Exploring the feasibility and acceptability of a school‐based self‐referral intervention for emotional difficulties in older adolescents: qualitative perspectives from students and school staff

Background

Adolescents with emotional difficulties need accessible, acceptable and evidence‐based mental health interventions. Self‐referral workshops (DISCOVER workshops) were offered to stressed 16‐ to 19‐year olds in 10 Inner London schools.

Method

Semistructured interviews were conducted with three groups of participants: students who attended a 1‐day workshop (n = 15); students who initially showed interest in the DISCOVER workshop programme, but decided not to take part (n = 9); and school staff who helped organise the programme in their schools (n = 10). Students were purposively sampled to ensure that those from Black and minority ethnic (BME) backgrounds were represented. Data were analysed using thematic analysis.

Results

The accounts generally indicate that the delivery and evaluation of this intervention is perceived as feasible and acceptable. Students, including those from BME backgrounds, described the setting as suitable and reported that the workshop helped them develop new understandings of stress and how to handle it. They expressed a preference for engaging and interactive activities, and valued a personalised approach to workshop provision. School staff felt that the workshop was in line with school values. They described some logistical barriers to providing the workshops in school settings, and expressed a desire for more information about the workshop in order to provide follow‐up support. The main reason students gave for nonparticipation was limited time.

Conclusions

Findings are discussed in relation to increasing the feasibility of implementing school‐based psychological interventions and the value of providing access to mental health support in schools.     

Symptoms of anxiety and depression in adolescent students; a perspective from Sri Lanka

Background  

Sri Lanka recorded an extraordinary high suicide rate for adolescents aged 15 - 19 in the early 1990s (46.5/100,000). With this in perspective, the Ministry of Health in Sri Lanka recommends school programmes for adolescents by mental health units of local hospitals.     

‘The challenges of sharing information when a young person is experiencing severe emotional difficulties’: implications for schools and CAMHS

Background

Supporting the education of children and young people with complex emotional mental health difficulties requires schools to have knowledge of their needs. Exchanging information about less visible mental health difficulties is, however, known to be complex. Exploring the perceptions of young people experiencing problems can explicate some of this complexity and identify solutions. Yet their views are rarely given credence in this context.

Methods

The findings were derived from a broader qualitative study exploring the school experiences of young people, aged 14–16 years, identified by CAMHS as having severe emotional difficulties. Their parents’ and teachers’ perceptions were also explored. Data were collected via semistructured interviews and analysed using thematic analysis.

Results

Findings demonstrated that young people experiencing emotional difficulties need to feel safe about exchanging private information pertaining to their mental health. Teachers having a basic knowledge of mental health promoted their safety as this ensured confidentiality. Participants reported that CAMHS practitioners needed to be more proactive regarding the practicalities of exchanging information.

Conclusions

Arguably, teachers need to have basic knowledge of mental health and schools need clearer mental health confidentiality guidance. CAMHS also have responsibility in identifying more information exchange mechanisms and young service users and parents can play a part in this.     

The association between transient childhood psychotic experiences and psychosocial outcomes in young adulthood: Examining the role of mental disorders and adult attachment

Aim

Evidence suggest individuals with mental disorders and psychotic experiences (PE), even transient PE, show poorer psychosocial outcomes relative to those with mental disorders. The concept of “attachment” is hypothesized as the mechanism by which people seek support in times of need. This can be measured as discrete styles or as positive (low avoidance/anxiety)/negative (high avoidance/anxiety) dimensions. Adult attachment has previously been examined on PE risk factors, but not outcomes. This study aimed to examine the relationship between transient childhood PE and adult psychosocial outcomes, comparing those with and without mental disorders. Second, to examine the role of adult attachment.

Method

Participants (n = 103) attended baseline (age 11–13) and 10-year follow-up. PE and mental disorders were measured using the Schedule for Affective Disorders and Schizophrenia for School-aged Children. Attachment and outcomes were measured using self-report measures. Analysis compared those with PE (with/without mental disorders), and mental disorders without PE, to controls, using linear and Poisson regression.

Results

PE was associated with lower self-esteem (β = −2.28, p = .03), perceived social support from friends (β = −2.80, p = .01), and higher stress in platonic relationships (IRR = 1.64). PE and mental disorders were associated with lower self-esteem (β = −5.74, p = .002), higher stress in romantic (IRR = 1.40) and platonic (IRR = 1.59) relationships, general stress (β = 5.60, p = .006), and mental distress (β = 5.67, p = .001). Mental disorders alone was not associated with any measure. Adult attachment dimensions attenuated some results.

Conclusions

This paper illustrates the association between transient PE and adult psychosocial outcomes, with & without co-occurring mental disorders, and demonstrates the role of adult attachment.     

International observatory on mental health systems: structure and operation

Introduction  

Sustained cooperative action is required to improve the mental health of populations, particularly in low and middle-income countries where meagre mental health investment and insufficient human and other resources result in poorly performing mental health systems.     

Developmental level and other factors associated with symptoms of mental disorders and problem behaviour in adults with intellectual disabilities living in the community

Background  

Studies of the relationship between the level of intellectual disability and mental and behavioural disorders have reported divergent findings regarding the direction of the relationship and how it is related to different mental disorders.     

Postoperative confusion and basilar artery stroke

Introduction  

Non-focal postoperative mental status changes can be challenging.     

Mental health among older married couples: the role of gender and family life

Purpose  

As shared family context may be an important influence on mental health, and gender differences in mental health, in later life we investigated how gender, family-related variables and gender roles were associated with mental health in older married couples.     

A preliminary taxonomy and a standard knowledge base for mental-health system indicators in Spain

Background  

There are many sources of information for mental health indicators but we lack a comprehensive classification and hierarchy to improve their use in mental health planning. This study aims at developing a preliminary taxonomy and its related knowledge base of mental health indicators usable in Spain.     

Sleep patterns and habits in high school students in Iran

Background  

Sleep patterns and habits in high school students in Iran have not been well studied to date. This paper aims to re-address this balance and analyse sleep patterns and habits in Iranian children of high school age.     

School effects on risk of non-fatal suicidal behaviour: a national multilevel cohort study

Objective

Research has demonstrated school effects on health, over and above the effects of students’ individual characteristics. This approach has however been uncommon in mental health research. The aim of the study was to assess whether there are any school-contextual effects related to socioeconomic characteristics and academic performance, on the risk of hospitalization from non-fatal suicidal behaviour (NFSB).

Methods

A Swedish national cohort of 447,929 subjects was followed prospectively in the National Patient Discharge Register from the completion of compulsory school in 1989–93 (≈16 years) until 2001. Multilevel logistic regression was used to assess the association between school-level characteristics and NFSB.

Results

A small but significant share of variation in NFSB was accounted for by the school context (variance partition coefficient <1 %, median odds ratio = 1.26). The risk of NFSB was positively associated with the school’s proportion of students from low socioeconomic status (SES), single parent household, and the school’s average academic performance. School effects varied, in part, by school location.

Conclusion

NFSB seems to be explained mainly by individual-level characteristics. Nevertheless, a concentration of children from disadvantaged backgrounds in schools appears to negatively affect mental health, regardless of whether or not they are exposed to such problems themselves. Thus, school SES should be considered when planning prevention of mental health problems in children and adolescents.     

Hope,despair and transformation: Climate change and the promotion of mental health and wellbeing

Background  

This article aims to provide an introduction to emerging evidence and debate about the relationship between climate change and mental health.     

Neighborhood Contexts and the Mediating Role of Neighborhood Social Cohesion on Health and Psychological Distress Among Hispanic and Non-Hispanic Residents

Background  

Neighborhood social cohesion (NSC) may contribute to understanding how neighborhood contexts influence the physical and mental health of residents.     

Relationships between parental mental illness and/or offending and offspring contact with the police in childhood: Findings from a longitudinal record-linkage study

Background

Parental offending and mental illness are associated with an increased risk of criminal behaviour in offspring during adolescence and adulthood, but the impact of such problems on younger children, including children's experiences of victimisation, is less well known.

Aim

To investigate the associations between parental offending and mental illness recorded prior to their offspring's age of 5 years and their offspring's contact with police as a ‘person of interest’, ‘victim’ or ‘witness’ between ages 5 and 13 years.

Methods

Our sample consisted of 72,771 children and their parents drawn from the New South Wales Child Development Study, an Australian longitudinal population-based record linkage study. Logistic regression analyses were conducted to examine associations between parental factors and offspring's police contact. Separate models examined the relationships between maternal or paternal offending and mental illness, as well as the combination among either or both parents, as the independent variables, and their child's police contact as the dependent variable.

Results

Parental offending and mental illness were each individually associated with indices of police contact among offspring. Stronger associations were observed when both offending and mental illness were present together (in either parent, or when one parent had both exposures). Stronger associations were evident for mothers with both factors across all offspring police contact types, relative to fathers with both factors, in fully adjusted models; that is, children of mothers with both factors were over four times as likely to have contact with police as a ‘person of interest’ (OR = 4.29; 95% CI = 3.75–4.92) and over three times as likely to have contact as a victim (OR = 3.35; 95% CI = 3.01–3.74) or witness (OR = 3.58; 95% CI = 3.03–4.24), than children whose mothers had no history of offending or mental illness.

Conclusions

Children with a parental history of offending and mental illness in early life are at an increased likelihood of early police contact as young as 5–13 years of age; it is vital that this is taken as a signal to help them and their affected families according to need.     

Individual and parental psychiatric history and risk for suicide among adolescents and young adults in Denmark

Background  

Both individual and familial histories of mental illness are substantial risk factors for suicide in young people.     

The contribution of Ghanaian pharmacists to mental healthcare: current practice and barriers

Background  

There is scant knowledge of the involvement of developing country pharmacists in mental healthcare. The objectives of this study were: to examine the existing role of Ghanaian community and hospital pharmacists in the management of mental illness, and to determine the barriers that hinder pharmacists' involvement in mental healthcare in Ghana.     

Research on Mental Sub-health of Chinese Han Adolescents with Different Nutritional Statuses

Objective

Explore the mental sub-health of Chinese Han adolescents with different nutritional statuses.

Mapping mental health finances in Ghana, Uganda, Sri Lanka, India and Lao PDR

Background  

Limited evidence about mental health finances in low and middle-income countries is a key challenge to mental health care policy initiatives. This study aimed to map mental health finances in Ghana, Uganda, India (Kerala state), Sri Lanka and Lao PDR focusing on how much money is available for mental health, how it is spent, and how this impacts mental health services.     

Public sector mental health systems in South Africa: inter-provincial comparisons and policy implications

Background  

There is growing recognition that mental health is an important public health issue in South Africa. Yet mental health services remain chronically under-resourced. The aim of this study was to document levels of current public sector mental health service provision in South Africa and compare services across provinces, in relation to current national policy and legislation.     

Determinants of psychological morbidity in survivors of the earthquake and tsunami in Aceh and Nias

Background  

The goal of this study was to collect information to inform the design of a mental health response following the massive December 2004 earthquake and tsunami in Aceh and North Sumatra, Indonesia. As well as exploring the effect on mental health of direct exposure to the tsunami the study was designed to examine the effect on mental health of immediate post-disaster changes in life circumstances (impact).