Depression in Low-Income Adolescents: Guidelines for School-Based Depression Intervention Programs

Adolescent depression is growing in interest to clinicians. In addition to the estimated 2 million cases of adolescent major depressive episodes each year, depressive symptoms in youth have become indicators of mental health complications later in life. Studies indicate that being low-income is a risk factor for depression and that socioeconomically disadvantaged teenagers are more than twice as likely to develop mental illnesses. Only an estimated 1 in 4 children with mental illnesses receive adequate help and 80% of these resources come through schools. Thus, this study focuses on establishing the importance of depression intervention programs in low-income high schools and designing novel guidelines for effective protocols. A compilation of expert opinion on depression screening, education, and treatment, as well as analysis of previously implemented school screening and awareness programs, are examined in order to understand key strategies. The results of this study finds that a multi-layered approach with screening, universal education, and interventions for those identified as being high-risk is most effective in addressing the mental health needs of low-income adolescents. To ensure feasibility and efficacy, screening should be conducted with a modified PHQ-a test and followed-up by timely clinical interviews by school psychologists. All students should receive universal depression education curriculum consisting of principles such as: depression literacy, asset theory, and promotion of help-seeking behaviors. Extending universal education to teachers would also be beneficial in promoting mental health communication and positive classroom environments. It is vital that those screening positive for depression or suicidality receive protocols geared towards high-risk youths, such as group Cognitive-Behavioral Therapy and facilitated mental health center referrals based on individual severity. Effectively addressing depression in school systems requires integration of mental health promotion, depression prevention, and psychotherapy—by taking this multidimensional approach, public health officials and school administrations can ensure that adequate resources are directed to those most in need

Why are health care interventions delivered over the internet? : a systematic review of the published literature

Background: As Internet use grows, health interventions are increasingly being delivered online. Pioneering researchers are using the networking potential of the Internet, and several of them have evaluated these interventions. Objective: The objective was to review the reasons why health interventions have been delivered on the Internet and to reflect on the work of the pioneers in this field in order to inform future research. Methods: We conducted a qualitative systematic review of peer-reviewed evaluations of health interventions delivered to a known client/patient group using networked features of the Internet. Papers were reviewed for the reasons given for using the Internet, and these reasons were categorized. Results: We included studies evaluating 28 interventions plus 9 interventions that were evaluated in pilot studies. The interventions were aimed at a range of health conditions. Reasons for Internet delivery included low cost and resource implications due to the nature of the technology; reducing cost and increasing convenience for users; reduction of health service costs; overcoming isolation of users; the need for timely information; stigma reduction; and increased user and supplier control of the intervention. A small number of studies gave the existence of Internet interventions as the only reason for undertaking an evaluation of this mode of delivery. Conclusions: One must remain alert for the unintended effects of Internet delivery of health interventions due to the potential for reinforcing the problems that the intervention was designed to help. Internet delivery overcomes isolation of time, mobility, and geography, but it may not be a substitute for face-to-face contact. Future evaluations need to incorporate the evaluation of cost, not only to the health service but also to users and their social networks. When researchers report the outcomes of Internet-delivered health care interventions, it is important that they clearly state why they chose to use the Internet, preferably backing up their decision with theoretical models and exploratory work. Evaluation of the effectiveness of a health care intervention delivered by the Internet needs to include comparison with more traditional modes of delivery to answer the following question: What are the added benefits or disadvantages of Internet use that are particular to this mode of delivery

Preventing suicide by young people

Introduction In 2013, 2,522 people died by suicide in Australia. Twenty-two of these were children aged 5- 14 years, 148 were adolescents aged 15-19 years, and a further 200 were young people aged 20-24 years. Although the suicide rate for children and adolescents is lower than that for some older age groups, suicide is the leading cause of death in children and young people. Suicide has immense effects on the families, friends, and communities of people who die by suicide, causing long lasting grief and guilt. Arguably, these effects are even greater when the person who died by suicide is young. It is estimated that suicide costs the Australian economy more than $17 billion per year. Researchers and policy makers recognise that suicide is preventable, yet suicide rates have changed little in the past 10 years. This discussion paper aims to focus a spotlight on the unique experience of young people. It does this by providing a critical analysis of existing policy and evidence based responses relevant to young people

Lifting the Burden of Addiction: Philanthropic Opportunities to Address Substance Use Disorders in the United States

Substance use disorders (SUDs), also known as substance abuse or addiction, affect an estimated 20 million or more adolescents and adults in the U.S. This guidance provides philanthropic funders with the tools & information to reduce immediate harm from substance use disorders and reduce the burden of the disorder over the long term. This includes reducing the damage the disorder causes to people with SUDs and their loved ones, reducing the overall incidence of SUDs, and reducing SUD-related costs to society. We present four strategies for philanthropic funders who want to help:- Save lives and reduce SUD-related illness and homelessness- Improve access to evidence-based treatment- Improve SUD care by changing systems and policies- Fund innovation to improve prevention and treatmen

Helping veterans through outreach

Master's Project (M.A.) University of Alaska Fairbanks, 2017The present Master's project seeks to develop a better understanding of Veterans and what they are going through. Research methods include extensive data on the high suicide rates of Veterans. Veteran and service members are in need of a service to them that will address the issue of suicide and what can be done to help and eliminate this problem. The programs that need to be designed to help needs should be in locations that have Veteran populations so as to serve them with their needs. Ultimately, Veterans Affairs (VA) officials have boosted their mental health personnel and suicide hotline staff in recent years, but at this time their data does not reflect it helping Veterans getting the help that they so desperately need.I. Introduction -- II. Research methods -- III. Literature review -- A. Understanding the veteran and their background -- B. What is being done to help the veteran -- C. Current best practices -- 1. Medical model approach -- 2. Veteran wellness counseling -- 3. Culturally integrated counseling -- V. Program design -- Project Implementation -- VI. Discussion -- VII. Conclusion -- References

Mental Health in the Workplace: Situation Analyses, United States

Mental illness constitutes one of the world\u27s most critical and social health problems. It affects more human lives and wastes more human resources than any other disabling condition. The ILO’s activities promote the inclusion of persons with physical, psychiatric and intellectual disabilities into mainstream training and employment structures. The ILO’s primary goals regarding disability are to prepare and empower people with disabilities to pursue their employment goals and facilitate access to work and job opportunities in open labour markets, while sensitising policy makers, trade unions and employers to these issues. The ILO\u27s mandate on disability issues is specified in the ILO Convention 159 (1983) on vocational rehabilitation and employment. No. 159 defines a disabled person as an individual whose prospects of securing, retaining, and advancing in suitable employment are substantially reduced as a result of a duly recognised physical or mental impairment. The Convention established the principle of equal treatment and employment for workers with disabilities

Adherence to the MoodGYM program: Outcomes and predictors for an adolescent school-based population

Background Program adherence has been associated with improved intervention outcomes for mental and physical conditions. The aim of the current study is to investigate adolescent adherence to an Internet-based depression prevention program in schools to identify the effect of adherence on outcomes and to ascertain the predictors of program adherence. Methods Data for the current study (N=1477) was drawn from the YouthMood Project, which was conducted to test the effectiveness of the MoodGYM program in reducing and preventing symptoms of anxiety and depression in an adolescent school-based population. The current study compares intervention effects across three sub-groups: high adherers, low adherers and the wait-list control condition. Results When compared to the control condition, participants in the high adherence intervention group reported stronger intervention effects at post-intervention and 6-month follow-up than participants in the low adherence group for anxiety (d=0.34–0.39 vs. 0.11–0.22), and male (d=0.43–0.59 vs. 0.26–0.35) and female depression (d=0.13–0.20 vs. 0.02–0.04). No significant intervention effects were identified between the high and low adherence groups. Being in Year 9, living in a rural location and having higher pre-intervention levels of depressive symptoms or self-esteem were predictive of greater adherence to the MoodGYM program. Limitations The program trialled is Internet-based and therefore the predictors of adherence identified may not generalise to face-to-face interventions. Conclusions The current study provides preliminary support for the positive relationship between program adherence and outcomes in a school environment. The identification of significant predictors of adherence will assist in identifying the type of user who will engage most with an online depression prevention program.ALC is supported by National Health and Medical Research Council (NHMRC)Fellowship 1013199, HC is supported by NHMRC Fellowship 525411, and KMG is supported by NHMRC Fellowship 42541

Protocol for a randomised controlled trial investigating the effectiveness of an online e health application for the prevention of Generalised Anxiety Disorder

BACKGROUND Generalised Anxiety Disorder (GAD) is a highly prevalent psychiatric disorder. Effective prevention in young adulthood has the potential to reduce the prevalence of the disorder, to reduce disability and lower the costs of the disorder to the community. The present trial (the WebGAD trial) aims to evaluate the effectiveness of an evidence-based online prevention website for GAD. METHODS/DESIGN The principal clinical question under investigation is the effectiveness of an online GAD intervention (E-couch) using a community-based sample. We examine whether the effect of the intervention can be maximised by either human support, in the form of telephone calls, or by automated support through emails. The primary outcome will be a reduction in symptoms on the GAD-7 in the active arms relative to the non active intervention arms. DISCUSSION The WebGAD trial will be the first to evaluate the use of an internet-based cognitive behavioural therapy (CBT) program contrasted with a credible control condition for the prevention of GAD and the first formal RCT evaluation of a web-based program for GAD using community recruitment. In general, internet-based CBT programs have been shown to be effective for the treatment of other anxiety disorders such as Post Traumatic Stress Disorder, Social Phobia, Panic Disorder and stress in clinical trials; however there is no evidence for the use of internet CBT in the prevention of GAD. Given the severe shortage of therapists identified in Australia and overseas, and the low rates of treatment seeking in those with a mental illness, the successful implementation of this protocol has important practical outcomes. If found to be effective, WebGAD will provide those experiencing GAD with an easily accessible, free, evidence-based prevention tool which can be promoted and disseminated immediately

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

The Psychological Needs of U.S. Military Service Members and Their Families: A Preliminary Report

Since September 11, 2001, American military service personnel and their families have endured challenges and stressful conditions that are unprecedented in recent history, including unrelenting operational demands and recurring deployments in combat zones. In response to concerns raised by members of the military community, the American Psychological Association (APA) President, Dr. Gerald Koocher, established the Task Force on Military Deployment Services for Youth, Families and Service Members in July of 2006. This Task Force was charged with: identifying the psychological risks and mental health-related service needs of military members and their families during and after deployment(s); developing a strategic plan for working with the military and other organizations to meet those needs; and constructing a list of current APA resources available for military members and families, as well as additional resources that APA might develop or facilitate in order to meet the needs of this population. At present, 700,000 children in America have at least one parent deployed. Having a primary caretaker deployed to a war zone for an indeterminate period is among the more stressful events a child can experience. Adults in the midst of their own distress are often anxious and uncertain about how to respond to their children's emotional needs. The strain of separation can weigh heavily on both the deployed parent and the caretakers left behind. Further, reintegration of an absent parent back into the family often leads to complicated emotions for everyone involved. This Task Force was established to examine such potential risks to the psychological well-being of service members and their families, acknowledging the changing context and impact of the deployment cycle, and to make preliminary recommendations for change and further review at the provider, practice, program, and policy levels. To meet the Task Force charge, we will first provide an overview of what is currently known about the impact of military deployments on service members and their families (spouses, children and significant others). In addition, we will discuss a number of programs that have been developed to meet the mental health needs of service members and their families, and we will describe the significant barriers to receiving mental health care within the Department of Defense (DoD) and Veterans Affairs (VA) system. Finally, we will offer several general recommendations for improving the psychological care offered to service members and their Military Deployment Services TF Report 5 families, and we will outline some specific proposals for how existing APA programs and resources can be employed or modified to support military communities