The mental health of staff working on Intensive Care Units over the COVID-19 winter surge of 2020 in England: a cross sectional survey.

Background: The COVID-19 pandemic generated a surge of critically ill patients greater than the NHS capacity. Additionally there have been multiple well-documented impacts associated with the national COVID-19 pandemic surge on ICU workers including an increased prevalence of mental health disorders on a scale potentially sufficient to impair high-quality care delivery. Aim: To identify prevalence of probable mental health disorders, functional impairment and establish demographic and professional predictors of probable mental health disorders, and functional impairment, in ICU staff between November 2020 to April 2021. Methods: English ICU staff were surveyed before, during and after the winter 2020/2021 surge using a survey which comprised of validated measures of mental health. Results: 6080 surveys were completed, by nurses (57.5%), doctors (27.9%), and other healthcare staff (14.5%). Reporting probable mental health disorders increased from 51% (prior to), to 64% (during) and then dropped to 46% (after) the peak. Younger, less experienced and nursing staff were most likely to report probable mental health disorders. Additionally, during and after the winter, over 50% of participants met threshold criteria for functional impairment. Staff who reported probable post-traumatic stress disorder, anxiety or depression were more likely to meet threshold criteria for functional impairment. Conclusions: The winter of 2020/2021 was associated with an increase in poor mental health outcomes and functional impairment during a period of peak caseload. These effects are likely to impact on patient care outcomes and the longer-term resilience of the healthcare workforce.

Mental health and loneliness in Scottish schools: A multilevel analysis of data from the Health Behaviour in School-aged Children study

Adolescent loneliness and poor mental health represent dual public health concerns. Yet, associations between loneliness and mental health, and critically, how these unfold in school settings are less understood. Framed by social ecological theory, this study aimed to identify key predictors of adolescent mental health, and examine school-level variation in the relationship between loneliness and mental health.Cross-sectional data on adolescents from the 2018 wave of the Health Behaviour in School-aged Children study (HBSC) in Scotland were used (N = 5,286). Mental health was measured as a composite variable containing items assessing: nervousness, irritability, sleep difficulties and feeling low. Loneliness was measured via a single item assessing how often adolescents felt ‘left out’. Multilevel models were used to identify key social ecological predictors of mental health, associations with loneliness, and between-school variation.Loneliness, as well as demographic, social, and school factors, were found to be associated with mental health. Schools accounted for around 8% of the variation in adolescents’ mental health, and the between-school difference in mental health was greater among adolescents with high levels of loneliness. Additionally, the negative effect of loneliness on mental health was stronger in schools with lower average mental health scores.The findings suggest that schools can play an important role in shaping adolescent mental health. Our study uniquely identifies that school-based interventions targeting mental health may be especially necessary among lonely adolescents, and programmes aimed at tackling loneliness may be more beneficial in schools with poorer mental health.

COVID-19 policies in practice and their direct and indirect impacts in Northern California jails

Context: Although the increased risk of COVID-19 in carceral facilities is well documented, little is known about the practical barriers to infection control and indirect impacts of pandemic policies in these settings. Evidence in jails is especially scarce. Methods: Between July 8, 2020 and April 30, 2021 we performed SARS-CoV-2 serology testing and administered a questionnaire among residents and staff in four Northern California jails. We analyzed seroprevalence in conjunction with demographic factors and survey responses of self-perceived COVID-19 risk, recent illness, COVID-19 test results, and symptom reporting behaviors. We additionally assessed COVID-19 policies in practice and evaluated their impacts on court dates, mental health, and routine health care. We engaged stakeholder representatives, including incarcerated individuals and their advocates, to guide study design, conduct, and interpretation. Findings: We enrolled 788 incarcerated individuals and 380 staff across four county jails. Most seropositive individuals had not previously tested positive for COVID-19, despite many suspecting prior infection. Among incarcerated participants, we identified deficient access to face masks and prevalent symptom underreporting associated with fears of isolation and perceptions of medical neglect in jail. Incarcerated participants also reported substantial hindrances to court cases and reductions in routine health care due to COVID-19. Incarcerated individuals and staff both cited worsened mental health due to COVID-19, which for incarcerated individuals was largely attributable to further isolation from loved ones and other pandemic restrictions on recreation and programming. Conclusions: Perceptions of inadequate protection from COVID-19 were pervasive among incarcerated individuals. Simultaneously, restrictive measures compounded poor mental health and fostered fears of isolation that undermined effective infection control. Custody officials should work to systematically improve provision of masks, understand and mitigate fears and mistrust, and take proactive steps to minimize the detrimental impacts of restrictive policies on residents' mental health and well-being.

Overlooked and unaddressed: A narrative review of mental health consequences of child marriages

Child Marriage (before the age of 18) affects over 12 million young women globally, annually. Despite acknowledgement of the negative impacts of the practice on reproductive health, mental health consequences are largely overlooked. Given the ability for poor mental health to intensify other health and social challenges, understanding the mental health consequences linked to child marriage is vital. Our study is the first to examine how mental health is approached in current literature on child marriage. Our conceptual framework was informed by a rapid assessment of key issues in the field. Systematic searches of papers published between 2000–2020 were completed on four electronic databases with no language restrictions. Our protocol was registered on Prospero (CRD42019139685). Articles were assessed using PRISMA guidelines, and their quality assessed using the Joanna Briggs Institute Critical Appraisal Tools. Of the 4,457 records identified, 21 papers meeting inclusion criteria were analysed using narrative synthesis. The final sample included 5 qualitative, 1 mixed-methods and 15 quantitative studies (14 cross-sectional and 1 longitudinal study) reporting on data from 12 countries, largely in the global south. Intimate partner violence, poverty, challenges in childbirth and isolation were identified as social factors linked to emotional distress by those married as children. Depression was the most reported mental disorder. Anxiety, phobias, psychological distress, substance misuse, negative well-being and anti-social personality disorder were reported less frequently. Findings highlight that while significant emotional distress and specific mental health conditions are linked to child marriage, gaps in our understanding remain. Future studies are needed to; clarify directionality in these relationships; understand the mental health needs of young men, LGBTQI communities and those in humanitarian settings. Given the well documented cyclical relationship between social determinants and mental health conditions, we outline a series of community-oriented interventions which blend psychological, social and structural support to promote mental health and wellbeing in the contexts of child marriage.

Working Conditions and Health Among Italian Ageing Workers

In many European countries requirements for retirement have been tightened, causing an increase in work participation of older workers, in spite their potentially poorer health may limit their work ability. This study aimed at assessing the diffusion of health problems and exposure to unfavorable working conditions among ageing workers in two Italian surveys, as well as comparing them with those observed in the same surveys conducted before the 2011 Italian pension reform tightening the normal retirement age. The 2013 National Health Survey (NHS) and Labour Force Survey (LFS) were employed to assess the prevalence of poor perceived health, health conditions and functional limitations, and of exposure to physical, psychosocial and organization factors at work, among 60–64 years workers. Poisson regression models were used to estimate Prevalence Ratios of health outcomes and unfavorable working conditions in the two surveys, compared to data from the 2005 (NHS) and 2007 (LFS) corresponding surveys, respectively. Among both men and women, approximately one quarter had at least one physical disorder or functional limitations and 15% poor mental health. Exposure to different ergonomic factors (15–30%) and working during unsocial hours (19%) were particularly diffused. A significant increase in the prevalence of functional limitations and of working at night or during unsocial hours was found in 2013, compared to corresponding data from 2005 and 2007, respectively. Our results indicate that exposure to ergonomic and organizational hazards should be reduced among ageing workers, to avoid decreased work ability, health damage or early exit from the labour market.

Mental Health and Access to Medical Care in Patients with Chronic Cardiovascular Conditions: An Analysis of the Behavior Risk Factor Surveillance System

Introduction. Poor mental health is associated with worse outcomes for chronic diseases. It is unclear whether mental illness predisposes to difficulties with healthcare access. Methods. Using a combined dataset of the 2016-2019 behavioral risk factor surveillance system, we included individuals who reported a chronic cardiovascular condition. Weighted multivariable logistic regression analyses were used to explore the association between domains of mental health and measures of healthcare access including delaying medical care, > 1 year since last routine checkup, lack of a primary care physician (PCP), and cost-related medication nonadherence (CRMNA). Results. Among 1,747, 397 participants, 27% had a chronic cardiovascular condition, 12% had clinical depression, and 12% had poor mental health. Those with poor mental health (OR 3.20 [3.08 – 3.33]) and clinical depression (OR 2.43 [2.35 – 2.52]) were more likely to report delays in medical care. Those with greater stress frequency (OR 8.47 [6.84 -10.49] stressed all of the time), lower levels of emotional support received (OR 3.07 [2.21 – 4.26] rarely get needed emotional support), and greater life dissatisfaction (6.66 [4.14 – 10.70] very dissatisfied) reported greater delays in medical care. Conclusions. Individuals with poor mental health have greater difficulty accessing medical care independent of socioeconomic variables.

Ecologies of Resilience for Australian High School Students from Refugee Backgrounds: Quantitative Study

Forced displacement of refugees, currently at record levels, leads to increased cultural diversity in many countries with benefits and challenges for individuals, communities, and societies. Refugees often face significant stressors both pre- and post-migration, and hence are at increased risk of poor mental health and wellbeing. Children and adolescents make up a significant proportion of refugees globally, and hence mental health supports for these young people are crucial. Current mental health research often uses pathologized approaches that focus on trauma, although there is growing literature highlighting the importance of a sense of belonging and the reduction in discrimination and social exclusion, emphasizing strengths and agency of individuals and communities. Resilience is often noted for its positive influence on mental health and wellbeing; however, research regarding how mechanisms of resilience function is still developing. This study investigated mental health and wellbeing of refugee-background Australian youth to better understand the role and function of resilience. Findings suggest that intersecting social ecologies, such as those within family, school, or community networks, contribute to development of identity and a sense of belonging for youth, which together form a resilient system that provides resources for wellbeing. Adaptations of school policy and practice can support positive mental health and wellbeing outcomes by contributing to and developing resilient environments, such as through building connections to family, improving positive recognition of cultural identity for individuals and across the whole school community, and actively working to minimize discrimination.

Emotion regulation-enhanced group treatment for gambling disorder: a non-randomized pilot trial

Background Despite the association of Gambling Disorder (GD) with poor mental health, treatment options generally lack components targeting emotional difficulties. This study investigated the feasibility and acceptability of adding strategies of emotion regulation to an eight-session weekly group treatment. Method This non-randomized pilot study recruited 21 treatment-seeking adults with GD, (mean age = 36.3, 19% females) from addiction care. In a mixed methods design, measures of within-group changes in self-reported symptoms of GD were complemented with thematic analysis of post-treatment interviews regarding the feasibility of the treatment. Results Within-group scores on the Gambling Symptoms Assessment Scale (G-SAS) showed a 47% decrease (β: -0.1599, 95% CI: − 0.2526 to − 0.0500) from pre-treatment to 12-month follow-up, with Hedges’ g = 1.07 (CI: 0.57–1.60). The number of GD-symptoms according to the Structured Clinical Interview for Gambling Disorder (SCI-GD) decreased from 7.0 (SD = 1.60) at pre-treatment to 2.1 (SD = 2.36) at 12-month follow-up. Participants completed an average of 6.3 sessions and rated the intervention high in satisfaction and acceptability. Feasibility interviews showed no noticeable negative effects or ethical issues. Furthermore, helpful components in the treatment were: increased awareness of emotional processes and strategies to deal with difficult emotions. Conclusions Adding emotion regulation strategies in the treatment of GD is feasible and acceptable and warrants further investigation in a controlled trial. Trial registration This study was registered with ClinicalTrials.gov (Identifier NCT03725735).

Linking Emotional Intelligence to Mental Health in Chinese High School Teachers: The Mediating Role of Perceived Organizational Justice

Compare with other professions, teachers are reported to have a higher risk of poor mental health. This study examined the relationships between emotional intelligence, perceived organizational justice, and mental health among Chinese high school teachers. Three hundred and eighty-one high school teachers, with their age range between 21 and 50 years, were administered the Emotional Intelligence Scale, Perceived Organizational Justice Scale, and Mental Health Scale. The result found that emotional intelligence and perceived organizational justice directly influence the mental health of high school teachers. In addition, perceived organizational justice mediated the association between emotional intelligence and mental health. Moreover, the present study analyzes the different role of subtypes of perceived organizational justice on the relationships between emotional intelligence and mental health, and the results showed that the mediating effects of perceived distributive justice and interactive justice on emotional intelligence and mental health are not significant, only the perceived procedural justice mediated the relationships between emotional intelligence and teachers’ mental health. The results are discussed in a conceptual context.