Major depressive disorder (MDD) is a leading cause of disability worldwide.
To examine the: (a) 12-month prevalence of DSM-IV MDD; (b) proportion aware that they have a problem needing treatment and ...who want care; (c) proportion of the latter receiving treatment; and (d) proportion of such treatment meeting minimal standards.
Representative community household surveys from 21 countries as part of the World Health Organization World Mental Health Surveys.
Of 51 547 respondents, 4.6% met 12-month criteria for DSM-IV MDD and of these 56.7% reported needing treatment. Among those who recognised their need for treatment, most (71.1%) made at least one visit to a service provider. Among those who received treatment, only 41.0% received treatment that met minimal standards. This resulted in only 16.5% of all individuals with 12-month MDD receiving minimally adequate treatment.
Only a minority of participants with MDD received minimally adequate treatment: 1 in 5 people in high-income and 1 in 27 in low-/lower-middle-income countries. Scaling up care for MDD requires fundamental transformations in community education and outreach, supply of treatment and quality of services.
The rapid growth in the use of mobile phone applications (apps) provides the opportunity to increase access to evidence-based mental health care.
Our goal was to systematically review the research ...evidence supporting the efficacy of mental health apps for mobile devices (such as smartphones and tablets) for all ages.
A comprehensive literature search (2008-2013) in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, PsycINFO, PsycTESTS, Compendex, and Inspec was conducted. We included trials that examined the effects of mental health apps (for depression, anxiety, substance use, sleep disturbances, suicidal behavior, self-harm, psychotic disorders, eating disorders, stress, and gambling) delivered on mobile devices with a pre- to posttest design or compared with a control group. The control group could consist of wait list, treatment-as-usual, or another recognized treatment.
In total, 5464 abstracts were identified. Of those, 8 papers describing 5 apps targeting depression, anxiety, and substance abuse met the inclusion criteria. Four apps provided support from a mental health professional. Results showed significant reductions in depression, stress, and substance use. Within-group and between-group intention-to-treat effect sizes ranged from 0.29-2.28 and 0.01-0.48 at posttest and follow-up, respectively.
Mental health apps have the potential to be effective and may significantly improve treatment accessibility. However, the majority of apps that are currently available lack scientific evidence about their efficacy. The public needs to be educated on how to identify the few evidence-based mental health apps available in the public domain to date. Further rigorous research is required to develop and test evidence-based programs. Given the small number of studies and participants included in this review, the high risk of bias, and unknown efficacy of long-term follow-up, current findings should be interpreted with caution, pending replication. Two of the 5 evidence-based mental health apps are currently commercially available in app stores.
ABSTRACT
BACKGROUND
Schools play an important role as providers of mental health services for adolescents; however, information on the broader picture of utilization of mental health services in ...educational versus other settings is limited because of the lack of national‐level data.
METHODS
Using multinomial logistic regression models based on national‐level data from the 2012–2015 National Survey on Drug Use and Health, we explore the characteristics of adolescents who received mental health treatment in educational and other settings. In addition, the study examines the reasons for seeking services in various treatment settings.
RESULTS
The analysis finds that while the majority of adolescents who access mental health services receive care at noneducational settings, slightly more than one‐third of them received services only in an educational setting. Adolescents who had public insurance, were from low‐income households, and were from racial/ethnic minority groups were more likely to access services in an educational setting only. Common reasons for accessing services in educational settings included problems with schools, friends, and family members.
CONCLUSIONS
Despite increased access to treatment in outpatient settings in the last decade, schools play an important role in providing access to mental health services for disadvantaged populations.
Accessible summary
What is known on the subject?
During the COVID‐19 pandemic, there has been research considering the impact on medical healthcare professionals and the mental health needs of the ...general population. However, limited focus has been placed on mental health services or mental health staff providing care in the community and in hospitals. While nurses make up the largest section of the mental health workforce in the UK, the impact that this pandemic has had on their work has been largely ignored.
What the paper adds to existing knowledge?
This paper provides a unique insight into the experiences and impact that the COVID‐19 pandemic has had on mental health nurses across a range of community and inpatient settings to understand what has changed in their work and the care they can and do provide during this crisis. This includes exploring how services have changed, the move to remote working, the impact of the protective equipment crisis on nurses and the difficult working conditions facing those in inpatient settings where there is minimal guidance provided.
What are the implications for practice?
By understanding the impact the pandemic has had on mental health nursing care, we can understand the gaps in guidance that exist, the challenges being faced and the impact the crisis has had on care for mental health service users. By doing so, we can plan for the ongoing nature of this pandemic and the aftermath that the crisis may leave for our service users and workforce alike.
Introduction
While evidence has emerged concerning the impact of COVID‐19 on the general population and the challenges facing health services, much less is known regarding how the pandemic has directly affected the delivery of mental health nursing care.
Aim
This paper aimed to explore how COVID‐19 has affected the ability of mental health nurses to deliver care in community and inpatient mental health services in the UK.
Method
We investigated staff reports regarding the impact of the COVID‐19 pandemic on mental healthcare and mental health service users in the UK, using a mixed‐methods online survey. A total of 897 nurses across a range of inpatient and community settings participated.
Discussion
Key themes within the data explore the following: new ways of working; remote working; risks of infection/infection control challenges; and the impact on service users. Targeted guidelines are required to support mental health nurses providing care and support during a pandemic to people in severe mental distress, often in unsuitable environments.
Implications for Practice
Service developments need to occur alongside tailored guidance and support for staff welfare supported by clear leadership. These findings identify areas requiring attention and investment to prepare for future crises and the consequences of the pandemic.
The Italian Psychiatric Reform of 1978 is reviewed here in terms of national/regional mental health (MH) policies and with the help of epidemiological data. The reform law was essentially a framework ...one, and Italy's 21 regions were called to draft detailed organizational norms and to implement their systems. This explains a relevant interregional variability, despite several national MH plans. In a recent survey, compliance with national standards found homogeneous implementation on structural parameters but quite a variable one on functional parameters (continuity, coordination, accessibility, specialization). Epidemiological data show the impact of regional variability on the quality of treatment provided. Because of discrepancies among regional information systems, we analyze data from six Italian regions, where regional case registers have long been implemented, focusing on adult population prevalence and incidence rates and outpatient-inpatient care. Indicators of service use and some national MH documents are discussed in relation to the system's future prospects.
The current state of college student mental health is frequently labeled a "crisis," as the demand for services and severity of symptomatology have appeared to increase in recent decades. Nationally ...representative findings are presented from the Center for Collegiate Mental Health, a practice research network based in the United States, composed of more than 340 university and college counseling centers, in an effort to illuminate trends in symptom severity and patterns in treatment utilization for the campus treatment seeking population. Clinical data collected over 5 academic years (2010-2015) showed small but significantly increasing trends for self-reported distress in generalized anxiety, depression, social anxiety, family distress, and academic distress, with the largest effect sizes observed for generalized anxiety, depression, and social anxiety. On the other hand, a significantly decreasing trend was observed for substance use. No significant changes were observed for eating concerns and hostility. Utilization data over 6 years indicated a gradual yet steady increase in the number of students seeking services (beyond the rate expected with increasing institutional enrollment), as well as increases in the number of appointments scheduled and attended, with great variation between centers. Within the context of changing national trends, we conclude that it is advisable to consider the specific needs of local centers to best accommodate distinct student bodies.
Mental Health Disparities Among College Students of Color Lipson, Sarah Ketchen; Kern, Adam; Eisenberg, Daniel ...
Journal of adolescent health,
September 2018, 2018-Sep, 2018-09-00, 20180901, Letnik:
63, Številka:
3
Journal Article
Recenzirano
Understanding the mental health needs of students of color is a growing priority on college and university campuses nationwide. This study aims to capture the state of mental health among students of ...color, including the prevalence of mental health problems and treatment utilization.
The sample is comprised of 43,375 undergraduate and graduate students at 60 institutions that participated in the survey-based Healthy Minds Study from 2012 to 2015. These data include over 13,000 students of color; we look separately at African-American, Latinx, Asian/Asian American, and Arab/Arab American students. Data are analyzed at the individual level using bivariate and multivariate modeling to elucidate variations across race/ethnicity. We examine symptom prevalence (measured by validated screens such as the Patient Health Questionnaire-9 for depression), help-seeking behaviors, and related factors (including knowledge and stigma).
Across race/ethnicity, we find modest variation in symptom prevalence and larger variation in service utilization. Overall, treatment use is lower among students of color relative to white students, even when controlling for other variables in regression models. Asian/Asian American students have the lowest prevalence of treatment, at only 20% among those with apparent mental health conditions. Attitudes related to mental health treatment also vary significantly and help to explain the primary findings.
College students of color represent a disparities population based on greater levels of unmet mental health needs relative to white students. This paper takes an important step toward understanding these needs and points to implications for future research and practice.
Zones of social abandonment are emerging everywhere in Brazil’s big cities—places like Vita, where the unwanted, the mentally ill, the sick, and the homeless are left to die. This haunting, ...unforgettable story centers on a young woman named Catarina, increasingly paralyzed and said to be mad, living out her time at Vita. Anthropologist João Biehl leads a detective-like journey to know Catarina; to unravel the cryptic, poetic words that are part of the “dictionary” she is compiling; and to trace the complex network of family, medicine, state, and economy in which her abandonment and pathology took form. An instant classic, Vita has been widely acclaimed for its bold fieldwork, theoretical innovation, and literary force. Reflecting on how Catarina’s life story continues, this updated edition offers the reader a powerful new afterword and gripping new photographs following Biehl and Eskerod’s return to Vita. Anthropology at its finest, Vita is essential reading for anyone who is grappling with how to understand the conditions of life, thought, and ethics in the contemporary world.
ABSTRACT
BACKGROUND:
Stigmatizing attitudes toward mental illness and low mental health literacy have been identified as links to social adversity, and barriers to seeking and adhering to treatment ...among adolescents suffering from mental illness. Prior research has found that it is possible to improve these outcomes using school‐based mental health awareness interventions. The purpose of this study was to review empirical literature pertaining to universal mental health awareness interventions aiming to improve mental health related outcomes among students enrolled in US K‐12 schools, especially minorities vulnerable to health disparities.
METHODS:
PsycINFO, Cochrane Library, PUBMED, and reference lists of relevant articles were searched for K‐12 school‐based mental health awareness interventions in the United States. Universal studies that measured knowledge, attitudes, and/or help‐seeking pertinent to mental health were included.
RESULTS:
A total of 15 studies were selected to be part of the review. There were 7 pretest/post‐test case series, 5 nonrandomized experimental trial, 1 Solomon 4‐groups, and 2 randomized controlled trial (RCT) designs. Nine studies measuring knowledge, 8 studies measuring attitudes, and 4 studies measuring help‐seeking, indicated statistically significant improvements.
CONCLUSIONS:
Although results of all studies indicated some level of improvement, more research on implementation of universal school‐based mental health awareness programs is needed using RCT study designs, and long‐term follow‐up implementation.
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