Current Mental Illness Research Articles

Prevalence of mental illness among Australian and New Zealand people in prison: A systematic review and meta-analysis of studies published over five decades.

The higher rate of mental illness, including severe psychotic disorders, among people in prisons compared to the general community is well-established. However, there have been no reviews or attempts to pool data on the reported prevalence of mental illness across prisons in Australia and New Zealand. A systematic search of electronic databases from 1966 to the end of 2020 was conducted to identify studies reporting rates of 'any' mental illness, and separately rates of psychotic illness, among adult men and women in Australian and New Zealand prisons. A meta-analysis was performed according to PRISMA guidelines (PROSPERO ID: CRD42021241946), with separate analyses conducted for lifetime and current prevalence rates. Seventeen studies, with a total of 10,209 people in prison, met inclusion criteria. The pooled lifetime prevalence of 'any' mental illness was 69.0% (95% confidence interval = [0.56, 0.79]), and the pooled lifetime prevalence for psychosis was 9.1% (95% confidence interval = [0.07, 0.12]). Meanwhile, the pooled prevalence for 'any' current mental illness was 54.0% (95% confidence interval = [0.39, 0.68]) and for any current psychosis was 6.4% (95% confidence interval = [0.04, 0.10]). There was substantial heterogeneity between studies, with evidence that lifetime rates of psychosis have increased over time, with true prevalence estimates in 95% of all comparable populations falling between 2.7% and 26.4%. The prevalence of mental illness, including severe psychotic illness, is high in Australian and New Zealand prisons. Furthermore, there is evidence that the prevalence of psychosis may be increasing over time, indicating more effort is needed to ensure diversion of people with mental illness away from the criminal justice system and into healthcare pathways.

Effect of drama training on self-esteem and personality strengths: A feasibility case control study of nidotherapy.

Although there are many case reports and qualitative studies on the likely positive effects of drama on mental health there have been few quantitative studies with mentally ill patients. To assess the effect of drama training in patients receiving nidotherapy with a range of mental and personality disorders on changes in self-esteem and personality strengths over a 1-month period compared with two control groups, one with similar mental disorders and another without, who had similar assessments but no acting involvement. A total of 19 patients were recruited from a mental health charity with current significant mental illness (active group: n = 6) (b) a control group of patients with current mental illness who were not involved in acting (n = 5), and an additional control group with no current mental illness (n = 8) The patients involved in drama were taking part in nidotherapy, an environmental intervention. Two self-rating scales, the Rosenberg Self-Esteem Scale (RSES) and Abbreviated Personality Strengths Scale (APSS) recorded changes in self-esteem and personality strengths at base-line and after 1 month in the participants. Random effects modelling was used to analyse the data. The intervention group showed positive improvement in personality strengths (p = .009) compared to the control group that had no mental illness, and also improved more than the control group with mental illness but not to a significant degree (p = .16). Self-esteem recorded with the Rosenberg scale was lower in those in the acting group at baseline compared with the other two groups (p = .088) but after acting training improved by 29% to be equivalent to the control groups. Despite the limited numbers in this study, and the consequent inability to make firm conclusions about the efficacy of drama therapy as part of nidotherapy, the findings suggest that larger trials of this approach are feasible and worth exploring. .

Research on the detection model of mental illness of online forum users based on convolutional network

Recently, there will be more than 4.62 billion social media users worldwide. A large number of users tend to publish personal emotional dynamics or express opinions on social media. These massive user data provide data support for the development of mental illness detection research and have achieved good results. However, it is difficult for current mental illness detection models to accurately identify key emotional features from a large number of posts issued by users to detect problem users. In view of the fact that the existing models cannot more accurately extract the words with high emotional contribution in the content of user posts, this paper proposes two hierarchical user post feature representation models, named Single-Gated LeakReLU-CNN (SGL-CNN) and Multi-Gated LeakyReLU-CNN (MGL-CNN). We leverage these 2 models to identify users with mental illness in online forums. For all posts published by each user within a certain time span, the model proposed in this paper can identify key emotional features in them and filter out other unimportant information as much as possible. In addition, the addition of gating units in this paper can significantly improve the performance of emotion detection tasks. The experimental results based on the task of RSDD dataset prove that the performance of the model proposed in this paper is superior to that of the existing methods.

Symptoms of depression and anxiety and stress among postgraduate trainees in Sri Lanka: Risk factors and implications for practice.

High workload, long working hours, and the need to study and work simultaneously put postgraduate trainee doctors at a high risk of depression, anxiety, and stress. A cross-sectional descriptive study was conducted among all postgraduate trainees registered at the Postgraduate Institute of Medicine (PGIM), Sri Lanka, using the 21-item Depression Anxiety Stress Scale (DASS-21). Eleven-point two percent (11.2%) had depressive symptoms, 8.9% had anxiety symptoms, and 1.9% had high levels of stress. Being female, having a past or current mental illness, not being supported by the trainers, being unfairly treated by trainers, dissatisfaction with the work environment, difficulty in coping with long working hours, and poor peer support were significantly associated with symptoms of depression and anxiety, and stress (P < 0.01). Given the association between psychological distress and the characteristics of training and work environment, the postgraduate training programs should be reviewed to ensure the psychological well-being of trainees.

Geographically varying associations between mentally unhealthy days and social vulnerability in the USA

ObjectivesA growing body of research has incorporated the Social Vulnerability Index (SVI) into an expanded understanding of the social determinants of health. Although each component of SVI and its association with individual-level mental health conditions have been well discussed, variation in mentally unhealthy days (MUDs) at a county level is still unexplored. To systematically examine the geographically varying relationships between SVI and MUDs across the US counties, our study adopted two different methods: 1) aspatial regression modeling (ordinary least square [OLS]); and 2) locally calibrated spatial regression (geographically weighted regression [GWR]). Study designThis study used a cross-sectional statistical design and geospatial data manipulation/analysis techniques. Analytical unit is each of the 3109 counties in the continental USA. MethodsWe tested the model performance of two different methods and suggest using both methods to reduce potential issues (e.g., Simpson's paradox) when researchers apply aspatial analysis to spatially coded data sets. We applied GWR after checking the spatial dependence of residuals and non-stationary issues in OLS. GWR split a single OLS equation into 3109 equations for each county. ResultsAmong 15 SVI variables, a combination of eight variables showed the best model performance. Notably, unemployment, person with a disability, and single-parent households with children aged under 18 years especially impacted the variation of MUDs in OLS. GWR showed better model performance than OLS and specified each county's varying relationships between subcomponents of SVI and MUDs. For example, GWR specified that 69.3% (2157 of 3109) of counties showed positive relationships between single-parent households and MUDs across the USA. Higher positive relationships were concentrated in Michigan, Kansas, Texas, and Louisiana. ConclusionsOur findings could contribute to the literature regarding social determinants of community mental health by specifying spatially varying relationships between SVI and MUDs across US counties. Regarding policy implementation, in counties containing more social and physical minorities (e.g., single-parent households and disabled population), policymakers should attend to these groups of people and increase intervention programs to reduce potential or current mental health illness. The results of GWR could help policymakers determine the specific counties that need more support to reduce regional mental health disparities.

Psychiatric consequences in hospitalized patients affected by COVID-19 (RECOVER-PSY)

IntroductionCOVID-19 had a significant impact on the mental health of the affected population. Such multifactorial risk for a deterioration of mental health suggests the need to identify groups of patients with psychiatric vulnerability and to establish strategies of intervention based on scientific evidence.ObjectivesThe aim of the study was to identify psychiatric outcomes one year after recovery and possible associations between these and the clinical, anamnestic, and sociodemographic variables.MethodsThe Mini International Neuropsychiatric Interview was employed to assess current and lifetime mental illness in a cohort of 100 patients discharged between March and April 2020 from COVID-19 wards of the San Paolo Hospital in Milan, Italy. The Kendall rank correlation coefficient was administered to measure the ordinal association between clinical-demographic variables and the psychiatric diagnoses of patients. Bivariate correlation was used to explore the association between psychiatric outcomes and the sample characteristics.ResultsAlmost one third of subjects screened positive for a diagnosis of a new psychiatric disorder, and a novel onset of psychiatric morbidity did not differ significantly in patients with and without a positive history of mental illness (42 and 58%). New psychiatric disorders were grouped into stress reactions, anxiety-group disorders and mood disorders. Concerning demographic characteristics, advanced age represented a protective factor against the onset of new psychiatric disorders (rτ = -0,203, p =0,008). Despite a lower risk of contracting the infection, women in our cohort were more vulnerable to psychiatric post-Covid symptoms (rτ =0,190, p =0,029). The correlation between the onset of new psychiatric disorders and some pre-admission vulnerability factors, such as an overweight condition (rτ =0,185, p =0,026) and a positive medical history for cigarette smoking (rτ =0,203, p =0,026), were statistically significant. Moreover, subjects who reported taking a therapy to control the infection prior to hospitalization were more likely to receive a new psychiatric diagnose (rτ =0,269, p =0,005). Of note, variables related to the severity of hospitalization such as oxygenation intensity, days of hospitalization, or requirement of intensive car were not associated with new psychiatric diagnoses.ConclusionsThe onset of psychiatric disorders shows a relevant frequency in patients hospitalized for COVID-19, suggesting that mental health services should structure adequate screening and diagnosis methods. Three levels of intervention can also be expected to reduce the overall risk and burden of psychiatric morbidity: increasing awareness regarding modifiable risk factors; guaranteeing a minimal level of mental health support to patients hospitalized for COVID-19; providing personalized interventions with respect to gender and age groups.Disclosure of InterestNone Declared

Automatic Depression Detection Using Smartphone-Based Text-Dependent Speech Signals: Deep Convolutional Neural Network Approach

Automatic diagnosis of depression based on speech can complement mental health treatment methods in the future. Previous studies have reported that acoustic properties can be used to identify depression. However, few studies have attempted a large-scale differential diagnosis of patients with depressive disorders using acoustic characteristics of non-English speakers. This study proposes a framework for automatic depression detection using large-scale acoustic characteristics based on the Korean language. We recruited 153 patients who met the criteria for major depressive disorder and 165 healthy controls without current or past mental illness. Participants' voices were recorded on a smartphone while performing the task of reading predefined text-based sentences. Three approaches were evaluated and compared to detect depression using data sets with text-dependent read speech tasks: conventional machine learning models based on acoustic features, a proposed model that trains and classifies log-Mel spectrograms by applying a deep convolutional neural network (CNN) with a relatively small number of parameters, and models that train and classify log-Mel spectrograms by applying well-known pretrained networks. The acoustic characteristics of the predefined text-based sentence reading automatically detected depression using the proposed CNN model. The highest accuracy achieved with the proposed CNN on the speech data was 78.14%. Our results show that the deep-learned acoustic characteristics lead to better performance than those obtained using the conventional approach and pretrained models. Checking the mood of patients with major depressive disorder and detecting the consistency of objective descriptions are very important research topics. This study suggests that the analysis of speech data recorded while reading text-dependent sentences could help predict depression status automatically by capturing the characteristics of depression. Our method is smartphone based, is easily accessible, and can contribute to the automatic identification of depressive states.

Racial and ethnic differences in behavioral health, criminal legal system involvement, and service needs among mental health court participants: Implications for service delivery.

Mental Health Courts (MHCs), an alternative to incarceration, aim to address behavioral health, social needs, and criminal recidivism and serve many adults with co-occurring mental health and substance use disorder (COD). Despite the growth in MHCs, little research has examined ethnic/racial differences in behavioral health and service needs of individuals with COD. This study used data from behavioral health and social assessments administered to 146 adults with COD entering a Massachusetts MHC. Multivariate linear and logistic regression controlling for key demographics tested differences between racial/ethnic groups on current and lifetime substance use, mental health symptoms, and history of criminal legal system involvement. Hispanic participants were more likely than non-Hispanic White participants to report current and lifetime serious mental illness and lifetime Emergency Department (ED) mental health treatment. Non-Hispanic White participants were more likely to report current and lifetime use of illicit substances, more recent outpatient and overall lifetime treatment attempts for substance use, and higher number of lifetime arrests compared to non-Hispanic Black participants. Lastly, non-Hispanic White participants also reported more recent outpatient and overall lifetime treatment attempts for substance use compared to Hispanic participants. Racial/ethnic differences in behavioral health and social needs of MHC enrollees with COD exist and should be considered in the planning and delivery of psychological and social services. Understanding the diverse population of new MHC enrollees is an important first step in identifying and addressing racial and ethnic disparities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Perceived risk of neurodevelopmental outcomes in offspring related to psychotropic and mental illness exposures in pregnancy and breastfeeding: a cross-sectional survey of women with past or current mental illness

ObjectivesTo investigate the perceived risk of psychotropic and mental illness exposures (1) during pregnancy or (2) while breastfeeding on offspring neurodevelopment, and factors associated with this perception in women with past/current mental illness.DesignCross-sectional, web-based study.SettingNationwide in Norway, June 2020–June 2021.ParticipantsWomen aged 18–55 years who were pregnant, recent mothers or planning a pregnancy, and had been offered antidepressants in the last 5 years.Primary and secondary outcome measuresPerceived risk of prenatal and breastmilk exposure to psychotropic medications and maternal mental illness on offspring neurodevelopmental outcomes.ResultsWe included 448 women: 234 pregnant, 146 mothers and 68 planning a pregnancy. On a 0–10 scale, women perceived antidepressants as least harmful both (1) in pregnancy (mean score 4.2, 95% CI 3.6 to 4.8) and (2) while breastfeeding (mean score 3.8, 95% CI 3.3 to 4.4), relative to antipsychotics, anxiety/sleeping medication or antiepileptics (mean score range: 6.3–6.5 during pregnancy, 5.5–6.2 while breastfeeding). Many participants were unfamiliar with psychotropics other than antidepressants. The perceived risk of mental illness exposure exceeded that of antidepressants (mean score range 5.6–5.9) in both exposure periods. Using general linear models, factors associated with greater antidepressant risk perception in both exposure periods included having lower education, non-Norwegian native language, and employment status (range mean score difference (β): 2.07–6.07). For pregnant women and mothers, there was an inverse association between perceived risk and the perceived antidepressant effectiveness in both exposure periods (range of β: −0.18 to –0.25).ConclusionsIn women with past/current mental illness, the perceived risk of antidepressant exposure on child neurodevelopment was lower than that for maternal mental illness. Other psychotropic medications were perceived as more harmful. As medication risk perception influences the decision-making regarding treatment of mental illness, pre- and pregnancy counselling should target women with characteristics associated with higher perceived risk.

Preconception risk factors and health care needs of pregnancy-planning women and men with a lifetime history or current mental illness: A nationwide survey.

While depression and anxiety are common in women and men of reproductive age, preconception interventions to optimize the health of individuals with mental illness before pregnancy is limited and focuses primarily on psychotropic medication management. Comparing individuals with depression, anxiety, and comorbidity to those with neither condition, we identified areas of preconception care optimization related to psychosocial risk factors, general physical health, medication use, and uptake of high-risk health behaviours. We also investigated differences in preconception health care use, attitudes, and knowledge. We conducted a nationwide survey of 621 women (n = 529) and men (n = 92) across Canada who were planning a pregnancy within five years, including those with lifetime or current depression (n = 38), anxiety (n = 55), and comorbidity (n = 104) and those without mental illness (n = 413). Individuals with depression, anxiety, and comorbidity were compared to individuals without mental illness using logistic regression, adjusted for age, sex, and education level. Individuals with a lifetime or current mental illness were significantly more likely to have several risk factors for suboptimal reproductive and perinatal outcomes, including increased rates of obesity, stress, fatigue, loneliness, number of chronic health conditions, and medication use. Further, they were more likely to have high-risk health behaviours including increased substance use, internet addiction, poorer eating habits, and decreased physical activity. By assessing depression, anxiety, or both separately, we also determined there was variation in risk factors by mental illness type. Our nationwide study is one of the first and largest to examine the preconception care needs of women and men with a lifetime or current mental illness who are pregnancy-planning. We found this population has many important reproductive and perinatal risk factors that are modifiable via preconception interventions which could have a significant positive impact on their health trajectories and those of their future children.

Longitudinal analysis of suicides among pharmacists during 2003-2018

BackgroundSuicide is one of the leading causes of death worldwide, and estimates of suicide among health professionals are higher than the general population. High rates of suicide among physicians and nurses have been described previously, but there is a lack of data for suicides completed by pharmacists. ObjectiveThe purpose of this study was to quantify the incidence, means, and characteristics of pharmacist suicides in the United States. MethodsData were obtained from the Centers for Disease Control and Prevention’s National Violent Death Reporting System (NVDRS) for the years 2003-2018. The dataset contained all suicides, coded by occupation, reported by medical examiners and law enforcement from 39 states and Washington DC and Puerto Rico. Suicide characteristics were compared between pharmacists and nonpharmacists. Age-adjusted rates were calculated for 2004, 2009, and 2014. ResultsDuring 2003-2018, the NVDRS contained 316 pharmacist suicides compared with 213,146 nonpharmacist suicides. The age-adjusted rates per 100,000 people were 19.6, 20.1, and 18.2 for 2004, 2009 and 2014, respectively. The most common means of suicide was firearm. Associated factors for suicide included job problems, current mental illness treatment, and suicide note. ConclusionSuicide rates among pharmacists are higher than the general population. Future research is needed to evaluate the context of job-related problems to mitigate risk. Encouraging help-seeking behaviors to identify and treat pharmacist depression is warranted.

An epigenetic association analysis of childhood trauma in psychosis reveals possible overlap with methylation changes associated with PTSD

Patients with a severe mental disorder report significantly higher levels of childhood trauma (CT) than healthy individuals. Studies have suggested that CT may affect brain plasticity through epigenetic mechanisms and contribute to developing various psychiatric disorders. We performed a blood-based epigenome-wide association study using the Childhood Trauma Questionnaire-short form in 602 patients with a current severe mental illness, investigating DNA methylation association separately for five trauma subtypes and the total trauma score. The median trauma score was set as the predefined cutoff for determining whether the trauma was present or not. Additionally, we compared our genome-wide results with methylation probes annotated to candidate genes previously associated with CT. Of the patients, 83.2% reported CT above the cutoff in one or more trauma subtypes, and emotional neglect was the trauma subtype most frequently reported. We identified one significant differently methylated position associated with the gene TANGO6 for physical neglect. Seventeen differentially methylated regions (DMRs) were associated with different trauma categories. Several of these DMRs were annotated to genes previously associated with neuropsychiatric disorders such as post-traumatic stress disorder and cognitive impairments. Our results support a biomolecular association between CT and severe mental disorders. Genes that were previously identified as differentially methylated in CT-exposed subjects with and without psychosis did not show methylation differences in our analysis. We discuss this inconsistency, the relevance of our findings, and the limitations of our study.

Trauma nurses’ Role and Emergency Management skills at Tertiary Care Hospital, Lahore

Background: Practicing in trauma unit can strengthen nurses’ knowledge about the association of past trauma and the impact of trauma on the patient’s current mental illness. An aim of this debate is to avoid potentially re-traumatizing a patient during their episode of care. This educational discussion can provide nurses with content that describes the interplay of neurological, biological, psychological, and social effects of trauma that may reduce the likelihood of re-traumatization. Although multidisciplinary environments, the translation into clinical practice by nurses working in emergency departments (EDs) is unknown. However, before ED nurses can begin to practice, they must first be provided with meaningful and specific education about their role. Therefore, the aim of this debate was to evaluate the role and emergency management skills of ED nurses. Methods: This debate was conducted as exploratory research with a descriptive study design. Quantitative data were collected with an 18-item pre-education and post-education questionnaire. Results: A total of 34 ED nurses participated in this education discussion. There was meaningful change (p &lt; 0.01, r ≥ 0.35) in 9 of the 18-items after discussion. The debate was based on the perceived effectiveness to evaluate the role and emergency management skills of ED nurses. Conclusion: Emergency department nurses became more informed of the interplay of trauma on an individual’s mental health. However, providing care to trauma patients in an ED setting was a considerable challenge primarily due to time constraints relative to the day-to-day. ED environment and rapid turnover of patients with potentially multiple and complex presentations. Despite this, nurses played a good role to reduce the likelihood of re-traumatization.

How do trauma nurses play their role and manage their emergency skills of management? A case study at a tertiary care hospital in Lahore

A greater understanding of the connection between a patient's history of trauma and the effects of that trauma on the patient's current mental illness can be gained by nurses who gain experience working in a trauma unit. One of the goals of this discussion is to find ways to provide care to patients without potentially further traumatising them. This educational discussion has the potential to provide nurses with content that describes the interplay of the neurological, biological, psychological, and social effects of trauma, which may reduce the likelihood of retraumatization. [This] discussion can be used to: It is unknown how the multidisciplinary nature of emergency departments (EDs) translates into clinical practise for nurses working in those departments. However, before emergency department nurses can begin working in the field, they must first receive an education that is both meaningful and specific to the role they will play. As a result, the purpose of this discussion was to assess the capabilities of emergency department nurses in terms of emergency management. Methods: This discussion was carried out in the form of exploratory research using a descriptive study layout. The pre-education and post-education questionnaires each had 18 questions, which allowed for the collection of quantitative data. The numbers show that there were a total of 34 emergency department nurses who took part in this education discussion. After the discussion, there was a significant change (p 0.01, r 0.35) in nine of the items in the list of eighteen. The perceived effectiveness of evaluating the role and emergency management skills of ED nurses was the primary point of contention in this argument. The nurses working in emergency departments became more knowledgeable about the impact that traumatic experiences can have on an individual's mental health. However, providing care to trauma patients in an emergency department setting was a significant challenge, and the primary reason for this was the limited amount of time that was available on a daily basis environment of the emergency department (ED) and the high volume of patients who may have multiple and/or complex presentations. Despite this, nurses played an important part in reducing the likelihood of the patients experiencing further trauma.

Using the stress–vulnerability model to better understand suicide in prison populations

Suicide is the culmination of the interaction of a number of factors with the critical component being distress. The contribution of mental illness as a vulnerability factor in an individual case of suicide by a prisoner may be significant, marginal or non-existent. Because of the high prevalence in prison populations of all risk factors for suicide, relying solely on those factors is of little use in elaborating the risk of suicide for a given prisoner. Whilst a current mental illness or past history of a suicide attempt are two factors that appear to be strongly associated with completed suicide, no screening or risk assessment tool has any proven efficacy in predicting suicide in prison populations. The stress–vulnerability model offers a more sophisticated and comprehensive assessment and also informs a more individualised needs-based management of the risk of suicide with an emphasis on detecting and responding to a prisoner’s distress.

Circumstances of Suicide Among Lesbian, Gay, Bisexual and Transgender Individuals

Suicide rates for sexual minorities are higher than the heterosexual population. The purpose of this study is to explore circumstances surrounding suicide completion to inform future intervention strategies for suicide among lesbian, gay, bisexual and transgender (LGBT) individuals. We completed a retrospective analysis of data from the National Violent Death Reporting System (NVDRS) from 2013-2017. Victims identified as transgender were considered separately. We stratified analysis by identified sex of the victim for the LGB population. Of the 16,831 victims whose sexual orientation or transgender status was known: 3886 (23.1%) were identified as female, 12,945 (76.9%) were identified as male. 479 (2.8%) were identified as LGBT; of these, 53 (11%) were transgender. LGBT victims were younger than non-LGBT victims. Male LGB victims were more likely to have a history of prior suicide attempts, past or current mental illness diagnosis, and were less likely to use firearms than male heterosexual victims. Female LGB victims were more likely to have problems in an intimate partner relationship than heterosexual women, while LGB men were more likely to have problems in family or other relationships. Transgender victims were again more likely to have mental health problems and a history of prior attempts, but less likely to have intimate partner problems and more likely to have a history of child abuse. These results highlight the importance of promoting suicide interventions that recognize the complex intersection between stated gender, sex, and sexuality and the different cultural impacts these identities can have.

The Impact of Prenatal Depression in Patients of High Risk Pregnancy Clinic on Obstetric Outcomes.

Prenatal depression is common and has been associated with risky maternal behavior, postpartum depression, and atypical child development. Still, its association with adverse perinatal outcomes is complex. The aim of our study was to look for this potential association in our region. The medical charts of women who were treated at our High-Risk Pregnancy Clinic and gave birth at our hospital were reviewed. The Edinburgh Postnatal Depression Scale (EPDS) was used to discover prenatal depression. Patients who reported past or current mental illness were excluded. We enrolled 202 women at a mean age of 32.81. Twin pregnancy was the most common reason for referral to the clinic (17.3%). The mean EPDS score was 4.63 (±4.66), with 15.3% scoring 10 or more. A significant correlation was found between the EPDS score and intrapartum fetal heart rate abnormalities, as well as with low birth weight. There were significant associations between the EPDS score and the maternal status of genetic disorder carrier, and the number of previous pregnancies, miscarriages, and elective termination of pregnancy. This study demonstrates a significant impact of the maternal psychological state on the obstetric outcome. In addition, we observed a significant association between maternal obstetric history, genetic data, and the risk of prenatal depression. Our study shows that completing the EPDS questionnaire is a very important part of the pregnancy follow-up, as it illuminates risk factors for prenatal depression and adverse perinatal outcomes.

The prevalence of mental illness and unmet needs of police custody detainees.

Internationally, there is evidence of high rates of mental disorders amongst police custody detainees but this literature is limited, and there has been little research into the unmet needs of police detainees in the UK, orelsewhere. Such research could support better focussedinterventions for improving health and recidivism outcomes. To examine psychiatric and developmental morbidity amongst police detainees, and ascertain differences in need between morbidity categories. We used a cross-sectional study design and interviewed a 40% sample of people entering police custody in one South London police station over a 2-week period. A series of standardised measures was administered to screen for the presence of mental illness, general health and social care needs. A cohort of 134 people was generated, of whom nearly one-third (39, 29%) had current mental illness (major depression and/or psychosis); more had a lifetime diagnosis (54, 40%). Just under a fifth met the threshold for post-traumatic stress disorder (11, 8%). Clinically relevant alcohol or daily cannabis use affected about one quarter of the sample. Twenty-one percent (or 28) screened positive for personality disorder, 11% (or 15) for attention deficit hyperactivity disorder and 4% (6) for intellectual disability. Nearly one-fifth (24, 18%) were at risk for suicide. Those with psychosis, and those deemed at risk for suicide, had the highest levels of unmet need and, indeed, overall need. The most frequent unmet need was for accommodation. Our findings not only confirm high rates of mental health problems amongst police detainees but also demonstrate their high risk of suicide and high levels of unmet need, especially as regards accommodation. This underscores the need to provide mental health services in police stations, to help identify and resolve these issues at this early stage in the criminal justice system. Extending accommodation capacity to help some arrestees may help to save lives and interrupt cycling through the criminal justice system.

Prevalence of Mental Illness and Mental Health Care Use Among Police Officers

Limited literature has characterized patterns of mental illnesses and barriers in seeking mental health care among police officers. To assess the prevalence of mental illness (diagnosis) and symptoms of mental illness, evaluate the characteristics of officers interested in seeking mental health care, and characterize perceptions of mental health care use. This survey study was conducted among officers at a large police department in Dallas-Fort Worth, Texas. Focus group sessions were conducted from April 1, 2019, to November 30, 2019, and the survey was conducted from January 1 to February 27, 2020. A total of 446 sworn, employed patrol officers who were present during the recruitment briefing were eligible to participate in surveys and focus groups. Officers reported lifetime or current diagnosis of depression, anxiety, and posttraumatic stress disorder, as well as current mental health symptoms (using validated screeners of depression, anxiety, posttraumatic stress disorder, and suicidal ideation or self-harm) and mental health care use in the past 12 months. Focus group data were collected to contextualize mental health care use. Logistic regression analyses were used for quantitative data, and focus groups were iteratively coded by 4 coders using inductive and deductive thematic identification. Of the 446 officers invited to participate, 434 (97%) completed the survey (mean [SD] age, 37 [10] years; 354 [82%] male; 217 White [50%]). Of these officers, 19 (17%) had sought mental health care services in the past 12 months. A total of 54 officers (12%) reported a lifetime mental health diagnosis, and 114 (26%) had positive screening results for current mental illness symptoms. Among officers with positive screening results, the odds of interest in using mental health services was significantly higher for officers with suicidal ideation or self-harm than for those who did not (adjusted odds ratio, 7.66; 95% CI, 1.70-34.48). Five focus groups were conducted with 18 officers and found 4 primary barriers in accessing mental health services: (1) inability to identify when they are experiencing a mental illness, (2) concerns about confidentiality, (3) belief that psychologists cannot relate to their occupation, and (4) stigma that officers who seek mental health services are not fit for duty. The study found that although few officers were seeking treatment, they were interested in seeking help, particularly those with suicidal ideation or self-harm. Additional interventions appear to be needed to systematically identify and refer officers to health care services while mitigating their concerns, such as fear of confidentiality breach.

Supportive maternity care services: A Danish study exploring parents’ experiences with perinatal mental health issues

Abstract Background Mental illness can have negative impact on pregnant women, their infants and their families, including adverse birth outcomes, as well as place children at risk of developing mental illness later in life. It is recommended to offer additional support in the ante - and postnatal period, but to be able to offer appropriate, timely and effective care, more knowledge is needed on women's own experiences. The aim of this paper is to explore women's experiences with mental illness in the context of pregnancy and early motherhood, and how they experience and engage with supportive services. Methods This paper presents selected findings from an ethnographic field study carried out in a Danish municipality. The findings are based on data from 22 women, who were recruited when they were pregnant or had a newborn baby. The women were currently facing or had previously suffered from one or multiple mental health conditions. Results Analysis found that women with current or prior mental illness experienced a high level of fear, worries and uncertainty during pregnancy and early motherhood, which shaped how they engaged with supportive maternity services. Some were deeply worried about their mental health and reached out for support to cope with this. Concerns about being a bad mother and about the potential influence of their mental illness on their infants were common. Furthermore, some women were scared of being judged as unfit mothers and losing custody of their children. Many experienced stigma surrounding mental illness, making some more hesitant about reaching out for support. Conclusions By providing new insight into women's own perspectives, this study contributes with in-depth knowledge on women's experiences with mental illness during pregnancy and early motherhood, and illustrates how engaging with supportive services may be an ambivalent experience.