Active school travel is associated with fewer suicide attempts among adolescents from low-and middle-income countries

Background/Objective: This study explored the association between active school travel (AST) and suicide attempts among adolescents in low- and middle-income countries (LMICs). Method: We used the data from the Global School-based Health Survey, including 127,097 adolescents aged 13-17 years from 34 LMICs. A self-reported survey was used to collect data on AST and suicide attempts as well as some variables. Multivariable logistic regression was performed to assess the association between AST and suicide attempts. A meta-analysis with random effects was undertaken to identify the difference in the association between AST and suicide attempts. Results: Across all the adolescents, the prevalence of AST was 37% and the prevalence of suicide attempts was 11.60%. Adolescents who engaged in AST were less likely to have suicide attempts irrespective of gender. The country-wise analysis indicated a large inconsistency in the association between AST and suicide attempt across the countries. Conclusions: AST would appear to be a protective factor for reducing suicide attempts among adolescents. However, the association between AST and suicide attempts varied greatly across the countries. Future studies should confirm the association between AST and suicide attempts.     

Engagement and Interaction: A Comparison Between Supported Employment and ATCs

The interaction and engagement patterns of 13 supported employees and 38 regular Adult Training Centre (ATC) attenders were compared. Data were obtained through direct observation within 13 employment sites and a representative sample of ATC organised activities. Results indicated that individual involvement was significantly higher in employment, compared to ATCs, but that the ATC group experienced significantly more social interaction, mainly due to higher levels of task specific dialogue between individuals and the service staff within ATCs. A breakdown of with whom interactions occurred revealed that individuals in ATCs tended to interact more often with care staff than anyone else. Individuals tended to interact more often during work with their non-disabled co-workers and a substantial proportion of time was spent interacting with the public. These findings suggest that the supported employment option yields advantages for individuals in some key aspects of community integration, compared to ATCs.     

Training Counsellors to Work with People who Live with Cancer: A Needs-led Approach to Planning

This paper traces the development of a cancer counselling service within a voluntary helping agency. The steps of recognizing the needs of people with cancer, identifying multi-faceted desired outcomes and the implementation of one specific goal, that of provision of a counselling service, are outlined. Significant events, stages and decisions made during this process are described and discussed. The emphasis throughout is on the importance of needs analysis and client group consultation in order that the planned service is best placed to meet such needs.     

Citizen Advocacy Observed: Tool or Tokenism?

Citizen advocacy, where a volunteer works in partnership with a vulnerable person, compliments self- and legal advocacy. In the context of mental health services, citizen advocacy is a tool for enabling and empowering people who use these services, and is founded on the recognition that mental health service users are frequently socially oppressed and disadvantaged. This article describes the development of a Citizen Advocacy service for people with mental health difficulties, and also the problems they brought to this service. The problems encountered in sustaining the service are noted and lessons are drawn for the future.     

Poverty and Mental Health: Underclaiming of Welfare Benefits

The study undertaken by a local MIND welfare benefits service found that 51% of people attending a local mental health resource centre were not receiving the welfare benefits to which they were entitled. Being in receipt of correct benefit entitlement was found to be unaffected by: whether a person had a long history of using mental health services; whether they had a care manager; or whether they had previously been given benefits advice. Women were less likely to be receiving their correct benefit entitlement than men. It is argued that the only way to guarantee that people receive their full benefit entitlement is to ensure that highly trained and experienced welfare benefits advisers are readily accessible to all people who use mental health services.     

The Role of Professional Training Experiences and Manualized Programs in ABA Providers’ Use of Parent Training With Children With Autism

Parent training, in which providers teach parents intervention strategies to promote their children’s skill acquisition and/or behavior management, is considered a best practice in the treatment for children with autism spectrum disorder (ASD) and yet is underutilized in community settings. The present study examined the role of training experiences and manual use in promoting the use of parent training by community providers who serve children with ASD. Applied behavior analysis (ABA) providers (N = 1,089) from across the United States completed self-report questionnaires online. The total number of professional training experiences related to parent training significantly predicted the extensiveness of providers’ use of parent training. Receiving supervision in parent training, being trained in a specific parent training approach, taking a course related to parent training, and participating in self-guided learning (e.g., webinar) were unique predictors of parent training extensiveness. While only 15% of ABA providers used manualized parent training programs, using a manual was also a unique predictor of parent training extensiveness. Parallel multiple mediator analyses demonstrated that family-, provider-, and organization-level barriers all partially mediated the relationship between number of training experiences and parent training extensiveness; only provider- and organization-level barriers mediated the relationship between manual use and parent training extensiveness. Recommendations for training and supporting providers at the pre-service and in-service levels are discussed as a means of increasing access to parent training for children with ASD in community settings.     

Group Intervention for Adolescent Anxiety and Depression: Outcomes of a Randomized Trial with Adolescents in Kenya

Youth mental health interventions in low-resource communities may benefit from including empirically supported elements, using stigma-free content, and using trained lay-providers. We developed and evaluated such an intervention, targeting adolescent depression and anxiety in Kenya, where mental health care is limited by social stigma and a paucity of providers. Kenyan adolescents (N = 51, ages 14–17, 60.78% female) from a school in an urban slum in Nairobi with self-reported moderate-to-severe symptoms of depression or anxiety were randomized to the 4-week “Shamiri” (“thrive”) group intervention or a study skills control intervention of equal duration. The Shamiri intervention included growth mindset, gratitude, and value affirmation exercises. The content was delivered by recent high school graduates (ages 17–21, 60% male) trained as lay-providers. Participants met in school once-a-week in groups of 9–12 youths (average group size 10). Compared to the study-skills control, Shamiri produced greater reductions in adolescent depression symptoms (p = .038; d = .32) and anxiety symptoms (p = .039; d = .54) from baseline to 4-week follow-up, and greater improvements in academic performance (p = .034; d = .32) from the school-term before versus after the intervention. There were no effects on overall social support or perceived control, but the Shamiri group showed larger increases in perceived social support from friends (p = .028, d = .71). This appears to be the first report that a brief, lay-provider delivered, community-based intervention may reduce internalizing symptoms and improve academic outcomes in high-symptom adolescents in Sub-Saharan Africa. Larger replications with extended follow-ups will help gauge the strength and durability of these effects.     

Parents’ postnatal depressive symptoms and their children's academic attainment at 16 years: Pathways of risk transmission

The aim of the study was to examine whether parents’ increased postnatal depressive symptoms predicted children's academic attainment over time and whether the parent–child relationship, children's prior academic attainment, and mental health mediated this association. We conducted secondary analyses on the Avon Longitudinal Study of Parents and Children data (12,607 mothers, 9,456 fathers). Each parent completed the Edinburgh-Postnatal Depression Scale at 8 weeks after the child's birth (predictor) and a questionnaire about the mother–child and father–child relationship at 7 years and 1 month (mediator). The children's mental health problems were assessed with the teacher version of the Strengths and Difficulties Questionnaire at 10–11 years (mediator). We used data on the children's academic attainment on UK Key Stage 1 (5–7 years; mediator) and Key Stage 4 (General Certificate of Secondary Education 16 years) (outcome). We adjusted for the parents’ education, and child gender and cognitive ability. The results revealed that parents’ depressive symptoms at 8 weeks predicted lower academic performance in children at 16 years. Mothers’ postnatal depressive symptoms had an indirect effect through children's mental health problems on academic outcomes at 16 years via negative mother–child relationship, and prior academic attainment. There was a significant negative indirect effect of fathers’ postnatal depressive symptoms on academic attainment at 16 years via negative father–child relationship on child mental health. The findings suggest that the family environment (parental mental health and parent–child relationship) and children's mental health should be potential targets for support programmes for children of depressed parents.