Workplace Mental Health Awareness Training: A Cluster Randomized Controlled Trial.

The mental health crisis among college students intensified amid the COVID-19 pandemic, suggesting an urgent need for innovative solutions to support them. Previous efforts to address mental health concerns have been constrained, often due to the underuse or shortage of services. Mobile health (mHealth) technology holds significant potential for providing resilience-building support and enhancing access to mental health care. This study aimed to examine the trends in mental health and well-being outcomes over 3 years among college students, with an exploratory aim to assess the potential impact of the Roadmap mHealth app on these outcomes. A fully automated longitudinal observational study was conducted remotely from a large public academic institution in the Midwestern United States, evaluating mental health and well-being outcomes among college students using the Roadmap mHealth app over 3 fall semesters from 2020 to 2022. The study enrolled 2164 college students in Year I, with 1128 and 1033 students returning in Years II and III, respectively. Participants completed various self-reported measures, including the Patient Health Questionnaire-9 for depression, Generalized Anxiety Disorder-7 for anxiety, and additional metrics for coping, flourishing, and loneliness. The findings indicated an evolving trajectory in students' mental health. In Year I, depression and anxiety levels were higher compared with levels reported between 2014 and 2019, remaining stable into Year II. However, significant decreases were noted by Year III for both depression (Year I mean 7.78, SD 5.65 vs Year III mean 6.21, SD 4.68; t108=-2.90; P=.01) and anxiety (Year I mean 6.61, SD 4.91 vs Year III mean 5.62, SD 4.58; t116=-2.02; P=.046). Problem-focused coping decreased initially from Year I (mean 2.46, SD 0.58) to Year II (mean 2.36, SD 0.60; t1073=-5.87; P<.001), then increased by Year III (mean 2.40, SD 0.63; t706=2.26; P=.02). Emotion-focused (Year I mean 2.33, SD 0.41 vs Year III mean 2.22, SD 0.47; t994=-7.47; P<.001) and avoidant coping (Year I mean 1.76, SD 0.37 vs Year III mean 1.65, SD 0.38; t997=-8.53; P=.02) consistently decreased. Loneliness significantly decreased from Year I (mean 5.79, SD 1.74) to Year III (mean 5.17, SD 1.78; t1013=-10.74; P<.001), accompanied by an increase in flourishing from Year I (mean 63.78, SD 14.76) to Year III (mean 66.98, SD 15.06; t994=7.22; P<.001). Analysis of app usage indicated that the positive piggy bank and gratitude journal were the favored activities. Greater engagement with the app was positively correlated with enhanced flourishing, even after adjusting for demographic and sociobehavioral factors (β=.04, SE .016; t3974=2.17; P=.03). In this study, students' mental health and well-being improved, with notable reductions in depression, anxiety, and loneliness, associated with an increase in flourishing. The app did not appear to worsen students' mental health. Based on the usage pattern, it is possible the app enhanced positive psychology-based practices. Future research should explore the efficacy of mHealth interventions through randomized controlled trials to further understand their impact on college students' mental health outcomes. ClinicalTrials.gov NCT04766788; https://clinicaltrials.gov/ct2/show/NCT04766788. RR2-10.2196/29561.

Rheumatoid arthritis (RA) pharmacotherapy may impact mental health outcomes by improving pain and stiffness, potentially by targeting inflammatory processes common to RA and depression. The objectives of this review were to ascertain the frequency of mental health assessments in RA pharmacotherapy trials, quantify the efficacy of RA pharmacotherapy for mental health outcomes, and explore the clinical and demographic factors related to mental health outcomes. Effective pharmacotherapy alone is unlikely to substantially improve mental health outcomes in most patients with RA. Integrated mental health care provided within routine clinical practice is essential to optimize mental and physical health outcomes.

Background: A systematic and comprehensive mental training program to enhance athletes’ mental toughness is critical. The aim of this study was to develop and validate a set of athletes’ systematic mental training programs.Methods: A mental toughness training program was developed, and the validity and reliability were tested on experts, practitioners, and athletes. Training program was analyzed using content validity index (I-CVI and S-CVI) and modified Kappa (k*). Furthermore, estimation of reliability of mental training model was analyzed by internal consistency approach with Cronbach’s alpha and inter-rater reliability (IRR) approach by using intraclass correlation coefficients (ICC).Result: A mental toughness training circle (MTTC) was successfully developed with four sections: general preparatory, specific preparatory, precompetitive, and competitive with 11 mental skills (positive thinking, mental log, goal-setting, breathing, relaxation, concentration, self-talk, mental imagery, leadership, managing anxiety, and managing emotions). Validation assessment found that the I-CVI and S-CVI values (S-CVI/Ave and S-CVI/UA) were 1.00, each suggesting excellent content validity. The modified Kappa value (k*) was 1 and categorized as excellent. The results of the reliability test using Cronbach's alpha showed that a value was in the range 0.723 to 0.835 with an overall value of 0.803. The results of the ICC analysis also confirmed that MTTC had a very high reliability coefficient value of 0.803. In addition, there was no significant difference from respondents’ assessment as proved by obtaining value ofF=0.754 with a p=0.644 (>0.05). This suggested that respondents tend to be consistent in assessing MTTC as a mental training set which was categorized as relevant (scale 3) or very relevant (scale 4).Conclusion: MTTC which has four sections with 11 mental skills is a set of mental training programs that have high quality. Further studies to validate this program in a bigger sample size is required.

Global mental health and HIV care: gaps and research priorities.

Although there is growing interest in mental health problems in university students there is limited understanding of the scope of need and determinants to inform intervention efforts. To longitudinally examine the extent and persistence of mental health symptoms and the importance of psychosocial and lifestyle factors for student mental health and academic outcomes. Undergraduates at a Canadian university were invited to complete electronic surveys at entry and completion of their first year. The baseline survey measured important distal and proximal risk factors and the follow-up assessed mental health and well-being. Surveys were linked to academic grades. Multivariable models of risk factors and mental health and academic outcomes were fit and adjusted for confounders. In 1530 students surveyed at entry to university 28% and 33% screened positive for clinically significant depressive and anxiety symptoms respectively, which increased to 36% and 39% at the completion of first year. Over the academic year, 14% of students reported suicidal thoughts and 1.6% suicide attempts. Moreover, there was persistence and overlap in these mental health outcomes. Modifiable psychosocial and lifestyle factors at entry were associated with positive screens for mental health outcomes at completion of first year, while anxiety and depressive symptoms were associated with lower grades and university well-being. Clinically significant mental health symptoms are common and persistent among first-year university students and have a negative impact on academic performance and well-being. A comprehensive mental health strategy that includes a whole university approach to prevention and targeted early-intervention measures and associated research is justified.

BackgroundThe COVID-19 pandemic has been associated with worsened metabolic and mental health in the general and perinatal population. The postpartum is a critical moment regarding these outcomes particularly in women with gestational diabetes mellitus (GDM). We investigated the cardio-metabolic and mental health outcomes before and during the pandemic in this population.MethodsThis cohort study included 418 women with GDM, recruited during two distinct periods. This included 180 women exposed to the pandemic (E+) and recruited between May 2020-April 2021 and 238 women who were not exposed to the pandemic during their postpartum period (attended a year before=non-exposed (E-)) and recruited between January-December 2019. Among the E+, a nested-subcohort of 120 women were exposed both during pregnancy and postpartum. During the pandemic, we adopted a hybrid follow-up of women that consisted of in-person consultations, regular contact via phone calls (35%), sent recorded exercise guide to patients to follow at home and linked to our website. We specifically focused on maintaining motivation and keeping a strong focus on healthy lifestyle behaviors. Obstetric, neonatal, cardio-metabolic and mental health outcomes were assessed during pregnancy and postpartum.ResultsThe pandemic was not associated with worsened weight, weight retention, glucose tolerance, metabolic syndrome, well-being or depression in the postpartum with the exception of a minimally increased HbA1c, diastolic blood pressure and lower emotional eating scores in E+ women (all p ≤ 0.046). In the nested subcohort, E+ women had a slightly increased HbA1c at the first GDM visit and a higher need for glucose-lowering medication (both p ≤ 0.014), but HbA1c at the end of pregnancy and other cardio-metabolic, mental health, obstetric and neonatal outcomes during pregnancy were similar.ConclusionsThe pandemic was not associated with any clinically relevant worsening of cardio-metabolic, mental health, obstetrical and neonatal outcomes in our GDM cohort. This was possibly due to a continued hybrid follow-up, and the partial lockdown in Switzerland.

SummaryBackgroundCulturally appropriate interventions that teach members of the public to provide early help towards a person developing a mental health problem or in a mental health crisis may improve access to services, social support, and mental health outcomes. This is the first study to evaluate the effectiveness of culturally adapted Mental Health First Aid (MHFA) Training for China.MethodsA two-arm wait-list pilot cluster randomised controlled trial (cRCT) was conducted in 3 settings in Shanghai (health services, workplaces and community settings). Intervention settings were paired according to type and one of each pair was randomly allocated to the intervention (MHFA Training for China) or the wait-list control group, with a 1:1 allocation. Participants were invited by the trial coordinators in each setting. They were asked to complete questionnaires at baseline (T1) and 1 month (T2) and 7 months after training (T3). Control group participants were asked to complete questionnaires at corresponding times. The primary outcome was participant intended actions (recommended or not recommended) towards a person experiencing a mental health problem or in a mental health crisis. Secondary outcomes included recognition of depression in a vignette; beliefs about the helpfulness of health professionals and interventions; helping actions; confidence in providing mental health first aid; and stigmatising attitudes.FindingsBetween April and May 2024, 6 clusters were recruited and randomised, with 3 in each of the intervention and control arms. Following exclusion of participants who did not provide data, 146 participants were included at baseline: 67 in the intervention group and 79 in the control group. For the primary outcome (recommended actions subscale), the intervention group showed a significantly larger improvement than the control group at T2 (8.19 [95% CI 4.05–12.34]; p < 0.001) and T3 (3.08 [95% CI −1.02 to 7.18]; p = 0.034). Differences in changes in non-recommended actions were non-significant. At T2, significant differences favouring the intervention group were observed in confidence to provide support, perceiving the person as dangerous or unpredictable and in recognition of depression in a vignette. There were no significant differences in secondary outcomes at T3.InterpretationDelivering culturally adapted MHFA Training for China more widely could improve support for people experiencing mental health problems in the community.FundingThis trial was supported the 10.13039/501100000925National Health and Medical Research Council under a 10.13039/100022974Global Alliance for Chronic Diseases grant (GNT1142395).

Predictors of Mental Health and School-Related Outcomes in First Year University Students: Identifying Prevention Targets

e19103 Background: As advancements in cancer therapies expand the population of long-term cancer survivors, it is important to understand long-term mental health (MH) outcomes associated with cancer experience. This study used a U.S. nationally-representative sample of adult cancer survivors to assess and compare MH outcomes across age groups. Methods: We used the 2015-2017 National Survey of Drug Use and Health to identify respondents aged 18-64 years who reported a history of cancer (survivors) or never had cancer. MH outcomes were operationalized as events in past year of: major depressive episodes, serious psychological distress, suicidal thoughts, suicidal plans, suicidal attempts, any mental illness, and serious mental illness. We compared these outcomes between survivors and those without cancer in adjusted regression analyses, controlling for respondents’ demographic (gender, race/ethnicity) and socioeconomic (health insurance, employment, education status, marital status) characteristics. All analyses were stratified by age group (18-34, 35-49, and 50-64 years). Results: When comparing 2,656 survivors and 112,952 adults without cancer within each age group, survivors had elevated prevalence of MH problems in in five of the seven domains of adverse MH measures. Among young adults (aged 18-34 years), survivors were more likely than their noncancer counterparts to experience major depressive episodes (18.1% versus 9.6%, p&lt; 0.001), serious psychological distress (34.2% versus 17.9, p&lt; 0.001), suicidal thoughts (10.5% versus 7.0%, p= 0.011), any mental illness (41.1% versus 23.3%, p&lt; 0.001), and serious mental illness (13.2% versus 5.9%, p&lt; 0.001) in the past year. These differences persisted in adjusted analyses ( p-values &lt; 0.01). While similar survivor-comparison differences were observed among older groups, the magnitude of these differences was smaller. When comparing MH outcomes across age groups among survivors, young adult survivors had the highest likelihood of experiencing MH problems across all seven domains of adverse MH measures ( p-values &lt; 0.05). Conclusions: This population-based study shows elevated prevalence of MH problems among adult cancer survivors, as compared to the general noncancer population. We also identified a clear age gradient in the prevalence of MH problems, with young adult survivors exhibiting the highest prevalence of adverse MH outcomes. Our findings highlight the importance of developing strategies to ensure early detection and screening of mental illness and improve access to MH treatment for cancer survivors.

Childhood obesity and mental health disorders are increasingly prevalent. While lifestyle interventions are widely recognized as effective for managing obesity in children and adolescents, their effects on mental health remain unclear. This study aimed to systematically evaluate the effects of lifestyle interventions on mental health outcomes among children and adolescents with overweight or obesity. In this systematic review and meta-analysis, we searched five databases (PubMed, Embase, MEDLINE, CENTRAL and CINAHL) for relevant randomised controlled trials (RCTs) or non-randomised studies of interventions (NRSIs) published from database inception to December 7, 2024, without language restrictions. Lifestyle interventions are defined as structured programs that promote health-related behavioural changes across diverse domains, such as physical activity, dietary adjustments, cognitive training, and psychosocial support. We included studies that assessed the effects of lifestyle interventions on mental health outcomes among children and adolescents with overweight or obesity. Two reviewers independently screened records for eligibility, extracted study-level data and assessed risk of bias of RCTs and NRSIs via the revised Cochrane Risk of Bias Tool for randomised controlled trials (RoB 2) and the Risk of Bias in Non-randomised Studies-of Interventions (ROBINS-I), and certainty of the evidence by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. RCTs were prioritized as the primary source of evidence, while NRSIs served as supplementary evidence. A random-effects meta-analysis model was performed to calculate pooled standardized mean differences (SMDs) and 95% confidence intervals (CIs). Subgroup analyses stratified by age, body mass index (BMI) category, intervention type, theoretical framework, duration, and World Bank income region, were further conducted to identify potential sources of heterogeneity. The review protocol was registered in PROSPERO, CRD42024571061. We identified 20,359 records, of which 26 studies (17 RCTs and nine NRSIs) involving 3511 children and adolescents with overweight or obesity were included. Mental health outcomes assessed included depression, anxiety, self-concept, self-efficacy, negative affect, quality of life, and emotional functioning. Lifestyle interventions evaluated encompassed physical activity, health education, emotion regulation, diet, and multicomponent approaches. Among RCTs, reductions in depression (SMD=-0.24, 95% CI:-0.39 to-0.10, I-square [I 2]=0.0%) and improvements in quality of life (SMD=0.24, 95% CI: 0.04-0.44, I 2=44.0%) were observed, with moderate certainty. Subgroup analyses revealed greater reductions in depression among adolescents and participants with obesity, in programs that involving multicomponent approaches, lasting below three months, using behavioural and cognitive theory, or being conducted in high-income countries (HICs). For quality of life, greater improvements were observed among participants with overweight or obesity, in programs based on behavioural and cognitive theory, or in those conducted in low- and middle-income countries (LMICs). Meanwhile, among NRSIs, reductions in depression (SMD=-0.22, 95% CI:-0.33 to-0.11, I 2 =11.5%), as well as enhancements in self-concept (SMD=0.19, 95% CI: 0.09-0.29, I 2=0.0%), quality of life (SMD=0.52, 95% CI: 0.23-0.81, I 2=86.2%), and emotional functioning (SMD=0.40, 95% CI: 0.21-0.60, I 2=0.0%) were noted. However, the effects on other mental health outcomes, including anxiety, negative affect, and self-efficacy, remain inconclusive. Lifestyle interventions modestly improve depressive symptoms and quality of life in children and adolescents with overweight or obesity, with additional benefits for self-concept and emotional functioning observed in NRSIs. These findings underscore the potential of lifestyle interventions to address both physical and mental health. Future research should focus on evaluating long-term psychological outcomes and developing cost-effective, culturally tailored interventions. This study was supported by National Natural Science Foundation of China (72474196).

Survivors of cancer are at risk for adverse mental and physical health outcomes. It is not well understood, however, how these outcomes are differentially experienced according to an individual's exposure to racism. This study sought to evaluate associations of race/ethnicity, and experiences of racism, with adverse health outcomes in survivors of cancer. Using the Behavioral Risk Factor Surveillance System database, data from 48,200 survivors between 2014 and 2020 were evaluated. Survey items included negative physical and emotional symptoms as a result of race-based treatment. Outcomes of interest included days of poor mental and physical health, activity limitations, depression, and inadequate sleep. Associations using prevalence ratios were evaluated. All historically marginalized racial/ethnic groups were more likely to experience at least one adverse health outcome compared with non-Hispanic White survivors. Those who physically experienced racism were 2.1 (95% CI, 1.64-2.69) times as likely to report poor physical health, 3.51 (95% CI, 2.61-4.71) times as likely to report poor mental health, 2.14 (95% CI, 1.77-2.58) times as likely to report inadequate sleep, 2.33 (95% CI: 1.91-2.83) times as likely to report depression, and 1.42 (95% CI, 1.04-1.93) times as likely to report activity limitations compared with those who have not experienced racism. Similar associations were observed for emotionally experienced racism. Racial inequities in health outcomes for survivors of cancer from marginalized racial/ethnic groups are well-established. Experienced racism contributes to adverse health outcomes and widens these disparities. Improving outcomes for survivors of cancer may require screening for experienced racism. Survivors of cancer from marginalized racial/ethnic populations are more likely to have poor mental and physical health than their non-Hispanic White counterparts. Whether survivors from certain racial/ethnic populations of smaller size also have poorer health is less well understood. Generally, individuals who report experienced racism also report poor health, this association has not been studied in survivors of cancer. This study, from a national survey of survivors of cancer, describes disparities in health outcomes experienced by a variety of racial and ethnic populations. Our findings suggest racism is associated with poor mental and physical health in survivors of cancer.

&lt;p&gt;Objective: Compared to heterosexual men, gay and bisexual men (GBM) are at an increased risk of adverse mental and sexual health outcomes. The psychological mediation framework (PMF; Hatzenbuehler, 2009) posits that minority stress is associated with changes in cognitive, affective, and social psychological processes, thereby leading to negative mental health outcomes among sexual minority individuals. This study examined whether these psychological processes account for the relationship between minority stress and poor mental health among GBM and extended the PMF to examine the effects on sexual health outcomes. Method: HIV-negative GBM (N = 465) completed a battery of self-report questionnaires assessing minority stress; cognitive, affective, and social processes; and mental and sexual health outcomes. Structural equation modeling was used to examine study hypotheses. Results: Findings partially supported the PMF by demonstrating that affective and social factors had a significant indirect effect in the relationship between minority stress and mental health outcomes; however, cognitive factors were nonsignificant. A significant indirect effect was found for cognitive factors in the relationship between minority stress and sexual health outcomes, whereas affective and social factors were nonsignificant. Conclusion: By uncovering the mediators underlying the relationship between minority stress and poor health outcomes, these findings have important clinical implications in the development of future interventions aimed at reducing adverse stigma-related health outcomes among GBM. The differential pattern of findings in the mental and sexual health models suggests that different psychological processes may need to be targeted in the treatment of mental health versus sexual health problems. &lt;/p&gt;

Lack of education, stigma, and negative self-attitudes are key barriers to help-seeking in Gaelic footballers. With the prevalence of mental health issues in Gaelic footballers and the increased risk of experiencing mental health challenges after injury, mental health literacy (MHL) interventions are necessary. To design and implement a novel MHL educational intervention program in Gaelic footballers. Controlled laboratory study. Online. Elite and subelite Gaelic footballers divided into intervention (n = 70; age = 25.1 ± 4.5 years) and control (n = 75; age = 24.4 ± 6.0 years) groups. In the intervention group, 85 participants were recruited, but 15 dropped out after completing baseline measures. A novel educational intervention program, "GAA [Gaelic Athletic Association] and Mental Health-Injury and a Healthy Mind," was designed to address the key components of MHL and was underpinned by the Theory of Planned Behavior and the Help-Seeking Model. The intervention was implemented online via a brief 25-minute presentation. Measures of stigma, help-seeking attitudes, and MHL were completed by the intervention group at baseline, immediately after viewing the MHL program, and at 1 week and 1 month after the intervention. The control group completed the measures at similar time points. Stigma decreased, and attitudes toward help-seeking and MHL increased in the intervention group from baseline to after the intervention (P < .05), with significant differences sustained at 1-week and 1-month follow-ups. Our results showed differences in stigma, attitudes, and MHL between groups across time points. Intervention participants provided positive feedback, and the program was appraised as informative. Remote online delivery of a novel MHL educational program can effectively decrease mental health stigma, improve attitudes toward help-seeking, and increase the recognition and knowledge of mental health issues. Gaelic footballers with improved MHL may be better equipped to manage their mental health and cope with stressors, leading to improved mental health outcomes and overall mental well-being.

Family environment interacts with CRHR1 rs17689918 to predict mental health and behavioral outcomes

The increasing prevalence of depression among university students has become a critical global concern, particularly in the context of rising academic demands and socio-psychological pressures. This study presents a multidimensional analysis of depression among students at University of Tabriz, examining the interplay between academic stress, socio-psychological determinants, and mental health outcomes within higher education. A mixed-methods research design was employed, combining quantitative and qualitative approaches to ensure comprehensive analysis. Data were collected from a sample of 120–220 students using standardized psychometric instruments, including the Zung Self-Rating Depression Scale, Taylor Manifest Anxiety Scale, and structured questionnaires assessing stress factors and coping behaviors. Comparative analysis was conducted to evaluate changes in psychological states before and during examination periods. The findings reveal a significant increase in anxiety and subclinical depressive symptoms during examination periods, with the proportion of students experiencing no depression decreasing markedly, while subdepressive conditions and high anxiety levels rise substantially. The study also identifies a high prevalence of hidden or unreported depressive states, indicating that a considerable number of students remain psychologically vulnerable without formal diagnosis. Key contributing factors include academic workload, uncertainty about future prospects, financial difficulties, social adaptation challenges, and limited awareness of effective stress management strategies. Furthermore, the results demonstrate a strong relationship between psychological stress and psychosomatic symptoms, highlighting the applicability of the biopsychosocial model in understanding student mental health. Gender and academic-level differences were also observed, suggesting that prolonged exposure to academic stress increases vulnerability over time. The study contributes to the existing literature by providing empirical evidence from a regional context and by integrating psychological, educational, and social dimensions into a unified analytical framework. The findings underscore the importance of early detection, mental health awareness, and the implementation of institutional support systems, including counseling services and stress management programs. In conclusion, addressing depression among university students requires a comprehensive and multidisciplinary approach that combines educational reform, psychological intervention, and preventive strategies to enhance student well-being and academic performance.