Exploring the use of social network interventions for adults with mental health difficulties: a systematic review and narrative synthesis.

BACKGROUND: People with mental health difficulties often experience social isolation. The importance of interventions to enhance social networks and reduce this isolation is increasingly being recognised. However, the literature has not yet been systematically reviewed with regards to how these are best used. This narrative synthesis aimed to investigate the role of social network interventions for people with mental health difficulties and identify barriers and facilitators to effective delivery. This was undertaken with a view to understanding how social network interventions might work best in the mental health field. METHODS: Systematic searches using combinations of synonyms for mental health difficulties and social network interventions were undertaken across 7 databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science) and 2 grey literature databases (EThoS and OpenGrey) from their inception to October 2021. We included studies reporting primary qualitative and quantitative data from all study types relating to the use of social network interventions for people with mental health difficulties. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. Data were extracted and synthesised narratively. RESULTS: The review included 54 studies, reporting data from 6,249 participants. Social network interventions were generally beneficial for people with mental health difficulties but heterogeneity in intervention type, implementation and evaluation made it difficult to draw definitive conclusions. Interventions worked best when they (1) were personalised to individual needs, interests and health, (2) were delivered outside formal health services and (3) provided the opportunity to engage in authentic valued activities. Several barriers to access were identified which, without careful consideration could exacerbate existing health inequalities. Further research is required to fully understand condition-specific barriers which may limit access to, and efficacy of, interventions. CONCLUSIONS: Strategies for improving social networks for people with mental health difficulties should focus on supporting engagement with personalised and supported social activities outside of formal mental health services. To optimise access and uptake, accessibility barriers should be carefully considered within implementation contexts and equality, diversity and inclusion should be prioritised in intervention design, delivery and evaluation and in future research.

Creating positive experiences of involvement in mental health research.

The importance of patient and public involvement (PPI) in mental health research is increasingly acknowledged by funders, researchers, and patients. However, the impact of PPI on those who bring their own lived experiences to research environments is underexplored. A retrospective reflective approach was undertaken collaboratively by four people bringing lived experiences of mental health difficulties to a study adapting a social network intervention for mental health services. Authors considered their experiences of involvement and how these affected them personally. We identified six characteristics of involvement that benefit not only research quality, but also people participating in PPI activities: reframing painful memories, recognising value, practising reciprocity, bridging gaps, countering stigma, and challenging established narratives. When designing and conducting research, it is important to engage empathetically with how involvement is experienced by different people. Values should be translated collaboratively into action so that unintended harms might be avoided. This Personal View offers reflections and recommendations to support this process.

Human third-party observers accurately track fighting skill and vigour along their unique paths to victory.

Sexual selection via male-male contest competition has shaped the evolution of agonistic displays, weaponry, and fighting styles, and is further argued to have shaped human psychological mechanisms to detect, process, and respond appropriately to cues of fighting ability. Drawing on the largest fight-specific dataset to date across the sports and biological sciences (N = 2765 fights), we examined how different indicators of fighting ability in humans reflect unique paths to victory and indicate different forms of perceived and actual resource-holding power (RHP). Overall, we discovered that: (1) both striking skill and vigour, and grappling skill and vigour, individually and collectively predict RHP; (2) different RHP indicators are distinguished by a unique path to victory (e.g., striking skill is a knockout-typical strategy, whereas grappling vigour is a submission-typical strategy); and (3) third-party observers accurately track fighting skill and vigour along their unique paths to victory. Our argument that different measures of RHP are associated with unique paths to victory, and third-party observers accurately track fighting vigour and skill along their unique paths to victory, advance our understanding not only of human contest competition, but animal contest theory more broadly.

Adapting a social network intervention for use in secondary mental health services using a collaborative approach with service users, carers/supporters and health professionals in the United Kingdom.

BACKGROUND: Social integration, shared decision-making and personalised care are key elements of mental health and social care policy. Although these elements have been shown to improve service user and service-level outcomes, their translation into practice has been inconsistent and social isolation amongst service users persists. AIM: To co-adapt, with service users, carers/supporters and health professionals, a web-based social network intervention, GENIE™, for use in secondary mental health services. The intervention is designed to support social activity and preference discussions between mental healthcare professionals and service users as a means of connecting individuals to local resources. METHODS: In Phase 1 (LEARN), we completed two systematic reviews to synthesise the existing evidence relating to the i) effectiveness and ii) the implementation of social network interventions for people with mental health difficulties. We undertook semi-structured interviews with a convenience sample of 15 stakeholders previously involved in the implementation of the intervention in physical healthcare settings. Interviews were also conducted with 5 national key stakeholders in mental health (e.g., policy makers, commissioners, third sector leads) to explore wider implementation issues. In Phase 2 (ADAPT), we worked iteratively with eight service users, nine carers, six professionals/volunteers and our patient and public advisory group. We drew on a framework for experience-based co-design, consisting of a series of stakeholder consultation events, to discuss the use of the social network intervention, in mental health services. Participants also considered factors that could serve as enablers, barriers, and challenges to local implementation. RESULTS: Across the stakeholder groups there was broad agreement that the social network intervention had potential to be useful within mental health services. In terms of appropriate and effective implementation, such an intervention was predicted to work best within the care planning process, on discharge from hospital and within early intervention services. There were indications that the social connection mapping and needs assessment components were of most value and feasible to implement which points to the potential utility of a simplified version compared to the one used in this study. The training provided to facilitators was considered to be more important than their profession and there were indications that service users should be offered the opportunity to invite a carer, friend, or family member to join them in the intervention. CONCLUSION: The GENIE™ intervention has been co-adapted for use in mental health services and a plan for optimal implementation has been co-produced. The next phase of the programme of work is to design and implement a randomised controlled trial to evaluate clinical and cost effectiveness of a simplified version of the intervention.

Unravelling reciprocal effects among young adults' binge drinking, stress, and anticipated regret.

Problematic alcohol consumption represents a critical risk to young adults' mental and physical health (WHO, 2018). As a result, understanding negative consequences that stem from young adults' binge drinking and inter-related factors that may mitigate increases in binge drinking has much to offer scholars and practitioners. In the current study, a two-wave random intercept cross-lagged panel design was used to examine the reciprocal inter-relations among stress, anticipated regret, and binge drinking within a lab-based study of young adults (N = 109, Mage = 19.85). Within-person findings indicated that high life stress and low anticipated regret predicted subsequent increases in binge drinking three months later, accounting for between-person stability in these constructs. All told, findings point to life stress as a robust predictor of increased binge drinking, and anticipated regret as a protective factor associated with reductions in binge drinking among young adults. Given that anticipated regret signalled subsequent drinking reductions, future research should consider ways to foreground anticipation of regret as a protective factor mitigating binge drinking increases.

Facial width-to-height ratio predicts fighting success: A direct replication and extension of Zilioli et al. (2014).

Zilioli et al. (2014) were the first to show an association between male facial width-to-height ratio (fWHR) and physical aggression and fighting ability in professional mixed-martial-arts fighters. Here, we re-examined this relationship by replicating (using all original measures) and extending (using 23 new variables related to fighting performance) Zilioli et al. (2014) in a statistically well-powered sample of 520 fighters using automatic and manual measures of the fWHR involving both eyelid and eyebrow landmarks, used interchangeably in previous reports (Studies 1-2). Most importantly, we successfully replicated Zilioli et al.'s (2014) central finding that fighters' fWHR, when manually calculated using the eyebrow landmark, predicted their fighting success (p = .004, controlling for body mass index and total fights). Consistent with past criticisms of using fight rather than fighter data to examine fighting success, which have argued that individual fights can be suddenly and unexpectedly determined and do not capture an individual's overall ability to succeed, Study 3 (N = 1367 fights) found no association between fWHR and singular victories. Studies 1-3 showed continual evidence that larger fWHRs were associated with grappling abilities, even after controlling for demographic and allometric factors. Strikingly, Study 3 discovered associations between all fWHR measures and grappling skill that remained robust before and after controlling for 17 different control variables. We discuss that grappling, or the act of taking down an opponent, involves a more aggressive, close-combat approach than does striking. Combined, these results offer additional support for the argument that fWHR may have been shaped by sexual selection.

Assessing the effectiveness of social network interventions for adults with a diagnosis of mental health problems: a systematic review and narrative synthesis of impact.

BACKGROUND: Social connections have been linked to the genesis and amelioration of mental health problems and thus have potential therapeutic value. PURPOSE: To identify the current evidence base, assess risk of bias and synthesise findings on the effectiveness of social network interventions for people with mental health problems. METHODS: Electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science, Scopus) and grey literature databases were systematically searched from inception to October 2021 using free text syntax combining synonyms for 'mental health problems' and 'social network interventions'. Articles were eligible for inclusion if they reported data from randomised controlled trials on the effectiveness of interventions designed to improve social networks for adults (18+) with mental health problems. Papers were independently reviewed for inclusion with conflicts resolved through consensus. Included papers were quality assessed and data extracted and synthesized narratively. Risk of bias was assessed using the Cochrane Risk of Bias Tool. RESULTS: Nine studies randomising 2226 participants were included. Four focused on those with a diagnosis of schizophrenia or psychosis, one on major depressive disorder and four included all types of mental health diagnoses. The current evidence base is of unclear quality. However, interventions which focused on supporting social activities appear to hold the most promise for enhancing social networks. Data on cost-effectiveness and research acceptability were limited, but suggest the potential economic feasibility of and acceptability for evaluating these interventions. CONCLUSION: There is emerging evidence that social network interventions can be effective in improving social connections for people with mental health problems. However, further evaluations with robust methodological approaches are required to inform evidence-based recommendations for health services.

'Care co-ordinator in my pocket': a feasibility study of mobile assessment and therapy for psychosis (TechCare).

OBJECTIVES: The aim of the project was to examine the acceptability and feasibility of a mobile phone application-based intervention 'TechCare', for individuals with psychosis in the North West of England. The main objectives were to determine whether appropriate individuals could be identified and recruited to the study and whether the TechCare App would be an acceptable intervention for individuals with psychosis. METHODS: This was a mixed methods feasibility study, consisting of a test-run and feasibility evaluation of the TechCare App intervention. SETTING: Early Intervention Services (EIS) for psychosis, within an NHS Trust in the North West of England. PARTICIPANTS: Sixteen participants (test-run n=4, feasibility study n=12) aged between 18 and 65 years recruited from the East, Central and North Lancashire EIS. INTERVENTION: A 6-week intervention, with the TechCare App assessing participants' symptoms and responses in real-time and providing a personalised-guided self-help-based psychological intervention based on the principles of Cognitive Behaviorual Therapy (CBT). RESULTS: A total of 83.33% (n=10) of participants completed the 6-week feasibility study, with 70% of completers achieving the set compliance threshold of ≥33% engagement with the TechCare App system. Analysis of the qualitative data suggested that participants held the view that the TechCare was both an acceptable and feasible means of delivering interventions in real-time. CONCLUSION: Innovative digital clinical technologies, such as the TechCare App, have the potential to increase access to psychological interventions, reduce health inequality and promote self-management with a real-time intervention, through enabling access to mental health resources in a stigma-free, evidence-based and time-independent manner. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT02439619.

Evaluation of a Suicide Prevention Program for the Energy Sector.

There is evidence indicating that traditionally male-dominated occupations are associated with greater risk of suicide. In Australia, MATES in Construction was developed as an occupational health initiative to prevent suicides in the industry. The program has recently been applied to the energy industry; however, little is known regarding exposure to suicide and suicide prevention interventions in this sector. The study aimed to examine the effectiveness of MATES in Energy general awareness training (GAT), and estimate the prevalence of recent suicidal ideation and exposure to suicidal behaviors in workers. A before and after design was used to examine the effectiveness of GAT training. Data were collected from 4887 participants undertaking GAT training at energy sites across Queensland, Australia. In total, 2% (97) of participants reported recent suicidal thoughts, 65% of participants reported they had known someone who had attempted suicide, and 69% had known someone who died by suicide. Significant improvements were found on all suicide literacy items after GAT training. Younger people were more likely to be positively affected by the intervention. The results indicate that the MATES in Energy program is successfully transitioning from the construction industry, and offers the first empirically supported suicide intervention tailored to the energy sector.

A Longitudinal Assessment of Two Suicide Prevention Training Programs for the Construction Industry.

As part of a suite of early intervention training and support services, Mates in Construction (MATES) provide two general awareness programs to promote mental health and suicide awareness and encourage help-offering and help-seeking in construction workers. General awareness training (GAT) is a one-hour session delivered to all construction workers on large to medium worksites, while MATES awareness training (MAT) maintains similar content but is of shorter duration and delivered informally to small workplaces. This study aimed to compare the effectiveness of the two programs using a before, after and follow-up design. Construction workers undertaking MAT or GAT training completed a short survey before and after their training and again at follow-up. Linear mixed-effect modelling indicated that GAT and MAT training provided similar results in improving suicide awareness and help-seeking intentions. Some variables showed a significant increase from pre-intervention to the three-month follow-up, indicating the long-term impact of some aspects of the training. The findings demonstrating the effectiveness of MAT training have important implications for MATES, as the training can be delivered to much smaller workplaces, making the program more widely available to the construction industry.

Deceptive Affectionate Messages: Mate Retention Deployed Under the Threat of Partner Infidelity.

Deceptive affectionate messages (DAMs) have been proposed to act as relational maintenance techniques and, as such, might be part of a greater repertoire of mate retention behaviors. We analyzed data from 1,993 Mechanical Turk participants to examine the relations between DAMs and mate retention, and whether these relations were mediated by the perceived risk of partner infidelity. In line with predictions, frequency of DAMs positively predicted general mate retention and cost-inflicting mate retention through the perceived risk of partner infidelity. In line with our nondirectional prediction, we also found that frequency of DAMs negatively predicted benefit-provisioning mate retention behaviors. In an exploratory mediation analysis of DAMs on benefit-provisioning mate retention via perceived partner infidelity, we surprisingly found that DAMs negatively predicted benefit-provisioning behavior due to the perceived risk of partner infidelity, suggesting that DAMs-but not benefit-provisioning mate retention-are deployed under the threat of partner infidelity. Overall, these findings suggest that DAMs might belong to a greater repertoire of mate retention (especially cost-inflicting) behaviors to thwart the possibility of partner infidelity.

Understanding the Barriers and Pathways to Male Help-Seeking and Help-Offering: A Mixed Methods Study of the Impact of the Mates in Construction Program.

The Mates in Construction (MATES) program was developed to address the issue of high suicide rates among males in the Australian construction industry. The program delivers early intervention training and support to construction workers. This mixed-methods study aimed to (1) examine the effectiveness of training for MATES connectors and (2) examine the barriers, motivations and pathways to help-seeking and help-offering for both MATES connectors and clients. A total of 104 volunteers completed a short survey before and after connector training sessions. Quantitative data analysis showed significant increases in connectors' self-reported suicide awareness, and willingness to offer help to workmates and seek help themselves. For the qualitative component, 27 connectors and clients participated in focus groups and individual interviews. Thematic analysis identified six themes from the connectors' data: awareness, skills and confidence; removing stigma; making a difference; simplicity of the model; understanding the industry; and visibility, camaraderie and passion. For clients, three key themes emerged: barriers and pathways to help-seeking; speaking the same language; and flow-on effects. The results provide evidence for the effectiveness of connector training and indicate that MATES's peer support model is enabling workers to overcome traditional barriers and attitudes to seeking and offering help.

TechCare: mobile assessment and therapy for psychosis - an intervention for clients in the Early Intervention Service: A feasibility study protocol.

OBJECTIVES: Technological advances in healthcare have shown promise when delivering interventions for mental health problems such as psychosis. The aim of this project is to develop a mobile phone intervention for people with psychosis and to conduct a feasibility study of the TechCare App. METHODS: The TechCare App will assess participant's symptoms and respond with a personalised guided self-help-based psychological intervention with the aim of exploring feasibility and acceptability. The project will recruit 16 service users and 8-10 health professionals from the Lancashire Care NHS Foundation Trust Early Intervention Service. RESULTS: In strand 1 of the study, we will invite people to discuss their experience of psychosis and give their opinions on the existing evidence-based treatment (cognitive behavioural therapy) and how the mobile app can be developed. In strand 2, we will complete a test run with a small number of participants (n = 4) to refine the mobile intervention (TechCare). Finally, in strand 3 of the study, the TechCare App will be examined in a feasibility study with 12 participants. CONCLUSION: It has been suggested that there is a need for a rapid increase in the efforts to develop the evidence base for the clinical effectiveness of digital technologies, considering mHealth research can potentially be helpful in addressing the demand on mental health services globally.