Ways to Mind Your Mental Health in Challenging Times: Tips for Youth [English and Spanish versions]

A Spanish translation of this publication is available to download under Additional Files. The isolation that youth and young adults have faced during the COVID-19 pandemic has negatively impacted their mental health. This tip sheet offers some ideas and supports that youth and young adults can use to connect with others and help them feel better. See our related COVID-19 products on our website

Self-cutting and prospective repetition of self-harm: studies of emergency department presentations in Ireland

Background Self-harm places an individual at increased risk of future self-harm and suicide, and indicates distress and maladaptive coping. Those who present to hospital with self-cutting form a significant minority of self-harm patients who are at increased risk of prospective repetition of self-harm and suicide compared with those presenting with intentional overdose. In addition to increased risk, there is emerging evidence of demographic, psychological, clinical, and social differences between those presenting with self-cutting and those presenting with overdose. Aim and Key Objectives The aim of the current doctoral work was to examine in detail the association between presenting with self-cutting and risk of prospective repetition. The objectives were: to identify evidence-based risk factors for repetition of self-harm among those presenting to emergency departments with self-harm; to compare demographic and presentation characteristics and prospective repetition across presentations of self-cutting only, self-cutting plus intentional overdose, and intentional overdose only; to compare prospective repetition and other characteristics within self-cutting presentations based on the type of treatment received; to compare self-cutting and intentional overdose patients on psychological risk and protective factors for repetition; and to examine the lived experience of engaging in repeated overdose and self-cutting. Methods The current doctoral work used a mixed-methods approach and is comprised of one systematic review and four empirical studies. The empirical studies were two registry-based prospective studies of Irish hospital presentations of self-harm, one prospective structured interview study, and one qualitative study using Interpretative Phenomenological Analysis. Results The systematic review identified several consistent and emerging risk factors for repetition of self-harm, compared to which self-cutting had a medium-sized effect. The registry studies demonstrated that the involvement of self-cutting, particularly less medically severe selfcutting, confers an increased risk of 1-month and 12-month repetition among Irish index selfharm presentations. The structured psychological study detected higher hopelessness and lower non-reactivity to inner experience among those presenting with self-cutting, and higher depression among those who repeated self-harm. Repeaters had lower baseline levels of protective psychological factors than non-repeaters and continued to have higher depression and hopelessness at follow-up. Finally, the qualitative study indicated that self-harm is a purposeful action taken in response to an overwhelming situation and is evaluated afterwards in terms of personal and social effects. Chosen method of self-harm seemed to be influenced by the desired outcome of the self-harm act, capability, accessibility and previous experience. Conclusion Despite limitations in terms of recruitment rates, the work presented in this thesis is innovative in examining the issue of the association between self-cutting and repetition from multiple perspectives. No one factor can reliably predict all repetition but self-cutting represents one consistent and easily detected risk factor for repetition. Those who present with self-cutting exhibit significant differences on demographic, clinical, and psychological variables compared with those presenting with intentional overdose, and seem to exhibit a more vulnerable profile. However, those who present with self-cutting do not form a discrete or homogenous group, and self-harm methods and levels of suicidal intent are liable to fluctuate over time

Tobacco use disorder and treatment: new challenges and opportunities

Tobacco use remains a global problem, and options for consumers have increased with the development and marketing of e-cigarettes and other new nicotine and tobacco products, such as heat-not-burn tobacco and dissolvable tobacco. The increased access to these new products is juxtaposed with expanding public health and clinical intervention options, including mobile technologies and social media. The persistent high rate of tobacco-use disorders among those with psychiatric disorders has gathered increased global attention, including successful approaches to individual treatment and organizational-level interventions. Best outcomes occur when medications are integrated with behavioral therapies and community-based interventions. Addressing tobacco in mental health settings requires training and technical assistance to remove old cultural barriers that restricted interventions. There is still low-hanging fruit to be gained in educating on the proper use of nicotine replacement medications, how smoking cessation can change blood levels of specific medications and caffeine, and how to connect with quitlines and mobile technology options. Future innovations are likely to be related to pharmacogenomics and new technologies that are human-, home-, and community-facing

Dignity in mental health practice and research: Time to unite on innovation, outreach and education

Dignity has been described as ‘the inherent and inalienable worth of all human beings irrespective of social status such as race, gender, physical or mental state. Dignity is, therefore, at the core of psychological well-being, social connection and humanity. Mental health interventions that explicitly promote and preserve dignity for people experiencing mental distress are growing in clinical practice and research in the USA, India, Europe and elsewhere. However, there is a need for more research and policy supporting the implementation and evaluation of these initiatives. Here, we highlight some of these programmes and make recommendations on how to further integrate dignity in mental health research, practice, outreach and education in India and the world

Interpreting Alaminos : the cultural context of form

Thesis (M. Arch.)--Massachusetts Institute of Technology, Dept. of Architecture, 1983.MICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCHIncludes bibliographical references (p. 131-133).This thesis presents a methodology for transforming designs from their traditional context to a new, though continuous, form. In particular, this thesis examines the interactional role of holism - and its underlying mechanisms - between Pilipino architecture and culture. Given this approach, I base my design of a community center for Alaminos, a medium-sized town in Pangasinan, the Philippines, on three levels of analysis: language, time, and behavior. To achieve transformational Pilipino architecture, I conclude that it must be (a) "personalistic" according to regional sensibilities (b) culturally defined and (c) nationally fulfilling in its accurate representation of the indigenous spirit.by Celine Maria Larkin.M.Arch

Top Tips for Running a Virtual Advisory Board [English, Spanish, Portuguese, and Mandarin versions]

Spanish, Portuguese and Mandarin translations of this publication are available to download under Additional Files. In this tip sheet, the iSPARC Stakeholder Engagement Program offers advice on how to run an advisory council virtually. It also talks about some of the benefits of having your council meet virtually. Learn more about the iSPARC Stakeholder Engagement Program here

Why Engage Frontline Staff When Implementing a New Practice? Five Important Reasons [English, Chinese and Vietnamese versions]

Chinese and Vietnamese translations of this publication are available to download under Additional Files below. This tip sheet offers five critical reasons to integrate frontline providers throughout the process of implementing a new practice, program, or policy at your organization

Stakeholder Engagement through Participatory Action Research at iSPARC

The Implementation Science & Practice-based Advances Research Center (iSPARC) is a new DMH-funded collaborative effort between the former Systems and Psychosocial Advances Research Center, Quantitative Health Sciences and Boston University\u27s Center for Psychiatric Rehabilitation. With 52 core and affiliate investigators, iSPARC features five interacting programs: Stakeholder Engagement, Public Mental Health and Implementation Research, Technical Assistance and Consultation, Workforce Development, and External Funding. The mission of the Stakeholder Engagement Program is to lead the mental health research community and beyond in working in partnership with individuals with lived mental health experience, their families, and the agencies that serve them. This program intersects with several of iSPARC\u27s activities. It includes three active advisory groups with more than 20 members representing youth, individuals with lived mental health experience, and family members. These advisory groups adopt a participatory action research (PAR) approach and seek to engage community stakeholders at every stage of research, from development through enrollment and dissemination. Starting in 2018, the Stakeholder Program will seek to increase engagement and diversity through several additional initiatives. A new community provider advisory group is currently being developed and the Program is working to assess and assure diversity across all advisory groups. The Program will use a structured assessment tool and continuous quality improvement approach to measure and facilitate participatory action research across all iSPARC\u27s projects. The Program will develop and disseminate products to assist other organizations in initiating and maintaining stakeholder engagement. The proposed poster will summarize these activities and include examples of products created

What are the physical and psychological health effects of suicide bereavement on family members? Protocol for an observational and interview mixed-methods study in Ireland

Introduction: Research indicates that experiencing the suicide of a relative can have a significant impact on family members' emotional health. However, research incorporating the impact of suicide bereavement on family members' physical health is sparse. This paper details the protocol for a mixed-methods study of suicide-bereaved family members. The study will primarily examine the physical and mental health needs of those bereaved by suicide. A secondary objective of the study is to describe the support service needs of family members bereaved by suicide. Methods and analysis: A mixed-methods approach, using semistructured interviews and self-report questionnaires, will be used. Interviews will be conducted with a group of 15–20 relatives who experienced suicide bereavement. This protocol will follow the COREQ checklist criteria for the reporting of qualitative research interviews. Thematic analysis will be used to examine experiences and impact of bereavement on psychological and physical health. Self-report quantitative data on well-being will be analysed using descriptive statistics. Ethics and dissemination: Ethical approval to conduct this study has been granted from the Clinical Research Ethics Committee of the Cork Teaching Hospitals. Pseudonyms will be given to participants to protect anonymity. It will be explained to participants that participation in the study is voluntary and they have to right to withdraw at any time. The findings of this research will be disseminated to regional, national and international audiences through publication in peer-reviewed international journals and presentations at scientific conferences. This research also forms part of a PhD thesis

What are the physical and psychological health effects of suicide bereavement on family members? An observational and interview mixed-methods study in Ireland

OBJECTIVES: Research focussing on the impact of suicide bereavement on family members\u27 physical and psychological health is scarce. The aim of this study was to examine how family members have been physically and psychologically affected following suicide bereavement. A secondary objective of the study was to describe the needs of family members bereaved by suicide. DESIGN: A mixed-methods study was conducted, using qualitative semistructured interviews and additional quantitative self-report measures of depression, anxiety and stress (DASS-21). SETTING: Consecutive suicide cases and next-of-kin were identified by examining coroner\u27s records in Cork City and County, Ireland from October 2014 to May 2016. PARTICIPANTS: Eighteen family members bereaved by suicide took part in a qualitative interview. They were recruited from the Suicide Support and Information System: A Case-Control Study (SSIS-ACE), where family members bereaved by suicide (n=33) completed structured measures of their well-being. RESULTS: Qualitative findings indicated three superordinate themes in relation to experiences following suicide bereavement: (1) co-occurrence of grief and health reactions; (2) disparity in supports after suicide and (3) reconstructing life after deceased\u27s suicide. Initial feelings of guilt, blame, shame and anger often manifested in enduring physical, psychological and psychosomatic difficulties. Support needs were diverse and were often related to the availability or absence of informal support by family or friends. Quantitative results indicated that the proportion of respondents above the DASS-21 cut-offs respectively were 24% for depression, 18% for anxiety and 27% for stress. CONCLUSIONS: Healthcare professionals\u27 awareness of the adverse physical and psychosomatic health difficulties experienced by family members bereaved by suicide is essential. Proactively facilitating support for this group could help to reduce the negative health sequelae. The effects of suicide bereavement are wide-ranging, including high levels of stress, depression, anxiety and physical health difficulties