Beyond silence: protocol for a randomized parallel-group trial comparing two approaches to workplace mental health education for healthcare employees

© 2015 Moll et al.; licensee BioMed Central. Background: Mental illness is a significant and growing problem in Canadian healthcare organizations, leading to tremendous personal, social and financial costs for individuals, their colleagues, their employers and their patients. Early and appropriate intervention is needed, but unfortunately, few workers get the help that they need in a timely way due to barriers related to poor mental health literacy, stigma, and inadequate access to mental health services. Workplace education and training is one promising approach to early identification and support for workers who are struggling. Little is known, however, about what approach is most effective, particularly in the context of healthcare work. The purpose of this study is to compare the impact of a customized, contact-based education approach with standard mental health literacy training on the mental health knowledge, stigmatized beliefs and help-seeking/help-outreach behaviors of healthcare employees. Methods/Design: A multi-centre, randomized, two-group parallel group trial design will be adopted. Two hundred healthcare employees will be randomly assigned to one of two educational interventions: Beyond Silence, a peer-led program customized to the healthcare workplace, and Mental Health First Aid, a standardized literacy based training program. Pre, post and 3-month follow-up surveys will track changes in knowledge (mental health literacy), attitudes towards mental illness, and help-seeking/help-outreach behavior. An intent-to-treat, repeated measures analysis will be conducted to compare changes in the two groups over time in terms of the primary outcome of behavior change. Linear regression modeling will be used to explore the extent to which knowledge, and attitudes predict behavior change. Qualitative interviews with participants and leaders will also be conducted to examine process and implementation of the programs. Discussion: This is one of the first experimental studies to compare outcomes of standard mental health literacy training to an intervention with an added anti-stigma component (using best-practices of contact-based education). Study findings will inform recommendations for designing workplace mental health education to promote early intervention for employees with mental health issues in the context of healthcare work. Trial registration: May 2014 - ClinicalTrials.gov: NCT02158871

Hope for “Continued Vitality”: Qualitative Study of Adults With Traumatic Brain Injury and Low Mood on Their Rehabilitation

ObjectiveDepression is highly comorbid with traumatic brain injury (TBI) with often complex and interacting symptomology that contributes to the experience of disability. Comorbid depression results in poorer TBI rehabilitation and downstream participation outcomes yet perspectives of this group regarding person-centered care is unknown.PurposeThis study aimed to explicate the perspectives of persons with TBI and depression on their values, preferences, and desired outcomes for optimal rehabilitation.MethodsA qualitative descriptive approach was taken. Thirteen adults [mean age: 40.5 (standard deviation 9.8)] diagnosed with TBI and with self-reported low mood were recruited through convenience sampling. Participants were predominantly female (n = 12) with concussion/mild TBI and at least 6 months post-injury. One-on-one, semi-structured interviews were conducted by phone with Canadian participants (March-May 2020). Interviews were transcribed; data were analyzed thematically by two researchers and the thematic map refined by the research team.ResultsThree themes were identified on values, preferences, and desired outcomes in person-centered care. Participants valued “validation” from healthcare providers and the health system to feel seen and believed about their conditions and concerns. They preferred for healthcare providers to “share the burden of managing care” through improved interactions and better access to concussion care. Participants expressed that “meaningful outcomes” were to be symptom free, to resume valued life activities, and to be able to adapt/be resilient. The latter indicated hope for “continued vitality” for life participation despite past and ongoing challenges.ConclusionsMany adults with TBI and self-identified low mood expressed rehabilitation experiences that were invalidating. Their identified values, preferences, and desired outcomes provide directions for better person-centered care by healthcare providers and health systems to support participation

An enhanced individual placement and support (IPS) intervention based on the Model of Human Occupation (MoHO); a prospective cohort study

Susan Prior - ORCID 0000-0003-3069-6961 http://orcid.org/0000-0003-3069-6961Donald Maciver - ORCID 0000-0002-6173-429X https://orcid.org/0000-0002-6173-429XKirsty Forsyth - ORCID 0000-0002-6732-1699 https://orcid.org/0000-0002-6732-1699Replaced original VoR with updated VoR 2020-07-09Background: Employment is good for physical and mental health, however people with severe mental illness (SMI) are often excluded from employment. Standard Individual Placement and Support (IPS) is effective in supporting around 55% of people with SMI into employment or education. Current research considers enhancements to IPS to improve outcomes for those requiring more complex interventions. Clinicians need to better understand who will benefit from these enhanced IPS interventions. This study offers a new enhanced IPS intervention and an approach to predicting who may achieve successful outcomes.Methods: This prospective cohort study included people with SMI who participated in an enhanced IPS service and had prolonged absence from employment. Secondary data analysis was conducted of data gathered in routine clinical practice. Univariate analysis coupled with previous research and clinical consultation was used to select variables to be included in the initial model, followed by a backward stepwise approach to model building for the final multiple logistic regression model with an outcome of successful or unsuccessful goal attainment (employment or education).Results: Sixty-three percent of participants in the enhanced IPS successfully attained employment or education. Significant relationships from bivariate analyses were identified between outcomes (employment or education) and seven psychosocial variables. Adapting Routines to Minimise Difficulties, Work Related Goals, and Living in an Area of Lesser Deprivation were found to be significant in predicting employment or education in the final multiple logistic regression model R2 = 0.16 (Hosmer-Lemeshow), 0.19 (Cox-Snell), 0.26 (Nagelkerke). Model χ2(7) = 41.38 p < .001.Conclusion: An enhanced IPS service had a 63% rate success in achieving employment or education, higher than comparable studies and provides an alternative to IPS-Lite and IPS-standard for more complex populations. Motivational and habitual psychosocial variables are helpful in predicting who may benefit from an enhanced IPS intervention supporting people after prolonged absence from employment.Trial registration: NCT04083404 Registered 05 September 2019 (retrospectively registered).This study was funded by the Scottish Government. The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.https://bmcpsychiatry.biomedcentral.com/https://doi.org/10.1186/s12888-020-02745-320pubpu

Occupational Therapy Intervention with Children Survivors of War

A preventive occupational therapy program with children surviving the Kosovo conflict is examined. The objective of the program was to facilitate the emotional expression of traumatic experiences in order to prevent the development of future psychological problems. The intervention was based on a community-centred approach with spirituality as a central focus of the intervention.The Model of Human Occupation and the Occupational Performance Process Model were utilized to guide the identification and intervention of occupational performance issues.The children’s return from a land of war to a land of children demonstrates the potential of occupational therapy intervention in this field. With increasing awareness of populations facing social and political challenges, there is a growing importance of the concept of occupational justice and the need to work against occupational apartheid.Cet article décrit un programme de prévention en ergothérapie qui était destiné aux enfants ayant survécu au conflit du Kosovo. L’objectif du programme était d’aider les enfants à exprimer les émotions qu’ils avaient ressenties lors d’expériences traumatiques afin de prévenir l’apparition de problèmes psychologiques. L’intervention était basée sur une approche communautaire s’articulant autour de la spiritualité. Le Modèle de l’occupation humaine et le Modèle du processus d’intervention dans le rendement occupationnel ont été utilisés pour cibler les difficultés en matière de rendement occupationnel et pour déterminer les interventions requises. Le retour des enfants d’un monde de guerre vers le monde de l’enfance démontre la possibilité de proposer une intervention ergothérapique dans ce domaine. La conscientisation de plus en plus grand face à la détresse des populations confrontées à des problèmes politiques et sociaux entraîne une augmentation de l’importance du concept de la justice occupationnelle et du besoin de lutter contre l’apartheid occupationnel

A weak scientific basis for gaming disorder: let us err on the side of caution

We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization

Factors associated with work integration for mental health consumers

grantor: University of TorontoResearch on work integration for mental health consumers has typically examined the relationship of clinical and individual variables to employment, and few conclusions have been reached. This study shifts the focus of inquiry to include individually-based variables as well as environmental variables. A mixed method design drawing on quantitative and qualitative approaches was used to examine factors associated with work integration for mental health consumers. Thirty-six consumers (N = 36) were recruited into one of two groups: (1) consumers who were employed in integrated settings (n = 17) and (2) consumers who had left their jobs within a six-month period prior to the study (n = 19). Quantitative data were collected on four variables: empowerment, social support, organizational culture/climate and person-environment fit. Instruments used were the Empowerment Questionnaire, the Interpersonal Support Evaluation List (ISEL), the Workplace Climate Questionnaire (WCQ) and the Organizational Culture Profile (OCP). Data analysis revealed significant group differences along the dimensions of organizational climate and person-environment fit. Significant differences in effect sizes of perceived characteristics of the workplace were also determined. Logistic regression analyses revealed that organizational climate and person-environment fit were significant predictors of employment status. Qualitative data were collected through semistructured interviews with participants in both groups. Content analysis revealed the following themes: the impact of the organization on job satisfaction and tenure, the importance of supervisory and coworker relationships and attitudes, and the meaningfulness of work.Ph.D

Gender Differences within Online Gaming: A Systematic Scoping Review Protocol

Aims: The aim of this protocol is to outline the design of a systematic scoping review that will identify, describe, and categorize gender differences in terms of gamer characteristics, online experiences and behaviors, and offline effects on the gamer. Settingsand Design: This review will be guided by the York framework for scoping reviews outlined by Arksey and O‟Malley, 2005. Methods and Design:A systematic search of eight peer-reviewed databases (Scopus, Web of Science, Social Science Abstracts, PsychInfo, CINAHL, Medline, Embase, and International Bibliography of Social Sciences) and four grey-literature databases (Open Grey Repository, Health Canada, Conference Papers Index, and Dissertation Abstracts International) was completed. Hand searches of key journals and reference lists of relevant studies were also completed. Two independent reviewers screened the titles and abstracts using a set of inclusion and exclusion criteria. Full texts were then screened to determine fulfillment of the inclusion and exclusion criteria. The results will be charted and presented thematically. Discussion: This review will use a broad range of search terms, sources, and dates in order to capture a large spectrum of literature relating gender differences in online gaming. This study will raise awareness of the importance of the need to examine gender issues concerning online gaming. It will provide a foundation for members of academia and the gaming industry to identify the themes of research that have emerged when examining gender differences since near the beginning of online gaming. Recommendations for future research were provided

Occupational Therapy Interventions in Mental Health : A Literature Review in Search of Evidence

A growing body of literature sheds light on occupational therapy (OT) interventions and outcomes in adult mental health. Although this research has not developed to the point where a systematic review is warranted, a synthesis of these findings is needed. This article provides an overview of OT interventions in adult mental health and their documented outcomes. Fifty peer-reviewed intervention studies targeting adults with mental illness were reviewed. Seven categories of interventions emerged: employment/education; psychoeducation; creative occupations/activity; time use/occupational balance; skills/habit development; group/family approaches; and animal-assisted therapy. Further research involving rigorous designs is needed to establish a solid evidence base for OT interventions in adult mental health