Mental Health Promotion Initiatives Research Articles

Be You: A national education initiative to support the mental health of Australian children and young people.

Early learning services and schools provide unique settings for mental health promotion and early intervention due to the potential for population-level dosage and reach in terms of reducing multiple risk factors and enabling protective factors among young people. Educators play a key role in supporting children and young people's experiences of, and access to mental health promotion opportunities, and hold unparalleled opportunity in terms of creating mental health-promoting learning environments. In 2018, the Australian National Mental Health in Education Initiative, Be You, was launched. Be You is a multi-million-dollar Australian government-supported initiative, freely available to all 24,000 early learning services, primary and secondary schools throughout Australia. The potential for subsequent population reach is proposed to potentially exceed that of any mental health promotion initiative for children and young people previously observed in Australia. Be You aims to foster mentally healthy learning communities across Australia through building capacity among educators to embed mental health promotion strategies. The Initiative was developed based on a review and integration of previous national mental health promotion frameworks, with an overall alignment to existing state and territory education, social and emotional well-being frameworks, and the Australian Curriculum. In delivering facilitated support from specialised consultants to early learning services and schools participating in the initiative, Be You draws on professional learning principles designed to build capacity in educators and educational systems relating to mental health promotion. It uses an updated, multi-module online platform providing interactive, evidence-based resources. This paper presents the Be You framework, describes the evidence sources used to inform the underlying principles and objectives, discusses the specific components that form the initiative, details the professional learning modules and content, and discusses potential implications for population mental health and prevention efforts.

Implementing Mental Health Promotion Initiatives-Process Evaluation of the ABCs of Mental Health in Denmark.

Treatment and prevention alone are unlikely to make a significant difference in reducing the burden of poor mental health and mental illness. Therefore, mental health promotion (MHP) initiatives are advocated. In 2014, the ABCs of mental health (ABCs) partnership was established in Denmark; in the partnership, partner organisations, e.g., municipalities and NGOs, use a research-based framework for MHP, the ABC-framework, to develop and implement MHP initiatives. This paper has two aims: (1) to outline the overall characteristics of these MHP initiatives; and (2) to explore local coordinator and stakeholder perceptions of the implementation processes and the impact of the MHP initiatives. Questionnaire surveys, individual interviews and group interviews were conducted during 2017–2020. The MHP initiatives were grouped according to three strategies: building MHP capacity, campaign activities to promote mental health awareness and knowledge and establishing and promoting opportunities to engage in mentally healthy activities. The ABC-framework was positively received and viewed as providing relevant knowledge for working with MHP as well as fostering intersectoral and interprofessional collaborations. However, using a bottom-up approach to develop and implement MHP initiatives can be time-consuming and resource demanding, and it requires a deliberate balancing of local adaptability and concrete guidance when engaging stakeholders and implementers. Overall, using the ABC-framework to develop and implement MHP initiatives holds great promise for advancing and promoting MHP practice.

The contradictions between Canadian capitalist processes and youth mental health: implications for mental health promotion.

Understanding how socio-economic processes inter-relate with young people's mental health is important to inform the development of responsive mental health promotion initiatives. Thirty diverse Canadian young people were engaged within a process of social praxis, underpinned by a historical-dialectical ontological perspective, to explore the inter-relation among socio-economic processes and youth mental health and implications for mental health promotion initiatives. Findings show several inter-related contradictory processes within two overarching contradictory dynamics that Canadian youth are navigating as they seek to realize their mental health needs. The first overarching contradictory dynamic is between monetized, private, individualistic, profit-oriented economic processes and young people's need for resources, freedom and time, and inclusive social spaces to enable their mental health needs. Participants' descriptions of their approaches to seeking to realize their mental health needs in this context reflects a second inter-related overarching contradiction between communal and individual approaches to enabling young people's mental health needs. In this context, young people are oriented inward to meet their mental health needs at the individual and inter-personal level, despite the crucial role of socio-economic processes to enabling their mental health needs. Despite varied access to resources, all participants struggled to balance meeting their mental health needs. Implications of these findings entail the need to focus on promoting synergistic relations among young people and socio-economic processes whereby enabling universal access to resources for young people's survival, physical health and comfort is foundational to multi-level mental health promotion initiatives.

Implications of Canadian youth views for measuring youth mental health from a socio-economic perspective.

Developing meaningful indicators to track youth mental health (MH) is important to support the development and evaluation of responsive mental health promotion (MHP) initiatives that address the socio-economic determinants of youth MH. Development of relevant indicators is challenged, however, by the lack of knowledge regarding the relations among socio-economic factors and youth MH. Thirty diverse young people from a Canadian metropolitan area were engaged within a process of social praxis to explore their experiences of the inter-relationship between their socio-economic environments and their MH and their processes of seeking to realize their MH. Participants emphasized 'needs' as foundational to MH, whereas 'wants', driven by materialistic and wealth-oriented values and social norms, constrained their MH. Their reflections on the inter-relations among their MH and socio-economic processes highlight eight inter-related MH needs within the Canadian socio-economic context. In this paper, we present these needs and show how these needs, young people's affective states, and their access to resources within co-evolving socio-economic processes (to enable their needs) illustrate the fundamental inter-relation between young people's MH and socio-economic processes. We identify implications for measuring youth MH within MHP practice, including the importance of iterative indicator frameworks that include measures of young people's access to resources to enable their MH needs and their degree of distress.

The benefits of a historical-dialectical ontology to critical mental health promotion research.

In this article, we explore challenges and opportunities in research oriented to understanding the relations among elements of socio-economic life and mental health (MH) and the development and evaluation of mental health promotion (HP) initiatives. We review the population health intervention research (PHIR) literature and respond to recommendations regarding social determinants of health and health inequities-focused research. We discuss three inter-related issue areas: first, the continued dominance of linear and individually oriented theories within predominantly quantitative research approaches and the underdevelopment of ontological and theoretical perspectives that capture complexity; second, the inconsistent use of measures of socio-economic status and health with a lack of attention to taken for granted assumptions; and third, the continued focus on measuring MH challenges to the neglect of exploring the meaning of MH in a positive sense. We extend recommendations within the PHIR literature by sharing our application of a historical-dialectical ontological perspective within a process of social praxis with diverse Canadian young people with varying degrees of access to socio-economic resources. Young people were engaged to explore the relations among socio-economic processes, young people's MH and implications for mental HP. We argue that this ontological perspective can support the development of structurally oriented critical qualitative research approaches in PHIR.

Mainland Chinese students’ mental health: baseline data and cautionary notes when exporting/importing psychological scales

ABSTRACTThere is a growing interest in mainland China about schools’ roles in supporting students to develop positive mental health. However, relatively little data have been collected about mainland Chinese students’ mental health. This article reports a collaborative study, by eastern and western researchers, to translate and administer the Strengths and Difficulties Questionnaire (SDQ) and a School Satisfaction Scale (SSS) to students in mainland China. We discuss the possible absence of some western psychological constructs in eastern contexts, and possible cultural differences in the levels of participants’ compliant responses. Descriptive results indicated that the mainland Chinese students’ SDQ responses were similar to students in comparative countries. Factor analyses indicated that the SDQ needed modification when used with our mainland Chinese sample. Structural equation modelling showed relationships between higher school satisfaction and lower mental difficulties. The study provides baseline data to inform school-based mental health promotion initiatives in mainland China. Broader outcomes are to inform researchers and educators about processes and cautions when using previously validated questionnaires in new cultural contexts. We highlight the need for close east–west researcher collaboration when exporting/importing psychological questionnaires.

The Fountain of Health: effective health promotion knowledge transfer in individual primary care and group community-based formats.

Assess the effectiveness of FoH KT delivered in individual and group-based formats. Pre- and post-intervention quality assurance survey of FoH KT. Interventions occurred in Nova Scotia, Canada. Adults over age 50 years without pre-existing dementia were targeted. A total of 92 participants received FoH KT in individualized (n = 41) and group-based (n = 51) formats. FoH KT (e.g. sharing evidence, lifestyle coaching, and goal setting) using a range of KT supports (e.g. FoH website, paper materials) was delivered to (1) individual patients by primary care clinicians and (2) community-based groups by lay leaders. The main outcome measure was participant pre- and post-quality assurance self-reports. Improvements were found in participant awareness of FoH, knowledge of evidence-based mental health promotion initiatives, and in application of this information in daily life in both individual and group-based settings. Improvements in participant knowledge about epigenetic factors that impact health and confidence with health behavior goal setting were reported in both contexts. Changes in self-perceptions of aging scores reached significance in the group intervention. FoH KT produced short-term positive self-reported changes in participants in both individual and group formats. Larger control studies with long-term follow up are needed to better assess effects of both individual and group formats of FoH KT and longer term impacts on health behaviors and outcomes.

Interactions between youth and mental health professionals: The Youth Aware of Mental health (YAM) program experience.

The Youth Aware of Mental health (YAM) experienceYouth stand at the core of much mental health promotion, yet little is written about their experiences of such efforts. We aimed to take this on by interviewing youth after they participated in Youth Aware of Mental Health (YAM), a universal mental health promotion program. YAM has a non-anticipatory methodology that provides youth with a safe space for reflection, role-play, and discussion. Addressing everyday mental health, YAM invites the experiences and issues relevant to the youth present to influence the program in a slightly different direction every time. The YAM instructor guides the participants but does not present the youth with given formulas on how to solve their problems. Like any mental health promotion, YAM appeals to some more than others in its intended audience and individuals engage with the program in many different ways. We set out to learn more about these experiences.Conversations about mental healthThirty-two semi-structured interviews were conducted with 15–17 year olds in Estonia, Italy, Romania and Spain. In these interviews, the researchers made an effort to discuss mental health in terms relevant to youth. Still, wide-ranging levels of motivation, ease with engaging in dialogue with mental health professionals, and comfort with the format and content of YAM were detected. The youth were clustered in five different groups relating to their positioning vis-à-vis the researcher during the interview. The following evocative labels were used: “interested”, “foot in the door”, “respect for authority”, “careful”, and “not my topic”. Corresponding labels were devised for their YAM experience: “engaged”, “initially hesitant”, “cautious”, “eager to please”, or “disengaged”. We also observed that the researchers brought their own expectations and employed a variety of approaches that led to anticipating answers, stating the obvious, or getting along better with some of the youth. These modes of interaction were categorized under: “favoritism”, “familiarity”, “frustration”, “out of sync”, and “insecurity”. Similar power dynamics likely transpire in other encounters between youth and researchers, including interventions such as YAM.Youth and mental health professionals: Noticing the dynamics at playAs mental health professionals, we need to be aware of the professional habits and biases that sometimes obstruct us in understanding the experiences of youth. By initiating dialogue and listening closely to youth we can find a way to those experiences. Qualitative research can help bring the underlying interplay between mental health professionals and youth to the surface while also orienting the conversation towards topics that matter to youth. Some youth are more interested or feel more at ease in speaking openly with mental health professionals, while others find such exchanges less appealing or almost intolerable. Future mental health promotion initiatives would benefit from involving youth in the design of interventions to create an inclusive atmosphere and engage with topics that appeal to youth with diverse experiences of mental health.

Receipt and Perceived Helpfulness of Mental Illness Information: Findings from the Australian National Survey of Mental Health and Wellbeing

ABSTRACT The distribution of mental illness information is a crucial element of mental health promotion initiatives. We assessed the receipt and perceived helpfulness of such information in Australia. Data from the Australian National Survey of Mental Health and Wellbeing indicated that, during the year prior to the survey, 33.7% of Australians received mental illness information; of these, 51.2% found it helpful. Among people with a mental disorder, 46.1% received information; of these, 67.4% found it helpful. Non-English speakers and the socially disadvantaged were less likely to receive mental illness information. Older and less educated respondents were less likely to both receive mental illness information and find it helpful. Mental health service users were more likely to receive mental illness information perceived as helpful than those who had not accessed such services. Better targeted information interventions are required to ensure those most likely to benefit receive mental illness-related information.

Mental Health Services for Students at Postsecondary Institutions: A National Survey.

Although the high prevalence of mental health issues among postsecondary students is well documented, comparatively little is known about the adequacy, accessibility, and adherence to best practices of mental health services (MHSs)/initiatives on postsecondary campuses. We evaluated existing mental health promotion, identification, and intervention initiatives at postsecondary institutions across Canada, expanding on our previous work in one Canadian province. A 54-question online survey was sent to potential respondents (mainly front-line workers dealing directly with students [e.g., psychologists/counsellors, medical professionals]) at Canada's publicly funded postsecondary institutions. Data were analyzed overall and according to institutional size (small [<2000 students], medium [2000-10 000 students], large [>10 000 students]). In total, 168 out of 180 institutions were represented, and the response rate was high (96%; 274 respondents). Most institutions have some form of mental health promotion and outreach programs, although most respondents felt that these were not a good use of resources. Various social supports exist at most institutions, with large ones offering the greatest variety. Most institutions do not require incoming students to disclose mental health issues. While counselling services are typically available, staff do not reliably have a diverse complement (e.g., gender or race diversity). Counselling sessions are generally limited, and follow-up procedures are uncommon. Complete diagnostic assessments and the use of standardized diagnostic systems are rare. While integral MHSs are offered at most Canadian postsecondary institutions, the range and depth of available services are variable. These data can guide policy makers and stakeholders in developing comprehensive campus mental health strategies.

The ‘Healthy Me’ project: evaluating a mental health promotion initiative in primary schools in Northern Ireland

The ‘Healthy Me’ project: evaluating a mental health promotion initiative in primary schools in Northern Ireland

Parents’ Perspectives of School Mental Health Promotion Initiatives are Related to Parents’ Self-Assessed Parenting Capabilities

Achieving broad-scale parent1engagement with school initiatives has proven elusive. This article reports survey data from 287 Maltese parents about their perceptions of the quality of their child's school's initiatives for promoting students’ wellbeing and mental health. Findings indicate that, on average, parents rated school initiatives highly. However, a MANCOVA of respondents grouped into three categories of Self-Assessed Parenting Capabilities (low, medium, high) showed that parents who held low perceptions of their own parenting capabilities also held significantly lower perceptions of the quality of schools’ mental health promotion initiatives. Less favourable dispositions towards school mental health promotion initiatives by parents with relatively low-parenting capabilities have implications for the design and delivery of school-based initiatives. For example, typical parent engagement, support and information provision activities (e.g., parent-teacher meetings, newsletters) might be less well received in families that arguably have a greater need to engage with such initiatives. This study has implications for whole-school mental health promotion initiatives that seek to include all parents.

Mental Health Promotion Among the Chronic Disabled Population in the Community

Societal ageing and the rising prevalence of chronic disease are important causes that underlie the growth in the number of disabled individuals. The disease-induced psychological distress experienced by this population not only decreases quality of life but also increases demand for healthcare. The healthcare policy for the disabled population currently focuses on community healthcare. Therefore, developing appropriate programs to promote mental health among the disabled population in community settings is a critical issue. The present paper reviews current mental health promotion initiatives that target the disabled population in the community and addresses mental healthcare issues that are prevalent among the chronically disabled; strategies of mental health promotion that use music therapy, reminiscence therapy, and horticultural therapy; and the roles and responsibilities of community professionals in mental healthcare. We offer these perspectives as a reference to promote mental health and to establish holistic community healthcare for chronically disabled individuals.

Sustainable professional learning for early childhood educators: Lessons from an Australia-wide mental health promotion initiative

New policy initiatives, such as those concerned with promoting young children’s positive mental health, highlight the need for good quality professional education in the early childhood education and care sector. However, although a wealth of literature exists from the school sector, little is known about professional education in early childhood education and care settings. This article presents an analysis of early childhood education and care educators’ perspectives about their professional learning during an initiative to promote young children’s mental health in 111 early childhood education and care centres in Australia. Questionnaires and feedback forms were collected from educators on four occasions over 2 years. In addition, programme facilitators rated the quality of implementation of the initiative in each centre. Thematic analysis indicated that the professional education was instrumental in building early childhood education and care educators’ knowledge about children’s social-emotional learning and mental health, increased educators’ self-efficacy for mental health promotion and encouraged a more collegial and collaborative workplace. Hierarchical linear modelling supported the learning gains identified in the qualitative analysis, but showed that the effect sizes for positive change depended on the quality of programme implementation. The findings highlight important synergies between opportunities for professional learning and workplaces that are conducive to transformation and renewal. Recommendations from participants for improvement included the need to ensure the relevance of content to local contexts, more extended learning opportunities, translation of unfamiliar language and more accessible timetabling of professional learning sessions. Issues concerning the need to advocate for, and sustain, professional education in early childhood education and care settings are discussed.

The potential contribution of Intermediary Organizations for implementation of school mental health

Questions persist regarding implementation of mental health promotion, prevention, and early intervention initiatives in schools. To date, attention has targeted the ‘Whats’ and ‘Hows’ in design and implementation. Ongoing clarification of ‘Who’ the key proponents are working in this space receives less consideration. This paper presents outcomes from a national colloquium involving leaders from organizations committed to school-based mental health practice in Australia. The aim of the colloquium was to introduce the concept of Intermediary Organizations (IOs) examining this for its potential contribution to improved mental health and school improvement. The central challenge for IOs is implementation, that is, assisting in knowledge mobilization connecting research to policy and practice. The colloquium discussion was grounded in an understanding of public value as an organizing principle for improving public sector effectiveness. The participants evaluated the nature, role, and potential contribution of...

Employee Health in the Mental Health Workplace: Clinical, Administrative, and Organizational Perspectives.

Issues of mental health and employee health have risen to increasing prominence in recent years. However, there have been few explorations of the clinical and administrative challenges that these issues raise, particularly in settings that are themselves mental health workplaces. In order to identify and understand such challenges, a brief case of acute employee illness in a mental health workplace is described followed by a discussion of salient clinical, administrative, and organizational considerations. The case raises questions about medicolegal responsibilities and relationships between clinicians and patients in mental health settings, illuminates tensions between clinical staff and human resources processes, and draws attention to the need for illness prevention and mental health promotion initiatives in the workplace. Increased awareness of these issues, complications, and potential solutions would benefit clinicians, administrators, and mental health institutions.

Did that Professional Education about Mental Health Promotion Make Any Difference? Early Childhood Educators’ Reflections upon Changes in Their Knowledge and Practices

Educators are at the heart of educational reforms, such as the introduction of mental health promotion initiatives into early childhood education and care (ECEC) settings. Good quality implementation of reforms requires educators to engage in high quality professional learning: If educators have not had opportunities to gain appropriate knowledge and expertise, new initiatives may be poorly implemented and may consequently achieve limited outcomes. This article reports ECEC educators’ perspectives about the impact on their knowledge and practices of the professional education component of the KidsMatter mental health promotion initiative. Educators from 111 ECEC services across Australia contributed a range of types of data, including questionnaires about their knowledge and self-efficacy, feedback about each professional education session, and photo stories about their changed professional practices. Participants indicated that their professional learning led to changed practices in areas such as interpreting children's behaviours, interacting with children, approaching parents, and collaborating with colleagues. Participants’ photo stories illustrate how professional education that focuses on content, active learning, coherence, and collaboration can positively influence knowledge and practices. However, if such gains are to last beyond relatively highly resourced start-up phases of initiatives, professional education needs to integrate with, and draw from, the ongoing availability of other professionals such as guidance and counselling staff, who have complementary knowledge and expertise; be recognised and embedded as a core component of ECEC educators’ roles and their workplace practices; and be culturally and contextually situated. Staff accounts of the impact of their professional learning on their practices can highlight to policy-makers the practical outcomes of strong investments in professional education. Awareness by other professions of the affordances and constraints faced by ECEC educators may contribute to interdisciplinary synergies among the range of professions involved in mental health promotion in educational settings.

The Motivational Interviewing Navigation Guide: a process for enhancing teachers' motivation to adopt and implement school-based interventions

There is a critical need to engage theory-driven research related to the deployment of mental health promotion initiatives and student outcomes. A growing body of research supporting the use of motivational interviewing and engagement strategies in education suggests that this approach may be promising to better understand mechanisms through which coaches, mentors or consultants influence the change in behaviour and improve the implementation of effective practices. Motivational interviewing is a specific approach to engagement that works to raise motivation for fostering change, and may also serve as a useful approach for maximizing teachers' roles within school-based mental health promotion efforts. In this article, we describe the Motivational Interviewing Navigation Guide (MING), which consists of a five-step process to motivate teachers to implement critical features of an intervention with fidelity. In addition, the potential barriers to implement the MING approach, as well as recommendations for fu...

Beyond Workers’ Compensation

The mental health of men is an important issue with significant direct and indirect costs emerging from work-related depression and suicide. Although the merits of men's community-based and workplace mental health promotion initiatives have been endorsed, few programs are mandated or formally evaluated and reported on. Conspicuously absent also are gender analyses detailing connections between masculinities and men's work-related depression and suicide on which to build men-centered mental health promotion programs. This article provides an overview of four interconnected issues, (a) masculinities and men's health, (b) men and work, (c) men's work-related depression and suicide, and (d) men's mental health promotion, in the context of men's diverse relationships to work (including job insecurity and unemployment). Based on the review, recommendations are made for advancing the well-being of men who are in as well as of those out of work.

Teachers’ knowledge and confidence for promoting positive mental health in primary school communities

This paper reports an investigation into Australian primary school teachers’ knowledge and confidence for mental health promotion. Questionnaires were delivered to 1397 teachers. In-depth interviews were held with 37 teachers. Quantitative results showed that half to two thirds of teachers felt efficacious and knowledgeable about selected components of mental health promotion. Independent judgments by staff about students’ mental health status concurred with students’ scores on the Strengths and Difficulties Questionnaire in about 75% of cases, indicating a good level of staff awareness about students’ mental health status. Exposure to the KidsMatter Primary mental health promotion initiative was associated with improvements in teachers’ efficacy, knowledge and pedagogy, with small to medium effect sizes. Qualitative analysis indicated that teachers’ subject-matter and pedagogical knowledge were heavily reliant on curriculum resources. Implications of the findings for the implementation of school-based mental health promotion initiatives are discussed.