Effective Mental Health Services Research Articles

"What Works" to Support LGBTQ+ Young People's Mental Health: An Intersectional Youth Rights Approach.

Despite overwhelming international evidence of elevated rates of poor mental health in LGBTQ+ youth compared to their cis-heterosexual peers, we know relatively little about effective mental health services for this population group. This study aims to produce the first early intervention model of "what works" to support LGBTQ+ youth with emerging mental health problems. Utilizing a mixed method case study, we collected data across 12 UK mental health service case study sites that involved: (a) interviews with young people, parents, and mental health practitioners (n = 93); (b) documentary analysis; (c) nonparticipant observation. The data analysis strategy was theoretical using the "explanation-building" analytical technique. Our analysis suggests an intersectional youth rights approach with 13 principles that must be enacted to provide good mental health services as advocated by the United Nations Convention on the Rights of the Child and World Health Organization. This approach should address the multiple forms of marginalization and stigmatization that LGBTQ+ youth may experience, enable informed independent decision-making, and uphold the right to freedom of safe self-expression. A rights-based approach to mental health services for LGBTQ+ young people is not prominent. This needs to change if we are to tackle this mental health inequality and improve the mental well-being of LGBTQ+ youth worldwide.

Factors influencing mental health service delivery during public health emergencies: a scoping review protocol

Background Unforeseeable public health emergencies (PHEs) profoundly impact psychological well-being and disrupt mental health care provision in affected regions. To enhance preparedness for future emergencies, it is crucial to understand the effectiveness of mental health services, their underlying mechanisms, the populations they are tailored to, and their appropriateness across distinct emergencies. The aim of this scoping review will be to explore how mental health services have responded to PHEs, focusing on their effectiveness as well as barriers and facilitators to implementation. Methods Following the five-stage Arksey-O'Malley guidance, as updated further by Westphaln and colleagues, this mixed-methods scoping review will search academic and grey literature. Publications related to mental health interventions and supports delivered during PHEs will be considered for inclusion. The interventions and supports are operationally defined as any adaptations to mental health service provision at the international, national, regional or community level as a consequence of PHEs. The “Four Ss” framework will be utilised to provide structure for the evidence synthesis and inform categorisation of interventions and supports delivered during PHEs. Any research methodology will be considered for inclusion. Two reviewers will independently screen titles, abstracts, and full texts of publications against eligibility criteria. The gathered data will be depicted in accordance with the Four Ss” framework through the utilisation of descriptive/analytical statistics and supplemented by narrative exploration of findings. Conclusions Considering the diverse research methodologies and the varied applicability of services in different contexts of PHEs, this review will offer insights into the type, effectiveness, and implementation barriers and facilitators of mental health interventions and supports delivered during PHEs. By employing the “Four Ss” framework, the review will guide decision-making bodies in identifying effective and practical aspects of mental health system operations during emergencies.

Applying the extension for community healthcare outcomes (ECHO) model to promote collaborative and effective school mental health services.

Applying the extension for community healthcare outcomes (ECHO) model to promote collaborative and effective school mental health services.

The Application of Big Data Technology in Teaching College Students’ Mental Health Education in Colleges and Universities

Abstract Advances in big data technology herald a new era for mental health education in higher education, offering novel solutions to age-old challenges in student psychological care. This paper investigates how big data’s analytical capabilities can surpass traditional, one-size-fits-all mental health assessments by leveraging detailed student data for personalized care. We applied data mining techniques to the mental health data of 1,200 students from College G, creating a rich database of psychological patterns and a mental health information exchange platform. The analysis led to the identification of 500 instances of psychological distress with an accuracy of 79.5% and unveiled patterns linking academic stress and adjustment difficulties to mental health issues. Our research underscores big data’s role in enhancing mental health interventions, providing the groundwork for more individualized and effective mental health services in academic settings.

기초정신건강복지센터 제공 사업에 대한 중장노년층의 인식

Objective : From September 1st to 30th 2023, an online survey was conducted on middle-aged and older people's nationwide. Total of 161 surveys were used as data and frequency analysis, Pearson chi-square test were performed using SPSS 25.0 program. Methods : From September 1st to 30th 2023, an online survey was conducted on middle-aged and older people's nationwide. Total of 161 surveys were used as data and frequency analysis, Pearson chi-square test were performed using SPSS 25.0 program. Results : As a result of the study, 'Don't know' showed the highest proportion in all projects except disaster health service support work. As a result of analyzing the level of awareness of the projects of the basic mental health welfare center according to general characteristics, the projects of the basic mental health welfare center, which showed a significant differences in the level of awareness depending on gender, age, residential area, marital status, child status, religion, highest academic qualification, type of occupation, family monthly income, family and relative experiences of mental illness, experience using the mental health welfare center. Among them, in the case of experience using the mental health welfare center, there was a exceptional difference in the level of perception in all projects. Conclusion : Active promotion of the projects and education on the use of mental health services should be conducted to raise the level of middle-aged and older people's awareness of the projects provided by the basic mental health welfare center and to provide effective mental health services for the public.

Global knowledge-power asymmetries and student mental health in sub-Saharan Africa

In the past decade concern about the mental health of university students has been growing worldwide. Yet epidemiological data and intervention research on student mental health comes predominantly from high income western countries in the Global North, with a relative scarcity of studies from sub-Saharan Africa and other countries in the Global South.  While universities in the Global North and Global South face similar challenges to provide accessible, acceptable, and effective mental health services to students, there are also important historical, cultural, economic, and political issues that make it necessary for context-sensitive research which is responsive to the needs of students in the Global South. Using South Africa (SA) as a case study, this commentary aims to explore the relevance and appropriateness of uncritically importing knowledge and “evidence-based” strategies to student mental health challenges from the Global North into sub-Saharan Africa. 

Approaching Jail Diversion and Prevention of Criminal Legal System Involvement Simultaneously.

Despite prolific jail diversion initiatives, people with serious mental illness continue to be overrepresented in the criminal legal system. This continued overrepresentation has led to recent calls to address social determinants of health and criminal risk factors rather than to allocate new resources to diverting people from the criminal legal system. This shift toward prevention by addressing social factors that influence health and criminal legal outcomes should occur alongside a continued focus on diversion to understand what works and for whom. An effective, well-funded, and comprehensive community-based mental health services system could serve as the ultimate intercept for preventing criminal legal system involvement.

Interpersonal Psychotherapy for College Students (IPT-CS): Feasibility, Acceptability, and Effectiveness of Group Modality

ABSTRACTDespite college students’ high rates of depression, a large treatment gap remains in which many students in need are not receiving evidence-based care. This pilot randomized controlled trial (RCT) delivered a novel adaptation of Interpersonal Psychotherapy for College Students (IPT-CS) in group modality at a college counseling center. Of 97 students expressing interest, 18 with mild to moderate depression were randomized to IPT-CS or referral-to-usual-care. The nine who initiated IPT-CS treatment had an average 96.67% attendance rate across 10 sessions and rated IPT-CS as satisfactory and accessible. Facilitators also rated IPT-CS as satisfactory, feasible, and faithful to IPT. Group-by-time analyses indicated that IPT-CS, compared to referral-to-usual-care, yielded a pattern of medium to large effects for depression, anxiety, quality of life, social adjustment and support, interpersonal concerns overall, and disconnection/loneliness specifically. As the pilot trial was powered to detect quite large effects, group-by-time analyses only reached statistical significance for depression and social support, as did within-group analyses for quality of life and interpersonal concerns overall. Importantly, reductions in depression and anxiety were clinically significant, dropping from moderate at pre-intervention to mild/no signs at post-intervention. These findings have implications for improving the accessibility, reach, and impact of effective mental health services for college students.

What factors facilitate partnerships between higher education and local mental health services for students? A case study collective

BackgroundHigher education institutions face challenges in providing effective mental health services for diverse student needs. In the UK, discrepancies between healthcare and education service provision create barriers for students and...

Urban insights into mental health: A study of depression and anxiety factors among urban adults of Bangladesh in the COVID-19 pandemic

ABSTRACT This study investigates the prevalence of depression and anxiety symptoms among urban adults in Bangladesh and explores the associated socio-demographic factors. An online cross-sectional survey was conducted from March to May 2021 among the adults living in Dhaka City, Bangladesh, using a standard questionnaire designed using Google Forms and sent via a unique uniform resource locator (URL). The Depression Anxiety Stress Scale 21 (DASS-21) was employed to assess symptoms of mental health issues. The survey included responses from 993 participants. The results indicate that about 40% of the urban adults had moderate-severe anxiety symptoms, while about 46% had depression symptoms. Urban adults’ level of education, gender, occupation, place of birth, and asset quintile were found to have a significant correlation with increased anxiety and depression. The findings stressed the need for developing effective mental health services and educational programs for urban people to meet their mental health needs and prevention mechanisms. There is an urgent need for interventions that specifically target mental health issues.

Your robot therapist is not your therapist: understanding the role of AI-powered mental health chatbots.

Artificial intelligence (AI)-powered chatbots have the potential to substantially increase access to affordable and effective mental health services by supplementing the work of clinicians. Their 24/7 availability and accessibility through a mobile phone allow individuals to obtain help whenever and wherever needed, overcoming financial and logistical barriers. Although psychological AI chatbots have the ability to make significant improvements in providing mental health care services, they do not come without ethical and technical challenges. Some major concerns include providing inadequate or harmful support, exploiting vulnerable populations, and potentially producing discriminatory advice due to algorithmic bias. However, it is not always obvious for users to fully understand the nature of the relationship they have with chatbots. There can be significant misunderstandings about the exact purpose of the chatbot, particularly in terms of care expectations, ability to adapt to the particularities of users and responsiveness in terms of the needs and resources/treatments that can be offered. Hence, it is imperative that users are aware of the limited therapeutic relationship they can enjoy when interacting with mental health chatbots. Ignorance or misunderstanding of such limitations or of the role of psychological AI chatbots may lead to a therapeutic misconception (TM) where the user would underestimate the restrictions of such technologies and overestimate their ability to provide actual therapeutic support and guidance. TM raises major ethical concerns that can exacerbate one's mental health contributing to the global mental health crisis. This paper will explore the various ways in which TM can occur particularly through inaccurate marketing of these chatbots, forming a digital therapeutic alliance with them, receiving harmful advice due to bias in the design and algorithm, and the chatbots inability to foster autonomy with patients.

Developmental trajectories and predictors of Internet gaming disorder across the university years: A person-centered five-wave cohort study

With a rapid rise in internet gaming, internet gaming disorder (IGD) has become a contemporary concern. However, little is known about the long-term dynamic changes in IGD over time. Using a person-centered five-wave longitudinal design, the current study explored the heterogeneous trajectories of IGD among 5787 students during their university years, and examined the role of protective and risk factors in differentiating distinct patterns of IGD. The growth mixture modeling revealed three distinct trajectories of IGD: stable-low pattern (n = 4575, 87.42 %), increasing pattern (n = 357, 6.80 %), and decreasing pattern (n = 302, 5.78 %). Additionally, the students with high self-control and self-compassion were more likely to be in the stable-low group instead of the other risk groups. Depressive symptoms and peer conflicts, as two time-varying variables, were significant risk predictors for IGD. These findings highlight the importance of identifying high-risk groups for IGD and providing them with personalized and effective mental health services to reduce their risk of developing IGD in the future.

Mental health of help-seeking outpatients pre and post COVID-19: A real-world data, multicentre study.

A great deal of research addresses the mental health implications of the COVID-19 pandemic for the general population. Little is known about the implications for mental health of help-seeking outpatients and for the effectiveness of mental health services. The present study investigated the mental health and treatment response of help-seeking outpatients before and during the COVID-19 pandemic. Routine outcome monitoring data from 3706 clients in the United States and Northern Europe was analysed using multilevel modelling with global subjective well-being as the dependent variable. As opposed to before the pandemic, during the pandemic, well-being scores were significantly higher at intake and improvement throughout treatment was significantly smaller in the US sample, while both were comparable in the EU sample. Although there is also evidence of less effective treatments since the pandemic, no conclusive picture emerges that portrays the impact of the pandemic on mental health as uniform. More research is needed to elucidate the impact of the pandemic on the help-seeking population.

Public stigma and attitudes towards seeking professional psychological help of undergraduate Psychology students and students of other majors in Hanoi, Vietnam

ABSTRACT The study aims to compare the differences in stigma and attitudes regarding seeking psychological professional help for mental health issues between undergraduate students who major in Psychology andother majors. Methods: There were 408 participants. All participants are undergraduate students in Hanoi, Vietnam. Results: The results indicated that students who major in Psychology had significantly lower stigma and more positive attitudes towards seeking professional mental health services compared to their counterparts. Majoring in Psychology might inform the students more about the effectiveness ofmental health services, which can lead to a decrease in stigma against seeking treatment. Conclusion: The study’s results highlight the importance of providing appropriate mental health education to undergraduate students to reduce stigma and improve help-seeking attitude.

Providing Self-Led Mental Health Support Through an Artificial Intelligence–Powered Chat Bot (Leora) to Meet the Demand of Mental Health Care

Digital mental health services are becoming increasingly valuable for addressing the global public health burden of mental ill-health. There is significant demand for scalable and effective web-based mental health services. Artificial intelligence (AI) has the potential to improve mental health through the deployment of chatbots. These chatbots can provide round-the-clock support and triage individuals who are reluctant to access traditional health care due to stigma. The aim of this viewpoint paper is to consider the feasibility of AI-powered platforms to support mental well-being. The Leora model is considered a model with the potential to provide mental health support. Leora is a conversational agent that uses AI to engage in conversations with users about their mental health and provide support for minimal-to-mild symptoms of anxiety and depression. The tool is designed to be accessible, personalized, and discreet, offering strategies for promoting well-being and acting as a web-based self-care coach. Across all AI-powered mental health services, there are several challenges in the ethical development and deployment of AI in mental health treatment, including trust and transparency, bias and health inequity, and the potential for negative consequences. To ensure the effective and ethical use of AI in mental health care, researchers must carefully consider these challenges and engage with key stakeholders to provide high-quality mental health support. Validation of the Leora platform through rigorous user testing will be the next step in ensuring the model is effective.

From treatment of mental disorders to the treatment of difficult life situations: A hypothesis and rationale

The group-level symptom-reduction model of mental health care emphasizes predetermined treatment guidelines for those mental and social difficulties that are diagnosable as mental health disorders on the basis of predetermined diagnostic criteria. The model have produced generalizable information to support medical decision-making for symptom reduction. However, it may have also increased the reification of diagnostic labels, and in so doing medicalized and stigmatized complex human-life experiences, with a lack of attention to a range of social determinants and existential factors associated with mental health. Since symptom-reduction model can easily lose sight of essential non-technical and contextual aspects of mental health care, including the quality of the interaction and other common factors needed to understand and treat mental health difficulties, there is doubts that the symptom-reduction model may actually decrease the effectiveness of mental health services, as compared to a holistic approach. Based on recent critiques of the group-level symptom-reduction model to mental health care, and research on common-factor perspectives on mental health treatments, holistic conceptions of humans, and naturalistic outcome studies from several holistic mental health services from different countries, I hypothesized that an ontological turn from the treatment of “mental disorders” to the treatment of “difficult life situations” will lead to a more personalized and comprehensive treatment approach, that mediates an improved effectiveness of mental health services.

„You Won’t Break the Ice and Won’t Talk about It“: Mental Health Professionals’ Difficulties in Providing Assistance to Individuals who Later Suicide

Accessible and effective mental health services for people at risk of suicide are one of the cornerstones of suicide prevention. However, some people suicide while receiving such help, and it is important to understand the reasons for this. In the absence of a direct way to reveal the experiences of people who have received services and subsequently suicided, the professionals providing mental health services are an important source of information on this process. The main aim of this study was to describe the main difficulties experienced by professionals supporting people who later suicided. The sample included 15 mental health professionals (7 psychiatrists, 6 medical psychologists, and 2 social workers) who experienced patient suicide. The data were collected using semi-structured interviews, which were then analysed using thematic analysis. The following themes were identified in the stories of the participants: lack of collaboration from the patient, specific topics that were challenging to work with, treatment limitations, difficulties in assessing suicide risk, reactions experienced when working with the suicidal patient, and the role of the patient’s relatives. Therefore, the results of this study speak about the challenge of being with a patient in a suicidal crisis, who is not inclined to accept help, while bearing the limitations of the system and oneself as a specialist. This causes intense experiences of helplessness and anger.

Profiles of childhood adversity and associated psychopathology in youth entering residential care.

We explore patterns of childhood adversity (CA) in youth entering residential care. We also examine possible sex differences as well as the association between these patterns and key indicators of clinical functioning, including emotional problems, conduct problems, hyperactivity/inattention, prosocial behavior, peer problems, and trauma symptoms. Data were obtained from archival records of 2,066 youth (Mage = 15.57, SD = 1.57) entering a family style residential program for the first time. The sample composition was: 65% boys, 45.8% White, 26.0% Black or African American, 12.5% Hispanic or Latino, 10.5% Multiracial, and 5.1% Other race. Inclusive latent class analysis was used to identify profiles of CA. Profile membership was used to examine sex differences and predict clinical functioning. Five CA profiles were found: (1) Low Exposure, (2) Familial Dysfunction, (3) Neglect/Emotional Abuse, (4) High Exposure without Sexual Abuse, and (5) High Exposure with Sexual Abuse. Girls were more likely than boys to be in Neglect/Emotional Abuse and High Exposure with Sexual Abuse profiles. Each CA profile was associated with distinct clinical outcomes. This study highlights the importance of considering CA patterns when working with youth entering residential care. CA screening and classification during residential care admissions could better inform interventions for youth and their families and potentially improve the effectiveness of mental health services received. Future research should continue to study the connections between CA profiles and clinical outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Perceptions of the key components of effective, acceptable and accessible services for children and young people experiencing common mental health problems: a qualitative study

BackgroundChildren and young people’s (CYP) mental health is a major public health concern internationally and the recent Covid-19 pandemic has amplified these concerns. However, only a minority of CYP receive support from mental health services due to the attitudinal and structural barriers they and their families encounter. For over 20 years, report after report has consistently highlighted the shortcomings of mental health services for CYP in the United Kingdom and attempts to improve services have been largely unsuccessful. The findings reported in this paper are from a multi-stage study that aimed to develop a model of effective, high-quality service design for CYP experiencing common mental health problems. The aim of the stage reported here was to identify CYP’s, parents’ and service providers’ perceptions of the effectiveness, acceptability and accessibility of services.MethodsCase studies were conducted of nine different services for CYP with common mental health problems in England and Wales. Data were collected using semi-structured interviews with 41 young people, 26 parents and 41 practitioners and were analysed using the Framework approach. Patient and Public Involvement was integrated throughout the study with a group of young co-researchers participating in data collection and analysis.ResultsFour key themes defined participants’ perceptions of service effectiveness, acceptability and accessibility. Firstly, open access to support with participants highlighting the importance of self-referral, support at the point of need and service availability to CYP/parents. Secondly, the development of therapeutic relationships to promote service engagement which was based on assessment of practitioner’s personal qualities, interpersonal skills and mental health expertise and underpinned by relational continuity. Thirdly, personalisation was viewed as promoting service appropriateness and effectiveness by ensuring support was tailored to the individual. Fourthly, the development of self-care skills and mental health literacy helped CYP/parents manage and improve their/their child’s mental health problems.ConclusionsThis study contributes to knowledge by identifying four components that are perceived to be central to providing effective, acceptable and accessible mental health services for CYP with common mental health problems irrespective of service model or provider. These components could be used as the foundations for designing and improving services.

Demographic Gradients of Mental Health in University Students: A Study of Medical Interns in Iran

Background: The mental health status of medical students is not optimistic. Understanding the factors associated with their poor mental health can contribute to alleviating this condition. Objectives: This study aimed to examine the mental health status of medical interns and its associated demographic and personal traits. Methods: From 2020 to 2021, 358 interns were enrolled in the study. Goldberg's general health questionnaire (GHQ-28) was used to assess their mental health, with scores ≥ 24 indicating poor mental health. Factors associated with GHQ scores were determined using multivariable regression. Results: Among the study population (age: 25.43 ± 2.31, 49.4% males), GHQ mean score was 30.09 ± 14.44, and 61.7% of interns had GHQ ≥ 24. Female gender (adjusted-OR: 1.78, P: 0.015), low hope for career prospects (adjusted-OR: 4.09, P: 0.001), and low and medium personal life satisfaction (adjusted-OR: 10.94, P < 0.001; adjusted-OR: 2.55, P: 0.001, respectively) significantly increased the risk of having poor mental health. Conclusions: In Iran, more than half of medical interns are not enjoying desirable mental health. Female students are more prone to being mentally unhealthy. Furthermore, lower hope and personal life satisfaction levels negatively affect students' mental health. Related university officials should identify the causes and develop effective preventive and therapeutic mental health services for interns. Female students should be the priority group.