scholarly journals A Smartphone App (BlueIce) for Young People Who Self-Harm: Open Phase 1 Pre-Post Trial (Preprint)

2017 ◽  
Author(s):  
Paul Stallard ◽  
Joanna Porter ◽  
Rebecca Grist

BACKGROUND Recent years have seen a significant increase in the availability of smartphone apps for mental health problems. Despite their proliferation, few apps have been specifically developed for young people, and almost none have been subject to any form of evaluation. OBJECTIVE This study aimed to undertake a preliminary evaluation of a smartphone app (BlueIce), coproduced with young people and designed to help young people manage distress and urges to self-harm. We aimed to assess the acceptability, safety, and use of BlueIce and to explore the effects on the primary outcome of self-harm and the secondary outcomes of psychological functioning. METHODS We undertook an open trial where we recruited young people aged 12 to 17 years attending specialist child and adolescent mental health services (CAMHS) who were currently self-harming or had a history of self-harm. Eligible participants were assessed at baseline and then given BlueIce. They were assessed 2 weeks later (post familiarization) and again at 12 weeks (post use). A behavior-screening questionnaire (Strengths and Difficulties Questionnaire) was completed along with standardized measures of depression (Mood and Feelings Questionnaire or MFQ) and anxiety (Revised Child Anxiety and Depression Scale or RCADS), taking into account self-reports of self-harm, app helpfulness, and safety. RESULTS All core CAMHS professional groups referred at least 1 young person. Out of 40 young people recruited, 37 (93%) elected to use BlueIce after familiarization, with 29 out of 33 (88%) wanting to keep it at the end of the study. No young person called the emergency numbers during the 12-week trial, and no one was withdrawn by his or her clinician due to increased risk of suicide. Almost three-quarters (73%) of those who had recently self-harmed reported reductions in self-harm after using BlueIce for 12 weeks. There was a statistically significant mean difference of 4.91 (t31=2.11; P=.04; 95% CI 0.17-9.64) on postuse symptoms of depression (MFQ) and 13.53 on symptoms of anxiety (RCADS) (t30=3.76; P=.001; 95% CI 6.17-20.90), which was evident across all anxiety subscales. Ratings of app acceptability and usefulness were high. CONCLUSIONS Our study has a number of methodological limitations, particularly the absence of a comparison group and a prospective way of assessing self-harm. Nonetheless, our findings are encouraging and suggest that BlueIce, used alongside a traditional CAMHS face-to-face intervention, can help young people manage their emotional distress and urges to self-harm.

2020 ◽  
pp. 103985622097005
Author(s):  
Oliver Smith ◽  
Jessica Bergmann ◽  
Ulrich Schall

Objective: General practitioners (GPs) are key health professionals for referrals to mental health specialists. Youth mental health issues are particularly challenging, requiring a competent assessment and understanding of appropriate referral pathways. We surveyed local GPs about their understanding of youth mental health problems and needs to competently look after young patients. Methods: GPs working in the Hunter region were contacted via email, fax and post over a 6-month period in 2019. Results: Seventy-five GPs participated. They reported 577 of 1698 (34%) of young people seen 2 weeks prior to being surveyed presented with a mental health problem. Predominantly, referrals were to private practice psychologists and Headspace. Almost a third (31%) reported having limited understanding of ‘at-risk mental state’ and are ‘not always comfortable’ when facing a young person with a mental health problem. Nearly all (95%) expressed interest in attending specialised training. GPs identified treatment costs, scarce access to psychiatrists and limited patient engagement as the main obstacles to help young people. Conclusions: Effective treatment of a mental health problem relies on early identification. GPs are seeing young people on a regular basis but don’t feel well equipped for this task and are keen to up-skill, which needs to be addressed by targeted training.


2021 ◽  
pp. 1-9
Author(s):  
R. Cunningham ◽  
A. Milner ◽  
S. Gibb ◽  
V. Rijnberg ◽  
G. Disney ◽  
...  

Abstract Background Unemployment and being not in the labour force (NILF) are risk factors for suicide, but their association with self-harm is unclear, and there is continuing debate about the role of confounding by prior mental health conditions. We examine associations between employment status and self-harm and suicide in a prospective cohort, taking into account prior mental-health-related factors. Methods We used linked data from the New Zealand Integrated Data Infrastructure. The outcomes were chosen to be hospital presentation for self-harm and death by suicide. The exposure was employment status, defined as employed, unemployed, or NILF, measured at the 2013 Census. Confounders included demographic factors and mental health history (use of antidepressant medication, use of mental health services, and prior self-harm). Logistic regression was used to model effects. Analyses were stratified by gender. Results For males, unemployment was associated with an increased risk of suicide [odds ratio (OR): 1.48, 95% confidence interval (CI): 1.20–1.84] and self-harm (OR: 1.55, 95% CI: 1.45–1.68) after full adjustment for confounders. NILF was associated with an increased risk of self-harm (OR: 1.43, 95% CI: 1.32–1.55), but less of an association was seen with suicide (OR: 1.19, 95% CI: 0.94–1.49). For females, unemployment was associated with an increased risk of suicide (OR: 1.30, 95% CI: 0.93–1.80) and of self-harm (OR: 1.52, 95% CI: 1.43–1.62), and NILF was associated with a similar increase in risk for suicide (OR: 1.31, 95% CI: 0.98–1.75) and self-harm (OR: 1.32, 95% CI: 1.26–1.40). Discussion Exclusion from employment is associated with a considerably heightened risk of suicide and self-harm for both men and women, even among those without prior mental health problems.


2020 ◽  
Vol 11 ◽  
Author(s):  
Annie Bryant ◽  
Jacalyn Guy ◽  
Joni Holmes ◽  

Children and adolescents with developmental problems are at increased risk of experiencing mental health problems. The Strengths and Difficulties Questionnaire (SDQ) is widely used as a screener for detecting mental health difficulties in these populations, but its use thus far has been restricted to groups of children with diagnosed disorders (e.g., ADHD). Transdiagnostic approaches, which focus on symptoms and soften or remove the boundaries between traditional categorical disorders, are increasingly adopted in research and practice. The aim of this study was to assess the potential of the SDQ to detect concurrent mental health problems in a transdiagnostic sample of children. The sample were referred by health and educational professionals for difficulties related to learning (N = 389). Some had one diagnosis, others had multiple, but many had no diagnoses. Parent-rated SDQ scores were significantly positively correlated with parent ratings of mental health difficulties on the Revised Child Anxiety and Depression Scale (RCADS). Ratings on the SDQ Emotion subscale significantly predicted the likelihood of having concurrent clinical anxiety and depression scores. Ratings on the Hyperactivity subscale predicted concurrent anxiety levels. These findings suggest the SDQ could be a valuable screening tool for identifying existing mental health difficulties in children recognized as struggling, as it can be in typically developing children and those with specific diagnoses.


2018 ◽  
Vol 6 (1) ◽  
pp. e32 ◽  
Author(s):  
Paul Stallard ◽  
Joanna Porter ◽  
Rebecca Grist

2021 ◽  
Vol 12 ◽  
Author(s):  
Louis Weinstock ◽  
Dunja Dunda ◽  
Hannah Harrington ◽  
Hannah Nelson

Presently, there is a real possibility of a second pandemic occurring: a grief pandemic. There are estimated to be over 1 million children and young people experiencing bereavement because of Covid-19. Adolescent grief is unique due to bio-psycho-social factors such as increased risk-taking, identity-formation, and limited capacity for emotional regulation. In this article, we will argue that adolescents are at increased risk of developing complicated grief during the Covid-19 pandemic, and that it is vital that services are improved to recognize and address this need before secondary problems emerge, including anxiety, depression, and substance abuse. Complicated grief in adolescents is widely underrecognized and often misdiagnosed as a range of mental health problems, addictions, and offending behavior. For example, 25% of <20 year olds who commit suicide have experienced childhood bereavement, whilst 41% of youth offenders have experienced childhood bereavement; this is in comparison with only 4% of the general population. Many of the broader risk factors for complicated grief were already increasing prior to the Covid-19 pandemic, including increased loneliness amongst young people, and the collapse of collective structures to help people manage grief. We propose that this pandemic could be a catalyst for mental health professionals to support and nurture the caring communities emerging in this time as an essential resource to prevent the onset of a grief pandemic.


Author(s):  
Erita Istriana

<p>Adolescence is a transitional stage in physical and psychological development, and in this stage multiple physical, emotional and social changes, can make adolescents vulnerable to mental health problems like self-harm and suicide. Self-harm and suicide are serious problems in children, adolescents and young people with the highest rates seen in those aged 16-24 years, and self-harm is highly correlated with the presence of anxiety disorders and depression.</p>


2020 ◽  
Vol 26 (2) ◽  
pp. 135-142
Author(s):  
Drew Simms

BackgroundTransgender youth have been found to be at higher risk of experiencing common mental health problems than their cisgender peers, but there has been little research into the mechanisms of peer support among this group. Research into how young people communicate about self-harm and suicidality on social media has found patterns of behavior in which young people encourage each other's risky and self-injurious actions, but whether this holds true among minority groups such as trans youth has not been established.MethodTwitter biographies were searched to find self-identifying trans people aged 14–18 years. The resulting accounts were searched for key words related to common mental health issues. The tweets caught by the search terms and their replies were coded into themes using a combination of inductive and deductive coding. The occurrence of themes were quantified and analyzed using SPSS 24.Results1,468 tweets were analyzed from 235 accounts; 133 (56.6%) of the accounts with relevant content received no public replies to tweets mentioning mental health issues. Of the 102 (43.4%) that did receive public replies, 64 (62.7%) received a maximum of two replies. Three themes were found in replies to tweets, Support, Feeling the Same Way, and Advice. Most replies were expressions of support, followed by expressions of feeling the same way; advice was rare. There were no incidents of replies that were dismissive of or encouraged self-injurious behavior.DiscussionFindings differ from existing research on how youth interact with each other online with regard to mental health issues: the trans youth in this study were not found to encourage risky and self-injurious behavior in each other. This has implications for caring for trans youth in mental health settings, where social media use is normally discouraged, as its use may be a protective factor for trans youth specifically.


2019 ◽  
Vol 30 (5) ◽  
pp. 218-223 ◽  
Author(s):  
Maddie Burton

Children and young people are increasingly experiencing mental health problems, including self-harm and suicidal behaviour. Maddie Burton explores the triggers of these two conditions and explains what practice nurses can do for their patients Children and young people’s mental health continues to be a cause for concern at a time of reduced mental health service provision. Worryingly, suicide and self-harm rates continue to rise. An estimated two hundred children and young people lose their lives annually through completed suicide. Half of that number will have a previous self-harm history. Practice nurses are often favoured by young people as being less stigmatising; therefore they can potentially provide opportunities for early help through being vigilant, informed, hearing the young person’s story and then knowing how to support and appropriately respond and signpost. This article explores both the differences between self-harm and suicidal behaviour, and how they are connected.


2015 ◽  
Vol 32 (1) ◽  
pp. 155-160 ◽  
Author(s):  
E. Power ◽  
M. Clarke ◽  
I. Kelleher ◽  
H. Coughlan ◽  
F. Lynch ◽  
...  

ObjectivesIncreasing rates of young people not in education, employment or training (NEETs) are a cause of concern both in Ireland and internationally, but little longitudinal research has examined the link between psychiatric disorder in young people and NEET status.MethodsThe Challenging Times (CT) Study is a longitudinal, population-based study of psychopathology among 212 young Irish people. Clinical interviews were performed at two time points: 12–15 years and 19–24 years.ResultsNEET status in young adulthood was associated with a sevenfold increased risk of current suicidal ideation. This result was independent of prior adolescent mental disorder. NEET young people had a fourfold increased odds of being diagnosed with a mental disorder in childhood or early adolescence compared with their economically active peers. NEET young people were at an almost threefold increased risk of any mental health disorder a twofold increased risk of anxiety disorder and threefold increased odds of suicide attempts over their lifetime compared with economically active peers.ConclusionsNEET young people are at increased risk for mental disorder and suicidal ideation. The association is bidirectional, as prior mental disorder in adolescence appeared to account for much of the association between NEET status and current mental health problems. However, economic inactivity conveys an increased risk for suicidal ideation over and above that due to prior disorder. Our findings provide a compelling economic and societal argument for early intervention and treatment of mental disorder and the importance of vocational interventions for reducing suicide risk in young adults.


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