Mental Health Provision Research Articles

The role of organizational supports in mitigating mental ill health in firefighters: A cohort study in Alberta, Canada.

IntroductionLittle is known about the effectiveness of ongoing mental health support in reducing the mental health impacts of a traumatic deployment.MethodsA cohort of firefighters was established among those deployed to a devastating wildfire in Alberta, Canada in May 2016. Firefighters completed three questionnaires: at recruitment giving details of exposures, a first follow‐up reporting mental health supports before, during, and after the fire and a second follow‐up, at least 30 months after the fire, with screening questionnaires for anxiety, depression, and posttraumatic stress disorder (PTSD). Fire chiefs were interviewed about mental health provisions. The impact of supports on mental ill health was estimated, adjusting for clustering within fire service and potential confounders.ResultsOf 1234 firefighters in the cohort, 840 completed the questionnaire on mental health supports. In total, 78 of 82 fire chiefs were interviewed. Analysis of the impact of supports on mental ill health included 745 firefighters from 67 fire services. Only 45.8% of reports of peer support were concordant between firefighters and fire chiefs. After adjusting for confounding, the odds ratios (OR) for peer support reported by both fire chief and firefighter were depressive disorder: OR = 0.22, 95% confidence interval (CI), 0.08–0.61; anxiety disorder: OR = 0.45, 95% CI, 0.24–0.82; PTSD: OR = 0.62, 95% CI, 0.37–1.02. Symptoms of anxiety and depression but not PTSD were reduced by resiliency training before the fire and by support offered within 48 h of return from deployment.ConclusionThe results suggest peer support in firefighters is protective but its availability is poorly recognized. PTSD was somewhat less responsive, perhaps reflecting the cumulative effects of previous exposures.

APA Applauds Passage of COVID-19 Relief Package

APA Applauds Passage of COVID-19 Relief Package

Impact of the COVID-19 pandemic on maternal mental heath

IntroductionAs countries adopt strict quarantines and lockdowns, increasing attention has been given to the impact on mental wellbeing. The influence of this on perinatal mental health and service provision is important to consider, as these women may be particularly vulnerable to the negative effects already seen in general and psychiatric populations.ObjectivesThe impact on global mental health of Covid-19, and the isolation measures used to combat it’s spread, is increasingly acknowledged. We were interested in the effect the pandemic has had specifically on the mental health of women in the peripartum period. By reflecting on our experiences, we hope to generate ideas to improve services.MethodsWe considered the effects of the pandemic in this high-risk population during each stage of contact with services. This included pre-conception, antenatal and postnatal periods, as well as the potential longitudinal and service effects. Recent case examples were identified and described from our busy and diverse South London perinatal psychiatry service.ResultsRecent referrals to our service suggest the current crisis has been a key trigger for the deterioration of many women’s mental health. This includes women who have been impacted by various factors related to the pandemic, at all stages of the perinatal period.ConclusionsIt is vital to maintain equality of access to perinatal services and to continue to consider how to deliver best care. This will involve adapting to the new working environment, and optimising care delivery using remote technologies where appropriate, in a way that is safe, accessible and acceptable to service users.

Advancing Mental Health Provision in Pharmacy (AMPLIPHY)

IntroductionImprovement of mental health is a priority in the NHS Long Term Plan (1), and pharmacists and their teams could provide enhanced support for people who take medicines for anxiety or depression, two of the most common mental health problems in the UK. However, a recent Cochrane review (2) identified no community pharmacy services focused on mental health.AimWe aimed to pilot a mental health support service, in community pharmacy: Advancing Mental Health Provision in Pharmacy (AMPLIPHY) to assess its feasibility and potential benefitMethodsThe AMPLIPHY service was codesigned through a workshop involving people with lived experience, pharmacists and researchers. The resultant programme is a series of consultations, beginning at the presentation of the qualifying prescription for an antidepressant, after a further 1–2 weeks and then as further prescriptions are presented, up to 3 months. People are eligible to enter the service if they are newly prescribed antidepressants for depression or anxiety, or have a change in medication, dose or quantity. Pharmacists and their teams identified people who met this criterion and invited them to participate. The service was intended to be patient-led, with the pharmacist helping the patient to define tangible aims and/or outcomes that they wanted to focus on, and providing sign-posting where required. Following brief one-day training, the pilot ran across ten pharmacies in Greater Manchester from November 2019 through March 2020. We triangulated results from: a) quantitative analysis of consultation data; b) content analysis of consultation records; and c) template analysis of semi-structured interviews with participating pharmacists at the start and end of the service. We aimed to obtain feedback from people on exit from the AMPLIPHY service, but this was curtailed due to the coronavirus pandemic. Consultations were recorded via the Pharmoutcomes system (a,b) and interviews were recorded and transcribed, with NVivo used to manage the interview dataset (c).ResultsSeventy-six patients participated in the service, across 9 of the 10 pharmacies. Seventy-five percent of patients had just one consultation. The median age was 39 (IQR 28–47) and 62% of patients were women. Most patients entered the service due to new prescription of antidepressant (74%), 17% due to a change in dose and the remainder due to change in medication or quantity. Sertraline was the most commonly prescribed medication (46%). The content analysis is indicating that consultations centred around one of five areas: health (n=31), lifestyle (n=62), medication (n=45), support (n=37) and patient’s descriptions of their feelings (n=31).ConclusionAMPLIPHY was accessed by a range of people, mainly on initiation of a new antidepressant. Parallels might be drawn with the New Medicines Service in England, but this does not currently extend to antidepressants. Consultations were not restricted to health and medication, but extended to other social and lifestyle aspects thus indicated that participants felt comfortable to disclose their personal situations to the pharmacist. This could support tailored interactions. However, more work is warranted to understand why most patients did not attend multiple consultations, and the immediate/ long-term impact from the patient’s perspective.

Analysis of the mental health response to COVID-19 and human rights concerns in the occupied Palestinian territories

PurposeThe coronavirus (COVID-19) pandemic has devastating effects around the world, influencing daily life and putting communities into unprecedented situations of anxiety, hardship and loss. It has a particularly severe effect on the mental health of individuals and highlights pre-existing challenges in mental health provision in different countries. The purpose of this paper is to examine the mental health response to COVID-19 in the occupied Palestinian territories (oPt) in relation to mental health concerns and the political situation.Design/methodology/approachThis study analyzes the double struggle of Palestinians not only dealing with COVID-19 but with the ongoing Israeli occupation and human rights violations and focuses on the challenges in providing mental health services due to existing inequalities, systemic discrimination and lack of resources as a result of the political system of oppression. The findings are based on previously published articles concerning mental health related to the COVID-19 outbreak in other countries, as well as the authors’ clinical experience in the oPt and direct involvement in providing mental health services.FindingsThe paper highlights how the current pandemic is being used to further attempts of annexation and political gains in Israel and how it exacerbated human rights violations due to the occupation. Emphasis is also put on the challenges in providing a Palestinian mental health response due to the high number of actors involved and the lack of preparedness at the level of mental health response provision.Originality/valueThe value of the works lies in putting the current pandemic in relation to human rights violations in the oPt due to the ongoing Israeli occupation and in highlighting how a mental health response to COVID-19 can be implemented during a state of emergency and despite a lack of preparedness in response services in the oPt.

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.

Administrative Segregation: A Review of State and Federal Policies

The use of administrative segregation in prison is a controversial correctional policy. Proponents argue this type of housing is necessary for maintaining institutional safety and order, whereas critics contend it is damaging to inmate mental health. Despite the increase in academic attention over the last decade, there is much that remains unknown about the uses and effects of this practice. This study addresses this gap in knowledge by content-analyzing the administrative segregation policies of 48 state and federal prison systems. The results provide evidence of consistency and discrepancy across key elements of these policies, including placement criteria and review procedures. Findings further highlight how basic information regarding mental health provisions and conditions of confinement are missing from a substantial number of policies. This investigation emphasizes a need for more governmental accountability and transparency in the use of this correctional policy and identifies several areas for future research.

Care to Quit: a stepped wedge cluster randomised controlled trial to implement best practice smoking cessation care in cancer centres

BackgroundCigarette smoking in people with cancer is associated with negative treatment-related outcomes including increased treatment toxicity and complications, medication side effects, decreased performance status and morbidity. Evidence-based smoking cessation care is not routinely provided to patients with cancer. The purpose of this study is to determine the effectiveness of a smoking cessation implementation intervention on abstinence from smoking in people diagnosed with cancer.MethodsA stepped wedge cluster randomised design will be used. All sites begin in the control condition providing treatment as usual. In a randomly generated order, sites will move to the intervention condition. Based on the Theoretical Domains Framework, implementation of Care to Quit will include (i) building the capability and motivation of a critical mass of key clinical staff and identifying champions; and (ii) identifying and implementing cessation care models/pathways. Two thousand one hundred sixty patients with cancer (diagnosed in the prior six months), aged 18+, who report recent combustible tobacco use (past 90 days or in the 30 days prior to cancer diagnosis) and are accessing anti-cancer therapy, will be recruited at nine sites. Assessments will be conducted at baseline and 7-month follow-up. The primary outcome will be 6-month abstinence from smoking. Secondary outcomes include biochemical verification of abstinence from smoking, duration of quit attempts, tobacco consumption, nicotine dependence, provision and receipt of smoking cessation care, mental health and quality of life and cost effectiveness of the intervention.DiscussionThis study will implement best practice smoking cessation care in cancer centres and has the potential for wide dissemination.Trial registrationThe trial is registered with ANZCTR (www.anzctr.org.au): ACTRN (ACTRN12621000154808) prior to the accrual of the first participant and will be updated regularly as per registry guidelines.

Educators' perceived mental health literacy and capacity to support students' mental health: associations with school-level characteristics and provision in England.

Conceptual frameworks for school-based, preventive interventions recognise that educators’ capacity is, in part, dependent on school-level characteristics. This study aimed to (i) examine the factor structure and internal consistency of the Mental Health Literacy and Capacity Survey for Educators (MHLCSE); (ii) assess responses in relation to supporting students’ mental health; (iii) describe schools’ mental health provision in terms of designated roles, training offered, and perceived barriers; (iv) investigate variance in MHLCSE outcomes explained by schools; and, (v) explore school-level predictors of educators’ perceived MHL and capacity after controlling for individual-level characteristics. A multi-level, cross-sectional design involving 710 educators across 248 schools in England was used, and secondary analyses of baseline data collected as part of the Education for Wellbeing Programme were conducted. Mental health provision data was available for 206 schools, of which 95% offered training to some staff, and 71% had a designated mental health lead. Secondary schools offered significantly more training than primary schools. Significant barriers included lack of capacity in Child and Adolescent Mental Health Services (CAMHS) and within school, and communication challenges between agencies. The amount of training offered by schools significantly predicted educators’ awareness and knowledge of mental health issues, treatments and services, legislation and processes for supporting students’ mental health and comfort providing active support, with increased training predicting higher scores. However, little variance was explained by schools (1.7–12.1%) and school-level variables (0.7–1.2%). Results are discussed in relation to current mental health and education policy in England.

Adequate Mental Health, a Prerequisite for Effective Administration

Mentality as well as Mental imbalance is a possible cause of crime and maladministration in most societies. Mental state is one important factor that can condition one’s mind to act one way or the other. This is why mental health is significant in one’s life. But it seems it is often neglected in health care considerations in most societies. Mentality and Mental health often condition the performance of an individual in a position of authority or public service. In most societies, credible governance or leadership seems to be taken for granted thus arbitrary selection or imposition of leaders, usurpation or violent coveting of offices, crime, domination or other forms of headship responsibilities without consideration on the mental states of individuals involved. Leadership is an important aspect of human organization. In an egalitarian society hegemony can make or mare a people. The thrust of this article is on mental health provisions and who should lead. One aspect of consideration, which this paper emphasizes, as a major discourse is Mentality and mental health as basic qualifications or prerequisite for leadership because of its varied consequences if not checked and certified in an individual before a leadership selection is made and also the ability to detect a misnomer by possible inference in an individual leader and the need for replacement or rehabilitation until one is proved fit. By observation, the paper exposes the many dangers of having a mentally indisposed personality as the leader with suggestions on how or who should be selected to run or lead a public office. At the end we suggested that people who should lead should be of sound mind, positive mentality showing positive character and must be tested mentally before they assume public office. Criteria for test has been subsequently and tentatively prescribed.

Mental health in higher education students and non-students: evidence from a nationally representative panel study.

Despite increasing policy focus on mental health provision for higher education students, it is unclear whether they have worse mental health outcomes than their non-student peers. In a nationally-representative UK study spanning 2010–2019 (N = 11,519), 17–24 year olds who attended higher education had lower average psychological distress (GHQ score difference = − 0.37, 95% CI − 0.60, − 0.08) and lower odds of case-level distress than those who did not (OR = 0.91, 95% CI 0.81, 1.02). Increases in distress between 2010 and 2019 were similar in both groups. Accessible mental health support outside higher education settings is necessary to prevent further widening of socioeconomic inequalities in mental health.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00127-021-02032-w.

Coping with COVID-19: The Strategies Adapted by Pakistani Students to Overcome Implications.

COVID-19 has speedily immersed the globe with 72+ million cases and 1.64 million deaths, in a span of around one year, disturbing and deteriorating almost every sphere of life. This study investigates how students in Pakistan have coped with the COVID-19. Zung’s self-rating anxiety scale (SAS) was used for measuring anxiety and the coping strategies were measured on four strategies i.e., seeking social support, humanitarian, acceptance, and mental disengagement. Among 494 respondents, 61% were females and 77.3% of the students were in the age group of 19–25 years. The study findings indicate that approximately 41 percent of students are experiencing some level of anxiety, including 16% with severe to extreme levels. Seeking social support seemed to be the least preferred coping strategy and that female students seek social support, humanitarian, and acceptance coping strategies more than males. Students used both emotion-based and problem-based coping strategies. The variables of gender, age, ethnicity, level and type of study, and living arrangement of the students were associated with usage of coping strategies. Findings showing that students do not prefer to seek social support. The study outcomes will provide basic data for university policies in Pakistan and the other countries with same cultural contexts to design and place better mental health provisions for students.

Crisis intervention for serious mental disorders. The example of the First Department of Psychiatry of Athens University

We describe the crisis management and resolution service for serious mental disorders established by the First Department of Psychiatry of the National and Kapodistrian University of Athens. The service is intended to meet patients' needs for adequate management of acute mental crisis without hospitalization, while implementing modern standards in mental care and considering existing restrictions in mental health resources and public expenditure. Last decade we witness an increase in demand for psychiatric beds in Psychiatric clinics of General Hospitals resulting in a drastic increase of auxiliary beds that becomes a serious problem in mental health provision. The shutdown of big psychiatric hospitals in the process of psychiatric reform, accompanied by a delay in the establishment of all the anticipated beds in general hospitals together with overloaded and insufficient network of mental health services in the community are the major determinants. Additionally, fiscal economic crisis of the last decade intensified even more the problem by diminishing funding for the recruitment of new personnel and drastically reducing allocated funding for new and old services. In 2016 we set up a crisis intervention service for serious mental disorders within the operational framework of the emergency psychiatric services of the Department of Psychiatry in Eginition Hospital in Athens. The crisis resolution team is composed by two psychiatrists, a psychiatric nurse, social workers, a psychologist, mental health volunteers, and mental health trainees/students. The patient enters the service through the emergency service when an indication for hospitalization is given by the emergency psychiatrist, followed by the clinical estimation of a member of our team. The therapeutic team convenes twice a week for the new entrants and for follow-up sessions with the participation of the patient and the family members whenever feasible. The rest of the therapeutic interventions take place during the week. The work 'with' the person and not 'to' the person encapsulates the philosophy of the service, which is characterized by a holistic treatment approach aiming to empower the individual strengths and sense of control of the patient for crisis resolution on the basis of a safe therapeutic milieu. Therapeutic interventions include family and supportive members, as well as community interventions. In summation, interventions consist of a) comprehensive evaluation (psychiatric/ physical) and therapeutic plan, b) psychopharmacological treatment, c) psychotherapeutic support for the patient and the family for management of the crisis, d) training for the management of future crises and e) referral to appropriate community services for follow up management and treatment. Treatment lasts approximately 6-8 weeks. Initial data of the evaluation study indicate clinical effectiveness and high levels of satisfaction for patients and family. Conclusively, crisis management and resolution services are feasible even in a time of heavy restrictions in recourses, and anticipated benefits are multiple for the economy, mental health provision, the public health system, patients and relatives alike.

Assessment Of Mental Health And Its Association With Socio Demographic Variables Among Students

The mental health of pharmacy students has been poor compared to other disciplines and has led to personal and professional consequences. The study was conducted to assess the prevalence of mental health of pharmacy students. It includes 351 randomly selected pharmacy students from a College of Pharmacy located in South India. A self-administered questionnaire was used to elicit information from the respondents. A score of ≥ 3 suggested poor mental while a score < 3 represented good mental health. Data were summarized using proportions, and chi-square test was used to explore associations between categorical variables. Level of significance was set at p < 0.05. The mean age of the respondents was 23.4 ± 4.3 years, 63.8% were males, and 0.091% was from the sixth and 23.07% from the fourth year levels of study. Based on the results 39.2% had a poor mental health status, compared to 60.8% with good mental health status. The factors significantly associated with poor mental health, were recent experience of mistreatment by trainers or colleagues, perceived inadequate monthly allowance and perception that medical training is stressful (p < 0.05). More than third of undergraduate pharmacy students with traits of poor mental health, provision of accessible mental health services/counselling is strongly recommended early in their training. More than half of students were responded that, they lost their sleep over worry and they had a feeling that they couldn’t overcome difficulties. Similarly, 63.81% of students lost their self-confidence and 66.09% students thought themselves worthless.

Assessment of the Mobile Mental Health Units' effectiveness in Cyclades islands.

In Greece, the provision of mental health shows inefficiencies in remote and inaccessible areas due to the lack of appropriate structures and access to healthcare. The purpose of this study was to assess the effectiveness of the Mobile Mental Health Units (MMHUs) in Cyclades with and without MMHUs' operation based on Real-World Evidence (RWE). The study population consisted of 724 people who visited the MMHUs of the western and northeastern Cyclades in 2015. The data derived from the patients' medical records of EPAPSY classified by International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) and the Global Assessment of Functioning (GAF) scale. The analysis revealed that 60.9% of the participants were women and the average age was 50.1. 50.4% of the people who visited MMHUs without referral from primary health care professionals and 18.8% with referral. The calculation of effectiveness was based on DALYs (Disability-Adjusted Life Years) and was performed according to the World Health Organization methodology. In the specific population, there are no recorded deaths caused by mental disorders and thus DALYs are equal to Years Lost due to Disability (YLDs) with MMHUs' operation. 18% of the population was diagnosed with mood disorders (F30-F39) and morbidity burden 9.49 (YLDs), while 17.5% of the patients were diagnosed with neurotic, stress-related and somatoform disorders (F40-F48) and corresponding morbidity burden 4.53 (YLDs). Our results revealed that the effectiveness of MMHUs corresponds to 17.98 Disability-Adjusted Life Years (DALYs) averted in 2015. The mood disorders and the neurotic, stress-related disorders have shown a high morbidity burden. Advanced age, non-permanent employment, existence of psychopathology in the family and referral on patients' own will were found to significantly affect the mental health status of the participants. The implementation and expansion of flexible and alternative community-based interventions, such as MMHUs, constitute a best practice both for obtaining higher clinical outcomes and for facing regional inefficiencies related to population's access to healthcare.

Nurses' Experiences of Psychiatric Care in Acute Care Units with an Open Door Policy.

Social distancing and the recent lock down due to COVID-19 has increased the feeling of disconnection, isolation, and suffering in vulnerable individuals and has brought forward questions regarding open acute care psychiatric units that cannot be answered by the literature. In Greece, there is no available research on how open ward environments are perceived and experienced by mental health professionals. The aim of the present study was to illuminate nurses' experiences of working in a public psychiatric hospital which traditionally operates with open doors. Eleven nursing care providers were interviewed, and thematic analysis was employed to explore their experiences of working in locked psychiatric acute care units. Participants described nursing care in units with an open door policy as "acceptance," "availability of staff," "real respect for the person," "ensuring patients' rights," "listening to the person," and "negotiation and not imposition." Trust in therapeutic relationships was perceived as greatly dependent on the trust being given to patients indirectly by the open door policy. Being trusted enhanced patients' self-determination and self-confidence leading to their empowerment. Containment of an acute mental health crisis took place through medication and meaningful discussions with patients and significant others rather than locking the door of the unit. Overall, meaningful care led to professional emancipation, but compassion fatigue narratives emphasized the need for continuous education, support and clinical supervision as necessary support for mental health nurses in a system of mental health provision often reduced to the point of crisis.

Mental Health Support Teams: How to maximise the impact of the new workforce for children and young people

Mental Health Support Teams were implemented with the aim of increasing mental health provision for children in schools. Ensuring the success of these teams requires the appropriate training, supervision and sustainability plan for the roles, and the ERG worked to produce a briefing paper outlining considerations we felt were important to enable to roles to be effective. The briefing also considered how to make the practitioner roles effective and sustainable. During the party conference session we focussed our political engagement on Children and Young People’s Mental Health with events on this topic at both Labour and Conservative party conferences. We officially launched our Mental Health Support Team (MHST) briefing at a Labour fringe panel event, attended by MPs, members of the ERG and Young Minds. As well as our own events, we engaged with policy makers and senior parliamentarians, including shadow education secretary Angela Rayner. All opportunities identified at conference have been followed up. Our MHST briefing was well received by external stakeholders, with the Central for Mental Health quoting our paper in Making the grade: How education shapes young people’s mental health. Additionally, colleagues at NHSE have made our briefing available on an online platform that will reach all of the MHST sites. However, it remains to be see how effects the MHSTs will become, particularly as the Government’s current target is only to cover 25 to 30 per cent of England.

BUILDING ONLINE AND TELEPHONE PSYCHOLOGICAL FIRST AID SERVICES IN A LOW RESOURCE SETTING DURING COVID-19: THE CASE OF KOSOVO

The COVID-19 pandemic and the measures brought for prevention of infections are associated with considerable psychosocial and psychological morbidity in the general population. Providing continuous mental health services during the pandemics is a challenge worldwide, especially in low- and middle-income countries (LMICs). This paper reports on the strategies and activities taken to protect public mental health during the COVID-19 pandemic in Kosovo. This included establishing online and phone psychological first aid services and developing psychoeducational videos and webinars. The paper concludes with several lessons learned during the process of establishing and maintaining these interventions, such as: initial political endorsement is crucial to gain and maintain the momentum of services; continuous training of volunteers is crucial for both addressing the needs/problems, which arise during the process of work and maintain the motivation of volunteers; promotion of the services is crucial; academic curricula training mental health professionals should include digital mental health related courses and manualization on how to establish this kind of services in midst of crisis is crucial in order to ensure quick operationalization when needed again especially in LMIC settings. The interventions developed provide opportunity for further research especially by evaluating the impact of the services and exploring how online and provision of mental health and psychoeducation services online could help to cover services gap in times of isolation, limited movement and situations similar to pandemics in settings with limited mental health services and resources. The situation with pandemics with COVID 19 is still far from ending. Future waves of infections and restriction could again spike the mental health and psychosocial and psychological strain of the general population, therefore being prepared in provisions of psychological first aid and other mental health services online is crucial.

Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts.

The COVID-19 pandemic and mitigation measures are likely to have a marked effect on mental health. It is important to use longitudinal data to improve inferences. To quantify the prevalence of depression, anxiety and mental well-being before and during the COVID-19 pandemic. Also, to identify groups at risk of depression and/or anxiety during the pandemic. Data were from the Avon Longitudinal Study of Parents and Children (ALSPAC) index generation (n = 2850, mean age 28 years) and parent generation (n = 3720, mean age 59 years), and Generation Scotland (n = 4233, mean age 59 years). Depression was measured with the Short Mood and Feelings Questionnaire in ALSPAC and the Patient Health Questionnaire-9 in Generation Scotland. Anxiety and mental well-being were measured with the Generalised Anxiety Disorder Assessment-7 and the Short Warwick Edinburgh Mental Wellbeing Scale. Depression during the pandemic was similar to pre-pandemic levels in the ALSPAC index generation, but those experiencing anxiety had almost doubled, at 24% (95% CI 23-26%) compared with a pre-pandemic level of 13% (95% CI 12-14%). In both studies, anxiety and depression during the pandemic was greater in younger members, women, those with pre-existing mental/physical health conditions and individuals in socioeconomic adversity, even when controlling for pre-pandemic anxiety and depression. These results provide evidence for increased anxiety in young people that is coincident with the pandemic. Specific groups are at elevated risk of depression and anxiety during the COVID-19 pandemic. This is important for planning current mental health provisions and for long-term impact beyond this pandemic.

Infant mental health in intensive care: Laying a foundation for social, emotional and mental health outcomes through regulation, relationships and reflection

Infants and their families who begin their lives in intensive care often experience short and long term behavioral, socioemotional and mental health challenges that often follow them into adulthood. Utilization of evidence-based infant mental health principles, approaches and strategies in the neonatal intensive care unit can contribute to the promotion of optimal outcomes for babies and their parents. In order to integrate mental health best practices into intensive care settings, an emphasis on infant and family regulation, optimal nurturing relationships and reflective practice is offered. Using a parallel process, similar strategies in support of intensive care professionals in their provision of appropriate mental health supports to babies and families is essential.