Losing It – Our Mental Health Emergency (2020): S01E02 – Three Teenage Girls

Introduction

As attitudes to mental health change during a surge in the number of people asking for help or harming themselves, this series joins the frontline care services in Nottinghamshire.

Nottinghamshire Healthcare NHS Foundation Trust opens its doors to TV cameras to reveal what it means to be in crisis.

Going to the heart of front line services as staff struggle to tackle an unprecedented rise in demand.

Outline

A young teen comes to A&E having self-harmed.

A 16-year-old is on the psychiatric ward.

And a 14-year-old’s eating disorder risks permanent harm to her body.

Losing It: Our Mental Health Emergency Series

Production & Filming Details

  • Release Date: 2020.
  • Original Network: Channel 4.

Losing It – Our Mental Health Emergency (2020): S01E01 – Laura & Briena

Introduction

As attitudes to mental health change during a surge in the number of people asking for help or harming themselves, this series joins the frontline care services in Nottinghamshire.

Nottinghamshire Healthcare NHS Foundation Trust opens its doors to TV cameras to reveal what it means to be in crisis.

Going to the heart of front line services as staff struggle to tackle an unprecedented rise in demand.

Outline

Two weeks after becoming a mum, Laura is sectioned having tried to drive into a brick wall.

And is 11-year-old Briena really suicidal, or is the underlying diagnosis more complicated?

Losing It: Our Mental Health Emergency Series

Production & Filming Details

  • Release Date:
  • Original Network: Channel 4.

Emotional Indicators of Urban Green Space Behaviour

Research Paper Title

Sitting or Walking? Analyzing the Neural Emotional Indicators of Urban Green Space Behavior with Mobile EEG.

Background

There is a close relationship between urban green space and the physical and mental health of individuals.

Most previous studies have discussed the impact of the structure of green space and its elements.

This study focused on the emotional changes caused by common behaviours in urban green space (walking and sitting).

Methods

The researchers recruited 40 college students and randomly assigned them to walking and sitting groups (20 students per group).

The two groups performed the same 8-min high-pressure learning task indoors and then performed 8-min recovery activities in a simulated urban green space (a bamboo-lawn space).

They used the Emotiv EPOC+ EEG headset to dynamically measure six neural emotional parameters:

  • ‘Engagement’;
  • ‘Valence’;
  • ‘Meditation’;
  • ‘Frustration’;
  • ‘Focus’; and
  • ‘Excitement’.

The researchers also conducted a pretest and post-test and used analysis of covariance (ANCOVA) to analyse the post-test data (with the pretest data as covariates).

Results

The results of the comparison of the two behaviours showed that the ‘valence’ and ‘meditation’ values of the walking group were higher than those of the sitting group, which suggests that walking in urban green space is more favourable for stress reduction.

The sitting group had a higher “focus” value than did the walking group, which suggests that sitting in urban green space is better for attention restoration.

Conclusions

The results of this study can provide guidance for urban green space planning and design as well as health guidance for urban residents.

Reference

Lin, W., Chen, Q., Jiang, M., Tao, J., Liu, Z., Zhang, X., Wu, L., Xu, S., Kang, Y. & Zeng, Q. (2020) Sitting or Walking? Analyzing the Neural Emotional Indicators of Urban Green Space Behavior with Mobile EEG. Journal of Urban Health. doi: 10.1007/s11524-019-00407-8. [Epub ahead of print].

Analysis of Voluntary vs Involuntary Admissions

Research Paper Title

Voluntary admissions for patients with schizophrenia: A systematic review and meta-analysis.

Background

Voluntary admission rates of schizophrenia vary widely across studies.

In order to make the topic be informed by evidence, it is important to have accurate estimates.

This meta-analysis examined the worldwide prevalence of voluntary admissions for patients with schizophrenia.

Methods

PubMed, EMBASE, PsycINFO, the Cochrane Library, Web of Science and Medline databases were systematically searched, from their commencement date until 19th November 2018.

Meta-analysis of included studies was performed using the random-effects model.

Results

Thirty-five studies with 134,100 schizophrenia patients were included.

The overall voluntary admission rate of schizophrenia was 61.9 % (95 %CI: 52.3 %-70.7 %), while the involuntary rate was 43.0 % (95 %CI: 34.8 %-51.7 %).

Subgroup analyses revealed that patients in Europe had significantly higher voluntary admission rates, while their North American counterparts were more likely admitted involuntarily.

Papers published prior to 2008 reported higher involuntary admission rates.

Meta-regression analyses showed that higher male percentage and higher study quality were significantly associated with higher voluntary admission rate.

Conclusions

Although the worldwide prevalence of voluntary admissions was higher than that of involuntary admissions, the latter was common for schizophrenia.

With the continuing liberalisation of mental health laws broadening community-based psychiatric services, the rate of voluntary psychiatric admissions is expected to further increase over time.

Reference

Yang, Y., Li, W., Lok, K.I., Zhang, Q., Hong, L., Ungvari, G.S., Bressington, D.T., Cheung, T. & Xiang, Y.T. (2019) Voluntary admissions for patients with schizophrenia: A systematic review and meta-analysis. Asian Journal of Psychiatry. 48:101902. doi: 10.1016/j.ajp.2019.101902. [Epub ahead of print].

Are Mental Health Apps Worthwhile?

Among the hundreds of thousands of apps available for health and fitness, among many others, millions of us have downloaded mental health apps for everything from breathing exercises to guided meditation.

However, a recent analysis now suggests that almost everyone gives up on such apps in just two weeks.

Amit Baumel (2019), at the University of Haifa in Israel and his colleagues, analysed the use of 93 popular mental health apps.

The data suggests that, after 15 days, more than 94% of users had stopped opening their apps.

Baumel and colleagues only studied apps that are available in English and that have been installed at least 10,000 times via the Google Play store.

App use differed depending on the kind of support provided.

On any given day, just over 4% of individuals who have downloaded mindfulness or meditation apps will use them. However this figure is 17% among those who have installed peer-support apps, which enable individuals to talk to someone who may be experiencing similar issues.

The team did not reveal which apps were included in the analysis, but the findings raise questions over how useful mental health apps are.

It is currently unknown how often an individual needs to use such apps for them to be effective.

Baumel and colleagues study confirms what the clinical community has known for a long time: a lot of individuals abandon these apps.

However, it should be noted that a low engagement rate does not necessarily mean mental health apps do not work – it could be an indication of how curious we are about these apps, and how easy it is to download them.

References

Baumel, A., Muench, F., Edan, S. & Kane, J.M. (2019) Objective User Engagement With Mental Health Apps: Systematic Search and Panel-Based Usage Analysis. Journal of Medical Internet Research. 21(9), e14567. https://www.jmir.org/2019/9/e14567/.

New Scientist. (2019) People Quickly Abandon Mental Health Apps. New Scientist. 16 November 2019, pp.14.

Owning & Managing a Business Can be Hazardous to your Mental Health

1.0 Introduction

Owning and Managing a Business Can be Hazardous to your Mental Health.

This article provides an overview of business ownership in the context of mental health.

If you are one of the millions of small and medium business owners around the globe, you probably have a good idea of how tough (and sometimes lonely) it can be at the top of the business – and how owning and managing your own business can be hazardous to your mental health.

It is well-known that our mental health can deteriorate, for a variety of reasons, and, if left unchecked, can lead to mental health problems.

Although depression and anxiety are likely to be the most common issues an owner faces, it is important to remember that mental health symptoms and conditions come in many forms.

2.0 Why Be a Business Owner?

Many of us are drawn to small business because working for others provides its own stresses, for example, the feeling of lost control as others make decisions we may feel unable to influence.

Being a business owner offers a level of freedom and control that we may be unable to achieve as an employee.

3.0 Factors Affecting Mental Health in Owners

Although the symptoms of mental health conditions can be similar between people, the triggers can be very different.

There are a number of factors that could lead to a deterioration in a business owner’s mental health, including:

  • Excessive stress;
  • A toxic work environment;
  • Poor leadership;
  • Uncertainty;
  • Long hours;
  • A lack of sleep; and
  • So on.

These can lead to burnout which, in turn, can lead to mental health conditions such as anxiety and depression.

Increased competition in your particular market or industry means added pressure to perform and stand out from the crowd, as well as potentially making it more difficult to be financially successful. Business costs may also be rising, possibly faster than your ability to increase sales and revenue – meaning the bottom line is impacted, aka less profit.

Using a contemporaneous example, the business uncertainty surrounding Brexit, especially for export-orientated businesses, can have a profound impact on business planning and sales generation.

4.0 A Blur between Personal, Family & Work

Small business ownership, especially, can be tough because there are few support structures for owners.

As an owner, you are responsible for everything and the lines between personal and family pressures and work are blurred or even non-existent.

Finally, the financial pressures are very real, as it is the owner’s money at stake not a large company’s money.

5.0 I’m In Control!

Business owners may be reluctant to seek, ask or talk about any mental health issues they may be facing due to the need to be perceived as having everything under control.

This means that business owners can, effectively, end up in rather stressful jobs.

With this in mind, most employees will be unaware of the stress attached to owning a business and how challenging cashflow, for example, can be. When margins are tight, paying wages can be extremely stressful. There are real life examples where owners have paid staff wages through their credit cards or overdrafts to ensure their employees get paid – mainly due to a feeling of guilt and not wanting to let them down. It can be stressful knowing that your employee’s family relies on the wage you are paying their loved one.

There is also the stress on marriages, especially if a couple is in business together.

6.0 The Value of Mentors

Other business owners understand what you, as a business owner, are going through. They understand the impact that long hours, for example, can have on the owner’s well-being and their families.

A business mentor can assist by helping the owner find ways of being more effective with their time, among other things.

7.0 Addressing Mental Health Issues

It is imperative that you do not do nothing.

There are a number of things owners can do, at both at an individual and organisational level:

  • Know the risks to mental health and well-being in your business.
    • What are the triggers?
  • Talk about mental health and well-being.
    • This helps to normalise it.
  • Leaders in your business need to be on board.
    • They must send the message to all staff that the business takes mental health seriously.
    • Role model what good mental health looks like and what we do when someone needs our help.
  • Get some education around mental health.
    • The reason that myths and fear exist is because of lack of awareness and knowledge.
    • There are workshops, coaches and even online courses now which help plug this knowledge gap.
  • Have the conversation with your people.
    • Not saying anything to someone who is struggling is not the way to go.
    • Simply asking “Are you OK?” is a really good start and shows the person that you have noticed and do care.
  • Sleep, nutrition, relationships and exercise all correlate with mental health, so check in on your people to see how they are going with these areas.
    • For example, if someone tells you that they have not been sleeping for two months, that is going to take its toll and something needs to be done.
  • Know who to go to.
    • Have an accessible list of contacts that you can call on for a range of different mental health and well-being matters.

It is important to seek support from someone who:

  • Has received appropriate training;
  • Is a registered practitioner; and
  • Has frequent supervision.

8.0 Pursing Good Mental Health

In the pursuit of good mental health, it is important to:

  • Understand our stressors;
  • Name our stressors;
  • Admit they exist; and
  • Aim to avoid them.

If our stressors cannot be avoided, we should attempt to better manage them.

Finally, when possible, it is important as a business owner to make time and take personal care of yourself.

New Channel 4 TV Series on Mental Health – Losing It: Our Mental Health Emergency

Introduction

As attitudes to mental health change during a surge in the number of people asking for help or harming themselves, this series joins the frontline care services in Nottinghamshire

Outline Series 01

Channel 4 begins broadcasting a new series on mental health on Tuesday 21 January 2020 at 10 pm.

Titled Losing It: Our Mental; Health Emergency, the series gains access to Nottinghamshire Healthcare, one of the UK’s largest mental health trusts.

With demand rising and resources stretched like never before, this series explores the unprecedented pressure on mental health services and the seemingly impossible decisions that clinicians have to make every day.

The series places viewers at the heart of the complex decision-making process, giving a unique insight into the pressures and challenges mental health trusts and patients must deal with daily.

Told with a frank first person perspective, this series gives a very personal view of mental illness in 2019; the tragedy, humour and complex challenges.

Outline Series 01, Episode 01

Two weeks after becoming a mum, Laura is sectioned having tried to drive into a brick wall.

And is 11-year-old Briena really suicidal, or is the underlying diagnosis more complicated?

About Nottinghamshire Healthcare NHS Foundation Trust

Nottinghamshire Healthcare provides integrated healthcare services, including mental health, intellectual disability and physical health services.

Over 9000 dedicated staff provide these services in a variety of settings, ranging from the community through to acute wards, as well as secure settings.

The Trust manages two medium secure units, Arnold Lodge in Leicester and Wathwood Hospital in Rotherham, and the high secure Rampton Hospital near Retford.

It also provides healthcare in prisons across the East Midlands.

Its budget for 2019/20 is £465m.

Why Do It?

The Trust made the decision to take part in the series in April 2019 to try and further reduce the stigma associated with mental illness.

The production company, Story Films, has an impressive track record in making sensitive films that deal with difficult topics.

Filming took place across Nottinghamshire during the summer of last year and features patients with a wide variety of diagnoses, including young people, families and people in crisis.

Production & Filming Details

  • Production: Story Films.
  • Distributor: Channel 4.
  • Release Date: 21 January 2020 (UK).
  • Running Time: 50 minutes.

A Review into Effective & Cost Effective Interventions of Child Mental Health Problems

Research Paper Title

Effective/cost effective interventions of child mental health problems in low- and middle-income countries (LAMIC): Systematic review.

Background

This systematic review protocol aims to examine the evidence of effectiveness and cost-effectiveness of interventions for children and adolescents with, or at risk of developing mental disorders in low- and middle-income countries (LAMICs).

Methods

The researchers will search Medline Ovid, EMBASE Ovid, PsycINFO Ovid, CINAHL, LILACS, BDENF and IBECS.

They will include randomised and non-randomised controlled trials, economic modelling studies and economic evaluations.

Participants are 6 to 18 year-old children and adolescents who live in a LAMIC and who present with, or are at high risk of developing, one or more of the conditions: depression, anxiety, behavioural disorders, eating disorders, psychosis, substance abuse, autism and intellectual disabilities as defined by the DSM-V. Interventions which address suicide, self-harm will also be included, if identified during the extraction process.

They will include in person or e-health interventions which have some evidence of effectiveness (in relation to clinical ad/or functional outcomes) and which have been delivered to young people in LAMICs.

They will also consider a wide range of delivery channels (e.g., in person, web-based or virtual, phone), different practitioners (healthcare practitioners, teachers, lay health care providers) and sectors (i.e., primary, secondary and tertiary health care, education, guardianship councils).

In the pilot of screening procedures, 5% of all references will be screened by two reviewers.

Divergences will be resolved by one expert in mental health research.

Reviewers will be retrained afterwards to ensure reliability.

The remaining 95% will be screened by one reviewer. Covidence web-based tool will be used to perform screening of references and full text paper, and data extraction.

Results

The protocol of this systematic review will be disseminated in a peer-reviewed journal and presented at relevant conferences.

The results will be presented descriptively and, if possible, meta-analysis will be conducted.

Ethical approval is not needed for anonymised secondary data.

Conclusions

The systematic review could help health specialists and other professionals to identify evidence-based strategies to deal with child and adolescents with mental health conditions.

Reference

Grande, A.J., Ribeiro, W.S., Faustino, C., de Miranda, C.T., Mcdaid, D., Fry, A., de Moraes, S.H.M., de Oliveira, S.M.D.V.L., de Farias, J.M., de Tarso Coelho Jardim, P., King, D., Silva, V., Ziebold, C. & Evans-Lacko, S. (2020) Effective/cost effective interventions of child mental health problems in low- and middle-income countries (LAMIC): Systematic review. Medicine (Baltimore). 99(1):e18611. doi: 10.1097/MD.0000000000018611.

4 Quick Tips for Coping with Depression

Four quick tips for those with a friend or relative with depression.

  1. Be aware that depression can be a hidden illness.
    • You may not know that someone close to you is struggling.
    • Keep an eye out for any telltale signs.
  2. Be there for your relative or loved one.
    • Even though they will not necessarily always appreciate it.
  3. Stay in touch with someone if you think they are struggling.
    • An individual with depression may try to withdraw and not contact you, but do not take it personally.
    • Be proactive when it comes to keeping in contact.
  4. Offer support as best you can.
    • But do not forget to also look after yourself.

What are the Effects from Perinatal Period to Adulthood on Psychosocial Stress & Adversity?

Research Paper Title

Psychosocial Stress and Adversity: Effects from the Perinatal Period to Adulthood.

Abstract

Early exposure to stress and adversity can have both immediate and lasting effects on physical and psychological health.

Critical periods have been identified in infancy, during which the presence or absence of experiences can alter developmental trajectories.

There are multiple explanations for how exposure to psychosocial stress, before conception or early in life, has an impact on later increased risk for developmental delays, mental health, and chronic metabolic diseases.

Through both epidemiologic and animal models, the mechanisms by which experiences are transmitted across generations are being identified.

Because psychosocial stress has multiple components that can act as stress mediators, a comprehensive understanding of the complex interactions between multiple adverse or beneficial experiences and their ultimate effects on health is essential to best identify interventions that will improve health and outcomes.

This review outlines what is known about the biology, transfer, and effects of psychosocial stress and early life adversity from the perinatal period to adulthood.

This information can be used to identify potential areas in which clinicians in neonatal medicine could intervene to improve outcomes.

Reference

Barrero-Castillero, A., Morton, S.U., Nelson, C.A. & Smith, V.C. (2019) Psychosocial Stress and Adversity: Effects from the Perinatal Period to Adulthood. NeoReviews. 20(12):e686-e696. doi: 10.1542/neo.20-12-e686.