Mental Health Tools Research Articles

Quando un gruppo di pazienti adolescenti diventa luogo comune in oncoematologia pediatrica

The group tool in mental health has a long tradition developed during the Second World War with the groups of traumatized soldiers created in England. In Pediatric Oncohematology the group does not have a very long history behind it; some experiences of support for younger patients, but above all for adolescents are reported. In 2020 a group with adolescent patients was founded at the Pediatric Oncohematology Service of the “Vito Fazzi” Hospital in Lecce, born as an experiential group and grown over time in numbers and in the perspective not only of elaborating the common experience but also of working together on supportive projects for children and above all for adolescents at diagnosis. After more than two years of weekly work, the group has changed and is now working on a new balance which, without renouncing the pleasure of helping children and peers, does not forget its mandate to process the experience.

Lessons Learned in Using the Score of Perceived Outcomes (ScoPeO) Tool in Mental Health and Psychosocial Support Programmes to Measure Quality of Life

Lessons Learned in Using the Score of Perceived Outcomes (ScoPeO) Tool in Mental Health and Psychosocial Support Programmes to Measure Quality of Life

Development and validation of tools to screen occupational mental health and workplace factors influencing it: for the Indian workforce.

An imbalance in the key organizational psychology constructs viz. "Workload", "Reward", "Community", "Control", "Values" and "Fairness" are potential factors leading to negative occupational mental health, i.e. burnout. Burnout, a psychological syndrome is the combination of emotional exhaustion, sense of reduced compassion and accomplishment. To note, the concept of occupational mental health in a nation with second largest workforce is nascent. Further, the utility of existing western tools in Indian subcontinent is limited by culturally inappropriateness, patented, less comprehensible and other factors. Present study attempted to develop tools to screen occupational mental health and workplace areas. Conventional steps involved in psychological tool development, viz. construct identification, drafting of pertinent questions, content validation, field testing of questions and others were adopted. After series of steps, tools for screening occupational mental health and key constructs influencing mental health at workplace (workplace assessment) were developed. The screening tools exhibited adequate test-retest reliability, internal consistency/reliability (cronbach's α>0.73) and correlation (correlation coefficient >0.6) with the general mental health in larger evaluation of 153 consenting workers. The proposed simple and easy to administer tool requires development of normative scores thereby aiding early diagnosis and management of those requiring intervention.

What have been the clinical outcomes of the Project Synergy/InnoWell digital health platform?

Project Synergy is a digital mental health tool for assessment, referral and follow-up of people with mental health problems. The Australian federal government Department of Health entered an AUD33 million formal funding arrangement with InnoWell, a proprietary company vehicle (primarily the consultancy firm PwC and University of Sydney) to continue development of Project Synergy. This followed an initial federal National Health and Medical Research Council grant of AUD5.5 million over the previous 3 years. However, based on the assessment of peer-reviewed research data, the Project Synergy/InnoWell platform does not seem to have demonstrated clinical outcomes of healthcare value to date.

Feasibility and preliminary efficacy of training health workers in detecting Priority Mental Health Conditions among adolescents in rural South India

IntroductionHalf of all mental disorders start during adolescence, before 14 years. In India, the current prevalence of mental disorders in 13–17 years age group was 7.3%. Many gaps persist in the mental healthcare delivery through the national mental health program, the low psychiatrist population ratio being one of them. Community health workers can play an essential role in providing mental healthcare in such resource-constrained settings. The World Health Organization mental health gap action program (WHO mhGAP) is a widely studied mental health tool that health workers can use to identify mental disorders. The study’s aim was to test the preliminary efficacy of training healthcare workers (HCWs) in identifying mental health conditions among adolescents using modified WHO mhGAP modules.MethodsThe feasibility study was carried out in two Primary Health Centers (PHCs) in rural Bengaluru. Study had two components: (1) training of HCWs on adolescent mental health and (2) detection of selected priority mental health conditions among adolescents by trained HCWs. HCWs were trained in five adolescent mental health conditions using a training manual and modified WHO mhGAP modules that excluded emergency presentations and management sections. Pre- and post-training assessments were carried out. A sample of 272 adolescents attending PHCs were assessed for any mental health condition by HCWs using mhGAP modules. A sub-sample of adolescents and all adolescents identified by HCWs with a mental health condition was interviewed by the investigator to validate the diagnosis. Qualitative interviews were carried out with participating HCWs to understand the acceptability of the intervention, acceptability, and barriers to training in identifying mental health conditions among adolescentsResultsA total of 23 HCWs underwent training. There was a significant increase in the mental health knowledge scores of HCWs post-training compared to baseline (p value <0.001). Out of 272 adolescents, 18 (6.8%) were detected to have any mental health condition by HCWs as per the modified WHO mhGAP modules. A sample of 72 adolescents consisting of all adolescents identified with a mental health condition by HCWs and a random sample of adolescents without any diagnosis were validated by the research investigator (AS). There was a good agreement between diagnosis by health workers and the research investigator with a Cohen’s Kappa of 0.88. Four themes emerged from the qualitative analysis.ConclusionsTraining was effective in improving the knowledge of HCWs. There was a good agreement between trained HCWs and the investigator in detecting adolescent mental health conditions using modified mhGAP modules. The modified WHO mhGAP can thus be used by trained non-specialist HCWs to screen for adolescent mental health conditions in primary health centers.

Feasibility of a secondary school-based mental health intervention: Reprezents' On The Level.

There is a need for innovative school-based mental health interventions to promote good mental health, healthy coping strategies, and engagement with support services. Consequently, Reprezent, a youth development organization, with mental health professionals and young people co-developed an online mental health intervention show, On The Level (OTL). This study assessed the acceptability and feasibility of delivering OTL to young people (aged 11-18years) in 36 secondary schools across London and Essex, UK. OTL was delivered online as part of the school curriculum, in classrooms at timepoint 1 (T1, 50min). Follow-up data was collected at timepoint 2 (T2) 4-6weeks later, during a 20-min OTL review show. For interactive OTL elements and data collection participants logged into an online survey. Measures of acceptability and engagement, mental health and well-being outcomes and intervention evaluation were taken at T1 and T2. We also assessed the feasibility of implementing the OTL intervention in secondary schools. 10,315 participants received the intervention (T1) and 3369 attended the follow-up session (T2), this high attrition, and potential selection bias, was due to only 30% of schools being able to take part in T2. Rates of acceptability were high among young people and school staff. At T1, 88% found OTL engaging, and 84% felt more confident they had the tools to help them better manage stress and anxiety. At T2, 66% viewed mental health in a more positive way, and 71% had better understanding of how to maintain good mental health. Rates of engagement with mental health tools and services were good, and significant reduction in levels of stress were found 4-6weeks after the OTL show (T2). The low mental health and well-being indices reported by the school children at baseline strongly support the need and use for a mental health intervention such as OTL in secondary schools. These findings indicated good feasibility and acceptability of OTL intervention and support the delivery of the OTL mental health intervention at UK-based secondary schools to educate young people about mental health and well-being and give them the necessary tools to support their mental health.

Focusing on Uptake: The Evolution of an Evidence-Informed Classroom Resource for Student Mental Health

It is widely recognized that the most effective student mental health interventions, tools, and resources are those that are solidly grounded in theory, evidence, and practice. But developing interventions in this way can be a time-consuming, challenging process. This article describes the process of developing a classroom resource to build social emotional learning skills among high school students in Ontario. The resource was informed by the latest research evidence while also being sensitive to the implementation context and needs of educators and students. In creating, evaluating, and revising these resources over several years, lessons have emerged about what it takes to navigate inherent challenges, balance competing needs and priorities, and ultimately develop an intervention that is both evidence-informed and implementation sensitive. Flexible funding, effective partnerships, and a commitment to contextual responsivity are key.

Finding voice in a year of collective trauma: Case study of an online photovoice project with youth.

In this article, we share findings from a qualitative case study of a virtual youth photovoice program implemented across three regions of the United States. The purpose of the program was to engage youth in research on a social issue relevant to them during an unprecedented year marked by two public health crises, COVID-19 and anti-Black racial violence. Results of an analysis of curriculum and archival program materials lend support for online strategies for youth engagement including individualized support and online audiovisual presentations with avatars. Racial justice and trauma-informed adaptations were designed to be responsive to youth needs for flexible programming and safe spaces. Themes captured in the first online gallery of youth photos include (1) tools for mental health, (2) meaningful connection, and (3) community advocacy, bringing attention to structural issues as well as family and community strengths. Findings suggest photovoice can be thoughtfully adapted for youth researchers and support individual and group storytelling in response to collective trauma.

Remote mental health care interventions during the COVID-19 pandemic: An umbrella review

Mitigating the COVID-19 related disruptions in mental health care services is crucial in a time of increased mental health disorders. Numerous reviews have been conducted on the process of implementing technology-based mental health care during the pandemic. The research question of this umbrella review was to examine what the impact of COVID-19 was on access and delivery of mental health services and how mental health services have changed during the pandemic. A systematic search for systematic reviews and meta-analyses was conducted up to August 12, 2022, and 38 systematic reviews were identified. Main disruptions during COVID-19 were reduced access to outpatient mental health care and reduced admissions and earlier discharge from inpatient care. In response, synchronous telemental health tools such as videoconferencing were used to provide remote care similar to pre-COVID care, and to a lesser extent asynchronous virtual mental health tools such as apps. Implementation of synchronous tools were facilitated by time-efficiency and flexibility during the pandemic but there was a lack of accessibility for specific vulnerable populations. Main barriers among practitioners and patients to use digital mental health tools were poor technological literacy, particularly when preexisting inequalities existed, and beliefs about reduced therapeutic alliance particularly in case of severe mental disorders. Absence of organizational support for technological implementation of digital mental health interventions due to inadequate IT infrastructure, lack of funding, as well as lack of privacy and safety, challenged implementation during COVID-19. Reviews were of low to moderate quality, covered heterogeneously designed primary studies and lacked findings of implementation in low- and middle-income countries. These gaps in the evidence were particularly prevalent in studies conducted early in the pandemic. This umbrella review shows that during the COVID-19 pandemic, practitioners and mental health care institutions mainly used synchronous telemental health tools, and to a lesser degree asynchronous tools to enable continued access to mental health care for patients. Numerous barriers to these tools were identified, and call for further improvements. In addition, more high quality research into comparative effectiveness and working mechanisms may improve scalability of mental health care in general and in future infectious disease outbreaks.

Meeting Young Adults' Social Support Needs across the Health Behavior Change Journey: Implications for Digital Mental Health Tools.

In pursuit of mental wellness, many find that behavioral change is necessary. This process can often be difficult but is facilitated by strong social support. This paper explores the role of social support across behavioral change journeys among young adults, a group at high risk for mental health challenges, but with the lowest rates of mental health treatment utilization. Given that digital mental health tools are effective for treating mental health conditions, they hold particular promise for bridging the treatment gap among young adults, many of whom, are not interested in - or cannot access - traditional mental healthcare. We recruited a sample of young adults with depression who were seeking information about their symptoms online to participate in an Asynchronous Remote Community (ARC) elicitation workshop. Participants detailed the changing nature of social interactions across their behavior change journeys. They noted that both directed and undirected support are necessary early in behavioral change and certain needs such as informational support are particularly pronounced, while healthy coping partnerships and accountability are more important later in the change process. We discuss the conceptual and design implications of our findings for the next generation of digital mental health tools.

Effect of the COVID-19 pandemic on the mental health, daily and occupational activities among health professionals in Colombia: a national study

BackgroundThe COVID-19 pandemic has placed an unprecedented physical and mental burden on healthcare workers who are frequently at high risk of infection, particularly in low-income countries. This study aimed to assess the prevalence and associated factors of anxiety, depression, and stress, as well as changes in daily and occupational activities among healthcare professionals due to the COVID-19 pandemic in Colombia.MethodsAn observational, cross-sectional study was conducted between February and June 2021. The survey incorporated validated mental health tools such as the Generalized Anxiety Disorder–7, the Patient Health Questionnaire-9, and the Perceived Stress Scale-10. Multivariable ordinal logistic regression analysis was performed to determine the factors associated with severe mental health outcomes.ResultsAmong 1345 healthcare workers the prevalence of anxiety, depression, and stress were 75.61, 59.18, and 53.09%, respectively. Anxiety (OR:1.44; 95%CI:1.16–1.8), depression (OR:1.74; 95%CI:1.27–2.37), and stress (OR:1.51; 95%CI:1.18–1.94) were more frequent in women, and individuals who expressed fear of a negative outcome (death, sequelae) (OR:2.25; 95%CI:1.60–3.25), (OR:1.49; 95%CI:1.03–2.16) and (OR:2.36; 95%CI:1.69–3.29) respectively. Age was negatively associated with anxiety (OR:0.98; 95%CI:0.98–0.99), stress (OR:0.98; 95%CI:0.97–0.99), and depression (OR:0.97; 95% CI:0.96–0.98). Reduction in consultations and surgeries (OR:1.01; 95%CI:1.0–1.01) was positively associated with anxiety. Due to the pandemic, most specialists expected to incorporate drastic long-term (> 1 year) changes in their clinical setting and daily activities.ConclusionsThe prevalence of anxiety, depression, and stress is higher among Colombian healthcare workers compared to previous reports. Further research regarding these psychological outcomes is needed to achieve early mental health intervention strategies.Trial registrationHospital Universitario Fundación Santa Fe, Ethical Committee Registration ID: CCEI-12992-2021.

How did female survivors of abuse use the arts to support their mental health and wellbeing during the COVID-19 pandemic? A qualitative exploration of their views

BackgroundGender-based violence is an important public health issue that has been exacerbated by the COVID-19 pandemic. Survivors often face barriers when seeking support for mental health and wellbeing and some find therapeutic value in creative arts. We aimed to explore how women with experiences of abuse used art during the pandemic to support mental health and wellbeing. MethodsIn two small, exploratory, qualitative studies, we conducted semi-structured online interviews with women aged 18 years or older, who had experienced gender-based violence, were currently safe from abuse, and were not living with someone who had been abusive. Women who were unable to speak, read, and understand study documentation in English were excluded. We recruited participants through our networks, third-sector services, and via social media. Interview questions asked participants about interest in the arts as a support tool for mental health after abuse and strategies used during the pandemic to support mental health or wellbeing. ARM analysed the dataset using reflexive thematic analysis using Nvivo. FindingsWe enrolled 20 women aged 24–61 years; 17 participants (85%) identified as White British. Interviews were conducted between April 16, 2021, and March 1, 2022. Participants reported using drawing, writing, singing, music, painting, and online art or craft groups to support their mental health and wellbeing during the pandemic. Participants said they were motivated at the start of the first UK lockdown to engage with creative arts as a way of practising mindfulness and self-reflection; providing calmness, escapism, and distraction; reducing boredom; and combating loneliness and social isolation. Although self-isolating, the social element of online art groups provided valuable opportunities for chat with others who shared similar lived experiences. InterpretationCreative arts provided a valuable resource for participants to self-manage their mental health and wellbeing during the pandemic. Connecting with others who had similar experiences of abuse supported coping and feelings of certainty. We conclude with a working example of how online platforms could provide avenues of support and community. FundingWellcome Trust.

Interrupting the Cycle: Association of Parental Stress and Child/Youth Psychotropic Medication Nonadherence

Efficacy of psychotropic medication depends in large part on successful adherence to prescribed regimens. This study investigated child/youth nonadherence in relation to family dynamics and informal support. The participants were 10,225 children and youth prescribed psychotropic medication and receiving services from 50 Ontario mental health agencies, assessed with the interRAI™ Child and Youth Mental Health (ChYMH) and ChYMH-Developmental Disability (ChYMH-DD) tools. Findings suggest a cycle of parental stress and child/youth medication nonadherence possibly leading to or even perpetuated by worsening psychiatric symptoms. Informal supports do not appear to moderate this cycle. While the present data cannot speak to causes of medication nonadherence in children/youth or where the cycle begins, the results are consistent with the extant literature calling for attention to parental wellbeing to support children/youth for optimal therapeutic benefits. Understanding home dynamics related to nonadherence can assist care planning that engages the family to achieve best possible child/youth outcomes.

Challenges in simultaneous validation of mental health screening tools in multiple languages: Adolescent assessments in Hausa and Pidgin in Nigeria

BackgroundWith growing global recognition of the need to address mental health, a key challenge is determining who needs mental health services. Most self-report screening tools were developed in English-speaking high-income settings, and this cultural milieu influences the types and content of items, the manner in which items are asked, and the options for responding to items. Approaches have been developed for transcultural translation and validation. However, these approaches are typically applied in one language at a time, which is of limited utility in linguistically diverse settings. MethodsTo address challenges in cross-cultural validation, we undertook a unique process of simultaneously validating tools in two languages in Nigeria. Through this dual-language validation, we explored how cultural and contextual differences may influence what is considered valid for a mental health tool. We validated the Depression Self Rating Scale, Child PTSD Symptom Scale (CPSS), and Disruptive Behavior Disorders Rating Scale with a community sample of 330 adolescents aged 12–17. Validity was assessed in Hausa and Pidgin, two languages commonly spoken in Nigeria. Clinical psychologists used the Kiddie-Schedule for Affective Disorders and Schizophrenia to establish caseness. ResultsMost items had good discriminant validity, except on the CPSS, on which only 8 of 17 items discriminated by caseness. Findings indicate the influence of culture (e.g., linguistic differences in translatability of items) and context (e.g., items that reflect experiences of hunger or foodborne illness; different PTSD caseness by language might reflect differential trauma exposure between populations). We also identified items that operated differently between languages. ConclusionWe identified shortcomings in cross-cultural validation procedures with regard to determining whether language, context, or or other differences influence performance of items. For future validation efforts, we recommend systematically collecting information on context and stressful/traumatic exposures as a way to contextualize interpretation of the validity findings. AcronymsDepression Self Rating Scale (DSRS), Child PTSD Symptom Scale (CPSS), Disruptive Behavior Disorders Rating Scale (DBDRS), Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), Area Under the Curve (AUC), Diagnostic Odds Ratio (DOR), Low- and Middle-Income Countries (LMICs), Posttraumatic Stress Disorder (PTSD).

Tourism as a Tool in Nature-Based Mental Health: Progress and Prospects Post-Pandemic.

The healthcare sector recognises the role of nature in mental health. The tourism sector is equipped to take people to national parks. The conservation sector gains support from visitors. Theoretical frameworks for mental health benefits from nature tourism include: tourism destinations and activities; tourist personalities and life histories; sensory and emotional components of tourist experiences; and intensity and duration of memories. Mental health deteriorated worldwide during the COVID-19 pandemic. Recovery of global economic productivity requires immediate, accessible, affordable mental health measures at national scales, and nature-based approaches provide the best option. Different countries have adopted a variety of public, private, or voluntary mechanisms. Some focus on design of activities, others on provision of facilities. Costs and implementation depend on key research questions: marginal benefits of nature tour guides or psychologists compared to self-guided nature experiences; comparisons between repeated brief visits and one-off nature holidays; effects of biodiversity, flagship species, and scenic or wilderness quality; and differences between individuals, depending on personalities, life histories, and mental health status and symptoms.

1.72 Psychotropic Medication Nonadherence in the Context of the Family

1.72 Psychotropic Medication Nonadherence in the Context of the Family

APA Debuts Mental Health Innovation Exchange

APA Debuts Mental Health Innovation Exchange

32.1 A Hybrid Trial Design to Introduce and Evaluate a Care Bundle for Mental Health Presentations to Pediatric Emergency Departments Across Canada

Emergency departments (EDs) are vital care settings for children during mental health crises. However, most EDs do not require the use of pediatric-specific mental health tools or have family-centered procedures in place to guide care. In this presentation, I will describe a trial designed to compare the effectiveness of routine ED mental health care to a novel care bundle that introduces new tools and procedures to care. I will also describe partnerships to support trial conduct and substudies designed to add value to the trial’s findings.

Changes in postoperative quality of life of pediatric total colonic aganglionosis patients: effect of pull-through technique.

To assess mid-/long-term quality of life (QOL) of total colonic aganglionosis (TCA) patients. Modified pre-existing QOL assessment tools for general lifestyle (GL), bowel function (BF), and mental health (MH) were administered to postoperative TCA patients from five institutions, who were at least 7years old to compare Duhamel (with pouch) and Swenson/Soave (without pouch) techniques between children (Ch 7-12years old), teenagers (Tn 13-19), and adults (Ad 20 and over). For MH, caregivers were also interviewed, but separately. Maximum scores were 12 for GL/MH and 18 for BF. There were 32 subjects. GL and BF scores increased significantly from Ch (GL 4.8 ± 2.5, BF: 11.3 ± 4.6) to Tn (GL 7.8 ± 2.6, BF 16.2 ± 3.0); scores for MH did not change significantly. Mean caregiver MH scores were significantly lower than mean subject MH scores for all age groups (subject scores: 10.1, 10.7, 10.7 versus caregiver scores: 6.8, 7.8, 8.1 for Ch, Tn, Ad, respectively). PT technique/presence of a pouch did not influence the incidence of enterocolitis or QOL scores. MH responses showed subjects felt better than caregivers believed. This discrepancy could cause conflict despite steadily improving GL/BF. QOL was unaffected by PT technique/presence of a pouch.

A new complex mental health test in a positive psychological framework.

According to the Maintainable Positive Mental Health Theory (MPMHT), the main pillars of positive mental health are global well-being, efficient coping that enables an individual to maintain positive conditions and functioning, savoring capacity, resilience, and dynamic self-regulation. This study presents the validation of a new five-scale mental health test (MHT), the MHT that operationalizes MPMHT. The methodology comprised two online cross-sectional studies using self-report questionnaires. Participants in Study I (n = 1,736; 448 males, 1,288 females; mean age 51.3 years; SD = 11.6 years) filled in the MHT, the Flow, the Positive emotions, Engagement, Positive Relationship, Meaning, Accomplishment Questionnaire (PERMA-Profiler), and the Flourishing Scale. Participants in Study II (n = 1,083; 233 males, 847 females; mean age 33.9 years; SD = 12.2 years) filled in the MHT, the Shortened Aspiration Index, the short form of the Beck Depression Inventory, the WHO Well-Being Index, the Satisfaction with Life Scale, the Purpose in Life Test, and the Schema Questionnaire–Short Form. Exploratory factor analysis (EFA) identified a five-factor structure with 17 items in Study I that was confirmed with excellent fit measures in confirmatory factor analysis in Study II. Both studies indicated a high level of internal consistency (above 0.70). In each subscale, a minimum part of 44% did not overlap with the set of the other subscales. The content validity of the subscales was confirmed by 10 tests of mental health. We found a positive correlation of the self-regulation and resilience subscales with age, while women showed a higher level of savoring than men at all age levels. When Study I was replicated after 2 weeks and again after 11 months, excellent internal consistency and good test–retest correlation values of the MHT scales were found. The MHT can thus be considered a reliable and valid measurement tool for mental health.