21-Day Stress Detox: Open Trial of a Universal Well-Being Chatbot for Young Adults

There has been a lot of interest in digital mental health interventions but adherence to online programmes has been less than optimal. Chatbots that mimic brief conversations may be a more engaging and acceptable mode of delivery. We developed a chatbot, called 21-Day Stress Detox, to deliver stress management techniques for young adults. The purpose of the study was to explore the feasibility, acceptability, and potential efficacy of this low-intensity digital mental health intervention in a non-clinical population of young adults. The content was derived from cognitive behavioural therapy (CBT) and included evidence-informed elements such as mindfulness and gratitude journaling. It was delivered over 21 daily sessions using the Facebook Messenger platform. Each session was intended to last about 5–7 min and included text, animated GIFs, relaxation tracks and reflective exercises. We conducted an open single-arm trial collecting app usage through passive data collection as well as self-rated satisfaction and qualitative (open-ended) feedback. Efficacy was assessed via outcome measures of well-being (World Health Organisation (Five) Well-being Index; WHO-5; and Personal Well-being Measure; ONS4); stress (Perceived Stress Scale–10 item version; PSS-10); and anxiety (Generalized Anxiety Disorder 7-item scale; GAD-7). One hundred and ten of the 124 participants who completed baseline commenced the chatbot and 64 returned the post-intervention assessment. Eighty-one percent were female and 51% were first year students. Forty-five percent were NZ European and 41% were Asian. Mean engagement was 11 days out 21 days (SD = 7.8). Most (81%) found the chatbot easy to use. Sixty-three percent rated their satisfaction as 7 out of 10 or higher. Qualitative feedback revealed that convenience and relatable content were the most valued features. There was a statistically significant improvement on the WHO-5 of 7.38 (SD = 15.07; p < 0.001) and a mean reduction on the PSS-10 of 1.77 (SD = 4.69; p = 0.004) equating to effect sizes of 0.49 and 0.38, respectively. Those who were clinically anxious at baseline (n = 25) experienced a greater reduction of GAD-7 symptoms than those (n = 39) who started the study without clinical anxiety (−1.56, SD = 3.31 vs. 0.67, SD = 3.30; p = 0.011). Using a chatbot to deliver universal psychological support appears to be feasible, acceptable, have good levels of engagement, and lead to significant improvements in well-being and stress. Future iterations of the chatbot should involve a more personalised content.

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PSYCHO-SOCIAL EXPERIENCES OF YOUTHS DURING THE COVID-19 LOCKDOWN: INSIGHTS FROM HARARE, ZIMBABWE

Business Excellence and Management ◽

10.24818/beman/2020.s.i.1-04 ◽

2020 ◽

Vol S.I. (1) ◽

pp. 46-59

Author(s):

Nicola Mazwi ◽

◽

Bongani Seremani ◽

Tsungai Kaseke ◽

Clemencia Lungu ◽

...

Keyword(s):

Mental Health ◽

Well Being ◽

World Health Organisation ◽

Social Experiences ◽

Psychological Services ◽

World Health ◽

Negative Effects ◽

Psychological Conditions ◽

As Stress ◽

Restrictive Measures

The COVID-19 pandemic that started in Wuhan, Hubei province in China in December 2019 has brought about varied psycho-social experiences to youths during the COVID-19 lockdown period. World Health Organisation warned that the coronavirus and the restrictive measures around it would have negative effects on people’s mental health and well-being. Current scientific literature reveals that in China, UK and Spain COVID-19 outbreak resulted in symptoms leading to psychological disorders while in Africa the 2014 Ebola outbreak resulted in social and economic breakdowns in people’s livelihoods. This qualitative study made use of document analysis as a research design. WhatsApp messages were analysed using thematic analysis. The study sought to explore how youths in Harare, Zimbabwe responded to the lockdown and ways in which the lives of the youths were psychologically and socially affected. Research questions were on; how youths in Harare responded to the lockdown; how the lockdown affected the youths; in what ways the lockdown affected psychological lives of the youths and what can be done in future in order to improve the lives of youths during pandemics. The study revealed that some youths of Harare presented psychological conditions leading to PTSD symptoms such as stress, confusion, anger, anxiety and depression while some embraced COVID-19 Lockdown as it improved family and social ties. It was also noted that youths should be able to access psychological services during epidemics in order to avert surges in mental health illnesses emanating from national lockdowns.

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Research beyond biomedical confines: towards better mental health and well-being for all

Neuroscience Research Notes ◽

10.31117/neuroscirn.v2i4.43 ◽

2019 ◽

Vol 2 (4) ◽

pp. 1-4

Author(s):

Jou Yin Teoh ◽

Kee Hean Lim

Keyword(s):

Mental Health ◽

Suicide Risk ◽

Age Groups ◽

Interdisciplinary Approach ◽

Well Being ◽

World Health Organisation ◽

World Health ◽

Neuroscience Research ◽

Working Together ◽

Health And Well Being

‘Working Together to Prevent Suicide’ is the theme of World Mental Health Day 2019. According to the World Health Organisation, suicide is the second leading cause of death for people aged 15-19 years old. One person dies of suicide every 40 seconds, with this form of death affecting people of all age groups in all countries. Hence in line with this year’s theme calling for a trans-sectoral and interdisciplinary approach to address this epidemic, we would like to invite all contributors and readers of Neuroscience Research Notes (NeurosciRN) to take a moment to reflect on how they - as researchers can contribute towards the facilitation, discussion and promotion of positive mental health, which in turn has been found to reduce suicide risk.

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Resilience in the Storm: Impacts of Changed Daily Lifestyles on Mental Health in Persons with Chronic Illnesses under the COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115875 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5875

Author(s):

Bobo Hi-Po Lau ◽

Mike Kwun-Ting Cheung ◽

Lucian Tsz-Hei Chan ◽

Cecilia Lai-Wan Chan ◽

Pamela Pui-Yu Leung

Keyword(s):

Mental Health ◽

Chronic Illness ◽

Support Groups ◽

Online Survey ◽

Well Being ◽

World Health Organisation ◽

Community Dwelling ◽

Chronic Illnesses ◽

World Health ◽

Psychological Resilience

Studies have shown individuals with chronic illnesses tend to experience poorer mental health compared to their counterparts without a chronic illness under the COVID-19 pandemic. The pervasive disruption on daily lifestyles due to social distancing could be a contributing factor. In this study, we collaborated with local patient support groups to explore the psychological adjustment among a group of community-dwelling individuals with chronic illnesses under the COVID-19 pandemic in Hong Kong. We collected responses from 408 adults with one or more chronic illnesses using an online survey. Results show that about one in four participants experienced moderate to high levels of depression (26.0%), anxiety (26.2%) and stress (20.1%) symptoms measured by the Depression, Anxiety and Stress Scale and the World Health Organisation-Five Well-Being Index. While 62.3% (gatherings) to 91.9% (contact with others) of participants reported changes in their daily lifestyles, these changes—both an increase and a decrease—were related to poorer mental health. The relationship was mediated by psychological resilience, measured by the Connor–Davidson Resilience Scale, with an estimate of indirect effect of −0.28 (95% confidence interval −0.44 to −0.10). In light of our findings, we urge social and healthcare professionals to support chronic illness patients to continue their daily lifestyles such as exercises and social contacts as much as possible by educating the public on feasible and practical preventive measures and enhance the psychological resilience of community-dwelling patients with scalable and efficacious psychological interventions.

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Sugar Habit Hacker: Initial evidence that a planning intervention reduces sugar intake

Journal of Behavioral Addictions ◽

10.1556/2006.2021.00054 ◽

2021 ◽

Author(s):

Matthew Brittain ◽

Nathan Consedine ◽

Kathleen L. Bagot ◽

Natalia Booth ◽

Simone N. Rodda

Keyword(s):

Brief Intervention ◽

Implementation Intention ◽

Well Being ◽

World Health Organisation ◽

World Health ◽

Sugar Consumption ◽

Post Intervention ◽

Self Monitoring ◽

Sugar Intake ◽

Implementation Planning

AbstractBackground and aimsSugar is a potentially addictive substance that is consumed in such high levels the World Health Organisation has set recommended consumption limits. To date there are no empirically tested brief interventions for reducing sugar consumption in adult populations. The current study aimed to preliminarily assess the feasibility of recruitment, retention, and intervention engagement and impact of a brief intervention.MethodsThis pre-post study recruited 128 adults from New Zealand to complete a 30-day internet-delivered intervention with in-person and email coaching. The intervention components were derived from implementation intention principles whereby the gap between intention and behaviour was targeted. Participants selected sugar consumption goals aligned with WHO recommendations by gender. To meet these goals, participants developed action plans and coping plans and engaged in self-monitoring. Facilitation was provided by a coach to maintain retention and treatment adherence over the 30 days.ResultsIntervention materials were rated as very useful and participants were mostly satisfied with the program. The total median amount of sugar consumed at baseline was 1,662.5 g (396 teaspoons per week) which was reduced to 362.5 g (86 teaspoons) at post-intervention evaluation (d = 0.83). The intervention was associated with large effects on reducing cravings (d = 0.59) and psychological distress (d = 0.68) and increasing situational self-efficacy (d = 0.92) and well-being (d = 0.68) with a reduction in BMI (d = 0.51).ConclusionThis feasibility study indicates that a brief intervention delivering goal setting, implementation planning, and self-monitoring may assist people to reduce sugar intake to within WHO recommendations.

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Digital cognitive–behavioural therapy for insomnia compared with digital patient education about insomnia in individuals referred to secondary mental health services in Norway: protocol for a multicentre randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2021-050661 ◽

2021 ◽

Vol 11 (6) ◽

pp. e050661

Author(s):

Håvard Kallestad ◽

Simen Saksvik ◽

Øystein Vedaa ◽

Knut Langsrud ◽

Gunnar Morken ◽

...

Keyword(s):

Mental Health ◽

Randomised Controlled Trial ◽

Patient Education ◽

Cognitive Behavioural Therapy ◽

Controlled Trial ◽

Behavioural Therapy ◽

Group Differences ◽

Post Intervention ◽

Cognitive Behavioural ◽

Randomised Controlled

IntroductionInsomnia is highly prevalent in outpatients receiving treatment for mental disorders. Cognitive–behavioural therapy for insomnia (CBT-I) is a recommended first-line intervention. However, access is limited and most patients with insomnia who are receiving mental healthcare services are treated using medication. This multicentre randomised controlled trial (RCT) examines additional benefits of a digital adaptation of CBT-I (dCBT-I), compared with an online control intervention of patient education about insomnia (PE), in individuals referred to secondary mental health clinics.Methods and analysisA parallel group, superiority RCT with a target sample of 800 participants recruited from treatment waiting lists at Norwegian psychiatric services. Individuals awaiting treatment will receive an invitation to the RCT, with potential participants undertaking online screening and consent procedures. Eligible outpatients will be randomised to dCBT-I or PE in a 1:1 ratio. Assessments will be performed at baseline, 9 weeks after completion of baseline assessments (post-intervention assessment), 33 weeks after baseline (6 months after the post-intervention assessment) and 61 weeks after baseline (12 months after the post-intervention assessment). The primary outcome is between-group difference in insomnia severity 9 weeks after baseline. Secondary outcomes include between-group differences in levels of psychopathology, and measures of health and functioning 9 weeks after baseline. Additionally, we will test between-group differences at 6-month and 12-month follow-up, and examine any negative effects of the intervention, any changes in mental health resource use, and/or in functioning and prescription of medications across the duration of the study. Other exploratory analyses are planned.Ethics and disseminationThe study protocol has been approved by the Regional Committee for Medical and Health Research Ethics in Norway (Ref: 125068). Findings from the RCT will be disseminated via peer-reviewed publications, conference presentations, and advocacy and stakeholder groups. Exploratory analyses, including potential mediators and moderators, will be reported separately from main outcomes.Trial registration numberClinicalTrials.gov Registry (NCT04621643); Pre-results.

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Physical activity and mental well-being under COVID-19 lockdown: a cross-sectional multination study

BMC Public Health ◽

10.1186/s12889-021-10931-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Costas I. Karageorghis ◽

Jonathan M. Bird ◽

Jasmin C. Hutchinson ◽

Mark Hamer ◽

Yvonne N. Delevoye-Turrell ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Young Adults ◽

Sedentary Behavior ◽

Online Survey ◽

Electronic Device ◽

Well Being ◽

Middle Aged ◽

Steps Per Day ◽

Western Nations

Abstract Background COVID-19 lockdowns have reduced opportunities for physical activity (PA) and encouraged more sedentary lifestyles. A concomitant of sedentariness is compromised mental health. We investigated the effects of COVID-19 lockdown on PA, sedentary behavior, and mental health across four Western nations (USA, UK, France, and Australia). Methods An online survey was administered in the second quarter of 2020 (N = 2541). We measured planned and unplanned dimensions of PA using the Brunel Lifestyle Physical Activity Questionnaire and mental health using the 12-item General Health Questionnaire. Steps per day were recorded only from participants who used an electronic device for this purpose, and sedentary behavior was reported in hours per day (sitting and screen time). Results In the USA and Australia samples, there was a significant decline in planned PA from pre- to during lockdown. Among young adults, Australians exhibited the lowest planned PA scores, while in middle-aged groups, the UK recorded the highest. Young adults exhibited the largest reduction in unplanned PA. Across nations, there was a reduction of ~ 2000 steps per day. Large increases in sedentary behavior emerged during lockdown, which were most acute in young adults. Lockdown was associated with a decline in mental health that was more pronounced in women. Conclusions The findings illustrate the deleterious effects of lockdown on PA, sedentary behavior, and mental health across four Western nations. Australian young and lower middle-aged adults appeared to fare particularly badly in terms of planned PA. The reduction in steps per day is equivalent to the non-expenditure of ~ 100 kcal. Declines in mental health show how harmful lockdowns can be for women in particular.

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Improvement in Cognitive Abilities, Mental and Emotional Well-being of Teenagers following a Meditation Retreat: An Open-Trial pilot study

Adolescent Psychiatry ◽

10.2174/2210676611666210210104431 ◽

2021 ◽

Vol 11 ◽

Author(s):

Divya Kanchibhotla ◽

Saumya Subramanian ◽

Shashank Kulkarni

Keyword(s):

Cognitive Abilities ◽

Well Being ◽

Poor Mental Health ◽

Cognitive Capacity ◽

World Health ◽

Repeated Measure ◽

Post Intervention ◽

Meditation Retreat ◽

Mental Well Being

Background: Background: Today’s teenagers face several challenges that result in poor mental health, depression and anxiety. Several studies in the past decade have explored meditation as an adjunctive therapy for mental illness however the long term residual benefits of meditation have rarely been studied. Objective: The aim of the study was to investigate the benefits of a four day meditation retreat on cognitive abilities, mental and emotional well-being of teenagers. Methods: 303 teenagers participated in this study. Cognitive abilities of the students were measured using theSix letter cancellation test (SLCT). Mental and emotional well-being was measured using World Health Organization Well-being index (WHO-5) and Strength and Difficulties questionnaire (SDQ) respectively. Data analysis was performed using paired sample t-test and repeated measure ANOVA. Results: Teenagers demonstrated a 33% increase in average accuracy for SLCT post intervention. WHO-5 mental well-being index scores also increased significantly (p <1). The participants experienced significant reduction in emotional problems and hyperactivity as measured by SDQ. The benefits of the retreat continued to persist, when measured after 40 days of the intervention. Conclusion: A well-structured meditation retreat has significant and long term benefits on teenagers’ mental well-being, emotional stability and cognitive capacity.

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Efficacy of ‘Foundations’, a Digital Mental Health App to Improve Mental Well-Being, during COVID-19: A Proof-of-Principle Randomised Controlled Trial (Preprint)

10.2196/preprints.30976 ◽

2021 ◽

Author(s):

Silvina Catuara-Solarz ◽

Bartlomiej Skorulski ◽

Inaki Estella ◽

Claudia Avella-Garcia ◽

Sarah Shepherd ◽

...

Keyword(s):

Mental Health ◽

Perceived Stress ◽

Intervention Group ◽

Well Being ◽

Self Report ◽

World Health ◽

Randomised Control Trial ◽

Control Group ◽

Mental Well Being ◽

Proof Of Principle

BACKGROUND Against a long-term trend of increasing demand, the COVID-19 pandemic has led to a global rise in common mental disorders. Now more than ever, there is an urgent need for scalable, evidence-based interventions to support mental well-being. OBJECTIVE The aim of this proof-of-principle study was to evaluate the efficacy of a mobile-based app in adults with self-reported symptoms of anxiety and stress in a randomised control trial that took place during the first wave of the COVID-19 pandemic in the UK. METHODS Adults with mild to severe anxiety and moderate to high levels of perceived stress were randomised to either the intervention or control arm. Participants in the intervention arm were given access to the app, Foundations, for the duration of the 4-week study. All participants were required to self-report a range of validated measures of mental well-being (10-item Connor-Davidson Resilience scale [CD-RISC-10]; 7-item Generalised Anxiety Disorder scale [GAD-7]; Office of National Statistics Four Subjective Well-being Questions [ONS-4]; World Health Organisation-5 Well-Being Index [WHO-5]) and sleep (Minimal Insomnia Scale [MISS]) at baseline and weeks 2 and 4; and, in addition, on perceived stress weekly (10-item Perceived Stress Score [PSS]). RESULTS 136 participants completed the study and were included in the final analysis. The intervention group (n=62) showed significant improvements compared to the control group (n=74) on measures of anxiety (GAD-7 score, delta from baseline to week 2 in the intervention group: -1.35 [SD 4.43]; control group: -0.23 [SD 3.24]; t134= 1.71 , P=.04), resilience (CD-RISC score, delta from baseline to week 2 in the intervention group: 1.79 [± SD 4.08]; control group: -0.31 [± SD 3.16]; t134 -3.37, P<.001), sleep (MISS score, delta from baseline to week 2 in the intervention group: -1.16 [± SD 2.67]; control group: -0.26 [± SD 2.29]; t134= 2.13, P=.01), and mental well-being (WHO-5 score, delta from baseline to week 2 in the intervention group: 1.53 [5.30]; control group: -0.23 [± SD 4.20]; t134= -2.16, P=.02) within 2 weeks of using Foundations, with further improvements emerging at week 4. Perceived stress was also reduced within the intervention group, although the results did not reach statistical significance relative to the control group (PSS score, delta from baseline to week 2 in the intervention group: -2.94 [± SD 6.84]; control group: -2.05 [± SD 5.34]; t134= 0.84, P=.20). CONCLUSIONS This study provides proof-of-principle that the digital mental health app, Foundations, can improve measures of mental well-being, anxiety, resilience, and sleep within 2 weeks of use, with greater effects after 4 weeks. It therefore offers potential as a scalable, cost-effective, and accessible solution to enhance mental well-being, even during times of crisis such as the COVID-19 pandemic.

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WHO Parents Skills Training (PST) programme for children with developmental disorders and delays delivered by Family Volunteers in rural Pakistan: study protocol for effectiveness implementation hybrid cluster randomized controlled trial

Global Mental Health ◽

10.1017/gmh.2017.7 ◽

2017 ◽

Vol 4 ◽

Cited By ~ 11

Author(s):

S. U. Hamdani ◽

P. Akhtar ◽

Zill-e-Huma ◽

H. Nazir ◽

F. A. Minhas ◽

...

Keyword(s):

Mental Health ◽

Developmental Disorders ◽

Controlled Trial ◽

Public Mental Health ◽

Skills Training ◽

Well Being ◽

Evidence Based ◽

Post Intervention ◽

Hybrid Cluster ◽

Rural Pakistan

Background.Development disorders and delays are recognised as a public health priority and included in the WHO mental health gap action programme (mhGAP). Parents Skills Training (PST) is recommended as a key intervention for such conditions under the WHO mhGAP intervention guide. However, sustainable and scalable delivery of such evidence based interventions remains a challenge. This study aims to evaluate the effectiveness and scaled-up implementation of locally adapted WHO PST programme delivered by family volunteers in rural Pakistan.Methods.The study is a two arm single-blind effectiveness implementation-hybrid cluster randomised controlled trial. WHO PST programme will be delivered by ‘family volunteers’ to the caregivers of children with developmental disorders and delays in community-based settings. The intervention consists of the WHO PST along with the WHO mhGAP intervention for developmental disorders adapted for delivery using the android application on a tablet device. A total of 540 parent-child dyads will be recruited from 30 clusters. The primary outcome is child's functioning, measured by WHO Disability Assessment Schedule – child version (WHODAS-Child) at 6 months post intervention. Secondary outcomes include children's social communication and joint engagement with their caregiver, social emotional well-being, parental health related quality of life, family empowerment and stigmatizing experiences. Mixed method will be used to collect data on implementation outcomes. Trial has been retrospectively registered at ClinicalTrials.gov (NCT02792894).Discussion.This study addresses implementation challenges in the real world by incorporating evidence-based intervention strategies with social, technological and business innovations. If proven effective, the study will contribute to scaled-up implementation of evidence-based packages for public mental health in low resource settings.Trial registration.Registered with ClinicalTrials.gov as Family Networks (FaNs) for Children with Developmental Disorders and Delays. Identifier: NCT02792894 Registered on 6 July 2016.

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Mental Health Policy in Ireland 1984–2004: theory, overview and future directions

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700008326 ◽

2004 ◽

Vol 21 (2) ◽

pp. 61-68 ◽

Cited By ~ 10

Author(s):

Brendan D Kelly

Keyword(s):

Mental Health ◽

Health Policy ◽

Mental Health Policy ◽

American Psychological Association ◽

Transnational Migration ◽

World Health Organisation ◽

World Health ◽

Future Directions ◽

Health Report ◽

The Eu

Recent years have seen renewed emphasis on the importance of mental health policy as a key component of health and social policy at both national and international levels. In 2001 the European Commission produced a public health framework for mental health in the EU. In the same year, the World Health Organisation devoted its annual health report to mental health and called on countries to formulate, update and implement mental health policies. The EU and WHO initiatives both recognised that the challenges facing mental health policy makers are increasingly transnational in scope, related to issues such as rapid demographic change, increased transnational migration, the protection of human rights and the implementation of a growing number of international laws, directives and protocols in relation to mental health care.Significant progress has been made in the development of Irish mental health services over the past 40 years. Nevertheless, many challenges remain. The aims of this paper are to outline:• Prevailing theoretical perspectives on mental health policy• Mental health policy in Ireland since the last major policy revision in 1984• Relevant economic and demographic changes in Ireland since 1984• Relevant clinical, legislative and policy developments in relation to mental health• Future directions for mental health policy.Electronic literature searches were performed using Psyclit (American Psychological Association, 1887–2003), Medline (United States National Library of Medicine, 1985 – 2003), with broad search terms related to mental health policy. Additional books and papers were identified by tracking back through references and consulting with colleagues. Policy documents and selected literature on Irish psychiatric services were reviewed and related to recent literature on mental health policy.

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