scholarly journals Interventions to improve children's access to mental health care: a systematic review and meta-analysis

2019 ◽  
Vol 29 ◽  
Author(s):  
L. Werlen ◽  
D. Gjukaj ◽  
M. Mohler-Kuo ◽  
M.A. Puhan
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Health Outcomes ◽  
Help Seeking ◽  
Meta Analysis ◽  
Mental Health Outcomes ◽  
School Based ◽  
Meta Analyses

Abstract Aims Mental disorders in children are a significant and growing cause of morbidity worldwide. Although interventions to help overcome barriers along the pathway to accessing health care for children with mental disorders exist, there is no overview of randomised controlled trials (RCTs) on these interventions as yet. This study aimed to systematically identify RCTs of interventions to improve access to mental health care for children and synthesise them using a conceptual framework of access to health care. Methods This systematic review was performed following a predefined protocol registered with PROSPERO (ID: CRD42018081714). We searched the databases MEDLINE, EMBASE, PsycINFO and CENTRAL for RCTs up to 15 May 2019 using terms related to the concepts ‘young people,’ ‘mental disorders’ and ‘help-seeking interventions’ and scanned reference lists from relevant studies. Two reviewers independently screened all identified articles in a two-stage process, extracted results on outcomes of interest (knowledge, attitudes, intentions, help-seeking, accessing care, mental health outcomes and satisfaction), assessed the risk of bias and conducted meta-analyses where deemed appropriate. Results After screening 5641 identified articles, 34 RCTs were eligible for inclusion. Eighty per cent of universal school-based interventions measuring knowledge (n = 5) and 67% measuring attitudes (n = 6) reported significantly better results compared with controls on those outcomes, whereas 20% measuring access to care (n = 5) and none measuring mental health outcomes (n = 7) did. In contrast, 71% of interventions targeting at-risk individuals (n = 21) reported better access to care compared with controls, while just 33% (n = 6) did for mental health outcomes. For satisfaction with care, this proportion was 80% (n = 5). Meta-analyses of interventions measuring initial appointment attendance yielded combined odds ratios of 3.11 (2.07–4.67) for appointment reminder interventions and 3.51 (2.02–6.11) for treatment engagement interventions. The outcomes for universal school-based interventions were heterogeneous and could not be summarised quantitatively through meta-analysis. Conclusions To have a population-level effect on improving children's access to mental health care, two-stage interventions that identify those in need and then engage them in the health-care system may be necessary. We need more evidence on interventions to target contextual factors such as affordability and infrastructural barriers.

A hidden pandemic? An umbrella review of global evidence on mental health in the time of COVID-19

2022 ◽  
Author(s):  
Marlee Bower ◽  
Scarlett Smout ◽  
Amarina Donohoe-Bales ◽  
Lily Teesson ◽  
Eleisha Lauria ◽  
...  
Keyword(s):  
Mental Health ◽  
General Population ◽  
Health Outcomes ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Mental Health Outcomes ◽  
Eligibility Criteria ◽  
Pooled Prevalence ◽  
Meta Review ◽  
Meta Analyses

Introduction: Vast available international evidence has investigated the mental health impacts of the COVID-19 pandemic. This review aims to synthesise evidence, identifying populations and characteristics associated with poor mental health.Methods: A meta-review of pooled prevalence of anxiety and depression, with subgroup analyses for the general population, healthcare workers (HCW) and COVID-19 patients; and a meta-synthesis of systematic reviews to collate evidence on associated factors and further mental disorders. Databases searched included Scopus, Embase, PsycINFO, and MEDLINE dated to May 2021. Eligibility criteria included systematic reviews and/or meta-analyses, published post-November 2019, reporting data in English on mental health outcomes during the pandemic.Results: Eighty-one systematic reviews were included, 51 of which incorporated meta-analysis. Meta-review overall anxiety prevalence was 29% (95%CI: 27–31%, I2: 99.83%), with subgroup prevalence as 35% (95%CI: 23–47%, I2: 97.4%) in COVID-19 patients, 29% in HCW (95%CI: 25– 32, I2: 99.8%) and 28% in the general population (95%CI: 25–31%, I2: 99.9%). Meta-review overall depression prevalence was 28% (95%CI: 26–30%, I2: 99.7), with subgroup prevalence as 30% (95%CI: 7–60%, I2: 99.8%) in COVID-19 patients, 28% (95%CI: 25–31%, I2: 99.7%) in HCW and 27% (95%CI: 25–30, I2: 99.8%) in the general population. Meta-synthesis found many experienced psychological distress and PTSD/PTSS during COVID-19, but pooled prevalence ranged substantially. Fear of, proximity to, or confirmed COVID-19 infection; undergoing quarantine; and COVID-19-related news exposure were associated with adverse mental health outcomes. Amongst other factors, people who are younger, female, LGBTIQ, pregnant, parents or experiencing low social support, financial issues or socio-economic disadvantage, tended to have poorer mental health during the pandemic period.Conclusions: Despite high volumes of reviews, the diversity of findings and dearth of longitudinal studies within reviews means clear links between COVID-19 and mental health are not available, although existing evidence indicates probable associations.

scholarly journals Discrimination, Life Stress, and Mental Health among Muslims: A Preregistered Meta-analysis and Systematic Review

2019 ◽  
Author(s):  
Ummul-Kiram Kathawalla ◽  
Moin Syed
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Life Stress ◽  
Meta Analysis ◽  
Mental Health Outcomes ◽  
Life Stressors ◽  
Muslim Community ◽  
Western Countries ◽  
Individual Discrimination ◽  
Meta Analyses

Stage 1 Registered Report: How is the current context of Islamophobia, anti-Muslim prejudice, and discrimination, associated with Muslim mental health in Western countries? A body of evidence suggests that experiences of discrimination and racism are associated with negative mental health outcomes for marginalized, minority populations (e.g., Paradies et al., 2015). Studies specifically with Muslim populations in Western countries have found mostly similar findings of an association between discrimination and negative mental health outcomes (Samari, Alcalá, & Sharif, 2018). The varied results in the literature calls for using statistical rigor and synthesis to provide clarity of the etiology of psychopathology in the Muslim community. In this study, we plan to conduct meta-analyses of the associations of both perceived discrimination and mental health and life stressors and mental health for Muslims living in Western countries. We aim to contribute to the literature on the experiences of Muslims and to the debate on the contribution of discrimination vs. life stressors on the development of mental health using meta-analytic methods. For added specificity, we examine both perceived individual discrimination and group discrimination and positive and negative mental health outcomes. We also plan to examine various study-related (e.g., publication bias), demographic, and identity-related moderators in these associations. In the current sociopolitical climate, this study is an important step to better serve the needs of the growing global Muslim community.

scholarly journals Impact of COVID-19 and other pandemics and epidemics on people with pre-existing mental disorders: a systematic review protocol and suggestions for clinical care

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e040229
Author(s):  
Anjali Sergeant ◽  
Emma Alaine van Reekum ◽  
Nitika Sanger ◽  
Alexander Dufort ◽  
Tea Rosic ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Disorders ◽  
Health Outcomes ◽  
Clinical Care ◽  
Health Resources ◽  
Healthcare Services ◽  
Mental Health Outcomes ◽  
Meta Analyses ◽  
The Impact

IntroductionThe current COVID-19 pandemic has resulted in high rates of infection and death, as well as widespread social disruption and a reduction in access to healthcare services and support. There is growing concern over how the pandemic, as well as measures put in place to curb the pandemic, will impact people with mental disorders. We aim to study the effect of pandemics and epidemics on mental health outcomes for people with premorbid mental disorders.Methods and analysisWith our predefined search strategy, we will search five databases for studies reporting on mental health outcomes in people with pre-existing mental disorders during pandemic and epidemic settings. Search dates are planned as follows: 5 May 2020 and 23 July 2020. The following databases will be searched: MEDLINE/PubMed, CINAHL, PsycINFO, MedRxiv and EMBASE. Data will be screened and extracted in duplicate by two independent reviewers. Studies involving non-clinical populations or patients diagnosed with a mental disorder during a pandemic/epidemic will be excluded. We will include data collected from all pandemics and epidemics throughout history, including the present COVID-19 pandemic. If possible, study findings will be combined in meta-analyses, and subgroup analyses will be performed. We hope that this review will shed light on the impact of pandemics and epidemics on those with pre-existing mental disorders. Knowledge generated may inform future intervention studies as well as healthcare policies. Given the potential implications of the current pandemic measures (ie, disruption of healthcare services) on mental health, we will also compile a list of existing mental health resources.Ethics and disseminationNo ethical approval is required for this protocol and proposed systematic review as we will only use data from previously published papers that have themselves received ethics clearance and used proper informed consent procedures.Systematic review registrationPROSPERO registration number: CRD42020179611.

To meta-analyse or not to meta-analyse: abortion, birth and mental health

2012 ◽  
Vol 200 (1) ◽  
pp. 12-14 ◽  
Author(s):  
Tim Kendall ◽  
Victoria Bird ◽  
Roch Cantwell ◽  
Clare Taylor
Keyword(s):  
Mental Health ◽  
Health Risk ◽  
Health Outcomes ◽  
Physical Health ◽  
Meta Analysis ◽  
Unwanted Pregnancy ◽  
Mental Health Outcomes ◽  
Physical Health Outcomes ◽  
The Individual ◽  
Meta Analyses

SummaryTwo recent meta-analyses claim that abortion leads to a deterioration in mental health. Previous reviews concluded that the mental health outcomes following an unwanted pregnancy are much the same whether the woman gives birth or terminates the pregnancy, although there is an increased mental health risk with an unwanted pregnancy. Meta-analysis is particularly susceptible to bias in this area. The physical health outcomes for women with an unwanted pregnancy have improved greatly by making abortion legal. To further improve the mental health outcomes associated with an unwanted pregnancy we should focus practice and research on the individual needs of women with an unwanted pregnancy, rather than how the pregnancy is resolved.

scholarly journals Mental Health Inequities and Disparities among African American Adults in the United States: The Role of Race

2020 ◽  
Vol 5 (3) ◽  
pp. p23
Author(s):  
Elizabeth Armstrong-Mensah ◽  
Harshita Patel ◽  
Priyanka Parekh ◽  
Crystal Lee
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
African Americans ◽  
Mental Health Care ◽  
Health Outcomes ◽  
Economic Status ◽  
The United States ◽  
Poor Quality ◽  
Mental Health Outcomes

Although the rate of mental illness among African Americans and Whites in the United Sates are similar, African Americans tend to have the worst mental health outcomes in the country. This is due to several inequities, particularly those associated with race such as discrimination, provider bias, stereotyping, weak socio-economic status, limited access to health insurance, poor quality mental health care, treatment gaps, culture, and stigma related to mental health care. Recognizing that the differences in mental health outcomes among minority populations in the United States is also driven by race and not just by brain chemistry, or environmental exposures, and developing strategies that target the issue of race, will not only lead to increased access to mental health services among African Americans, but will generally improve upon their mental health status. This article discusses mental health disparities among African Americans, the inequities that cause them, and strategies for addressing the disparities with a focus on race.

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