Depression and Self-Harm Risk Assessment in Online Forums

Users suffering from mental health conditions often turn to online resources for support, including specialized online support communities or general communities such as Twitter and Reddit. In this work, we present a neural framework for supporting and studying users in both types of communities. We propose methods for identifying posts in support communities that may indicate a risk of self-harm, and demonstrate that our approach outperforms strong previously proposed methods for identifying such posts. Self-harm is closely related to depression, which makes identifying depressed users on general forums a crucial related task. We introduce a large-scale general forum dataset ("RSDD") consisting of users with self-reported depression diagnoses matched with control users. We show how our method can be applied to effectively identify depressed users from their use of language alone. We demonstrate that our method outperforms strong baselines on this general forum dataset.Comment: Expanded version of EMNLP17 paper. Added sections 6.1, 6.2, 6.4, FastText baseline, and CNN-

The FDA “black box” warning on antidepressant suicide risk in young adults: More harm than benefits?

The decision made in the year 2004 by the U.S. Food and Drug Administration (FDA) to require a boxed warning on antidepressants regarding the risk of suicidality in young adults still represents a matter of controversy. The FDA warning was grounded on industry-sponsored trials carried one decade ago or earlier. However, within the past decade, an increasing number of reports have questioned the actual validity of the FDA warning, especially considering a decline in the prescription of the antidepressant drugs associated with an increase in the rate of suicidal events among people with severe depression. The present report provides an overview of the FDA black box warning, also documenting two Major Depressive Disorder patients whose refusal to undergo a pharmacological antidepressant treatment possibly led to an increased risk for suicidal behaviors. The concerns raised by the FDA black box warning need to be considered in real-world clinical practice, stating the associated clinical and public health implications

Suicide and self-harm in Britain: researching risk and resilience using UK surveys

Aim The main aim of this study was to raise awareness of surveys that could be used to inform self-harm and suicide prevention work. We asked: What UK survey datasets are available for research? What aspects of people’s lives are associated with self-harm and attempted suicide? How do statistical findings resonate with people’s lived experience? What implications do they see? Findings Survey analyses revealed that risk factors for self-harm are wide ranging and include: Mental health Physical health and health behaviours Social relationships Stressful events Employment and financial circumstances Identity and demographics Many different factors are independently associated with self-harm. There is a dose relationship, with more exposure to a factor linked with increased risk. Risks are cumulative that is, exposure to multiple factors is associated with greater risk. Through facilitated consultation, men with lived experience, bereaved family members, and practitioners identified recommendations for responding to suicidal distress in men. These related to the following three main areas: 1. Recognising need: who is ‘ill enough’? Permission - men said that they often did not know they were entitled to help Ask - people who outwardly appear to be functioning may not be Persistence - ask and offer help more than once. 2. Facilitating access: right words, time and place What is available - support is needed with ongoing stress as well as for crises Find the words - men wanted examples of how to ask for help Allow time - employers expect recovery to be swift, some men felt rushed to come off medications or were discharged from services they still needed. 3. Adjusting delivery: equal engagement Power - some were uncomfortable with service dynamics, preferring peer support Every service contact counts - negative contacts had particular impact Safe spaces - may be different for men and women. Methods There were three strands of work: Secondary analysis of nine survey series, spanning more than twenty years Linkage of 144,000 survey participants to information on whether they were alive in 2013 and whether they had taken their own life Facilitated consultation, through depth interviews with people with lived experience

Strategies to minimise the incidence of suicide and suicidal behaviour

This resource sheet provides a review of policies and programs that aim to prevent suicide and suicidal behaviour. Suicidal behaviour refers to actions that can result in death, such as taking an overdose or deliberately crashing a car. The scope of this resource sheet does not include self-injury that is part of the cultural grieving process (‘sorry business’). While it is known that high levels of mental health and wellbeing decrease the risk of suicide, programs to promote mental health and wellbeing are also not considered in this resource sheet, as they are the subject of a separate resource sheet Strategies and practices for promoting the social and emotional wellbeing of Aboriginal and Torres Strait Islander people. Effective mental health promotion programs include cultural healing programs, culturally appropriate mental health services and the Indigenous Hip Hop program. Also important are Indigenous adaptations of effective mainstream programs such as the Resourceful Adolescent Program, MindMatters (a mental health promotion program for secondary schools) and the Triple P-Positive Parenting Program. Suicide is strongly associated with the use of alcohol and other drugs. Strategies to reduce alcohol and other drug-related harm are also not included as they are the subject of a separate resource sheet Reducing alcohol and other drug related harm. This resource sheet considers suicide prevention policies and programs that have been implemented in both remote and non-remote parts of Australia and internationally. It assesses their strengths and limitations and their actual, or likely, effectiveness in relation to Indigenous Australians

Internet addiction in students: prevalence and risk factors

The last decade has witnessed a large increase in research on the newly emerging mental health problem of Internet addiction. Rather than looking at Internet addiction per se, this study focused on particular activities on the Internet that might be potentially addictive and linked them to personality traits that might predispose individuals to Internet addiction. The aims of this study were (i) to assess the prevalence of clinically significant levels of Internet addiction, and to (ii) discern the interplay between personality traits and specific Internet uses in increasing the risk for Internet addiction. This cross-sectional online survey used data from 2,257 students of an English university. Results indicated that 3.2% of the students were classified as being addicted to the Internet. The included personality traits and uses of online activities explained 21.5% of the variance in Internet addiction. A combination of online shopping and neuroticism decreased the risk for Internet addiction, whereas a combination of online gaming and openness to experience increased it. In addition to this, frequent usage of online shopping and social online activities, high neuroticism and low agreeableness significantly increased the chances of being addicted to the Internet. Findings and their implications are discussed

Youth and the future: effective youth services for the year 2015

This report provides an understanding of the services required by young people in the year 2015, based on a thorough analysis of recent trends and expert projections of those trends. The report analyses key social and economic changes for young people in Australia over the past 10 to 20 years including movements in population, education, employment/unemployment and the labour market, incomes, family and household structure, health, and crime and justice

COPe-support - a multi-component digital intervention for family carers for people affected by psychosis: study protocol for a randomized controlled trial.

BACKGROUND: Psychosis often causes significant distress and impacts not only in the individuals, but also those close to them. Many relatives and friends ('carers') provide long-term support and need resources to assist them. We have co-produced a digital mental health intervention called COPe-support (Carers fOr People with Psychosis e-support) to provide carers with flexible access to high quality psychoeducation and interactive support from experts and peers. This study evaluates the effectiveness of COPe-support to promote mental wellbeing and caregiving experiences in carers. METHODS: This study is a single-blind, parallel arm, individually randomized controlled trial (RCT) comparing COPe-support, with attention control. Both groups continue to receive usual care. COPe-support provides interactive web-based psychoeducation on psychosis-related issues, wellbeing-promotion and network support through forums. The attention-control is a non-interactive online information resource pack. Carers living in England are eligible if they provide at least weekly support to a family member or close friend affected by psychosis, and use internet communication (including emails) daily. All trial procedures are run online, including collection of outcome measurements which participants will directly input into our secure platform. Following baseline assessment, a web-based randomization system will be used to allocate 360 carers to either arm. Participants have unlimited access to the allocated condition for 40 weeks. Data collection is at three time points (10, 20, and 40 weeks after randomization). Analyses will be conducted by trial statisticians blinded to allocation. The primary outcome is mental wellbeing measured by Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), at 20 weeks. As well as an intention-to-treat analysis, a complier average causal effect (CACE) analysis will be conducted to estimate the intervention effect in participants who have accessed COPe-support content twice or more. The secondary objectives and analysis will examine other health and caregiving-related outcomes and explore mechanisms. In a process evaluation, we will interview 20% of the intervention arm participants regarding the acceptability of COPe-support. We will explore in detail participants' usage patterns. DISCUSSION: The results of this trial will provide valuable information about the effectiveness of COPe-support in promoting wellbeing and caregiving experiences in carers. TRIAL REGISTRATION: The RCT is registered with the Current Controlled Trials registration (ISRCTN 89563420, registration date: 02/03/2018)

Improving e-therapy for mood disorders among lesbians and gay men

Introduction This toolkit provides the first comprehensive set of guidelines for tailoring mood-disorder e-therapies to the needs of same-sex attracted people. It gives developers of e-therapies a set of practical recommendations for adjusting e-therapies to more effectively accommodate lesbians and gay men. These recommendations are supported by in-depth research that was designed specifically to inform this toolkit. Summaries of this research are provided in the toolkit and detailed findings are available in published research articles. This toolkit also provides information on the mental health-related challenges that are often faced by same-sex attracted people and links readers to key resources and organisations for further information. Checklists and other tools are included as aids for developers to assess the inclusiveness and relevance of e-therapies to lesbians and gay men. In short, this toolkit contains an extensive set of tools and explains why and how they could be implemented

Self-monitoring Practices, Attitudes, and Needs of Individuals with Bipolar Disorder: Implications for the Design of Technologies to Manage Mental Health

Objective To understand self-monitoring strategies used independently of clinical treatment by individuals with bipolar disorder (BD), in order to recommend technology design principles to support mental health management. Materials and Methods Participants with BD (N = 552) were recruited through the Depression and Bipolar Support Alliance, the International Bipolar Foundation, and WeSearchTogether.org to complete a survey of closed- and open-ended questions. In this study, we focus on descriptive results and qualitative analyses. Results Individuals reported primarily self-monitoring items related to their bipolar disorder (mood, sleep, finances, exercise, and social interactions), with an increasing trend towards the use of digital tracking methods observed. Most participants reported having positive experiences with technology-based tracking because it enables self-reflection and agency regarding health management and also enhances lines of communication with treatment teams. Reported challenges stem from poor usability or difficulty interpreting self-tracked data. Discussion Two major implications for technology-based self-monitoring emerged from our results. First, technologies can be designed to be more condition-oriented, intuitive, and proactive. Second, more automated forms of digital symptom tracking and intervention are desired, and our results suggest the feasibility of detecting and predicting emotional states from patterns of technology usage. However, we also uncovered tension points, namely that technology designed to support mental health can also be a disruptor. Conclusion This study provides increased understanding of self-monitoring practices, attitudes, and needs of individuals with bipolar disorder. This knowledge bears implications for clinical researchers and practitioners seeking insight into how individuals independently self-manage their condition as well as for researchers designing monitoring technologies to support mental health management

The cutting-edge of clinical psychology? : the internet, mental health & self-harm support groups

The aim of this study is to investigate the role of the internet within the area of mental health support. The first paper reviews the current literature surrounding the use of the internet for self-help and intervention purposes. It highlights investigations into the outcomes, benefits and disadvantages in using this medium for support and therapeutic input. It also highlights the implications within clinical psychology for future research and service development. This is presented in terms of on-going interventions and support, as well as for use within a 'stepped-care' model of service delivery. The second paper presents an empirical investigation into users' experiences of using online support groups concerned with self-harming behaviour. The literature surrounding this area was noted as particularly sparse. The study uses a mixed method incorporating both quantitative and qualitative analysis. Exploration into the responses towards individuals who disclose self-harming behaviour is also performed using a simulated online forum post to which participants 'role-played' replies. The third paper presents a reflective account of the research process. It includes reflection around the area of using the internet as a research tool. It also specifically highlights a methodological critique of the empirical methods with reference to online ethical research guidelines presented by the British Psychological Society (BPS, 2007). Personal reflections on the process, and dealing with a potentially distressing subject matter are also discussed