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Magwood O, Saad A, Ranger D, Volpini K, Rukikamirera F, Haridas R, Sayfi S, Alexander J, Tan Y, Pottie K. Mobile apps to reduce depressive symptoms and alcohol use in youth: A systematic review and meta-analysis: A systematic review. Campbell Syst Rev 2024; 20:e1398. [PMID: 38680950 PMCID: PMC11047135 DOI: 10.1002/cl2.1398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 01/17/2024] [Accepted: 03/18/2024] [Indexed: 05/01/2024]
Abstract
Background Among youth, symptoms of depression, anxiety, and alcohol use are associated with considerable illness and disability. Youth face many personal and health system barriers in accessing mental health care. Mobile applications (apps) offer youth potentially accessible, scalable, and anonymous therapy and other support. Recent systematic reviews on apps to reduce mental health symptoms among youth have reported uncertain effectiveness, but analyses based on the type of app-delivered therapy are limited. Objectives We conducted this systematic review with youth co-researchers to ensure that this review addressed the questions that were most important to them. The objective of this review is to synthesize the best available evidence on the effectiveness of mobile apps for the reduction of depressive symptoms (depression, generalized anxiety, psychological distress) and alcohol use among youth. Search Methods We conducted electronic searches of the following bibliographic databases for studies published between January 1, 2008, and July 1, 2022: MEDLINE (via Ovid), Embase (via Ovid), PsycINFO (via Ovid), CINAHL (via EBSCOHost), and CENTRAL (via the Cochrane Library). The search used a combination of indexed terms, free text words, and MeSH headings. We manually screened the references of relevant systematic reviews and included randomized controlled trials (RCTs) for additional eligible studies, and contacted authors for full reports of identified trial registries or protocols. Selection Criteria We included RCTs conducted among youth aged 15-24 years from any setting. We did not exclude populations on the basis of gender, socioeconomic status, geographic location or other personal characteristics. We included studies which assessed the effectiveness of app-delivered mental health support or therapy interventions that targeted the management of depressive disorders and/or alcohol use disorders. We excluded apps that targeted general wellness, apps which focused on prevention of psychological disorders and apps that targeted bipolar disorder, psychosis, post-traumatic stress disorder, attention-deficit hyperactivity disorder, substance use disorders (aside from alcohol), and sleep disorders. Eligible comparisons included usual care, no intervention, wait-list control, alternative or controlled mobile applications. We included studies which reported outcomes on depressive symptoms, anxiety symptoms, alcohol use and psychological distress over any follow-up period. Data Collection and Analysis We standardized the PICO definitions (population, intervention, comparison, and outcome) of each included study and grouped studies by the type of therapy or support offered by the app. Whenever app design and clinical homogeneity allowed, we meta-analyzed outcomes using a random-effects model. Outcome data measured using categorical scales were synthesized using odds ratios. Outcome data measured using continuous scales were synthesized as the standardized mean difference. We assessed the methodological quality of each included study using the Cochrane Risk of Bias 2.0 tool and we assessed certainty of the evidence using the GRADE approach. Main Results From 5280 unique citations, we included 36 RCTs published in 37 reports and conducted in 15 different countries (7984 participants). Among the 36 included trials, we assessed two with an overall low risk of bias, 8 trials with some concern regarding risk of bias, and 26 trials with a high risk of bias. Interventions varied in the type of therapy or supports offered. The most common intervention designs employed mindfulness training, cognitive behavioral therapy (CBT), or a combination of the two (mindfulness + CBT). However, other interventions also included self-monitoring, medication reminders, cognitive bias modification or positive stimulation, dialectical behavioral therapy, gamified health promotion, or social skill building. Mindfulness apps led to short term improvements in depressive symptoms when compared to a withheld control (SMD = -0.36; 95% CI [-0.63, -0.10]; p = 0.007, n = 3 RCTs, GRADE: very low certainty) and when compared to an active control (SMD = -0.27; 95% CI [-0.53, -0.01]; p = 0.04, n = 2 RCTs, GRADE: very low). Apps delivering this type of support also significantly improved symptoms of anxiety when compared to a withheld control (SMD = -0.35; 95% CI [-0.60, -0.09]; p = 0.008, n = 3 RCTs, GRADE: very low) but not when compared to an active control (SMD = -0.24; 95% CI [-0.50, 0.02]; p = 0.07, n = 2 RCTs, GRADE: very low). Mindfulness apps showed improvements in psychological stress that approached statistical significance among participants receiving the mindfulness mobile apps compared to those in the withheld control (SMD = -0.27; 95% CI [-0.56, 0.03]; p = .07, n = 4 RCTs, GRADE: very low). CBT apps also led to short-term improvements in depressive symptoms when compared to a withheld control (SMD = -0.40; 95% CI [-0.80, 0.01]; p = 0.05, n = 2 RCTs, GRADE: very low) and when compared to an active control (SMD = -0.59; 95% CI [-0.98, -0.19]; p = 0.003, n = 2 RCTs, GRADE: very low). CBT-based apps also improved symptoms of anxiety compared to a withheld control (SMD = -0.51; 95% CI [-0.94, -0.09]; p = 0.02, n = 3 RCTs, GRADE: very low) but not when compared to an active control (SMD = -0.26; 95% CI [-1.11, 0.59]; p = 0.55, n = 3 RCTs, GRADE: very low). Apps which combined mindfulness and CBT did not significantly improve symptoms of depression (SMD = -0.20; 95% CI [-0.42, 0.02]; p = 0.07, n = 2 RCTs, GRADE: very low) or anxiety (SMD = -0.21; 95% CI [-0.49, 0.07]; p = 0.14, n = 2 RCTs, GRADE: very low). However, these apps did improve psychological distress (SMD = -0.43; 95% CI [-0.74, -0.12]; p = 0.006, n = 2 RCTs, GRADE: very low). The results of trials on apps to reduce alcohol use were inconsistent. We did not identify any harms associated with the use of apps to manage mental health concerns. All effectiveness results had a very low certainty of evidence rating using the GRADE approach, meaning that apps which deliver therapy or other mental health support may reduce symptoms of depression, anxiety and psychological distress but the evidence is very uncertain. Authors' Conclusions We reviewed evidence from 36 trials conducted among youth. According to our meta-analyses, the evidence is very uncertain about the effect of apps on depression, anxiety, psychological distress, and alcohol use. Very few effects were interpreted to be of clinical importance. Most of the RCTs were small studies focusing on efficacy for youth at risk for depressive symptoms. Larger trials are needed to evaluate effectiveness and allow for further analysis of subgroup differences. Longer trials are also needed to better estimate the clinical importance of these apps over the long term.
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Affiliation(s)
- Olivia Magwood
- Bruyère Research InstituteOttawaOntarioCanada
- Interdisciplinary School of Health Sciences, Faculty of Health SciencesUniversity of OttawaOttawaOntarioCanada
| | - Ammar Saad
- Bruyère Research InstituteOttawaOntarioCanada
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | | | - Kate Volpini
- Department of Family MedicineUniversity of OttawaOttawaOntarioCanada
| | | | - Rinila Haridas
- Bruyère Research InstituteOttawaOntarioCanada
- Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- School of NursingUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Shahab Sayfi
- Bruyère Research InstituteOttawaOntarioCanada
- Department of Biology, Faculty of ScienceUniversity of OttawaOttawaOntarioCanada
| | - Jeremie Alexander
- Bruyère Research InstituteOttawaOntarioCanada
- Department of Biochemistry and Biomedical ScienceMcMaster UniversityHamiltonOntarioCanada
| | - Yvonne Tan
- Bruyère Research InstituteOttawaOntarioCanada
- Department of Biomedical and Molecular Sciences, Faculty of Arts and ScienceQueen's UniversityKingstonOntarioCanada
| | - Kevin Pottie
- Bruyère Research InstituteOttawaOntarioCanada
- Departments of Family Medicine and Epidemiology and BiostatisticsWestern UniversityLondonOntarioCanada
- Department of Family MedicineDalhousie UniversityHalifaxNova ScotiaCanada
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Hassan A, Deshun Z. Psychophysiological Impact of Touching Landscape Grass among Older Adults. J Urban Health 2024:10.1007/s11524-024-00875-7. [PMID: 38739226 DOI: 10.1007/s11524-024-00875-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 05/14/2024]
Abstract
Few studies have investigated plants' healing effects, particularly through touch-based therapy, on older adults. As hypertension rates continue to climb worldwide, touch-based therapy for hypertension prevention has become a significant priority in public health initiatives. This study investigated the impact of tactile interaction with real grass (a landscape activity) versus artificial grass on older adults' physical and cognitive abilities. Employing a within-subject design, we assessed the physiological and emotional effects of touching real grass versus artificial glass for 10 min. Study participants included 50 Chinese individuals, with an average age of 85.64 ± 3.72 years. Measurements included blood pressure, electroencephalogram, State-Trait Anxiety Inventory, and standard deviation (SD). Analyzing the SD data revealed that participants experienced a heightened sense of relaxation and calmness after touching real grass, compared to artificial grass. Furthermore, the participants' brainwave patterns-measured in mean power units-exhibited an upward trend while interacting with real grass, whereas they exhibited a downward trend during the interaction with artificial grass. Moreover, the mean systolic blood pressure significantly decreased following interaction with real grass. These findings suggest that engaging with real grass through touch potentially alleviates mental stress, in contrast to the effects of artificial grass.
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Affiliation(s)
- Ahmad Hassan
- College of Architecture and Urban Planning, Tongji University, 1239 Siping Rd, Shanghai, People's Republic of China.
| | - Zhang Deshun
- College of Architecture and Urban Planning, Tongji University, 1239 Siping Rd, Shanghai, People's Republic of China.
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Barbic S, Mallia E, Wuerth K, Ow N, Marchand K, Ben-David S, Ewert A, Turnbull H, Gao C, Ding X, Dhillon A, Hastings K, Langton J, Tee K, Mathias S. Implementing Foundry: A cohort study describing the regional and virtual expansion of a youth integrated service in British Columbia, Canada. Early Interv Psychiatry 2024. [PMID: 38736277 DOI: 10.1111/eip.13538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/08/2024] [Accepted: 04/19/2024] [Indexed: 05/14/2024]
Abstract
AIM Integrated youth services (IYS) have been identified as a national priority in response to the youth mental health and substance use (MHSU) crisis in Canada. In British Columbia (BC), an IYS initiative called Foundry expanded to 11 physical centres and launched a virtual service. The aim of the study was to describe the demographics of Foundry clients and patterns of service utilization during this expansion, along with the impact of the COVID-19 pandemic. METHODS Data were analysed for all youth (ages 12-24) accessing both in-person (April 27th, 2018-March 31st, 2021) and virtual (May 1st, 2020-March 31st, 2021) services. Cohorts containing all clients from before (April 27th, 2018-March 16th, 2020) and during (March 17th, 2020-March 31st, 2021) the COVID-19 pandemic were also examined. RESULTS A total of 23 749 unique youth accessed Foundry during the study period, with 110 145 services provided. Mean client age was 19.54 years (SD = 3.45) and 62% identified as female. Over 60% of youth scored 'high' or 'very high' for distress and 29% had a self-rated mental health of 'poor', with similar percentages seen for all services and virtual services. These ratings stayed consistent before and during the COVID-19 pandemic. CONCLUSIONS Foundry has continued to reach the target age group, with a 65% increase in number of clients during the study period compared with the pilot stage. This study highlights lessons learned and next steps to promote youth-centred data capture practices over time within an integrated youth services context.
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Affiliation(s)
- Skye Barbic
- Foundry, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Providence Research, Vancouver, British Columbia, Canada
- Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada
| | | | | | - Nikki Ow
- Foundry, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kirsten Marchand
- Foundry, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada
| | - Shelly Ben-David
- School of Social Work, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | | | | | - Chloe Gao
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Experimental Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- MD/PhD Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Xiaoxu Ding
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Avneet Dhillon
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katherine Hastings
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Karen Tee
- Foundry, Vancouver, British Columbia, Canada
| | - Steve Mathias
- Foundry, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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Rao S, Dimitropoulos G, Jardine R, Quickstad J, Satam L, Qureshi M, Bui T, Todorova AA, Tumaneng Y, Suthakaran A, Dalley K, Smith S, Patten SB. Primus Inter PARES: First among equals-practical strategies for young adult PAtient RESearch partners (PARES) by young adult PARES. Res Involv Engagem 2024; 10:45. [PMID: 38720386 PMCID: PMC11077772 DOI: 10.1186/s40900-024-00576-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/18/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND This manuscript is coauthored by 15 young adult Patient RESearch partners (PARES) with lived and living mental health experiences and three institutional researchers across Canada involved in a patient-oriented research (POR) study called the HEARTS Study: Helping Enable Access and Remove Barriers To Support for Young Adults with Mental Health-Related Disabilities. We share our reflections, experiences and lessons learned as we grapple with the field of POR for its lack of clarity, hierarchical structures, internalized ableism, and accessibility challenges, among others. To mitigate the difficulties of POR, we started by laying the groundwork for equality by embracing the principle of Primus Inter Pares: First Among Equals as the foundation of our approach. In this way, we began with what we know for certain: the inherent worth and dignity of young adults as equal partners, recognizing their expertise, worldviews, creativity, and capacity to contribute meaningfully and intentionally to the research that affects their lives and futures. MAIN BODY The manuscript underscores the need to reconceptualize meaningful engagement in POR, advocating a shift from traditional, biased paradigms that fail to address the complexities faced by young adults with mental illness. It introduces what we have termed Adaptive and Differential Engagement, underscoring the necessity of tailoring participation to individual preferences and circumstances alongside a Tripartite Compensation model that promotes fair and holistic remuneration in research collaborations. Then we discuss the approaches we have conceptualized, such as Equitable Dialogue, Trust Architecture, Community Continuum, Unity in Diversity, Shared Stewardship, and Agile Frameworks that collectively aim to overcome barriers like language intimidation, power imbalances, framework fatigue, consultation burnout, trust deficits, and systemic discrimination and exclusion. The manuscript does not seek to prescribe any universal or standardized solutions; in fact, it seeks the opposite. Instead, it offers a thoughtful and transparent contribution to the POR canon, providing resources for young adults eager to engage in research and institutional researchers aspiring to collaborate with them. CONCLUSION This manuscript is a product of our collective learning and critical self-evaluation. By integrating theoretical insights with practical strategies, we present a justice-oriented blueprint for an inclusive and egalitarian approach to POR. We advocate for applications of POR that are responsive to the individualized contexts of young adult PARES, ensuring their perspectives are central to the research with the resources to take the lead should they choose.
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Affiliation(s)
- Sandy Rao
- Faculty of Social Work, University of Calgary, Calgary, Canada.
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada.
| | - Gina Dimitropoulos
- Faculty of Social Work, University of Calgary, Calgary, Canada
- Department of Psychiatry, University of Calgary, Calgary, Canada
- Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada
| | - Rae Jardine
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Julien Quickstad
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Laetitia Satam
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Mohammad Qureshi
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Thyra Bui
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Antoaneta Alexandrova Todorova
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Ysabelle Tumaneng
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Abitha Suthakaran
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Kaiden Dalley
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Stacie Smith
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
- Faculty of Education, Mount Saint Vincent University, Halifax, NS, Canada
| | - Scott B Patten
- Department of Psychiatry, University of Calgary, Calgary, Canada
- Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
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Hiew Y, Powell NL, Wong QY, Fong ZH, Fong YJ, Chee TT. Factors associated with informal and formal help-seeking among Asian adolescents with nonsuicidal self-injury. Clin Child Psychol Psychiatry 2024:13591045241241109. [PMID: 38565258 DOI: 10.1177/13591045241241109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Although nonsuicidal self-injury (NSSI) is prevalent among adolescents and is associated with an increased risk of adverse outcomes, many adolescents with NSSI do not seek help. However, there is a lack of research on the factors that may increase the likelihood of help-seeking, especially within Asia. To address this gap, the present study examined whether certain factors were associated with informal and formal help-seeking - specifically gender, severity of NSSI, functions of NSSI and authoritative parenting. 121 adolescents (Mage = 16.2 years, 71.1% female) were recruited from specialist outpatient clinics and inpatient psychiatric wards from a public hospital in Singapore. One caregiver per adolescent was also recruited. Data from self-report questionnaires were analysed using logistics regression analyses. The results suggest that the severity of NSSI increases the likelihood of informal help-seeking, while adolescents who have parents with more authoritative parenting style are less likely to seek informal help. Gender and functions of NSSI were not found to be associated with help-seeking. The findings from this study can guide professionals in their efforts to encourage help-seeking within Asian populations, as well as inform prevention and treatment programs for Asian adolescents with NSSI.
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Affiliation(s)
- Yvette Hiew
- Department of Psychology, National University of Singapore, Singapore
| | | | - Qiu Yan Wong
- Department of Psychology, National University of Singapore, Singapore
| | - Zhi Hui Fong
- Department of Psychological Medicine, National University Health System, Singapore
| | - Ying Jie Fong
- Department of Psychological Medicine, National University Health System, Singapore
| | - Tji Tjian Chee
- Department of Psychological Medicine, National University Health System, Singapore
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Niwenahisemo LC, Hong S, Kuang L. Assessing anxiety symptom severity in Rwandese adolescents: cross-gender measurement invariance of GAD-7. Front Psychiatry 2024; 15:1346267. [PMID: 38528981 PMCID: PMC10962260 DOI: 10.3389/fpsyt.2024.1346267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/15/2024] [Indexed: 03/27/2024] Open
Abstract
Background Anxiety disorders are among the most common mental health problems experienced by adolescents worldwide because of their evident significant impact on their quality of life and functioning. The generalized anxiety disorder item (GAD-7) was manufactured to identify the severity of self-reported anxiety symptoms. Efforts to address and screen for mental health problems in Rwanda have been limited, and the importance of screening for anxiety disorders is high. The primary aim of this study was to analyze the psychometric properties of the Kinyarwanda version of the Generalized Anxiety Disorder GAD-7, and then test the measurement invariance of the GAD-7 by gender. Methods We used the Rwandese version of GAD-7 among secondary school students in Kigali city (n=1813). Measurement invariance of the GAD-7 across gender and report on anxiety symptom severity prevalence. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine measurement invariance. Results Our findings demonstrated that in the sample of 1813 adolescents aged between 12 and 17 years, generalized anxiety symptoms prevalence rates were higher in females (46.4%) than males (n= 29.8%) GAD-7 demonstrated good reliability and validity coefficients with a Cronbach's α of .077 and KMO and Bartlett test of Sphericity = 0.835. In addition to these psychometric properties, the GAD-7 screening scale had equivalence for configural and metric invariance across groups with excellent fit indices, and we confirmed partial scalar invariance across groups. Conclusion The GAD-7 can be used in cross-group comparison of generalized anxiety disorder prevalence, and we acknowledge that full scalar invariance is generally difficult to confirm, especially due to gender differences. We recommend that future studies further investigate populations living in rural areas and conduct trials that will focus on anxiety-specific treatment in Rwandan Clinical health care centers to determine the diagnostic accuracy of this screening tool.
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Affiliation(s)
| | - Su Hong
- *Correspondence: Su Hong, ; Li Kuang,
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Richter Sundberg L, Gotfredsen A, Christianson M, Wiklund M, Hurtig AK, Goicolea I. Exploring cross-boundary collaboration for youth mental health in Sweden - a qualitative study using the integrative framework for collaborative governance. BMC Health Serv Res 2024; 24:322. [PMID: 38468279 DOI: 10.1186/s12913-024-10757-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/20/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Youth mental health is a major health concern in almost every country. Mental health accounts for about 13% of the global burden of disease in the 10-to-19-year age group. Still there are significant gaps between the mental health needs of young people and the quality and accessibility of available services. Collaboration between health and social service actors is a recognized way of reducing gaps in quality and access. Yet there is little scientific evidence on how these collaborations are applied, or on the challenges of cross-boundary collaboration in the youth mental health space. This study aims to explore how collaboration is understood and practiced by professionals working in the Swedish youth mental health system. METHODS We conducted 42 interviews (November 2020 to March 2022) with health and social care professionals and managers in the youth mental health system in Sweden. Interviews explored participants' experience and understanding of the purpose, realization, and challenges of collaboration. Data were analysed under an emergent study design using reflexive thematic analysis. RESULTS The analysis produced three themes. The first shows that collaboration is considered as essential and important, and that it serves diverse purposes and holds multiple meanings in relation to professionals' roles and responsibilities. The second addresses the different layers of collaboration, in relation to activities, relationships, and target levels, and the third captures the challenges and criticisms in collaborating across the youth mental health landscape, but also in growing possibilities for future development. CONCLUSION We conclude that collaboration serves multiple purposes and takes many shapes in the Swedish youth mental health system. Despite the many challenges, participants saw potential in further building collaboration. Interestingly our participants also raised concerns about too much collaboration. There was scepticism about collaboration directing attention away from young people to the professionals, thereby risking the trust and confidentiality of their young clients. Collaboration is not a panacea and will not compensate for an under-resourced youth mental health system.
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Affiliation(s)
| | - Anne Gotfredsen
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Monica Christianson
- Department of Nursing, Sexual and Reproductive Health, Umeå University, Umeå, Sweden
| | - Maria Wiklund
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Anna-Karin Hurtig
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Isabel Goicolea
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Kim K, Au-Yeung A, Dagher D, Jacobs N, Martin-Hill D, Wekerle C. Exploring the relevance of a psychology-based resilience app (JoyPop™) for Indigenous youth. Child Abuse Negl 2024; 148:106343. [PMID: 37451896 DOI: 10.1016/j.chiabu.2023.106343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/15/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Despite facing challenges to mental wellness from ongoing multifold trauma, Indigenous youth continue to galvanize their resilience. One pathway undertaken is embracing technology. The JoyPop™ youth resilience mobile application (app) was invited by Six Nations of the Grand River (SN) leadership to consider its use with their reserve youth. OBJECTIVE This study explored the feasibility of JoyPop™ research from the SN community adult perspective for appropriateness and relevance to SN youth, as a precursor to a user-experience study with community youth. METHODS Semi-structured, online interviews with 19 adult community members (26 % male) about JoyPop™ were conducted with nominated stakeholders from SN. Based on a standard presentation of the app, comments were solicited about app features, design, and relevance to Haudenosaunee culture. Interviews were transcribed, coded in a double-blind fashion, and analyzed for themes. RESULTS Most offered positive feedback, with some level of support for each feature of JoyPop™. Themes were identified (Need for Indigenous Design, Incorporation of Indigenous Culture, Appreciation of Ease, Flexibility and Personalization), stemming from comments of appraisal and suggestions for adaptations (e.g., incorporating more cultural elements, localized resources, simplification of app). CONCLUSIONS The JoyPop™ app was viewed as positive and relevant, based on feedback from adults within SN. Adaptations were identified by adults to better fit SN youth needs, and research with SN youth is pending before implementation of adaptations. Research with other communities is encouraged to expand the reach of technology interventions, to holistically support Indigenous youth mental health in a culturally relevant way.
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Affiliation(s)
- Katherine Kim
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Allison Au-Yeung
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Danielle Dagher
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Norma Jacobs
- Department of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Dawn Martin-Hill
- Department of Anthropology, Indigenous Studies Program, McMaster University, Hamilton, Ontario, Canada
| | - Christine Wekerle
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Optentia Research Unit, North-West University, South Africa; Department of Psychiatry and Behavioral Neuroscience, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
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Rao S. The Access Paradox: unmet healthcare needs among young adults in Alberta - an exploratory study of the systemic ironies in healthcare accessibility. Int J Ment Health Nurs 2024. [PMID: 38183386 DOI: 10.1111/inm.13285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/19/2023] [Indexed: 01/08/2024]
Abstract
There is a pressing need to investigate how young adults' access to healthcare, including how delayed help-seeking behaviours and the complexities inherent in traditional healthcare systems, exacerbate the challenges they face. This study explores the associations among functional impairments, self-perceptions of health, anxiety and mood disorders and their potential relationship to unmet healthcare needs among young adults aged 20-29. This cross-sectional study used data from the 2017-2018 Canadian Community Health Survey to analyse a sample of 1636 young adults from Alberta, Canada. Central to the analysis was the application of conceptual framework of access to health care, as it offers a comprehensive view of healthcare access. Among the sampled young adults, 7.0% reported unmet healthcare needs. Self-perceived unmet healthcare needs were significantly associated with anxiety disorders, functional impairments-specifically cognitive and social skills, and self-perceptions of poor or fair mental health, as opposed to those perceiving their mental health as excellent. Multivariable analyses incorporating extraneous variables were not statistically significant, emphasising the critical role of systemic and structural factors in healthcare access. The study presents preliminary insights into the intricate dynamics shaping unmet healthcare needs. These insights can guide future research and practice advances, particularly in developing targeted interventions that effectively reduce healthcare disparities and enhance access to healthcare services for young adults.
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Affiliation(s)
- Sandy Rao
- Faculty of Social Work, University of Calgary, Calgary, Canada
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10
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Al Omari O, Amandu G, Al-Adawi S, Shebani Z, Al Harthy I, Obeidat A, Al Dameery K, Al Qadire M, Al Hashmi I, Al Khawldeh A, ALBashtawy M, Aljezawi M. The lived experience of Omani adolescents and young adults with mental illness: A qualitative study. PLoS One 2023; 18:e0294856. [PMID: 38011180 PMCID: PMC10681192 DOI: 10.1371/journal.pone.0294856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
There is currently limited knowledge about the firsthand experiences of adolescents and young adults with mental health problems and the meanings they ascribe to these experiences, particularly within Arab countries. This study, therefore, aimed to explore the lived experience of Omani adolescents and young adults with a mental health problem. A sample of 15 participants aged 13-22 diagnosed with a range of mental health problems took part in the study. A qualitative interview guide consisting of open-ended questions was used to allow participants to speak in-depth about their experiences. Using the thematic analysis approach to uncover patterns in the data, three major themes emerged: "living in darkness", "perilous journey" and "uncertain future". Results show that the progress of adolescents and young adults with mental health problems is characterized by several challenges; the most significant of which is having insufficient knowledge about their illness, leading to unnecessary delays in their treatment. These findings shed light on the breadth and depth of the experience of adolescents and young adults with mental health problems and lay the groundwork for further examinations. Implications lie in the development of approaches for preventing or mitigating difficulties faced by adolescents and young adults with mental health problems.
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Affiliation(s)
- Omar Al Omari
- College of Nursing, Sultan Qaboos University, Muscat, Oman
- College of Nursing, Yarmouk University, Irbid, Jordan
| | - Gerald Amandu
- College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Samir Al-Adawi
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Zubaida Shebani
- College of Education, Sultan Qaboos University, Muscat, Oman
| | | | - Arwa Obeidat
- College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | - Mohammad Al Qadire
- College of Nursing, Sultan Qaboos University, Muscat, Oman
- Princess Salma Faculty of Nursing Al al-Bayt University, Mafraq, Jordan
| | - Iman Al Hashmi
- College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | | | - Maen Aljezawi
- College of Nursing, Sultan Qaboos University, Muscat, Oman
- Princess Salma Faculty of Nursing Al al-Bayt University, Mafraq, Jordan
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11
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Maricic J, Bjelic S, Jelic K. The Role of Self-Compassion and Attributions in the Mental Health of Older Adolescents amid the COVID-19 Pandemic. Int J Environ Res Public Health 2023; 20:6981. [PMID: 37947539 PMCID: PMC10648687 DOI: 10.3390/ijerph20216981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/06/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
This study aimed to examine the relationship among self-compassion, attributional styles, and mental health and their components in older adolescents in the context of the COVID-19 pandemic. The role of each component of self-compassion (self-kindness, common humanity, mindfulness, self-judgment, isolation, and over-identification) and attributions (globality, stability, self-worth, and negative consequences) in predicting mental health was also analyzed. There were 322 participants aged 18 to 22 that participated in an online survey. The participants filled out a form that consisted of sociodemographic questions, COVID-19-related questions, the Self-Compassion Scale, the Mental Health Continuum-short form-and the Cognitive Styles Questionnaire-very short form. The results indicated moderate levels of self-compassion, attributions, and mental health in participants. Furthermore, gender differences in self-compassion were confirmed, meaning that male participants had higher total levels of self-compassion, and certain differences were observed on attribution subscales, but not on well-being subscales. Self-compassion and mental health were found to be positively correlated with each other and negatively correlated with negative attributions. Of the four attributional components, stability and negative consequences were revealed to be significant negative predictors in the first step but lost their significance with the inclusion of self-compassion components in the second step of the analysis. Regarding the six components of self-compassion, self-kindness, recoded isolation, and common humanity were significant positive predictors in the second step of the analysis. COVID-19-related items did not show any significant intergroup differences. Our findings contribute to a better understanding of the relationship between positive mental health, self-compassion, and attributions in older adolescents so that they can be used as theoretical support for related interventions, especially during and after times of crisis, such as a pandemic.
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Affiliation(s)
- Jelena Maricic
- Faculty of Croatian Studies, University of Zagreb, 10000 Zagreb, Croatia (K.J.)
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12
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Halsall T, Daley M, Hawke LD, Henderson J, Matheson K. "You can create a little bit more closure in your own story when someone really connects with it": exploring how involvement in youth peer support work can promote peer development. Int J Ment Health Syst 2023; 17:34. [PMID: 37875958 PMCID: PMC10594763 DOI: 10.1186/s13033-023-00608-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/12/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Peer support relates to the provision of social/emotional support that is delivered by individuals with lived experience of a key characteristic that is shared with clients. Although the main objective of peer support is to enhance client outcomes, through their involvement, peers derive a secondary benefit to their own personal development. This study applied a hybrid participatory-realist approach to identify what works, for whom, why and in what circumstances within the LOFT Transitional Age Youth (TAY) peer services. This paper presents findings related to the processes and possible benefits of being involved in peer work for the peer supporters themselves. METHODS Semi-structured interviews and focus groups were completed with peer and non-peer staff from the TAY program. A qualitative analysis applied a retroductive approach that involved both inductive and deductive processes to identify relevant themes. RESULTS Four program theories and one over-arching context were identified through the analyses. Program theories were related to: (1) enhancing self-efficacy and self-determination through peer involvement in program design, (2) increasing peer resiliency and self-care through effective supervision, (3) developing professional skills and opportunities for career advancement through peer practice and (4) overcoming stigma through the recognition of the value of peer lived experience. CONCLUSIONS Peer practice holds significant potential for the enhancement of the mental health system as well as to increase our understanding of stigma. The findings from this study offer critical new insights into the dynamics of how professional peer practice can support the personal development of youth peers and how programming can be intentionally designed to enhance these benefits.
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Affiliation(s)
- Tanya Halsall
- University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada.
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada.
| | - Mardi Daley
- LOFT Community Services, 721 Bloor St. W Suite 103, Toronto, ON, M6G 1L5, Canada
| | - Lisa D Hawke
- Centre for Addiction and Mental Health, 1000 Queen St W, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1L8, Canada
| | - Jo Henderson
- Centre for Addiction and Mental Health, 1000 Queen St W, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1L8, Canada
| | - Kimberly Matheson
- University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
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13
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Bower M, Donohoe-Bales A, Nguyen AQH, Smout S, Boyle J, Barrett E, Partridge SR, Mandoh M, Simmons M, Valanju R, Yan F, Ou C, Meas D, Guo K, Mautner D, Al Hadaya I, Rose D, Teesson M. Mental health and wellbeing outcomes of youth participation: A scoping review protocol. PLoS One 2023; 18:e0293006. [PMID: 37847717 PMCID: PMC10581453 DOI: 10.1371/journal.pone.0293006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 09/15/2023] [Indexed: 10/19/2023] Open
Abstract
There is growing recognition that young people should be given opportunities to participate in the decisions that affect their lives, such as advisory groups, representative councils, advocacy or activism. Positive youth development theory and sociopolitical development theory propose pathways through which youth participation can influence mental health and wellbeing outcomes. However, there is limited empirical research synthesising the impact of participation on youth mental health and/or wellbeing, or the characteristics of activities that are associated with better or worse mental health and/or wellbeing outcomes. This scoping review seeks to address this gap by investigating the scope and nature of evidence detailing how youth participation initiatives can influence mental health and/or wellbeing outcomes for participants. To be eligible, literature must describe youth (aged 15-24) in participation activities and the impact of this engagement on participant mental health and/or wellbeing outcomes. A systematic scoping review of peer-reviewed and grey literature will be conducted using Scopus, PsycINFO, Embase, Medline and grey literature databases. The scoping review will apply established methodology by Arksey and O'Malley, Levac and colleagues and the Joanna Briggs Institute. Title, abstract, and full text screening will be completed by two reviewers, data will be extracted by one reviewer. Findings will be reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), including a qualitative summary of the characteristics of youth participation and their influence on youth mental health outcomes. Youth advisory group members will be invited to deliver governance on the project from the outset; participate in, and contribute to, all stages of the review process; reflect on their own experiences of participation; and co-author the resulting publication. This scoping review will provide essential knowledge on how participation activities can be better designed to maximise beneficial psychosocial outcomes for involved youth.
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Affiliation(s)
- Marlee Bower
- Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Amarina Donohoe-Bales
- Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Andre Quan Ho Nguyen
- Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Scarlett Smout
- Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Julia Boyle
- Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Emma Barrett
- Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Stephanie R. Partridge
- Engagement and Codesign Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Mariam Mandoh
- Engagement and Codesign Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Magenta Simmons
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Radhika Valanju
- Youth Mental Health Advisory Team (YMHAT), Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Fulin Yan
- Youth Mental Health Advisory Team (YMHAT), Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Cheryl Ou
- Youth Mental Health Advisory Team (YMHAT), Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Danica Meas
- Youth Mental Health Advisory Team (YMHAT), Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Kailin Guo
- Youth Mental Health Advisory Team (YMHAT), Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Dominik Mautner
- Youth Mental Health Advisory Team (YMHAT), Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Imeelya Al Hadaya
- Youth Mental Health Advisory Team (YMHAT), Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Dominique Rose
- Youth Mental Health Advisory Team (YMHAT), Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Maree Teesson
- Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
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14
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Wang J, Xie Y, Xu H, Wan Y, Tao F. Moderating effects of smoking and drinking on the relationship between biological rhythm and psychological health and gender differences among adolescents. BMC Psychiatry 2023; 23:731. [PMID: 37817125 PMCID: PMC10566120 DOI: 10.1186/s12888-023-05253-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023] Open
Abstract
OBJECTIVES To determine whether smoking and drinking moderate the correlation between biological rhythm and mental health and the role of gender differences in these moderating effects. METHODS Adolescents from three cities, all twelve middle schools (N = 7,986), named Shenzhen, Nanchang and Shenyang in China, were asked to complete a standardized questionnaire including the details of biological rhythm, psychological health, and the status of smoking and drinking. The PROCESS program was used to analyze whether smoking and drinking moderated the relationship between biological rhythm and psychological health. RESULTS The analyses revealed poorer psychological health and greater likelihood of smoking and drinking in participants with higher scores for biological rhythm disorder (P < 0.001). Specifically, smoking and drinking accelerated the relationship between biological rhythm and psychological health in the total sample (B = 0.05, P < 0.05; B = 0.06, P < 0.001) and only the subgroup of girls (B = 0.09, P < 0.05; B = 0.12, P < 0.001), respectively. CONCLUSIONS As the findings suggest, attention should be given to smoking, drinking and gender-specific approaches employed to alleviate the psychological disorders of adolescents with biological rhythm disorders.
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Affiliation(s)
- Jiaojiao Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yang Xie
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
- Moe Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
| | - Huiqiong Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
- Moe Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
| | - Yuhui Wan
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
- Moe Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China.
- Moe Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China.
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China.
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15
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Chong MK, Hickie IB, Cross SP, McKenna S, Varidel M, Capon W, Davenport TA, LaMonica HM, Sawrikar V, Guastella A, Naismith SL, Scott EM, Iorfino F. Digital Application of Clinical Staging to Support Stratification in Youth Mental Health Services: Validity and Reliability Study. JMIR Form Res 2023; 7:e45161. [PMID: 37682588 PMCID: PMC10517388 DOI: 10.2196/45161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 05/31/2023] [Accepted: 06/26/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND As the demand for youth mental health care continues to rise, managing wait times and reducing treatment delays are key challenges to delivering timely and quality care. Clinical staging is a heuristic model for youth mental health that can stratify care allocation according to individuals' risk of illness progression. The application of staging has been traditionally limited to trained clinicians yet leveraging digital technologies to apply clinical staging could increase the scalability and usability of this model in services. OBJECTIVE The aim of this study was to validate a digital algorithm to accurately differentiate young people at lower and higher risk of developing mental disorders. METHODS We conducted a study with a cohort comprising 131 young people, aged between 16 and 25 years, who presented to youth mental health services in Australia between November 2018 and March 2021. Expert psychiatrists independently assigned clinical stages (either stage 1a or stage 1b+), which were then compared to the digital algorithm's allocation based on a multidimensional self-report questionnaire. RESULTS Of the 131 participants, the mean age was 20.3 (SD 2.4) years, and 72% (94/131) of them were female. Ninety-one percent of clinical stage ratings were concordant between the digital algorithm and the experts' ratings, with a substantial interrater agreement (κ=0.67; P<.001). The algorithm demonstrated an accuracy of 91% (95% CI 86%-95%; P=.03), a sensitivity of 80%, a specificity of 93%, and an F1-score of 73%. Of the concordant ratings, 16 young people were allocated to stage 1a, while 103 were assigned to stage 1b+. Among the 12 discordant cases, the digital algorithm allocated a lower stage (stage 1a) to 8 participants compared to the experts. These individuals had significantly milder symptoms of depression (P<.001) and anxiety (P<.001) compared to those with concordant stage 1b+ ratings. CONCLUSIONS This novel digital algorithm is sufficiently robust to be used as an adjunctive decision support tool to stratify care and assist with demand management in youth mental health services. This work could transform care pathways and expedite care allocation for those in the early stages of common anxiety and depressive disorders. Between 11% and 27% of young people seeking care may benefit from low-intensity, self-directed, or brief interventions. Findings from this study suggest the possibility of redirecting clinical capacity to focus on individuals in stage 1b+ for further assessment and intervention.
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Affiliation(s)
- Min K Chong
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | | | - Sarah McKenna
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Mathew Varidel
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - William Capon
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Tracey A Davenport
- Design and Strategy Division, Australian Digital Health Agency, Sydney, Australia
| | - Haley M LaMonica
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Vilas Sawrikar
- School of Health and Social Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Adam Guastella
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sharon L Naismith
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
- Healthy Brain Ageing Program, University of Sydney, Sydney, Australia
| | - Elizabeth M Scott
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
- St Vincent's and Mater Clinical School, The University of Notre Dame, Sydney, Australia
| | - Frank Iorfino
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
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16
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Rickwood DJ, Coleman-Rose CL. The effect of survey administration mode on youth mental health measures: Social desirability bias and sensitive questions. Heliyon 2023; 9:e20131. [PMID: 37809858 PMCID: PMC10559918 DOI: 10.1016/j.heliyon.2023.e20131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/31/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023] Open
Abstract
Aim Research on trends in youth mental health is used to inform government policy and service funding decisions. It often uses interviewer-administered surveys, which may be affected by mode effects related to social desirability bias. This study sought to determine the impact of survey administration mode on mental health measures, comparing mode effects for sensitive mental health measures (psychological distress and wellbeing) and non-sensitive (physical activity) measures. Methods Data were from two large national community samples of young Australians aged 12-25 years conducted in 2020 (N = 6238) and 2022 (N = 4122), which used both interviewer-administered and self-report modes of data collection. Results Results showed participants reported lower psychological distress and higher wellbeing in the interviewer-assisted compared with the self-report mode. No mode effects were found for the non-sensitive physical activity measures. No interaction between mode and gender was found, but an age group by mode interaction revealed that those in the 18-21 and 22-25-year age groups were more strongly affected than younger adolescents. Conclusions These findings suggest underestimates of mental health issues from interview survey formats, particularly for young adults. The results show how even a weak mode effect can have a large impact on mental health prevalence indicators. Researchers and policy makers need to be aware of the impact social desirability bias can have on mental health measures and consider taking steps to mitigate this effect.
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Daneshmand R, Acharya S, Zelek B, Cotterill M, Wood B. Changes in Children and Youth's Mental Health Presentations during COVID-19: A Study of Primary Care Practices in Northern Ontario, Canada. Int J Environ Res Public Health 2023; 20:6588. [PMID: 37623173 PMCID: PMC10454016 DOI: 10.3390/ijerph20166588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/27/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023]
Abstract
Recent research suggests that children and youth are at increased risk of anxiety and depression due to the indirect effects of the COVID-19 pandemic. In Canada, children and youths may face additional hurdles in accessing mental health services in rural areas due to socioeconomic disadvantages and healthcare provider shortages worsened by the pandemic. Our study aimed to assess changes in primary healthcare utilization related to depression and anxiety among children and youth aged 10-25 years in Northern Ontario, Canada. We analyzed de-identified electronic medical record data to assess primary healthcare visits and prescriptions for depression and anxiety among children and youth aged 10-25 years. We used provider billing data and reasons for visits and antidepressant/antianxiety prescriptions compared with 21 months pre-pandemic (1 June 2018 to 28 February 2020) and 21 months during the pandemic (1 April 2020 to 31 December 2021). Our interrupted time series analysis showed an average increase in visits by 2.52 per 10,000 person-months and in prescriptions by 6.69 per 10,000 person-months across all ages and sexes. Females aged 10 to 14 years were found to have the greatest relative change in visits across all age-sex groups. The greatest relative increases in antianxiety and antidepression prescriptions occurred among females and males aged 10 to 14 years, respectively. These findings indicate that there were increased anxiety and depression presentations in primary healthcare among children and youths living in northern and rural settings during the COVID-19 pandemic. The increased primary healthcare presentations of anxiety and depression by children and youths suggest that additional mental health resources should be allocated to northern rural primary healthcare to support the increased demand. Adequate mental health professionals, accessible services, and clinical recommendations tailored to northern rural populations and care settings are crucial.
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Affiliation(s)
- Roya Daneshmand
- Thunder Bay Regional Health Research Institute, Thunder Bay, ON P7B 6V4, Canada
- Section of Family Medicine, Northern Ontario School of Medicine (NOSM) University, Thunder Bay, ON P7B 5E1, Canada; (S.A.); (B.Z.); (M.C.)
| | - Shreedhar Acharya
- Section of Family Medicine, Northern Ontario School of Medicine (NOSM) University, Thunder Bay, ON P7B 5E1, Canada; (S.A.); (B.Z.); (M.C.)
| | - Barbara Zelek
- Section of Family Medicine, Northern Ontario School of Medicine (NOSM) University, Thunder Bay, ON P7B 5E1, Canada; (S.A.); (B.Z.); (M.C.)
| | - Michael Cotterill
- Section of Family Medicine, Northern Ontario School of Medicine (NOSM) University, Thunder Bay, ON P7B 5E1, Canada; (S.A.); (B.Z.); (M.C.)
| | - Brianne Wood
- Thunder Bay Regional Health Research Institute, Thunder Bay, ON P7B 6V4, Canada
- Section of Family Medicine, Northern Ontario School of Medicine (NOSM) University, Thunder Bay, ON P7B 5E1, Canada; (S.A.); (B.Z.); (M.C.)
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Glowacki K, Affolder J, Macnab B, Ewert A, Tee K, Wenger M, Chan G, Mathias S, Barbic S. Infusing wellness opportunities into integrated youth services. BMC Psychiatry 2023; 23:403. [PMID: 37277769 DOI: 10.1186/s12888-023-04809-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 04/20/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Appropriate health services and health promotion strategies for young people with mental health and substance use (MHSU) concerns are critical for recovery. Foundry, an integrated youth services (IYS) initiative for young people ages 12-24 in British Columbia (BC), Canada, has recently added leisure and recreational activities (referred to as the Wellness Program) into its services. The objectives of this study were to: (1) describe how the Wellness Program was implemented over a two-year period into IYS (2) provide an overview of what the Wellness Program is, who accessed the program since inception and initial evaluation results. METHODS This study was part of the developmental evaluation of Foundry. A phased approach was used to implement the program at nine centres. Data was accessed from Foundry's centralized platform 'Toolbox' and included activity type, number of unique youth and visits, additional services sought, information about how youth found out about the centre, and demographics. Qualitative data was also accessed from focus groups (n=2) conducted with young people (n=9). RESULTS Over the two-year period, 355 unique youth accessed the Wellness Program, with 1319 unique visits. Almost half (40%) of youth identified the Wellness Program as the first point of access to Foundry. A total of 384 different programs were offered targeting five wellness domains (physical, mental/emotional, social, spiritual, and cognitive/intellectual). The majority of youth identified as young girls/women (58.2%), 22.6% as gender diverse, and 19.2% as young men/boys. The mean age was 19 years, and most participants were between the ages of 19-24 years (43.6%). From the thematic analysis of focus groups, we found young people enjoyed the social aspect of the program with peers and facilitators, and identified program improvements that are being considered as the program grows. CONCLUSIONS This study provides insight into the development and implementation of leisure-based activities (known as the Wellness Program) into IYS and can be used as a guide by international IYS initiatives. The initial reach of programs over two years is promising, and these programs are acting as a potential gateway for young people to access other health services.
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Affiliation(s)
- Krista Glowacki
- Faculty of Medicine, Department of Occupational Science and Occupational Therapy, The University of British Columbia, T325 - 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
- Centre for Health Evaluation & Outcome Sciences, Providence Health Care, #588-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
| | - Jennifer Affolder
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Therapeutic Recreation, Douglas College, PO Box 2503, New Westminster, BC, V3L 5B2, Canada
| | - Brooke Macnab
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
| | - Alayna Ewert
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
| | - Karen Tee
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
| | - Matt Wenger
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
| | - Godwin Chan
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
| | - Steve Mathias
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Providence Research, 10th Floor - 1190 Hornby Street, Vancouver, BC, V6Z 2K5, Canada
| | - Skye Barbic
- Faculty of Medicine, Department of Occupational Science and Occupational Therapy, The University of British Columbia, T325 - 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
- Centre for Health Evaluation & Outcome Sciences, Providence Health Care, #588-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Providence Research, 10th Floor - 1190 Hornby Street, Vancouver, BC, V6Z 2K5, Canada
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19
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Kourgiantakis T, Markoulakis R, Lee E, Hussain A, Lau C, Ashcroft R, Goldstein AL, Kodeeswaran S, Williams CC, Levitt A. Access to mental health and addiction services for youth and their families in Ontario: perspectives of parents, youth, and service providers. Int J Ment Health Syst 2023; 17:4. [PMID: 36918893 PMCID: PMC10011786 DOI: 10.1186/s13033-023-00572-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 01/31/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Canadian youth (aged 16-24) have the highest rates of mental health and addiction concerns across all age groups and the most unmet health care needs. There are many structural barriers that contribute to the unmet mental health care needs of youth including lack of available and appropriate services, high costs, long wait times, fragmented and siloed services, lack of smooth transition between child and adult services, stigma, racism, and discrimination, as well as lack of culturally appropriate treatments. Levesque et al. (2013) developed a framework to better understand health care access and this framework conceptualizes accessibility across five dimensions: (1) approachability, (2) availability, (3) affordability, (4) appropriateness, and (5) acceptability. The purpose of this study was to explore access to addiction and mental health services for youth in Ontario, Canada from the perspectives of youth, parents, and service providers. METHODS This qualitative study was a university-community partnership exploring the experiences of youth with mental health concerns and their families from the perspectives of youth, caregivers, and service providers. We conducted semi-structured interviews and used thematic analysis to analyze data. RESULTS The study involved 25 participants (n = 11 parents, n = 4 youth, n = 10 service providers). We identified six themes related to structural barriers impacting access to youth mental health and services: (1) "The biggest barrier in accessing mental health support is where to look," (2) "There's always going to be a waitlist," (3) "I have to have money to be healthy," (4) "They weren't really listening to my issues," (5) "Having more of a welcoming and inclusive system," and (6) "Health laws aren't doing what they need to do." CONCLUSION Our study identified five structural barriers that map onto the Levesque et al. healthcare access conceptual framework and a sixth structural barrier that is not adequately captured by this model which focuses on policies, procedures, and laws. The findings have implications for policies and service provisions, and underline the urgent need for a mental health strategy that will increase access to care, improve mental health in youth, decrease burden on parents, and reduce inequities in mental health policies and services.
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Affiliation(s)
- Toula Kourgiantakis
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada.
| | - Roula Markoulakis
- Family Navigation Project, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Eunjung Lee
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Amina Hussain
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Carrie Lau
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Rachelle Ashcroft
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Abby L Goldstein
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, Toronto, ON, Canada
| | - Sugy Kodeeswaran
- Family Navigation Project, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Charmaine C Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Anthony Levitt
- Family Navigation Project, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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20
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Xi W, Banerjee S, Olfson M, Alexopoulos GS, Xiao Y, Pathak J. Effects of social deprivation on risk factors for suicidal ideation and suicide attempts in commercially insured US youth and adults. Sci Rep 2023; 13:4151. [PMID: 36914764 PMCID: PMC10011396 DOI: 10.1038/s41598-023-31387-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
We used US nationwide commercial insurance claims data (2011-2015) to study the effect of social deprivation on clinical and demographic risk factors for suicidal ideation (SI) and suicide attempts (SA) among US youth and adults < 65 years, after having a mental health or substance use disorder-related outpatient encounter. Neighborhood social deprivation level was summarized by the quintile of social deprivation index (SDI) at individuals' zip code level. Cox proportional hazard models were used to evaluate the effect of social deprivation on demographic and clinical risk factors for SI and SA. The study cohort consisted of 317,383 individuals < 65 years, with 124,424 aged < 25 (youth) and 192,959 aged between 25 and 64 (adults). Neighborhood social deprivation impacted risk factors for SI and SA differently for youth and adults. Among youth, SDI interacted with multiple risk factors for both SI and SA. The effects of the risk factors were larger on youth from middle socioeconomic neighborhoods. Among adults, risk of SI was the strongest in the most deprived neighborhoods, but risk of SA did not vary by neighborhood deprivation level. Our findings suggest community-based suicide prevention initiatives should be tailored according to neighborhood deprivation level and the targeted individual's age to maximize the impact.
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Affiliation(s)
- Wenna Xi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Samprit Banerjee
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Mark Olfson
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | | | - Yunyu Xiao
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Jyotishman Pathak
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, 10065, USA. .,Department of Psychiatry, Weill Cornell Medicine, White Plains, NY, 10605, USA.
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21
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Ge R, Sassi R, Yatham LN, Frangou S. Neuroimaging profiling identifies distinct brain maturational subtypes of youth with mood and anxiety disorders. Mol Psychiatry 2023; 28:1072-1078. [PMID: 36577839 PMCID: PMC10005933 DOI: 10.1038/s41380-022-01925-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022]
Abstract
Mood and anxiety disorders typically begin in adolescence and have overlapping clinical features but marked inter-individual variation in clinical presentation. The use of multimodal neuroimaging data may offer novel insights into the underlying brain mechanisms. We applied Heterogeneity Through Discriminative Analysis (HYDRA) to measures of regional brain morphometry, neurite density, and intracortical myelination to identify subtypes of youth, aged 9-10 years, with mood and anxiety disorders (N = 1931) compared to typically developing youth (N = 2823). We identified three subtypes that were robust to permutation testing and sample composition. Subtype 1 evidenced a pattern of imbalanced cortical-subcortical maturation compared to the typically developing group, with subcortical regions lagging behind prefrontal cortical thinning and myelination and greater cortical surface expansion globally. Subtype 2 displayed a pattern of delayed cortical maturation indicated by higher cortical thickness and lower cortical surface area expansion and myelination compared to the typically developing group. Subtype 3 showed evidence of atypical brain maturation involving globally lower cortical thickness and surface coupled with higher myelination and neural density. Subtype 1 had superior cognitive function in contrast to the other two subtypes that underperformed compared to the typically developing group. Higher levels of parental psychopathology, family conflict, and social adversity were common to all subtypes, with subtype 3 having the highest burden of adverse exposures. These analyses comprehensively characterize pre-adolescent mood and anxiety disorders, the biopsychosocial context in which they arise, and lay the foundation for the examination of the longitudinal evolution of the subtypes identified as the study sample transitions through adolescence.
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Affiliation(s)
- Ruiyang Ge
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Roberto Sassi
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital, Vancouver, BC, Canada
| | - Lakshmi N Yatham
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Sophia Frangou
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. .,Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. .,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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22
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Libon J, Alganion J, Hilario C. Youth Perspectives on Barriers and Opportunities for the Development of a Peer Support Model to Promote Mental Health and Prevent Suicide. West J Nurs Res 2023; 45:208-214. [PMID: 35919018 PMCID: PMC9902963 DOI: 10.1177/01939459221115695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Suicide prevention is a public health priority. The purpose of this study was to elicit and document the perspectives of youth (ages 15-24) on the development of a peer support model for mental health promotion and suicide prevention for youth in small communities in western Canada. A qualitative descriptive approach informed by a socioecological framework was used to conduct the study. Eleven youth participated in a series of three co-design workshops. Data collection was conducted remotely using Zoom. Data were analyzed using thematic analysis. The following three themes are identified: (a) contextual factors for youth; (b) community spaces and social media; and (c) apps and integrated care. These themes elucidated challenges faced by the youth, strategies for reducing barriers for youth who need support, and opportunities for enhancing youth mental health through responsive community-identified services. Overall, youth were supportive of the potential use of peer support to augment services in their communities.
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Affiliation(s)
- Jackie Libon
- Faculty of Nursing, University of Alberta, AB, Canada
- Jackie Libon, Faculty of Nursing, Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada.
| | | | - Carla Hilario
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, BC, Canada
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23
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Read A, Lutgens D, Malla A. A Descriptive Overview of Mental Health Services Offered in Post-Secondary Educational Institutions Across Canada. Can J Psychiatry 2023; 68:101-108. [PMID: 36200430 PMCID: PMC9923134 DOI: 10.1177/07067437221128168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Access to adequate mental health (MH) services is necessary for nearly half of Canadian youth (18-24 years) who enroll in post-secondary education given the relatively high risk of MH problems. Our objectives were to determine the status of MH services available to students in post-secondary institutions in Canada and to determine the extent to which these services are based on the principles of a high-quality youth MH (YMH) service. METHOD Information on MH services was collected from websites of a representative sample (N = 67) of post-secondary institutions across all provinces. Data were analysed descriptively according to four categories (universities with a Faculty of Medicine (FoM) n = 18, other large universities n = 15, small universities n = 16, and colleges n = 18). RESULTS Most institutions provided 24-h crisis line support (84%) and indicated the availability of free counselling or psychotherapy (n = 62 of 67, 92.5%), while only a minority indicated provision of an initial clinical assessment (25%) and provision of multiple sessions of therapy (37%). Wait time for first contact was impressively low (<72 h) in the minority of institutions (40%) which provided this information. Access to either a prescribing physician or psychiatrist was infrequent, though several mentioned an unexplained model of "stepped care" and outside referrals. While relevant information was not uniformly easy to access, larger institutions both with and without a FoM appear to be better poised to provide MH services. None of the institutions appeared to follow all the principles of service delivery recommended for a high-quality YMH, with only two showing early identification activities. CONCLUSIONS MH services in post-secondary institutions may need a transformation similar to YMH services, including a clear pathway to care, an initial clinical assessment, early identification of MHA disorders, and better utilization of institutional resources through greater collaboration and matching of timely interventions to the presenting problems.
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Affiliation(s)
- Alana Read
- Department of Psychology, 6082Capilano University, North Vancouver, British Columbia, Canada
| | - Danyael Lutgens
- Department of Psychology, 6082Capilano University, North Vancouver, British Columbia, Canada
| | - Ashok Malla
- Department of Psychiatry, 5620McGill University, Montreal, Quebec, Canada
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24
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Shah JL, Moinfar Z, Anderson KK, Gould H, Hutt-Macleod D, Jacobs P, Mitchell S, Nguyen T, Rodrigues R, Reaume-Zimmer P, Rudderham H, Rudderham S, Smyth R, Surood S, Urichuk L, Malla AK, Iyer SN, Latimer E. Return on investment from service transformation for young people experiencing mental health problems: Approach to economic evaluations in ACCESS Open Minds (Esprits ouverts), a multi-site pan-Canadian youth mental health project. Front Psychiatry 2023; 14:1030407. [PMID: 36896344 PMCID: PMC9988897 DOI: 10.3389/fpsyt.2023.1030407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 01/03/2023] [Indexed: 02/23/2023] Open
Abstract
INTRODUCTION Mental health problems are common globally, and typically have their onset in adolescence and early adulthood-making youth (aged 11-25) an optimal target for prevention and early intervention efforts. While increasing numbers of youth mental health (YMH) initiatives are now underway, thus far few have been subject to economic evaluations. Here we describe an approach to determining the return on investment of YMH service transformation via the pan-Canadian ACCESS Open Minds (AOM) project, for which a key focus is on improving access to mental health care and reducing unmet need in community settings. APPROACH As a complex intervention package, it is hoped that the AOM transformation will: (i) enable early intervention through accessible, community-based services; (ii) shift care away toward these primary/community settings and away from acute hospital and emergency services; and (iii) offset at least some of the increased costs of primary care/community-based mental health services with reductions in the volume of more resource-intensive acute, emergency, hospital or specialist services utilized. Co-designed with three diverse sites that represent different Canadian contexts, a return on investment analysis will (separately at each site) compare the costs generated by the intervention, including volumes and expenditures associated with the AOM service transformation and any contemporaneous changes in acute, emergency, hospital or service utilization (vs. historical or parallel comparators). Available data from health system partners are being mobilized to assess these hypotheses. ANTICIPATED RESULTS Across urban, semi-urban and Indigenous sites, the additional costs of the AOM transformation and its implementation in community settings are expected to be at least partially offset by a reduction in the need for acute, emergency, hospital or specialist care. DISCUSSION Complex interventions such as AOM aim to shift care "upstream": away from acute, emergency, hospital and specialist services and toward community-based programming which is more easily accessible, often more appropriate for early-stage presentations, and more resource-efficient. Carrying out economic evaluations of such interventions is challenging given the constraints of available data and health system organization. Nonetheless, such analyses can advance knowledge, strengthen stakeholder engagement, and further implementation of this public health priority.
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Affiliation(s)
- Jai L Shah
- ACCESS Open Minds, Douglas Research Centre, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Zeinab Moinfar
- ACCESS Open Minds, Douglas Research Centre, Montreal, QC, Canada
| | - Kelly K Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Institute of Clinical and Evaluative Sciences, Toronto, ON, Canada
| | | | | | - Philip Jacobs
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Stephen Mitchell
- Canadian Mental Health Association Lambton Kent, Chatham-Kent, ON, Canada
| | - Thanh Nguyen
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Rebecca Rodrigues
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Paula Reaume-Zimmer
- Canadian Mental Health Association Lambton Kent, Chatham-Kent, ON, Canada.,Bluewater Health, Chatham-Kent, ON, Canada
| | | | | | - Rebecca Smyth
- Canadian Mental Health Association Lambton Kent, Chatham-Kent, ON, Canada
| | | | | | - Ashok K Malla
- ACCESS Open Minds, Douglas Research Centre, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Srividya N Iyer
- ACCESS Open Minds, Douglas Research Centre, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Eric Latimer
- ACCESS Open Minds, Douglas Research Centre, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
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25
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Shams F, Tai AM, Kim J, Boyd M, Meyer M, Kazemi A, Krausz RM. Adherence to e-health interventions for substance use and the factors influencing it: Systematic Review, meta-analysis, and meta-regression. Digit Health 2023; 9:20552076231203876. [PMID: 37780062 PMCID: PMC10540609 DOI: 10.1177/20552076231203876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/08/2023] [Indexed: 10/03/2023] Open
Abstract
Background Substance use disorders affect 36 million people globally, but only a small proportion of them receive the necessary treatment. E-health interventions have been developed to address this issue by improving access to substance use treatment. However, concerns about participant engagement and adherence to these interventions remain. This review aimed to evaluate adherence to e-health interventions targeting substance use and identify hypothesized predictors of adherence. Methods A systematic review of literature published between 2009 and 2020 was conducted, and data on adherence measures and hypothesized predictors were extracted. Meta-analysis and meta-regression were used to analyze the data. The two adherence measures were (a) the mean proportion of modules completed across the intervention groups and (b) the proportion of participants that completed all modules. Four meta-regression models assessed each covariate including guidance, blended treatment, intervention duration and recruitment strategy. Results The overall pooled adherence rate was 0.60 (95%-CI: 0.52-0.67) for the mean proportion of modules completed across 30 intervention arms and 0.47 (95%-CI: 0.35-0.59) for the proportion of participants that completed all modules across 9 intervention arms. Guidance, blended treatment, and recruitment were significant predictors of adherence, while treatment duration was not. Conclusion The study suggests that more research is needed to identify predictors of adherence, in order to determine specific aspects that contribute to better exposure to intervention content. Reporting adherence and predictors in future studies can lead to improved meta-analyses and the development of more engaging interventions. Identifying predictors can aid in designing effective interventions for substance use disorders, with important implications for e-health interventions targeting substance use.
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Affiliation(s)
- Farhud Shams
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Andy M.Y. Tai
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jane Kim
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Marisha Boyd
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Maximilian Meyer
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, University of Basel Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Alireza Kazemi
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Reinhard Michael Krausz
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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26
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Murray SH, Mccormick CM. Within versus between group designs, and not timing of onset of puberty, influence sex and age differences in intake of palatable food in rats. Physiol Behav 2022; 257:113997. [DOI: 10.1016/j.physbeh.2022.113997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022]
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Halsall T, Daley M, Hawke L, Henderson J, Matheson K. “You can kind of just feel the power behind what someone's saying”: a participatory-realist evaluation of peer support for young people coping with complex mental health and substance use challenges. BMC Health Serv Res 2022; 22:1358. [PMCID: PMC9667436 DOI: 10.1186/s12913-022-08743-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/27/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
Youth peer support, as a practice that aligns youth engagement and participatory approaches, has become increasingly popular in the context of youth mental health services. However, there is a need for more evidence that describes how and why youth peer support practice might be effective. This study was designed to examine a peer support service for youth experiencing complex challenges with mental health, physical health and/or substance use to better understand key features and underlying mechanisms that lead to improved client outcomes.
Methods
We applied a hybrid realist-participatory approach to explore key issues and underlying theoretical assumptions within a youth peer support approach for young people (age 14–26) experiencing complex mental health and substance use challenges. We used semi-structured interviews and focus groups with staff, including peers (N = 8), clinical service providers and administrative staff (N = 15), to develop the theories and a client survey to validate them. Our qualitative thematic analysis applied a retroductive approach that involved both inductive and deductive processes. For the client survey (N = 77), we calculated descriptive statistics to examine participant profiles and usage patterns. Pearson correlations were examined to determine relationships among concepts outlined in the program theories, including context, mechanism and outcome variables.
Results
Our analyses resulted in one over-arching context, one over-arching outcome and four program theories. Program theories were focused on mechanisms related to 1) positive identity development through identification with peers, 2) enhanced social connections, 3) observational learning and 4) enhanced autonomy and empowerment.
Conclusions
This study serves as a unique example of a participatory-realist hybrid approach. Findings highlight possible key components of youth peer practice and shed light on the functional mechanisms that underlie successful peer practice. These key components can be examined in other settings to develop more comprehensive theories of change with respect to youth peer support and can eventually be used to develop guidelines and standards to strengthen practice. This research contributes to an expanding body of literature on youth peer support in mental health and connects peer practice with several social theories. This research begins to lay a foundation for enhanced youth peer support program design and improved outcomes for young people experiencing complex mental health and substance use challenges.
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Paetzold I, Schick A, Rauschenberg C, Hirjak D, Banaschewski T, Meyer-Lindenberg A, Butz S, Floesser C, Schueltke L, Boehnke JR, Boecking B, Reininghaus U. A Hybrid Ecological Momentary Compassion–Focused Intervention for Enhancing Resilience in Help-Seeking Young People: Prospective Study of Baseline Characteristics in the EMIcompass Trial. JMIR Form Res 2022; 6:e39511. [PMID: 36331526 PMCID: PMC9675017 DOI: 10.2196/39511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/19/2022] [Accepted: 08/09/2022] [Indexed: 11/06/2022] Open
Abstract
Background Young people are a target population for mental health–related early intervention and prevention. Although evidence for early intervention is promising, availability of and access to youth mental health services remain limited. Therefore, the development of an evidence-based hybrid intervention is urgently needed. Objective This study aimed to present a manual for a hybrid intervention, combining an ecological momentary intervention and face-to-face sessions aimed for enhancing resilience in help-seeking young people based on compassion-focused interventions, and explore whether participants’ baseline characteristics are associated with putative mechanisms and outcomes of the EMIcompass intervention. Specifically, we aimed to explore initial signals as to whether participants’ sociodemographic, clinical, and functional characteristics at baseline are associated with putative mechanisms (ie, change in self-compassion, change in emotion regulation, working alliance, training frequency); and whether participants’ sociodemographic, clinical, and functional characteristics, self-compassion, and emotion regulation at baseline are associated with clinical outcomes (ie, psychological distress and general psychopathology at postintervention and 4-week follow-ups) in the experimental condition and obtain first parameter estimates. Methods We recruited young people aged 14 to 25 years, with psychological distress, Clinical High At-Risk Mental State, or first episodes of severe mental disorder for an exploratory randomized controlled trial with assessments at baseline and postintervention and 4-week follow-ups. A structured manual was developed and optimized based on a pilot study’s manual, a scoping review of existing literature and manuals, exchange with experts, the team’s clinical experience of working with compassion-focused interventions, and the principles of ecological momentary interventions. This analysis focuses on the experimental condition receiving the EMIcompass intervention. Results A total of 46 young individuals were randomized to the experimental condition. There was evidence for initial signals of effects of age (B=0.11, 95% CI 0.00-0.22), general psychopathology (B=0.08, 95% CI −0.01 to 0.16), and clinical stage (B=1.50, 95% CI 0.06-2.93) on change in momentary self-compassion and change in emotion regulation from baseline to postintervention assessments. There was no evidence for associations of other baseline characteristics (eg, gender, minority status, and level of functioning) and putative mechanisms (eg, overall self-compassion, working alliance, and training frequency). In addition, except for an initial signal for an association of momentary self-compassion at baseline and psychological distress (B=−2.83, 95% CI −5.66 to 0.00), we found no evidence that baseline characteristics related to clinical outcomes. Conclusions The findings indicated the reach of participants by the intervention largely independent of sociodemographic, clinical, and functional baseline characteristics. The findings need to be confirmed in a definitive trial. Trial Registration German Clinical Trials Register NDRKS00017265; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017265 International Registered Report Identifier (IRRID) RR2-10.2196/27462
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Affiliation(s)
- Isabell Paetzold
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Anita Schick
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Rauschenberg
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sebastian Butz
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Chiara Floesser
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Leonie Schueltke
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Benjamin Boecking
- Tinnitus Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- ESRC Centre for Society and Mental Health and Social Epidemiology Research Group, King's College London, London, United Kingdom
- Health Service and Population Research Department, Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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Edwards J, Kamali M, Georgiades S, Waddell C, Georgiades K. Provincial and Territorial Variation in Barriers in Accessing Healthcare for Children and Youth With Mental and Neurodevelopmental Health Concerns in Canada. Can J Psychiatry 2022; 67:867-869. [PMID: 35938630 PMCID: PMC9561698 DOI: 10.1177/07067437221114005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jordan Edwards
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
| | - Mahdis Kamali
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
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30
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Stewart SL, Semovski V, Lapshina N. Adolescent Inpatient Mental Health Admissions: An Exploration of Interpersonal Polyvictimization, Family Dysfunction, Self-Harm and Suicidal Behaviours. Child Psychiatry Hum Dev 2022:10.1007/s10578-022-01450-4. [PMID: 36315373 DOI: 10.1007/s10578-022-01450-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/03/2022]
Abstract
The mental health system is impacted by extreme delays in the provision of care, even in the face of suicidal behaviour. The failure to address mental health issues in a timely fashion result in a dependence on acute mental health services. Improvement to the mental health care system is impacted by the paucity of information surrounding client profiles admitted to inpatient settings. Using archival data from 10,865 adolescents 12-18 years of age (Mage = 14.87, SDage = 1.77), this study aimed to examine the characteristics of adolescents admitted to psychiatric inpatient services in Ontario, Canada. Multivariate binary logistic regression revealed that adolescents reporting interpersonal polyvictimization, greater family dysfunction and higher risk of suicide and self-harm had a greater likelihood of an inpatient mental health admission. The interRAI Child and Youth Mental Health assessment can be used for care planning and early intervention to support adolescents and their families before suicide risk is imminent.
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Affiliation(s)
- Shannon L Stewart
- Faculty of Education, The University of Western Ontario, 1137 Western Road, N6G 1G7, London, ON, Canada
| | - Valbona Semovski
- Faculty of Education, The University of Western Ontario, 1137 Western Road, N6G 1G7, London, ON, Canada.
| | - Natalia Lapshina
- Faculty of Education, The University of Western Ontario, 1137 Western Road, N6G 1G7, London, ON, Canada
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31
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Moran P, Moreno-Betancur M, Coffey C, Spry EA, Patton GC. Impact of early intervention on the population prevalence of common mental disorders: 20-year prospective study. Br J Psychiatry 2022; 221:558-566. [PMID: 35125126 DOI: 10.1192/bjp.2022.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The potential for early interventions to reduce the later prevalence of common mental disorders (CMD) first experienced in adolescence is unclear. AIMS To examine the course of CMD and evaluate the extent to which the prevalence of CMD could be reduced by preventing adolescent CMD, or by intervening to change four young adult processes, between the ages of 20 and 29 years, that could be mediating the link between adolescent and adult disorder. METHOD This was a prospective cohort study of 1923 Australian participants assessed repeatedly from adolescence (wave 1, mean age 14 years) to adulthood (wave 10, mean age 35 years). Causal mediation analysis was undertaken to evaluate the extent to which the prevalence of CMD at age 35 years in those with adolescent CMD could be reduced by either preventing adolescent CMD, or by intervening on four young adult mediating processes: the occurrence of young adult CMD, frequent cannabis use, parenting a child by age 24 years, and engagement in higher education and employment. RESULTS At age 35, 19.2% of participants reported CMD; a quarter of these participants experienced CMD during both adolescence and young adulthood. In total, 49% of those with CMD during both adolescence and young adulthood went on to report CMD at age 35 years. Preventing adolescent CMD reduced the population prevalence at age 35 years by 3.9%. Intervening on all four young adult processes among those with adolescent CMD, reduced this prevalence by 1.6%. CONCLUSIONS In this Australian cohort, a large proportion of adolescent CMD resolved by adulthood, and by age 35 years, the largest proportion of CMD emerged among individuals without prior CMD. Time-limited, early intervention in those with earlier adolescent disorder is unlikely to substantially reduce the prevalence of CMD in midlife.
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Affiliation(s)
- Paul Moran
- Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Margarita Moreno-Betancur
- Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, and Department of Paediatrics, University of Melbourne, Australia
| | - Carolyn Coffey
- Centre for Adolescent Health, Royal Children's Hospital Murdoch Children's Research Institute, Australia
| | - Elizabeth A Spry
- Centre for Adolescent Health, Royal Children's Hospital Murdoch Children's Research Institute, Australia.,Centre for Social and Early Emotional Development, Deakin University, Australia
| | - George C Patton
- Centre for Adolescent Health, Royal Children's Hospital Murdoch Children's Research Institute, Australia
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Semovski V, King CB, Stewart SL. Mental Health Service Urgency in Children's Mental Health: Factors Impacting the Need for Expedited Services. Child Psychiatry Hum Dev 2022; 53:765-775. [PMID: 33835279 DOI: 10.1007/s10578-021-01161-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 12/21/2022]
Abstract
Delayed access to mental health services for children and adolescents has been linked to an increased risk of harm and nonattendance to scheduled appointments. While studies suggest that the lack of standardized assessments for prioritizing individuals has contributed to long wait times, the inconsistent use of assessments across service sectors in Ontario continues to persist. This has contributed to a paucity of information surrounding which children and adolescents may require urgent mental health services. Using a large secondary data set, this study examined whether service sector (e.g., school), and other individual client characteristics (e.g., age, sex, legal guardianship, interpersonal and school conflict) predicted greater mental health service urgency in 61,448 children and adolescents assessed using the interRAI Child and Youth Mental Health Screener. Binary logistic regression revealed that all predictors, except for sector, showed a significant effect on service urgency. Findings are instrumental in prioritization, reducing the likelihood that children with acute needs remain on waitlists.
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Affiliation(s)
- Valbona Semovski
- Faculty of Education, The University of Western Ontario, 1137 Western Road, London, ON, N6G 1G7, Canada.
| | - Colin B King
- Faculty of Education, The University of Western Ontario, 1137 Western Road, London, ON, N6G 1G7, Canada
| | - Shannon L Stewart
- Faculty of Education, The University of Western Ontario, 1137 Western Road, London, ON, N6G 1G7, Canada
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33
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Kourgiantakis T, Markoulakis R, Hussain A, Lee E, Ashcroft R, Williams C, Lau C, Goldstein AL, Kodeeswaran S, Levitt A. Navigating inequities in the delivery of youth mental health care during the COVID-19 pandemic: perspectives of youth, families, and service providers. Can J Public Health 2022; 113:806-816. [PMID: 35852728 PMCID: PMC9663755 DOI: 10.17269/s41997-022-00670-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 06/28/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES There have been concerns about the adverse effects of the COVID-19 pandemic on Canadian youth (aged 16-24) as they have the highest rates of mental health concerns. The objectives of the present study were to explore the experiences of youth with mental health and/or addiction concerns and their families during the pandemic, and to examine how adequate and equitable mental health services have been for youth and families from the perspectives of youth, parents, and service providers. METHODS Using a descriptive qualitative research design and a university-community partnership, we conducted individual interviews with youth, parents, and service providers. The study involved a total of 25 participants (n=15 service users, n=10 service providers). Among the service users, 11 participants were parents and four were youth. We used thematic analysis to analyze interview data. RESULTS The thematic analysis identified three themes in the data: (1) youth mental health concerns have increased, whereas supports have decreased, (2) families end up being the treatment team with increased burden, little support, and lack of recognition, and (3) inadequate and inequitable mental health services for youth and families are amplified during the pandemic. CONCLUSION At a time when mental health needs were higher, the mental health care system offered less support to youth and their families. For a more equitable response to the pandemic, we need an accessible and integrated mental health care system that shows a commitment to addressing social determinants and reducing health disparities and inequities in access to mental health services.
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Affiliation(s)
- Toula Kourgiantakis
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4 Canada
| | - Roula Markoulakis
- Family Navigation Project, Sunnybrook Research Institute, Toronto, ON Canada ,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON Canada
| | - Amina Hussain
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4 Canada
| | - Eunjung Lee
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4 Canada
| | - Rachelle Ashcroft
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4 Canada
| | - Charmaine Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4 Canada
| | - Carrie Lau
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4 Canada
| | - Abby L. Goldstein
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON Canada
| | - Sugy Kodeeswaran
- Family Navigation Project, Sunnybrook Health Sciences Centre, Toronto, ON Canada
| | - Anthony Levitt
- Family Navigation Project, Sunnybrook Health Sciences Centre, Toronto, ON Canada ,Faculty of Medicine, University of Toronto, Toronto, ON Canada
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Abstract
INTRODUCTION Canadian youth (aged 15-24) have the highest rates of cannabis use globally. There are increasing concerns about the adverse effects of cannabis use on youth physical and mental health. However, there are gaps in our understanding of risks and harms to youth. This scoping review will synthesise the literature related to youth cannabis use in Canada. We will examine the relationship between youth cannabis use and physical and mental health, and the relationship with use of other substances. We will also examine prevention strategies for youth cannabis use in Canada and how the literature addresses social determinants of health. METHODS AND ANALYSIS Using a scoping review framework developed by Arksey and O'Malley, we will conduct our search in five academic databases: MEDLINE, Embase, APA PsycInfo, CINAHL and Web of Science's Core Collection. We will include articles published between 2000 and 2021, and articles meeting the inclusion criteria will be charted to extract relevant themes and analysed using a qualitative thematic analysis approach. ETHICS AND DISSEMINATION This review will provide relevant information about youth cannabis use and generate recommendations and gaps in the literature. Updated research will inform policies, public education strategies and evidence-based programming. Results will be disseminated through an infographic, peer-reviewed publication and presentation at a mental health and addiction conference. Ethics approval is not required for this scoping review.
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Affiliation(s)
- Toula Kourgiantakis
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Travonne Edwards
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Eunjung Lee
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Judith Logan
- John P. Robarts Library, University of Toronto, Toronto, Ontario, Canada
| | | | - Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Monique Simon-Tucker
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Charmaine C Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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35
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Gavurova B, Tarhanicova M. Young Adults and Sick Leave Length of Mental Illnesses. Front Public Health 2022; 10:882707. [PMID: 35769771 PMCID: PMC9234197 DOI: 10.3389/fpubh.2022.882707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesThe objective was to explore whether a sick leave length related to mental morbidity differs across different occupational categories.MethodsIn the analysis, registry of sick leaves was analyzed. Provided analysis is focused on the length of sick leaves related to mental diseases caused by substance use or other factors. Dependent variable is the sick leave length, and the independent variables are the categories of disease and occupation. Kruskal–Wallis test, Shapiro–Wilk test, and Brown–Forsythe (B–F) are used.ResultsThere are differences in mental sick leave lengths caused by substance use or other factors. In the case of mental illnesses attributable to drugs, differences in the sick leave duration among different working groups were not found. Considering mental disorders caused by other factors, there are differences in the sick leave duration among different working groups.ConclusionsThere is no evidence of longer sick leave in people diagnosed with mental disorder related to substance use. Differences in occupational categories do not relate to sick leave length.
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Affiliation(s)
- Beata Gavurova
- Faculty of Management and Economics, Tomas Bata University in Zlín, Zlín, Czechia
- *Correspondence: Beata Gavurova
| | - Miriama Tarhanicova
- Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
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36
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Jack SM, Duku E, Whitty H, Van Lieshout RJ, Niccols A, Georgiades K, Lipman EL. Young mothers' use of and experiences with mental health care services in Ontario, Canada: a qualitative descriptive study. BMC Womens Health 2022; 22:214. [PMID: 35672725 PMCID: PMC9172978 DOI: 10.1186/s12905-022-01804-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 05/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background Despite the high prevalence of mental health issues among young mothers, their subsequent needs for mental health care support does not correlate with their access and use of services. The purpose of this study, grounded in the experiences of young mothers living in Ontario, Canada, was to describe their experiences of using mental health services during the perinatal period, and to identify the attributes of services and professionals that influenced their decision to engage with mental health services.
Methods As the qualitative component of a sequential explanatory mixed methods study, the principles of qualitative description informed sampling, data collection, and analysis decisions. In-depth, semi-structured interviews were conducted with a purposeful sample of 29 young mothers (≤ 21 years) who met diagnostic criteria for at least one psychiatric disorder, and who were ≥ 2 months postpartum. Interview data were triangulated with data from ecomaps and a sub-set of demographic data for this purposeful sample from the survey conducted in the quantitative study component. Qualitative data were analyzed using both conventional content analysis and reflexive thematic analysis; the subset of survey data extracted for these 29 participants were analyzed using descriptive statistics. Results Young mothers identified the need to have at least one individual, either an informal social support or formal service provider who they could talk to about their mental health. Among participants deciding to seek professional mental health support, their hesitancy to access services was grounded in past negative experiences or fears of being judged, being medicated, not being seen as an active partner in care decisions or experiencing increased child protection involvement. Participants identified organizational and provider attributes of those delivering mental health care that they perceived influenced their use of or engagement with services. Conclusion Organizations or health/social care professionals providing mental health services to young pregnant or parenting mothers are recommended to implement trauma-and violence-informed care. This approach prioritizes the emotional and physical safety of individuals within the care environment. Applying this lens in service delivery also aligns with the needs of young mothers, including that they are actively listened to, treated with respect, and genuinely engaged as active partners in making decisions about their care and treatment.
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Affiliation(s)
- Susan M Jack
- School of Nursing, McMaster University, HSC 3H48B, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada.
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Heather Whitty
- Institute for Innovation and Implementation, School of Social Work, University of Maryland Baltimore, Baltimore, USA
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Alison Niccols
- Ron Joyce Children's Health Centre, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Ellen L Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Jordan G, Burke L, Bailey J, Kreidstein S, Iftikhar M, Plamondon L, Young C, Davidson L, Rowe M, Bellamy C, Abdel-Baki A, Iyer SN. A Mixed Methods Study Examining Citizenship Among Youth With Mental Health Challenges. Front Psychiatry 2022; 13:852947. [PMID: 35664471 PMCID: PMC9158458 DOI: 10.3389/fpsyt.2022.852947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Multiple stakeholders have recently called for greater research on the barriers to citizenship and community belonging faced by people with mental health challenges. Citizenship has been defined as a person's access to the rights, roles, responsibilities, resources and relationships that help people feel a sense of belonging. Factors that may impact citizenship include financial precarity; intersecting forms of marginalization and oppression (e.g., racism); and the mental health care people receive. Research has yet to examine experiences of citizenship among youth with mental health challenges. To address this gap, this study will examine how youth experience citizenship; predictors of citizenship; how citizenship shapes recovery; and the degree to which youth are receiving citizenship-oriented care. Methods The research objectives will be evaluated using a multiphase mixed methods research design. Quantitative data will be collected cross-sectionally using validated self-report questionnaires. Qualitative data will be collected using a hermeneutic phenomenological method using semi-structured interviews and focus groups. Analyses Multiple stepwise regression analyses will be used to determine predictors of citizenship and if of citizenship predict recovery. Pearson correlations will be computed to determine the relationship between participants' perceived desire for, and receipt of citizenship-oriented care. Phenomenological analysis will be used to analyze qualitative data. Findings will then be mixed using a weaving method in the final paper discussion section. Conclusion Findings from this study may support the development of citizenship-oriented healthcare in Canada.
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Affiliation(s)
- Gerald Jordan
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Yale Program for Recovery and Community Health, Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Laura Burke
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Julia Bailey
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Sof Kreidstein
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Myera Iftikhar
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Lauren Plamondon
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Courtney Young
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Larry Davidson
- Yale Program for Recovery and Community Health, Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Michael Rowe
- Yale Program for Recovery and Community Health, Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Chyrell Bellamy
- Yale Program for Recovery and Community Health, Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Amal Abdel-Baki
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Srividya N. Iyer
- Department of Psychiatry, McGill University, Montreal, QC, Canada
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Samji H, Wu J, Ladak A, Vossen C, Stewart E, Dove N, Long D, Snell G. Review: Mental health impacts of the COVID-19 pandemic on children and youth - a systematic review. Child Adolesc Ment Health 2022; 27:173-189. [PMID: 34455683 PMCID: PMC8653204 DOI: 10.1111/camh.12501] [Citation(s) in RCA: 315] [Impact Index Per Article: 157.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The COVID-19 pandemic has posed an unprecedented threat to global mental health. Children and adolescents may be more susceptible to mental health impacts related to their vulnerable developmental stage, fear of infection, home confinement, suspension of regular school and extracurricular activities, physical distancing mandates, and larger scale threats such as global financial recessions and associated impacts. Our objective was to review existing evidence of the COVID-19 pandemic's global impact on the mental health of children and adolescents <19 years of age and to identify personal and contextual factors that may enhance risk or confer protection in relation to mental health outcomes. METHODS We conducted a search of peer-reviewed and preprint research published in English from January 1, 2020, to February 22, 2021. We included studies collecting primary data on COVID-19-related mental health impacts on children and adolescents. We graded the strength of included articles using the Oxford Centre for Evidence-Based Medicine rating scheme. RESULTS Our search and review yielded 116 articles presenting data on a total of 127,923 children and adolescents; 50,984 child and adolescent proxy reports (e.g., parents, healthcare practitioners); and >3,000 chart reviews. A high prevalence of COVID-19-related fear was noted among children and adolescents, as well as more depressive and anxious symptoms compared with prepandemic estimates. Older adolescents, girls, and children and adolescents living with neurodiversities and/or chronic physical conditions were more likely to experience negative mental health outcomes. Many studies reported mental health deterioration among children and adolescents due to COVID-19 pandemic control measures. Physical exercise, access to entertainment, positive familial relationships, and social support were associated with better mental health outcomes. CONCLUSIONS This review highlights the urgent need for practitioners and policymakers to attend to and collaborate with children and adolescents, especially those in higher risk subgroups, to mitigate short- and long-term pandemic-associated mental health effects.
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Affiliation(s)
- Hasina Samji
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.,British Columbia Centre for Disease Control, Vancouver, BC, Canada.,British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Judy Wu
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Amilya Ladak
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Caralyn Vossen
- School of Population and Global Health, McGill University, Montreal, QC, Canada
| | - Evelyn Stewart
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Division of Clinical and Behavioural Neurosciences, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,British Columbia Mental Health and Substance Use Research Institute, Vancouver, BC, Canada
| | - Naomi Dove
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - David Long
- Division of Clinical and Behavioural Neurosciences, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Gaelen Snell
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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39
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Shah JL, Jones N, van Os J, McGorry PD, Gülöksüz S. Early intervention service systems for youth mental health: integrating pluripotentiality, clinical staging, and transdiagnostic lessons from early psychosis. Lancet Psychiatry 2022; 9:413-422. [PMID: 35430004 DOI: 10.1016/s2215-0366(21)00467-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/29/2021] [Accepted: 11/16/2021] [Indexed: 12/21/2022]
Abstract
Challenges associated with operationalising services for the at-risk mental state for psychosis solely in that same diagnostic silo are increasingly well recognised-namely, the differential risk for psychosis being a function of sampling enrichment strategies, declining transition rates to psychosis, questions regarding the validity of transition as an outcome, and the frequent development of non-psychotic disorders. However, recent epidemiological and clinical research suggests that not all threshold-level psychoses are likely to occur homotypically; early-stage non-psychotic syndromes might exhibit heterotypic shifts to a first episode of psychosis, without an identifiable at-risk mental state. These findings, along with the relevance of outcomes beyond traditional diagnoses or syndromes, have substantive implications for developing next-generation early intervention infrastructures. Along with the idea of general at-risk clinics for early-stage pluripotential syndromes, we examine how this reality might affect service design, such as the need for close linkage with centres of expertise for threshold-level disorders when transitions to later stages occur, the balance between generic and specific interventions amid the need for person-centred care, and the challenges this reorientation might pose for broader mental health systems.
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Affiliation(s)
- Jai L Shah
- Prevention and Early Intervention Program for Psychosis (PEPP)-Montreal, Montreal, QC, Canada; ACCESS Open Minds, Douglas Hospital Research Centre, Montreal, QC, Canada; Department of Psychiatry, McGill University, Montreal, QC, Canada.
| | - Nev Jones
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Jim van Os
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, Netherlands; Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, Netherlands; Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Sinan Gülöksüz
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, Netherlands; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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40
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Krygsman A, Vaillancourt T. Elevated social anxiety symptoms across childhood and adolescence predict adult mental disorders and cannabis use. Compr Psychiatry 2022; 115:152302. [PMID: 35245889 DOI: 10.1016/j.comppsych.2022.152302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 02/15/2022] [Indexed: 11/24/2022] Open
Abstract
AIM We assessed the heterogeneous development of self-reported social anxiety symptoms across childhood and adolescence (ages 10 to 18; N = 701) and examined whether these groups predicted clinically derived diagnoses of social anxiety disorder (SAD), generalized anxiety disorder (GAD), depressive episodes, panic disorder (PD), agoraphobia, obsessive compulsive disorder (OCD), and substance use in adulthood (ages 19 to 22). RESULTS Three distinct social anxiety symptom trajectories were found: a high increasing group (15.5%), a moderate group (37.3%), and a low group (47.2%). The high increasing and moderate trajectory groups were differentiated from the low trajectory group on the adult mental disorders examined: SAD (high OR = 15.74; moderate OR = 11.72), GAD (high OR = 13.08; moderate OR = 8.98), depressive episode (high OR = 19.75), PD (high OR = 8.43; moderate OR = 5.90), agoraphobia (high OR = 16.39; moderate OR = 9.68), and OCD (high OR = 3.49; moderate OR = 2.98). The high and moderate groups were not differentiated on SAD, GAD, PD, or OCD but were differentiated on depressive episodes (OR = 3.24). Relative to the low and moderate trajectory groups, the high increasing social anxiety symptoms trajectory group also predicted cannabis use, but not alcohol use in adulthood. Gender, ethnicity, household income, and parental education were accounted for when predicting adult outcomes. CONCLUSION These results highlight the importance of early treatment of symptoms of childhood social anxiety in the prevention of mental health problems in adulthood.
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Affiliation(s)
- Amanda Krygsman
- Counselling Psychology, Faculty of Education, University of Ottawa, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Canada; Department of Psychology, Faculty of Social Sciences, University of Ottawa, Canada.
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41
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Ferrari M, Sabetti J, McIlwaine SV, Fazeli S, Sadati SMH, Shah JL, Archie S, Boydell KM, Lal S, Henderson J, Alvarez-Jimenez M, Andersson N, Nielsen RKL, Reynolds JA, Iyer SN. Gaming My Way to Recovery: A Systematic Scoping Review of Digital Game Interventions for Young People's Mental Health Treatment and Promotion. Front Digit Health 2022; 4:814248. [PMID: 35465647 PMCID: PMC9021794 DOI: 10.3389/fdgth.2022.814248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/26/2022] [Indexed: 11/13/2022] Open
Abstract
Nearly all young people use the internet daily. Many youth with mental health concerns, especially since the Covid-19 pandemic, are using this route to seek help, whether through digital mental health treatment, illness prevention tools, or supports for mental wellbeing. Videogames also have wide appeal among young people, including those who receive mental health services. This review identifies the literature on videogame interventions for young people, ages 12-29, and maps the data on game use by those with mental health and substance use problems, focusing on evidence for the capacity of games to support treatment in youth mental health services; how stakeholders are involved in developing or evaluating games; and any potential harms and ethical remedies identified. A systematic scoping review methodology was used to identify and assess relevant studies. A search of multiple databases identified a total of 8,733 articles. They were screened, and 49 studies testing 32 digital games retained. An adapted stepped care model, including four levels, or steps, based on illness manifestation and severity, was used as a conceptual framework for organizing target populations, mental health conditions and corresponding digital games, and study results. The 49 selected studies included: 10 studies (20.4%) on mental health promotion/prevention or education for undiagnosed youth (Step 0: 7 games); 6 studies (12.2%) on at-risk groups or suspected mental problems (Step 1: 5 games); 24 studies (49.0%) on mild to moderate mental conditions (Steps 2-3: 16 games); and 9 studies (18.4%) focused on severe and complex mental conditions (Step 4: 7 games). Two interventions were played by youth at more than one level of illness severity: the SPARX game (Steps 1, 2-3, 4) and Dojo (Steps 2-3 and 4), bringing the total game count to 35 with these repetitions. Findings support the potential integration of digital games in youth services based on study outcomes, user satisfaction, relatively high program retention rates and the potential usefulness of most games for mental health treatment or promotion/prevention. Most studies included stakeholder feedback, and involvement ratings were very high for seven games. Potential harms were not addressed in this body of research. This review provides an important initial repository and evaluation of videogames for use in clinical settings concerned with youth mental health.
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Affiliation(s)
- Manuela Ferrari
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
- *Correspondence: Manuela Ferrari
| | - Judith Sabetti
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Sarah V. McIlwaine
- Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Sahar Fazeli
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - S. M. Hani Sadati
- Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Integrated Studies in Education, McGill University, Montreal, QC, Canada
| | - Jai L. Shah
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Suzanne Archie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Katherine M. Boydell
- Black Dog Institute and School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Shalini Lal
- Douglas Mental Health University Institute, Montreal, QC, Canada
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Health Innovation and Evaluation Hub, Université de Montréal Hospital Research Centre, Montreal, QC, Canada
| | | | - Mario Alvarez-Jimenez
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Neil Andersson
- Department of Family Medicine, McGill University, Montreal, QC, Canada
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Mexico
| | | | | | - Srividya N. Iyer
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
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42
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Lee GY, Hickie IB, Occhipinti JA, Song YJC, Camacho S, Skinner A, Lawson K, Hockey SJ, Hilber AM, Freebairn L. Participatory Systems Modelling for Youth Mental Health: An Evaluation Study Applying a Comprehensive Multi-Scale Framework. Int J Environ Res Public Health 2022; 19:4015. [PMID: 35409697 DOI: 10.3390/ijerph19074015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 11/29/2022]
Abstract
The youth mental health sector is persistently challenged by issues such as service fragmentation and inefficient resource allocation. Systems modelling and simulation, particularly utilizing participatory approaches, is offering promise in supporting evidence-informed decision making with limited resources by testing alternative strategies in safe virtual environments before implementing them in the real world. However, improved evaluation efforts are needed to understand the critical elements involved in and to improve methods for implementing participatory modelling for youth mental health system and service delivery. An evaluation protocol is described to evaluate the feasibility, value, impact, and sustainability of participatory systems modelling in delivering advanced decision support capabilities for youth mental health. This study applies a comprehensive multi-scale evaluation framework, drawing on participatory action research principles as well as formative, summative, process, and outcome evaluation techniques. Novel data collection procedures are presented, including online surveys that incorporate gamification to enable social network analysis and patient journey mapping. The evaluation approach also explores the experiences of diverse stakeholders, including young people with lived (or living) experience of mental illness. Social and technical opportunities will be uncovered, as well as challenges implementing these interdisciplinary methods in complex settings to improve youth mental health policy, planning, and outcomes. This study protocol can also be adapted for broader international applications, disciplines, and contexts.
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43
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Boksa P, Hutt-MacLeod D, Clair L, Brass G, Bighead S, MacKinnon A, Etter M, Gould H, Sock E, Matoush J, Rabbitskin N, Ballantyne C, Goose A, Rudderham H, Plourde V, Gordon M, Gilbert L, Ramsden VR, Noel V, Malla A, Iyer SN. Demographic and Clinical Presentations of Youth using Enhanced Mental Health Services in Six Indigenous Communities from the ACCESS Open Minds Network. Can J Psychiatry 2022; 67:179-191. [PMID: 34796730 PMCID: PMC8935596 DOI: 10.1177/07067437211055416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE In many Indigenous communities, youth mental health services are inadequate. Six Indigenous communities participating in the ACCESS Open Minds (AOM) network implemented strategies to transform their youth mental health services. This report documents the demographic and clinical presentations of youth accessing AOM services at these Indigenous sites. METHODS Four First Nations and two Inuit communities contributed to this study. Youth presenting for mental health services responded to a customized sociodemographic questionnaire and presenting concerns checklist, and scales assessing distress, self-rated health and mental health, and suicidal thoughts and behaviors. RESULTS Combined data from the First Nations sites indicated that youth across the range of 11-29 years accessed services. More girls/women than boys/men accessed services; 17% identified as LBGTQ+. Most (83%) youth indicated having access to at least one reliable adult and getting along well with the people living with them. Twenty-five percent of youth reported difficulty meeting basic expenses. Kessler (K10) distress scores indicated that half likely had a moderate mental health problem and a fourth had severe problems. Fifty-five percent of youth rated their mental health as fair or poor, while 50% reported suicidal thoughts in the last month. Anxiety, stress, depression and sleep issues were the most common presenting problems. Fifty-one percent of youth either accessed services themselves or were referred by family members. AOM was the first mental health service accessed that year for 68% of youth. CONCLUSIONS This report is the first to present a demographic and clinical portrait of youth presenting at mental health services in multiple Indigenous settings in Canada. It illustrates the acceptability and feasibility of transforming youth mental health services using core principles tailored to meet communities' unique needs, resources, and cultures, and evaluating these using a common protocol. Data obtained can be valuable in evaluating services and guiding future service design. Trial registration name and number at Clinicaltrials.gov: ACCESS Open Minds/ACCESS Esprits ouverts, ISRCTN23349893.
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Affiliation(s)
- Patricia Boksa
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Daphne Hutt-MacLeod
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Eskasoni Mental Health Services and ACCESS Open Minds Eskasoni, Eskasoni First Nation, Nova Scotia, Canada
| | - Lacey Clair
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Elsipogtog Health and Wellness Centre and ACCESS Open Minds New Brunswick, Elsipogtog First Nation, New Brunswick, Canada
| | - Gregory Brass
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Aaschihkuwaataauch (ACCESS Open Minds Cree Nation of Mistissini) and Mental Health Maanuuhiikuu, Pimuhteheu (Public Health Department), Cree Board of Health and Social Services of James Bay, Cree Nation of Mistissini, Quebec, Canada
| | - Shirley Bighead
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Sturgeon Lake Health Centre, Sturgeon Lake First Nation, Saskatchewan, Canada
| | - Aileen MacKinnon
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Saqijuq-ACCESS OM-Puvirnituq, Puvirnituq, Quebec, Canada and Saqijuaq (Puvirnituq, Kangirsuk, Akulivik)
| | - Meghan Etter
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,ACCESS Open Minds Ulukhaktok, Ulukhaktok, Northwest Territories and Inuvialuit Regional Corporation, Inuvik, Northwest Territories, Canada
| | - Hayley Gould
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Eskasoni Mental Health Services and ACCESS Open Minds Eskasoni, Eskasoni First Nation, Nova Scotia, Canada
| | - Eva Sock
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Elsipogtog Health and Wellness Centre and ACCESS Open Minds New Brunswick, Elsipogtog First Nation, New Brunswick, Canada
| | - Julie Matoush
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Aaschihkuwaataauch (ACCESS Open Minds Cree Nation of Mistissini) and Mental Health Maanuuhiikuu, Pimuhteheu (Public Health Department), Cree Board of Health and Social Services of James Bay, Cree Nation of Mistissini, Quebec, Canada
| | - Norma Rabbitskin
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Sturgeon Lake Health Centre, Sturgeon Lake First Nation, Saskatchewan, Canada
| | - Clifford Ballantyne
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Sturgeon Lake Health Centre, Sturgeon Lake First Nation, Saskatchewan, Canada
| | - Annie Goose
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,ACCESS Open Minds Ulukhaktok, Ulukhaktok, Northwest Territories and Inuvialuit Regional Corporation, Inuvik, Northwest Territories, Canada
| | - Heather Rudderham
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Eskasoni Mental Health Services and ACCESS Open Minds Eskasoni, Eskasoni First Nation, Nova Scotia, Canada
| | - Vickie Plourde
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,School of Psychology, 5568University of Moncton, Moncton, New Brunswick, Canada
| | - Maria Gordon
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Aaschihkuwaataauch (ACCESS Open Minds Cree Nation of Mistissini) and Mental Health Maanuuhiikuu, Pimuhteheu (Public Health Department), Cree Board of Health and Social Services of James Bay, Cree Nation of Mistissini, Quebec, Canada
| | - Lorna Gilbert
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Sturgeon Lake Health Centre, Sturgeon Lake First Nation, Saskatchewan, Canada
| | - Vivian R Ramsden
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Academic Family Medicine, 7235University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Valerie Noel
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Ashok Malla
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Srividya N Iyer
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Burt H, Doan Q, Landry T, Wright B, McKinley KW. The Impact of Universal Mental Health Screening on Pediatric Emergency Department Flow. Acad Pediatr 2022; 22:210-216. [PMID: 34757025 DOI: 10.1016/j.acap.2021.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/15/2021] [Accepted: 09/20/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVE AND HYPOTHESIS Assess the impact of universal mental health screening with MyHEARTSMAP on emergency department (ED) flow, an important aspect of feasibility. We hypothesized that the difference in departmental level ED length of stay (LOS) for screening and matched nonscreening days is less than 30 minutes. METHODS We conducted a 2-center, retrospective cohort study between December 2017 and June 2019. At each center, random mental health screening days were assigned over the course of 15 consecutive months. We matched each 24-hour screening day to a unique nonscreening day based on: location (Center 1 or Center 2); day type (weekday: Monday-Thursday or weekend: Friday-Sunday); date (±28 days); and 24-hour volume (±15 patients). We collected retrospective patient flow data, including LOS, across all ED visits to determine the difference in departmental level median LOS between matched screening and nonscreening days. RESULTS There was not a statistically significant difference in departmental LOS between screening and nonscreening days. Overall, the difference in departmental LOS was -4.0 minutes (95% confidence interval, -9.8, 1.8) for screening days compared to nonscreening days, with a difference of -2.0 minutes (-9.0, 4.9) at Center 1 and -6.0 minutes (-15.4, 3.4) at Center 2. CONCLUSIONS Our findings show that universal mental health screening with MyHEARTSMAP can be implemented without a significant impact of ED LOS.
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Affiliation(s)
- Heather Burt
- School of Population and Public Health, University of British Columbia (H Burt and Q Doan), Vancouver, British Columbia, Canada
| | - Quynh Doan
- School of Population and Public Health, University of British Columbia (H Burt and Q Doan), Vancouver, British Columbia, Canada; Department of Pediatrics, University of British Columbia (Q Doan), Vancouver, British Columbia, Canada
| | - Taryne Landry
- Faculty of Medicine, University of British Columbia (T Landry), Vancouver, British Columbia, Canada; Faculty of Medicine, University of Alberta (T Landry), Edmonton, Alberta, Canada
| | - Bruce Wright
- Department of Pediatrics, University of Alberta (B Wright), Edmonton, Alberta, Canada
| | - Kenneth W McKinley
- Emergency Medicine Section of Data Analytics, Children's National (KW McKinley), Washington, DC.
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Chadi N, Ryan NC, Geoffroy MC. COVID-19 and the impacts on youth mental health: emerging evidence from longitudinal studies. Can J Public Health 2022; 113:44-52. [PMID: 35089589 PMCID: PMC8796598 DOI: 10.17269/s41997-021-00567-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/03/2021] [Indexed: 12/14/2022]
Abstract
Several experts have warned that the current coronavirus disease 2019 (COVID-19) pandemic and associated confinement measures may have taken a devastating toll on youth mental health. While the COVID-19 pandemic has certainly created important challenges for children and youth, these claims vastly rely on cross-sectional data collected during the pandemic, from which it is difficult to draw firm conclusions. In this commentary, we offer a critical appraisal of the evidence from emerging longitudinal studies spanning the pre- and intra-pandemic period with a focus on internalizing and externalizing disorders, suicidality, eating disorders and substance use. We also discuss important research considerations in the monitoring of the long-term impacts of the COVID-19 pandemic on youth mental health as well as promising interventions to help mitigate potential long-lasting consequences of this unprecedented public health crisis.
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Affiliation(s)
- Nicholas Chadi
- CHU Ste-Justine Research Center, 3175 Ch de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada. .,Division of Adolescent Medicine, Department of Pediatrics, Université de Montréal, Montreal, QC, Canada.
| | - Natalie Castellanos Ryan
- CHU Ste-Justine Research Center, 3175 Ch de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.,School of Psychoeducation, Université de Montréal, 90, Av. Vincent-d'Indy, Montreal, QC, H2V 2S9, Canada
| | - Marie-Claude Geoffroy
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.,Department of Education and Counselling Psychology, McGill University, Montreal, QC, Canada
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Carrier L, Shin HD, Rothfus MA, Curran JA. Protective and resilience factors to promote mental health among Indigenous youth in Canada: a scoping review protocol. BMJ Open 2022; 12:e049285. [PMID: 35039281 PMCID: PMC8765014 DOI: 10.1136/bmjopen-2021-049285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 11/02/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Many mental health concerns emerge in adolescence and young adulthood, making this a critical period to initiate early interventions for mental health promotion and illness prevention. Although Indigenous young people in Canada are at a higher risk of mental health outcomes and faced with limited access to appropriate care and resources, they have unique strengths and resilience that promote mental health and wellness. Furthermore, resilience has been described as a 'healing journey' by Indigenous peoples, and interventions that account for the culture of these groups show promise in promoting mental health and wellness. As such, there is a need for innovative mental health interventions for Indigenous youth that transcend the Western biomedical model, use a strengths-based approach, and account for the cultural practices and belief systems of Indigenous peoples. This scoping review aims to explore the resilience and protective factors that promote mental health and wellness for Indigenous youth in present-day Canada with the aim of compiling and summarising the available literature on this topic to date. METHODS AND ANALYSIS The review will follow Joanna Briggs Institute methodology for conducting scoping reviews. The reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews checklist and guidelines. We will include both published and unpublished grey literature and search the following databases: PubMed, CINAHL, PsycINFO, Education Resources Information Center, Embase and Scopus. The search of all databases was conducted on 26 August 2021. Further, we will use government and relevant Indigenous organisation websites. Two reviewers will independently screen and select the articles and extract the data. ETHICS AND DISSEMINATION No ethical approval is required for this study. We will share the results through conference presentations and an open-access publication in a peer-reviewed journal. A lay-language report will be created and disseminated to community organisations that work with Indigenous youth.
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Affiliation(s)
- Leah Carrier
- Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Hwayeon Danielle Shin
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Melissa A Rothfus
- W.K. Kellogg Health Sciences Library, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Janet A Curran
- Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
- Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada
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47
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Rajwani K. Should Adolescents be Included in Emerging Psychedelic Research? Canadian Journal of Bioethics 2022. [DOI: 10.7202/1089784ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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48
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Waibel S, Wu WL, Smith M, Johnson LK, Janke RD. Selection of Pediatric Mental Health Quality Measures for Health System Improvement in British Columbia Based on a Modified Delphi Approach. Front Pediatr 2022; 10:866391. [PMID: 35874563 PMCID: PMC9298984 DOI: 10.3389/fped.2022.866391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/26/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has highlighted the importance of mental wellbeing. The identification and implementation of quality measures can improve health outcomes and patient experience. The objective was to identify and define a core set of valid and relevant pediatric mental health quality measures that will support health system evaluation and quality improvement in British Columbia, Canada. METHODS The study consisted of four phases. First, a comprehensive database search identified valid pediatric quality measures focused on mental health and substance use (MH/SU). Second, the identified quality measures were mapped to focus areas, which were then prioritized by two stakeholder groups consisting of 26 members. Third, up to two representative measures for each prioritized focus area were pre-selected by an expert panel (n = 9). And fourth, a three-step modified Delphi approach was employed to (1) assess each quality measure on a 7-point Likert scale against three relevance criteria (representative of a quality problem, value to intended audience and actionable), (2) discuss the results, and (3) select and rank the most relevant measures. Forty-eight stakeholders were invited to participate; of those 24 completed the round 1 survey, 21 participated in the round 2 discussion and 18 voted in the round 3 selection and ranking survey. For round 1, consensus was determined when at least 70% of the response rates were within the range of five to seven. For round 3, Kendall's coefficient of concordance W was used as an estimator of inter-rater reliability. RESULTS One-hundred pediatric mental health quality measures were identified in the database search. Of those, 37 were mapped to ten focus areas. Pre-selection resulted in 19 representative measures moving forward to the Delphi study. Eleven measures met the consensus thresholds and were brought forward to the round 2 discussion. Round 3 ranking showed moderate to strong raters' agreement (Kendall's W = 0.595; p < 0.01) and resulted in the following five highest-ranked measures: level of satisfaction after discharge from inpatient admission due to MH/SU, number of patients experiencing seclusion or restraint, length of time from eating disorder referral to assessment, number of ED visits due to MH/SU, and number of readmissions to ED. CONCLUSION The selected core set of valid and relevant pediatric quality measures will support sustainable system change in British Columbia. The five top-ranked measures will be refined and tested for data collection feasibility before being implemented in the province.
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Affiliation(s)
- Sina Waibel
- Child Health BC, Provincial Health Services Authority, Vancouver, BC, Canada.,Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Wan Ling Wu
- Child Health BC, Provincial Health Services Authority, Vancouver, BC, Canada
| | | | - L Kit Johnson
- Child Health BC, Provincial Health Services Authority, Vancouver, BC, Canada
| | - Rita D Janke
- Child Health BC, Provincial Health Services Authority, Vancouver, BC, Canada
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Krygsman A, Farrell AH, Brittain H, Vaillancourt T. Depression Symptoms, Mattering, and Anti-mattering: Longitudinal Associations in Young Adulthood. Journal of Psychoeducational Assessment 2021. [DOI: 10.1177/07342829211050519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We examined the dynamic interplay of depression symptoms, mattering (i.e., self-evaluation of importance or significance to others), and anti-mattering across four years of development in young adulthood (age 20–23; N = 452) using a cross-lagged panel model (CLPM). Support for a transactional model between anti-mattering and depression symptoms was found. Specifically, anti-mattering positively predicted later depression symptoms and depression symptoms consistently predicted later anti-mattering. Depression symptoms also shared a negative association with later mattering but not the reverse, supporting a symptoms-driven model of depression symptoms and mattering. Auto-regressive paths, residual covariances, and cross-lagged paths were invariant over time. Accounting for gender, household income, parental education, and fear of COVID-19 as covariates did not change the results. The stability of mattering and anti-mattering suggest careful consideration of how to effectively change these patterns. The implications for assessment and intervention on mattering or anti-mattering in the prevention and treatment of depression are discussed.
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Affiliation(s)
| | - Ann H. Farrell
- Faculty of Education, University of Ottawa, Ottawa, Canada
| | | | - Tracy Vaillancourt
- Faculty of Education, University of Ottawa, Ottawa, Canada
- Faculty of Social Sciences, University of Ottawa, Ottawa, Canada
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Nash L, Isobel S, Thomas M, Nguyen T, van der Pol R. Clinician stakeholder experiences of a new youth mental health model in Australia: A qualitative study. Early Interv Psychiatry 2021; 15:1637-1643. [PMID: 33393193 DOI: 10.1111/eip.13104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/26/2020] [Accepted: 12/13/2020] [Indexed: 11/26/2022]
Abstract
AIM Late teens and early adulthood is the peak age of onset for mental disorders. Currently, there is a gap between primary mental health care and more intensive mental health services for young people in New South Wales (NSW), Australia. Two headspace Early Intervention Teams (hEITs) were developed to bridge this gap in Sydney Local Health District (SLHD), in Sydney, Australia. This study aims to explore clinician experiences of hEIT after the first 2 years of implementation. METHODS Semistructured interviews were conducted with key clinicians working within hEIT or closely associated with hEIT. Nine interviews were conducted, transcribed and analysed using qualitative thematic analysis. RESULTS Four themes were identified: (1) building a bridge between services, (2) filling a clinical gap, (3) service collaborations and their challenges and (4) difficulties of small team size. CONCLUSIONS There is evidence that clinicians value the service provided by hEIT. There are difficulties such as referral confusion, staff turnover and suggestions to increase staffing to improve the stability, skill diversity and viability of the service. Findings have implications for other collaborative youth mental health models.
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Affiliation(s)
- Louise Nash
- Sydney Local Health District Mental Health Service, Sydney, New South Wales, Australia.,Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sophie Isobel
- Sydney Local Health District Mental Health Service, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Margaret Thomas
- Sydney Local Health District Mental Health Service, Sydney, New South Wales, Australia
| | - Thao Nguyen
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Renae van der Pol
- Sydney Local Health District Mental Health Service, Sydney, New South Wales, Australia
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