Qualitative Investigation into the Mental Health of Healthcare Workers in Japan during the COVID-19 Pandemic

The COVID-19 pandemic has negatively impacted the mental health of healthcare workers in many countries including Japan. While many survey-based findings have reported the serious state of their wellbeing among healthcare workers, the first-hand experience of the mental health and coping in this population remains to be evaluated. Accordingly, this study aimed to appraise them using constructionist thematic analysis on semi-structured interviews attended by a purposive and snowball sample of 24 healthcare workers in Japan conducted in December 2020–January 2021. Four themes were identified: (1) increased stress and loneliness, (2) reduced coping strategies, (3) communication and acknowledgement as a mental health resource, and (4) understanding of self-care. Participants noted that the characteristics of Japanese work culture such as long hours, collectivism and hatarakigai (i.e., meaning in work) to explain these themes. These findings suggest that robust support at an organizational and individual level, capturing intrinsic values, are particularly important for this key workforce to cope with increased stress and loneliness, leading to better patient care.

An Evaluation of 5-Year Web Analytics for HeadsUpGuys: A Men’s Depression E-Mental Health Resource

The present study reports an evaluation of web analytics, over a 5-year period, for HeadsUpGuys.org , an eHealth resource for men with depression. Google Analytics, Search Console, and Tag Manager were used to monitor user activity over the course of the website’s first 5 years (June 15, 2015–June 15, 2020). Through this period, HeadsUpGuys had a total of 1,665,356 unique users, amounting to 1,948,481 sessions and 3,328,258 page views. Organic traffic accounted for the highest proportion (53.44%; n = 1,041,277) of website sessions. Four of the top 10 Google search queries that brought users to the website related to suicidality. Three countries (United States, United Kingdom, Canada) accounted for almost three-quarters (71.10%; n = 1,385,485) of the site’s traffic. Nearly three-quarters (73.35%; n = 1,429,285) of sessions occurred on a mobile device. The goal conversion rate for the Self Check was 60.27%. The average time on page was 2 min 53 s, with a bounce rate of 65.92%, and an exit rate of 57.20%. The goal conversion rate for the Stress Test was 52.89%. The average time on page was 4 min 8 s, with a bounce rate of 72.40% and an exit rate of 48.88%. The conversion rate for the final goal was 11.53%, indicating that approximately one in 10 visitors to the site had a session of at least 3 min. The findings illustrate the potential of eHealth resources to support men’s mental health and provide a real-world benchmark to help advance the men’s eHealth field.

Using Peer Support to Strengthen Mental Health During the COVID-19 Pandemic: A Review

Background: The coronavirus (COVID-19) pandemic has had a significant impact on society's overall mental health. Measures such as mandated lockdowns and physical distancing have contributed to higher levels of anxiety, depression, and other metrics indicating worsening mental health. Peer support, which is peer-to-peer provided social and emotional support, is an underutilized and effective mental health resource that can potentially be used to ameliorate mental health during these times.Objective: This review aims to summarize the toll that this pandemic has had on society's mental health as found in peer-reviewed literature from October 2019 to March 2021, as well as suggest the utility of peer support to address these needs.Methods: References for this review were chosen through searches of PubMed, Web of Science, and Google Scholar for articles published between October 2019 and March 2021 that used the terms: “coronavirus,” “COVID-19,” “mental health,” “anxiety,” “depression,” “isolation,” “mental health resources,” “peer support,” “online mental health resources,” and “healthcare workers.” Articles resulting from these searches and relevant references cited in those articles were reviewed. Articles published in English, French and Italian were included.Results: This pandemic has ubiquitously worsened the mental health of populations across the world. Peer support has been demonstrated to yield generally positive effects on the mental health of a wide variety of recipients, and it can be provided through numerous accessible mediums.Conclusions: Peer support can overall be beneficial for improving mental health during the COVID-19 pandemic and may be an effective tool should similar events arise in the future, although the presence of a few conflicting studies suggests the need for additional research.

Impact of Jointly Using an e–Mental Health Resource (Self-Management And Recovery Technology) on Interactions Between Service Users Experiencing Severe Mental Illness and Community Mental Health Workers: Grounded Theory Study

Background e–Mental health resources are increasingly available for people who experience severe mental illness, including those who are users of community mental health services. However, the potential for service users (SUs) living with severe mental illness to use e–mental health resources together with their community mental health workers (MHWs) has received little attention. Objective This study aims to identify how jointly using an interactive website called Self-Management And Recovery Technology (SMART) in a community mental health context influenced therapeutic processes and interactions between SUs and MHWs from their perspective. Methods We conducted a qualitative study using a constructivist grounded theory methodology. Data were collected through individual semistructured interviews with 37 SUs and 15 MHWs who used the SMART website together for 2 to 6 months. Data analysis involved iterative phases of coding, constant comparison, memo writing, theoretical sampling, and consultation with stakeholders to support the study’s credibility. Results A substantive grounded theory, discovering ways to keep life on track, was developed, which portrays a shared discovery process arising from the SU-worker-SMART website interactions. The discovery process included choosing to use the website, revealing SUs’ experiences, exploring these experiences, and gaining new perspectives on how SUs did and could keep their lives on track. SUs and MHWs perceived that their three-way interactions were enjoyable, beneficial, and recovery focused when using the website together. They experienced the shared discovery process as relationship building—their interactions when using the website together were more engaging and equal. Conclusions Jointly using an e–mental health resource elicited recovery-oriented interactions and processes between SUs and MHWs that strengthened their therapeutic relationship in real-world community mental health services. Further work to develop and integrate this novel use of e–mental health in community mental health practice is warranted.

Using peer support to strengthen mental health during the COVID-19 pandemic: a review (Preprint)

BACKGROUND The coronavirus (COVID-19) pandemic has had a significant impact on society’s overall mental health with a notable effect on healthcare providers. To manage this global crisis, governments have had to implement numerous measures such mandated lockdowns and physical distancing to minimize the risk of overloading healthcare systems. Altogether, these measures have contributed to higher levels of anxiety, depression, insomnia, post-traumatic stress disorder, and other metrics indicating worsening mental health. Unfortunately, the availability of crucial mental health resources and support remains scarce during this time as services attempt to transition to an effective online delivery model. Peer support, which is peer-to-peer provided social and emotional support, is an underutilized and effective mental health resource that is easily delivered/accessed in-person by members within a social distancing bubble, or virtually across different bubbles. OBJECTIVE This review aims to summarize the toll that this pandemic has had on society’s mental health as found in peer-reviewed literature from October 2019 to March 2021, as well as suggest the utility of peer support to address these needs. Lastly, we provide strategies to effectively deliver peer support so that members of the community can better support one another during these unprecedented times. METHODS References for this review were chosen through searches of PubMed, Web of Science, and Google Scholar for articles published between October 2019 and March 2021 that used the terms: “coronavirus”, “COVID-19”, “mental health”, “anxiety”, “depression”, “isolation”, “mental health resources”, “peer support”, “online mental health resources”, and “healthcare workers”. Articles resulting from these searches and relevant references cited in those articles were reviewed. Articles published in English, French and Italian were included. RESULTS As stated in peer-reviewed literature, this pandemic has ubiquitously worsened the mental health of populations across the world, which is further exacerbated by extended periods of lockdown. Peer support has been demonstrated to yield positive effects on the mental health of a wide variety of recipients, and it can be provided through numerous accessible mediums such as web/mobile applications, video-conferencing software, workshops, telephone services, and student programs. CONCLUSIONS The provision of peer support can be very beneficial for improving mental health during the COVID-19 pandemic and may be an effective tool should similar events arise in the future. CLINICALTRIAL N/A

Mental Health Resource Use Among Patients Undergoing Curative Intent Treatment for Bladder Cancer

Background Patients with bladder cancer may experience mental health distress. Mental health-care service (MHS) use can quantify the magnitude of the problem. Methods The Ontario Cancer Registry was used to identify all patients with bladder cancer treated with curative-intent cystectomy or radiotherapy in Ontario, Canada (2004-2013). Population-level databases were used to identify MHS use (visits to general practitioner, psychiatrist, emergency department, or hospitalization). Generalized estimating equations were used to compare rates of MHS use. Baseline, peritreatment, and posttreatment MHS use were defined as visits from 2 years to 3 months before, 3 months before to 3 months after, and from 3 months after to 2 years after start of treatment, respectively. Results From 2004 to 2013, 4296 patients underwent cystectomy (n = 3332) or curative-intent radiotherapy (n = 964). Compared with baseline, the rate of MHS use was higher in the peritreatment (adjusted rate ratio [aRR] = 1.64, 95% confidence interval [CI] = 1.48 to 1.82) and posttreatment periods (aRR = 1.45, 95% CI =1.30 to 1.63). By 2 years posttreatment, 24.6% (95% CI = 23.4% to 25.9%) of all patients had MHS use. Patients with baseline MHS use had substantially higher MHS use in the peritreatment (aRR = 5.77, 95% CI = 4.86 to 6.86) and posttreatment periods (aRR = 4.58, 95% CI = 3.78 to 5.55). Female patients had higher use MHS use overall, but males had a higher incremental increase in the posttreatment period compared with baseline (2-sided Pinteraction = .02). Male patients had a statistically significant increase in MHS use following surgery or radiotherapy, whereas female patients only had an increase following surgery. Conclusions MHS use is common among patients undergoing treatment for bladder cancer, particularly in the peritreatment period. Screening for mental health concerns in this population is warranted.

Predictors of Psychological Distress and Mental Health Resource Utilization among Employees in Malaysia

We sought to examine predictors of psychological distress among employees as well as the level of awareness and usage of available mental health resources by employees through their own organizations. The Malaysian Healthiest Workplace survey cross-sectional dataset was used to explore the association between psychological distress, a range of health conditions, as well as mental health resource awareness and usage in a sample of 11,356 working Malaysian adults. A multivariate logistic regression was conducted to determine predictors of high psychological distress. Comorbid illnesses that were associated with psychological distress were mental illness (OR 6.7, 95% CI 4.39–10.14, p = 0.001), heart conditions (OR 2.17, 95% CI 1.18–3.99, p = 0.012), migraines (OR 1.59, 95% CI 1.33–1.90, p = 0.001), bronchial asthma (OR 1.43, 95% CI 1.11–1.85, p = 0.006), and hypertension (OR 1.42, 95% CI 1.07–1.88, p = 0.016) compared to individuals with no comorbid conditions. A total of 14 out of 17 comorbid medical illnesses were associated with elevated levels of psychological distress among employees. Awareness and usage of support services and resources for mental health were associated with lower psychological distress. These findings extend the literature by providing further evidence on the link between chronic illness, occupational type, as well as awareness and use of mental health resources by psychological distress status.

A longitudinal evaluation of web analytics for HeadsUpGuys: A men’s depression e-mental health resource (Preprint)

BACKGROUND There has been rapid growth in the area of eHealth as a means to delivering tailored health interventions for men. Yet, there have been few attempts at developing eHealth programs specifically oriented to men with depression, and by extension little is known about the uptake and usage patterns of potential end-users. OBJECTIVE The objective of the present study was to conduct a longitudinal evaluation of web analytics for HeadsUpGuys.org, an eHealth resource for men with depression. The study focused on user engagement, traffic sources, and goal conversion (i.e., specific interactivity targets). METHODS Google Analytics, Search Console, and Tag Manager were used to monitor user activity over the course of the website’s first five years (June 15, 2015 – June 15, 2020). These tools were used to harvest data regarding the number of visits, visit duration, bounce rates, most visited pages; traffic filters, country sources, city sources; and goal conversion relating to three specific outcomes [Self Check (depression screen) completion, Stress Test (stress checklist and rating) completion, session of at least 3 minutes]. RESULTS Through its first five years of operation, HeadsUpGuys had a total of 1,665,356 unique users, amounting to 1,948,481 sessions and 3,328,258 pageviews. One in seven visits (14.53%) was from a returning user. Organic traffic accounted for the highest proportion (53.44%) of all the website sessions. Four of the top 10 Google search queries that brought users to the website related to suicidality. Three countries (United States, United Kingdom, Canada) accounted for almost three-quarters (71.10%) of the site’s traffic. Nearly three-quarters (73.35%) of sessions occurred on a mobile device. The goal conversion rate for the Self Check was 60.27%. The average time on page was 2 minutes 53 seconds, with a bounce rate of 65.92%, and an exit rate of 57.20%. The goal conversion rate for the Stress Test was 52.89%. The average time on page was 4 minutes 8 seconds, with a bounce rate of 72.40% and an exit rate of 48.88%. The conversion rate for the final goal was 11.53%, indicating that approximately one in ten visitors to the site had a session of at least 3 minutes. CONCLUSIONS The volume of traffic and the conversion rates affirm the acceptability and usability of HeadsUpGuys. The study illustrates the potential of eHealth resources to support men’s mental health and provides some guidance to advancing the men’s eHealth field.

Impact of Jointly Using an e–Mental Health Resource (Self-Management And Recovery Technology) on Interactions Between Service Users Experiencing Severe Mental Illness and Community Mental Health Workers: Grounded Theory Study (Preprint)

BACKGROUND e–Mental health resources are increasingly available for people who experience severe mental illness, including those who are users of community mental health services. However, the potential for service users (SUs) living with severe mental illness to use e–mental health resources together with their community mental health workers (MHWs) has received little attention. OBJECTIVE This study aims to identify how jointly using an interactive website called <i>Self-Management And Recovery Technology</i> (SMART) in a community mental health context influenced therapeutic processes and interactions between SUs and MHWs from their perspective. METHODS We conducted a qualitative study using a constructivist grounded theory methodology. Data were collected through individual semistructured interviews with 37 SUs and 15 MHWs who used the SMART website together for 2 to 6 months. Data analysis involved iterative phases of coding, constant comparison, memo writing, theoretical sampling, and consultation with stakeholders to support the study’s credibility. RESULTS A substantive grounded theory, <i>discovering ways to keep life on track</i>, was developed, which portrays a shared discovery process arising from the SU-worker-SMART website interactions. The discovery process included choosing to use the website, revealing SUs’ experiences, exploring these experiences, and gaining new perspectives on how SUs did and could keep their lives on track. SUs and MHWs perceived that their three-way interactions were enjoyable, beneficial, and recovery focused when using the website together. They experienced the shared discovery process as relationship building—their interactions when using the website together were more engaging and equal. CONCLUSIONS Jointly using an e–mental health resource elicited recovery-oriented interactions and processes between SUs and MHWs that strengthened their therapeutic relationship in real-world community mental health services. Further work to develop and integrate this novel use of e–mental health in community mental health practice is warranted.

Socio-economic disadvantage and resource distribution for mental health care; a model proposal and example application for Victoria, Australia

The attached pre-print (accepted manuscript ) paper describes an application of available epidemiological evidence in guiding the adjustment of mental health resources to areas. Described with an illustrative application in Victoria, Australia. We have also provided our research data as a supplementary spreadsheet to showcase our analytic approach (the spreadsheet cam also easily be adapted to calculate mental health resource adjustments in other states and territories, or nationally).