scholarly journals Alternatives to mental health admissions for children and adolescents experiencing mental health crises: A systematic review of the literature

2021 ◽  
pp. 135910452110447
Author(s):  
Denisa A Clisu ◽  
Imogen Layther ◽  
Deborah Dover ◽  
Russell M Viner ◽  
Tina Read ◽  
...  
Keyword(s):  
Mental Health ◽  
Web Of Science ◽  
Multisystemic Therapy ◽  
Risk Of Bias ◽  
Future Research ◽  
Inpatient Setting ◽  
Review Of The Literature ◽  
Children And Young People ◽  
Randomised Controlled

Background: Many children and young people (CYP) presenting with mental health crises are admitted to hospital due to concerns around illness severity and risk. Whilst inpatient admissions have an important role for such children, there are a number of burdens associated with them, and safe avoidance of admissions is favourable. We systematically reviewed the literature for studies of interventions reported as alternatives to a hospital admission in CYP presenting with mental health crises, in any inpatient setting. Methods: Three databases (PsychInfo, PubMed and Web of Science) were searched for peer-reviewed papers in October 2020, with an updated search in May 2021. Results: We identified 19 papers of interventions delivered in the emergency department, the home, outside of home but outside of clinics and in hospital clinics. The quality of most included studies was low, with less than half being randomised controlled trials and only half of these at low risk of bias. The best quality studies and greatest evidence for efficacy came from in-home interventions, in particular multisystemic therapy, which improved psychological outcomes, and though a large number of CYP still ended up being admitted, there appeared to be decreased length of stay. Conclusions: Overall, we could not recommend a particular intervention as an alternative to inpatient admission; however, our review describes benefits across a range of types of interventions that might be considered in multi-modal treatments. We also provide recommendations for future research, in particular the evaluation of new interventions as they emerge.

scholarly journals Alternatives to mental health admissions for children and adolescents experiencing mental health crises: a systematic review of the literature

2021 ◽  
Author(s):  
Denisa Clisu ◽  
Imogen Layther ◽  
Deborah Dover ◽  
Russell M Viner ◽  
Tina Read ◽  
...  
Keyword(s):  
Mental Health ◽  
Web Of Science ◽  
Community Services ◽  
Multisystemic Therapy ◽  
Future Research ◽  
Inpatient Stay ◽  
Review Of The Literature ◽  
Children And Young People ◽  
Randomised Controlled

Background: Increasingly more children and young people (CYP) present in mental health crises, many being hospitalised due to concerns around illness severity and lack of community services. To release the burden of admission, we systematically reviewed the literature on the effects of proposed alternatives to CYP in crises. Methods: Three databases (PsychInfo, PubMed and Web of Science) were searched for peer-reviewed papers in October 2020, with an updated search in May 2021. Results: We identified 19 papers of interventions delivered in the emergency department, the home, outside of home but outside of clinics and in hospital clinics. The best evidence came from in-home interventions, in particular multisystemic therapy (MST), which proved to be promising alternatives by improving psychological outcomes and decreasing length of inpatient stay. The quality of included studies was low, with less than half being randomised controlled trials and only half of these at low risk of bias. Conclusions: We could not recommend a particular intervention as an alternative to inpatient admission, however our review describes benefits across a range of types of inteventions that might be considered in multi-modal treatments. We also provide recommendations for future research, in particular the evaluation of new interventions as they emerge.

scholarly journals Effect of a physical activity and sleep m-health intervention on a composite activity-sleep behaviour score and mental health: a mediation analysis of two randomised controlled trials

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Mitch J. Duncan ◽  
Anna T. Rayward ◽  
Elizabeth G. Holliday ◽  
Wendy J. Brown ◽  
Corneel Vandelanotte ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Trial Registration ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Sleep Health ◽  
Intervention Effects ◽  
Symptoms Of Depression ◽  
Randomised Controlled

Abstract Background To examine if a composite activity-sleep behaviour index (ASI) mediates the effects of a combined physical activity and sleep intervention on symptoms of depression, anxiety, or stress, quality of life (QOL), energy and fatigue in adults. Methods This analysis used data pooled from two studies: Synergy and Refresh. Synergy: Physically inactive adults (18–65 years) who reported poor sleep quality were recruited for a two-arm Randomised Controlled Trial (RCT) (Physical Activity and Sleep Health (PAS; n = 80), or Wait-list Control (CON; n = 80) groups). Refresh: Physically inactive adults (40–65 years) who reported poor sleep quality were recruited for a three-arm RCT (PAS (n = 110), Sleep Health-Only (SO; n = 110) or CON (n = 55) groups). The SO group was omitted from this study. The PAS groups received a pedometer, and accessed a smartphone/tablet “app” using behaviour change strategies (e.g., self-monitoring, goal setting, action planning), with additional email/SMS support. The ASI score comprised self-reported moderate-to-vigorous-intensity physical activity, resistance training, sitting time, sleep duration, efficiency, quality and timing. Outcomes were assessed using DASS-21 (depression, anxiety, stress), SF-12 (QOL-physical, QOL-mental) and SF-36 (Energy & Fatigue). Assessments were conducted at baseline, 3 months (primary time-point), and 6 months. Mediation effects were examined using Structural Equation Modelling and the product of coefficients approach (AB), with significance set at 0.05. Results At 3 months there were no direct intervention effects on mental health, QOL or energy and fatigue (all p > 0.05), and the intervention significantly improved the ASI (all p < 0.05). A more favourable ASI score was associated with improved symptoms of depression, anxiety, stress, QOL-mental and of energy and fatigue (all p < 0.05). The intervention effects on symptoms of depression ([AB; 95%CI] -0.31; − 0.60,-0.11), anxiety (− 0.11; − 0.27,-0.01), stress (− 0.37; − 0.65,-0.174), QOL-mental (0.53; 0.22, 1.01) and ratings of energy and fatigue (0.85; 0.33, 1.63) were mediated by ASI. At 6 months the magnitude of association was larger although the overall pattern of results remained similar. Conclusions Improvements in the overall physical activity and sleep behaviours of adults partially mediated the intervention effects on mental health and quality of life outcomes. This highlights the potential benefit of improving the overall pattern of physical activity and sleep on these outcomes. Trial registration Australian New Zealand Clinical Trial Registry: ACTRN12617000680369; ACTRN12617000376347. Universal Trial number: U1111–1194-2680; U1111–1186-6588. Human Research Ethics Committee Approval: H-2016-0267; H-2016–0181.

scholarly journals Tri-Response Police, Ambulance, Mental Health Crisis Models in Reducing Involuntary Detentions of Mentally Ill People: Protocol for a Systematic Review

2021 ◽  
Vol 18 (15) ◽  
pp. 8230
Author(s):  
Julia Heffernan ◽  
Ewan McDonald ◽  
Elizabeth Hughes ◽  
Richard Gray
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Assessment Tool ◽  
Public Health Practice ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Future Research ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Response Models

Police, ambulance and mental health tri-response services are a relatively new model of responding to people experiencing mental health crisis in the community, but limited evidence exists examining their efficacy. To date there have been no systematic reviews that have examined the association between the tri-response model and rates of involuntary detentions. A systematic review examining co-response models demonstrated possible reduction in involuntary detention, however, recommended further research. The aim of this protocol is to describe how we will systematically review the evidence base around the relationship of the police, ambulance mental health tri-response models in reducing involuntary detentions. We will search health, policing and grey literature databases and include clinical evaluations of any design. Risk of bias will be determined using the Effective Public Health Practice Project Quality Assessment Tool and a narrative synthesis will be undertaken to synthesis key themes. Risk of bias and extracted data will be summarized in tables and results synthesis tabulated to identify patterns within the included studies. The findings will inform future research into the effectiveness of tri-response police, ambulance, and mental health models in reducing involuntary detentions.

scholarly journals Nocturnal digital surveillance in aged populations and its effects on health, welfare and social care provision: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matt X. Richardson ◽  
Maria Ehn ◽  
Sara Landerdahl Stridsberg ◽  
Ken Redekop ◽  
Sarah Wamala-Andersson
Keyword(s):  
Systematic Review ◽  
Standard Care ◽  
Social Care ◽  
Grey Literature ◽  
Care Quality ◽  
Risk Of Bias ◽  
Future Research ◽  
Care Provision ◽  
Digital Surveillance

Abstract Background Nocturnal digital surveillance technologies are being widely implemented as interventions for remotely monitoring elderly populations, and often replace person-based surveillance. Such interventions are often placed in care institutions or in the home, and monitored by qualified personnel or relatives, enabling more rapid and/or frequent assessment of the individual’s need for assistance than through on-location visits. This systematic review summarized the effects of these surveillance technologies on health, welfare and social care provision outcomes in populations ≥ 50 years, compared to standard care. Method Primary studies published 2005–2020 that assessed these technologies were identified in 11 databases of peer-reviewed literature and numerous grey literature sources. Initial screening, full-text screening, and citation searching steps yielded the studies included in the review. The Risk of Bias and ROBINS-I tools were used for quality assessment of the included studies. Result Five studies out of 744 identified records met inclusion criteria. Health-related outcomes (e.g. accidents, 2 studies) and social care outcomes (e.g. staff burden, 4 studies) did not differ between interventions and standard care. Quality of life and affect showed improvement (1 study each), as did economic outcomes (1 study). The quality of studies was low however, with all studies possessing a high to critical risk of bias. Conclusions We found little evidence for the benefit of nocturnal digital surveillance interventions as compared to standard care in several key outcomes. Higher quality intervention studies should be prioritized in future research to provide more reliable evidence.

scholarly journals M.I.C.E—Mental Health Intervention for Children with Epilepsy: a randomised controlled, multi-centre clinical trial evaluating the clinical and cost-effectiveness of MATCH-ADTC in addition to usual care compared to usual care alone for children and young people with common mental health disorders and epilepsy—study protocol

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sophie D. Bennett ◽  
◽  
J. Helen Cross ◽  
Anna E. Coughtrey ◽  
Isobel Heyman ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Usual Care ◽  
Psychological Intervention ◽  
Mental Health Disorders ◽  
Long Term Conditions ◽  
Children And Young People ◽  
Health Disorders ◽  
Randomised Controlled

Abstract Background Mental health disorders in the context of long-term conditions in children and young people are currently overlooked and undertreated. Evidence-based psychological treatments for common childhood mental health disorders (anxiety, depression and disruptive behaviour disorders) have not been systematically evaluated in young people with epilepsy despite their high prevalence in this population. The aim of this multi-site randomised controlled trial is to determine the clinical and cost-effectiveness of adding a modular psychological intervention to usual care for the mental health disorders in comparison to assessment-enhanced usual care alone. Methods In total, 334 participants aged 3–18 years attending epilepsy services will be screened for mental health disorders with the Strengths and Difficulties Questionnaire (SDQ) and the diagnostic Development and Wellbeing Assessment (DAWBA). Those identified as having a mental health disorder and consenting to the trial will be randomised to either receive up to 22 sessions of the modular psychological intervention (MATCH-ADTC) delivered over the telephone over 6 months by non-mental health professionals in addition to usual care or to assessment-enhanced usual care alone. Outcomes will be measured at baseline, 6 months and 12 months post-randomisation. It is hypothesised that MATCH-ADTC plus usual care will be superior to assessment-enhanced usual care in improving emotional and behavioural symptoms. The primary outcome is the SDQ reported by parents at 6 months. Secondary outcomes include parent-reported mental health measures such as the Revised Children’s Anxiety and Depression Scale, quality of life measures such as the Paediatric Quality of Life Inventory and physical health measures such as the Hague Seizure Severity Scale. Outcome assessors will be blinded to group assignment. Qualitative process evaluations and a health economic evaluation will also be completed. Discussion This trial aims to determine whether a systematic and integrated approach to the identification and treatment of mental health disorders in children and young people with epilepsy is clinically and cost-effective. The findings will contribute to policies and practice with regard to addressing mental health needs in children and young people with other long-term conditions. Trial registration ISRCTN ISRCTN57823197. Registered on 25 February 2019.

scholarly journals Mindfulness in Motion for People with Multiple Sclerosis: A Feasibility Study

2017 ◽  
Vol 19 (5) ◽  
pp. 225-231 ◽  
Author(s):  
Rachel M. Gilbertson ◽  
Maryanna D. Klatt
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Multiple Sclerosis ◽  
Mindfulness Meditation ◽  
Short Form ◽  
Physical Symptoms ◽  
Future Research ◽  
Five Facet Mindfulness Questionnaire ◽  
Anxiety Depression

Background: Mindfulness in Motion is an 8-week mindfulness-based intervention that uses yoga movement, mindfulness meditation, and relaxing music. This study examined the feasibility of using Mindfulness in Motion in people with multiple sclerosis (MS) and the effect of this program on stress, anxiety, depression, fatigue, and quality of life in people with MS. Methods: Twenty-two people with MS completed the 8-week mindfulness program as well as assessments 1 week before and after the intervention. Results: Pre/post comparison of four self-reported questionnaires—the Mental Health Inventory, 36-item Short Form Health Status Survey, Modified Fatigue Impact Scale, and Five Facet Mindfulness Questionnaire—showed significant improvement in physical functioning, vitality, and mental health. Specifically, improvements were seen in anxiety, depression, and positive affect; cognitive, psychosocial, and overall functioning regarding fatigue; and mindfulness in the areas of observing, acting with awareness, nonjudgment, and nonreactivity. Conclusions: Due to the uncertainty in disease progression associated with MS, and the multiplicity of mental and physical symptoms associated with it, programming that addresses anxiety, depression, and fatigue is a key area of future research in MS disease management. Mindfulness in Motion proved to be a feasible program yielding positive results, supporting the need for research to determine the extent to which the program can improve quality-of-life outcomes for people with MS.

scholarly journals Economia solidária, saúde mental e inclusão: uma revisão de literatura / Solidarity economy, mental health and inclusion: a literature review

2020 ◽  
Vol 4 (4) ◽  
pp. 674-687
Author(s):  
Ioneide De Oliveira Campos ◽  
Rafael Moraes Reis
Keyword(s):  
Mental Health ◽  
Web Of Science ◽  
Case Reports ◽  
Self Management ◽  
Review Of The Literature ◽  
Inclusion Criteria ◽  
Solidarity Economy ◽  
Collective Work ◽  
Qualitative Approaches ◽  
Salud Mental

A Economia Solidária é uma alternativa para inserção laboral de pessoas com transtornos mentais. Realizou-se uma revisão da literatura, com o propósito de conhecer o que tem sido publicado sobre Economia Solidária, inclusão e Saúde Mental, quais os objetivos e métodos de pesquisa, quem são os profissionais e populações-alvo e quais os resultados obtidos nos estudos. Foram considerados os seguintes critérios para a realização desse estudo: a importância da temática para o contexto da Saúde Mental e a identificação de pesquisas e relatos de experiência que informassem práticas em Saúde Mental e Economia Solidária. A revisão foi realizada nas bases: Web of Science, DOAJ, PubMed, SciElo e LILACS, sem restrições de ano. Os descritores utilizados foram “economia solidária”, “saúde mental” e “inclusão”. Vinte e nove (n=29) artigos foram encontrados e, após a aplicação dos critérios de inclusão, dez foram analisados na íntegra. Trinta e quatro (n=34) profissionais estiveram envolvidos nas pesquisas, sendo a Terapia Ocupacional, Enfermagem e Psicologia, as profissões que apareceram mais frequentemente.  Todos os estudos encontrados eram qualitativos e foram conduzidos no Brasil. A entrevista foi o método mais adotado. Os resultados dos estudos sinalizaram ganhos para aspectos intrínsecos dos usuários no que se refere a autogestão, expressão, empoderamento, e também extrínsecos, como a questão familiar e do trabalho coletivo. A revisão agregou conhecimento que permitem refletir sobre a importância da interdisciplinaridade, do trabalho colaborativo em rede, e sobre a necessidade de documentação das experiências em Economia Solidária no país. AbstractThe Solidarity Economy is an alternative for the labour inclusion of people with mental health. A review of the literature was conducted in order to know what has been published on the issue of Solidarity Economy, Inclusion and Mental Health, what are the objectives and research methods, who are the professionals and populations’ target, and the results identified in the research. We considered the following criteria: the importance of the issue in the mental health context and identification of studies and case reports which informed practice in Mental Health and Solidarity Economy. The search was done at the databases: Web of Science, DOAJ, PubMed, Scielo and LILACS, with no year restrictions. The descriptors used were "solidarity economy", "mental health" and "inclusion". Twenty-nine (n=29) were found and after the inclusion criteria filter, ten articles were analysed. Thirty-four (n=34) professionals were involved in the studies and the most were Occupational Therapy, Nursing and Psychology. All the studies found used qualitative approaches and were conducted in Brazil. The interview was the most adopted method for data collection. The results indicate outcomes for users' intrinsic aspects such as self-management, expression, empowerment, and also extrinsic, such as family and collective work. The review added knowledge to reflect about the interdisciplinary and collaborative network, and also on the documentation of experiences in Solidarity Economy in the country.Keywords: Mental health; Solidarity economy; Public policies; Inclusion; Research.ResumenLa Economía Solidaria es una alternativa para la inserción laboral de personas con trastornos mentales. Se realizó una revisión de la literatura, con el fin de conocer qué se ha publicado sobre Economía Solidaria, inclusión y Salud Mental, cuáles son los objetivos y métodos de investigación, quiénes son los profesionales y las poblaciones objetivo y cuáles son los resultados obtenidos. Se consideraron los siguientes criterios para realizar este estudio: la importancia del tema para el contexto de la salud mental y la identificación de informes de investigación y experiencia que informarían las prácticas con la Salud Mental y la Economía Solidaria. La revisión se realizó en las bases de datos: Web of Science, DOAJ, PubMed, Scielo y LILACS, sin restricciones de año. Los descriptores utilizados fueron "economía solidaria", "salud mental" e "inclusión". Veintinueve (n = 29) artículos fueron encontrados y, después de aplicar los criterios de inclusión, diez fueron analizados en su totalidad. Treinta y cuatro (n = 34) profesionales participaron en las investigaciones, siendo la Terapia Ocupacional, Enfermería y Psicología las profesiones que aparecieron con más frecuencia. Todos los estudios encontrados fueron cualitativos y se realizaron en Brasil. La entrevista fue el método más adoptado. Los resultados de los estudios señalaron ganancias para los aspectos intrínsecos de los usuarios, como la autogestión, la expresión, el empoderamiento y también los aspectos extrínsecos, como el tema del trabajo familiar y colectivo. La revisión agregó conocimiento que nos permite reflexionar sobre la importancia de la interdisciplinariedad, así como el trabajo en red colaborativo, y sobre la necesidad de documentar experiencias en Economía Solidaria en el país.Palabras clave: Salud mental; Economía solidaria; Políticas públicas; Inclusión; Investigación.      

scholarly journals How the Pilates Method Can Influence Sports Performance in Different Modalities

2020 ◽  
Vol 25 (264) ◽  
pp. 139-152
Author(s):  
Manoela Abreu ◽  
Franciele Carvalho Santos ◽  
Ana Laura Nogueira ◽  
Matheus Lima Zampieri ◽  
Dernival Bertoncello
Keyword(s):  
Systematic Review ◽  
Methodological Quality ◽  
Web Of Science ◽  
Sports Performance ◽  
Review Of The Literature ◽  
Control Groups ◽  
Future Studies ◽  
Pilates Method

The aim of this study was to perform a systematic review of the literature in order to investigate the effects of the Pilates Method on athletes of different sports. Methods: Researches were carried out in databases (SciELO, LILACS, PubMed, Web of Science and SCOPUS) and to evaluate the methodological quality of the studies, the PEDro scale was used. Results: Of the 87 studies found, only four were included. Meta-analyzes to assess flexibility using the Wells Bank's Sit and Reach test and a fleximeter indicated improvement after Pilates application, although there were no statistically significant differences compared to the control groups (Wells Bank's Sit and Reach test: 2 , 83 95% CI: -0.73 to 6.38, I² = 99%; Fleximeter: -0.78, 95% CI: -1.84 to 0.27, I² = 0%). Conclusion: There is evidence of benefits after Pilates intervention. Future studies with standardized protocols, according to the chosen sport, are necessary to determine how the Pilates Method can improve athletes' performance.

The Imposter Phenomenon in the Medical Profession

2020 ◽  
pp. 148-166
Author(s):  
Rebecca C. Grossman
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Coping Strategies ◽  
Ethnic Minorities ◽  
Medical Profession ◽  
Future Research ◽  
Review Of The Literature ◽  
Imposter Phenomenon ◽  
Internal Experience ◽  
The Impact

The imposter phenomenon, or imposter syndrome, is defined as an internal experience of feeling like an intellectual fraud, despite external evidence of an individual's accomplishments, and results in an inability to internalise a sense of success. It is common among high-achieving people, and appears to be more common in women and ethnic minorities. In this chapter, a systematic review of the literature will be presented on imposter syndrome in the medical profession. Topics covered include purported aetiology, implications (including the impact on mental health and career progression), limitations of research, potential coping strategies, and avenues for future research.

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