Research Snapshot: A Preliminary Randomized Controlled Evaluation of a Universal Healthy Relationships Promotion Program for Youth

This study evaluated the Health Relationships Plus program (HRP) with a group of Canadian youth. HRP aims to promote positive mental health and reduce bullying and substance misuse. Researchers found that HRP participation significantly reduced the odds of physical bullying victimization at one-year follow-up compared to the control group

Research Snapshot: GSA members\u27 experiences with a structured program to promote well-being

The Fourth R\u27s HRP for LGBT2Q+ Youth helps bolster positive mental wellness and encourage skill development among queer, trans, and gender diverse youth. It was adapted from the Healthy Relationships Plus Program (HRPP) - an evidence-informed, small group universal prevention program for youth that promotes positive mental health and well-being, and prevents risky behaviours. The HRP for LGBT2Q+ Youth was developed in consultation with academics, educators, and youth, and consists of 17 sessions, each lasting 45 minutes

Research Snapshot: Changes in depression and positive mental health among youth in a healthy relationships program

This study explored and identified meaningful groups of youth based on their depression symptoms over time. Researchers found that youth who reported high levels of depression prior to the program experienced a significant decline in depressive symptoms and improved mental well-being following the program

The depression report: a new deal for depression and anxiety disorders.

Crippling depression and chronic anxiety are the biggest causes of misery in Britain today. They are the great submerged problem, which shame keeps out of sight. But if you mention them, you soon discover how many families are affected. According to the respected Psychiatric Morbidity Survey, one in six of us would be diagnosed as having depression or chronic anxiety disorder, which means that one family in three is affected. That is the bad news. The good news is that we now have evidence-based psychological therapies that can lift at least a half of those affected out of their depression or their chronic fear. These new therapies are not endless nor backwardlooking treatments. They are short, forward-looking treatments that enable people to challenge their negative thinking and build on the positive side of their personalities and situations. The most developed of these therapies is cognitive behaviour therapy (CBT). The official guidelines from the National Institute for Clinical Excellence (NICE) say these treatments should be available to all people with depression or anxiety disorders or schizophrenia, unless the problem is very mild or recent. But the NICE guidelines cannot be implemented because we do not have enough therapists. In most areas waiting lists for therapy are over nine months, or there is no waiting list at all because there are no therapists. So, if you go to the GP, all that can be provided is medication (plus at some surgeries a little counselling). But many people will not take medication, either because they dislike the side effects or because they want to control their own mood. The result is tragic. Only one in four of those who suffer from depression or chronic anxiety is receiving any kind of treatment. The rest continue to suffer, even though at least half of them could be cured at a cost of no more than £750. This is a waste of people’s lives. It is also costing a lot of money. For depression and anxiety make it difficult or impossible to work, and drive people onto Incapacity Benefits. We now have a million people on Incapacity Benefits because of mental illness – more than the total number of unemployed people receiving unemployment benefits. At one time unemployment was our biggest social problem, but we have done a lot to reduce it. So mental illness is now the biggest problem, and we know what to do about it. It is time to use that knowledge. 2 But can we afford the £750 it costs to treat someone? The money which the government spends will pay for itself. For someone on Incapacity Benefit costs us £750 a month in extra benefits and lost taxes. If the person works just a month more as a result of the treatment, the treatment pays for itself. So we have a massive problem – the biggest problem they have for one in three of our families. But we also have a solution that can improve the lives of millions of families, and cost the taxpayer nothing. We should implement the NICE guidelines; and most people with mental illness should be offered the choice of psychological therapy. Everyone who wants something done should write to their MP calling for action.

Effectiveness of psychological interventions for smoking cessation in adults with mental health problems: A systematic review

Purpose: People with long-term mental health problems are heavier smokers than the general population, and suffer greater smoking-related morbidity and mortality. Little is known about the effectiveness of psychological smoking cessation interventions for this group. This review evaluates evidence from randomized controlled trials (RCTs) on the effectiveness of psychological interventions, used alone or with pharmacotherapy, in reducing smoking in adults with mental health problems. Methods: We searched relevant articles between January 1999 and March 2019 and identified 6,200 papers. Two reviewers screened 81 full-text articles. Outcome measures included number of cigarettes smoked per day, 7-day point prevalence abstinence, and continuous abstinence from smoking. Results: Thirteen RCTs, involving 1,497 participants, met the inclusion criteria. Psychological interventions included cognitive behavioural therapy (CBT), motivational interviewing (MI), counselling, and telephone smoking cessation support. Three trials resulted in significant reductions in smoking for patients receiving psychological interventions compared with controls. Two trials showed higher 7-day point prevalence in intervention plus nicotine replacement therapy (NRT) versus standard care groups. Four trials showed that participants who combined pharmacotherapy (bupropion or varenicline) with CBT were more likely to reduce their smoking by 50% than those receiving CBT only. Four out of five trials that compared different psychological interventions (with or without NRT) had positive outcomes regardless of intervention type. Conclusions: This study contributes to our understanding in a number of ways: The available evidence is consistent with a range of psychological interventions being independently effective in reducing smoking by people with mental health problems; however, too few well-designed studies have been conducted for us to be confident about, for example, which interventions work best for whom, and how they should be implemented. Evidence is clearer for a range of psychological interventions – including CBT, MI, and behavioural or supportive counselling – being effective when used with NRT or pharmacotherapy. Telephone-based and relatively brief interventions appear to be as effective as more intense and longer-term ones. There is also good evidence for a strong dose-response relationship – increased attendance predicts improved outcomes – and for interventions having more positive than negative effects on psychiatric symptoms

How should we evaluate research on counselling and the treatment of depression? A case study on how NICE’s draft 2018 guideline considered what counts as best evidence

Background: Health guidelines are developed to improve patient care by ensuring the most recent and “best available evidence” is used to guide treatment recommendations (NICE Guidance, 2017). NICE’s revised guideline development methodology acknowledges that evidence needed to answer one question (treatment efficacy) may be different from evidence needed to answer another (cost effectiveness, treatment acceptability to patients; NICE, 2014/2017). This review uses counselling in the treatment of depression as a case study, and interrogates the constructs of ‘best’ evidence and ‘best’ guideline methodologies. Method: The review comprises six sections: (1) the implications of diverse definitions of counselling in research; (2) research findings from meta-analyses and randomised controlled trials (RCTs); (3) limitations to trials-based evidence; (4) findings from large routine outcome datasets; (5) the inclusion of qualitative research that emphasises service-user voices; and (6) conclusions and recommendations. Results: Research from meta-analyses and RCTs reviewed in the draft 2018 NICE guideline is limited but positive in relation to the effectiveness of counselling in the treatment for depression. The weight of evidence suggests little, if any, advantage to CBT over counselling once bias and researcher allegiance are taken into account. A growing body of evidence from large NHS datasets also evidences that counselling is both effective and cost-effective when delivered in NHS settings. Conclusion: Recommendations in NICE’s own updated procedures suggest that sole reliance on RCTs and meta-analyses as best methodologies is no longer adequate. There is a need to include large standardised collected datasets from routine practice as well as the voice of patients via high-quality qualitative research

Primary health care delivery models in rural and remote Australia – a systematic review

© 2008 Wakerman et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background One third of all Australians live outside of its major cities. Access to health services and health outcomes are generally poorer in rural and remote areas relative to metropolitan areas. In order to improve access to services, many new programs and models of service delivery have been trialled since the first National Rural Health Strategy in 1994. Inadequate evaluation of these initiatives has resulted in failure to garner knowledge, which would facilitate the establishment of evidence-based service models, sustain and systematise them over time and facilitate transfer of successful programs. This is the first study to systematically review the available published literature describing innovative models of comprehensive primary health care (PHC) in rural and remote Australia since the development of the first National Rural Health Strategy (1993–2006). The study aimed to describe what health service models were reported to work, where they worked and why. Methods A reference group of experts in rural health assisted in the development and implementation of the study. Peer-reviewed publications were identified from the relevant electronic databases. 'Grey' literature was identified pragmatically from works known to the researchers, reference lists and from relevant websites. Data were extracted and synthesised from papers meeting inclusion criteria. Results A total of 5391 abstracts were reviewed. Data were extracted finally from 76 'rural' and 17 'remote' papers. Synthesis of extracted data resulted in a typology of models with five broad groupings: discrete services, integrated services, comprehensive PHC, outreach models and virtual outreach models. Different model types assume prominence with increasing remoteness and decreasing population density. Whilst different models suit different locations, a number of 'environmental enablers' and 'essential service requirements' are common across all model types. Conclusion Synthesised data suggest that, moving away from Australian coastal population centres, sustainable models are able to address diseconomies of scale which result from large distances and small dispersed populations. Based on the service requirements and enablers derived from analysis of reported successful PHC service models, we have developed a conceptual framework that is particularly useful in underpinning the development of sustainable PHC models in rural and remote communities

Conscious and Non-Conscious Measures of Emotion: Do They Vary with Frequency of Pornography Use?

Increased pornography use has been a feature of contemporary human society, with technological advances allowing for high speed internet and relative ease of access via a multitude of wireless devices. Does increased pornography exposure alter general emotion processing? Research in the area of pornography use is heavily reliant on conscious self-report measures. However, increasing knowledge indicates that attitudes and emotions are extensively processed on a non-conscious level prior to conscious appraisal. Hence, this exploratory study aimed to investigate whether frequency of pornography use has an impact on non-conscious and/or conscious emotion processes. Participants (N = 52) who reported viewing various amounts of pornography were presented with emotion inducing images. Brain Event-Related Potentials (ERPs) were recorded and Startle Reflex Modulation (SRM) was applied to determine non-conscious emotion processes. Explicit valence and arousal ratings for each image presented were also taken to determine conscious emotion effects. Conscious explicit ratings revealed significant differences with respect to “Erotic” and “Pleasant” valence (pleasantness) ratings depending on pornography use. SRM showed effects approaching significance and ERPs showed changes in frontal and parietal regions of the brain in relation to “Unpleasant” and “Violent” emotion picture categories, which did not correlate with differences seen in the explicit ratings. Findings suggest that increased pornography use appears to have an influence on the brain’s non-conscious responses to emotion-inducing stimuli which was not shown by explicit self-report.© 2017 by the author