Why campaigns that stigmatize smokers can make them want to quit even less

Recent years have seen the rise of anti-smoking campaigns. While these campaigns are often successful at getting people to quit, Sara Evans-Lacko writes that their negativity can lead to the opposite of their intended effect. She argues that the stigma that such approaches bring can lower smokers’ self-esteem, making it harder for them to quit, or make them angry and want to smoke more

Can cash transfer programmes help mental health outcomes among Africa’s young people?

The importance of youth mental health is being increasingly recognised as a key determinant of population health outcomes. As the dominant social protection tool across the Africa, could cash transfer programmes act as a tool to improve mental health among this demographic

Cost of depression in the workplace across eight diverse countries – collectively US$250 billion

Depression is a leading cause of disability worldwide. Previous research has shown that by far the greatest contributor to the overall economic impact of depression is loss in productivity; including both increased absenteeism and presenteeism-related costs in the workplace. However, there is very little research on the costs of depression outside of Western countries and high-income countries. Using data from a survey of 8,000 employees across 8 countries spanning diverse cultures and levels of economic development, we found that workplace depression collectively costs almost US$250 billion. When analysing data from Brazil, Canada, China, Japan, South Korea, Mexico, South Africa and the USA, we found that between 0.1% and 4.9% of a country’s GDP was lost due to absenteeism and presenteeism in the workplace

The role of managers in promoting social acceptance among people with depression in the workplace

Our research highlights the important role that managers and organisations can play by creating supportive working environments that promote social acceptance for employees with depression. By doing so, employees will feel more comfortable in discussing any potential mental health issues early on. Our findings suggest that some responses, such as flexible working hours, may be helpful but are not necessarily adequate, and also emphasise the importance of support and openness of managers in addition to flexible working hours

Global patterns of workplace productivity for people with depression: absenteeism and presenteeism costs across eight diverse countries

Depression is a leading cause of disability worldwide. Research suggests that by far, the greatest contributor to the overall economic impact of depression is loss in productivity; however, there is very little research on the costs of depression outside of Western high-income countries. Thus, this study examines the impact of depression on workplace productivity across eight diverse countries

THE WOUNDED HEALER: AN EFFECTIVE ANTI-STIGMA INTERVENTION TARGETED AT THE MEDICAL PROFESSION?

Aims: To investigate whether a brief, contact based anti-stigma interventionentitled, ‘The Wounded Healer’ can positively influence participants’ views towards mental health challenges in medical students and doctors. We also wanted to raise awareness of the importance of registering witha General Practitioner (GP) and consulting him/her when under mental distress. Background: Despite the perception that medical students and doctors should be ‘invincible’, mental health challenges are common in this population. Doctors and medical students have low levels of help-seeking for their own psychiatric problems often only presenting to mental health services once a crisis arises. Fear of exposure to stigmatization is a critical factor contributing to symptom concealment and is a major barrier to accessing mental health services. Method: The Wounded Healer was delivered to participants in 6 cohorts across the United Kingdom (UK): Cambridge Medical School (n=97), Manchester Medical School (n=36), Manchester University International Society (n=25), Sheffield Medical School (n=21), Foundation Doctors in the North West of England (n=54) and Southampton Medical School (n=23) (total sample size n=256). Immediately following the intervention, we hand distributed paper questionnaires that contained stigma constructs to each individual participant.Answers were on a Likert-type scale and there was also space for free-text comments which were subjected to thematic analysis. Results: 174/219 (79.5%) of respondents agreed or strongly agreed that their views towards mental health issues were more positive after the talk. 172/219 (78.5%) of respondents agreed or strongly agreed that the talk made them more understanding and accepting of medical students and doctors with mental illness. 156/219 (71.3%) of respondents agreed or strongly agreed that the talk made them more aware of the importance of registering with a GP and consulting him/her if they felt they were under mental distress. Conclusion: Following the delivery of the anti-stigma Wounded Healer intervention a majority of respondents stated that they viewed mental health challenges in medical students and doctors in a more positive way. A majority of respondents also demonstrated a better awarenessof registering and consulting a GP if they develop mental distress. Further research which incorporates validated assessments of stigma (at baseline and at follow-up points after the intervention has been delivered), a control group and larger sample sizes are needed to determine if the Wounded Healer intervention can cause a sustained reduction in the stigma associated with mental health challenges in healthcare professionals and encourage help-seeking behaviour for mental health challenges

Complexity and Continuity of Treatments Among Privately Insured Youth Diagnosed with Bipolar Disorder

Objectives: To examine longitudinal patterns of complexity, continuity, and initiation of treatment for youth diagnosed with bipolar disorder. Additionally, we explore bipolar diagnosis stability and its relationship to observed treatment patterns. Methods: A cohort of 426 privately insured youth (ages 6–18) diagnosed with bipolar disorder was identified from the 2000–2001 Thomson/Medstat-MarketScan® database. Medication complexity was defined as number of different psychotropic medication classes dispensed during a 6-month period following a new treatment episode of bipolar disorder. Treatment continuity was examined over a 6-month follow-up period, specifically focusing on mood stabilizing medications and antidepressant monotherapy. Predictors of complexity and continuity were investigated. Results: Fifty-five percent of youth received more than one and 25% received three or more different types of psychotropic medication classes during follow-up. This was contrasted with several youth having no prescription fills (21%) and 31% discontinuing mood stabilizing medication. Youth with a stable bipolar diagnosis were more likely to have continuity of mood stabilizing prescriptions (OR: 4.05), but also greater psychotropic medication complexity. Age, health status/comorbidity, and being in a managed care plan were also related to complexity and continuity of psychotropic medication class regimens. Conclusions: More evidence is needed on the causal patterns leading to increased psychotropic medication complexity and continuity and how diagnosis of bipolar disorder may drive treatment patterns

Is manager support related to workplace productivity for people with depression: a secondary analysis of a cross-sectional survey from 15 countries

Objectives To examine variations in manager reactions and support for people with depression and to investigate how these reactions are related to (1) absenteeism and (2) presenteeism due to depression among employees with self-reported depression across 15 diverse countries. Design Secondary data analysis of cross-sectional survey data. Setting 15 countries, diverse in geographical region and gross domestic product (GDP): Brazil, Canada, China, Denmark, France, Germany, Great Britain, Italy, Japan, Mexico, Spain, South Africa, South Korea, Turkey and the USA. Participants 16 018 employees and managers (approximately 1000 per country). Primary and secondary outcome measures We assessed level of absenteeism as measured by number of days taken off work because of depression and presenteeism score. Results On average, living in a country with a greater prevalence of managers saying that they avoided talking to the employee about depression was associated with employees with depression taking more days off work (B 4.13, 95% CI 1.68 to 6.57). On average, living in a country with a higher GDP was marginally associated with employees with depression taking more days off of work (p=0.09). On average, living in a country with a greater prevalence of managers actively offering help to employees with depression was associated with higher levels of presenteeism (B 7.08, 95% CI 6.59 to 7.58). Higher country GDP was associated with greater presenteeism among employees with depression (B 3.09, 95% CI 2.31 to 3.88). Conclusions Manager reactions were at least as important as country financial resources. When controlling for country GDP, working in an environment where managers felt comfortable to offer help and support to the employee rather than avoid them was independently associated with less absenteeism and more presenteeism

Development of public stigma toward people with mental health problems in Czechia 2013–2019

BACKGROUND: We aimed to assess the changes in public stigma towards people with mental health problems in Czechia; and to investigate the association between these and the exposure to the ongoing mental health care reform and one of its implementation projects focused on reducing stigma. METHODS: We analyzed data from three cross-sectional surveys representative of the Czech adult population. We used linear regression models to compare population attitudes and desire for future contact with people with mental health problems between the 2013/2014 baseline and the 2019 follow-up. In our 2019 sample, we employed linear regression models to assess the relationship between exposure to mental health care reform and nation-wide anti-stigma campaign, and population stigmatizing attitudes and intended behavior. We utilized a propensity score matching procedure to mitigate potential bias. RESULTS: The 2013, 2014, and 2019 datasets consisted of 1797, 1810, and 1077 participants, respectively. Population attitudes improved significantly between 2014 and 2019 (B = 0.99, 95% CI = 0.06; 1.93), but we did not detect a change in population desire for future contact with people with mental health problems. Exposure to the nationwide anti-stigma campaign or mental health care reform was associated with more favorable attitudes (B = 4.25, 95% CI = 2.07; 6.42 and B = 7.66, 95% CI = 3.91; 11.42), but not with higher desire for future contact with people with mental health problems. CONCLUSIONS: Mental health care reform and its nation-wide anti-stigma project seems to have a positive impact on population attitudes, but not on desire for future contact with people with mental health problems

How best to mobilise social support to improve children and young people’s loneliness

Social support is a well-recognised protective factor for children’s mental health. Whilst many interventions exist that seek to mobilise social support to improve children’s mental health, not much is known about how to best do this. Annette Bauer, Madeleine Stevens, Martin Knapp, and Sara Evans-Lacko report key findings of a systematic review of the literature on approaches for preventing and reducing mental health problems among children and young adults