Examining mental health literacy and its correlates using the overclaiming technique

The present study examined mental health literacy among the British general public using the overclaiming technique, where participants rate for familiarity a series of items, some of which are foils resembling real items. In total, 344 Britons rated for familiarity 30 mental health disorders, of which six were foils, and also completed measures of the Big Five personality factors, self-rated intelligence, self-reported knowledge of psychiatry, psychiatric skepticism, and their personal details. Using signal detection analysis, responses on the overclaiming measure were used to compute an accuracy index (accuracy in distinguishing real mental health disorders from foils) and a response bias (the tendency to response affirmatively to both real disorders and foils). Preliminary analysis showed that there were no significant sex differences on either the accuracy or response bias indices. Further analyses showed that greater accuracy was significantly predicted by higher self-rated intelligence, greater knowledge of psychiatry, and lower psychiatric skepticism. These results are discussed in terms of the benefits of using the overclaiming technique and signal detection analysis in the study of mental health literacy.     

心理健康素养：概念、评估、干预与作用

心理健康素养是促进心理健康的重要途径。狭义概念指帮助人们认识、处理和预防心理疾病的相关知识和信念; 广义概念指综合运用心理健康知识、技能和态度, 保持和促进心理健康的能力。心理健康素养常采用情景案例问卷、单维或多维评估量表等进行评估, 可以通过社会运动、学校教育、自助式应用程序、心理健康急救培训等方式进行有效干预提高, 其中心理健康知识、心理疾病识别、情绪调节、减少病耻感、积极的求助态度等成分都有促进心理健康的作用。未来研究可以在建构评估指标体系、探索作用机制、扩展涵盖群体与内容、加强实证干预研究等方面深入开展。     

中国人心理健康素养干预效果的元分析

本研究遵循PRISMA-Protocol, 运用元分析的技术, 以心理健康素养的知识、污名态度和求助为结果变量, 考察干预效果及影响因素, 以期为更高效地提升心理健康素养提供参考。元分析共纳入38项研究。结果发现：干预对知识、污名态度和求助的即时效果量达到显著的中到大的效果(知识：g = 0.70, 污名态度：g = -0.52, 求助：g = 1.18)。亚组分析结果表明：心理健康素养的干预效果受地域、被干预者类型、干预中的互动与接触以及试验类型等多个变量的影响。后续研究应进一步探索心理健康素养的调节变量, 并结合中国文化, 制定针对不同干预对象的个性化干预方案, 以提升干预效益。     

中国国民心理健康素养的现状与特点

本研究以系统的全国抽样调查方式, 了解我国国民心理健康素养现状。结果显示, 我国成年公众的心理健康素养总体处于中偏低水平; 其发展水平在地域、人口学分布上比较均衡; 在结构上, 公众心理健康素养的发展表现出心理健康维护和促进的素养高于心理疾病应对的素养, 自助的素养高于助人的素养两个特点。调查还发现, 个体心理健康素养中, 知识观念部分个体差异较大, 态度和习惯部分个体差异较小; 在心理健康素养的社会性影响因素方面, 社会经济地位是所考察变量中效应最大的因素, 且其对素养的知识观念方面影响较大, 对素养的态度习惯方面影响较小。调查结果提示, 要充分认识心理健康素养提升任务的艰巨性; 在实践策略上, 宜以提升心理疾病应对的素养作为当前的工作重点和突破口。     

Have Broad‐Based Community and Professional Education Programs Influenced Mental Health Literacy and Treatment Seeking of those with Major Depression and Suicidal Ideation?

Mental health literacy is the knowledge and beliefs about mental disorders that aid in their recognition, management, or prevention; it is also a determinant of help seeking. As such, it is presumed to be important in community suicide prevention programs. In Australia there have been a number of government, professional, and charitable organizations as well as pharmaceutical company suicide prevention initiatives which have been designed to enhance public and professional knowledge about mental disorders, particularly depression. This naturalistic study conducted between 1998 and 2004 in a random and representative population sample examined the changes in mental health literacy and treatment seeking of those with major depression, both with and without suicidal ideation, and those who were neither depressed nor suicidal. Results indicated that there was marked improvement in mental health literacy for all three groups, although there was less change for those most in need of intervention (i.e., those with major depression and suicidal ideation). Furthermore, there were fewer changes in appropriate treatment seeking in those with major depression and suicidal ideation. These findings are consistent with literature reporting limited problem solving and decision making in those who are suicidal, and indicate that there are limits to broadbased community education programs. More focused suicide prevention initiatives are required, specifically for those who are depressed and suicidal.     

Hmong Mental Health Needs Assessment: A Community-Based Partnership in a Small Mid-Western Community

The overall goal of this assessment was to verify the mental health needs of Hmong living in a mid-west community in order clarify the format, content, and feasibility of providing mental health services for Hmong in the future. Using a Community-Based Participatory Research (CBPR) model, we held four focus groups with 36 men, women, adolescents and professionals, all of Hmong descent, as well as interviewed 28 individual medical, mental health, education, and social service providers in the Eau Claire community. Our Hmong sample was frequently unclear about what “mental” health meant, indicating a low level of mental health literacy. Results confirmed that there are significant mental health needs in this refugee and immigrant population. Participants described problems consistent with depression, post-traumatic stress disorder (PTSD), anxiety disorders, somatoform disorders, and severe social stress and acculturation difficulties in every generation. Elder people and male adolescents were described as the most disaffected and in need of immediate services. It will be critical to address mental health literacy before designing future interventions. Treatment suggestions were provided with the intention of removing barriers and incorporating culturally sensitive methodologies, while continuing to work closely with our local mental health providers and Hmong leadership.     

Mental health literacy of those with major depression and suicidal ideation: an impediment to help seeking

Mental health literacy is the knowledge and beliefs about mental disorders that aid their recognition, management, or prevention, and is an important determinant of help seeking. This has relevance in suicide prevention, particularly for those with major depression, the clinical condition most frequently associated with suicidal behavior. In this study of a random and representative community sample, a vignette depicting classical features of major depression was presented to subjects along with questions related to mental health literacy. The responses of those with major depression, as delineated by the Primary Care Evaluation of Mental Disorders instrument, both with and without suicidal ideation, were compared to those of a third group of respondents. The results demonstrated that despite increased professional contact by those with major depression and suicidal ideation, there were few differences among the three groups on either open-ended or direct questions related to mental health literacy. This indicates that increased professional contact in itself was not related to increased mental health literacy, and suggests that more specific psychoeducational programs are required.     

Communicating evidence‐based mental health care to service users

There is a significant gap between evidence‐based mental health care and patients, their family members and carers. To inform preventative mental health care among existing and potential service users, this review identifies effective methods for communicating evidence. A systematic review located 14 publications that met search criteria. Several methods can effect behavioural and/or intermediary change among existing and/or potential service users: namely, mass media; health warning labels; policy change; community interventions; school‐based programs; parent programs; and psychoeducation. Robust evidence, however, is lacking. Although effective approaches are likely to be founded on several factors, the review concludes with a discussion of a research agenda, and appropriate methodologies that could strengthen the knowledge base that guides the communication of evidence‐based mental health care to service users. This agenda has important implications for practitioners, policymakers, and researchers, which are also discussed.     

Major depression can be prevented

The 2009 Institute of Medicine report on prevention of mental, emotional, and behavioral disorders (National Research Council & Institute of Medicine, 2009b) presented evidence that major depression can be prevented. In this article, we highlight the implications of the report for public policy and research. Randomized controlled trials have shown that the incidence of major depressive episodes can be significantly reduced. Meta-analyses suggest that 22% to 38% of major depressive episodes could be prevented with currently available methods. We argue that if major depressive episodes can be prevented, the health care system should provide routine access to evidence-based depression prevention interventions, just as it provides inoculations for other common and debilitating health problems. At the same time, researchers should pursue the major directions advocated by the Institute of Medicine report to increase the enduring effectiveness of future prevention interventions. These directions include taking a developmental perspective, learning to identify groups at high risk, and testing evidence-based interventions that are likely to have the widest reach. Scientific evidence has shown that clinical depression can be averted. Our societies must take action to reduce clinical depression to the lowest possible level. This article is one of three in a special section (see also Biglan, Flay, Embry, & Sandler, 2012; Yoshikawa, Aber, & Beardslee, 2012) representing an elaboration on a theme for prevention science developed by the 2009 report of the National Research Council and Institute of Medicine.     

Development of the Uni Virtual Clinic: an online programme for improving the mental health of university students

ABSTRACT

There is growing recognition of the importance of addressing the mental health needs of young people attending university. Anonymous, scalable, and evidence-based online interventions can help to reduce burden on university services and increase access to care for marginalised or disconnected students. This paper reports the participatory design methods used to develop the Uni Virtual Clinic (UVC), a comprehensive online programme that was designed to prevent and treat mental health problems and related issues in university students. Data evaluating the participatory design process is also presented. The potential for the implementation of the UVC within university-based counselling services is strong, and has potential to reduce the prevalence of mental disorders in a high-risk group of young people.     

Prejudice,social stress,and mental health in lesbian,gay, and bisexual populations: conceptual issues and research evidence

In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.     

Integrated treatment of co-occurring mental illness and addiction: clinical intervention, program, and system perspectives

Individuals with mental illness and addiction comprise at least half of the patients in most mental health treatment systems. This combination results in increased risk for frequent psychiatric relapses, poor medication compliance, violence, suicide, legal problems, and high utilization of the emergency room or inpatient services. Traditional mental health and addiction treatments have not adequately addressed these co-occurring disorders due to clinical interventions, programs, and system flaws that have not addressed the individual's needs. Integrated treatment requires both an understanding of mental illness and addiction and the means to integrate and modify the traditional treatment approaches in both the mental health and addiction treatment fields. There is strong evidence to support the efficacy and effectiveness of integrated treatment in this population. All mental health clinicians should become experienced and skilled in the core psychotherapy approaches to treating substance use disorders, including motivational enhancement therapy, relapse prevention (cognitive-behavioral therapy), and 12-step facilitation. In addition, integrated treatment includes integrating medications for both addiction and mental illness with the behavioral therapies and other psychosocial interventions. This article reviews the clinical intervention, program, and system components of integrated treatment and specific clinical interventions for this population.     

A qualitative evaluation of a mental health literacy intervention for parents delivered through community sport clubs

Intervention studies have rarely targeted parent mental health literacy despite its importance for adolescent mental health. This qualitative study evaluated the experiences of parents (n = 352) who participated in the Ahead of the Game mental health literacy workshop delivered through community sport clubs. Moreover, the study aimed to investigate the relevance, retention and use of intervention content by parents, assess the acceptability and feasibility of delivering mental health education through community sport clubs, and identify strategies for increased engagement. In total, 17 parents (13 mothers, four fathers) participated in semi-structured interviews up to one month after the workshop. Reflexive thematic analysis revealed that parents perceived mental health education as important and valuable, and believed the community sport club was an appropriate setting to discuss adolescent mental health. Parents reported increased awareness and knowledge of mental health disorders and help-seeking options, and increased confidence and preparedness to communicate and assist someone experiencing a mental health issue. The workshop stimulated conversation about mental health between parents and their children, and between parents within and outside the sport club community. Parents used information and resources provided in the workshop to help those in their networks and reflected back on the workshop when noticing changes in their adolescent’s behavior. Potential additions to the workshop (as suggested by parents) included increased discussion among parents as well as opportunities for further information sessions or tailored online material. Future research might look to engage more fathers, actively encourage parents to aid in the recruitment of others, and investigate long-term adolescent mental health outcomes.     

Psychiatric diagnoses of infants and toddlers referred to a community mental health system

There has been increased interest in improving mental health assessment and treatment of young children. However, there are limited data regarding the prevalence of psychiatric disorders among infants and toddlers. The recent development of measures and classification systems that are specific to this age group has enabled researchers to begin to investigate the social, emotional, and behavioral problems of young children. The present study reviews the major research that has been conducted in this area and examines the prevalence of psychiatric diagnoses of infants and toddlers referred to a public community mental health system. The current investigation also compares the frequency of diagnoses of children who have been evaluated based on the Diagnostic and Statistical Manual (4th edition) with another group of children who were diagnosed based on the Diagnostic Classification: 0-3 system. Although there were some differences between the two samples and classification systems, analysis indicated that parent-child relational problems, adjustment difficulties, regulatory problems, and developmental disorders are some of the more common diagnoses prevalent among young children referred for outpatient treatment. As diagnostic measures and classification systems continue to improve, clinicians will have a better understanding of the mental health problems and treatment needs of young children.     

Toward a Culturally Responsive Model of Mental Health Literacy: Facilitating Help‐Seeking Among East Asian Immigrants to North America

Studies have consistently found that East Asian immigrants in North America are less likely to use mental health services even when they experience levels of distress comparable to Euro‐Americans. Although cultural factors that may prevent East Asian immigrants from seeking mental health care have been identified, few studies have explored ways to foster appropriate help‐seeking and use of mental health services. Recent work on mental health literacy provides a potential framework for strategies to increase appropriate help‐seeking and use of services. This paper reviews the literature on help‐seeking for mental health problems among East Asian immigrants living in Western countries to critically assess the relevance of the mental health literacy approach as a framework for interventions to improve appropriate use of services. Modifications needed to develop a culturally responsive framework for mental health literacy are identified.     

Counting the stitches that count: Preventive intervention promises and public health

Continued public support for the design, implementation, and dissemination of preventive interventions depends on achievement of four major criteria: (a) Reductions in the incidence or prevalence rates of diagnosable emotional and behavioral disorders, (b) reductions in the need for mental health services through effective primary and secondary interventions, (c) enhancement of the effectiveness of obtained services as screening and early detection efforts are implemented, and (d) reductions in the nation's health care costs associated with emotional and behavioral dysfunctions. Strategies including risk reduction, risk avoidance, health promotion, empowerment, and resource development are preventive insofar as they contribute to achievement of the aforementioned outcomes.     

Couple therapy,family therapy and systemic interventions for adult‐focused problems: the current evidence base

This paper updates previous similar reviews published in JFT in 2000, 2009 and 2014. It presents evidence from meta‐analyses, systematic literature reviews and controlled trials for the effectiveness of couple therapy, family therapy, and systemic interventions for adults with a range or relationship and mental health problems. The evidence supports the effectiveness of systemic interventions, either alone or as part of multimodal programmes, for relationship distress, psychosexual problems, intimate partner violence, anxiety disorders, mood disorders, alcohol problems, psychosis and adjustment to chronic physical illness.     

A school-based mental health consultation curriculum

Many articles have been written about mental health consultation and school-based consultation, but little has been written about how consultants are to be prepared for their role. Other authors focus on the theory or process aspects of the approach but do not take the next step in specifying what neophite consultants need to learn. The following paper presents one position on consultation that integrates a theoretical model, a process model, and a curriculum for training school-based mental health consultants. Elements of the proposed curriculum include: ethics, relationship building, maintaining rapport, defining problems, gathering data on what has already transpired, gathering data on the client, sharing information, generating interventions, supporting interventions, and following up and disengaging.     

Positive mental imagery and mental health amongst university students in Pakistan

Mental health problems amongst university students pose a major public health challenge, and this is particularly the case in Pakistan. Alongside broader societal and cultural pressures, cognitive factors likely also play a role in the development of and resilience to mental health problems and may provide a feasible target for interventions. The current study built on previous research in primarily European samples investigating the relationship between one cognitive factor, positive future-oriented mental imagery, and mental health, extending this to a sample of university students in Pakistan (N = 1838). In a cross-sectional design, higher vividness of positive future-oriented mental imagery was associated with lower levels of depressive symptoms and higher levels of positive mental health amongst participants completing questionnaire measures on paper (N = 1430) or online (N = 408). In the sample completing the measures on paper, these relationships remained statistically significant even when controlling for socio-demographic and mental health-related variables. The results provide a foundation for further investigating positive mental imagery as a potential mechanism of mental health and intervention target amongst university students in Pakistan.     

Adult Asperger Syndrome and the Utility of Cognitive-Behavioral Therapy

Asperger syndrome (AS) is a developmental disorder that was first recognized in the United States in 1994 with the publication of DSM-IV (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 1994). As a relatively new concept to the United States, both within the professional community and public awareness, the diagnosis has most often applied to children, but there is a large cohort of affected adults who have never been diagnosed or properly treated. Many of these individuals are now seeking treatment for the symptoms of AS and/or comorbid mental health problems (e.g., mood and anxiety disorders). Clinicians are in need of practical and evidence-based interventions to address the problems presented by this growing patient population, but there are few such resources available. This article will present a framework for conceptualizing the mental health needs of adults with AS, using the evidence-based approaches found in the cognitive-behavior therapy (CBT) literature to inform treatment.