scholarly journals Social Determinants of Mental Health During a Year of the COVID-19 Pandemic

2021 ◽  
Author(s):  
Savannah Minihan ◽  
Amy Orben ◽  
Annabel Songco ◽  
Elaine Fox ◽  
Cecile D. Ladouceur ◽  
...  

Belonging is a basic human need, with social isolation signaling a threat to biological fitness. Sensitivity to ostracism varies across individuals and the lifespan, peaking in adolescence. Government-imposed restrictions upon social interactions during COVID-19 may therefore be particularly detrimental to young people and those most sensitive to ostracism. Participants (N = 2367; 89.95% female, 11-100 years) from three countries with differing levels of government restrictions (Australia, UK, and USA) were surveyed trice at three-month intervals (May 2020 – April 2021). Young people, and those living under the tightest government restrictions, reported the worst mental health, with these inequalities in mental health remaining constant throughout the study period. Further dissection of these results revealed that young people high on social rejection sensitivity reported the most mental health problems at the final assessment. These findings help account for the greater impact of enforced social isolation on young people’s mental health, and open novel avenues for intervention.

2019 ◽  
Vol 14 (10) ◽  
pp. 1-8 ◽  
Author(s):  
Jackson Alun ◽  
Barbara Murphy

Loneliness and social isolation are increasingly being acknowledged as risk factors for both physical and mental health problems. Recent statistics demonstrate that loneliness and isolation are on the rise internationally, to the point of being classed as an epidemic. In this paper, the authors outline some of the recent research linking loneliness and isolation to significant chronic diseases such as cardiovascular disease and type II diabetes; mental health disorders such as anxiety and depression; cognitive disorders and dementia. Isolation has also been shown to compromise recovery after acute cardiac events, being associated with increased hospital readmission and premature death. Indeed, isolation has now been identified as a risk factor equivalent in effect to traditional risk factors such as smoking, hypertension and obesity. While distinguishing between objective and subjective indicators of isolation, the authors highlight the complexity of this phenomenon, both in terms of definition and measurement, as well as the interplay between subjective and objective indicators. Important clinical implications for health professionals working with cardiac patients are also proposed, in terms of screening for isolation, and possible interventions to support patients at risk of isolation. The aim of the current article is to emphasise the importance of acknowledging loneliness and isolation as key risk factors requiring urgent attention, both in research and in clinical practice.


BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033317
Author(s):  
Rachel M Hiller ◽  
Sarah L Halligan ◽  
Richard Meiser-Stedman ◽  
Elizabeth Elliott ◽  
Emily Rutter-Eley

ObjectivesYoung people who have been removed from their family home and placed in care have often experienced maltreatment and there is well-developed evidence of poor psychological outcomes. Once in care, foster carers often become the adult who provides day-to-day support, yet we know little about how they provide this support or the challenges to and facilitators of promoting better quality carer–child relationships. The aim of this study was to understand how carers support the emotional needs of the young people in their care and their views on barriers and opportunities for support.Design and participantsParticipants were 21 UK foster carers, recruited from a local authority in England. They were predominantly female (86%), aged 42–65 years old and ranged from those who were relatively new to the profession (<12 months’ experience) to those with over 30 years of experience as a carer. We ran three qualitative focus groups to gather in-depth information about their views on supporting their foster children’s emotional well-being. Participants also completed short questionnaires about their training experiences and sense of competence.ResultsOnly half of the sample strongly endorsed feeling competent in managing the emotional needs of their foster children. While all had completed extensive training, especially on attachment, diagnosis-specific training for mental health problems (eg, trauma-related distress, depression) was less common. Thematic analysis showed consistent themes around the significant barriers carers faced navigating social care and mental health systems, and mixed views around the best way to support young people, particularly those with complex mental health needs and in relation to reminders of their early experiences.ConclusionsFindings have important implications for practice and policy around carer training and support, as well as for how services support the mental health needs of young people in care.


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.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Kleszczewska ◽  
J Mazur ◽  
A Dzielska ◽  
T Gaspar ◽  
M Gaspar de Matos

Abstract Background The project was an answer to the results of the HBSC (Health Behaviour of School-aged Children) study 2013/2014 which indicated an alarming situation regarding the adolescents' mental health. The aim was to investigate mental health problems of Polish and Portuguese youth and to create tools and materials which can be a professional help in this matter. Improve the youth project consisted of two main elements: research and implementation phase. The mixed-method approach was applied in the project. Quantitative and qualitative research methods were used. 2004 pupils (aged 13-19) were surveyed in 89 schools in 2017/ 2018 in Poland. Findings form qualitative study were guidelines for quantitative research. Perception of stress among young people was selected as the leading subject. Short Form Perceived Stress Scale (PSS-4) in a shorter version of 4-statement were used. There were two advisory boards: first - practitioners (psychologists, pedagogists, teachers, social workers) and second - adolescents. Both were consulted to prepare all materials. Results Stress levels are higher in girls than in boys, and they increase with age: between 13 and 19 year of age the increase in the prevalence of high stress level was 5,3% in boys and 12.5% in girls. Family affluence, school achievements and school burden were identified as stress determinants of adolescents. Materials presenting the data and giving practical information and tools on how to support adolescents in coping with stress: guide for adults, guide for youth created by youth and scenario of workshops. 20 workshops for young people run by young people were organised in both countries for about 200 adolescents Results and materials were presented to youth organizations, social institutions and decision makers responsible for youth policy during two 'Improve the Youth' conferences in Poland and in Portugal.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 943.1-943
Author(s):  
S. Eulert ◽  
M. Niewerth ◽  
J. Hörstermann ◽  
C. Sengler ◽  
D. Windschall ◽  
...  

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


Author(s):  
Anja Čuš ◽  
Julian Edbrooke-Childs ◽  
Susanne Ohmann ◽  
Paul L. Plener ◽  
Türkan Akkaya-Kalayci

Nonsuicidal self-injury (NSSI) is a major mental health problem associated with negative psychosocial outcomes and it most often starts in early adolescence. Despite this, adolescents are rarely involved in informing the development of interventions designed to address their mental health problems. This study aimed to (1) assess adolescents’ needs and preferences about future interventions that are delivered through smartphones and (2) develop a framework with implications for designing engaging digital mental health interventions. Fifteen adolescent girls, aged 12–18 years, who met diagnostic criteria for a current NSSI disorder and were in contact with mental health services, participated in semi-structured interviews. Following a reflexive thematic analysis approach, this study identified two main themes: (1) Experiences of NSSI (depicts the needs of young people related to their everyday experiences of managing NSSI) and (2) App in Context (portrays preferences of young people about smartphone interventions and reflects adolescents’ views on how technology itself can improve or hinder engaging with these interventions). Adolescent patients expressed interest in using smartphone mental health interventions if they recognize them as helpful, relevant for their life situation and easy to use. The developed framework suggests that digital mental health interventions are embedded in three contexts (i.e., person using the intervention, mental health condition, and technology-related factors) which together need to inform the development of engaging digital resources. To achieve this, the cooperation among people with lived experience, mental health experts, and human computer interaction professionals is vital.


Author(s):  
Matteo Catanzano ◽  
Sophie D Bennett ◽  
Marc S Tibber ◽  
Anna E Coughtrey ◽  
Holan Liang ◽  
...  

Aim: This study was part of a broader project to examine the acceptability, feasibility and impact of a transdiagnostic mental health drop-in centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long-term physical health conditions (LTCs). The aims of this investigation were to characterise: (i) the use of such a centre, (ii) the demographics and symptoms of those presenting to the centre, and (iii) the types of support that are requested and/or indicated. Methods: A mental health “booth” was located in reception of a national paediatric hospital over one year. Characteristics of young people with LTCs and their siblings/parents attending the booth were defined. Emotional/behavioural symptoms were measured using standardised questionnaires including the Strengths and Difficulties Questionnaire (SDQ). Participants subsequently received one of four categories of intervention: brief transdiagnostic cognitive behaviour therapy (CBT), referral to other services, neurodevelopmental assessment or signposting to resources. Results: One hundred and twenty-eight participants were recruited. The mean age of young people was 9.14 years (standard deviation: 4.28); 61% identified as white and 45% were male. Over half of young people recruited scored in the clinical range with respect to the SDQ. Presenting problems included: anxiety (49%), challenging behaviour (35%), low mood (22%) and other (15%). Conclusions: A considerable proportion of young people with LTC in a paediatric hospital scored in the clinical range for common mental health problems, indicating a potential for psychological interventions.


2005 ◽  
Vol 15 (2) ◽  
pp. 137-155 ◽  
Author(s):  
Debra Rickwood

AbstractFor young people still at school, the school setting is vital to their mental health and wellbeing. Not only does the school environment have a direct and indirect impact on mental health, it provides an opportunistic setting in which to identify and respond to emerging mental health problems. To do this effectively, schools and school staff must work in collaboration with the young people themselves, their families, and other support services within the community, particularly primary health care services, including general practice. The importance of developing effective partnerships and care pathways between schools and the primary health care sector is being increasingly acknowledged, and initiatives such as MindMatters Plus GP have advanced our understanding in this area.


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