Different Phases of ATS Use Call for Different Interventions: a Large Qualitative Study in Europe

Abstract Background: Amphetamine Type Stimulants (ATS) are globally widely used. However, there is limited understanding of what influences different phases of ATS use, as well as whether this varies by type of ATS user (groups). The ATTUNE study investigated which factors shape individual ATS use patterns. In this article, we report on these phases into and out of ATS use, and propose a set of recommendations for prevention, harm reduction and treatment of the different phases of ATS use.Methods: Qualitative, semi-structured interviews (n= 237) were conducted in five different European countries with participants who had used ATS, varying from a few times in a lifetime to daily. Results: Most ATS users consumed amphetamine only (28%), followed by amphetamine and MDMA (17%). Yet, types of ATS used differed between the countries. We found that that ATS users have various motives for and dynamic patterns of ATS use with alternating phases of increase, continuation and decrease. Cessation was pursued in different ways and for diverse reasons, such as mental health problems and maturing out. Availability seemed not an issue, regardless of the type of user, phase or country.Conclusions: These findings demonstrate that tailor-made interventions are needed for the diverse user types and different phases or patterns of ATS use, to reduce possible harms of use. We recommended a set of interventions for the different ATS phases. These include drug checking services, peer-led information, self-management of ATS use, mental health support to help people cope with stressful life events and prevent uncontrolled use, and follow-up support after treatment.

Download Full-text

‘Five hours to sort out your life’: qualitative study of the experiences of university students who access mental health support

BJPsych Open ◽

10.1192/bjo.2021.947 ◽

2021 ◽

Vol 7 (4) ◽

Author(s):

Phoebe Barnett ◽

Laura-Louise Arundell ◽

Hannah Matthews ◽

Rob Saunders ◽

Stephen Pilling

Keyword(s):

Mental Health ◽

University Students ◽

Mental Health Problems ◽

Informed Choice ◽

Full Time ◽

Structured Interviews ◽

Provision Of Services ◽

Mental Health Support ◽

Health Support ◽

University Services

Background Previous qualitative research suggests that university students feel that current service provision does not meet their needs. Exploring the reasons for this may help to promote service change, encourage the uptake of care, improve outcomes and increase satisfaction within university services. Aims This study aimed to improve the understanding of how students experience the process of accessing and using mental health support, barriers and facilitators to treatment, and how students would adapt provision to improve experiences. Method Semi-structured interviews were conducted with 16 full-time students who had used mental health services at university. Data were analysed using thematic analysis. Results Five higher-order themes were identified: personalisation and informed choice, simplifying the process, feeling abandoned ignored or invisible, stigma, and superiority of private and external services. Sixteen subthemes were identified within these themes. Conclusions Findings indicate that access to mental health support should be simplified, with collaboration across university and external health and care services, to prevent students feeling lost or abandoned when seeking care. An inclusive approach to support access and provision of services for all presentations of mental health problems should be developed.

Download Full-text

MyCare study: protocol for a controlled trial evaluating the effect of a community-based intervention on psychosocial, clinical outcomes and hospital admission rates for adults with severe mental illness

BMJ Open ◽

10.1136/bmjopen-2020-040610 ◽

2020 ◽

Vol 10 (11) ◽

pp. e040610

Author(s):

Renée O'Donnell ◽

Melissa Savaglio ◽

Debra Fast ◽

Ash Vincent ◽

Dave Vicary ◽

...

Keyword(s):

Mental Health ◽

Mental Illness ◽

Hospital Admission ◽

Clinical Outcomes ◽

Controlled Trial ◽

Community Based ◽

Admission Rates ◽

Mental Health Support ◽

Health Support

IntroductionPeople with serious mental illness (SMI) often fail to receive adequate treatment. To provide a higher level of support, mental health systems have been reformed substantially to integrate mental healthcare into the community. MyCare is one such community-based mental health model of care. This paper describes the study protocol of a controlled trial examining the effect of MyCare on psychosocial and clinical outcomes and hospital admission and duration rates for adults with SMI.Methods and analysisThis is a multisite non-randomised controlled trial with a 3, 6 and 12-month follow-up period. The study participants will be adults (18–64 years of age) with SMI recruited from Hobart, Launceston and the North-West of Tasmania. The treatment group will include adults who receive both the MyCare intervention and standard mental health support; the control group will include adults who receive only standard mental health support. The primary outcome includes psychosocial and clinical functioning and the secondary outcome will examine hospital admission rates and duration of stay. Mixed-effects models will be used to examine outcome improvements between intake and follow-up. This trial will generate the evidence needed to evaluate the effect of a community mental health support programme delivered in Tasmania, Australia. If MyCare results in sustained positive outcomes for adults with SMI, it could potentially be scaled up more broadly across Australia, addressing the inequity and lack of comprehensive treatment that many individuals with SMI experience.Ethics and disseminationThis study has been approved by the Tasmanian Health and Medical Human Research Ethics Committee. The findings will be disseminated to participants and staff who delivered the intervention, submitted for publication in a peer-reviewed journal and shared at academic conferences.Trial registration numberACTRN12620000673943.

Download Full-text

STAVOVI PREMA OSOBAMA S POTEŠKOĆAMA MENTALNOG ZDRAVLJA

Annual of Social Work ◽

10.3935/ljsr.v28i1.391 ◽

2021 ◽

Vol 28 (1) ◽

pp. 181-203

Author(s):

Ana Petak ◽

Sanja Narić ◽

Roberta Matković

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Health Problems ◽

Significant Interaction Effect ◽

College And University ◽

Mental Health Support ◽

Mental Health Difficulties ◽

Support Seeking ◽

Health Support ◽

Attitudes Toward Mental Illness

ATTITUDES TOWARD PEOPLE WITH MENTAL HEALTH DIFFICULTIES The implementation of modern approaches that seek to deinstitutionalize traditional psychiatric services is hampered by unfavorable attitudes of the community towards people with mental disabilities. Stigma is one of the most important factors that delay seeking help and negatively affects the quality of life of people with mental health problems. The research was conducted to describe attitudes towards people with mental health problems and determine their relationship with socio-demographic variables, information, and personal experience with mental health problems. There were 108 participants aged 21 to 59 (71% female, 64.5% college and university degrees). The Community Attitudes toward Mental Illness scale (CAMI) (Taylor & Dear, 1981) and a survey questionnaire were used online. Participants have generally benevolent attitudes toward all dimensions of the scale. Higher self-assessment of knowledge about mental health problems leads to more favorable attitudes towards authoritarianism, and younger age to less social restraint. Participants with a high school diploma have more negative attitudes towards the dimensions of authoritarianism and benevolence than participants with a university degree. There are no significant differences in attitudes regarding the experience of seeking mental health support, but on the authoritarian dimension, there is a significant interaction effect of being informed and mental health support seeking. The results indicate the importance of further research into the relationship between attitudes and mental health support seeking and the level of being informed on mental health issues. Key words: mental health; mental health difficulties; attitudes; stigmatization

Download Full-text

Natural language processing reveals vulnerable mental health support groups and heightened health anxiety on Reddit during COVID-19: an observational study

10.31234/osf.io/xvwcy ◽

2020 ◽

Author(s):

Daniel Mark Low ◽

Laurie Rumker ◽

Tanya Talkar ◽

John Torous ◽

Guillermo Cecchi ◽

...

Keyword(s):

Mental Health ◽

Machine Learning ◽

Natural Language Processing ◽

Natural Language ◽

Support Groups ◽

Language Processing ◽

Mental Health Problems ◽

Health Anxiety ◽

Mental Health Support ◽

Health Support

Background: The COVID-19 pandemic is exerting a devastating impact on mental health, but it is not clear how people with different types of mental health problems were differentially impacted as the initial wave of cases hit. Objective: We leverage natural language processing (NLP) with the goal of characterizing changes in fifteen of the world's largest mental health support groups (e.g., r/schizophrenia, r/SuicideWatch, r/Depression) found on the website Reddit, along with eleven non-mental health groups (e.g., r/PersonalFinance, r/conspiracy) during the initial stage of the pandemic. Methods: We create and release the Reddit Mental Health Dataset including posts from 826,961 unique users from 2018 to 2020. Using regression, we analyze trends from 90 text-derived features such as sentiment analysis, personal pronouns, and a “guns” semantic category. Using supervised machine learning, we classify posts into their respective support group and interpret important features to understand how different problems manifest in language. We apply unsupervised methods such as topic modeling and unsupervised clustering to uncover concerns throughout Reddit before and during the pandemic. Results: We find that the r/HealthAnxiety forum showed spikes in posts about COVID-19 early on in January, approximately two months before other support groups started posting about the pandemic. There were many features that significantly increased during COVID-19 for specific groups including the categories “economic stress”, “isolation”, and “home” while others such as “motion” significantly decreased. We find that support groups related to attention deficit hyperactivity disorder (ADHD), eating disorders (ED), and anxiety showed the most negative semantic change during the pandemic out of all mental health groups. Health anxiety emerged as a general theme across Reddit through independent supervised and unsupervised machine learning analyses. For instance, we provide evidence that the concerns of a diverse set of individuals are converging in this unique moment of history; we discover that the more users posted about COVID-19, the more linguistically similar (less distant) the mental health support groups became to r/HealthAnxiety (ρ = -0.96, P<.001). Using unsupervised clustering, we find the Suicidality and Loneliness clusters more than doubled in amount of posts during the pandemic. Specifically, the support groups for borderline personality disorder and post-traumatic stress disorder became significantly associated with the Suicidality cluster. Furthermore, clusters surrounding Self-Harm and Entertainment emerged. Conclusions: By using a broad set of NLP techniques and analyzing a baseline of pre-pandemic posts, we uncover patterns of how specific mental health problems manifest in language, identify at-risk users, and reveal the distribution of concerns across Reddit which could help provide better resources to its millions of users. We then demonstrate that textual analysis is sensitive to uncover mental health complaints as they arise in real time, identifying vulnerable groups and alarming themes during COVID-19, and thus may have utility during the ongoing pandemic and other world-changing events such as elections and protests from the present or the past.

Download Full-text

Exploring the acceptability of a digital mental health platform incorporating a virtual coach: The good, the bad, and the opportunities

Health Informatics Journal ◽

10.1177/1460458221994873 ◽

2021 ◽

Vol 27 (1) ◽

pp. 146045822199487

Author(s):

Anthony Venning ◽

Madeleine CE Herd ◽

Tassia K Oswald ◽

Sabran Razmi ◽

Fiona Glover ◽

...

Keyword(s):

Mental Health ◽

Mental Health Professionals ◽

User Engagement ◽

Behaviour Therapy ◽

Structured Interviews ◽

Negative Experiences ◽

The People ◽

Cognitive Behaviour ◽

Mental Health Support ◽

Health Support

Digital Mental Health Platforms offer feasible options to increase access to mental health support. This study aimed to examine the acceptability of a Low Intensity Cognitive Behaviour Therapy Digital Mental Health Platform, containing a Virtual Coach, with University Students ( n = 16) and Mental Health Professionals ( n = 5). Semi-structured interviews, exploratory focus groups, and inductive thematic analysis were conducted. Four overarching themes were identified, with potential users and professionals highlighting positive aspects, elements to be improved, and ambivalent feelings towards the platform overall. However, participants predominately expressed negative experiences indicating that the Virtual Coach was unrelatable and hard to engage with. While Virtual Coaches and similar Digital Mental Health Platforms have the potential to overcome barriers for those attempting to access mental health services, their effectiveness may be limited if the people who need them are not drawn to and then consistently engaged with them. Based on the feedback attained for this specific Digital Mental Health Platform, recommendations are provided for future developers aiming to create similar platforms, to assist in their uptake and ensure ongoing user engagement.

Download Full-text

Usual care for mental health problems in children with epilepsy: A cohort study

F1000Research ◽

10.12688/f1000research.15492.1 ◽

2018 ◽

Vol 7 ◽

pp. 1907 ◽

Cited By ~ 1

Author(s):

Alice Welch ◽

Roz Shafran ◽

Isobel Heyman ◽

Anna Coughtrey ◽

Sophie Bennett

Keyword(s):

Mental Health ◽

Cohort Study ◽

Young People ◽

Mental Health Problems ◽

Health Problems ◽

Routine Practice ◽

Children And Young People ◽

Mental Health Support ◽

Mental Health Difficulties ◽

Health Support

Background: Epilepsy is one of the most common chronic paediatric conditions. Children and young people with epilepsy are at a significantly higher risk of developing mental health problems relative to the general population, yet the majority of these problems are unrecognised and under-treated in clinical practice. Although there is little epilepsy-specific guidance as to what interventions to use, researchers suggest there is no reason why clinicians should not be using the evidence base. Given the poor prognosis of untreated mental health difficulties, this cohort study sought to identify what psychological treatment young people with epilepsy with mental health needs receive in routine practice. Methods: Participants were children and young people aged 3 to 18 attending paediatric neurology clinics. The parents of those children who met threshold for impairing symptoms on the Strengths and Difficulties questionnaire were asked to complete the Development and Well-being Assessment (DAWBA), an online clinical assessment designed to generate psychiatric diagnoses. Participants who met clinical threshold for a disorder according to the DAWBA were provided with a bespoke measure asking questions regarding their experience with treatment for mental health support. Results: 16 of the 46 parents who completed the DAWBA reported that they had experienced previous or current support for their child’s mental health difficulties. The mental health support offered to families was highly variable, inadequate and often not clearly compliant with existing UK National Institute for Health and Clinical Excellence (NICE) guidelines for mental health treatment in children and young people. Conclusions: The present study demonstrates the inconsistency and inadequacy of mental health provision for children and young people with epilepsy. Future work should explore reasons for the treatments offered failing to adhere to existing guidance for mental health difficulties in children, as well as possible solutions to this.

Download Full-text

Worker Preferences for a Mental Health App Within Male-Dominated Industries: Participatory Study

JMIR Mental Health ◽

10.2196/mental.8999 ◽

2018 ◽

Vol 5 (2) ◽

pp. e30 ◽

Cited By ~ 16

Author(s):

Dorian Peters ◽

Mark Deady ◽

Nick Glozier ◽

Samuel Harvey ◽

Rafael A Calvo

Keyword(s):

Mental Health ◽

Emergency Services ◽

Mental Health Problems ◽

Mobile Apps ◽

Well Being ◽

User Research ◽

Health Technologies ◽

Mental Health Support ◽

Health Support ◽

Male Dominated

Background Men are less likely to seek help for mental health problems, possibly because of stigma imposed by cultural masculine norms. These tendencies may be amplified within male-dominated workplaces such as the emergency services or transport industries. Mobile apps present a promising way to provide access to mental health support. However, little is known about the kinds of mental health technologies men would be willing to engage with, and no app can be effective if the intended users do not engage with it. Objective The goal of this participatory user research study was to explore the perceptions, preferences, and ideas of workers in male-dominated workplaces to define requirements for a mental health app that would be engaging and effective at improving psychological well-being. Methods Workers from male-dominated workplaces in rural, suburban, and urban locations took part in an exploratory qualitative study involving participatory workshops designed to elicit their perspectives and preferences for mental health support and the design of an app for mental health. Participants generated a number of artifacts (including draft screen designs and promotional material) designed to reify their perceptions, tacit knowledge, and ideas. Results A total of 60 workers aged between 26 and 65 years, 92% (55/60) male, from male-dominated workplaces in rural (16/60, 27%), suburban (14/60, 23%), and urban (30/60, 50%) locations participated in one of the 6 workshops, resulting in 49 unique feature ideas and 81 participant-generated artifacts. Thematic analysis resulted in a set of feature, language, and style preferences, as well as characteristics considered important by participants for a mental health app. The term “mental health” was highly stigmatized and disliked by participants. Tools including a mood tracker, self-assessment, and mood-fix tool were highly valued, and app characteristics such as brevity of interactions, minimal on-screen text, and a solutions-oriented approach were considered essential by participants. Some implementation strategies based on these findings are included in the discussion. Conclusions Future mental health mobile phone apps targeting workers in male-dominated workplaces need to consider language use and preferred features, as well as balance the preferences of users with the demands of evidence-based intervention. In addition to informing the development of mental health apps for workers in male-dominated industries, these findings may also provide insights for mental health technologies, for men in general, and for others in high-stigma environments.

Download Full-text

Natural Language Processing Reveals Vulnerable Mental Health Support Groups and Heightened Health Anxiety on Reddit During COVID-19: Observational Study

Journal of Medical Internet Research ◽

10.2196/22635 ◽

2020 ◽

Vol 22 (10) ◽

pp. e22635 ◽

Cited By ~ 1

Author(s):

Daniel M Low ◽

Laurie Rumker ◽

Tanya Talkar ◽

John Torous ◽

Guillermo Cecchi ◽

...

Keyword(s):

Mental Health ◽

Machine Learning ◽

Natural Language Processing ◽

Natural Language ◽

Support Groups ◽

Language Processing ◽

Mental Health Problems ◽

Health Anxiety ◽

Mental Health Support ◽

Health Support

Background The COVID-19 pandemic is impacting mental health, but it is not clear how people with different types of mental health problems were differentially impacted as the initial wave of cases hit. Objective The aim of this study is to leverage natural language processing (NLP) with the goal of characterizing changes in 15 of the world’s largest mental health support groups (eg, r/schizophrenia, r/SuicideWatch, r/Depression) found on the website Reddit, along with 11 non–mental health groups (eg, r/PersonalFinance, r/conspiracy) during the initial stage of the pandemic. Methods We created and released the Reddit Mental Health Dataset including posts from 826,961 unique users from 2018 to 2020. Using regression, we analyzed trends from 90 text-derived features such as sentiment analysis, personal pronouns, and semantic categories. Using supervised machine learning, we classified posts into their respective support groups and interpreted important features to understand how different problems manifest in language. We applied unsupervised methods such as topic modeling and unsupervised clustering to uncover concerns throughout Reddit before and during the pandemic. Results We found that the r/HealthAnxiety forum showed spikes in posts about COVID-19 early on in January, approximately 2 months before other support groups started posting about the pandemic. There were many features that significantly increased during COVID-19 for specific groups including the categories “economic stress,” “isolation,” and “home,” while others such as “motion” significantly decreased. We found that support groups related to attention-deficit/hyperactivity disorder, eating disorders, and anxiety showed the most negative semantic change during the pandemic out of all mental health groups. Health anxiety emerged as a general theme across Reddit through independent supervised and unsupervised machine learning analyses. For instance, we provide evidence that the concerns of a diverse set of individuals are converging in this unique moment of history; we discovered that the more users posted about COVID-19, the more linguistically similar (less distant) the mental health support groups became to r/HealthAnxiety (ρ=–0.96, P<.001). Using unsupervised clustering, we found the suicidality and loneliness clusters more than doubled in the number of posts during the pandemic. Specifically, the support groups for borderline personality disorder and posttraumatic stress disorder became significantly associated with the suicidality cluster. Furthermore, clusters surrounding self-harm and entertainment emerged. Conclusions By using a broad set of NLP techniques and analyzing a baseline of prepandemic posts, we uncovered patterns of how specific mental health problems manifest in language, identified at-risk users, and revealed the distribution of concerns across Reddit, which could help provide better resources to its millions of users. We then demonstrated that textual analysis is sensitive to uncover mental health complaints as they appear in real time, identifying vulnerable groups and alarming themes during COVID-19, and thus may have utility during the ongoing pandemic and other world-changing events such as elections and protests.

Download Full-text

Worker Preferences for a Mental Health App Within Male-Dominated Industries: Participatory Study (Preprint)

10.2196/preprints.8999 ◽

2017 ◽

Author(s):

Dorian Peters ◽

Mark Deady ◽

Nick Glozier ◽

Samuel Harvey ◽

Rafael A Calvo

Keyword(s):

Mental Health ◽

Emergency Services ◽

Mental Health Problems ◽

Mobile Apps ◽

Well Being ◽

User Research ◽

Health Technologies ◽

Mental Health Support ◽

Health Support ◽

Male Dominated

BACKGROUND Men are less likely to seek help for mental health problems, possibly because of stigma imposed by cultural masculine norms. These tendencies may be amplified within male-dominated workplaces such as the emergency services or transport industries. Mobile apps present a promising way to provide access to mental health support. However, little is known about the kinds of mental health technologies men would be willing to engage with, and no app can be effective if the intended users do not engage with it. OBJECTIVE The goal of this participatory user research study was to explore the perceptions, preferences, and ideas of workers in male-dominated workplaces to define requirements for a mental health app that would be engaging and effective at improving psychological well-being. METHODS Workers from male-dominated workplaces in rural, suburban, and urban locations took part in an exploratory qualitative study involving participatory workshops designed to elicit their perspectives and preferences for mental health support and the design of an app for mental health. Participants generated a number of artifacts (including draft screen designs and promotional material) designed to reify their perceptions, tacit knowledge, and ideas. RESULTS A total of 60 workers aged between 26 and 65 years, 92% (55/60) male, from male-dominated workplaces in rural (16/60, 27%), suburban (14/60, 23%), and urban (30/60, 50%) locations participated in one of the 6 workshops, resulting in 49 unique feature ideas and 81 participant-generated artifacts. Thematic analysis resulted in a set of feature, language, and style preferences, as well as characteristics considered important by participants for a mental health app. The term “mental health” was highly stigmatized and disliked by participants. Tools including a mood tracker, self-assessment, and mood-fix tool were highly valued, and app characteristics such as brevity of interactions, minimal on-screen text, and a solutions-oriented approach were considered essential by participants. Some implementation strategies based on these findings are included in the discussion. CONCLUSIONS Future mental health mobile phone apps targeting workers in male-dominated workplaces need to consider language use and preferred features, as well as balance the preferences of users with the demands of evidence-based intervention. In addition to informing the development of mental health apps for workers in male-dominated industries, these findings may also provide insights for mental health technologies, for men in general, and for others in high-stigma environments.

Download Full-text

Mental health of UK Members of Parliament in the House of Commons: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2018-027892 ◽

2019 ◽

Vol 9 (7) ◽

pp. e027892 ◽

Cited By ~ 2

Author(s):

Daniel Poulter ◽

Nicole Votruba ◽

Ioannis Bakolis ◽

Frances Debell ◽

Jayati Das-Munshi ◽

...

Keyword(s):

Mental Health ◽

Support Services ◽

Mental Health Problems ◽

House Of Commons ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Members Of Parliament ◽

Mental Health Support ◽

Health Support ◽

Age And Sex

ObjectivesThe purpose of this study was to assess (1) the overall mental health of Members of Parliament (MPs) and (2) awareness among MPs of the mental health support services available to them in Parliament.DesignAn anonymous self-completed online cross-sectional survey was conducted in December 2016.Setting56th UK House of Commons.ParticipantsAll 650 members of the 56th UK House of Commons were invited to participate; 146 MPs (23%) completed the survey.OutcomesThe General Health Questionnaire-12 was used to assess age- and sex-standardised prevalence of probable common mental disorders (CMD). Results were compared with a nationally representative survey, the Health Survey for England (HSE) 2014. Core demographic questions, MPs’ awareness of available mental health services, their willingness to discuss mental health issues with party Whips and fellow MPs and the effects of employment outside Parliament were assessed.ResultsComparison of MP respondents with HSE comparator groups found that MPs have higher rates of mental health problems (age- and sex-standardised prevalence of probable CMD in 49 surveyed MPs 34% (95% CI 27% to 42%) versus 17% (95% CI 13% to 21%) in the high-income comparison group). Survey respondents were younger, more likely to be female and more educated compared with all MPs. 77% of MPs (n=112) did not know how to access in-house mental health support. 52% (n=76) would not discuss their mental health with party Whips or other MPs (48%; n=70).ConclusionsMPs in the study sample had higher rates of mental health problems than rates seen in the whole English population or comparable occupational groups. Most surveyed MPs are unaware of mental health support services or how to access them. Our findings represent a relatively small sample of MPs. There is a need for MPs to have better awareness of, and access to, mental health support.

Download Full-text