scholarly journals Proof-of-concept support for the development and implementation of a digital assessment for perinatal mental health: a mixed methods study (Preprint)

2021 ◽  
Author(s):  
Nayra Anna Martin-Key ◽  
Benedetta Spadaro ◽  
Thea Sofie Schei ◽  
Sabine Bahn
Keyword(s):  
Mental Health ◽  
Health Assessment ◽  
Mental Healthcare ◽  
Perinatal Period ◽  
Perinatal Mental Health ◽  
Health Concerns ◽  
Mental Health Assessment ◽  
Digital Assessment ◽  
Mental Health Concerns ◽  
The Uk

BACKGROUND Perinatal mental health symptoms commonly remain underdiagnosed and undertreated in maternity care settings in the UK, with outbreaks of disease, like the coronavirus (COVID-19) pandemic, further disrupting access to adequate mental health support. Digital technologies may offer an innovative way to support the mental health needs of women and their families throughout the perinatal period, as well as assist midwives in the recognition of perinatal mental health concerns. However, little is known about the acceptability and perceived benefits and barriers to using such technologies. OBJECTIVE To conduct a mixed methods evaluation of the current state of perinatal mental healthcare provision in the UK, as well as users’ (women and partners) and midwives’ interest in using a digital mental health assessment throughout the perinatal period. METHODS Eight hundred and twenty-nine women, 103 partners, and 90 midwives participated in the study, which entailed completing an online survey. Quantitative data were explored using descriptive statistics. Open-ended response data were first investigated using thematic analysis. Resultant themes were then mapped onto the components of the Capability, Opportunity, and Motivation Model of Behavior (COM-B model) and summarized using descriptive statistics. RESULTS The provision of adequate perinatal mental healthcare support was limited, with experiences varying significantly across respondents. There was a strong interest in using a digital mental health assessment to screen, diagnose, and triage perinatal mental health concerns, particularly among women and midwives. The digital assessment was seen to be well placed within maternity healthcare settings, with in-person only and blended care (i.e., in-person and remote support) approaches being preferred by women and partners in the event of further care being advised. Identified benefits and barriers mainly related to physical opportunity (e.g., accessibility), psychological capability (e.g., cognitive skills) and automatic motivation (e.g., emotions). CONCLUSIONS This study provides proof-of-concept support for the development and implementation of a digital mental health assessment to inform clinical decision-making in the assessment of perinatal mental health concerns in the UK.

m-Health solutions for perinatal mental health: a systematic search and appraisal following the App Evaluation Model (Preprint)

2021 ◽  
Author(s):  
Benedetta Spadaro ◽  
Nayra Anna Martin-Key ◽  
Erin Funnell ◽  
Sabine Bahn
Keyword(s):  
Mental Health ◽  
Evaluation Model ◽  
Health Assessment ◽  
Depression Scale ◽  
Perinatal Mental Health ◽  
Post Traumatic Stress ◽  
Model Framework ◽  
Mental Health Assessment ◽  
App Store ◽  
Google Play

BACKGROUND Currently, the screening of perinatal mental health symptoms is confined to maternity and primary care settings. Critically, the ever-increasing pressure on healthcare systems has resulted in under-recognition of perinatal mental disorders. Digital mental health tools, such as applications (apps) could provide an option for accessible perinatal mental health screening and assessments. However, there is a lack of information regarding the availability and effectiveness of perinatal app options. OBJECTIVE To evaluate the current state of diagnostic and screening apps for perinatal mental health available on the Google Play store (Android) and Apple App store (iOS), and to review their features following the App Evaluation Model framework. METHODS A systematic review approach was used to identify perinatal mental health assessment apps on the Apple App store and Google Play store. 14 apps met inclusion criteria, were downloaded, and reviewed in a standardized manner using the App Evaluation Model framework. The framework comprised 107 questions allowing for a comprehensive assessment of app origin, functionality, engagement features, security, and clinical use. RESULTS The majority of apps were developed by for-profit companies (n=10), followed by private individuals (n=2), and trusted healthcare companies (n=2). Three apps were only available on Android devices, four were available only on iOS devices, and seven on both platforms. Approximately a third of apps (n=5) had been updated within the last 180 days. Most apps did not have enough reviews to display average ratings. Twelve apps offered the Edinburgh Postnatal Depression Scale (EPDS) in its original version or in rephrased versions. Additionally, one app included screening scales for anxiety, insomnia, and post-traumatic stress disorder. Engagement, input, and output features included reminder notifications, connection to therapists, and free writing features. Six apps offered psychoeducational information or references. Privacy policies were available for 11 of the 14 apps, with a median Flesch-Kincaid reading grade level of 12.3 One app claimed to be compliant with Health Insurance Portability and Accountability Act standards, two apps claimed to be General Data Protection Regulation compliant. Of the apps that could be accessed in full (n=10), all appeared to fulfil the claims stated in their description. Only one app referenced a relevant peer-reviewed study. All the apps provided a warning for use highlighting that the mental health assessment result should not be interpreted as a diagnosis nor as a substitute for medical care, hence all the apps were regarded as reference apps and not self-help tools. Only three apps allowed users to export or email their mental health test results. CONCLUSIONS These results support the view that there is space for designing and improving perinatal mental health applications. To this end, we recommend three areas of focus for app developers and clinicians looking to design apps for perinatal mental health assessment.

scholarly journals Educational needs of practice nurses in mental health

2011 ◽  
Vol 3 (2) ◽  
pp. 142 ◽  
Author(s):  
Anne Prince ◽  
Katherine Nelson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Assessment ◽  
Behavioural Therapy ◽  
Postal Survey ◽  
Health Concern ◽  
Health Concerns ◽  
Practice Nurses ◽  
Mental Health Concern ◽  
Mental Health Concerns

INTRODUCTION: Large numbers of patients see practice nurses (PNs) daily for their health care. Many of these patients will have a mental health need. International research suggests that practice nurses are undertaking mental health assessment and interventions without the requisite skills and knowledge. AIM: To describe the needs of PNs in mental health education and to explore any involvement with patients with mental health concerns. METHODS: Postal survey of PNs in Hawkes Bay and Tairawhiti regions. Analysis was by descriptive, correlation and inferential statistics and content analysis for open questions. RESULTS: Fifty-two respondents completed the survey (response rate 36%) and the results demonstrate that these PNs are caring for patients with an extensive range of mental health concerns daily. Most common are people with depression and anxiety. The nurses perform a variety of mental health interventions such as counselling and advice on medication and have minimal confidence in their skill level. Their expressed learning needs included education on many mental health conditions including suicidal ideation, all types of depression and bipolar disorder, and of therapies such as cognitive behavioural therapy and family therapy. DISCUSSION: PNs require education and support specifically designed to meet their identified needs in mental health to help improve care to patients. This will require collaboration between secondary mental health services, primary mental health nurses and tertiary institutions. With targeted education these nurses should become more confident and competent in their dealings with people who present to their practice with a mental health concern. KEYWORDS: Education; mental health; practice nurse; survey; primary health care

Referral for Management of Emotional Health Issues During the Perinatal Period: Does Mental Health Assessment Make a Difference?

Birth ◽  
2013 ◽  
Vol 40 (4) ◽  
pp. 297-306 ◽  
Author(s):  
Nicole Reilly ◽  
Sheree Harris ◽  
Deborah Loxton ◽  
Catherine Chojenta ◽  
Peta Forder ◽  
...  
Keyword(s):  
Mental Health ◽  
Emotional Health ◽  
Health Assessment ◽  
Perinatal Period ◽  
Health Issues ◽  
Mental Health Assessment

scholarly journals Assessing the Mental Health of Fathers, Other Co-parents, and Partners in the Perinatal Period: Mixed Methods Evidence Synthesis

2021 ◽  
Vol 11 ◽  
Author(s):  
Zoe Darwin ◽  
Jill Domoney ◽  
Jane Iles ◽  
Florence Bristow ◽  
Jasmine Siew ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Professionals ◽  
Evidence Synthesis ◽  
Health Assessment ◽  
Depression Scale ◽  
Perinatal Period ◽  
Service Level ◽  
Screening Tools ◽  
Perinatal Mental Health ◽  
Published Evidence

Introduction: Five to 10 percentage of fathers experience perinatal depression and 5–15% experience perinatal anxiety, with rates increasing when mothers are also experiencing perinatal mental health disorders. Perinatal mental illness in either parent contributes to adverse child and family outcomes. While there are increasing calls to assess the mental health of both parents, universal services (e.g., maternity) and specialist perinatal mental health services usually focus on the mother (i.e., the gestational parent). The aim of this review was to identify and synthesize evidence on the performance of mental health screening tools and the acceptability of mental health assessment, specifically in relation to fathers, other co-parents and partners in the perinatal period.Methods: A systematic search was conducted using electronic databases (MEDLINE, PsycINFO, Maternity, and Infant Care Database and CINAHL). Articles were eligible if they included expectant or new partners, regardless of the partner's gender or relationship status. Accuracy was determined by comparison of screening tool with diagnostic interview. Acceptability was predominantly assessed through parents' and health professionals' perspectives. Narrative synthesis was applied to all elements of the review, with thematic analysis applied to the acceptability studies.Results: Seven accuracy studies and 20 acceptability studies were included. The review identified that existing evidence focuses on resident fathers and assessing depression in universal settings. All accuracy studies assessed the Edinburgh Postnatal Depression Scale but with highly varied results. Evidence on acceptability in practice is limited to postnatal settings. Amongst both fathers and health professionals, views on assessment are mixed. Identified challenges were categorized at the individual-, practitioner- and service-level. These include: gendered perspectives on mental health; the potential to compromise support offered to mothers; practitioners' knowledge, skills, and confidence; service culture and remit; time pressures; opportunity for contact; and the need for tools, training, supervision and onward referral routes.Conclusion: There is a paucity of published evidence on assessing the mental health of fathers, co-mothers, step-parents and other partners in the perinatal period. Whilst practitioners need to be responsive to mental health needs, further research is needed with stakeholders in a range of practice settings, with attention to ethical and practical considerations, to inform the implementation of evidence-based assessment.

scholarly journals Mental Health Concerns Related to the COVID-19 Pandemic on Twitter in the UK

2021 ◽  
Author(s):  
Daiwei Zhang ◽  
Yue Liu ◽  
Senqi Zhang ◽  
Li Sun ◽  
Pin Li ◽  
...  
Keyword(s):  
Mental Health ◽  
Urban Areas ◽  
Topic Modeling ◽  
Latent Dirichlet Allocation ◽  
Allocation Model ◽  
Health Concerns ◽  
Health Related ◽  
Mental Health Concerns ◽  
Twitter Users ◽  
The Uk

AbstractBackgroundAmid the COVID-19 pandemic, mental health-related symptoms (such as depression and anxiety) have been actively mentioned on social media.ObjectiveIn this study, we aimed to monitor mental health concerns on Twitter during the COVID-19 pandemic in the United Kingdom (UK), and assess the potential impact of the COVID-19 pandemic on mental health concerns of Twitter users.MethodsWe collected COVID-19 and mental health-related tweets from the UK between March 5, 2020 and January 31, 2021 through the Twitter Streaming API. We conducted topic modeling using Latent Dirichlet Allocation model to examine discussions about mental health concerns. Deep learning algorithms including Face++ were used to infer the demographic characteristics (age and gender) of Twitter users who expressed mental health concerns related to the COVID-19 pandemic.ResultsWe showed a positive correlation between COVID-19-related mental health concerns on Twitter and the severity of the COVID-19 pandemic in the UK. Geographic analysis showed that populated urban areas have a higher proportion of Twitter users with mental health concerns compared to England as a whole. Topic modeling showed that general concerns, COVID-19 skeptics, and Death toll were the top topics discussed in mental health-related tweets. Demographic analysis showed that middle-aged and older adults might be more likely to suffer from mental health issues or express their mental health concerns on Twitter during the COVID-19 pandemic.ConclusionsThe COVID-19 pandemic has noticeable effects on mental health concerns on Twitter in the UK, which varied among demographic and geographic groups.

scholarly journals Suicidal Ideation in Pregnant and Postpartum Women Veterans: An Initial Clinical Needs Assessment

2019 ◽  
Vol 185 (1-2) ◽  
pp. e105-e111 ◽  
Author(s):  
Mercedes J Szpunar ◽  
Jennifer N Crawford ◽  
Selena A Baca ◽  
Ariel J Lang
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Suicidal Ideation ◽  
Longitudinal Research ◽  
Women Veterans ◽  
Perinatal Period ◽  
Health Concerns ◽  
Time Points ◽  
Pregnancy And Postpartum ◽  
Mental Health Concerns

Abstract Introduction Pregnancy and postpartum, or the perinatal period, are times when women are particularly vulnerable to mental health concerns, including suicidal ideation. Risk factors for suicidal ideation during this period of a woman’s life are depression and exposure to trauma, the latter of which may occur during military operations. The number of women veterans in the United States continues to rise, as does their use of maternity benefits. In this pilot study, we examined the feasibility of recruiting pregnant veterans for longitudinal research. We hypothesized that hopelessness and depressive symptoms would be related to suicidal ideation during the perinatal period, and we investigated a possible relationship between post-traumatic stress symptoms (PTSS) and suicidal ideation. Materials and Methods Using the designated Veterans Affairs (VA) maternity care coordinator’s census, we contacted pregnant women veterans for assessment during the 3rd trimester of pregnancy and 6 weeks postpartum at the San Diego VA. Between September 2017 and October 2018, 28 women volunteers completed the following measures: the Columbia-Suicide Severity Rating Scale (C-SSRS); the Beck Hopelessness Scale (BHS); the Edinburgh Postnatal Depression Scale (EPDS); and the PTSD Checklist for DSM-5 (PCL-5). We used correlational analyses and descriptive statistics to determine associations among the measures. Results As gathered from the C-SSRS, over 30% of the veteran women had past lifetime suicide attempts, and over 10% of the veterans had suicidal ideation in the perinatal period. Both depression and PTSS rates neared 30% during pregnancy and postpartum. Hopelessness and depressive symptoms were positively correlated at both time points. While the intensity of lifetime suicidal ideation was correlated with postpartum depressive symptoms, there was no correlation with current suicidal ideation and depressive symptoms. PTSS correlated with both depressive symptoms and hopelessness, but not suicidal ideation, at both time points. There was no correlation between hopelessness and suicidal ideation during the perinatal period in this cohort. Conclusions It is important to understand the mental health needs of perinatal veterans given their vulnerability to develop mental health concerns, including suicidal ideation. The unpredicted pattern of correlations determined in this study implies the need for multifaceted measures for safety-related mental health assessment of perinatal veterans, including assessment for PTSS. Strengths of this study include its longitudinal assessment and a sampling from a general population of veterans. Limitations include small sample size, a single gestational time point, and loss of participants who did not return for their postpartum assessment. We demonstrated the feasibility of longitudinal research with pregnant and postpartum veterans, but additional assessment points during the perinatal period could help identify critical times for mental health intervention in this population.

scholarly journals The effects of the first wave of the COVID-19 pandemic on the presentation of adolescents to acute mental health services in NHS Lanarkshire

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S276-S277
Author(s):  
Youstina Nagiub ◽  
Rekha Hegde
Keyword(s):  
Mental Health ◽  
Young People ◽  
Detrimental Effect ◽  
Health Assessment ◽  
List Type ◽  
General Increase ◽  
Exclusion Criteria ◽  
Mental Health Assessment ◽  
The Uk ◽  
Age Range

AimsThis project aimed to assess the effects of COVID-19 on the mental health of adolescents, reflected through their presentations to A&E departments in NHS Lanarkshire.MethodThe psychiatry liaison database was searched for referrals of 17 year olds and under from April until August 2020.All referrals to all acute hospital sites in Lanarkshire received from any source were included. The only exclusion criteria applied were age over 17 and unavailable assessment information.The sources searched for information were: patient's electronic notes, Mental Health Assessment forms, Mental Health Risk Assessment forms and electronic letters. The following information was gathered: –patient's age–date, source and reason for referral–hospital site of assessment–outcome of assessmentResult–Between April and August 2020, the number of CAMHS A&E referrals increased every month except in July.–The age range of CAMHS patients presenting to A&E were 12-17 years, with 17 being the most common age seen.–87% of referrals were from A&E.–The two most common reasons for referrals were drug overdose and suicidal ideation.–The most common outcome of assessment was a CAMHS referral.–COVID-19 was a trigger for an adolescent's presentation to A&E in 31% of cases, the most common cause being struggling with the lockdown/restrictions.ConclusionThe mental health charity YoungMinds carried out several surveys throughout the COVID-19 pandemic's first wave. They demonstrated a detrimental effect on young people's mental health in the UK.YoungMinds surveys revealed that 32% and 41% of young people experienced “much worse” mental health due to COVID-19. The findings of NHS Lanarkshire were similar, with 31% of adolescents presenting to A&E as a result of COVID-19.No adolescent included in this review had contracted COVID-19 at any point. Their mental health was therefore impacted by the indirect effects of COVID-19 rather than the direct effects of infection. For the 31% of CAMHS presentations to A&E which were due to COVID-19, most young people struggled with the lockdown/restrictions.The number of presentations to A&E increased every month between April and August 2020 except for July. This could be due to people's initial fear of coming to hospital and catching COVID-19. However, as infection and death rates decreased towards the summer, people may have regarded hospitals as safer. The general increase in referrals every month may also be a reflection of the worsening of young people's mental health the longer the pandemic extended.

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