Ongoing Mental Health Research Articles

A Contemplation on Rehabilitation Models for Adult Clients with Dual Diagnosis of Acquired Brain Injury and Mental Illness in Australia

Acquired Brain Injury (ABI) of different forms represents one of the major public health problems for the world. Numerous neuropsychiatric disorders are associated with brain Injury including depression, anxiety disorder, irritability and aggression and mania which makes the presentation of these patients complex. The dual diagnosis of ABI and mental illness is often missed making the management of these patients difficult. Review of literature, websites and case study examples are used to illustrate the implications on care needs and discharge planning of these patients post rehabilitation phase. Majority of the models reviewed in Australia have advanced approaches for rehabilitation of clients with brain injury but none of them other than the brain disorders programme in Victoria offers rehabilitation services to clients with dual diagnosis of acquired brain injury and mental illness. Despite of the evidence that ABI can often result in ongoing mental health problems, there are a few facilities that provide for this dual diagnosis and there is not even a single model of rehabilitation which can cater for the needs of these patients. Current and existing models offer alternative approaches that are particularly applicable to person with disabilities. These include the strength-based and empowerment approaches as we ll as case management and independent living models.

Profile of Young Suicide Attempt Survivors in a Tertiary Care Hospital in Puducherry.

Context:Puducherry has the highest suicide prevalence rate in India by 2014, predominantly among the 14–30 years age group.Aims:The aim of the present study is to study the characteristics of adolescent and youth suicide attempters in Puducherry and measure the suicide intent.Settings and Design:An observational study of 6 months duration was conducted in the Department of Psychiatry, at Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.Materials and Methods:Modified version of World Health Organizations SUicide PREvention Multisite Intervention Study on Suicidal questionnaire was used to collect sociodemographic data and Beck's suicide intent scale was used to measure the suicide intent scores. International Classification of Diseases-10 was used for diagnosis.Statistical Analysis:Statistical Package for the Social Sciences version 13 was used for descriptive analysis and correlation statistics. P value was set as <0.05.Results:Of 56 eligible participants, 40 formed the sample, their mean age was 18. 13 (±2.50), more females (1.1:1), rural, literate, lower socioeconomic status (67.5%), mostly single (90%), living in nuclear (95%), and Hindu (87.5%). One hundred percent had psychosocial stressors before suicide attempt. Acute stress disorder/adjustment disorder was the most common diagnosis. Emotionally unstable and anankastic personality traits were seen in 12%. Pesticide ingestion (45%) was the most common suicide method. Sixty percent attempted suicide within <30 min of suicidal contemplation. Statistical associations were found between the alleged purpose, seriousness, attitude toward living/dying, conception about medical rescuability, and the overall suicide intent.Conclusions:Adolescent and youth suicide attempts occur due to psychosocial stressors rather than due to the past or on-going mental health disorders with above personality traits suggest poor coping skills and resilience taken to deal with stressful situations by younger people.

Are Psychiatrists Prepared for Health Care Reform? Yes and No

Are Psychiatrists Prepared for Health Care Reform? Yes and No

Trends in Receipt of Mental Health Treatments Among Adults in the United States, 2008–2013

This study examined trends in the 12-month prevalence of receiving mental health treatments among adults 18 years or older and among different generational cohorts in the United States between 2008 and 2013. We examined data from 274,900 persons 18 years or older who participated in the 2008-2013 National Surveys on Drug Use and Health (then linked to the 2011-2014 Area Health Resources Files at the county level). Multivariable logistic regressions were applied to assess trends in the model-adjusted prevalence of receiving mental health treatments. Between 2008 and 2013, the 12-month prevalence of mental illness (MI) remained stable in adults 18 years or older in the United States and in each of the examined generational cohorts. Receipt of psychotropic medications without inpatient or outpatient treatment increased in the overall adult population, baby boomers with MI, and Generation X with MI. The increase was 23.8% (6.3% to 7.8%, P < .001) among all adults, 28.4% (20.4% to 26.2%, P = .010) among baby boomers with MI, and 34.7% (14.7% to 19.8%, P = .001) among Generation X with MI. Among the Silent Generation with MI, receipt of mental health treatments remained unchanged. The prevalence of receiving psychotropic medications without inpatient or outpatient treatment increased among the overall adult population, baby boomers with MI, and Generation X with MI between 2008 and 2013. With the ongoing mental health parity and health reform efforts, further studies are warranted to monitor trends in mental health treatment in these populations.

Mind how you cross the gap! Outcomes for young people who failed to make the transition from child to adult services: the TRACK study.

Aims and methodThe Transitions of Care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK) study was a multistage, multicentre study of adolescents' transitions between child and adult mental health services undertaken in England. We conducted a secondary analysis of the TRACK study data to investigate healthcare provision for young people (n = 64) with ongoing mental health needs, who were not transferred from child and adolescent mental health services (CAMHS) to adult mental health services mental health services (AMHS).ResultsThe most common outcomes were discharge to a general practitioner (GP; n = 29) and ongoing care with CAMHS (n = 13), with little indication of use of third-sector organisations. Most of these young people had emotional/neurotic disorders (n = 31, 48.4%) and neurodevelopmental disorders (n = 15, 23.4%).Clinical implicationsGPs and CAMHS are left with the responsibility for the continuing care of young people for whom no adult mental health service could be identified. GPs may not be able to offer the skilled ongoing care that these young people need. Equally, the inability to move them decreases the capacity of CAMHS to respond to new referrals and may leave some young people with only minimal support.

Long-term hospitalizations for schizophrenia in the Czech Republic 1998–2012

Deinstitutionalization has not been pursued in the post-communist Europe until recently. The population of psychiatric patients institutionalized in the regional mental hospitals is, however, largely understudied. The aim of this study is to assess discharges of long-term inpatients with schizophrenia from Czech psychiatric hospitals and to analyse re-hospitalizations within this group. The nationwide register of all-cause inpatient hospitalizations was merged with the nationwide register of all-cause deaths on an individual level basis. Descriptive statistics, survival analysis and logistic regression were performed. 3601 patients with schizophrenia previously hospitalized for more than a year were discharged from Czech mental hospitals between 1998 and 2012. This included 260 patients hospitalized for >20years. Nearly one fifth (n=707) of the long-term patients died during the hospitalization; and discharges of 19.36% (n=697) were only administrative in their nature. Out of 2197 truly discharged patients, 14.88% (n=327) were re-hospitalized within 2weeks after the discharge. The highest odds of rehospitalization were associated with being discharged against medical advice (OR 5.27, CI: 3.77–7.35, p<0.001). These data are important for the ongoing mental health care reforms in the Czech Republic and other countries in the Central and Eastern Europe.

A model of integrated health care in a poverty-impacted community in New York City: Importance of early detection and addressing potential barriers to intervention implementation

ABSTRACTDisruptive behavior disorders (DBDs) are chronic, impairing, and costly behavioral health conditions that are four times more prevalent among children of color living in impoverished communities as compared to the general population. This disparity is largely due to the increased exposure to stressors related to low socioeconomic status including community violence, unstable housing, under supported schools, substance abuse, and limited support systems. However, despite high rates and greater need, there is a considerably lower rate of mental health service utilization among these youth. Accordingly, the current study aims to describe a unique model of integrated health care for ethnically diverse youth living in a New York City borough. With an emphasis on addressing possible barriers to implementation, integrated models for children have the potential to prevent ongoing mental health problems through early detection and intervention.

Marginal regression analysis of recurrent events with coarsened censoring times.

Motivated by an ongoing pediatric mental health care (PMHC) study, this article presents weakly structured methods for analyzing doubly censored recurrent event data where only coarsened information on censoring is available. The study extracted administrative records of emergency department visits from provincial health administrative databases. The available information of each individual subject is limited to a subject-specific time window determined up to concealed data. To evaluate time-dependent effect of exposures, we adapt the local linear estimation with right censored survival times under the Cox regression model with time-varying coefficients (cf. Cai and Sun, Scandinavian Journal of Statistics 2003, 30, 93-111). We establish the pointwise consistency and asymptotic normality of the regression parameter estimator, and examine its performance by simulation. The PMHC study illustrates the proposed approach throughout the article.

Prevalence and nature of mental disorders among young offenders in custody and community: A meta-analysis

IntroductionPrevalence studies show that nearly 80% of young offenders present psychiatric comorbidity. Juvenile offenders are at 3 times higher risk of being diagnosed with a psychiatric disorder. Recent systematic reviews have mainly focused on youth in detention neglecting youth in the community. Females and ethnic minorities have been overlooked in the literature in spite of the increasing rates of psychiatric disorders striking these groups.ObjectiveTo perform a meta-analysis on the prevalence rates of various mental disorders including depression, psychosis, PTSD, conduct disorder, ADHD, learning disabilities and personality disorders among young offenders. Self-harm and suicidal behaviour are examined too.AimsTo compare the prevalence of psychiatric disorders among young offenders across custody and community and to emphasise on gender, age, and ethnic variations.MethodsRelevant studies have been identified with computer-assisted searching and scanning of reference lists. Prevalence of mental disorders based on gender, age and ethnicity along with potential moderating factors are extracted from the included studies. Meta-regression is performed to test covariates that might have contributed to differences in prevalence rates across studies.ResultsAfter searching the relevant literature, 99 studies were determined to be eligible for data extraction.ConclusionsYoung offenders with ongoing mental health problems comprise a vulnerable group within forensic psychiatric services that needs special attention. More prevalence studies should be conducted to improve mental health provision. Ethnic, gender, and age variations across young offenders should be addressed and turn interventions into a tailored process that responds to the young person's particular treatment needs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Am I My Brother\u2019s Keeper? Moral Dimensions of Informal Caregiving in a Neoliberal Society

Within the current Dutch policy context the role of informal care is revalued. Formal care activities are reduced and family and friends are expected to fill this gap. Yet, there is little research on the moral ambivalences that informal care for loved ones who have severe and ongoing mental health problems entails, especially against the backdrop of neoliberal policies. Giving priority to one’s own life project or caring for a loved one with severe problems is not reconciled easily. Using a case study we illustrate the moral ambivalences that persons may experience when they try to shape their involvement and commitment when a relative is in need. The case comes from a research project which explores whether it is possible to reduce coercive measures in psychiatry by organizing a Family Group Conference. The purpose of the article is to explore what theoretical concepts such as ‘communities of fate’, ‘communities of choice’ and ‘personal communities’ add in understanding how persons shape their involvement and commitment when a family member experiences recurrent psychiatric crises.

Same-Day Counseling: Study Protocol for the Evaluation of a New Mental Health Service.

BackgroundSingle-session counseling is being implemented across Canada to increase the accessibility and availability of mental health services. Despite increasing use, existing research on single-session counseling is sparse and has methodological limitations. In addition, some stakeholders are skeptical that this model of care can support meaningful change for clients.ObjectiveThe aim of this study is to evaluate a new single-session counseling program (called Same-Day Counseling) offered in an outpatient community mental health clinic in Northwestern Ontario, Canada.MethodsClients who attend Same-Day Counseling services will be given the opportunity to participate in the program evaluation. Those who consent will complete measures before their session, after their session, and at 1-month follow-up. Data will provide information on who accesses Same-Day Counseling (eg, typical presenting problems, symptom severity), client satisfaction with services, and whether clients benefit from the services (eg, improved functioning and reduced symptom severity).ResultsData collection is underway with 80 participants having completed baseline measures and 55 participants having completed follow-up measures. Data collection is expected to conclude in December 2015.ConclusionsThis study is designed to contribute to the literature regarding the integration of single-session counseling into ongoing mental health services, with additional attention to methodological rigour. Our approach will help to address ongoing concerns regarding the implementation of single-session counseling, and inform health care providers and policy makers regarding the utility of this model for addressing the mental health care need of the community.

Quality of Life of Persons Injured on 9/11: Qualitative Analysis from the World Trade Center Health Registry.

Introduction: A number of studies published by the World Trade Center Health Registry (Registry) document the prevalence of injuries sustained by victims of the World Trade Center Disaster (WTCD) on 9/11. Injury occurrence during or in the immediate aftermath of this event has been shown to be a risk factor for long-term adverse physical and mental health status. More recent reports of ongoing physical health and mental health problems and overall poor quality of life among survivors led us to undertake this qualitative study to explore the long-term impact of having both disaster-related injuries and peri-event traumatic exposure on quality of life in disaster survivors. Methods: Semi-structured, in-depth individual telephone interviews were conducted with 33 Registry enrollees who reported being injured on 9/11/01. Topics included: extent and circumstance of the injury(ies), description of medical treatment for injury, current health and functional status, and lifestyle changes resulting from the WTCD. The interviews were recorded, transcribed, and inductively open-coded for thematic analysis.Results: Six themes emerged with respect to long term recovery and quality of life: concurrent experience of injury with exposure to peri-event traumatic exposure (e.g., witnessing death or destruction, perceived life threat, etc.); sub-optimal quality and timeliness of short- and long-term medical care for the injury reported and mental health care; poor ongoing health status, functional limitations, and disabilities; adverse impact on lifestyle; lack of social support; and adverse economic impact. Many study participants, especially those reporting more serious injuries, also reported self-imposed social isolation, an inability to participate in or take enjoyment from previously enjoyable leisure and social activities and greatly diminished overall quality of life.Discussion: This study provided unique insight into the long-term impact of disasters on survivors. Long after physical injuries have healed, some injured disaster survivors report having serious health and mental health problems, economic problems due to loss of livelihood, limited sources of social support, and profound social isolation. Strategies for addressing the long-term health problems of disaster survivors are needed in order to support recovery.

Exploratory Evaluation of Co-produced Groups in a Community Psychiatry Organisation in England

This study evaluated co-produced rehabilitative social groups in English community psychiatric services. It aimed to describe the experience and views of staff and service users involved in group planning and delivery. A convenience sample (four staff and three service users) took part in this qualitative study. Service user co-producers were current/previous patients of secondary psychiatric services. The groups pre-existed this evaluation and included creative writing, walking, glass-crafting and reading activities. Interviews were semi-structured and transcribed verbatim. Thematic analysis was carried out by the first author using NVivo10 (©QSR) and reviewed and discussed with the second author. Co-production improved self-esteem, empowerment and purpose, and enabled recovery for service user co-producers. Staff provided necessary support for people with ongoing mental health problems. Risks were limited and well managed. Future research could examine the experiences of group participants who were not involved in co-production, and how organisational infrastructure can encourage these groups.

G503(P) A 3 year study of paediatric mental health admissions to a general paediatric ward

Aims The increasing prevalence of mental health problems is a well-recognised phenomenon in the paediatric population. While there are reviews of presentations to accident and emergency and to in-patient psychiatric hospitals, there are few studies of child mental health admissions to a general paediatric ward. The aim of this study was to investigate the prevalence of mental health conditions on a general medical paediatric ward and care pathways once admitted. Method A retrospective case note study was performed of all cases admitted to a general paediatric ward between March 2011 and March 2014 in a district general hospital that required psychiatric review. Time of presentation, reason for presentation and admission, waiting time for psychiatric review, outcome of review and length of stay were all recorded, as well as the mental health background of those who presented. Results 201 cases were identified, the youngest was 9 years old the median age was 15 years. Mental health admissions have increased from 38 between March 2011 and February 2012 to 93 from March 2013 to February 2014. The most common reason for presentation (58%) was overdose, followed by suicidal ideation (15%) and self-harm (11%), (Figure 1). Sixty percent of these admissions occur out of hours. 76% of children who present are already known to the Child And Adolescent Mental Health Service (CAMH). Of children admitted to the ward 49% required CAMH review only. Of these reviews, 16% occurred the same day as admission, 51% the following day and 6% waited more than a day for review. The most common outcome of review was discharge with CAMH follow up as an outpatient (73%) Conclusion Mental health admissions to the general paediatric ward increased in our population, reflecting the national trend. Most of these admissions occurred out of hours when there is no specialist child mental health cover. As a consequence of this most children did not see a physician with expertise in mental health on the day of admission. Most admissions were discharged with ongoing mental health follow up adding to the burden placed on CAMH.

Who is in the transition gap? Transition from CAMHS to AMHS in the Republic of Ireland

The ITRACK study explored the process and predictors of transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) in the Republic of Ireland. Following ethical approval, clinicians in each of Ireland's four Health Service Executive (HSE) areas were contacted, informed about the study and were invited to participate. Clinicians identified all cases who had reached the transition boundary (i.e. upper age limit for that CAMHS team) between January and December 2010. Data were collected on clinical and socio-demographic details and factors that informed the decision to refer or not refer to the AMHS, and case notes were scrutinised to ascertain the extent of information exchanged between services during transition. A total of 62 service users were identified as having crossed the transition boundary from nine CAMHS [HSE Dublin Mid-Leinster (n=40, 66%), HSE South (n=18, 30%), HSE West (n=2, 3%), HSE Dublin North (n=1, 2%)]. The most common diagnoses were attention deficit hyperactivity disorder (ADHD; n=19, 32%), mood disorders (n=16, 27%), psychosis (n=6, 10%) and eating disorders (n=5, 8%). Forty-seven (76%) of those identified were perceived by the CAMHS clinician to have an 'on-going mental health service need', and of these 15 (32%) were referred, 11 (23%) young people refused and 21 (45%) were not referred, with the majority (12, 57%) continuing with the CAMHS for more than a year beyond the transition boundary. Young people with psychosis were more likely to be referred [χ 2 (2, 46)=8.96, p=0.02], and those with ADHD were less likely to be referred [χ 2 (2, 45)=8.89, p=0.01]. Being prescribed medication was not associated with referral [χ 2 (2, 45)=4.515, p=0.11]. In referred cases (n=15), there was documented evidence of consent in two cases (13.3%), inferred in another four (26.7%) and documented preparation for transition in eight (53.3%). Excellent written communication (100%) was not supported by face-to-face planning meetings (n=2, 13.3%), joint appointments (n=1, 6.7%) or telephone conversations (n=1, 6.7%) between corresponding clinicians. Despite perceived on-going mental health (MH) service need, many young people are not being referred or are refusing referral to the AMHS, with those with ADHD being the most affected. CAMHS continue to offer on-going care past the transition boundary, which has resource implications. Further qualitative research is warranted to understand, in spite of perceived MH service need, the reason for non-referral by the CAMHS clinicians and refusal by the young person.

Intensive case management for high-risk patients with first-episode psychosis: service model and outcomes

The first episode of psychosis is a crucial period when early intervention can alter the trajectory of the young person's ongoing mental health and general functioning. After an investigation into completed suicides in the Early Psychosis Prevention and Intervention Centre (EPPIC) programme, the intensive case management subprogramme was developed in 2003 to provide assertive outreach to young people having a first episode of psychosis who are at high risk owing to risk to self or others, disengagement, or suboptimal recovery. We report intensive case management model development, characterise the target cohort, and report on outcomes compared with EPPIC treatment as usual. Inclusion criteria, staff support, referral pathways, clinical review processes, models of engagement and care, and risk management protocols are described. We compared 120 consecutive referrals with 50 EPPIC treatment as usual patients (age 15-24 years) in a naturalistic stratified quasi-experimental real-world design. Key performance indicators of service use plus engagement and suicide attempts were compared between EPPIC treatment as usual and intensive case management, and psychosocial and clinical measures were compared between intensive case management referral and discharge. Referrals were predominately unemployed males with low levels of functioning and educational attainment. They were characterised by a family history of mental illness, migration and early separation, with substantial trauma, history of violence, and forensic attention. Intensive case management improved psychopathology and psychosocial outcomes in high-risk patients and reduced risk ratings, admissions, bed days, and crisis contacts. Characterisation of intensive case management patients validated the clinical research focus and identified a first episode of psychosis high-risk subgroup. In a real-world study, implementation of an intensive case management stream within a well-established first episode of psychosis service showed significant improvement in key service outcomes. Further analysis is needed to determine cost savings and effects on psychosocial outcomes. Targeting intensive case management services to high-risk patients with unmet needs should reduce the distress associated with pathways to care for patients, their families, and the community. National Health & Medical Research Council and the Colonial Foundation.

Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Programme for providing innovative mental health care in rural communities in India.

India has few mental health professionals to treat the large number of people suffering from mental disorders. Rural areas are particularly disadvantaged due to lack of trained health workers. Ways to improve care could be by training village health workers in basic mental health care, and by using innovative methods of service delivery. The ongoing Systematic Medical Appraisal, Referral and Treatment Mental Health Programme will assess the acceptability, feasibility and preliminary effectiveness of a task-shifting mobile-based intervention using mixed methods, in rural Andhra Pradesh, India. The key components of the study are an anti-stigma campaign followed by a mobile-based mental health services intervention. The study will be done across two sites in rural areas, with intervention periods of 1 year and 3 months, respectively. The programme uses a mobile-based clinical decision support tool to be used by non-physician health workers and primary care physicians to screen, diagnose and manage individuals suffering from depression, suicidal risk and emotional stress. The key aim of the study will be to assess any changes in mental health services use among those screened positive following the intervention. A number of other outcomes will also be assessed using mixed methods, specifically focussed on reduction of stigma, increase in mental health awareness and other process indicators. This project addresses a number of objectives as outlined in the Mental Health Action Plan of World Health Organization and India's National Mental Health Programme and Policy. If successful, the next phase will involve design and conduct of a cluster randomised controlled trial.

The Role of the Family and Family-Centered Programs and Policies

Summary Families influence their children's health in two ways that are amenable to public policy--through their financial and other investments in children, and through the quality of care that they provide. In general, children who receive more resources or better parenting are healthier than those who don't. Public policies, therefore, might improve children's health either by giving families more resources or by helping parents provide better care. When it comes to financial resources, write Lawrence Berger and Sarah Font, the research is straightforward--programs that add to disadvantaged families' incomes, whether in cash or in kind, can indeed improve their children's health. The Earned Income Tax Credit, for example, has been linked to higher birth weights and greater cognitive achievement. When it comes to programs that target quality of care, however, the picture is more complex. At the low end of the spectrum, poor parenting shades into neglect or abuse, which can seriously harm children's health and development. Thus we might expect that the child protective services system, which has the power to intervene and protect children in such cases, could also improve children's health in the long run. But Berger and Font find that the system's ability to affect children's health is limited, largely because it becomes involved in children's lives only after damage has already occurred. Other programs, however, have the potential to improve parenting, reduce maltreatment, and thus enhance children's health and development. Home visiting programs show particular promise, as do large-scale, community-level primary prevention programs. ********** Childhood health is associated with a wide variety of outcomes throughout the life course, from ongoing physical and mental health to disability, mortality, and socioeconomic status. Families bear the primary responsibility for making direct investments in children, as well as for regulating and allotting other public and private investments. That is, families provide the caregiving context in which most children grow and develop; they also provide and allocate resources to children. In this way, families play the primary role in promoting child health and development. Thus, any effort to promote child health must necessarily involve families. Yet the quality of the family environments in which children are raised varies considerably; in particular, not all families provide safe, stable, and high-quality care. In this article, we first explain how families are believed to influence children's health. In particular, we focus on family context (structure, composition, and access to resources) and parenting behaviors. We consider health in a broad sense, including physical, social-emotional, behavioral, cognitive, and mental health and development. Second, we describe the role of the child protective services (CPS) system in protecting children from familial harm and intervening with families where child maltreatment has occurred. We conclude that CPS has limited ability to influence child health, because it primarily intervenes only after harm has occurred and because a combination of resource constraints and a relatively narrow mandate means that CPS focuses on only a small proportion of children and families. Third, we review other policies and programs that can influence family contexts and behaviors before harm has occurred. We highlight several promising programs--including economic support, community-level interventions, and home visiting programs--that have the potential to improve the quality of care children receive, reduce child maltreatment, and positively influence child health and development. How Do Families Influence Child Health? Families are thought to influence child health through three primary mechanisms: biological and genetic endowments, financial investments (goods and services purchased), and behavioral investments (caregiving quantity and quality). …

Emotional Intelligence of Youth Accessing Residential and Day Treatment Programs: Association with Psychological and Interpersonal Difficulties

Background: Youth with emotional and behavioural problems often experience ongoing mental health challenges placing them at risk for less than optimal attainment of scholastic and occupational goals. Emotional intelligence (EI) has consistently been associated with good mental health (Martins et al.). The purpose for this study was to explore EI in a sample of youth with emotional and behavioural problems severe enough to warrant residential or day treatment. A second purpose was to explore the relationship of EI with psychological and interpersonal difficulties. Methods: Cross-sectional surveys were administered to youth accessing residential and day mental health treatment programs. Results: Thirty youth (mean age 15.30 years, SD1.64; 70% female) reported low Global EI (Total sum 123.00, SD 22.4), and interpersonal problems was strongly correlated with EI. Conclusion: Youth accessing intensive mental health services reported low emotional intelligence and problems with interpersonal relationships. Implications for focusing research and intervention efforts on fostering interpersonal social skills that may improve youths' quality of their relationships and emotional intelligence are discussed.

The problem with prison

Both the UK and the USA have disproportionately high prison populations compared with other countries. The inmates are predominantly male, and many of them suffer from ongoing mental health problems.