Glass craft – dimensions of joy: a platform for mental health and well-being

Nurses suffering in silence: Addressing the stigma of mental health in nursing and healthcare.

Caitlyn Donaldson, Policy Officer at the Royal Society for Public Health, looks at positive mental wellbeing and how it is being promoted through the work of the RSPH.Mental health and wellbeing is increasingly becoming key topic for the RSPH, and we support the recent NHS Mandate for England1 which states that there needs to be parity between mental and physical health, acknowledging that there can be 'No health without mental health'2The WHO defines mental health as a state of wellbeing in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make contribution to his or her community. As in the WHO's definition of health (a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity) mental health is not just the absence of illness, but requires an additional positive 'something' to be present in the individual. Thus, the concept of an individual's mental health state is increasingly being uncoupled from mental illness, and being seen to consist of psychological, emotional and social components.The highest state of subjective wellbeing is seen by many experts as the place where emotional, psychological and social wellbeing are combined, enabling individuals to flourish.3 Thus, rather than simply focusing on preventing and treating mental illness, there is potential to actively promote positive mental health.Mental health and wellbeing impacts upon an individual's physical health, relationships, education, work and ability to reach their potential. At population level, it has consequences for the country's economy, levels of crime, drug and alcohol dependence and homelessness,4 and as Friedli states: health is also key pathway through which social inequality impacts on health.5Many of the key determinants of mental health are located within social and economic domains,6 which provides opportunity for intervention.In 2011 nef published report to address the question of how flourishing mental health could be promoted and increased.7 The result was their five ways to wellbeing: 'connect'; 'be active'; 'take notice'; 'keep learning'; and 'give'. These five ways are easily applied at individual, community, organizational and strategic levels; and evidence suggests that they are being used in many different settings to encourage improved mental wellbeing.The RSPH believes that policymakers at national and local level have responsibility to ensure that policies help address, not increase, inequalities in mental health and wellbeing. The Department of Health's mental health implementation framework8 provides an important perspective on translating policy into practical actions for improving mental health and we support the use of mental wellbeing impact assessment (MWIA), to ensure that policy, programme, service or project has maximum equitable impact on people's mental wellbeing - at individual, community or national level. We also endorse the Guidance for Commissioning Public Mental Health Services,9 which provides the rationale for spending on mental health and also explains what good quality public mental health interventions look like. …

BackgroundIt has been argued that though correlated with mental health, mental well-being is a distinct entity. Despite the wealth of literature on mental health, less is known about mental well-being. Mental health is something experienced by individuals, whereas mental well-being can be assessed at the population level. Accordingly it is important to differentiate the individual and population level factors (environmental and social) that could be associated with mental health and well-being, and as people living in deprived areas have a higher prevalence of poor mental health, these relationships should be compared across different levels of neighbourhood deprivation.MethodsA cross-sectional representative random sample of 1,209 adults from 62 Super Output Areas (SOAs) in Belfast, Northern Ireland (Feb 2010 – Jan 2011) were recruited in the PARC Study. Interview-administered questionnaires recorded data on socio-demographic characteristics, health-related behaviours, individual social capital, self-rated health, mental health (SF-8) and mental well-being (WEMWBS). Multi-variable linear regression analyses, with inclusion of clustering by SOAs, were used to explore the associations between individual and perceived community characteristics and mental health and mental well-being, and to investigate how these associations differed by the level of neighbourhood deprivation.ResultsThirty-eight and 30 % of variability in the measures of mental well-being and mental health, respectively, could be explained by individual factors and the perceived community characteristics. In the total sample and stratified by neighbourhood deprivation, age, marital status and self-rated health were associated with both mental health and well-being, with the ‘social connections’ and local area satisfaction elements of social capital also emerging as explanatory variables. An increase of +1 in EQ-5D-3 L was associated with +1SD of the population mean in both mental health and well-being. Similarly, a change from ‘very dissatisfied’ to ‘very satisfied’ for local area satisfaction would result in +8.75 for mental well-being, but only in the more affluent of areas.ConclusionsSelf-rated health was associated with both mental health and mental well-being. Of the individual social capital explanatory variables, ‘social connections’ was more important for mental well-being. Although similarities in the explanatory variables of mental health and mental well-being exist, socio-ecological interventions designed to improve them may not have equivalent impacts in rich and poor neighbourhoods.

Introduction & BackgroundSocial media use has been proposed as a cause of worsening mental health and wellbeing over the last decade, but its role in mitigating some of the effects of social distancing during the pandemic showed that it also has the potential to improve these outcomes. Whilst existing research disagrees on the degree to which social media use harms or helps, there is growing consensus around the need to move from global measures of social media use to specific measures of types of social media use. These new measures can enable an exploration of proposed mechanisms and causal pathways linking social media use and mental health and wellbeing. A commonly proposed mechanism is nighttime social media use reducing sleep quality, and consequently harming mental health and wellbeing.
 Objectives & ApproachWe aimed to investigate the relationships between the time Twitter users post content and their mental health, wellbeing and sleep quality using direct measurements of Twitter use linked to standardised mental health measures in a well-characterized cohort.
 This study uses approximately 1.5 million Tweets harvested between January 2008 and March 2023 from 622 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). These Tweets have been linked to questionnaire data collected on six occasions spanning April 2019 to May 2021. These questionnaires included standard measures of depressive symptoms, anxiety symptoms, mental wellbeing and difficulty sleeping.We have taken two approaches to explore these relationships, using circular statistical methods novel to social media data analysis to account for day/night cycles. The first approach used mixed effect models to investigate the association between the time a Tweet was posted and the mental health, mental wellbeing and sleep quality of the poster. The second approach explored the relationships between the mean hour participants post Tweets in a given time period, and their mental health, mental wellbeing and sleep quality.
 Relevance to Digital FootprintsThis research is highly relevant to Digital Footprints, due to its use of data directly extracted from a social media site. The methodologies employed in analysing this alongside more traditional epidemiological survey data provides an example of how digital footprint data can complemented by high quality ground truths.
 ResultsThere was evidence that the timing of Twitter activity was predictive of the mental wellbeing and sleep quality of participants, even after adjustment for demographic, educational and socio-economic covariates. However, the hour a Tweet was posted at explained very little of the variation in the mental wellbeing or sleep quality of the participant who posted it (0.1% and less than 0.1% respectively). There was weak to no evidence that the timing of Twitter activity was predictive of the depressive and anxiety symptoms of participants.
 Conclusions & ImplicationsWhilst this study found evidence that the hour participants post on Twitter is predictive of their mental wellbeing and sleep quality, the amount of variation explained by these models suggests that this is not a clinically relevant risk factor. This study supports arguments in the literature that the use of social media has a very small and insignificant effect on mental health, wellbeing and sleep quality.

BackgroundGlobally, promoting mental health and well-being among adolescents has become a public health priority, especially for adolescents living with a physical chronic condition (CC), as research suggests they may be more at risk of developing mental health co-morbidities. Valid and reliable instruments are needed to measure and better understand mental health and mental well-being among adolescents living with a CC. To this end, we reviewed studies reporting on mental health and well-being instruments used in adolescent populations living with a chronic physical condition/disease globally.MethodsWe used a systematic review method guided by PRISMA to identify assess mental health and mental well-being instruments used in adolescents living with a CC. In this instance, mental health instruments were defined as those representing negative domains of mental health (i.e. depression and anxiety) while mental well-being instruments included positive aspects of mental health (i.e. self-concept and resilience).ResultsWe identified 22 articles, which included 31 instruments that were used to measure either mental health (n = 8) or mental well-being (n = 15) or both (n = 8) in adolescents living with a CC. Of these, thirteen studies used a Health-Related Quality of Life (HRQoL) scale to measure mental health and/or mental well-being. The KIDSCREEN questionnaires and the Strengths and Difficulties Questionnaire were identified as being frequently used across the 22 studies. Additionally, 7 out of the 31 instruments were disease specific, with 3 focusing on adolescents with diabetes. All the instruments were developed in high income countries and adapted for use in lower- and middle-income countries (LMICs). Adolescents with Type 1 Diabetes (n = 7) and HIV (n = 4) were researched in 11 out of 22 studies. Only eight studies were conducted in LMIC, of which four were in Africa.ConclusionsHRQoL instruments are useful in measuring mental health and well-being in adolescents living with a CC. However, relatively few valid measures of mental health and mental well-being for adolescents living with a CC exist, which accentuates the paucity of research on mental health and mental well-being of adolescents who are living with a CC. Specific measures need to be developed in and for LMICs where cultural contexts affect mental well-being in unique ways.Systematic review registration: PROSPERO CRD42020186707.

BackgroundYoung adults and especially those with pre-existing mental health conditions, such as disordered eating and self-harm, appear to be at greater risk of developing metal health problems during the COVID-19 pandemic. However, it is unclear whether this increased risk is affected by any changes in lockdown restrictions, and whether any lifestyle changes could moderate this increased risk.MethodsIn a longitudinal UK-based birth cohort (The Avon Longitudinal Study of Parents and Children, ALSPAC) we assessed the relationship between pre-pandemic measures of disordered eating and self-harm and mental health during the COVID-19 pandemic in 2657 young adults. Regression models examined the relationship between self-reported disordered eating, self-harm, and both disordered eating and self-harm at age 25 years and depressive symptoms, anxiety symptoms and mental wellbeing during a period of eased restrictions in the COVID-19 pandemic (May–July 2020) when participants were aged 27–29 years. Analyses were adjusted for sex, questionnaire completion date, pre-pandemic socioeconomic disadvantage and pre-pandemic mental health and wellbeing. We also examined whether lifestyle changes (sleep, exercise, alcohol, visiting green space, eating, talking with family/friends, hobbies, relaxation) in the initial UK lockdown (April–May 2020) moderated these associations.ResultsPre-existing disordered eating, self-harm and comorbid disordered eating and self-harm were all associated with the reporting of a higher frequency of depressive symptoms and anxiety symptoms, and poorer mental wellbeing during the pandemic compared to individuals without disordered eating and self-harm. Associations remained when adjusting for pre-pandemic mental health measures. There was little evidence that interactions between disordered eating and self-harm exposures and lifestyle change moderators affected pandemic mental health and wellbeing.ConclusionsYoung adults with pre-pandemic disordered eating, self-harm and comorbid disordered eating and self-harm were at increased risk for developing symptoms of depression, anxiety and poor mental wellbeing during the COVID-19 pandemic, even when accounting for pre-pandemic mental health. Lifestyle changes during the pandemic do not appear to alter this risk. A greater focus on rapid and responsive service provision is essential to reduce the impact of the pandemic on the mental health of these already vulnerable individuals.Plain English summaryThe aim of this project was to explore the mental health of young adults with disordered eating behaviours (such as fasting, vomiting/taking laxatives, binge-eating and excessive exercise) and self-harm during the COVID-19 pandemic. We analysed data from an established study that has followed children from birth (in 1991 and 1992) up to present day, including during the pandemic when participants were 28 years old. We looked at the relationship between disordered eating and/or self-harm behaviours from before the pandemic and mental health problems (symptoms of depression and anxiety) and mental wellbeing during the pandemic. We also explored whether there were any lifestyle changes (such as changes in sleep, exercise, visiting green space) that might be linked to better mental health and wellbeing in young adults with disordered eating and self-harm. We found that young adults with prior disordered eating and/or self-harm had more symptoms of depression and anxiety, and worse mental wellbeing than individuals without prior disordered eating or self-harm. However, lifestyle changes did not appear to affect mental health and wellbeing in these young adults. Our findings suggest that people with a history of disordered eating and/or self-harm were at high risk for developing mental health problems during the pandemic, and they will need help from mental health services.

Background Study conditions are relevant for university students’ mental health and well-being. Previous research identified single factors associated with mental health, but it remains unclear, which study conditions at higher education institutions should be priority targets for institutional action. The aim of this study is to provide a comprehensive overview of students’ satisfaction with their study conditions and to analyse their associations with students’ mental health. Methods The cross-sectional StudiBiFra study encompasses data from 24,533 students across 13 higher education institutions in Germany. Data was collected between June 2021 and March 2023 using the Bielefeld Questionnaire on Study Conditions and (Mental) Health. Students rated study conditions in 22 domains and four scales of mental health outcomes. Mean scores for all scales were calculated and linear regressions were used to analyse bivariate associations. Results All domains of study conditions were associated with all domains of students’ men-tal health with regression coefficients ranging from r = 0.21 to r = 0.78. The more satisfied students were with their study conditions, the higher the reported well-being, and the lower the depressive symptoms, cognitive stress symptoms, and exhaustion. The highest associations were found for the domains of study conditions “examinations and academic achievements”, “time requirements”, and “fit of course content/competency development” with highest re-gression coefficients for the outcome of exhaustion. Conclusions The findings reveal significant moderate to high associations for all assessed study conditions with students’ mental health. Institutional action should focus on these study conditions by emphasising topics such as applying competencies during studies and good co-ordination of content and examinations. Thus, decreasing student burden and time pressure has the potential to promote mental well-being. Key messages • Study conditions are significantly associated with students’ mental health. • Higher education institutions should focus on study conditions to promote students’ mental well-being.

People with chronic mental health conditions (CMHC) commonly experience social issues (e.g., social isolation and stigma), and emotion regulation difficulties, which impede their recovery. One option for promoting social connectedness and enhanced emotional states is facilitating arts-based groups (ABG) for people with CMHC. The current thesis aimed to advance understanding of how ABG can facilitate improved mental wellbeing outcomes, in the context of people pursuing mental health recovery, by exploring the social and emotional impacts of participating in a choir and a creative writing group. Furthermore, to provide a theoretical framework for studying ABG, the ‘social cure’ approach, based on social identity theory and self-categorisation theory, was applied (Haslam, Jetten, Cruwys, Dingle, & Haslam, 2018).This thesis began by systematically reviewing the literature on the mental health and wellbeing outcomes of group singing for people with a mental health condition (Chapter 2). Across seven longitudinal studies there were consistent findings indicating that group singing has a positive impact on mental health and wellbeing. Furthermore, six qualitative studies uncovered related perceived benefits to choir participation including enhanced emotional states, a sense of belonging, and self-confidence. Regarding creative writing groups, no previous studies had empirically tested the benefits of participating in creative writing in a group setting for people with CMHC.To assesses the longitudinal impact of ABG on mental wellbeing, 34 choir members and 25 creative writing group members (Mage = 46 years, 51% female, 86% mental health diagnosis) were recruited from a community organisation. In Chapter 3 the quantitative data from this year-long investigation was explored. Regardless of whether participants were in the choir or creative writing group, their mental wellbeing improved (d = .52). In accordance with the social cure approach, improvements in mental wellbeing were related to greater identification with the groups. Thus, participating in the group only benefited participants’ mental wellbeing, when the group became a meaningful part of their identity. The processes through which identification with the ABG leads to mental wellbeing were examined in a qualitative analysis of interviews from the same sample, in Chapter 4. Participants reported gaining psychological resources – belonging, support, agency, esteem, purpose, and enjoyment – which aligns with the benefits of gaining a shared group identity. These two empirical studies provide support for the social cure theoretical framework in explaining how ABG participation aids mental health recovery.In Chapter 5 the impact of participating in the ABG on participants’ emotions throughout a group day was examined, as well as exploring participants’ emotion regulation strategies. This study included members of a community choir (not experiencing CMHC) as a comparison group. The average scores on measures of emotion regulation revealed that compared with the comparison choir, people with CMHC were more likely to actively look for problems in their current situation. Despite this, all participants experienced an increase in positive emotions and decrease in negative emotions during the arts-based activity. In addition, it was found that people with CMHC reported preferring to talk to other people or doing something active to improve their emotional state than withdrawing or being alone. Therefore, these findings suggest that engaging in ABG could help people with CMHC to regulate their emotions.In the final empirical chapter, the social and emotional impact of performances by the choir on their audience was assessed to explore the potential impact of recovery choir performances on mental health stigma in the community. In the first study 322 first year psychology students from an Australian university watched video clips of the choir embedded into an online survey in a between-subjects experiment with four conditions: recovery choir singing / recovery choir not singing / comparison choir singing / comparison choir not singing. The second study replicated this design with 403 UK residents. These studies found that watching the choir singing increased the audience members’ positive emotions toward the choristers. Furthermore, positive emotions mediated the effect of watching choir singing on social acceptance and connectedness with the performers. Additionally, in a field study, 50 audience members of a live performance by the recovery choir were surveyed before and after the concert, again demonstrating that audiences’ positive emotions toward the choristers increased. These studies demonstrate that choir performances by people with CMHC can increase affiliative feelings toward the choristers.In summary, this thesis indicates that ABG can have a meaningful impact on the mental wellbeing of people with CMHC, and the broader community’s feelings toward them. Thus, this thesis supports the implementation of ABG in mental health care as an intervention which has the potential to maintain the mental wellbeing of people with CMHC living in the community. The thesis concludes with ideas for the future directions in research and evidence-based practice with ABG from the social cure perspective as part of a growing movement in social prescribing for mental health conditions.

Introduction: Stress is the physiological response to any stimulus that requires mental or physical focus or exertion. Police officers are responsible for enforcing laws in their jurisdiction. As there is a rise in the personal risk of verbal and physical assaults, as well as ongoing involvement in a range of unpleasant situations, the duties of law enforcement officers tend to become fundamentally stressful. This research aims to assess work-related stress and mental well-being among police personnel in the Mangalore jurisdiction. Methods: A Descriptive study was conducted with 220 police personnel from the Mangalore Jurisdiction from March 3, 2023, to March 31, 2023. The Operational Police Stress Questionnaire and Warwick-Edinburgh Mental Wellbeing Scales were used to gather data from participants selected through a disproportionate stratified random sampling technique. To determine the relationship between police officers' mental wellness and their level of work-related stress, Karl Pearson's Correlation Coefficient was calculated. Results: 87.3% of the police personnel experienced high stress, followed by 10.5% who had medium stress, and 2.2% who had low stress. The majority, 59.6% of police personnel, had medium mental well-being, 35.9% had high mental well-being, and 4.5% had low mental well-being. The results also showed that there was no significant correlation (r = 0.034) between work-related stress and mental well-being among police personnel. Conclusion: This study concluded that there is a high level of work-related stress among police personnel in the Mangalore jurisdiction, which is directly or indirectly affecting their mental well-being.

Calls to address concerning evidence surrounding mental health and wellbeing in doctoral researchers have grown internationally in recent years. Adopting an ecological systems approach, this article explores doctoral researchers’ perspectives on what influences mental health and wellbeing in early-stage doctoral research. Forty-seven doctoral researchers took part in focus groups exploring mental health and wellbeing in the first year of doctoral study. The framework generated through our thematic and connecting analyses emphasises the interdependency of the various layers of the environment surrounding early-stage doctoral researchers. In line with our theoretical perspective, we describe the influence of: individual factors; the microsystem; the mesosystem; the exosystem; and the macrosystem. Participants highlighted the impact of the broader working culture in academia on their mental health and wellbeing, which permeated other, more proximal layers within their environment. This article contributes knowledge that can aid the development of interventions seeking to support mental health and wellbeing in doctoral researchers. Furthermore, our findings suggest that without the adoption of a whole-systems approach, efforts to improve mental health and wellbeing in these researchers could be difficult.

Editor's evaluation: Investigating the relationship of COVID-19 related stress and media consumption with schizotypy, depression, and anxiety in cross-sectional surveys repeated throughout the pandemic in Germany and the UK

Decision letter: Investigating the relationship of COVID-19 related stress and media consumption with schizotypy, depression, and anxiety in cross-sectional surveys repeated throughout the pandemic in Germany and the UK

Orientation: Work-related stress has deleterious effects on mental health, resulting in disorders such as anxiety, depression and increased absenteeism. Research purpose: The purpose of this study was to develop a comprehensive management model that addresses work-related stress and enhances the mental well-being of primary school teachers in Gauteng, South Africa. The study is grounded on the Positive Emotions, Engagement, Relationships, Meaning, and Accomplishment (PERMAH) model. Motivation for the study: Learner achievement is inextricably linked to the well-being of teachers. Exploring how positive mental health constructs can boost teachers’ resilience can result in efficacious educational quality and student success. Research approach/design and method: Confirmatory sequential mixed-method research design was used, with quantitative Phase 1 employing a structural equation model (SEM). The Work-Related Stress Questionnaire (WRSQ) was used to collect data, yielding a return rate of n = 251 and (n = 218) valid responses. Qualitative data Phase 2 comprised nine teachers selected purposively, using semi-structured interviews with open-ended questions. Thematic analysis was used to analyse the data. Main findings: The quantitative findings demonstrated significant negative relationships between low social support, burnout and teachers’ mental well-being, accounting for 59% of the variance. The qualitative findings revealed themes of positive emotions, engagement, relationships, meaning, accomplishment and health. Practical/management implications: This study serves as a buoy for the implementation of positive psychology principles and interventions in cultivating teachers’ mental well-being. Contribution/value-add: The study’s contributions serve as a framework for the creation of evidence-based management interventions that improve teachers’ mental well-being.

BackgroundFollowing the emergence of COVID-19 in the UK, on March 18th 2020 the majority of schools in England closed and families and teachers were tasked with providing educational support for children and adolescents within the home environment. Little is known, however, regarding the impact of remote teaching and learning on the mental wellbeing of parents/carers and teaching staff.MethodsThe Coronavirus Education (COV-ED) online survey explored the practicalities of learning and teaching from home for 329 parents/carers and 117 teachers of 11–15 year old adolescents in England, during June/July 2020, and the associated impact on their mental wellbeing. Participants were recruited through schools and via University of Warwick social media channels. Data was analysed using a series of Multiple Linear and Multivariate Regressions.ResultsDespite coping well with the challenges of remote learning, a third of teachers reported below average mental wellbeing on the Warwick-Edinburgh Mental Wellbeing Scale. Multivariate regression revealed that wellbeing was associated with access to resources and confidence to teach from home. Almost half of parents/carers surveyed reported below average wellbeing. Multivariate regression revealed that poor wellbeing was more common in those who were also working from home and who lacked support for their own mental health. Concerns about their child’s mental health and lack of access to electronic devices and workspace were also significantly associated with the mental wellbeing of parents/carers.ConclusionsWhilst young people’s mental health and wellbeing has, and continues to be a national priority, the mental health and wellbeing of the families and teachers supporting them has not previously been explored. Our survey population was of predominantly white British heritage, female and living in the West Midlands UK, therefore, findings should be treated with caution. Findings provide a snapshot of factors that may be of significance to families and schools in supporting the mental wellbeing of those tasked with learning from home. They will help i) increase knowledge and awareness with regard to future support of families and teachers during similar crises; ii) enable the design and development of practical solutions in the delivery of remote teaching and learning; and, iii) help address the mental wellbeing needs of those tasked with supporting adolescents.

Understanding the Health and Well-Being of Early Adolescents Throughout the World: Findings From the 2017–2018 Survey of Health Behavior in School-Aged Children