scholarly journals Psychological Screening and Tracking of Athletes and Digital Mental Health Solutions in a Hybrid Model of Care: Mini Review

10.2196/22755 ◽  
2020 ◽  
Vol 4 (12) ◽  
pp. e22755
Author(s):  
Luke Balcombe ◽  
Diego De Leo
Keyword(s):  
Mental Health ◽  
Machine Learning ◽  
Hybrid Model ◽  
Mental Health Problems ◽  
Health Screening ◽  
Mental Health Screening ◽  
Model Of Care ◽  
Psychological Screening ◽  
Prevention And Intervention ◽  
Digital Platforms

Background There is a persistent need for mental ill-health prevention and intervention among at-risk and vulnerable subpopulations. Major disruptions to life, such as the COVID-19 pandemic, present an opportunity for a better understanding of the experience of stressors and vulnerability. Faster and better ways of psychological screening and tracking are more generally required in response to the increased demand upon mental health care services. The argument that mental and physical health should be considered together as part of a biopsychosocial approach is garnering acceptance in elite athlete literature. However, the sporting population are unique in that there is an existing stigma of mental health, an underrecognition of mental ill-health, and engagement difficulties that have hindered research, prevention, and intervention efforts. Objective The aims of this paper are to summarize and evaluate the literature on athletes’ increased vulnerability to mental ill-health and digital mental health solutions as a complement to prevention and intervention, and to show relationships between athlete mental health problems and resilience as well as digital mental health screening and tracking, and faster and better treatment algorithms. Methods This mini review shapes literature in the fields of athlete mental health and digital mental health by summarizing and evaluating journal and review articles drawn from PubMed Central and the Directory of Open Access Journals. Results Consensus statements and systematic reviews indicated that elite athletes have comparable rates of mental ill-health prevalence to the general population. However, peculiar subgroups require disentangling. Innovative expansion of data collection and analytics is required to respond to engagement issues and advance research and treatment programs in the process. Digital platforms, machine learning, deep learning, and artificial intelligence are useful for mental health screening and tracking in various subpopulations. It is necessary to determine appropriate conditions for algorithms for use in recommendations. Partnered with real-time automation and machine learning models, valid and reliable behavior sensing, digital mental health screening, and tracking tools have the potential to drive a consolidated, measurable, and balanced risk assessment and management strategy for the prevention and intervention of the sequelae of mental ill-health. Conclusions Athletes are an at-risk subpopulation for mental health problems. However, a subgroup of high-level athletes displayed a resilience that helped them to positively adjust after a period of overwhelming stress. Further consideration of stress and adjustments in brief screening tools is recommended to validate this finding. There is an unrealized potential for broadening the scope of mental health, especially symptom and disorder interpretation. Digital platforms for psychological screening and tracking have been widely used among general populations, but there is yet to be an eminent athlete version. Sports in combination with mental health education should address the barriers to help-seeking by increasing awareness, from mental ill-health to positive functioning. A hybrid model of care is recommended, combining traditional face-to-face approaches along with innovative and evaluated digital technologies, that may be used in prevention and early intervention strategies.

scholarly journals Psychological Screening and Tracking of Athletes and Digital Mental Health Solutions in a Hybrid Model of Care: Mini Review (Preprint)

2020 ◽  
Author(s):  
Luke Balcombe ◽  
Diego De Leo
Keyword(s):  
Mental Health ◽  
Machine Learning ◽  
Hybrid Model ◽  
Mental Health Problems ◽  
Health Screening ◽  
Mental Health Screening ◽  
Model Of Care ◽  
Psychological Screening ◽  
Prevention And Intervention ◽  
Digital Platforms

BACKGROUND There is a persistent need for mental ill-health prevention and intervention among <i>at-risk</i> and vulnerable subpopulations. Major disruptions to life, such as the COVID-19 pandemic, present an opportunity for a better understanding of the experience of stressors and vulnerability. Faster and better ways of psychological screening and tracking are more generally required in response to the increased demand upon mental health care services. The argument that mental and physical health should be considered together as part of a biopsychosocial approach is garnering acceptance in elite athlete literature. However, the sporting population are unique in that there is an existing stigma of mental health, an underrecognition of mental ill-health, and engagement difficulties that have hindered research, prevention, and intervention efforts. OBJECTIVE The aims of this paper are to summarize and evaluate the literature on athletes’ increased vulnerability to mental ill-health and digital mental health solutions as a complement to prevention and intervention, and to show relationships between athlete mental health problems and resilience as well as digital mental health screening and tracking, and faster and better treatment algorithms. METHODS This mini review shapes literature in the fields of athlete mental health and digital mental health by summarizing and evaluating journal and review articles drawn from PubMed Central and the Directory of Open Access Journals. RESULTS Consensus statements and systematic reviews indicated that elite athletes have comparable rates of mental ill-health prevalence to the general population. However, peculiar subgroups require disentangling. Innovative expansion of data collection and analytics is required to respond to engagement issues and advance research and treatment programs in the process. Digital platforms, machine learning, deep learning, and artificial intelligence are useful for mental health screening and tracking in various subpopulations. It is necessary to determine appropriate conditions for algorithms for use in recommendations. Partnered with real-time automation and machine learning models, valid and reliable behavior sensing, digital mental health screening, and tracking tools have the potential to drive a consolidated, measurable, and balanced risk assessment and management strategy for the prevention and intervention of the sequelae of mental ill-health. CONCLUSIONS Athletes are an <i>at-risk</i> subpopulation for mental health problems. However, a subgroup of high-level athletes displayed a resilience that helped them to positively adjust after a period of <i>overwhelming</i> stress. Further consideration of stress and adjustments in brief screening tools is recommended to validate this finding. There is an unrealized potential for broadening the scope of mental health, especially symptom and disorder interpretation. Digital platforms for psychological screening and tracking have been widely used among general populations, but there is yet to be an eminent athlete version. Sports in combination with mental health education should address the barriers to help-seeking by increasing awareness, from mental ill-health to positive functioning. A hybrid model of care is recommended, combining traditional face-to-face approaches along with innovative and evaluated digital technologies, that may be used in prevention and early intervention strategies.

scholarly journals POS1321 MENTAL HEALTH SCREENING IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 943.1-943
Author(s):  
S. Eulert ◽  
M. Niewerth ◽  
J. Hörstermann ◽  
C. Sengler ◽  
D. Windschall ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Health Problems ◽  
Functional Limitations ◽  
Health Problems ◽  
Health Screening ◽  
Mental Health Screening ◽  
Psychological Support ◽  
Web Based ◽  
Patient Health

Background:Mental disorders often begin in the vulnerable phase of adolescence and young adulthood. Young people with chronic diseases are particularly at risk. Early recognition of mental health problems is necessary in order to be able to support those affected in a timely and adequate manner. By implementing a web-based generic screening tool for mental health in routine care, patients with juvenile idiopathic arthritis (JIA) and mental health conditions can be identified and provided with targeted treatment.Objectives:To investigate the prevalence of mental health conditions in young people with JIA in routine rheumatology care.Methods:Mental health screening is implemented as an add-on module to the National Paediatric Rheumatology Database (NPRD). The current data was gathered over a period of 24 months. Patients complete the screening tool which includes the Patient Health Questionnaire1 (PHQ-9, score 0-27) and the Generalized Anxiety Disorder scale2 (GAD-7, score 0-21) via a web-based questionnaire. The cut-off for critical values in PHQ-9 and GAD-7 were defined as values ≥ 10. Simultaneously, other data, such as sociodemographic data, disease activity (cJADAS10, score 0-30), functional status (CHAQ, score 0-3) were collected as well.Results:The analysis included 245 patients (75% female) with a mean age of 15.7 years and a mean disease duration of 8.8 years. 38.8% of the patients had oligoarthritis (18.0% OA, persistent/20.8% OA, extended) and 23.3% RF negative polyarthritis. At the time of documentation 49 patients (30.6%) had an inactive disease (cJADAS10 ≤ 1) and 120 (49.4%) no functional limitations (CHAQ = 0). In total, 53 patients (21.6%) had screening values in either GAD-7 or PHD-9 ≥10. Patients with critical mental health screening values showed higher disease activity and more frequent functional limitations than inconspicuous patients (cJADAS10 (mean ± SD): 9.3 ± 6 vs. 4.9 ± 4.9; CHAQ: 0.66 ± 0.6 vs. 0.21 ± 0.42). When compared to males, females were significantly more likely to report either depression or anxiety symptoms (11.7% vs. 24.9%, p = 0.031).17.6% of all patients with valid items for these data reported to receive psychological support, meaning psychotherapeutic support (14.5%) and/or drug therapy (8.6%). Among those with a critical mental health screening score, 38.7% received psychological support (psychotherapeutic support (35.5%) and/or drug therapy (16.1%)).Conclusion:Every fifth young person with JIA reported mental health problems, however, not even every second of them stated to receive psychological support. The results show that screening for mental health problems during routine adolescent rheumatology care is necessary to provide appropriate and targeted support services to young people with a high burden of illness.References:[1]Löwe B, Unützer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care. 2004 Dec;42(12):1194-201.[2]Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22; 166(10):1092-7.[3]The screening data were collected as part of COACH (Conditions in Adolescents: Implementation and Evaluation of Patient-centred Collaborative Healthcare), a project supported by the Federal Ministry of Education and Research (FKZ: 01GL1740F).Disclosure of Interests:Sascha Eulert: None declared, Martina Niewerth: None declared, Jana Hörstermann: None declared, Claudia Sengler: None declared, Daniel Windschall: None declared, Tilmann Kallinich: None declared, Jürgen Grulich-Henn: None declared, Frank Weller-Heinemann Consultant of: Pfizer, Abbvie, Sobi, Roche, Novartis, Ivan Foeldvari Consultant of: Gilead, Novartis, Pfizer, Hexal, BMS, Sanofi, MEDAC, Sandra Hansmann: None declared, Harald Baumeister: None declared, Reinhard Holl: None declared, Doris Staab: None declared, Kirsten Minden: None declared

scholarly journals Mental Health in Children with Cerebral Palsy: Does Screening Capture the Complexity?

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
H. M. Bjorgaas ◽  
I. Elgen ◽  
T. Boe ◽  
M. Hysing
Keyword(s):  
Mental Health ◽  
Cerebral Palsy ◽  
Psychiatric Disorders ◽  
Mental Health Problems ◽  
Health Problems ◽  
Health Screening ◽  
Mental Health Screening ◽  
High Prevalence ◽  
Children With Cerebral Palsy ◽  
Bergen Child Study

Introduction. Children with cerebral palsy (CP), one of the most common childhood neurological disorders, often have associated medical and psychological symptoms. This study assesses mental health problems compared to population controls and the ability of a mental health screening tool to predict psychiatric disorders and to capture the complexity of coexisting symptoms.Methods. Children with CP (N=47) were assessed according to DSM-IV criteria using a psychiatric diagnostic instrument (Kiddie-SADS) and a mental health screening questionnaire (SDQ). Participants from the Bergen Child Study, a large epidemiological study, served as controls.Results. Children with CP had significantly higher means on all problem scores including impact scores. Two in three children scored above 90th percentile cutoff on Total Difficulties Score (TDS), and 57% met criteria for a psychiatric disorder, yielding a sensitivity of 0.85 and a specificity of 0.55. Mental health problems coexisted across symptom scales, and peer problems were highly prevalent in all groups of psychiatric disorders.Conclusion. A high prevalence of mental health problems and cooccurrence of symptoms were found in children with CP compared to controls. Screening with SDQ detects mental health problems, but does not predict specific disorders in children with CP. ADHD is common, but difficult to diagnose due to complexity of symptoms. Mental health services integrated in regular followup of children with CP are recommended due to high prevalence and considerable overlap of mental health symptoms.

Refugees' Responses to Mental Health Screening

2003 ◽  
Vol 46 (2) ◽  
pp. 235-250 ◽  
Author(s):  
Nancy Ovitt ◽  
Christopher R. Larrison ◽  
Larry Nackerud
Keyword(s):  
Mental Health ◽  
Qualitative Data ◽  
Mental Health Problems ◽  
The United States ◽  
Health Screening ◽  
Mental Health Screening ◽  
High Rate ◽  
Structured Interviews ◽  
Hopkins Symptom Checklist ◽  
Migration Factors

For a variety of reasons related to pre- and post-migration factors, refugees experience a high rate of mental health problems. The early detection of these problems among refugees arriving in the United States benefits those individuals, the agencies that sponsor them and the communities that absorb them. The development of culturally-sensitive mental health screening instruments to identify pathology among refugees has been the focus of some research. This study explores the reactions of eight Bosnian refugees who were administered the Hopkins Symptom Checklist-25 as part of a mental health screening during the resettlement process. Through structured interviews with this sample, the authors elicited qualitative data about the mental health screening, from which preliminary conclusions were drawn about including such screening in the resettlement process.

scholarly journals An integrated model of care for young people with liver disease and transplant

2018 ◽  
Vol 6 (3) ◽  
pp. 424
Author(s):  
Anna Hames ◽  
Anna Simpson ◽  
Faith Matcham ◽  
Jemma Day ◽  
Deepak Joshi ◽  
...  
Keyword(s):  
Mental Health ◽  
Liver Disease ◽  
Young People ◽  
Real Time ◽  
Mental Health Problems ◽  
Health Problems ◽  
Health Screening ◽  
Mental Health Screening ◽  
Clinical Team ◽  
Patient Reported

Rationale, aims and objectives: Young people (YP) with chronic illness have increased risk of mental health problems.   This   paper   evaluates   the   feasibility,   acceptability   and effectiveness of incorporating routine electronic mental health screening into the standard multidisciplinary healthcare of YP with chronic liver disease and liver transplant.Methods: One hundred and eighty-seven YP (mean age 18 years, 53% female) attending routine appointments in a tertiary service in the UK completed mental health screening prior to their clinic appointment. These standardized measures (the 9-item Patient Health Questionnaire [PHQ9] and the 7-item Generalised Anxiety questionnaire [GAD7]) were completed using an informatics system that facilitates routine collection of patient-reported outcomes, with real-time feedback to guide clinical care. Responses are immediately uploaded to medical notes and evaluated by the clinical team. Fifty-three YP completed an additional feasibility measure. YP screening positive were assessed by the clinical team, with appropriate support offered. Level of clinician agreement with screening programme was ascertained by the team’s clinical psychologist.Results: YP reported that completing the electronic screening was acceptable, a positive experience and that routine mental health screening in this manner would not affect the way they felt about coming to clinic. Clinician judgement corroborated 31 of the 33 YP who screened as positive for anxiety/depression. Screening did not effectively identify all YP warranting psychosocial input.Conclusions: Screening using electronic measures, with responses uploaded in real-time to medical notes for consultant review, can facilitate the rapid identification of mental health problems in YP with physical health problems, in an acceptable and time/cost-effective way. This should be combined with the support of embedded mental health practitioners within physical healthcare environments.

scholarly journals Evaluation of the use of standardized methods to identify mental health problems among refugees

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Delilovic ◽  
K Lonnroth ◽  
A Hagstrom
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Problems ◽  
Health Problems ◽  
Health Screening ◽  
Mental Health Screening ◽  
Health Needs ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers

Abstract Background The number of refugees arriving and residing in Sweden remains high. They represent one of the most vulnerable sub-populations in the country, who carry a disproportional part of the disease burden. Information on health status, health determinants and the extent to which refugees get access to needed services is limited. In Sweden refugees are offered a free-of -charge health examination (HE). Yet, standardized mental health screening is often neglected as a part of the HE. A pilot project aimed to initiate early mental health screening was implemented. Methods The Refugee Health Screener-13 (RHS-13) was identified as an efficient, valid, and reliable tool for assessing mental health in this population and was integrated into the HE. The RHS-13 was administrated by nurses conducting the HE at two primary health care centers in Stockholm. Results During the one-month pilot 80 individuals were screened. The majority originated from Syria, DR Congo and Afghanistan and the distribution by migration background were 58% quota refugees, 35% asylum seekers and 8% others (family reunification and undocumented migrants). Of those screened, 30% screened positive for risk of mental health (cut off ≥11). Out of those who screened positive, 29% screened for mild mental health, 33% for moderate mental health and 38% for severe mental health problems. No statistically significant differences in RHS score were found according to country of origin, sex and age. The results are preliminary. Implementation will continue for 12 months at 4 primary health care centers. Conclusions This pilot demonstrated feasibility of RHS-13 in routine care. The findings reinforce the need for standardized guidelines and procedures for mental health screening of refugees. Routine mental health screening should be a part of the overall comprehensive HE, which could improve systematic monitoring of mental health care needs for refugees and ensure access to appropriate mental health care. Key messages Standardized procedures for identifying mental health problems among refugees is feasible and can identify health needs while ensuring equitable health examinations. Standardized procedures for identifying mental health problems among refugees is feasible and can identify health needs while ensuring equitable health examinations.

Preliminary Validation of the Subjective Academic Problems Scale: A New Tool to Aid in Triaging School Mental Health Screening Results

2017 ◽  
Vol 33 (3) ◽  
pp. 242-256 ◽  
Author(s):  
Tyler L. Renshaw
Keyword(s):  
Mental Health ◽  
Rating Scale ◽  
Mental Health Problems ◽  
School Mental Health ◽  
Measurement Model ◽  
Health Screening ◽  
Mental Health Screening ◽  
Self Report ◽  
Academic Problems ◽  
Behavior Rating Scale

The purpose of the present study was to investigate the preliminary structural, convergent, and incremental classification validity of responses to the Subjective Academic Problems Scale (SAPS), which is a seven-item self-report behavior rating scale intended for use as a triaging tool within secondary-level school mental health screening contexts. Findings from psychometric analyses carried out with Sample 1 ( N = 177) indicated that responses to the SAPS were characterized by a unidimensional measurement model and that scores derived from the scale had convergent validity with scores from several other self-reported measures of student wellbeing and mental health problems. Results from analyses conducted with Sample 2 ( N = 219) confirmed the unidimensionality of responses to the SAPS measurement model and demonstrated that SAPS scores had incremental validity, when used in conjunction with scores from a self-report internalizing problems screener, for identifying students with greater levels of mental health risk. Implications for future research and practice are discussed.

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