Mental health risk and audit integrity: Exploring the mediating role of is audit effectiveness in Big 4 institutions: An SPSS–PLS approach

Effective systems of care for youth with emotional disorders require shared values among stakeholders toward a variety of mental health issues. Juvenile courts represent one stakeholder group whose values can affect the delivery of services to young offenders with or at risk of emotional disturbances. This research uses statewide data from Tennessee to assess the mental health orientation (MHO) of juvenile courts, their use of treatment options for offenders, and whether MHO influences the treatment referral decision. Results show that courts have a positive MHO, but this subjective orientation does not correspond to higher treatment referral rates. Moreover, service referrals are at a considerably lower rate than estimates of need for this population of youth would predict. While positive MHO suggests a basis for nurturing the shared vision required for effective systems of care, other factors must be considered to account for courts' underutilization of treatment options for juvenile offenders.

ObjectivesThis study aimed to identify those at high risk of poor mental health among nursing students and to examine the relationships and consistency among five mental health assessments.DesignA cross-sectional design...

Background:Treatment gap for mental health care in low- and middle-income (LAMI) countries is very large, and building workforce using the locally available resources is very much essential in reducing this gap. The current study is a preliminary work toward this direction.Materials and Methods:A single group pre- and post-design was considered for assessing the feasibility of Mental Health Orientation (MHO) Program for Self-Help Group members. Assessment of participants’ MHO using Orientation Towards Mental Illness (OMI) scale was undertaken at three levels: Baseline assessment before the intervention, after completing 2 days orientation program, and 6 weeks later.Results:Analysis of data resulted in statistically significant mean scores in the domains of areas of causation (F[1.41, 40.7] = 21.7, P < 0.000, ηp2 = 0.428), perception of abnormality (F[1.27, 36.8] = 15.8, P < 0.000, ηp2 = 0.353), treatment (F[1.42, 41.3] = 34.8, P < 0.000, ηp2 = 0.546), and after effect (F[1.36,39.4] = 26.7, P < 0.000, ηp2 = 0.480). Although the overall mean scores of all the domains of OMI were found to be statistically significantly different, there was no significant difference in the mean scores between post and follow-up assessments on areas of causation (μd = 1.27, P = 0.440) and treatment (μd = 1.00, P = 0.156).Conclusion:Overall, the findings of our study demonstrate that brief MHO program can exert a beneficial effect on bringing about significant change in the orientation of the participants toward mental illness but need to be refreshed over time to make the impact of the program stay longer.

Experiences of stigma, mental health, and coping strategies in Lebanon among Lebanese and displaced Syrian men who have sex with men: A qualitative study

Victimization is a well-established driver of sexual minority youth's (SMY) mental health and substance use risk. The current study examined and extended this research by exploring how victimization, cybervictimization, and non-parental supportive adults contribute to SMY's vulnerability to poor mental health and substance use. Using data from the first representative sample of Texas youth that measures sexual identity, we analyzed sex-stratified models of the association between sexual identity, mental health, and substance use, and the confounding effects of victimization, cybervictimization, and non-parental adult support. Victimization was more common among SMY and accounted for a greater proportion of sexual identity disparities on mental health and substance use, especially for males. Sexual minority females were more likely to report cybervictimization than heterosexual youth, and cybervictimization was associated with mental health risk. SMY reported fewer available non-parental supportive adults, which was associated with more sadness, suicidality, and polysubstance use. Our study adds to extant evidence that victimization drives SMY's increased susceptibility to mental health and substance use risk. Schools should implement inclusive policies that prohibit bullying based on sexual minority identity and offer professional development opportunities for supporting SMY.

AimsTo demonstrate identification and response to mental health issues in CYP (children and young people) who attend for sexual abuse assessments.To assess if information on ACEs (Adverse childhood experience) in...

Responding to signals of mental and behavioral health risk in pragmatic clinical trials: Ethical obligations in a healthcare ecosystem

Addressing Social Determinants of Mental Health in Pediatrics During the Coronavirus Disease 2019 Pandemic.

To identify distinct profiles of adolescent mental and behavioral health risks and variation over cohorts and demographic strata from 1999 through 2021. We expected increased mental health risks and decreased behavioral health risks. We analyzed repeated, cross-sectional, nationally representative samples of high school students from the 1991-2021 national Youth Risk Behavior Survey (N = 178 658) using latent class analysis. Adolescents self-reported mental and behavioral health risk behaviors, including internalizing (depressive symptoms, suicidality), substance use (alcohol, marijuana use), sexual risk behaviors (number of sexual partners, effective birth control), and violence (weapons carriage, fighting). We identified 5 distinct profiles. The largest group, Low Everything (48% of adolescents), grew notably in prevalence from 1999 to 2021. The smallest, High Internalizing (9% of adolescents), also grew. High Sex (20%), High Everything (13%), and High Substance Use (10%) all decreased, with all trajectories strengthening between 2019 and 2021 during the COVID-19 pandemic. Younger adolescents predominated in the Low Everything and High Internalizing profiles, and older adolescents predominated in the High Sex and High Everything profiles. Females were more prevalent in the High Internalizing and High Sex profiles, and males were more prevalent in the High Everything and High Substance Use profiles. White adolescents were overrepresented in the High Substance Use profile, and youth of color were overrepresented in the other profiles. Results showing decreasing proportions of adolescents reporting comorbid mental and behavioral health risks or behavioral health risks only, but increases in mental health problems only, help to identify and target key populations for prevention and treatment efforts.

There is increasing evidence that the COVID‐19 pandemic has had substantial mental health impacts for adolescents. Yet, few definitive studies have investigated which adolescents were at higher risk of poor mental health and well‐being during the pandemic. Data were drawn from the Childhood to Adolescence Transition Study, a prospective cohort study of students in Australia (N = 1211). Prevalence of mental health outcomes (depressive symptoms, anxiety symptoms, self‐harm and good subjective well‐being) was estimated in school Years 5–12, where Years 11 (2020) and 12 (2021) coincided with the pandemic. The age‐ and sex‐adjusted relative risk of each mental health outcome for each priority group during the pandemic were estimated. During the pandemic, over 50% of study participants reported depressive symptoms, and one quarter reported anxiety symptoms. There was a decrease in good subjective well‐being compared with pre‐pandemic years, while self‐harm prevalence remained similar. History of mental health problems, school disengagement and frequent peer victimisation increased the risk of experiencing mental health problems during the pandemic. Schools play a central role in maintaining the mental health and good subjective well‐being of students, and this is particularly important during periods of social disruption, such as the COVID‐19 pandemic.

Background: In 2015, Nepal was struck by two massive earthquakes with magnitudes over the 7.0 Richter Scale, imposing short- and long-term mental health risks. This review aims to: (a) evaluate mental health risk among the earthquake survivors; and, (b) identify factors that influence it. Methods: The following databases: Scopus and PubMed were searched to identify studies published from 2015 to July 2020 on the mental health risk among the Nepali populations. Inclusion criteria were: (a) primary research related to mental health after the 2015 earthquakes in Nepal, (b) English language articles, (c) access to full-text literature, and (d) studies conducted on the general population of Nepal. Exclusion criteria were: (a) newspaper articles or other forms of popular media, (b) grey records and reviews or, (c) studies carried out among patients in a clinical setting. Key features and risk of bias factors were extracted from each study to obtain necessary characteristics for further analysis of results. Results: The initial search produced 134 articles, however, a total, 14 studies fulfilled the inclusion criteria and were explored for this review. Ten of these articles were obtained from established databases, and four additional studies were obtained from other sources. Findings indicate that post-traumatic stress was mostly present among earthquake survivors with rates varying from 4.9% to 51%. Mental health risks for children and adolescent were mostly high with rates greater than 23% across studies. However, the adult prevalence rate for mental health risk was lower than that of children and adolescents, with most rates across studies lower than 20%. Socio-demographic factors (such as gender and age) and methodological heterogeneities such as variations in study design and mental health tools used to assess rates were associated factors that potentially influenced the findings. Conclusion: Mental health risks are present among earthquake survivors in Nepal. Various factors have been identified as potential mental health risk rate influencers including sex, with females presenting as the higher at-risk group for mental health relative to males. Methodological issues such as a wide range of mental health assessment instruments employed across studies can potentially impact rates.

BackgroundThis paper is a part of the work of the group that carried out the report "The state of the mental health in Europe" (European Commission, DG Health and Consumer Protection, 2004) and deals with the mental health issues related to the migration in Europe.MethodsThe paper tries to describe the social, demographical and political context of the emigration in Europe and tries to indicate the needs and (mental) health problems of immigrants. A review of the literature concerning mental health risk in immigrant is also carried out. The work also faces the problem of the health policy toward immigrants and the access to health care services in Europe.ResultsMigration during the 1990s has been high and characterised by new migrations. Some countries in Europe, that have been traditionally exporters of migrants have shifted to become importers. Migration has been a key force in the demographic changes of the European population. The policy of closed borders do not stop migration, but rather seems to set up a new underclass of so-called "illegals" who are suppressed and highly exploited. In 2000 there were also 392.200 asylum applications.The reviewed literature among mental health risk in some immigrant groups in Europe concerns: 1) highest rate of schizophrenia; suicide; alcohol and drug abuse; access of psychiatric facilities; risk of anxiety and depression; mental health of EU immigrants once they returned to their country; early EU immigrants in today disadvantaged countries; refugees and mental healthDue to the different condition of migration concerning variables as: motivation to migrations (e.g. settler, refugees, gastarbeiters); distance for the host culture; ability to develop mediating structures; legal residential status it is impossible to consider "migrants" as a homogeneous group concerning the risk for mental illness. In this sense, psychosocial studies should be undertaken to identify those factors which may under given conditions, imply an increased risk of psychiatric disorders and influence seeking for psychiatric care.Comments and RemarksDespite in the migrants some vulnerable groups were identified with respect to health problems, in many European countries there are migrants who fall outside the existing health and social services, something which is particularly true for asylum seekers and undocumented immigrants. In order to address these deficiencies, it is necessary to provide with an adequate financing and a continuity of the grants for research into the multicultural health demand. Finally, there is to highlight the importance of adopting an integrated approach to mental health care that moves away from psychiatric care only.

Raising risk awareness by supporting employers to include Mental Health safety programs within existing systems for occupational health and safety requirements. Globally, psychological disorders are the leading causes of workplace disability. Associated with the level of disability, poor mental health results in higher absenteeism rates and lower productivity in the workplace. With Mental illness now emerging as a leading safety hazard in the workplace, employers should prioritise Mental Health Safety programs that many members of their workforce will inevitably require to remain safe at work and perform well. Such programs aim to improve awareness, staff knowledge and manager education on how to recognise and respond to employees that are indicating signs of poor mental health and provide occupational support systems and workplace adjustments for early intervention and recovery. Process A climate analysis is conducted prior to the introduction of a Workplace Mental Health program to assess the level of workplace readiness. The analysis includes an investigation with a cross section of workers to identify viable mental health risks in the workplace. Lead indicators include absenteeism rates, cultural survey review, complaints and conflict measurement via human resources and the frequency and duration of workers compensation claims. Once determined, an industry specific mental health program is implemented. The program will focus on policy and procedural development, fusion of the program into existing safety systems, mental health education, employee participation providing practical skills/tools for workers and managers to comply with safety obligations and mental health competency; to identify and respond to signs of poor mental health in the workplace. Education programs increase awareness, drive a better understanding of workplace obligations and support managers on how to approach an employee and assess the level of risk and provide systematic support. Managers are up skilled in the awareness of anxiety, depression, burnout and suicidal ideation. Risk reporting for ongoing program evaluation should be considered when introducing a mental health safety program within the workplace to validate ongoing delivery and provide the workplace with the capability to mitigate ongoing mental health risks in the workplace. Conclusion By introducing workplace mental health safety programs workers and managers better understand their role and have the relevant skills to prevent and manage mental health risks in the workplace. Providing information, instruction, training and supervision has assisted in protecting workers from mental health risks, directly impacting overall performance at work including; holistic approach to workplace safety (physical and psychological) improved productivity lower absenteesim increased employee engagement less interpersonal conflicts and complaints. (Reduction in alleged bullying culture) more robust workplace relationships between manager and worker Employers have an obligation to provide and maintain workplace safety, this includes managing mental health at work. Employers should therefore implement preventive measures to optimize the fit between an individual worker and his or her psychosocial, organisational and physical working environment, to reduce mental injuries or aggravating pre - exiting mental health issues of their employees. Investing in creating a more mentally healthy workplace is beneficial to all staff from Senior level management to frontline workers As a result, employees are more engaged, more motivated, morale will be higher and staff will have the capability to perform their role at an optimum level. Mental health safety systems are vital to providing ‘entire workplace safety system; and will benefit the worker and workplace by stabilising organisational performance through the reduction of abseenteesim, presenteesim and health claims.

Human services occupations are highly exposed to mental health risks, thus psychosocial risk management is critical to assure healthy and safe working conditions, promote mental health and commitment, and prevent fluctuation of employees. However, still little is known about prominent psychosocial risk factors in various human services work. To identify prominent psychosocial risk factors of mental health in human services occupations and to explore their individual and organizational correlates in 19 European countries. Cross-sectional survey using data from the European Union's Labor Force Survey among 379,759 active employees in 19 European countries. First, a descriptive analysis was carried out to establish the prevalence of mental health risk factors. Then sociodemographic correlates of occupational mental health risk factors were assessed by means of Pearson's chi-squared test. Finally, correlations were explored between perceived psychosocial risk factors and human vs. non-human services occupations, as well as contextual variables by applying multilevel logistic and multinomial regression analyses. The prevalence of mental health risk was 45.1%. Work overload (19.9%), dealing with difficult clients (10.2%), and job insecurity (5.8%) were the most prevalent mental health risk factors among European employees. We identified significant differences in the prevalence of mental health risks and specific mental health risk factors among employees according to sex, age, and educational attainment. The prevalence of mental health risks was significantly higher among women (47.0%, man: 43.3%), workers aged 35-50 years (47.5%, >50: 44.4%, <35: 42.3%), and those with the higher level of education (51.9%, secondary with diploma: 42.6%, elementary: 36.2%). Employees working in healthcare in Northern Europe were most likely to be exposed to mental health risks (AME = 0.717). Working in healthcare in Northern Europe was the strongest predictor of reporting work overload (AME = 0.381). Working in social care in Central and Eastern Europe was the strongest predictor of reporting dealing with difficult clients (AME = 0.303) as the most prevalent mental health risk factor. Understanding the impact of employment in specific human services occupations on mental health and its specific occupational stressors are vital to improve mental health and safety at work and maintain high quality services.

Identifying children at the highest risk of negative health effects is a prerequisite to effective public health policies in Southern Africa. A central ongoing debate is whether poverty, orphanhood or parental AIDS most reliably indicates child health risks. Attempts to address this key question have been constrained by a lack of data allowing distinction of AIDS-specific parental death or morbidity from other causes of orphanhood and chronic illness. To examine whether household poverty, orphanhood and parental illness (by AIDS or other causes) independently or interactively predict child health, developmental and HIV-infection risks. We interviewed 6 002 children aged 10 - 17 years in 2009 - 2011, using stratified random sampling in six urban and rural sites across three South African provinces. Outcomes were child mental health risks, educational risks and HIV-infection risks. Regression models that controlled for socio-demographic co-factors tested potential impacts and interactions of poverty, AIDS-specific and other orphanhood and parental illness status. Household poverty independently predicted child mental health and educational risks, AIDS orphanhood independently predicted mental health risks and parental AIDS illness independently predicted mental health, educational and HIV-infection risks. Interaction effects of poverty with AIDS orphanhood and parental AIDS illness were found across all outcomes. No effects, or interactions with poverty, were shown by AIDS-unrelated orphanhood or parental illness. The identification of children at highest risk requires recognition and measurement of both poverty and parental AIDS. This study shows negative impacts of poverty and AIDS-specific vulnerabilities distinct from orphanhood and adult illness more generally. Additionally, effects of interaction between family AIDS and poverty suggest that, where these co-exist, children are at highest risk of all.