Informal Mental Health Research Articles

Factors associated with intentions to seek formal and informal mental health help among college students with suicidal thoughts and behaviors

Objective Identify factors associated with formal and informal mental health help-seeking intentions among college students reporting suicidal thoughts and behaviors (STBs). Participants College students with STBs in the 2018-2020 Healthy Minds Study. Methods Cross-sectional secondary analysis using logistic regressions to determine whether demographic (age, sex, race, religion, and finances) and psychosocial factors (mental health, perceptions about mental health help, and barriers) are associated with (in)formal help-seeking intentions. Results Positive significant factors for all help-seeking intentions included being in a romantic relationship, Christian, symptoms of anxiety, or positive beliefs and knowledge about therapy efficacy. Depressive symptoms, Black/African American, psychological inflexibility, low perceived need, and barriers were negatively associated. Informal help-seeking was negatively associated with Hispanic/Latinx and personal stigma toward mental health. Formal help-seeking was positively associated with Asian/Asian American and negatively associated with financial stress. Conclusions Unique factors were associated with formal or informal help-seeking intentions in college students with STBs.

Mental Health Carers’ Support Experiences in Australia

Informal mental health carers play a crucial role in supporting individuals with depression and anxiety. However, there is a lack of knowledge on how to effectively support these carers and promote their well-being. This mixed-method study aimed to explore the support needs of carers of a person with depressive or anxiety symptoms, living in Australia. Sixty-seven carers (female 76 %, median age 48) completed an online survey, and 22 completed semi-structured interviews about their support experiences. Over half of the survey respondents reported high levels of psychological distress on the Kessler Psychological Distress Scale (K10), and 63% reported understanding and adjusting to the caregiving role as the most needed areas of support, as identified on the Caregiver Perspective Questionnaire (CPQ). Through thematic analysis of the interviews, four key themes emerged describing carers’ support experiences and needs: connecting with formal services, responding to the care-recipient, connecting socially, and caring for the self. The analysis also found that time constraints and stigma can be significant support barriers for these carers. This is the first time that a study has investigated the support experiences and needs of carers of a person with depressive or anxiety symptoms, living in Australia. The findings contribute to current literature on mental health carers and offer novel and tangible insights into future research and support opportunities.

Evaluating mental health awareness and attitudes among international students in Japan during the COVID-19 pandemic

ObjectivesInternational students in Japan face unique mental health challenges stemming from cultural and linguistic differences, potentially accentuated by the COVID-19 pandemic. However, research on the mental health of this demographic is scarce. This study aims to describe their mental health status, awareness of mental health resources, and attitudes toward seeking mental health support. MethodsThis study conducted analyses based on data collected though an online survey at a national university in Japan during October and November 2022. International students were surveyed about their mental health status, awareness, and attitude. Descriptive statistics and Chi-square tests were employed to examine the associations between survey responses and demographic variables. ResultsAmong the 116 surveyed participants, 6.9% reported experiencing poor mental health, 16.4% rated their mental health as fair, and 1.7% expressed uncertainly about their mental health status. Similarly, 4.3% indicated poor physical health, 21.6% rated their physical health as fair, and 0.9% expressed uncertainty about their physical health. Additionally, 16.4% felt that their mental health adversely affected their daily life and academics, and 12.1% believed that their physical health had a similar negative impact. Awareness of mental health resources was notably low, with only 25.9% of students being informed. Furthermore, limited awareness was observed among older students (χ2 = 8.176, p < 0.01), degree-seeking students (χ2 = 4.727, p < 0.05), and those from African countries (χ2 = 4.721, p < 0.05), compared to their counterparts. A total of 10.4% expressed reluctance to pursue informal mental health support, and 9.5% showed similar reservations about seeking formal support. ConclusionThe study underscores the critical need for targeted outreach and the development of accessible, culturally sensitive mental health interventions for international students in Japan. Enhancing awareness and accessibility of mental health resources can contribute to the wellbeing of this demographic, potentially improving academic outcomes and fostering a more inclusive, supportive environment for international students, thereby advancing international collaboration and understanding.

Depression and help-seeking behaviors among college students: Findings from the Healthy Minds Study 2018-2019

Objective To determine the likelihood of using formal and informal mental health services among college students according to prior history of depression diagnosis and presence of depression symptoms. Participants College students from 79 universities in the U.S. and Canada who participated in the Healthy Minds Study, 2018-2019. Methods Odds ratios and 95% confidence intervals via logistic regression were estimated for the likelihood of using informal and formal mental health services stratified by depression diagnosis and severity of depression symptoms and further stratified by race/ethnicity. Results We report increased odds of using formal mental health services with increasing depression severity symptoms and increased odds of using formal mental health services among students without a clinical depression diagnosis. The odds of service utilization varied by race/ethnicity. Conclusions The likelihood of seeking mental health services differs depending on the history of formal depression diagnosis, current symptoms, and race/ethnicity among college students.

Youth mental health first aid training with diverse educators.

Schools are the most likely place for students to receive formal or informal mental health services and support. Classroom educators often provide informal mental health support to students and referrals to school-based services. Despite their key role, educators often feel underprepared in recognizing concerning symptoms in youth and supporting student mental health. This mixed-methods study explored the effectiveness of in-person Youth Mental Health First Aid (YMHFA) training on a diverse sample of 106 educators (Mage = 22, SD = 1.9 years, 96% ethnic minorities): City Year AmeriCorps members who work in diverse low-income schools in Florida. We culturally adapted the program to better meet the needs of the participants and the students they serve as over 95% of the students they served were people of color. Quantitative survey data were collected at three time points (pre, post, and 3 months after the training) to examine whether YMHFA training better equipped classroom educators to support students' mental health. Overall, training was associated with improvements in mental health literacy, knowledge of school-based mental health providers, confidence, and intentions to engage in mental health first aid (MHFA) behaviors. Notably, educators reported greater engagement in mental health first aid behaviors at the 3-month follow-up than before training. No improvement in mental health stigma was observed. Some improvements (i.e., mental health literacy, intentions to help) were not sustained at the follow-up. Qualitative data generally supported quantitative findings and suggested that the YMHFA program with cultural consideration is suitable for this diverse sample of classroom educators. Educators' suggestions to improve the training to support culturally and linguistically diverse students' mental health are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

‘It feels meaningful’: How informal mental health caregivers in an LGBTQ community interpret their work and their role

Many members of lesbian, gay, bisexual, trans and gender diverse, and queer (LGBTQ) communities provide informal mental health support to peers. This type of support is valuable for people who receive it – even helping to prevent suicide. It is also meaningful to those who provide it. In this article, we focus on how LGBTQ people derive meaning from their experiences of supporting peers. In-depth interviews with 25 LGBTQ people in Melbourne, Australia, indicate that those providing informal mental health support to fellow community members recognise their roles as meaningful in three main ways: in terms of self, relationships and communities. Recognising the meanings that LGBTQ caregivers derive from helping fellow community members provides useful information service providers and policymakers seeking to better address mental distress in LGBTQ communities and support caregivers. It is useful to understand this meaningful work in an LGBTQ context as caregiving that challenges gendered and heteronormative assumptions about what care is, and who provides it.

Barriers and facilitators of older adults for professional mental health help-seeking: a systematic review

BackgroundOlder adults are at an increased risk for mental health issues, yet they are less likely to seek professional help. This systematic review aims to identify and summarize literature on the barriers and facilitators that older adults face when seeking professional mental health help.MethodsA comprehensive literature search was conducted using multiple databases including PubMed-Medline, EMBASE, ProQuest central, CINAHL and Scopus to identify relevant studies published between 2010 and 2021 that focused on barriers and/or facilitators to seeking help for depression, anxiety, and psychological distress among older adults aged 65 years or older. Studies’ risk of bias was assessed using the Newcastle–Ottawa Scale and results of studies were synthesized guided by the methodological framework of Rodgers and colleagues.ResultsA total of eight cross-sectional studies, from Australia, United States, Mexico, Netherlands, and Malaysia met the inclusion criteria for this review. Included studies reported that the majority of their participants had anxiety or depression, yet they exhibited a preference for informal mental health help over professional help. Stigma, negative beliefs about mental health professional services, and cost were the most reported barriers. Main reported facilitators were prior positive experience with mental health services and high socioeconomic status.ConclusionOlder adults are in need of interventions normalizing mental health help seeking and ensuring these services are accessible in terms of costs. This should be the focus of policy makers, healthcare providers, and public health practitioners working with older adults.Protocol registrationPROSPERO 2021 CRD42021238853.

Prevalence of substance use and mental health problems among transgender and cisgender U.S. adults: Results from a national probability sample

Transgender individuals experience numerous health disparities relative to cisgender individuals. However, most transgender-health studies have focused on convenience samples with limited generalizability. This study utilized data from the 2016–2018 TransPop Study, the first national probability sample of transgender adults (n=274) with a cisgender comparison sample (n=1162). Using multivariable logistic regression, adjusted for demographics, we compared the prevalence of hazardous drinking, problematic drug use, serious psychological distress, suicidality, and non-suicidal self-injury between transgender and cisgender individuals and among transgender men (n=78), transgender women (n=120), and transgender nonbinary individuals (n=76). Among transgender individuals, 28.2% (95%CI 21.2–35.2) and 31.2% (95%CI 23.8–38.7) reported hazardous drinking and problematic drug use, respectively; 44.4% (95% CI 35.8–53.0) reported recent suicidal ideation, 6.9% (95% CI 2.3–11.5) reported a recent suicide attempt, and 21.4% (95% CI 14.5%-28.4%) reported recent non-suicidal self-injury. In their lifetime, 81.3% (95%CI 75.1–87.5) of transgender respondents had suicidal ideation, 42.0% (95%CI 34.2–49.8) had attempted suicide, and 56.0% (95% CI 48.2–63.8) reported non-suicidal self-injury. Most (81.5%; 95%CI 75.5–87.5) had utilized formal mental health care and 25.5% (95%CI 18.5–32.4) had sought informal mental health support. There were no differences in alcohol or drug-use outcomes between transgender and cisgender adults. Compared to cisgender adults, transgender adults had higher odds of serious psychological distress (aOR=3.1; 95%CI 1.7–5.7), suicidal ideation (recent: aOR=5.1, 95%CI 2.7–9.6); lifetime: aOR=6.7, 95%CI 3.8–11.7), lifetime suicide attempts (aOR=4.4, 95%CI 2.4–8.0), and non-suicidal self-injury (recent: aOR=13.0, 95%CI 4.8–35.1); lifetime: aOR=7.6, 95%CI 4.1–14.3). Transgender nonbinary adults had the highest odds for all outcomes, including substance use outcomes. Findings from these national probability samples support those of earlier convenience-sample studies showing mental health disparities among transgender adults relative to cisgender adults, with nonbinary individuals at highest risk. These findings also highlight variations in risk across sub-groups of transgender individuals.

Mental Health Issues for Frontline Hospital Staff During Height of Covid Pandemic 2020

AbstractIntroductionWhen the SARS-Cov2 virus hit the New York and New Jersey metropolitan area in Spring 2020, hospitals and hospital workers were hit hard with a new unknown pathogen that either killed people or made them very ill. There were large numbers of severely ill patients that strained resources. Hospital workers had extraordinary stress with multiple additional patients, the need to use personal protective equipment (PPE) in short supply, and faced with a pathogen that had no treatments beyond care and support initially.MethodsWe surveyed our hospital workers in late Spring 2020 to identify the main stressors and find out what measures were helpful. An online anonymous survey included questionnaires about sleep, mood, outside stressors, helpful measures, and how they coped generally. All levels of hospital workers were surveyed. Resources were provided to all respondents.ResultsOver 240 individuals responded to the survey; most respondents were women (76%). ‘Workplace stressors’ topped the chart for 98 of our respondents. The worst workplace stressor that was cited was ‘irritable workforce,’ but ‘lack of ‘protocols’ and ‘shortage of PPE’ were also cited as stressors. ‘Other’ (not described) and ‘taking care of an ill relative’ were rated highly. Those who had ‘symptoms everyday:’ Anhedonia (loss of pleasure or interest), 13%; feeling down and hopeless, 12%; sleep disturbance, 41%; low energy, feeling tired, 29%; appetite disturbance, 26%; poor concentration and attention, 15%. Respondents told us what resources they used and what was most helpful; exercise was most frequently cited as helpful.Lessons Learned and DiscussionVarious resources for formal and informal mental health support were provided to all respondents at the time of survey. Our hospital mounted its own response with support services, as did our medical school and university. A "warm line" was available through the Department of Psychiatry from late March 2020; tip sheets and online groups were widely circulated; State Department of Health provided resources. There were formal peer support sessions and workers helped each other. Medical students provided child care, shopping, and transport. We learned that extra support for workers and more frequent rest and recharge time are important. A weekly "town hall" was instituted and a weekly update about the hospital and support in healthy activities are widely circulated to employees. Those with active PTSD (some were very disturbed by the number of deceased patients) were referred to professional providers. Hospitals need to be ready to deal with epidemics and pandemics more effectively in order to mitigate stress and support workers. Being prepared, not just with equipment, but with protocols in how to proceed should another pandemic come. We learned that listening to workers is important. Workers also need to know how valued they are.FundingDepartment of Psychiatry, New Jersey Medical School

Psychological distress, non-medical use of prescription medications, and perceived unmet mental health care needs: a cross-sectional study of Ontario students.

The non-medical use of prescription medications among adolescents has become a concerning public health issue. This study assessed the prevalence of the non-medical use of prescription medications in Ontario high school students, and explored the moderating effect of this use on the relationship between psychological distress and unmet mental health needs. Cross-sectional data for 4896 students, age 14-18, were drawn from the 2019 Ontario Student Drug Use and Health Survey. Psychological distress was measured using the Kessler-6 Distress Scale, unmet mental health needs were defined by self-report (yes/no), and non-prescription medication use was defined by self-reported frequency of use. Using logistic regression, we explored the effect of the non-medical use of prescription medications on the relationship between psychological distress and unmet mental health needs. High proportions of Ontario students reported serious psychological distress (22%), some degree of unmet mental health need (38%), and/or non-medical use of prescription medications (13%). While there were strong associations between psychological distress and unmet mental health need, this association was weaker among those reporting non-medical use of prescription medications (OR = 3.3, 95% CI 1.9-5.7) compared to non-users (OR = 5.6, 95% CI 4.5-7.1). Our findings suggest that Ontario students experiencing distress and using non-prescribed medications are less likely to identify a need for mental health support, highlighting the consequences of apparent self-medication through misuse of prescription medications. To assist in the redirection of adolescent perceptions of healthy coping strategies, population-based educational programming, with targeted promotion of both formal and informal mental health care resources, should be considered.

Online Communities for Child-Attracted Persons as Informal Mental Health Care: Exploring Self-Reported Wellbeing Outcomes.

Online support communities are gaining attention among child-attracted persons (CAPs). Though research has largely focused on the negative consequences these environments create for potential offending, they may also provide a beneficial alternative to more formal treatment settings. To assess the utility for clinical and therapeutic purposes, this analysis focused on subcultural dynamics to examine self-reported wellbeing outcomes of participation in a Dutch forum for CAPs. A total of 15 semi-structured interviews were conducted with moderators, members and mental health professionals involved in the community. Thematic analyses demonstrated that by means of informal social control, bonds of trust and social relational education, the network aims to regulate the behavior and enhance the wellbeing of its marginalized participants. Key outcomes include a decreased sense of loneliness and better coping with stigma, to the point that participants experience less suicidal thoughts. Association with prosocial peers also helps to set moral boundaries regarding behavior towards children, although we cannot fully rule out potential adverse influences. Online support networks offer a stepping stone to professional care that fits individual needs of CAPs, while also providing an informal environment that overcomes limitations of physical therapy and that extents principles of existing prevention and desistance approaches.

Recommendations for Optimizing xaʔtus (First Face) for Mental Health Training: Insights from Key Informants.

Native adolescents experiencing mental health challenges, including substance misuse, often prefer to seek support from their peers and other informal sources, which may be due to lack of access to, and cultural fit with, professional behavioral health services. xaʔtus (First Face) for Mental Health is a Tribal community-based intervention designed to strengthen networks of informal mental health support and open pathways to more formal support. We sought insights from key informants to optimize the planning, promotion, and delivery of First Face trainings to seven Tribal communities in the Northwest United States. We conducted three focus groups with (1) teens completing a residential chemical dependency program at the Healing Lodge of the Seven Nations (n = 10), (2) clinical staff representing the Healing Lodge's Behavioral Health Department (n = 9), and (3) community members representing educators and social service professionals at five of the Tribal nations that support the Healing Lodge (n = 6). Discussion generated planning, promotion, and training recommendations. Planning recommendations focused on showing respect for trainees' time by holding the training during convenient times and factoring in trainees' commitments to work and family, integrating the training into high school science or health education classes, and taking steps to protect trainees' physical safety in the age of COVID while avoiding "Zoom fatigue." Promotion recommendations highlighted community members' possible reluctance to become a First Face due to fear about the responsibilities associated with taking on this role and the need to emphasize the personal relevance of First Face training. In terms of training delivery, participants emphasized the importance of including engaging, interactive activities; instructing future First Faces in self-care; and acknowledging the impact of traumatic contemporary experiences on mental health, while at the same time preventing heated and distressing political debates. We describe our response to participants' recommendations and the rationale for those responses.

“We Should Be Talking About This More”

Recent research has revealed that popular social media platforms are emerging as crucial digital health sources for individuals across demographics, but more so for adolescents and young adults (Lupton, 2021; McCashin &amp; Murphy, 2022; Montag et al., 2021). ΤikTok is the latest social networking tool said to be functioning as a source of informal mental health communication and is increasingly being utilized for giving and seeking advice, sharing information and personal stories about the symptoms, effects, challenges, and coping strategies related to stress and anxiety, among other mental health issues (McCashin &amp; Murphy, 2022). Despite the rapid growth of TikTok-based research, investigations of mental health-relevant content on this platform are still very few. The current study aims to contribute to this body of research through a content analysis of the most popular TikTok videos labelled with pertinent hashtags, namely #anxiety, #stress, and #stressrelief. The aim is to map the practices through which TikTok content creators appropriate the platform’s affordances in order to create content and generate interactions around a focal object of common concern. The analysis focuses on diverse aspects of the platform’s use as a medium for creating stress- and anxiety-related content, including the content creator identity and presentation, video format, type and purpose, audience engagement levels, as well as reported sources, symptoms, consequences, and coping techniques of stress and anxiety. The examination of TikTok user practices offers insights into the evolving patterns of consumption and production of digital content, and cultural production in a social media context.

Black Barbershops: Exploring Informal Mental Health Settings Within the Community

The barbershop is a landmark in the Black community, providing a site for cultural exchange, discussion forums and a point of psychological connection for African American men. Barbershops offer safe spaces for culturally responsive engagement, discourse, and guidance without stigma. Researchers and service providers have utilized Black barbershops for physical health outreach, understanding Black masculinity, exploring intersections of sexuality, and informal mental health support. The Black barbershop offers a nuanced, culturally relevant perspective of African American men, which is valuable to current and future human service providers, educators, and stakeholders in formulating effective interventions and practices with Black men. Utilizing video voice participatory action research (PAR) qualitative methodology, this study explored the experiences of African American (or Black) men using community barbershops as informal mental health care settings. The study explored the experiences of ten (N = 10) African American men, ages 18-75, from either the San Bernardino County or Los Angeles County areas who utilized Black barbershops as informal mental health care settings. The results suggested that African American men were willing to embark on conversations about their mental health within their barbershops, reporting that these experiences yielded them significant psychological, emotional, and social well-being. The authors recommend future collaboration efforts to join with existing informal mental healthcare settings such as Black barbershops to support community-based, culturally relevant healing spaces for African American men.

“My problems aren't severe enough to seek help”: Stress levels and use of mental health supports by Canadian hospital employees during the COVID-19 pandemic

Due to the unique set of stressors associated with the COVID-19 pandemic, healthcare workers in acute care settings may be facing elevated rates of mental health symptomatology. The purpose of this study was to assess levels of depression, anxiety, and stress in a sample of healthcare employees working in hospitals and their use of formal and informal mental health supports. Data was gathered over a three-week period in December 2020 as COVID cases began to rise sharply in Ontario, Canada. Results from an online survey of 650 healthcare employees suggested that overall levels of depression, anxiety, and stress were mild. However, a significant minority of participants reported severe or extremely severe levels of depression (14.4%), anxiety (21.8%), and stress (13.5%). Levels of distress were higher among women, younger participants, those who did not work directly with COVID+ patients, and those who were redeployed. Use of formal mental health supports (e.g., Employee Assistance Plans, teletherapy) was very low (<10%), with the most frequently-reported reason for not using supports being “problems not severe enough to require this service”. Implications are considered for healthcare policy decisions as hospital systems attempt to address the mental health needs of their employees.

The Nature and Impact of Informal Mental Health Support in an LGBTQ Context: Exploring Peer Roles and Their Challenges.

BackgroundResearch shows that LGBTQ communities experience high levels of suicidality and mental ill health. They also face significant barriers to accessing adequate mental health treatment in service settings. In response to these factors, it is likely that LGBTQ community members turn to their peers for informal mental health-related support. Such support, however, is largely undefined, the extent of it poorly understood and its impacts on those who perform it underexplored.MethodsWe explored the nature and impact of informal mental health-related support provided by peers in LGBTQ communities in Melbourne, Australia. Drawing on semi-structured in-depth interviews with 25 LGBTQ adults in 2020, we explored how and why peers provided mental health support to friends, partners, housemates and even strangers and the impact this had on them.ResultsWe found that participants performed support roles as extensions of their existing relationships. We demonstrate that the support roles of the safe friend, housemate and partner, among others, represent everyday relationships stretched—even to breaking point—to incorporate informal mental health support. Each of these support roles is distinct, but they can all potentially result in similar impacts on those performing them. One of the more significant of these is burnout.ConclusionsLGBTQ community members face a diverse range of challenges when they support peers with their mental health. Informal peer-support roles are a significant responsibility for those performing them. LGBTQ community members stepping up to support others should be better supported to help manage their roles and the impacts of performing them.Policy ImplicationsFindings can contribute to policy that not only addresses high levels of mental ill health in LGBTQ communities, but also seeks to help peers in support roles to prevent them from being negatively impacted.

The influence of caregiver attitudes and socioeconomic group on formal and informal mental health service use among youth.

Young people can receive mental health care from many sources, from formal and informal sectors. Caregiver characteristics/experiences/beliefs may influence whether young people get help and the type of care or support used by their child. We investigate facilitators/barriers to receiving formal and/or informal care, particularly those related to the caregiver's profile. We interviewed 1,400 Brazilian primary caregivers of young people (aged 10-19), participants of a high-risk cohort. Caregivers reported on young people's formal/informal mental health care utilization, and associated barriers and facilitators to care. Data were also collected on youth mental health and its impact on everyday life; and caregiver characteristics-education, socioeconomics, ethnicity, mental health, and stigma. Logistic regression models were used to examine the relationship between caregiver and young people characteristics with formal/informal care utilization. Persistence and greater impact of youth mental health conditions were associated with a higher likelihood of care, more clearly for formal care. Caregiver characteristics, however, also played a key role in whether young people received any care: lower parental stigma was associated with greater formal service use, and lower socioeconomic class showed higher odds of informal care (mainly from religious leaders). This study highlights the key role of the caregivers as gatekeepers to child treatment access, particularly parental stigma influencing whether young people received any mental health care, even in a low resource setting. These results help to map barriers for treatment access and delivery for young people, aiming to improve intervention efforts and mental health support.

Mental Health Promotion and Stigma Reduction Among University Students Using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) Framework: Protocol for a Mixed Methods Study.

BackgroundRapid urbanization, academic pressures, and developmental life transition stressors contribute to mental health stress for postsecondary students in China. Effective prevention, early identification, and timely intervention are challenged by stigma, a lack of mental health literacy, and inadequate mental health resources.ObjectiveOur implementation science (IS) research project is aimed at evaluating the use of an evidence-informed mental health promotion intervention named Acceptance and Commitment to Empowerment – Linking Youth and ‘Xin’ (hearts) (ACE-LYNX) to promote university student mental health in Jinan, China.MethodsWe will engage and collaborate with Shandong Mental Health Center, the provincial mental health center, and six local universities in different regions of Jinan. The ACE-LYNX intervention aims to reduce social stigma against mental illness, enhance mental health literacy, and improve access to quality mental health care by increasing interdisciplinary collaboration and forming a mental health network. It is based on two evidence-based approaches, Acceptance and Commitment Therapy (ACT) and Group Empowerment Psychoeducation (GEP), and it will be delivered through online learning and in-person group training. The project will train 90 interdisciplinary professionals using the model. They will in turn train 15 professionals and 20 students at each university. The project will adopt the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework, which provides a structure to examine the process and outcomes of implementation using mixed methods comprising quantitative and qualitative approaches along five dimensions: reach, efficacy, adoption, implementation, and maintenance.ResultsOver the course of the project, 720 champions will be directly trained. They will contribute to developing a formal and informal mental health network, strengthened by student-led mental health initiatives and professional-led initiatives to promote collaborative care and facilitated care pathways. We anticipate that our project will reach out to 11,000 to 18,000 students.ConclusionsThis IS protocol will outline our unique intervention model and key steps to contextualize, implement, and evaluate community-based mental health intervention.International Registered Report Identifier (IRRID)PRR1-10.2196/25592

Informal care and the impact on depression and anxiety among Swedish adults: a population-based cohort study

BackgroundAs the population is ageing, the need for informal caregivers increases, and thus we need to know more about the effects on caregivers. This study aims to determine both cross-sectional and longitudinal associations between perceived limitation of informal caregiving and mental health of caregivers.MethodsThis population-based cohort study was based on the Swedish Psykisk hälsa, Arbete och RelaTioner (PART) study, and 9346 individuals aged 18–65 were included. Data were collected through questionnaires, interviews and Swedish registers. Informal care was defined as care given to a family member. Self-reported and diagnosed depression and anxiety were included as outcomes. Covariates included sex, age, social support and socio-economic position. Ordinal logistic regression and Cox regression were performed to determine the associations between caregiving and anxiety or depression.ResultsSelf-reported depression and anxiety was only increased among those experiencing limitations (adjusted odds ratios [aOR] 2.00, 95% confidence intervals [CI] 1.63–2.47 for depression; aOR 2.07, 95% CI 1.57–2.74 for anxiety) compared to those not giving care, respectively. The adjusted hazard ratio (aHR) were increased for diagnosed depression (aHR 1.97, 95% CI 1.27–3.05) and for diagnosed anxiety (aHR 1.86, 95% CI 1.06–3.25) among those giving care and experiencing limitations, compared to those not giving care. No significant associations were found in caregivers without limitations.ConclusionCaregivers experiencing limitations showed a significant association with short- and long-term anxiety and depression. This study implies the importance of exploring the degree to which informal caregiving can be provided without adding burden to caregivers.

Rates and predictors of uptake of mental health support during the COVID-19 pandemic: an analysis of 26,720 adults in the UK in lockdown

PurposeThe coronavirus disease 2019 (COVID-19) pandemic has put a great strain on people’s mental health. A growing number of studies have shown worsening mental health measures globally during the pandemic. However, there is a lack of empirical study on how people support their mental health during the COVID-19 pandemic. This study aimed to examine a number of formal and informal mental health support. Further, it explored factors that might be associated with the use of different types mental health support.MethodsData from 26,720 adults in the UCL COVID-19 Social Study were analysed between 13th April 2020 and 3rd July 2020. Data were analysed using logistic and Poisson regression models.ResultsAbout 45% of people reported talking to friends or family members to support their mental health, 43% engaging in self-care activities, 20% taking medication, 9% speaking to mental health professionals, 8% talking to a GP or other health professional, and another 8% using helpline or online services. Gender, education, living status, loneliness, pre-existing mental health conditions, general depression and anxiety, coping and personality were found to be associated with the use of mental health support.ConclusionWhile the negative impacts caused by the COVID-19 pandemic are inevitable, people can play an active role in managing their mental health. Understanding the patterns and predictors of various kinds of mental health support during the pandemic is crucial for future service planning and delivery through recognising potential barriers to mental health care faced by certain groups.