Risk For Mental Health Issues Research Articles

Characterising the number and type of presentations to a tertiary emergency department by young people affected by drugs and alcohol

Objective The aim of this study was to investigate the frequency and type of emergency department (ED) presentations involving drugs and/or alcohol (DA) among young people. Methods A retrospective chart review was conducted of patients aged 14-25 years who presented to the ED at a tertiary hospital between 7 October and 25 November 2013. Data were collected on standardised data sheets, including whether DA was a factor in the patient's presentation. Results In all, 713 ED presentations of patients aged 14-25 years were included in this review (mean age 20 years). Of these, 94 (13%) presentations involved DA (median blood alcohol level 0.12%; range 0.01-0.39%); among patients aged 14-17 years, 13 (8%) presentations involved DA. Patient presentations involving DA were more likely to occur overnight and at weekends, had higher Australasian Triage Scale scores and had longer ED lengths of stay. These patients were also more likely to present with aggression, because of an assault, or with mental health disorders. Conclusion DA are involved in a substantial number of presentations of young people to the ED and are associated with an increased risk of assault and aggression. Public health strategies should target the links between DA use and mental health in young people. What is known about the topic already? It is known that the use of alcohol and drugs in young people is an ongoing public health concern. Research suggests this cohort of the population is more likely to present to an ED with an injury than the comparative age group not intoxicated by drugs or alcohol, and is more likely to be reviewed after hours. Alcohol is the predominant drug that had been used by young people at the time of the present study. What does this paper add? This paper reviews the number and types of presentations to a tertiary ED. In so doing, many more areas were researched (rather than simply link to injury) and, as a result, it was found that young people present to the ED with an increased risk of mental health issues and an increased risk of aggression. The study also found that young people intoxicated with DA most commonly presented for different reasons than the same sober cohort. What are the implications for practitioners? We know that young people intoxicated with DA represent a different public health issue than the sample group, and, as a result, public health initiatives must concentrate on the confounding factors of the presenting complaint, notably education surrounding the risk of mental health disturbance and increased aggression rates. Furthermore, the study should benefit practitioners, showing that more mental health services should be available after hours for this cohort presenting with issues related to DA.

The Development of Cigarette Smoking Behavior Among Juvenile Offenders in Adolescence and Early Adulthood: ADHD Symptomatology as a Risk Factor

Background Cigarette use is a public health issue and juvenile offenders are at risk for engagement in substance use. Attention deficit hyperactivity disorder (ADHD) has been linked to elevated risk for cigarette use and juvenile offenders are at elevated risk for mental health issues. Objectives To elucidate general patterns of development of cigarette use among juvenile offenders and examine the role that ADHD symptomatology plays for predicting development. Methods The Pathways to Desistance data (2000–2010) follow 1,354 juvenile offenders across 84 months following a recent conviction for a serious offense. Using group-based trajectory modeling, this research sought to elucidate heterogeneity in general developmental patterns of cigarette use across adolescence and early adulthood. This research then extended the method by using multinomial logistic regression to investigate the relevance of ADHD symptomatology and covariates for predicting trajectory group assignment. Results A five-group trajectory model was found to best fit the data. Groups elucidated were: Abstaining, Late Onset, Decelerating, Moderate Chronic, and High Chronic. When all covariates were controlled, increases in ADHD symptomatology presentation were associated with increased risk of assignment to the High Chronic cigarette smoking group. This group was characterized by early onset and chronic course of daily cigarette use. Conclusions/importance: Juvenile offenders are at increased risk for participation in daily cigarette use and high and chronic levels of daily use during adolescence and early adulthood. ADHD symptomatology is a risk factor for early initiation and chronic daily cigarette-smoking behaviors.

Adverse childhood experiences and mental health: Comparing the link in rural and urban men who have sex with men

BackgroundResearch shows individuals experiencing adverse childhood experiences (ACEs) as well as identifying as a man who has sex with other men (MSM) are at an increased risk for mental health issues. Less has been studied, however, on ACEs in MSM; with even fewer studies investigating non-urban (e.g., rural/small town/suburban) MSM, as most research features urban samples. This is problematic due to studies showing that rurality can influence the behavior of MSM. The current study comparatively investigates the impact of ACEs on the mental health of rural/small town/suburban and urban MSM. MethodsParticipants included 156 MSM residing in Oklahoma. Linear regression was used to test the association between ACEs’ and mental health (anxiety, depressive symptoms, and loneliness). Split-sample regressions were conducted on rural/small town/suburban and urban MSM. ResultsACEs were associated with all three mental health outcomes in the full sample. However, ACEs were significantly linked to anxiety and depressive symptoms only in urban MSM. LimitationsLimitations include a smaller sample size with limited racial/ethnic variations. ConclusionsResults suggest that living in an urban environment may amplify the risks of ACEs, rural/small town/suburban MSM may acquire outside, unique support networks which work to limit the effect of ACEs, or that rural/small town/suburban MSM may manifest the effects of ACEs differently (or a combination of the three). Trauma-informed programming has been shown to effectively reduce mental health issues, yet consideration is generally not given with regards to rurality. Future programming and research should consider rurality/urbanity as influential factor.

A qualitative investigation to inform yoga intervention recruitment practices for racial/ethnic minority adolescents in outpatient mental health treatment

ObjectiveYoga is recognized as an effective approach to improving overall physical and mental health; however, there may be perceived barriers to yoga participation, particularly among populations most at risk for mental health issues. We conducted qualitative formative research to help inform recruitment practices for a future study and to specifically understand the barriers and facilitators to engagement in yoga practice among racial/ethnic minority adolescents, as well as adolescents in outpatient mental health treatment. MethodsQualitative data were collected at a community health clinic that serves low income families in southeastern Florida. Using semi structured interviews with racial and ethnic minority adolescents between 12 and 17 years old, participants were asked about beliefs and perceptions about yoga, as well as recommendations on recruiting peers. A thematic analysis approach was used to identify and examine common themes. ResultsTwenty interviews were conducted and eight major themes emerged from the data. Themes were grouped as (1) Facilitators to recruitment and (2) Barriers to recruitment. InterpretationAdvertising free yoga that emphasizes the social, physical, and mental benefits can help assuage negative perceptions of yoga and promote the advantages of yoga among teenagers. Having recruitment materials and modalities that highlight inclusivity of all genders and physical abilities in the yoga classes are also important in facilitating participation. Understanding perceptions of yoga, as well as perceived barriers and facilitators, among racially/ethnically diverse adolescents in outpatient mental health treatment, can assist recruitment efforts, increase yoga intervention participation, and ultimately, improve mental health outcomes for underserved populations.

Picture This! Bringing joy into Focus and Developing Healthy Habits of Mind: Rationale, design, and implementation of a randomized control trial for young adults

Research shows that daily experiences of awe, curiosity, gratitude, joy, and love can put the average person on a trajectory of growth, success, and positive social connection, and can also prevent those who are suffering from following a downward spiral. Nonetheless, data show that most people are not functioning at optimal capacity. In fact, just 20% of people may be categorized as “flourishing,” with the vast majority of people merely “languishing,” at risk for mental health issues, or with clinical levels of mental health concerns. Despite the success of the Positive Psychology movement and the proliferation of Positive Psychology Interventions, the field remains in need of high quality studies that test potential mechanisms of change. The Picture This! intervention, informed by Positive Psychology principles, was designed to improve well-being and decrease depressive symptoms in young adults. This paper details the rationale, design, and implementation of a 4-group randomized control trial (RCT) to test the effectiveness of Picture This!. Specific indices of mental health and well-being (e.g., depressive symptoms, gratitude) were measured at baseline and at the conclusion of the intervention along with potential mechanisms of change (i.e., attentional bias, cognitive style), while positive emotion and general well-being were assessed daily over the 21-day intervention period. If successful, this intervention may provide critical behavioral, cognitive, and attentional tools that, once internalized, can be drawn upon for years to come.

Expressions of emotional distress in active duty military personnel with mild traumatic brain injury: A qualitative content analysis

ABSTRACTService members (SMs) who sustain traumatic brain injury (TBI) during deployment have increased risk for mental health issues. Mental health treatment can be challenging in military settings where treatment seeking is often stigmatized. Adequate care relies on accurate interpretations of SMs’ verbal accounts of distress, but little is known about how SMs, embedded in a culture that values resilience and self-reliance, relay emotional distress. We performed qualitative analyses of recordings from a telephone-based intervention with 25 SMs who sustained deployment-related mild TBI (mTBI) to elucidate thematic and dialectal patterns. Consistent with our expectations, SMs rarely used explicit depressive terms while discussing their emotional distress. More prevalent was language suggestive of an overarching theme of loss of control, whereby SMs’ stress, anxiety, and anger were often attributable to SMs’ perceptions that they had incomplete jurisdiction over their own lives. This study may help mental health providers improve engagements with SMs and Veterans, preventing misunderstandings and even improper diagnoses or referrals that could result from a strict reliance on the more customary expressions of distress.

Mental health of the bisexual Veteran

ABSTRACTDespite evidence showing that bisexual individuals may be at greater risk for mental health issues than lesbian and gay individuals, they are often combined into a single group, with lesbian and gay individuals the actual focus of the research. This study aims to address this gap in the literature among US Veterans. Using data collected from a multicity purposive sample (N = 4,493), logistic regression was used to analyze whether the following groups differ in current posttraumatic stress disorder (PTSD) and depression: (a) bisexual (n = 101) vs. heterosexual Veterans (n = 4,271); (b) bisexual vs. lesbian/gay Veterans (n = 121); (c) lesbian/gay vs. heterosexual Veterans; and (d) combined group of lesbian, gay, and bisexual (LGB; n = 222) vs. heterosexual Veterans. Controlling for significant covariates, bisexual Veterans had 2.5 times the risk of severe depression (95% confidence interval [CI] = 1.34–4.67; p = 0.004) and 2.3 times the odds of PTSD (95% CI = 1.40–3.77; p = 0.001) relative to heterosexual Veterans. Bisexual Veterans had 3 times the risk of severe depression (95% CI = 1.22–7.44; p = 0.017) and 1.9 times the risk of PTSD (95% CI = 1.02–3.70; p = 0.045) compared to lesbian/gay Veterans. Lesbian/gay Veterans had no significant difference in risk for depression compared to heterosexual Veterans. However, the combined group of LGB Veterans had 1.6 times the odds of PTSD (95% CI = 1.12–2.15; p = 0.008) compared to heterosexual Veterans. These findings suggest that past research showing mental health disparities between LGB and heterosexual individuals may be driven by the inclusion of bisexual individuals. Research should assess bisexual individuals as a distinct group, and future studies should explore factors leading to depression and PTSD among bisexual Veterans.

Perceptions of mental health and mental health services among college students in Vietnam and the United States

The global burden of mental health disorders is a significant public health issue. One population that has a risk for mental health issues is college students. Little is known about perceptions of mental illness and mental health services among college students in Vietnam. The purpose of this study is to describe perceptions of mental illness and mental health services among college students in Vietnam, and to compare them with those in the United States (US). The cross-sectional data were collected using a self-administered survey from January to March in 2018 at a national university in Vietnam, and a state university in the US. The study revealed differences in perceptions of causes of mental health between Vietnamese and US participants. Vietnamese participants tended to believe that individuals with mental illness were dangerous and need to be kept out from the community, while US participants perceived that mental illnesses are the same as other illnesses. An important indicator of Vietnamese perceptions of mental health was the low likelihood of seeking formal help because of preference for seeking help from family or friends for mental illness. Interventions, such as mental health awareness campaigns or training courses should be provided for college students in Vietnam. Some strategies to improve mental health among college students used in the US may help to reduce stigma toward mental illness in Vietnam.

Psychiatry: A discipline at specific risk of mental health issues and addictive behavior? Results from the national BOURBON study

BackgroundPhysicians are at risk for burnout, anxiety and depression. ObjectiveTo explore the self-reported mental health status, substance use behavior and motives of a national sample of interns in psychiatry compared to other specialties. MethodsInterns of the 35 French Medicine faculties were recruited through mailing lists and social networks between December 2016 and May 2018 and fulfilled internet anonymized questionnaires. ResultsOverall, 2165 interns (302 interns in psychiatry and 1863 in other specialties) mean aged 25.9 years (±2.8), 35% males were included in the present study. In multivariate analyses, interns in psychiatry were found to have higher rates of current tobacco smoking (aOR = 1.9 [1.4–2.5], p < 0.001), alcohol use disorder (aOR = 1.5 [1.2–2.0], p = 0.001), cannabis use disorder (aOR = 2.7 [1.8–4.2], p < 0.001)). They were more frequently followed by a psychiatrist and/ or a psychologist (aOR = 2.5 1.9–3.3], p < 0.001), they consumed more often antidepressants (aOR = 3.8 [2.2–6.6], p < 0.001) and anxiolytic (aOR = 1.8[1.2–2.8]; p = 0.006). They reported to have been more frequently exposed to sexual assault (aOR = 2.2 [1.1–4.8], p = 0.04) and physical assault (aOR = 1.9[1.3–2.9], p = 0.002), and to have lower vitality (β = 3.5 [0.6–6.4], p = 0.02). Interns in psychiatry reported to have more often experienced ecstasy (aOR = 1.6 [1.2–2.3], p = 0.004), mushrooms (aOR = 1.5 [1.1–2.2], p = 0.04), amphetamines (aOR = 1.9 [1.2–3.1], p = 0.009) and LSD (aOR = 1.8 [1.1–3.1], p = 0.04). Beyond classical motives for this consumption (party, group effect), interns in psychiatry reported to seek more frequently disinhibition (aOR = 1.7 [1.3–2.2], p < 0.001), dealing with anxiety (aOR = 1.7 [1.3–2.3], p = 0.001), and to seek both stimulant (aOR = 1.4 [1.1–1.9], p = 0.04) and sedative effects (aOR = 1.9[1.3–2.7], p = 0.001). ConclusionsInterns in psychiatry are more exposed to violence during medical studies, they report lower vitality and increased substance use behavior. Their motives for consumption suggest mental health problems associated with increased engagement in psychotherapy and self-medication of antidepressant/anxiolytic. This population should be targeted as a specific vulnerable population among interns in medicine to prevent ulterior bad health outcomes.

Demographic, Social, and Mental Health Aspects of American Indian and Alaska Native Adolescents in Hawai'i.

American Indians and Alaska Natives (AI/ANs) constitute 2.2% of Hawai'i's population. Unfortunately, very little is known about the mental health of AI/AN youth in Hawai'i. The purpose of this study (N = 7,214; 1992-1996) was to describe AI/AN adolescents versus non-AI/AN youth regarding demographic, social, and mental health variables. The results suggested that AI/AN adolescents were more open to different types of social-emotional supports, had relatively more non-traditional families with a smaller social network, and may be more vulnerable to academic and health difficulties, with particular risk for mental health issues for mixed AI/AN-Native Hawaiians. Implications are discussed, including intervention, socio-political issues, and future research.

Impact of a Virtual Learning Program on Social Isolation for Older Adults

The Virtual Learning Program was developed to provide isolated English-speaking older adults in Quebec access to Cummings Centre programming through live webcasting and videos on demand. The objectives of the program were to: increase social engagement and reduce the risk for mental health issues associated with chronic illness and caregiving; and provide opportunities for lifelong learning including access to health promotion and prevention information in English. This paper presents a practice perspective of the innovative and successful use of digital technology to reach and engage older adults experiencing social isolation. Preliminary results show that the program is simple, provides opportunities for lifelong learning, and has the potential to reduce social isolation. Program challenges and suggestions for therapeutic recreation practice will be discussed. Subscribe to TRJ

The Applicability of Resilience Training to the Mitigation of Trauma-Related Mental Illness in Military Personnel [Formula: see text

Ongoing participation by the United States in military operations around the world places military personnel at an increased potential for exposure to trauma, which may directly result in an increased risk for mental health issues. It is important to develop and test new approaches to prevent and mitigate the effects of trauma in military personnel. One such area of research is focused on psychological resilience to prevent the sequelae of trauma. This article examines empirical research of resilience training in military personnel and discusses the potential applicability of such training in this population. In this literature review, four randomized control trials and one retrospective, parallel group study were reviewed. Each intervention had the goal of mitigating behavioral health issues after trauma exposure. The results of the various interventions were wide-ranging from no measurable difference in treatment groups to significant differences in outcomes. Despite the inconclusive results of our review, we have determined that resilience training for active duty service members to help prevent the deleterious effects of trauma on mental health is a compelling and necessary avenue for further research.

Aerobic exercise training in children and adolescents with inflammatory bowel disease: Influence on psychological functioning, sleep and physical performance – An exploratory trial

People with Inflammatory Bowel Disease (IBD) are at risk for mental health issues, poor sleep quality and limited engagement in physical activity (PA). Standard treatment consists of immune modulating pharmaceuticals though evidence is growing that aerobic exercise training (AET) could serve as an adjuvant option to reduce disease symptoms and improve mental health. The aim of the present exploratory trial was to investigate possible AET effects on psychological functioning, symptoms of depression, sleep and physical activity in paediatric patients with IBD.Twenty-one paediatric patients with IBD and 23 gender- and age-matched healthy controls (HC) were assessed. The IBD group was further split into a “remission-group” (IBD-RE; n = 14) and an “active disease group” (IBD-AD; n = 7). All participants completed an 8-week AET exergame intervention reaching 60–80% of maximum heart rate for 5 days per week. At baseline and after 8 weeks, psychological functioning, depressive symptoms, objective sleep EEG, subjective sleep and objective and subjective PA were assessed.AET improved the exercise capacity of all participants. Self-reported fitness and daily physical activity increased in IBD-AD, but not in IBD-RE and HC. No improvements were observed for psychological functioning, depressive symptoms or subjective sleep. Objective sleep improved, deep sleep increased, light sleep decreased, and in the IBD-AD group the number of arousals after sleep onset decreased. Descriptively, the IBD-AD group reported lower psychological functioning and poorer subjective sleep quality.Among paediatric patients with IBD and healthy controls, an exergaming intervention has the potential to improve exercise capacity, self-reported fitness, daily physical activity, and aspects of objective sleep. Results suggest that children and adolescents in an active state of IBD are at increased risk of poor psychological functioning and poor sleep quality.

Mental health risks and stressors faced by urban refugees: Perceived impacts of war and community adversities among Somali refugees in Nairobi.

There is a gap in understanding of refugee mental health risks unique to urban areas of low-income countries. A qualitative rapid appraisal using focus group interviews with community stakeholders explored main stressors pervasive by Somali refugees in Nairobi, Kenya. This study identified the intersection of war trauma and daily stressors that affect both functional and structural challenges and risk of mental health issues among Somali urban refugees. Findings underscore the importance of understanding mental health in the broader context of community adversities, suggesting development of contextually informed interventions responsive to complex needs of urban refugees.

Engaging Experts: Expanding Participation and Enhancing Research in Chinese Eldercare Institutions

ABSTRACTDue to the myriad factors straining China’s traditional family-based eldercare system, today unprecedented numbers of older adults are turning to institutions for caregiving needs. As researchers and policy makers organize conferences, analyze trends, and allocate resources, the subjective experiences of elders themselves are often forgotten or ignored. While providers recognize that institutionalized elders are at an increased risk for mental health issues, most cite personnel and resource shortages as insurmountable barriers to provision. Using examples from ethnographic research in Chinese eldercare institutions, this article examines the link between participation and mental health for contemporary Chinese elders and makes a case for expanding the role of elders in research in order to improve both the experience and understanding of institutional eldercare.

Intergenerational Forum to Enhance Students’ Engagement and Learning Outcomes: A Community-Based Participatory Research Study

ABSTRACTThe Intergenerational Forum (IF) is an innovative intervention that engages students in conducting community-based participatory research (CBPR). This set of guided learning opportunities is designed to improve college students’ understanding of aging and health issues in their communities. In this study, a total of 252 mentoring hours were provided in kind by 78 students. The majority of these youth volunteers were aspiring health professionals who had received intensive academic and field training to strengthen their interpersonal skills and ability to build meaningful one-on-one relationships with vulnerable populations. Additionally, these student volunteers were at higher risk for mental health issues. Findings revealed that as a result of IF, students were able to improve their knowledge and attitudes toward working with older people. Students were able to combine ideas from courses when completing this IF assignment. Particularly, levels of active and collaborative learning were` enriched by engagement with people representing different economic backgrounds, political views, and religious beliefs. Major themes emerged in students’ narrative data revealed their learning outcomes in the areas of self-awareness, empathy, empowerment, and new perspectives about ageism.

A paternal methyl donor-rich diet altered cognitive and neural functions in offspring mice

Dietary intake of methyl donors, such as folic acid and methionine, shows considerable intra-individual variation in human populations. While it is recognized that maternal departures from the optimum of dietary methyl donor intake can increase the risk for mental health issues and neurological disorders in offspring, it has not been explored whether paternal dietary methyl donor intake influences behavioral and cognitive functions in the next generation. Here, we report that elevated paternal dietary methyl donor intake in a mouse model, transiently applied prior to mating, resulted in offspring animals (methyl donor-rich diet (MD) F1 mice) with deficits in hippocampus-dependent learning and memory, impaired hippocampal synaptic plasticity and reduced hippocampal theta oscillations. Gene expression analyses revealed altered expression of the methionine adenosyltransferase Mat2a and BK channel subunit Kcnmb2, which was associated with changes in Kcnmb2 promoter methylation in MD F1 mice. Hippocampal overexpression of Kcnmb2 in MD F1 mice ameliorated altered spatial learning and memory, supporting a role of this BK channel subunit in the MD F1 behavioral phenotype. Behavioral and gene expression changes did not extend into the F2 offspring generation. Together, our data indicate that paternal dietary factors influence cognitive and neural functions in the offspring generation.

Associations between social media and cyberbullying: a review of the literature.

Cyberbullying is a significant public health concern that can lead to increased risk of mental health issues, including psychological and developmental problems or suicide. However, because cyberbullying is a relatively recent phenomenon, there is a lack of agreement among researchers about the definition and prevalence of cyberbullying as well as methods for measuring its prevalence. In this review, we evaluate papers published between January 2013 to August 2015 that explored cyberbullying through the medium of social media. The aims of the study are to (I) clarify the characteristics of people involved in cyberbullying, and (II) identify the types of instruments used to measure cyberbullying on social media. In particular, we attempt to understand the factors underlying abuser behavior, how abusive behavior affects the well-being of victims, and how bystanders mitigate or contribute to the act of cyberbullying.

Editorial

Welcome to the final edition of Children Australia for 2016. For this edition, I am pleased to be guest co-editor along with regular editors Jennifer Lehmann and Rachael Sanders. Living in rural and remote Australia can bring a high level of satisfaction and many rewards, including a strong caring community, rich, longstanding social relationships, outdoor lifestyle, happy childhood memories and psychological, cultural, spiritual and economic connections to country. Rural living and working can also bring unique challenges including harsh climatic conditions and crises, a tyranny of distance, isolation, family hardships, limited services and infrastructure, reduced education and employment opportunities; and increased risk of mental health issues, family violence and child safety concerns. The demands of providing remote area health, welfare and other professional services include high visibility and trying to ‘fit in’, managing confidentiality, and dual and inter-relationships. These and other geographical and environmental challenges lead to low workforce retention rates that, in turn, leave significant gaps in service provision for children, families and communities, including Aboriginal communities (Jervis-Tracey et al., 2016; Lehmann, 2015; Robinson, Mares, &amp; Arney, 2016).

Towards a framework for psychological resilience in children and adolescents with Borderline Intellectual Functioning

Abstract Psychological well-being is one of the greatest concerns in children and adolescents with Borderline Intellectual Functioning (BIF). Those youths are frequently exposed to stress and social inequality, and they are particularly prone to developing mental health issues which persist through adolescence and into adult life. The purpose of this article is to introduce a framework for promoting psychological resilience in children and adolescents with BIF. Three interrelated and complementary factors require professional attention and efforts to improve resilience in children with borderline intelligence: a) protecting a child’s self-worth, b) generating sources of social support, c) training of adaptive coping skills. The significance of early diagnosis and continuous monitoring of a child’s development is also discussed. Children with BIF should be provided with internal (self-worth, coping skills) and external (social support) resources to enhance their resilience and ability to confront adversities, and to reduce the risk of mental health issues.