Mental Health Clinicians Research Articles

Communication with Health Personnel and Human Rights: A Perspective from People with Mental Disorders

AbstractMental health care has focused on participation, which, in addition to improving recovery processes, constitutes a tool to defend the human rights of people with mental disorders. For this participation, communication is a fundamental element. The objective of the present research was to analyzed the perception of the human rights and communication with healthcare personnel in care processes, from leaders of mutual aid groups or support groups in various contexts of Colombia. It is expected that the generated information can contribute to the evaluation of the quality of mental health services from a human rights and health participation perspective, in contexts similar to the one being analyzed. A qualitative approach has been used, which takes information from six leaders of support groups for mental health, in four regions of Colombia. Said information was analyzed through a thematic analysis, contrasting with the vision of the researchers and with the current theory. It is found that the subject of communication was made up of categories such as Previous ineffective treatments and Perception of a violation of dignity. Communication barriers are pointed out, such as attitudes of mental health professionals, but the influence that the health system and social and political barriers can have on the same communication is recognized. From the perception of leaders of mental health support groups, it is concluded that it is necessary to improve aspects of communication in health personnel. In addition, clinical mental health care could also be a space for the promotion of human rights.

Building bridges: mobile mental health care units in four European countries

Abstract Background Individuals living in rural and remote areas may have limited access to mental healthcare due to lack of facilities, socioeconomic reasons, stigma and lack of mental health literacy. To meet the needs and provide needs-based care care mobile mental health care clinics were established in some countries in Europe, including in Belgium, Germany, Greece and in Moldowa. A mobile clinic is a customized motor vehicle that travels to communities to provide mental health care. The mobile clinics are an integral part of the health care system and help ensure access to mental care. Aims To describe mobile care clinics in two countries in Europe using a case study design. Results Mobile clinics deliver a wide variety of mental health services, are heterogeneous and consist of multidisciplinary teams, including physicians, social workers, and other health professionals. The organization and financing of the Mobile mental health clinics is different in the four countries (e.g. part of the mental health care system in Belgium, and Moldova, part of initiatives in Germany and Greece). Due to data protection no detailed data on patients can be provided at the moment. The structures on mental health care mobile clinics in the four countries will be described in detail in the talk. Discussion Mobile clinics often serve as a bridge between communities and the mental health care system. Another important issue in rural areas is the ongoing aging of the population. The number of Elderly patients is expected to rise in the future. The care of those patients is challenging for the mental health and the primary care system. There is a necessity for establishing bridges between mobile clinics and hospital care.

Going Insane: Battered Muslim Women Reclaim a Positive Identity.

This study examines the process of identity negotiation of 15 Muslim women who resisted severe abuse by their husbands and extended family by becoming mentally ill and thereafter, divorcing. Content analysis of the interview narratives shows that these women were poor, married young, and endured years of battering, isolation, and silencing for the sake of family honor and children's well-being. Entrapped within a web of sociocultural norms legitimizing wife beating, and abusive extended family relationships that annihilate their voice by branding them as maj'nuna/insane, these women explained that they were terrorized helpless victims fearing the stigma of being labeled insane and the resultant harm to their children. With the deterioration of their health, threat of annihilation, and imminent danger to themselves and their children, these women broke through the normative oppressive framework by becoming maj'nuna/mentally ill. Detached from the extended family and no longer caring to endorse a label that discredited what they said or did, these women overtly resisted by escaping to the family of origin and/or mental health clinic to reveal the abuse, divorce, and seek treatment. Severing all family ties, and now residing in public housing, these women felt safe to renegotiate a favorable identity and reclaim the right to live with dignity. Implications/recommendations: (1) The criminalization of battering and prosecution of batterers is not enough to deter when cultural norms sanction battering, (2) additional diagnostic categories are needed to identify the precursors of battering within the strategies of overt and covert resistance battered women adopt in collectivistic cultures such as mental and neurophysiological dysfunctions, and (3) it is necessary to transcend the individualistic model titling battered women within the false dichotomy of victimization or agency as it fails to reflect battered women's experience in collectivistic cultures and their resistant strategies to abuse in the extended family.

Development of a framework of the skills and attributes needed by mental health professionals to provide optimal clinical care to people experiencing complex psychosis: A Delphi consensus study.

Complex psychosis is associated with high social and economic costs. The key skills and attributes needed by mental health professionals to provide optimal clinical care to people experiencing complex psychosis have not previously been defined. A framework detailing these skills and attributes is needed to support the identification of training needs for those working with this population. A modified online Delphi method was used to reach consensus on the skills and attributes essential for mental health professionals to deliver optimal clinical care to people experiencing complex psychosis. Participants were international healthcare professionals and academic researchers who self-identified as experts in complex psychosis. Participants were asked to rate their level of agreement with each item on a five-point Likert-type scale and to provide comments. Qualitative feedback was used to modify existing, or create new, items for subsequent rounds. 64 responses were received across three Delphi rounds. 167 items reached consensus and were endorsed (132 in Round 1, 31 in Round 2 and 4 in Round 3). Median score range for endorsed items was 4.5/5, with 88.6% scoring 5/5. All 167 endorsed items were included in the framework, categorised into 14 overarching domains. Multiple skills and attributes were identified as being core components required in the delivery of optimal care by mental health professionals to people experiencing complex psychosis. The resulting framework provides a benchmark for training and skill development of mental health clinicians at both individual and team levels to optimise effective working with this high-needs population.

Negative Beliefs About Working with Health Problems and Support at Work as Predictors for Return to Work for People Struggling with Common Mental Disorders.

The purpose of this study was to investigate predictors for return to work for people struggling with common mental disorders on sick leave or at risk of sick leave. The first aim of this study was to evaluate the psychometric properties of a set of statements exploring different conditions at the workplace and assumptions about working with health problems, by investigating the factor structure, reliability and construct validity of these statements. The second aim of this study was to investigate the predictive value of the identified factors. A total of 797 patients from an outpatient mental health clinic were included in a naturalistic observational study. The study design was longitudinal. The participants filled out self-report questionnaires pre- and post-treatment. A principal component factor analysis with a varimax rotation identified two factors, Negative beliefs about working with health problems and Support at work, displaying high internal consistency, 0.83 and 0.84, respectively. Separately, both factors were significant predictors of full return to work after treatment. The final multivariable analysis including both factors left Negative beliefs about working with health problems as a significant predictor explaining unique variance. Negative beliefs about working with health problems and Support at work are important predictors for work status after treatment and should therefore be addressed during treatment for common mental disorders to assist people return to work.

The Prevalence of Polycystic Ovary Syndrome and Fibromyalgia in Women with Borderline Personality Disorder and Their Association with Childhood Abuse

Childhood abuse is a significant factor in the development of borderline personality disorder (BPD) and many physical health disorders, including polycystic ovary syndrome (PCOS) and fibromyalgia. This study aimed to examine the prevalence of PCOS and fibromyalgia in women with BPD compared to the general population. Additionally, it compared the prevalence of these conditions in women who experienced different types of childhood abuse (emotional, physical, or sexual). Participants were identified from the Multidisciplinary Alfred Psychiatry research centre’s Women’s Mental Health Clinic database, including 150 women diagnosed with BPD. Clinicians collected information on PCOS, fibromyalgia, and trauma history. Results showed higher rates of PCOS (17.3%) and fibromyalgia (8.7%) in women with BPD compared to general population samples. Emotional abuse was associated with the highest PCOS prevalence (22.8%), while co-occurring physical, sexual, and emotional abuse was linked to the highest fibromyalgia prevalence. These findings highlight the significant prevalence of PCOS and fibromyalgia in women with BPD and their association with childhood abuse.

Child and adolescent sleep disturbances and psychopathology in a mental health clinic sample

IntroductionChildren and adolescents treated in specialty mental health services are more likely to have sleep disturbances than those without mental health problems. Few studies have investigated the relationship between sleep and psychopathology in broad clinical samples of children. We examined the relationship between sleep disturbance and age on internalizing and externalizing psychopathology in a sample who sought treatment at children's mental health centers.MethodsSecondary data analyses were completed on a sample of children (N = 13,472; aged 4 to 18; 55% male) from 39 children's mental health agencies in Ontario, Canada, who completed a semi-structured assessment, the interRAI Children and Youth Mental Health (ChYMH). A split-half sample approach was utilized (S1 n = 6,773, S2 n = 6,699). Hierarchical regressions examined the effects of sleep disturbances (i.e., difficulty falling asleep, staying asleep, night waking, bedtime resistance, falling asleep during the day) on internalizing and externalizing symptoms, above and beyond established child- (i.e., age, sex, sensory sensitivity, pain) and family-level variables (family functioning, caregiver distress, parenting strengths). Age was tested as a moderator for sleep disturbances on both outcome variables.ResultsOverall, 6.7% of children had clinically significant sleep disturbance scores (≥10 out of 16) on the interRAI ChYMH. In both samples, sleep disturbances predicted internalizing (S1 ΔR2 = 10%, S2 ΔR2 = 10%) and externalizing symptoms (S1 ΔR2 = 2%, S2 ΔR2 = 1%), above and beyond child and family variables. Age moderated the relationship between sleep disturbances and internalizing symptoms (S1 ß = 0.07; S2 ß = 0.07; ΔR2 = 0.004 in both samples), but not externalizing symptoms; sleep disturbance was more strongly related to internalizing symptoms amongst adolescents (ß = 0.98) than children (ß = 0.62).DiscussionThe relationship between sleep and internalizing symptoms appears to change as children move through development. Further, sleep was a stronger predictor of internalizing problems in adolescents than children, suggesting an additional focus of clinician efforts in this age group. These findings strengthen the importance of routine assessment of sleep, as is done with the interRAI ChYMH.

Access to urban community mental health services: does geographical distance play a role?

Mental health challenges are a pressing concern in Australia, which account for a significant portion of the disease burden and economic costs, yet a substantial number of those affected do not utilise necessary professional support. This study evaluates distance decay effect on adults' community mental health services in North Metropolitan Western Australia and explores factors influencing service use. Data were extracted from the Mental Health Information Data Collections including the records of consumers receiving face-to-face services from the Community Mental Health Clinics in the North Metro Health Service during March 2022 to March 2023. Additionally, socio-demographic information for each suburb and population data were obtained from the Australian Bureau of Statistics. The distance between residential suburbs and clinic locations was calculated. Descriptive statistics were used to describe the characteristics of the study population. A hierarchical linear regression analysis was used to explore whether the distance of suburb to the nearest community clinic was related to service utilisation. A total of 3,453 consumers received direct services across the North Metro Health Service Community Mental Health Clinics. Findings highlighted the impact of proximity to clinics on service utilisation, with suburbs closer to clinics exhibiting higher visit rates (p = 0.004). The data also showed a strong positive correlation between gender (percentage of females in the suburb) and living in socially and economically disadvantaged areas with consumer visits per thousand residents. These findings underscore the importance of addressing accessibility barriers and tailoring mental health services to meet the diverse needs of the community.

Dialectical Behavior Therapy for Adolescents: Examining Preliminary Pretreatment Expectations and Preferences.

Dialectical behavior therapy for adolescents (DBT-A) is an evidence-based treatment for adolescents with multiple emotional and behavioral problems. Research has demonstrated the posttreatment acceptability of DBT-A by parents and adolescents. However, no study has systematically explored the expectations and preferences of adolescents before beginning DBT-A treatment. The goals of this study were to investigate adolescents' pretreatment expectations for DBT-A by developing the Adolescent Expectancies for Therapy Scale (AETS), adapted from the Parent Expectancies for Therapy Scale, and to explore their preferences regarding treatment delivery format. Participants were 21 adolescents (ages 13-18) with varying race-ethnicities who were referred for DBT-A in either a group private practice or a community mental health clinic. Participants completed the AETS and the Preferences Rating Form, which examined the extent to which participants preferred each of seven treatment modifications or preferred to keep DBT-A as is. Findings indicated that, before beginning DBT-A, adolescents had moderate expectations for the outcome and process of the therapy, and approximately half reported that they preferred to be separate from their parents during multifamily skills group sessions (for at least part of the time) and to add weekly teen-only support groups to DBT-A. The AETS had adequate internal consistency (Cronbach's α=0.88). Understanding adolescents' pretreatment expectations and preferences for the format in which DBT-A is delivered can help clinicians better engage adolescents during the intake and orientation process.

Radicalisation in adolescents: mental health considerations for violent extremism.

To outline current understanding and recommended mental health and psychiatric considerations for radicalisation and violent extremism among adolescents. Overview of recent research regarding violent extremism in adolescents and relationships with mental illness and other psychosocial determinants. Relevant international and Australasian research is outlined, with an emphasis on adolescents. Psychiatric considerations, intervention and policy implications will be explored. Adolescents who become radicalised form a heterogenous group with complex, multifaceted needs from mental disorder, familial, societal and/or environmental contributions. Thus, assessment and management need to be individualised. Mental health clinicians working with at-risk and radicalised adolescents should maintain a high index of suspicion for mental illness (particularly psychosis and depressive disorder) and neurodevelopmental disorder. Identified psychiatric conditions warrant prioritised mental health treatment. There may be a relationship between specific psychopathology and certain ideological beliefs and behaviours. Radicalised adolescents pose challenges with risk of serious harm to others, presentation complexity, multifactorial contributors and associations with varied psychopathology. All adolescents at risk of radicalisation or who are radicalised, should receive comprehensive mental health assessment and prompt assertive treatment of identified psychiatric conditions.

Linking housing, socio-demographic, environmental and mental health data at scale

Mental disorders are a growing problem worldwide, putting pressure on healthcare systems and wider society. Anxiety and depression are estimated to cost the global economy US$1 trillion per year, yet only 2% of global median government healthcare expenditure goes towards mental health. There is growing evidence linking housing, socio-economic status and local environmental conditions with mental health inequalities. The aim of this paper is to link several open-access datasets at the local area level (N = 32,844) for England to clinical mental health metrics and describe initial statistical findings. Two mental health metrics were used: Small Area Mental Health Index (SAMHI) and diagnosed depression prevalence. To demonstrate the utility of the longitudinal mental health data, changes in depression prevalence were investigated over two study periods (2011–19, i.e. austerity; and 2019–22, i.e. COVID-19). These data were linked to housing data (energy efficiency, floor area, year built, type and tenure) from Energy Performance Certificates (EPCs); socio-demographic data (age, sex, income and education deprivation, household size) from administrative records; and local environment data (winter temperature, air pollution and access to green space). The linked dataset provides a useful resource with which to investigate the social and environmental determinants of mental health. Practice relevance Initial observations of the data revealed a non-linear relationship between home energy efficiency (EPC band) and the mental health metrics, with depression prevalence higher in local areas where the mode EPC bands were C and D, compared with B and E. Researchers can further investigate this relationship using the dataset through robust statistical analysis, adjusting for confounding variables. National and local governments may use the dataset to help allocate resources to prevent and treat mental health conditions. Practitioners can map and interrogate the data to describe their local areas and make preliminary conclusions about the relationships between the built environment and mental health. This preliminary analysis of the data demonstrated a gradient in SAMHI and depression prevalence with income and employment deprivation at the local area level.

"He Just Wants Someone to Hear Him and Listen to Him": Barriers and Facilitators to Autistic Youth with Anxiety Receiving Quality Mental Healthcare.

About half of autistic youth present with clinically interfering anxiety. Psychotherapies with exposure-focused elements are effective in academic clinical settings and controlled trials. However, there is relatively less research examining the implementation of modified interventions for autistic youth with anxiety in community mental health settings. The current study explores community members' perceptions of barriers and facilitators that impact autistic youth with anxiety's receipt of quality mental health services in their community. Semi-structured interviews were conducted with 15 autistic youth, 15 caregivers of autistic youth, 11 community mental health clinicians, and 8 community mental health clinic leaders. Interviews were analyzed thematically. Participants shared their experiences with facilitators and barriers to autistic youth with anxiety receiving quality mental healthcare. Themes that emerged include (1) characteristics of the autistic youth, (2) engagement of autistic youth and caregivers, (3) building rapport between providers, autistic youth, and caregivers, (4) access to mental health services, (5) intervention fit, and (6) provider characteristics. Based on participants' perspectives and suggestions, future directions for anxiety treatment programs tailored for autistic youth include building more time into the intervention sessions to build rapport, incorporating autistic youth's preferences into provider matches, and providing families with more psychoeducation.

Effects of probiotic and vitamin D co-supplementation on clinical symptoms, mental health, and inflammation in adult patients with migraine headache: a randomized, triple-blinded, placebo-controlled trial

BackgroundMigraine headache is a major public health problem. Routine medications for migraine treatment are not useful in treating all patients and may have some side effects. The present study aimed to investigate the effect of vitamin D and probiotic co-supplementation on clinical characteristics of migraine, daily functioning, mental health outcomes, and serum levels of high-sensitivity C-reactive protein (hs-CRP).MethodsIn this randomized, triple-blinded, placebo-controlled trial, patients aged 18 to 55 years diagnosed with migraine based on the International Classification of Headache Disorders-3 (ICHD-3) were randomized to either vitamin D (50,000 IU every 2 weeks) plus probiotic (4.5 × 1011 CFU per day) or placebo for 12 weeks. The Headache Impact Test (HIT-6) and Depression, Anxiety, and Stress Scale (DASS) questionnaires were administered to patients at baseline and after 12 weeks. In addition, the frequency, duration, and severity of migraine headaches per month were assessed using a self-administered 30-day headache diary at baseline and the end of the intervention. Anthropometric indices, blood pressure, and serum levels of 25-hydroxy vitamin D and hs-CRP were also examined at first and the end of the study.ResultsSeventy-two migraine patients with a mean age of 37.46 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 8.32 years were included in this trial. Probiotic and vitamin D co-supplementation compared to placebo resulted in a significant increase in serum levels of vitamin D (+ 12.86 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 1.64 vs. + 1.12 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 0.80 ng/mL, P < 0.001). The between-group analysis in the adjusted model showed a significantly greater reduction in migraine headache frequency (− 3.17 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 0.84 vs. − 1.25 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 0.34; P = 0.031) and severity (− 1.55 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 0.35 vs. + 0.67 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 0.29; P = 0.017) in the probiotic and vitamin D group than the placebo group. No significant difference was found between the two arms of the intervention regarding the change in headache duration, hs-CRP, scores of DASS, and HIT-6 questionnaires (P > 0.05).ConclusionsThis trial showed that probiotic and vitamin D co-supplementation for 12 weeks has beneficial effects on migraine headache characteristics. Further research is needed to confirm this finding.

'Clinical Is the Pinnacle': Nurse Academics' Perspectives and Opinions of Their Students Undertaking Mental Health Clinical Placements.

Clinical placements form an integral and important part of preregistration nursing student learning. The theory-practice gap has been identified as problematic, with clinical experience being a key strategy to address this. Despite this, the perceptions of nurse academics teaching preregistration mental health nursing regarding clinical placements have not been widely explored. To garner perspectives and experiences of mental health clinical placements from nurse academics teaching mental health nursing to preregistration nursing students. A descriptive qualitative study involving 19 nurse academics from 13 metropolitan and regional Australian universities, who were involved in the design and delivery of preregistration mental health nursing content. Data were analysed thematically. The study adhered to the Standards for Reporting Qualitative Research (SRQR). Participants reported that inappropriate clinical placements generate negative student experiences. Furthermore, mental health placements in nonspecialist settings such as medical-surgical or aged care compromised student learning and posed a barrier to linking theory to practice. Increasing meaningful and appropriate mental health clinical placements in nurse education requires investment and support from multiple stakeholders. Nurse academics are crucial stakeholders in terms of understanding the impact of mental health clinical placements. Appropriate mental health clinical placements are central to effective comprehensive nurse education. Academics teaching mental health in preregistration curricula are significant stakeholders, and their informed perceptions are central to compel change.

Unveiling Post-COVID-19 syndrome: incidence, biomarkers, and clinical phenotypes in a Thai population

BackgroundPost-COVID- 19 syndrome (PCS) significantly impacts the quality of life of survivors. There is, however, a lack of a standardized approach to PCS diagnosis and management. Our bidirectional cohort study aimed to estimate PCS incidence, identify risk factors and biomarkers, and classify clinical phenotypes for enhanced management to improve patient outcomes.MethodsA bidirectional prospective cohort study was conducted at five medical sites in Hatyai district in Songkhla Province, Thailand. Participants were randomly selected from among the survivors of COVID-19 aged≥18 years between May 15, 2022, and January 31, 2023. The selected participants underwent a scheduled outpatient visit for symptom and health assessments 12 to 16 weeks after the acute onset of infection, during which PCS was diagnosed and blood samples were collected for hematological, inflammatory, and serological tests. PCS was defined according to the World Health Organization criteria. Univariate and multiple logistic regression analyses were used to identify biomarkers associated with PCS. Moreover, three clustering methods (agglomerative hierarchical, divisive hierarchical, and K-means clustering) were applied, and internal validation metrics were used to determine clustering and similarities in phenotypes.FindingsA total of 300 survivors were enrolled in the study, 47% of whom developed PCS according to the World Health Organization (WHO) definition. In the sampled cohort, 66.3% were females, and 79.4% of them developed PCS (as compared to 54.7% of males, p-value <0.001). Comorbidities were present in 19% (57/300) of all patients, with 11% (18/159) in the group without PCS and 27.7% (39/141) in the group with PCS. The incidence of PCS varied depending on the criteria used and reached 13% when a quality of life indicator was added to the WHO definition. Common PCS symptoms were hair loss (22%) and fatigue (21%), while mental health symptoms were less frequent (insomnia 3%, depression 3%, anxiety 2%). According to our univariate analysis, we found significantly lower hematocrit and IgG levels and greater ALP levels in PCS patients than in patients who did not develop PCS (p-value< 0.05). According to our multivariable analysis, adjusted ALP levels remained a significant predictor of PCS (OR 1.02, p-value= 0.005). Clustering analysis revealed four groups characterized by severe clinical symptoms and mental health concerns (Cluster 1, 4%), moderate physical symptoms with predominant mental health issues (Cluster 2, 9%), moderate mental health issues with predominant physical symptoms (Cluster 3, 14%), and mild to no PCS (Cluster 4, 77%). The quality of life and ALP levels varied across the clusters.InterpretationThis study challenges the prevailing diagnostic criteria for PCS, emphasizing the need for a holistic approach that considers quality of life. The identification of ALP as a biomarker associated with PCS suggests that its monitoring could be used for early detection of the onset of PCS. Cluster analysis revealed four distinct clinical phenotypes characterized by different clinical symptoms and mental health concerns that 'exhibited varying impacts on quality of life. This finding suggested that accounting for the reduced quality of life in the definition of PCS could enhance its diagnosis and management and that moving toward personalized interventions could both improve patient outcomes and help reduce medicalization and optimally target the available resources.FundingThe research publication received funding support from Medical Council of Thailand (Police General Dr. Jongjate Aojanepong Foundation), Hatyai Hospital Charity and Wellcome Trust.

Characteristics of Clinical Supervision for Mental Health Nurses: A Survey Study Using the MCSS-26.

To describe the characteristics and perceived effectiveness of clinical supervision mental health nurses are receiving and further explore any statistical correlations between the perceived effectiveness and satisfaction with the supervisee, supervisor and supervision characteristics. A cross-sectional survey. An online survey was distributed to nurses working in public mental health services in Victoria, Australia. A universal recruitment approach was used, and 422 nurses participated in the survey. Of these, 220 nurses who are participating in clinical supervision were eligible for the MCSS-26 survey. A licensed MCSS-26 questionnaire. Mental health nurses in the studied environment were likely to receive individual supervision from a senior mental health nurse, with the most common frequency being monthly for 31-60 min, and half receiving it within their workplace location. Half of the participants chose their own supervisor. Our findings indicate that nurses who engage in clinical supervision outside of their immediate workplace and receive individual supervision from a nurse of the same grade perceive higher effectiveness. We also found that clinical nurses may find it most difficult to engage in effective clinical supervision due to time constraints. This study uniquely contributes to the current clinical supervision literature by reporting the uptake and detailed characteristics of supervision, a facet often overlooked in existing research. This study reported the characteristics of the supervision, supervisor and the supervisee that are associated with the effective clinical supervision. These insights can lead to tailored implementation strategies that consider the specific roles and settings of nurses. CROSS (Sharma etal. 2021). No patient or public contribution.

Problematic and Harmful Social Media Use among Adolescents Receiving Intensive Psychiatric Care.

Although research has shown both positive and negative mental health correlates of social media use, few studies focus on adolescents who are receiving intensive psychiatric care. The purpose of this study was to describe problematic media use, experiences of cybervictimization and sextortion, and correlates with adolescents' health in a sample of adolescents (N = 97; 53.6% female) in a partial psychiatric hospitalization program. Approximately one-quarter of participants reported being cybervictimized at least once over the past month and 17.5% of participants reported ever experiencing sextortion. Greater problematic media use was associated with lower physical activity and greater feelings of loneliness. In a subsample of 51 participants, questions were asked regarding who they had gone to for support regarding experiences of online harm, and barriers to disclosing such experiences. The majority of youth who experienced cybervictimization indicated going to a friend for support but rarely endorsed telling a mental health clinician about it. Even fewer disclosed their experience of sextortion, with nearly half reporting not telling anyone (44.4%). Given the rates of online harm experienced by youth in acute psychiatric treatment, screening for and conducting brief interventions on problematic or risky social media use is recommended.

Psychological distress and academic success: a two-year study comparing the outcome of two online interventions at a university counseling and consultation service in Italy.

The mental health of college students has been a significant concern in higher education, representing a priority for the institutions. Enhancing effective online interventions could represent excellent support for university counseling services that deal with students' well-being. The present study aimed to evaluate the effectiveness of two online interventions provided by the Counseling and Consultation Service for Students (SACS) of the University of L'Aquila (Italy), namely Videochat with Clinical Mental Health consultation (VCMH) and Therapist-supported Internet Cognitive Behavioral Therapy (Ts-iCBT), a 12-module asynchronous program for anxiety management. The primary outcome was focused on the emotional well-being of students (GHQ-12). The secondary academic outcome was represented by the attainment of their final degree. Students requesting help from the SACS between March 2020 and March 2022 during different periods of the COVID-19 pandemic restrictions were asked to fill out a brief structured screening tool and access the PSYDIT.COM platform. Based on their personal preferences, students chose to access one of the two different online interventions: VCMH and Ts-iCBT. Over the two-year duration of this study, 379 students (267 women, 70.4%) contacted the service. Out of 334 students, 72.5% asked to be included in the Ts-iCBT group, whereas 27.5% expressed a preference for the VCMH group. A statistically significant decrease in emotional distress was obtained by both forms of online intervention, highlighting a better outcome for VCMH. In addition to clinical variables, 28.8% of students who completed online interventions attained their degree, with a statistically significantly higher percentage of graduated students in the Ts-iCBT compared to VCMH group. A high proportion of students (37.7% of total sample) dropped out (DO) of digital interventions, with a statistically significant lower rate of dropouts in the VCMH group. The effectiveness of online interventions is extremely promising and yields a growing source of suggestions for use in providing more tailored interventions. Videochats and frequent therapist online contacts would be recommended for more severe psychopathological conditions. Students in conditions of moderate and non-severe emotional distress who feel more able to "manage the problem alone" could be addressed to asynchronous online interventions.

Current and Future Implementation of Digitally Delivered Psychotherapies: An Exploratory Mixed-Methods Investigation of Client, Clinician, and Community Partner Perspectives.

Following the initial outbreak of the COVID-19 pandemic, mental health clinicians rapidly shifted service delivery from in-person to digital. This pivot was instrumental in maintaining continuity of care and meeting increased mental health service demands. Many mental health services have continued to be offered via digital delivery. The long-term implications of delivering services via digital media remain unclear and need to be addressed. This study aimed to identify current micro (i.e., clinician-patient interactions), meso (i.e., clinician-clinic manager interactions), and macro (i.e., government-policy maker interactions) level issues surrounding the use of digital mental health interventions (DMHI). Such integrated assessments are important for optimizing services to improve treatment outcomes and client satisfaction. Participants were recruited between January 2022 and April 2023. Quantitative data were collected using a survey informed by the Hexagon Tool. Qualitative data were collected from online semi-structured interviews and focus groups and analyzed using rapid thematic analysis. Survey data were collected from 11 client and 11 clinician participants. Twenty-six community partner participants were interviewed for this study. Client and clinician participants expressed satisfaction with the implementation of DMHI. Community partner participants generally agreed, reporting that such services will play an integral role in mental healthcare moving forward. Community partners shared that certain issues, such as uncertainty surrounding policies and regulations related to digital delivery, must be addressed in the future. Participants in this study supported the use of DMHI despite difficulties implementing these programs, asserting that such services are not a temporary fix but a pivotal cornerstone in the future of mental healthcare service delivery.

A Qualitative Examination of Clinician Anxiety about Suicide Prevention and Its Impact on Clinical Practice.

Clinician distress about working with patients at risk for suicide is well documented in the literature, yet little work has examined its pervasiveness across clinical settings. We conducted a secondary analysis of qualitative data gathered from 26 clinicians in primary care and outpatient mental health clinics serving both adult and child clients on their perception of evidence-based practice use for suicide screening, assessment, and brief intervention. Qualitative data were coded for any mentions of clinician anxiety or emotional response, and brief quantitative measures were collected to characterize our sample. When discussing broader barriers to implementation, 85% of participants spontaneously mentioned anxiety or heightened emotional responses related to delivering suicide prevention practices to those at risk for suicide. Common themes included low self-efficacy in suicide prevention skills, distress related to escalating care, efforts to alleviate such distress, and difficulty related to tolerating the uncertainty inherent in suicide prevention work. Similarly, while standardized anxiety ratings for participants were consistent with those of non-clinical norming samples, clinicians reported mild to moderate anxiety when screening for suicide risk (M = 3.64, SD = 2.19, Range = 0-8) and engaging in safety planning (M = 4.1, SD = 2.88, Range = 1-7) on post-interview surveys. In contrast, survey responses reflected generally high self-efficacy in their ability to screen for suicide risk (M = 7.66, SD = 1.29, Range = 5.25-10) and engage in safety planning (M = 8.25, SD = 0.87, Range = 7-9.5). Findings highlight pervasiveness of clinician distress when implementing suicide prevention practices and can inform future suicide prevention implementation efforts.