Family-Involved Mental Health Care Among OEF/OIF Veterans With and Without PTSD Using VHA Administrative Records

Prior research indicates that veterans are interested in including family members in health care and that family-inclusive mental health treatment can improve treatment outcomes. Consequently, the Veterans Health Administration’s (VHA) directive requires providers to offer family-inclusive mental health services to veterans. However, the extent to which veterans engage in family-inclusive mental health services at the VHA remains unclear. Using data from a longitudinal registry of male and female veterans with and without posttraumatic stress disorder, we examined the extent to which veterans included family members in their mental health care and predictors of engagement in family-involved therapy visits using VHA administrative records over a 5-year time span. Of the 1,329 veterans who received mental health care during the study, 8.4% received a family therapy visit—the number of visits per veteran ranged from 1 to 34. Results from logistic regressions indicate that relative to White veterans, Black veterans were 61.0% less likely to receive a family-involved therapy visit. Married veterans or veterans living with a partner, and veterans with poor romantic relationship functioning, were more likely to receive a family-involved therapy visit. These findings indicate that only a small percentage of veterans received a family therapy visit across 5 years. Efforts to understand barriers to family-involved therapy visits and strategies to increase engagement in family-involved visits may improve clinical outcomes and promote patient-centered care.     

Training and Supervising Lay Providers in Kenya: Strategies and Mixed-Methods Outcomes☆☆☆

ObjectiveTraining lay providers to deliver mental health interventions is both effective and cost-effective. However, more research is needed to document training and supervision procedures and to collect lay providers’ feedback.MethodsThis study documents training and supervision from a randomized controlled trial of the Shamiri intervention, a four-session, school-based intervention that significantly reduced symptoms of anxiety and depression in Kenyan adolescents. We delivered a 10-hour training to 13 lay providers, M (SD)_age = 21.00 (1.95), %_female = 61.54. We also hosted 30-minute supervision meetings twice weekly. Training and supervision were delivered primarily by undergraduates. Independent raters coded session recordings for fidelity and quality of services, and we collected quantitative and qualitative feedback from lay providers.ResultsReliability and mean ratings for all six of our fidelity and quality measures (delivering required content, adhering to specified details, thoroughness, skillfulness, clarity, and purity) were very good to excellent. Lay provider quantitative ratings of training were also overwhelmingly positive, with an overall satisfaction rating of 6.46/7.00. We identified central qualitative themes in lay provider comments: Generally, comments about training style, content, and personal interactions were overwhelmingly positive, and many lay providers reported personal growth. Comments about timing and location of training were mixed.ConclusionsThis study provides preliminary evidence that a very brief training delivered primarily by undergraduates can teach high school-graduate lay providers to deliver effective mental health interventions. Additionally, we discuss lessons learned and implications for future research, including the importance of considering local context when planning and of continuously collecting and addressing lay provider feedback.     

“转换-坚持”对低阶层健康的保护作用及其机制

低社会阶层是不良健康状况最可靠的社会决定因素之一。然而, 很少有人理解为什么同样处于低阶层, 有些个体却能保持良好的健康状况。在大量实证研究的基础上, 研究者们发现“转换-坚持”策略这一心理因素能有效保护处于逆境中的低阶层者的健康, 使其免于受到疾病的侵扰。当个体面临持续或频繁的压力时, “转换-坚持”策略减轻了下丘脑-垂体-肾上腺轴的急性生理激活, 有效抑制了低阶层面临逆境时的生理应激反应, 随着时间的推移, 阻止了致病过程的发展; 同时, 该策略还减少了低阶层者的不良健康行为, 进而对健康起到保护作用。未来研究应在深入探索核心机制基础上开发出有效的干预方案, 为解决我国相对贫困问题中的健康贫困提供新的路径。     

2010~2020中国内地小学生心理健康问题检出率的元分析

我国小学生心理健康问题的检出率莫衷一是, 为整合调查结果并分析其原因, 对2010~2020年来检索到的相关研究进行了元分析。结果显示：(1)小学生心理健康问题的检出率由高到低依次是睡眠问题(25.2%, 95% CI = [0.16, 0.37])、抑郁(14.6%, 95% CI = [0.12, 0.18])、焦虑(12.3%, 95% CI = [0.06, 0.23])、攻击行为(4.1%, 95% CI = [0.02, 0.10])、退缩(3.8%, 95% CI = [0.02, 0.06])、违纪行为(3.7%, 95% CI = [0.02, 0.07])、躯体化(3.6%, 95% CI = [0.02, 0.07])。(2)测量工具、检出标准、检出时间是导致小学生心理健康问题检出率不一致的关键因素。总体而言, 我国小学生除了睡眠问题、抑郁和焦虑检出率偏高外, 整体心理健康状况尚可。未来应开发适合中国小学生的心理健康状况测评工具及检出标准, 为心理健康问题的预防和精准干预提供支持。     

2010~2020中国内地高中生心理健康问题检出率的元分析

我国高中生心理健康问题的检出率亟需关注, 许多研究对此进行了探究, 但结果并不一致。为明确近10年来我国高中生心理健康问题的检出状况及其影响因素, 对检索后获得的252项研究进行了元分析。结果发现: 检出率由高到低依次是抑郁(28.0%)、焦虑(26.3%)、睡眠问题(23.0%)、自我伤害(22.8%)、自杀意念(17.1%)、躯体化(9.8%)、自杀计划(6.9%)、自杀企图(未遂) (2.9%)。我国高中生心理健康问题检出率受出版年代、测量工具、检出标准、检出时间、年级和区域影响。未来应着力编制标准化测评工具、构建心理健康教育长效机制并对高年级、欠发达地区高中生的心理健康问题予以重点关注。     

Sleep interventions for performance,mood and sleep outcomes in athletes: A systematic review and meta-analysis

Sleep is fundamental to sports performance and other health outcomes such as mental wellbeing. This systematic review explored the effects of sleep interventions implemented among athletes on performance, sleep, and mood outcomes. Five databases were searched, returning 5996 records for screening. Of these, 27 articles met the inclusion criteria (16 controlled deigns, 11 uncontrolled; athletes n = 617; male n = 432, female n = 93, non-binary/other n = 0 or not reported n = 92). Narrative synthesis of all studies based on intervention type suggested that sleep hygiene, assisted sleep, and sleep extension interventions may be associated with improved sleep, performance, and mood outcomes. Twelve controlled trials were eligible for quantitative meta-analysis, investigating the effect of sleep interventions on athlete sleep, performance, and negative affect, compared to controls post-intervention. Utilizing random-effects meta-analyses, sleep interventions improved subjective sleep quality (g = 0.62, 95% CI [0.21, 1.02]), reduced sleepiness (g = 0.81, 95% CI [0.32, 1.30]) and decreased negative affect (g = 0.63, 95% CI [0.27, 0.98]), but did not appear to influence subjective sleep duration. No effects were identified for objective sleep measures (e.g., actigraphy), or aerobic/anaerobic performance indices. While sleep interventions may offer some benefit to athletes, caution is warranted given limitations of the extant research relating to small, non-representative studies with methodological concerns.     

Life-Ecology Integrated Security in Building a Global Community of Health for Human Beings

The sudden onslaught of the COVID-19 pandemic brought people the most serious global public health emergency since the end of World War II. Posing a threat to human survival and development, the pandemic has given prominence to global issues concerning life safety and ecological security and triggered studies on their integrated advancement. Only by fully understanding the importance and urgency of the life-ecology integrated security and establishing the new idea, new strategy, new plan, and basic path can we survive deadly emergencies, build a community with a shared future and health for all, and jointly contribute to and share the benefits of a safe, healthy and beautiful world with common prosperity, long-lasting peace and stability of humanity.     

A geography of contaminated sites,mental health and wellbeing: The body,home, environment and state at Australian PFAS sites

Health geographers have long been interested in the connection between place and mental health, proposing that settings influence mental health and vice versa. Research on environmental contamination has tended to focus on the former part of this relationship, examining how the mental health and wellbeing of residents living nearby are affected by the contamination. There has been little investigation of the latter component: how mental health and wellbeing may shape place. This article seeks to explore how the mental health and wellbeing of residents living on or near environmental contamination may be both affected by and reproduced in place. It considers this in a case study of per- and poly-fluoroalkyl substances (PFAS) contamination in New South Wales, Australia, by drawing on interviews with residents. Focus is placed on examining how residents report psychological distress associated with the contamination and how this distress may permeate beyond the contaminated site to become enmeshed in other places at different scales, such as the body, home, local environment, and state. Ultimately, it is proposed that these places reproduce distress on their own and require just as much attention in addressing adverse psychological effects as the physical contamination itself.     

Never Turn Your Back on a Wave

This article reviews the intersections of personal and professional life development for the author. She offers perspective on three important life lessons that have guided her in this rewarding life path. First, be responsible in fulfilling and seeking professional opportunities. Second, be nice—respectful, warm, collegial, collaborative; treat others with the respect you want to receive yourself. Finally, “Never turn your back on a wave”—face the challenges that life presents, forthrightly, with energy and enthusiasm, and enjoy a full and fulfilling career and personal life.