Enhancing the mental health promotion component of a health and personal development programme in Irish schools

This study set out to examine the impact of a health and personal development programme (the Social, Personal and Health Education Programme) which had been ‘enhanced’ by the addition of a mental health promotion component. Students aged 12–16 years attending 17 secondary schools were randomly allocated as clusters to participate in either the standard programme (SP) or the enhanced programme (EP). Both programmes were delivered over an eight-month period. Questionnaires assessing help-seeking, emotional and behavioural difficulties and students' views of school social environment were completed by students in both groups at pre-intervention, post-intervention and at six-month follow-up. One thousand and seventy-two students participated. Analyses were carried out on the 782 students (72.9%) for whom data were available at all three time points. Both groups showed improvement over time in terms of emotional and behavioural difficulties, with male students identified as ‘at risk’ in the EP showing significantly greater improvements than males ‘at risk’ in the SP. Although there were few differences in outcomes between the groups, males identified as ‘at risk’ appeared to benefit selectively from the EP.     

Building mental health promotion capacity in health care: results from Phase I of a workforce development project

The development of mental-health-promoting health care systems is dependent on having a skilled and informed workforce to effectively integrate mental health promotion (MHP) into programme and service delivery. This paper describes Phase I (September 2009-July 2010) of Health Compass, an innovative, multi-phased project that aims to transform health care practice and shift organizational culture by enhancing the capacity of health care providers to further promote patient, client and family mental well-being. Phase I of Health Compass examined the current state of MHP within British Columbia's Provincial Health Service Authority health care services. The findings, based on group discussions and key informant interviews, examined health care providers' current understanding and knowledge of MHP; identified existing strategies, facilitators and barriers that help or hinder the incorporation of MHP into health care practice and services; and identified preferred learning modalities for development and piloting of future MHP resources in Phases II and III.     

Teachers as mental health promoters: a study of teachers' understanding of the concept of mental health

Based on results from a mixed method approach, using focus group interviews (N = 15) and survey research (N = 1575, this paper explores Norwegian K12 teachers' understanding of the concept of mental health. The theoretical framework of analysis is a socio-ecological and systemic perspective, seeing conceptual understanding as a result of a complex interplay between factors on individual, organizational and state/society levels. Existing research indicates that mental health is an unfamiliar term in a school context, and often negatively loaded. Our results support this, but show significant differences in school type, where teachers in higher grades report more frequent use of the term, more positive term-loading and less tendency to prefer ‘well-being’ as a substitute, rather than as a complementary term to mental health. These teachers also report significantly higher levels of organizational support on mental health promotion. At individual level, experience and further education were important for differences in conceptual understanding.     

The meaning of mental health from elderly women's perspectives: a basis for health promotion

PROBLEM: To gain a deeper understanding of the meaning of mental health. METHODS: Qualitative interviews with 16 women between the ages of 71 and 92. The data were collected and analyzed using a phenomenological approach. FINDINGS: The essence of mental health is the experience of confirmation, trust and confidence in the future, as well as a zest for life, development, and involvement in one's relationship to oneself and to others. CONCLUSIONS: Creating arenas for encounters confirming the individual's human existence and dignity is an important basis for the psychiatric nurse's health-promotion work.     

Tensions along the path toward mental health literacy for new immigrant mothers: perspectives on mental health and mental illness

This study explored how mothers approach their own mental health literacy and that of their teenage children. The research used focus groups and questions based on the messaging of a community-based mental health awareness program called ‘Talking about Mental Illness’ (TAMI) to investigate the nature of mental health perceptions and attitudes of new immigrant mothers and illustrate how the program’s messaging can contribute to or build upon their levels of mental health literacy. A qualitative thematic assessment of the knowledge and perceptions of the study participants, all recent immigrants to Canada from India, Bangladesh, Iran, and Romania within the last three years and mothers of high school students, was undertaken. The findings show that participants appreciate the importance of fostering mental health understanding and discussion with their children at the same time that they encounter obstacles to the advancement of their mental health literacy.     

The contribution of a mobile mental health unit to the promotion of primary mental health in rural areas in Greece: A 2-year follow-up

During the 2 years of the mobile mental-health unit's operation in Northwestern Greece, the referrals increased rapidly with 29.4% of patients never having received mental-health care before, while hospitalizations and relapses reduced significantly, indicating that community-oriented programs can contribute greatly to successfully addressing the needs of patients in remote rural areas.     

Satisfaction with primary and specialized mental health care among patients with mental disorders

The purpose of this article is to assess the satisfaction of patients who received primary or specialized mental health care, and to identify variables associated with each level of care. This cross-sectional study included 325 patients with mental disorders (MDs). We used a conceptual framework based on Andersen’s behavioral model, comprising predisposing factors, enabling factors, and needs; socio-demographic, clinical, needs-related, service-use, and quality-of-life variables were integrated into the model. We performed adjusted multiple linear regression models. The mean score on patient satisfaction for primary and specialized care was approximately 4 (range: 3.67–5.0). Regarding enabling factors, better continuity of care and having a case manager were associated with patient satisfaction for both types of care; help received from services and relatives was positively associated with patient satisfaction in primary care, whereas patients on welfare were more likely to be dissatisfied with specialized care. Number of needs was negatively associated with patient satisfaction in primary care and, marginally so, in specialized care. Suicidal ideation was marginally associated with patient dissatisfaction for specialized care only.

Results revealed a high level of patient satisfaction with each type of care, with significant variables related to continuity of care, case management, and needs. The study suggests the critical importance of addressing patient needs comprehensively, and of establishing long-term, individual recovery plans that promote patient satisfaction. Collaboration between relatives of patients and professionals in patient treatment is closely related to satisfaction with primary care. Accounting for the presence of suicidal ideation and patient vulnerability is fundamental to increasing patient satisfaction with specialized care. Increased patient follow-up in the community, work integration, provision of supported housing, and rapid crisis intervention may help improve patient satisfaction with mental health service (MHS) while supporting recovery.     

Positive mental health effects of the Coping With Strain (CWS) course on employees: a four-year longitudinal randomized controlled trial

The Coping With Strain (CWS) course is a modified version of the Coping With Depression (CWD) course. CWD has been shown to reduce depression in several target groups. However, no other study has tested a modified CWD course delivered at the workplace to promote mental health. As mental health problems among employees remain a neglected area in many countries, and initiatives at the workplace often lack documentation of effects, we tested the effects of CWS on self-esteem, self-efficacy and vitality. After advertisement at workplaces, 119 employees were randomized into Intervention Group 1 (IG1), which immediately participated in CWS, or Intervention Group 2 (IG2), which functioned as a control group for six months until its participation in CWS. The follow-up period lasted for four years in both IG1 and IG2. Linear mixed models were fitted to the data. Self-efficacy, self-esteem and vitality increased significantly during the course and showed further significantly elevated levels at the follow-ups. CWS delivered at the workplace has short-term effects and the long-term effects may be maintained over a period of four years.     

Survey of Australian mental health nurses on physical activity promotion

Physical activity is important to the physical and mental health of people with serious mental illness (SMI). This study investigated views of public mental health nurses on physical activity promotion for consumers with SMI, through a national electronic survey in Australia. Consumers with SMI were viewed to be less physically active than the general community. Two-thirds of nurses wanted training on exercise support of consumers. Motivation of consumers was indicated to be a major barrier. There was great variability in discussion frequency between nurses and exercise physiologists. An analysis of open comments revealed two themes: (1) access – opportunities for health education, participation in physical activity programmes and nurses' connections to exercise physiologists; and (2) commitment – nurses promoting physical activity and building competencies. Findings indicate that initiatives to increase physical activity promotion for people with SMI are likely to be supported by nurses in the mental health sector of Australia.     

中学生心理卫生状况调查及相关因素分析

目的：研究中学生心理健康水平及影响因素。方法：以群体分层抽样法，共抽取受试样本2066例。采用症状自评量表（SCL-90）、艾森克个性问卷（EPQ）、青少年心理卫生调查表（自编），对宝鸡市12所中学初一至高三的六个年级的中学生进行问卷调查。结果：表明约9％的中学生有心理健康问题。中学生心理健康问题依次为强迫、人际关系敏感、敌对、偏执、抑郁、焦虑等。偏相关分析发现中学生心理健康水平与神经质、精神质、年级、学习任务、性别等呈正相关。结论：中学生心理健康值得高度重视；神经质与精神质的个性倾向、年级、学习任务等是影响中学生心理健康的重要因素。     

Identifying key strategies to promote positive mental health of young people in the state of Kerala,India

In the context of the shortage of resources to close the alarming treatment gap of mental disorders, interventions to promote mental health have become a priority of policy makers in low and middle-income countries (LMICs) like India. In this paper, we document an attempt to identify key strategies to promote positive mental health of young people in the state of Kerala, India. Our results could be used for integrating the concept of positive mental health into public health interventions in the state. Focus group discussions among different groups of stakeholders were used to gather information about their attitudes, perceptions or opinions followed by a Delphi exercise involving policy-makers and experts to come to a consensus approach. In-depth exploration of possible policy options was made possible with the participation of experts in related fields using qualitative techniques. Findings from this qualitative study suggest that a life cycle approach may be helpful in identifying areas for possible effective policy interventions for promoting mental health in young people. Improving education and employment opportunities at a macro-level will have a positive impact on mental health. In conclusion, the promotion of mental health among young people should find a prominent place in health policies at national level.     

Developing mental health services in Nigeria

This grass-roots level mental health awareness programme considerably increased use of community-based mental health services in a part of Nigeria where knowledge about treatability of mental illness was limited. The benefits of the programme were sustained for a significant period after the initial awareness programme. In order for attitude changes to be reinforced, similar awareness programmes must be repeated at regular intervals.     

Building resilience through school-based health promotion: a systematic review

This article draws together the evidence through a systematic review of the literature regarding the effectiveness of a health-promoting school (HPS) approach to building resilience. The electronic databases searched included the following: CINAHL, Cochrane Library, Health Reference Center, Informit Search, MEDLINE, ProQuest, PsycINFO, PubMed, ScienceDirect, Scopus, Social Services Abstracts and Web of Science. The study finds that the effectiveness of programmes to enhance resilience among school staff and students and the impact on parents needs more consideration. Although insufficient information was given to comment on costs, a certain amount of financial investment was considered to be important for success. This study indicates that continued investment in research in this area is needed. Also, ongoing long-term evaluation (both process and outcome) is necessary to provide evidence about the effectiveness of using the HPS approach to promote resilience.     

影响小学生心理健康的多因素分析

为探讨儿童心理健康问题的影响因素。方法 采用分层整群抽样的方法,应用心理诊断测验手册调查了四川省绵阳市城乡４－６年级小学生１６８０名。结果 表明３２．４４％的儿童有心理健康问题,０．５４％的儿童疑有重性精神病。结论儿童心理健康问题的主要危险因素为父母离异,寄养,父亲职业及农村儿童。并且随年级增高心理健康问题亦逐级增多。     

Meeting employees where they are: The rise of workplace mental health services

Many key organizations have called attention to the importance of addressing workplace mental health. In this Open Forum piece, two academic psychiatrists present recommendations from their experiences providing psychiatric care in a corporate setting. A literature review using the PubMed database was performed. The search found no peer review articles that discuss the topic of employer-sponsored mental health services outside of traditional employee assistant programs. Based on first-hand experience, the authors of this forum describe key issues and best practices to ensure employer-sponsored mental health services are a successful treatment for patients and mental health providers alike.     

Instructor insights into delivery of Mental Health First Aid USA: A case study of mental health promotion across one state

The Mental Health First Aid (MHFA) course is being used as a tool for educating communities worldwide about mental health. MHFA instructors' experiences in delivering MHFA are not widely documented. In this study, MHFA instructors in 1 state were interviewed and surveyed about their experiences. The findings are that the most common reason for becoming an MHFA instructor was to have a community impact; the most frequently mentioned instructor-identified characteristic was strong teaching or presentation skills, with past clinical experience or education being helpful. Agencies typically deliver MHFA in a team-teaching model, utilize informal marketing or advertisement and often offer the course at a financial loss. Findings suggest that in delivering MHFA, agencies should be deliberate in selecting and training instructors and in creating an agency delivery plan.     

Getting started: assimilatory processes of uptake of mental health promotion and primary prevention programmes in elementary schools

Although there is evidence that multi-systemic mental health promotion and primary prevention programmes can improve children's mental health, lack of widespread dissemination of evidence-based programmes limits their impact on population levels of health. Schools and teachers are frequent collaborators in programme development, evaluation and implementation. However, we know little about the pre-implementation processes that affect adoption (rather than implementation) of evidence-based programmes in new school sites. In this two-wave study, which spanned across one academic school year, qualitative interviews were collected from 20 school staff involved in the initiation of the WITS^® Programs (The WITS^® acronym stands for Walk Away, Ignore, Talk it Out and Seek Help.) for the prevention of peer victimization in rural elementary schools. These Program champions and early starters describe iterative processes of personalization that assimilated Program objectives to personal beliefs. They also worked to integrate new programme activities into ongoing teaching strategies, school programmes and school philosophies before marketing programme resources to others. Barriers to uptake are also identified.     

Interdisciplinary research framework for multisectoral mental health policy development

This paper proposes an interdisciplinary research framework for developing mental health policy in countries where a multisectoral approach to population mental health is not yet on the policy agenda. The proposed mental health policy research framework contains two structural elements: research on the policy content and policy process dimensions. The content dimension defines mental health policy as being a multisectoral policy encompassing positive mental health for all, the prevention and treatment of mental disorders, and the social and human rights consequences of poor mental health. The process dimension is based on the cyclical model of policy processes as described by Kingdon’s theory of agenda-setting and Rochefort’s analysis of the factors which affect mental health policy-making. The framework presents an innovative approach to researching mental health policy, bringing a more interdisciplinary focus and an explicit emphasis on policy-making.