The influence of animal ownership on mental health for people with severe mental illness: Findings from a UK population cohort study

Abstract Background and aims: There is increasing evidence to suggest companion animal ownership may positively impact mental health and wellbeing. However, there is limited research related to the role of companion animal ownership for mental health that focuses on people living with severe mental illness (SMI). We aimed to explore the connection among loneliness, mental health, wellbeing, animal ownership, and the perceived strength of the human-animal bond in this population. Methods: We conducted a survey in an existing UK cohort of people living with SMI. The survey questionnaire included standardized measures to collect information related to mental health, loneliness, and the perceived strength of the human-animal bond. Results: Of 286 participants who had previously consented to participate in the follow-up survey, 170 participants (59.4%) completed the survey. Of these, 81 (47.6%) owned at least one animal, and most perceived to have a strong human-animal bond with their companion animal as indicated by the Comfort from Companion Animals Scale (M = 39.80 of a maximum score of 44). However, regression analyses showed that owning an animal was not significantly associated with wellbeing, depression, anxiety, or loneliness scores. Likewise, the perceived strength of the human-animal bond was not significantly associated with animal species owned or wellbeing, depression, and anxiety scores. Conclusion: The findings provide a counterpoint to the commonly held assumption that companion animals are beneficial for all owners’ mental health. Further exploration of the role of human-animal relationships, including challenges and support needs related to animal ownership, in people living with SMI is required

Remote data collection during COVID-19 restrictions : an example from a refugee and asylum seeker participant group in the UK

This article describes how one trial site of the Refugee Emergency: Defining and Implementing Novel Evidence-based psychosocial interventions (RE-DEFINE) study, designed to evaluate a Self Help+ intervention with Arabic-speaking refugees and asylum seekers currently living in the UK and experiencing stress, was adapted to accommodate social distancing rules and working from home during the COVID-19 restrictions. Digital divide, risk and safety management, acceptability of remote data collection and practical considerations are described. The adaptions to methods have practical implications for researchers looking for more flexible approaches in response to continuing restrictions resulting from COVID-19, and the authors believe that others could adopt such an approach. The need for a further acceptability study focusing on human and economic costs and benefits of telephone and video as an alternative to face-to-face data collection is indicated

Challenges and solutions to nicotine replacement therapy access: observations from SCIMITAR+

Background Given, smoking results in poor physical and mental health, reducing tobacco harm is of high importance. Recommendations published by National Institute for Health and Care Excellence to reduce smoking harms included provision of support, use of nicotine containing products and commissioning of smoking cessation services. Aims This report explores the difficulties in obtaining such support, as observed in a recently conducted randomised controlled trial in patients with severe mental ill health, and outlines suggestions to improve facilitation of provision. Methods Data collected during the Smoking Cessation Intervention for severe Mental Ill Health Trial (SCIMITAR+) trial, was reviewed to identify the difficulties experienced, across the trial, with regards to access and provision of NRT. Actions taken to facilitate access and provision of NRT were collated to outline how provision could be better facilitated. Results Access to nicotine replacements therapy (NRT) varied across study settings and in some instances proved impossible for patients to access. Difficulty in access was irrespective of a diagnosis of severe mental ill health. Where NRT was provided, this was not always provided in accordance with NICE guidelines. Conclusions Availability of smoking cessation support, and NRT provision would benefit from being made clearer, simpler and more easily accessible so as to enhance smoking cessation rates

The role of animal ownership for people with severe mental illness during the Covid-19 pandemic: a mixed-method study investigating links with health and loneliness

Research has reported the benefits of companion animals for people with severe mental illness (SMI). However, this evidence base is fragmented and unclear. The COVID-19 pandemic presents an opportunity to explore the role of companion animals in the context of social distancing and isolation measures for people with SMI. Therefore, we aimed to investigate the links between mental and physical health and animal ownership in people with SMI and to explore animal owners’ perceptions related to human–animal interactions during the pandemic restrictions. A survey was conducted with a previously assembled cohort of individuals with SMI in the UK. The survey included previously validated and new bespoke items measuring demographics, and outcomes related to mental and physical health, and human–animal interactions. The survey also included a question inviting free-text responses, allowing participants to describe any experiences of their human–animal relationships during the pandemic. Of 315 participants who consented to participate, 249 (79%) completed the survey. Of these, 115 (46.2%) had at least one companion animal. Regression analyses indicated that animal ownership was not significantly associated with well-being and loneliness. However, animal ownership was associated with a self-reported decline in mental health (b = 0.640, 95% CI [0.102–1.231], p = 0.025), but no self-reported change in physical health. Thematic analysis identified two main themes relating to the positive and negative impact of animal ownership during pandemic restrictions. Animal ownership appeared to be linked to self-reported mental health decline in people with SMI during the second wave of the pandemic in the UK. However, the thematic analysis also highlighted the perceived benefit of animal ownership during this time. Further targeted investigation of the role of human–animal relationships and the perceived human–animal bond for human health is warranted

Smoking cessation in severe mental illness: : combined long-term quit rates from the UK SCIMITAR trials programme

Simon Gilbody, Emily Peckham, Della Bailey, Catherine Arundel, Paul Heron, , , , and members of the SCIMITAR+ collaborative

SCIMITAR+ Trial: A randomised study within a trial (SWAT) of a contingent financial reward to improve trial follow-up

Objectives To evaluate the effectiveness of a contingent financial incentive (£10 note in addition to a routinely provided £10 voucher) versus no contingent financial incentive, on improving the retention rate in a randomised controlled trial (RCT). Methods A two arm ‘Study within a Trial’ (SWAT) embedded within a host RCT (SCIMITAR+). Participants were randomised to the SWAT using a 2:1 (intervention:control) allocation ratio. The primary outcome measure was the proportion of participants completing a CO breath measurement at the first SCIMITAR+ follow up time point (6 months). Secondary outcomes were withdrawing from follow-up after contact and time from assessment due date to completion. Analyses were conducted using logistic or Cox Proportional Hazards regression as appropriate. Results A total of 434 participants were randomised into this SWAT. Completion of the CO breath measurement at 6 months was 88.5% (n=247) in the intervention arm of the SWAT and 85.4% (n=123) in the control arm. The difference (3.1%) was not statistically significant (p=0.36; OR 1.29, 95% CI 0.71-2.33, p=0.41). There was also no evidence of a difference in the proportion of participants withdrawing from follow-up after contact (intervention n=7 (2.5%), control n=5 (3.5%); OR 0.76, 95% CI 0.23-2.44, p=0.64), nor in terms of proximity of 6-month visit completion to due date (HR 1.07, 95% CI 0.86-1.33, p=0.55). Conclusion Contingent financial incentives did not statistically significantly increase rates of face-to-face follow-up completion within the SCIMITAR+ trial population. However, the sample size of this SWAT was constrained by the size of the host trial and power was limited. This SWAT adds to the body of evidence for initiatives to increase response rates in trials. Key Words SWAT, retention; randomized controlled tria

Health-risk behaviours among people with severe mental ill health : understanding modifiable risk in the Closing the Gap Health Study

© 2023 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/BACKGROUND: People with severe mental ill health (SMI) experience some of the largest health inequalities of any sector within society. For these inequalities to be reduced, an understanding of the behavioural determinants of health in this population is needed. AIMS: Utilising data from the Closing the Gap Health Study, we aimed to assess the extent to which people with SMI report health-risk factors and behaviours, their interest in modifying them, and the factors associated with being motivated to modify these behaviours. METHOD: Adult (≥18 years old) participants were recruited via primary and secondary care in the English National Health Service. To be eligible, participants needed to have a documented diagnosis of schizophrenia, psychotic disorders or bipolar disorder. Data were collected by survey on demographics, general physical health, diet, physical activity, alcohol, smoking and body mass index. RESULTS: Between April 2016 and March 2020, n = 9914 participants were recruited. Among people with SMI, high rates of obesity (37.5%), infrequent physical activity (62.0%), not meeting current guidelines (≥5) for the consumption of fruit and vegetables (85.0%) and smoking (42.2%) were observed. However, most participants were motivated to reduce health-risk behaviours. Perceiving the importance of health-promoting behaviours, being of poorer general health and being female were significantly associated with being motivated to modify health-risk behaviours. CONCLUSIONS: Despite experiencing poor physical and mental health outcomes compared with the general population, and contrary to popular misconceptions, people with SMI perceive health as important and are motivated to make behavioural changes to improve health.Peer reviewe