Problem substance use among New Zealand secondary schools students

This report explores the health issues and contexts of New Zealand secondary school students who use substances at very high levels. Young people who use substances more than their peers are likely to have high rates of absenteeism from school and may be early school leavers. The Ministry of Health aims to support recovery and wellness and minimise the harm that addiction can cause. To support this, they asked the Adolescent Health Research Group (AHRG) of the University of Auckland to provide data about secondary school students using substances in ways that are likely to be problematic. The Ministry suggested that this population be defined using variables relating to alcohol, marijuana, other substances use and binge drinking. This report is based on Youth’12: The national health and wellbeing survey of 8500 New Zealand secondary school students. It provides evidence and awareness of the problems that are connected to substance use and highlights the fact that New Zealand adolescents appear to be using less alcohol, less marijuana and fewer other substances than they were in recent years. However, substance use remains a significant problem for a minority of students and it causes substantial personal, social and economic harm. The report finds that approximately 11 percent of New Zealand high school students use substances at levels that are likely to cause them significant current harm and may cause long-term problems. Those with substance use problems are likely to have higher rates of mental health problems, unwanted sexual contact, unsafe sex, exposure to violence, cigarette smoking, risky driving experiences, less likely to ‘like school’ and other harms. This report enables youth addiction treatment services to develop their scope of practice to incorporate these wider problems, and assist funders and planners, frontline youth service managers and youth workers to deliver relevant services. • Authors: Fleming, T. Lee, A.C., Moselen, E., Clark, T.C., Dixon, R. & The Adolescent Health Research Group, University of Auckland&nbsp

Tips for research recruitment: The views of sexual minority youth

Researchers often experience difficulties recruiting hard-to-reach populations. This is especially so for studies involving those who have been historically stigmatized, such as individuals who challenge heteronormative expectations or people who experience mental ill health. The authors aimed to obtain the views of sexual minority adolescents (n=25) about what encouraged their participation in a research project. The authors used a general inductive approach to analyze interview data. Feedback consisted of 2 main overarching themes: tips and suggestions for future research and appreciate participants’ motivation to get involved in research. Strategies for how recruitment can be optimized for studies involving sexual minority young people are discussed

From secrecy to discretion: The views of psychological therapists' on supporting Chinese sexual and gender minority young people

Objective Little is known about how to best meet the mental health needs of sexual and/or gender (SG) minority young people who are also an ethnic minority (i.e., double minority youth). We aimed to explore the views of mental health providers (hereafter ‘therapists’ for brevity) on the needs of Chinese SG minority youth in a Western nation (New Zealand) and the therapeutic approaches to best address these needs. Method Semi-structured interviews were conducted with eight therapists (including medical practitioners, counsellors, a psychotherapist, and a social worker). All were providers of talking therapies or counselling, experienced in working with Chinese and/or SG minority youth. A general inductive approach to qualitative data analysis was used to identify themes. Results Four categories of mental health needs emerged. These were needs for love and acceptance; migration and Chinese cultural needs; managing cis-heteronormativity and coming-out needs; and intersectional needs of ‘double rejection’. A ‘double-minority-specific’ therapeutic process was identified. This process suggests therapists successfully engage young people through three phases of therapeutic engagement: from exploration of a SG minority orientation; via segmentation of identity and cautious coming out practice; to a sense of accepted and managed, but often discrete identities. Dimensions of therapy to support Chinese SG minority youth prioritized relational, individually-tailored, holistic approaches that attend to potential barriers. Conclusion The results suggest that therapists perceive intersectional challenges for Chinese SG minority youth in a Western context. Tailored therapeutic approaches are advocated to support double minority young people

How LGBT+ Young People Use the Internet in Relation to Their Mental Health and Envisage the Use of e-Therapy: Exploratory Study

Background: Lesbian, gay, bisexual, and transgender (LGBT) youth and other young people diverse in terms of their sexuality and gender (LGBT+) are at an elevated risk of mental health problems such as depression. Factors such as isolation and stigma mean that accessing mental health services can be particularly challenging for LGBT+ young people, and previous studies have highlighted that many prefer to access psychological support on the Web. Research from New Zealand has demonstrated promising effectiveness and acceptability for an LGBT+ focused, serious game–based, computerized cognitive behavioral therapy program, Rainbow Smart, Positive, Active, Realistic, X-factor thoughts (SPARX). However, there has been limited research conducted in the area of electronic therapy (e-therapy) for LGBT+ people. Objective: This study aimed to explore how and why LGBT+ young people use the internet to support their mental health. This study also sought to explore LGBT+ young people’s and professionals’ views about e-therapies, drawing on the example of Rainbow SPARX. Methods: A total of 3 focus groups and 5 semistructured interviews were conducted with 21 LGBT+ young people (aged 15-22 years) and 6 professionals (4 health and social care practitioners and 2 National Health Service commissioners) in England and Wales. A general inductive approach was used to analyze data. Results: LGBT+ youth participants considered that the use of the internet was ubiquitous, and it was valuable for support and information. However, they also thought that internet use could be problematic, and they highlighted certain internet safety and personal security considerations. They drew on a range of gaming experiences and expectations to inform their feedback about Rainbow SPARX. Their responses focused on the need for this e-therapy program to be updated and refined. LGBT+ young people experienced challenges related to stigma and mistreatment, and they suggested that strategies addressing their common challenges should be included in e-therapy content. Professional study participants also emphasized the need to update and refine Rainbow SPARX. Moreover, professionals highlighted some of the issues associated with e-therapies needing to demonstrate effectiveness and challenges associated with health service commissioning processes. Conclusions: LGBT+ young people use the internet to obtain support and access information, including information related to their mental health. They are interested in LGBT-specific e-therapies; however, these must be in a contemporary format, engaging, and adequately acknowledge the experiences of LGBT+ young people

The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial

Objective To evaluate whether a new computerised cognitive behavioural therapy intervention (SPARX, Smart, Positive, Active, Realistic, X-factor thoughts) could reduce depressive symptoms in help seeking adolescents as much or more than treatment as usual

Body size and weight, and the nutrition and activity behaviors of sexual and gender minority youth: Findings and implications from New Zealand

Objective:To describe the body size and weight, and the nutrition and activity behaviors of sexual and gender minority (SGM) students, and compare them with those of exclusively opposite-sex-attracted cisgender students. Male and female SGM students were also compared. Design: Data were from a nationally representative health survey. Setting: Secondary schools in New Zealand, 2012. Subjects: A total of 7,769 students, 9% were SGM individuals. Results: Overall, weight control behaviors, poor nutrition and inactivity were common and, in many cases, more so for SGM students. Specifically, male SGM students were significantly more likely to have tried to lose weight (aOR=1.95; 95% CI 1.47, 2.59), engage in unhealthy weight control (aOR=2.17; 95% CI 1.48, 3.19), consume fast food and takeaways (aOR=2.89; 95% CI 2.01, 4.15), and be physically inactive (aOR=2.54; 95% CI 1.65, 3.92), and were less likely to participate in a school sports team (aOR=0.57; 95% CI 0.44, 0.75), compared with other males. Female SGM students were significantly more likely to engage in unhealthy weight control (aOR=1.58; 95% CI 1.20, 2.08), be overweight or obese (aOR=1.24; 95% CI 1.01, 1.53), and consume fast food and takeaways (aOR=2.19; 95% CI 1.59, 3.03), and were less likely to participate in a school sports team (aOR=0.62; 95% CI 0.50, 0.76), compared with other females. Generally, female SGM students were more negatively affected than comparable males, except they were less likely to consume fast food and takeaways frequently (aOR 0.62; 95% CI 0.40, 0.96). Conclusions: SGM students reported increased weight control behaviors, poor nutrition and inactivity. Professionals, including public health nutritionists, must recognize and help to address the challenges facing sexual and gender minorities

Enhancing an online cognitive behavioural therapy intervention for depression: Harnessing the feedback of sexual and gender minority youth to help improve SPARX

Objective SPARX is an online cognitive behavioural therapy self-help intervention for adolescent depression provided in serious game format. Since 2014, it has been freely available in Aotearoa New Zealand (NZ) due to funding from the NZ government. In 2020/21, feedback from sexual and gender minority youth (SGMY) was used to refine and update SPARX. Method Three online focus groups and follow-up email consultations involved 12 SGMY (16 to 25 years old) in NZ. A general inductive approach was used to analyse data. Results SGMY had specific needs as well as preferences and four themes were identified: attend to our contextual realities; portrayals of sexual and gender minority people in games; envisaged ideals for serious gaming and appraisals of SPARX. SGMY feedback was used to improve SPARX for this unique population, with the updates launched in October 2021. Conclusions SGMY are underserved in terms of their mental health needs. Refining or tailoring existing interventions proffers a potential way forward in terms of addressing these needs

Juegos serios para el tratamiento o la prevención de la depresión: una revisión sistemática

Serious games (computerised interventions which utilise gaming for serious purposes) have been shown to support improved outcomes in several health conditions. We aimed to review evidence regarding serious games for depression. We undertook electronic searches of PsycInfo, EMBASE and Medline, using terms relevant to computer games and depression. We included fulltext articles published in English in peer-reviewed literature since 2000, where the intervention was designed to treat or prevent depression and which included pre-and post-intervention measurement of depression. Nine studies relating to a total of six interventions met inclusion criteria. Most studies were small and were carried out by the developers of the programs. All were tested with young people (ages between 9 and 25 years). Most reported promising results with some positive impact on depression although one universal program had mixed results. Serious gaming interventions show promise for depression, however evidence is currently very limited.Se ha demostrado que los juegos serios (intervenciones computarizadas que utilizan juegos) mejoran los resultados en diferentes problemas de salud. Pretendemos examinar las evidencias de estos juegos para la depresión. Se realizaron búsquedas electrónicas en PsycINFO, EMBASE y Medline usando términos relacionados con juegos de ordenador y depresión. Se incluyeron artículos publicados desde el año 2000, donde se diseñó la intervención para tratar o prevenir la depresión incluyendo medidas pre- y post-intervención. Nueve estudios sobre un total de seis intervenciones cumplieron los criterios de inclusión. La mayoría de estos fueron pequeños y los llevaron a cabo los desarrolladores de los programas. Todos incluían población joven (9 - 25 años). La mayoría presentan resultados prometedores con un impacto positivo sobre la depresión aunque un programa universal tuvo resultados mixtos. Se concluye que las intervenciones basadas en juegos serios son prometedoras para la depresión, aunque la evidencia es todavía muy limitada

SERIOUS GAMES FOR THE TREATMENT OR PREVENTION OF DEPRESSION: A SYSTEMATIC REVIEW

Abstract: Serious games (computerised interventions which utilise gaming for serious purposes) have been shown to support improved outcomes in several health conditions. We aimed to review evidence regarding serious games for depression. We undertook electronic searches of PsycInfo, EMBASE and Medline, using terms relevant to computer games and depression. We included fulltext articles published in English in peer-reviewed literature since 2000, where the intervention was designed to treat or prevent depression and which included pre-and post-intervention measurement of depression. Nine studies relating to a total of six interventions met inclusion criteria. Most studies were small and were carried out by the developers of the programs. All were tested with young people (ages between 9 and 25 years). Most reported promising results with some positive impact on depression although one universal program had mixed results. Serious gaming interventions show promise for depression, however evidence is currently very limited. Keywords: Depression; adolescents; computerised CBT; serious gaming; e-therapy. Juegos serios para el tratamiento o la prevención de la depresión: una revisión sistemática Resumen: Se ha demostrado que los juegos serios (intervenciones computarizadas que utilizan juegos) mejoran los resultados en diferentes problemas de salud. Pretendemos examinar las evidencias de estos juegos para la depresión. Se realizaron búsquedas electrónicas en PsycINFO, EMBA-SE y Medline usando términos relacionados con juegos de ordenador y depresión. Se incluyeron artículos publicados desde el año 2000, donde se diseñó la intervención para tratar o prevenir la depresión incluyendo medidas pre-y post-intervención. Nueve estudios sobre un total de seis intervenciones cumplieron los criterios de inclusión. La mayoría de estos fueron pequeños y los llevaron a cabo los desarrolladores de los programas. Todos incluían población joven (9 -25 años). La mayoría presentan resultados prometedores con un impacto positivo sobre la depresión aunque un programa universal tuvo resultados mixtos. Se concluye que las intervenciones basadas en juegos serios son prometedoras para la depresión, aunque la evidencia es todavía muy limitada