Short Warwick Edinburgh Mental Wellbeing Research Articles

Mental health after the COVID-19 pandemic among Finnish youth: a repeated, cross-sectional, population-based study

High levels of mental health problems among young people were reported during the COVID-19 pandemic, but studies of the post-pandemic period are scarce. We assessed mental health problems among Finnish youth before, during, and after the COVID-19 pandemic using nationwide population-based samples. Our aim was to examine in which direction the heightened levels of adolescent mental health problems have developed after the pandemic. In this national, repeated cross-sectional, population-based study in Finland, we recruited students at lower and upper secondary level (aged 13-20 years) who were taking part in the Finnish School Health Promotion (SHP) survey in 2015-23 (119 681-158 897 participants per round). The SHP is based on total sampling and conducted biennially between March and May. Self-reports covered the seven-item Generalized Anxiety Disorder Scale; the two-item Patient Health Questionnaire for depression; the Mini Social Phobia Inventory for social anxiety; the Short Warwick-Edinburgh Mental Wellbeing Scale for mental wellbeing; loneliness; the Sick, Control, One Stone, Fat, Food measure for disordered eating; and suicidality (suicidal ideation, deliberate self-harm, and suicide attempts). Scales were dichotomised using validated cutoffs. Presence of any and comorbid mental health problems was assessed. Logistic (for dichotomised outcomes) and linear (for Short Warwick-Edinburgh Mental Wellbeing Scale) mixed effects models were used to analyse the effect of survey year on mental health, controlling for sociodemographic background factors and stratified by gender and school level. Cisgender and transgender youth were compared. Between 2015 and 2023, the SHP study recruited 722 488 students (371 634 [51·6%] girls and 348 857 [48·4%] boys) with a mean age of 15·8 years (SD 1·3) who were either in the eighth and ninth grades of comprehensive school or the first and second years of general and vocational upper secondary schools in Finland. The proportion of participants with generalised anxiety, depression, and social anxiety symptoms above the cutoff increased from pre-COVID-19 levels to 2021 and remained at these higher levels in 2023 among all study groups. Among girls in lower secondary education, prevalence of generalised anxiety, depression, and social anxiety symptoms increased from 2021 to 2023, as did social anxiety among girls in upper secondary education. Among boys, the proportion with social anxiety symptoms decreased between 2021 and 2023. Mental wellbeing scores decreased in all groups between 2021 and 2023, and disordered eating increased in girls, and in boys in lower secondary education. Suicidality increased in girls but not in boys. Loneliness was the only measure to show improvement in all groups from 2021 to 2023. In 2023, 55 895 (72·6%) of 76 994 girls and 22 718 (32·8%) of 69 205 boys reported at least one mental health problem, and 37 250 (48·4%) girls and 9442 (13·6%) boys reported comorbid mental health problems. Among both transfeminine and transmasculine youth, the prevalence of generalised anxiety and depression symptoms decreased from 2021 to 2023, but compared with cisgender youth, the proportions were significantly higher throughout. The effects of the COVID-19 pandemic on youth mental health could be long lasting. In this study, the substantial change for the better among transgender youth was a positive exception. Providing adequate support and treatment for young people with poor mental health is essential, but solutions to the mental health crisis need to address a wider societal perspective and should be developed in partnership with young people. NordForsk, Research Council of Finland. For the Finnish and Swedish translations of the abstract see Supplementary Materials section.

Prevalence and co-occurrence of cognitive impairment in children and young people up to 12-months post infection with SARS-CoV-2 (Omicron variant)

BackgroundCognitive impairment is often reported after SARS-CoV-2 infection, yet evidence gaps remain. We aimed to (i) report the prevalence and characteristics of children and young people (CYP) reporting “brain fog” (i.e., cognitive impairment) 12-months post PCR-proven SARS-CoV-2 infection and determine whether differences by infection status exist and (ii) explore the prevalence of CYP experiencing cognitive impairment over a 12-month period post-infection and investigate the relationship between cognitive impairment and poor mental health and well-being, mental fatigue and sleep problems. MethodsThe Omicron CLoCk sub-study, set up in January 2022, collected data on first-time PCR-test-positive and PCR-proven reinfected CYP at time of testing and at 3-, 6- and 12-months post-testing. We describe the prevalence of cognitive impairment at 12-months, indicating when it was first reported. We characterise CYP experiencing cognitive impairment and use chi-squared tests to determine whether cognitive impairment prevalence varied by infection status. We explore the relationship between cognitive impairment and poor mental health and well-being, mental fatigue and trouble sleeping using validated scales. We examine associations at 3-, 6- and 12-months post-testing by infection status using Mann-Whitney U and chi-square tests. ResultsAt 12-months post-testing, 7.0 % (24/345) of first-positives and 7.5 % (27/360) of reinfected CYP experienced cognitive impairment with no difference between infection-status groups (p = 0.78). The majority of these CYP experienced cognitive impairment for the first time at either time of testing or 3-months post-test (no difference between the infection-status groups; p = 0.60). 70.8 % of first-positives experiencing cognitive impairment at 12-months, were 15-to-17-years-old as were 33.3 % of reinfected CYP experiencing cognitive impairment (p < 0.01). Consistently at all time points post-testing, CYP experiencing cognitive impairment were more likely to score higher on all Strengths and Difficulties Questionnaire subscales, higher on the Chalder Fatigue sub-scale for mental fatigue, lower on the Short Warwick-Edinburgh Mental Wellbeing Scale and report more trouble sleeping. ConclusionsCYP have a fluctuating experience of cognitive impairment by 12-months post SARS-CoV-2-infection. Cognitive impairment is consistently correlated with poorer sleep, behavioural and emotional functioning over a 12-month period. Clinicians should be aware of cognitive impairment post-infection and its co-occurring nature with poorer sleep, behavioural and mental health symptoms.

Evaluating the impact of a UK recovery college on mental well-being: pre- and post-intervention study.

Recovery colleges provide personalised educational mental health support for people who self-refer. The research evidence supporting them is growing, with key components and the positive experiences of attendees reported. However, the quantitative outcome evidence and impact on economic outcomes is limited. To evaluate the impact of attending a UK recovery college for students who receive a full educational intervention. This is a pre- and post-intervention study, with predominantly quantitative methods. Participants recruited over an 18-month period (01.2020-07.2021) completed self-reported well-being (Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS)) and recovery (Process of Recovery (QPR)) surveys, and provided details and evidence of employment and educational status. Descriptive statistics for baseline data and Shapiro-Wilk, Wilcoxon signed-rank and paired t-tests were used to compare pre- and post-intervention scores, with Hedges' g-statistic as a measure of effect size. Medical records were reviewed and a brief qualitative assessment of changes reported by students was conducted. Of 101 student research participants, 84 completed the intervention. Well-being (mean SWEMWBS scores 17.3 and 21.9; n = 80) and recovery (mean QPR scores 27.2 and 38.8; n = 75) improved significantly (P < 0.001; Hedges' g of 1.08 and 1.03). The number of economically inactive students reduced from 53 (69%) to 19 (24.4%). No research participants were referred for specialist mental health support while students. 'Within-self' and 'practical' changes were described by students following the intervention. Findings detail the largest self-reported pre-post data-set for students attending a recovery college, and the first data detailing outcomes of remote delivery of a recovery college.

The impact of the Covid-19 pandemic on mental health in Danish school children in 5th to 7th grade.

We wanted to examine the impact of the Covid-19 pandemic on mental health in Danish school children in 5th to 7th grade (11 to 15 years), and whether the impact differed across age and sex. We included 793 and 391 school children from winter 2020 and winter 2021, respectively. Mental health was measured using the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), Strengths and Difficulties Questionnaire (SDQ), and Brief Resilience Scale (BRS). Data were analyzed by sex using linear regression models adjusting for grade (age), cohabitation, geographical region, employment status of parents, and schools as clusters. Girls in 5th grade and boys in 6th grade during Covid-19 had statistically significant lower well-being (SWEMWBS) compared with before Covid-19. Girls in 5th and 6th grade during Covid-19 had non-statistically significant lower scores on all subscales of SDQ compared with girls before Covid-19. Girls in 7th grade during Covid-19 had statistically significant lower total difficulty score (SDQ) and fewer conduct problems (SDQ) compared with girls before Covid-19. Boys in 5th grade during Covid-19 had statistically significant fewer conduct problems (SDQ) compared with boys before Covid-19. This study indicates that the Covid-19 pandemic impacted Danish school children differently across sex and grade (age). During Covid-19, mental health tended to be better among the oldest girls and worse among the youngest girls compared with girls before Covid-19. Boys in 6th grade had poorer mental well-being, and boys in 5th grade had fewer conduct problems during Covid-19 compared with before Covid-19.

Exploration of Evaluation Practices in Social Prescribing Services in Ireland: A Cross-Sectional Observational Study.

National health services in Ireland and the UK fund the majority of social prescribing services and have issued recommendations for evaluation. However, it is not known what outcomes are prioritised for evaluation within individual services and what evaluation methods are used to capture recommended outcomes. A survey was carried out to examine evaluation practices of social prescribing services on the island of Ireland. This study used a cross-sectional observational design. The sample was all the staff involved in delivering and/or managing SP services on the island of Ireland. Questionnaires were distributed at a national SP conference and online. Closed-response questions were analysed using descriptive statistics. Content analysis was used for open-ended questions. Eighty-four usable surveys were returned (50% from the Republic of Ireland and 50% from Northern Ireland). All respondents (100%) agreed on the importance of measuring SP outcomes. The most frequently measured outcomes were health and well-being (89.2%) and loneliness (84%). The least frequently measured outcome was the satisfaction of healthcare professionals referring to SP: 78.4% of respondents never measured this outcome. The most frequently used measurement tool was the Short Warwick Edinburgh Mental Well-Being Scale, with 38/76 (50%) respondents using this measure. There was a lack of standardised measures identified for some outcomes. For example, 70% of respondents reported always measuring physical activity (PA), but only four respondents identified a specific PA measure. In open-ended questions, respondents recommended flexibility in evaluation methods to reflect the complexity and individualised focus of SP. They also identified the need for protected time to complete evaluations and recommended a national strategy to inform priorities in evaluations. This study demonstrates a wide variation on the island of Ireland on how SP services are measuring outcomes, with many outcomes rarely or never measured using standardised measures. Agreement is needed on a core outcome set for social prescribing in order to guide service delivery and evaluations.

Association between friendship quality and subjective wellbeing in adolescents: a cross-sectional observational study

BackgroundFriendships play a vital role in the social lives of teenagers, and friendship quality can substantially impact the adolescents’ overall health and wellbeing. This study aimed to investigate the association between friendship quality and subjective wellbeing in Northern Irish adolescents. MethodsIn this cross-sectional observational study, we used data from the second wave of the Wellbeing in Schools Survey, conducted in Northern Ireland from April 2 to May 31, 2018. This survey used a clustering sampling method and included students aged 15–19 years. The survey was approved by the School of Social Sciences, Education and Social Work's Research Ethics Committee, with pupil opt-in and parental opt-out consents. Participants from the survey's initial wave in 2016 were considered eligible. Data on friendship quality and classroom friendships were gathered. Subjective wellbeing was assessed using the 7-item Short Warwick-Edinburgh Mental Wellbeing Scale. Metrics for psychological wellbeing (6 items), mood (7 items), and friendship quality (6 items) were taken from the KIDSCREEN-52 questionnaire. All items were rated on a 1–5 point Likert scale. We examined the association between friendship network quality and subjective wellbeing outcomes through social network analysis and network autocorrelation modelling. FindingsOf 1542 students invited, 1189 (77%) from 83 schools responded to the friendship network queries. Slightly more than half of these participants were female (609 [51%] girls and 580 [49%] boys), and the median age was 16 years (range 14–19, IQR 16–16). The median overall friendship score stood at 20 (IQR 18–26, with possible scores ranging from 6 to 30). Adjusted network autocorrelation models indicated that higher friendship quality scores were significantly associated with improved psychological wellbeing (β=0·3448, p<0·0001), subjective wellbeing (β=0·3075, p<0·0001), and a reduction in negative mood (β=–0·1934, p<0·0001). InterpretationThe study found that friendship quality had a significant association with mood, psychological wellbeing, and subjective wellbeing in adolescents. The results emphasise the value of fostering positive social relationships among adolescents, with a particular focus on the quality of their friendships. Next stages of this research include longitudinal analysis to test these associations more robustly. FundingTaibah University.

Exploring substance misuse in a prison in Wales: a cross-sectional analysis

BackgroundSince 2015, the risks of dying due to drug-related causes are higher in prison than in the general population, with opiates and psychoactive substances being the most common substances recorded on death certificates in prison. Many individuals use drugs before entering the prison environment, it is not clear which individuals continue to use drugs while in prison. This study is a first step towards identifying characteristics of those who use drugs in prison, while exploring substances commonly used. MethodsThis retrospective cross-sectional analysis was performed on 299 men (mean age 38 years [SD 11]) in a long-stay UK prison in South Wales who participated in a research study exploring cardiometabolic risk in prison, in which substance misuse was included as a risk variable. All men aged 25 years or older with no previous diagnosis of cardiometabolic illness were eligible to participate. Data were collected between Oct 7 and Oct 23, 2019. Participants were asked details about their substance use before and since entering the prison. Mental wellbeing was assessed using the short Warwick Edinburgh Mental Wellbeing Score and low mental wellbeing calculated as 1 SD below the population mean score. To examine associations between characteristics (age groups, mental wellbeing, exposure to prison environment) and drug use, we used binary logistic regression (adjusted for characteristics such as age group, mental wellbeing, and exposure to prison environment ). FindingsOverall, 195 (65%) of 299 participants reported a history of drug use before entering prison. Since entering prison 49 (16%) participants reported using drugs including methadone, and 24 (8%) reported using drugs excluding methadone. The next leading substances used in prison were spice (11 [4%] participants) and cannabis (six [2%] participants). All those who used drugs in prison had a history of drug use. Individuals more likely to continue using drugs in prison were aged 39 years and younger (adjusted odds ratio [aOR] 4·72, 95% CI 1·88–11·89; p=0·0009), with reported low mental wellbeing (3·38, 1·54–7·41; p=0·002), and had spent collectively more than 2·5 years in the prison environment (4·77, 2·09–10·91; p=0·0002). InterpretationThis study, from a limited sample, describes the characteristics of those who use drugs in prison. Harm reduction interventions targeted to these individuals could reduce the risk of prison drug-related deaths. These findings should be interpreted with some caution, as this is a single site and may not reflect the wider UK prison environment. FundingPublic Health Wales.

Does mindfulness-based wellbeing training increase self-reported and perceived health among teachers?

Abstract Background Teachers are reporting increased stress, burnout, and workload at schools. Previous studies have shown that mindfulness-based (MF-based) programs are potential interventions to decrease stress and improve wellbeing among teachers. The aim of this Healthy Learning Mind -teacher study was to investigate the effects of a MF-based wellbeing training on several dimensions of wellbeing among teachers in Finnish comprehensive schools. Methods We developed a MF-based wellbeing training tailored for teachers (8 weeks) and organized the training by three teaching methods: 1) contact teaching; 2) online teaching and 3) combination of both contact and online teaching. Outcome variables are: wellbeing (The Short Warwick-Edinburgh Mental Well-Being Scale), work ability (Work Ability Index) and perceived stress (Single Item Measure of Stress). A total of 50 teachers answered to both baseline and follow-up questionnaires. Additionally perceived health benefits were reported. Results MF-based wellbeing training showed beneficial effects on teachers’ perceived health: better ability to calm down, relax, regulate emotions and to manage difficult situations as well as better tools for stress management in classrooms. Additionally teachers reported that their own mindfulness practice had a beneficial effect on students’ calmness, attention and kindness as well as on interaction with students. Analysed results on outcome variables will be presented at the conference. Conclusions First results suggest that MF-based wellbeing training has several perceived health benefits among teachers in strengthening teachers’ ability to regulate emotions and decrease stress and to adopt tools for solving challenging situations with students. Furthermore, teachers reported that their own mindfulness practice had a favorable effect on students’ wellbeing and social-emotional competence. Enhancing teachers’ wellbeing is beneficial for both teachers themselves and for students. Key messages • MF-based wellbeing training can be seen as a potential intervention to decrease perceived stress and increase perceived health benefits among teachers and to support teachers in their profession. • More research is needed to understand how teachers’ own mindfulness practice affects wellbeing among students and interaction in classrooms.

Employment quality, past unemployment, mental health and wellbeing in the UK

Abstract Background Low employment quality (EQ) has been associated with adverse mental health. Past unemployment may also be linked to reduced mental health and wellbeing later on and may influence subsequent EQ. However, understanding of the role (past) unemployment history may play in the association of (present) EQ and mental health and well-being is limited. This paper aims to fill this gap. Methods We drew on a subsample of employees aged 25 to 60 from wave 4 of the UK Household Longitudinal Study. We applied Latent Class Analysis (LCA) to derive typologies of EQ within 6 dimensions. We fitted logistic regressions to assess the links between EQ, lifetime unemployment, and mental well-being and psychological distress (measured using the Short Warwick-Edinburgh Mental Wellbeing Scale and the 12-item General Health Questionnaire, respectively). Results The LCA yielded an optimal solution of 6 EQ clusters, with some similarities to previous typologies. Men and women in precarious employment forms characterised by unfavourable employment conditions including lower labour income and potential underemployment reported higher odds for low mental well-being (men OR:1.54, 95% CI:1.06-2.24; women OR:1.37, 95% CI:1.04-1.81), and so did women in precarious forms characterised by, amongst others, lower labour income and more prevalent long and irregular hours (OR:1.44, 95% CI:1.08-1.93), compared to those in the most standard and favourable arrangement. Some further well-being inequalities were observed across the EQ spectrum. Simultaneously, prior unemployment (of length) was also linked to reduced well-being among both genders, with no dose-response relationship. Precarious clusters were, however, not linked to increased odds of psychological distress. Conclusions Men and women in low EQ or with prior unemployment experience had higher odds of low mental well-being in the UK. Our analysis shows the need to consider employment trajectories regarding mental health outcomes. Key messages • Low multidimensional EQ and past unemployment experience of length are both related to reduced mental well-being in the UK. • No links were observed with regards to low employment quality and elevated psychological distress.

Exploring the Relationship Between Self-Compassion and Compassion for Others: The Role of Psychological Distress and Wellbeing.

We addressed construct validity and explored the relationship between self-compassion and compassion for others using the two main current operationalizations of compassion (Neff's and the Sussex-Oxford Compassion Scales, SOCSs). Relationships with psychological distress and wellbeing, and potential differences in the association between self-compassion and compassion for others by level of psychological distress and wellbeing were also explored. Participants (n = 811) completed the Spanish adaptations of the Self-Compassion Scale (SCS), the Compassion Scale (CS), the SOCSs (for the self/others), the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), and the Depression Anxiety Stress Scales-21 (DASS-21). We fitted bifactor models to estimate the general factor of each construct for the different operationalizations, and calculated correlations between them. Relationships between self-compassion and compassion for others from the same operationalization were intermediate, while those between the same constructs from different operationalizations were large. Both constructs showed positive associations with wellbeing, while only self-compassion was associated with decreased psychological distress. Participants with good mental health showed higher associations between self-compassion and compassion for others than those with poorer mental health. Self-compassion and compassion for others appear to be dimensional constructs that can converge or diverge. When they converge, it is associated with better mental health.

A randomized controlled trial on the effectiveness of the abridged illness management and recovery program for people with schizophrenia spectrum disorders.

This study aimed to investigate the effectiveness of an abridged version of the Illness Management and Recovery Programme (AIMR) that was modified and developed in Hong Kong through a mult-centre randomized controlled trial for patients with schizophrenia spectrum disorders. This study was implemented in 10 occupational therapy departments, psychiatric day hospitals of 7 Hospital Authority clusters in Hong Kong. A total of 211 patients with schizophrenia or schizoaffective disorder was recruited and randomized into either the experimental or the control condition. In the control group, the subjects went through conventional occupational therapy programmes. In the experimental group, the subjects went through an additional 10-session programme of AIMR. were measured at baseline, completion of the AIMR, and 3-month after the AIMR programme. Measures include the expanded version of the Brief Psychiatric Rating Scale (BPRS-E), the client version of the Illness Management and Recovery Scale (IMRS), the Snyder Hope Scale, the Social and Occupational and Occupational Functioning Assessment Scale (SOFAS), the WHO Quality of Life Scale (WHOQOL-BREF), and the Chinese Version of the Short Warwick-Edinburgh Mental Well-Being Scale (C-SWEMWBS). Both the experimental and control cohorts had comparable clinical and socio-demographic characteristics except years of education and duration of illness. These two variables were entered as covariates in the linear mixed model which showed that the experimental group had significantly higher improvement than the control group in terms of illness management (F = 4.82; p = .03; Cohen's d = .45), functional (F = 10.65; p = .001; Cohen's d = .58), and hope (F = 5.52; p = .02; Cohen's d = .08) measures after the completion of treatment. The results supported the effectiveness of the AIMR programm which would be important in the recovery oriented practices in psychiatry.

Item response theory-based psychometric analysis of the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) among adolescents in the UK

BackgroundMiddle and late adolescence is the period in a person's life that is most vulnerable to mental health problems. To enable an evidence base that can support policies to prevent such problems, it is crucial to have good quality, reliable, and accurate measurement tools for mental well-being. One of them is the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). This study aimed to test the psychometric properties of the SWEMWBS on a large sample of adolescents aged 16 to 19 from the United Kingdom (UK) (N = 8,090). Data were from four waves of the longitudinal panel study Understanding Society.MethodsThe analysis was conducted using Item Response Theory (IRT), which is the most appropriate method for testing psychometric properties. The Graded Response Model (GRM) was applied to the data. The reliability and criterion validity of the SWEMWBS were also examined.ResultsThe presented results confirm the very good psychometric properties of the SWEMWBS amongst adolescents aged 16 to 19 years. The assumptions for the use (unidimensionality, local non-independence, monotonicity) of IRT were met. The results of GRM showed very high discriminant power for all items. The five-category response scale performed optimally; however, differences were found between points on the response scale both between and within items. In general, the scale as a whole showed very good functioning, but particularly in the negative values of mental well-being.ConclusionsThe SWEMWBS was confirmed as a concise, reliable, and valid instrument for measuring mental well-being among older UK adolescents.

Being more satisfied with romantic relationship status is associated with increased mental wellbeing in people with experience of psychosis.

Romantic relationships represent one of the most salient sources of social support. In general population studies, they are associated with both physical and psychological benefits. Research suggests that for people with psychosis, romantic relationships may also have a positive impact on a range of outcomes, but the reasons for these associations are still unclear. This study aims to investigate whether satisfaction with romantic relationships status is associated with better wellbeing outcomes in people with experience of psychosis and explore three possible psychological mediators of this relationship. Participants who had previously sought support for psychosis (n = 190) completed an online survey including measures of relationship status satisfaction (the Satisfaction with Relationship Scale) as well as measures of psychotic symptoms (the CAPE-42), general well-being (Short Warwick-Edinburgh Mental Wellbeing Scale) and several psychological variables relevant to the pathway between romantic relationships and well-being outcomes, namely loneliness, internalised stigma, self-esteem and attachment. Fearful attachment and partner criticism were negatively associated with relationship status satisfaction. Having a partner was positively associated with relationship status satisfaction. Higher levels of relationship status satisfaction were associated with lower psychotic symptoms and higher mental wellbeing. This relationship was mediated by loneliness, internalised stigma, and self-esteem. Mental health services should be mindful of the associations between romantic relationship satisfaction and wellbeing. Service users with a fearful attachment style may particularly benefit from support in this area.

Sleep hygiene behaviours mediate the association between health/e-health literacy and mental wellbeing.

Health literacy and e-health literacy are important factors helping people shape awareness of health behaviours in different aspects, including sleep hygiene behaviours. Good sleep hygiene behaviours promote sleep quality and are beneficial to overall mental wellbeing. We aimed to examine if sleep hygiene behaviours may mediate the association between health literacy/e-health literacy and mental wellbeing. Adult Iranian subjects (n = 9775; mean [SD] age = 36.44 [11.97] years; 67.3% females) completed the Health Literacy Instrument for Adults, eHealth Literacy Scale, three items on sleep hygiene behaviour that have been used in prior researchand the Short Warwick Edinburgh Mental Wellbeing Scale. Data were then subjected to structural equation modelling (SEM) including 500 bootstrapping resampling to examine whether sleep hygiene is a mediator in the relationship between health literacy/e-health literacy and mental wellbeing. Both health literacy and e-health literacy were significantly associated with mental wellbeing (r = .63 for health literacy and .39 for e-health literacy; p < .001) and sleep hygiene behaviours (r = .58 for health literacy and .36 for e-health literacy; p < .001). Sleep hygiene behaviours were significantly associated with mental wellbeing (r = .42; p < .001). Moreover, SEM that incorporated bootstrapping approaches indicated that sleep hygiene behaviours were significant mediators in the association between health literacy/e-health literacy and mental wellbeing. We conclude that health literacy and e-health literacy are associated with mental health wellbeing in the Iranian population. Additionally, the association could be mediated via sleep hygiene behaviours. The study was co-designed with healthcare providers from the vice-Chancellor's Office for Health Affairs of Qazvin University of Medical Sciences as equal partners. Moreover, the women's health volunteers were involved in the design of the study.

Prevention of Poor Physical and Mental Health through the Green Social Prescribing Opening Doors to the Outdoors Programme: A Social Return on Investment Analysis.

There is growing interest in green social prescribing and connecting with nature-based activities to promote social cohesion along with improving levels of health, wealth and well-being. The Outdoor Partnership is a third sector organisation based in North Wales offering nature based social prescribing interventions. Individuals experiencing poor mental health and wellbeing are referred from GPs, community mental health services, and third sector organisations to the 'Opening the Doors to the Outdoors' (ODO) programme which is a 12-week outdoor walking and climbing green prescribing intervention. The purpose of the ODO programme is to provide a supportive environment to increase levels of physical activity among participants leading to improvements in overall health and mental wellbeing while promoting socialisation among peers. In this evaluation of a preventative green social prescribing intervention, a mixed method social return on investment (SROI) approach used quantitative and qualitative data from ODO participants. Data collection took place from April 2022-November 2022. Mental wellbeing data was collected at baseline and at 12 weeks using the Short Warwick Edinburgh Mental Wellbeing Scale, a social trust question, an overall health question, and the International Physical Activity Questionnaire- short form. Baseline and follow-up data was available for 52 ODO participants. Results indicate that for every £1 invested in the ODO programme, social values ranging from £4.90 to £5.36 were generated.

“Make it the done thing”: an exploration of attitudes towards rest breaks, productivity and wellbeing while working from home

ObjectiveTaking regular rest breaks while working positively impacts productivity and wellbeing. While home and hybrid working styles have become a popular choice for employees, the impact of, and perceptions towards, taking breaks while working at home is poorly understood. The current research aimed to explore attitudes towards taking rest breaks while working from home and capture levels of breaks taken, wellbeing and productivity in a sample of UK white-collar workers.MethodsA mixed method approach was applied where self-report data from an online survey were gathered from individuals (N = 140) from one organisation. Open-ended questions regarding attitudes and perceptions towards rest break behaviours were obtained. Further quantitative measures included the number of breaks taken while working from home, levels of productivity (measured by the Health and performance Presenteeism subscale) and mental wellbeing (measured by the Short Warwick-Edinburgh Mental wellbeing scale). Both quantitative and qualitative analysis approaches were applied.ResultsQualitative responses indicated two overarching themes (1) Personal and (2) Organisational sat above four further themes including Movement outside, Structure of home working, Home environment and Digital presence. Additionally, quantitative findings indicated that the number of breaks taken outside was associated with positive changes in wellbeing.ConclusionEmployers could aim to support employees working from home in taking outside breaks through flexible working patterns, authentic leadership, and a change in company social norms around break behaviours. Such organisational changes could help to improve workforce productivity and wellbeing.

Effect of the COVID-19 pandemic on adolescent mental health and substance use up to March, 2022, in Iceland: a repeated, cross-sectional, population-based study.

Poor mental health in the first year of the COVID-19 pandemic has been well documented in adolescents; however, less is known about the longer-term effect of the pandemic. We aimed to examine adolescent mental health and substance use as well as covariates associated with these outcomes 1 year or more into the pandemic. A nationwide sample of adolescents aged 13-18 years enrolled in school in Iceland were invited to complete surveys administered during October-November or February-March, 2018, October-November, 2020, February-March or October-November, 2021, and February-March 2022. The survey was in Icelandic for all administrations and offered to adolescents aged 13-15 years in English in 2020 and 2022 and in Polish in 2022. Surveys assessed depressive symptoms (Symptom Checklist-90); mental wellbeing (Short Warwick Edinburgh Mental Wellbeing Scale); and the frequency of cigarette smoking, e-cigarette use, and alcohol intoxication. Covariates comprised age, gender, and migration status as determined by language spoken at home, level of social restrictions based on residency, parental social support, and sleep duration (≥8 h nightly). Weighted mixed-effect models were used to determine the effect of time and the covariates on mental health and substance use. The main outcomes were assessed in all participants with more than 80% of the necessary data, and multiple imputation was used to handle missing data. Bonferroni corrections were used to adjust for multiple testing and analyses were considered significant at a p value of <0·0017. 64 071 responses were submitted and analysed between 2018 and 2022. Elevated depressive symptoms and worsened mental wellbeing across girls and boys aged 13-18 years were observed to have been maintained up to 2 years into the pandemic (p>0·0017). Alcohol intoxication initially decreased during the pandemic but increased again as social restrictions eased (p<0·0001). No changes were observed in cigarette smoking and e-cigarette use during the COVID-19 pandemic. Higher levels of parental social support and an average sleep duration of 8 h or more per night were associated with mental health better outcomes and less substance use (p<0·0001). Social restrictions and migration background were inconsistently associated with the outcomes. Population-level prevention targeting adolescent depressive symptoms should be prioritised in health policy in the wake of COVID-19. Icelandic Research Fund.

A school-based cross-sectional study to understand the public health measures needed to improve the emotional and mental wellbeing of young carers aged 12 to 14 years

The emotional and mental wellbeing of young carers is known to be poorer than their peers. Data from a large cross-sectional school survey of 7,477 12 to 14 year olds (72 per cent response rate) living in Cornwall, South West of England, were analysed to assess whether existing school-based interventions support the wellbeing of young carers. Outcome measures were derived from the Short Warwick-Edinburgh Mental Wellbeing Scale and the Strengths and Difficulties Questionnaire. Young carers experienced greater emotional and mental wellbeing problems than their peers. Being eligible for free school meals did not attenuate these higher needs, indicating that broader support other than financial measures are needed, such as education, health and care plans which were associated with higher mental wellbeing among young carers. Early community and school-based interventions that consider the complex needs of young carers, especially emotional wellbeing, are needed.

Changes in mental well-being during the COVID-19 pandemic: A longitudinal study among Danes from 2019 to 2021

Numerous studies have shown that the COVID-19 pandemic had large influence on mental health during the first lockdown, but fewer studies have focused on the long-term influence on mental health. In a national longitudinal study, we examined mental well-being measured just before (fall 2019) and twice during (falls of 2020 and 2021) the COVID-19 pandemic. We utilized the Danish Health and Wellbeing Survey with questionnaires collected in 2019, 2020 and 2021 among the same study population consisting of 8179 persons. The outcome was mental well-being measured by the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). Linear regression models were conducted to evaluate change in SWEMWBS from 2019 to 2021. The SWEMWBS distribution was similar in 2019, 2020 and 2021, although the distribution moved to lower scores in 2020 compared to 2019 and moved slightly to higher scores in 2021 compared to 2020. Mean SWEMWBS decreased from 24.8 (95%CI 24.7–25.0) in 2019 to 24.1 (24.0–24.2) in 2020 and increased to 24.4 (24.3–24.6) in 2021 (p < 0.001). The mean decrease from 2019 to 2020 and increase from 2020 to 2021 was strongest among women, persons below age 75 years, persons without depression and among persons with higher education and with employment. In conclusion, we find that mental well-being decreased from 2019 to 2020 and slightly increased from 2020 to 2021 without reaching the pre-pandemic level. These changes are statistically significant but small and support that COVID-19 may only have had a small long-term influence on mental health in the general population.

Associations of time spent gardening with mental wellbeing and life satisfaction in mid-to-late adulthood

There is relatively limited research investigating the mental health benefits of gardening. In this cross-sectional study, survey data from 4,919 middle-aged and older adults (46–80 years, 57% women) from Brisbane, Australia, were used to examine the associations of time spent gardening (0, 1–149 or ≥150 min/week) with indicators of mental wellbeing (measured with the Short Warwick-Edinburgh Mental Wellbeing scale) and singe-item measure of life satisfaction. We also investigated whether such associations differed between younger and older age groups (≤63 years and >64 years). Multilevel linear regression models were used to control for individual- and area-level confounders (e.g., gender, neighbourhood disadvantage). Of all participants, 37% reported no gardening, 42% reported gardening for 1–149 min weekly, and 21% reported ≥150 min of weekly gardening. Compared to participants who did not engage in gardening, those who gardened for ≥150 min per week were more likely to report better mental wellbeing (β = 0.64, 95% CI [0.35, 0.93], p < .001; range 7–35) and life satisfaction (β = 0.33, 95% CI [0.18, 0.48], p <. 001; range 1–10). Stratified analyses revealed that these effects were stronger for participants aged 64 years and older. These findings contribute to a burgeoning body of research that indicates gardening may be beneficial for mental health and life satisfaction, that gardening for at least 2.5 hrs per week is linked with better mental health outcomes, and that gardening may be particularly beneficial for older adults.