Search results for: risk factors for mental health

Authors: Michelle Nighswander

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Suicide can be a tragic response to mental illness. It is difficult for people to disclose or discuss suicidal impulses. The stigma surrounding mental health can create a reluctance to seek help for mental illness. Patients may feel pressure to exhibit a socially desirable demeanor rather than reveal these issues, especially if they sense their healthcare provider is pressed for time or does not have an extensive history with their provider. Overcoming these barriers can be challenging. Although there are several validated depression and suicide risk instruments, varying processes used to administer these tools may impact the truthfulness of the responses. A literature review was conducted to find evidence of the impact of the environment on the accuracy of depression screening. Many investigations do not describe the environment and fewer studies use a comparison design. However, three studies demonstrated that computerized self-reporting might be more likely to elicit truthful and accurate responses due to increased privacy when responding compared to a face-to-face interview. These studies showed patients reported positive reactions to computerized screening for other stigmatizing health conditions such as alcohol use during pregnancy. Computerized self-screening for depression offers the possibility of more privacy and patient reflection, which could then send a targeted message of risk to the healthcare provider. This could potentially increase the accuracy while also increasing time efficiency for the clinic. Considering the persistent effects of mental health stigma, how these screening questions are posed can impact patients’ responses. This literature review analyzes trends in depression screening methodologies, the impact of setting on the results and how this may assist in overcoming one barrier caused by stigma.

Keywords: computerized self-report, depression, mental health stigma, suicide risk

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Authors: Charles Amoatey

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The issue of risk in the mining industry is a global phenomenon and the Ghanaian mining industry is not exempted. The main purpose of this study is to identify the critical risk factors affecting the mining industry. The study takes an integrated view of the mining industry by examining the contribution of various risk factors to mining project failure in Ghana. A questionnaire survey was conducted to solicit the critical risk factors from key mining practitioners. About 80 respondents from 11 mining firms participated in the survey. The study identified 22 risk factors contributing to mining project failure in Ghana. The five most critical risk factors based on both probability of occurrence and impact were: (1) unstable commodity prices, (2) inflation/exchange rate, (3) land degradation, (4) high cost of living and (5) government bureaucracy for obtaining licenses. Furthermore, the study found that risk assessment in the mining sector has a direct link with mining project sustainability. Mitigation measures for addressing the identified risk factors were discussed. The key findings emphasize the need for a comprehensive risk management culture in the entire mining industry.

Keywords: risk, assessment, mining, Ghana

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Authors: Jennis Delina Giles, Nimesha Liyanage, Damindi Senadheera, Dilan Randima, Kushnara Suriyawansa

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Mental health is essential during childhood, adolescence, and adulthood. Mental health issues can influence one's thoughts, disposition, and conduct. A record number of mental health problems are caused by a global pandemic. Prevention of mental disease is vital for both children and adults. We desired to develop a web application for those with mental health difficulties. This web application will provide group chat, discussion, a community feed, and counseling services. The community feed function provides information regarding scheduled conversation space meetings, and the counselor uploads uplifting thoughts and tales of patients who received proper care and overcame mental health issues. Community feed can filter content based on user preferences. The mental health system for adults and adolescents will be updated. The community feed delivers relevant and instructive postings, links, and images so that service recipients can benefit from other platform features and receive encouraging words to assist them in overcoming mental health difficulties.

Keywords: bio medical, mental helath care, empower youths & adults, counselling

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Authors: Phayong Thepaksorn

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The objective of this study was to assess whether living in proximity to a roofing fiber cement factory in southern Thailand was associated with physical, mental, social, and spiritual health domains measured in a self-reported health risk assessment (HRA) questionnaire. A cross-sectional study was conducted among community members divided into two groups: near population (living within 0-2 km of factory) and far population (living within 2-5 km of factory)(N=198). A greater proportion of those living far from the factory (65.34%) reported physical health problems than the near group (51.04 %)(p=0.032). This study has demonstrated that the near population group had higher proportion of participants with positive ratings on mental assessment (30.34%) and social health impacts (28.42%) than far population group (10.59% and 16.67 %, respectively) (p<0.001). The near population group (29.79%) had similar proportion of participants with positive ratings in spiritual health impacts compared with far population group (27.08%). Among females, but not males, this study demonstrated that a higher proportion of the near population had a positive summative score for the self-HRA, which included all four health domain, compared to the far population (p <0.001 for females; p=0.154 for males). In conclusion, this self-HRA of physical, mental, social, and spiritual health domains reflected the risk perceptions of populations living in the vicinity of the roofing fiber cement factory. This type of tool can bring attention to population concerns and complaints in the factory’s surrounding community. Our findings may contribute to future development of self-HRA for HIA development procedure in Thailand.

Keywords: cement dust, health impact assessment, risk assessment, walk-though survey

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Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

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Authors: Takeo Shibata, Arihito Endo, Chika Hiraga, Akemi Kunimatsu, Yoko Shimizu

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Introduction: A health promotion program, Yuzawa family health plan, was initiated in 2002. It has been held for fifteen years. Yuzawa Town is famous with hot springs and ski resorts. We evaluated the changes in mental status in elementary school children. Methods: questionnaires survey had been held every five years. 196 questionnaires were corrected (94 boys and 102 girls). Changes for their anxieties, loneliness, confiding, problem-solving, risk breaching, communications, happiness, and life satisfaction were evaluated by chi-square test. Results: The rate of loneliness and life dissatisfactions decreased. The rates of happiness, confiding in grandparents, and risk breaching, increased. Especially, happiness rates increased for boys, loneliness rate decreased for girls, confiding in grandparents and risk breaching rate increased for girls. Conclusion: Our health promotion programs could increase mental health status in elementary school children.

Keywords: health promotion, mental status, elementary school, loneliness, happiness

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Authors: Muhammad Rafiq, Lamae Zulfiqar, Nazish Idrees Chaudhary

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A growing number of research focuses on healthy and unhealthy eating behaviors and their impact on health. It was intended to study the Islamic point of view on eating behavior, its impact on mental health and preventative strategies in the light of the Quran and Sunnah. Different articles and Islamic sayings related to eating behaviors and mental health were reviewed in detail. It was also revealed scientifically and through Islamic point of view that appropriate quantity, quality and timings of food have positive effects on mental health. Therefore, a 3Rs model of eating behaviors has been proposed.

Keywords: food intake, mental health, quality of food, quantity of food

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Authors: Khadiga Kahwa, Aniza Ismail

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Depression, anxiety, and stress are associated with decreased role functioning, productivity, and quality of life. International students are more prone to psychological distress as they face many stressors while studying abroad. The objectives of the study were to determine the prevalence and associated factors of depression, anxiety, and stress among international students, their help-seeking behavior, and their awareness of the available on-campus mental support services. A cross-sectional study with a purposive sampling method was performed on 280 international students at Universiti Kebangsaan Malaysia (UKM) between the age of 18 and 35 years. The Depression Anxiety Stress Scale-21 (DASS-21) questionnaire was used anonymously to assess the mental health of students. Socio-demographic, help-seeking behavior, and awareness data were obtained. Independent sample t-test, one-way ANOVA test, and multiple linear regression were used to explore associated factors. The overall prevalence of depression, anxiety, and stress among international students were 58.9%, 71.8%, and 53.9%, respectively. Age was significantly associated with depression and anxiety. Ethnicity showed a significant association with depression and stress. No other factors were found to be significantly associated with psychological distress. Only 9.6% of the international students had sought help from on-campus mental support services. Students who were aware of the presence of such services were only 21.4% of the participants. In conclusion, this study addressed the gap in the literature on the mental health of international students and provided data that could be used in intervention programs to improve the mental health of the increasing number of international students in Malaysia.

Keywords: anxiety, depression, stress, help-seeking behavior, students

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Authors: Mona Nikidehaghani, Freda Hui

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In Australia, one-third of mental health carers provide 40 hours or more of unpaid care per week. These hidden workers contribute significantly to the Australian mental health workforce by providing unpaid services both direct and indirect to people in their care. However, carers are often neglected in the healthcare system because Government services focus on those with a mental health condition rather than those supporting them. The aim of this study is to evaluate the perceptions of mental health carers on the effectiveness of community services designed for carers and how these services could be improved. We collaborated with One Door Mental Health, a community organisation that supports mental health carers. Through semi-structured interviews with 27 mental health carers residing in the Illawarra region (NSW), we documented their daily challenges and evaluated outcomes of the current programs for carers. Our findings demonstrate that services such as education programs enable capacity building and improve the social life and mental health of carers. Drawing on the perceptions of mental health carers, this study maps pathways for making meaningful changes in the lives of carers and proposes an outcome framework to evaluate the impact of a community organisation on the lives of their clients. The framework prepared by this project would be replicable, allowing other community organisations to measure the outcomes and improve their services.

Keywords: capacity building, community development, community service, mental health carers

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Authors: Shu-Hsi Ho

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The problems of aging and number of widowed peers gradually rise in Taiwan. It is worth to concern the related issues for elderly after the death of a spouse. Hence, this study is to examine the impact of spousal death on the surviving spouse’s self-perceived health and mental health for the elderly in Taiwan. A cross section data design and ordered logistic regression models are applied to investigate whether marriage is associated significantly to self-perceived health and mental health for the widowed older Taiwanese. The results indicate that widowed marriage shows significant negative effects on self-perceived health and mental health regardless of widows or widowers. Among them, widows might be more likely to show worse mental health than widowers. The belief confirms that marriage provides effective sources to promote self-perceived health and mental health, particularly for females. In addition, since the social welfare system is not perfect in Taiwan, the findings also suggest that family and social support reveal strongly association with the self-perceived health and mental health for the widows and widowers elderly.

Keywords: logistic regression models, self-perceived health, widow, widower

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Authors: Tabitha D. Hussein, Arigu M. Sunday

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This paper is an attempt to gauge the conception and misconception of mental health in the Gwafan community, Jos North Plateau State, Nigeria (West Africa), to ascertain which side of the scale the pendulum swings. Mental health education and awareness are necessary for healthy community development. However, in a society such as ours in Nigeria (Africa) that is not knowledge-based, it is easy for people to embrace hearsay, speculations, superstition, and the supernatural. The objectives of this paper are two folds: first, to examine the level of awareness of the people on mental health, or the lack of it; second, to ascertain their access to mental health services and good practices. The methodology adopted is qualitative research, and the instrument used is T-test related. The findings include, first, the fact that a larger population has misconceptions about Mental Health. Second, this misconception is a result of a lack of basic knowledge of Mental Health. Based on the aforementioned, the paper recommends that there is a need for more Mental Health Education among the populace and access to Mental Health services and practices (Preventative and Curative). The paper concludes that in a society that is not knowledgebase, every attempt should be made to shift people’s mindset from superstitious knowledge to evidence-based knowledge, which can empower them to make informed decisions not only on mental Health but on associative Health issues that can aid their wellbeing, livelihood and sustainable development as a whole.

Keywords: conceptions, misconceptions, mental health, knowledge, superstition, service delivery

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Authors: K. Sekulová, M. Šimon

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The article demonstrates on a case study how it is possible to identify MSD risk. It is based on a dissertation risk identification model of occupational diseases formation in relation to the work activity that determines what risk can endanger workers who are exposed to the specific risk factors. It is evaluated based on statistical calculations. These risk factors are main cause of upper-extremities musculoskeletal disorders.

Keywords: case study, upper-extremity musculoskeletal disorders, ergonomics, risk identification

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Authors: Rabia Mushtaq, Uroosa Javaid

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It has been observed that health professionals are at higher danger of stress in light of the fact that being a specialist is physically and emotionally demanding. The study aimed to investigate the relationship between workplace stress and mental wellbeing among health professionals. Sample of 120 male and female health professionals belonging to two age groups, i.e., early adulthood and middle adulthood, was employed through purposive sampling technique. Job stress scale, mindful attention awareness scale, and Warwick Edinburgh mental wellbeing scales were used for the measurement of study variables. Results of the study indicated that job stress has a significant negative relationship with mental wellbeing among health professionals. The current study opened the door for more exploratory work on mindfulness among health professionals. Yielding outcomes helped in consolidating adapting procedures among workers to improve their mental wellbeing and lessen the job stress.

Keywords: health professionals, job stress, mental wellbeing, mindfulness

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Authors: Chia-Yi Wu, Jung-Chen Chang, Wen-Yu Hu, Ming-Been Lee

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In nearly all physical health conditions, suicide risk is increased compared to healthy people even after adjustment for age, gender, mental health, and substance use diagnoses. In order to highlight the importance of suicide risk assessment for the inpatients and early identification and engagement for inpatients’ mental health problems, a study was designed aiming at developing a comprehensive psychosomatic nursing engagement (PSNE) model with standardized operation procedures informing how nurses communicate, assess, and engage with the inpatients with emotional distress. The purpose of the study was to promote the gatekeeping role of clinical nurses in performing brief assessment and interventions to detect depression and anxiety symptoms among the inpatients, particularly in non-psychiatric wards. The study will be carried out in a 2000-bed university hospital in Northern Taiwan in 2019. We will select a ward for trial and develop feasible procedures and in-job training course for the nurses to offer mental health care, which will also be validated through professional consensus meeting. The significance of the study includes the following three points: (1) The study targets at an important but less-researched area of PSNE model in the cultural background of Taiwan, where hospital service is highly accessible, but mental health and suicide risk assessment are hardly provided by non-psychiatric healthcare personnel. (2) The issue of PSNE could be efficient and cost-effective in the identification of suicide risks at an early stage to prevent inpatient suicide or to reduce future suicide risk by early treatment of mental illnesses among the high-risk group of hospitalized patients who are more than three-times lethal to suicide. (3) Utilizing a brief tool with its established APP ('The Five-item Brief Symptom Rating Scale, BSRS-5'), we will invent the standardized procedure of PSNE and referral steps in collaboration with the medical teams across the study hospital. New technological tools nested within nursing assessment/intervention will concurrently be invented to facilitate better care quality. The major outcome measurements will include tools for early identification of common mental distress and suicide risks, i.e., the BSRS-5, revised BSRS-5, and the 9-item Concise Mental Health Checklist (CMHC-9). The main purpose of using the CMHC-9 in clinical suicide risk assessment is mainly to provide care and build-up therapeutic relationship with the client, so it will also be used to nursing training highlighting the skills of supportive care. Through early identification of the inpatients’ depressive symptoms or other mental health care needs such as insomnia, anxiety, or suicide risk, the majority of the nursing clinicians would be able to engage in critical interventions that alleviate the inpatients’ suffering from mental health problems, given a feasible nursing input.

Keywords: mental health care, clinical outcome improvement, clinical nurses, suicide prevention, psychosomatic nursing

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Authors: Ghorbanali Mohammadi

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Background: Due to the widespread outbreak of the COVID-19 virus, a large number of people become infected with the disease every day and go to hospitals. The acute condition of this disease has caused the death of many people. Since all the stages of treatment for these people happen in the hospitals, nurses are at the forefront of the fight against this virus. This causes nurses to suffer from physical and mental health problems. Methods: Physical and mental problems in nurses were assessed using the Depression, Anxiety and Stress Scale (DASS-42) of Lovibond (1995) and the Nordic Questionnaire. Results: 90 nurses from emergency, intensive care, and coronary care units were examined, and a total of 180 questionnaires were collected and evaluated. It was found that 37.78%, 47.78%, and 21.11% of nurses have symptoms of depression, anxiety, and stress, respectively. 40% of the nurses had physical problems. In total, 65.17% of them were involved in one or more mental or physical illnesses. Conclusions: Of the three units surveyed, the nurses in intensive care, emergency room, and coronary care units worked more than ten hours a day. Examining the interaction of physical and mental health problems indicated that physical problems can aggravate mental problems.

Keywords: depression anxiety and stress scale of Lovibond, nordic questionnaire, mental health of nurses, physical health problems in nurses

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Authors: Dina Farran, Mark Ashworth, Fiona Gaughran

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Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.

Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems

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Authors: Seung Hun Lee, Sang Yeoup Lee

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Objectives: To investigate associations between degrees of obesity using correlations between obesity indices and cardiometabolic risk factors. Methods: BMI, waist circumference (WC), fasting insulin, fasting glucose, lipids, and visceral adipose tissue (VAT) area using computed tomographic images were measured in 113 obese female without cardiovascular disease (CVD). Correlations between obesity indices and cardiometabolic risk factors were analyzed in obese subgroups defined using sequential obesity indices. Results: Mean BMI and WC were 29.6 kg/m2 and 92.8 cm. BMI showed significant correlations with all five cardiometabolic risk factors until the BMI cut-off point reached 27 kg/m2, but when it exceeded 30 kg/m2, correlations no longer existed. WC was significantly correlated with all five cardiometabolic risk factors up to a value of 85 cm, but when WC exceeded 90 cm, correlations no longer existed. Conclusions: Our data suggest that moderate weight-loss goals may not be enough to ameliorate cardiometabolic markers in severely obese patients. Therefore, individualized weight-loss goals should be recommended to such patients to improve health benefits.

Keywords: correlation, cardiovascular disease, risk factors, obesity

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Authors: Mithlesh Chourase

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Health of the transgender is as important as any other population sub-groups. However, little is known about the issues of mental health problems and health seeking behaviour of transgender in India. This paper examines the depression, stigma problem and suicidality (risk of suicide) among the transgender people in Mumbai city. The study used the primary survey data conducted in Mumbai city among the transgender community with a total sample of 120 among the transgender. Both qualitative and quantitative data was collected on demographic and socio-economic characteristic, general health and sexual health problems, mental health and health seeking behaviour among transgender. The quantitative results revealed that among the transgender, the prevalence of depression was very high. In this community 58.3% and 45.8 % of the transgender were suffered from depression and stigma problem respectively. On the other hand 42% and 48% of the transgender attempted suicide and experienced discrimination in the society. The qualitative results also revealed that the transgender were suffered from physical violence especially due to being a transgender, stressed due to being a transgender, experienced discrimination everywhere, experienced sexual health problems especially HIV, partner problem etc. As a result the prevalence of depression, self-harm attempt and suicidal attempt was common among this community.

Keywords: transgender, depression, Mumbai, mental health

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Authors: Mariana Mangas, Yaroslava Martins, Ana Charraz, Ana Matos Pires

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Introduction: Health literacy empowers people of knowledge, motivation and skills to access, understand, evaluate and mobilize information relating to health. Although the benefits of public knowledge of physical disease are widely accepted, knowledge about mental disorder has been compatibly neglected. Nowadays there is considerably evidence that literacy is of great importance for the promotion of health and prevention of mental illness. Objective: Disclosure the concept and importance of mental health literacy and introduce the literacy program of Psychiatry Service of Hospital José Joaquim Fernandes. Methodology: A search was conducted on PubMed, using keywords “literacy” and “mental health”. A description of mental health literacy interventions implemented on Psychiatry Service of Hospital José Joaquim Fernandes was performed, namely, psychoeducation programs for depression and bipolar disorder. Results and discussion: Health literacy enables patient to be able to actively participate in his treatment. The improving of mental health literacy can promote early identification of mental disorders, improve treatment results, increase the use of health services and allow the community to take action to achieve better mental health. Psychoeducation is very useful in improving the course of disease and in reducing the number of episodes and hospitalizations. Bipolar patients who received psychoeducation and pharmacotherapy have no relapses during the program and last year. Conclusion: Mental health literacy is not simply a matter of having knowledge, rather, it is knowledge linked to action which can benefit mental health.

Keywords: mental health, literacy, psychoeducation, knowledge, empowerment

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Authors: Kathryn Watson

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In 2020 North Carolina passed legislation mandating all educators be trained in identifying, referring, and supporting students showing signs of mental health issues, drug use, suicidal ideation, and sex trafficking. This study collected survey responses from 226 educators in North Carolina to better understand their perspectives on the legislation and their self-efficacy in supporting student mental health needs. Key findings of the study reveal that the mandated trainings increased educator awareness of student mental health, and higher awareness was linked to higher self-efficacy in supporting student mental health needs. Additionally, the results showed that educators who identify as Black had lower levels of self-efficacy in supporting student mental health. Additionally, rural educators were least likely to support the legislation in comparison to their urban and suburban counterparts. These findings can help inform policymakers in evaluating the policy and district decision-makers in selecting and implementing school-based mental health training.

Keywords: school-based mental health, education policy, student health, North Carolina, K-12 education

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Authors: Mulusew G. Jebena, David Lindstrom, Tefera Belachew, Craig Hadley, Carl Lachat, Patrick Kolsteren

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Background: The biological and psychosocial consequence of food insecurity on physical health and nutritional status has been reported. But, its effect on mental health during adolescence remains unexplored. Thus, the main aim of this analysis is to examine the mechanism by which food insecurity is linked to mental health among adolescents living in Jimma, Southwest Ethiopia. Methods: We used data from third round observation of Jimma Longitudinal Family and Youth Survey (JLFSY). A total of 1,521 adolescents included for the main analysis. Food insecurity was measured using 5-items scale and The Self Reporting Questionnaire (SRQ-20) was used to measure mental distress. Structural equation modeling analysis was done using maximum likelihood estimation method. Model diagnostics test was reported. All p values were two tailed and P value ≤ 0.05 was used to determine statistical significance. Results: The prevalence of mental distress was 20.8%, 95% CI: (18.8, 22.9). After adjusted for covariates, the final model depicts food insecurity was associated with adolescent mental distress (β=.324). This analysis showed 94.1% of the effect of food insecurity on mental distress is direct. By contrast, 5.9% of the food insecurity effect is mediated by physical health. In addition, Self-rated health (β=.356), socioeconomic status (β=-.078) parental educational (β= .170), living in urban (β= .193) and female headed household (β=.205) were associated with adolescent mental distress. Conclusions: This finding highlights the direct effect of food insecurity on adolescent mental distress. Therefore, any intervention aimed to improve mental distress of adolescents should consider strategies to improve access to sufficient, safe, and nutritious food. Beside this, prevention of underlying factors such as psychosomatic health illness and improving socio economic status is also very critical. Furthermore longitudinal relationship of the long term effect of food insecurity on mental health should be investigated.

Keywords: adolescent, Ethiopia, food insecurity, mental health

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Authors: Marko Živanović, Jovana Bjekić, Maša Vukčević Marković

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Professionals and volunteers involved in refugee protection and support are on a daily basis faced with people who have experienced numerous traumatic experiences and, as such, are subjected to secondary traumatization (ST). The aim of this study was to provide insight into risk factors for ST in helpers working with refugees in Serbia. A total of 175 participants working with refugees fulfilled: Secondary Traumatization Questionnaire, checklist of refugees’ traumatic experiences, Hopkins Symptoms Checklist (HSCL) assessing depression and anxiety symptoms, quality of life questionnaire (MANSA), HEXACO personality inventory, and COPE assessing coping mechanisms. In addition, participants provided information on work-related problems. Qualitative analysis of answers to the question about most difficult part of their job has shown that burnout-related issues are clustered around three recurrent topics that can be considered as the most prominent generators of stress, namely: ‘lack of organization and cooperation’, ‘not been able to do enough’, and ‘hard to take it and to process it’. Factor analysis (Maximum likelihood extraction, Promax rotation) have shown that ST comprises of two correlated factors (r = .533, p < .01), namely Psychological deficits and Intrusions. Results have shown that risk factor for ST could be find in three interrelated sources: 1) work-related problems; 2) personality-related risk factors and 3) clients’ traumatic experiences. Among personality related factors, it was shown that risk factor for Intrusions could be find in – high Emotionality (β = .221, p < .05), and Altruism (β = .322, p < .01), while low Extraversion (β = -.365, p < .01) represents risk factor for Psychological deficits. In addition, usage of maladaptive coping mechanisms –mental disengagement (r = .253, p < .01), behavioral disengagement (r = .274, p < .01), focusing on distress and venting of emotions (r = .220, p < .05), denial (r = .164, p < .05), and substance use (r = .232, p < .01) correlate with Psychological deficits while Intrusions corelate with Mental disengagement (r = .251, p < .01) and denial (r = .183, p < .05). Regarding clients’ traumatic experiences it was shown that both quantity of traumatic events in country of origin (for Deficits r = .226, p < .01; for Intrusions r = .174, p < .05) and in transit (for Deficits r = .288, p < .01), as well as certain content-related features of such experiences (especially experiences which are severely dislocated from ‘everyday reality’) are related to ST. In addition, Psychological deficits and Intrusions have shown to be accompanied by symptoms of depression (r = .760, p < .01; r = .552, p < .01) and anxiety (r = .740, p < .01; r = .447, p < .01) and overall lower life quality (r = -.454, p < .01; r = .256, p < .01). Results indicate that psychological vulnerability of persons who are working with traumatized individuals can be found in certain personality traits, and usage of maladaptive coping mechanisms, which disable one to deal with work-related issues, and to cope with quantity and quality of traumatic experiences they were faced with, affecting ones’ psychological well-being. Acknowledgement: This research was funded by IRC Serbia.

Keywords: mental health, refugees, secondary traumatization, traumatic experiences

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Authors: Maciej Bialorudzki, Zbigniew Izdebski, Alicja Kozakiewicz, Joanna Mazur

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The quality of sleep is extremely important for physical and mental health, especially among professional groups exposed to the suffering of the people they serve. The aim of the study is to assess sleep quality and various aspects of physical and mental health. A nationwide cross-sectional survey conducted in the first quarter of 2022 included 2227 healthcare professionals from 114 Polish hospitals and specialized outpatient clinics. The following distribution for each professional group was obtained (22% doctors; 52.6% nurses; 7.3% paramedics; 10.1% other medical professionals; 7.9% other non-medical professionals). The mean age of the respondents was 46.24 (SD=11.53). The Jenkins Sleep Scale with four items (JSS-4) was used to assess sleep quality, yielding a mean value of 5.35 (SD=5.20) in the study group and 13.7% of subjects with poor sleep quality using the cutoff point of the mean JSS-4 sum score as >11. More often, women than men reported poorer sleep quality (14,8% vs. 9,1% p=0,002). Respondents with poor sleep quality were more likely to report occupational burnout as measured by the BAT-12 (43.1% vs. 12.9% p<0.001) and high levels of stress as measured by the PSS-4 (72.5% vs. 27.5% p<0.001). In addition, those who declare experiencing a traumatic event compared to those who have not experienced it has an almost two times higher risk of poorer sleep quality (OR:1.958; 95% CI:1.509-2.542; p<0.001). In contrast, those with occupational burnout had more than five times the risk of those without occupational burnout (OR:5.092; 95% CI: 3.763-6.889; p<0.001). Sleep quality remains an important predictor of stress levels, job burnout, and quality of life assessment.

Keywords: quality of sleep, medical staff, mental health, physical health, occupational burnout, stress

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Authors: Silsila Sherzad, Hazrat Ali Khan, Tabasum Sherzad, Hazratullah, Sanaullah

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Objective: To study the prevalence of common Mental health disorders among forcibly displaced people and to compare with the common mental health disorders among host community members. Study design: Analytical Study. Place of study: Balochistan institute of psychiatry and behavioral sciences, Quetta, Baluchistan, Pakistan. Methodology: Data from the Outpatient department were analyzed to numerate both the host community and refugees. Out of 4120, 354 refugee patients were identified using their proof registration (POR) card and for 3776 of the host community using their computerized national identity card (CNIC), data was analyzed for the prevalence of mental health disorders among them. Results: This study states that Afghan Refugees presented to OPD services of Balochistan institute of psychiatry and behavioral sciences, 47% were diagnosed as Major depressive disorder with/without psychosis, 19% with Generalized anxiety disorder, 5% were diagnosed as Bipolar Affective disorder, 5% With schizophrenia, 4% as Post-traumatic stress disorder, 3% as migraine, 3% conversion disorder, 2% Obsessive-compulsive disorder, 1% somatoform disorder and 10% of them presented with other psychiatric disorders, while in host community 21% were diagnosed as Major depressive disorder with/without psychosis, 24% as Generalized anxiety disorder, 12% as somatoform disorder, 10% as Obsessive-compulsive disorder, 8% as migraine, 7% as conversion disorder, 4% as Bipolar Affective disorder, 3% as schizophrenia, 3% as Mental and behavioral disorder due to substance misuse and rest of 7% presented with other psychiatric disorders. Conclusion: The conclusion of this study states that mental health disorders are more common among refugees than in other populations. The result of this study shows that there is a big difference in the prevalence of mental health disorders among displaced people and the rest of the population. Some Mental health disorders are present in a higher percentage among displaced people rather than among the host community, while some other disorders are present in a lower percentage among displaced people rather than among the host community. This study also highlights that further studies are needed to determine risk and protective factors within the host community.

Keywords: forced displacement, mental health, Afghan refugees, depression

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Authors: Harjyot Khosa

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In India and south Asia, stigma and discrimination against transgender community remain disproportionately high. Lack of mental health care restricts effective treatment and care for both physical and mental health. Knowledge assessment of 80 counsellors across India reflected that only 28% counsellors knew about the transgender community. Whereas, only 6% of them felt, that transgender community require a specific mental health support, considering the stigma they face in day to day life. Lastly, 62% did agree that they require specific training to address unmet needs of transgender community. A robust counselling module was developed with focus on technical counselling skills and strategies, specific counselling issues, identity and sexuality, disclosure, hormone therapy and sex reassignment surgery. Mental health related support should be an integral part of government and non-government programs for the overall well-being of transgender community who face stigma and discrimination at every level. Needs based capacity building and technical assistance is required towards providing mental health support for transgender populations and their partners.

Keywords: identity and sexuality, mental health, stigma, transgender

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Authors: Winnie Kung, Xinhua Liu, Debbie Huang, Patricia Kim, Keon Kim, Xiaoran Wang, Lawrence Yang

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Considerable Asian Americans were exposed to the World Trade Center attack due to the proximity of the site to Chinatown and a sizeable number of South Asians working in the collapsed and damaged buildings nearby. Few studies focused on Asians in examining the disaster’s mental health impact, and even less longitudinal studies were reported beyond the first couple of years after the event. Based on the World Trade Center Health Registry, this study examined the trajectory of PTSD of individuals directly exposed to the attack from 2-3 to 5-6 years after the attack, comparing Asians against the non-Hispanic White group. Participants included 2,431 Asians and 31,455 Whites. Trajectories were delineated into the resilient, chronic, delayed-onset and remitted groups using PTSD checklist cut-off score at 44 at the 2 waves. Logistic regression analyses were conducted to compare the poorer trajectories against the resilient as a reference group, using predictors of baseline sociodemographic, exposure to the disaster, lower respiratory symptoms and previous depression/anxiety disorder diagnosis, and recruitment source as the control variable. Asians had significant lower socioeconomic status in terms of income, education and employment status compared to Whites. Over 3/4 of participants from both races were resilient, though slightly less for Asians than Whites (76.5% vs 79.8%). Asians had a higher proportion with chronic PTSD (8.6% vs 7.4%) and remission (5.9% vs 3.4%) than Whites. A considerable proportion of participants had delayed-onset in both races (9.1% Asians vs 9.4% Whites). The distribution of trajectories differed significantly by race (p<0.0001) with Asians faring poorer. For Asians, in the chronic vs resilient group, significant protective factors included age >65, annual household income >$50,000, and never married vs married/cohabiting; risk factors were direct disaster exposure, job loss due to 9/11, lost someone, and tangible loss; lower respiratory symptoms and previous mental disorder diagnoses. Similar protective and risk factors were noted for the delayed-onset group, except education being protective; and being an immigrant a risk. Between the 2 comparisons, the chronic group was more vulnerable than the delayed-onset as expected. It should also be noted that in both comparisons, Asians’ current employment status had no significant impact on their PTSD trajectory. Comparing between Asians against Whites, the direction of the relationships between the predictors and the PTSD trajectories were mostly the same, although more factors were significant for Whites than for Asians. A few factors showed significant racial difference: Higher risk for lower respiratory symptoms for Whites than Asians, higher risk for pre-9/11 mental disorder diagnosis for Asians than Whites, and immigrant a risk factor for the remitted vs resilient groups for Whites but not for Asians. Over 17% Asians still suffered from PTSD 5-6 years after the WTC attack signified its persistent impact which incurred substantial human, social and economic costs. The more disadvantaged socioeconomic status of Asians rendered them more vulnerable in their mental health trajectories relative to Whites. Together with their well-documented low tendency to seek mental health help, outreach effort to this population is needed to ensure follow-up treatment and prevention.

Keywords: PTSD, Asian Americans, World Trade Center Attack, racial differences

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Authors: Rebecca-Lee Kuhnert, Ron Rapee

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Up to 15% of Australian youth will experience an emotional disorder, yet relatively few get the help they need. Schools provide an ideal environment through which we can identify young people who are struggling and provide them with appropriate help. Universal mental health screening is a method by which all young people in school can be quickly assessed for emotional disorders, after which identified youth can be linked to appropriate health services. Despite the obvious logic of this process, universal mental health screening has received little scientific evaluation and even less application in Australian schools. This study will develop methods for Australian education systems to help identify young people (aged 9-17 years old) who are struggling with existing and emerging emotional disorders. Prior to testing, a series of focus groups will be run to get feedback and input from young people, parents, teachers, and mental health professionals. They will be asked about their thoughts on school-based screening methods and and how to best help students at risk of emotional distress. Schools (n=91) across New South Wales, Australia will be randomised to do either immediate screening (in May 2021) or delayed screening (in February 2022). Students in immediate screening schools will complete a long online mental health screener consisting of standard emotional health questionnaires. Ultimately, this large set of items will be reduced to a small number of items to form the final brief screener. Students who score in the “at-risk” range on any measure of emotional health problems will be identified to schools and offered pathways to relevant help according to the most accepted and approved processes identified by the focus groups. Nine months later, the same process will occur among delayed screening schools. At this same time, students in the immediate screening schools will complete screening for a second time. This will allow a direct comparison of the emotional health and help-seeking between youth whose schools had engaged in the screening and pathways to care process (immediate) and those whose schools had not engaged in the process (delayed). It is hypothesised that there will be a significant increase in students who receive help from mental health support services after screening, compared with baseline. It is also predicted that all students will show significantly less emotional distress after screening and access to pathways of care. This study will be an important contribution to Australian youth mental health prevention and early intervention by determining whether school screening leads to a greater number of young people with emotional disorders getting the help that they need and improving their mental health outcomes.

Keywords: children and young people, early intervention, mental health, mental health screening, prevention, school-based mental health

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Authors: Wondale Getinet Alemu, Lillian Mwanri, Clemence Due, Telake Azale, Anna Ziersch

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Background: Mental illness is one of the most severe, chronic, and disabling public health problems that affect patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023. Methods: A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total number of study participants who had a follow-up appointment during the data collection period (2400) by the total sample size of 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the QoL of people with mental illness. The domains and Health-Related Quality of Life (HRQoL) were identified. The indirect and direct effects of variables were calculated using structural equation modeling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance. Results: A total of 636 (99.7%) participants responded and completed the WHOQOL-BREF questionnaire. The mean score of overall HRQoL of people with mental illness in the outpatient clinic was (49.6 ± 10 Sd). The highest QoL was found in the physical health domain (50.67 ±9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41±10 Sd). Rural residents, drug nonadherence, suicidal ideation, not getting counseling, moderate or severe subjective severity, the family does not participate in patient care, and a family history of mental illness had an indirect negative effect on HRQoL. Alcohol use and psychological health domain had a direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having a history of mental illness in the family had both direct and indirect effects on QoL. Furthermore, sociodemographic factors (residence, educational status, marital status), social support-related factors (self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use,) and clinical factors (objective and subjective severity of illness, not getting counseling, suicidal ideation, number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL. Conclusions: In this study, the QoL of people with mental illness was poor, with the psychological health domain being the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors directly and indirectly, affect QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the scourge of mental health, including the development of policy and practice drivers that address the above-identified factors.

Keywords: quality of life, mental wellbeing, mental illness, mental disorder, Ethiopia

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Authors: James D. Beauchemin

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This study tested whether youth mental health care quality, operationalized as the extent to which youth and families experienced system-of-care principles in service interactions with providers, varied by level of youth need after adjusting for sociodemographic and treatment factors. The relationship of quality to clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1,124 caregivers of youths ages 5 to 20 within a statewide system-of-care, adjusted analyses indicated youths with the most intensive needs were significantly less likely to experience high-quality care (51% vs. 63%, p=0.016), with marked deficits on 6 of 9 items. Receipt of lower-quality care predicted less improvement in youth functioning. Despite considerable effort to develop systems-of-care for youths with the most severe mental health needs, these data suggest quality disparities remain for the most impaired youths. Policy and intervention development may be needed to improve the quality of care for this population.

Keywords: system-of-care, adherence, mental health, youth

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Authors: Natalie Frandsen

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Pursuing post-secondary education is a milestone for many Canadian youths. This transition involves many changes and opportunities for growth. However, this may also be a period where challenges arise. Perhaps not surprisingly, mental health challenges for post-secondary students are common. This poses difficulties for students and instructors. Common mental-health-related symptoms (e.g., low motivation, fatigue, inability to concentrate) can affect academic performance, and instructors may need to provide accommodations for these students without the necessary expertise. ‘Distance education’ has been growing and gaining momentum in Canada for three decades. As a consequence of the COVID-19 pandemic, post-secondary institutions have been required to deliver courses using ‘remote’ methods (i.e., various online delivery modalities). The learning challenges and subsequent academic performance issues experienced by students with mental-health-related disabilities studying online are not well understood. However, we can postulate potential factors drawing from learning theories, the relationship between mental-health-related symptoms and academic performance, and learning design. Identifying barriers and opportunities to academic performance is an essential step in ensuring that students with mental-health-related disabilities are able to achieve their academic goals. Completing post-secondary education provides graduates with more employment opportunities. It is imperative that our post-secondary institutions take a holistic view of learning by providing learning and mental health support while reducing structural barriers. Health-promoting universities and colleges infuse health into their daily operations and academic mandates. Acknowledged in this Charter is the notion that all sectors must take an active role in favour of health, social justice, and equity for all. Drawing from mental health promotion and Universal Design for Learning (UDL) frameworks, relevant adult learning concepts, and critical digital pedagogy, considerations for mental-health-promoting, online learning community development will be summarized. The education sector has the opportunity to create and foster equitable and mental health-promoting learning environments. This is of particular importance during a global pandemic when the mental health of students is being disproportionately impacted.

Keywords: academic performance, community, mental health promotion, online learning

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