scholarly journals Assessment of Population Well-Being With the Mental Health Quotient (MHQ): Development and Usability Study (Preprint)

2020 ◽  
Author(s):  
Jennifer Jane Newson ◽  
Tara C Thiagarajan

BACKGROUND Existing mental health assessment tools provide an incomplete picture of symptom experience and create ambiguity, bias, and inconsistency in mental health outcomes. Furthermore, by focusing on disorders and dysfunction, they do not allow a view of mental health and well-being across a general population. OBJECTIVE This study aims to demonstrate the outcomes and validity of a new web-based assessment tool called the Mental Health Quotient (MHQ), which is designed for the general population. The MHQ covers the complete breadth of clinical mental health symptoms and also captures healthy mental functioning to provide a complete profile of an individual’s mental health from clinical to thriving. METHODS The MHQ was developed based on the coding of symptoms assessed in 126 existing Diagnostic and Statistical Manual of Mental Disorders (DSM)–based psychiatric assessment tools as well as neuroscientific criteria laid out by Research Domain Criteria to arrive at a comprehensive set of semantically distinct mental health symptoms and attributes. These were formulated into questions on a 9-point scale with both positive and negative dimensions and developed into a web-based tool that takes approximately 14 min to complete. As its output, the assessment provides overall MHQ scores as well as subscores for 6 categories of mental health that distinguish clinical and at-risk groups from healthy populations based on a nonlinear scoring algorithm. MHQ items were also mapped to the DSM fifth edition (DSM-5), and clinical diagnostic criteria for 10 disorders were applied to the MHQ outcomes to cross-validate scores labeled at-risk and clinical. Initial data were collected from 1665 adult respondents to test the tool. RESULTS Scores in the normal healthy range spanned from 0 to 200 for the overall MHQ, with an average score of approximately 100 (SD 45), and from 0 to 100 with average scores between 48 (SD 21) and 55 (SD 22) for subscores in each of the 6 mental health subcategories. Overall, 2.46% (41/1665) and 13.09% (218/1665) of respondents were classified as clinical and at-risk, respectively, with negative scores. Validation against DSM-5 diagnostic criteria showed that 95% (39/41) of those designated clinical were positive for at least one DSM-5–based disorder, whereas only 1.14% (16/1406) of those with a positive MHQ score met the diagnostic criteria for a mental health disorder. CONCLUSIONS The MHQ provides a fast, easy, and comprehensive way to assess population mental health and well-being; identify at-risk individuals and subgroups; and provide diagnosis-relevant information across 10 disorders.

10.2196/17935 ◽  
2020 ◽  
Vol 7 (7) ◽  
pp. e17935 ◽  
Author(s):  
Jennifer Jane Newson ◽  
Tara C Thiagarajan

Background Existing mental health assessment tools provide an incomplete picture of symptom experience and create ambiguity, bias, and inconsistency in mental health outcomes. Furthermore, by focusing on disorders and dysfunction, they do not allow a view of mental health and well-being across a general population. Objective This study aims to demonstrate the outcomes and validity of a new web-based assessment tool called the Mental Health Quotient (MHQ), which is designed for the general population. The MHQ covers the complete breadth of clinical mental health symptoms and also captures healthy mental functioning to provide a complete profile of an individual’s mental health from clinical to thriving. Methods The MHQ was developed based on the coding of symptoms assessed in 126 existing Diagnostic and Statistical Manual of Mental Disorders (DSM)–based psychiatric assessment tools as well as neuroscientific criteria laid out by Research Domain Criteria to arrive at a comprehensive set of semantically distinct mental health symptoms and attributes. These were formulated into questions on a 9-point scale with both positive and negative dimensions and developed into a web-based tool that takes approximately 14 min to complete. As its output, the assessment provides overall MHQ scores as well as subscores for 6 categories of mental health that distinguish clinical and at-risk groups from healthy populations based on a nonlinear scoring algorithm. MHQ items were also mapped to the DSM fifth edition (DSM-5), and clinical diagnostic criteria for 10 disorders were applied to the MHQ outcomes to cross-validate scores labeled at-risk and clinical. Initial data were collected from 1665 adult respondents to test the tool. Results Scores in the normal healthy range spanned from 0 to 200 for the overall MHQ, with an average score of approximately 100 (SD 45), and from 0 to 100 with average scores between 48 (SD 21) and 55 (SD 22) for subscores in each of the 6 mental health subcategories. Overall, 2.46% (41/1665) and 13.09% (218/1665) of respondents were classified as clinical and at-risk, respectively, with negative scores. Validation against DSM-5 diagnostic criteria showed that 95% (39/41) of those designated clinical were positive for at least one DSM-5–based disorder, whereas only 1.14% (16/1406) of those with a positive MHQ score met the diagnostic criteria for a mental health disorder. Conclusions The MHQ provides a fast, easy, and comprehensive way to assess population mental health and well-being; identify at-risk individuals and subgroups; and provide diagnosis-relevant information across 10 disorders.


2020 ◽  
Vol 163 (4) ◽  
pp. 2073-2095
Author(s):  
Kimberly Bryan ◽  
Sarah Ward ◽  
Liz Roberts ◽  
Mathew P. White ◽  
Owen Landeg ◽  
...  

AbstractThe global literature on drought and health highlights a variety of health effects for people in developing countries where certain prevailing social, economic and environmental conditions increase their vulnerability especially with climate change. Despite increased focus on climate change, relatively less is known about the health-drought impacts in the developed country context. In the UK, where climate change–related risk of water shortages has been identified as a key area for action, there is need for better understanding of drought-health linkages. This paper assesses people’s narratives of drought on health and well-being in the UK using a source-receptor-impact framing. Stakeholder narratives indicate that drought can present perceived health and well-being effects through reduced water quantity, water quality, compromised hygiene and sanitation, food security, and air quality. Heatwave associated with drought was also identified as a source of health effects through heat and wildfire, and drought-related vectors. Drought was viewed as potentially attributing both negative and positive effects for physical and mental health, with emphasis on mental health. Health impacts were often complex and cross-sectoral in nature indicating the need for a management approach across several sectors that targets drought and health in risk assessment and adaptation planning processes. Two recurring themes in the UK narratives were the health consequences of drought for ‘at-risk’ groups and the need to target them, and that drought in a changing climate presented potential health implications for at-risk groups.


2018 ◽  
Vol 42 (2) ◽  
pp. 146 ◽  
Author(s):  
Mark Hughes

Objectives The aim of the present study was to examine the health and well being of older lesbian, gay, bisexual, transgender and intersex (LGBTI) people, the health issues that concern them, the services they use and challenges accessing services. Methods This study comprised a survey of the health and well being of 312 LGBTI people aged 50 years and over in New South Wales. The survey included the Short-Form 12 (SF-12) measure of health-related quality of life, the Kessler 10 (K10) measure of psychological distress, and the three-item Loneliness Scale. Results Higher levels of psychological distress, lower mental health and greater loneliness were found among this sample than is typically found in the general population. Mental health was lower among carers and those not in a relationship, while psychological distress was greater among those living alone and those experiencing higher rates of loneliness. The most commonly accessed health service was a general practitioner (GP), with most respondents reporting that they were open about their sexuality to their GP and that they had a regular GP. Some reported difficulties accessing health services because of their gender or sexual diversity. Conclusions Although many older LGBTI people are well, both physically and mentally, they do appear to face increased risk of certain health issues compared with the general population. What is known about the topic? Overseas research indicates that older LGBTI people may be at greater risk of certain physical and mental health conditions than the general population. What does this paper add? This paper provides Australian data, using well-validated instruments, on the health and well being of older LGBTI people. It provides evidence of the health issues that older LGBTI people are most concerned about and the barriers they face in accessing services. What are the implications for practitioners? It is important for health practitioners to be aware that older LGBTI people appear to be at increased risk of certain physical and mental health issues, such as loneliness and psychological distress. Providing opportunities for clients to identify their gender or sexual diversity may assist in monitoring risk factors and enable referral to promote healthy aging.


2021 ◽  
Vol 19 (9) ◽  
pp. 133-146
Author(s):  
Robyn R. Gershon, MHS, DrPH ◽  
Alexis A. Merdjanoff, PhD ◽  
Gabriella Y. Meltzer, BA ◽  
Rachael Piltch-Loeb, MSPH, PhD ◽  
Jonathan Rosen, MS, CIH, FAIHA ◽  
...  

Background and purpose: Early on in the COVID-19 pandemic, New York City (NYC) vowed to “keep the subways running” despite the lack of plans in place for protecting the health and well-being of transit workers. This study was designed to assess the impact of employment during the early phase of the pandemic on this essential frontline workforce. Methods, settings, and study participants: A convenience sample of members (stratified by job title) of the NYC Transport Workers Union, Local 100, was recruited in August 2020 to participate in an anonymous, cross-sectional, internet-based survey. Results: The demographics of the sample participants (N = 645) reflected union membership, ie, 82 percent male, 29 percent Black; 27 percent Hispanic, and 59 percent ≥age 50 years. At the time of the “NYC Pause” (March 22, 2020) when mandatory stay-at-home orders were issued, transit workers had limited worksite protections. Many reported a lack of such basics as face masks (43 percent), hand sanitizer (40 percent), and disposable gloves (34 percent). A high proportion (87 percent) were concerned about getting infected at work. Lack of certain protections was significantly associated with both fear of contagion at work and mental health symptoms. Nearly 24 per­cent of participants reported a history of COVID-19 infection. Self-reported infection was significantly correlated with lack of certain protections, including respiratory masks (p 0.001), disposable gloves (p 0.001), and hand sanitizer (p 0.001). Infection was also significantly associated with mental health symptoms (p 0.001). By August 2020, despite participants reporting that many worksite protections were then in place, 72 percent of workers were still fearful for their safety at work, eg, because of potential exposure due to passengers not wearing masks, and risk of verbal abuse and physical assault by passengers angered when asked to wear face masks. Workers who were fearful for their safety at work were more than six times more likely to report mental health symptoms (p 0.001). Conclusions: Lack of worksite protections before “NYC Pause” (March 22, 2020) was significantly associated with self-reported infection, fear, and mental health symptoms in TWU, Local 100 members. To reduce the risk of adverse impacts associated with bioevents in all essential work groups, and across all essential occupational settings, infection control preparedness, early recognition of risk, and implementation of tailored risk reduction strategies are imperative. Pandemic preparedness is fundamental to protecting the health and well-being of essential workers and crucial in controlling the spread of disease in the community. Bioevent preparedness for all essential frontline workgroups will also help reduce occupational health inequities. Workers at risk, regardless of setting, deserve and have the right to equal protections under federal and state law.


2021 ◽  
Author(s):  
Tabo Akafekwa ◽  
Elizabeth Dalgarno ◽  
Arpana Verma

AbstractObjectiveThis study explores the impact of the COVID 19 lockdown measures on the mental health and well-being of unpaid carers, who make up the largest number of the carer population in England.Study designA systematic review research protocol was designed and used to conduct the review along with the Enhancing Transparency in Reporting the synthesis of Qualitative Research - ENTREQ statement [43]. Pre-determined inclusion and exclusion criteria were used. EndNote X9 reference management was used and the search process was represented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram [76]. Appraisal of the included research was carried out using the Critical Appraisal Skills Programme (CASP) [57]. Line by line coding was done using inductive thematic synthesis and EPPI Reviewer 4 software [60].ResultsFour themes emerged; immediate worries or fears, adapting to change, post pandemic fears and use of technology.ConclusionThe measures put in place during the first lockdown period have had detrimental impacts on unpaid carers, putting them at greater risk of burnout. However, use of digital platforms could have a positive impact on well-being. Recommendations for further research are provided.What is new?Key findings?Discontinued or reduced access to activities and services during the first lockdown during the pandemic has had a negative impact on both people who require care and their carers.Carers prioritise the mental health and wellbeing needs of the people they care for over their own.Further qualitative research from different groups of carers would be useful to gain a deeper understanding of the impact of the COVID 19 pandemic measures on unpaid carers.Use of digital technology and digital platforms may be useful tools for carers both during the pandemic and after.What this adds to what is known?There have been very few qualitative studies on the impact of the COVID 19 pandemic on the mental health and wellbeing of unpaid carers, this review has synthesised their findings and will contribute to future research.Unpaid carers are known to be at risk of poor mental health and wellbeing outcomes, this review demonstrates that they are even more at risk due to the increased reliance on them during the pandemic.What is this implication and what should change?There is limited qualitative data available from a range of different groups of carers for example, spouse carers, parent carers, carers of people who have specific needs or conditions. Therefore, purposeful sample research to determine the needs of groups of carers during the COVID 19 pandemic could be valuable.Unpaid carers who do not have appropriate support are more at risk of poor mental health and wellbeing outcomes. During the pandemic services have had to adapt to the various rules implemented. Digital adaptations to the provision of support to both carers and the people they care for could be beneficial both during and after the pandemic.


2021 ◽  
Author(s):  
Amelia Eisenstadt ◽  
Shaun Liverpool ◽  
Elisa Infanti ◽  
Roberta Maria Ciuvat ◽  
Courtney Carlsson

BACKGROUND Among the general public there appears to be a growing need and interest in receiving digital mental health and well-being support. In response to this, a number of mental health apps (MHapps) are becoming available for monitoring, managing and promoting positive mental health and well-being. Thus far, the evidence supports positive outcomes when users engage with digital interventions. However, there is high variability in the theoretical base informing MHapps and the features incorporated. Such differences can have implications for the efficacy of the apps and the level of engagement among specific target population groups. Moreover, such heterogeneity may influence the extent to which the data from various MHapps can be pooled to assess the strength of the evidence. OBJECTIVE We aimed to systematically review the available research on MHapps that promote emotion regulation, positive mental health, and well-being in the general population aged 18-45. More specifically, the review aimed at providing a systematic description of the theoretical background and features of MHapps while evaluating any potential effectiveness. METHODS A comprehensive literature search of key databases; MEDLINE (via Ovid), EMBASE (via Ovid), PsycINFO (via Ovid), Web of Science, and the Cochrane Register of Controlled Trials (CENTRAL) was conducted until January 2021. Studies were included if they described standalone mental health and well-being apps for adults without a formal mental health diagnosis. All studies were quality assessed against the Mixed Methods Appraisal Tool. In addition, the Cochrane risk-of-bias tool (ROB-2) was used to assess randomized control trials (RCTs). Data were extracted using a modified extraction form the Cochrane Handbook of Systematic Reviews. A narrative synthesis and meta-analysis was then undertaken to address the review aims. RESULTS In total, 3156 abstracts were identified. Of these, 52 publications describing 48 MHapps met the inclusion criteria. Together the studies evaluated interventions across 15 countries. Thirty-nine RCTs were identified that suggested there is some support for the role of individual MHapps in improving and promoting mental health and well-being. Regarding pooled effect, MHapps, when compared to controls, showed a small effect for reducing mental health symptoms (k = 19, g = -0.24, 95% CI [-0.34, -0.14], p < .05) and improving well-being (k = 13, g = 0.17, 95% CI [0.05, 0.29], p < .05), and a medium effect for emotion regulation (k = 6, g = 0.49, 95% CI [0.23,0.74], p<.05). There is also a wide knowledge base of creative and innovative ways to engage users in techniques, such as mood monitoring and guided exercises. Mindfulness and Cognitive Behavioural approaches appear to be the most common among MHapp developers. Studies were generally assessed to contribute unclear or high risk of bias, or be of medium to low methodological quality. CONCLUSIONS The emerging evidence for MHapps that promote positive mental health and well-being continue to show some evidence of promise. Despite a wide range of MHapps, there are not many that specifically promote emotion regulation. However, our findings may position emotion regulation as an important mechanism for inclusion in future positive mental health and well-being MHapps. A fair proportion of the included studies were pilot or feasibility trials (k = 17, 33%), and full scale RCTs reported high attrition rates and non-diverse samples. Given the number and pace at which MHapps are being released, further robust research is warranted to inform the development and testing of evidence-based programs. CLINICALTRIAL Mia Eisenstadt, Elisa Infanti, Shaun Liverpool. Characteristics and effectiveness of mobile apps that promote emotion regulation and well-being in the general population: a systematic review protocol. PROSPERO 2020 CRD42020213051 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020213051


BJPsych Open ◽  
2019 ◽  
Vol 5 (6) ◽  
Author(s):  
Kirsty Dunn ◽  
Deborah Kinnear ◽  
Andrew Jahoda ◽  
Alex McConnachie

Background Caring for a child with intellectual disabilities can be a very rewarding but demanding experience. Research in this area has primarily focused on mothers, with relatively little attention given to the mental health of fathers. Aims The purpose of this review was to summarise the evidence related to the mental health of fathers compared with mothers, and with fathers in the general population. Method A meta-analysis was undertaken of all studies published by 1 July 2018 in Medline, PsycINFO, CINAHL and EMBASE, using terms on intellectual disabilities, mental health and father carers. Papers were selected based on pre-defined inclusion and exclusion criteria. Results Of 5544 results, 20 studies met the inclusion criteria and 12 had appropriate data for meta-analysis. For comparisons of fathers with mothers, mothers were significantly more likely to have poor general mental health and well-being (standardised mean difference (SMD) −0.38, 95% CI −0.56 to −0.20), as well as higher levels of depression (SMD, −0.46; 95% CI −0.68 to −0.24), stress (SMD, −0.32; 95% CI −0.46 to −0.19) and anxiety (SMD, −0.30; 95% CI −0.50 to −0.10). Conclusions There is a significant difference between the mental health of father and mother carers, with fathers less likely to exhibit poor mental health. However, this is based on a small number of studies. More data is needed to determine whether the general mental health and anxiety of father carers of a child with intellectual disabilities differs from fathers in the general population.


2016 ◽  
Vol 11 (2) ◽  
pp. 91-110 ◽  
Author(s):  
Claire Parker ◽  
Ruth Marlow ◽  
Marc Kastner ◽  
Felix May ◽  
Oana Mitrofan ◽  
...  

Purpose – The purpose of this paper is to explore the association between children who are at risk of being or who have been excluded from school between the ages of 4 and 12 years and the role of psychopathology, development and attainment. Design/methodology/approach – A case-control approach was conducted. Cases were children who had been excluded from school compared to those who had no reported exclusions and normative data where possible. A range of measures were used to collect information from the parent, child and teacher on areas covering the child’s mental health and well-being. Findings – The findings showed the number of difficulties faced by children who are at risk of being or who have been excluded from school compared to gender- and age-matched controls and normative data increased. Behavioural difficulties were apparent in the majority of the cases and an alarming number of children reported self-harm. Interestingly nearly all the cases had recognised needs, but not all of them were accessing appropriate services. Practical implications – There have been a number of changes regarding the identification and support of children’s mental health and well-being. This study highlights gaps in resources and provision, particularly around behavioural difficulties for children who are presenting as not coping in school. Originality/value – The findings from the SKIP study indicate the complexities and compounded difficulties faced by children who are experiencing exclusion from school. By implementing a systematic group of assessments the study was able to identify these complexities of need across a vulnerable group of children.


2019 ◽  
Vol 3 (1) ◽  
pp. 107-123 ◽  
Author(s):  
Douglas H. Schultz ◽  
Takuya Ito ◽  
Levi I. Solomyak ◽  
Richard H. Chen ◽  
Ravi D. Mill ◽  
...  

We all vary in our mental health, even among people not meeting diagnostic criteria for mental illness. Understanding this individual variability may reveal factors driving the risk for mental illness, as well as factors driving subclinical problems that still adversely affect quality of life. To better understand the large-scale brain network mechanisms underlying this variability, we examined the relationship between mental health symptoms and resting-state functional connectivity patterns in cognitive control systems. One such system is the fronto-parietal cognitive control network (FPN). Changes in FPN connectivity may impact mental health by disrupting the ability to regulate symptoms in a goal-directed manner. Here we test the hypothesis that FPN dysconnectivity relates to mental health symptoms even among individuals who do not meet formal diagnostic criteria but may exhibit meaningful symptom variation. We found that depression symptoms severity negatively correlated with between-network global connectivity (BGC) of the FPN. This suggests that decreased connectivity between the FPN and the rest of the brain is related to increased depression symptoms in the general population. These findings complement previous clinical studies to support the hypothesis that global FPN connectivity contributes to the regulation of mental health symptoms across both health and disease.


10.2196/12546 ◽  
2019 ◽  
Vol 6 (7) ◽  
pp. e12546 ◽  
Author(s):  
Katarzyna Stawarz ◽  
Chris Preist ◽  
David Coyle

Background Technology can play an important role in supporting mental health. Many studies have explored the effectiveness, acceptability, or context of use of different types of mental health technologies. However, existing research has tended to investigate single types of technology at a time rather than exploring a wider ecosystem that people may use. This narrow focus can limit our understanding of how we could best design mental health technologies. Objective The aim of this study was to investigate which technologies (smartphone apps, discussion forums and social media, and websites and Web-based programs) people use to support their mental health and why, whether they combine and use more than one technology, what purpose each technology serves, and which features people find the most valuable. Methods We conducted an online survey to gather responses from members of the public who use technology to support their mental health and well-being. The survey was advertised on social media and via posters at a university. It explored usage patterns, frequently used features, and engagement with technology. To gain deeper insights into users’ preferences, we also thematically analyzed open-ended comments about each technology type and suggestions for improvements provided by the respondents. Results In total, 81 eligible participants completed the survey. Smartphone apps were the most commonly used technology, with 78% of the participants (63/81) using them, either alone (40%) or in combination with other technologies (38%). Each type of technology was used for specific purposes: apps provided guided activities, relaxation, and enabled tracking; social media and discussion forums allowed participants to learn from the experiences of others and use that knowledge to understand their own situation; and Web-based programs and websites helped to find out how to deal on a day-to-day basis with stress and anxiety. The analysis of open-ended responses showed that although many people valued technology and felt it could support targeted activities, it was not seen as a substitute for traditional face-to-face therapy. Participants wanted technology to be more sophisticated and nuanced, supporting personalized and actionable recommendations. There was evidence that participants mistrusted technology, irrespective of the type, and had broader concerns regarding the impact of overuse of technology. Conclusions People use different types of technology to support their mental health. Each can serve a specific purpose. Although apps are the most widely used technology, mixing and matching different types of technology is also common. Technology should not be seen as a replacement for traditional psychotherapy, rather it offers new opportunities to support mental health as part of an overall ecosystem. People want technology to be more nuanced and personalized to help them plan informed actions. Future interventions should explore the use of multiple technologies and their combined effects on mental health support.


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