Attitude and behaviour change – it takes a generation

AimThis scoping review aims to better understand the extent and nature of research activity on the topic of mental health problems in young people with childhood-onset physical disabilities. Specifically, we document what has been investigated in terms of the occurrence and experience of mental health problems among young people with childhood-onset physical disabilities, and their access to mental health services.MethodsWe searched four databases (Medline, PsycINFO, CINAHL, Embase) for articles published between 2007 and 2019. Studies were included if they addressed: (1) young people between the ages of 13 and 24 with a childhood-onset physical disability, and (2) mental health assessment, treatment, or service access and use.ResultsWe identified 33 peer-reviewed studies that focused mainly on young people with cerebral palsy, juvenile arthritis, and spina bifida. The most common mental health problems investigated were depression and mood related difficulties (73%), anxiety (39%), and social/behavioural issues (33%) and the most common age range was 13 to 17. Ten studies explored access, use, and experiences of mental health services; stigma; caregiver mental health; and value for comprehensive care, using qualitative, quantitative, or mixed methods.ConclusionsFindings suggest the importance of developing integrated models of service delivery to identify and address the mental health needs of this population, and consensus on best practices for assessment and reporting rates of subclinical symptoms and psychiatric conditions.

ABSTRACTNurses' mental health is of paramount importance, both in terms of patient safety and the sustainability of the workforce. Age, years in the profession, in post and personal experience or exposure to mental health problems are relevant to the mental health nursing workforce crisis in the United Kingdom. This study aimed to determine the relationship between age, years in the profession and post and self-reported experience of mental health problems using an online cross-sectional survey of 225 UK mental health nurses. Number of years in post was inversely correlated with overall experience of mental health problems, particularly living with someone else with mental health problems. Those with experience of living with someone with mental health problems had significantly fewer years of professional experience than those without. This article discusses possible explanations for this phenomenon and makes the case for future research on the topic.

The pandemic has dealt a severe blow to everyone, but especially to people with previous vulnerabilities, such as people with lived experience of mental health problems. Studies on the increased incidence of all types of mental disorders have been published incessantly since the beginning of the pandemic. However, not much has been said about the impact of the pandemic in terms of their rights, already hampered by stigma and social discrimination before the pandemic. The full inclusion of people with lived experience of mental health problems as full citizens is a limitation in all societies, and it implies a burden in their recovery journeys. In these pandemic times, we think the rights of persons with lived experience of mental health problems deserves special attention. We carried out two focus groups with 17 key participants with different mental health expertise from three Spanish-speaking countries (Chile, Colombia, and Spain) to consider possible violations of rights that have occurred in the pandemic context but also experiences of individual and collective resilience that have helped maintain well-being among this group of people.

Co-design is one of the human-centered design approaches that allows end users to significantly and positively impact the design of mental health technologies. It is a promising approach to foster user acceptance and engagement in digital mental health solutions. Surprisingly, there is a lack of understanding of what co-design is in this field. In this paper, co-design is approached as a cocreation process involving persons with a lived experience of mental health problems, health professionals, and design experts who lead and facilitate the overall creative process. This paper describes an initial co-design research protocol for the development of a mobile app that aims to improve access to mental health care. It highlights the characteristics of a co-design approach in e-mental health rooted in human-centered design and led by design experts alongside health experts. The paper focuses on the first steps (phase 1) of the co-design process of the ongoing Mentallys project. This Mentallys project will be located in Montréal (Quebec, Canada). The method approach will be based on the "method stories," depicting the "making of" this project and reflecting adjustments needed to the protocol throughout the project in specific situations. Phase 1 of the process will focus on the desirability of the app. Targeted participants will include people with a lived experience of mental health problems, peer support workers and clinicians, and 3 facilitators (all design experts or researchers). Web-based sessions will be organized because of the COVID-19 pandemic, using Miro (RealtimeBoard Inc) and Zoom (Zoom Video Communications, Inc). Data collection will be based on the comments, thoughts, and new ideas of participants around the imaginary prototypes. Thematic analysis will be carried out after each session to inform a new version of the prototype. We conducted 2 stages in phase 1 of the process. During stage 1, we explored ideas through group co-design workshops (divergent thinking). Six co-design workshops were held: 2 with only clinicians (n=7), 2 with peer support workers (n=5) and people with a lived experience of mental health problems (n=2), and 2 with all of them (n=14). A total of 6 facilitators participated in conducting activities in subgroups. During stage 2, ideas were refined through 10 dyad co-design sessions (convergent thinking). Stage 2 involved 3 participants (n=3) and 1 facilitator. Thematic analysis was performed after stage 1, while analytic questioning is being performed for stage 2. Both stages allowed several iterations of the prototypes. The design of the co-design process, the leadership of the design expertise throughout the process, and the different forms of co-design activities are key elements in this project. We highly recommend that health researchers partner with professional designers or design researchers who are familiar with co-design. DERR1-10.2196/47220.

<p><strong><em>Background: </em></strong><em>Changes during pregnancy can cause physical and psychological symptoms, such as anxiety. However, many mothers do not undergo mental health condition detection by healthcare professionals, often due to misconceptions or lack of awareness.</em><strong><em> </em></strong></p><p><strong><em>Objectives: </em></strong><em>This study aims to analyze the relationship between mothers’ experiences and perceptions in seeking mental health support during pregnancy and up to two years postpartum.</em></p><p><strong><em>Methods: </em></strong><em>The design of this study is a retrospective cohort. The sample consisted of 249 respondents. The research was conducted in December 2024 at Karang Kitri Public Health Center, Sriamur Public Health Center, and the practices of midwives Luvvia Afriansid, Anita, Hj. Fitri, and Srimahi Public Health Center. The dependent variable was the experience of mental health problems, particularly anxiety, from pregnancy until two years postpartum. Statistical analysis was performed using multivariate logistic regression.</em> <em>Mothers’ perceptions of mental health detection were measured using the Mental Health Seeking Questionnaire, and anxiety levels were assessed using the Hamilton Anxiety Rating Scale (HAM-A). The relationship between the two variables was analyzed using multivariate logistic regression.</em><em></em></p><p><strong><em>Results: </em></strong><em>The analysis showed that prior experience of mental health problems (particularly anxiety) did not significantly affect mothers’ perceptions of the importance of mental health detection (p = 0.142; p > 0.05). However, education level was significantly related to perception (p = 0.023; OR = 0.09), indicating that lower education levels are associated with lower positive perceptions toward mental health detection.</em><strong><em> </em></strong><em></em></p><strong><em>Conclusions: </em></strong><em>The study revealed no significant relationship between maternal anxiety and perceptions of seeking mental health support, as many mothers experiencing moderate to severe anxiety did not recognize their symptoms as a mental health concern or seek professional help</em>

Despite young British Bangladeshis experiencing a higher prevalence of mental health problems than the White British population, they are comparatively underrepresented in mental health research and fewer access services. This study aimed to identify priorities and preferences for mental health support among young British Bangladeshis, as well as strategies to enhance the cultural appropriateness and accessibility of services. A qualitative study was conducted in London and Leicester, with participants recruited through voluntary and community organisations. In-depth interviews were held with young people with lived experience of mental health problems (n = 12), their family members (n = 7) and Bangladeshi community workers from voluntary sector organisations (n = 7). Data were analysed using thematic framework analysis. Participants' priorities for mental health support included reducing stigma, raising awareness, and addressing intergenerational and identity-related stressors. Preferences centred on culturally and linguistically appropriate care delivered by therapists familiar with Bangladeshi values in trusted community settings. Suggested strategies for improving existing services included enhancing access by providing support in trusted community spaces, building trust through the involvement of culturally aware professionals, and involving families and community leaders to reduce stigma and promote open discussion around youth mental health. This study identifies a need for culturally tailored, linguistically accessible and community-rooted mental health support for British Bangladeshi youth. Representatives from these communities should be actively involved in the development of future programmes and policies, ensuring that support is both relevant and sustainable.

The aim of this article is to present selected findings from a doctoral study on the subjective well-being and subjective experience of mental health problems in UK mental health nurses. Here the concept of 'nurses' well-being' is explored. Data were drawn from a survey of 237 mental health nurses about their mental health and well-being and from interviews with 27 mental health nurses with personal experience of mental health problems and high subjective well-being. While nurses' subjective well-being is relatively low, some use strategies to support their well-being in and outside the workplace. Activities outside work that improved their wellbeing were physical exercise, mindfulness practice, spending time in nature and listening to music. Well-being was associated with clear boundaries between home and work life, regular clinical supervision and translating learning from work with patients to nurses' own lives. Healthcare employers' staff health and well-being strategies should be informed by nurses' insights into what works for them. This may mean offering opportunities to take part in well-being activities. There are also opportunities to improve staff well-being through shared initiatives open to nurses and patients, and through an inclusive and empowering approach to staff engagement.

Mental health problems (MHPs) are increasingly prevalent in academia, yet most attention has focused on students. Academics, who often support students with MHPs, may themselves experience significant mental health challenges. This systematic review aimed to explore university academics’ experiences of MHPs, following PRISMA guidelines. A comprehensive search was conducted using six electronic databases and eleven studies representing approximately 4,000 participants met the eligibility criteria. Eleven studies (qualitative, quantitative and mixed-methods) involving roughly 4,000 participants were included. Thematic analysis identified five major themes: precipitators of MHPs, prevalence of MHPs, predisposing and protective factors of MHPs, prevention of help-seeking for MHPs and pursuing solutions for MHPs. Findings from this review highlight that a considerable proportion of university academics experience symptoms of depression, anxiety and stress at levels that are often severe. Risk factors include being female, single, childless and holding a doctorate. Despite the high prevalence of MHPs in academic staff, many do not seek help due to barriers such as stigma associated with MHPs, fear of professional repercussions and time constraints. These findings may contribute to the development of effective strategies to support the mental well-being of university academics. Despite growing interest, research on the mental health of academics remains limited and warrants further investigation.

Purpose: Public health campaigns are still relatively rare in mental health. This paper aims to find consensus on the preventive self-management actions (i.e. “healthy behaviors”) for common mental health problems (e.g. depression and anxiety) that should be recommended in mental health campaigns directed at the general public. Approach: A 3-round Delphi study Participants: 23 international experts in mental health and 1447 members of the public, most of whom had lived experience of mental health problems. Method: The modified Delphi study combined quantitative and qualitative data collection: 1) online qualitative survey data collection thematically analyzed, 2) recommendations rated for consensus, 3) consensus items rated by public panel on a Likert scale. Results: Expert consensus was reached on 15 behaviors that individuals can engage in to sustain mental health. Eight were rated as appropriate by more than half (50%) of the public panel, including: avoiding illicit drugs (80%, n = 1154), reducing debt (72%, n = 1043), improving sleep (69%, n = 1000), regulating mood (65%, n = 941), having things to look forward to (60%, n = 869). Conclusions: A series of healthy behaviors for the promotion and protection of mental health received expert and public consensus. To our knowledge, this is the first study to offer a set of actions for public health messaging for the prevention of poor mental health. Future research should focus on evaluating effectiveness of these actions in a universal primary prevention context.

Women's mental health during pregnancy: A participatory qualitative study.

The aim of this research scoping review was to assemble an evidence base for the UK on mental health service user experiences and perspectives on mental health-related targeted violence and hostility ('disability hate crime'). It also aims to address some of the gaps in the knowledge on risk management, help-seeking and prevention from the perspectives of those who experienced targeted violence and hostility because of their mental health problems or psychiatric status. Seven key mental health and social care bibliographic databases were searched for relevant UK research studies from 1990 until 2016. Grey literature was identified through online searches. A scoping review charting approach and thematic analysis methodology were used to analyse the studies. In total 13 studies were finally included, over half of which used survey methods. All studies included people with experiences of mental health problems. The studies provide information on: the types of potential hate crime; indicate where incidents take place; give some insight into the victims' relationship with the perpetrators; the location of incidents as well as the psychological, social, financial and physical impacts on the victim; the types of help-seeking behaviours adopted by the victims; a range coping strategies that people with mental health problems adopted in response to experiences of targeted violence or abuse. This scoping review provides a UK-based overview of mental health service user concepts and experiences of mental health-related targeted violence and hostility ('disability hate crime'). It reveals some specific issues relating to mental health and disability hate crime. Further investigation into disability hate crime with a specific focus on mental health is required. This is a UK-based overview, which offers a useful comparator for researchers, practitioners and policy-makers internationally.

IntroductionA mental health peer support program was implemented at two reference institutions in Central Catalonia. The program culturally and contextually adapted successful international projects by training people with experience of mental health problems and ensuring their employment in multidisciplinary health care teams. This study explores the influence of peer interventions in mental health on the three groups of participants: peer support workers, service users, and mental health professionals.MethodsA mixed observational method design included pre-, inter-, and post-experimental components and a qualitative description of the impact. The triangulation of the qualitative and quantitative findings showed its coherence and facilitated the understanding of the results. Outcomes and measures were as follows: self-stigma (Self-Stigma Questionnaire); life satisfaction (Scale of Satisfaction with Life); participation in relevant activities (Engagement in Meaningful Activities Survey); personal recovery (Scale-revised Recovery Assessment); occupational performance (Canadian Occupational Performance Measure); and attitudes toward mental illness (Community Attitudes toward Mental Illness).ResultsThe program showed beneficial effects on peer support workers' (PSW) perceptions of occupational performance, specifically on the ability to find work (p = 0.038), work as a peer support worker (p = 0.016), give to the community (p = 0.011), and satisfaction in the ability to find work (p = 0.031). The assessment made by the three groups of participants was very positive: the PSWs showed an increase in self-esteem and a feeling of usefulness; users of the service described the experience as a source of hope and optimism in their recovery process; and professionals described the program as a positive step in their professional growth.DiscussionThe peer-to-peer strategy is a source of hope in the personal recovery process, providing meaning to life for the PSWs while providing an extra source of support to service users in their process of personal recovery. The results offer us lines of improvement for future implementations. PSW's final emphasis has us reflecting on improvements to enhance their own wellness in mental health care services. The findings show the importance of working on life projects and their impact on the recovery process.

The health crisis of mental health stigma

Aim: The study aimed to assess the extent to which financial and/or mental health problems resulting from the COVID-19 pandemic were associated with an increased risk of alcohol consumption. Methods: Data stemmed from a Swedish cross-sectional population survey (n = 9122) collected during the second half of 2020. Questions were asked about changes in alcohol consumption during the pandemic and to what extent financial and mental health problems were experienced. Logistic regression analysis was used to estimate whether exposure to these problems was related to increasing consumption and as a complementary analysis to decreased drinking. An additive interaction analysis was conducted to assess whether there was a joint effect of these problems. Results: The proportion of respondents who reported increased alcohol consumption was higher among those who had experienced financial or mental health problems, and it rose with the severity of negative experiences. However, findings from logistic regressions (including both exposure variables and covariates) showed that only experiences of mental health problems significantly elevated the risk (odds ratio) of increased consumption. Experiences of mental health problems were also related to a higher likelihood of decreasing consumption, although the odds ratio was lower. No interaction effects were found. Conclusions: Although alcohol consumption overall declined in Sweden during the pandemic, a group experiencing pandemic-related mental health problems increased their drinking. A parallel decline in drinking in a subgroup of individuals experiencing mental health problems adds nuance to the findings and is suggested to be influenced by specific pandemic-related circumstances.

Background The aims of this study were to assess lay people's ability to recognize personality disorders as psychological ‘illnesses’ and to establish their beliefs concerning causes and treatment of each disorder.Methods Two hundred fourteen participants answered a questionnaire, consisting of three case vignettes describing paranoid, narcissistic and obsessive–compulsive personality disorders, according to DSM‐IV‐TR, each followed by 20 attitudinal statements concerning aetiology and treatment.Results Narcissistic personality disorder was the disorder least recognized as a psychological ‘illness’. Overall, psychological causes and treatments were given more prominence than biological ones. Results suggest that personal experience of mental health problems (whether theoretical or practical) seems to improve ‘illness’ recognition.Conclusion To the extent that personality disorders were recognized as psychological ‘illnesses’, recognition was increased if the personality disorder was related to a similar Axis I disorder. Experience of mental health problems and knowledge of psychology or psychiatry improves ‘illness’ recognition, although not for every personality disorder. Psychological causes were endorsed more strongly than biological causes for all disorders—but again, the extent to which a disorder was thought to have a psychological rather than biological cause varied as a function of the disorder. A similar pattern was observed for treatment preferences. Copyright © 2010 John Wiley & Sons, Ltd.