Mental Health Prevention Programs Research Articles

The effect of stress exposure on depressive symptoms and major depressive episode among US Afro-Caribbean women.

This study examines whether stress exposures experienced within and across various life domains (e.g., interpersonal, financial) are predictors of depression among Afro-Caribbean women, an understudied ethnic group within the US Black female population. A sample of Afro-Caribbean women (N = 878) was drawn from the National Survey of American Life (NSAL), the first nationally representative psychiatric epidemiology survey focused on the mental health of the US Afro-Caribbean and African American populations. Negative binomial regression analysis was conducted for depressive symptoms, and binary logistic regression results are presented for past-year and lifetime major depressive episode. Analyses examined the relative effect of five stress exposures on depression: major discrimination, everyday discrimination, past-month chronic stress, financial strain, and negative interactions with family. Of the five stress exposures, chronic stress and financial strain were associated with increased risk for both recent (e.g., past week) and more distal (i.e., past-year and lifetime) experiences of depression. Though experiences with discrimination were associated with depression, its effects were attenuated when other stressors were taken into account. Mental health prevention and intervention programs must address stress concerns that are chronic in nature and stressors that reflect financial instability for Afro-Caribbean women.

Psychiatric morbidity among undergraduate students of university of Ilorin, Kwara state, Nigeria

IntroductionThe Nigerian tertiary education system admits mostly teenagers and young adults from different ethno-religious and family backgrounds, some of whom may have inherent risks and predisposition to mental illness. They then undergo stressful conditions related to the university life such as long durations of lectures, over-crowding, and lack of social amenities, haphazard lecture schedules as well as incessant industrial strike actions of academic and non- academic staff. In spite of these, there appears to be few studies on the burden of emotional and mental disorders among Nigerian University students, and none was cited suggesting interventions that may be appropriate.ObjectivesThe objectives of the study is to determine the prevalence of psychiatric morbidity and its associated factors among undergraduate students of Univesity of IlorinMethodsThis is a cross-sectional study using multi staged systematic randomization. A self-administered socidemographic questionnaire and the 12 item general health questionnaire (GHQ -12) was administered on 3,300 students.ResultsPsychiatric morbidity was found to be 23.6% of the 3179 analyzable returned questionnaires. Factors found to be significantly associated with psychiatric morbidity included female gender, relationship with parents, parental employment status and family structure. Students on scholarship were more likely to have mental illness. Other associated factors include whether course of study was the preferred one and relationships with peers and lecturers on campus. About 46.6% of the students were willing to have internet based mental health intervention programmes.ConclusionsThe data obtained from this study is relevant for the formation of mental health promotion and prevention programs on our campus.Disclosurethis study is part of the first phase of a three phase study. it aims to explore the factors associated with psychiatric morbidity among University student as a precursor for determining appropriate mental health interventions. it was partly funded by the

Psychosocial burden and working conditions during the COVID-19 pandemic in Germany: The VOICE survey among 3678 health care workers in hospitals

ObjectiveThe aim of this cross-sectional web-based study was to examine self-reported mental distress, psychosocial burdens, working conditions and potential risk and protective factors for depressive and anxiety symptoms during the COVID-19 pandemic in health care workers (HCW). MethodsIn the largest survey on mental health of HCW conducted during the first wave of COVID-19 in Europe (N = 8071 HCW), we investigated depressive (Patient Health Questionnaire-2, PHQ-2), and anxiety symptoms (Generalized Anxiety Disorder-2, GAD-2), working conditions, and psychosocial burden of 3678 HCW of three health care professions in hospitals: physicians (n = 1061), nurses (n = 1275), and medical technical assistants (MTA, n = 1342). ResultsThe prevalence of clinically significant levels of depressive and anxiety symptoms was 17.4% and 17.8% for physicians, 21.6% and 19.0% for nurses, and 23.0% and 20.1% for MTA, respectively. All three professions demonstrated significantly elevated PHQ-2 and GAD-2 scores, when compared with general German population before the pandemic, but lower scores in relation to that during the pandemic. Multiple linear regression analyses revealed that higher levels of depressive symptoms were associated with insufficient recovery during leisure time, increased alcohol consumption, and less trust in colleagues in difficult situations at work. In addition, elevated anxiety scores were related to increased fear of becoming infected with COVID-19. ConclusionDuring the pandemic HCW demonstrated a lower burden of mental distress compared to the general population. Nevertheless, a high percentage of HCW demonstrates psychosocial distress, so that the establishment of regular mental health screening and prevention programmes for HCW is indicated.

Evidence Synthesis of Digital Interventions to Mitigate the Negative Impact of the COVID-19 Pandemic on Public Mental Health: Rapid Meta-review.

BackgroundAccumulating evidence suggests the COVID-19 pandemic has negative effects on public mental health. Digital interventions that have been developed and evaluated in recent years may be used to mitigate the negative consequences of the pandemic. However, evidence-based recommendations on the use of existing telemedicine and internet-based (eHealth) and app-based mobile health (mHealth) interventions are lacking.ObjectiveThe aim of this study was to investigate the theoretical and empirical base, user perspective, safety, effectiveness, and cost-effectiveness of digital interventions related to public mental health provision (ie, mental health promotion, prevention, and treatment of mental disorders) that may help to reduce the consequences of the COVID-19 pandemic.MethodsA rapid meta-review was conducted. The MEDLINE, PsycINFO, and CENTRAL databases were searched on May 11, 2020. Study inclusion criteria were broad and considered systematic reviews and meta-analyses that investigated digital tools for health promotion, prevention, or treatment of mental health conditions and determinants likely affected by the COVID-19 pandemic.ResultsOverall, 815 peer-reviewed systematic reviews and meta-analyses were identified, of which 83 met the inclusion criteria. Our findings suggest that there is good evidence on the usability, safety, acceptance/satisfaction, and effectiveness of eHealth interventions. Evidence on mHealth apps is promising, especially if social components (eg, blended care) and strategies to promote adherence are incorporated. Although most digital interventions focus on the prevention or treatment of mental disorders, there is some evidence on mental health promotion. However, evidence on process quality, cost-effectiveness, and long-term effects is very limited.ConclusionsThere is evidence that digital interventions are particularly suited to mitigating psychosocial consequences at the population level. In times of physical distancing, quarantine, and restrictions on social contacts, decision makers should develop digital strategies for continued mental health care and invest time and efforts in the development and implementation of mental health promotion and prevention programs.

Meta-analysis of Prevalence of Depression, Anxiety and Stress Among University Students

Background: The global burden on mental disorders have become too advanced with serious consequences on health and society. Over the years, depression, stress, and anxiety have become more common symptoms which affect all over population pyramid irrespective of the gender. Mental disorders are second most health indicator that causes morbidity.
 Objectives: The mental disorders affect the entire population and both genders equally. Present study was conducted to carry out meta-analysis study to highlight the prevalence of anxiety, depression, and stress among university students.
 Methodology: Various search engines i.e. Google scholar, Duckduckgo, AOL, Baidu, Yahoo as well as books and newsletter were used to collect the data.
 Results: Despite tremendous development in the era of health and education, there is significant prevalence (79.5%) of anxiety, depression, and stress in medical students that leads to morbidity and poor mental health disorders among these students.
 Conclusion: It is concluded from meta-analysis study that prevalence of depression and anxiety is alarmingly high. There is a need of the hour to develop and design the mental health prevention programs and health education programs to overcome this issue.

Alcohol, Tobacco, and Comorbid Psychiatric Disorders and Associations With Sexual Identity and Stress-Related Correlates.

The authors examined psychiatric comorbidities associated with alcohol use disorders and tobacco use disorders among heterosexual, bisexual, and gay and lesbian men and women in the United States and whether stress-related factors were predictive of comorbidities. The authors used data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012-2013, N=36,309) to examine the co-occurrence of past-year alcohol or tobacco use disorder with past-year anxiety disorders, mood disorders, and posttraumatic stress disorder by sexual identity (heterosexual, bisexual, gay or lesbian) and sex. The authors also examined the association of stress-related factors and social support with the presence of comorbidities. Comorbidities were more prevalent among women and sexual minorities, particularly bisexual women. More than half of bisexual (55%) and gay or lesbian (51%) individuals who met criteria for a past-year alcohol use disorder had a psychiatric comorbidity, while only one-third of heterosexual individuals who met criteria for a past-year alcohol use disorder did. Similar differences were found among those who met criteria for a past-year tobacco use disorder. Among sexual minorities, the frequency of sexual orientation discrimination (adjusted odds ratio range=1.08-1.10), number of stressful life events (adjusted odds ratio range=1.25-1.43), and number of adverse childhood experiences (adjusted odds ratio range=1.04-1.18) were significantly associated with greater odds of comorbidities. Greater social support was significantly inversely associated with tobacco use disorder comorbidities (adjusted odds ratio range=0.96-0.97). This research suggests that integrated substance use and mental health prevention and treatment programs are needed, particularly for individuals who identify as sexual minorities. The increased stressors experienced by sexual minority individuals may be important drivers of these high levels of comorbidities.

A qualitative study of friendships in old age: The case of a nursing home in Turkey

This study aims to understand, discuss, and describe the unique friendship dynamics of the elderly. A qualitative method-phenomenological design was adopted to obtain in-depth information. The study group comprised nursing home residents (n = 17), with nine female and eight male residents over the age of 65. The data collected through two focus group interviews were analyzed using MAXQDA 2018-Version 2018. According to the data analysis, sub-codes for the definitions of friendship by the elderly could be separated into five generic categories: behavioral processes (assistance, sharing, boundaries, altruism, and graciousness); cognitive processes (trust, respect, commitment and fidelity, compatibility, and morality); affective processes (intimacy and requirement); structural characteristics (openness, vigilance, reciprocity, and support during good times and bad); and distinctive features (despair, references to the past, health competence, and caregiver as a friend). Although it has been recognized that the elderly offer similar statements as other age groups with regard to the emotional, behavioral and cognitive definitions of friendship, it has been observed that they often refer to the past when they are expressing their friendships and that establishing and maintaining friendships depend on their health status and capabilities. Establishing a friendship with the caregiver is a remarkable characteristic of this period. The results of this research, which aimed to examine the friendship dynamics of the elderly, can be a resource for researchers who discuss the theory of friendship and aging and can be used as a source for the development of elderly care, social support services, and preventive mental health programs for the elderly.

Fattori predittivi del drop-out: accettabilità e impegno nel parent training

L'obiettivo di questa revisione è identificare metodi efficaci per migliorare l'impegno e l'adesione delle famiglie ai programmi di parent training (BPT). Nonostante la letteratura indichi risultati positivi, spesso le famiglie mostrano uno scarso impegno, fino a giungere a un precoce abbandono del percorso terapeutico. Ciò comporta una serie di conseguenze negative per le famiglie, i clinici, la ricerca e il servizio sanitario nazionale. La letteratura, ad oggi, individua alcuni fattori predittivi del drop-out e varie componenti da includere nei parent training per aumentare l'impegno e l'adesione alle procedure di intervento. Tra strategie di coinvolgimento, alcuni autori suggeriscono l'utilizzo di un promemoria degli appuntamenti, brevi discussioni iniziali sulla necessità di impegnarsi, metodi di coinvolgimento dei sistemi familiari, adattamenti strutturali del programma, incentivi finanziari, aumento del supporto familiare e colloqui motivazionali. Nonostante i programmi BPT abbiano un'elevata efficacia nel cambiamento del comportamento genitoriale, la letteratura evidenzia elevati livelli di drop-out, ragion per cui gli studi presentati hanno piccoli campioni che limitano il potere statistico e la generalizzabilità dei risultati.

Sexual-orientation based discrimination is associated with anxiety and depression in young physicians. A national study.

IntroductionThe professional risk factors for depression and anxiety are underexplored in young physicians. While there has been increasing research on the mental health and well-being of lesbian, gay and bisexual patients, few studies have examined the mental health and well-being of lesbian, gay and bisexual young physicians. ObjectiveThe objective of the present study was to determine the prevalence of Sexual Orientation-Based Discrimination (SOBD) in French young physicians and if SOBD was associated with increased anxiety and depression in this population. MethodThis national study is a cross-sectional observational epidemiological national study. The participants were recruited between April 1st 2019 and June 31st 2019. One question with binary answer was asked on SOBD. Mental health was assessed by Hamilton Anxiety & Depression scales. ResultsOn the 2003 participants, 148 (7%) reported SOBD exposure, 647 (32%) current anxiety disorders and 174 (9%) a current major depressive disorder according to their HAD score. SOBD was almost twice more frequently reported in participants with anxiety disorder and major depression (respectively 10%,vs 6% and 12% vs. 7%, p<0.05). In the first model of multivariate analyses, current anxiety disorder was significantly associated with being woman (adjusted odds ratio aOR=1.688, 95%CI 1.350-2.110, p<0.001) and SOBD (aOR=1.729, 95%CI 1.226-2.440, p=0.002). In the second model of multivariate analyses, current major depression was significantly associated with only SOBD (aOR=1.748, 95%CI 1.057-2.888, p=0.029). ConclusionSOBD has been associated with increased rates of anxiety disorder and major depression in young physicians and should be targeted in mental health prevention programs.

Socio-demographic characteristics, lifestyle factors, multi-morbid conditions and depressive symptoms among Nepalese older adults

BackgroundDepressive symptoms (DS) are a well-recognized public health problem across the world. There is limited evidence with regard to DS and its associates, such as socio-demographic characteristics, lifestyle factors and chronic conditions in low-income countries like Nepal. In this study, we aimed to assess the level of DS and its relationship with socio-demographic characteristics, lifestyle factors and chronic disease conditions among community dwelling older people in Nepal.MethodsWe conducted a cross-sectional study of 794 older adults aged 60 or above residing in the rural setting of the Sunsari and Morang districts of eastern Nepal between January and April 2018. Multi-stage cluster sampling was adopted to select the study participants. Data included socio-demographics, lifestyle factors, self-reported chronic disease conditions and the Geriatric depression scale. On Geriatric depression scale, an older adult with a test score greater than five were defined as having depressive symptoms. Determinants of DS were estimated through the generalized estimating equation (GEE) approach by considering exchangeable correlation structure among clusters.ResultsIn our study samples, nearly 55.8% of the older adults were found to be suffering from DS. We found a significant association between DS and being female (aOR: 1.25, 95% CI: 0.89–2.09), Buddhism (aOR: 1.95, 95% CI: 1.58–2.42), Dalits (aOR: 2.60, 95% CI: 1.19–5.65), unemployed, low family income (aOR: 1.77, 95% CI: 1.07–2.92), smokers (aOR: 1.49, 95% CI: 1.01–2.20) and having chronic multi-morbid conditions (aOR: 1.67, 95% CI: 1.09–2.55).ConclusionsThe prevalence of DS was high among community-dwelling older adults in eastern Nepal. Our findings suggest the need for mental health prevention and management programs targeting the older population in rural Nepal.

The relationship between early risk-taking behavior and mental health problems among a nationally representative sample of Australian youth

BackgroundEarlier engagement in risk-taking behaviors has been associated with more severe mental health problems across development. However, sex differences in risk-outcome relationships remain underexplored and mental health outcomes spanning both ends of the internalizing and externalizing spectra are rarely considered within the same sample. The present study examined associations between age at initiation of alcohol use, illicit drug use, and sexual intercourse, and symptoms of internalizing, externalizing, depression and self-harm, for males and females. MethodsThe present study analyzed self-report survey data from a nationally representative sample of Australian adolescents (N=2,950). Logistic regression models were conducted separately for males and females to test the association of early (age 15 or younger) and concurrent (age 16–17) initiation of alcohol use, illicit drug use and sexual behavior with symptoms of internalizing, externalizing, depression and self-harm at age 16–17. ResultsRisk-taking behaviors were associated with all mental health outcomes. Generally, earlier initiation of risk-taking behaviors demonstrated stronger associations with mental health outcomes than concurrent initiation. Associations between risk-taking behaviors and mental health outcomes varied by participant sex and mental health outcome. LimitationsMechanisms underlying the relationship between risk-taking behaviors and mental health problems were not tested and the sample had not yet reached early adulthood. ConclusionsRisk-taking behaviors, particularly when initiated early, share links with multiple mental health problems in adolescence. Public health strategies to delay the onset of risk-taking behaviors may therefore incur multiple benefits as might an integrated approach to mental health prevention programs for youth.

Can We Predict the Evolution of Depressive Symptoms, Adjustment, and Perceived Social Support of Pregnant Women from Their Personality Characteristics? A Technology-Supported Longitudinal Study.

Background: Research exploring the relationship between personality and important pregnancy outcomes (i.e., depressive symptoms, adjustment, and perceived social support) tends to be cross-sectional, arguably due to the difficulties of conducting longitudinal and mental health research in this population. The objective of this study is to use a web-based solution to longitudinally explore how personality traits are associated, not only with the co-occurrence of these outcomes but also with their evolution during pregnancy. Stability and change of these outcomes will also be investigated. Methods: The sample included 85 pregnant women attending several medical centers in Spain. The web-based assessment included sociodemographic and obstetric variables (ad hoc) and personality (at the second trimester only), and outcomes at both the second and the third trimester (i.e., depressive symptoms, adjustment, and perceived social support). Results: The results showed that adjustment worsened from the second to the third trimester of pregnancy. Neuroticism (N), low extraversion (E), and psychoticism (P) were cross-sectionally and longitudinally associated with outcomes. In addition, N and, to a lesser extent P, uniquely contributed to the evolution of these outcomes in the multivariate analyses, including autoregressions. Conclusion: Personality and especially N and P should be evaluated early during pregnancy mental health screening. The use of a web page appears to be a useful tool for that purpose. Technologies might also help disseminate mental health prevention programs for these women, which would be especially recommended for those with a personality profile characterized by high N and P and, to a lesser extent, low E.

Examination of the Relationship between Parenting Identity and Internalizing Problems: A Preliminary Examination of Gender and Parental Status Differences

ABSTRACTThis study sought to examine the associations between parental identity commitment, in-depth exploration, and reconsideration of commitments with mental health outcomes (i.e., symptoms of depression and generalized anxiety). Furthermore, the current study examined differences in associations between both current and expecting parents. A diverse cross-sectional sample of 328 current and expectant parents (82.6% female; Mage = 35.36 years; SD = 11.34 years, range 18–76 years) completed an online survey measuring parental identity, depressive symptoms and general anxiety. Consistent with previous literature and our hypothesis, parental identity commitment was negatively associated with generalized anxiety and depression. Additionally, reconsideration of commitment was positively associated with generalized anxiety and depression. In-depth exploration was positively associated with symptoms of anxiety, possibly as a result of lengthy periods of apprehension or questioning of parental identity. No significant difference was found among first-time expecting parents and current parents regarding the association between parental identity processes and mental health outcomes. Findings from this study illustrate the role parental identity has in general adult adaptation and shows the importance of mental health prevention and intervention programs for current and expecting parents.

Common Elements of Childhood Universal Mental Health Programming

Despite the availability of multiple mental health prevention and promotion programs for children, challenges related to their dissemination limit their reach and impact. This review identifies the most common practice elements of effective childhood universal mental health programming for children ages 3-11, based on a structured interpretation and coding of program manuals and descriptions in peer-reviewed articles. Across a range of program goals and targeted outcomes, psychoeducation and problem solving emerged as the most common practice elements, followed by social skills training, insight building, and communication skills. These skills were largely taught via role-plays and modeling. Synthesizing what we know from the universal mental health programming literature has potential to facilitate dissemination of information to inform the development, adaptation or adoption of programs for children.

Suicide prevention among young people: A study protocol for evaluating Youth Aware of Mental Health in Australian secondary schools.

BackgroundSuicide is the leading cause of death for Australians aged 15–24 years, with rates increasing over the past decade. As young people can be particularly vulnerable to mental health problems and suicidal behaviour, they are an important and obvious target for suicide prevention efforts. This study aims to determine the feasibility, acceptability, and impact of a universal, mental health and suicide prevention program – Youth Aware of Mental Health (YAM) – for young people in Australia. MethodsThis trial takes place in Australian schools, across four regions in New South Wales that form part of LifeSpan, a larger integrated suicide prevention research trial. YAM will be delivered to Year 9 students in up to 124 schools over two years. Participating students will complete a questionnaire at baseline, 3-months post-intervention, and at 6 and 12-month follow-up. The primary outcome is feasibility and acceptability of YAM. Secondary outcomes are suicidal ideation, new reports of suicide attempt, stigma towards suicide, knowledge about suicide, help-seeking (intentions and behaviours), and depressive symptoms. ResultsYAM is expected to be delivered, with high fidelity, to the majority of schools within the trial regions. Improvements in secondary outcomes are expected to be observed from baseline to 3-months post-intervention and longitudinal effects at 6 and 12-month follow-up. ConclusionsFindings from this research will contribute to the evidence-base for suicide prevention programs in Australian schools and, if proven effective, YAM could be widely delivered in Australian secondary schools, providing a valuable new resource.

Psychosocial factors of deliberate self-harm in Afghanistan: a hospital based, matched case-control study.

Deliberate self-harm is not only a major global public health problem but also an important index of psychological distress and a risk factor for suicide. We aimed to determine the psychosocial risk factors for deliberate self-harm in patients aged ≥ 16 years presenting to tertiary care hospitals in Kabul, Afghanistan. A matched case-control study was conducted from February 2015 to May 2015. We recruited 185 cases (patients with deliberate self-harm) and 555 age- and sex-matched controls (patients with general medical conditions) from 4 tertiary care hospitals in Kabul. We developed a questionnaire to record the sociodemographic characteristics of the participants, history of domestic violence, drug abuse and details about the act of deliberate self-harm, including the methods used. To assess depression and anxiety, we used the WHO self-reporting questionnaire (SRQ-20). Matched odds ratios with 95% confidence interval using conditional logistic regression were used to determine statistically significant associations between psychosocial factors and deliberate self-harm. Family conflicts, domestic violence, interpersonal arguments and living in extended families were found to be significantly associated with deliberate self-harm. In Afghanistan, deliberate self-harm appears to be predominately related to interpersonal problems and family conflicts. About two-thirds of females and more than half of males scored positive for depression, yet none were receiving treatment for this. These findings have important policy implications for mental health and suicide prevention programmes in the country.

Cost-effectiveness of a mindfulness-based mental health promotion program: economic evaluation of a nonrandomized controlled trial with propensity score matching

BackgroundMental health promotion programs have been shown to reduce the burden associated with mental distress and prevent the onset of mental disorders, but evidence of cost-effectiveness is scarce.ObjectiveTo evaluate the cost-effectiveness of a mindfulness-based mental health prevention program provided by health coaches in a multi-site field setting in Germany.MethodsThe single-study based economic evaluation was conducted as part of a nonrandomized controlled trial, comparing the effects of a group-based prevention program to usual care based on propensity score matching. Participants (N = 1166) were recruited via a large statutory health insurance fund. Health outcome was assessed with the Hospital Anxiety and Depression Scale (HADS). Cost outcomes were actually incurred costs compiled from the health insurance’ records. Incremental cost-effectiveness ratios (ICER) were analyzed from a societal and a health care perspective for a 12-month time horizon with sampling uncertainty being handled using nonparametric bootstrapping. A cost-effectiveness acceptability curve was graphed to determine the probability of cost-effectiveness at different willingness-to-pay ceiling ratios.ResultsFrom a societal perspective, prevention was cost-effective compared to usual-care by providing larger effects of 1.97 units on the HADS (95% CI [1.14, 2.81], p < 0.001) at lower mean incremental total costs of €-57 (95% CI [− 634, 480], p = 0.84), yielding an ICER of €-29 (savings) per unit improvement. From a health care perspective, the incremental health benefits were achieved at additional direct costs of €181 for prevention participants (95% CI [40, 318], p = 0.01) with an ICER of €91 per unit improvement on the HADS. Willingness-to-pay for the prevention program to achieve a 95% probability of being cost-effective compared to usual-care, was estimated at €225 per unit improvement on the HADS score from a societal, and €191 from a health care perspective respectively. Sensitivity analyses suggested differential cost-effect-ratios depending on the initial distress of participants.LimitationsDue to the complexity of the field trial, it was not feasible to randomize participants and offer an active control condition. This limitation was met by applying a rigorous matching procedure.ConclusionsOur results indicate that universal mental health promotion programs in community settings might be a cost-effective strategy to enhance well-being. Differences between the societal and health care perspective underline the call for joint funding in the dissemination of preventive services.Trial registrationGerman Clinical Trials Registration ID: DRKS00006216 (2014/06/11, retrospective registration).

Capacity-building and training opportunities for implementation science in mental health

This article traces efforts over the past decade by the National Institute of Mental Health, of the US National Institutes of Health, and other US organizations to build capacity for mental health researchers to advance activities in implementation science. Authors briefly chronicle the antecedents to the field's growth, and describe funding opportunities, workshop and conferences, training programs, and other initiatives that have collectively engaged hundreds of mental health researchers in the development and execution of implementation studies across the breadth of contexts where mental health care and prevention programs are delivered to those in need. The authors summarize a number of key initiatives and present potential next steps to further build the capacity for a new generation of implementation studies in mental health.

Bullying victimization and depression among left-behind children in rural China: Roles of self-compassion and hope

BackgroundBullying victimization among school-aged children is an important public health issue that may affect their well-being and mental health. However, few studies have been conducted on left-behind children in rural China, who are defined as the children who stay in rural areas for more than six months and have one or both parents migrating to urban areas for work. The mechanisms through which bullying victimization will influence depression have disproportionally adopted a psychopathological perspective, and the protective factors are understudied. ObjectiveThis study aims at investigating the factors that might contribute to breaking up the vicious circle between bullying victimization and developmental problems, focusing on the protective role of self-compassion and hope in the association between bullying victimization and depression. MethodsUsing questionnaires, data were collected from a sample of 1091 school-aged left-behind children from west and central China. ResultsCompared with rural children living with their parents, left-behind children reported a higher level of bullying victimization. Bullying victimization was positively associated with depression through decreased self-compassion and hope, and self- compassion played a more crucial role than hope in the linkage between bullying victimization and depression. ConclusionsOur study's findings suggest that it is necessary to incorporate self-compassion and hope in mental health prevention and intervention programs targeting left-behind children with bullying victimization experiences.

School-Based Mental Health Promotion andPrevention Program "Turn 2 Us" Reduces Mental Health Risk Behaviors in Urban, Minority Youth.

Turn 2 Us (T2U) is an elementary school-based mental health promotion and prevention program in New York City. It targets fourth- and fifth-grade students at risk for social/emotional and behavioral problems and provides a range of services to students, staff, and parents. The purpose of this study is to determine if T2U decreases internalizing and externalizing behaviors in participating students. Teachers measured students' symptoms before and after participation using the strengths and difficulties questionnaire (SDQ). Change in the total SDQ score was analyzed using Wilcoxon rank-sum nonparametric testing. We assessed the effects of covariates on the score change with linear regression models. The 185 unique students who participated in the intervention showed a significant improvement in total SDQ score (Z=-4.107, p < .001). Students who were at higher risk prior to the intervention showed greatest improvement in behaviors. None of the covariates assessed affected the change in SDQ score. Regression models showed that higher initial SDQ scores predicted higher post-intervention SDQ scores (β=0.681, p < .001). T2U significantly decreased internalizing and externalizing behaviors in participating students, with the greatest impact for highest risk students. This study helps validate T2U's unique and comprehensive approach.