Claire Henderson, Paul Williams, Kirsty Little, Graham Thornicroft
{"title":"Mental health problems in the workplace: changes in employers' knowledge, attitudes and practices in England 2006-2010.","authors":"Claire Henderson, Paul Williams, Kirsty Little, Graham Thornicroft","doi":"10.1192/bjp.bp.112.112938","DOIUrl":"10.1192/bjp.bp.112.112938","url":null,"abstract":"<p><strong>Background: </strong>In 2006 the Shaw Trust charity found high levels of ignorance and poor preparedness to deal with mental health problems among 480 senior employers in the UK. The UK government, non-governmental organisations and Time to Change (TTC) have since provided relevant assistance to employers.</p><p><strong>Aims: </strong>To examine whether there have been improvements in mental health-related knowledge, attitudes and workplace practices among British senior employers between 2006 and 2010.</p><p><strong>Method: </strong>A telephone survey was conducted of senior British employers (n = 480 in 2006 and n = 500 in 2009 and 2010).</p><p><strong>Results: </strong>An increased awareness of common mental health problems was detected. Employers continued to believe that job candidates should disclose a mental health problem, but became less likely to view colleagues' attitudes as a barrier to employing someone with such a problem. Formal policies on mental health and the use of workplace accommodations became increasingly common.</p><p><strong>Conclusions: </strong>These results are consistent with those of the TTC national public attitudes and the Viewpoint survey of service users between 2008 and 2010, which showed improved public attitudes to mental illness and a reduction in experiences of discrimination in employment.</p>","PeriodicalId":77411,"journal":{"name":"The British journal of psychiatry. Supplement","volume":"55 ","pages":"s70-6"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40224730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bettina Friedrich, Sara Evans-Lacko, Jillian London, Danielle Rhydderch, Claire Henderson, Graham Thornicroft
{"title":"Anti-stigma training for medical students: the Education Not Discrimination project.","authors":"Bettina Friedrich, Sara Evans-Lacko, Jillian London, Danielle Rhydderch, Claire Henderson, Graham Thornicroft","doi":"10.1192/bjp.bp.112.114017","DOIUrl":"10.1192/bjp.bp.112.114017","url":null,"abstract":"<p><strong>Background: </strong>Education Not Discrimination (END) is the component of the Time to Change programme intended to reduce mental health stigma among professionals and professional trainees.</p><p><strong>Aims: </strong>To investigate the impact of the END anti-stigma programme on medical students immediately and after 6 months with regard to knowledge, attitudes, behaviour and empathy.</p><p><strong>Method: </strong>A total of 1452 medical students participated in the study (intervention group n = 1066, control group n = 386). Participants completed questionnaires at baseline, and at immediate and 6-month follow-up. Groups were compared for changes in stigma outcomes.</p><p><strong>Results: </strong>All measures improved in both groups, particularly among students with less knowledge and more stigmatising attitudes and intended behaviour at baseline. At immediate follow-up the intervention group demonstrated significantly greater improvements in stigma-related knowledge and reductions in stigma-related attitudes and intended behaviour, relative to the control group. At 6 months' follow-up, however, only one attitude item remained significantly better.</p><p><strong>Conclusions: </strong>Although the intervention produced short-term advantage there was little evidence for its persistent effect, suggesting a need for greater integration of ongoing measures to reduce stigma into the medical curriculum.</p>","PeriodicalId":77411,"journal":{"name":"The British journal of psychiatry. Supplement","volume":"55 ","pages":"s89-94"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40226835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Evans-Lacko, Claire Henderson, Graham Thornicroft, Paul McCrone
{"title":"Economic evaluation of the anti-stigma social marketing campaign in England 2009-2011.","authors":"Sara Evans-Lacko, Claire Henderson, Graham Thornicroft, Paul McCrone","doi":"10.1192/bjp.bp.112.113746","DOIUrl":"10.1192/bjp.bp.112.113746","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the economic impact of social marketing anti-stigma campaigns in relation to people with mental illness is limited.</p><p><strong>Aims: </strong>To describe the economic impact of the Time to Change (TTC) anti-stigma social marketing campaign, including the potential effects on the wider economy.</p><p><strong>Method: </strong>Data collected for the evaluation of TTC were combined with the social marketing campaign expenditure data to investigate differences in knowledge, attitudes and behaviour in relation to campaign awareness. To evaluate the return on investment, we applied a decision model that estimated the impact on employment for people with depression.</p><p><strong>Results: </strong>Based on average national social marketing campaign costs, the economic benefits outweighed costs even if the campaign resulted in only 1% more people with depression accessing services and gaining employment if they experienced a health improvement. The cost per person with improved intended behaviour was at most £ 4 if we assume the campaign was responsible for 50% of the change. Costs associated with improved knowledge and attitudes, however, were more variable.</p><p><strong>Conclusions: </strong>The findings suggest that the TTC anti-stigma social marketing campaign is a potentially cost-effective and low-cost intervention for reducing the impact of stigma on people with mental health problems.</p>","PeriodicalId":77411,"journal":{"name":"The British journal of psychiatry. Supplement","volume":"55 ","pages":"s95-101"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40226836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preventing depression and promoting resilience: feasibility study of a school-based cognitive-behavioural intervention.","authors":"Paul Stallard, Rhiannon Buck","doi":"10.1192/bjp.bp.112.119172","DOIUrl":"10.1192/bjp.bp.112.119172","url":null,"abstract":"<p><strong>Background: </strong>The limited reach and effectiveness of psychological treatments for adolescent depression have fuelled interest in alternative approaches designed to promote resilience. Schools offer a convenient location for the widespread delivery of depression prevention programmes, although little research has evaluated the feasibility of delivering interventions in this setting.</p><p><strong>Aims: </strong>To investigate the feasibility of delivering and evaluating a universal school-based depression prevention programme for children aged 12-16 years.</p><p><strong>Method: </strong>A three-arm pilot study was conducted in one UK secondary school (n = 834).</p><p><strong>Results: </strong>Interventions had good reach (96%), with high rates of consent (89%) and reasonable retention (78%). The majority of intervention sessions were delivered as intended, with 85% of students attending seven or more sessions. The programme was acceptable to students and teachers, with the specific content of the active intervention being rated differently from the control programmes.</p><p><strong>Conclusions: </strong>Delivering and undertaking methodologically robust evaluations of universal school-based depression programmes is feasible.</p>","PeriodicalId":77411,"journal":{"name":"The British journal of psychiatry. Supplement","volume":"54 ","pages":"s18-23"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40211862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashleigh Lin, Renate L E P Reniers, Stephen J Wood
{"title":"Clinical staging in severe mental disorder: evidence from neurocognition and neuroimaging.","authors":"Ashleigh Lin, Renate L E P Reniers, Stephen J Wood","doi":"10.1192/bjp.bp.112.119156","DOIUrl":"https://doi.org/10.1192/bjp.bp.112.119156","url":null,"abstract":"<p><p>A new approach to understanding severe mental illnesses such as schizophrenia and affective disorders is to adopt a clinical staging model. Such a model defines the extent of the illness such that earlier and milder phenomena are distinguished from later, more impairing features. Part of the appeal of such a model is that it should have cross-diagnostic applications, but to date there has been no attempt to examine imaging or neurocognitive evidence for staging in this way. We review these two domains of study with particular focus on major depression and bipolar affective disorder. Although there is some support for the staging model in affective disorders, conclusions are limited by the large variability in the clinical samples studied, especially with regard to the presence of psychotic symptoms. We suggest that future research needs to take a transdiagnostic and longitudinal approach.</p>","PeriodicalId":77411,"journal":{"name":"The British journal of psychiatry. Supplement","volume":"54 ","pages":"s11-7"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.bp.112.119156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40211907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Transfers and transitions between child and adult mental health services.","authors":"Moli Paul, Tamsin Ford, Tami Kramer, Zoebia Islam, Kath Harley, Swaran P Singh","doi":"10.1192/bjp.bp.112.119198","DOIUrl":"10.1192/bjp.bp.112.119198","url":null,"abstract":"<p><strong>Background: </strong>Transfer of care from one healthcare provider to another is often understood as a suboptimal version of the process of transition.</p><p><strong>Aims: </strong>To separate and evaluate concepts of transfer and transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS).</p><p><strong>Method: </strong>In a retrospective case-note survey of young people reaching the upper age boundary at six English CAMHS, optimal transition was evaluated using four criteria: continuity of care, parallel care, a transition planning meeting and information transfer.</p><p><strong>Results: </strong>Of 154 cases, 76 transferred to AMHS. Failure to transfer resulted mainly from non-referral by CAMHS (n = 12) and refusal by service users (n = 12) rather than refusal by AMHS (n = 7). Four cases met all criteria for optimal transition, 13 met none; continuity of care (n = 63) was met most often.</p><p><strong>Conclusions: </strong>Transfer was common but good transition rare. Reasons for failure to transfer differ from barriers to transition. Transfer should be investigated alongside transition in research and service development.</p>","PeriodicalId":77411,"journal":{"name":"The British journal of psychiatry. Supplement","volume":"54 ","pages":"s36-40"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40211866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevention and early intervention for borderline personality disorder: current status and recent evidence.","authors":"Andrew M Chanen, Louise McCutcheon","doi":"10.1192/bjp.bp.112.119180","DOIUrl":"https://doi.org/10.1192/bjp.bp.112.119180","url":null,"abstract":"<p><p>Borderline personality disorder (BPD) is a leading candidate for developing empirically based prevention and early intervention programmes because it is common in clinical practice, it is among the most functionally disabling of all mental disorders, it is often associated with help-seeking, and it has been shown to respond to intervention, even in those with established disorder. Moreover, it can be reliably diagnosed in its early stages and it demarcates a group with high levels of current and future morbidity and mortality. Data also suggest considerable flexibility and malleability of BPD traits in youth, making this a key developmental period during which to intervene. Novel indicated prevention and early intervention programmes have shown that BPD in young people responds to intervention. Further work is required to develop appropriate universal and selective preventive interventions.</p>","PeriodicalId":77411,"journal":{"name":"The British journal of psychiatry. Supplement","volume":"54 ","pages":"s24-9"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.bp.112.119180","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40211863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK.","authors":"Patrick McGorry, Tony Bates, Max Birchwood","doi":"10.1192/bjp.bp.112.119214","DOIUrl":"https://doi.org/10.1192/bjp.bp.112.119214","url":null,"abstract":"<p><p>Despite the evidence showing that young people aged 12-25 years have the highest incidence and prevalence of mental illness across the lifespan, and bear a disproportionate share of the burden of disease associated with mental disorder, their access to mental health services is the poorest of all age groups. A major factor contributing to this poor access is the current design of our mental healthcare system, which is manifestly inadequate for the unique developmental and cultural needs of our young people. If we are to reduce the impact of mental disorder on this most vulnerable population group, transformational change and service redesign is necessary. Here, we present three recent and rapidly evolving service structures from Australia, Ireland and the UK that have each worked within their respective healthcare contexts to reorient existing services to provide youth-specific, evidence-based mental healthcare that is both accessible and acceptable to young people.</p>","PeriodicalId":77411,"journal":{"name":"The British journal of psychiatry. Supplement","volume":"54 ","pages":"s30-5"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.bp.112.119214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40211865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mental health services for young people: matching the service to the need.","authors":"Max Birchwood, Swaran P Singh","doi":"10.1192/bjp.bp.112.119149","DOIUrl":"https://doi.org/10.1192/bjp.bp.112.119149","url":null,"abstract":"<p><p>It is now known that the onset of severe and recurring mental health problems begins for the most part before the age of 25: this provides a clear focus for preventive strategies and public mental health that are a feature of many health policy frameworks. The present distinction between child and adolescent mental health services and adult services at 16 or 18 does not fit easily with these data and the now well-documented problems of transition suggest that a fundamental review of services for young people is overdue. This supplement provides an overview of the epidemiological, conceptual and service structures for young people with emergent and existing mental health problems, and asks the question, 'How should we design services for young people to promote prevention and service engagement, and to improve outcomes?'</p>","PeriodicalId":77411,"journal":{"name":"The British journal of psychiatry. Supplement","volume":"54 ","pages":"s1-2"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.bp.112.119149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40211906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevention, innovation and implementation science in mental health: the next wave of reform.","authors":"Patrick McGorry","doi":"10.1192/bjp.bp.112.119222","DOIUrl":"https://doi.org/10.1192/bjp.bp.112.119222","url":null,"abstract":"<p><p>Although the corrosive effect of mental ill health on human health and happiness has long been recognised, it is only relatively recently that mental illness has been acknowledged as one of the major threats to economic productivity worldwide. This is because the major mental disorders most commonly have their onset during adolescence and early adulthood, and therefore have a disproportionate impact on the most productive decades of life. With the costs associated with mental ill health estimated to double over the next two decades, a greater emphasis on prevention and early intervention has become even more imperative. Although prevention largely remains aspirational for many reasons, early intervention is well within our current reach and offers the potential to significantly reduce the impact of mental ill health on our health, happiness and prosperity in the immediate future.</p>","PeriodicalId":77411,"journal":{"name":"The British journal of psychiatry. Supplement","volume":"54 ","pages":"s3-4"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.bp.112.119222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40211864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}