Is There Value in Targeted Screening & Intervention Programmes of Anxiety in Young Adult Offspring with Parental Mental Health Problems?

Research Paper Title

Associations of maternal and paternal mental health problems with offspring anxiety at age 20 years: Findings from a population-based prospective cohort study.

Background

Epidemiological studies indicate that children of parents with mental health problems are at an increased risk of developing anxiety disorders.

Few studies have investigated this relationship in young adults.

Methods

Participants were from the Raine Study, which is a multi-generational birth cohort study in Australia. Maternal anxiety and depression in late childhood were assessed using the Depression, Anxiety, and Stress Scale (DASS-42), and paternal lifetime mental health problems were assessed using a self-reported questionnaire.

The short form of DASS-42 (DASS-21) was used to assess anxiety symptoms among offspring at age 20. Negative binomial regression model was used to quantify the association. Data were available for 1,220 mother-offspring and 1,190 father-offspring pairs.

Results

After adjusting for potential confounders, the researchers found an increased risk of anxiety in young adult offspring exposed to maternal anxiety in late childhood and paternal lifetime mental health problems. However, they observed no increased risks of anxiety in offspring exposed to maternal depressive symptoms. Their sensitivity analysis based on the log-binomial model (binary outcome) as well as the linear model (log-transformed data) confirmed the robustness of the main results.

Conclusions

The findings suggest there can be value to consider and apply targeted screening and intervention programmes of anxiety in the young adult offspring with parental mental health problems.

Reference

Ayano, G., Betts, K., Lin, A., Tait, R. & Alati, R. (2021) Associations of maternal and paternal mental health problems with offspring anxiety at age 20 years: Findings from a population-based prospective cohort study. Psychiatry Research. doi: 10.1016/j.psychres.2021.113781. Online ahead of print.

What is Mental Health Triage (Australia)?

Introduction

Mental health triage is a clinical function conducted at point of entry to health services which aims to assess and categorise the urgency of mental health related problems.

Background

The mental health triage service may be located in the Emergency Department, Community Mental Health Services, Call Centre, or co-located with other specialist mental health services such as the Crisis Assessment and Treatment Team.

Emergency Services such as police and ambulance may also have a co-located mental health triage service.

There is considerable variation in the clinical settings in which mental health triage services may be operating, therefore service delivery models vary, however, the essential function is to determine the nature and severity of the mental health problem, determine which service response would best meet the needs of the patient, and how urgently the response is required.

A core function of mental health triage is to conduct risk assessment that aims to determine whether the patient is a risk of harming self or others as a result of their mental state, and to assess other risks related to mental illness. As with other triage models, the mental health triage clinician must assign a category of urgency to the case, which is recorded using verbal indicators of risk such as ‘extreme risk’ through to ‘low risk’, or by using numerical (urgency= time-to-treatment) categories 1 (immediate) to 5 (2 hours), as per the 5-point Australasian Triage Scale.

Mental Health Triage Training

In 2006 the Centre for Psychiatric Nursing Research and Practice introduced a 2 day mental health triage training programme designed and facilitated by Dr Natisha Sands.

The focus of the programme is on providing specific, targeted education to support triage duty and intake clinicians in conducting point of entry mental health assessment and service provision to Area Mental Health Services.

The aim of the programme is to increase the quality and consistency of mental health triage service delivery, by providing the clinician with sound theoretical and practical knowledge to guide clinical practice.

The expected outcomes of participation in the program are increased confidence and skill in triage clinical practice, improvement in the quality of service delivery, improvement in the quality of triage documentation, and professional development and support of clinical staff.

Brief Overview of the Programme

  • Telephone skills (phone manner, phone assessment, problem callers).
  • Risk assessment (assessment, diagnosis, priority, action).
  • Medico-legal issues.
  • Decision-making (the phases of triage, under pressure, influences, resource management, decision-making frameworks).
  • Negotiation skills (other agencies, team, clients, families).
  • Crisis management (identification, types of crises, problem solving, diffusion, resolution).
  • Secondary consultation and education (other services/agencies, clients, families).
  • Effective documentation (risk assessment, incidents, care planning, confidentiality, electronic documentation, exchange of information).
  • Engaging consumers (consumer centred service delivery).

The programme is open to mental health triage, duty, and intake clinicians of all disciplines, and is suitable for both novice and expert clinicians and is designed to assist clinicians engaged in both face-to-face and telephone only triage.

Book: Life Is a Four-Letter Word

Book Title:

Life Is a Four-Letter Word: A Mental Health Survival Guide for Professionals.

Author(s): Andy Salkeld.

Year: 2020.

Edition: First (1st), Illustrated Edition.

Publisher: Practical Inspiration Publishing.

Type(s): Paperback and Kindle.

Synopsis:

  • Do you ever feel you’re a fraud and about to be found out?
  • Do you feel an expectation to keep going and to be strong?
  • Do you ever think what it would be like to just… ‘STOP’?

You are not alone. Mental ill health impacts one in four people every year, and professionals in high-pressure jobs are especially vulnerable.

Life is a Four-Letter Word is a mental health survival guide for professionals, from a high-flying Big 4 accountant who has struggled with depression, anxiety, stress and suicidal thoughts and learned a lot along the way.

Andy now advocates positive action around mental health, working closely with business leaders across the UK to help them build mentally healthy cultures. He is a renowned speaker and writer on mental health, entrepreneurship and finance.

A New Definition of Mental Health!

Research Paper Title

A proposed new definition of mental health.

Background

The authors propose a new approach to the definition of mental health, different than the definition proposed by the World Health Organisation, which is established around issues of person’s well-being and productivity.

It is supposed to reflect the complexity of human life experience.

Introduction

The definition of mental health proposed by the World Health Organization (WHO) is organised around a hedonic and eudaimonic perspective, in which a key role is assigned to person’s well-being and productivity. While regarding well-being as a desirable goal for many people, its inclusion in the definition of mental health raises concerns. According to Keyes, well-being includes emotional, psychological and social well-being, and involves positive feelings (e.g., happiness, satisfaction), positive attitudes towards own responsibilities and towards others, and positive functioning
(e.g., social integration, actualisation and coherence).

However, people in good mental health experience a wide range of emotions, such as sadness, anger or unhappiness; most adolescents are often unsatisfied, unhappy about present social organisation and may lack social coherence. Does this mean that they are not in good mental health? A person responsible for her/his family might feel desperate after being fired from his/her job, especially in a situation characterised by scarce occupational opportunities; should we question her/his mental health? Actually, raising the bar of mental health may create unrealistic expectations, encourage people
to mask most of their emotions while pretending constant happiness, and even favour their isolation when they feel sad, angry or worried.

Also the concept of positive functioning (“can work productively and fruitfully”), in line with the eudaimonic tradition, raises concerns, as it implies that a person at an age or in a physical or even political condition preventing her/him from working productively is not by definition in good mental health.

The definition of mental health is clearly influenced by the culture that defines it. However, as also advocated by Vaillant, an effort can be made to identify elements that have a universal importance for mental health, as for example, vitamins and the four basic food groups are universally given a key role in eating habits, in spite of cultural differences.

You can read the rest of the article here.

Reference

Galderisi, S., Heinz, A., Kastrup, M., Beezhold, J. & Sartorius, N. (2020) A proposed new definition of mental health. Psychiatria Polska. 51(3), pp.407-411. doi: 10.12740/PP/74145. Epub 2017 Jun 18.

Book: Encyclopedia of Mental Health

Book Title:

Encyclopedia of Mental Health.

Author(s): Howard S. Friedman.

Year: 2015.

Edition: Second (2nd).

Publisher: Academic Press.

Type(s): Hardcover and Kindle.

Synopsis:

The Encyclopedia of Mental Health, Second Edition, tackles the subject of mental health, arguably one of the biggest issues facing modern society. The book presents a comprehensive overview of the many genetic, neurological, social, and psychological factors that affect mental health, also describing the impact of mental health on the individual and society, and illustrating the factors that aid positive mental health.

The book contains 245 peer-reviewed articles written by more than 250 expert authors and provides essential material on assessment, theories of personality, specific disorders, therapies, forensic issues, ethics, and cross-cultural and sociological aspects. Both professionals and libraries will find this timely work indispensable.

  • Provides fully up-to-date descriptions of the neurological, social, genetic, and psychological factors that affect the individual and society.
  • Contains more than 240 articles written by domain experts in the field.
  • Written in an accessible style using terms that an educated layperson can understand.
  • Of interest to public as well as research libraries with coverage of many important topics, including marital health, divorce, couples therapy, fathers, child custody, day care and day care providers, extended families, and family therapy.

Do Older Adults with Parent(s) Alive Experience Higher Psychological Pain and Suicidal Ideation?

Research Paper Title

Do Older Adults with Parent(s) Alive Experience Higher Psychological Pain and Suicidal Ideation? A Cross-Sectional Study in China.

Background

Elderly mental health promotion is an important task in the current “Healthy China Action”.

This study aims to:

  1. Clarify the psychological pain and suicidal ideation of the Chinese elderly with different parental states;
  2. Examine the associated factors of psychological pain and suicidal ideation; and
  3. Examine the relationship between psychological pain and suicidal ideation.

Methods

A sample of 4622 adults aged 60 years and older were included in this study, from the China’s Health-related Quality of Life Survey for Older Adults 2018.

Results

Participants with both parents alive demonstrated the heaviest psychological pain, and those with one parent alive observed significantly lowest psychological pain and suicidal ideation.

Participants who were single, divorced, or widowed, live in rural areas, had higher education level, had lower family income, suffered from two or more chronic diseases, and had no self-care ability were more likely to experience psychological pain and suicidal ideation.

In addition, higher psychological pain was significantly associated with the occurrence of suicidal ideation.

Conclusions

In China, much more attention should be paid to the mental health condition of the elderly, especially for those with both parents alive.

Moreover, the associated factors above should be considered to develop targeted health interventions.

Reference

Yang, Y., Wang, S., Hu, B., HAo, J., Hu, R., Zhou, Y. & Mao, Zongfu. (2020) Do Older Adults with Parent(s) Alive Experience Higher Psychological Pain and Suicidal Ideation? A Cross-Sectional Study in China. International Journal of Environmental Research and Public Health. 17(17), pp.E6399. doi: 10.3390/ijerph17176399.

Examining National Trends in the Care of Different Mental Health Problems & in Different Treatment Settings among Adolescents

National Trends in Mental Health Care for US Adolescents.

Background

The prevalence of adolescent depression and other internalising mental health problems has increased in recent years, whereas the prevalence of externalising behaviours has decreased. The association of these changes with the use of mental health services has not been previously examined.

Therefore, the purpose of this study was to examine national trends in the care of different mental health problems and in different treatment settings among adolescents.

Methods

Data for this survey study were drawn from the National Survey on Drug Use and Health, an annual cross-sectional survey of the US general population. This study focused on adolescent participants aged 12 to 17 years interviewed from January 1, 2005, to December 31, 2018. Data were reported as weighted percentages and adjusted odds ratios (aORs) and analysed from July 20 to December 1, 2019.

Time trends in 12-month prevalence of any mental health treatment or counselling in a wide range of settings were examined overall and for different:

  • Sociodemographic groups;
  • Types of mental health problems (internalising, externalising, relationship, and school related); and
  • Treatment settings (inpatient mental health, outpatient mental health, general medical, and school counselling).

Trends in the number of visits and nights in inpatient settings were also examined.

Results

A total of 47,090 of the 230,070 adolescents across survey years (19.7%) received mental health care. Of these, 57.5% were female; 31.3%, aged 12 to 13 years; 35.8%, aged 14 to 15 years; and 32.9%, aged 16 to 17 years.

The overall prevalence of mental health care did not change appreciably over time. However, mental health care increased among girls (from 22.8% in 2005-2006 to 25.4% in 2017-2018; aOR, 1.11; 95% CI, 1.04-1.19; P = .001), non-Hispanic white adolescents (from 20.4% in 2005-2006 to 22.7% in 2017-2018; aOR, 1.08; 95% CI, 1.03-1.14; P = .004), and those with private insurance (from 19.4% in 2005-2006 to 21.2% in 2017-2018; aOR, 1.11; 95% CI, 1.04-1.18; P = .002).

Internalising problems, including suicidal ideation and depressive symptoms, accounted for an increasing proportion of care (from 48.3% in 2005-2006 to 57.8% in 2017-2018; aOR, 1.52; 95% CI, 1.39-1.66; P < .001), whereas externalising problems (from 31.9% in 2005-2006 to 23.7% in 2017-2018; aOR, 0.67; 95% CI, 0.62-0.73; P < .001) and relationship problems (from 30.4% in 2005-2006 to 26.9% in 2017-2018; aOR, 0.75; 95% CI, 0.69-0.82; P < .001) accounted for decreasing proportions.

During this period, use of outpatient mental health services increased from 58.1% in 2005-2006 to 67.3% in 2017-2018 (aOR, 1.47; 95% CI, 1.35-1.59; P < .001), although use of school counselling decreased from 49.1% in 2005-2006 to 45.4% in 2017-2018 (aOR, 0.86; 95% CI, 0.79-0.93; P < .001).

Outpatient mental health visits (eg, private mental health clinicians, from 7.2 in 2005-2006 to 9.0 in 2017-2018; incidence rate ratio, 1.30; 95% CI, 1.23-1.37; P < .001) and overnight stays in inpatient mental health settings (from 4.0 nights in 2005-2006 to 5.4 nights in 2017-2018; incidence rate ratio, 1.18; 95% CI, 1.02-1.37; P = .03) increased.

Conclusions

This study’s findings suggest that the growing number of adolescents who receive care for internalising mental health problems and the increasing share who receive care in specialty outpatient settings are placing new demands on specialty adolescent mental health treatment resources.

Reference

Mojtabai, R. & Olfson, M. (2020) National Trends in Mental Health Care for US Adolescents. JAMA Psychiatry. 77(7), pp.1-12. doi: 10.1001/jamapsychiatry.2020.0279. Online ahead of print.

Research Paper Title

National Trends in Mental Health Care for US Adolescents.

Background

The prevalence of adolescent depression and other internalising mental health problems has increased in recent years, whereas the prevalence of externalising behaviours has decreased. The association of these changes with the use of mental health services has not been previously examined.

Therefore, the purpose of this study was to examine national trends in the care of different mental health problems and in different treatment settings among adolescents.

Methods

Data for this survey study were drawn from the National Survey on Drug Use and Health, an annual cross-sectional survey of the US general population. This study focused on adolescent participants aged 12 to 17 years interviewed from January 1, 2005, to December 31, 2018. Data were reported as weighted percentages and adjusted odds ratios (aORs) and analysed from July 20 to December 1, 2019.

Time trends in 12-month prevalence of any mental health treatment or counselling in a wide range of settings were examined overall and for different:

  • Sociodemographic groups;
  • Types of mental health problems (internalising, externalising, relationship, and school related); and
  • Treatment settings (inpatient mental health, outpatient mental health, general medical, and school counselling).

Trends in the number of visits and nights in inpatient settings were also examined.

Results

A total of 47,090 of the 230,070 adolescents across survey years (19.7%) received mental health care. Of these, 57.5% were female; 31.3%, aged 12 to 13 years; 35.8%, aged 14 to 15 years; and 32.9%, aged 16 to 17 years.

The overall prevalence of mental health care did not change appreciably over time. However, mental health care increased among girls (from 22.8% in 2005-2006 to 25.4% in 2017-2018; aOR, 1.11; 95% CI, 1.04-1.19; P = .001), non-Hispanic white adolescents (from 20.4% in 2005-2006 to 22.7% in 2017-2018; aOR, 1.08; 95% CI, 1.03-1.14; P = .004), and those with private insurance (from 19.4% in 2005-2006 to 21.2% in 2017-2018; aOR, 1.11; 95% CI, 1.04-1.18; P = .002).

Internalising problems, including suicidal ideation and depressive symptoms, accounted for an increasing proportion of care (from 48.3% in 2005-2006 to 57.8% in 2017-2018; aOR, 1.52; 95% CI, 1.39-1.66; P < .001), whereas externalising problems (from 31.9% in 2005-2006 to 23.7% in 2017-2018; aOR, 0.67; 95% CI, 0.62-0.73; P < .001) and relationship problems (from 30.4% in 2005-2006 to 26.9% in 2017-2018; aOR, 0.75; 95% CI, 0.69-0.82; P < .001) accounted for decreasing proportions.

During this period, use of outpatient mental health services increased from 58.1% in 2005-2006 to 67.3% in 2017-2018 (aOR, 1.47; 95% CI, 1.35-1.59; P < .001), although use of school counselling decreased from 49.1% in 2005-2006 to 45.4% in 2017-2018 (aOR, 0.86; 95% CI, 0.79-0.93; P < .001).

Outpatient mental health visits (eg, private mental health clinicians, from 7.2 in 2005-2006 to 9.0 in 2017-2018; incidence rate ratio, 1.30; 95% CI, 1.23-1.37; P < .001) and overnight stays in inpatient mental health settings (from 4.0 nights in 2005-2006 to 5.4 nights in 2017-2018; incidence rate ratio, 1.18; 95% CI, 1.02-1.37; P = .03) increased.

Conclusions

This study’s findings suggest that the growing number of adolescents who receive care for internalising mental health problems and the increasing share who receive care in specialty outpatient settings are placing new demands on specialty adolescent mental health treatment resources.

Reference

Mojtabai, R. & Olfson, M. (2020) National Trends in Mental Health Care for US Adolescents. JAMA Psychiatry. 77(7), pp.1-12. doi: 10.1001/jamapsychiatry.2020.0279. Online ahead of print.

Is There a Mental Health Crisis among Canadian Postsecondary Students?

Research Paper Title

Mental Health among Canadian Postsecondary Students: A Mental Health Crisis?

Background

Recent reports express concerns about a mental health crisis among postsecondary students. These assertions, however, often arise from surveys conducted in postsecondary settings that lack the broader context of a referent group. The objectives of this study were:

  • To assess the mental health status of postsecondary students 18 to 25 years old from 2011 to 2017; and
  • To compare the mental health status of postsecondary students to nonstudents.

Methods

Prevalence was estimated for a set of mental health outcomes using seven annual iterations of the Canadian Community Health Survey (2011 to 2017). Logistic regression was used to derive odds ratio estimates comparing mental health status among postsecondary students and nonstudents, adjusting for age and sex. Random effects metaregression and meta-analyses techniques were used to evaluate trends in prevalence and odds ratio estimates over time.

Results

Over the study period, the prevalence of perceived low mental health, diagnosed mood and anxiety disorders, and past-year mental health consultations increased among female students, whereas binge drinking decreased among male students. With the exception of perceived stress, the odds of experiencing each mental health outcome were lower among postsecondary students compared to nonstudents.

Conclusions

These findings do not support the idea that postsecondary students have worse mental health than nonstudents of similar age. The perception of a crisis may arise from greater help-seeking behaviour, diminishing stigma, or increasing mental health literacy. Regardless, the observance of these trends provide an opportunity to address a previously latent issue.

Reference

Wiens, K., Bhattarai, A., Dores, A., Pedram, P., Williams, J.V.A., Bulloch, A.G.M. & Patten, S.B. (2020) Mental Health among Canadian Postsecondary Students: A Mental Health Crisis? Canadian Journal of Psychiatry. 65(1), pp.30-35. doi: 10.1177/0706743719874178. Epub 2019 Sep 4.

Could Programmes to Improve Mental Health Literacy Facilitate Formal as well as Informal Help-seeking among Unemployed Persons with Mental Health Problems?

Research Paper Title

Mental health literacy and help-seeking among unemployed people with mental health problems.

Background

Unemployed people with mental health problems often do not use available mental health services.

Help-seeking may depend on knowledge, recognition and attitudes associated with mental health – a concept referred to as mental health literacy (MHL).

Therefore the aim of this study was to investigate the influence of MHL on help-seeking intentions and behaviours among unemployed individuals with mental health problems.

Methods

A total of 301 unemployed individuals with mental health problems were recruited mainly from employment agencies in Southern Germany.

MHL was assessed by the Mental Health Knowledge Schedule (MAKS), the Depression Literacy Scale (DLS), and the Depression with Suicidal Thoughts Vignette.

Help-seeking intentions and behaviours were measured using the General Help-Seeking Questionnaire (GHSQ).

Associations between MHL and help-seeking intentions and behaviours were tested using regression analyses and structural equation modelling (SEM).

Results

All three MHL scales were significantly positively associated with help-seeking intentions and behaviors.

In their SEM model, greater MHL was significantly associated with increased intentions and behaviours to seek help from health professionals (formal help) and from family and friends (informal help).

Conclusions

Among unemployed persons with mental health problems, programmes to improve MHL could facilitate formal as well as informal help-seeking.

Future research should examine the efficacy of MHL-interventions to increase help-seeking.

Reference

Waldmann, T., Staiger, T., Oexle, N. & Rusch, N. (2020) Mental health literacy and help-seeking among unemployed people with mental health problems. Journal of Mental Health (Abingdon, England). 29(3), pp.270-276. doi: 10.1080/09638237.2019.1581342. Epub 2019 Mar 12.

What are the Perceptions of Mental Health and Perceived Barriers to Mental Health Help-Seeking Amongst Refugees?

Research Paper Title

Perceptions of Mental Health and Perceived Barriers to Mental Health Help-Seeking Amongst Refugees: A Systematic Review.

Background

Despite elevated rates of psychological disorders amongst individuals from a refugee background, levels of mental health help-seeking in these populations are low.

There is an urgent need to understand the key barriers that prevent refugees and asylum-seekers from accessing help for psychological symptoms.

This review synthesises literature examining perceptions of mental health and barriers to mental health help-seeking in individuals from a refugee background.

The researchers analysis, which complies with PRISMA reporting guidelines, identified 62 relevant studies.

Methods

Data extraction and thematic analytic techniques were used to synthesise findings from quantitative (n = 26) and qualitative (n = 40) studies.

Results

They found that the salient barriers to help-seeking were:

  • Cultural barriers, including mental health stigma and knowledge of dominant models of mental health;
  • Structural barriers, including financial strain, language proficiency, unstable accommodation, and a lack of understanding of how to access services, and
  • Barriers specific to the refugee experience, including immigration status, a lack of trust in authority figures and concerns about confidentiality.

Conclusions

The researchers discuss and contextualise these key themes and consider how these findings can inform the development of policies and programmes to increase treatment uptake and ultimately reduce the mental health burden amongst refugees and asylum-seekers.

Reference

Byrow, Y., Pajak, R., Specker, P. & Nickerson, A. (2020) Perceptions of Mental Health and Perceived Barriers to Mental Health Help-Seeking Amongst Refugees: A Systematic Review. Clinical Psychology Review. 75:101812. doi: 10.1016/j.cpr.2019.101812. Epub 2019 Dec 24.