The Mountaineering Expedition as a Mental Health Support Metaphor for European High-Performance Athletes

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

In April 2003 the Alberta government integrated specialized mental health services, formerly organized independently, with the health regions, which are responsible for general health services. The objective of this article is to determine whether the transfer was associated with an increase or decrease in the share of resources in the region allocated to mental health care relative to total spending for health care. The measure of the share for mental health care is the total costs for mental health care resources as a percentage of total health care spending. Resources and spending examined were those that were actually or potentially under the regions' control. Annual costs for mental health services in the province were obtained for a seven-year period (fiscal year [FY] 2000 through FY 2006) from provincial utilization records for all residents in the province. Unit costs were assigned to each visit. The trend in the share measure was plotted for each year. The share for mental health care increased overall from FY 2000 (7.6%) to FY 2003 (8.2%), but returned to pre-FY 2003 levels in the three years after the transfer (7.6%). Despite concerns expressed before the transfer by federal and provincial reports over the level of expenditures devoted to mental health care, the integration of mental health services with other health services did not result in an increase of the share for mental health care.

Lesbian, gay, bisexual, trans, queer/questioning, plus young people have a higher risk of poor mental health in comparison to cisgendered heterosexual young people, and they underutilise mental health services and support. In addition, there is a paucity of research conducted in United Kingdom examining mental health early intervention provision for lesbian, gay, bisexual, trans, queer/questioning, plus young people. To produce a model of what works for early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people and increase understanding of lesbian, gay, bisexual, trans, queer/questioning, plus young people's access to, navigation of, and engagement with mental health support. This was a multi-methods theory-led case study evaluation with three distinct stages: (1) a meta-narrative review of existing literature to develop a theoretical framework to explain effective mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people; (2) an online and offline service mapping exercise to locate current mental health early intervention support for lesbian, gay, bisexual, trans, queer/questioning, plus young people in the United Kingdom in order to produce a service typology; and (3) a theory-led case study evaluation of 12 case study sites selected from the service typology produced in stage 2, to establish the components of appropriate quality, early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people. Stage 1 produced an interdisciplinary theoretical framework indicating that early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus youth must prioritise addressing normative environments that marginalise youth, lesbian, gay, bisexual, trans, queer/questioning, plus identities and mental health problems. Stage 2 mapping found 111 services, the majority in urban settings in England. There was an absence of mainstream National Health Service support that specifically addressed the needs of lesbian, gay, bisexual, trans, queer/questioning, plus young people. The majority of lesbian, gay, bisexual, trans, queer/questioning, plus youth mental health support was provided by voluntary/community organisations. Stage 3 case study evaluation found that an intersectional, youth-rights approach is the most appropriate way to deliver early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people. Youth rights should underpin mental health support to address the multiple marginalisation, isolation and stigmatisation that lesbian, gay, bisexual, trans, queer/questioning, plus young people may experience and to enable them to make informed independent decisions about their own bodies and lives, and for the right to freedom of safe self-expression to be upheld. The model that we have produced contains 13 principles that are necessary to the provision of mental health support, and to improve access to, engagement with, and navigation of mental health services. In the United Kingdom, a rights-based approach to mental health service provision is not prominent. In addition, at the time of writing, lesbian, gay, bisexual, trans, queer/questioning, plus young people are facing active legislative and policy attacks on their human rights. This study provides the first large-scale theory-led evaluation of early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people with common mental health problems. The resulting intersectional, youth-rights approach provides evidence on ways of improving lesbian, gay, bisexual, trans, queer/questioning, plus young people's mental health. Further research on the implementation of an intersectional, youth-rights approach to early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people with mental health problems is required. This study is registered as PROSPERO CRD42019135722. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/09/04) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 47. See the NIHR Funding and Awards website for further award information.

Mental health in elite and youth athletes: emerging strategies and evidence-based trends: a narrative review

Linnemayr, Sebastian PhD; Barreras, Joanna L. PhD; Izenberg, Max MSc; Brooks, Ronald A. PhD; Gonzalez, Ana BA; MacCarthy, Sarah DSc Author Information

The COVID-19 pandemic has taken a significant mental and emotional toll on critical care nurses. High patient acuity, staffing shortages, and increased care needs both in the hospital and in the community are contributing to increases in depression, anxiety, and overall burnout. Nurses who perceive, internalize, anticipate, and experience stigma may be hesitant to engage in mental health care and self-stewardship. Resultingly, stigma is a detriment to the mental health and overall well-being of critical care nurses. The American Nurses Association recognizes this stigma and is committed to dismantling stigma as a barrier to mental health care. Nurses may fear social and professional consequences associated with receiving mental health care. Nursing leaders and organizations can take steps to reduce stigma related to mental health care and support self-stewardship among critical care nurses.

BackgroundA growing gap has emerged between people with mental illness and health care professionals, which in recent years has been successfully closed through the adoption of peer support services (PSSs). Peer support in mental health has been variously defined in the literature and is simply known as the help and support that people with lived experience of mental illness or a learning disability can give to one another. Although PSSs date back to several centuries, it is only in the last few decades that these services have formally evolved, grown, and become an integral part of the health care system. Debates around peer support in mental health have been raised frequently in the literature. Although many authors have emphasized the utmost importance of incorporating peer support into the health care system to instill hope; to improve engagement, quality of life, self-confidence, and integrity; and to reduce the burden on the health care system, other studies suggest that there are neutral effects from integrating PSSs into health care systems, with a probable waste of resources.ObjectiveIn this general review, we aimed to examine the literature, exploring the evolution, growth, types, function, generating tools, evaluation, challenges, and the effect of PSSs in the field of mental health and addiction. In addition, we aimed to describe PSSs in different, nonexhaustive contexts, as shown in the literature, that aims to draw attention to the proposed values of PSSs in such fields.MethodsThe review was conducted through a general search of the literature on MEDLINE, Google Scholar, EMBASE, Scopus, Chemical s, and PsycINFO. Search terms included peer support, peer support in mental health, social support, peer, family support, and integrated care.ResultsThere is abundant literature defining and describing PSSs in different contexts as well as tracking their origins. Two main transformational concepts have been described, namely, intentional peer support and transformation from patients to peer support providers. The effects of PSSs are extensive and integrated into different fields, such as forensic PSSs, addiction, and mental health, and in different age groups and mental health condition severity. Satisfaction of and challenges to PSS integration have been clearly dependent on a number of factors and consequently impact the future prospect of this workforce.ConclusionsThere is an internationally growing trend to adopt PSSs within addiction and mental health services, and despite the ongoing challenges, large sections of the current literature support the inclusion of peer support workers in the mental health care workforce. The feasibility and maintenance of a robust PSS in health care would only be possible through collaborative efforts and ongoing support and engagement from all health care practitioners, managers, and other stakeholders.

BackgroundAustralian rural and regional communities are marked by geographic isolation and increasingly frequent and severe natural disasters such as drought, bushfires and floods. These circumstances strain the mental health of their inhabitants and jeopardise the healthy mental and emotional development of their adolescent populations. Professional mental health care in these communities is often inconsistent and un-coordinated. While substantial research has examined the barriers of young people’s mental health and help-seeking behaviours in these communities, there is a lack of research exploring what adolescents in rural and regional areas view as facilitators to their mental health and to seeking help when it is needed. This study aims to establish an in-depth understanding of those young people’s experiences and needs regarding mental health, what facilitates their help-seeking, and what kind of mental health education and support they want and find useful.MethodWe conducted a qualitative study in 11 drought-affected rural and regional communities of New South Wales, Australia. Seventeen semi-structured (14 group; 3 individual) interviews were held with 42 year 9 and 10 high school students, 14 high school staff, and 2 parents, exploring participants’ experiences of how geographical isolation and natural disasters impacted their mental health. We further examined participants’ understandings and needs regarding locally available mental health support resources and their views and experiences regarding mental illness, stigma and help-seeking.ResultsThematic analysis highlighted that, through the lens of participants, young people’s mental health and help-seeking needs would best be enabled by a well-coordinated multi-pronged community approach consisting of mental health education and support services that are locally available, free of charge, engaging, and empowering. Participants also highlighted the need to integrate young people’s existing mental health supporters such as teachers, parents and school counselling services into such a community approach, recognising their strengths, limitations and own education and support needs.ConclusionsWe propose a three-dimensional Engagement, Empowerment, Integration model to strengthen young people’s mental health development which comprises: 1) maximising young people’s emotional investment (engagement); 2) developing young people’s mental health self-management skills (empowerment); and, 3) integrating mental health education and support programs into existing community and school structures and resources (integration).

Mental health impacts on college campuses are on the rise. According to the National College Health Assessment, students reported increased depression and anxiety symptoms that overwhelmed their studies. Recent studies show that 1 in 6 undergraduates felt too depressed to function, 1 in 5 felt overwhelming anxiety, and 1 in 15 seriously considered suicide (Rafal et al.). This is exacerbated by a time of great uncertainty and stress due to the COVID-19 pandemic. How can campuses prepare a safety net of non-clinical mental health support to best support students? The purpose of this Action Research study was to develop a model for graduate student education to aid future Student Affairs practitioners in identifying and intervening in emerging mental health issues of undergraduate students. The study utilized a Collaborative Learning Community to discuss the issues at hand and create a pilot program for Master's students at one Student Affairs program. Research findings include the application of a foundation of mental health literacy, needed understanding and support of high-risk populations, recommended graduate student preparation, and a need to redefine roles of Student Affairs practitioners around mental health support. The overarching conclusion is that the field of Student Affairs must redefine its role around non-clinical mental health support. This should be done by integrating a theory/practice approach founded in mental health literacy into Master's preparation programs. This would include specific information on mental health disorders, warning signs, risk factors, mental health support, high-risk populations, and trauma-informed practice.--Author's abstract

Students who are marginalised based on varying identities, backgrounds and characteristics are highly vulnerable to mental health challenges, but many do not receive appropriate support from healthcare services. Several barriers have been identified, including cultural and systemic factors. Therefore, everyday coping strategies and support in different settings are vital. This study examines the mental health coping strategies and support needs among marginalised students in the United Kingdom (UK). We analysed qualitative and quantitative data from a cross-sectional survey conducted between December 2021 and July 2022. Statistical analysis was conducted on data obtained using the abbreviated version of the Coping Orientation to Problems Experienced Inventory (Brief-COPE). Qualitative content analysis was applied to data collected using open-ended questions. From a subsample of 788 further and higher education students, 581 (73.7%) students (M = 25 years, SD = 8.19) were categorised as marginalised based on ethnicity, sex/gender, sexuality, religious beliefs, first language, birth country, age (i.e., mature students), and having special education needs/disabilities. Marginalised students had significantly higher scores for problem-focused, emotion-focused and avoidant coping strategies/practices compared to other students. Coping strategies included talking to friends and family, practising religion or spirituality, engaging in creative/innovative activities like hobbies, using entertainment as a distraction, waiting to see if things improve and isolating. Students expressed a need for improved or tailored services, additional academic support, and appropriate social support. These included contemporary approaches to support mental health, such as online provisions, regular mentor/personal tutor meetings, lowered academic pressures and opportunities for organised peer support. The findings from this study highlight significant and timely evidence on coping strategies and support needs among a wide range of marginalised student groups in the UK. This study provides important knowledge that is useful to inform personalised culturally appropriate mental health support that can be offered in education settings.

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

BackgroundExisting mental health treatments are insufficient for addressing mental health needs at scale, particularly for teenagers, who now seek mental health information and support on the web. Single-session interventions (SSIs) may be particularly well suited for dissemination as embedded web-based support options that are easily accessible on popular social platforms.ObjectiveWe aimed to evaluate the acceptability and effectiveness of three SSIs, each with a duration of 5 to 8 minutes (Project Action Brings Change, Project Stop Adolescent Violence Everywhere, and REFRAME)—embedded as Koko minicourses on Tumblr—to improve three key mental health outcomes: hopelessness, self-hate, and the desire to stop self-harm behavior.MethodsWe used quantitative data (ie, star ratings and SSI completion rates) to evaluate acceptability and short-term utility of all 3 SSIs. Paired 2-tailed t tests were used to assess changes in hopelessness, self-hate, and the desire to stop future self-harm from before to after the SSI. Where demographic information was available, the analyses were restricted to teenagers (13-19 years). Examples of positive and negative qualitative user feedback (ie, written text responses) were provided for each program.ResultsThe SSIs were completed 6179 times between March 2021 and February 2022. All 3 SSIs generated high star ratings (>4 out of 5 stars), with high completion rates (approximately 25%-57%) relative to real-world completion rates among other digital self-help interventions. Paired 2-tailed t tests detected significant pre-post reductions in hopelessness for those who completed Project Action Brings Change (P<.001, Cohen dz=−0.81, 95% CI −0.85 to −0.77) and REFRAME (P<.001, Cohen dz=−0.88, 95% CI −0.96 to −0.80). Self-hate significantly decreased (P<.001, Cohen dz=−0.67, 95% CI −0.74 to −0.60), and the desire to stop self-harm significantly increased (P<.001, Cohen dz=0.40, 95% CI 0.33 to 0.47]) from before to after the completion of Project Stop Adolescent Violence Everywhere. The results remained consistent across sensitivity analyses and after correcting for multiple tests. Examples of positive and negative qualitative user feedback point toward future directions for SSI research.ConclusionsVery brief SSIs, when embedded within popular social platforms, are one promising and acceptable method for providing free, scalable, and potentially helpful mental health support on the web. Considering the unique barriers to mental health treatment access that many teenagers face, this approach may be especially useful for teenagers without access to other mental health supports.

The COVID-19 outbreak has affected the sports field unprecedentedly. The emergency alert has deprived athletes of training in a suitable environment, as they are faced with cancellations of relevant events in their sports careers. This situation can cause stress levels and other emotional disorders similar to those experienced by athletes during periods of injury. Since the relationship between psychological factors and sports injuries is well-studied, the Global Psychological Model of Sports Injury (MGPLD) is applied to this historical situation for athletes. The purpose of this study was to analyze the relationships between perfectionism and trait anxiety with indicators of mental health (mood, depression, state anxiety, and stress) in high-performance athletes during confinement due to the COVID-19 pandemic, as well as to explore the coping strategies that athletes have applied and whether they are perceived as useful for managing negative emotional states. A cross-sectional study was conducted through online questionnaires during April 2020, adapting the Psychological Assessment Protocol of the High-Performance Sports Center of Murcia (Spain), to assess the psychological effects of confinement in a cross-cultural sample of 310 athletes (141 women and 169 men) from different countries in Europe, Asia, and America, and from diverse sports disciplines. The protocol comprised six instruments that test perfectionism, trait anxiety, mood states, stress, depression, coping strategies, and sleep. It was answered online via Google Forms. The results show that maladaptive perfectionism was related to all the indicators of athletes' mental health. However, athletes' levels of anxiety, stress, and depressive symptoms are relatively low, and the use of coping strategies such as cognitive restructuring and emotional calm was associated with lower levels of negative emotional states. Besides, the Iceberg Profile, a suitable fit for the mental health model, is observed in the mood of athletes, both in men and in women, although women showed higher levels of anxiety, stress, and depression than men. A strong relationship was observed between maladaptive perfectionism and martial arts sports discipline, superior to other sports. In short, it can be concluded that high-performance athletes in the studied sample showed negative emotional state values below the expected average. Finally, the proposals for practical applications of the results collected are discussed.

Improving mental health in the workplace

Limited research concerning existing inequities in mental health care and support services in the United Kingdom captures perceptions and lived experiences of the significantly underrepresented Muslim population. Underpinned by social constructivist theory, we used consultation to facilitate public and patient involvement and engagement (PPIE) to identify inequities in mental health care and support experienced by Muslims from minoritised ethnic communities living in deprived areas in Liverpool, UK. The rationale was to (a) better inform standards and policies in healthcare and (b) provide a psychologically safe space to members of the Muslim community to share perceptions and experiences of mental health care and support services. To ensure trustworthiness of the data, member checking was adopted. This paper describes the procedure to achieving this consultation, including our recruitment strategy, data collection and analysis as well as key findings. Twenty-seven consultees attended the women's consultation and eight consultees attended the men's consultation. Consultees were from Yemeni, Somali, Sudanese, Egyptian, Algerian, Pakistani and Moroccan communities and share the Islamic faith. Four key interlinked themes were identified from consultees' narratives: (1) broken cycle of trust; (2) an overmedicalised model of care; (3) community mental health prevention initiatives; and (4) culturally conscious training and education. The Muslim population has identified numerous barriers to accessing mental health support and there is a need to resource activities that would aid deeper understanding of mental health support needs through continuous and meaningful community initiatives. This would afford mental health practitioners and organisations opportunities for developing realistic anti-racism strategies, effectively adopting social prescription, strengthening partnerships and collaborations aimed at supporting delivery of evidence-based mental health care provisions to tackle mental health inequities. This paper reports on the involvement and engagement of Muslims from minoritised ethnic communities living in the Liverpool city region.