Experience Of Mental Illness Research Articles

"Going Beyond Darkness"-Lingering Images and Ideation of Self-Destruction.

This paper is a personal reflection on the persistence of self-destructive thoughts and ideations in individuals with a history of self-destructiveness. Personal narratives are essential for understanding mental health and illness, particularly for those with a history of self-destructive behaviour. I, a researcher with lived experience of mental illness and self-destructiveness, highlight the importance of presenting them in their raw and unmediated form. This paper is a first-person narrative where I use my own personal experiences to illustrate and analyse the persistence of self-destructive thoughts.

Mental Health Implications of Weight Loss Medications: A Narrative Review

Obesity and mental illness are commonly encountered clinical issues that nurse practitioners manage. A bidirectional and complex relationship exists between these 2 clinical concerns, with management of either condition affecting the other. Individuals with obesity and/or mental illness experience disparities in health outcomes. Even among individuals without mental health conditions, pharmacologic management of obesity can have mental health adverse effects. This review discusses current weight loss medications and their mental health implications. Nurse practitioners caring for individuals with obesity and/or mental health conditions can benefit from considering the effect of each medication on physical and mental health outcomes.

Improving physical healthcare for people experiencing mental illness: The COMITMENT project

Abstract Background People experiencing mental illness (PMI) face significant challenges in accessing and using somatic healthcare services, reducing their overall life expectancy by up to 20 years. The COMITMENT project aimed to identify barriers and facilitators in accessing and using somatic healthcare services for PMI and co-design strategies that could address existing challenges. Methods This study employed a qualitative participatory approach, involving a “trialogic” steering group composed of a person with lived experience of mental illness, a family member and caregiver of PMI, as well as a health professional. Two co-design workshops were conducted with members of each trialogic group, based on “World Café” methodology, facilitating open discussion between and among the three perspectives. Data was gathered through participant observations and systematically collecting participants’ workshop contributions, and analyzed thematically. Results Overall, 52 people participated in the two workshops. Findings identified six overarching themes regarding challenges in somatic healthcare access/use for PMI: (1) accessibility and facility design, (2) support and bureaucracy, (3) awareness among healthcare professionals, (4) societal awareness, (5) structural diversity of services, and (6) lack of networking abilities. Notable insights include inclusivity design requirements for healthcare facilities and the importance of integrating lived experiences of PMI into the training of healthcare professionals to reduce stigma. Conclusions This study underscores the critical need for systemic changes to improve somatic care for PMI. It suggests that greater awareness among healthcare professionals, coupled with more inclusive service design and enhanced networking abilities, could substantially improve the quality of healthcare for PMI. The COMITMENT project provides robust and co-designed results for social, systemic, and political reforms aimed at reducing healthcare inequity. Key messages • This study shows how direct involvement of relevant stakeholders improves the design of interventions that truly meet the needs of people with mental illness regarding somatic healthcare services. • To improve healthcare access and treatment for people experiencing mental illness, systemic social, design, educational, and political changes and adaptations are required.

Complications after cardiac implantable electronic devices in patients with severe mental illness: a Danish nationwide study

Abstract Background Patients with mental illness experience higher rates of postoperative complications and mortality across several types of surgery, but knowledge is lacking in relation to cardiac implantable electronic device (CIED) implantations. Purpose Our study aimed to investigate the 7-day, 30-day, and 90-day postoperative complication rate and mortality in patients with severe mental illness compared to the general population. Methods All adult patients in Denmark with a first-time pacemaker or ICD implantation during the study period from July 1995 to December 2022 were identified using the Danish nationwide registers. Severe mental illness was defined as having a preexisting diagnosis of schizophrenia and other non-affective psychotic disorders, bipolar affective disorders or major depressive disorder. Postoperative complications were obtained as diagnosis codes possibly relating to device implantation and categorized into seven types of complications: arterial thrombosis, venous thrombosis, pneumothorax, bleeding, infection, device function problem, and death. Stratified logistic regression analyses adjusted for sex and age were used to calculate the odds of postoperative complications within 7, 30, and 90 days of device implantation. Results Among 108,790 patients who had a de novo pacemaker or ICD implantation the mean age was 73.5 (± 12.8), 37.5% were women and 3,393 (3.1%) of the patients had preexisting severe mental illness. In total, 10,690 (9.8%) patients had one or more complications within 90 days. The number of patients with severe mental illness who experienced a complication were 407 (12.0%) while it was 10,283 (9.8%) of those without severe mental illness. Odds of death (OR 1.57, 95% CI: 1.03-2.29) were higher in patients with severe mental illness 7 days postoperatively, and 30 days postoperatively odds of venous thromboembolism (OR: 1.69, 95% CI: 1.05-2.56) and death (OR: 1.62, 95% CI: 1.29-2.01) were higher in patients with severe mental illness. 90 days postoperatively odds of venous thrombosis (OR: 1.95, 95% CI: 1.37-2.70), infection (OR: 1.45, 95% CI: 1.16-1.79), and death (OR: 1.40, 95% CI: 1.19-1.65) were higher in patients with severe mental illness compared to patients without severe mental illness, while the odds of pneumothorax were lower at all three time points for patients with severe mental illness (OR 7-days: 0.49, 95% CI: 0.21-0.95). The odds of arterial thrombosis, bleeding and device function problems were similar between the two groups at all three time points. Conclusion Severe mental illness was associated with increased risk of several types of complications and death following CIED implantation. This indicates that further care and attention is needed to ensure adequate treatment of patients with severe mental illness suffering from cardiac arrhythmias.Forest plot, SMI: severe mental illness

An exploratory cross-cultural study of community-based health literacy interventions to promote the mental well-being of disadvantaged and disabled young Africans: a multi-method approach.

This study explores the impact of community-based health literacy interventions on the health and mental well-being of disadvantaged young Africans in Zambia, Sierra Leone, Rwanda, and South Africa. The pandemic has exacerbated mental health problems amongst children and young people, underscoring the urgent need for equitable access to mental healthcare resources. Emphasizing the importance of equitable access to mental healthcare resources, the research addresses educational and income disparities in low- and middle-income countries (LMICs), particularly amongst young Africans with disabilities or vulnerabilities. The study comprised 1,624 young Africans, of whom 1,592 were surveyed, while 191 later participated in in-depth interviews and focus groups. Additionally, 32 participants exclusively joined focus groups. Participants were recruited to complete the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS), WHO-5 Well-being Index, Pandemic Anxiety Scale (PAS), and Self-rating of Happiness, as well as semi-structured interviews or focus groups. The findings highlight the significance of tailored health literacy interventions in addressing mental health challenges and promoting well-being in marginalized African communities. In the sample, 43.1% (686) reported to have at least a physical disability or serious health condition and 51.4% (818) had special educational needs (SENs). Mental health scores were significantly lower in participants with two or more physical disabilities and pre-existing mental health problems. Factors significantly associated with poor mental health included poor health literacy, physical disabilities, and pre-existing mental health problems. Four main themes were generated from the thematic analysis: early childhood trajectories and mental illness experiences; positionality, open communication, and mental illness experience; mental illness experience, emotional honesty, and social stratification; and spirituality, cultural beliefs, and mental illness experience. The study emphasizes the need for context-specific, culturally appropriate health literacy interventions to support the mental health and well-being of young Africans in LMICs. By focusing on the lived experiences of disadvantaged groups, the research contributes to a better understanding of effective strategies for promoting health literacy and addressing health inequalities in African communities during and after health emergencies.

Peer navigation intervention for individuals with serious mental illness reentering the community after jail incarceration: a qualitative case study

BackgroundCriminal legal system-involved individuals with serious mental illness (SMI) experience more challenges accessing mental health and other community services than those without a history of criminal legal system involvement. A formative qualitative study was conducted to explore feasibility and acceptability and inform the adaptation of a mental health peer navigation intervention for individuals with SMI reentering the community after jail incarceration.MethodsIn-depth qualitative interviews and focus-group discussions were conducted with mental health peer navigators (i.e., certified mental health peer support specialists, peer recovery coaches) and individuals with lived experience of SMI and criminal legal system involvement (N = 20 total). Data were analyzed using applied thematic analysis.ResultsFour major themes emerged: (1) Feasibility and acceptability of peer-provided services: all participants reported that peer navigation services would be feasible and acceptable for individuals with SMI reentering the community after jail incarceration; (2) roles of peer navigators in addressing barriers to care: peers can address barriers to care experienced during community reentry and contribute towards service linkage/engagement; (3) shared identity and combating stigma: having a shared identity with peer navigators may minimize the impact of stigma and make it easier for clients with multiple marginalized identities to seek support; and (4) peer navigator skills and recommendations for the planned program: essential peer navigation skills include authenticity, reliability, active listening, advocacy, trauma-informed care, motivational interviewing, and empathy. Recommendations for the planned program include initiating services while clients are in custody, emphasizing the voluntary nature of peer support, knowing the limits of a peer navigation intervention, and offering support for peer navigators while on the job.ConclusionParticipants saw peer navigation services for individuals with SMI with criminal legal system involvement as potentially feasible and acceptable. Such programs may enhance their impact by offering supportive supervision, emphasizing the voluntary nature of the service, and acknowledging recovery as a self-directed endeavor.

Coping style as a predictor of anxiety in relatives of patients with mental illness-a single-center study

BackgroundRelatives of patients with mental illnesses such as schizophrenia and depression experience significant levels of anxiety. Accurately predicting their anxiety levels is crucial for the development of effective anti-anxiety interventions aimed at mitigating associated adverse outcomes.MethodsIn this cross-sectional study, 238 relatives of patients with mental illness were recruited, and their responses were collected using the generalised anxiety disorder-7 (GAD-7) and simplified coping style questionnaire (SCSQ) scales. One-way analysis of variance and t-test were used to assess the mean scores of GAD-7 and SCSQ among relatives with varying characteristics. Pearson’s correlations were used to examine the correlation between anxiety levels and coping style. Multi-level regression analyses were used to identify the impact of the independent variables on anxiety.ResultsAmong all relatives of patients with mental illness who participated in this survey, 238 completed the questionnaire. Females exhibited a higher mean GAD-7 score (9.72 ± 0.25) compared to males. Among participants aged 18–25 years, the GAD-7 (8.12 ± 0.17) score was the highest. Additionally, relatives of patients experiencing their first episode or with a disease duration of < 1 year, as well as relatives of patients with schizophrenia and depression, displayed higher GAD-7 scores. Correlation analysis revealed a positive correlation between anxiety and SCSQ (negative coping styles) (r = 0.476, p < 0.01). Multi-level regression analyses demonstrated that demographic variables (R2 = 0.474, F = 21.402, p < 0.01) and SCSQ (R2 change = 0.638, F = 37.526, p < 0.01) were significantly and positively associated with anxiety among relatives of patients with mental illness.ConclusionsMost relatives of patients with mental illness experience varying levels of anxiety, which are influenced by their coping styles.

Qualitative Exploration of Experiences of Mental Illness and Stigma Management Strategies Among University Students in Lahore

Current literature on student mental health offers ample evidence of a worldwide increase in the prevalence of mental health issues among university students. However, there is limited literature from a social constructionist approach within Pakistan examining the student perception of mental illness, stigma, stigma management, and barriers to help-seeking. This study attempts to bridge the gap by conducting a descriptive qualitative study using the social constructionist framework to understand the perception of mental illness and its corresponding stigma in a fluid, non-canonical fashion. Semi-structured interviews with 11 university students reveal the personalized meanings given to the critical terms within the study. Intersectional dimensions of gender, class, and level of education are extensively explored, considering the student’s perceptions. The reflexive thematic analysis identifies perceived determinants of mental illnesses, the perceived relationship between mental illness and stigma, stigma management strategies employed by respondents, and perceived coping mechanisms. In Pakistan, where mental illness is not only prevalent but highly stigmatized, this research hopes to be a valuable addition to scholarly research on mental health and illness among young people in higher education institutes.

Care models for coexisting serious mental health and alcohol/drug conditions: the RECO realist evidence synthesis and case study evaluation.

People with severe mental illness who experience co-occurring substance use experience poor outcome including suicide, violence, relapses and use of crisis services. They struggle to access care and treatment due to a lack of an integrated and co-ordinated approach which means that some people can fall between services. Despite these concerns, there is limited evidence as to what works for this population. To undertake a realist evaluation of service models in order to identify and refine programme theories of what works under what contexts for this population. Realist synthesis and evaluation using published literature and case study data. Mental health, substance use and related services that had some form of service provision in six locations in the United Kingdom (five in England and one in Northern Ireland). People with lived experience of severe mental illness and co-occurring substance use, carers and staff who work in the specialist roles as well as staff in mental health and substance use services. Eleven initial programme theories were generated by the evidence synthesis and in conjunction with stakeholders. These theories were refined through focus groups and interviews with 58 staff, 25 service users and 12 carers across the 6 case study areas. We identified three forms of service provision (network, consultancy and lead and link worker); however, all offered broadly similar interventions. Evidence was identified to support most of the 11 programme theories. Theories clustered around effective leadership, workforce development and collaborative integrated care pathways. Outcomes that are meaningful for service users and staff were identified, including the importance of engagement. The requirement for online data collection (due to the COVID-19 pandemic) worked well for staff data but worked less well for service users and carers. Consequently, this may have reduced the involvement of those without access to information technology equipment. The realist evaluation co-occurring study provides details on how and in what circumstances integrated care can work better for people with co-occurring severe mental health and alcohol/drug conditions. This requires joined-up policy at government level and local integration of services. We have also identified the value of expert clinicians who can support the workforce in sustaining this programme of work. People with co-occurring severe mental health and alcohol/drug conditions have complex and multifaceted needs which require a comprehensive and long-term integrated approach. The shift to integrated health and social care is promising but will require local support (local expert leaders, network opportunities and clarity of roles). Further work should evaluate the effectiveness and cost-effectiveness of service models for this group. This study is registered as PROSPERO CRD42020168667. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: NIHR128128) and is published in full in Health Technology Assessment; Vol. 28, No. 67. See the NIHR Funding and Awards website for further award information.

Using Intervention Mapping to co-design a psychosocial service with youth experiencing mental illness

BackgroundDescriptions of service development processes in the youth mental health sector are lacking. Further, youth with lived experience of mental illness are rarely involved in service design. Intervention Mapping (IM) is a well-established framework for program development, implementation and evaluation, yet its applicability in the youth mental health sector is unknown. This paper describes the use of IM methodology to co-design and develop a psychosocial service to support youth aged 10-25 years experiencing mental illness in Tasmania, Australia. MethodsThe six steps of IM were followed: 1) needs assessment; 2) define program outcomes and objectives; 3) program design; 4) program production; 5) implementation planning; and 6) evaluation planning. ResultsKey outputs of each IM step are described. The service was successfully co-designed with young people at the centre of each step. The service includes wrap-around psychosocial support from lived-experience peer-support workers; outreach; and flexible frequency/intensity/duration to achieve young people’s psychosocial goals. ConclusionsThis is the first study to document the use of IM in co-designing a psychosocial service with youth experiencing mental illness. IM may provide a valuable roadmap for the youth mental health sector in supporting collaborative service design, implementation and evaluation planning, and systematic documentation of service development.

Predicting Parental Post-Traumatic Stress Symptoms Following their Child's Stay in a Pediatric Intensive Care Unit, Prior to Discharge.

Objective: Develop an inpatient predictive model of parental post-traumatic stress (PTS) following their child's care in the Pediatric Intensive Care Unit (PICU). Design: Prospective observational cohort. Setting: Two tertiary care children's hospitals with mixed medical/surgical/cardiac PICUs. Subjects: Parents of patients admitted to the PICU. Interventions: None. Measurements and Main Results: Preadmission and admission data from 169 parents of 129 children who completed follow up screening for parental post-traumatic stress symptoms at 3-9 months post PICU discharge were utilized to develop a predictive model estimating the risk of parental PTS 3-9 months after hospital discharge. The parent cohort was predominantly female (63%), partnered (75%), and working (70%). Child median age was 3 years (IQR 0.36-9.04), and more than half had chronic illnesses (56%) or previous ICU admissions (64%). Thirty-five percent (60/169) of parents met criteria for PTS (>9 on the Post-traumatic Stress Disorder Symptom Scale-Interview). The machine learning model (XGBoost) predicted subjects with parental PTS with 76.7% accuracy, had a sensitivity of 0.83 (95% CI 0.586, 0.964), a specificity of 0.72 (95% CI 0.506, 0.879), a precision of 0.682 (95% CI 0.451, 0.861) and number needed to evaluate of 1.47 (95% CI 1.16, 1.98). The area under the receiver operating curve was 0.78 (95% CI 0.64, 0.92). The most important predictive pre-admission and admission variables were determined using the Local Interpretable Model-Agnostic Explanation, which identified seven variables used 100% of the time. Composite variables of parental history of mental illness and traumatic experiences were most important. Conclusion: A machine learning model using parent risk factors predicted subsequent PTS at 3-9 months following their child's PICU discharge with an accuracy of 76.7% and number needed to evaluate of 1.47. This performance is sufficient to identify parents who are at risk during hospitalization, making inpatient and acute post admission mitigation initiatives possible.

A comparison of challenging and positive caregiving experiences for caregivers of individuals with schizophrenia spectrum and bipolar disorders

BackgroundCaregivers of people with serious mental illness experience challenges that may affect their mental health. Few researchers have explored whether positive or negative caregiver experiences differ due to disorder characteristics of the person receiving care. We aimed to determine whether caregiver appraisals and psychological functioning differed between caregivers of those diagnosed with schizophrenia spectrum (SSD) and bipolar disorder (BD). MethodsCaregivers of people with SSD and BD participated in an online self-report survey assessing appraisals, distress, anxiety, depression, and psychological wellbeing. Independent samples t-tests and multivariate generalised linear models determined group differences, and Pearson correlation coefficients and Fisher z-score transformations determined differences in the strength of correlations between groups. Results108 caregivers participated in the study. Caregivers of people with SSD reported significantly greater negative appraisals of the care recipient's negative symptoms and dependency. Caregivers did not differ on positive appraisals. Both groups reported moderate distress, mild anxiety and depression, and moderate psychological wellbeing, but did not differ. Higher negative caregiver appraisals were more strongly associated with higher distress, anxiety and depression, and lower psychological wellbeing, for caregivers of those with SSD than BD. LimitationsSmall between group sample sizes, and analyses may have been moderated by significant demographic differences between groups. ConclusionsCaregivers can experience difficulties associated with their role, and some differences may be attributed to the care recipient's disorder. Future research and interventions should consider specific disorder characteristics, such as symptom profiles, to better support caregivers in having their specific needs addressed whilst themselves providing care.

Internalized stigma and its correlates in families of persons with mental illness in Qatar: a cross-sectional study

AbstractPersons with mental illness (PWMI) experience rejection, isolation, and discrimination in employment, education, and housing due to the prejudice associated with the illness. Families affiliated with PWMI often internalize the public’s prejudice towards mental illness. Such internalized stigma can further impact the health and quality of life of both PWMI and their families. This study aimed to examine the level and correlates of internalized stigma in family members of PWMI in Qatar. A cross-sectional study of 106 family members was conducted using the Family Internalized Stigma Mental Illness Scale. The mean stigma score was 2.04 suggesting a mild level of stigma overall. Being married was found to be a predictor of higher levels of internalized stigma, while having college education or higher predicted lower levels of stigma. The overall stigma scores among family members were not high, which may reflect the protective stance families take towards about their relatives with mental illness. Some sociodemographic attributes predicted trends in internalized stigma among our surveyed sample. Future research efforts in this area may help increase understanding of internalized stigma in this population to inform stigma reduction efforts.

Creating communities that care: social representation of mental health in two urban poor communities in Ghana

Building caring communities is fundamental to achieving a community-based approach to mental health. Understanding how communities perceive mental illness provides critical insight into fostering mental health awareness and care. We explored the perceptions of mental illness among members of two urban poor communities in Accra, Ghana. Qualitative data were collected from 77 participants through key informant interviews, focus group discussions, and situated conversations. Using theory-driven thematic analysis based on social representations theory, findings revealed cognitive-emotional representations of mental illness. The communities demonstrated high awareness of the multilevel factors contributing to mental illness risk and experiences, drawing on five sources of knowledge: embodied, common sense, medical, cultural, and religious. Mental illness representations informed the classification and legitimization of mental illness based on the severity of conditions and the identity of sufferers. These findings provide valuable insights for planning community mental health interventions that address both social and institutional care needs.

A forgotten pioneer in Australian psychiatry: Dr Edward Waldegrave Wardley (1813-1872).

British-born Dr Edward Waldegrave Wardley (MRCSL, 1842) is an unacknowledged pioneer in the history of mental health care in Australia. Between 1857 and 1872, he assisted in the development of a policy of non-restraint across lunatic asylums in New South Wales (NSW). He then went on to extend this approach to the treatment of NSW's criminally insane patients. In addition, he trialled experiments to intellectually engage educated psychiatric patients across the colony. A prolific writer, and sufferer of chronic depression, Dr Wardley serves as a unique example of a nineteenth-century alienist with lived experience of mental illness.

Echoes of Madness: Exploring Disability and Mental Illness in Hellblade: Senua’s Sacrifice

Video games are known for many things, but nuanced portrayals of characters with mental illness might not be one of them. This trend, however, has gradually started to shift with games like Hellblade: Senua’s Sacrifice, which aim to convey a genuine experience of mental illness to the player. Through a close reading of different instances in the game, this paper shows how Hellblade complicates the usual sanist ideas seen in most other games by taking an ambiguous stance, using mental illness as a representational tool. Furthermore, it avoids some of the more sensationalist and problematic tropes often employed in such representations, like the supercrip and the Cartesian divide of the body and mind. In order to show this, we have employed Mitchel and Snyder’s concept of narrative prosthesis to demonstrate how the game does not in fact rely on Senua’s disability as an exotic feature of the narrative to hook players in. By combining insights from disability and mad studies, we show how this game is a step in the right direction when it comes to challenging the perceptions of mental illness prevalent in pop culture.

Examining bystander intervention for peer depression and sociodemographic correlates among university students in Singapore.

The Advancing Research To Eliminate Mental Illness Stigma (ARTEMIS) study evaluated the impact of an intervention developed and implemented in Singapore on attitudes towards depression in university students. We aimed to assess the likelihood of university students intervening when their peers suffer from depression, before and after the ARTEMIS intervention. 390 students were recruited from a university in Singapore. The ARTEMIS intervention comprised a lecture by a trained mental health professional, a sharing session by a person with lived experience of depression, and a question-and-answer segment with a panel. The Bystander Intervention Scale for Depression (BISD) was administered at baseline, post-intervention, and 3-month follow-up. BISD assessed four factors: acceptance of responsibility to intervene, knowledge on how to intervene, awareness of depression among peers, and vigilance towards possible symptoms of depression. Linear mixed models were conducted to investigate associations. Sociodemographic correlates were also examined. A favourable shift in all factors was observed at post-intervention, which weakened at 3-month follow-up. Having past experience in the mental health field (β=1.50) and older age (β=0.18) were significantly associated with knowledge on how to intervene. Having social contact with mental illness (SCMI) and past experience in the mental health field (PEMHF) were significantly associated with awareness of depression among peers (SCMI β=0.89, PEMHF β=0.43) and vigilance towards possible symptoms of depression (SCMI β=0.39, PEMHF β=0.61). The short-term results of the intervention appeared promising across all BISD factors; however, these results were not sustained after 3 months. Future research should include the impact of 'booster' interventions over time. Sociodemographic factors that were identified to be significant correlates should also be considered when planning for future interventions.

Oral health knowledge, attitudes, and practices of people living with mental illness: a mixed-methods systematic review

People living with mental illness experience poorer oral health outcomes compared to the general population, yet little is known about their oral health knowledge, attitudes, and practices. The aim of this mixed-methods systematic review was to synthesise evidence regarding oral health knowledge, attitudes, and practices of people living with mental illness to inform preventative strategies and interventions. Database searches were conducted in PubMed, MEDLINE, PsycINFO, CINAHL, ProQuest, and Scopus with no limitations placed on the year of study. All studies available in the English language, that explored the oral health knowledge, attitudes, and/or practices of people with a mental illness were included. Articles were excluded if they primarily pertained to intellectual disability, behavioural and psychological symptoms of dementia, drug and alcohol or substance use, or eating disorders. A thematic synthesis was undertaken of 36 studies (26 high-moderate quality), resulting in 3 themes and 9 sub-themes. Study participants ranged from n = 7 to n = 1095 and aged between 15–83 years with most having a diagnosis of schizophrenia, schizoaffective, or bipolar affective disorder. People diagnosed with a mental illness were found to have limited oral health knowledge, particularly regarding the effects of psychotropic medication. Various barriers to oral health care were identified, including high dental costs, the negative impact of mental illness, dental fears, lack of priority, and poor communication with dental and health care providers. Study participants often displayed a reduced frequency of tooth brushing and dental visits. The findings highlight the potential for mental health care providers, oral health and dental professionals, mental health consumers, and carers to work together more closely to improve oral health outcomes for people with mental illness. The systematic review protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO), (registration ID CRD42022352122).

Contextualising mental health: interdisciplinary contributions to a new model for tackling social differences and inequalities in mental healthcare

ABSTRACT Many classical approaches in the area of phenomenological pscyhopathology focus on structures of lived experience of mental illness and overlook the role social context plays in the formation of lived experiences. The paper addresses this issue and contributes to recent research which has pointed out that there is a need for an approach to mental health which investigates the role of context in shaping lived experiences. We propose a conception of contextuality (or situatedness) which we develop in terms of two main characteristics: intersectionality and social relationality of the human condition. We take context to be shaped by social interdependence and by the intersection of multiple factors including gender, race, ethnicity, class, socio-economic status and power relations. We develop this analysis in relation to substance misuse, refer to, and compare, certain case studies and perspectives from Brazil to illustrate our approach which can, however, be applied to other areas of mental health. We suggest that the proposed contextual approach is crucial for an in-depth understanding of psychopathology from a phenomenological perspective and in relation to contemporary ethico-political issues concerning social differences and inequalities in mental health.

Attitudes and Knowledge of Electroconvulsive Therapy: An Exploration of Medical Students' Perspectives.

To explore knowledge and attitudes of medical students before and after exposure to a technology-enhanced learning and teaching (TELT) session about electroconvulsive therapy (ECT). Adequate knowledge of and attitudes toward ECT is essential for medical students. However, the impact of teaching on knowledge and attitudes is infrequently studied. Fourth- and fifth year medical students at the University of Glasgow were provided with an online questionnaire before and after engaging in a remote TELT session, led by a consultant psychiatrist with expertise in ECT. The online teaching session used resources developed by a multidisciplinary team who specialize in ECT. The teaching session lasted around 1 hour. The questionnaire contained 3 sections: baseline demographics, knowledge of ECT, and attitudes toward ECT. Changes in scores were analyzed. Sixty-seven students completed the teaching session. Response rate to the precourse questionnaire was 68.7% (n = 46), and the postcourse questionnaire was 44.8% (n = 30). Prior to engaging with the learning materials, 9 students reported no knowledge of ECT and a third believed that ECT did not cause a seizure. In general, students who had personal experience of mental illness (friend, relative, or self) had more positive attitudes toward ECT and higher knowledge scores. In general, an increase in knowledge and attitude scores was found in the postcourse questionnaire. Exposing medical students to a TELT session focused on ECT during their psychiatric placement appeared to improve knowledge and attitudes surrounding ECT.