Commissioning for equity. Equal access, equal care? Can London deliver the race equality action plan for mental health? Executive summary

This report has been produced by the London Health Observatory (LHO) for the London Development Centre to provide a London baseline for monitoring specific actions in the Delivering Race Equality (DRE) action plan. The report summarises the findings of an analysis of the information collected from all of London's nine Mental Health NHS providers, and 22 independent providers for the national census of inpatients in mental health hospitals and facilities in England and Wales on 31 March 2005 .

Promoting positive mental health at work: a guide for employers

This booklet is one in a series aimed at promoting health in the workplace. It outlines to employers the importance of employees' mental health, good practice to support positive mental health at work, the legal requirements with regard to working environments and mental health, and key steps for action.�

Risk factors associated with mental health issues in adolescents: a integrative review

Objective: To identify the risk factors associated with mental health issues in adolescents. Method: An integrative review was conducted in four databases with publications from 2007 to 2013. The terms Adolescent and Mental Health were used to search adequate articles as DeCs/MeSH bases. Results: Publications were found in different journals in different fields of knowledge and the quantitative research was the most frequent. The mental health issues were categorized as individual factors; drug related factors, school factors, family factors, social factors and STDs/Aids related factors. The most addressed category was individual factors, with 23 publications. Conclusion: The integrative review allowed to point important questions to be addressed in preventive actions by the health professional, including the nurse, to create a space that works with risk conditioning factors in adolescents for mental health aggravation.


Mindfulness Practices and Children’s Emotional and Mental Well-Being: Activities to Build and Strengthen Everyday Resilience Adapted for Primary School Teachers

This project reviewed current research on mental health and Canadian children, and then examined the practice of mindfulness as a means of supporting well-being and circumventing the potential detrimental effects of mental health problems. By contextualizing these findings within the recently released educational vision of the Ontario Ministry of Education (2014), which identifies well-being as one of the core principles of education in Ontario, this project investigated how mindfulness-based practices can be brought into the primary grade classroom. The ultimate purpose of this project is the development of a handbook for Ontario teachers of students in grades 1 to 3 (ages 6 to 8). This resource was developed from a comprehensive literature review and provides educators with easy-to-follow activities to use in the classroom to encourage the development of resilience and emotional well-being through mindfulness. The handbook also includes additional information and resources regarding both mindfulness and mental health that may be helpful to teachers, students, and parents.

« Good night, sleep tight, don’t let the bed bugs bite» : exploring the mental health fallout of urban bed bug infestation in Montréal, Québec

Problématique : La littérature scientifique ne contient actuellement aucune étude épidémiologique portant sur la relation entre l’exposition à une infestation de punaises de lit (Cimex lectularis) et la santé mentale. L’objectif de cette étude est d’explorer la relation entre le statut d’exposition aux punaises de lit et des mesures de dépression, anxiété et perturbation du sommeil. Méthodes : Cette recherche est une étude transversale basée sur une analyse secondaire des données provenant de N=91 adultes locataires de logements insalubres qui ont répondu à un questionnaire de santé au moment d’interventions médico-environnementales menées par la direction de santé publique de Montréal entre janvier et juin 2010. Le questionnaire de santé inclut le « Questionnaire de santé du patient (QSP-9) », qui est un outil mesurant les symptômes associés à la dépression, l’outil de dépistage d’anxiété généralisée (GAD-7) et les items 1-18 de l’indice de la qualité du sommeil de Pittsburgh (PSQI). L’association entre une exposition autorapportée à une infestation de punaises de lit et le niveau de perturbation du sommeil selon la sous-échelle correspondante du PSQI, les symptômes dépressifs selon le QSP-9 et les symptômes anxieux selon le GAD-7, a été évaluée en utilisant une analyse de régression linéaire multivariée. Des données descriptives relatives aux troubles de sommeil autodéclarés et à des comportements reliés à un isolement social, dus à une exposition aux punaises de lit, sont aussi présentées. Résultats : L’échantillon comprenait 38 hommes et 53 femmes. Parmi les 91 participants, 49 adultes ont signalé une exposition aux punaises de lit et de ce nombre, 53,06% (26/49) ont déclaré des troubles de sommeil et 46,94% (23/49) des comportements d’isolement social, en raison de l’exposition. Les adultes exposés à des punaises de lit ont obtenu des résultats significativement plus élevés sur le QSP-9 (p=0,025), le GAD-7 (p=0,026) et sur la sous-échelle mesurant la perturbation du sommeil (p=0,003) comparativement à ceux qui n’étaient pas exposés. Conclusions : Cette première étude exploratoire met en évidence une association significative entre l’état d’exposition aux punaises de lit et des troubles de sommeil, ainsi que des symptômes anxieux et dépressifs, indiquant que ceux qui sont exposés aux punaises de lit représentent un groupe possiblement à risque de développer des problèmes de santé mentale. Ces résultats viennent en appui aux initiatives des décideurs pour organiser des efforts coordonnés d’éradication au niveau des villes et des provinces.

An approach from positive psychology to mental health of university freshmen in Concepcion (Chile)

University is a demanding and changing environment for first year students, what could affect their mental health and their academic performance. Due these conditions, this research wanted to analyze mental health in freshmen of a private university in, Concepción, Chile, oriented by an approach from positive psychology. 554 were selected and surveyed to evaluate three variables: self-Esteem, satisfaction with life and optimism. furthermore, socio-demographic characteristics and mental health problems were assessed. Outcomes show that students evaluate positively themselves, their life and future. In addition, these variables are related with age, type of former school, religion, depression and anxiety. Systematic relationship found between these three strengths of mental health and their inverse relationship with the most prevalent problems in this area highlight the relevance that these three variables could have to define preventive and remedial strategies to promote student welfare.

Influence of psychosocial risk factors on the trajectory of mental health problems from childhood to adolescence: a longitudinal study

Background Longitudinal epidemiological studies involving child/adolescent mental health problems are scarce in developing countries, particularly in regions characterized by adverse living conditions. We examined the influence of psychosocial factors on the trajectory of child/adolescent mental health problems (CAMHP) over time. Methods A population-based sample of 6- to 13-year-olds with CAMHP was followed-up from 2002–2003 (Time 1/T1) to 2007–2008 (Time 2/T2), with 86 out of 124 eligible children/adolescents at T1 being reassessed at T2 (sample loss: 30.6%). Outcome: CAMHP at T2 according to the Child Behavior Checklist/CBCL’s total problem scale. Psychosocial factors: T1 variables (child/adolescent’s age, family socioeconomic status); trajectory of variables from T1 to T2 (child/adolescent exposure to severe physical punishment, mother exposure to severe physical marital violence, maternal anxiety/depression); and T2 variables (maternal education, child/adolescent’s social support and pro-social activities). Results Multivariate analysis identified two risk factors for child/adolescent MHP at T2: aggravation of child/adolescent physical punishment and aggravation of maternal anxiety/depression. Conclusions The current study shows the importance of considering child/adolescent physical punishment and maternal anxiety/depression in intervention models and mental health care policies.

Mental Health Services for Nursing Home Residents: What Will It Cost?

The Nursing Home Reform Act of 1987 requires nursing homes to provide basic mental health services for all residents and to give active mental health treatment, a set of specialized mental health services, to those residents who are admitted with a serious mental illness. This article examines the potential size of the nursing home population who will require mental health services, its demographic composition, and the facilities in which these individuals reside using the Institutional Population Component of the National Medical Expenditure Survey. Estimates of the potential costs of providing monthly psychotherapy and pharmacological management to this population in nursing homes indicate that the mandate will have significant financial effects on nursing facilities. Conclusions about how the requirements for maintaining the mental and psychosocial well-being of nursing home residents may affect the future of nursing home care and mental health care are considered.

No sports – no mental health? Analysis of longitudinal effects in SHP data.

Results from the Zurich study have shown lasting associations between sport practice and mental health. The effects are pronounced in people with pre-exising mental health problems. This analysis aims to replicate these results with the large Swiss Household Panel data set and to provide more differentiated results. The analysis covered the interviews 1999-2003 and included 3891 stayers, i.e., participants who were interviewed in all years. The outcome variables are depression / blues / anxiety, weakness / weariness, sleeping problems, energy / optimism. Confounding variables include sex, age, education level, citizenship. The analyses were carried out with mixed models (depression, optimism) and GEE models (weakness, sleep). About 60% of the SHP participants practise weekly or daily an individual or a team sport. A similar proportion enjoys a frequent physical activity (for half an hour minimum) which makes oneself slightly breathless. There are slight age-specific differences but also noteworthy regional differences. Practice of sport is clearly interrelated with self-reported depressive symptoms, optimism and weakness. This applies even though some relevant confounders – sex, educational level and citizenship – were introduced into the model. However, no relevant interaction effects with time could be shown. Moreover, direct interrelations commonly led to better fits than models with lagged variables, thus indicating that delayed effects of sport practice on the self-reported psychological complaints are less important. Model variants resulted for specific subgroups, for example, participants with a high vs. low initial activity level. Lack of sport practice is an interesting marker for serious psychological symptoms and mental disorders. The background of this association may differ in different subgroups, and should stimulate further investigations in this area.

Factors Related to Mental Health of Native Americans in Eastern Tribes

This paper is part of a five-year research project funded by the National Institute on Disability and Rehabilitation Research (NIDRR) that addresses the health, disability and service needs of Native Americans in eastern tribes. The Participatory Action Research model with a community-based approach was used to facilitate collaboration among the participating tribes. Native American research technicians conducted individual interviews with members of their tribes. Demographics, prevalence of disabilities, and various factors associated with health and mental health are presented. Of the 858 tribal members who responded to survey questions, the third most prominent health problem reported was mental illness.

Air Force Web Preventive Health Assessment (AF WEBPHA) mental health screening effectiveness

The U.S. Air Force assesses Active Duty Air Force (ADAF) health annually using the Air Force Web-based Preventative Health Assessment (AF WebPHA). The assessment is based on a self-administered survey used to determine the overall Air Force health and readiness, as well as, the individual health of each airman. Individual survey responses as well as groups of responses generate further computer generated assessment and result in a classification of 'Critical', 'Priority', or 'Routine', depending on the need and urgency for further evaluation by a health care provider. The importance of the 'Priority' and 'Critical' classifications is to provide timely intervention to prevent or limit unfavorable outcomes that may threaten an airman. Though the USAF has been transitioning from a paper form to the online WebPHA survey for the last three years it was not made mandatory for all airmen until 2009. The survey covers many health aspects including family history, tobacco use, exercise, alcohol use, and mental health. ^ Military stressors such as deployment, change of station, and the trauma of war can aggravate and intensify the common baseline worries experienced by the general population and place airmen at additional risks for mental health concerns and illness. This study assesses the effectiveness of the AF WebPHA mental health screening questions in predicting a mental health disorder diagnosis according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes generated by physicians or their surrogates. In order to assess the sensitivity, specificity, and positive predictive value of the AF WebPHA as a screening tool for mental health, survey results were compared to ascertain if they generated any mental health disorder related diagnosis for the period from January 1, 2009 to March 31, 2010. ^ Statistical analysis of the AF WebPHA mental health responses when compared with matching ICD-9-CM codes found that the sensitivity for 'Critical' or 'Priority' responses was only 3.4% and that it would correctly predict those who had the selected mental health diagnosis 9% of the time.^

PREPAID MENTAL HEALTH SERVICES: A NATIONAL PERSPECTIVE

The purpose of this 1982 national survey of all operational prepaid health plans, or PHPs (including health maintenance organizations), was to provide information on the current coverage of PHP mental health and substance abuse services, benefits and service provision, general and mental health organization characteristics, mental health service costs, and physical and mental health service utilization.^ Two survey instruments were designed, pretested and distributed to all operational PHPs throughout the United States. A total of 237 PHPs were surveyed, of which 205 (86.50 percent) completed and returned both questionnaires.^ One result of the rapid growth in the PHP field over the past ten years has been the expansion in both the number of PHPs as well as the organizational characteristics of these PHPs. However, little attention in the research literature has been given to the application of empirical results to the PHP arrangements. This project has attempted to contribute to current knowledge regarding prepaid mental health services from a national perspective, and explore, on a preliminary descriptive basis, the variety of potential service delivery arrangements for physical and mental health services (total services) and for mental health services.^ The study emphasized that PHPs must continue to monitor the costs and utilization of mental health services, particularly in light of the apparent elimination of data collection and statistical summary responsibilities within the federal government regarding PHP activities as well as the proposed legislation to eliminate mandated mental health and substance abuse services from basic health plan benefits for federally qualified PHPs. ^

Work instability versus mental health

This contribution is part of a research on guidance and employment in La Plata , province of Buenos Aires (Argentina) undertaken jointly by the Chairs of Preventive Psychology and Vocational Guidance, both pertaining to the course of studies for Psychology at the National University of La Plata. This research is based on four axes, namely, education-work-social policies-health. This paper shall focus around the health axis, which is not provided with placement and employment services. Some unsystematical guidance experiences from the services of Adolescence and Mental Health are currently under way in the area. Research points to the existence of new demands of psychological treatment from a population ("the new poor") afraid of losing their jobs -or even unemployed- who was not in the habit of going to the public hospital. In the casuistry explored here, people afraid of losing their jobs present more psychosomatic complexities. Local population is also analysed and the said analysis is linked with several national and international research projects.

Work instability versus mental health

This contribution is part of a research on guidance and employment in La Plata , province of Buenos Aires (Argentina) undertaken jointly by the Chairs of Preventive Psychology and Vocational Guidance, both pertaining to the course of studies for Psychology at the National University of La Plata. This research is based on four axes, namely, education-work-social policies-health. This paper shall focus around the health axis, which is not provided with placement and employment services. Some unsystematical guidance experiences from the services of Adolescence and Mental Health are currently under way in the area. Research points to the existence of new demands of psychological treatment from a population ("the new poor") afraid of losing their jobs -or even unemployed- who was not in the habit of going to the public hospital. In the casuistry explored here, people afraid of losing their jobs present more psychosomatic complexities. Local population is also analysed and the said analysis is linked with several national and international research projects.

Work instability versus mental health

This contribution is part of a research on guidance and employment in La Plata , province of Buenos Aires (Argentina) undertaken jointly by the Chairs of Preventive Psychology and Vocational Guidance, both pertaining to the course of studies for Psychology at the National University of La Plata. This research is based on four axes, namely, education-work-social policies-health. This paper shall focus around the health axis, which is not provided with placement and employment services. Some unsystematical guidance experiences from the services of Adolescence and Mental Health are currently under way in the area. Research points to the existence of new demands of psychological treatment from a population ("the new poor") afraid of losing their jobs -or even unemployed- who was not in the habit of going to the public hospital. In the casuistry explored here, people afraid of losing their jobs present more psychosomatic complexities. Local population is also analysed and the said analysis is linked with several national and international research projects.