Competent Mental Health Research Articles

Integrating large language models in mental health practice: a qualitative descriptive study based on expert interviews

BackgroundProgress in developing artificial intelligence (AI) products represented by large language models (LLMs) such as OpenAI’s ChatGPT has sparked enthusiasm for their potential use in mental health practice. However, the perspectives on the integration of LLMs within mental health practice remain an underreported topic. Therefore, this study aimed to explore how mental health and AI experts conceptualize LLMs and perceive the use of integrating LLMs into mental health practice.MethodIn February–April 2024, online semi-structured interviews were conducted with 21 experts (12 psychiatrists, 7 mental health nurses, 2 researchers in medical artificial intelligence) from four provinces in China, using snowballing and purposive selection sampling. Respondents’ discussions about their perspectives and expectations of integrating LLMs in mental health were analyzed with conventional content analysis.ResultsFour themes and eleven sub-themes emerged from this study. Firstly, participants discussed the (1) practice and application reform brought by LLMs into mental health (fair access to mental health services, enhancement of patient participation, improvement in work efficiency and quality), and then analyzed the (2) technological-mental health gap (misleading information, lack of professional nuance and depth, user risk). Based on these points, they provided a range of (3) prerequisites for the integration of LLMs in mental health (training and competence, guidelines for use and management, patient engagement and transparency) and expressed their (4) expectations for future developments (reasonable allocation of workload, upgrades and revamps of LLMs).ConclusionThese findings provide valuable insights into integrating LLMs within mental health practice, offering critical guidance for institutions to effectively implement, manage, and optimize these tools, thereby enhancing the quality and accessibility of mental health services.

Predictor Role of Intimate Domestic Violence During Pregnancy and Mental Health in Maternal Competency with Moderating Role of Motherinfant Attachment: A Structural Equation Model

Introduction: Intimate domestic violence causes psychological consequences in pregnancy and maternal competency. We aimed to assess the effect of domestic violence on mental health and maternal competency with the moderating role of mother-infant attachment behavior. Methods: This prospective longitudinal study was conducted on 254 primiparous mothers in the third trimester of pregnancy referring to selected health centers in Qazvin province, Iran. Data collection tools were questionnaires. Data were analyzed by SPSS and Smart Partial Lease Square3 software. Results: The results of the structural equations model showed that domestic violence has a positive and significant effect on mental health disorders (β = 0.87). Mental health disorder has a negative and significant effect on parental acceptance (β = -0.55). Domestic violence has a negative and significant effect on mother-infant attachment behavior (β = -0.83), also mother-infant attachment behavior is a moderator of the relationship between pregnancy violence and maternal competency (T-value = 3.17). Conclusion: The results revealed that domestic violence during pregnancy affects the mental health of pregnant mothers and maternal competency and mother-infant attachment behavior moderates this relationship. Therefore, it is recommended that mothers facing domestic violence be identified and receive psychological support and counseling, and also improve maternal competence and mother-infant attachment behavior in mothers exposed to violence.

Study tours as strategy in building multi-level public health system transformation in Ukraine (UA)

Abstract With 14 million Ukrainians in need of psychological aid (UNDP) and a strained health system, UA urgently requires mental health and psychological support services (MHPSS). As a TA partner on the USAID funded Public Health System Recovery and Resilience project in UA, the Philadelphia (PHL) team supports capacity building for population-based MHPSS at the community level with a study tour strategy. Such approaches apply to other countries interested in remodeling public health systems. The strategy aims to advance community based MHPSS through in person tours in PHL with remote follow up to stimulate vision, exchange ideas and accelerate action among governmental, community, and academic partners. The study tours presented overviews on health policy, system development, program services delivered to children and adults, community interventions, and workforce development of professionals and paraprofessionals. All included the foundational principles of trauma-informed practice. The June 2023 tour hosted 11 decision makers and regional officials who embraced the vision for system development and endorsed further engagement. The December 2023 tour hosted 13 practitioners and coordinators of health and social services to observe community programs. Results include development of PHL NGOs and UA social service hub partnerships to implement train the trainer programs for peers/people with lived experience and for mural arts programs to promote community engagement and empowerment. The September 2024 tour involves university partners from nursing, social work and psychology and PHL counterparts to strengthen curricula to include mental health competencies, support faculty development with potential for collaborative research and student exchange, and design post-graduate continuing education courses for upskilling the incumbent workforce. Study tours and direct exchange are an effective strategy for capacity building for MHPSS in Ukraine to address population health needs. Key messages • The sequenced study tour strategy affects distinct levels of change makers in UA. The results are governmental buy-in, partnerships for programmatic development, and academic advancement. • The study tour model promotes systematic change and offers solutions to MHPSS workforce shortages through information exchange, relationship building, and capacity development.

Cascade effects of a parenting-focused program for divorced families on three health-related outcomes in emerging adulthood.

Using data from a 15-year longitudinal follow-up of a randomized controlled trial of a parenting-focused preventive intervention for divorced families (N = 240) with children aged 9-12, the current study examined alternative cascading pathways through which the intervention led to improvements in offspring's perceived health problems, BMI, and cigarette smoking in emerging adulthood. It was hypothesized that the program would lead to improvements in these health-related outcomes during emerging adulthood through progressive associations between program-induced changes in parenting and offspring outcomes, including mental health problems, substance use, and competencies. Intervention-induced improvements in positive parenting at posttest led to improvements in mental health problems in late childhood/early adolescence, which led to lower levels of mental health and substance use problems as well as higher levels of competencies in adolescence, which led to improvements in the health-related outcomes. Academic performance predicted all three health-related outcomes and other aspects of adolescent functioning showed different relations across outcomes. Results highlight the potential for intervention effects of preventive parenting interventions in childhood to cascade over time to affect health-related outcomes in emerging adulthood.

Mental Health Competence of Faculty In a State University

Mental Health Competence of Faculty In a State University

Enhancing Digital Health Awareness and mHealth Competencies in Medical Education: Proof-of-Concept Study and Summative Process Evaluation of a Quality Improvement Project.

Currently, there is a need to optimize knowledge on digital transformation in mental health care, including digital therapeutics (eg, prescription apps), in medical education. However, in Germany, digital health has not yet been systematically integrated into medical curricula and is taught in a relatively small number of electives. Challenges for lecturers include the dynamic field as well as lacking guidance on how to efficiently apply innovative teaching formats for these new digital competencies. Quality improvement projects provide options to pilot-test novel educational offerings, as little is known about the acceptability of participatory approaches in conventional medical education. This quality improvement project addressed the gap in medical school electives on digital health literacy by introducing and evaluating an elective scoping study on the systematic development of different health app concepts designed by students to cultivate essential skills for future health care professionals (ie, mobile health [mHealth] competencies). This proof-of-concept study describes the development, optimization, implementation, and evaluation of a web-based elective on digital (mental) health competencies in medical education. Implemented as part of a quality improvement project, the elective aimed to guide medical students in developing app concepts applying a design thinking approach at a German medical school from January 2021 to January 2024. Topics included defining digital (mental) health, quality criteria for health apps, user perspective, persuasive design, and critical reflection on digitization in medical practice. The elective was offered 6 times within 36 months, with continuous evaluation and iterative optimization using both process and outcome measures, such as web-based questionnaires. We present examples of app concepts designed by students and summarize the quantitative and qualitative evaluation results. In total, 60 students completed the elective and developed 25 health app concepts, most commonly targeting stress management and depression. In addition, disease management and prevention apps were designed for various somatic conditions such as diabetes and chronic pain. The results indicated high overall satisfaction across the 6 courses according to the evaluation questionnaire, with lower scores indicating higher satisfaction on a scale ranging from 1 to 6 (mean 1.70, SD 0.68). Students particularly valued the content, flexibility, support, and structure. While improvements in group work, submissions, and information transfer were suggested, the results underscore the usefulness of the web-based elective. This quality improvement project provides insights into relevant features for the successful user-centered and creative integration of mHealth competencies into medical education. Key factors for the satisfaction of students involved the participatory mindset, focus on competencies, discussions with app providers, and flexibility. Future efforts should define important learning objectives for digital health literacy and provide recommendations for integration rather than debating the need for digital health integration.

Perceived mental health skills and competence among occupational health physicians.

Mental-health-based consultations in occupational health (OH) are increasing due to ongoing changes in working life. We studied the self-assessed mental health competence of trainees and trainers in OH specialist physician training. We conducted an online survey from June to August 2022. We analysed how trainees and trainers in OH assessed their own competence in mental health practice with N (%) and means (standard deviation [SD]). We analysed the underlying assumptions about competences specific to OH using an explanatory factor analysis. We applied the Kruskal-Wallis test to determine differences between trainees and trainers using the variables in the factor analysis. Respondents' perceptions of mental health competence were more positive among trainers (mean 3.97, SD 0.72) than trainees (mean 3.66, SD 1.08, P = 0.2123). Based on trainee physicians' own assessments, more experience increases competence, until after 7 years, when the perceived competence seems to decrease. The trainer physicians' self-assessed mental health competence decreased over time. With factor analyses, we identified five competence factors: general mental health, workplace risks and resources, rehabilitation, promotion and prevention, and special skills. In our results, individual-level mental health competences such as work ability evaluation and to manage return-to-work processes were evaluated better than community-based proactive processes. Physicians in OH specialist physician training self-assessed their mental health competence better at the employee level than at the workplace level. Based on our results, we need to develop the curriculum of OH specialist physician training to meet the needs of working life in support of mental health.

Mental Health Needs of Asian American Older Adults: Bridging the Inequity Gap.

The mental health needs of Asian American older adults are complex and multifaceted. Despite their rich diversity, Asian American older adults face significant challenges, including mental health stigma, cultural stress, limited English proficiency, and historical trauma. In addition, the coronavirus disease 2019 pandemic reignited preexisting anti-Asian attitudes of hostility, discrimination, blame, and scapegoating. The historical context of Asian immigration to the United States, impact of race-based discrimination, and recent resurgence of anti-Asian hate crimes impact mental health in Asian American older adults. Thus, there is a need for a culturally sensitive and competent mental health care workforce, culturally tailored interventions, and family involvement. In the context of research and policy, it is critical to prioritize increased funding and research focus on culturally tailored instrument development, interventions, and policy initiatives informed by recent findings to safeguard this population from hate crimes and discrimination. [Journal of Psychosocial Nursing and Mental Health Services, 62(7), 11-15.].

Learning and achieving basic mental health competence in placement studies with the support of a tool: A qualitative study of student nurses’ experiences

BackgroundLearning basic mental health care competence is often challenging for the bachelor of science student nurses, and many lack basic mental health care competence to ensure safe and confident mental health care practice. Mental health assessment is an integrated part of this competence. ObjectiveThe objective of this study was to explore and describe in depth how student nurses experience learning and achieving basic mental health competence while on mental health placement with the support of a learning tool. DesignAn explorative and descriptive qualitative design was conducted to gain insight on how student nurses experienced learning basic mental health competence when on placement. SettingA diversity of mental health placement settings in which student nurses were involved with patient care or welfare were approached; general psychiatric wards (n = 2), psychiatric ward for elderly people (n = 1), community mental health in-patient facilities (n = 2) and unconventional placements in the community (n = 9). Unconventional placements are a diversity of non-clinical service contexts. ParticipantsThe participants comprised student nurses in their 3rd and final year while on mental health placement. Potential participants received information from course coordinators, the online learning platform, and from teachers in plenary. Using purposive sampling, 14 student nurses were recruited. MethodsIndividual semi-structured interviews were conducted online and in person at two campuses of one university in Norway between August 2020 and December 2021. The interviews were transcribed and thematically analysed as described by Braun and Clarke. ResultsStudents expressed insecurity in a new clinical context. They engaged in new learning situations and realized the diversity of nursing practice. Unconventional placements were described as challenging contexts for learning basic mental health care competence. ConclusionsThis qualitative study provided insight into how student nurses experience learning mental health assessment, and gaining relational, communicative, and ethical competence while on placement. Students revealed their insecurities and challenges in learning in a new context. Awareness of clinical learning opportunities on placement when preparing student nurses to learn basic mental health competence may help improve their confidence.

Teachers' competence: How to protect teachers' mental health from the burden caused by students' private in-class use of technical devices?

The current study investigated how students' private in-class use of technical devices is associated with teachers' mental health. Data of 361 teachers from primary and secondary schools in Germany were assessed via online surveys. The present cross-sectional results show a positive association between burden caused by the students' private in-class use of technical devices and teachers' depression symptoms. Both were negatively linked to teachers' positive mental health (PMH) and teachers' competence in handling students' private in-class use of technical devices. In a moderated mediation analysis, the association between burden and depression symptoms was mediated by PMH. Teachers' competence moderated the link between PMH and depression symptoms. Specifically, the higher the competence, the weaker the relationship between both variables. Thus, the protective effect of teachers' competence could be especially important in persons with low PMH. Competence training in handling students' use of technical devices is discussed as a potential step that could protect teachers' mental health.

Mental health competencies are stronger determinants of well-being than mental disorder symptoms in both psychiatric and non-clinical samples

The present study aimed to investigate whether the strength of mental health competencies and the severity of mental disorder symptoms, and their interaction, differ in the strength of their associations with several dimensions of well-being in Hungarian adult psychiatric and non-clinical samples. All respondent in the psychiatric sample (129 patients (44 male, 85 female)) and in the non-clinical community sample (253 adults (43 male, 210 female)) completed the Mental Health Test, six measures of well-being and mental health, and the Symptom Checklist-90-Revised. Including both mental health competencies and mental disorder symptoms in a regression model in both samples can predict patients’ well-being even more accurately. Mental health competencies were positively related; mental disorder symptoms were negatively related to subjective well-being. In all models and in both samples, mental health competencies were found to be stronger determinants of well-being than mental disorder symptoms. The interaction of mental health competencies and mental disorder symptoms is no more predictive of well-being in either psychiatric or non-clinical samples than when the effects of each are considered separately. The assessment of mental health competencies has an important predictive value for well-being in the presence of psychopathological symptoms and/or mental disorders.

Phacoemulsification Plus Intraocular Lens Implantation with Gold Nanoparticles for Complicated Cataract Secondary to Uveitis: Efficacy Analysis

This study analyzes the efficacy of phacoemulsification (PE) plus intraocular lens implantation (IOLI) in patients with complicated cataracts secondary to uveitis. Nanostructured photothermal ring integrated (nano)-intraocular lens (IOLs) were developed to improve the biocompatibility and optical properties of IOLs. However, data on the safety profile and effectiveness of IOLI for patients with complicated cataracts secondary to uveitis are scarce, and studies have questioned the safety of PE in patients undergoing cataract surgery. We used gold nanoparticle (AuNP)-modified commercially available intraocular IOLs combined with PE technology to treat patients with complicated cataracts secondary to uveitis. First, we found that AuNP-modified IOLs were effective in reducing macrophage and bacterial adhesion and were biocompatible with the organism. Then, 64 patients with complicated cataracts secondary to uveitis were totally selected from February 2019 to February 2022, of which 33 cases were treated with PE+IOLI (test group) and 31 with conventional small-incision extracapsular cataract extraction (SIECCE) and IOLI (control group). Intergroup comparisons based on efficacy, safety, visual acuity (VA), aqueous humor protein levels before and after treatment, and quality of life (assessed with the Generic Quality of Life Inventory-74, GQOLI-74) revealed higher overall treatment efficacy and postoperative VA, as well as lower complication rate and postoperative aqueous humor protein levels, in the test group than the control group. Moreover, the test group had higher GQOLI-74 scores in the dimensions of physical function, mental health, psychological health, and social competence than the control group. Thus, PE+IOLI is more suitable for patients with complicated cataracts secondary to uveitis than conventional SIECCE+IOLI. PE+IOLI can improve treatment efficacy and safety, as well as patient VA and quality of life.

Primary Mental Health Competencies for Palliative Medicine Physicians: A Consensus-Prioritized List

Primary Mental Health Competencies for Palliative Medicine Physicians: A Consensus-Prioritized List

Effectiveness of Individual-Based Strategies to Reduce Nurse Burnout: An Umbrella Review

Aims. This umbrella review aims to comprehensively synthesize and analyze the findings of available systematic reviews on the effectiveness of individual-based strategies for reducing nurse burnout occurring in hospital-based settings. Methods. Following JBI guidelines, an umbrella review was conducted to integrate the effectiveness of various strategies to reduce burnout. Systematic reviews were searched in the Embase, MEDLINE (Ovid), Cochrane Library, CINAHL (EBSCO), Scopus, and WOS databases. Inclusion criteria included studies published in any language from database inception to April 2023. Eligibility assessment involved two independent reviewers who evaluated titles, abstracts, and full texts. The systematic reviews were critically evaluated using JBI SUMARI. The results were narratively synthesized and grouped by strategy. Results. Eleven systematic reviews were included, covering the years 2012 to 2021. The appraisal tools varied, though all included reviews were of high quality. The strategies were categorized into three domains: mental health (51%), physical activities (26%), and professional competence (13%). The interventions most identified were mindfulness-based stress reduction for mental health, yoga for physical activities, and professional competence education. These individual-based strategies were shown to effectively eliminate emotional exhaustion (72.7%), depersonalization (44%), and occupational stress (78%) among nurses in hospital-based settings. Conclusion. Mental health, physical activities, and professional competence are strategies to reduce nurse burnout. Implementing these approaches in healthcare settings can improve emotional exhaustion, depersonalization, and occupational stress of nurses.

The Childhood Resilience Study: Resilience and emotional and behavioural wellbeing experienced by Australian Aboriginal and Torres Strait Islander boys and girls aged 5-9 years.

Resilience is a process of drawing on internal or external strengths to regain, sustain or improve adaptive outcomes despite adversity. Using a child resilience measure co-designed with Aboriginal and Torres Strait Islander communities, we investigate: 1) children's personal, family, school and community strengths; 2) gender differences; and 3) associations between resilience and wellbeing. 1132 parent/caregivers of children aged 5-12 years were recruited to the Childhood Resilience Study, including through the Aboriginal Families Study. The Aboriginal Families Study is a population-based cohort of 344 mothers of an Aboriginal and/or Torres Strait Islander child. This paper focuses on the wave 2 survey data on child resilience at age 5-9 years (n = 231). Resilience was assessed with the Child Resilience Questionnaire-parent/caregiver report (CRQ-P/C), categorised into tertiles of low, moderate and high scores. Child emotional/behavioural wellbeing and mental health competence was assessed with the parent-report Strengths and Difficulties Questionnaire. All Tobit regression models adjusted for child age. Aboriginal and Torres Strait Islander girls had higher resilience scores compared to boys (Adj.β = 0·9, 95%CI 0·9-1·4), with higher School Engagement, Friends and Connectedness to language scale scores. Resilience scores were strongly associated with wellbeing and high mental health competence. A higher proportion of girls with low resilience scores had positive wellbeing than did boys (73.3% versus 49.0%). High resilience scores were associated with lower SDQ total difficulties score after adjusting for child age, gender, maternal age and education and family location (major city, regional, remote) (Adj.β = -3.4, 95%CI -5.1, -1.7). Compared to the Childhood Resilience Study sample, Aboriginal Families Study children had higher mean CRQ-P/C scores in the personal and family domains. High family strengths can support Aboriginal and Torres Strait Islander children at both an individual and cultural level. Boys may benefit from added scaffolding by schools, family and communities to support their social and academic connectedness.

The new Foundation Programme Mental Health Curriculum: foundation doctors' perceptions of its importance and their competency: pre-post psychiatric placement evaluation study.

The new 2021 UK Foundation Programme Curriculum mandates foundation doctors to acquire mental health competencies. This study aimed to evaluate the effectiveness of psychiatry placements in facilitating competency attainment, foundation doctors' perceived importance of acquiring these and their preferred teaching methods. Utilising Kirkpatrick's evaluation framework, the study employed a pre-post intervention design assessing the impact of psychiatry placements on 135 foundation doctors across three cohorts from August 2021 to March 2022. Initially, foundation doctors assigned high importance to mental health competencies. Post-placements, this perceived importance improved slightly, whereas that of clinical skills scenarios slightly decreased. Significant confidence increases were observed in recognising and assessing specific psychiatric disorders. Foundation doctors favoured small seminar groups and on-the-job ad hoc teaching. Qualitative insights underscored the need for context-specific teaching. Psychiatry placements enhance foundation doctors' confidence and perceived importance of mental health competencies as specified by the curriculum. Addressing clinical scenario gaps through context-specific teaching and transferable skills development is essential. Customised teaching approaches, especially small seminars and ad hoc teaching, hold promise for effective mental health training.

Efficacy of a virtual nursing simulation-based education to provide psychological support for patients affected by infectious disease disasters: a randomized controlled trial.

Virtual simulation-based education for healthcare professionals has emerged as a strategy for dealing with infectious disease disasters, particularly when training at clinical sites is restricted due to the risk of infection and a lack of personal protective equipment. This research evaluated a virtual simulation-based education program intended to increase nurses' perceived competence in providing psychological support to patients affected by infectious disease disasters. The efficacy of the program was evaluated via a randomized controlled trial. We recruited 104 nurses for participation in the study and allocated them randomly and evenly to an experimental group and a control group. The experimental group was given a web address through which they could access the program, whereas the control group was provided with a web address that directed them to text-based education materials. Data were then collected through an online survey of competence in addressing disaster mental health, after which the data were analyzed using the Statistical Package for the Social Sciences(version 23.0). The analysis showed that the experimental group's disaster mental health competence (F = 5.149, p =.026), problem solving process (t = 3.024, p =.003), self-leadership (t = 2.063, p =.042), learning self-efficacy (t = 3.450, p =.001), and transfer motivation (t = 2.095, p =.039) significantly statistically differed from those of the control group. A virtual nursing simulation-based education program for psychological support can overcome limitations of time and space. The program would also be an effective learning resource during infectious disease outbreaks. This Korean clinical trial was retrospectively registered (21/11/2023) in the Clinical Research Information Service ( https://cris.nih.go.kr ) with trial registration number KCT0008965.

Mental health competencies are stronger determinants of well-being than mental disorder symptoms even in psychiatric samples

IntroductionExploring the positive psychological and behavioural dimensions of people living with mental disorders can establish a firm ground in a therapeutic alliance for setting up positive life goals.ObjectivesThe present study aimed to explored whether the strength of the mental health capacities and the severity of mental disorder symptoms and the interaction of the two differ in the strength of their associations with several dimensions of well-being on Hungarian adult psychiatric and non-clinical community samples.MethodsThe psychiatric sample (129 patients (44 male, 85 female)) was collected in four Hungarian healthcare facilities using a cross-sectional design. The non-clinical community sample (253 adults (43 male, 210 female)) was collected online using a cross-sectional design. All the respondents completed the Mental Health Test, six well-being and mental health measures, and the Symptom Checklist-90-Revised.ResultsIncluding both the mental health competencies and mental disorder symptoms variables in one regression model in both samples can predict patients’ well-being even more accurately. Mental health competencies related positively; mental disorder symptoms connected negatively to subjective well-being. In all models and both samples, mental health competencies were found to be a stronger determinant of well-being than the mental disorder symptoms. The interaction of mental health functioning and mental disorders is no more predictive of well-being in either psychiatric or non-clinical samples than when the effects of each are considered separately.ConclusionsThe assessment of mental health competencies has an important predictive value for well-being in the presence of psychopathological symptoms and/or mental disorders.Disclosure of InterestNone Declared

Effectiveness of Physical Activities in Students’ Mental Health at Elementary Level

This study investigates the effectiveness of physical activities in improving the mental health of elementary students. Preliminary analysis reveals a significant positive correlation between participation in physical activities and various indicators of mental health, including self-esteem, emotional regulation, and social competence. Certain types of activities, such as team sports and outdoor play, appear particularly beneficial. The study underscores the importance of integrating physical activities into the school curriculum to support the overall well-being and academic success of elementary students. The research was exclusively of a quantitative type. The association between students' physical activity levels and their mental health at a particular moment in time was investigated using a correlation research methodology. The elementary school children enrolled in public schools in District Layyah made up the study's population. There were 37,820 kids in the target population overall, comprising students in Grades 6, 7, and 8. There were 37820 people in total, and 380 pupils were chosen at random to make up the sample. Indicators of mental health and levels of physical activity were measured using a survey questionnaire. Structured questionnaires were used to gather data from the chosen group of primary school pupils. Using the proper statistical techniques, such as inferential and descriptive statistics, the collected data was examined. The data were summarized using descriptive statistics including mean, standard deviation, and frequency distributions. Inferential statistics, such as correlation analysis, were used to investigate the connections between primary school kids' levels of physical exercise and their mental health outcomes. All statistical tests were conducted with a significance threshold of p < 0.05. To make it easier to grasp and analyze the results, the data analysis results were presented as tables and figures. Based on the findings, the research questions were answered and conclusions were made. This study is important because it offers guidance on how parents, legislators, and educators can help their children engage in physical activity. Evidence-based guidelines, treatments, and policies aimed at improving mental and physical well-being can be informed by the results.

Loneliness in Pregnancy and Parenthood: Impacts, Outcomes, and Costs.

Background: Becoming a parent has been highlighted as a period associated with increased risks for loneliness, with around one-third of parents reporting feeling lonely often or always. However, as most understanding of loneliness is based on elderly or student cohorts, further insights into the costs of parental loneliness is needed. Method: We conducted a literature review of impacts of loneliness in pregnancy and parenthood and present a synthesis of the health, social, societal, and economic costs. We draw on evidence about impacts and costs of loneliness in other cohorts to help provide a wider context to understand the impacts and costs and how parental loneliness differs from other populations. Results: Similar to literature with elderly cohorts, parental loneliness has impacts on health and wellbeing, such as depression in new parents and increased general practitioner (GP) visits in pregnancy. But also has intergenerational impacts via its association with poor mental health and social competence and increased respiratory tract infections in the child. Physical health impacts widely associated with loneliness in other cohorts have yet to be examined in parents. Loneliness in parents is likely to result in social withdrawal further isolating parents and wider societal and economic costs relating to absence from employment and informal caring roles. Conclusion: Parental loneliness has the potential for negative and pervasive impacts. As parental loneliness has wide ranging and intergenerational impacts it is important that a multi-sectoral perspective is used when examining its costs.