Mental Health Support Research Articles

Review Paper on AI Chatbot for Mental Health Support

Review Paper on AI Chatbot for Mental Health Support

Spiritual practices and mental well-being: A quantitative study among university students

This study explores the role of spiritual practices in promoting mental well-being among university students. The research focuses on key areas such as stress management, resilience, emotional balance, and finding meaning in life. A quantitative survey was conducted with 134 students from various disciplines, and the results indicate that spiritual practices can provide significant mental health benefits. Gender and age differences were observed, with women generally reporting higher emotional benefits from spirituality and older students finding greater meaning in life through spiritual engagement. The findings highlight the importance of a personalized approach to mental health support, recognizing that spirituality may not be universally effective for all students. The discussion emphasizes the need for diverse mental health interventions that incorporate both spiritual and non-spiritual strategies to cater to individual needs.

Challenges of remote working, perceived peer support, mental health and well-being of WIL students

PurposeThis study explored the relationship between perceived peer support, mental health and the well-being of students enrolled in work-integrated learning (WIL) at a Canadian institute of higher education, who were completing remote work experiences.Design/methodology/approachAn online survey and virtual semi-structured interviews were used to collect data. The online survey captured demographic information as well as measures of perceived peer support, loneliness, positive mental health (PMH) and stressors associated with the on-going pandemic. The interviews captured narratives regarding peer support, attitudes surrounding remote work, mental health and well-being.FindingsWIL students completing remote work terms experienced only moderate levels of peer support, moderate loneliness, below-average PMH and all the stressors associated with the on-going pandemic. Data also revealed that completing a remote work term negatively impacted work communications, opportunities to build connections with colleagues and overall motivation. On the other hand, WIL students appreciated the flexibility and comfort of working from home, as well as reduced work-related expenses.Originality/valueWith remote work experiences increasing globally and now a reality for many WIL students, the potential negative effects emphasize the importance of providing social and mental health support and resources, especially during stressful times.

Communication with Health Personnel and Human Rights: A Perspective from People with Mental Disorders

AbstractMental health care has focused on participation, which, in addition to improving recovery processes, constitutes a tool to defend the human rights of people with mental disorders. For this participation, communication is a fundamental element. The objective of the present research was to analyzed the perception of the human rights and communication with healthcare personnel in care processes, from leaders of mutual aid groups or support groups in various contexts of Colombia. It is expected that the generated information can contribute to the evaluation of the quality of mental health services from a human rights and health participation perspective, in contexts similar to the one being analyzed. A qualitative approach has been used, which takes information from six leaders of support groups for mental health, in four regions of Colombia. Said information was analyzed through a thematic analysis, contrasting with the vision of the researchers and with the current theory. It is found that the subject of communication was made up of categories such as Previous ineffective treatments and Perception of a violation of dignity. Communication barriers are pointed out, such as attitudes of mental health professionals, but the influence that the health system and social and political barriers can have on the same communication is recognized. From the perception of leaders of mental health support groups, it is concluded that it is necessary to improve aspects of communication in health personnel. In addition, clinical mental health care could also be a space for the promotion of human rights.

Mental health status and quality of life among Thai people after the COVID-19 outbreak: a cross-sectional study

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on individuals’ mental health and well-being worldwide. This study investigated the prevalences of and association between mental health and quality of life (QOL) in Thailand after the COVID-19 outbreak. A cross-sectional study was conducted among Thai individuals aged ≥ 20 years across all regions. Descriptive statistics, chi-square tests, and multiple logistic regression analyses were performed to examine the association between mental health and QOL. A total of 1,133 participants (mean age: 35.1 ± 17.2 years) completed the survey. The prevalence of depression with PHQ-9 instrument was 19.4%. Depression was significantly associated with those who have had family members die from COVID-19 infection (adjusted odds ratio [AOR] 2.27, 95% confidence interval [CI] [1.13–4.52]). The percentages of depression, anxiety, and stress with DASS-21 instrument were 32.4%, 45.4%, and 24.1%, respectively. Smokers and alcohol consumption had approximately 1.5-time higher risk of stress compared with non-smokers and no alcohol consumption (AOR = 1.50, 95% CI [1.01–2.24], AOR = 1.48, 95% CI [1.09–2.02], respectively). An association was observed between socioeconomic factors such as job and income loss and mental health outcomes. Depression, anxiety, and stress were significantly negatively associated with QOL. This study demonstrates a strong association between mental health and QOL among Thai people after the COVID-19 outbreak. The findings underscore the need for interventions targeting lifestyles, including those addressing alcohol consumption and smoking, especially among those who have had family members die from COVID-19 infection and mental health support services that can address depression, anxiety, and stress to improve the overall well-being of the population.

Youth mental health outreach interventions: lessons from an experience capitalisation process

Abstract Issue Young people face socioeconomic, geographical and cultural barriers to access care and support in mental health. Practitioners implement outreach initiatives to improve mental health and address health inequalities, mostly developed in a ‘no-request for care’ context. Methods To better understand the implementation mechanisms of these initiatives, Fondation de France commissioned the French Society for Public Health to carry out an experience capitalisation to inspire other professionals. Experience capitalisation method was used, based on in depth interviews with project stakeholders. Covered themes were: the description of history, strategies and activities; identification of key moment and key levers; skills and knowledge used. Results Nine mental health outreach projects implemented across regions of France were selected with the help of a multidisciplinary steering committee. Each project was synthetised in a capitalisation document and a cross-sectional analysis was undertaken. Lessons • A variety of outreach approaches were carried on: meeting adolescents in the street or at coffee shops; home-based interventions; consultations in converted van etc. • Outreach is not just a matter of physically moving outside health structures but requires non-judging and flexible stance to adjust to the youth’s pace and will. To extend their approach to mobility, professionals deepen their team’s multidisciplinarity, broaden cross-sector partnerships and mobilise new skills and creativity. • Adolescents’ participation to care or support plans was one of projects strengths, whether they suffer from anxiety or mental disorders. However, their participation in governance and decisions regarding global projects remained limited. Key messages • To reduce mental health inequalities and enhance youth participation in outreach interventions, empowerment and wellbeing of interventions practitioners should also be supported. • Capitalisation of experience in health promotion is a promising method contributing to professional acknowledgment and development of shared knowledge on interventions implementation.

Loneliness and Social Isolation: qualitative study among youth in vulnerable situations

Abstract Background Loneliness and social isolation are increasing among young people, particularly those in vulnerable NEET (Not in Education, Employment or Training) situations, potentially leading to poor health and well-being outcomes. We aim to explore these challenges from the perspective of NEET youngsters and link workers who support them in co-creating individual action plans for their social and economic integration. Methods Data were collected through in-depth and semi-structured interviews with 15 young people in NEET situations, aged 18-34, and 7 link workers from several social organisations in rural and urban areas in Portugal. The young participants were selected based on their age, educational level, mental health needs, and urban/rural regions. Thematic analysis was used to analyse the interviews. Results The results showed a convergence between the perspectives of young people and link workers on the factors that influence social isolation and loneliness, including social and emotional skill deficits, excessive use of social media platforms, and mental health problems. Young people reported to being heavily involved in social media platforms, which often did not translate into meaningful relationships in real life. Youngsters also highlighted the lack of local support and community resources in rural areas. Link workers identified specific challenges young migrants face in community integration, including language barriers (for the youth with a migrant origin) and lack of familiarity with local resources. Conclusions This study highlights social media platforms, mental health and social and emotional skill deficits as main factors contributing to the social isolation and loneliness of young people in a NEET situation. This emphasizes the importance of integrated proximity-based interventions that incorporate community resource mapping and local support networks, including mental health support services, and promote multi-sector collaboration. Key messages • Social media platforms, mental health needs, and social and emotional skill deficits drive social isolation in NEET youth, stressing integrated, community-focused interventions. • Proximity-based strategies with community mapping and mental health support enhance NEET youths’ social integration, urging cross-sector collaboration.

Scoping Review of Health Literacy Interventions among Migrant Communities in Europe

Abstract Background The increase in migration trends in Europe has brought attention to the significant health disparities between migrant and native populations, which are largely rooted in social determinants of health such as economic difficulties, language barriers, and limited access to services. Tailored health literacy (HL) interventions can serve as an intermediate factor between social determinants of health and health outcome, thereby holding great potential for addressing these disparities. Despite a growing body of research on migrant health, there remains a gap in our understanding of effective HL interventions for this population. Methods A scoping review was conducted following the Joanna Briggs Institute (JBI) updated guidelines and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Electronic searches were carried out across five databases (PubMed, SCOPUS, Web of Science, PsychINFO, and CINHAL) and supplemented by a manual search. We included European studies on migrant HL interventions, conducted between 2011 and 2023, and published in English or Portuguese language. Results Out of 1018 records, 7 studies met eligibility criteria. Predominantly situated in Northern and Western Europe (85.5%), interventions primarily targeted female migrants (71.4%) through in-person courses (42.9%). Identified intervention strengths included culturally adapted content, migrant engagement, and access to written materials. Gaps included mental health interventions and community outreach. Conclusions This scoping review provides a comprehensive overview of HL interventions targeting migrant populations, highlighting their characteristics, strengths, and gaps. These findings serve as a foundational step towards developing guidelines for effective HL interventions within migrant communities. Key messages • Most European health literacy interventions for migrants target women and are conducted in North or West Europe. • Cultural adaptation and community engagement are key strengths of migrant health literacy interventions, yet gaps remain in mental health support and community outreach efforts.

Meaning-making of mental health among reception center clients in Finland

Abstract Introduction Asylum seekers and refugees face significant challenges, including high rates of mental health issues, as they navigate unfamiliar societal systems and norms. However, little is known about their subjective experiences of mental health and the mental health support in everyday social encounters. This study aims to explore the meaning-making of mental health and the experiences of receiving mental health support among clients of Finnish reception centers (FRCs). Methods Semi-structured individual in-person interviews were conducted with 11 reception center clients from various locations in Finland, with an interpreter present in four interviews. Interviews lasted approximately 60-90 minutes. Thematic analysis was employed to identify recurring themes and subthemes. Results Preliminary findings indicate a diversity in the meaning-making of mental health among participants. While some discussed mental health in terms of stress, others approached the topic analytically, while some avoided it altogether. Participants highlighted the importance of access to external resources, such as schools, language courses, and employment, for enhancing overall well-being. Trust in FRC staff emerged as a crucial factor in seeking and receiving assistance for mental health concerns. Additionally, participants exhibited resilience, suggesting benefits of empowering them during this challenging period. Conclusions Adopting a holistic approach to mental health care within FRCs is imperative. Understanding how clients construct meaning around mental health is particularly relevant for training FRC staff, who serve as primary points of contact for asylum seekers and refugees in Finland. Moreover, amplifying the voices of reception center clients can contribute to improving services and enhancing the health and well-being of this population in Finland. Key messages • It is necessary to adopt a holistic approach to mental health care within reception centers, one that addresses broader social determinants of mental health. • Trust in the staff of Finnish reception centers is a critical factor in facilitating the seeking and receiving of assistance for mental health concerns among asylum seekers and refugees.

The relationship between mental health and employment: a systematic review of cohort studies

Abstract Background Knowledge on the bi-directional association between employment status and mental health is important, as it affects multiple dimensions of our daily lives, both at the individual and societal level. Given that the mental health status and employment situation of individuals are likely to change over time, there is an important need for longitudinal data to better understand causality patterns in this association and the underlying mechanisms. Methods A systematic review was carried out based on the PRISMA guidelines in 3 electronic databases: PubMed, Embase, and PsycInfo. Studies eligible for inclusion were cohort studies, involving the general population, and assessing the relationship between employment status and mental health longitudinally. Results In total, 3,733 studies were identified and 36 met the inclusion criteria. The eleven studies focusing on the social causation hypothesis highlighted the negative long-term impact of unemployment and unstable employment on mental health. Four studies observed mental health improvements upon re-entering employment, although limited and in more specific contexts. The fourteen studies focusing on the health selection hypothesis found a lower probability for individuals with mental health problems in finding and maintaining employment. Finally, the eleven studies assessing the two hypothesis simultaneously found that mental health problems were both a consequence of and risk factor for poor employment status, although some important moderating factors, such as gender differences, influence the direction and strength of the association. Conclusions This review underscores the bi-directional association between the employment status and mental health of individuals, highlighting the need to develop targeted prevention (e.g. mental health support in the workplace) and interventions strategies (e.g. supported employment programs) in both the mental health and labor market systems. Key messages • The bidirectional link between employment and mental health highlights the need for concurrent responses to break the vicious cycle between poor mental health and social exclusion. • To reduce the clinical and social burden of mental health problems, gender differences must be taken into account in mental health and employment support practices and policies.

Learnings from ‘Everyone In’ initiative in England for improving health of people facing homelessness

Abstract Issue The COVID-19 pandemic presented an unprecedented health risk to people experiencing homelessness including risk of infection due to inability to self-isolate, and pandemic restrictions adding barriers to accessing health support. The English Government implemented the ‘Everyone In’ policy at the start of the COVID-19 pandemic, which offered accommodation to those who were (or at risk of) sleeping rough. This led to integration of support for health, care and housing. Description of the problem Between January-October 2023, a qualitative study was undertaken to understand what worked well and less well in implementing the ‘Everyone In’ initiative for improving physical and mental health outcomes for people experiencing homelessness. People who were provided accommodation and those involved in the planning or delivery of the initiative were interviewed. Results Flexibility in provision of funding and support, lack of red tape and joined-up working between partners across sectors were key positives of implementing the policy. ‘Everyone In’ also led to new ways of supporting and overcoming barriers to support, for example, provision for people with no recourse to public funds. Access to health services for people experiencing homelessness was improved by strengthened relationships with service providers, and outreach within the accommodation for wrap-around support. Challenges were faced in support for substance use. Data sharing practices, mental health support, and recognition of trauma were areas that could have worked better. Lessons Availability of flexible and earmarked funding is crucial in implementing strategies for improving outcomes in homelessness. Many short and long-term initiatives have been launched as a result of ‘Everyone In’. This study highlights the importance of partnership working, supported housing and maintaining flexible, responsive approaches to interventions to meet the health and social care needs of people experiencing homelessness. Key messages • Multi-sectoral partnerships and integrating housing with health and care support can improve access to services. • Availability of flexible funding for homelessness strategies supports adaptable and responsive service provision.

Mental health support for healthcare workers: what is it about governance and policy implementation

Abstract Background We adopt a health system and governance perspective to address the mental health needs of healthcare workers, considering the nature of interventions and the levels and actors involved in governance. The aim is to move the debate forward by identifying governance gaps hampering the implementation of health workforce policies and exploring strategies to effectively increase mental health support. Methods A qualitative comparative methodology is applied based on a case study design utilising a multi-level intersectoral governance matrix. The assessment matrix comprises four key categories: health policy and data, social policy and psycho-social conditions, organisation of work, and job and professional conditions. We conducted a rapid assessment of healthcare workforce developments in the European context, drawing on secondary sources and country experts. The country sample comprises Germany, Portugal, Romania, Switzerland and the United Kingdom. Results Awareness of mental health threats among healthcare workers increased, but policy discourse is driven by service delivery and labour market demands. The attention to healthcare workers’ needs is stronger on the international level especially supported by WHO action, and weakest at national/regional levels. Although organisations and professions demonstrate varying degrees of activity, their efforts are scattered and lack sustainability. Similar challenges were identified across healthcare systems, including limited action, disconnected actors, missing coordination, and a lack of attention to governance gaps and system weaknesses. Conclusions There are similar problems across countries. Mental health policy is driven by labour market needs and ignores research evidence and the individual needs. Successful mental health policy implementation needs multi-level governance and coherent coordination mechanisms, and generally greater attention to the ‘human side’ of the healthcare workforce. Speakers/Panelists Sara Alidina Central Administration of the Health System, Lisbon, Portugal Tomas Zapata WHO/Europe, Copenhagen, Denmark

Novi Sad cultural stations as healthy buildings for wellbeing concept

Abstract Creating spaces for all citizens through the cultural stations project within the Novi Sad - European Capital of Culture 2022 has set an example of applying the concept of well-being which involves integrating various elements that support physical, mental, and social health. Cultural stations project in the city of Novi Sad is a concept supporting cultural programming, healthy food options, mental health support, accessibility and inclusivity, as well as community engagement. Social interaction in urban areas is vital for mental and emotional well-being, fostering a sense of belonging and community, diverse cultural programming that appeals to different groups, cultural activities such as art exhibitions, performances, workshops, and community events provide opportunities for creativity, learning, and social engagement, enhancing overall well-being. Access to cultural stations, spending time there has been linked to reduced stress, improved mood, and increased feelings of well-being within 7 neighborhoods of Novi Sad. This includes providing barrier-free access, accommodations for individuals with disabilities, and programming that is inclusive and welcoming to everyone. Participation of the local community in the design, programming, and management of cultural stations is also important. By integrating these principles into the design, programming, and management of cultural stations, Novi Sad creates vibrant, inclusive, and healthy spaces that contribute to the overall well-being of its residents and visitors. Cultural stations are located in different parts of the city in order to provide accessibility to all citizens. Their arrangement is in accordance with the recommendations of green construction and restoration, and the interior and surroundings foster respect for nature and nature-based solutions. Also, they are developing different content in line with culture, but also science, health and smart solutions as a tool for well-being.

Exploring the Challenges of Context in Accessing Mental Health Support in Rural New Zealand: A Case Study Approach.

This paper explores the complexities that impact access to mental health services in rural New Zealand. Historical, cultural, social and political factors will be examined against the philosophical positioning of Foucault and Fairclough. This research is a single-embedded case study design exploring participants' discourses in the context of a rural, bounded geographical area of New Zealand. The results show that mental health support that addresses people's actual needs rather than the needs that governments map against ever-changing policy is required and that an awareness of context within case study research is important. The process of case study design is described, including building upon a rationale for selecting the case, collecting data and conducting case analysis and interpretation. This study examines factors influencing the real-life rural context of accessing mental health support. This article demonstrates that case-study research can be valuable for navigating context complexity and developing nuanced understandings of complex phenomena. The paper highlights how the multifaceted case study context is more than mapping discourses against a rural backdrop. It is necessary to consider the power dynamics that shape experiences and their impact on service creation and its consequent delivery. Rather than services being created that are complex and not meeting people's needs, there is a need to listen to the people who have experienced mental health distress and provide services and support in locations other than clinical settings.

Strengthening youth mental health capacities in Albania: Training primary healthcare professionals

Abstract Background Addressing mental health issues among children and adolescents globally is crucial, necessitating interventions at the primary healthcare (PHC) level. The training programme in Albania equipped PHC professionals with skills for early identification, support, and referral for youth mental health issues. Given the global prevalence of such challenges, our intervention serves as a valuable model for enhancing mental health services in communities. Objectives The training aimed to develop the capacities of Albanian PHC professionals in improving mental health and psychosocial wellbeing among youth. Through innovative training sessions using participatory action methods, it was sought to answer key questions: How can Albanian PHC professionals better identify and support youth mental health issues? What innovative approaches can enhance mental health training for Albanian healthcare personnel? How can community engagement be strengthened to support youth mental health initiatives in Albania? Results Following the programme, 525 healthcare professionals in Albania received training, showing improved knowledge and skills in youth mental health support. They emphasized the importance of community engagement, standardized documentation, and specialized mental health services. Preliminary results indicate increased awareness and readiness among Albanian PHC professionals to address youth mental health needs. Conclusions The programme underscores the significance of equipping Albanian PHC professionals with comprehensive skills to tackle youth mental health challenges. Lessons learned have broader implications for strengthening mental health services globally, emphasizing collaboration, standardized protocols, and targeted interventions. Key messages • Strengthening PHC capacity in Albania improves early identification and support for youth mental health, enhancing overall wellbeing. • Tailored training and community engagement are vital for effective mental health interventions at the grassroots level in Albania.

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

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

6.M. Scientific session: Risk And Resilience Factors Of Mental Health During COVID: European Multi-country Data Findings

Abstract The COVID-19 pandemic significantly affected mental health. It worsened the mental health and well-being of those already vulnerable or exposed to excess pandemic-related stress. In addition, lockdowns and other measures created additional obstacles to mental health support access. In response, the European Commission funded the RESPOND project in 2020, aimed at enhancing the preparedness of mental health systems for pandemics and global crises. As part of the RESPOND project, (meta-)analyses were conducted on prospective cohort datasets, national health register data, and multi-country individual participant data (IPD). The aim was to examine whether there was a change in prevalence rates of mental health conditions (e.g., anxiety and depression) in the general adult population of the EU during, compared to before and in between, the COVID-19 pandemic waves. Analyses on risk factors (e.g. sociodemographic- and economic factors, severity of COVID-19 infection, (lack of) social activity and support, and loneliness) associated with psychological distress and mental disorders as well as resilience and well-being (coping strategies and core value orientations) in the general population or specific vulnerable groups were conducted as well. This workshop will feature five talks covering various aspects of the RESPOND epidemiological analyses. First, an introduction and rationale of the RESPOND study on short- and long-term impacts of the COVID-19 pandemic and outbreak response, will be provided. Subsequently, findings from the multi-country longitudinal COvid MEntal healTh Survey (COMET) on forecasting psychological distress throughout the pandemic will be presented. Second, findings from the French TEMPO (Trajectoires EpideMiologiques en POpulation) cohort and merged datasets will be presented indicating associations and interactions between socioeconomic factors, mental health, and public health behaviours during the pandemic. Third, using data of a large Belgian prospective cohort, fluctuations in risk of psychological distress across study waves and the factors associated with individual trajectories of psychological distress during the COVID-19 pandemic will be presented. Fourth, the risk of SARS-CoV-2 infection, severe COVID-19 outcomes, and death among individuals with various mental disorders, based on Spanish health records, will be presented with specific attention to sex differences. Finally, based on the IPD meta-analyses of 9 European cohorts, findings on stressor reactivity, resilience trajectories, and factors associated with resilient outcomes and vulnerability are presented. By presenting a selection of findings from large datasets together, we aim to facilitate discussions on critical topics such as vulnerability and resilience to mitigate mental health impacts in future public health crises. Key messages • Targeting specific individual vulnerabilities appears to be more effective in reducing the pandemics’ mental health impact than solely responding to pandemic-related fluctuations. • Research and harmonised data on vulnerability and resilience factors are essential for guiding the development of targeted interventions and support systems for vulnerable populations during crises.

Prenatal risk factors for child executive function at 3–5 years of age: the roles of maternal mood, substance use, and socioeconomic adversity in a prospective cohort study

BackgroundA growing body of literature links prenatal mood and substance use to children's cognitive and behavioral development. The relative contribution of these risk factors on children's executive function (EF) in the context of socioeconomic adversities needs further evaluation. To address this gap, we investigated the role of prenatal maternal anxiety and depression on childhood EF, specifically inhibitory control and working memory, within the context of socioeconomic adversities and prenatal substance use. We hypothesized that higher maternal mood symptoms, higher persistent prenatal drinking and smoking, and lower socioeconomic status would be associated with lower EF skills during early childhood.MethodsWe used data from 334 mother–child dyads followed prospectively through pregnancy and the offspring’s childhood. Prenatal maternal depression and anxiety were assessed via standardized questionnaires. Prenatal alcohol and tobacco consumption were assessed via a timeline follow-back interview. The EF touch battery assessed child inhibitory control and working memory at 3–5 years of age (4.76 ± 0.58 years, 171 females). Separate linear regression models were used to estimate the association of prenatal tobacco, alcohol, anxiety, and depression exposure with our two components of child EF, inhibitory control and working memory, while adjusting for gestational age, sex, and age at assessment. The following variables were also included as covariates: maternal educational achievement, employment status, parity, and household crowding index.ResultsChildren of mothers with high trait anxiety scores had reduced inhibitory control compared to children of mothers without trait anxiety or depression (β = -0.12, 95% CI:-0.22,-0.01). Children of mothers in the moderate to high continuous smoking group showed lower inhibitory control (β = − 0.19, 95% CI:-0.38,-0.01) compared to children of mothers in the none smoking group. Additionally, lower maternal education and higher household crowding were each associated with reduced inhibitory control. We found no significant association between prenatal maternal depression, anxiety, or socioeconomic factors with working memory.ConclusionsThese results underscore the need for comprehensive context-specific intervention packages, including mental health support for women to promote healthy inhibitory control development in children.

Mental health trajectories among Syrian refugees in Norway: A longitudinal cohort study

Abstract Background Refugees encounter various risk factors that can affect their mental health throughout the migration process. However, while most studies focus on mental health challenges at the time of resettlement, only a few explore these changes over an extended period. This study aims to explore changes in mental health among Syrian refugees in Norway and to identify influencing factors. Methods This is a prospective cohort study using data from CHART and Integration for Health studies, which followed Syrian refugees granted settlement in Norway. Data collection took place in Lebanon between 2017-2018 (baseline), and at one- and four-years post-arrival in Norway. Assessments for anxiety/depression and post-traumatic stress disorder (PTSD) were conducted using the Hopkins Symptom Checklist (HSCL-10) and the Harvard Trauma Questionnaire, respectively. Mixed-effects logistic regression analyzed temporal changes, with results presented as odds ratio (OR) with 95% confidence intervals (CI). The study also explored the effect modification of outcomes by the following baseline factors: age, gender, education. Results A total of 132 participants were included in all three data collection points. There was a decrease in the proportion of participants reporting anxiety/depression (from 30% to 28%, OR 0.1, 95% CI 0.1 - 0.2) four years post-settlement. The proportion of participants reporting PTSD symptoms decreased one year after settlement (from 4% to 3%, OR 0.3, 95% CI 0.1 - 0.7), but increased to 4% four years after arrival, showing no improvement from baseline (OR 0.8, 95% CI 0.4 - 2.0). No interactions were observed between changes over time and baseline variables. Conclusions After four years in Norway, Syrian refugees reported improvement in anxiety/depression, but PTSD symptoms worsened. This highlights the need for ongoing support that extends beyond the initial phases of resettlement. Key messages • Refugees face various risk factors that affect their mental health throughout the migration process. • Ongoing mental health support for refugees is essential, beyond the initial resettlement phase.

Depression and its risk factors in a conflict-affected population: findings from a nationwide survey

Abstract Introduction The impact of armed conflict and war on mental health is well documented, with limited data on populations living in unrecognized states. In this study, we examined the prevalence and risk factors of symptoms of depression among the Nagorno-Karabakh population during a ceasefire period, prior to a blockade, full-scale military attack, and their forced displacement. Methods A total of 1023 women, aged 18-49 years, from all regions of Nagorno-Karabakh, participated in a population-based household survey in 2022, which included the Center for Epidemiologic Studies-Depression (CES-D) 16-item scale to assess their depression symptoms. Simple and multivariable linear regression analyses explored the socio-demographic factors associated with CES-D score. Results The mean CES-D score was 8.90 (SD = 8.93), and 13.1% of the respondents had a score >18 (presence of depressive symptoms). The adjusted linear regression showed that CES-D score was higher among divorced (2.66, SE = 1.15, p-value=0.021) or widowed (3.09, SE = 1.57, p-value=0.049) vs. married, and among those having war-related deaths in the household in the previous 2 years (8.60, SE = 1.65, p-value<0.001) vs. not having. Conversely, a vocational/university level (-2.33, SE = 0.70, p-value=0.001) or post-graduate education (-3.81, SE = 1.72, p-value=0.027) vs less than secondary/secondary level, and 3-5 members in the household (-2.71, SE = 1.16, p-value=0.020) vs.1-2 members were significantly associated with lower CES-D score. Conclusions Our findings suggest that depression symptoms are highly prevalent among women in conflict-affected areas, with specific socio-demographic factors increasing the risk of depression symptoms. These results highlight the importance of providing mental health support and interventions for women in conflict-affected areas, particularly for those who experienced loss in the family due to war, are divorced or widowed, live in small households, and have lower education. Key messages • Depression symptoms are highly prevalent among women of reproductive age in areas affected by armed conflict and war. • Mental health intervention is recommended for women in conflict-affected areas who experienced loss due to war, are divorced or widowed, live in small households and/or have lower education.