scholarly journals Economics of mental well-being: a prospective study estimating associated health care costs and sickness benefit transfers in Denmark

2021 ◽  
Author(s):  
Ziggi Ivan Santini ◽  
Hannah Becher ◽  
Maja Bæksgaard Jørgensen ◽  
Michael Davidsen ◽  
Line Nielsen ◽  
...  
Keyword(s):  
Health Care ◽  
Mental Illness ◽  
Healthcare Costs ◽  
Psychiatric Morbidity ◽  
Government Expenditure ◽  
Well Being ◽  
Population Based ◽  
Sickness Benefit ◽  
A Prospective Study ◽  
Mental Well Being

Abstract Background Previous literature has examined the societal costs of mental illness, but few studies have estimated the costs associated with mental well-being. In this study, a prospective analysis was conducted on Danish data to determine 1) the association between mental well-being (measured in 2016) and government expenditure in 2017, specifially healthcare costs and sickness benefit transfers. Methods Data stem from a Danish population-based survey of 3,508 adults (aged 16 + years) in 2016, which was linked to Danish registry data. A validated scale (WEMWBS) was used for the assessment of mental well-being. Costs are expressed in USD PPP. A two-part model was applied to predict costs in 2017, adjusting for sociodemographics, health status (including psychiatric morbidity and health behaviour), as well as costs in the previous year (2016). Results Each point increase in mental well-being (measured in 2016) was associated with lower healthcare costs ($− 42.5, 95% CI = $− 78.7, $− 6.3) and lower costs in terms of sickness benefit transfers ($− 23.1, 95% CI = $− 41.9, $− 4.3) per person in 2017. Conclusions Estimated reductions in costs related to mental well-being add to what is already known about potential savings related to the prevention of mental illness. It does so by illustrating the savings that could be made by moving from lower to higher levels of mental well-being both within and beyond the clinical range. Our estimates pertain to costs associated with those health-related outcomes that were included in the study, but excluding other social and economic outcomes and benefits. They cover immediate cost estimates (costs generated the year following mental well-being measurement) and not those that could follow improved mental well-being over the longer term. They may therefore be considered conservative from a societal perspective. Population approaches to mental health promotion are necessary, not only to potentiate disease prevention strategies, but also to reduce costs related to lower levels of mental well-being in the non-mental illness population. Our results suggest that useful reductions in both health care resource use and costs, as well as in costs due to sick leave from the workplace, could be achieved from investment in mental well-being promotion within a year.

scholarly journals Mental well-being and mental illness: findings from the Adult Psychiatric Morbidity Survey for England 2007

2011 ◽  
Vol 199 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Scott Weich ◽  
Traolach Brugha ◽  
Michael King ◽  
Sally McManus ◽  
Paul Bebbington ◽  
...  
Keyword(s):  
Mental Illness ◽  
Common Mental Disorders ◽  
Psychiatric Morbidity ◽  
Population Sample ◽  
Secondary Analysis ◽  
Well Being ◽  
Icd 10 ◽  
Components Analysis ◽  
Nationally Representative ◽  
Mental Well Being

BackgroundMental well-being underpins many aspects of health and social functioning, and is economically important.AimsTo describe mental well-being in a general population sample and to determine the extent to which mental well-being and mental illness are independent of one another.MethodSecondary analysis of a survey of 7293 adults in England. Nine survey questions were identified as possible indicators of mental well-being. Common mental disorders (ICD-10) were ascertained using the Revised Clinical Interview Schedule (CIS-R). Principal components analysis was used to describe the factor structure of mental well-being and to generate mental well-being indicators.ResultsA two-factor solution found eight out of nine items with strong loadings on well-being. Eight items corresponding to hedonic and eudaemonic well-being accounted for 36.9% and 14.3% of total variance respectively. Separate hedonic and eudaemonic well-being scales were created. Hedonic well-being (full of life; having lots of energy) declined with age, while eudaemonic well-being (getting on well with family and friends; sense of belonging) rose steadily with age. Hedonic well-being was lower and eudaemonic well-being higher in women. Associations of well-being with age, gender, income and self-rated health were little altered by adjustment for symptoms of mental illness.ConclusionsIn a large nationally representative population sample, two types of well-being were distinguished and reliably assessed: hedonic and eudaemonic. Associations with mental well-being were relatively independent of symptoms of mental illness. Mental well-being can remain even in the presence of mental suffering.

scholarly journals COVID-19 is having a destructive impact on health-care workers’ mental well-being

2020 ◽  
Author(s):  
Kris Vanhaecht ◽  
Deborah Seys ◽  
Luk Bruyneel ◽  
Bianca Cox ◽  
Gorik Kaesemans ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Residential Care ◽  
Health Care Workers ◽  
Well Being ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Care Workers ◽  
Sources Of Support ◽  
Mental Well Being

Abstract Background The coronavirus disease 2019 (COVID-19) may aggravate workplace conditions that impact health-care workers’ mental health. However, it can also place other stresses on workers outside of their work. This study determines the effect of COVID-19 on symptoms of negative and positive mental health and the workforce’s experience with various sources of support. Effect modification by demographic variables was also studied. Methods A cross-sectional survey study, conducted between 2 April and 4 May 2020 (two waves), led to a convenience sample of 4509 health-care workers in Flanders (Belgium), including paramedics (40.6%), nurses (33.4%), doctors (13.4%) and management staff (12.2%). About three in four were employed in university and acute hospitals (29.6%), primary care practices (25.7%), residential care centers (21.3%) or care sites for disabled and mental health care. In each of the two waves, participants were asked how frequently (on a scale of 0–10) they experienced positive and negative mental health symptoms during normal circumstances and during last week, referred to as before and during COVID-19, respectively. These symptoms were stress, hypervigilance, fatigue, difficulty sleeping, unable to relax, fear, irregular lifestyle, flashback, difficulty concentrating, feeling unhappy and dejected, failing to recognize their own emotional response, doubting knowledge and skills and feeling uncomfortable within the team. Associations between COVID-19 and mental health symptoms were estimated by cumulative logit models and reported as odds ratios. The needed support was our secondary outcome and was reported as the degree to which health-care workers relied on sources of support and how they experienced them. Results All symptoms were significantly more pronounced during versus before COVID-19. For hypervigilance, there was a 12-fold odds (odds ratio 12.24, 95% confidence interval 11.11–13.49) during versus before COVID-19. Positive professional symptoms such as the feeling that one can make a difference were less frequently experienced. The association between COVID-19 and mental health was generally strongest for the age group 30–49 years, females, nurses and residential care centers. Health-care workers reported to rely on support from relatives and peers. A considerable proportion, respectively, 18 and 27%, reported the need for professional guidance from psychologists and more support from their leadership. Conclusions The toll of the crisis has been heavy on health-care workers. Those who carry leadership positions at an organizational or system level should take this opportunity to develop targeted strategies to mitigate key stressors of health-care workers’ mental well-being.

How Czecho-Slovakia Bounces Back: Population-Based Validation of the Brief Resilience Scale in Two Central European Countries

2021 ◽  
pp. 003329412110296
Author(s):  
Jana Furstova ◽  
Natalia Kascakova ◽  
Iva Polackova Solcova ◽  
Jozef Hasto ◽  
Peter Tavel
Keyword(s):  
Convergent Validity ◽  
Factor Model ◽  
Age Groups ◽  
Reliability And Validity ◽  
Well Being ◽  
Population Based ◽  
Resilience Scale ◽  
Significant Difference ◽  
Mental Well Being ◽  
Best Fit

Objective In recent years, resilience has become a focus of research in the medical and behavioral sciences. The Brief Resilience Scale (BRS) was developed to assess the individual ability to recover from stress (“to bounce back”) after experiencing adversities. The aim of the study was to validate the Czech and Slovak versions of the BRS. Methods A representative sample of the Czech and Slovak populations (NCZ = 1800, mean age MCZ = 46.6, SDCZ = 17.4, 48.7% of men; NSK = 1018, mean age MSK = 46.2, SDSK = 16.6, 48.7% men) completed a survey assessing their health and well-being. Several confirmatory factor analysis (CFA) models of the BRS were compared to find the best fit. Cronbach’s alpha and McDonald’s omega coefficients of reliability were evaluated. Convergent validity was assessed by correlating resilience (BRS), physical and mental well-being (SF-8) and psychopathology symptoms (BSI-53). Differences in gender and age groups were appraised. Results A single-factor model with method effects on the reverse items was evaluated to best fit the data in both the Czech and Slovak samples (χ2CZ(6) = 39.0, p < 0.001, CFICZ = 0.998, TLICZ = 0.995, RMSEACZ = 0.055, SRMRCZ = 0.024; χ2SK(6) = 23.9, p < 0.001, CFISK = 0.998, TLISK = 0.995, RMSEASK = 0.054, SRMRSK = 0.009). The reliability was high in both samples (αCZ = 0.80, ωCZ = 0.85; αSK = 0.86, ωSK = 0.91). The BRS was positively associated with physical and mental well-being and negatively associated with somatization, depression and anxiety. In both countries, a lower BRS score was associated with higher age. Czech men reported significantly higher BRS scores than women. No significant difference was found in the mean BRS scores between the two countries. Conclusion This study provides evidence of good psychometric properties, reliability and validity of the Czech and Slovak adaptations of the BRS.

scholarly journals Improving community health networks for people with severe mental illness: a case study investigation

2015 ◽  
Vol 3 (5) ◽  
pp. 1-234 ◽  
Author(s):  
Vanessa Pinfold ◽  
Daryl Sweet ◽  
Ian Porter ◽  
Cath Quinn ◽  
Richard Byng ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Community Health ◽  
Well Being ◽  
Personal Networks ◽  
System Level ◽  
Network Type ◽  
Care System

IntroductionPolicy drivers in mental health to address personal recovery, stigma and poor physical health indicate that new service solutions are required. This study aimed to understand how connections to people, places and activities were utilised by individuals with severe mental illness (SMI) to benefit health and wellbeing.MethodsA five-module mixed-methods design was undertaken in two study sites. Data were collected from 150 network-mapping interviews and 41 in-depth follow-up interviews with people with SMI; in-depth interviews with 30 organisation stakeholders and 12 organisation leaders; and 44 telephone interviews with practitioners. We undertook a three-stage synthesis process including independent lived experience feedback, and a patient and public involvement team participated in tool design, data collection, analysis and write-up.ResultsThree personal network types were found in our study using the community health network approach: diverse and active; family and stable; formal and sparse. Controlled for other factors we found only four variables significantly associated with which network type a participant had: living alone or not; housing status; formal education; long-term sickness or disability. Diagnosis was not a factor. These variables are challenging to address but they do point to potential for network change. The qualitative interviews with people with SMI provided further understanding of connection-building and resource utilisation. We explored individual agency across each network type, and identified recognition of the importance and value of social support and active connection management alongside the risks of isolation, even for those most affected by mental illness. We identified tensions in personal networks, be that relationships with practitioners or families, dealing with the impact of stigma, or frustrations of not being in employment, which all impact on network resources and well-being. The value of connectedness within personal networks of people, place and activity for supporting recovery was evident in shaping identity, providing meaning to life and sense of belonging, gaining access to new resources, structuring routines and helping individuals ‘move on’ in their recovery journey.Health-care practitioners recognised that social factors were important in recovery but reported system-level barriers (workload, administrative bureaucracy, limited contact time with clients) in addressing these issues fully. Even practitioners working in third-sector services whose remit involved increasing clients’ social connection faced restrictions due to being evaluated by outcome criteria that limited holistic recovery-focused practices. Service providers were keen to promote recovery-focused approaches. We found contrasts between recovery ideology within mental health policy and recovery practice on the ground. In particular, the social aspects of supporting people with SMI are often underprioritised in the health-care system. In a demanding and changing context, strategic multiagency working was seen as crucial but we found few examples of embedded multisector organisation partnerships.ConclusionWhile our exploratory study has limitations, findings suggest potential for people with SMI to be supported to become more active managers of their personal networks to support well-being regardless of current network type. The health and social care system does not currently deliver multiagency integrated solutions to support SMI and social recovery.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Socioeconomic gradients and mental health: implications for public health

2015 ◽  
Vol 206 (6) ◽  
pp. 461-465 ◽  
Author(s):  
Sarah Stewart-Brown ◽  
Preshila Chandimali Samaraweera ◽  
Frances Taggart ◽  
Ngianga-Bakwin Kandala ◽  
Saverio Stranges
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Employment Status ◽  
Linear Trend ◽  
Well Being ◽  
Odds Ratios ◽  
Factors Associated ◽  
Middle Range ◽  
The Unemployed ◽  
Mental Well Being

BackgroundResearch on mental well-being is relatively new and studies of its determinants are rare.AimsTo investigate whether the socioeconomic correlates of mental well-being mirror those for mental illness.MethodUsing logistic regression analyses, the independent odds ratios of high and low mental well-being, compared with middle-range mental well-being, were estimated for a number of sociodemographic variables known to be associated with mental illness from 13 983 participants in the 2010 and 2011 Health Surveys for England.ResultsIndependent odds ratios for low mental well-being were as expected from studies of mental illness with increased odds for the unemployed (OR = 1.46, 95% CI 1.01–2.10) and those aged 35–54 years (OR = 1.58, 95% CI 1.35–1.84) and reduced odds for the married (OR = 0.78, 95% CI 0.62–0.97). A linear trend was observed with education and equivalised income. Odds ratios for high mental well-being differed from those for low mental well-being with regard to age (55+ years: OR = 1.48, 95% CI 1.23–1.79); employment status where there was an association only with retirement (OR = 1.35, 95% CI 1.09–1.69); education where there was no association; and equivalised income for which the association was non-linear.ConclusionsOdds ratios for low mental well-being mirrored those for mental illness, but not those for high mental well-being, suggesting that the socioeconomic factors associated with positive mental health are different from those associated with mental illness.

scholarly journals Sleep and Mental Health Among Older Adults in the Canadian Longitudinal Study on Aging

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Rodrigues ◽  
K Nicholson ◽  
P Wilk ◽  
G Guaiana ◽  
S Stranges ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Older Adults ◽  
Mental Illness ◽  
Sleep Duration ◽  
Sleep Problems ◽  
Well Being ◽  
Health Initiatives ◽  
Mental Well Being ◽  
Health And Well Being

Abstract Background Global studies have demonstrated consistent associations between sleep problems and mental health and well-being in older adults, however Canadian data are lacking. We investigated associations between sleep quantity and quality with both mental illness symptoms and well-being among older adults in Canada. Methods We used cross-sectional baseline data from the Canadian Longitudinal Study on Aging, a national survey of 30,097 community-dwelling adults aged 45 years and older. Self-reported sleep measures included average past-week sleep duration (short [&lt;6h], normal [6-8h], long [&gt;8h]), and sleep quality (satisfied or dissatisfied vs neutral). Mental illness outcomes included depressive symptoms and psychological distress. Mental well-being outcomes included self-rated mental health and satisfaction with life. We used modified Poisson regression models with adjustment for sociodemographic, behavioural, and clinical factors, and stratification by sex and age to explore effect modification. Results In the unadjusted analysis, short and long sleep duration and sleep dissatisfaction were associated with higher mental illness symptoms and lower well-being across all outcomes. Sleep satisfaction was associated with a lower likelihood of mental illness symptoms and better well-being. Short sleep duration was associated with the largest effects on mental health outcomes. Self-rated mental health and depressive symptoms had the largest associations with sleep measures. Effects were larger in males and the 45 to 54 year age group. Conclusions Preliminary evidence suggests sleep duration and quality are associated with symptoms of depression, psychological distress, and poor mental well-being among older adults. We are unable to determine whether sleep problems are a cause or consequence of poor mental health. Nonetheless, sleep may be an important target for public health initiatives to improve mental health and well-being among older adults. Key messages Our findings contribute further evidence that sleep difficulties are associated with adverse health outcomes including higher mental illness symptoms and lower well-being among older adults. Sleep disturbances are an unmet public health problem, and may be an important target for public health initiatives to improve mental health and well-being among older adults.

scholarly journals A Web-Based Recovery Program (ICUTogether) for Intensive Care Survivors: Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Beverley Ewens ◽  
Helen Myers ◽  
Lisa Whitehead ◽  
Karla Seaman ◽  
Deborah Sundin ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Critical Illness ◽  
Family Support ◽  
Well Being ◽  
Web Based ◽  
Time Points ◽  
Recovery Program ◽  
The Impact ◽  
Mental Well Being

BACKGROUND Those who experience a critical illness or condition requiring admission to an intensive care unit (ICU) frequently experience physical and psychological complications as a direct result of their critical illness or condition and ICU experience. Complications, if left untreated, can affect the quality of life of survivors and impact health care resources. Explorations of potential interventions to reduce the negative impact of an ICU experience have failed to establish an evidence-based intervention. OBJECTIVE The aim of this study is to evaluate the impact of a Web-based intensive care recovery program on the mental well-being of intensive care survivors and to determine if it is a cost-effective approach. METHODS In total, 162 patients that survived an ICU experience will be recruited and randomized into 1 of 2 groups. The intervention group will receive access to the Web-based intensive care recovery program, ICUTogether, 2 weeks after discharge (n=81), and the control group will receive usual care (n=81). Mental well-being will be measured using the Hospital Anxiety and Depression Scale, The Impact of Events Scale-Revised and the 5-level 5-dimension EuroQoL at 3 time points (2 weeks, 6 months, and 12 months post discharge). Family support will be measured using the Multidimensional Scale of Perceived Social Support at 3 time points. Analysis will be conducted on an intention-to-treat basis using regression modeling. Covariates will include baseline outcome measures, study allocation (intervention or control), age, gender, length of ICU stay, APACHE III score, level of family support, and hospital readmissions. Participants’ evaluation of the mobile website will be sought at 12 months postdischarge. A cost utility analysis conducted at 12 months from a societal perspective will consider costs incurred by individuals as well as health care providers. RESULTS Participant recruitment is currently underway. Recruitment is anticipated to be completed by December 2020. CONCLUSIONS This study will evaluate a novel intervention in a group of ICU survivors. The findings from this study will inform a larger study and wider debate about an appropriate intervention in this population.

scholarly journals Pediatric Resident’s Perception of Night Float System Compared to 24 Hours System, a Prospective Study 

2020 ◽  
Author(s):  
Fahad Alsohime ◽  
Hamad Alkhalaf ◽  
Hissah Almuzini ◽  
Malak Alyahya ◽  
Reema Allhidan ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Prospective Study ◽  
Negative Impact ◽  
Well Being ◽  
Pediatric Residents ◽  
System A ◽  
Call System ◽  
A Prospective Study

Abstract Background:This study aims to evaluate the pediatric residents’ perceptions of the Night Float (NF) on-call system and its impact on their well-being, education and patient safety and compare it with the previous traditional 24-hour on-call system. Methods: This is a prospective study conducted in two pediatric residents training centers who applied the NF on call system as a pilot project. The senior residents (PGY-3 & PGY-4) enrolled in the two training centers were invited to participate in this study before changing the on-call system and 6 months after starting the new NF on-call system. A self-administered online questionnaire was distributed to them. A five-point Likert-type scale was used to rank the residents’ responses (1 means strongly disagree & 5 means strongly agree), covering three main domains; residents’ well-being, ability to deliver health care, and their medical education experience. Pre- and post-intervention scores were presented as means and compared using the t-test for paired samples.Results: A total of 42 residents participated in the survey. Of these, 24 (57.1%) were females. All participants were senior residents; 25 (59.6%) were third year residents while 17 (40.4%) were fourth year residents. Participants felt that most aspects of the three domains were improved by the introduction of the NF system. The NF system was perceived to have less adverse health effect on the residents (Mean 2.37±1.01), compared to the 24 hours on-call system (Mean 4.19±0.60), P ˂0.001. The NF system was perceived to have less exposure to personal harm, less negative impact on the quality of care, better work efficiency, reduced potential for medical error, more successful teaching and fewer disruptions to other rotations compared to the 24 hours on-call system, (P ˂0.001).Conclusion: The senior residents’ perception about the 24-hour on-call system has shown a negative impact on the residents’ well-being and education of residents and patient safety compared to an on-call system with more restrictive duty hours. The perception of the restricted duty hours was perceived to be less harmful, more useful from pedagogic aspect and has positive impact on the quality of delivered health care services.

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