Showing papers in "Journal of Mental Health in 2019"
TL;DR: To review the published research literature relating to the process of peer support and its underpinning mechanisms to better understand how and why it works, five mechanisms were found to underpin peer support relationships.
Abstract: Background: The employment of Peer Support Workers, who themselves have experience of significant emotional distress, can promote recovery at an individual and organisational level. While research examining the benefits of peer support within mental health services continues to grow, an understanding of how, and through what processes, these benefits are reached remains under-developed.Aims: To review the published research literature relating to the process of peer support and its underpinning mechanisms to better understand how and why it works.Method: A scoping review of published literature identified studies relating to peer support mechanisms, processes and relationships. Studies were summarised and findings analysed.Results: Five mechanisms were found to underpin peer support relationships (lived experience, love labour, the liminal position of the peer worker, strengths-focussed social and practical support, and the helper role).Conclusions: The identified mechanisms can underpin both the success and difficulties associated with peer support relationships. Further research should review a broader range of literature and clarify how these mechanisms contribute to peer support in different contexts.
99 citations
TL;DR: This report results from the convening of an international consortium of peer leaders from six continents to develop consensus on a common, core set of guiding principles and values to ensure a robust future for the development of effective, culturally responsive forms of peer support.
Abstract: Objective: While mental health peer support originated in its contemporary form in English-speaking countries, it is now spreading rapidly across the globe. This rapid growth presents two major challenges. The first pertains to "role integrity" and the second to the possible culture-bound nature of peer support; a concern which has attended the emergence of peer support in countries that have significantly different worldviews.Method: Recognizing the growth of peer support and the resulting challenges, this report results from the convening of an international consortium of peer leaders from six continents (all but Antarctica). Following an environmental scan of the state of peer support globally, this group moved to develop consensus on a common, core set of guiding principles and values to ensure a robust future for the development of effective, culturally responsive forms of peer support.Findings: Key principles, values and practices considered essential to peer support are presented.Conclusions and implications for practice: Assuming that sufficient political and community support are generated, there can be considerable enthusiasm for the expansion of peer support around the globe. Peer leaders are encouraged, however, to develop and deliver peer support both with integrity to its founding values in a civil rights and social justice framework and with responsiveness to local cultural worldviews.
76 citations
TL;DR: As peer workers ride over the horizon to the rescue of economically embattled mental health services the authors have occasion to pause, take stock and ask ourselves if the peer support that is currently provided is fit for purpose.
Abstract: As peer workers ride over the horizon to the rescue of economically embattled mental health services we have occasion to pause, take stock and ask ourselves if the peer support that is currently em...
75 citations
TL;DR: Stigma towards people with BPD is perpetuated through poor BPD health literacy by patients and MHPs that stalls effective treatment and engagement, and disempowers all concerned, deferring responsibility to others.
Abstract: Background: People with borderline personality disorder (BPD) experience significant stigma, particularly at the interface of care delivery.Aims: To compare and contrast what stigma looks like with...
67 citations
TL;DR: It would be prudent for interventions targeted at veterans with mental health difficulties to attempt to address the range of issues faced by this population rather than focus on a particular presenting problem.
Abstract: Background: Evidence suggests that veterans with mental health issues have poorer treatment outcomes than civilian counterparts. Understanding the difficulties faced by veterans could help focus treatments and improve outcomes.Aims: To survey a representative sample of treatment-seeking veterans to explore their mental health needs.Methods: A random sample of UK veterans who had engaged with a national mental health charity in the UK was drawn. Individuals completed questionnaires about their health, military experiences and pre-enlistment vulnerabilities.Results: Four hundred and three out of six hundred (67.2%) participants returned completed questionnaires. PTSD was the most commonly endorsed mental health difficulty (82%), followed by problems with anger (74%), common mental health difficulties (72%) and alcohol misuse (43%). Comorbidity was frequent; with 32% of those with PTSD meeting criteria for three other health outcomes versus only 5% with PTSD alone.Conclusions: Results indicate the complexity of presentations within treatment seeking veterans. These difficulties may partly explain the poorer treatment outcomes reported in veterans in comparison to the general public. As such, it would be prudent for interventions targeted at veterans with mental health difficulties to attempt to address the range of issues faced by this population rather than focus on a particular presenting problem.
59 citations
TL;DR: A theory of MHL can guide future researchers to clearly delineate important constructs and their interrelationships and help inform how to improve MHL at both the individual and community level.
Abstract: Background: Mental health literacy (MHL) is one increasingly researched factor thought to influence mental health behaviors. Researchers have argued for expanding the definition of MHL to include a...
59 citations
TL;DR: This review found medium to high quality evidence supporting the use of narrative exposure therapy (NET), and a lack of culturally adapted treatments was apparent and there was less evidence to support standard cognitive behavioural therapy, Eye Movement Desensitisation and Reprocessing (EMDR) and multidisciplinary treatments.
Abstract: Background: Europe is in the midst of the largest refugee migration since the Second World War; there is an urgent need to provide an updated systematic review of the current best evidence for managing mental distress in refugee populations.Aims: The aim of this review is to provide an exhaustive summary of the current literature on psychosocial interventions, both trauma- and non-trauma-focused, for refugee populations experiencing post-traumatic stress disorder (PTSD), depressive or anxiety symptoms. To produce recommendations for future research and current clinical practice.Method: Searches were conducted in PubMed, PsychINFO (Hosted by Ovid), PILOTS and Social Services Abstracts; 5305 articles were screened and 40 were included.Results: This review found medium to high quality evidence supporting the use of narrative exposure therapy (NET). A lack of culturally adapted treatments was apparent and there was less evidence to support standard cognitive behavioural therapy (CBT), Eye Movement Desensitisation and Reprocessing (EMDR) and multidisciplinary treatments.Conclusion: NET produced positive outcomes in refugees from a diverse range of backgrounds and trauma types. There is a general dearth of research in all intervention types: further research should include more "real-world" multidisciplinary interventions that better model clinical practice. Recommendations for evaluating local need, and creating a culturally sensitive workforce are discussed.
59 citations
TL;DR: For adolescents, gender appears to play a significant, but not exclusive, role in the inclination to seek professional help for mental health problems.
Abstract: Background: While the onset of many mental health problems occurs in adolescence, these problems are severely undertreated in this age group. To inform early intervention for adolescents, we investigated the effect of gender and education type on perception of barriers to help seeking, mental health literacy, and the awareness and use of mental health services. Method: A web-based survey using vignettes, open-ended and multiple choice items was administered to upper secondary school students in two counties in Norway. Results: The survey was completed by 1249 students (88% response rate) with an average age of 17.6 years and 56% were female. Compared to males, the females were better in identifying psychological problems of anxiety and trauma, awareness of mental health services (p < 0.001) and perceived more barriers for seeking help (cost and waiting time; p < 0.001). For use of all mental health services, the effect of education type was greater than the effect of gender. Conclusion: For adolescents, gender appears to play a significant, but not exclusive, role in the inclination to seek professional help for mental health problems. We hypothesise that the observed gender difference in use of services is related to the gender difference in awareness of referral pathway services and the influence of parents in help-seeking process.
54 citations
TL;DR: The need for further research examining the perspectives of suicidal middle-aged men and their close family and friends is demonstrated.
Abstract: Background: Male suicide rates are higher than their female counterparts in almost every country around the world. Several developed countries have attempted to implement suicide prevention program...
47 citations
TL;DR: Better understanding of philosophical differences and collaborative planning and service delivery may foster shared approaches in CAMHS and AMHS to better meet the needs of transitioning youth.
Abstract: Background: Differences in care philosophies may influence transitions from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). Aims: To review literature about CAMHS and AMHS care philosophies and their influence on transitions. Method: MEDLINE, PsycINFO, Embase and CINAHL databases were searched electronically using keywords related to transitions, youth and mental disorders. Content relating to philosophies of care was searched manually. Descriptive themes were extracted and the analysis suggested four hypotheses of how care philosophies influence transitions. Results: Of the 1897 identified articles, 12 met eligibility criteria. Findings reveal consistent differences in care philosophies between CAMHS (developmental approach, involving families and nurturing) and AMHS (clinical/diagnosis-focus, emphasis on client autonomy and individual responsibility). Conclusions: Better understanding of philosophical differences and collaborative planning and service delivery may foster shared approaches in CAMHS and AMHS to better meet the needs of transitioning youth.
46 citations
TL;DR: In this article, early identification of probable post-traumatic stress disorder (PTSD) can lead to early intervention and treatment, using supervised machine learning (ML) for early diagnosis and treatment.
Abstract: Background: Early identification of probable post-traumatic stress disorder (PTSD) can lead to early intervention and treatment.Aims: This study aimed to evaluate supervised machine learning (ML) c...
TL;DR: Negative conditions in self-perceived emotional or overall health condition are associated with the increased likelihood of smartphone overuse in Korean college students.
Abstract: Background: Several studies suggest that subjective health status is closely related to various behavioral addictions, but there are few studies on smartphone overuse.Aim: This study investigated t...
TL;DR: Lived experience practitioners can provide a vital contribution to stigma reduction broadly, however, the stigma and discrimination they face within work roles must be addressed to allow this contribution to be effective.
Abstract: Background: Lived experience practitioners can contribute to improved outcomes for people with mental illness, supplementing traditional mental health services and reducing health care costs. Howev...
TL;DR: By understanding the challenges facing researchers, and drawing on the factors that encourage and support those already engaging with young people, a framework to support genuine and meaningful youth participation in mental health research can be developed.
Abstract: Background: Involving young people in co-designing and conducting youth mental health research is essential to ensure research is relevant and responsive to the needs of young people. Despi...
TL;DR: The MDRS-22 is the first male-sensitive depression scale to be psychometrically validated using CFA techniques in independent and cross-nation samples and was effective for identifying those with a recent suicide attempt.
Abstract: Background: Clinical practice and literature has supported the existence of a phenotypic sub-type of depression in men. While a number of self-report rating scales have been developed in order to e...
TL;DR: Based on a large, representative sample of Chinese undergraduate students, the Chinese version of the SCL-90 revealed both strengths and limitations, suggesting the need for further research.
Abstract: Background: Despite the widespread application of the Chinese version of Symptom Check List 90 (SCL-90) amongst undergraduate students, researchers have not thoroughly evaluated its psychometric fe...
TL;DR: The pilot findings indicate that most patients who read open therapy notes find them valuable for understanding and engaging in their mental health care, with minimal adverse effects.
Abstract: Background: Though patients’ access to clinicians’ visit notes may improve patient engagement and strengthen patient–clinician relationships, it is unknown whether these benefits extend to ...
TL;DR: While, a number of items demonstrated minor metric invariance, there was no evidence that they influenced overall scores meaningfully, and findings have implications for the use of the RCADS in an English-speaking European population.
Abstract: Background: The psychometric properties of the Revised Child Anxiety and Depression Scale (RCADS) have been established cross-culturally, yet psychometric evidence is lacking for an English-speaking European population. Aim: This research sought to further cross-validate the measure in a non-clinical Irish adolescent sample, and to test for gender and age-based differential item functioning in depression and anxiety. Method: Participants were Irish second-level school students (N = 345; 164 male; 12-18 years, M =14.97, SD = 1.44). Confirmatory factor analysis for categorical data (confirmatory item factor analysis) and multiple-indicator multiple-cause (MIMIC) modelling to identify items displaying possible metric invariance were conducted. Results: A six-factor model fit the data well in both gender samples and both school cycles, as a proxy for age samples. Gender-based metric invariance for 5 of 47 items and age-based metric invariance for three items were identified. However, the magnitudes were small. Internal consistency and validity were also established. Conclusions: While, a number of items demonstrated minor metric invariance, there was no evidence that they influenced overall scores meaningfully. The RCADS can reasonably be used without adjustment in male and female, younger and older, adolescent samples. Findings have implications for the use of the RCADS in an English-speaking European population.
TL;DR: All those involved in the management of SMI must be aware of how social support networks hinder or contribute to recovery and to identify the barriers that prevent social networks from being mobilized.
Abstract: Background: Social networks are known to have a major influence on the recovery journey of people with severe mental illness (SMI).Aims: To understand the role of bonding and bridging social capital in the recovery process following SMI and to identify the barriers that prevent social networks from being mobilized.Method: A review of major electronic databases for qualitative studies from 2006 to 2015 (41 papers) was undertaken for thematic synthesis.Result: The main themes for bonding social capital included: a buffer for isolation and loneliness, variations depending on illness stages, balance in relationships and connections as a source of self-management. Main themes for bridging social capital comprised: feeling powerless and excluded from community/health care, social care beyond the illness, social care barriers and social inclusion through community groups.Conclusion: All those involved in the management of SMI must be aware of how social support networks hinder or contribute to recovery. ...
TL;DR: The results suggest that stigmatization toward different mental illnesses stem from combinations of different stigmatized beliefs, and regardless of participants’ own depression status, their perceptions that depression is controllable predicted depression-related stigmatization.
Abstract: Background: Although mental health stigmatization has myriad pernicious consequences, it remains unknown whether mental disorders are stigmatized for the same reasons.Aims: This study identified th...
TL;DR: Education campaigns may be effective by focusing on aspects of MI highlighting similarity with non-diagnosed people, and that people with MI can recover, according to a study of university students.
Abstract: Background: Stigma associated with mental illness (MI) results in underutilization of mental health care. We must understand factors contributing to stigma to shape anti-stigma campaigns.Aims: To investigate the factors influencing stigma in university students.Method: Undergraduate psychology students completed measures on causal attribution, stigma, social distance, implicit person theory (IPT), and familiarity.Results: The hypothesis was partially supported; people who felt personality traits were unchangeable (i.e. entity IPT) were more likely to stigmatize individuals with mental disorders and desired more social distance from them. Familiarity with people with a MI individually predicted less desire for social distance, yet the redundancy of the predictors made the effect of familiarity on stigma fall just short of statistical significance. Judgments of biogenetic causal attribution were related to higher stigma levels, but not so when familiarity and IPT were taken into account.Conclusions:...
TL;DR: People with schizophrenia develop ways of being resilient to negative events which should inform therapeutic interventions, and this study investigated resilience to negative stressors in people with disorders on the schizophrenia spectrum using a qualitative methodology.
Abstract: Background: Negative stressors can aggravate the impact of schizophrenia. However, some people find ways of combating such stressors. There is a dearth of research examining factors which enable in...
TL;DR: Consumer participation can contribute positively to nurse education, however representativeness presents a major barrier, potentially enabling nurses to dismiss experiences of consumer academics and educators as exceptional rather than typical.
Abstract: Background: Developing recovery-oriented services, and ensuring genuine consumer participation in all aspects of services are central components of contemporary Australian mental health policy. However, attitudes of mental health professionals present a significant barrier. Given the positive impact of education on health professionals’ attitudes, particularly when consumers are involved, further exploration of consumer involvement in education is required.Aims: To enhance understanding of the role consumers can play within mental health nursing education.Method: A qualitative exploratory project was undertaken involving individual interviews with mental health nurse academics and consumer educators.Results: Two main themes emerged from nurse participants: Recovery in action, consumer educators were able to demonstrate and describe their own recovery journey; and not representative, some participants believed consumer educators did not necessary reflect views and opinions of consumers more broadly...
TL;DR: It is suggested that multifaceted strategies for advancing collaboration with consumers are most effective and it is imperative to attend to several barriers simultaneously to redress the inherent power disparity.
Abstract: Background: Collaboration between researchers who have lived experience of mental illness and services (consumer researchers) and mental health researchers without (other mental health researchers)...
TL;DR: Support for the reliability and validity of T-PSS-10 is provided suggesting that it can be used as a screening instrument by health professionals working with Turkish college students.
Abstract: Background: The Turkish version of the Perceived Stress Scale (T-PSS-10) measures the extent to which situations in one’s life are appraised as stressful.Aims: The purpose of this study was to eval...
TL;DR: The paper highlights the potential for individuals to access dynamic and responsive support within online forums and reflects upon the major areas that mental health professionals need to be aware of when entering into this arena.
Abstract: Background: Young people increasingly look towards the Internet for support. Online forums have been developed to provide mental health support, but they have received little attention in the resea...
TL;DR: Community mental health rehabilitation service-users risk finding themselves excluded by a “digital divide” and action is needed to ensure equal access to online opportunities, including healthcare innovations.
Abstract: Background: UK society is undergoing a technological revolution, including meeting health needs through technology. Government policy is shifting towards a “digital by default” position. Studies have trialled health technology interventions for those experiencing psychosis and shown them to be useful.Aims: To gauge levels of engagement with mobile phones (Internet-enabled or cell phone), computers and the Internet in the specific population of community mental health rehabilitation.Method: Two surveys were conducted: with service-users on use/non-use of technologies, and interest in technology interventions and support; and with placements on facilities and support available to service-users.Results: Levels of engagement in this population were substantially less than those recorded in the general UK and other clinical populations: 40.2% regularly use mobiles, 17.5% computers, and 14.4% the Internet. Users of all three technologies were significantly younger than non-users. Users of mobiles and co...
TL;DR: With appropriate research and careful implementation, e-mental health has the potential to be a valuable part of mental healthcare in developing countries.
Abstract: Background: e-Mental health services have the capacity to overcome barriers to care and reduce the unmet need for psychological services, particularly in developing countries. However, it is unknow...
TL;DR: The results of this study indicate that a brief intervention based on improv exercises may provide a strong and efficient treatment for patients with anxiety and depression.
Abstract: Background: Improvisational theater exercises (improv) are used in various settings to improve mental health and medical outcomes. However, there is little documented evidence of the effect...
TL;DR: It was found that the well-being variables loaded on three separate factors, indicating that the tripartite model was consistent with the data, and structural and discriminant validity was supported.
Abstract: Background: The tripartite model of mental well-being offers a comprehensive account of the nature of mental well-being. According to this model, mental well-being is composed of three distinct yet related dimensions of subjective (hedonic), psychological and social well-being.Aims: The present study investigated the structural and discriminant validity of the three well-being factors.Methods: A large American sample (N = 2732) was used. Data were analyzed using both Confirmatory Factor Analysis (CFA) and Exploratory Structural Equation Modeling (ESEM).Results: It was found that the well-being variables loaded on three separate factors, indicating that the tripartite model was consistent with the data. Discriminant validity was further evidenced by moderate correlations between the latent factors, and differential relationships with the Big Five personality traits. ESEM proved to be a more appropriate approach for analyzing the data given the presence of cross-loadings.Conclusions: These results s...