Population Mental Health Research Articles

Perceived discrimination as a mediator between cultural identity and mental health symptoms among racial/ethnic minority adults in the United States: insights from the Health Information National Trends Survey 6.

This study examined the role of perceived discrimination as a mediator between cultural identity and mental health symptoms among adults from racial/ethnic minority groups in the United States. Data were gathered from the National Cancer Institute's (NCI) Health Information National Trends Survey (HINTS) 6, a nationally representative survey. The mediating role of perceived discrimination was investigated using structural equation modeling (SEM) analysis. The study found significant associations between demographic and lifestyle factors and mental health symptoms. Non-Hispanic Blacks or African Americans and Hispanics were less likely than Non-Hispanic Whites to have mental health symptoms. Individuals between the ages of 35 and 49, 50 to 64, 65 to 74, and 75 and older had lower odds of mental health symptoms. Gender differences revealed that females had a higher risk of mental health issues than males. Socioeconomic factors, such as household income and employment status, played a significant role, with higher household income and employment status being associated with a decreased likelihood of mental health symptoms. The study emphasizes the role of perceived discrimination as a mediator, suggesting that it fully mediated the association between cultural identity and mental health symptoms. These findings highlight the significance of addressing discrimination experiences in fostering the mental health of adults from diverse backgrounds. The findings highlight the need to take racial, ethnic, and socioeconomic inequities, as well as cultural identity and prejudice, into account in mental health research and interventions. The identified risk and protective factors can guide interventions and policies to enhance this population's mental health.

Barriers and facilitators to the implementation of digital technologies in mental health systems: a qualitative systematic review to inform a policy framework

BackgroundDespite the potential for improved population mental health and wellbeing, the integration of mental health digital interventions has been difficult to achieve. In this qualitative systematic review, we aimed to identify barriers and facilitators to the implementation of digital technologies in mental healthcare systems, and map these to an implementation framework to inform policy development.MethodsWe searched Medline, Embase, Scopus, PsycInfo, Web of Science, and Google Scholar for primary research articles published between January 2010 and 2022. Studies were considered eligible if they reported barriers and/or facilitators to the integration of any digital mental healthcare technologies. Data were extracted using EPPI-Reviewer Web and analysed thematically via inductive and deductive cycles.ResultsOf 12,525 references identified initially, 81 studies were included in the final analysis. Barriers and facilitators were grouped within an implementation (evidence-practice gap) framework across six domains, organised by four levels of mental healthcare systems. Broadly, implementation was hindered by the perception of digital technologies as impersonal tools that add additional burden of care onto both providers and patients, and change relational power asymmetries; an absence of resources; and regulatory complexities that impede access to universal coverage. Facilitators included person-cantered approaches that consider patients’ intersectional features e.g., gender, class, disability, illness severity; evidence-based training for providers; collaboration among colleagues; appropriate investment in human and financial resources; and policy reforms that tackle universal access to digital health.ConclusionIt is important to consider the complex and interrelated nature of barriers across different domains and levels of the mental health system. To facilitate the equitable, sustainable, and long-term digital transition of mental health systems, policymakers should consider a systemic approach to collaboration between public and private sectors to inform evidence-based planning and strengthen mental health systems.Protocol registrationThe protocol is registered on PROSPERO, CRD42021276838.

Predictors of Population Mental Health in Montana: An Occupational Justice Perspective.

Population-level analyses can demonstrate occupational injustices and their impact on population health. The objective of this article is to examine whether population-level occupational factors are related to the mental health of Montanans. We used linear regression models of the 2021 Montana County Health Rankings to examine the association between occupational justice and mental health, adjusting for covariates. Predictor variables were access to exercise, insufficient sleep, healthy food access, food insecurity, proximal jobs, and social support. Outcome variables were frequent mental health distress and poor mental health days. Adjusted models showed significant associations between both insufficient sleep (β = 0.25, 95% confidence interval [CI] = [0.0.11, 0.40]; Table 2) and food insecurity (β = 0.32, 95% CI = [0.22, 0.43]) and poor mental health days z scores. Adjusted models also showed significant associations between insufficient sleep (β = 0.18, 95% CI = [0.10, 0.26]) and food insecurity (β = 0.19, 95% CI = [0.12, 0.25]) and frequent mental health distress. Future research should study whether targeting sleep and food security can enhance Montanans's mental health.

Protective factors for suicidal ideation: a prospective study from adolescence to adulthood.

Adolescent suicidality is associated with negative outcomes in adulthood. Suicide prevention has traditionally focused on identifying risk factors, yet suicide rates have remained stable. With suicidality often going undetected-especially suicidal ideation, further knowledge about protective factors is needed. The main objective of this study was to investigate potential protective factors for suicidal ideation from adolescence to adulthood. The study employed longitudinal population survey data, "Youth and Mental Health Study" consisting of self-reports at two-time points (mean age 14.9, SD = 0.6 and 27.2, SD = 0.6) (n = 2423 and n = 1198). Protective factors (at individual, social and environmental level) were selected based on a priori knowledge. Internal consistency of scales was analyzed using McDonald's omega. We used a linear mixed model with suicidal ideation as the dependent variable, time-points, a protective factor variable and their interaction as covariates, and individual participant as random effects. We adjusted for sex and also conducted separate analyses for males and females. The Benjamini-Hochberg procedure was used to adjust p-values for multiple hypotheses. Investigated protective factors were associated with temporal change in suicidal ideation (significant interactions). For both sexes, less emotion-orientated coping, higher self-perception scores, greater levels of physical activity and higher school wellbeing/connectedness were protective factors for suicidal ideations. Secure attachment and higher family function were protective factors for females only. The effects in adolescence were mostly maintained in adulthood. In this study, several protective factors for suicidal ideation persisted into adulthood, with distinct differences between males and females.

Mental Health Polypharmacy in "Non-Coded" Primary Care Patients: The Effect of Deprescribing.

Background: Mental health (MH) polypharmacy, defined as prescribing multiple mental health medications for the same condition, presents significant challenges in clinical practice. With varying prevalence rates and an increasing trend, particularly in the UK, this deprescribing prospective quality improvement project aimed to address the complexities and risks associated with MH polypharmacy. Patients and Methods: A large primary care centre in London was selected for this project. Electronic records of 667 patients (non-coded in mental health lists) were analysed as a result of the absence of a Systematised Nomenclature of Medicine Clinical Terms (SNOMED CT) for mental health. Seventy-two non-coded patients exhibiting "same-class" as well as "adjunctive" and "augmentation" polypharmacy were identified. Their demographic and health data, including MH diagnoses, physical status, and lifestyle habits, were evaluated. This deprescribing prospective project included 68 patients and employed a model inspired by the Plan-Do-Study-Act (PDSA) cycle, focusing on reducing psychotropic, adjunctive, and augmentative medications while monitoring mental health control through face-to-face consultations using the Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder Assessment-7 (GAD-7) scores, alongside physical health parameters. Results: The project revealed a significant decrease in the average number of psychotropic and adjunct medications from initial consultations to the end of the 18-month period. Additionally, a marked reduction in reported side effects and drug interactions was observed. Improvements in mental health control, as evidenced by PHQ-9 and GAD-7 scores, were noted. Physical health parameters, including BMI, blood pressure, heart rate, HbA1c, and cholesterol levels, also showed significant improvements. Educational initiatives for patients and clinicians were successfully implemented, contributing to these positive outcomes. Discussion: The project faced challenges like balancing medication reduction with mental health stability, patient apprehension, and the absence of standardised protocols. However, the successful reduction in medication numbers and the improvement in health outcomes highlight the effectiveness of the model. This project underscores the necessity of a tailored approach to MH polypharmacy, emphasising continuous education, clinical titration, and adherence to guidelines. Future research is needed to develop clear guidelines for medication combination in mental health care and to understand the long-term effects of polypharmacy in mental health populations. Conclusions: This project demonstrates the potential for significant improvements in the management of MH polypharmacy. By carefully managing medication reductions and employing a comprehensive care approach, including patient education and clinician training, the project achieved improvements in both mental and physical health outcomes. These findings suggest a promising direction for future practices in MH polypharmacy management.

Mapping the landscape: surf therapy program delivery

Surf therapy is a structured intervention which utilizes surfing as a vehicle to achieve therapeutic benefit (International Surf Therapy Organization [ISTO], 2019). Surf therapy is presently delivered internationally within a diverse array of contexts and populations. Despite the publication of many internal evaluation studies, little research has examined themes common to the process of surf therapy across programs. The present study recruited a sample of ISTO-affiliated surf therapy programs (n = 33) to engage with an online survey, Mapping the Stoke, examining core aspects of surf therapy structure and process internationally. Findings indicated both similarities across current program delivery internationally, with examples of primary similarities including target age (adolescents and young adults) and population (mental health), recruitment (self-referral), and structure (group sessions), geographic delivery (major cities) and challenges (funding). Areas of greater diversity included support staff (roles/qualifications), therapeutic aims, measures (outcome) and therapeutic structures. The present study outlines concrete structures and processes which appear integral to the delivery of surf therapy across cultures.

Daily routine disruptions and psychiatric symptoms amid COVID-19: a systematic review and meta-analysis of data from 0.9 million individuals in 32 countries

BackgroundThere is currently a deficit of knowledge about how to define, quantify, and measure different aspects of daily routine disruptions amid large-scale disasters like COVID-19, and which psychiatric symptoms were more related to the disruptions. This study aims to conduct a systematic review and meta-analysis on the probable positive associations between daily routine disruptions and mental disorders amid the COVID-19 pandemic and factors that moderated the associations.MethodsPsycINFO, Web of Science, PubMed, and MEDLINE were systematically searched up to April 2023 (PROSPERO: CRD42023356846). Independent variables included regularity, change in frequency, and change in capability of different daily routines (i.e., physical activity, diet, sleep, social activities, leisure activities, work and studies, home activities, smoking, alcohol, combined multiple routines, unspecified generic routines). Dependent variables included symptoms and/or diagnoses of mental disorders (i.e., depression, anxiety, post-traumatic stress disorder, and general psychological distress).ResultsFifty-three eligible studies (51 independent samples, 910,503 respondents) were conducted in five continents. Daily routine disruptions were positively associated with depressive symptoms (r = 0.13, 95% CI = [0.06; 0.20], p < 0.001), anxiety symptoms (r = 0.12, 95% CI = [0.06; 0.17], p < 0.001), and general psychological distress (r = 0.09, 95% CI = [0.02; 0.16], p = 0.02). The routine-symptom associations were significant for physical activity, eating, sleep, and smoking (i.e., type), routines that were defined and assessed on regularity and change in capability (i.e., definition and assessment), and routines that were not internet-based. While the positive associations remained consistent across different sociodemographics, they were stronger in geo-temporal contexts with greater pandemic severity, lower governmental economic support, and when the routine-symptom link was examined prospectively.ConclusionsThis is one of the first meta-analytic evidence to show the positive association between daily routine disruptions and symptoms of mental disorders among large populations as COVID-19 dynamically unfolded across different geo-temporal contexts. Our findings highlight the priority of behavioral adjustment for enhancing population mental health in future large-scale disasters like COVID-19.

Environmental pollution and health in Chilean older adults: Impact on quality of life and functional autonomy.

Due to increased urbanization and industry, environmental pollution is a serious public health concern. Globally, the quality of life is particularly lowered by exposure to high amounts of particulate matter (PM). Chile has five industrial zones with high pollution levels, called "sacrifice zones."However, the effect of polluted air on the quality of life and functional autonomy (FA) of older people living in industrial zones with high pollution levels is unknown. Therefore, this study aimed to determine the quality of life and FA differences between Chilean older women (OW) living in areas with lower and higher PM levels. Seventy-twoOW volunteered for this study. The sample was divided into Zone 1 (PM2.5 ≤ 15 µg/m3, n = 36) and Zone 2 (PM2.5 > 15 µg/m3, n = 36). The variables were quality of life-assessed through the SF-36v2.0 questionnaire, and FA-assessed through the GDLAM protocols. Differences between zones were tested by Student's t-test and Mann-Whitney test, both for independent samples (p < 0.05). All eight dimensions of quality of life were lower in Zone 2, of which the role emotional (RE) showed significant differences between zones (p < 0.05). Performance on the GDLAM protocols and the FA index were lower in Zone 2 (p ˃ 0.05). OWin Zone 2 showed lower quality of life and FA. PM could affect the older population's physical and mental health and, therefore, the quality of life.

Integrated Digital Mental Health Care: A Vision for Addressing Population Mental Health Needs.

The unmet need for mental health care continues to rise across the world. This article synthesizes the evidence supporting the components of a hypothetical model of integrated digital mental health care to meet population-wide mental health needs. This proposed model integrates two approaches to broadening timely access to effective care: integrated, primary care-based mental health services and digital mental health tools. The model solves for several of the key challenges historically faced by digital health, through promoting digital literacy and access, the curation of evidence-based digital tools, integration into clinical practice, and electronic medical record integration. This model builds upon momentum toward the integration of mental health services within primary care and aligns with the principles of the Collaborative Care Model. Finally, the authors present the major next steps toward implementation of integrated digital mental health care at scale.

Remote sensing mental health: A systematic review of factors essential to clinical translation from validation research.

Mental illness remains a major global health challenge largely due to the absence of definitive biomarkers applicable to diagnostics and care processes. Although remote sensing technologies, embedded in devices such as smartphones and wearables, offer a promising avenue for improved mental health assessments, their clinical integration has been slow. This scoping review, following preferred reporting items for systematic reviews and meta-analyses guidelines, explores validation studies of remote sensing in clinical mental health populations, aiming to identify critical factors for clinical translation. Comprehensive searches were conducted in six databases. The analysis, using narrative synthesis, examined clinical and socio-demographic characteristics of the populations studied, sensing purposes, temporal considerations and reference mental health assessments used for validation. The narrative synthesis of 50 included studies indicates that ten different sensor types have been studied for tracking and diagnosing mental illnesses, primarily focusing on physical activity and sleep patterns. There were many variations in the sensor methodologies used that may affect data quality and participant burden. Observation durations, and thus data resolution, varied by patient diagnosis. Currently, reference assessments predominantly rely on deficit focussed self-reports, and socio-demographic information is underreported, therefore representativeness of the general population is uncertain. To fully harness the potential of remote sensing in mental health, issues such as reliance on self-reported assessments, and lack of socio-demographic context pertaining to generalizability need to be addressed. Striking a balance between resolution, data quality, and participant burden whilst clearly reporting limitations, will ensure effective technology use. The scant reporting on participants' socio-demographic data suggests a knowledge gap in understanding the effectiveness of passive sensing techniques in disadvantaged populations.

Promotion of mental health and prevention of mental disorders in a rich welfare state: A Norwegian perspective

The population's mental health - their ability to handle emotions, think rationally, control their behavior, and maintain good relations with others - is a county's most important resource. Failing ability to do so, causes a country's most burdensome illnesses, mental distress and mental disorder, and hinders optimal utilization of other resources. In Norway, prevalence of mental illness is similar to that of other rich countries. Cost of mental illness corresponds to four times the cost of running the armed forces. In working age, loss of health from mental illness is greater than from all somatic non-communicable illness together, and loss of healthy life years is comparable to that of all cancers together. More treatment cannot curb this. Prevention is the only way out. Based on known risk and protecting factors, thirteen strategic principles for an effective prevention plan are presented together with the new Norwegian escalation plan for mental health 2023–2033. Four evidence-based priorities are recommended: universal mental health screening in pregnancy and early motherhood, mandatory guidance of all new day-care center teachers, mental health as a separate subject in school, and employment for all. Finally, with reference to human rights, seven mental health rights are suggested to assure that all organizations become mental health promoting.

Coping with the Mental Health Impacts of Climate Change: A Green Script for Sustainable Action

The climate emergency is an existential threat to human health and environmental sustainability. Recent climate-induced events, such as Australia’s catastrophic bushfires of 2019–2020 and floods of 2022, demonstrate the impacts of the climate crisis on physical and mental health of populations. Using a cross-sectional online survey (N = 5483), we examine how Australians are coping with climate change impacts on mental health. The survey included qualitative questions (open-ended comment boxes and ‘other’ spaces throughout the survey) and quantitative questions (e.g., Likert and bipolar scales) on demographics and the mental health impacts of climate change, environmental behaviour engagement (EBE), and mental health help-seeking (MHHS). Australians are using a range of individual and collective coping strategies to help cope with climate change problems, experiences, and anxiety. They have developed a range of coping strategies including contact with nature, taking sustainability actions, practicing problem-focused and meaning-focused coping, and mental health help-seeking, that need to be understood and reinforced by health professionals. Our findings also highlight a link between direct experience of a climate change event and participants’ EBE and MHHS. We recommend assessment processes and green prescribing as a sustainability action intervention framework that health professionals can offer as a response to ongoing community concern about climate change.

National Policy Index (NPI) for worker mental health and its relationship with enterprise psychosocial safety climate

National occupational health and safety (OHS) policy (e.g., legislation) underpins worker health protection and is imperative for healthy and safe working populations. In the interest of bolstering mental health through decent work, this study undertakes a global analysis of OHS policy for worker mental health and develops and validates a short tool quantifying national policy approaches—the National Policy Index (NPI, for worker mental health). Data were collected across 45 countries from 164 global experts (and/or expert groups) to capture policy presence, priority action areas, and drivers and barriers surrounding policy implementation. Analysis revealed top global psychosocial concerns are harassment, mobbing or bullying, work overload, discrimination, and poor work-life balance. Policy priorities are harassment, mobbing or bullying, discrimination, and physical violence. The psychosocial hazards/risks that are most addressed in policies or regulated are physical violence, discrimination, harassment, mobbing or bullying. The main driver for managing hazards is workplace senior management support and having specific national regulations, and the main barrier is poor resource availability. Further, the NPI was developed through exploratory factor analysis and validated through significant correlation with a national policy audit and to the 2019 European Survey of Enterprises on New and Emerging Risks data, which reports enterprise level psychosocial safety climate (PSC, organisational policies, practices, and procedures for stress prevention). The correlation between the NPI and enterprise-level PSC highlights the critical role of national policy in protecting worker population mental health. Yet above and beyond national policy, national union density also related to enterprise PSC indicating that social action is also imperative. Findings suggest that global mental health can be reinforced via decent work outlined in national policy approaches, particularly legislation, as well as via senior management support, and collective approaches such as union action.

Sensitivity to change in well-being and health-related quality of life in adults with eating disorder symptoms: ICECAP-A versus EQ-5D-5L.

Economic evaluations of treatments help to inform decisions on allocating health care resources. These evaluations involve comparing costs and effectiveness in terms of quality of life. To calculate quality-adjusted life years, generic health related quality of life is often used, but is criticized for not being sensitive to change in mental health populations. Another approach, using experienced well-being measured through capabilities with the ICECAP-A, has been proposed as an alternative. The aim of this study was to investigate whether changes in individuals with eating disorder (ED) symptoms can be better captured using health related quality of life (EQ-5D-5L) or well-being (ICECAP-A). Measurements at two time points with an interval of 1 year were used from a sample of 233 participants with self-reported ED symptoms. An analysis of variance was used to test whether the EQ-5D-5L and ICECAP-A differed in sensitivity to change over time. In order to compare the two questionnaires in terms of clinically significant outcome, the reliable change index and clinical cut-off score were calculated. The two questionnaires did not differ in sensitivity to change. More individuals had recovered but also more had deteriorated according to the EQ-5D-5L compared to the ICECAP. The present study revealed no differences in sensitivity to change in health-related quality of life or well-being in individuals with ED symptoms in the context of mild clinical change. Results corroborated the pervasiveness of low quality of life in this population, even after alleviation of ED symptoms. Measuring treatment benefits in terms of improvements in quality of life is an integral part of economic evaluations in health care. It was expected that these treatment benefits would be better captured as changes in well-being (measured with the ICECAP-A) than as changes in health-related quality of life (measured with the EQ-5D-5L) for individuals with ED symptoms. Based on the results of this study, no preference for one of the two approaches was found.

The social determinants of mental health and disorder: evidence, prevention and recommendations.

People exposed to more unfavourable social circumstances are more vulnerable to poor mental health over their life course, in ways that are often determined by structural factors which generate and perpetuate intergenerational cycles of disadvantage and poor health. Addressing these challenges is an imperative matter of social justice. In this paper we provide a roadmap to address the social determinants that cause mental ill health. Relying as far as possible on high-quality evidence, we first map out the literature that supports a causal link between social determinants and later mental health outcomes. Given the breadth of this topic, we focus on the most pervasive social determinants across the life course, and those that are common across major mental disorders. We draw primarily on the available evidence from the Global North, acknowledging that other global contexts will face both similar and unique sets of social determinants that will require equitable attention. Much of our evidence focuses on mental health in groups who are marginalized, and thus often exposed to a multitude of intersecting social risk factors. These groups include refugees, asylum seekers and displaced persons, as well as ethnoracial minoritized groups; lesbian, gay, bisexual, transgender and queer (LGBTQ+) groups; and those living in poverty. We then introduce a preventive framework for conceptualizing the link between social determinants and mental health and disorder, which can guide much needed primary prevention strategies capable of reducing inequalities and improving population mental health. Following this, we provide a review of the evidence concerning candidate preventive strategies to intervene on social determinants of mental health. These interventions fall broadly within the scope of universal, selected and indicated primary prevention strategies, but we also briefly review important secondary and tertiary strategies to promote recovery in those with existing mental disorders. Finally, we provide seven key recommendations, framed around social justice, which constitute a roadmap for action in research, policy and public health. Adoption of these recommendations would provide an opportunity to advance efforts to intervene on modifiable social determinants that affect population mental health.

Stressful life events exhibit complex patterns of associations with depressive symptoms in two population-based samples using network analysis

BackgroundStressful life events (SLEs) constitute key risk factors for depression. However, previous studies examining associations between SLEs and depression have been limited by focusing on single events, combining events into broad categories, and/or ignoring interrelationships between events in statistical analyses. Network analysis comprises a set of statistical methods well-suited for assessing relationships between multiple variables and can help surpass several limitations of previous studies. MethodsWe applied network analysis using mixed graphical models combining two large-scale population-based samples and >34,600 randomly sampled adults to investigate the associations between SLEs and current depressive symptoms in the general population. ResultsNumerous SLEs were uniquely associated with specific symptoms. Strong pairwise links were observed between SLEs during the past year and individual symptoms, e.g., between having experienced illness or injury and sleeping problems, having been degraded or humiliated and feeling blue, and between financial problems and hopelessness and being worried and anxious. Several SLEs, such as financial problems, sexual abuse, and having been degraded or humiliated, were associated with symptoms across more than one timepoint. More recent SLEs were generally more strongly associated with depressive symptoms. Several life events were strongly interrelated, such as multiple forms of abuse, and financial problems, unemployment, divorce, and serious illness or injury. LimitationsLimitations include a retrospective SLE measure, cross-sectional data, a brief self-report measure of depressive symptoms, and possible attrition bias in the sample. ConclusionsOur findings may have implications for public health efforts seeking to improve population mental health.

Psychological status of general population 1 year after the outbreak of COVID-19: a cross-sectional study based on SCL-90.

The mental health of populations is usually affected after a disaster event. However, it is not known what the level of mental health of Chinese population 1 year after COVID-19, nor what factors influence it. This study aimed to examine the mental health status of general population in Chengdu 1 year after COVID-19, and then analyse influencing factors. This study is a cross-sectional survey based on the SCL-90 questionnaire. Continuous data were described as M and SD, and counting data were described as frequencies(n) and percentages (%). Chi-square test or Fisher's exact test were used for statistical inference, and significance variables were included in the binary logistic regression equation for multivariate analysis. There were 172 participants with positive screening results. Age, marital status, number of kids, self-perceived health and the presence of chronic disease had an effect on screening results. Logistic regression analysis showed that age and self-perceived health were the main influencing factors. Young people aged 18-19 and those who consider themselves not very healthy were at higher risk of poor mental health 1 year after the COVID-19 outbreak. Community institutions and community workers should focus on the mental health status of people 1 year after COVID-19, with a focus on people with poor self-perceived health and younger age groups, and take early preventive measures.

What is the impact of successive COVID-19 lockdowns on population mental health? Findings from an Australian natural experiment using health service data.

ObjectiveThe causal effect of successive population-wide lockdowns in response to increased COVID-19 cases on mental health has yet to be examined using robust methods. A natural experiment design underpinned by objective data can improve our understanding surrounding the definitive impact of social distancing restrictions.MethodsThe study employed a natural experiment design underpinned by objective data. Health service cost for visits to general practitioners and psychologists and medication dispensing costs served as objective measures of mental health. Difference-in-difference (DID) estimators, which in this study quantify differences in spending changes between groups over time, were produced based on three comparisons: Victoria 2020 lockdown comparison, Victoria 2021 lockdown comparison, and New South Wales (NSW) 2021 lockdown comparison. Specifically, differences in public health service spending during lockdown periods and the same timeframe in 2019 for Victoria and NSW, and control groups (remaining states and territories), were compared.ResultsPositive estimator values indicate that public health service spending for Victoria and NSW increased more during lockdown periods compared to control states and territories. The Victorian lockdowns of 2020 and 2021, but not the NSW lockdown of 2021, resulted in increased public spending for general practitioner mental health consults (2020 DID estimator: $8498.96 [95% CI $4012.84, $12,373.57], 2021 DID estimator: $6630.06 [95% CI $41.27, $13,267.20], all monetary values in AUD$) and short visits to psychologists (2020 DID estimator: $628.82 [95% CI $466.25, $796.00], 2021 DID estimator: $230.11 [95% CI $47.52, $373.98]). The first Victorian lockdown in 2020 and the NSW lockdown in 2021 resulted in greater spending on short visits to clinical psychologists. Spending on long visits to psychologists and clinical psychologists and medication spending did not change.ConclusionsStrict lockdowns can have an adverse impact on population mental health. The impact is particularly evident in those who have a history of previous mental health concerns but does not necessitate extra use of medications, suggesting that psychological care can address the adverse impact of the lockdowns.

Качество жизни детей и подростков с онкогематологическими заболеваниями в период пандемии COVID‑19

The COVID-19 coronavirus pandemic is affecting the somatic and mental health of populations across the planet. Patients with cancer form a risk group with severe complications of COVID-19. The objective of the study was to examine the quality of life of children and adolescents after completion of antitumor therapy in a pandemic setting. Materials and methods. Specialists from of the clinical and rehabilitation scientific center “Russkoye pole” of the Dmitri Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology conducted a comparative analysis of the results of testing patients and their parents according to the PedsQL™4.0 questionnaires. Results. Patients hospitalized in 2021 have lower physical functioning parameters (63.62) than patients hospitalized before the pandemic in the first half of 2019 (70.89), p &lt; 0.001. Parents reported significantly more positive attitudes towards quality of life assessments during the pandemic compared to those made by children. Conclusion. Differences in quality of life scores between patients in remission of oncohematological diseases before the pandemic and in the pandemic setting based on both children's and parents' assessments have been identified, which may be due to the impact of the novel coronavirus pandemic on some aspects of child and adolescent functioning. Key words: quality of life, oncohematological diseases, COVID-19 coronavirus pandemic, children

Factors associated with loneliness in rural Australia: A web-based cross-sectional survey

BackgroundLoneliness affects approximately 35% of rural Australians with detrimental impacts on physical, emotional, and social health. This study aims to identify the factors associated with loneliness among adults in a rural Australian population. MethodsThe study was a web-based cross-sectional survey conducted between February and April 2023 among adults living in a rural Australian population. The survey, which was distributed using social media, consisted of 37 items including demographic information (17 items) and the UCLA Loneliness Scale Version 3 (20 items). Collected data were analysed using univariate and multivariable analysis to identify the factors associated with loneliness in this population. ResultsA total of 225 respondents, mostly aged 30–49yrs (42.7%) participated in this study. The majority were Australia-born (88.4%), females (79.6%), employed (70%) and a third of participants were married (34.7%) at the time of this study. The median loneliness score (55 [IQR 47.0–61.0]) was significantly lower among participants who took part in community, sporting or hobby groups (36.2%) compared to those who abstained from these activities (51.5, [IQR 45.3–58.0] vs 56.0 [IQR 48.0–62.0]; p = 0.037). However, this association was nullified, after adjusting for covariates. Those who rated their overall health as worse (i.e., ‘poor’ 62.5 [IQR 54.8–64.0]) had significantly higher median loneliness scores than those who self-rated their overall health as ‘excellent’ (46.0 [IQR 32.3–54.3]; p < 0.001). After adjusting for covariates, poorer self-rated overall health remained significantly associated with loneliness, in contrast to ratings of ‘good’, ‘very good’ and ‘excellent’. ConclusionsResults indicate that in this rural Australian population, loneliness is associated with worse self-reported overall health, whilst participation in social groups appear to ameliorate loneliness. Policy aimed at reducing loneliness should therefore facilitate measures that improve this population's physical and mental health.