Impact Of Mental Health Difficulties Research Articles

Saving and Empowering young lives in PAKistan (SEPAK): An Exploratory Cluster Randomized Controlled Trial (cRCT)

IntroductionSuicide is a leading cause of death among young people and most deaths by suicide occur in low and middle-income countries. School is the best place where we can identify and respond to youth suicide risk. School-based interventions for suicide prevention in young people have been successful across US, Europe and Australia, but require adaptations to be acceptable and feasible in Pakistan.ObjectivesTo develop and test culturally adapted preventative interventions for suicidal behaviours among pupils in secondary schools in Pakistan. The qualitative component aimed at exploring the views of students, parents, teachers and general practitioners on cultural adaptation, experience of participation, areas of improvement and suggestions for scale-up of the school-based suicide prevention program (SEPAK).MethodsA clustered randomised controlled trial. The four culturally modified interventions 1) Linking Education and Awareness of Depression and Suicide Awareness (LEADS) Training for pupils (students=260) 2) the Question, Persuade, and Refer (QPR) for teachers (students=203) 3) QPR for parents (students=445); 4) Screening by Professionals (Profscreen) (students=260) were compared against control intervention (educational posters) (students=227). Structured questionnaires were administered at baseline and 1-month post-intervention to assess suicidal behaviours, psychological well-being and quality of life. A total of 8 focus groups (FGs) were conducted at pre and post intervention stage with each stakeholders.ResultsPatient and public involvement and Engagement (PPIE) was strongly embedded in the project to ensure meaningful benefits for participants. A total of 40 schools were recruited from 8 cities across Pakistan. A total of 243 students attended LEADS intervention, 92 teachers and 304 parents completed QPR training, and 9 general practitioners were trained in ProfScreen. The retention rate at follow-up was 99% that shows feasibility of delivering intervention package in Pakistan. All participants marked SEPAK as effective in identifying risk of and preventing self-harm and suicide in young people and in improving pathways to treatment. Interventions were perceived as helpful in improving knowledge about mental health, impact of mental health difficulties on functioning, reducing stigma, equipping stakeholders to identify and signpost at-risk people. Improvement in clinical and teaching practice as well as understanding others behaviors were also reported.ConclusionsThis study suggest feasibility of integrating a suicide prevention program in existing educational system and highlights positive role of creating awareness about suicide in youth, introduction of school-based mental health programs, parental counseling and strengthening of the health system by training general practitioners in early identification of suicide risk and promoting suicide prevention strategiesDisclosure of InterestNone Declared

Predictors of contact with services for mental health problems among children with comorbid long-term physical health conditions: a follow-up study

Children with long-term physical health conditions (pLTCs) are at increased risk of developing mental health comorbidities, although most do not access services for their mental health. No previous studies have examined the determinants of contact with services for mental health concerns among this group of children. This 3-year longitudinal study involved a population-based sample of children aged 5–16 years from the British Child and Adolescent Mental Health Surveys conducted in 1999 and 2004. In children with comorbid pLTCs and mental health disorders at baseline (N = 397), we examined associations between several child-, family- and service-related factors and (a) contact with primary health care, (b) contact with paediatrics and (c) contact with child and adolescent mental health services over 3-year follow-up (2002 and 2007). Separate multivariable binary logistic regressions were conducted for each service. The impact of mental health difficulties on the child and contact with the teacher predicted contact with all three services. Adolescent age, female gender, larger family size, some or marked academic difficulties, and having parents with educational qualification(s) were specific predictors of contact with primary health care. Male gender, stressful life events, and contact with primary health care were specific predictors of contact with child and adolescent mental health services. No other factors predicted contact with paediatrics. Our findings highlight the role of child-, family-, and service-related factors in accessing mental health care in children with comorbid pLTCs and mental health disorders which could inform planning and provision of services to reduce unmet mental health needs.

Assessing the impact of mental health difficulties on young people’s daily lives: protocol for a scoping umbrella review of measurement instruments

IntroductionAn important consideration for determining the severity of mental health symptoms is their impact on youth’s daily lives. Those wishing to assess ‘life impact’ face several challenges: First, various measurement...

Calidad de Vida y Salud Mental en Adultos Adoptados

This paper analyses psychological adjustment and checks a suggested theoretical model that relates the presence of psychopathological symptoms to a worse health-related quality of life (HRQOL) in adult adoptees. The sample consisted of 177 young adopted adults (mean age 27.67). Measures of psychopathological symptoms (SCL-90), quality of life (SF-12), self-esteem (RSES), and resilience (BRS) were taken. The multiple mediation model shows that, in addition to the direct association between psychopathological symptomatology and a poorer HRQOL, resilience, and self-esteem have a buffering effect on this relationship. As a conclusion, empirical evidence of the impact of mental health difficulties on the HRQOL of adopted people is shown. The presence of positive psychological resources, such as resilience and self-esteem, causes psychopathological dimensions, such as anxiety, depression, phobias, or psychoticism to decrease. This paper supports the inclusion of resilience-building programs as a health promotion strategy, especially in the case of psychopathology, and among post-adoption services.

Quality of life for older autistic people: The impact of mental health difficulties

BackgroundHaving a mental health condition is related to significantly lower subjective Quality of Life (QoL) for people on the autism spectrum. Many autistic people do not participate in so-called ‘normative’ outcomes, i.e. the achievement of lifecourse goals judged to be important by adults in the general population (e.g. being employed). This study aimed to investigate whether there is an association between the presence of mental health conditions, subjective QoL and participation in normative outcomes in older autistic people. Methods69 autistic people (n = 48 males) aged 55 years and over were identified from two studies that are part of the UK Autism Spectrum Adulthood and Ageing research programme. Participants provided demographic data to establish normative outcome participation, and completed the World Health Organisation (WHO) QoL measure (WHOQoL-BREF) and the Hospital Anxiety and Depression Scale (HADS). Illustrative quotes focusing on normative outcomes were available from in-depth interviews (n = 8). ResultsQoL scores across all domains were lower for individuals who met indicative clinical cut-offs for depression (F(8,126) = 6.171, p < 0.001); findings were similar for anxiety (F(8,126) = 3.902, p < 0.001). Subjective QoL did not differ according to participation in normative outcomes (F(12,124.64) = 1.363, p = 0.192). The illustrative quotes suggested that aspects of daily life were related to QoL (i.e. friendships). ConclusionsFor older autistic people, the presence and severity of a likely mental health condition (i.e anxiety and depression) were associated with poorer QoL. However, participation in general population lifecourse goals may not well represent QoL of older autistic people, suggesting that service supports should be individually responsive.

Supporting the mental health of children and young people: An exploratory survey of secondary school views and service needs

Young people’s mental health is an increasingly prominent issue in Scotland. Closing the attainment gap is a key priority of the Scottish Government’s National Improvement Framework. Given the established link between adverse childhood experiences and mental health difficulties and the impact of mental health difficulties on educational attainment and life outcomes, it is crucial to ensure that schools are well-equipped to support pupils with mental health difficulties. This report outlines the results of an exploratory survey of a convenience sample of 12 secondary schools across Scotland looking at current practice and policies. The practice implications of these findings are discussed.

Carers and co-production: enabling expertise through experience?

Purpose– The purpose of this paper is to provide a brief overview of the literature to date which has focused on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration.Design/methodology/approach– The paper presents key outcomes from studies which have explicitly attempted to introduce co-produced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice.Findings– Informal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision making. This issue is considered alongside new policy recommendations which advocate the development of co-produced services and care.Research limitations/implications– Despite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic.Practical implications– Despite these challenges, coproduction in mental healthcare represents a real opportunity for the skills and experience of family members to be taken into account and could provide a mechanism to achieve the “triangle of care” with input, recognition and respect given to all (service users, carers, professionals) whose lives are touched by mental distress. However, lack of attention in relation to carer perspectives, expertise and potential involvement could undermine the potential for coproduction to act as a vehicle to encourage person-centred care which accounts for social in addition to clinical factors.Social implications– The families of people with severe and enduring mental illness assume a major responsibility for the provision of care and support to their relatives over extended time periods (Roseet al., 2004). Involving carers in discussions about care planning could help to provide a wider picture about the impact of mental health difficulties, beyond symptom reduction. The “co-production of care” reflects a desire to work meaningfully and fully with service users and carers. However, to date, little work has been undertaken in order to coproduce services through the “triangle of care” with carers bringing their own skills, resources and expertise.Originality/value– This paper debates the current involvement of carers across mental healthcare and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and satisfaction with mental healthcare. The critique of current work highlights the danger of increasing expectations on service providers to undertake work aligned to key initiatives (shared decision-making, person-centred care, co-production), that have common underpinning principles but, in the absence of practical guidance, could be addressed in isolation rather than as an integrated approach within a “triangle of care”.

The Extent and Specificity of Relative Age Effects on Mental Health and Functioning in Early Adolescence

PurposeAlthough extensive evidence indicates that being younger within a school cohort is associated with poorer academic functioning, much less is known about such relative age effects (RAEs) for mental health - the focus of the current investigation. MethodsData from 23,379 11- to 13-year-olds attending state-maintained secondary schools in England were analyzed to investigate RAEs on mental health measured using the Strengths and Difficulties Questionnaire. Participants were grouped into oldest, middle, and youngest thirds of their academic year based on their month of birth relative to their cohort. Hierarchical linear regression analysis evaluated RAEs and gender- or deprivation-related moderation of such effects. ResultsRelatively younger adolescents had significantly more emotional symptoms and peer problems compared with relatively older individuals in a year group, although effect sizes were small. These effects were not moderated by gender or deprivation. Impact of mental health difficulties on other aspects of functioning was also greater among relatively younger children. Larger RAEs are observed in the younger cohort (11–12 years) compared with those in the 12- to 13-year-olds, thereby indicating that RAEs might attenuate with age. ConclusionsBeing relatively younger than classmates is associated with increased internalizing symptoms, poorer peer relationships, and higher impact of mental health difficulties on functioning at school and home. The findings support wider inclusion of relative age in understanding mental health difficulties and its inclusion as a potential risk factor in studies investigating the development of psychopathology, especially for internalizing symptoms. Possible mechanisms of the effects detected are discussed.

The effectiveness of a universal school-based programme on coping and mental health: a randomised, controlled study of Zippy’s Friends

The purpose of this study was to evaluate Zippy’s Friends, a universal school programme that aims at strengthening children’s coping skills. The sample consisted of 1483 children (aged 7–8 years) from 91 second-grade classes in 35 schools. The schools were matched and randomly assigned to intervention or control conditions. Coping was assessed by the Kidcope checklist for children and an adapted version for parents. Parents and teachers reported mental health outcomes using the Strengths and Difficulties Questionnaire. Controlling for the hierarchical structure of the data, latent variable regression analysis indicated that the programme had a significant positive effect on coping and on the impact of mental health difficulties in daily life. Subgroup analyses suggested that coping was improved in girls and children from the low socio-economic subgroup, whereas the impact of mental health difficulties was reduced in boys.