Mental Ill-health Research Articles

Perspective matters in recovery: the views of persons with severe mental illness, family and mental health professionals on collaboration during recovery, a qualitative study.

Recovery from severe mental illness, including psychosis has been described as a personal and unique process, but it rarely is a journey undertaken without profound influences of significant others (family, mental health professionals). Diverging perspectives between persons with severe mental illness, family and professionals are frequent during the recovery process, notably in psychotic disorders. We aimed to explore processes of collaboration during recovery, to inform recovery supporting practices. Current qualitative study had a participatory design and was set within long-term mental healthcare for severe mental illness. We conducted semi-structured interviews and focus groups with persons with severe mental illness (most had a history of psychosis), family and professionals on their mutual contact during recovery. Using reflexive thematic analysis, we developed themes representing processes of collaboration during recovery. We described roles persons with severe mental illness, family and professionals attribute to each other in mutually influential terms of unconditional and meaningful contact (which takes time to establish) and problem-oriented aspects. Secondly, experienced differences over problem definition, "needing help" and consequently over the role parties attribute to one another, may result in negative interactions, in the area of having expectations; (not) informing; (not) having agency to change; experiencing (dis)agreement or struggle. unconditional, meaningful contact and knowing each other's perspective are important to fruitful interaction in a triad when perspectives on mental health problems diverge. Relationally centered and process oriented care with continuity of family and professionals involved are needed to advance recovery in severe mental illness, especially psychosis.

Acceptance and commitment therapy as a transdiagnostic approach to adolescents with different anxiety disorders: study protocol.

Adolescence increases vulnerability to mental ill-health, particularly anxiety disorders like Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD). Still, the understanding of Psychological Flexibility/Inflexibility (PF/PI) as a transdiagnostic framework relevant to explaining these difficulties and the efficacy of Acceptance and Commitment Therapy (ACT) in addressing adolescent SAD and GAD remains limited. Hence, this study has two aims: examining the role of PI/PF on adolescents' mental health and assessing ACT's efficacy for adolescent SAD and GAD. We will collect data from 400 community adolescents and employ network analysis to explore connections between PI/PF processes, anxiety, and flourishing. We will also investigate pathways linking PI/PF processes with flourishing and anxiety across samples (clinical SAD, clinical GAD, and mentally healthy groups), expecting to find similar patterns. Furthermore, a Randomized Controlled Trial with three groups (control, SAD experimental and GAD experimental), each comprising 29 participants, and four assessment moments (pre- and post-intervention and 3- and 6-months follow-up) will be conducted. Similar improvements are anticipated in both experimental groups, driven by changes in PI/PF processes. Findings from this work will provide valuable evidence to PI/PF as accurate conceptualizations of human suffering and expand the transdiagnostic application of ACT to adolescents with anxiety disorders.

The weight of office? A scoping review of mental health issues and risk factors in elected politicians across democratic societies.

The mental health and capacity to govern of democratically-elected politicians have become burgeoning topics of interest. Notably, in fulfilling demanding and high-stress roles, political officeholders could encounter distinctive risk factors, yet existing research literature about these subpopulations remains underexplored. This scoping review aimed to systematically examine the breadth of available evidence on mental health issues and risk factors affecting democratically-elected politicians internationally and to identify future research needs. Using pre-defined eligibility criteria based on JBI guidelines, a systematic keyword search was conducted in May 2024 of MEDLINE, Scopus, and APA PsycNet, supplemented by snowballing techniques. Only those studies reporting primary, empirical evidence on mental ill-health or risk factors with psychological correlates from serving politicians in "Full" or "Flawed" democracies (per Democracy Index) were included from 1999 to 2024. Titles and abstracts were screened and the full-texts of potentially eligible literature were assessed before extraction and synthesis. Eighteen sources met the eligibility criteria, cumulatively encompassing ~3,500 national, state, and municipal politicians across seven democracies (Australia, Canada, the Netherlands, Norway, New Zealand, the United Kingdom, and the United States). Cross-sectional surveys were predominantly utilized, with lesser use of mixed-methods approaches, qualitative interviews, and longitudinal cohorts. Violence emerged as a key concept, with twelve sources (66.7%) underlining its psychological toll and certain data indicating a disproportionate impact on female officeholders. Furthermore, four sources (22.2%) explored general psychopathology trends, revealing varying but sizeable mental ill-health and high-risk alcohol consumption rates, and two studies (11.1%) demonstrated adverse effects from specific occupational conditions. Current literature suggests that democratically-elected politicians can face complex mental health challenges. However, significant research gaps remain, including a paucity of prevalence estimates, longitudinal data, and intervention studies. Equally, the underrepresentation of most democratic countries accentuates the need for a more diverse evidence-base to better support the mental wellbeing of politicians worldwide.

Abstract 4147606: The Risk of Cardiac Events Associated with Psychiatric Drugs in Patients with Long QT Syndrome.

Introduction: Long QT syndrome (LQTS) is a potentially life-threatening genetic heart disease. Patients with LQTS may also have co-existent mental health illnesses that may benefit from psychiatric medications. However, because many of these medications have QT-prolonging potential (www.crediblemeds.org), many of these patients receive suboptimal mental health care. Objective: To evaluate the frequency, management, and incidence of breakthrough cardiac events (BCEs) in patients with LQTS and concomitant mental health issues treated with psychiatric medications. Methods: A retrospective review was conducted on patients cared for in Mayo Clinic's Windland Smith Rice Genetic Heart Rhythm Clinic between 2000 and 2024 focusing on patients with LQTS and a concomitant psychiatric diagnosis requiring medication with known, possible or conditional risk of torsades de pointes (TdP). Electronic medical records were reviewed for data. BCEs were defined as LQTS-triggered syncope, seizures, appropriate ICD therapy, sudden cardiac arrest (SCA), or sudden cardiac death (SCD). Patients with missing information were excluded. Results: Overall, 195 /1899 LQTS patients [10%, 86 (43%) with LQT1, 83 (42%) with LQT2, and 16 (8%) with LQT3] had a concomitant psychiatric diagnosis requiring medication [150 female (76%), mean age at diagnosis 27 ± 18 years, median follow-up time 6.6 years (IQR 2.9-13)]. The most common psychiatric conditions were depression (71%), anxiety (62%), and ADHD (9%). The mean duration of therapy was 3.36 +/- 3.48 years and the most common medications used were fluoxetine (26%), sertraline (14%), and escitalopram (11%). There was no significant difference in QTc after starting the first psychiatric medication when compared to baseline (473 ± 33 vs 474 ± 35 ms, p=0.6). Prior to their LQTS diagnosis and while therefore untreated, 61/195 (31%) had at least 1 LQTS-associated cardiac event. This occurred in the setting of a psychiatric drug in 7 patients (11%). Following LQTS diagnosis and treatment, 14/195 patients (7%) have experienced a non-lethal BCE of which only 3/14 (21%) while on psychiatric medications. Conclusions: Although avoidance of medications with known QT-prolonging potential is prudent, attention to patient’s overall well-being besides just their LQTS must be given. After correct diagnosis and treatment, LQTS patients with concomitant mental health issues may be safely and effectively treated with medications known to prolong QTc.

Psychological and social factors associated with mental health of European dual career athletes: A systematic review.

Dual careers (DCs) are challenging trajectories followed by athletes willing to develop their academic/professional career with their athletic careers. These trajectories usually entail additional stressors, which can decrease athletes' mental health or even increase their risk of mental ill-health. While existing research has recognized the importance of psychological and social factors in both of these areas separately, we lack systematic knowledge on which factors are associated with European DC athlete mental health outcomes, making evidence-based practice more challenging. In this regard, to advance the European DC tradition and to provide a strong base for researchers and practitioners working within this field, this systematic review aims to appraise this evidence identifying and categorizing the psychological and social factors associated with the European DC athletes' mental health. We conducted this review according to Preferred Reporting for Systematic Reviews and Meta-Analysis guidelines and performed the systematic search in six databases, finding 56 eligible articles. Our analysis identified 35 different psychological and social factors, most showing significant associations with athletes' mental health. Notably, affect, stress, motivational climate, mindfulness, resilience, perfectionism, goal orientation, motivation, and basic psychological need satisfaction showed the strongest evidence associated with mental health. Overall, this review provides a comprehensive synthesis of psychological and social factors, advancing the holistic ecological approach in dual careers and athlete mental health. Yet, our results highlight the need to strengthen the evidence regarding these factors and provide specific research avenues, such as focus on DC-specific factors and consideration of DC athlete definition and career trajectories.

How is coaches’ social identity leadership related to mental health in elite athletes? The mediating role of satisfaction with performance

ABSTRACT It has been found that the way high-performance coaches lead influences both athletes’ performance and mental health. However, limited research exists on the Social Identity Approach to leadership in elite sports, despite growing interest in coaching science regarding interpersonal behaviours and leadership. This study investigates the empirical links between coaches’ leadership, sport performance and mental health from a social identity approach. One hundred and forty-five elite athletes (M age = 20.6 years; SD = 4.1; 62% women, 38% men) answered questionnaires measuring coaches’ social identity leadership, sport performance satisfaction and mental health. The overall structural equation model (SEM) accounted for 36% and 19% of the variances in athletes’ mental health and mental illness dimensions, respectively. There was a positive association between perceived coaches’ social identity leadership and sport performance satisfaction, explaining 10% of its variance. Coaches’ social identity leadership predicted athletes’ mental health but not mental illness. Sport performance satisfaction positively influenced mental health and negatively impacted mental illness. Fostering a sense of “we” and “us” within elite sport training groups is instrumental in promoting sport performance satisfaction and, consequently, enhancing the mental health of athletes. Coaching educational courses may benefit from social identity leadership in interpersonal behaviours.

LBTQ parents’ bonding experiences after complicated births: managing minority stress and traumatic experiences

ABSTRACT Background Birth complications increase the risk of birth injuries and neonatal complications, as well as the risk of experiencing childbirth as a trauma. This, in turn, increases the risk of postpartum mental ill-health and may affect early bonding with the baby. Birth complications add additional stress on lesbian, bisexual, transgender and queer (LBTQ) parents, as they also must navigate hetero- and cisnormative assumptions, being subject to othering, and negative attitudes from healthcare staff. Aim To explore LBTQ parents’ experiences of bonding with their child following a complicated birth. Methods Semi-structured interviews with 22 birthing and non-birthing parents. Interviews were recorded, transcribed, and analysed using thematic analysis. Results The results describe obstructive and facilitating factors. Being traumatised was the main obstacle for mentally engaging with the baby. A focus on physical injuries and healing hindered caretaking and bonding for birthing parents. Stress related to their parental role was obstructive for some non-birthing parents, who struggled to find space to process their own experiences when the partner and/or child was not well. Other non-birthing parents experienced a head start in the bonding process when their partner was injured. Some birthing parents had positive bonding experiences despite the birth complications, as they felt an alliance with their child in the harsh situation. Conclusion Complicated births and minority stressors can increase the risk of bonding difficulties and mental ill-health. Tailored, LBTQ-competent care is essential to support both birthing and non-birthing parents in overcoming these challenges.

Effectiveness, efficacy, acceptability, and feasibility of trauma-informed depression, anxiety, and substance use prevention programs for young people aged 12-25 years: A mixed-methods systematic review.

Mental ill-health and substance use bear significant public health burden on young people. Prevention is key. Trauma-informed approaches to prevention of mental ill-health and substance use demonstrate significant promise, yet it is unclear how well existing approaches work for young people targeting mental ill-health and substance use. This review aimed to assess the effectiveness, feasibility, and acceptability of trauma-informed mental ill-health and/or substance use prevention programs for young people. We searched the PsycINFO, CINAHL, Embase, MEDLINE, and Cochrane Library reference databases for peer-reviewed studies of trauma-informed mental ill-health and/or substance use prevention programs for young people published between 2013 and 2022. Studies in any language were included and reference lists of included articles were scanned for additional studies of relevance. In total, 30 studies were included in this review, comprising five randomized controlled trials (RCTs), seven non-RCTs, 10 quasi-experimental designs, and eight qualitative studies. Among the 30 studies, 27 unique trauma-informed prevention interventions were detailed. Eighteen studies reported statistically significant decreases in mental ill-health, and two studies reported significant decreases in substance use outcomes among participants, up to 6 months following the interventions. Most preventative interventions with statistically significant effects were selective (rather than universal or indicated) in their approach (n = 10, 55%). Broad acceptability and feasibility of trauma-informed prevention programs was observed among studies reporting this information though most quantitative studies were at high risk of bias and/or did not include a control group, whilst qualitative studies tended to report research conducted without a priori research aims. This review synthesizes for the first-time evidence on the effectiveness (or efficacy), feasibility, and acceptability of trauma-informed mental ill-health and/or substance use programs for young people, especially for those exposed to traumatic or adverse experiences. While there are promising efficacy outcomes, further research conducting rigorous, well-powered RCTs is required for large-scale evaluation and scaling of the potential preventative benefits of such programs.

An Urgent Call for Suicide Prevention in Indonesia: The Clinicians’ Role in Preventing Suicide

Introduction: Since suicide is a complicated matter, multiple sectors must be involved. Globally, there were 703,000 suicide cases in 2019. Over the past three years, there has been a rise in suicide instances in Indonesia. Treating those who are at risk of suicide is difficult since suicide situations, like mental health illnesses, continue to carry stigma. To provide a statistical overview of suicide cases and the role of clinicians in preventing suicide cases. Methods: Searching for statistical data in Indonesia, we used Pubmed with the keyword “statistics”, “suicide”, “Indonesia”. Searching for data regarding risk factors and prevention of suicide, we also used Pubmed with the keywords “risk factor”, “prevention”, “screening”, “suicide”. Results: Globally, in 2019 the average rate of suicide cases was around 9.0 cases per 100,000 population. In Indonesia, exact data regarding the prevalence of suicide cases is still unknown. A person committing suicide can be caused by many factors such as previous mental disorders, relationship conflicts, legal problems, violence, financial problems, social exclusion, and low socioeconomic status. In addition to providing appropriate management, a clinician must provide education and outreach to the public regarding warning signs and risk factors for suicide, restrictions on tools for suicide, screening, and also remind every patient, especially patients with mental disorders, to continue to pray to be given health. Conclusion: A clinician has a role ranging from education and related outreach, screening, and also pharmacological and non-pharmacological management of someone at risk of suicide

An Exploration of the Barriers and Facilitators Shaping Vaping Cessation Among Australian Young Adults

This study of 18–24-year-old young adults (YAs) in Australia who use, or used to use, nicotine vape products (NVPs) sought to explore their experiences when attempting to quit vaping to understand the barriers and identify facilitators of cessation. We analysed data from a survey (n = 532) of 422 YAs who vape and 110 YAs who used to vape, as well as interactive workshops (n = 12) and semi-structured interviews (n = 3), which included 7 YAs using and 8 no longer using NVPs. Social Cognitive Theory informed the data collection, with open-ended questions exploring how personal, environmental and behavioural factors shaped vaping cessation. Qualitative analyses revealed 11 themes shaping vaping cessation, including the normalisation of vaping, easy access and a desire to fit in. Vaping cessation was complicated by using NVPs to manage symptoms of mental ill-health. Additionally, former vapers reported using combustibles to replace vaping, highlighting the risk of health impacts from smoking. Potential support sources included friends and general practitioners, or family doctors. Support service development must consider de-normalising vaping, addressing underlying mental health issues and providing effective campaigns around the health risks of vaping and smoking. The findings highlight the need to invest in vaping cessation, and they can inform the design of vaping cessation programs to better support those trying to quit and ensure the success of their quit attempts.

Mental Health and Crime: Exploring the Link

This paper discusses the complex connection present in factors of mental health and criminality in people, or how various psychological disorders may shape the inclination towards crime and the manner in which crime is dealt with by the justice system. We critique and evaluate literature catered towards various aspects such as the extent of mental illness in offenders, the influence of mental conditions on making decisions and addressing the factors related to mental illnesses that may hinder rehabilitation such as stigma. To add on, we assess in what ways such sociocultural structures as socio- economic positioning, and availability of mental care, relation to crime and mental health. Using a transdisciplinary perspective, we seek to develop implementation strategies and proposals that would serve people with mental health illness in correctional facilities, in a way that would not compromise fairness and encourage rehabilitation. The data indicate that enhancing mental health services and embedding mental health care into the criminal justice system can minimize the rates of reoffending and beneficially impact individual’s lives as well as the overall society.

Multidimensional employment trajectories and dynamic links with mental health: Evidence from the UK Household Longitudinal Study.

Low-quality and precarious employment have been associated with adverse mental health and wellbeing. More evidence is needed on how the quality of employment trajectories - including transitions in and out of unemployment, inactivity, and employment of varying quality - are associated with individuals' mental health over time. This paper aimed to derive a typology of multidimensional employment trajectories and assess associations with mental health in the UK. Data from waves 1-9 of the UK Household Longitudinal Study were used (2009-2019). Individuals aged 30-40 at baseline were included (N=1603). Using multichannel sequence and clustering analyses, we derived a typology of employment trajectories across employment statuses and four employment quality indicators. We assessed associations with subsequent psychological distress, accounting for baseline mental health. Changes in average General Health Questionnaire scores are described. A typology of five trajectory clusters highlighted stable and secure and precarious/low-quality trajectories for both men and women. Women who reported being economically inactive at most waves had higher odds of experiencing psychological distress than did women in 'standard' trajectories, regardless of baseline mental health. Women's scores of psychological distress in the 'precarious' group on average increased along their trajectories characterized by instability and transitions in/out of unemployment, before a move into employment. Men who likely moved in and out of unemployment and economic inactivity, with low probability of paid employment, reported increased psychological distress at the end of follow-up. This may partly be due to pre-existing mental ill-health. This paper shows the importance of high-quality employment for individuals' mental health over time. Researchers need to consider dynamic associations between employment quality and mental health across the life-course.

The Hope Therapy Effect Toward Depression, Anxiety, and Stress of Tuberculosis Patients with Multi-Drug Resistance at Jayapura’s Healthcare Center, Papua

Background: Indonesia is the third country with a high-rate case of tuberculosis with multi-drug resistance, for a percentage of 5% per 100.000 population. In Papua, TB-MDR becomes the main problem of health with a successful percentage of medication at 68.7%, an indicator of WHO higher than 85%. The complexity and the prolonged occurrence make the patients to have mental health illnesses, such as depression, anxiety, and stress. The field data of depression cases consisted of 65 patients. 50% with had mild depression, 20% with moderate, and 25.55 with severe. Patients with anxiety ranged from 16.7% to 37.29%. Patients with severe stress consisted of 20%. The mental illness health problems for TB-MDR patients required the roles of the nurses, such as counseling based on HOPE therapy. Purpose: Analyzed the effects of HOPE therapy to manage depression, anxiety, and stress levels. Methods: Quasi-experimental research applied a systematically assigned control group. The population consisted of patients with TB-MDR receiving medication at Jayapura's healthcare center, 40 individuals. Results: HOPE therapy effects for depression, stress, and anxiety levels applied the Wilcoxon test. The obtained result was a p-value lower than 0.05. The results indicated the effect of HOPE therapy medication on depression, stress, and anxiety levels. The intervention group had decreased depression, stress, and anxiety levels with p-values of 0.043 and 0.012. The results contradicted the control group. The obtained p-value was higher than 0.05, indicating no effect. The p-values were 0.721, 0.532, and 0.670. Conclusion: HOPE therapy was useful for TB-MDR patients with mental illness. The administered HOPE therapy for patients could improve their confidence and hopes to live better and recover.

Towards Sustainable Mental Health Using the Finnish Mood Scale

The interest in mental health in a sports context has increased in recent years. However, there is no scientifically sound measurement tool for assessing sport-related mental health symptoms in the Finnish language. One of the most frequently used measurement tools for such symptoms in English is the Brunel Mood Scale (BRUMS). The purpose of the present study was to adapt and validate a Finnish version of the BRUMS, referred to as the Finnish Mood Scale (FIMS). The 24-item, 6-factor FIMS was administered to 445 Finnish participants concurrently with Finnish versions of the Depression, Anxiety, and Stress Scale (DASS-21) and the Psychobiosocial States Scale (PBS-S). The sample consisted of 259 females (58.2%), 177 males (39.8%), and 9 who did not disclose their gender (2%), aged 16 to 75 years (M = 35.65, SD = 13.70). Sixty-two participants (13.9%) reported being a competitive athlete, 273 (61.3%) were regular exercisers, and 109 (24.5%) did not exercise regularly. A six-factor modified CFA model indicated an adequate fit to the data (CFI = 0.944, TLI = 0.934, RMSEA = 0.060). Concurrent measures correlated with FIMS in line with theoretical predictions, supporting convergent and divergent validity. Males reported significantly more positive mood scores than females. Physically active participants reported significantly more positive mood scores than inactive individuals, endorsing the mental health benefits of physical exercise. Findings indicate that the FIMS is a suitable measurement tool to screen mood modalities in Finnish populations aged 16 years and older. FIMS may be useful for the early detection of mental ill-health, thus, promoting sustainable mental health.

Implementing patient navigation for cancer prevention among individuals with mentally ill-health

Abstract Issue In Europe, over 80 million people experience mental ill-health and there are 4 million new cancer diagnoses each year. Individuals experiencing mental ill-health exhibit higher rates of cancer morbidity and mortality, with this excess attributed to risky health behaviors and obstacles encountered when accessing often fragmented healthcare systems. Description of the problem The aim of Co-CAPTAIN is the pilot implementation and evaluation of the Patient Navigation Model (PNM) for the improvement of primary cancer prevention in individuals with mental ill-health, adapted through participatory co-design in the European context. The project will adopt a cohort-based study design, commencing data collection at baseline and succeeded by three follow-ups (6 weeks, 9 months, 18 months). It will utilize a mixed-methods approach, combining quantitative and qualitative methodologies to assess diverse outcomes of PNM, facilitating both exploratory and confirmatory research. Qualitative data will be obtained through semi-structured interviews, while quantitative data will be collected using validated questionnaires and items developed ad hoc. The project will involve four pilot sites in Europe (Austria, Greece, Poland and Spain), where the PNM will be adapted to the specificities of national healthcare and support systems. The implementation phase is expected to begin in June 2024. Results During implementation, gathering both quantitative and qualitative data will offer valuable insights into feasibility and effectiveness, establishing a baseline for reshaping health and social care policies for individuals with mental ill-health across Europe. Lessons Co-CAPTAIN project aims to reduce health disparities for individuals with mental ill-health by improving overall health and reducing cancer burdens, leading to cost reductions in European health and social care systems. Key messages • The project aims to deliver an innovative solution based on the PNM, to address health disparities among individuals with mental ill-health by reducing cancer burden. • Combination of qualitative and quantitative methodologies to assess diverse outcomes.

The economics of mental ill-health in the EU/EEA

Abstract This presentation will provide an overview of the challenges and costs of mental ill health in 29 EU/EEA countries and an economic assessment of options to address current policy gaps. Nearly 20% of people in the EU/EEA experience mental ill health, with a particularly high prevalence among vulnerable groups such as people on low incomes or young people. However, in the majority of cases, and particularly for those with milder forms, these conditions go undiagnosed. Even when diagnosed, access to quality health services is sub-optimal, mainly due to financial issues or waiting times. The European Union and its Member States have identified mental ill health as a major public health threat, but there are still significant policy gaps and a lack of evidence on the most effective and cost-effective interventions to implementation. Building on its methodology for identifying and evaluating better public health policies for better lives, the OECD has recently extended the scope of its economic work to mental health. This presentation will start by providing an estimate of the health and economic burden of mental ill health in EU/EEA countries and will present evaluations of best practices in this field recently introduced by EU Member States. The talk will not only present the results of the analyses but will also use the identified case studies to discuss the approach used and some of the methodological issues involved in carrying out economic analysis for a set of diseases with high burden but relatively low mortality.

Barriers and facilitators to healthcare services of people with mental ill-health in Europe

Abstract Background People with mental ill-health (PMIH) have higher cancer mortality rates than the general population. Barriers to healthcare service access may be a contributing factor. The EU-funded CO-CAPTAIN project aims to reduce health inequalities by improving overall health and reducing cancer burden by adapting and implementing the Patient Navigation (PN) Model targeted at PMIH. This qualitative study explored healthcare system experiences of PMIH in Austria, Greece, Poland, and Spain. Methods Eighty-one participants (22-76 years old), including 34 PMIH, 10 caregivers, 14 care team members, 12 mental health organization representatives, and 11 service manager representatives, were recruited. Semi-structured interviews focused on awareness of cancer risk factors, healthcare system experiences, and perspectives on PN as an intervention. Interviews were transcribed verbatim and analyzed using thematic analysis. Results Three major themes emerged: (1) somatic health relevance and preventive services utilization and (2) barriers / (3) facilitators to preventive services access. Knowledge of cancer prevention services varied greatly. Participants were aware of associations between risky health behaviors and health. Burden of mental health problems and discrimination, insufficient access to information, and lack of service flexibility were noted as barriers. Considerations of individual circumstances, social support, and empowerment were named as facilitators. Conclusions Tailored interventions involving healthcare professionals and PMIH in development of supportive environments and health literacy have the potential of overcoming identified barriers to the use of healthcare services. Key messages • People experiencing mental ill-health are faced with significant structural barriers when accessing somatic health services. • Understanding people’s needs in terms of access and utilization of health care allows us to define guidelines for future personalized healthcare solutions.

Cancer Prevention in People Experiencing Mental Ill-Health: A co-designed Patient Navigation Concept

Abstract Introduction People experiencing mental ill-health have greater disparities in cancer specific morbidity and mortality. Factors influencing cancer prevention include increased risk behaviours and frequent encounters with barriers to health care utilization. The Patient Navigation Model (PNM) has been proven to reduce barriers in accessing cancer preventive care in vulnerable populations. To facilitate successful implementation, the conceptual features of the PNM were co-designed with patients and other relevant stakeholders. Methods Twelve focus groups were conducted in January 2024 at four pilot sites in Austria, Greece, Poland, and Spain. Iterative focus group discussions were carried out following key considerations for the PNM as outlined by DeGroff et al., audio recorded and transcribed verbatim. Transcripts were analysed deductively using a directed content analysis while allowing for potential inductive emergence of codes and topics. A total of 50 participants attended, representing five groups (individuals with mental ill-health, care givers, care team members, representatives of mental health organizations, and representatives of service managers). Results The co-design focus groups allowed for the PNM to be contextually adapted to each pilot site, but similarities in the approach emerged within the following four themes: 1) the requirement for a person-centred approach, 2) consideration of both person-specific and context-specific needs, 3) flexibility and competencies of navigators and 4) variation of navigation services (e.g., improving health literacy, promoting a healthy lifestyle, and providing practical support). Conclusions Participatory approaches in co-designing interventions allow for context specific development of interventions to meet the requirements of people with complex needs. Co-designing the PNM is part of activities of the CO-CAPTAIN project funded by the European Union’s Horizon Europe Programme (GA 101104784). Key messages • The Patient Navigation Model for Primary Cancer Prevention is a tailored intervention aiming to meet the needs of individuals experiencing mental ill-health. • The conceptual features of the Patient Navigation Model for Primary Cancer Prevention were co-designed with patients and other relevant stakeholders.

Health economics and services research in symbiosis: STREAMLINEing mental health services in Austria

Abstract Objectives The cost of mental diseases exceeds 4% of GDP in Europe. In Austria, every 5th person lives with mental ill-health (MIH). Ongoing epidemiological, demographic and societal changes increase the need for easily accessible, better integrated and good value services. In STREAMLINE, we combine, harmonize and implement the latest methods in human service mapping and economic costing to optimize future service provision and financing for MIH in Austria. Methods We comprehensively assess the availability, activity and affordability of human services targeting MIH in Vienna within the health and social care, education, labour and justice sectors based on a conceptual mind map. We identify services through extensive literature, document and web searches plus expert consultations. Services are mapped and costed according to the European PECUNIA methods: classification of the main service types using the international DESDE taxonomy of human services; development of Reference Unit Costs using the PECUNIA RUC templates with primary data; validation of the results with secondary data; compilation of a comprehensive multi-sectoral service catalogue; and synthesis for spatial and policy analyses. Results We identified 756 sources, 75% individual organisations, 5% multi-organisations and 20% existing provider lists. 84% relate to health and social care, 10% labour, and 3% education and justice sectors each. 58% deliver care to adults, 37% to children & adolescents, and 5% support carers. Further service mapping and RUCs will be presented. Discussion STREAMLINE pioneers in coordinated public mental health services and economics research at scale. Assessed levels of fragmentation call for better integration, improved transition, reduced spatial inequity and increased support for carers. Results increase the feasibility of service evaluations from a societal perspective. Planned public service atlas facilitates information and access for service users and carers. Funding: WWTF Key messages • New methods for harmonized health services and economics research allow comprehensive information for optimized future mental health service planning and financing. • Assessed levels of fragmentation highlight the need for better integration, improved transition, reduced spatial inequity and increased support for carers.

“When the Bills Keep on Coming:” the Experiences of Seafood Processors During the COVID-19 Pandemic

ABSTRACT Essential workers were at increased risk during the COVID-19 pandemic, including seafood processors who are often rendered invisible within the public sphere. To examine the health and safety concerns of seafood processors, many who are low income or im/migrant workers on H-2B visas, our team conducted qualitative research with 44 participants. We found that in addition to high occupational health hazards that existed before the pandemic, COVID-19 increased workers’ financial risks, which put them in more dangerous health and safety positions, since they needed to work through physical and mental health illness. These financial risks can be seen through the themes of paid sick leave, mental health, economic duress, and primary care access. We conclude with three recommendations to the H-2B visa worker program, which will not only decrease health disparities for im/migrant workers, but also increase health equity across seafood worker populations.