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"Mental Health Programs"
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THE CORE CONNECTORS INITIATIVE: DEVELOPMENT OF A YOUTH MENTAL HEALTH PROGRAM
This paper provides an overview of the development and field-test evaluation of a group-based youth mental health promotion program known as the Core Connectors Initiative (CCI). CCI is a program that aims to help youth gain mental health knowledge and peer support competencies, and reinforce positive help-seeking behaviour. The purpose of the study was to evaluate and refine CCI by examining whether it attains its training objectives of mental health literacy, gatekeeper training, and fostering positive youth development, while exploring helpful and unhelpful participant experiences of the program. CCI was field-tested during the latter half of the 2017/2018 school year at 3 different locations: a private school, a community centre, and a public school. Using mixed methods, the evaluation yielded information on the strengths and areas of growth for future program development. The quantitative data were collected from a sample of 29 youth, while the qualitative data were collected from 9 youth using the Enhanced Critical Incident Technique. The converging data highlight the importance of connection, the value of critical mental health literacy, and the importance of clarifying expectations. The lessons learned from implementing this program can be applied to other youth mental health promotion programs.
Journal Article
Predicting Participation in a Post-disaster Mental Health Program
A retrospective naturalistic evaluation was undertaken to identify if pre- and post-disaster factors may predict the likelihood of those considered \"at risk\" of post-traumatic stress disorder (PTSD) entering a post-disaster clinical treatment program.
The intake data of 881 people referred to the program following the Queensland (Australia) natural disasters of 2010-11 was evaluated. Those referred scored >2 on the Primary Care PTSD scale. Assessment included the disaster exposure experience, demographic and clinical information, and measures of coping and resilience. Descriptive analyses and a Classification Tree Analysis (CTA) were undertaken to ascertain which factors may predict treatment participation.
The treatment group (TG) in comparison to the non-treatment group (NTG) were more likely to perceive their life was threatened (85.1% vs 8.1%), less able to cope (67% vs 25.8%) and less resilient (4.2% vs 87.5%). The CTA using all the assessment variables found the Connor-Davidson (2-item scale) (
0.001), degree of property damage (
0.001), financial losses (
< 0.001), perception their life was threatened (
0.001) and insurance claims (
0.003) distinguished the TG from the NTG.
The study identified factors that distinguished the TG from the NTG and predicted the likelihood of participation in a post-disaster mental health treatment.
Journal Article
Mental Health Programme in India: Has the tide really turned?
Mental disorders in India form a major public health concern and the efforts to tackle these dates back to four decades, by way of the National Mental Health Programme (NMHP) and its operational arm, the District Mental Health Programme (DMHP). Although the progress of NMHP (and DMHP) was relatively slower till recently, the last 4-5 years have seen rapid strides with several initiatives, including (i) expansion of DMHPs to 90 per cent of the total districts of the country, (ii) the National Mental Health Policy and (iii) strengthening the Mental Health Legislation by way of providing explicit provisions for rights of persons with mental illnesses. Among others, factors responsible for this accelerated growth include the easily accessible digital technology as well as judicial activism. Federal and State cooperation is another notable feature of this expansion. In this review, the authors summarize the available information on the evolution of implementation and research aspects related to India's NMHP over the years and provide a case for the positive turn of events witnessed in the recent years. However, the authors caution that these are still baby steps and much more remains to be done.
Journal Article
Evaluating a Mental Health Program for Palestinian Refugees in Lebanon
Medecins sans Frontière, an international non-governmental organization, initiated a mental health program for Palestinian refugees living in Lebanon. To evaluate the impact of the program after its completion, focus groups were conducted with three target groups: (1) patients, (2) staff, and (3) local community stakeholders. Participants voiced overall satisfaction with the program. The program provided easy access, good quality care, decreased stigma, as perceived by participants, and revealed a sense of community contentedness. In addition, several short-term outcomes were achieved, such as increasing the numbers of patients visiting the center/receiving mental health treatment. However, lack of planning for sustainability and proper procedures for hand-over of the program constituted a major downfall. Program discontinuation posed ethical dilemmas, common in provisional interventions in underprivileged refugee communities.
Journal Article
Underneath the Mask of the Strong Black Woman Schema: Disentangling Influences of Strength and Self-Silencing on Depressive Symptoms among U.S. Black Women
Recent investigations have elucidated the influence of the Strong Black Woman (SBW) Schema on the mental health and treatment seeking behaviors of Black women in the United States. However, the SBW schematic characteristics that produce depression have yet to be identified. The current study fills this void in the literature through a quantitative examination of how characteristics of the SBW Schema relate to depressive symptomology. Analyses were based on 194 participants, including college students (n = 98) and community members (n = 96), ranging in age from 18 to 82 years-old (M = 37.53, SD = 19.88). As hypothesized, various manifestations of self-silencing were found to significantly mediate the relationship between the perceived obligation to manifest strength (a SBW characteristic) and depressive symptomatology. The present study advances the idea that depressive symptoms are related to endorsement of the SBW Schema and highlights self-silencing as a mechanism by which this relationship occurs. These results offer evidence and clarification of the impact of the SBW Schema on Black women’s mental health and identify specific points of intervention for mental health practitioners conducting therapeutic work with Black women. We provide recommendations for future research to avoid pathologizing strength and we discuss the implications and potential benefits of integrating a Womanist theoretical perspective into counseling for Black women, a population that has historically underutilized mental health resources.
Journal Article
A Systematic Review and Meta-Analysis of School-Based Stress, Anxiety, and Depression Prevention Programs for Adolescents
Given the recent rise in adolescent mental health issues, many researchers have turned to school-based mental health programs as a way to reduce stress, anxiety, and depressive symptoms among large groups of adolescents. The purpose of the current systematic review and meta-analysis is to identify and evaluate the efficacy of school-based programming aimed at reducing internalizing mental health problems of adolescents. A total of 42 articles, including a total of 7310 adolescents, ages 11–18, met inclusion for the meta-analyses. Meta-analyses were completed for each of the three mental health outcomes (stress, depression, and anxiety) and meta-regression was used to determine the influence of type of program, program dose, sex, race, and age on program effectiveness. Overall, stress interventions did not reduce stress symptoms, although targeted interventions showed greater reductions in stress than universal programs. Overall, anxiety interventions significantly reduced anxiety symptoms, however higher doses may be necessary for universal programs. Lastly, depression interventions significantly reduced depressive symptoms, but this reduction was moderated by a combination of program type, dose, race, and age group. Although, school-based programs aimed at decreasing anxiety and depression were effective, these effects are not long-lasting. Interventions aimed at reducing stress were not effective, however very few programs targeted or included stress as an outcome variable. Implications for practice, policy and research are discussed.
Journal Article
Longitudinal increases in childhood depression symptoms during the COVID-19 lockdown
ObjectiveThere has been widespread concern that so-called lockdown measures, including social distancing and school closures, could negatively impact children’s mental health. However, there has been little direct evidence of any association due to the paucity of longitudinal studies reporting mental health before and during the lockdown. This present study provides the first longitudinal examination of changes in childhood mental health, a key component of an urgently needed evidence base that can inform policy and practice surrounding the continuing response to the COVID-19 pandemic.MethodsMental health assessments on 168 children (aged 7.6–11.6 years) were taken before and during the UK lockdown (April–June 2020). Assessments included self-reports, caregiver reports, and teacher reports. Mean mental health scores before and during the UK lockdown were compared using mixed linear models.ResultsA significant increase in depression symptoms during the UK lockdown was observed, as measured by the Revised Child Anxiety and Depression Scale (RCADS) short form. CIs suggest a medium-to-large effect size. There were no significant changes in the RCADS anxiety subscale and Strengths and Difficulties Questionnaire emotional problems subscale.ConclusionsDuring the UK lockdown, children’s depression symptoms have increased substantially, relative to before lockdown. The scale of this effect has direct relevance for the continuation of different elements of lockdown policy, such as complete or partial school closures. This early evidence for the direct impact of lockdown must now be combined with larger scale epidemiological studies that establish which children are most at risk and tracks their future recovery.
Journal Article
School-based Mental Health Interventions Targeting Depression or Anxiety: A Meta-analysis of Rigorous Randomized Controlled Trials for School-aged Children and Adolescents
Past meta-analyses in mental health interventions failed to use stringent inclusion criteria and diverse moderators, therefore, there is a need to employ more rigorous methods to provide evidence-based and updated results on this topic. This study presents an updated meta-analysis of interventions targeting anxiety or depression using more stringent inclusion criteria (e.g., baseline equivalence, no significant differential attrition) and additional moderators (e.g., sample size and program duration) than previous reviews. This meta-analysis includes 29 studies of 32 programs and 22,420 students (52% female, 79% White). Among these studies, 22 include anxiety outcomes and 24 include depression outcomes. Overall, school-based mental health interventions in grades K-12 are effective at reducing depression and anxiety (ES = 0.24, p = 0.002). Moderator analysis shows that improved outcomes for studies with anxiety outcomes, cognitive behavioral therapy, interventions delivered by clinicians, and secondary school populations. Selection modeling reveals significant publication and outcome selection bias. This meta-analysis suggests school-based mental health programs should strive to adopt cognitive behavioral therapy and deliver through clinicians at the secondary school level where possible.
Journal Article
Trauma-Informed Practices in Schools Across Two Decades: An Interdisciplinary Review of Research
Attention to childhood trauma and the needfor trauma-informed care has contributed to the emerging discourse in schools related to teaching practices, school climate, and the delivery of trauma-related in-service and preservice teacher education. However, though trauma-informed systems of care include schools, empirical work informing trauma-informed teaching and teacher education that is reflected back to those audiences is less established. This interdisciplinary overview and synthesis of literature examined interventions used in schools to determine the dominant framework used for promoting and practicing trauma-informed care in schools and the effectiveness of school-based supports for trauma-affected youth to identify implications for changing teaching practice. While multiple disciplines conduct research using different methodologies examining trauma-informed practices in schools, educators are underexamined in this work. Additionally, education researchers began engaging in research on trauma-informed practices in schools more recently, and as such, research emanating from education researchers comprises a small portion of this review. Drawing across the work, we offer recommendations for a more robust, interdisciplinary research agenda with the intentional purpose to change teacher practice.
Journal Article