Adequate Mental Health Research Articles

Achieving universal health coverage inSub-Saharan Africa through the reformation of mental health financing

Insufficient financing is limiting mental health services for universal health coverage (UHC) in sub-Saharan Africa (SSA). Without ambitious steps to enhance mental health services, UHC will fall far below its historical agenda; however, adequate mental health financing could strengthen governments’ capacity to provide additional budgetary resources. This paper aims to identify potential strategies for more equitable and sustainable mental health financing in SSA. Using Uganda as a key example, we provide a contextual analysis and highlight current gaps. We draw parallels with successful countries and discuss recommendations for engagement from the global mental health community. This perspective focuses on health systems, mental disease burden, and macro-fiscal situation. Drivers of fiscal space for health indicate prospects to boost mental health budgets for socioeconomic development. Governments should conduct consistent mental health investment cases and expedite fiscal space for aggressive taxation to health reforms.

Low mental health literacy is associated with depression and anxiety among adults: a population-based survey of 16,715 adults in China

BackgroundMental health literacy is a predictor of health outcomes in psychological distress. However, limited research has explored whether low mental health literacy is associated with recent depression and anxiety.MethodsWe used data from the Guangdong Mental Health Survey, a provincial representative and a population-based survey with a multistage stratified cluster random sampling method. We included adults aged 18 and above living in communities from September to December 2021 in Guangdong, China. Eligible participants were those who completed the mental health literacy questionnaire and assessments for depression and anxiety symptoms. We assessed the proportion of individuals with low mental health literacy by categories of psychological symptoms and whether low mental health literacy was associated with depressive and anxiety symptoms in the general population and subgroups.ResultsA total of 16,715 adults were included. We found that individuals with more severe symptoms had a greater proportion of low mental health literacy- it went from 89.4% in participants without depression or anxiety to 96.2% in people who co-occurred with depression and anxiety (x2 = 21.457, P < 0.001). After controlling confounders, low mental health literacy was associated with depression (adjusted Odds Ratio, aOR [95%CI]:2.74 [1.92–4.04]) and anxiety (2.27 [1.49–3.64]) in the total sample, when compared with adequate mental health literacy.ConclusionsThis study found a positive association between low mental health literacy and the presence of depression and anxiety. Tackling inadequate mental health literacy may be a key strategy to promote psychological well-being across the lifespan, especially for young adults.

Secondary traumatization in refugee care—EMDR intervention for interpreters (STEIN): a study protocol for a quasi-randomized controlled trial

BackgroundBy the end of 2022, more than 100 million people worldwide fled their homes. Before, during and after their flight, refugees have high risk of experiencing traumatic events. Accordingly, around every third refugee is affected by posttraumatic stress disorder. For adequate mental health care, the service of interpreters is often urgently needed to overcome existing language barriers. However, repeated exposure with details of traumatic narratives, as experienced by interpreters, can be burdensome and can lead to trauma sequela symptoms in terms of secondary traumatic stress. Only few studies have examined the treatment of secondary traumatic stress to date. Based on the recommendations for the treatment of posttraumatic stress disorder with confrontational methods, this study was designed to evaluate the effectiveness of an eye movement desensitization and reprocessing (EMDR) intervention in a sample of interpreters working in refugee care suffering from secondary traumatic stress symptoms.MethodsTo evaluate the effectiveness of an EMDR intervention for the treatment of secondary traumatic stress symptoms, a quasi-randomized controlled trial using a waiting group design will be performed. Participants will be treated with a maximum of 6 sessions based on EMDR standard protocol. Primary outcome is the symptom load of secondary traumatic stress, assessed with the Questionnaire for Secondary Traumatization, while secondary outcomes comprise further symptom complexes such as PTSD due to self-experienced traumatic events, depression, anxiety, and somatization as well as quality of life, quality of professional life, and psychological wellbeing that will be assessed with the PDS, PHQ-9, GAD-7, SSD-12, SF-12, PROQOL-5, and WHO-5, respectively.DiscussionOur primary interest is to determine the efficacy of an EMDR intervention in interpreters affected by secondary traumatic stress, especially how many sessions are needed for significant symptom reduction. Change of associated symptom complexes and quality of life will be investigated. Reprocessing one’s own stressful experiences may also contribute to this, which is not the focus of the treatment but relevant to the EMDR protocol. This study aims to assess if EMDR could be an acceptable, effective, and time-efficient method for reducing work-related secondary traumatization.Trial registrationGerman Clinical Trials Register, DRKS00032092, registered 16 June 2023.

Core Mental Health Clinician Capacity and Use Rates in the US Military

Active duty service members have higher mental health stress and cannot choose where to live. It is imperative to understand how geographic access may be associated with their ability to obtain mental health treatment and how the COVID-19 pandemic was associated with these patterns. To identify changes in the prevalence and intensity of mental health care use when service members experienced changes in core mental health clinician (defined to include psychiatrists, psychiatric nurse practitioners, clinical psychologists and social workers, and marriage and family therapists) capacity in their communities and whether patterns changed from before to after the onset of the COVID-19 pandemic. This retrospective cohort study of the active duty population between January 1, 2016, and December 31, 2022, was conducted using individual fixed-effects models to estimate changes in the probability of mental health care visits and visit volume when a person moved across communities with adequate core mental health clinician capacity (≥1 clinician/6000 beneficiaries), shortage areas (<1 clinician/6000 beneficiaries), and areas with 0 clinicians within a 30-minute drive time. All US active duty service members stationed in the continental US, Hawaii, and Alaska were included. Data were analyzed from January through July 2024. The first set of outcomes captured the probability of making at least 1 mental health care visit in a given quarter; the second set of outcomes captured the intensity of visits (ie, the number of visits log transformed). This study included 33 039 840 quarterly observations representing 2 461 911 unique active duty service members from the Army, Navy, Marines, and Air Force (1 959 110 observations among Asian or Pacific Islander [5.9%], 5 309 276 observations among Black [16.1%], 5 287 168 observations among Hispanic [16.0%], and 18 739 827 observations among White [56.7%] individuals; 27 473 563 observations among males [83.2%]; mean [SD] age, 28.20 [7.78] years). When an active duty service member moved from a community with adequate capacity at military treatment facilities to one with 0 clinicians within a 30-minute drive, the probability of a mental health visit to any clinician decreased by 1.13 percentage points (95% CI, -1.21 to -1.05 percentage points; equivalent to a 11.6% relative decrease) and the intensity of total visits was reduced by 7.7% (95% CI, -9.0% to -6.5%). The gap increased from before to after the onset of the COVID-19 pandemic, from 8.5% (equivalent to -0.82 percentage points [95% CI, -0.92 to -0.73 percentage points]) to 16.2% (equivalent to -1.58 percentage points [95% CI, -1.70 to -1.46 percentage points]) in the probability of visiting any clinician type for mental health. In this study, active duty personnel assigned to locations without core military mental health clinicians within a 30-minute drive time were less likely to obtain mental health care and had fewer mental health care visits than those in communities with adequate military mental health capacity even if there was adequate coverage from the civilian sector. The care disparity increased after the onset of the COVID-19 pandemic.

Clinicians’ perspectives on strategies for suicide prevention in Pakistan: a qualitative inquiry

Suicide is a public health concern and represents one of the increasing causes of mortality worldwide. In Pakistan, the severity of suicide is worsened by the lack of a national prevention program and adequate mental health facilities. This study, through 16 in-depth interviews with clinicians, aimed to identify prevention strategies. Two main categories emerged: community-level strategies (eg raising awareness, psychoeducation, restricting access to lethal means) and clinician-level strategies (eg training programs, safety plans, fundraising, tele-counseling). Effective prevention requires comprehensive policies to overcome existing barriers.

Psychological status of medical security teams in Winter Olympic Games and Paralympics under COVID-19.

Medical security work for the 2022 Beijing Winter Olympic and Paralympics faced enormous challenges under COVID-19. This study aimed to investigate the mental status of those medical team members to provide a reference for scientifically implementing medical security services for large-scale events. In this prospective cohort study, the Patient Health Questionnaire-9, Self-rating Anxiety Scale, General Self-Efficacy Scale, and Psychological Questionnaire for Emergent Events of Public Health (PQEEPH) were administered to 145 members of the medical team. A generalized mixed linear model was used to analyze the impact of work duration, position, on/off rotation, and gender on psychological status. Work duration significantly impacted depression, anxiety, self-efficacy, and all dimensions of PQEEPH. Women scored higher than men in the PQEEPH dimensions of depression, neurasthenia, fear, and total score. Working status affected the dimensions of depression, neurasthenia, and total score. Deterioration in emotional state became apparent in the fourth week and recovered 1 week after the task concluded, while self-efficacy decreased from beginning to end. All the medical team members experienced emotional deterioration and decreased self-efficacy in medical security tasks. To maintain a medical team's psychological wellbeing during large-scale activities, rotation times should be set reasonably, and adequate mental health services should be provided.

Factors that Affect Mental Health in Adolescents: A Literature Review

Adolescence is a critical period in individual development marked by various physical, emotional, and social changes. Mental health at this age is very important because it can affect development and quality of life in adulthood. This research aims to identify and analyze factors influencing adolescent mental health through a literature review. The method used in this literature review is literature analysis from several international databases such as Scopus, Science Direct, PubMed, and Google Scholar. The results of the literature review show that adolescent mental health is influenced by various factors, including individual, family, school environment, and social factors. Individual factors include genetics, personality, and traumatic experiences. Family factors include family dynamics, parental support, and economic conditions. School environmental factors include academic pressure, peer relationships, and teacher support. Meanwhile, social factors include social media, community environment, and access to mental health services. This literature review found that the interaction between these factors plays an important role in shaping adolescent mental health. Strong social support, a stable family environment, and access to adequate mental health services can contribute positively to adolescent mental health. Conversely, high academic pressure, experiences of bullying, and lack of social support may be significant risk factors.

Prison mental health in South-East Asia: A narrative review.

South-East Asia is a densely populated region with a considerable, however, under-prioritized mental health burden. Little is known about the mental health burden and services status in the prisons of the region. We aimed to investigate the individual country-wise prison mental health status in South-East Asian region. We performed a narrative review based on the evidence available in PubMed, Scopus, PsycINFO, Google, and Google Scholar considering the review objectives. We highlighted country perspectives on total population, prison numbers, prisoner numbers, the prevalence of psychiatric disorders and suicide among prisoners, prison mental health services, current challenges, and ways ahead. We discussed the prison mental health of five countries (Bangladesh, India, Indonesia, Nepal, and Sri Lanka). We found overcrowding (131.4%-215.6%) in the prisons, a high prevalence of psychiatric disorders in the prisons (40%-100%), negligible prison mental health services, and a lack of data on prison suicide with some variations among the five countries. Among the countries, Bangladesh has the highest prevalence (66.4%-100%) of psychiatric morbidity with an absence of a mental health system. Prison mental health in tSouth-East Asia is a neglected domain and warrants attention regarding ensuring adequate mental health services to the prisoners as there are high unmet mental health needs and an absence of poorly supported mental health needs.

Mental health and employment outcomes in working-age US adults, 2010-2019.

Individuals with severe mental illness experience greater unemployment and barriers to workforce re-entry. However, less is known about additional indicators of employment stability for individuals across mental illness severity. This study aims to examine associations between mental illness severity, use and adequacy of mental health treatment, and indicators of employment stability. In this repeated cross-sectional study, 2010-2019 data from the U.S. National Survey of Drug Use and Health were used to construct multivariate logistic regression models predicting the odds of part-time employment, past-year work interruption, number of past-year employers, and past-month health-related work absence by mental illness severity and adequacy of mental health treatment. Compared to individuals with no mental illness, those with any and severe mental illness had significantly higher odds of part-time employment (adjusted odds ratios [AORs] = 1.51 and 2.16, 95% confidence intervals [CIs] 1.4-1.6 and 2.0-2.3), multiple past-year employers (AORs = 1.78 and 2.34, CIs 1.7-1.9 and 2.1-2.6), past-year work interruption (AORs = 1.69 and 2.20, CIs 1.6-1.8 and 2.1-2.4), and >7 days of past-month work absence (AORs = 2.51 and 3.82, CIs 2.3-2.8 and 3.3-4.5). Among respondents with mental illness, perceived inadequacy of mental treatment predicted higher odds of all adverse employment outcomes. Compared to those with no mental illness, individuals with mental illness of any severity have higher odds of employment instability. Policy and programmatic support aimed at addressing the needs of individuals with mental illness, including access to adequate mental health treatment, are needed to facilitate continued, competitive employment.

Immediate mental health status of refugees during the Ukrainian armed conflict of 2022.

The study assessed stressors and the immediate mental health status of the Ukrainian refugees during the ongoing Ukrainian armed conflict of 2022 and analyzed strategies for reducing anxiety levels. The questionnaire-based prospective study was undertaken in Lviv, Ukraine (five study groups) and Israel (two groups) among 27,901 refugees and 1,259 controls. We assessed the levels of anxiety with General Anxiety Disorder-7 (GAD-7; score range = 0-21, mild to severe) and Refugees' Anxiety Reasons-6 (RAR-6) with a score ranging from 30 (no anxiety) to 6 (extreme anxiety) questionnaires. RAR-6 assessed worries about personal safety, money matters, relatives under fire, the future of the country, limited medications, and general mental fatigue. The study involved refugees in the migration phase and internally displaced persons. The GAD-7 score of 16.1 ± 2.6 (severe anxiety) showed that all participants experienced anxiety during current hostilities. The RAR-6 score of 21.8 ± 1.7 demonstrated that participants worried about numerous acute problems, but the results varied from group to group. The refugees who moved abroad independently and without a clear goal had the worst GAD-7 score of 19.4 ± 1.7. The refugees who traveled abroad in a group-organized manner had the best RAR-6 score of 24.8 ± 1.5, while passing through Lviv refugees had the worst RAR-6 score of 19.0 ± 1.6 (p = .03). During hostilities, refugees, internally displaced persons, and regular inhabitants are mentally affected to varying degrees. For refugees, group-organized travel abroad is the best option to maintain adequate mental health, followed by an internal refugee status and traveling abroad independently (the worst strategy). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Delivery of Mental Health Services in Bhutan: Challenges and Way Forward

ABSTRACTBhutan is known for its developmental philosophy of Gross National Happiness. Bhutan introduced mental health services in 1997 with the launch of Mental Health Program. Mental health includes psychological, emotional, and social well‐being. The Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital in the capital city Thimphu is the only psychiatric unit providing specialized mental health services in Bhutan. The psychiatric unit consists of multidisciplinary team rendering both out‐ and in‐patient mental health services. However, mental health services were gradually integrated in district hospitals, Primary Healthcare Centres and in schools. Although mental health services are an essential component of the healthcare system, the system faces numerous difficulties. Inaccessibility to mental health services due to geographical location and inadequate mental health professionals poses challenges in addressing mental health issues. Mental health issues are perceived differently, and the people with mental health issues often suffer from stigmatization creating barriers in seeking mental health services. Therefore, misconception and stigma associated to mental illness also cause greater challenges in delivering mental health services. Mental health funding has been substantially lower than the World Health Organization recommended mental health budget, amounting to 1% of health budget. Inadequate mental health funding remained a serious concern for the last few decades. Adequate mental health funding is vital in expanding the overall Mental Health Program and improving both the quality and quantity of mental health professionals. Additionally, enhancing community mental health initiatives will reinforce mental health services. Furthermore, there is a need for advancements in evidence and mental health research to support evidence‐based practices and enhance mental health literacy.

Evaluation of “Cognitive Behavioral Intervention for Trauma in Schools” (CBITS) in child welfare programs in Germany: study protocol of a randomized controlled trial

BackgroundChildren and adolescents growing up in child welfare institutions have been frequently exposed to traumatic events and psychosocial stress and show elevated rates of mental disorders. Yet, there is a lack of empirically supported treatments to provide adequate mental health care for children in care suffering from trauma-related mental disorders such as posttraumatic stress disorder (PTSD), depression, and anxiety. The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) is an evaluated trauma-focused cognitive-behavioral group intervention, which has proven to be effective in reducing symptoms of PTSD, depression, and anxiety for traumatized children in group settings. The trial will evaluate the effectiveness of the CBITS intervention as an outreach treatment compared with an enhanced treatment-as-usual condition (TAU +) within the German mental health and child welfare system.MethodsIn a randomized controlled trial (RCT) involving N = 90 children and adolescents, we will compare CBITS with TAU + . Participants between 8 and 16 years, reporting at least one traumatic event and moderate posttraumatic stress symptoms (PTSS), will be randomized within their child welfare institution to either one of the conditions using a CATS-2 severity-stratified block randomization. Assessments will take place at baseline, as well as 4 months and 10 months after baseline. The primary outcome is the severity of PTSS after 4 months. Secondary outcomes are depression, anxiety, irritability/anger, quality of life, and global functioning level.DiscussionThe results of our trial will provide evidence regarding effective treatment options for traumatized children in care, which represent an understudied population with limited access to mental health care. Additionally, it could serve as a blueprint for implementing trauma-focused outreach group treatments for children in care and increase the accessibility to appropriate treatment.Trial registrationClinical Trials.gov NCT06038357 D. September 13, 2023.

The Moral Impacts of Organizational Stress on Correctional Officers

Organizational stress (i.e., structural aspects of the organization such as excessive workload, shiftwork, gossip) has long been found by public safety personnel to be more impactful on their health and wellness than operational stress (i.e., inherent stresses of the job such as altercations, intervention in suicide behaviors). In the current study, which engages semi-structured interviews conducted with 28 correctional officers employed at one provincial prison in Atlantic Canada, we unpack through a lens of moral distress four prevalent sources of organizational stress among correctional officers that emerged in the data without categories precogitated, with a focus on participant experiences and expressed similarities across accounts: (1) management, (2) staff retention, (3) training needs, (4) lack of mental health support. Findings indicate organizational stress has a significant impact on correctional officers and these sources of organizational stress are exacerbated by officers’ moral and ethical vulnerabilities emergent from their conditions of employment. We recommend several practical changes to ease the strains and moral harms felt by correctional officers and better support their mental health and well-being, such as increasing staffing levels, providing more education and training opportunities for frontline officers and senior leaders, and providing more adequate mental health support for correctional officers.

The prevalence of post-traumatic stress disorder among emergency medical services personnel in Saudi Red Crescent Authority, Riyadh, Saudi Arabia.

Determining the prevalence of PTSD and contributing variables among (EMS) specialists was the goal of the current investigation. Furthermore, limited evidence exists regarding the application of PCL-5 for EMT practitioners, and the incidence of PTSD among different age groups and genders in Saudi Arabia. This cross-sectional descriptive study includes 211 prehospital care providers of the Saudi Red Crescent Authority stations in Riyadh. The randomization was done using Google Forms into subgroups according to participants' gender, years of experience, occupations, and average working hours. The presence and severity of PTSD symptoms were evaluated using the 20-item PTSD Checklist for DSM-5 (PCL-5) self-report questionnaire. Data were analyzed using Pearson Chi-Square, Mann-Whitney and Kruskal-Wallis tests. The reliability statistics were calculated using Cronbach's Alpha for the 20-survey questionnaire. The comparison of PCL-5 total scores indicated more PTSD symptomatology among females (1.61 + 0.799) as compared to male workers (1.13 + 0.642). The total score of PTSD demonstrated no statistically significant (P=0.79) differences between our age group classifications. In terms of the participants' city (Riyadh), the total PTSD score was less than the cutoff point which is 31. PTSD total score may not be affected by working experience as indicated by the non-significant difference in prevalence among EMT practitioners having <5 years, 5-10 years and above 10 years of working experience (P=0.215 with X2 = 3.076). PTSD incidence is affected by the type of occupation as statistically significant differences between groups (P=0.001) were recorded depending on the position and responsibilities of EMS practitioners. PTSD is also affected by average working hours per week, and there were statistically significant differences between groups (P=0.001). The total score of PTSD in the case of emergency service practitioners was found to be 33.7% among all the research participants, which may be regarded as a high prevalence when compared to the general population. Our investigations would contribute to a better understanding of the underlying factors of mental stress in EMS specialists in Saudi Arabia and to the development of adequate mental health practices.

Navigating the emotional terrain of prison reentry: State‐sanctioned gendered violence

AbstractThe emotional experiences of incarceration are directly tied to state‐sanctioned gendered violence. Most incarcerated women have a history of trauma, stemming directly from broader socio‐political and economic forces, which is further rendered throughout the incarceration and reentry process. The carceral system in the United States disrupts family and social support systems, fails to provide accessible and adequate mental health and substance use services, and denies stabilization resources such as housing, employment, and citizenry for women once released from prison, yet their emotional experiences are largely absent in analyses of this gendered violence. Drawing from a larger intimate ethnography project with a woman, LaTasha, recently released from a 25‐year to life prison sentence, this article examines how women negotiate and express emotions within the context of prison reentry contributing to feminist anthropological scholarship on state‐sanctioned gender violence. Through an in‐depth analysis of the challenges LaTasha faces in rebuilding relationships with family, navigating a system in which she has been outcasted, and asserting herself after being systematically disempowered, we gain insight into the ways in which carceral systems have prevented emotional complexity resulting in a form of incipient and largely invisible violence.

Experiences using an online therapist-guided psychotherapy platform (OPTT) in correctional workers with depression, anxiety, and PTSD.

Correctional workers (CWs) are frequently exposed to potentially traumatic events in the workplace, leading to an increased prevalence of mental health concerns. Online psychotherapy can address many of the barriers CWs face when seeking adequate mental health care. Despite their benefits, CWs' experience using digital mental health interventions is relatively unknown. This information could be valuable in developing enhanced care delivery to improve recruitment, retention, satisfaction, and treatment outcomes. This study investigated the experiences of a sample of CWs enrolled in a clinical trial evaluating the efficacy of the Online Psychotherapy Tool (OPTT) in this population. Participants were surveyed and interviewed to capture their opinions and feedback on the program. Survey analysis was conducted through Qualtrics statistical analysis software. The interview transcripts and open-ended survey questions were analyzed using thematic analysis methods in NVivo. Participants (n=14) were cis-gender, predominantly white, with an average age of 38 years. While most respondents preferred in-person therapy, they also reported the benefits of the online psychotherapy program. Specifically, they expressed positive perceptions of the platform, the quality and interaction of their care provider, and the homework assignments and skills learned. Lack of motivation to complete weekly homework assignments was a frequently cited challenge. Unhelpful aspects of the therapy noted issues with the online format and frustration with certain program elements. Participants expressed a positive outlook on the program, the platform, and treatment outcomes. A preference for in-person therapy was still indicated, demonstrating the need to focus on engagement in digital mental health interventions. In addition, the findings of this study shed light on the factors that can influence help-seeking in this population, including stigma in the work environment, demanding work schedules, workplace perceptions, and previous experiences accessing mental health services.

Data-Driven Decision Support Tool Co-Development with a Primary Health Care Practice Based Learning Network

Background The Alliance for Healthier Communities is a learning health system that supports Community Health Centres (CHCs) across Ontario, Canada to provide team-based primary health care to people who otherwise experience barriers to care. This case study describes the ongoing process and lessons learned from the first Alliance for Healthier Communities’ Practice Based Learning Network (PBLN) data-driven decision support tool co-development project. Methods We employ an iterative approach to problem identification and methods development for the decision support tool, moving between discussion sessions and case studies with CHC electronic health record (EHR) data. We summarize our work to date in terms of six stages: population-level descriptive-exploratory study, PBLN team engagement, decision support tool problem selection, sandbox case study 1: individual-level risk predictions, sandbox case study 2: population-level planning predictions, project recap and next steps decision. Results The population-level study provided an initial point of engagement to consider how clients are (not) represented in EHR data and to inform problem selection and methodological decisions thereafter. We identified three initial meaningful types of decision support, with target application areas: risk prediction/screening, triaging specialized program referrals, and identifying care access needs. Based on feasibility and expected impact, we started with the goal to support earlier identification of mental health decline after diabetes diagnosis. As discussions deepened around clinical use cases associated with example prediction task set ups, the target problem evolved towards supporting the upstream task of organizational planning and advocacy for adequate mental health care service capacity to meet incoming needs. Conclusions This case study contributes towards a tool to support diabetes and mental health care, as well as lays groundwork for future CHC EHR-based decision support tool initiatives. We share lessons learned and reflections from our process that other primary health care organizations may use to inform their own co-development initiatives.

Mental health impact of the Russian-Ukraine war on Canadian residents with or without Ukrainian descent

IntroductionWar tends to produce fear. The devastating and traumatic occurrences of war can have both short- and long-term effects on the mental well-being of populations. Russia’s invasion of Ukraine indirectly affects all populations, especially individuals of Ukrainian descent.ObjectivesTo assess the mental health impact of the Russian invasion of Ukraine on Canadian residents who subscribed to ‘Text4Hope Ukraine’ program and to ascertain if there are differences in mental health impacts between those with and without Ukrainian descent.MethodsCanadians were invited to self-subscribe to the text messaging program. An online survey was used to collect sociodemographic, war-related, and clinical information; stress, resilience, likely anxiety disorder and likely depressive disorder from subscribers. Outcome measures included baseline scores using validated scales. Data were analyzed using SPSS Version 25. To examine the association of psychological problems with the sociodemographic and war-related factors, univariate analysis using the Chi-square/Fishers Exact test was performed with two-tailed significance (p ≤ .05). An independent sample t-test with two-tailed significance (p-value ≤ 0.05) was employed to assess the differences in the respective mean scores of the psychological problems across the two groups. The first group represents the participants who did not have citizenship or ancestors from Ukraine (NUk), while the second group represents the respondents are Ukrainian who either have previously held citizenship or have ancestors/family from Ukraine (Ukr). No imputation of missing data and reported data represents the complete responsesResultsStudy findings reflected prevalence of low resilience (59.7%), moderate to high stress (87.5%), likely Generalized Anxiety Disorder (45.8%) and likely Major Depressive Disorder (38.9%). Respondents who identified as female had a higher likelihood of presenting with low resilience (χ2(1) = 5.68, p = .02) and likely Generalized Anxiety Disorder (χ2 (1) = 4.85, p = .03) compared to male respondents. There was no statistically significant difference in the mean scores of the four psychological problems based on any of the variables that suggest Ukrainian descent or not (p&gt;.05).ConclusionsWar can have negative impacts on all populations irrespective of their location, or association of individuals with the impacted country. This study provides valuable insights into the mental health impact of the Russian invasion of Ukraine on a specific sample of Canadian residents who subscribed to the ‘Text4Hope Ukraine’ text messaging program. This information is relevant when planning mental health intervention for this population. Governments should target and provide adequate mental health and psychosocial support or interventions for global populations at risk during war.Disclosure of InterestNone Declared

A spark of genius and a flash of madness: Nikola Tesla and his struggles with mental illness

IntroductionAn example of the unification of the contrast between artistic creativity and discipline of science, Nikola Tesla engineer and physicist, was also a prolific inventor that contributed to the transformation of modern society. Having resurfaced in the mainstream culture as a mythical figure, he appears to be enjoying a renaissance of posthumous recognition and praise. Throughaccounts available directly from his autobiography and descriptions offered by those who worked with him, the existence of the inventor´s eccentricities appear to reveal the existence of mental health disorder.ObjectivesThe authors explore Tesla and the psychopathology that accompanied him throughout his periods of brilliance and as well as hardship.MethodsThe authors conducted a brief non-structured narrative literature review. The keywords used during the research, alone or in combination, included: Nikola Tesla, psychopathology and mental illness. The works consulted included: news articles, autobiographies and biographies. Of these, those that were written in the English language and deemed most pertinent to the explored theme were chosen for review in this work.ResultsThe popular image of the mad scientist, which describes a brilliant but solitary and eccentric individual focused on their work is one that could be applied to Tesla. Documents reveal that he suffered a nervous breakdown, as well as having symptoms that point to a probably presence of obsessive-compulsive disorder, of which included counting and cleanliness rituals, exacerbated by chronic insomnia.ConclusionsThere appears to be anecdotal evidence pointing to an eventual relationship between creative genius and mental pathology. Although not formally evidenced through the scientific literature, exploring the life and accomplishments of Tesla serve as a significant example of a spark of genius perhaps ignited by mental illness. Tesla demonstrated suffering associated with his symptoms especially when considering the end of his life. At the time, adequate mental health interventions and treatments were not widely available, with his diagnosis probably being considered the quirks of genius and not the symptoms of disease.Disclosure of InterestNone Declared

What some physicians say about caring for patients with disability: Responses to open-ended question to nationwide physician survey

BackgroundFor over 50 years, federal disability civil rights laws have mandated that patients with disability receive equitable health care. However, disabled patients continue to experience health care disparities. ObjectiveTo explore physicians’ views, in their own words, about caring for patients with disability. MethodsReview of responses to open-ended question at the end of a nationally representative survey of 714 outpatient physicians about their experiences caring for adult disabled patients. The open-ended question asked for additional comments participants wanted to share. Only 108 (15.1 %) survey participants provided responses suitable for analysis (e.g., legible, complete thought). All issues reported here reflect comments from ≥5 participants. ResultsCommon concerns involved high costs, too little time, insufficient space, inadequate training, and lack of adequate mental health services to care for disabled patients. Many physicians appeared frustrated by legal requirements that they cover accommodation costs. Multiple physicians described as “unfair” having to pay for sign language interpreters, especially since interpreter costs generally exceed reimbursements for patients’ visits. Physicians also commented on high costs and space demands of accessible exam tables, especially for small practices, and on challenges accommodating patients with severe obesity, including concerns that patients with severe obesity could damage their exam tables. Some participants suggested that disabled patients require advocates to get good quality care. ConclusionsAlbeit limited by the small number of responses, these open-ended comments from our nationwide survey of physicians suggest some doctors view certain accessibility requirements as unfair to them or infeasible in their practice environments.