Risk Of Poor Mental Health Research Articles

The Role of Adaptive Goal Processes in Mental Wellbeing in Chronic Pain.

Chronic pain, experienced as pain persisting for three months or longer, is associated with risk of poor mental health and disability. Research has implicated adaptive goal processes as important to mental wellbeing in a range of populations. However, research has rarely assessed these mechanisms in relation to pain characteristics and mental wellbeing in chronic pain populations. This study aimed to examine the potentially mediating roles of goal flexibility and goal tenacity in the relationships between pain intensity and pain interference and mental wellbeing among individuals with chronic pain. Community members who self-identified as experiencing non-cancer chronic pain (N = 315) completed an online self-report survey on goal tenacity, goal flexibility, mental wellbeing, pain intensity, and pain interference. Unexpectedly, pain intensity was not significantly related to mental wellbeing, when controlling for pain interference. However, pain interference was directly and significantly associated with mental wellbeing. Both goal flexibility and goal tenacity mediated the relationship between pain interference and mental wellbeing, whilst controlling for pain intensity. The results provide support for the protective role of adaptive goal processes in mental wellbeing in those with chronic pain and highlight the importance of pain interference in relation to mental wellbeing.

Adolescents at risk of mental health problems in the COVID‐19 pandemic: A prospective population‐based study of the effects of government mandates and school closures

AbstractThere is increasing evidence that the COVID‐19 pandemic has had substantial mental health impacts for adolescents. Yet, few definitive studies have investigated which adolescents were at higher risk of poor mental health and well‐being during the pandemic. Data were drawn from the Childhood to Adolescence Transition Study, a prospective cohort study of students in Australia (N = 1211). Prevalence of mental health outcomes (depressive symptoms, anxiety symptoms, self‐harm and good subjective well‐being) was estimated in school Years 5–12, where Years 11 (2020) and 12 (2021) coincided with the pandemic. The age‐ and sex‐adjusted relative risk of each mental health outcome for each priority group during the pandemic were estimated. During the pandemic, over 50% of study participants reported depressive symptoms, and one quarter reported anxiety symptoms. There was a decrease in good subjective well‐being compared with pre‐pandemic years, while self‐harm prevalence remained similar. History of mental health problems, school disengagement and frequent peer victimisation increased the risk of experiencing mental health problems during the pandemic. Schools play a central role in maintaining the mental health and good subjective well‐being of students, and this is particularly important during periods of social disruption, such as the COVID‐19 pandemic.

Leading Predictors of COVID-19-Related Poor Mental Health in Adult Asian Indians: An Application of Extreme Gradient Boosting and Shapley Additive Explanations.

During the COVID-19 pandemic, an increase in poor mental health among Asian Indians was observed in the United States. However, the leading predictors of poor mental health during the COVID-19 pandemic in Asian Indians remained unknown. A cross-sectional online survey was administered to self-identified Asian Indians aged 18 and older (N = 289). Survey collected information on demographic and socio-economic characteristics and the COVID-19 burden. Two novel machine learning techniques-eXtreme Gradient Boosting and Shapley Additive exPlanations (SHAP) were used to identify the leading predictors and explain their associations with poor mental health. A majority of the study participants were female (65.1%), below 50 years of age (73.3%), and had income ≥ $75,000 (81.0%). The six leading predictors of poor mental health among Asian Indians were sleep disturbance, age, general health, income, wearing a mask, and self-reported discrimination. SHAP plots indicated that higher age, wearing a mask, and maintaining social distancing all the time were negatively associated with poor mental health while having sleep disturbance and imputed income levels were positively associated with poor mental health. The model performance metrics indicated high accuracy (0.77), precision (0.78), F1 score (0.77), recall (0.77), and AUROC (0.87). Nearly one in two adults reported poor mental health, and one in five reported sleep disturbance. Findings from our study suggest a paradoxical relationship between income and poor mental health; further studies are needed to confirm our study findings. Sleep disturbance and perceived discrimination can be targeted through tailored intervention to reduce the risk of poor mental health in Asian Indians.

A comparative study of mental health status among left-behind, migrant, and local adolescents in China

ObjectiveInfluence of migration on mental impairments among adolescents has been well assessed. However, there lack empirical data on multiple mental health problems and comparisons of children who suffer from different parental migration. This study aims to compare the mental health status among left-behind adolescents (LBA), migrant adolescents (MA), and local adolescents (LA). MethodsA total of 67,532 adolescents were investigated on depression, anxiety, sleep disturbance, and psychotic-like experiences (PLEs). The LBA were registered in Shenzhen's hukou (household register system) and are living in Shenzhen while their parent(s) has/have migrated to work elsewhere for over 6 months. MA, defined as adolescents who immigrated with parents from other places, are living but not registered in Shenzhen hukou. LA referred to adolescents who were registered in Shenzhen hukou and are living with their parents. Social-demographics, family function, and school climate were also evaluated as influential factors. ResultsThe prevalence of overall mental health problems was 37.4 % for LBA, which was higher than that of MA (27.9 %) and LA (27.1 %). Females, adolescents with chronic physical illness, and with family history of mental disorders are all contributed to the increased occurrence of mental health issues. Poorer family function and school climate were also negatively associated with mental health among the three types of adolescents. ConclusionLBA is at a higher risk for poor mental health than other adolescents. Interventions that promoting family function and improving school climate may be helpful, especially for girls with chronic physical illness, or with family history of mental disorders.

FACTORS ASSOCIATED WITH VOLUNTEERING AMONG FAMILY CAREGIVERS OF OLDER ADULTS

Abstract Family caregiving has been linked to an increased risk of poor mental health, poor physical health, and higher rates of perceived social isolation among caregivers. Despite the connection between caregiving and negative outcomes, or perhaps because of this connection, caregivers seek out and enjoy other life roles and activities including formal volunteerism. To explore the connection between informal caregiving and volunteering and establish the representative prevalence of formal volunteering among caregivers, descriptive and multivariate logistic regression analyses were carried out with data from 1,745 caregivers in the National Study of Caregiving (NSOC) (2017). Utilizing social capital theory four models were constructed with salient demographic characteristics associated with volunteering (model 1), caregiving context (model 2), caregiver physical and mental health (model 3), along with participation in informal and formal social networks (model 4). About a quarter of the sample participated in volunteering (26%). The average age was 60.5 years (SD = 14.3) and more than half consisted of female caregivers (67.11%). Non-Hispanic Whites (62.9%) were the majority of the sample, followed by non-Hispanic Blacks (28%), Hispanic (6.5%), and caregivers in other racial/ethic groups (2.6%). Gender, educational achievement, caregiving for a spouse, coresiding with care recipient, caregiving for multiple care recipients, quality of relationship with care recipient, caregiver psychological well-being, having emotional/physical support, attending religious services, and group activity participation were all significant indicators for caregiver volunteerism. Findings support the importance of both human and social capital in volunteering among caregivers.

TRAJECTORIES OF ANXIETY SYMPTOMS DURING THE COVID-19 PANDEMIC AMONG OLDER ADULTS

Abstract Older adults face particular challenges during the COVID-19 pandemic, including increased risk for morbidity and mortality (CDC, 2021). Social distancing and lockdown to prevent contagion may create social isolation and loneliness, adversely affecting mental and physical health. We examined anxiety symptom trajectories of older adults and identified risk and protective factors during the early months of the COVID-19 pandemic. We also examined how anxiety symptoms were associated with both between- and within-person variations in loneliness, social contacts, and physical problems. We sampled 247 older adults (Mage = 71.1, SD = 7.3, range = 51 - 95), who participated in eight weekly longitudinal online surveys from April 28 to June 23, 2020. Multilevel modeling analysis controlling for age, gender, marital status, and education showed that anxiety symptoms significantly decreased in the first few weeks, but then increased around week 6 of the study period. At the between-person level, individuals with higher levels of both loneliness and physical problems were at risk for experiencing higher levels of anxiety, but social contacts were not significant. Middle-aged participants reported higher anxiety symptoms than older participants. Women experienced higher anxiety symptoms than men. As a protective factor, individuals who were high in resilience had significantly lower anxiety symptoms over time, compared to those with low in resilience. In the within-person level, anxiety symptoms were positively coupled with both loneliness and physical symptoms over time. We conclude that lonely individuals and those in poor health were at greater risk of poor mental health during the pandemic.

NEW BEREAVEMENT IS A RISK FACTOR FOR BINGE DRINKING, SMOKING, AND POOR MENTAL HEALTH (2019 GEORGIA BRFSS)

Abstract This presentation advances studies of population health by estimating the association between new bereavement and binge drinking rates among adults aged 50 years and older. In other reports, bereavement is associated with significantly higher rates of binge drinking among older adults. In 2019, the state of Georgia used an optional module in the Behavioral Risk Factor Surveillance Survey (BRFSS) to measure the prevalence of new bereavement. This is the first effort to capture population-level data on bereavement in Georgia. 45% of adults (4 million persons) aged 18 and older were newly bereaved in the 24 months prior to survey. Highest bereavement rates: adults aged 55 to 64 years (51%), unemployed (49%), and Black respondents (60%). Binge drinking rate for bereaved was 31 % (versus 23.6% not bereaved). Combined bereavement and binge drinking increased risk for poor mental health (OR = 2.83) and smoking (OR = 4.54).

Can Digital Communication Protect Against Depression for Older Adults With Hearing and Vision Impairment During COVID-19?

During social isolation imposed by the coronavirus disease 2019 (COVID-19) pandemic, older adults with impaired hearing and vision potentially experienced more communication challenges, increasing their risk for poor mental health. Digital communication (e.g., video calls, e-mail/text/social media) may alleviate in-person isolation and protect against depression. We addressed this question using data from the National Social Life, Health, and Aging Project, a nationally representative panel study of community-dwelling older adults. Two thousand five hundred fifty-eight adults aged 55 and older comprised the analytic sample. Interviewer rating at baseline (2015-2016) classified those with vision impairment (VI) or hearing impairment (HI). Olfactory impairment (OI) was measured by objective testing. During COVID-19 (2020-2021), respondents reported how often they contacted nonhousehold family or friends and whether this was by phone, e-mail/text/social media, video, or in-person. They also quantified the frequency of depressive feelings. Older adults with VI or HI but not OI at baseline were significantly less likely to report regular use of video calling and e-mail/text/social media during the pandemic compared to those without impairment. Sensory impairments did not affect the frequency of phone or in-person communication. Adults with VI or HI were more likely to experience frequent depressive feelings during COVID-19. Video calls mitigated this negative effect of VI- and HI-associated depressive feelings in a dose-dependent manner. Among communication modalities, video calling had a protective effect against depressive feelings for people with sensory impairment during social isolation. Improving access to and usability of video communication for older adults with sensory impairment could be a strategy to improve their mental health.

Daily COVID-19 Stressor Effects on Children's Mental Health Depend on Pre-pandemic Peer Victimization and Resting Respiratory Sinus Arrhythmia.

Children's risk of poorer mental health due to the COVID-19 pandemic may depend on risk and protective factors heading into the pandemic. This study examined same-day associations between COVID-19 stressors and children's mental health using a daily diary design across 14days, and considered the moderating roles of pre-pandemic peer victimization experiences and resting respiratory sinus arrhythmia (RSA; an indicator of cardiac regulatory capacity). Forty-nine Canadian children aged 8-13years (Mage = 10.69, 29 girls) participated in the final wave of a longitudinal study just prior to the pandemic and a daily diary extension during the pandemic (N = 686 pandemic measurement occasions). Multilevel modeling indicated that children had poorer mental health on days when they experienced a COVID-19 stressor (e.g., virtual academic difficulties, social isolation). A three-way interaction indicated that this association was stronger for those with higher pre-pandemic peer victimization experiences and lower pre-pandemic resting RSA; however, highly victimized children with higher resting RSA did not experience poorer mental health on days with COVID-19 stressors. Findings offer preliminary insights into the preceding risk and protective factors for children's mental health amidst major subsequent stress.

Social Return on Investment (SROI) of mental health related interventions-A scoping review.

There is a growing recognition of the need to effectively assess the social value of public health interventions through a wider, comprehensive approach, capturing their social, economic and environmental benefits, outcomes and impacts. Social Return on Investment (SROI) is a methodological approach which incorporates all three aspects for evaluating interventions. Mental health problems are one of the leading causes of ill health and disability worldwide. This study aims to map existing evidence on the social value of mental health interventions that uses the SROI methodology. A scoping evidence search was conducted on Medline, PubMed, Google Scholar and relevant gray literature, published in English between January 2000 and March 2021 to identify studies which capture the SROI of mental health interventions in high- and middle-income countries. Studies that reported mental health outcomes and an SROI ratio were included in this review. The quality of included studies was assessed using Krlev's 12-item quality assessment framework. The search identified a total of 435 records; and 42 of them with varying quality met the study inclusion criteria. Most of the included studies (93%) were non-peer reviewed publicly available reports, predominantly conducted in the United Kingdom (88%); and majority (60%) of those studies were funded by charity/non-for-profit organizations. Out of 42 included studies, 22 were targeted toward individuals experiencing mental health problems and the remainder 20 were targeted to vulnerable groups or the general population to prevent, or reduce the risk of poor mental health. Eighty-one percent of included studies were graded as high quality studies based on Krlev's 12-item quality assessment framework. The reported SROI ratios of the included studies ranged from £0.79 to £28.00 for every pound invested. This scoping review is a first of its kind to focus on SROI of mental health interventions, finding a good number of SROI studies that show a positive return on investment of the identified interventions. This review illustrates that SROI could be a useful tool and source of evidence to help inform policy and funding decisions for investment in mental health and wellbeing, as it accounts for the wider social, economic and environmental benefits of public health interventions. More SROI research in the area of public health is needed to expand the evidence base and develop further the methodology.

Factors influencing the well-being of Asian American LGBT individuals across the lifespan: perspectives from leaders of community-based organizations

BackgroundLesbian, gay, bisexual, and transgender (LGBT) individuals have documented disparities in mental health that are experienced across the life course. However, limited research has been conducted to identify the factors which contribute to evaluated risk for poor mental health among older Asian Americans who identify as LGBT. The purpose of this study was to determine the perspectives of leaders of community-based organizations about the mental health needs and concerns of their LGBT constituents from diverse Asian backgrounds.MethodsSemi-structured qualitative interviews were conducted with leaders of community-based organizations serving the needs of LGBT individuals. A qualitative framework analysis approach was used to identify, analyze and report themes within the data.Results11 members of community organizations located in California (54.5%), Chicago (27.2%), and New York (18.1%) were interviewed. Chronic stress was identified as negatively impacting constituents’ lives and was attributed to social determinants of health, including inadequate housing, financial insecurity, discrimination, barriers to adequate health care, and immigration status. Ageism, social isolation, language barriers, and limited connections to cultural, religious, or LGBT communities were identified as factors impacting middle-aged and older adults. Participants identified homelessness, violence, and lack of parental acceptance as contributing to distress among youth and younger adults. The most vulnerable community members were identified as gender minorities, undocumented individuals, and individuals with limited English proficiencies. Organizational leaders described strategies to address social determinants.ConclusionsAsian Americans who are LGBT are confronted with substantial risks for poor mental health that are linked to modifiable social determinants of health. Organizations serving these populations play a vital role in meeting the needs of a highly underserved population.

The burdens of poverty during the COVID-19 pandemic.

Individuals living at-risk-of-poverty have an increased risk of poor mental health. The pandemic and its societal impacts might have negative effects especially on this group widening the gap between rich and poor and also exacerbate gender gaps, which in turn might impact social cohesion. The objective of this longitudinal study was to determine if people living at-risk-of-poverty were more vulnerable to economic and psychosocial impacts of the pandemic and showed poorer mental health. Moreover, gender differences were analyzed. We drew data from a sample of N = 10,250 respondents of two time points (T1 starting from October 2020, T2 starting from March 2021) of the Gutenberg COVID-19 Study. We tested for differences between people living at-risk-of-poverty and more affluent respondents regarding economic impacts, psychosocial stressors, as well as depressiveness, anxiety and loneliness, by comparing mean and distributional differences. To test for significant discrepancy, we opted for chi-square- and t-tests. The analysis sample compromised N = 8,100 individuals of which 4,2% could be classified as living at-risk-of-poverty. 23% of respondents living at-risk-of-poverty had a decrease in income since the beginning of the pandemic-twice as many as those not living at-risk-of-poverty, who reported more often an increase in income. Less affluent individuals reported a decrease in working hours, while more affluent people reported an increase. Between our survey time points, we found a significant decrease in these economic impacts. Gender differences for economic changes were only found for more affluent women who worked more hours with no change in income. Less affluent respondents were more impacted by psychosocial stressors, depressiveness, anxiety, and loneliness. Gender differences were found particularly with regard to care responsibilities. Our results indicate a widening in the gap between the rich and the poor at the beginning of the pandemic. Gender differences concerning economic changes affect more affluent women, but women in both income groups are more burdened by care responsibilities, which might indicate a heightened resurgence of gender role in times of crisis. This increase in inequality might have impacted social cohesion.

Coping Styles Utilized during Suicide and Sudden Death Bereavement in the First Six Months.

Individuals bereaved by suicide experience substantial emotional distress and are at risk for poorer mental health, substance use concerns, and suicidal behaviors. This study aimed to explore whether those bereaved by suicide reported different coping styles compared to those bereaved by sudden death in the first six months. It also aimed to determine whether a previous mental health diagnosis (PMHD) and experiencing stigma and/or shame impacted the utilization of adaptive and maladaptive coping. The sample was constituted by individuals bereaved by suicide (n = 142) compared to those bereaved by sudden death (n = 63), six months after loss. The study included immediate family members who were 18 years or older and understood the English language. After controlling for demographics there were no significant differences in coping styles between bereavement types. Regardless of bereavement type, having a PMHD was associated with increased avoidant and problem-focused coping, and stigma and shame were each associated with increased avoidant coping. Women were also more likely to report using adaptive coping. Findings demonstrate no difference by bereavement type and have implications for the tailoring of grief/postvention supports that are sensitive to perceived stigma/shame to better facilitate utilization of adaptive emotion-focused coping, particularly for men and those with pre-existing mental health problems.

P087 What is keeping Australian farmers awake at night? Associations between sleep and mental health

Abstract Introduction In Australia, suicide rates are higher in farmers compared to the general population. The relationship between poor sleep and mental health is well known, yet there is limited evidence examining Australian farmers’ sleep and the role sleep plays in farmers mental health. Therefore, this study investigated the sleep and mental health of Australian farmers using an online questionnaire. Methods Farmers aged 18 and older (n=101; 52 males) completed a questionnaire (REDCap). The questionnaire included the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and Depression Anxiety Stress Scales (DASS-21). PSQI and ISI scores were split into normal values (‘below threshold’; PSQI<5; ISI<8) and abnormal values (‘above threshold’). Independent t-tests (Mann-Whitney) were performed to assess differences in mental health between the two threshold groups. Results Most participants worked full time (89%) on a family farm (70%) and were aged 26-55 (61%). Individuals with PSQI scores above threshold had higher DASS-21 scores across all subscales (p≤0.01; Depression 4.9±3.9; Anxiety 7.6±4.4; Stress 3.8±3.7) compared to those below threshold (Depression 2.9±3.0; Anxiety 5.1±3.2; Stress 1.9±2.0). All DASS-21 subscales scores were also higher in individuals with ISI scores above threshold (p<0.001; Depression 5.0±3.9; Anxiety 7.3±4.2; Stress 3.8±4.1) compared to those below threshold (Depression 2.5±2.9; Anxiety 4.5±3.0; Stress 1.7±1.9). Discussion Results suggest that Australian farmers who have insomnia symptoms and poor sleep quality are at a higher risk of poor mental health. Identifying at-risk individuals by examining sleep quality, then investigating and treating sleep problems, may improve mental health amongst farmers.

Lessons learned from the impact of Covid-19 on the work of disability support organisations that support employers of social care personal assistants in England.

Social care Personal Assistants (PAs) are directly employed by individuals to assist with activities of daily living such as help or support with personal care, shopping, household tasks and community participation. This option is encouraged by UK public funding. In England, disabled people's support organisations initially offered assistance with such arrangements, although numbers doing this have declined. The Covid-19 pandemic provided the opportunity to ask those remaining organisations providing support for PA employers about their activities during this time and the questions being posed to them by PA employers. This paper reports data from 15 interviews undertaken March-July 2021 with disability support organisation representatives. We identified one overarching theme 'Working to prevent and challenge marginalisation of PA employers', with three related subthemes: (1) Advocating for the voice of a forgotten group; (2) Needing to be proactive and (3) Adapting to new tasks and ways of working. Participant accounts focused on representing the needs of disabled people to the authorities and providing concise, timely and accurate information to PA employers, particularly around the use of public funds during Covid-19. Remote working amplified the digital-divide, resulting in these organisations working hard to ensure PA employers received important information about their support options. Befriending services and Covid-hubs were established by some organisations to reduce isolation and risks of poor mental health amongst PA employers. Many of the challenges facing PA employers existed pre-pandemic but were perceived to have been heightened during it, reflecting the value of and need for the work of these local support organisations. Our findings suggest areas where effective contingency planning drawn from closer collaboration between disability support organisations and central and local government might usefully be focussed. The potential for specific services or organisations to be commissioned to provide such support is discussed.

Selling one’s future: over-indebtedness and the risk of poor mental health and the role of precarious employment – results from the Scania Public Health Cohort, Sweden

ObjectivesThe credit market has expanded rapidly, increasing the risk of over-indebtedness among those who lack secure employment or adequate income, an issue of concern in the COVID-19 aftermath. We investigated...

3.O. Workshop: Structural stigma shapes LGBTQ+ mental health and well-being across countries

Abstract Lesbian, gay, bisexual, transgender and queer (LGBTQ+) people around the world have been shown to suffer from disparities in mental health and well-being relative to cisgender heterosexual people. Past research aiming to explain these gaps has referenced the added stress experienced by LGBTQ+ people in the form of, for example, interpersonal discrimination, rejection, and harassment (i.e., minority stress). While these phenomena exist at the interpersonal level, emerging evidence suggests that discriminatory structural-level factors, such as policies, norms and rules (i.e., structural stigma), may be just as influential in shaping LGBTQ+ mental health and well-being. Given the passage of a slate of bills limiting sexual and gender minority rights and banning open speech around these issues across many different countries, this is an extremely timely issue for sexual and gender minority health. This workshop will give examples of cutting-edge research on the ways in which structural stigma affects mental health and well-being for LGBTQ+ people. Dr. Dinah Gutermuth (University of Exeter, UK) will discuss findings from a global study (conducted in partnership with the BBC) including older and younger LGB individuals from 113 different countries, showing that structural stigma impairs social capital and creates disparities in loneliness between younger and older LGB individuals. Berk Can Ünsal (Eötvös Loránd University, Hungary) will present data from Europe highlighting structural stigma as a risk factor, and community participation as a protective factor, for depression in sexual and gender minority people. Dr. John Pachankis (Yale University, USA) will present results on how migration from countries of varying levels of structural stigma shapes depression and suicidality in sexual minority men. Finally, Dr. Richard Bränström (Karolinska Instituet, Sweden), will discuss how average life satisfaction improved from 2012-2019 for sexual minority people across Europe, with greater increases in countries with higher levels of structural stigma. Together, these presentations will demonstrate the far-reaching effects of structural stigma on LGBTQ+ mental health and well-being around the world. Key messages • Lesbian, gay, bisexual, transgender and queer (LGBTQ+) people around the world have been shown to suffer from disparities in mental health and well-being relative to cisgender heterosexual people. • Structural stigma is an important factor determining risk for poor mental health among LGBTQ+ individuals across countries.

Isostrain among tourism employees in Tunisia during COVID-19 pandemic

Abstract Background Psychological and social factors related to work activity can improve or deteriorate the physical and mental health of employees. Since the COVID-19 pandemic, the psychological well-being of workers has been strongly affected. Particularly, jobs with isostrain characterized by high work demands and low work control, coupled with low social support, place employees at highest risk for poor mental health. We aimed to assess the factors associated with isostrain among employees in the tourism sector in Sousse. Methods A cross-sectional study was conducted between September and November 2020 among tourism workers belonging to 12 hotels and restaurants in Sousse, Tunisia, using a self-administered questionnaire. ‘Isostrain’ was assessed using the Karasek questionnaire. ‘Isostrain’ is a situation where there is a combination of ‘jobstrain’ (‘tension at work') and low social support (score below the median of the group). SPSS 20 software was used to analyze the data. Results A total of 226 workers were included. The mean age was 38.2 ± 9.6 years. The sex ratio was 2.7. The majority of employees (64.8%) were working at workplace during COVID-19 lockdown. The prevalence of isostrain was 5.4%. Isostrain was reported by 5.7% of women (p = 1). All workers older than 50 years did not have isostrain (p = 0.6). Moreover, isostrain was found among 6.6% of workers with less than 5 years of work experience (p = 0.4), 4.8% of married employees (p = 0.7), and 7.6% of employees with a university education (p = 0.53). Conclusions Isostrain can affect employees in the tourism sector. Social support should be promoted among workers to ensure good mental health. Key messages • Prevalence of isostrain in tourism sector of Sousse during COVID-19 pandemic is quite high. • Preventive strategies of mental health should be promoted at workplace in Tunisia.

Pre-pandemic resilience to trauma and mental health outcomes during COVID-19.

PurposeThe stress-sensitization hypothesis posits that individuals with prior trauma are at elevated risk for poor mental health when faced with subsequent stressors. Little work has examined whether those who have demonstrated psychological resilience to prior trauma would show either increased resilience or vulnerability to subsequent stressors. We examined pre-pandemic psychological resilience to lifetime trauma in relation to mental health outcomes amid the coronavirus disease 2019 (COVID-19) pandemic, a major societal stressor.MethodsThe sample included 16,900 trauma-exposed women from the Nurses’ Health Study II. Pre-pandemic resilience was defined by psychological health in 2017–2019 (characterized by levels of both distress and positive emotional well-being) relative to lifetime trauma. Resilience was defined categorically by cross-classifying unfavorable, adequate, and favorable psychological health by higher versus lower trauma burden, and continuously as the residual difference in predicted versus actual psychological health regressed on trauma burden. Mental health outcomes as of May–August 2020 included psychological distress symptoms and overall positive emotional well-being. Associations were assessed using covariate-adjusted regression models.ResultsPre-pandemic resilience was associated with lower distress and higher well-being early in the COVID-19 pandemic. Relative to the women showing highest resilience (favorable psychological health despite higher trauma), only those with lower trauma and favorable prior psychological health had significantly lower distress and higher positive emotional well-being during the pandemic. Higher continuous pre-pandemic resilience was also significantly associated with lower distress and higher positive emotional well-being during the pandemic.ConclusionPreventing mental health problems following trauma may contribute to protecting population well-being amid major stressors.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00127-022-02367-y.

An intervention to improve the self-efficacy of key workers to support parental wellbeing at an early childhood intervention service in Australia: a stepped wedged randomized cluster trial

Purpose It is well documented parents of children who have a disability are at an increased risk of poor mental health and wellbeing. A capacity building program designed to build key worker self-efficacy to support the mental health of parents accessing early childhood intervention services (ECIS) for their child was trialled. Materials and Methods A stepped-wedge cluster randomised trial design was utilised to deliver and evaluate a 12-month intervention program, comprising tailored professional development, resource development and sustainability measures. The repeated measurements on individuals in six clusters over three follow-up periods were analysed using linear mixed models. Comparison of the control and new program statistical means (adjusted for period effects) were assessed with an F test. Results Key workers reported increased confidence to talk to parents about their own wellbeing (d = 0.51, F(1, 51.8) = 4.28, p = 0.044) and knowledge of parental mental wellbeing improved (p = 0.006). A reduction in staff sick leave partially offset the cost of the intervention. Conclusions A multi-pronged intervention targeted at key workers was found to be an effective way to ensure parental wellbeing is supported at an ECIS in Australia. Trial Registration ACTRN12617001530314 Implications for Rehabilitation There are implications for the development of children whose parents are experiencing high stress and poor mental health, whereby parents of children with disability or developmental delays are at increased risk. Findings from this study support the recommendation that a key worker is provided to holistically support families who access Early Childhood Intervention Services to aid in reducing poor parental wellbeing and child outcomes. Improved confidence to support and initiate conversations regarding parental wellbeing by key workers, in combination with support from management and the organisation to undertake this as part of their role, is a positive finding from this intervention study.