RESUMEN
OBJECTIVE: Mental health lived experience organizations (LEOs) and their lived experience workforce are increasingly recognized as invaluable. However, a deeper understanding of the elements that enhance or inhibit LEOs' efficacy is required to learn how to sustain LEOs and support their workforce. Rapid international expansion has resulted in significant LEO growth and change, challenging many LEOs to adapt. With this rapid expansion, the field is evolving faster than many LEOs can keep pace with. This review, codesigned and coproduced in partnership with a LEO to draw on both lived experience and academic perspectives, aims for a deeper understanding of which elements within a LEO enhance or inhibit its efficacy, growth, and support for its lived experience workforce. METHODS: A systematic search of peer-reviewed and non-peer-reviewed literature, following the PRISMA-ScR guidelines and JBI methodology, identified 60 records published in English between 2000 and 2022. RESULTS: The results indicate general agreement regarding which LEO elements are important (e.g., culture, leadership, board composition, organizational structure, financial arrangements, and professionalization). However, considerable disagreements exist regarding the relative influence of several of these elements, especially funding arrangements, in which funder and LEO values often diverge; training for increased lived experience professionalization; and partnerships with medical model-focused mental health services. CONCLUSIONS: Organizational disagreements relate to managing future LEO growth and advancing the lived experience workforce while preserving LEOs' unique characteristics that make them valued mental health services. Further research should examine community differences among LEOs, including hybrid LEOs within services and non-LEO mental health organizations.
RESUMEN
BACKGROUND: The COVID-19 pandemic placed an additional mental health burden on individuals and families, resulting in widespread service access problems. Digital mental health interventions suggest promise for improved accessibility. Recent reviews have shown emerging evidence for individual use and early evidence for multiusers. However, attrition rates remain high for digital mental health interventions, and additional complexities exist when engaging multiple family members together. OBJECTIVE: As such, this scoping review aims to detail the reported evidence for digital mental health interventions designed for family use with a focus on the build and design characteristics that promote accessibility and engagement and enable cocompletion by families. METHODS: A systematic literature search of MEDLINE, Embase, PsycINFO, Web of Science, and CINAHL databases was conducted for articles published in the English language from January 2002 to March 2024. Eligible records included empirical studies of digital platforms containing some elements designed for cocompletion by related people as well as some components intended to be completed without therapist engagement. Platforms were included in cases in which clinical evidence had been documented. RESULTS: Of the 9527 papers reviewed, 85 (0.89%) met the eligibility criteria. A total of 24 unique platforms designed for co-use by related parties were identified. Relationships between participants included couples, parent-child dyads, family caregiver-care recipient dyads, and families. Common platform features included the delivery of content via structured interventions with no to minimal tailoring or personalization offered. Some interventions provided live contact with therapists. User engagement indicators and findings varied and included user experience, satisfaction, completion rates, and feasibility. Our findings are more remarkable for what was absent in the literature than what was present. Contrary to expectations, few studies reported any design and build characteristics that enabled coparticipation. No studies reported on platform features for enabling cocompletion or considerations for ensuring individual privacy and safety. None examined platform build or design characteristics as moderators of intervention effect, and none offered a formative evaluation of the platform itself. CONCLUSIONS: In this early era of digital mental health platform design, this novel review demonstrates a striking absence of information about design elements associated with the successful engagement of multiple related users in any aspect of a therapeutic process. There remains a large gap in the literature detailing and evaluating platform design, highlighting a significant opportunity for future cross-disciplinary research. This review details the incentive for undertaking such research; suggests design considerations when building digital mental health platforms for use by families; and offers recommendations for future development, including platform co-design and formative evaluation.
Asunto(s)
COVID-19 , Familia , Humanos , Familia/psicología , Servicios de Salud Mental , Telemedicina , Salud Mental , SARS-CoV-2 , PandemiasRESUMEN
Although many young people demonstrate resilience and strength, research and clinical evidence highlight an upward trend in mental health concerns among those aged 12 to 25 years. Youth-specific digital mental health interventions (DMHIs) aim to address this trend by providing timely access to mental health support for young people (12-25 years). However, there is a considerable gap in understanding young people user experiences with digital interventions. This review, co-designed with Australia's leading mental health organization Beyond Blue, utilizes a systematic methodology to synthesize evidence on user experience in youth-oriented digital mental health interventions that are fully or partially guided. Five relevant online databases were searched for articles published from 2018 to 2023, yielding 22,482 articles for screening and 22 studies were included in the present analysis. User experience outcomes relating to satisfaction and engagement were assessed for each included intervention, with experience indicators relating to usefulness, usability, value, credibility, and desirability being examined. Elements associated with positive/negative outcomes were extracted. Elements shown to positively influence user experience included peer engagement, modern app-based delivery, asynchronous support, and personalized content. In contrast, users disliked static content, homework/log-keeping, the requirement for multiple devices, and social media integration. Asynchronous interventions showed high satisfaction but faced engagement issues, with combined asynchronous/synchronous interventions reporting better completion rates. DMHIs offer a promising platform for youth mental health support and has the potential to dramatically increase the reach of interventions through the adoption of technological and user experience best practices. While young people respond positively to many aspects of intervention modernization, such as interactive, app-based design, other concepts, such as social media integration, they need to be adopted by the field more cautiously to ensure trust and engagement.Trial Registration CRD42023405812.
Asunto(s)
Servicios de Salud Mental , Humanos , Adolescente , Adulto Joven , Niño , Adulto , Trastornos Mentales/terapia , Telemedicina , Aplicaciones Móviles , Satisfacción del PacienteRESUMEN
Youth-specific digital mental health interventions (DMHI) represent an emerging field of study, and aim to increase access, improve socioemotional outcomes, and, where required, support triage to targeted interventions. However, prior reviews have reported inconsistent findings on the clinical effectiveness of such interventions in young adults (12-25 years). Further, shortfalls remain for the impact of guided interventions based on the mode of delivery and the type of human support personnel (e.g., professional or peer) guiding the intervention. In response, this systematic review, co-designed with Australia's leading mental health organization, aims to assess the effectiveness of guided digital programs in improving youth socioemotional outcomes. Included studies involve young people experiencing mental ill-health, receiving brief (i.e., 1-12 sessions), digitally delivered (at least partially) psychological interventions that were guided or partially guided, tested in a type of experimental study, with a socioemotional outcome. Specific socioemotional outcomes examined were depression, anxiety, stress, wellbeing, mindfulness, and quality of life. A systematic search of the contemporary published and grey literature identified 22,482 records with 32 relevant records published between 2018 and 2023. A narrative synthesis guided integration of findings. Results demonstrated strong evidence for the effectiveness of guided interventions on socioemotional outcomes (i.e., depression, anxiety, stress) yet these effects were short-lived. When factoring in the use of different control groups (i.e., active vs. inactive), inconsistent effects were observed for the socioemotional outcomes of depression, anxiety, and stress. The mode of delivery (i.e., asynchronous, synchronous, combined) and the type of human support personnel did not appear to impact socioemotional outcomes. Results indicate efficacious brief digital interventions for depression and anxiety include refresher/follow-up content, goal setting content, and relapse prevention content. In contrast, poor efficacy is associated with interventions that include homework tasks, self-monitoring, and log-keeping content.PROSPERO, ID CRD42023405812.
Asunto(s)
Intervención Psicosocial , Humanos , Adolescente , Adulto Joven , Adulto , Niño , Intervención Psicosocial/métodos , Trastornos Mentales/terapia , Telemedicina , Evaluación de Resultado en la Atención de SaludRESUMEN
Digital parenting programs aim to increase program access, improve psychosocial outcomes for parents and children, and support triage to targeted interventions where required. This meta-analysis assessed the efficacy of online parenting programs in improving parenting skills and capabilities, and by consequence, the mental health and well-being of parents and children, and the quality of the parent-child relationship. Studies were included if they were: (1) online, (2) self-delivered, (3) designed for universal general population prevention, (4) evaluated experimental or quasi-experimental designs, and (5) assessed parent and child emotional and/or relational health, from pregnancy to 5 years of age. A systematic search of electronic databases and grey literature identified 22 studies that met inclusion criteria, including 24 independent samples, with 5671 unique parents. Meta-analyses were conducted using random effects models and Cohen's d effects. Small-to-moderate improvements in parent depression, anxiety, self-efficacy, and social support were observed. No effects on parent stress, satisfaction, or parent-child relationship quality were observed. Meta-regression and sub-group analysis were conducted to identify sensitivity or moderation effects. Collectively, findings suggest any benefits of online parenting programs mostly occur at the time of the intervention, for parent mental health and well-being outcomes, and that enduring effects are unlikely. However, given the cost effectiveness and accessibility of online programs, further research into ways of sustaining effects on parenting outcomes is warranted. Furthermore, given the centrality of the parent-child bond to child development across the lifecourse, additional investment in new digitally facilitated approaches focusing on this bond are likewise warranted.PROSPERO registration CRD42021275647.
Asunto(s)
Responsabilidad Parental , Padres , Humanos , Niño , Preescolar , Padres/psicología , Responsabilidad Parental/psicología , Crianza del Niño , Emociones , AnsiedadRESUMEN
The impact of family violence (FV) on children is a significant global public policy issue. Earliest identification of FV among children is critical for preventing escalating sequelae. While practitioners routinely ask adults about FV, there are relatively few measures that enable children to reliably self-report on their own safety. This review sought to systematically identify and appraise all available child self-report measures for screening and assessment of FV in both clinical and research settings. Database searching was conducted in January 2022. Articles were eligible for review if they included a validated child (5-18 years) self-report measure of FV (including victimization, perpetration, and/or exposure to inter-parental violence). Screening of an initial 4,714 records identified a total of 85 articles, representing 32 unique validated instruments. Results provide an up-to-date catalog of child self-report measures of FV, intended to benefit practitioners, services and researchers in selecting appropriate tools, and in understanding their suitability and limitations for different cohorts and practice goals. While just under half of the measures captured both exposure to inter-parental violence and direct victimization, none captured all three domains of exposure, victimization and perpetration together. Instruments with provision for input from multiple respondents (e.g., both child and parent report) and with assessment of contextual risk factors were few. Findings point to the need for developmentally appropriate, whole-of-family screening and assessment frameworks to support children in the early identification of family safety concerns.
Asunto(s)
Víctimas de Crimen , Violencia Doméstica , Humanos , Factores de Riesgo , Autoinforme , Preescolar , Niño , AdolescenteRESUMEN
BACKGROUND: Mental health policy and service design is increasingly recognizing the importance of the lived experience voice and its inclusion in all aspects of work. Effective inclusion requires a deeper understanding of how best to support lived experience workforce and community members to meaningfully participate in the system. OBJECTIVES: This scoping review aims to identify key features of organizational practice and governance that facilitate the safe inclusion of lived experience in decision-making and practice within mental health sector contexts. Specifically, the review focuses on mental health organizations devoted to lived experience advocacy or peer support or those in which lived experience membership (paid or voluntary) is central to advocacy and peer support operations. METHODS: This review protocol was prepared with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and registered with the Open Science Framework. The review will be guided by the Joanna Briggs Institute methodology framework and is being conducted by a multidisciplinary team including lived experience research fellows. It will include published and grey literature, including government reports, organizational online documents, and theses. Included studies will be identified through comprehensive searches of five databases: PsycINFO (Ovid), CINAHL (EBSCO), EMBASE (Ovid), MEDLINE (Ovid), and ProQuest Central. Studies published in English from 2000 onwards will be included. Data extraction will be guided by pre-determined extraction instruments. Results will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews flow chart. Results will be presented in tabular form and narratively synthesized. The planned commencement and completion dates for this review were July 1, 2022 and April 1, 2023. DISCUSSION: It is anticipated that this scoping review will map the current evidence base underpinning organizational practices in which lived experience workers are involved, specifically in the mental health system. It will also inform future mental health policy and research. TRIAL REGISTRATION: Registration: Open Science Framework (registered: July 26, 2022; registration DOI: 10.17605/OSF.IO/NB3S5).
Asunto(s)
Política de Salud , Servicios de Salud Mental , Salud Mental , Humanos , Características Culturales , Gobierno , Metaanálisis como Asunto , Proyectos de Investigación , Literatura de Revisión como Asunto , Revisiones Sistemáticas como AsuntoRESUMEN
Recently, the lived and living experience (LLE) workforce in mental health and alcohol and other drugs (AOD) sectors has expanded. Despite widespread benefit of this inclusion, some LLE practitioners have encountered personal and professional challenges in their workforce roles. An essential avenue to address these challenges is through provision of training to ensure adequate LLE role preparation, and to support integration of LLE workforces within mental health and AOD settings. We aim to understand the primary components applied in LLE training programs (i.e., content and methods), the outcomes from program participation, and to summarize observed patterns between training components and outcomes. This rapid review utilized a systematic methodology following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to synthesize existing literature on training programs for service users or carers/family in lived experience roles, in the mental health and AOD workforce. We searched CINAHL, PsycINFO, Medline, and Web of Science databases. We identified 36 relevant studies. Findings indicate short- and long-term impacts of training participation for this emerging workforce, with the most promising outcomes being increased professional knowledge and skills and improved personal psychosocial wellbeing and trauma recovery. Other positive training outcomes included high trainee satisfaction, increased application of training skills, and employment/education opportunities following training completion. Gaps and training limitations were noted in relation to the training content/delivery, trainee reservations, and personal barriers to training participation or completion. In response to program benefits and limitations investigated, we present recommendations for improving training processes for this workforce.
Asunto(s)
Cuidadores , Salud Mental , Humanos , Recursos HumanosRESUMEN
Internalisation of appearance ideals moderates the relationship between exposure to media images and body dissatisfaction. To date, the role of thin- and muscular-ideal internalisation in the context of social media remains under explored, particularly for boys. As such, we aimed to explore how social media use (Instagram and Snapchat) was related to body dissatisfaction, and whether thin- and muscular-ideal internalisation would moderate this relationship in a sample of 1153 adolescent boys and girls (55.42% males; Mage = 13.71, SD = 1.14). As hypothesised, social media use, and thin- and muscular ideal internalisation were positively correlated with body dissatisfaction in both genders. In moderation analyses, thin-ideal internalisation emerged as the only variable that had a significant effect on body dissatisfaction in both genders. Additionally, the influence of social media use on body dissatisfaction was moderated by muscular-ideal internalisation in boys, whereby for boys with high muscular-ideal internalisation, greater social media use was associated with greater body dissatisfaction. The two-way (muscular x thin-ideal internalisation) and three-way interaction (social media use x thin-ideal internalisation x muscular-ideal internalisation) effects on body dissatisfaction were non-significant. These findings emphasise the importance of considering the sociocultural environment (i.e., new media influences) as frameworks for understanding body dissatisfaction and suggest targeting of internalisation of appearance ideals in body dissatisfaction prevention programs.
Asunto(s)
Insatisfacción Corporal , Medios de Comunicación Sociales , Adolescente , Imagen Corporal , Mecanismos de Defensa , Femenino , Humanos , Masculino , Satisfacción PersonalRESUMEN
Nanostructure incorporation into devices plays a key role in improving performance, yet processes for preparing two-dimensional (2D) arrays of colloidal nanoparticles tend not to be universally applicable, particularly for soft and oxygen-sensitive substrates for organic and perovskite-based electronics. Here, we show a method of transferring reverse micelle-deposited (RMD) nanoparticles (perovskite and metal oxide) on top of an organic layer, using a functionalized graphene carrier layer for transfer printing. As the technique can be applied universally to RMD nanoparticles, we used magnetic (γ-Fe2O3) and luminescent (methylammonium lead bromide (MAPbBr3)) nanoparticles to validate the transfer-printing methodology. The strong photoluminescence from the MAPbBr3 under UV illumination and high intrinsic field of the γ-Fe2O3 as measured by magnetic force microscopy (MFM), coupled with Raman measurements of the graphene layer, confirm that all components survive the transfer-printing process with little loss of properties. Such an approach to introducing uniform 2D arrays of nanoparticles onto sensitive substrates opens up new avenues to tune the device interfacial properties.