ABSTRACT Objectives To examine the extent of the impact of the COVID-19 pandemic on the mental health and well-being of mental health professionals (MHPs) in the Netherlands and understand their needs during the COVID-19 pandemic. Design and setting A cross-sectional, mixed-methods study was conducted with MHPs from the Netherlands from June 2020 to October 2020, consisting of an online survey and three online focus group discussions. Participants Participants were MHPs from various occupational groups (psychologists, social workers, mental health nurses, developmental education workers, etc). Primary and secondary outcome measures The online survey included questions about work-related changes due to COVID-19 perceived resilience to stress, changes in lifestyle behaviours and mental health symptoms. The focus group discussions focused mostly on work experiences during the first wave of the COVID-19 pandemic. Results MHP’s reported an increase in experience workload during the pandemic (mean score 8.04 based on a scale of 1-10) compared to before the pandemic (mean score of 7). During the first wave of the pandemic, 50% of respondents reported increased stress, 32% increased sleeping problems and 24% increased mental health problems. Adverse occupational (eg, increased workload OR 1.72, 95% CI 1.28–2.32), psychological (eg, life satisfaction OR 0.63, 95% CI 0.52–0.75), lifestyle (eg, increased sleep problems OR 2.80, 95% CI 2.07–3.80) and physical factors (decline in physical health OR 3.56, 95% CI 2.61–4.85) were associated with a decline in mental health. Participants expressed significant concern in the focus group discussions about the duration of the pandemic, the high workload, less work-life balance and lack of contact with colleagues. Suggestions to improve working conditions included ensuring clear communication about guidelines and facilitating worker contact and support via peer-to- peer coaching where experiences can be shared. Conclusions The current study indicates that MHP experienced a decline in mental health status during the first wave of the COVID-19 pandemic, which should be taken into consideration by employers, policymakers and researchers.
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Background:Victimization among children is associated with adverse effects on their physical and psychological health. Many health complaints follow as a result of bullying and anxiety and depression also precede bullying. The Dutch school-wide antibullying program ‘Prima’ was developed based on techniques and scientific insights that are known to be effective. In this randomized trial we investigate the effects of school-wide antibullying program on bullying behavior and self-esteem and depression.Methods:A total of 4,229 students of grade 3 to 6 of 31 primary schoolsparticipated in this study. The schools were randomly assigned to three conditions. Condition A was offered a teachertraining, an online screening tool for bullying behavior, and a set of practice- and evidence-based guidelines to deal with difficult bullying situations. Condition B included all of condition A plus a series of eight lessons for the students. Condition C was the control group. A questionnaire was filled out by the students before and after the intervention.Results:Results from the pretest showed that 16% of the students was bullied regularly. There was a significant difference between bullied and non-bullied children in their reported mental health. Bullied students indicated much more depressive symptoms compared to non-bullied students (3,67 vs 1,67, p= .000). Bullied children also indicated lower self-esteem (16,74 vs 19,84, p = .000). The effects of the intervention program are currently analyzed and will be presented at the conference in the fall of 2018.Conclusions:Bullying is strongly related to mental health issues among children. To address mental health issues among youth, schools should focus on evidence-based anti-bullying programs as a vital part of a wider school policy.Key messages:-Bullying has a strong impact on the wellbeing and mental health of children.-School programs focused on preventing bullying can therefore reduce health complaints among children.
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Introduction: From the patient and staff perspective, care delivery for patients experiencing a mental health problem in ambulance and emergency department (ED) settings is challenging. There is no uniform and internationally accepted concept to reflect people with a mental health problem who require emergency care, be it for, or as a result of, a mental health or physical health problem. On initial presentation to the emergency service provider (ambulance or ED), the cause of their healthcare condition/s (mental health and/or physical health) is often initially unknown. Due to this (1) the prevalence and range of underlying causes (mental and/or physical) of the patients presenting condition is unknown; (2) misattribution of physical symptoms to a mental health problem can occur and (3) diagnosis and treatment of the initial somatic complaint and cause(s) of the mental/physical health problem may be hindered.This study will name and define a new concept: 'mental dysregulation' in the context of ambulance and ED settings. Methods and analysis: A Delphi study, informed by a rapid literature review, will be undertaken. For the literature review, a steering group (ie, persons with lived experience, ED and mental health clinicians, academics) will systematically search the literature to provide a working definition of the concept: mental dysregulation. Based on this review, statements will be generated regarding (1) the definition of the concept; (2) possible causes of mental dysregulation and (3) observable behaviours associated with mental dysregulation. These statements will be rated in three Delphi rounds to achieve consensus by an international expert panel (comprising persons with lived experience, clinicians and academics). Ethics and dissemination: This study has been approved by the Medical Ethical Committee of the University of Applied Sciences Utrecht (reference number: 258-000-2023_Geurt van der Glind). Results will be disseminated via peer-reviewed journal publication(s), scientific conference(s) and to key stakeholders.
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Formal elements are often used in art therapy assessment. The assumption is that formal elements are observable aspects of the art product that allow reliable and valid assessment of clients’ mental health. Most of the existing art therapy assessment instruments are based on clinical expertise. Therefore, it is not clear to what degree these instruments are restricted to formal elements. Other aspects might also be included, such as clinical expertise of the therapist. This raises the question of whether and how formal elements as observable aspects of the art product are related to clients’ mental health. To answer this question, four studies are presented that look at: (1) a meta-theoretical description of formal elements; (2) operationalization of these formal elements so they can be analyzed reliably in clients’ art products; (3) establishment of reliable and clinically relevant formal elements; (4) the relationship between formal elements and adult clients’ mental health. Results show that the combination of the formal elements “movement,” “dynamic,” and “contour” are significantly interrelated and related to clients’ mental health, i.e., psychopathology, psychological flexibility, experiential avoidance, and adaptability. These findings give insight in the diagnostic value of art products and how they may add to clients’ verbal expression and indicate their potential to benefit from therapy.
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Introduction: Worldwide, there is an increase in the extent and severity of mental illness. Exacerbation of somatic complaints in this group of people can result in recurring ambulance and emergency department care. The care of patients with a mental dysregulation (ie, experiencing a mental health problem and disproportionate feelings like fear, anger, sadness or confusion, possibly with associated behaviours) can be complex and challenging in the emergency care context, possibly evoking a wide variety of feelings, ranging from worry or pity to annoyance and frustration in emergency care staff members. This in return may lead to stigma towards patients with a mental dysregulation seeking emergency care. Interventions have been developed impacting attitude and behaviour and minimising stigma held by healthcare professionals. However, these interventions are not explicitly aimed at the emergency care context nor do these represent perspectives of healthcare professionals working within this context. Therefore, the aim of the proposed review is to gain insight into interventions targeting healthcare professionals, which minimise stigma including beliefs, attitudes and behaviour towards patients with a mental dysregulation within the emergency care context. Methods and analysis: The protocol for a systematic integrative review is presented, using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols recommendations. A systematic search was performed on 13 July 2023. Study selection and data extraction will be performed by two independent reviewers. In each step, an expert with lived experience will comment on process and results. Software applications RefWorks-ProQuest, Rayyan and ATLAS.ti will be used to enhance the quality of the review and transparency of process and results. Ethics and dissemination: No ethical approval or safety considerations are required for this review. The proposed review will be submitted to a relevant international journal. Results will be presented at relevant medical scientific conferences.
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Background: Research into termination of long-term psychosocial treatment of mental disorders is scarce. Yearly 25% of people in Dutch mental health services receive long-term treatment. They account for many people, contacts, and costs. Although relevant in different health care systems, (dis)continuation is particularly problematic under universal health care coverage when secondary services lack a fixed (financially determined) endpoint. Substantial, unaccounted, differences in treatment duration exist between services. Understanding of underlying decisional processes may result in improved decision making, efficient allocation of scarce resources, and more personalized treatment.
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Abstract Background Clients with severe mental illness (SMI) have overall poor physical health. SMI reduces life expectancy by 5–17 years, primarily due to physical comorbidity linked to cardiometabolic risks that are mainly driven by unhealthy lifestyle behaviours. To improve physical health in clients with SMI, key elements are systematic somatic screening and lifestyle promotion. The nurse-led GILL eHealth was developed for somatic screening and the imple‑ mentation of lifestyle activities in clients with SMI. Aims of this study are to evaluate the efectiveness of the GILL eHealth intervention in clients with SMI compared to usual care, and to evaluate the implementation process, and the experiences of clients and healthcare providers with GILL eHealth. Methods The GILL study encompasses a cluster-randomised controlled trial in approximately 20 mental health care facilities in the Netherlands. The randomisation takes place at the team level, assigning clients to the eHealth inter‑ vention or the usual care group. The GILL eHealth intervention consists of two complementary modules for somatic screening and lifestyle promotion, resulting in personalised somatic treatment and lifestyle plans. Trained mental health nurses and nurse practitioners will implement the intervention within the multidisciplinary treatment context, and will guide and support the participants in promoting their physical health, including cardiometabolic risk management. Usual care includes treatment as currently delivered, with national guidelines as frame of reference. We aim to include 258 clients with SMI and a BMI of 27 or higher. Primary outcome is the metabolic syndrome severity score. Secondary outcomes are physical health measurements and participants’ reports on physical activity, perceived lifestyle behaviours, quality of life, recovery, psychosocial functioning, and health-related self-efcacy. Measurements will be completed at baseline and at 6 and 12 months. A qualitative process evaluation will be conducted alongside, to evaluate the process of implementation and the experiences of clients and healthcare professionals with GILL eHealth. Discussion The GILL eHealth intervention is expected to be more efective than usual care in improving physical health and lifestyle behaviours among clients with SMI. It will also provide important information on implementation of GILL eHealth in mental health care. If proven efective, GILL eHealth ofers a clinically useful tool to improve physical health and lifestyle behaviours.
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Maintaining mental health can be quite challenging, especially when exposed to stressful situations. In many cases, mental health problems are recognized too late to effectively intervene and prevent adverse outcomes. Recent advances in the availability and reliability of wearable technologies offer opportunities for continuously monitoring mental states, which may be used to improve a person’s mental health. Previous studies attempting to detect and predict mental states with different modalities have shown only small to moderate effect sizes. This limited success may be due to the large variability between individuals regarding e.g., ways of coping with stress or behavioral patterns associated with positive or negative feelings. A study was set up for the detection of mental states based on longitudinal wearable and contextual sensing, targeted at investigating between-subjects variations in terms of predictors of mental states and variations in how predictors relate to mental states. At the end of March 2022, 16 PhD candidates from the Netherlands started to participate in the study. Over nine months, we collected data in terms of their daily mental states (valence and arousal), continuous physiological data (Oura ring) and smartphone data (AWARE framework including GPS and smartphone usage). From the raw data, we aggregated daily values for each participant in terms of sleep, physical activity, mental states, phone usage and GPS movement. First results (six months into the study at the time of writing) indicate that almost all participants show a large variability in ratings of daily mental states, which is a prerequisite for predictive modeling. Direction, strength and standard deviations of Spearman correlations between valence, arousal and the different variables suggest that several predictors of valence and arousal are more subject dependent than others. In future analyses, we will test and compare different versions of predictive modeling to highlight the potential of wearable technologies for mental state monitoring and the personalized prediction of the development of mental problems.
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Abstract Background: People with severe mental illness (SMI) often suffer from long-lasting symptoms that negatively influence their social functioning, their ability to live a meaningful life, and participation in society. Interventions aimed at increasing physical activity can improve social functioning, but people with SMI experience multiple barriers to becoming physically active. Besides, the implementation of physical activity interventions in day-to-day practice is difficult. In this study, we aim to evaluate the effectiveness and implementation of a physical activity intervention to improve social functioning, mental and physical health. Methods: In this pragmatic stepped wedge cluster randomized controlled trial we aim to include 100 people with SMI and their mental health workers from a supported housing organization. The intervention focuses on increasing physical activity by implementing group sports activities, active guidance meetings, and a serious game to set physical activity goals. We aim to decrease barriers to physical activity through active involvement of the mental health workers, lifestyle courses, and a medication review. Participating locations will be divided into four clusters and randomization will decide the start of the intervention. The primary outcome is social functioning. Secondary outcomes are quality of life, symptom severity, physical activity, cardiometabolic risk factors, cardiorespiratory fitness, and movement disturbances with specific attention to postural adjustment and movement sequencing in gait. In addition, we will assess the implementation by conducting semi-structured interviews with location managers and mental health workers and analyze them by direct content analysis. Discussion: This trial is innovative since it aims to improve social functioning in people with SMI through a physical activity intervention which aims to lower barriers to becoming physically active in a real-life setting. The strength of this trial is that we will also evaluate the implementation of the intervention. Limitations of this study are the risk of poor implementation of the intervention, and bias due to the inclusion of a medication review in the intervention that might impact outcomes. Trial registration: This trial was registered prospectively in The Netherlands Trial Register (NTR) as NTR NL9163 on December 20, 2020. As the The Netherlands Trial Register is no longer available, the trial can now be found in the International Clinical Trial Registry Platform via: https:// trial search. who. int/ Trial2. aspx? Trial ID= NL9163.
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