Sociodemographic Correlates of Mental Health Treatment Seeking Among College Students: A Systematic Review and Meta-Analysis.

OBJECTIVE: College students have high rates of mental health problems and low rates of treatment. Although sociodemographic disparities in student mental health treatment seeking have been reported, findings have not been synthesized and quantified. The extent to which differences in perceived need for treatment contribute to overall disparities remains unclear. METHODS: A systematic search of PubMed, PsycInfo, and Embase was conducted. Studies published between 2007 and 2022 were included if they reported treatment rates among college students with mental health problems, stratified by sex, gender, race-ethnicity, sexual orientation, student type, student year, or student status. Random-effects models were used to calculate pooled prevalence ratios (PRs) of having a perceived need for treatment and of receiving treatment for each sociodemographic subgroup. RESULTS: Twenty-one studies qualified for inclusion. Among students experiencing mental health problems, consistent and significant sociodemographic differences were identified in perceived need for treatment and treatment receipt. Students from racial-ethnic minority groups (in particular, Asian students [PR=0.49]) and international students (PR=0.63) reported lower rates of treatment receipt than White students and domestic students, respectively. Students identifying as female (sex) or as women (gender) (combined PR=1.33) reported higher rates of treatment receipt than students identifying as male or as men. Differences in perceived need appeared to contribute to some disparities; in particular, students identifying as male or as men reported considerably lower rates of perceived need than students identifying as female or as women. CONCLUSIONS: Findings highlight the need for policy makers to address barriers throughout the treatment-seeking pathway and to tailor efforts to student subgroups to reduce treatment disparities.

Access to intrauterine contraceptives in the Southern District Health Board catchment.

AIM: Recent changes in funding have reduced the cost of the highly effective levonorgestrel-releasing intrauterine system (LIUS) contraceptives (Mirena and Jaydess). This paper explores equity of access to intrauterine contraceptives for Maori and the general population by locating and surveying all potential providers within the Southern District Health Board catchment area. METHODS: Using online survey, e-mail or phone, we asked if intrauterine contraceptive insertion was provided, what device was provided, cost and number of appointments required. ArcGIS 10.6.1 software was used to estimate population distribution, and to create service areas showing distance to nearest current providers for Maori and the general population. RESULTS: All 88 potential providers agreed to participate; two thirds (66.3%) provided some intrauterine contraceptive insertion. Approximately three quarters of the Maori and general population live within 5km of a primary provider. Costs ranged from $0 to $270, in addition to the cost of the required consultations. Number of consultations required varied from one to three. CONCLUSIONS: Cost and travel time likely remain barriers to accessing intrauterine contraceptives for a significant population within this catchment. Increasing the capacity for all primary providers to offer insertion, funding the insertion process, minimising the number of appointments required and providing mobile services would improve access.

Listening to the Therapeutic Needs of Male Survivors of Childhood Sexual Abuse.

Childhood sexual abuse of males is not uncommon with estimated prevalence rates across countries and different studies indicating that 8% of boys experience sexual abuse before age 18. A number of adverse outcomes are recognized in terms of mental health, behavioral, and relational difficulties. However, research also indicates that there is potential for healing. The present study explores the barriers, benefits, and processes involved in engagement in formal therapy for adult survivors of CSA from the male survivor's point of view. Nine men spoke of their treatment experiences in response to semistructured interviews. Participants were all members of a group for male survivors of sexual abuse. Seven participants reported benefiting from treatment. Interpretative phenomenological analysis (IPA) of the interviews identified three superordinate themes: "motivation to engage in treatment," "developing a connection with treatment providers," and "changing thinking about the abuse." These themes reveal a number of obstacles that are encountered in seeking treatment including stigma, process barriers, and engagement of a skilled and empathic therapist. For the men who were able to take part in therapy despite these barriers, improved quality of life were noted through the two primary mechanisms of relationship and changed thinking. Key changes in thinking included developing an awareness that they were not responsible for the abuse, understanding the effects of abuse, and developing an identity distinct from the experience of abuse. These changes in thinking occurred within the context of a robust therapeutic relationship.

The Dunedin dementia risk awareness project: pilot study in older adults.

AIMS: The USA and UK governmental and academic agencies suggest that up to 35% of dementia cases are preventable. We canvassed dementia risk and protective factor awareness among New Zealand older adults to inform the design of a larger survey. METHOD: The modified Lifestyle for Brain Health scale quantifying dementia risk was introduced to a sample of 304 eligible self-selected participants. RESULTS: Two hundred and sixteen older adults (≥50 years), with mean ± standard deviation age 65.5 ± 11.4 years (50-93 years), completed the survey (71% response rate). Respondents were mostly women (n = 172, 80%), European (n = 207, 96%), and well educated (n = 100, 46%, with a tertiary qualification; including n = 17, 8%, with a postgraduate qualification). Around half of the participants felt that they were at a future risk of living with dementia (n = 101, 47%), and the majority felt that this would change their lives significantly (n = 205, 95%), that lifestyle changes would reduce their risk (n = 197, 91%), and that they could make the necessary changes (n = 189, 88%) and wished to start changes soon (n = 160, 74%). Only 4 of 14 modifiable risk or protective factors for dementia were adequately identified by the participants: physical exercise (81%), depression (76%), brain exercises (75%), and social isolation (83%). Social isolation was the commonly cited risk factor for dementia, while physical exercise was the commonly cited protective factor. Three clusters of brain health literacy were identified: psychosocial, medical, and modifiable. CONCLUSION: The older adults in our study are not adequately knowledgeable about dementia risk and protective factors. However, they report optimism about modifying risks through lifestyle interventions.

Investigating the care needs of those with endometriosis: Are we listening to the patients?

What do women with endometriosis need? What are the things that would make their lives easier? Where are the gaps in their care? Questions like these can only be answered by women themselves. The development of an unmet needs survey for women with endometriosis would facilitate the design of patient-centred interventions to meet these needs and ultimately improve quality of life.