Neighbourhood & Mental Health During Covid-19: Any Link?

Research Paper Title

Examine the associations between perceived neighbourhood conditions, physical activity, and mental health during the COVID-19 pandemic.

Background

This study examined how neighbourhood conditions changed and how neighbourhood conditions were associated with physical activity and mental health during the COVID-19 pandemic among Americans.

Methods

The major outcomes were stratified by the neighbourhood’s poverty and regression models were used to assess the associations between neighbourhood conditions and their change during the pandemic and the outcomes of physical activity and mental health.

Results

The results show that low-poverty neighbourhoods had more health-promoting neighbourhood conditions before the outbreak and more positive changes during the outbreak. Health-promoting neighbourhood conditions were associated with higher physical activity and moderate physical activity and lack of negative neighbourhood conditions such as crime/violence and traffic were associated with a lower risk of mental health problems including loneliness, depression, and anxiety. Mental health problems were also significantly associated with the COVID-19 infection and death and household income level.

Conclusions

The findings suggest that it is plausible that the disparities of physical activity and mental health by neighbourhood exacerbate due to the pandemic and people who are living in socioeconomically disadvantaged neighbourhoods bear increasingly disproportionate burden.

Reference

Yang, Y. & Xiang, X. (2021) Examine the associations between perceived neighborhood conditions, physical activity, and mental health during the COVID-19 pandemic. Health & Place. doi: 10.1016/j.healthplace.2021.102505. Online ahead of print.

Book: Community Psychology – Linking Individuals and Communities

Book Title:

Community Psychology – Linking Individuals and Communities.

Author(s): James Dalton, Maurice Elias, and Abraham Wandersman.

Year: 2011.

Edition: Third (3rd).

Publisher: Cengage Learning Custon Publishing.

Type(s): Hardcover and Paperback.

Synopsis:

Learn through application with community psychology! Featuring concrete examples and numerous study tools, this psychology text helps you understand the concepts and then provides opportunities for you to apply them. Brief outlines of chapter content, anticipatory questions, key points, brief exercises, summaries, and self tests are just a few of the tools that will help you succeed in this course. Programs and citizen initiatives for enriching the quality of individual and community life – such as Alcoholics Anonymous and the San Francisco Depression Prevention Project – show you what community psychology means in the real world. At the end of each chapter, you will find website references to model or recommended projects that connect you to community resources.

On This Day … 08 August

  • Happiness Happens Day,

What is Happiness Happens Day?

In 1999 the Society declared 08 August as the “Admit You’re Happy Day”, now known as the “Happiness Happens Day”.

The idea was inspired by the event that happened the previous year on the same date- the first member joined the Society.

In 1998 the Society asked the governors in all 50 states for a proclamation, with nineteen of them sending one.

What is the Secret Society of Happy People?

Secret Society of Happy People (SOHP) is an organisation that celebrates the expression of happiness.

Founded in August 1998, the society encourages thousands of members from all around the globe to recognise their happy moments and think about happiness in their daily life.

Purpose of SOHP?

The Secret Society of Happy People supports people who want to share their happiness despite the ones who don’t want to hear happy news.

Their mottos include “Happiness Happens” and “Don’t Even Think of Raining on My Parade”.

The main purpose of the Society is to stimulate people’s right to express their happiness “as loud as they want”.

Other Events

  • Happiness Happens Month:
    • Celebration of happiness was expanded in 2000, and thanks to the support of not-so-secretly-happy members from around the world, the Society declared August as Happiness Happens Month.
    • The purpose of Happiness Happens Day and Month is to share happiness and encourage people to talk and think about happiness.
  • HappyThon:
    • Every year, the Society organises an online social media event known as HappyThon, on Happiness Happens Day.
    • The aim of this event is to send inspirational messages via social networks, emails or texts, share happy moments, philosophy, quotes, etc.
    • HappyThon is the first online social media event that promotes happiness around the world.
  • Since 1998 the Society have been organising voting and announcing the Happiest Events and Moments of the Year.
  • Before the end of the century, a vote for 100 of the Happiest Events, Inventions and Social Changes of the Century was organised.
  • In the third week of January the Society hosted Hunt for Happiness Week.
  • They asked the current governors for a proclamation, with seven of them providing one.

What is the Value of Mental Health First Aid for the UK Armed Forces?

Research Paper Title

Mental health first aid for the UK Armed Forces.

Background

Education programmes in mental health literacy can address stigma and misunderstanding of mental health.

This study investigated self-rated differences in knowledge, attitudes and confidence around mental health issues following participation in a bespoke Mental Health First Aid (MHFA) training course for the Armed Forces.

Methods

The mixed methods approach comprised quantitative surveys and qualitative interviews.

A survey, administered immediately post-training (n = 602) and again at 10-months post-attendance (n = 120), asked participants to rate their knowledge, attitudes and confidence around mental health issues pre- and post-training.

Results

Quantitative findings revealed a significant increase in knowledge, positive attitudes and confidence from the post-training survey which was sustained at 10-months follow-up.

Semi-structured telephone interviews (n = 13) were conducted at follow-up, 6-months post-attendance.

Qualitative findings revealed that participation facilitated an ‘ambassador’ type role for participants.

Conclusions

This study is the first to have investigated the effect of MHFA in an Armed Forces community.

Findings show participants perceived the training to increase knowledge regarding mental health and to enhance confidence and aptitude for identifying and supporting people with mental health problems.

Results suggest that such an intervention can provide support for personnel, veterans and their families, regarding mental health in Armed Forces communities.

Reference

Crone, D.M., Sarkar, M., Curran, T., Baker, C.M., Hill, D., Loughren, E.A., Dickson, T. & Parker, A. (2020) Mental health first aid for the UK Armed Forces. Health Promotion International. 35(1), pp.132-139. doi: 10.1093/heapro/day112.

What is the Social Impact of Health Insurance Care Utilisation in Low- & Middle-Income Countries?

Research Paper Title

The impact of social, national and community-based health insurance on health care utilisation for mental, neurological and substance-use disorders in low- and middle-income countries: a systematic review.

Background

Whilst several systematic reviews conducted in Low- and Middle-Income Countries (LMICs) have revealed that coverage under social (SHI), national (NHI) and community-based (CBHI) health insurance has led to increased utilisation of health care services, it remains unknown whether, and what aspects of, these shifts in financing result in improvements to mental health care utilisation.

The main aim of this review was to examine the impact of SHI, NHI and CBHI enrolment on mental health care utilisation in LMICs.

Methods

Systematic searches were performed in nine databases of peer-reviewed journal articles: Pubmed, Scopus, SciELO via Web of Science, Africa Wide, CINAHL, PsychInfo, Academic Search Premier, Health Source Nursing Academic and EconLit for studies published before October 2018.

The quality of the studies was assessed using the Effective Public Health Practice Project quality assessment tool for quantitative studies.

Results

Eighteen studies were included in the review.

Despite some heterogeneity across countries, the results demonstrated that enrollment in SHI, CBHI and NHI schemes increased utilisation of mental health care.

This was consistent for the length of inpatient admissions, number of hospitalisations, outpatient use of rehabilitation services, having ever received treatment for diagnosed schizophrenia and depression, compliance with drug therapies and the prescriptions of more favourable medications and therapies, when compared to the uninsured.

The majority of included studies did not describe the insurance schemes and their organizational details at length, with limited discussion of the links between these features and the outcomes.

Given the complexity of mental health service utilisation in these diverse contexts, it was difficult to draw overall judgements on whether the impact of insurance enrollment was positive or negative for mental health care outcomes.

Conclusions

Studies that explore the impact of SHI, NHI and CBHI enrolment on mental health care utilisation are limited both in number and scope.

Despite the fact that many LMICs have been hailed for financing reforms towards universal health coverage, evidence on the positive impact of the reforms on mental health care utilisation is only available for a small sub-set of these countries.

Reference

Docrat, S., Besada, D., Cleary, S. & Lund, C. (2020) The impact of social, national and community-based health insurance on health care utilization for mental, neurological and substance-use disorders in low- and middle-income countries: a systematic review. Health Economics Review. 10(1), pp.11. doi: 10.1186/s13561-020-00268-x.

Would Strengthening Community Health Systems for Mental Health Improve Access & Increase Utilisation of Services?

Research Paper Title

Strengthening Mental Health Systems in Zambia.

Background

Studies in mental health care for low resource settings indicate that providing services at primary care level would significantly improve provision and utilisation of mental health services.

Challenges related to inadequate funding were noted as significant barriers to service provision, with the contribution of low knowledge of mental health conditions and stigma in the community.

This study aimed to explore the barriers to the use of mental health services in Zambia, suggesting health systems thinking approaches to solving these challenges.

Methods

Primary data were collected through individual interviews from 12 participants; primary caregivers, health workers from public health institutions that treat mental health conditions and policymakers and implementers.

The digitally recorded responses were transcribed and analysed using thematic analysis.

Results

Key barriers to care included inadequate funding, few human resources, poor infrastructure and stigma.

Barriers to care at policy, facility and individual or community level could be alleviated by strengthening the mental health system.

Engagement of community health workers and increasing efforts to sensitise the community about mental health would prove beneficial.

Conclusions

Strengthening the community health systems for mental health could improve access and increase utilisation of services.

Reference

Munakampe, M.N. (2020) Strengthening Mental Health Systems in Zambia. International Journal of Mental Health Systems. 14:28. doi: 10.1186/s13033-020-00360-z. eCollection 2020.

Do we need Evidence-based Rehabilitation Programmes to Facilitate Community Integration & Functional Recovery?

Research Paper Title

Addressing Severe Mental Illness Rehabilitation in Colombia, Costa Rica, and Peru.

Background

Many Latin American countries face the challenge of caring for a growing number of people with severe mental illnesses while promoting deinstitutionalisation and community-based care.

This article presents an overview of current policies that aim to reform the mental health care system and advance the employment of people with disabilities in Colombia, Costa Rica, and Peru.

Methods

The authors conducted a thematic analysis by using public records and semi-structured interviews with stakeholders.

The authors found evidence of supported employment programmes for vulnerable populations, including people with disabilities, but found that the programmes did not include people with severe mental illnesses.

Results

Five relevant themes were found to hamper progress in psychiatric vocational rehabilitation services:

  1. Rigid labour markets;
  2. Insufficient advocacy;
  3. Public subsidies that create conflicting incentives;
  4. Lack of deinstitutionalised models; and
  5. Lack of reimbursement for evidence-based psychiatric rehabilitation interventions.

Conclusions

Policy reforms in these countries have promoted the use of medical interventions to treat people with severe mental illnesses but not the use of evidence-based rehabilitation programmes to facilitate community integration and functional recovery.

Because these countries have other supported employment programmes for people with non-psychiatric disabilities, they are well positioned to pilot individual placement and support to accelerate full community integration among individuals with severe mental illnesses.

Reference

Cubillos, L., Muñoz, J., Caballero, J., Mendoza, M., Pulido, A., Carpio, K., Udutha, A.K., Botero, C., Borrero, E., Rodríguez, D., Cutipe, Y., Emeny, R., Schifferdecker, K. & Torrey, W.C. (2020) Addressing Severe Mental Illness Rehabilitation in Colombia, Costa Rica, and Peru. Psychiatric Services (Washington, D.C.). 71(4):378-384. doi: 10.1176/appi.ps.201900306. Epub 2020 Jan 3.

Training Community Mental Health: Local Trainers vs Master Trainers

Research Paper Title

Evaluating a Train-the-Trainer Approach for Increasing EBP Training Capacity in Community Mental Health.

Background

Research suggests the train-the-trainer (TtT) model may be an effective approach to training community mental health providers in evidence-based practice (EBP).

Methods

This study compared pre- and post-training consultation outcomes as well as standardised measures of trainer attributes and behaviours between university-based master trainers and experienced community-based supervisors, trained under the TtT approach.

Results

Findings suggest local and master trainers are equivalent in terms of clinical teaching effectiveness and trainee-perceived charisma.

Conclusions

Master trainers may have higher trainee-perceived credibility, but training and consultation outcomes are equivalent across the types of trainers, with the exception of behavioural problems where clinicians trained by local trainers and master trainers saw significantly greater growth than those who received training and consultation by master trainers.

Reference

Triplett, N.S., Sedlar, G., Berliner, L., Jungbluth, N., Boyd, M. & Dorsey, S. (2020) Evaluating a Train-the-Trainer Approach for Increasing EBP Training Capacity in Community Mental Health. The Journal of Behavioral Health Services & Research. doi: 10.1007/s11414-019-09676-2. [Epub ahead of print].

What is the Sustainability of a Biobehavioural Intervention Implemented by Therapists & Sustainment in Community Settings?

Research Paper Title

Sustainability of a biobehavioral intervention implemented by therapists and sustainment in community settings.

Background

The ultimate aim of dissemination and implementation of empirically supported treatments (ESTs) in behavioural medicine is:

  • Sustainability of the therapist/provider’s EST usage; and
  • Sustainment of EST delivery in the setting.

Thus far, sustainability has been understudied, and the therapist and setting variables that may be influential are unclear.

The purpose of the study was to test the therapists’ sustainability of a cancer-specific EST using a prospective longitudinal design and examine its predictors.

Methods

Oncology mental health therapists (N = 134) from diverse settings (N = 110) completed training in the biobehavioural intervention (BBI) and were provided with 6 months of support for implementation, with no support thereafter. BBI usage (percent of patients treated) was reported at 2, 4, 6, and 12 months.

Using a generalised estimating equation with a logistic link function, 12-month sustainability (a non-significant change in usage from 6 to 12 months) was studied along with therapist, supervisor, and setting variables as predictors.

Results

BBI usage increased through 6 months and, importantly, usage was sustained from 6 (68.4% [95% CI = 62.2%-73.9%]) to 12 months (70.9% [95% CI = 63.6%-77.3%]), with sustainment in 66 settings (60.0%).

Predictors of implementation-to-sustainability usage were therapists’ early intentions to use the BBI (p < .001) and from the setting, supervisors’ positive attitudes toward ESTs (p = .016).

Conclusions

Adding to the DI literature, a health psychology intervention was disseminated, implemented, and found sustainable across diverse therapists and settings.

Therapists and setting predictors of usage, if modified, might facilitate future sustainability/sustainment of ESTs.

Reference

Ryba, M.M., Lo, S.B. & Andersen, B.L. (2019) Sustainability of a biobehavioral intervention implemented by therapists and sustainment in community settings. Translational Behavioral Medicine. pii: ibz175. doi: 10.1093/tbm/ibz175. [Epub ahead of print].