. A total of 350 patients between 14 and 50 years will be recruited in 6 Countries (Italy, Colombia, Spain, The Netherlands, Turkey) for 24 months. Real-time electroencephalogram (EEG) and patient cognitive assessment will be correlated with biological sample analysis. A patient empowerment tool will be deployed to ensure patient commitment and to translate patient stories into data. The resulting data will be used to train the artificial intelligence/machine learning (AI/ML) predictive tool.

The role of peer support in recovery among clients with mental illness attending the psychiatric service in a tertiary hospital in Malaysia: a qualitative study

BACKGROUND

The understanding that mental health recovery is a personal and subjective experience informs mental health policies in many countries. However, most of the populations in these studies are from the West, limiting their applicability in Asia. Peer support in mental health refers to helping and mentoring people who have overcome similar obstacles. Despite being proven to be effective in promoting recovery, little is known about its use in Malaysian psychiatric patients. This study aims to explore the participants' perspectives on their concept of recovery and how the peer support group (PSG) aid them to achieve recovery.

METHODOLOGY

This study was conducted on clients with mental illness who attended the PSG provided by the Community Psychiatry and Psychosocial Intervention Unit in National University Malaysia Medical Centre. A qualitative generic inductive approach was employed in this thematic exploratory study. Purposive sampling was the method used to collect the data for this thematic exploratory study. In-depth interviews of 11 study participants were audio recorded and transcribed verbatim. Data were analyzed using Braun and Clarke (2006) descriptive thematic analysis method.

RESULTS

The findings of this study highlighted six key themes; three pertaining to the participants' perspectives on the meaning of recovery (1. Gaining self-reliance and social inclusion, 2. Personal growth and improved life circumstances in recovery, and 3. Symptoms improvement) and another three pertaining to how the peer support group aids recovery (1. Empowerment and growth through peer support, 2. Promoting well-being, 3. Social connection and support).

CONCLUSION

The findings of this study provide valuable insights into the perspectives of psychiatry clinic patients enrolled in PSG on the concept of recovery and the role of such groups in their recovery journey. The findings demonstrated that the PSG complemented the participants' perspectives on recovery, reinforcing the notion that a comprehensive and person-centered approach to mental health services is essential for successful and sustained recovery outcomes.

Digital mental health and peer support: Building a Theory of Change informed by stakeholders' perspectives

Digital Mental Health and Peer support has the potential to bridge gaps in support through its scalability and accessibility. Despite the increasing use of these platforms, there remains a lack of understanding of how they operate in real life, from initial engagement to longer-term impact. We aimed to explore the key inputs, processes, user interactions, assumptions, barriers, facilitators, outcomes, and impacts associated with the use of DMH and peer support platforms by developing a Theory of Change with stakeholders. Stakeholders (n = 77) contributed to the formulation of the Theory of Change through a series of online workshops, focus groups, interviews, and open-ended survey feedback. Workshops were structured to capture information related to aspects of the Theory of Change and to allow stakeholders to provide feedback to improve the diagram. A thematic framework approach was used to analyze transcripts to enable comparisons of factors reported by members, commissioners, and platform staff. Stakeholders identified a variety of factors contributing to initial inputs, processes, outcomes, and impact. Engagement emerged as the most significant barrier to the use of platforms. Motivations for use included filling in gaps in available support, connecting with others and upskilling. Different member types determined how users would interact with the platform which could influence the social response of others. Outcomes were largely positive including provision of a safe online space, improvement in wellbeing, and feeling connected to others. Stakeholders noted impact was harder to identify due to the preventative nature of these platforms but suggested this related to the knowledge of available support, reduction in waiting for support and in referrals, and increasing engagement and uptake of the platforms. Stakeholders identified assumptions regarding internet access as a significant barrier. The Theory of Change illustrated three distinct pathways in digital mental health and peer support. Further research is needed to improve engagement and factors influencing engagement, the member experience and how impact is measured.

The role of peer social relationships in psychological distress and quality of life among adolescents with type 1 diabetes mellitus: a longitudinal study

BACKGROUND

Adolescents with type 1 diabetes mellitus suffer from diabetes distress and poor health-related quality of life (HRQOL) since living with the condition that differentiates them from their peers. The present study investigated the effects of peer support and stress on diabetes distress and HRQOL and whether positive coping mediated the effects.

METHODS

We used a prospective study design. A total of 201 adolescents with type 1 diabetes mellitus from 20 cities in 4 provinces were recruited.Participants complete two separate surveys at approximately 18-month intervals. The scales employed at both Time 1 and Time 2 included the Diabetes-Specific Peer Support Measure, Diabetes Stress Questionnaire for Youths, Simplified Coping Style Questionnaire, 5-item Problem Areas in Diabetes Scale, and the Diabetes Quality of Life for Youth scale.

RESULTS

Baseline peer stress directly predicted diabetes distress and HRQOL at 18 months, even controlling for age, gender, and peer support. However, the direct effect of baseline peer support on 18-month diabetes distress and HRQOL was insignificant. Baseline peer support indirectly affected diabetes distress and HRQOL at 18 months through positive coping, indicating that positive coping plays a mediating role.

CONCLUSION

The findings suggest that peer social relationships, especially peer stress, and positive coping are promising intervention targets for adolescents facing challenges in psychosocial adaptation.

Enhancing emotional health and engagement in Chinese English language learners: an approach from teachers' autonomy- supportive behavior, teachers' harmony, and peer support in a two-sample study

Background

In the evolving landscape of Chinese education, understanding the factors that influence the emotional health and engagement of English language learners is increasingly vital. Against this backdrop, our study delves into how teachers' autonomy-supportive behavior, teachers' harmony, and peer support impact these key educational outcomes.

Aim

This study investigates the roles of teachers' autonomy-supportive behavior, teachers' harmony, and peer support in influencing the emotional health and engagement of English language learners in China.

Method

Involving a diverse sample of 68 English Language Teachers and their 389 students from various Chinese universities, the study leverages a convenience sampling method.

Results

Key findings indicate that students' emotional health is predominantly influenced by peer support, while student engagement is significantly affected by a combination of teachers' autonomy-supportive behavior, peer support, and teachers' harmony. These outcomes highlight the importance of both teacher behavior and peer relationships in educational settings, underscoring their crucial roles in enhancing student well-being and engagement. The study's methodology, incorporating a diverse sample from multiple educational institutions and a comprehensive analytical approach, offers robust insights. However, the limitations of convenience sampling and reliance on self-reported data necessitate a careful interpretation of the findings.

Implications

Implications from this research are vital for educational policy and practice, emphasizing the need for interventions that enhance teacher-student relationships and foster supportive peer environments. This study adds to the body of knowledge on factors influencing emotional health and engagement among English language learners, advocating for a comprehensive approach in educational strategies and interventions.

Understanding University Students' Perspectives towards Digital Tools for Mental Health Support: A Cross-country Study

Background

Organisational and individual barriers often prevent university students from seeking mental health support. Digital technologies are recognised as effective in managing psychological distress and as a source of health-related information, thus representing useful options to address mental health needs in terms of accessibility and cost-effectiveness. However, university students' experiences and perspectives towards such interventions are little known.

Objectives

We thus aimed to expand the existing base of scientific knowledge, focusing on this special population.

Methods

Data were from the qualitative component of "the CAMPUS study", longitudinally assessing the mental health of students at the University of Milano-Bicocca (Italy) and the University of Surrey (UK). We conducted in-depth interviews and thematically analysed the transcripts using the framework approach.

Results

An explanatory model was derived from five themes identified across 33 interviews (15 for Italy, 18 for the UK). Students perceived that social media, apps, and podcasts could deliver relevant mental health content, ranging from primary to tertiary prevention. Wide availability and anonymity were perceived as advantages that make tools suitable for preventive interventions, to reduce mental health stigma, and as an extension of standard treatment. These goals can be hindered by disadvantages, namely lower efficacy compared to face-to-face contact, lack of personalisation, and problematic engagement. Individual and cultural specificities might influence awareness and perspectives on the use of digital technologies for mental health support.

Conclusion

Although considering some specific features, digital tools could be a useful instrument to support the mental health needs of students. Since personal contact remains crucial, digital tools should be integrated with face-to-face interventions through a multi-modal approach.

Exploring the meaning of peer support used by undergraduate nursing students who have experienced clinical-related critical incidents: A hermeneutic study

BACKGROUND

Undergraduate nursing students may access support from peers after having experienced critical incidents during experiential learning opportunities. While researchers have addressed peer support relative to academic or day-to-day stress in undergraduate nursing students, there is a paucity of data on the context of clinical related critical incidents.

OBJECTIVE

To better understand undergraduate nursing students' experiences of using peer support after clinical related critical incidents.

DESIGN

Experiential learning places undergraduate nursing students at risk of encountering critical incidents. Gadamer's philosophical hermeneutics was the research approach used to explore the meaning of peer support accessed by undergraduate nursing students who had experienced clinical related critical incidents.

SETTING

Participants were recruited from a Canadian university.

PARTICIPANTS

A purposive sample was used to recruit nine students who were enrolled in a baccalaureate nursing program. Data collection involved conducting semi-structured interviews over 12 months in 2021-2022.

METHOD

The interviews with participants were recorded and transcribed and the data was analyzed using the interpretive method of hermeneutics.

RESULTS

Findings from this research revealed that peer support was an effective informal method of providing immediate assistance to undergraduate nursing students. Inherent in this support was a safe space where students experienced a sense of belonging which normalized the incident and minimized isolation. Support was perceived by some participants as reciprocal as both the traumatized individual and the peer supporter benefited from the organic connection.

CONCLUSIONS

This study highlighted the importance of nurturing a psychologically safe clinical learning environment where students who experience critical incidents may seek timely support from peers and clinical instructors.

A systematic scoping review of peer support interventions in integrated primary youth mental health care

Peer support, defined as the social and emotional support offered and received by individuals with a shared experience of mental health difficulties, is gaining popularity in youth mental health settings. This systematic scoping review aimed to collate and synthesise the evidence on key aspects of peer support interventions within integrated youth services and educational settings. Specifically, it synthesised evidence on the (1) assessed mental health outcomes in peer support interventions, (2) key characteristics and associated roles of peer support workers (PSWs) and (3) barriers and facilitators to implementation. A search of peer reviewed articles from January 2005 to June 2022 across five electronic databases (PsychINFO, Pubmed, Scopus, ERIC and CINAHL) was conducted. A total of 15 studies retrieved in the search met the inclusion criteria and were included in the review. This review supports previous research indicating that peer support has potential for improving recovery related outcomes. While a variety of interventions and PSW roles were reported, studies could be strengthened by providing more in-depth information on intervention content. Examples of barriers to implementation included staff concerns around confidentiality of peer support relationships as well as PSWs' confidence in their roles. Facilitators included positive support from staff members and role clarity.

Social Network Characteristics and Depressive Symptoms of Italian Public Health Medical Residents: The Public Health Residents' Anonymous Survey in Italy (PHRASI)

Despite the high impact of the COVID-19 pandemic on social interactions and healthcare workers' (HWs') mental health, few studies have investigated the association between social network characteristics and HWs' mental health, particularly during the pandemic. Therefore, we aimed to assess the associations between public health residents' (PHRs') social network characteristics and depression. We used data from the Public Health Residents' Anonymous Survey in Italy (PHRASI), a nationwide cross-sectional study. Social network characteristics were self-reported. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire. Linear and logistic models adjusted for age, sex, physical activity, and alcohol were used. A moderation analysis by sex was also performed. A total of 379 PHRs participated in the survey (58% females, median age of 30 years). More peer-to-peer (odds ratio OR = 0.62 (0.47-0.83)) and supervisor support (OR = 0.49 (0.36-0.68)), more social participation ((OR) = 0.36 95% CI (0.25-0.50)), and having a partner (OR = 0.49 (0.25-0.96)) were significantly associated with a lower risk of clinically relevant depressive symptoms. Work-to-private-life interference was significantly associated with a higher risk of clinically relevant depressive symptoms (OR = 1.77 (1.28-2.45)). Promoting a supportive work environment and social participation as well as reducing work-to-private life interference can contribute to reducing the high burden among PHRs.

Exploring the impact of COVID-19 on the psychological well-being of oncology healthcare professionals

AIMS

To explore how psychological well-being is maintained by healthcare professionals (HCPs) employed in a cancer setting during the COVID-19 pandemic.

DESIGN

A qualitative design using diaries and interviews to collect data was used to gain insights into how HCPs managed their well-being during the pandemic.

METHODS

Interpretative Phenomenological Analysis (IPA) was used to analyse diaries and interviews completed by 66 HCPs during the second pandemic lockdown period (December 2020-April 2021). A total of 102 HCPs were recruited, drawn from five groups: nursing staff, radiographers, medical staff, allied health professionals (AHPs) (non-radiographers) and support staff.

RESULTS

The majority of participants adjusted to the challenges of the pandemic using positive coping strategies, although difficult days required the mobilization of additional resources. Emotion management was regulated through peer relationships, professional roles and the workplace, sustained through communities of practice involving knowledge exchange, shared goals and social interactions. Maintaining high-quality patient care was a source of job satisfaction, providing a route through which positive emotions could be channelled; however, it was juxtaposed with threats to well-being from busy workloads and variable organizational responsiveness. Work routines provided a platform for well-being, underpinned by the sharing of problems and solutions within peer networks.

CONCLUSION

This study has highlighted the dynamic nature of well-being amongst HCPs during the pandemic. Well-being interventions should build on the preferred coping strategies of HCPs, focusing on the way individuals coalesce in groups to learn from and support one another.

IMPACT

HCPs may experience different psychological responses when exposed to a pandemic situation. This study identifies the strategies used by HCPs to maintain positive psychological well-being within professional roles, whilst adjusting to emerging well-being threats. Key components of HCP's well-being are addressed, which are relevant to clinical practice and the broader healthcare workforce.

PATIENT OR PUBLIC CONTRIBUTION

Research team members included public representatives who contributed to the development, methods, data collection and analysis of the study. They supported the development of the Research Assistant by providing mock interview skills training.

Transforming mental healthcare in higher education through scalable mental health interventions

A significant number of young people throughout the world are experiencing mental health concerns. Many young people will develop their first mental health concerns or will be managing their symptoms while enrolled in institutions of higher education. Although many colleges and universities are aware of the significant mental health needs among their students, the mental health and psychosocial needs of students often exceed the availability of resources and cultural and contextual barriers, such as stigma, may further impede access to care. Such gaps and barriers in mental health may lead to poor prognosis as well as negative educational and social outcomes. We propose that non-specialist delivered mental health and psychosocial interventions may play a critical role in reducing the gaps in care for students in higher education. In particular, non-specialist delivered care can complement existing specialized services to provide stepped models of care. Importantly, the adaptation and implementation of non-specialist delivered mental health and psychosocial support interventions in higher education may lead to innovative strategies for increasing access to care in this context, but may lead to adaptations that could apply to contexts outside of higher education as well.

Understanding the self-management experiences and support needs during pregnancy among women with pre-existing diabetes: a qualitative descriptive study

BACKGROUND

With the increasing prevalence of pre-existing type 1 and type 2 diabetes in pregnancy and their associated perinatal risks, there is a need to focus on interventions to achieve optimal maternal glycemia to improve pregnancy outcomes. One strategy focuses on improving diabetes self-management education and support for expectant mothers with diabetes. This study's objective is to describe the experience of managing diabetes during pregnancy and identify the diabetes self-management education and support needs during pregnancy among women with type 1 and type 2 diabetes.

METHODS

Using a qualitative descriptive study design, we conducted semi-structured interviews with 12 women with pre-existing type 1 or 2 diabetes in pregnancy (type 1 diabetes, n = 6; type 2 diabetes, n = 6). We employed conventional content analyses to derive codes and categories directly from the data.

RESULTS

Four themes were identified that related to the experiences of managing pre-existing diabetes in pregnancy; four others were related to the self-management support needs in this population. Women with diabetes described their experiences of pregnancy as terrifying, isolating, mentally exhausting and accompanied by a loss of control. Self-management support needs reported included healthcare that is individualized, inclusive of mental health support and support from peers and the healthcare team.

CONCLUSIONS

Women with diabetes in pregnancy experience feelings of fear, isolation and a loss of control, which may be improved through personalized management protocols that avoid "painting everybody with the same brush" as well as peer support. Further examination of these simple interventions may yield important impacts on women's experience and sense of connection.

Prospective associations between peer support, academic competence, and anxiety in college students

Previous literature has demonstrated that peer support is instrumental for the promotion of adaptive academic and mental health outcomes; however, limited research has examined prospective directional associations between peer support and adjustment within college settings. The purpose of this study was to investigate the longitudinal associations between peer support, academic competence, and anxiety among U.S. college students. U.S. students from a diverse 4-year university (N = 251, 75% women, 24% men, and < 1% a different gender) reported on peer support, academic competence, and anxiety using validated questionnaires at two time points (Fall term of sophomore year and Spring term of senior year). Results showed that peer support was positively associated with academic competence over time but was not significantly related to future anxiety. Academic competence did not significantly predict peer support or anxiety over time, but anxiety was associated with lower future academic competence. These findings offer insight into how types of social relationships link with academic motivation and anxiety over time within educational settings.

An 8-Week Peer Health Coaching Intervention among College Students: A Pilot Randomized Study

This study explored the effects of an 8-week peer coaching program on physical activity (PA), diet, sleep, social isolation, and mental health among college students in the United States. A total of 52 college students were recruited and randomized to the coaching (n = 28) or the control group (n = 24). The coaching group met with a trained peer health coach once a week for 8 weeks focusing on self-selected wellness domains. Coaching techniques included reflective listening, motivational interviews, and goal setting. The control group received a wellness handbook. PA, self-efficacy for eating healthy foods, quality of sleep, social isolation, positive affect and well-being, anxiety, and cognitive function were measured. No interaction effects between time and group were significant for the overall intervention group (all p > 0.05), while the main effects of group difference on moderate PA and total PA were significant (p < 0.05). Goal-specific analysis showed that, compared to the control group, those who had a PA goal significantly increased vigorous PA Metabolic Equivalent of Task (METs) (p < 0.05). The vigorous METs for the PA goal group increased from 1013.33 (SD = 1055.12) to 1578.67 (SD = 1354.09); the control group decreased from 1012.94 (SD = 1322.943) to 682.11 (SD = 754.89); having a stress goal significantly predicted a higher post-coaching positive affect and well-being, controlling the pre-score and other demographic factors: B = 0.37 and p < 0.05. Peer coaching showed a promising effect on improving PA and positive affect and well-being among college students.

Young Adult Mental Health Beyond the COVID-19 Era: Can Enlightened Policy Promote Long-Term Change?

The status of mental health for adolescents and young adults has aptly been termed a "crisis" across research, clinical, and policy quarters. Arguably, the status quo provision of mental health services for adolescents and young adults is neither acceptable nor salvageable in its current form. Instead, only a wholesale policy transformation of mental health sciences can address crises of this scope. Pandemic-related impacts on mental health, particularly among young adults, have clearly exposed the need for the mental healthcare field to develop a set of transformative priorities to achieve long overdue, systemic changes: (1) frequent mental health tracking, (2) increased access to mental health care, (3) working with and within communities, (4) collaboration across disciplines and stakeholders, (5) prevention-focused emphasis, (6) use of dimensional descriptions over categorical pronouncements, and (7) addressing systemic inequities. The pandemic required changes in mental healthcare that can and should be the beginning of long-needed reform, calling upon all mental health care disciplines to embrace innovation and relinquish outdated traditions.

The Sources of Research Self-Efficacy in Postgraduate Nursing Students: A Qualitative Study

Postgraduate students are required to undertake a series of research assignments. Research self-efficacy is regarded as the sense of faith in their ability to accomplish research tasks. However, it is unclear how research self-efficacy plays a role in second-year nursing postgraduate students who have been enrolled for a period of time and have not yet met graduation requirements. This study aims to explore the sources of second-year nursing postgraduate students’ research self-efficacy in response to research tasks. A descriptive phenomenological approach was used in this study. A total of 13 second-year nursing postgraduate students participated in semi-structured interviews using a purposive sampling method. Content analysis was applied to analyze the interview data after verbatim transcription. Participants stated that they had gained a great deal of support but were somewhat less confident. Three themes were refined: (a) intrinsic sources of research self-efficacy (differences in cognitive ability, internal driving force, with successful experience), (b) extrinsic sources of research self-efficacy (family support, peer support, mentor support), and (c) unmet support may cause low self-confidence (inadequate self-support, inadequate extrinsic-support, lack of motivation from successful experiences). The postgraduate students in this study accepted the objectives of the master’s training and actively practiced research exploration. They were motivated to persevere through their internal and external support, albeit with some negative aspects that deserve our attention. Interventions for postgraduate students’ cognitive awareness, constant support during their postgraduate career, and finally, guiding summaries may have a positive impact on their self-efficacy.