Mental Health Early Intervention Research Articles

The supervision of experienced secondary school‐based counsellors: A situational analysis constructivist grounded theory exploration of best practice

AbstractIntroduction and AimsSecondary school‐based counselling (SSBC) is used widely throughout the United Kingdom (UK) as an early mental health intervention, and clinical supervision is necessary for its safe and effective practice. Currently, there does not exist a body of research to inform best practice in this area of supervision. The purpose of this study was to explore the supervisory requirements of the experienced secondary school‐based counsellor and what best practice looks like.MethodThis study used situational analysis constructivist grounded theory methodology to explore and develop a grounded theory of best practice in supervising the experienced secondary school counsellor in the UK. The descriptions of best practice were examined from the interviews of 17 experienced secondary school counsellors and/or supervisors.FindingsFrom the data emerged one core category (‘a good fit’) which encapsulated four theoretical categories (‘the supervisory relationship’, ‘understanding the working context’, ‘safeguarding’ and ‘the shared supervisory journey’). The study indicates that the supervisor needs an understanding of the unique context of the secondary school as a therapist's working environment in order to support the supervisee with often complex work. There needs to be an awareness of how elements from within the school and/or counselling agency can impact on the supervision regarding boundaries, trust and containment so they do not impact the supervision in a detrimental way.ConclusionsSupervisor and supervisee need a shared understanding of the nature of supervision within this context for it to be a ‘good fit’ for both. This has implications for supervision training and the externality of supervision within this context.

8102 Hyperandrogenism and its Influence on Emotional and Social Development in Adolescent Daughters of Women with Polycystic Ovary Syndrome

Abstract Disclosure: J.P. del Rio: None. R. Gonzalo: None. M. Maliqueo: None. B. Echiburu: None. A. Ladron de Guevara: None. P. Gaspar: None. M. Alejandro: None. N.R. Crisosto: None. Introduction: Polycystic Ovarian Syndrome (PCOS) is the most prevalent endocrine disorder in adolescents. PCOS is characterized by hyperandrogenism, which can modulate brain maturation, especially in highly neuronal plasticity periods, such as intra-uterine life and adolescence. Daughters of women with PCOS (dPCOS) will probably be exposed to hyperandrogenism during these two periods. However, the effects of hyperandrogenism on psychosocial development have not yet been fully characterized. Objectives: To characterize the consequences of hyperandrogenism in the emotional status and social cognition (SC) on dPCOS. Methods/Design: Analytical cross-sectional study. dPCOS and controls between 12 to 25 years old were recruited. Participants underwent a complete clinical evaluation, serum hormone determinations (including total testosterone, SHBG, androstenedione, 17-OH-progesterone, and OGTT-I with 4 collections (0’-30’-90’-120´)) and ovarian ultrasound characterization. Emotional status and SC were estimated by measurements of affects (PANAS), strength and difficulties (SDQ), self-reported empathy (EQ/SQ and AQ), and gaze patterns measurement via Eye-Tracking (while completing an emotional recognition task). Results: 33 participants were recruited, 15 cases and 18 controls. Median age was 17 and 18 years, respectively. The dPCOS presented a larger anogenital distance (cm) (9.7 vs 7.8; p=0.014), Ferryman-Gallwey score mean (13.0 vs 2.0; p=<0.001) and free androgen index value (7.5 vs 4.1; p=0.004), suggesting hyperandrogenism exposure during intrauterine and adolescence periods. Regarding emotional status and SC, dPCOS exhibited a predominantly negative affective status (PANAS 8.0 vs 2.0, p=0.049) and a higher score in socio-emotional problems (SDQ 2,5 vs 1,5; p=0,047). The eye-tracking registration showed that dPCOS presented a longer time to first fixation in areas of interest (s) (0,35 vs 0,28; p=0,037), which was associated with a worse endpoint in emotional recognition (aR2=-0,920; f=19,48; Pr >|t|=<0,049). Furthermore, the 2D:4D ratio (intrauterine marker of androgen exposure) and insulin levels at 60’ were correlated with a predominance of negative affects (rho=0,51; p=0,019 and rho= -0,48; p=0,035), and 2D:4D ratio was also correlated with less prosocial behaviors (coef=-2,39; P>|t|=0,049). Conclusions: Clinical and hormonal markers suggest that dPCOS are exposed to hyperandrogenism during the most critical neuroplasticity periods. This exposure is associated with a predominance of negative affects, more social-emotional difficulties and worse performance on emotional recognition and prosocial behavior. Considering PCOS patient’s elevated psychiatric comorbidity, early mental health intervention becomes crucial, underscoring the necessity for in-depth study on hyperandrogenism's impacts on psychosocial development. Presentation: 6/3/2024

8102 Hyperandrogenism and its Influence on Emotional and Social Development in Adolescent Daughters of Women with Polycystic Ovary Syndrome

Abstract Disclosure: J.P. del Rio: None. R. Gonzalo: None. M. Maliqueo: None. B. Echiburu: None. A. Ladron de Guevara: None. P. Gaspar: None. M. Alejandro: None. N.R. Crisosto: None. Introduction: Polycystic Ovarian Syndrome (PCOS) is the most prevalent endocrine disorder in adolescents. PCOS is characterized by hyperandrogenism, which can modulate brain maturation, especially in highly neuronal plasticity periods, such as intra-uterine life and adolescence. Daughters of women with PCOS (dPCOS) will probably be exposed to hyperandrogenism during these two periods. However, the effects of hyperandrogenism on psychosocial development have not yet been fully characterized. Objectives: To characterize the consequences of hyperandrogenism in the emotional status and social cognition (SC) on dPCOS. Methods/Design: Analytical cross-sectional study. dPCOS and controls between 12 to 25 years old were recruited. Participants underwent a complete clinical evaluation, serum hormone determinations (including total testosterone, SHBG, androstenedione, 17-OH-progesterone, and OGTT-I with 4 collections (0’-30’-90’-120´)) and ovarian ultrasound characterization. Emotional status and SC were estimated by measurements of affects (PANAS), strength and difficulties (SDQ), self-reported empathy (EQ/SQ and AQ), and gaze patterns measurement via Eye-Tracking (while completing an emotional recognition task). Results: 33 participants were recruited, 15 cases and 18 controls. Median age was 17 and 18 years, respectively. The dPCOS presented a larger anogenital distance (cm) (9.7 vs 7.8; p=0.014), Ferryman-Gallwey score mean (13.0 vs 2.0; p=<0.001) and free androgen index value (7.5 vs 4.1; p=0.004), suggesting hyperandrogenism exposure during intrauterine and adolescence periods. Regarding emotional status and SC, dPCOS exhibited a predominantly negative affective status (PANAS 8.0 vs 2.0, p=0.049) and a higher score in socio-emotional problems (SDQ 2,5 vs 1,5; p=0,047). The eye-tracking registration showed that dPCOS presented a longer time to first fixation in areas of interest (s) (0,35 vs 0,28; p=0,037), which was associated with a worse endpoint in emotional recognition (aR2=-0,920; f=19,48; Pr >|t|=<0,049). Furthermore, the 2D:4D ratio (intrauterine marker of androgen exposure) and insulin levels at 60’ were correlated with a predominance of negative affects (rho=0,51; p=0,019 and rho= -0,48; p=0,035), and 2D:4D ratio was also correlated with less prosocial behaviors (coef=-2,39; P>|t|=0,049). Conclusions: Clinical and hormonal markers suggest that dPCOS are exposed to hyperandrogenism during the most critical neuroplasticity periods. This exposure is associated with a predominance of negative affects, more social-emotional difficulties and worse performance on emotional recognition and prosocial behavior. Considering PCOS patient’s elevated psychiatric comorbidity, early mental health intervention becomes crucial, underscoring the necessity for in-depth study on hyperandrogenism's impacts on psychosocial development. Presentation: 6/3/2024

Infant and Early Childhood Mental Health (IECMH) and Early Childhood Intervention: Intentional Integration.

Infant and Early Childhood Mental Health (IECMH) is a multidisciplinary field of inquiry, practice, and policy concerned with enhancing the social-emotional competence of infants and young children. Early Childhood Intervention (ECI) is a system of services that supports infants and toddlers with disabilities and their families. ECI providers promote a child's development in all domains, including social-emotional. The purpose of this paper is to describe how two systems, Early Childhood Intervention and Infant Early Childhood Mental Health, collaborate when serving children who have developmental delays or disabilities and their families and other caregivers. We will discuss two models used to promote social-emotional development, the Pyramid Model and IECMH Consultation, and provide three examples that demonstrate how ECI and IECMH intersect at both the family, classroom, and system levels.

Impact of a philosophical intervention on the reduction of depression in high school students.

Adolescence is a critical and challenging period in development; therefore, it is of utmost importance to address and prevent disorders such as depression or anxiety. The present study aimed to evaluate the effect of a philosophical intervention on depression rates in high school students. The method consisted of the evaluation of depression before and after the intervention with the BDI-Y test. Of the cases of the young people attended in the intervention workshops, on average, their depressive classification decreased by 67%. The implementation of the workshops with content in ethical values can be a model of early mental health intervention to reduce the levels of depression in high school students, which created a multiplier effect in the class groups, as well as in the increase of coexistence and teamwork.

Psychometric properties of the positive mental health questionnaire: short form (PMHQ-SF18) in young adults.

Positive Mental Health (PMH) plays a pivotal role in the promoting of mental health. Assessing this phenomenon is essential for early recognition and intervention in mental health. To date, only one tool was validated with 39 items to assess PMH among Portuguese young adults. This study sought to examine the psychometric properties of the short version of the Positive Mental Health Questionnaire (PMHQ) among Portuguese university students. The PMHQ Short Form was administered to a sample of 3,647 university students via an online platform. Exploratory and confirmatory factor analyses were performed. The principal factor solution was employed because some items showed higher levels of kurtosis. Multivariate analysis was tested using the Mardia's Test, Henze-Zirkler, and Royston. Findings of content, construct validity tests, and Cronbach's alfa demonstrated the satisfactory validity and suitable reliability of the PMHQ-Short Form (PMHQ-SF). The exploratory factor analysis produced six dimensions of the PMHQ-SF with three items in each factor demonstrating adequate internal reliability. The global internal consistency was 0.92, with factors ranging between 0.60 to 0.82. The results suggest that the PMHQ-SF is reliable, easier, and more practical to complete by university students due to the shortening of the number of items. The PMHQ-SF is useful for assessing positive mental health in young adults. The final version of the instrument contains from 32 to 18 items.

Self-Reported Concerns among Australian Secondary School Students: Associations with Mental Health and Wellbeing

BackgroundExcessive worry during adolescence can significantly impact mental health. Understanding adolescent concerns may help inform mental health early intervention strategies.ObjectiveThis study aimed to identify frequent concerns among Australian secondary school students, exploring individual and demographic differences. Whether adolescents’ most frequently reported concern was associated with mental health and wellbeing was also investigated.MethodsA total of N = 4086 adolescents (Mage = 13.92) participated in an online survey, reporting their top concerns alongside demographic characteristics, mental health, and wellbeing. Data were analysed using both qualitative and quantitative approaches.ResultsThematic analysis identified 11 different themes of adolescent concerns. A frequency analysis showed concerns relating to ‘School and Academics’ were most common (24.52% of all responses), consistent across females, males, school location (regional vs metropolitan areas), and socioeconomic background. Sexuality and gender diverse adolescents more frequently reported concerns about ‘Mental Health and Wellbeing’ and ‘Social Relationships’. Linear mixed models found ‘School and Academic’ concerns were associated with lower symptoms of depression (p < .001, d = 0.16) and anxiety (p < .001, d = 0.19) and higher wellbeing (p = .03, d = 0.07) compared to all other concerns.Conclusion‘School and Academic’ concerns were most common, however not associated with poorer mental health or wellbeing. Sexuality and gender diverse adolescents were more likely to report concerns regarding ‘Mental Health and Wellbeing’ and ‘Social Relationships’. Efforts aimed solely at reducing academic stress may not be the most effective approach to improving adolescent mental health. Longitudinal data into how concerns evolve over time could provide a nuanced understanding of their relationship with future mental health challenges.

Maternal antenatal mental health and its associations with perinatal outcomes and the use of healthcare services in children from the NINFEA birth cohort study.

To investigate the associations between maternal mental health disorders before and during pregnancy and perinatal outcomes and child healthcare utilization between 6 and 18months of age. Among the 6814 mother-child pairs from the Italian Internet-based NINFEA birth cohort, maternal depression, anxiety, and sleep disorders diagnosed by a physician before and during pregnancy were assessed through self-reported questionnaires completed during pregnancy and 6months after delivery. Perinatal outcomes (preterm birth, birth weight, small for gestational age, congenital anomalies, and neonatal intensive care unit (NICU)) and children's healthcare utilization (emergency department (ED) visits, hospitalizations, and outpatient visits) were reported by mothers at 6 and 18months postpartum. We used regression models adjusted for maternal age, education, parity, country of birth, region of delivery, and household income. Maternal mental health disorders were not associated with perinatal outcomes, except for depression, which increased the risk of offspring admission to NICU, and anxiety disorders during pregnancy, which were associated with preterm birth and lower birth weight. Children born to mothers with depression/anxiety disorders before pregnancy, compared to children of mothers without these disorders, had an increased odds of a visit to ED for any reason (odds ratio (ORadj) = 1.26, 95% confidence interval (CI): 1.02-1.54), of an ED visit resulting in hospitalization (ORadj = 1.75, 95%CI: 1.27-2.42), and of planned hospital admissions (ORadj = 1.55, 95%CI: 1.01-2.40). These associations with healthcare utilization were similar for mental disorders also during pregnancy. The association pattern of maternal sleep disorders with perinatal outcomes and child healthcare utilization resembled that of maternal depression and/or anxiety disorders with these outcomes. Conclusion: Antenatal maternal mental health is a potential risk factor for child-health outcomes and healthcare use. Early maternal mental health interventions may help to promote child health and reduce healthcare costs. What is Known: • Poor maternal mental health affects pregnancy outcomes and child health, and children of mothers with mental health conditions tend to have increased healtcare utilization. • Parents with poor mental health often face challenges in caring for their children and have less parenting self-efficacy, which could potentially lead to frequent medical consultations for minor health issues. What is New: • Maternal pre-pregnancy mental disorders were not associated with preterm birth, low birth weight, SGA, and congenital anomalies, except for depression, which increased the risk of offspring admission to NICU. Anxiety disorders during pregnancywere associated with lower birth weight and an increased odds of preterm birth. • Maternal depression and/or anxiety and sleep disorders, both before and during pregnancy, were associated with an increase in children's healthcare utilization between 6 and 18months of life.

Using quality improvement to pursue equity: lessons from healthcare

Against a backdrop of stalling life expectancy, the COVID-19 pandemic highlighted the need to tackle inequities in healthcare. Quality improvement has become an increasingly recognised way of tackling complex problems in healthcare. This article presents a step-by-step approach for the use of quality improvement to pursue equity at an NHS provider in England. The Model for Improvement was used to set an aim, develop a theory of change and measures, and test change ideas through plan-do-study-act cycles. A five-step sequence of improvement was used to provide a structured approach to identifying and tackling problems. Projects were designed to use a time series testing strategy in which baseline data were collected, a change was introduced and data continued to be collected over time to assess improvement. The results of three teams that have demonstrated sustained improvements were analysed using statistical process control charts. The teams' achievements included a 27% increase in access to early intervention mental health services for ethnic minority groups; a 92% reduction in racist incidents on inpatient wards; and a reduction in the gap between cervical screening rates for different age groups from 8% to 3%. Quality improvement offers those closest to the delivery of care a way of systematically making improvements in equity. Further opportunities for the field include the use of experimental designs to test combinations of interventions and potential scalability of quality improvement methods across systems with multiple partners.

Chatbots for Well-Being: Exploring the Impact of Artificial Intelligence on Mood Enhancement and Mental Health

Introduction Over the past few years, Psychiatry has undergone a significant transformation with the integration of Artificial Intelligence (AI). This shift has been driven by the increasing demand for mental health services, as well as advances in AI technology. AI analyzes extensive datasets, including text, voice, and behavioral data, aiding in mental health diagnosis and treatment. Consequently, a range of AI-based interventions has been developed, including chatbots, virtual therapists and apps featuring cognitive-behavioral therapy (CBT) modules. Notably, chatbots, as conversational agents, have emerged as valuable tools, assisting users in monitoring emotions and providing evidence-based resources, well-being support, psychoeducation and adaptive coping strategies.ObjectivesThis study aims to investigate the impact of AI chatbots on improving mental health, evaluate their strengths and weaknesses and explore their potential for early detection and intervention in mental health issues.Methods A literature review was conducted through PubMed and Google Scholar databases, using keywords ‘artificial intelligence’, ‘chatbot’ and ‘mental health’. The selection focused on the most relevant articles published between January 2021 and September 2023.ResultsMental health chatbots are highly personalized, with a primary focus on addressing issues such as depression or anxiety within specific clinical population groups. Through the integration of Natural Language Processing (NLP) techniques and rule-based AI algorithms, these chatbots closely simulate human interactions and effectively instruct users in therapeutic techniques. While chatbots integrating CBT principles have gained widespread use and extensive research attention, some also incorporate alternative therapeutic approaches, including dialectical behavior therapy, motivational interviewing, acceptance and commitment therapy, positive psychology or mindfulness-based stress reduction. AI chatbots provide substantial advantages in terms of accessibility, cost-effectiveness and improved access to mental health support services. Nonetheless, they also exhibit limitations, including the absence of human connection, limited expertise, potential for misdiagnosis, privacy concerns, risk of bias and limitations in risk assessment accuracy.ConclusionsAI-based chatbots hold the potential to enhance patient outcomes by enabling early detection and intervention in mental health issues. However, their implementation in mental health should be approached with caution. Further studies are essential to thoroughly evaluate their effectiveness and safety.Disclosure of InterestNone Declared

Understanding the emotional and practical support needs of family care-partners of Veterans to promote well-being

LAY SUMMARY Some family care-partners of Australian Veterans have high levels of distress and feel there is little consideration or acknowledgement of the role they play in supporting Veterans in their day-to-day lives. They also feel limited support is available as a family carer. Family care-partners rarely prioritize their own well-being, leaving them at risk of poor health outcomes. This study extended previous work in South Australia to attempt to understand the physical and mental health status of family care-partners across the country. It sought to identify care-partners’ emotional and practical support needs, determine whether access to supports was available, and discuss the broader impact of the caring role. While fewer care-partners participated than anticipated, the findings suggest that the psychological well-being of family care-partners is impacted by their caring role, and there is a need for accessible supports that are culturally safe, non-judgmental, and promote wellness and early mental health intervention for the care-partner, Veteran, and entire family unit.

Exploring the symptom patterns of depression and anxiety among teachers during COVID-19: A latent profile analysis.

The present study used the latent profile analysis (LPA) approach to explore the symptom patterns of depression and anxiety among Chinese teachers during COVID-19 and its relationship with fear of COVID-19 and suicidal ideation. A sample of 6,121 teachers from primary and secondary schools in a district-level administrative unit in southern China was used. The LPA was employed to identify different symptom patterns of depression and anxiety. We subsequently used logistic regression to analyze the effects of demographic variables on the different profiles. The Bolck-Croon-Hagenaars method assessed the relationships between each profile and fear of COVID-19 and suicidal ideation. The study identified five significant latent profiles and two subtypes in the moderate psychological disorder group. We also found that gender, professional title, and age significantly influenced the distribution of the profiles. The risk for both fear of COVID-19 and suicidal ideation was highest in the severe psychological disorder group. The high anxiety subtype had a significantly greater fear of the new coronavirus epidemic than the high depression subtype, which had a significantly higher level of suicidal ideation than the high anxiety subtype. The profiles we identified have distinct features that confirm their unique patterns of symptom endorsement. Our study may have important implications for early warning and intervention in teacher mental health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Brief cognitive behavioural therapy for eating disorders symptomatology among a mixed sample of adolescents and young adults in primary care: A non-randomised feasibility and pilot study.

Brief and accessible therapies for people with an eating disorder is an important health target. Ten-session cognitive behavioural therapy (CBT-T) is a brief treatment evaluated in people with a non-underweight eating disorder. This study aimed to evaluate the feasibility and preliminary effectiveness of CBT-T for young people in primary care. This cohort pilot study used group (adolescents vs. young adults) by time (over four time points) Generalised Linear Mixed Model analysis. Participants included 13-25-year-olds attending an early intervention mental health service, receiving 10 sessions of CBT-T. Feasibility was assessed using recruitment, retention and satisfaction. Eating and other pathology measures were administered at baseline, weeks four and 10, and 12-week follow-up. Of the 63 commencing treatment, 38 completed 10 CBT-T sessions (60%). Most (94%) reported high treatment satisfaction. Significant reductions in eating pathology, depression and stress were found. Age group did not yield differences in CBT-T outcome, with large to very large effect sizes across outcome variables. Anxiety was associated with attrition. This study provides preliminary support for the use of CBT-T in primary care, across adolescence and early adulthood. Findings require replication in other clinical settings and comparison to other clinical approaches and control populations.

The Relationship between Academic Performance, Peer Pressure, and Educational Stress as It Relates to High School Students’ Openness to Seeking Professional Psychological Help

Adolescents, especially high school students, are more susceptible to stress and encounter other mental health issues. This is linked to extrinsic causes like academics, family, and friends. However, previous studies have shown low rates of students seeking professional psychological help for their problems. This study investigate the relationship among factors including academic performance, educational stress, peer pressure and openness to seeking professional psychological help. We conducted this study with 471 high school students (grades 10–12) engaged. The questionnaire was based on three measurements: peer pressure short form (PPSF), educational stress scale for adolescents (ESSA), and openness to seeking professional psychological help (ATSPPH_O). The Mann-Whitney U test, Kruskal-Wallis test and The PLS-SEM method were used to evaluate this research. The results showed that: (i) students with a higher level of peer pressure have a greater openness to seeking professional psychological help; (ii) the more open to seeking professional psychological help, the higher educational stress that students got; (iii) students with a higher level of peer pressure have greater educational stress; (iv) the openness to seeking professional psychological help would mediate the relationship between peer pressure and educational stress; (v) there was a significant difference between academic performance of peer pressure. On the one hand, counselors, clinicians, and therapists must identify students who are experiencing educational stress in the context of peer pressure as vulnerable groups in need of early mental health interventions. On the other hand, educators and teachers must consider the impact of peer pressure on students' academic performance and devise appropriate teaching strategies.

Tracing Tomorrow: young people’s preferences and values related to use of personal sensing to predict mental health, using a digital game methodology

BackgroundUse of personal sensing to predict mental health risk has sparked interest in adolescent psychiatry, offering a potential tool for targeted early intervention.ObjectivesWe investigated the preferences and values of UK...

Intersectionality informed and narrative-shifting whole school approaches for LGBTQ+ secondary school student mental health: A UK qualitative study.

School is a key site for prevention and early intervention in public mental health, with sexual and gender minority students being a priority group for action. Context is important in understanding how school inclusion of sexual and gender minorities shapes mental health and well-being, with rapidly changing social and political forces necessitating ongoing research. This coproduced UK secondary school-based study aimed to understand (a) key components of mentally, socially and emotionally healthy school environments for LGBTQ+ students considerate of intersecting minoritised identities; (b) staff information, skills and capacity needs and (c) factors influencing uptake and implementation. Online interviews and focus groups were conducted with 63 participants (22 staff, 32 students (aged 13-19 years), and 9 training providers), diverse in relation to gender and sexual identity, ethnicity, religious and social context. Data were analysed thematically. One overarching theme captured the need for an intersectionality-informed, contextually adaptable, whole school approach which 'shifts the narrative' away from deficit thinking, challenging prevailing cis/heteronormative and White norms. This underpinned four themes: (1) 'Feeling safe, seen and celebrated: embedding intersectional signs, signals and symbols', (2) 'Everyone's business: the need for collaboration', (3) 'Embedding a culture of change', and (4) 'Re-locating the problem: challenging deficit thinking'. Contextually diverse research is needed which critically addresses ways in which social power enacted interpersonally and structurally serves to hinder schools from enacting LGBTQ+ inclusivity. Evidence to inform and develop implementation strategies for institutional changes and to advocate for wider socio-political support is also key to mitigate the potential for widening inequities linked to inequitable school environments.

Risk Factors for Depression Among Middle-Aged to Older People Living With HIV in Lima, Peru.

Depression is prevalent among aging people living with HIV (PLWH) worldwide. We sought to identify depression risk factors among a group of middle-aged and older PLWH in Lima, Peru. We assessed risk factors for depression among PLWH over age 40 receiving care in an HIV clinic in Lima, Peru. The Patient Health Questionnaire-9 (PHQ-9) was administered. We performed descriptive statistics and logistic regression analyses. Mean age was 51.7 ± 7.7 years with 15.3% females. One-quarter of participants had depression with higher frequency in females. Risk factors that significantly increased the risk of depression included female sex (adjusted prevalence ratio [aPR] = 2.19 [95%CI 1.07-4.49]), currently smoking (aPR = 2.25 [95%CI 1.15-4.43]), and prior opportunistic infection (aPR = 2.24 [95%CI 1.05-4.76]). Our study demonstrates that PLWH who are female, current smokers, or had an opportunistic infection have higher risk of depression. Identifying PLWH at-risk for depression is key to early mental health interventions.

A collaborative, school-based wraparound support intervention for fostering children and youth's mental health

Early mental health interventions are needed in response to a growing mental health crisis among children and youth. Schools are promising sites for early intervention because they have existing infrastructure for engaging with students. Specifically, collaborative initiatives involving community partnerships allow schools to leverage shared resources to deliver mental health support. However, more research is needed to guide the development of early interventions so that they effectively address students' mental health needs. The present study explored the role of collaborative, school mental health services in fostering children and youth's mental health, through All in for Youth, a wraparound model of support in Edmonton, Canada. Three research questions were addressed: What mental health concerns do children and youth experience? What are the factors that impact the use of collaborative school mental health services? Do collaborative school mental health services lead to perceived mental health impacts among children and youth? A multiple methods secondary analysis was conducted on school cohort data across seven elementary and junior high schools (n = 2,073 students), and interview and focus group data (n = 51 students, grades 2–9; n = 18 parents/caregivers). The quantitative findings indicated that 42.7% of students accessed any type of mental health service across the schools, with close to equivalent service use by gender (50.2% male, 49.5% female, 0.3% genderqueer) and grade (kindergarten-grade 9; M = 10%, SD = 1.9%, range = 6.3%−13%). Participants accessed mental health services in primarily individual or combined individual and group settings (72.9%) and as an informal client (75.1%). The interview and focus group findings revealed high mental health needs among students, which were exacerbated by the COVID-19 pandemic. In response to these needs, a supportive school culture, adequate school communication, and a stable and well-resourced mental health workforce promoted access to collaborative school mental health services. Finally, mental health services supported children and youth through the experience of having a supportive relationship with a safe and caring adult, an improved capacity to cope with school and life, and improved family functioning. The findings underscore the importance of developing school mental health services that take an ecological, wraparound approach to addressing students' multi-faceted mental health needs.

NAVIGATE Program Directors' perspectives on treatment for early psychosis.

Since the release of the Recovery After Initial Schizophrenia Episode-Early Treatment Program results in 2015, the United States Congress expanded funding for early intervention programs and these programs now exist in every state. The purpose of the present study was to understand the real-world experience of NAVIGATE Program Directors with respect to identifying and recruiting patients with early psychosis and engaging families in treatment. Utilizing a mixed-methods sequential explanatory design, researchers surveyed 32 program directors in 13 states and engaged in 22 follow-up interviews to explore how NAVIGATE is being translated to serve individuals experiencing early psychosis and their families. We found that program directors using the NAVIGATE model encountered difficulty identifying diagnosis at admission and that supporting families of individuals experiencing psychosis was an important aspect of the program with unique complexity. These findings have important implications for future mental health research on early intervention programs and may serve to stimulate future research on how early intervention mental health programs can better serve individuals recovering from psychosis and support their families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Level of fear towards COVID-19 and its determinants among healthcare providers in Malaysia: A cross-sectional study.

Malaysia is one of the hardest-hit countries by COVID-19 in Asia. The rapidly rising number of cases had sparked fear among healthcare providers. This study aimed to assess the determinants of fear towards COVID-19 among healthcare providers in primary care settings. This online-based cross-sectional study was conducted among 1280 healthcare providers aged ≥18 years from 30 primary care clinics in the state of Selangor, Malaysia. The Fear of COVID-19 Scale was used to assess the level of fear, and the results were analysed using multiple linear regression. The mean age of the respondents was 36 years, and the mean working experience was 11 years. The majority of the respondents were women (82.4%) and Malays (82.3%). The factors that were significantly correlated with higher levels of fear were underlying chronic disease (ß=1.12, P=0.002, 95% confidence interval [CI]=0.08, 3.15), concern about mortality from COVID-19 (ß=3.3, P<0.001, 95% CI=0.19, 7.22), higher risk of exposure (ß=0.8, P<0.001, 95% CI=0.14, 5.91), concern for self at work (ß=2.8, P=0.002, 95% CI=0.08, 3.10) and work as a nurse (ß=3.6, P<0.001, 95% CI=0.30, 7.52), medical laboratory worker (ß=3.0, P<0.001, 95% CI=0.12, 4.27) and healthcare assistant (ß=3.9, P<0.001, 95% CI=0.17, 5.73). The level of fear was inversely correlated with a higher work-related stress management score (ß=-0.9, P<0.001, 95% CI=-0.14, -5.07) and a higher sleep quality score (ß=-1.8, P<0.001, 95% CI=-0.28, -10.41). Family physicians should be vigilant and identify healthcare providers at risk of developing COVID-19-related fear to initiate early mental health intervention.