Youth-led co-production of mental health promotion in Pakistan: intergenerational influences

Youth with mental health needs face barriers in seeking and accessing help, especially in resource-constrained settings in Majority World Countries. Community engagement is thus important for mental health promotion, particularly in addressing stigma. Engagement can be enhanced by involving peer educators and by relating to intergenerational experiences in the sociocultural context of the community. The aim of this study was to explore how intergenerational experiences and perspectives can inform the co-production of youth-led mental health promotion in a Majority World Country, Pakistan. We recruited 11 families (one grandmother, mother and granddaughter in each family) as advisers from two disadvantaged areas of Karachi, and 14 peer educators. Training for peer educators included seminars, experiential activities, three participatory workshops with family advisers and supervision. A sub-sample of family advisers and peer educators attended four focus groups, and peer educators completed reflective diaries following each activity. Data were integrated and subjected to thematic codebook analysis. The three themes related to enabling and hindering factors towards co-production of mental health promotion, incorporation of intergenerational resilience and cascading knowledge to communities. The findings highlighted potential benefits of youth-led mental health promotion that contextualizes intergenerational experiences for those communities. Peer educator roles should be supported by training, and mental health promotion should be integrated within local service systems.

Perspective on clinical high-risk for psychosis in Africa

Clinical High Risk for Psychosis has evolved in recent years as a conceptual and clinical entity, representing a shift in focus from the syndromal psychosis state to a recognition of the pre-psychotic state as a period of potential preventive intervention. Much existing evidence has been generated from well-resourced countries, with a more limited body of literature available from Africa and other Majority World countries. Against a backdrop of prevailing systemic challenges, it is necessary to appraise the state of knowledge on Clinical High Risk for Psychosis in Africa. In this perspective article, we cover epidemiology, risk factors, predictors of psychosis conversion, as well as an overview of sociocultural factors, notably stigma, and the barriers to mental health services in African settings. We discuss existing and promising assessment approaches and reflect on preventive and early intervention strategies. We conclude with recommendations including the need for more clinical, longitudinal, and collaborative research anchored in an integrative transdisciplinary approach. We highlight the need for more culturally valid assessment tools and strategies to improve access to and utilization of services while also reducing stigma.

Adolescent perspectives on gendered ideologies in physical activity within schools: Reflections on a female-focused intervention

There has been growing concern about rising physical inactivity levels in female adolescents, with schools taking some responsibility to address this. Programmes designed for and by girls are increasingly being used by developing or delivering a programme of change and consultation to improve physical activity, physical education, and sport in school. However, to build an understanding of the nuances of such interventions, and better appreciate any gendered benefits and challenges, girls’ voices need to be heard. Based on data from 16 focus groups from 8 schools participating in a female-focused intervention trial (“Girls Active”), we explored adolescent girls’ views of this type of intervention. We used reflexive organic thematic analysis to understand key issues. Four themes were developed: stereotypes; choice; empowerment and voice; and equality. Our feminist approach centralised adolescent girls’ voices, thereby recognising that physical activity is rooted in patriarchal constructions that position girls as naturally uninterested in sport and activity. We suggest gender-focused interventions can actively address stereotypes by listening to girls.

Locked up While Locked Down: Prisoners’ Experiences of the COVID-19 Pandemic

Worldwide, the COVID-19 pandemic has had a devastating impact on prisoners. The prison environment and prisoner health put prison populations at a higher risk of contracting COVID-19. As a result, prison systems have adopted mitigation strategies to reduce the transmission of the virus into and within prisons. These strategies, however, have had an unintended impact on prisoners and their living conditions. In this article, we explore prisoners’ lived experiences of the pandemic in English and Welsh prisons, captured through correspondence with prisoners throughout 12 months of regime restrictions, from April 2020 to April 2021. Drawing on prisoner narratives, the analysis reveals how the restricted regime has exacerbated the pains of imprisonment and had a detrimental impact on prisoners.

The reimagination of school-based physical activity research in the COVID-19 era

Deirdre Harrington and Michelle O'Reilly discuss the article "Effectiveness and cost-effectiveness of the GoActive intervention to increase physical activity among UK adolescents: A cluster randomised controlled trial" by Kirsten Corder and colleagues.

Potential of social media in promoting mental health in adolescents

The growing prevalence of adolescent mental disorders poses significant challenges for education and healthcare systems globally. Providers are therefore keen to identify effective ways of promoting positive mental health. This aim of this qualitative study was to explore perceptions that social media might be leveraged for the purposes of mental health promotion amongst adolescents aged between 11 and 18 years. Utilizing focus groups conducted with adolescents (N = 54), educational professionals (N = 16) and mental health practitioners (N = 8). We explored their views about the value of social media for this purpose. Three themes were identified. First, social media appears to have potential to promote positive mental health. Second, adolescents frequently utilize social media and the internet to seek information about mental health. Finally, there are benefits and challenges to using social media in this way. We conclude that despite challenges of using social media and the risks, social media does offer a useful way of educating and reaching adolescents to promote mental wellbeing.

A Geospatial Analysis of Adult Major Trauma Transit Time in Dublin

Aims To estimate ambulance transit time of Major Trauma patients from scene to Emergency Department (ED) in order to inform future trauma network design. Methods Dublin Fire Brigade data was analysed and each Major Trauma incident was mapped. Actual distance and time to the receiving ED was measured and estimates of distances and times from each of these incidents to any ED in Dublin (any potential Major Trauma Centre) were formulated using Google Maps in Internet Explorer 11. Results Adult trauma (n=500) was evenly distributed throughout Dublin. The median transit time to each ED varied from 5 to 8 minutes with a longest time of 26 minutes. The calculated median transit time from an incident to any ED was 18 minutes with a maximum estimated transit time of 40 minutes. Conclusion The data demonstrated that all patients could get to any Dublin ED with a median time of 18 minutes and within the internationally recommended transfer time of 45 minutes to a Major Trauma Centre.

Discursive Psychology: Implications for Counseling Psychology

In this article, we present discursive psychology (DP), a qualitative approach that focuses on the study of conversational and textual materials, including everyday interactions. Although DP is well-established methodologically and theoretically, and is used widely in Europe and in the Commonwealth countries, it is relatively unknown in counseling psychology in the United States. As such, the purpose of this article is to provide a general overview of DP and offer guidance for researchers who may be interested in studying and using DP. We thus discuss practical considerations for utilizing DP, including the development of research questions, carrying out data collection, and conducting DP-informed analyses. We also provide a general overview of the history of DP and key resources for those interested in studying it further, while noting the usefulness of DP for counseling psychology.

Review of mental health promotion interventions in schools

PURPOSE

The prevalence of mental disorders amongst children and adolescents is an increasing global problem. Schools have been positioned at the forefront of promoting positive mental health and well-being through implementing evidence-based interventions. The aim of this paper is to review current evidence-based research of mental health promotion interventions in schools and examine the reported effectiveness to identify those interventions that can support current policy and ensure that limited resources are appropriately used.

METHODS

The authors reviewed the current state of knowledge on school mental health promotion interventions globally. Two major databases, SCOPUS and ERIC were utilised to capture the social science, health, arts and humanities, and education literature.

RESULTS

Initial searches identified 25 articles reporting on mental health promotion interventions in schools. When mapped against the inclusion and exclusion criteria, 10 studies were included and explored. Three of these were qualitative and seven were quantitative.

CONCLUSIONS

A range of interventions have been tested for mental health promotion in schools in the last decade with variable degrees of success. Our review demonstrates that there is still a need for a stronger and broader evidence base in the field of mental health promotion, which should focus on both universal work and targeted approaches to fully address mental health in our young populations.

Whose Responsibility is Adolescent's Mental Health in the UK? Perspectives of Key Stakeholders

The mental health of adolescents is a salient contemporary issue attracting the attention of policy makers in the UK and other countries. It is important that the roles and responsibilities of agencies are clearly established, particularly those positioned at the forefront of implementing change. Arguably, this will be more effective if those agencies are actively engaged in the development of relevant policy. An exploratory study was conducted with 10 focus groups including 54 adolescents, 8 mental health practitioners and 16 educational professionals. Thematic analysis revealed four themes: (1) mental health promotion and prevention is not perceived to be a primary role of a teacher; (2) teachers have limited skills to manage complex mental health difficulties; (3) adolescents rely on teachers for mental health support and education about mental health; and (4) the responsibility of parents for their children's mental health. The research endorses the perspective that teachers can support and begin to tackle mental well-being in adolescents. However, it also recognises that mental health difficulties can be complex, requiring adequate funding and support beyond school. Without this support in place, teachers are vulnerable and can feel unsupported, lacking in skills and resources which in turn may present a threat to their own mental well-being.

Barriers for unaccompanied refugee minors in accessing mental health care: Is it the therapy or the therapist?

Introduction

Refugee children, particularly unaccompanied refugee minors, present with disproportionately high prevalence of mental health and emotional difficulties. However, the mental health service access and treatment engagement of this vulnerable group has been consistently shown to be poorer than the general population. Despite of this, so far there hasn’t been much research to explore the possible underlying reasons or barriers for these young people to access mental health service in their host countries.

Aims and objectives

This research aims to understand unaccompanied refugee children's barriers to access and utilize mental health services. To explore any potential characteristics in the service provision that can be linked with the observed poor treatment engagement and service access is also an objective of this study.

Methods

The study was conducted by using semi-structured interviews with 15 unaccompanied asylum seeking minors and their carers to elicit their views, perceptions and beliefs based on their experience of receiving treatment from a specialist mental health service in the UK.

Results

The interview transcripts were analysed using thematic analysis. The main findings were categorised into two broad themes, the participants’ perceptions of the intervention received, and perception of the professionals involved. The different elements and pertinent issues within these two broad areas were discussed.

Conclusions

Findings will help stimulate further exploratory research gaining better understanding of the barriers for these young people to access treatment, and contribute in developing innovative services that are more efficient in engaging this vulnerable group and suitable to meet their specific needs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.