Area Of Mental Health Research Articles

The Glass Ceiling Thickens: How The COVID‐19 Pandemic Negatively Impacted Academic Medicine Faculty

INTRODUCTIONInequities faced by women in academic medicine before the COVID‐19 pandemic are well‐known, yet there are little formal data on exactly how the pandemic has affected faculty, particularly in academic medicine. The purpose of this cross‐sectional study was to elucidate the impact of the pandemic on faculty in academic medicine and identify whether it is disproportionately affecting populations, focusing specifically on responsibilities at home, work, and mental health according to gender identification, faculty rank, and faculty appointment.METHODSAn online questionnaire was distributed in February 2021 to faculty at academic medicine centers. This questionnaire asked respondents to provide demographic data, answer questions about their responsibilities at home and work, and indicate whether and how the pandemic has affected both. Respondents were also asked questions on self‐care and mental health and to document how their institution(s) can assist faculty in mitigating struggles associated with the pandemic. Responses were analyzed via quantitative (Pearson’s chi‐square tests) and qualitative (thematic analysis) means.RESULTSWomen, mid‐, and early‐career faculty were more likely to be responsible for the care of others (p=0.014), and the impact of the pandemic on caring for others was negative, especially for early career faculty (p=0.019). Research, teaching, and clinical practice were negatively impacted by the pandemic, with women feeling this more severely in clinical practice (p=0.003), as a result of an increased teaching load (p=0.042), and inadequate work environment (p=0.013). Women (p<0.01), early career‐faculty (p<0.01), and clinical faculty (p=0.029) were also more negatively impacted by the pandemic in the areas of self‐care and mental health. While there was no significant difference in who requested a leave of absence or tenure clock extension, early‐career and women faculty were more likely to fear retribution for such requests. Faculty provided actionable suggestions to combat these negative effects under five themes, including Flexible Expectations, Support, Mental Health, Compensation, and Communication.CONCLUSIONPre‐pandemic stress and burnout among faculty in academic medicine has been well documented, and this study demonstrates that academic medicine faculty, particularly women and early‐career faculty, continue to feel additional burdens secondary to the COVID‐19 pandemic. These data can be utilized by administrations and future studies to make informed decisions regarding policies and programs created to assist those populations who are most vulnerable to the effects of the pandemic.SIGNIFICANCETo the authors’ knowledge, this is the first study to provide both quantitative and qualitative data demonstrating a negative impact of the COVID pandemic on academic medicine faculty, particularly women and early career faculty. These data are necessary to create change to improve recruitment and retention of quality faculty.

Mortality Rate and Quality of Life in Patients with Intertrochanteric Fractures Treated with Dynamic Hip Screw

Background: Intertrochanteric (IT) fracture is one of the most common fractures in adults. Dynamic hip screw (DHS) surgery is a surgical procedure for IT fracture treatment. This study evaluated the mortality rate and quality of life (QOL) among these patients one year after the surgery.&#x0D; Methods: This cohort study was conducted on 110 patients with IT fractures treated with DHS from 2017 to 2019. A questionnaire was completed for each patient before, during, and after surgery. Preoperative information included demographics, height, weight, body mass index (BMI), smoking, diabetes, variables such as IT fracture classification, injury mechanism, lateral wall, and the American Society of Anesthesiologists (ASA) comorbidity classification. Tip-apex distance (TAD), nail position at the femoral head, and the amount of bleeding during the operation were achieved during and immediately after the surgery. The mortality rate was determined one year after the surgery, and the surviving patients were assessed by the 36-Item Short Form Survey (SF-36) questionnaire.&#x0D; Results: The mortality rate among patients who underwent DHS was 31.81%. There was no significant difference between living and dead patients regarding demographic information, surgical techniques, and comorbidities. There was no association between patients regarding the average of all areas of physical, mental, and overall health and gender. There was no significant relationship between the mean of physical and mental health with the duration of hospital stay and the amount of bleeding during surgery. A history of diabetes, high blood pressure, and smoking in these patients was not associated with mortality and QOL.&#x0D; Conclusion: The patient’s age is the most important risk factor for mortality after the DHS surgery.

Integrative Brain Dynamics in Childhood Bullying Victimization: Cognitive and Emotional Convergence Associated With Stress Psychopathology.

Bullying victimization is a form of psychological stress that is associated with poor outcomes in the areas of mental health and learning. Although the emotional maladjustment and memory impairment following interpersonal stress are well documented, the mechanisms of complex cerebral dysfunctions have neither been outlined nor studied in depth in the context of childhood bullying victimization. As a contribution to the cross-disciplinary field of developmental psychology and neuroscience, we review the neuropathophysiology of early life stress, as well as general psychological stress to synthesize the data and clarify the versatile dynamics within neuronal networks linked to bullying victimization. The stress-induced neuropsychological cascade and associated cerebral networks with a focus on cognitive and emotional convergence are described. The main findings are that stress-evoked neuroendocrine reactivity relates to neuromodulation and limbic dysregulation that hinder emotion processing and executive functioning such as semantic cognition, cognitive flexibility, and learning. Developmental aspects and interacting neural mechanisms linked to distressed cognitive and emotional processing are pinpointed and potential theory-of-mind nuances in targets of bullying are presented. The results show that childhood stress psychopathology is associated with a complex interplay where the major role belongs to, but is not limited to, the amygdala, fusiform gyrus, insula, striatum, and prefrontal cortex. This interplay contributes to the sensitivity toward facial expressions, poor cognitive reasoning, and distress that affect behavioral modulation and emotion regulation. We integrate the data on major brain dynamics in stress neuroactivity that can be associated with childhood psychopathology to help inform future studies that are focused on the treatment and prevention of psychiatric disorders and learning problems in bullied children and adolescents.

Psychiatric disorders among employment requiring firearms.

Individuals who carry guns as a requirement of employment frequently experience hazards that can be stress inducing, violent, traumatizing, or cause personal injury. This study used data from the Collaborative Psychiatric Epidemiological Surveys (CPES; n=20,013), to examine mental health diagnoses of individuals that ever worked at a job requiring a firearm. Consistent with existing literature, the findings indicated that those who worked in professions requiring a firearm showed similar risk of mental health diagnoses as law enforcement officers which includes symptoms of trauma, mood disorders, and alcohol use. Further, race/ethnic differences emerged in patterns of mental health diagnoses, suggesting sociocultural differences influence diagnoses. These findings indicate the necessity for further investigation of the understudied area of mental health of those within employment positions that require firearms.

Relationships Between Climate Mitigation Actions and Mental Health: A Systematic Review of the Research Landscape

The impacts of climate change-related events on mental health and emotional wellbeing have gained increased attention in recent years. However, research exploring how climate mitigation action, i.e., moving toward more sustainable lifestyles, interrelates with mental health is arguably a more hidden body of work. This research is scattered across fields and uses a variety of concepts to explore both the role that emotional and mental health management skills may play in enabling personal climate mitigation actions, as well as the ways in which accelerated transitions toward lower carbon emitting ways of life may impact on mental wellbeing at both an individual and societal level. Our systematic review therefore aims to bring together for the first time research which has been undertaken in the emerging area of mental health and climate mitigation action. To facilitate this exploration, systematic Web of Science searches were undertaken which: (1) identified 165 publications exploring climate change and mental health issues broadly, and (2) identified 26 publications relating climate mitigation actions with specific mental health impacts (anxiety, trauma, suicide, OCD). We find that mental health is primarily being seen as an outcome of climate change impacts, not a factor in our ability to work to avoid them. The limited work which does exist around mental health and climate mitigation action focusses on anxiety and trauma and spans the psychological, psychosocial, public health and wider social sciences. Anxiety and trauma-avoidance has been found to both stimulate and stifle action in different circumstances. One explanation may be the role organizations (and other social structures like family or gender identities) play in maintaining cultures which either support social defenses against mitigation action or provide emotionally-safe spaces for building climate commitment. Anticipating potential mental health impacts during policy planning—and putting in place appropriate support measures—will be vital to successfully meeting climate targets. We therefore conclude with implications for policy and practice, including the need to: build appropriate psychological support into behavior change interventions, work with groups who can provide each other with emotional peer support, and ensure health and social care professionals are given adequate training.

The glass ceiling thickens: the impact of COVID-19 on academic medicine faculty in the United States

ABSTRACT The inequities faced by women in academic Medicine before the COVID-19 pandemic are well established. However, there is little formal data regarding exactly how the pandemic has affected faculty. This cross-sectional study investigated the impact of the pandemic on responsibilities at home, work, and mental health according to gender identification, faculty rank, and faculty appointment. In February 2021, an online questionnaire was broadly distributed to academic medicine faculty. Respondents were asked to provide demographic data, answer questions about their responsibilities at home and work, mental health, and how the pandemic has influenced these. Respondents were also asked to document what their institution(s) can do to help faculty through the pandemic. Responses were analyzed via Pearson’s chi-square tests and thematic analysis. Women faculty were more likely to be responsible for the care of others (70%, p = 0.014), and the impact was negative, especially for early career faculty (p = 0.019). Productivity in research, teaching, and clinical practice were negatively impacted, with women feeling this in clinical practice (p = 0.005), increased teaching load (p = 0.042), and inadequate work environment (p = 0.013). In the areas of self-care and mental health, women (p < 0.001), early career-faculty (p < 0.001), and clinical faculty (p = 0.029) were more negatively impacted. Early-career women were more likely to fear retribution. Five themes emerged, including Flexible Expectations, Support, Mental Health, Compensation, and Communication. Pre-pandemic stress and burnout were rampant, and this study demonstrates that academic medicine faculty are still suffering. It is the authors’ hope that administrations can utilize these data to make informed decisions regarding policies enacted to assist populations who are most vulnerable to the effects of the pandemic.

The Impact of Psychological First aid Training on the Providers: A Systematic Review.

The consensus is that psychological first aid is a practical, early psychosocial intervention to mitigate the distress caused by disasters. This review aimed to investigate PFA training's efficacy in the existing studies and evaluate these programs' impact on trainees. MEDLINE (National Library of Medicine, Bethesda, MD), EMBASE (Elsevier, Amsterdam, Netherlands), PsycInfo (American Psychological Association, Washington, DC), and Cochrane Library (John Wiley & Sons, Hobken, NJ, USA) were searched on August 1, 2020 without language and date limitation. The Cochrane Risk of Bias tool for randomized controlled trials and the Risk of Bias in Non-Randomized Studies - of Interventions (ROBINS-I) (Cochrane, London, UK) were used to assess the quality of the studies included. SPSS (IBM Corp., Endicott, NY, USA) was used for descriptive, comparative, and correlational summaries. From 376 articles, only 9 studies met the criteria and were included after screening. The most common outcome was knowledge improvement, followed by increased confidence, and competence. Other outcomes encompassed Attitude, preparedness, and therapeutic engagement. PFA is the most suggested early intervention aftermath and could be acquired by professionals and non-professionals in the mental health area. Nonetheless, to obtain the desired outcome, PFA training programs' quality is vital. This review revealed that most training programs' duration was short, without scenario-based interactions and post-training supervisions. More controlled trials are required to measure the effectiveness of PFA training on the providers.

Educating rural girls in their life skills through painting

Education is the foundation stone and girls are the pillars for the sustainable development of a nation. National Education Policy 2020 of India has touched life skill to bring forth some modifications in curriculum for mental well-being of adolescents, but an exclusive picture mode is missing in all life skill fields of studies. Focusing on the literacy on selected life skills through a contemporary creative medium, this article presents a new methodological approach in life skill training. Pictures generally attract children.A module with digital paintings on life skill quotes was prepared by the researcher and after training of rural girl participants, significant difference in the calculated T-test value from the table value was observed in analysis. Thus result gave initial evidence within the context by the participants on the effectiveness of the use of digital painting in the module in training life skills selected for the study, which has great educational significance in mental health area.

Exploring Hispanic health attitudes and behaviours for more informed cross-cultural marketing

Many global pharmaceutical brands have made strong commitments to improve cross-cultural inclusion in their marketing communications by considering the needs of diverse communities. To stay true to those commitments and to be successful in them requires strong data and insights about those communities. This study evaluates the health attitudes and behaviours of Hispanics compared with non-Hispanics in order to develop foundational knowledge to begin improving cross-cultural pharmaceutical marketing. The study draws on information captured from a series of online discussion boards, a quantitative survey and qualitative focus groups to understand potential differences in definitions of health, people and places of healthcare consumption and opportunities for marketing innovation. The investigation shows that many nuances of Hispanic healthcare needs and preferences are not currently being addressed by pharmaceutical marketers. It also identifies specific gaps in the areas of mental health and digital technology. The findings from this research can be used by pharmaceutical marketers to develop more effective cross-cultural communications targeted at Hispanics.

Early impact on sleep and mental health during the mandatory social isolation of COVID-19 outbreak: an obser vational cross-sectional study carried out in Argentina.

IntroductionThe mandatory social isolation (MSI) due to the pandemic caused by COVID-19 in the world produced many changes in sleep and different areas of mental health. Objectives: To evaluate the early effects of MSI on sleep, anxiety, and depression in Argentina.Material and MethodsAn anonymous observational cross-sectional web-based study was distributed throughout the country and was completed by 2,594 respondents to analyze demographic information, quality of sleep, REM sleep-related events, depressive, and anxiety symptoms.ResultsThe study revealed that 53, 21, 22, 23, and 16% of people surveyed were poor sleepers, had dream-related behaviors, nightmares, depression, and anxiety symptoms, respectively. Multivariate logistic regression showed a positive correlation between anxiety, being a poor sleeper, and having nightmares.ConclusionWe identified the early effects of MSI on sleep quality, dreaming activity, anxiety, and depression in Argentina during the COVID-19 outbreak. Our findings can be used to formulate sleep and psychological interventions to improve mental health during the pandemic and post-pandemic times.

Review: Adult Outcome as Seen Through Controlled Prospective Follow-up Studies of Children With Attention-Deficit/Hyperactivity Disorder Followed Into Adulthood.

To describe adult outcome of people with attention-deficit/hyperactivity disorder (ADHD) diagnosed in childhood and its several key predictors via a review of 7 North American controlled prospective follow-up studies: Montreal, New York, Milwaukee, Pittsburgh, Massachusetts General Hospital (MGH), Berkeley, and 7-site Multimodal Treatment Study of Children With ADHD (MTA). All studies were prospective and followed children with a diagnosis of ADHD and an age- and gender-matched control group at regular intervals from childhood (6-12 years of age) through adolescence into adulthood (20-40 years of age), evaluating symptom and syndrome persistence, functional outcomes, and predictors of these outcomes. The rates of ADHD syndrome persistence ranged from 5.7% to 77%, likely owing to varying diagnostic criteria and the source of information (self-report vs informant report) across the studies. However, all studies observed high rates of symptomatic persistence ranging from 60% to 86%. The 7 studies were largely consistent in finding that relative to control groups, research participants with childhood-diagnosed ADHD had significant impairments in the areas of educational functioning, occupational functioning, mental health, and physical health as well as higher rates of substance misuse, antisocial behavior, and unsafe driving. The most consistently observed predictors of functional outcomes included ADHD persistence and comorbidity, especially with disruptive behavior disorders. Childhood ADHD has high rates of symptomatic persistence, which is associated with negative functional outcomes. Characteristics that predict these negative outcomes, such as comorbid disruptive behavior disorders, may be important targets for intervention.

What factors do young people define as determinants of their well-being? findings from the improve the youth project.

BackgroundThe UN has recognised well-being as a main goal of The Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030).ObjectiveThe aim was to identify the areas of mental health that are the most significant to teenagers.Material and methodsThe mixed-method approach was applied. Quantitative research included adolescents aged 11–15 years (6,026 in Portugal; 4,545 in Poland). HBSC study results (2013/2014) were analysed in terms of the following variables: self-rated health, life satisfaction (Cantril Ladder, KIDSCREEN-10 Index), and psychosomatic complaints (SCL scale). Focus workshops took place in 2018, with 72 teenagers aged 14 to 16.Results16.6% of the Polish participants and 12.7% of the Portuguese participants were concerned about their health. Polish participants were less satisfied with their life [KIDSCREEN score: 25.48 for Poland (SD=6.39), and 29.96 (SD=6.03) for Portugal]. Both nations associated mental health (MH) with the family setting and relationships with friends. An additional association among Portuguese teenagers involved social issues, whereas Polish adolescents were more focussed on relationships with various people in their environment, as well as on experiencing issues at school and in the family.ConclusionsAdolescent MH is determined by stress, environmental pressure and high expectations. The viewpoints of adolescents are the most valuable source of knowledge for specialists, researchers and youth institutions, who can benefit greatly from taking advantage of this resource.

Use of Live Community Events on Facebook to Share Health and Clinical Research Information With a Minnesota Statewide Community: Exploratory Study.

BackgroundCommunity engagement can make a substantial difference in health outcomes and strengthen the capacity to deal with disruptive public health events such as the COVID-19 pandemic. Social media platforms such as Facebook are a promising avenue to reach the broader public and enhance access to clinical and translational science, and require further evaluation from the scientific community.ObjectiveThis study aims to describe the use of live community events to enhance communication about clinical and health research through a Facebook platform case study (Minnesota [MN] Research Link) with a Minnesota statewide community. We examined variables associated with video engagement including video length and type of posting.MethodsFrom June 2019 to February 2021, MN Research Link streamed 38 live community events on its public Facebook page, MN Research Link. Live community events highlighted different investigators’ clinical and health research in the areas of mental health, health and wellness, chronic diseases, and immunology/infectious diseases. Facebook analytics were used to determine the number of views, total minutes viewed, engagement metrics, and audience retention. An engagement rate was calculated by the total number of interactions (likes, shares, and comments) divided by the total length of the live event by the type of live community event.ResultsThe 38 live community events averaged 23 minutes and 1 second in duration. The total time viewed for all 38 videos was 10 hours, 44 minutes, and 40 seconds. Viewers’ watch time averaged 23 seconds of content per video. After adjusting for video length, promotional videos and research presentations had the highest engagement and retention rates. Events that included audience participation did not have higher retention rates compared to events without audience participation.ConclusionsThe use of live community events showed adequate levels of engagement from participants. A view time of 23 seconds on average per video suggests that short informational videos engage viewers of clinical and translational science content. Live community events on Facebook can be an effective method of advancing health promotion and clinical and translational science content; however, certain types of events have more impact on engagement than others.

Viability Study of Machine Learning-Based Prediction of COVID-19 Pandemic Impact in Obsessive-Compulsive Disorder Patients.

BackgroundMachine learning modeling can provide valuable support in different areas of mental health, because it enables to make rapid predictions and therefore support the decision making, based on valuable data. However, few studies have applied this method to predict symptoms’ worsening, based on sociodemographic, contextual, and clinical data. Thus, we applied machine learning techniques to identify predictors of symptomatologic changes in a Spanish cohort of OCD patients during the initial phase of the COVID-19 pandemic.Methods127 OCD patients were assessed using the Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) and a structured clinical interview during the COVID-19 pandemic. Machine learning models for classification (LDA and SVM) and regression (linear regression and SVR) were constructed to predict each symptom based on patient’s sociodemographic, clinical and contextual information.ResultsA Y-BOCS score prediction model was generated with 100% reliability at a score threshold of ± 6. Reliability of 100% was reached for obsessions and/or compulsions related to COVID-19. Symptoms of anxiety and depression were predicted with less reliability (correlation R of 0.58 and 0.68, respectively). The suicidal thoughts are predicted with a sensitivity of 79% and specificity of 88%. The best results are achieved by SVM and SVR.ConclusionOur findings reveal that sociodemographic and clinical data can be used to predict changes in OCD symptomatology. Machine learning may be valuable tool for helping clinicians to rapidly identify patients at higher risk and therefore provide optimized care, especially in future pandemics. However, further validation of these models is required to ensure greater reliability of the algorithms for clinical implementation to specific objectives of interest.

Associations between Sleep and Mental Health in Adolescents: Results from the UK Millennium Cohort Study.

(1) Background: There is a growing interest in investigating the relationship between sleep and mental health development in adolescents. This study aims to further investigate this relationship by identifying the specific associations between several sleep problems in adolescents and several mental health areas, and the role of gender in these associations. (2) Methods: Data from the Millennium cohort survey containing 11,553 individuals at 13–14 years old was included. Nighttime sleep duration and bedtime during weekdays and weekends, night awakening frequency, and sleep onset latency were assessed using self-reported questionnaires. Affective symptom and emotional and behavioural problems were examined with self-reported questionnaires. (3) Results: Regression analyses and path analysis models suggested that frequent night awakening was associated with all the outcomes, and hyperactivity/inattention was the outcome that presented a higher number of significant associations with sleep patterns. Long sleep onset latency and late bedtime at school days were associated with higher risk of emotional and behavioural difficulties. Further, poor sleep seems to manifest more externally in males, while more internally in females. (4) Conclusions: Specific sleep problems should be considered when assessing mental health in adolescence, which would allow more targeted prevention and intervention strategies. Further, special attention should be given to gender differences when addressing sleep and mental health.

Group-tailored feedback on online mental health screening for university students: using cluster analysis

BackgroundThe method by which mental health screening result reports are given affects the user’s health behavior. Lists with the distribution of scores in various mental health areas is difficult for users to understand, and if the results are negative, they may feel more embarrassed than necessary. Therefore, we propose using group-tailored feedback, grouping people of similar mental health types by cluster analysis for comprehensive explanations of multidimensional mental health.MethodsThis cross-sectional, observational study was conducted using a qualitative approach based on cluster analysis. Data were collected via a developed mental screening website, with depression, anxiety, sleep problems, perfectionism, procrastination, and attention assessed for 2 weeks in January 2020 in Korea. Participants were randomly recruited, and sample size was 174. Total was divided into 25 with severe depression/anxiety (SDA+) and 149 without severe depression/anxiety (SDA-) according to the PHQ-9 and GAD-7 criteria. Cluster analysis was conducted in each group, and an ANOVA was performed to find significant clusters. Thereafter, structured discussion was performed with mental health professionals to define the features of the clusters and construct the feedback content initially. Thirteen expert counselors were interviewed to reconstruct the content and validate the effectiveness of the developed feedback.ResultsSDA- was divided into 3 using the k-means algorithm, which showed the best performance (silhouette score = 0.32, CH score = 91.67) among the clustering methods. Perfectionism and procrastination were significant factors in discretizing the groups. SDA+ subgroups were integrated because only 25 people belonged to this group, and they need professional help rather than self-care. Mental status and treatment recommendations were determined for each group, and group names were assigned to represent their features. The developed feedback was assessed to improve mental health literacy (MHL) through integrative and understandable explanations of multidimensional mental health. Moreover, it appeared that a sense of belonging was induced to reduce reluctance to face the feedback.ConclusionsThis study suggests group-tailored feedback using cluster analysis, which identifies groups of university students by integrating multidimensions of mental health. These methods can help students increase their interest in mental health and improve MHL to enable timely help.

Behavioral Interventions to Improve Home-Based Office-Workers’ Health

Many organizations have traditionally supported their employees’ physical and mental health through a variety of office-based programs and interventions. The shift from in-office work to working from home, which has been accelerated by the COVID-19 pandemic, requires organizations to update their toolbox to continue supporting a healthy and happy workforce. In this paper, we review research on successful, evidence-based interventions in four key areas of physical and mental health: physical activity and sedentary behavior, nutrition, loneliness, and stress. We show how organizations could adapt these interventions to a home-based office environment and conclude by highlighting areas of future research, as well as by discussing the role of health professionals and policymakers in designing effective interventions for the future of work.

Отечественный и зарубежный опыт оказания экстренной психологической помощи населению

The article presents the foreign and national experience of providing emergency psychological assistance. The analysis of modern publications made it possible to determine the specifics of psychotraumatic situations, as well as the psychological states of victims requiring emergency psychological intervention, to formulate the principles of providing this assistance. The practice of organizing the work of specialists of emergency psychological and social services with victims, survivors of domestic violence, victims of terrorist attack and other emergencies, medical workers and volunteers providing various assistance in the conditions of the COVID-19 pandemic in Russia and abroad is highlighted. The article considers the system of organization of psychological assistance by specialists of psychological service in the Russian Federation. The problem of assessment of the effectiveness of psychological assistance is actualized by the example of the methodology of monitoring and assessment of actions in the area of mental health and psychosocial support in emergency situations.

Incidence and risk factors for postintensive care syndrome in a cohort of critically ill patients

OBJECTIVE: To determine the incidence of postintensive care syndrome in a cohort of critically ill patients admitted to the intensive care unit and to identify risk factors related to its development in the physical, cognitive and mental health areas. METHODS: This was a prospective observational cohort study developed in the intensive care unit of a university hospital. Patients with intensive care unit stays equal to or longer than one week and the need for mechanical ventilation for more than 3 days, shock or delirium were included in the study. Demographic variables, reasons for admission, diagnoses, sedation, type of mechanical ventilation used, complications and length of stay were recorded. A univariate analysis was performed to identify risk factors related to postintensive care syndrome. The scales used for the assessment of the different spheres were Barthel, Pfeiffer, Hospital Anxiety and Depression Scale and Impact of Event Scale-6. The main variables of interest were postintensive care syndrome incidence overall and by domains. Risk factors were examined in each of the health domains (physical, cognitive and mental health). RESULTS: Eighty-seven patients were included. The mean Acute Physiology and Chronic Health Evaluation II score was 16.5. The mean number of intensive care unit days was 17. The incidence of global postintensive care syndrome was 56.3% (n = 49, 95%CI 45.8 - 66.2%). The incidence of postintensive care syndrome in each of the spheres was 32.1% (physical), 11.5% (cognitive), and 36.6% (mental health). CONCLUSIONS: The incidence of postintensive care syndrome is 56.3%. The mental health sphere is the most frequently involved. The risk factors are different depending on the area considered.

Stake holder perspectives on the role of accredited social health activists (ASHAs) in Indian public mental healthcare space: A qualitative study.

Community health workers such as Accredited Social Health Activists (ASHAs) are existing resources who can facilitate the bridging of the mental health treatment gap. Knowing about the perspectives of ASHAs in delivering mental health care and other professionals with experience working in the area of community mental health is imperative. As part of an implementation research project aimed at comparing the effectiveness of two training methods for community health workers (ASHAs), we conducted five focussed group discussions including four with ASHAs (n = 34) and one with other stakeholders (n = 10). Focussed Group Discussion (FGD) was conducted under the following themes: acceptance and feasibility of provision of mental health services from ASHA's point of view and understanding the supply and demand side opportunities and challenges. The discussion began with open-ended questions, allowing for new themes to emerge until saturation was reached. ASHAs were willing to incorporate mental health identification (and referral) in their regular activities without additional perceived burden. ASHAs were easily able to identify severe mental disorders (SMDs). For substance use disorders (SUDs), due to factors such as normalization of substance consumption and stigma, there was a felt difficulty in the recognition by ASHAs. ASHAs' difficulty in identifying the CMDs was because of poor awareness in both those with mental illness and ASHAs. Incentivizing the work of ASHAs was thought to yield more returns. ASHAs have the potential to be excellent resources for easy screening, identification, and follow-up of those with mental health concerns in the community. Policies to involve them need to evolve.