Mental Health Research Articles

The Influence of Job Crafting on Nurses’ Intent to Stay: A Cross-Sectional Study

Background/Objectives: The increasing rates of nurse turnover pose significant challenges to healthcare systems, negatively impacting patient outcomes and increasing operational costs. Despite the recognized importance of retaining nursing staff, factors contributing to turnover intentions, such as job dissatisfaction and burnout, remain inadequately addressed. Developing job crafting skills among nurses can be a proactive strategy to mitigate these issues, leading to a more engaged and committed workforce. The aim of this study was to analyze nurses’ job crafting and its relationship with the intention to stay at their working hospitals or to leave the nursing profession. Methods: A cross-sectional, correlational study was conducted with a sample of 284 registered nurses using a self-reported online questionnaire with the standardized Spanish version of the Job Crafting Scale. Mann–Whitney U and Kruskal–Wallis nonparametric tests were used to determine statistically significant differences between two or more different groups for the job crafting variable, respectively. The Spearman correlation coefficient was calculated to explore the relationships between variables. Results: Mean scores obtained for the Job Crafting Scale indicated that nurses in the study had a high level of job crafting. Nurses with lower scores for the ‘Decreasing hindering job demands’ subscale had a significantly lower intention to stay at their workplace. Greater ‘Decreasing hindering job demands’ scores were significantly associated with a lower intention to leave the nursing profession. Lower nurses’ intention to leave the nursing profession was significantly associated with a greater intention to stay at hospitals. Conclusions: Improving ‘Decreasing hindering job demands’ job crafting skills to “decrease hindering job demands” through workload management, time management training, supportive supervision, resource availability, autonomy encouragement, promotion of team collaboration, and mental health support. It could lead to greater retention of nurses in their workplaces and in the nursing profession. Nursing managers and leaders should consider improving the job crafting skill “Decrease Hindering Job Demands” among nurses as a potential strategy for effective retention of nurses to address the challenges of the global nursing shortage.

Mental health services for the deaf: an exploratory study of the aetiology, sources of information, and access to mental health services among deaf persons in Ghana

Mental health services for the deaf: an exploratory study of the aetiology, sources of information, and access to mental health services among deaf persons in Ghana

Imitative inhibitory control is associated with psychotic experiences in a sample from the general population

Psychotic experiences (PE) are prevalent and associated with several negative mental health outcomes in both clinical and general population, particularly in young people. A promising avenue to understand the mechanisms underlying PE is to investigate functions that may be related to specific neural systems. One of these key cognitive mechanisms is the ability to control our imitative responses, which is strongly linked to an adequate social functioning. Emergent evidence suggests that impairments in this function might be involved in the early expressions of psychosis, but few studies have investigated its association with PE in a sample from the general population. Using an imitation-inhibition paradigm we examined this relationship in a community sample of young healthy individuals (N=204) and found that increased levels of PE levels were associated with lower imitative inhibitory control. These effects seem to be specific to imitation-inhibition as no correlation was found for a more general cognitive control as addressed by a Stroop-like task. In addition, these effects seem to be more evident for paranoid ideations. Overall, our results suggest that imitative inhibitory control can serve as a proxy to detect abnormalities associated with psychotic experiences.

Clinical Characteristics of Inpatients with Schizophrenia Spectrum Disorder Treated with Electroconvulsive Therapy: A Population-Level Cross-Sectional Study: Titre: Caractéristiques cliniques des patients hospitalisés présentant un trouble du spectre de la schizophrénie et traités par électrochocs : Une étude de population transversale

Objective Electroconvulsive therapy (ECT) is an evidence-based treatment for schizophrenia when anti-psychotic medications do not sufficiently control symptoms of psychosis or rapid response is required. Little is known about how it is used in routine clinical practice. The aim of this study was to identify the association of demographic and clinical characteristics with administration of ECT for schizophrenia spectrum disorders (SSD). Methods Among psychiatric inpatients with a diagnosis of SSD in Ontario, Canada (2006–2023), patient-level socio-demographic and clinical characteristics were described in those who did and did not receive ECT. We used multi-variable logistic regression to assess the association between patient-level characteristics and administration of ECT during index hospitalization. Results From 164,632 admissions, 2,168 (1.3%) involved exposure to ≥1 inpatient ECT procedure. Compared to those not receiving ECT, those receiving ECT were older, had higher rates of pre-admission medication use, medical and psychiatric comorbidities, outpatient mental health service use, but lower rates of substance use disorders. In the multi-variable logistic regression model, patient-level characteristics most strongly associated with receiving inpatient ECT were the presence of catatonia (odds ratio [OR]: 5.83; 95% confidence interval [95% CI]: 4.01–8.46), comorbid depression (OR: 2.49; 95% CI: 2.07–2.98), obsessive-compulsive disorder (OR: 2.16; 95% CI: 1.55–3.00), while characteristics most strongly associated with not receiving inpatient ECT were myocardial infarction (OR: 0.44; 95% CI: 0.20–0.95) and family conflict towards patient (OR: 0.47; 95% CI: 0.31–0.71). Neither severity of psychotic symptoms, non-command auditory hallucinations nor delusions were associated with administration of ECT. Conclusions While characteristics associated with the use of ECT are generally consistent with the indications for ECT (e.g., catatonia, mood disorders), ECT is rarely used amongst individuals with SSD. Severity of psychotic symptoms was not associated with the use of inpatient ECT suggesting an opportunity to increase the use of ECT in this population.

Reduction in Restraint and Critical Incidents in a Norwegian Residential Treatment Facility for Children Aged 7–13 Following the Implementation of the Neurosequential Model of Therapeutics

In child and adolescent inpatient, residential and day-treatment facilities, the use of physical restraints and the occurrence of critical incidents are a significant problem. Restraints may sometimes be necessary if a child exhibits dangerous aggressive behavior, but may also be misused or overused, and have been shown to be preventable in many cases. This study aims to investigate if the implementation of the Neurosequential Model of Therapeutics (NMT) has an effect on the annual number of physical restraint incidents in a residential treatment facility for children with complex mental health disorders. Data before and after NMT implementation were collected from the agency’s restraint records. The results showed that post-NMT implementation, there was a substantial and sustained reduction in restraint incidents, with a Cohen’s d value of 2.03, indicating a very large effect. Limiting restraint use in treating children with complex mental health disorders can foster a safer and more therapeutic environment, with potential improvements in treatment outcomes. This study demonstrated a substantial drop in restraint incidents following the implementation of the Neurosequential Model in a residential facility for children aged 7–13. This reduction is presumably pivotal for children with complex mental health disorders, making treatment less coercive and offering promise for settings in which restraint incidents are a concern.

Strengthening social presence and connectedness in 100% online courses through CONNECT

Over recent years, higher education has seen a significant shift toward online courses. Factors driving this change include digital technology ubiquity, diverse student populations, workforce demands, and the increasing need for more flexible learning environments (Serrano et al., 2019). However, while online course enrolments are rising faster than on-campus courses, retention rates remain lower (Australian Government, 2021). Evidence suggests that online education can negatively impact students’ sense of connection, leading to feelings of isolation and disempowerment (Roddy et al., 2017). This is also reflected in the Australian University Mental Health framework (Orygen, 2020) which emphasises creating supportive online learning environments that promote student well-being. The Australian Universities Accord (Australian Government, 2024) calls for universities to embrace TEL. However, given that research has shown the need for more professional development (PD) and support for online educators (Ahern and Biedermann, 2022; 2023), innovative, evidence-based strategies are needed for organisations to build capacity in online teaching. Drawing on a comprehensive review of literature, the authors developed CONNECT: a framework to enhance social presence and connectedness in online learning (Ahern et al., 2024). Grounded in research underpinned by Garrison et al.’s (2000) Community of Inquiry (CoI) framework, the principles of Universal Design for Learning (CAST, 2018) and leveraging TEL, this framework offers educators a roadmap for nurturing a sense of community that positively influences student well-being, engagement, and overall success. Key components of the CONNECT framework are: C - Communication is responsive and supportive O - Optimal online presence N - Nurture educational and professional growth N - Networking opportunities fostered E - Engaging communities of learning C - Contemporary and authentic content T - Timely and effective feedback for learning (Ahern et al., 2024). The study follows a quasi-experimental design to evaluate the effectiveness of CONNECT in guiding teaching staff to use evidence-based strategies to promote belonging and connectedness in online education. In phase one, CONNECT was implemented within a 100% online postgraduate (PG) subject. This presentation will showcase online teaching strategies used to apply all elements of CONNECT as implemented in phase one. Phase two, also showcased, involved creating and releasing an online short course as professional development for teaching staff across two PG online courses at the authors’ university: Master of Nursing (MN) and Graduate Certificate of Diabetes Education (GCDE). After these implementation phases, the third phase will measure the effectiveness of CONNECT across the two PG courses. Data will be collected via (i) a student survey and (ii) a staff survey. Data analysis will compare the experimental group (participants enrolled or teaching in MN or GCDE) against the control group (participants not enrolled or teaching in MN or GCDE). Data will be collected from students and teachers across Australian universities offering 100% online courses. We hypothesise that by implementing CONNECT, the study will (1) Show improved student satisfaction in the experimental group and (2) Add to the body of evidence to inform and support teaching staff to develop strategies that can help build connectedness and social presence in online learning.

Gym and swim: a co-facilitated exercise program that improves community connection, confidence, and exercise habits in a community mental health service

Gym and swim: a co-facilitated exercise program that improves community connection, confidence, and exercise habits in a community mental health service

Impact of cable lock distribution on firearm securement after emergent mental health evaluation: a randomized controlled trial

Abstract Background Suicide-related presentations to pediatric emergency departments (PED) have increased in recent years. PED providers have the opportunity to reduce suicide risk by counseling on restricting access to lethal means. Supplementing lethal means counseling (LMC) with safety device distribution is effective in improving home safety practices. Data on PED-based LMC in high-risk patient populations is limited. The objective of this study was to determine if caregivers of children presenting to PED for mental health evaluation were more likely to secure all household firearms if given cable-style gun locks in addition to LMC. Methods In this randomized controlled trial, caregivers completed a survey regarding storage practices of firearms and medication in the home. Participants were randomized to receive LMC (control) or LMC plus 2 cable-style gun locks (intervention). Follow-up survey was distributed 1 month after encounter. Primary outcome was proportion of households reporting all household firearms secured at follow-up. Secondary outcomes included: removal of lethal means from the home, purchase of additional safety devices, use of PED-provided locks (intervention only), and acceptability of PED-based LMC. Results Two hundred participants were enrolled and randomized. Comparable portions of study groups completed follow-up surveys. Control and intervention arms had similar proportions of households reporting all firearms secured at baseline (89.9% vs. 82.2%, p = 0.209) and follow-up (97.1% vs. 98.5%, p = 0.96), respectively. Other safety behaviors such as removal of firearms (17.6% vs. 11.8%, p = 0.732), removal of medication (19.1% vs. 13.2%, p = 0.361), and purchase of additional safety devices (66.2% vs. 61.8%, p = 0.721) were also alike between the two groups. Both groups held favorable views of PED-based counseling. Within the intervention group, 70% reported use of provided locks. Preference for a different style of securement device was the most cited reason among those not using PED-provided locks. Conclusions PED-based LMC is a favorably-viewed, effective tool for improving home safety practices in families of high-risk children. Provision of cable-style gun locks did not improve rate of firearm securement compared LMC alone—likely due to high baseline rates of firearm securement and preference for different style of lock among non-utilizers. Clinical Trial Registration ID: NCT05568901. Clinicaltrials.gov. https://clinicaltrials.gov/. Retrospectively registered October 6, 2022. First participant enrollment: June 28, 2021.

Welcoming 2025: Considering Novel Models of Supporting Youth Mental Health

Welcoming 2025: Considering Novel Models of Supporting Youth Mental Health

Infants show negative changes in affect and physiology when re‐experiencing a stressor, its context, and a positive event 24‐h later

AbstractExposure to early life stress shapes further development, affects later stress reactivity, and mental health outcomes. Despite the central role of early experiences, there is little understanding of how these rapidly forgotten events gain their influence. An infant's ability to cope with everyday stressors is founded on successful co‐regulation through mother‐infant interaction. A significant disruption of this interaction through the Face‐to‐Face Still‐Face paradigm elicits a well‐documented behavioral and physiological stress response in infants. What has yet to be explored is whether infants show regulatory adaptions when encountering the situation over again. To fill this gap, 80 mother‐infant dyads were observed in the lab on two consecutive days. Infants in the experimental condition (n = 40) were exposed to a double Still‐Face paradigm on day one. Infants in the control group (n = 40) completed time‐matched episodes of typical play during their first visit. Mother‐infant dyads from both groups returned to the lab 24 h later and participated in the double Still‐Face paradigm. Changes in behavior (positive and negative affect), physiology (heart rate), and salivary cortisol, compared to day one and between groups, were evaluated and used to infer adaption to the previous experienced laboratory visit. Infants in the experimental condition showed a significant decrease in positive affect (p = 0.016) and an increase in heart rate (p < 0.001) on day two, compared to controls, even during baseline measures and a neutral first play episode. Infants in the control condition showed a significant decrease in affect (p = 0.05) and non‐significant increase in heart rate on day two when first encountering the Still‐Face paradigm. Infants in the experimental condition showed significant higher heart rate on day two compared to the control group (p = 0.046). Infants in the experimental condition also exhibited a marginally significant increase in salivary cortisol on day two, compared to day one (p = 0.054). The change in infant heart rate was independent of maternal heart rate which did not differ between day one and day two, or between groups. Findings suggest that a previous stressful experience may elicit a behavioral and physiological adaption in infants 24 h later. Our results suggest that even a short, acute stressful event can elicit a lasting stress response in infants 24 h later. The effect we observed was specific to the context of the stressful event, not just the stressor. More precisely, the effect “spilled over” from the stressful experience on day one into the baseline measure of day two, usually a neutral experience. The results could have implications for further research on how stressful experiences may shape the stress response.

Youth Mental Health: The Role of Culture & KTE Approaches in Expanding the Research Workforce

ABSTRACTDespite efforts to expand the youth mental health workforce, disparities continue to persist in service provision, the effectiveness of existing programs and practices, and in research. While there is no quick fix to rectify these issues, expanding the research workforce can serve as a preliminary step in reducing many of the disparities that exist. The current work highlights the necessity for increased efforts to recruit a population of experts (i.e., practitioners) into the research workforce that possesses a level of knowledge and expertise largely untapped by research producers. Furthermore, knowledge transfer and exchange (KTE) methodologies are offered as innovative approaches that can be harnessed to facilitate this change. To provide rationale for expanding not only the research workforce but reimagining historical notions of what research is, and who qualifies as belonging in this space, with examples of action steps that can be utilized by producers to attract practitioners. The use of KTE and related approaches to attract practitioners to research has positive implications including but not limited to expanding the youth mental health workforce.

Fear of COVID-19 and mental health status among the medical students of a selected medical college in Bangladesh

Fear of COVID-19 and mental health status among the medical students of a selected medical college in Bangladesh

Delivering a mental health response vehicle service in Wales: a pilot initiative

Delivering a mental health response vehicle service in Wales: a pilot initiative

Attitudes of primary healthcare nurses towards people living with mental illness in Botswana

Background: The global disease burden attributable to mental and neurological disorders has been increasing over the years. World Health Organization (WHO) recommends the integration of mental health services into existing primary healthcare framework as one strategy for dealing with the burden. Understanding the attitudes of nurses towards people with mental illness is important for a successful integration and management outcome of patients.Aim: This study aimed to determine primary healthcare nurses’ attitudes towards people with mental illness.Setting: The study was conducted at Greater Lobatse health district, one of the primary healthcare districts in Botswana.Methods: A cross-sectional study was conducted among 202 nurses working in the greater Lobatse health district from 01 May 2023 to 30 November 2023. Convenience sampling was used. Data were collected using a structured self-administered questionnaire.Results: The prevalence of negative attitudes was 51.5%. The mean age (standard deviation [s.d.]) of respondents was 33.4 (8.0) years. Being a non-specialised nurse (B= –0.184; p = 0.014), having a personal history of mental illness (B = –0.215; p = 0.002), and having poor knowledge about mental illness (B = –0.149; p = 0.032) were associated with negative attitudes.Conclusion: More than half of the respondents have negative attitudes towards people with mental illness. This justifies the need for training and educational programmes and anti-stigma campaigns among primary healthcare nurses to mitigate negative attitudes.Contribution: This study provides insight into primary healthcare nurses’ attitudes towards people with mental illness.

The well-being paradox: Comparing prosocial and self-kindness interventions for mental health benefits.

The well-being paradox: Comparing prosocial and self-kindness interventions for mental health benefits.

Machine Learning for Mental Health: Applications, Challenges, and the Clinician's Role

Machine Learning for Mental Health: Applications, Challenges, and the Clinician's Role

Long Term Outcomes in Patients With Differences in Sex Development in Lucknow, India

ABSTRACTContextThe long term outcomes for individuals with a difference in sex development (DSD) are influenced by ethnic, socio‐cultural and economic factors, besides the medical issues. Data from India on these aspects are sparse.Design and MeasurementsWe report on gender identity, patients' opinion regarding timing of genitalia surgery, suicidal thoughts, romantic inclination, and quality of life (QOL, SF36 scale), in 31 young adults with a DSD.ResultsMedian (IQR) age was 23 (19–27) years; 16 raised male, 15 female. Age at first surgery was 6.0 (2.0–16.25) years. Gender identity in 30 patients remained identical with sex of rearing. Majority (27) thought the timing of genital surgery should be in childhood. Six of 31 patients had attempted suicide at least once. Four patients reported sexual abuse in the past. Twelve patients reported romantic relationships, rates similar to reports from India, with seven reporting sexual intercourse. Eleven of 31 patients reported aversion to and fear of sexual activity, due to fear of rejection. Heterosexual orientation was reported by 25 of 29 patients. QOL scores were not different between patients and 46 healthy controls or 43 people with type 1 diabetes. Mental QOL scores were lower for those with history of teasing (37.10 ± 16.01 vs. 47.76 ± 9.4 in those without, p = 0.04) and with suicidal thoughts (33.9 ± 14.51 vs. 45.65 ± 13.2 for those without, p = 0.04).ConclusionsThe absence of prominent gender dysphoria in our young adults was noteworthy, as was their preference for early genital surgery. Lack of adequate mental health support is a high alert for our teams involved in the care of DSD and as well as for policy‐makers.

The state of mental health among older Chinese and the role of children

The state of mental health among older Chinese and the role of children

A live online exercise program for older adults improves depression and life-space mobility: A mixed-methods pilot randomized controlled trial

Background Aging is the primary risk factor for sarcopenia and mobility limitations. Exercise reduces these risks, but older adults have low levels of participation in physical activity and exercise. We investigated the preliminary effectiveness of a live, online exercise program on community-dwelling older adults’ physical activity levels. Methods A mixed-method pilot randomized controlled trial was conducted according to CONSORT 2010 statement: extension for pilot and feasibility trials. Sedentary older adults (65–80 years) were randomly assigned to the online exercise intervention (ACTIVE) or a waitlist control (CON) group. Outcomes were measured pre-randomization and following the 8-week intervention for ACTIVE and CON and two months following the end of the intervention for the ACTIVE group. Outcomes included habitual physical activity levels, depression, anxiety, loneliness, life-space mobility, nutrition risk, and feasibility. All participants were invited to participate post-intervention in individual semi-structured qualitative interviews. Reporting of the qualitative research followed the checklist for the Consolidated Criteria for Reporting research. Results Seventeen older adults (71% women) were allocated to ACTIVE group, while 15 were allocated to CON group (87% women). Following the intervention, participants in the ACTIVE group reported reduced symptoms of depression (ACTIVE: pre = 4.2 ± 2.5; post = 2.2 ± 1.9; CON: pre = 3.5 ± 2.1, post = 3.5 ± 2.1; p <0.001) and improved life-space mobility (ACTIVE: pre = 62.4 ± 14.7; post = 71.8 ± 16.0; CON: pre = 65.1 ± 19.0, post = 63.6 ± 22.0; p = 0.003) compared to waitlist control participants. The ACTIVE group had good adherence (97%) and acceptability (98%). Twenty-two participants participated in qualitative interviews. Five themes were identified, including (1) Feasibility of the online exercise program; (2) Perceived health benefits and improvements; (3) Registered Kinesiologists and Physiotherapists contributed to perceived safety; (4) Social connectivity associated with synchronous/live delivery; and (5) Growing old gracefully and preventing disability. Conclusions Our online exercise program was acceptable to older adults, had good adherence, reduced depression, and increased life space. Participants reported improved functional and mental health benefits. Further research is warranted to expand on these findings. Trial registration NCT04627493; 13/11/2020.

Empowering primary care physicians in child and adolescent psychiatry: a needs assessment on collaborative care in Dubai

BackgroundChild and adolescent psychiatric disorders pose significant public health concerns necessitating prompt intervention. Primary care physicians (PCPs) play a critical role as initial points of contact, facilitating early detection, management, and referral of these conditions. In Dubai, integrating mental health services into primary care faces unique challenges, highlighting the need for systemic reforms and enhanced PCP training.ObjectiveThis study investigated perceptions, barriers, and systemic challenges encountered by PCPs in managing child and adolescent psychiatric conditions in Dubai’s primary care setting. It also assessed family physicians’ involvement and preparedness in this domain.MethodsUsing a mixed-methods approach, we conducted a survey among family physicians in Dubai Health facilities and analyzed patient data from family medicine clinics. The survey evaluated formal training, preparedness, encounter frequency, and referral patterns for psychiatric care in young patients. Qualitative insights from open-ended survey questions provided additional understanding of specific challenges.ResultsFindings revealed significant gaps in formal training, with only 33.3% of respondents trained in child and adolescent psychiatry during medical education, and 21.1% participating in Continuing Medical Education (CME). A majority (54.4%) of PCPs felt unprepared to manage psychiatric care in young patients. Patient data analysis showed a predominance of male patients (59.9%) and identified Autism Spectrum Disorder (43.1%) as the most common condition, emphasizing the reliance on specialized care through a high referral rate (63.1%). Major barriers included time constraints, limited psychiatric knowledge, resistance to mental health services, systemic and structural issues, communication challenges, and resource shortages.ConclusionEnhanced training and systemic reforms are urgently needed to integrate mental health services effectively into Dubai’s primary care. Implementing structured collaborative care models, fostering interdisciplinary collaboration, and addressing systemic barriers are crucial for improving child and adolescent psychiatric condition management. These initiatives promise better patient outcomes and more efficient healthcare resource utilization.