Subjective mental well-being among higher education students in Finland during the first wave of COVID-19.

AIMS: Increased mental health problems during the COVID-19 pandemic have become a major concern among young adults. Our aim was to understand which COVID-19-related questions predicted mental well-being during the outbreak. METHODS: Two cross-sectional datasets were used. The primary dataset was collected in May 2020 (n = 1001), during the initial COVID-19 outbreak, and the secondary in April 2019 (n = 10866), before the pandemic. Mental well-being was assessed with the Short Warwick-Edinburgh Mental Well-Being Scale. Relationships between mental well-being and COVID-19-related questions were investigated with lasso regression. As an exploratory analysis, two-way ANOVAs were used to compare mental well-being before and during the outbreak. RESULTS: Higher levels of mental well-being were associated with lower levels of academic stress and COVID-19-related worry, along with a higher satisfaction with the procedures and information provided by the higher education institutions and the government. COVID-19-related symptoms and infections did not have an impact on students' mental well-being during the outbreak. Small to moderate effect sizes across the time points were detected, indicating an overall decrease in mental well-being across age and gender during the outbreak. CONCLUSIONS: COVID-19 had an impact on higher education students' mental well-being. Higher education institutes may play a crucial role in protecting their students' well-being during uncertain times.

Intersectoral partnerships and competencies for mental health promotion: a Delphi-based qualitative study in Finland.

The importance of intersectoral collaboration and partnership working in mental health promotion, together with the requisite competencies for effective collaboration, is widely acknowledged. This Delphi-based qualitative study examined how intersectoral collaboration and partnership work are constructed and adopted in mental health promotion practice. Descriptive data from a Delphi panel of mental health promotion practitioners working in the health sector (n = 32) were used as a data source. Thematic analysis was used to analyze the data. Applying the theory of collaborative advantage, eight themes of collaboration advantage and the related competencies were identified: management structure, leadership, communication and language, common aims, working processes, resources, trust, and commitment and determination. The themes capture the competencies required to influence and work with others to improve the mental health and wellbeing of individuals and communities. The identified theme areas can be used to inform education and training and capacity building for professional practice in mental health promotion. Future research is needed to explore other possible collaborative advantage themes in mental health promotion practice and the competencies required to facilitate effective partnerships across sectors. Further investigations are also needed on the identified theme areas in order to develop and guide capacity building and training in mental health promotion.

Profiles of subjective health among people living alone: a latent class analysis.

BACKGROUND: Living alone has increased globally and especially in Finland where 45% of all households are single occupancy. Epidemiological research has found that living alone a risk factor for a wide range of adversities related to quality of life but the rapidly-changing demographics of people living alone calls for a more detailed investigation of their subjective health status. METHODS: Using a cross-sectional survey sent for a random sample of Finnish residents in single-person households (n = 884), we explored with latent class analysis whether the respondents form different health profiles based on the three health dimensions defined by the World Health Organization: physical, social, and mental well-being. The identified groups were then compared in terms of demographic characteristics with the χ2 test and quality of life using linear regression models. Sensitivity analyses were run using more refined, manual 3-step BCH method. RESULTS: Four distinct health profiles were found: Languishing (4%), Managing (35%), Healthy (30%), and Flourishing (31%). The groups differed in most socio-demographic aspects such as marital and employment status, but not in terms of geographic location or gender (apart from group Languishing that contained more men). Controlling for these socio-demographic differences, all groups showed different average levels of perceived quality of life to the expected direction. CONCLUSIONS: Our findings suggest that people living alone are indeed a very heterogeneous group in terms of subjective health. Instead of seeing living alone as a mere risk for low quality of life, concept of living alone should be understood more broadly both in public discussion and scientific research.

Suicide prevention training: self-perceived competence among primary healthcare professionals.

Objective: The aim is to report the outcomes of the suicide prevention training in terms of the self-perceived impact on the participants.Design: The three-hour training consisted areas of risk and protective factors, screening and evaluating suicide risk, raising concerns and confronting suicidal patients, and treating suicidal ideation in primary healthcare and the associated referral processes.Subjects: The studied participants consisted of general practitioners, nurses, public health nurses and social work professionals.Main outcome measures: Participants assessed their own competence on online form regarding four training areas prior to and two weeks after the training.Results: The response rate was 25%. The self-perceived competence of the healthcare professionals increased in all training areas and in all occupational groups. The healthcare professionals' competence regarding the risk and protective factors training area saw the greatest increase across all professional groups except nurses. There were, however, differences between the groups.Conclusion: Suicide prevention training for primary healthcare professionals did increase the self-perceived competence of the participants in all areas covered by the training. Regular follow-up training is required in order for these improvements to be further developed and retained.Key pointsAfter the suicide prevention training all participants self-perceived increase in their competence in all training areas.The GPs self-perceived most increase in risk and protective factors and nurses in raising concerns and confronting suicidal patients.The GPs' lowest increase was in the area of treating suicidal ideation in primary health care and the referral processes.

Mental health promotion competencies in the health sector in Finland: a qualitative study of the views of professionals.

AIMS: In this study, we aimed to investigate what competencies are needed for mental health promotion in health sector practice in Finland. METHODS: A qualitative study was carried out to seek the views of mental health professionals regarding mental health promotion-related competencies. The data were collected via two focus groups and a questionnaire survey of professionals working in the health sector in Finland. The focus groups consisted of a total of 13 professionals. Further, 20 questionnaires were received from the questionnaire survey. The data were analysed using the qualitative data analysis software ATLAS.ti Scientific Software Development GmbH, Berlin. A content analysis was carried out. RESULTS: In total, 23 competencies were identified and clustered under the categories of theoretical knowledge, practical skills, and personal attitudes and values. In order to promote mental health, it is necessary to have a knowledge of the principles and concepts of mental health promotion, including methods and tools for effective practices. Furthermore, a variety of skills-based competencies such as communication and collaboration skills were described. Personal attitudes and values included a holistic approach and respect for human rights, among others. CONCLUSIONS: The study provides new information on what competencies are needed to plan, implement and evaluate mental health promotion in health sector practice, with the aim of contributing to a more effective workforce. The competencies provide aid in planning training programmes and qualifications, as well as job descriptions and roles in health sector workplaces related to mental health promotion.

Exploring the structure and psychometric properties of the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) in a representative adult population sample.

This article reports the psychometric properties of both full and the abbreviated (Short) Warwick-Edinburgh Mental Well-being Scales (WEMWBS; SWEMWBS) in the Finnish general population. A large cross-sectional dataset (N = 5,335) was collected as part of the nationally representative FinHealth Study in 2017. Exploratory and confirmatory factor analyses of the data evaluated one-, two-, three-, and bi-factorial solutions with a split-half approach. McDonald's omega was used to assess internal consistency and convergent validity was evaluated using four established mental health and well-being scales (BDI-6, GHQ-12, MHI-5, EUROHIS-QOL8). Contrary to previous findings, our results supported a three-factor model of the full scale with separate, yet highly correlated, mental, social, and eudemonic well-being factors. For the SWEMWBS, the bi-factor model showed the best fit, with a strong general mental well-being factor and a weaker specific eudemonic well-being factor. In this sampling context, the social aspect of mental well-being may be considered a separable construct from other mental well-being dimensions and the shorter 7-item version might thus be a preferable option when assessing overall mental well-being.

Mental Health and Mental Wellbeing Impact Assessment Frameworks-A Systematic Review.

Mental health is largely shaped by the daily environments in which people live their lives, with positive components of mental health emphasising the importance of feeling good and functioning effectively. Promoting mental health relies on broad-based actions over multiple sectors, which can be difficult to measure. Different types of Impact Assessment (IA) frameworks allow for a structured approach to evaluating policy actions on different levels. A systematic review was performed exploring existing IA frameworks relating to mental health and mental wellbeing and how they have been used. A total of 145 records were identified from the databases, from which 9 articles were included in the review, with a further 6 studies included via reference list and citation chaining. Five different mental-health-related IA frameworks were found to be implemented in a variety of settings, mostly in relation to evaluating community actions. A Narrative Synthesis summarised key themes from the 15 included articles. Findings highlight the need for participatory approaches in IA, which have the dual purpose of informing the IA evaluation and advocating for the need to include mental health in policy development. However, it is important to ensure that IA frameworks are user-friendly, designed to be used by laypeople in a variety of sectors and that IA frameworks are operational in terms of time and monetary resources.

Positive Mental Health of Finnish People Living Alone: The Role of Circumstantial Factors and Leisure-Time Activities.

Living alone has become more common across Europe. Past research has consistently identified living alone as a risk factor for poor mental health while evidence on the positive dimension(s) of mental health has been scarce. Positive mental health has been associated with rather stable circumstantial factors, such as socio-economic characteristics and social relationships, and day-to-day activities in the form of leisure participation, in general populations. In this study, our objective was to assess these relationships among people living alone. We specified a structural equation model in a random sample of Finnish people living alone (n = 884), with the circumstantial factors as (exogenous) explanatory variables, participation in various leisure activities as mediators, and positive mental health as the outcome. In the model, more frequent engagement in several leisure-time activities, including being in contact with family/friends and physical activity in nature, were positively associated with positive mental health. The circumstantial factors that most strongly explained both leisure participation and positive mental health were the number of friends, being in a relationship, and having no limiting illnesses. In conclusion, among Finnish people living alone, social and functional factors appear to be more strongly associated with leisure participation and positive mental health than socio-economic factors.

Use of Health Services Among People Living Alone in Finland.

Although health issues are more common in people living alone than in those living with someone, research on the service use of people living alone has focused on older age groups. Based on large Finnish cross-sectional health survey (FinHealth 2017, n = 4686), we examined the difference in the use and assessment of health services between those living alone and those living with someone, and whether some sub-groups within those living alone use or perceive the use of health care services differently to those living with someone. The adjusted proportions, based on logistic regression models controlling for demographic variables and perceived health and mental health, showed that those living alone had seen a doctor in the past year less often (65.5%) than those not living alone (71.9%). People living alone had also less often had a health examination in the past 5 years (72.4%) than those not living alone (79.2%), and this proportion was particularly low within people living alone with high levels of depressive symptoms (59.0%) compared to lower levels (75.0%). Conclusively, among people living alone, those who suffer from depressive symptoms might be a potential group that does not receive the same levels of preventive care than others.

Living alone and positive mental health: a systematic review.

BACKGROUND: Living alone has become more common in today's societies. Despite the high number of the population living alone, research directed towards the mental wellbeing issues related to living alone has been limited. This systematic literature review aimed to assess the association between living alone and positive mental health. METHODS: We conducted searches in Medline, Web of Science, Cochrane Library, CINAHL, PsycINFO, and other complementary databases from January 1998 to May 2019. Randomised trials and observational studies investigating adults over 18 years of age and living alone (defined as living in a single household or a household size of one person) were eligible. The primary outcome was positive mental health, defined as comprising both hedonic and eudaimonic elements of mental wellbeing, and it was measured with the Warwick-Edinburgh Mental Well-being Scale and/or theWHO-5 Index. Two reviewers independently screened and selected data; one reviewer extracted data, and the second checked the extracted data. A narrative synthesis described the quality and content of the evidence. Included studies were appraised using relevant Joanna Briggs Institute checklist. RESULTS: A total of 4 cross-sectional studies (22,591 adult participants) were included after screening of 341 titles and abstracts and 46 full-text articles. These studies were conducted in Europe and were published between 2014 and 2017. The studies differed in their measurements of positive mental health (WHO-5 Well-Being Index, 3 studies; WEMWBS, 1 study), sources of data (1 regional, 1 national, and 2 European-level studies), and study populations (regional study, adults over 65 years of age; national-level study, mental health nurses over 21 years of age; European-level studies, employees between 15 and 65 years of age and adults over 18 years of age). A potential association between living alone and low positive mental health was found in three out of the four studies. Our findings were limited as the number of included studies was low and the quality of evidence varied across studies. CONCLUSIONS: This review allows a limited look at the association between living alone and positive mental health. Because the number of included studies was low and the quality of evidence varied across studies, further research is warranted.