Public mental health: a psychiatry and public health perspective.

Mental health issues are fast becoming one of society's greatest health challenges with evidence of higher levels of illness and strain on psychiatric services. The reasons for this trend of increasing mental health problems across the population are complex and there is an urgent need to research and deliver effective public mental health strategies. In this perspective piece we argue that psychiatrists and public health physicians have unique knowledge and perspectives on population mental health. The development of interdisciplinary initiatives and training posts would result in clinicians with expertise to drive forward public mental health strategies. Focused and sustained advocacy and collaboration are necessary for prioritisation of public mental health on policymakers' agendas.

Public mental health and the COVID-19 pandemic.

COVID-19 has presented society with a public health threat greater than any in living memory, leaving us to question almost every aspect of our society. An ever increasing concern is how we protect the global population from mental illness and whether public mental health policies can achieve this. In this article I reflect on the history of mental health service development, and furthermore on how COVID-19 might impact on the delivery of public mental health strategies into the future.

Physician suicide during the COVID-19 pandemic in Iran

Suicide is a significant and global public mental health problem. The suicide rate in Iran is disturbingly high;it has been reported to be 5.3 per 100.000 individuals. A meta-analysis indicated that physicians were at risk, with a reported standardized mortality risk of 1.44%. The rate of suicide has also been reported to be increasing in residents, in addition to a higher rate in senior specialists. Several possible suicides among Iran's resident doctor population have occurred in a short period, underlining the vital need for suicide prevention initiatives. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Exploring the Effect of Emotional Labor on Turnover Intention and the Moderating Role of Perceived Organizational Support: Evidence from Korean Firefighters.

Synthesizing the conservation of resource theory, proximal withdrawal state theory, and job demands-resources theory, the present study examined the relationships between two dimensions of emotional labor (i.e., surface and deep acting) and turnover intention, as well as the moderating role of perceived organizational support in these relationships, such as the context of Korean firefighters. Using survey data drawn from fire organizations in Gyeonggi-do, the largest province of South Korea, we found that both surface and deep acting are positively related to firefighter turnover intentions. Further analysis indicates that the perceived organizational support of firefighters, vital for public health and safety, attenuates the positive relationship between surface acting and turnover intention but has no significant moderating effect on the relationship between deep acting and turnover intention. Our results suggest that perceived organizational support acts through essential psychological resources to recover the loss of emotional resources and contributes to the retention of firefighter personnel who primarily perform challenging and stressful work, including firefighting and offering emergency medical services. Thus, this study examines a crucial tool to ensure firefighters' public mental health.

Impact of the COVID pandemic on mental health and training opportunities of Public Health Residents from 4 European countries: A cross-sectional study.

Objectives: There is little evidence on the impact of the COVID-19 pandemic on Public Health Residents' (PHR) mental health (MH). This study aims at assessing prevalence and risk factors for depression, anxiety and stress in European PHR during the COVID-19 pandemic. Methods: Between March and April 2021, an online survey was administered to PHR from France, Italy, Portugal and Spain. The survey assessed COVID-19 related changes in working conditions, training opportunities and evaluated MH outcomes using the Depression Anxiety Stress Scales-21. Multivariable logistic regressions were applied to identify risk factors. Results: Among the 443 respondents, many showed symptoms of depression (60.5%), anxiety (43.1%) and stress (61.2%). The main outcome predictors were: female gender for depression (adjOR = 1.59, 95%CI [1.05-2.42]), anxiety (adjOR = 2.03, 95%CI [1.33-3.08]), and stress (adjOR = 2.35, 95%CI [1.53-3.61]); loss of research opportunities for anxiety (adjOR = 1.94, 95%CI [1.28-2.93]) and stress (adjOR = 1.98, 95%CI [1.26-3.11]); and COVID-19 impact on training (adjOR = 1.78, 95%CI [1.12-2.80]) for depression. Conclusions: The pandemic had a significant impact on PHR in terms of depression, anxiety and stress, especially for women and who lost work-related opportunities. Training programs should offer PHR appropriate MH support and training opportunities.

The Local Awareness-Raising of Public Mental Health in the Capital City of Poland through Launch of Local Alliance against Depression.

The goal of this brief report is to show the specificity of building local alliances against depression in an Eastern European country within and after the series of 2021 lockdowns. It will be described in the form of a short communication piece. The semi-peripheral specificity of Poland adds some insights which will be useful for other leaders of similar alliances globally. This short report can be read as a higher resolution of the European Alliance Against Depression (EAAD) method activities known from other recent works. We want to answer the question of how to begin the activity and launch such an alliance in the semi-peripheral context of non-Western Europe.

A hidden pandemic? An umbrella review of global evidence on mental health in the time of COVID-19.

Background: The mental health impacts of the COVID-19 pandemic remain a public health concern. High quality synthesis of extensive global literature is needed to quantify this impact and identify factors associated with adverse outcomes. Methods: We conducted a rigorous umbrella review with meta-review and present (a) pooled prevalence of probable depression, anxiety, stress, psychological distress, and post-traumatic stress, (b) standardised mean difference in probable depression and anxiety pre-versus-during the pandemic period, and (c) comprehensive narrative synthesis of factors associated with poorer outcomes. Databases searched included Scopus, Embase, PsycINFO, and MEDLINE dated to March 2022. Eligibility criteria included systematic reviews and/or meta-analyses, published post-November 2019, reporting data in English on mental health outcomes during the COVID-19 pandemic. Findings: Three hundred and thirty-eight systematic reviews were included, 158 of which incorporated meta-analyses. Meta-review prevalence of anxiety symptoms ranged from 24.4% (95%CI: 18-31%, I 2: 99.98%) for general populations to 41.1% (95%CI: 23-61%, I 2: 99.65%) in vulnerable populations. Prevalence of depressive symptoms ranged from 22.9% (95%CI: 17-30%, I 2: 99.99%) for general populations to 32.5% (95%CI: 17-52%, I 2: 99.35) in vulnerable populations. Prevalence of stress, psychological distress and PTSD/PTSS symptoms were 39.1% (95%CI: 34-44%; I 2: 99.91%), 44.2% (95%CI: 32-58%; I 2: 99.95%), and 18.8% (95%CI: 15-23%; I 2: 99.87%), respectively. Meta-review comparing pre-COVID-19 to during COVID-19 prevalence of probable depression and probable anxiety revealed standard mean differences of 0.20 (95%CI = 0.07-0.33) and 0.29 (95%CI = 0.12-0.45), respectively. Conclusion: This is the first meta-review to synthesise the longitudinal mental health impacts of the pandemic. Findings show that probable depression and anxiety were significantly higher than pre-COVID-19, and provide some evidence that that adolescents, pregnant and postpartum people, and those hospitalised with COVID-19 experienced heightened adverse mental health. Policymakers can modify future pandemic responses accordingly to mitigate the impact of such measures on public mental health.

Psychological distress and anxiety in Arab refugees and migrants during the COVID-19 pandemic in Germany.

The COVID-19 pandemic is associated with various psychological stressors due to health-related, social, economic, and individual consequences, especially for minority groups such as refugees and other migrants who live in unstable conditions and have lost their social support groups. The aim of this study was to explore the impacts of the COVID-19 pandemic on this specific population in Germany.This study used a mixed-method approach. A total of 85 migrants took part in an online survey in Germany from April to July 2020. The questionnaire included demographic information and measures of psychological distress, anxiety and depressive symptoms, as well as risk and protective factors for psychological health during the COVID-19 pandemic. Semi-structured interviews with 10 refugees were conducted between May and June 2020. In our sample, 54.5% expressed fear of being infected with COVID-19. Participants spent several hours per day thinking about COVID-19 (M = 3.13 hours). Psychological and social determinants of mental health showed stronger associations with anxiety regarding COVID-19 than experiences with the disease. Interviews showed that especially for refugees with limited information regarding access to medical treatment, the pandemic increased already-existing psychological symptoms and worries about their families back home and reminded them of their flight from their home country to Europe. The COVID-19 pandemic is associated with psychological distress, anxiety, and depression in refugees and migrants in Germany. Information on where to get medical treatment, if needed, is of utmost importance to this population group, in addition to other strategies such as maintaining a healthy lifestyle and social contacts, and acceptance of strategies to cope with anxiety and negative emotions.

Subjective attitudes moderate the social connectedness in esports gaming during COVID-19 pandemic: A cross-sectional study.

Background: Electronic sports (esports) has become a practical intervention for young people craving social connections since the COVID-19 pandemic. Past studies have shown an equivocal role of esports participation in boosting social ties or social connectedness. It is unclear if their relationship is affected by subjective attitudes of gamers. Moreover, the present COVID-19 pandemic may further modify this relationship to a greater extent. Objective: This study primarily aimed to investigate the moderating effect of participants' subjective attitudes toward esports gaming on the relationship between in-game interaction during esports participation and participants' anticipated social connectedness among Chinese young adults during the COVID-19 lockdown periods in China. Methods: We conducted a nationwide online questionnaire survey through the Credamo platform among 550 Chinese young adults in the present study. The Social Connectedness Scale-Revised was used to assess participants' social connectedness levels. Results: Four hundred and fifty-three participants were included in the final analysis. The effective response rate was 82.4%. Our results showed that the esports participation measured by in-game communication frequency among participants, as an independent factor, was negatively associated with participants' social connectedness scores (ß = -0.13, p < 0.05). However, when the moderating effect of subjective attitudes toward esports gaming was considered, the association between communication frequency and social connectedness scores was turned into the opposite direction with a larger effect size (ß = 0.35, p < 0.001). Conclusion: Our primary finding revealed that a positive mindset in esports gaming is indispensable in boosting social connectedness. Overall, our study provided supporting evidence for the benefits of esports on individuals' social connectedness. In future circumstances similar to the COVID-19 era, playing esports games is strongly encouraged in an attempt to maintain social connections and relieve psychological stress. In the meantime, we believe that having a positive esports experience, often associated with a positive mindset during gaming, can better promote social connectedness. Nevertheless, the amount of time spent on gaming per day should be of great concern, as esports games can be addictive, especially for teenagers and college students.

Public mental health during and after the SARS-CoV-2 pandemic: Opportunities for intervention via emotional self-efficacy and resilience.

Importance: During the pandemic, the number of United States adults reporting clinically significant symptoms of anxiety and depression sky-rocketed, up from 11% in 2020 to more than 40% in 2021. Our current mental healthcare system cannot adequately accommodate the current crisis; it is therefore important to identify opportunities for public mental health interventions. Objective: Assess whether modifiable emotional factors may offer a point of intervention for the mental health crisis. Design setting and participants: From January 13 to 15, 2022, adults living in the United States were recruited via Amazon Mechanical Turk to complete an anonymous survey. Main outcomes and measures: Linear regressions tested whether the primary outcomes during the SARS-CoV-2 pandemic (depressive and anxiety symptoms, burnout) were associated with hypothesized modifiable risk factors (loneliness and need for closure) and hypothesized modifiable protective factors (the ability to perceive emotions and connect with others emotionally; emotion-regulation efficacy; and resilience, or the ability to "bounce back" after negative events). Results: The sample included 1,323 adults (mean [SD] age 41.42 [12.52] years; 636 women [48%]), almost half of whom reported clinically significant depressive (29%) and/or anxiety (15%) symptoms. Approximately 90% of participants indicated feeling burned out at least once a year and nearly half of participants (45%) felt burned out once a week or more. In separate analyses, depressive symptoms (Model A), anxiety symptoms (Model B), and burnout (Model C) were statistically significantly associated with loneliness (ßModel A, 0.38; 95% CI, 0.33-0.43; ßModel B, 0.30; 95% CI, 0.26-0.36; ßModel C, 0.34; 95% CI, 0.28-0.41), need for closure (ßModel A, 0.09; 95% CI, 1.03-1.06; ßModel B, 0.13; 95% CI, 0.97-0.17; ßModel C, 0.11; 95% CI, 0.07-0.16), recent stressful life events (ßModel A, 0.14; 95% CI, 0.10-0.17; ßModel B, 0.14; 95% CI, 0.11-0.18; ßModel C, 0.10; 95% CI, 0.06-0.15), and resilience (ßModel A, -0.10; 95% CI, -0.15 to -0.05; ßModel B, -0.18; 95% CI, -0.23 to -0.13; ßModel C, -0.11; 95% CI, -0.17 to -0.05). In addition, depressive and anxiety symptoms were associated with emotional self-efficacy (ßModel A, -0.17; 95% CI, -0.22 to -0.12; ßModel B, -0.11; 95% CI, -0.17 to -0.06), and beliefs about the malleability of emotions (ßModel A, -0.08; 95% CI, -0.12 to -0.03; ßModel B, -0.09; 95% CI, -0.13 to -0.04). Associations between loneliness and symptoms were weaker among those with more emotional self-efficacy, more endorsement of emotion malleability beliefs, and greater resilience, in separate models. Analyses controlled for recent stressful life events, optimism, and social desirability. Conclusion and relevance: Public mental health interventions that teach resilience in response to negative events, emotional self-efficacy, and emotion-regulation efficacy may protect against the development of depressive symptoms, anxiety, and burnout, particularly in the context of a collective trauma. Emotional self-efficacy and regulation efficacy may mitigate the association between loneliness and mental health, but loneliness prevention research is also needed to address the current mental health crisis.

The Effects of the First Phase of the Covid-19 Pandemic on the Mental Health of Children and Adolescents With preexisting Psychiatric Conditions.

Few studies have examined the impact of the initial school closures and stay-at-home orders on those vulnerable children and adolescents with preexisting psychiatric conditions. In our study, we explore the impact on this population and identify risk and resilience factors by looking both at those children who were impacted negatively as well as those who were impacted positively by this period. Questionnaires were administered by child and adolescent psychiatrists to 101 parents of child and adolescent outpatients in a mental health clinic as well as 75 of the adolescents, themselves, during the initial stay-at-home orders in Israel. Parents and their children were asked how the situation changed the symptoms for which the children are being treated at our clinic. Information regarding demographic, family, and individual factors was also gathered. The largest group of parents (44%) reported improvement in their child's symptoms during this period, whereas 33% reported no change and 25% reported worsening. Risk factors included parental stress and level of child preoccupation with Covid-19. The major protective factor was parental presence. Although home confinement during the Covid-19 pandemic can lead to worsening mental health status among children, it can also provide an opportunity for those with previous mental health conditions to improve and strive. For these children to improve during such a period, decreased social and academic demands and increased parental presence seem to be key factors. For those who deteriorate, identifying and targeting parental stress can be as important as targeting the child's stress during such times.

Physician suicide during the COVID-19 pandemic in Iran

Suicide is a significant and global public mental health problem. The suicide rate in Iran is disturbingly high;it has been reported to be 5.3 per 100.000 individuals. A meta-analysis indicated that physicians were at risk, with a reported standardized mortality risk of 1.44%. The rate of suicide has also been reported to be increasing in residents, in addition to a higher rate in senior specialists. Several possible suicides among Iran's resident doctor population have occurred in a short period, underlining the vital need for suicide prevention initiatives. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

A community-led intervention to build neighbourhood identification predicts better wellbeing following prolonged COVID-19 lockdowns.

Introduction: A growing body of research supports the importance of social cohesion for population wellbeing. However, the majority of this research has been correlational, and rarely have interventions been evaluated. Method: We conducted a two-timepoint study investigating the role of Neighbour Day, a grass-roots, community-led intervention that seeks to build social cohesion across the population. Among a sample of 843, 125 were Neighbour Day participants while the remainder were not. Results: We found that, compared to non-participants, Neighbour Day participants had significantly higher neighbourhood identification, experienced greater social cohesion, and had larger neighbourhood social networks. Between timepoints, the majority of the sample experienced prolonged lockdowns to prevent COVID-19 transmission, and so unsurprisingly, wellbeing declined and psychological distress increased. However, Neighbour Day participants were protected against these negative mental health effects of lockdown. These benefits of Neighbour Day participation were mediated via neighbourhood identification. Discussion: Overall, the findings speak to the promise of large-scale interventions to build social identity, particularly due to their capacity to build resilience and protect people's wellbeing during times of collective change or crisis.

Exploration of Correlations between COVID-19 Vaccination Choice and Public Mental Health Using Google Trend Search.

Since the global COVID-19 pandemic has great impact on human health and life style, the vaccination is the most effective method for disease control and prevention. However, not all people are willing to be vaccinated because some critical factors affect vaccination aspiration and vaccine choice of the public population. Among these factors, public mental health belongs to a political issue. In this study, Google Trend Search was used to explore the correlation between COVID-19 vaccination choice and public mental health during the period from August/2020 to December/2021. The results suggested that the main public concerns of COVID-19-related mental illnesses are positively correlated with the new cases amount but are negatively correlated with total cases and vaccinated cases amount. Moreover, the results support that the public population took more interest in the Pfizer/BNT COVID vaccine and Moderna COVID vaccine than the AstraZeneca COVID vaccine. Our study shows that investigations of the public mental health should be set up and conducted widely. A complete vaccination program combined with a policy for the improvement of public mental health are very effective for the control and prevention of COVID-19.

Consumer experience of mental health services during the COVID-19 pandemic: Evidence from an Australian mental health system

COVID-19 has increased the need for mental health care but disrupted its delivery. We examined impacts of the first year of the COVID-19 pandemic on consumer experience of NSW hospital and community mental health services, compared to their pre-COVID baseline. We also examined whether increased telehealth use was associated with changes in the quantity or experience of community mental health care. Data were 73,488 Your Experience of Service (YES) surveys from state mental health services in New South Wales (NSW), Australia, grouped into three periods: pre-COVID (January 2018 to March 2020), early-COVID (April to June 2020) and stable-COVID (July to December 2020). Experience scores were compared using mixed effects ordinal logistic regression. Supplementary questions on telehealth and community care (n=621) were examined by multinomial logistic regression. Experience scores improved significantly during the early-COVID period for community consumers and during the stable-COVID period for hospital consumers. Of community clients, 78% received some or all care by telehealth. Positive experience was more likely when most or all care was by telehealth and the amount of care increased. A reduced quantity of care, regardless of care modality, was the strongest predictor of worse experience. Increased service provision and telehealth support were well received over the first year of the pandemic. When contact hours are reduced due to COVID-19 risk mitigation strategies, it is vital to provide alternative methods of care such as telephone, or internet support, rather than just reducing face to face contact hours. © The Author(s), 2022.

Variable feelings of cohesion, trust, individualism and exclusion and their consequences on Swiss public mental health during the ongoing COVID-19 pandemic

Introduction: The first cases of COVID-19 in Switzerland were related to the Milan cluster in February 2020. Border crossing restrictions were imposed and economic support measures worth 40 billion Swiss francs were announced. By 24th September 2021 Switzerland achieved a fully vaccination rate of 54%, confirmed 836'000 cases and 11'060 deaths. Objective(s): The objective was to describe and analyse the mental health of the general Swiss population under the ongoingCOVID-19 pandemic and it's social changes: including a case description, transgenerational influence and psychosocial treatment opportunities Methods: To answer the research question, I used deepened internet research, population interviews among different age gropus and colloquies with healthcare providers and federal authorities. Result(s): Different psychosocial phenomena lead to the transgenerational influence. Unfortunately, vaccination rate is slowed down by this pandemic's impacts on public mental health. While during the first wave the positive feelings of cohesion and trust dominated, the mood changed afterwards to anxiousness and reactive individualism. Among all generations the fear of infection was shown to be a general booster of anxiety and distress. In fact, Swiss experts perceive the corona crisis as a catalysator for depression and anxiety disorders. Conclusion(s): Specific psychosocial treatment has to address general and individual vulnerability factors. However, staying in touch with family members, pursuing meaningful activities and being physically active can all help to overcome COVID-19 related mental health issues.

The effects of forest therapy on public mental health and circular economy: A policy support model in Japan.

Background: Forest therapy has gained popularity in Japan and even other nations/regions due to its health benefits. In addition, forest therapy has contributed to the development of circular economy and industrial upgrading. Japanese successful practice can serve as a model for other countries in the Asia-Pacific region. To this end, the aim of this study was to determine whether forest therapy can improve the whole well-being of the participants and has a positive effect on the development of circular economy in the region. Methods: Both empirical and inductive research methods were used; empirical approach was conducted to perform comparative analysis of regional data that was retrieved from the research project of Japanese Forestry Agency in 2015. Specifically, the efficacy of forest therapy on physical (blood glucose, blood pressure, body weight) and mental (sleep quality e.g.,) health outcomes among 815 participants was investigated. Regional data are from the statistics of Iiyama City from 1990 to 2005. After the concept of forest therapy became popular in the late 1990s, this element had a great positive impact on the economic benefits of Ishiyama City and other major forest scenic areas. We summarize and analyze a series of policies made by relevant departments of the Japanese government in the years from 2019 to 2021 to promote forest therapy and related circular industry development. Results: Significant (pre-to-post participation) changes in physical measure was observed. Firstly, mean weight of those overweight participants decreased across three different time points (pre-test/enrollment = 79.7 kg, 3-month participation = 77.2, and 6-month participation = 76.8 kg), while overall mean weight of the participants decreased to 61, 60.5, and 60.4 kg, respectively. Secondly, Participant with normal weight showed a decrease on mean HbA1C (from 6.09 to 6.06) at Week 24, while overweight participants demonstrated a slight change 6.03-6.01 after 6 months the average HOMA-IR for overweight participants decreased from 3.5 to 2.5 at Week 24, while participants with normal weight demonstrated a decrease from 2.2 to 1.7 at Week 24. Forest Therapy has emerged in Japan since Mid-1990s and has attracted a large number of tourists all over the world due to its unique health benefits. Conclusion: Forest therapy in Japan has positive effects on whole well-being of Japanese residents and it has helped public mental health promotion and economic growth. Under the guidance and support of government policies, it can promote the development of circular economy and industrial transformation and set a model of Japanese forest therapy development for other countries in the Asia-Pacific region.

A Treatment Model for Young Adults with Severe Mental Disorders in a Community Mental Health Center: The Crisalide Project and the Potential Space.

In line with priorities set by the Italian Ministry of Health and international literature, the "Crisalide project" provides specific care pathways aimed at young adults (YA) with severe mental disorders (SMD). As described in Materials and Methods, it consists of three lines of activity: transition to adult mental health services (TSMREE/CSM 17-19); Diagnostic, Therapeutic, and Assistance Pathways for Young Adults (PDTA-YA); high-intensity treatment center for young adults "Argolab2 Potential Space". The aim of the study is to assess the results relating to the first three years of implementation of this clinical-organizational model (2018/2020) according to the process indicators identified by the ministry. Among the population aged 18-30 under treatment, results show increased prevalence (30%) and incidence (26%); 0% treatment conclusions due to the expiration of the conventional time limit; 0% involuntary hospitalizations (TSO); 0% STPIT hospitalizations; 0% repeated hospitalizations; 0% hospitalizations in the common mental disorders diagnostic group. Among the population of Argolab2 Potential Space, 45.4% have resumed studies; 40.9% have had a first work experience; 22.7% have obtained educational or training qualifications, and 18.2% live in independent houses. At a time when the academic literature underlines the terrible impact of the COVID-19 pandemic on this population, the present study confirms that specific treatment processes for young populations are a protective factor.

Level of Fear and Its Determinants in the Indian Population Due to COVID-19 Disease.

Background The novel coronavirus disease 2019 (COVID-19) infection was declared a global health emergency by the World Health Organization. A total of three waves across most of the states in India have been reported to date, during which strict lockdown was imposed and conditional relaxations were offered between the subsequent waves. Amid the high morbidity and mortality, there has been severe psychological distress among people which has led to mental health impairment. Methodology We investigated the level of fear in the Indian population due to COVID-19 using the Fear of COVID-19 Scale (FCS-19) and various factors influencing it. A cross-sectional study was undertaken across India among participants more than 18 years of age by recruiting participants through social media platforms such as WhatsApp and Instagram. Along with the FCS-19 questionnaire, sociodemographic information about the participants, preexisting history of comorbidities, and psychiatric illnesses were collected. The study sample was drawn by convenience technique, and the data were collected over two months from October 2021 to December 2021. Results A total of 419 participants (212 females and 207 males) participated in the study. The mean FCS-19 score of the population was 18.29 ± 6.43 (SD). Participants with a history of COVID-19-related deaths in their own family or surrounding areas had a significantly higher FCS-19 score than those without a history of COVID-19-related deaths. The mean FCS-19 score for healthcare professionals was also significantly lower than for other professions. FCS-19 scores were significantly higher among participants with psychiatric conditions than those without. Conclusions The study showed a positive association between a preexisting mental health disease and FCS-19 score and a negative association if the participant was a healthcare professional. While other factors such as age, gender, residential area, and preexisting comorbidity did not show a significant association with fear associated with COVID-19.