Regional differences in mental health in Great Britain.

STUDY OBJECTIVE--The aim was to study the pattern and magnitude of regional differences in psychiatric morbidity and compare these with regional differences in all cause mortality. DESIGN--The study was a secondary analysis of data from a cross sectional survey. The main outcome was the prevalence of psychiatric morbidity. This was assessed using the general health questionnaire, a self administered measure of neurotic symptoms. SETTING--England, Wales and Scotland. PARTICIPANTS--9003 adults were selected from the electoral register. MAIN RESULTS--The prevalence of psychiatric morbidity was 31% with a statistically significant difference between the regions (p = 0.006). All four northern regions of England had a higher prevalence of psychiatric morbidity than the four southern regions. These differences were comparable in size to the regional differences in all cause mortality. Scotland had low psychiatric morbidity but high all cause mortality while Greater London had high psychiatric morbidity but low mortality. Regional variation in psychiatric morbidity was less marked within social classes I and II and among those living in urban areas. CONCLUSIONS--Psychiatric morbidity is common and is an important public health problem. Regions with relatively high psychiatric morbidity did not always have relatively high mortality. Knowledge of the causes of these regional differences could ultimately lead to preventive action and be important when distributing health service resources.     

Impact of organisational change on mental health: a systematic review

Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web of Knowledge combining MeSH search terms for exposure and outcome. The criterion for inclusion was original data on exposure to organisational change with mental health problems as outcome. Both cross-sectional and longitudinal studies were included. We found in 11 out of 17 studies, an association between organisational change and elevated risk of mental health problems was observed, with a less provident association in the longitudinal studies. Based on the current research, this review cannot provide sufficient evidence of an association between organisational change and elevated risk of mental health problems. More studies of long-term effects are required including relevant analyses of confounders.     

Organisational justice and mental health: a systematic review of prospective studies

The models most commonly used, to study the effects of psychosocial work factors on workers' health, are the Demand-Control-Support (DCS) model and Effort-Reward Imbalance (ERI) model. An emerging body of research has identified Organisational Justice as another model that can help to explain deleterious health effects. This review aimed: (1) to identify prospective studies of the associations between organisational justice and mental health in industrialised countries from 1990 to 2010; (2) to evaluate the extent to which organisational justice has an effect on mental health independently of the DCS and ERI models; and (3) to discuss theoretical and empirical overlap and differences with previous models. The studies had to present associations between organisational justice and a mental health outcome, be prospective, and be entirely available in English or in French. Duplicated papers were excluded. Eleven prospective studies were selected for this review. They provide evidence that procedural justice and relational justice are associated with mental health. These associations remained significant even after controlling for the DCS and ERI models. There is a lack of prospective studies on distributive and informational justice. In conclusion, procedural and relational justice can be considered a different and complementary model to the DCS and ERI models. Future studies should evaluate the effect of change in exposure to organisational justice on employees' mental health over time.     

Racial/ethnic differences in attitudes toward seeking professional mental health services

OBJECTIVES: This study examined racial/ethnic differences in attitudes toward seeking mental health services. METHODS: Data from the National Comorbidity Survey, which administered a structured diagnostic interview to a representative sample of the US population (N = 8098), were analyzed. Multiple logistic regression was used, and data were stratified by need for mental health services. RESULTS: African Americans with depression were more likely than Whites with depression to "definitely go" (odds ratio [OR] = 1.8, P < .001) seek mental health services. African Americans with severe psychiatric disorders were less likely to be "somewhat embarrassed if friends knew they sought care" (OR = 0.3, P < .001) than were their White counterparts. CONCLUSIONS: African Americans reported more positive attitudes toward seeking mental health services than did Whites.     

Abortion and long-term mental health outcomes: a systematic review of the evidence

Claims that women who have elective abortions will experience psychological distress have fueled much of the recent debate on abortion. It has been argued that the emotional sequelae of abortion may not occur until months or years after the event. Despite unclear evidence on such a phenomenon, adverse mental health outcomes of abortion have been used as a rationale for policy-making. We systematically searched for articles focused on the potential association between abortion and long-term mental health outcomes published between January 1, 1989 and August 1, 2008 and reviewed 21 studies that met the inclusion criteria. We rated the study quality based on methodological factors necessary to appropriately explore the research question. Studies were rated as Excellent (no studies), Very Good (4 studies), Fair (8 studies), Poor (8 studies), or Very Poor (1 study). A clear trend emerges from this systematic review: the highest quality studies had findings that were mostly neutral, suggesting few, if any, differences between women who had abortions and their respective comparison groups in terms of mental health sequelae. Conversely, studies with the most flawed methodology found negative mental health sequelae of abortion.     

Child maltreatment prevention: a systematic review of reviews

Objective

To synthesize recent evidence from systematic and comprehensive reviews on the effectiveness of universal and selective child maltreatment prevention interventions, evaluate the methodological quality of the reviews and outcome evaluation studies they are based on, and map the geographical distribution of the evidence.

Methods

A systematic review of reviews was conducted. The quality of the systematic reviews was evaluated with a tool for the assessment of multiple systematic reviews (AMSTAR), and the quality of the outcome evaluations was assessed using indicators of internal validity and of the construct validity of outcome measures.

Findings

The review focused on seven main types of interventions: home visiting, parent education, child sex abuse prevention, abusive head trauma prevention, multi-component interventions, media-based interventions, and support and mutual aid groups. Four of the seven – home-visiting, parent education, abusive head trauma prevention and multi-component interventions – show promise in preventing actual child maltreatment. Three of them – home visiting, parent education and child sexual abuse prevention – appear effective in reducing risk factors for child maltreatment, although these conclusions are tentative due to the methodological shortcomings of the reviews and outcome evaluation studies they draw on. An analysis of the geographical distribution of the evidence shows that outcome evaluations of child maltreatment prevention interventions are exceedingly rare in low- and middle-income countries and make up only 0.6% of the total evidence base.

Conclusion

Evidence for the effectiveness of four of the seven main types of interventions for preventing child maltreatment is promising, although it is weakened by methodological problems and paucity of outcome evaluations from low- and middle-income countries.     

The effectiveness of positive mental health programs in adults: A systematic review

A systematic review was conducted. So, electronic database including CINAHL, Embase, MEDLINE, Pubmed, Scopus and Cochrane‐Central were explored in January 2017 and in October 2017. The aim of this systematic review is to identify, appraise and synthesize the best evidence for the effectiveness of programmes of positive mental health in adults. Mental health is regarded as an ideal functioning state of the human being, which emphasizes the relevance of promoting the person's qualities in the optimization of their potential. Mental health is not inert and definitive but a dynamic and variable state. Studies were reviewed and data extracted by two independent reviewers using Joanna Briggs Institute standardized critical appraisal and data extraction instruments. Six studies met the inclusion criteria for the analysis. However, a meta‐analysis could not be performed. The results suggest that positive mental health programmes improve adults’ mental condition, although there is neither evidence of content formalization nor of programme sessions criteria. The review findings indicate that interventions promoting positive mental health of young adults can be implemented effectively in community settings with various programmes and results.     

A trauma-informed approach in Canadian mental health policies: A systematic mapping review

Trauma is a hidden epidemic and a public health concern in Canada and globally. To address the pervasiveness of trauma in general and clinical populations, a trauma-informed approach (TIA) has been widely promoted in the field of mental health (MH). This study explores how a TIA has been incorporated in Canadian MH policies across all provinces and territories, and in both government and non-government organizations. A systematic mapping review in multiple search sites resulted in a total of 60 TIA policy documents in MH policies. The findings indicated that despite the broad range of the search period which went back as far as the 1980s, TIA policies started emerging in 2010 in the field of Canadian MH. Our research findings also showed an increased understanding of a broad definition and various types of trauma and an acknowledgement of its causes and impacts on multiple levels. This highlighted the importance of all levels of services in TIA. Through this search, we identified the widespread use of different terminologies to refer to TIA. This may create confusion about what TIA means in policy, research, and practice. We propose areas for improvement such as including experiences of marginalized populations, explicitly centering cultural and gender sensitive approaches in TIA policy initiatives, clarifying the standard definition of TIA and its implementation services, and establishing indicators and evaluation methods for future research and policy directions.     

The treatment of child and adolescent mental health problems in primary care: a systematic review

BACKGROUND: There is significant potential to increase the accessibility and effectiveness of child and adolescent mental health services through the involvement of primary care professionals and the delivery of interventions in the primary care setting. However, little is known about the actual clinical and cost-effectiveness of such service delivery. OBJECTIVE: The aim of the study was to review systematically the evidence concerning the effectiveness of interventions for child and adolescent mental health problems in primary care, and interventions designed to improve the skills of primary care staff. METHODS: Searches were made of The Cochrane Clinical Trials Register, MEDLINE, PSYCINFO, EMBASE and CINAHL, together with correspondence with subject experts and authors of studies, and checking of references in identified papers. RESULTS AND CONCLUSIONS: There was some preliminary evidence that treatments by specialist staff working in primary care were effective, although the quality of included studies was variable and no data were available on the cost-effectiveness of interventions. Equally, some educational interventions show potential for increasing the skills and confidence of primary care staff, but controlled evaluations were rare and few studies reported actual changes in professional behaviour or patient health outcomes. A significant programme of research is required if the potential for child and adolescent mental health services in primary care is to be realized in an effective and efficient way.     

Poorer self-perceived health among migrants and ethnic minorities versus the majority population in Europe: a systematic review

Objectives  

Knowledge about self-perceived health can help us understand the health status and needs among migrants and ethnic minorities in the European Union (EU) which is essential to improve equity and integration. The objective was to examine and compare self-perceived health among migrant and ethnic minority groups in the EU countries.