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Mental disorders account for at least 18% of global disease burden, and the associated annual global costs are projected to be US$6 trillion by 2030. Evidence-based, cost-effective public mental health (PMH) interventions exist to prevent mental disorders from arising, prevent associated impacts of mental disorders (including through treatment), and promote mental wellbeing and resilience. However, only a small proportion of people with mental disorders receive minimally adequate treatment. Compared with treatment, there is even less coverage of interventions to prevent the associated impacts of mental disorders, prevent mental disorders from arising, or promote mental wellbeing and resilience. This implementation failure breaches the right to health, has increased during the COVID-19 pandemic, and results in preventable suffering, broad impacts, and associated economic costs. In this Health Policy paper, we outline specific actions to improve the coverage of PMH interventions, including PMH needs assessments, collaborative advocacy and leadership, PMH practice to inform policy and implementation, training and improvement of population literacy, settings-based and integrated approaches, use of digital technology, maximising existing resources, focus on high-return interventions, human rights approaches, legislation, and implementation research. Increased interest in PMH in populations and governments since the onset of the COVID-19 pandemic supports these actions. Improved implementation of PMH interventions can result in broad health, social, and economic impacts, even in the short-term, which support the achievement of a range of policy objectives, sustainable economic development, and recovery., Competing Interests: Declaration of interests AJ, MM, PU, CL, SS, JC, and JA are members of the Public Mental Health Working Group for the World Psychiatric Association's 2020–2023 Action Plan. JC has contributed to national policy in England, has done mental health needs assessments for local authorities in England (for which his employer received payment); is strategic and clinical director of the Royal College of Psychiatrist's Public Mental Health Implementation Centre; and is a public mental health advisor to WHO Europe. CL has received research funding from the UK Department for International Development, UK National Institute for Health Research, US National Institute of Mental Health, UK Economic and Social Research Council, European Commission, the Wellcome Trust, and Prudential Africa. NS has received honoraria for lectures from the Lundbeck company and from several universities. JA has contributed to national and state policy and service development in his role as a senior public servant., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Mental disorders account for almost a third of UK disease burden. Cost effective public mental health interventions have broad public health relevant impacts. Since coverage of such interventions is low, assessment of local coverage is important., Methods: A total of 23 Joint Strategic Needs Assessments (JSNAs) around London were assessed for different mental health intelligence., Results: Mental health was poorly covered and difficult to locate in JSNAs. Only a minority of JSNAs mentioned most mental disorders while far fewer JSNAs provided local prevalence estimates or numbers receiving treatment. Only 6% JSNAs included local wellbeing levels and any mental wellbeing promotion initiative mentioned included no information about coverage. Most JSNAs provided little information about impact of mental disorder or broader determinants on mental health. No JSNAs included associated economic implications or information about size of mental health unmet need., Conclusions: Lack of mental health representation in JSNAs means local authorities and clinical commissioning groups cannot perform statutory duties to assess local health needs to inform strategic development and commissioning. This perpetuates poor coverage of public mental health interventions. Actions to improve mental health representation in JSNAs are suggested. Improved coverage of such interventions will result in broad public health relevant impacts and associated economic savings., (© The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com)

There is considerable evidence that various psychiatric conditions can be prevented through the implementation of effective evidence-based interventions. Since a large proportion of lifetime mental illness starts before adulthood, such interventions are particularly important during childhood and adolescence. Prevention is important for the sustainable reduction of the burden of mental disorder since once it has arisen, treatment can only reduce a relatively small proportion of such burden. The challenge for clinicians is to incorporate such interventions into non-clinical and clinical practice as well as engaging with a range of other service providers including public health. Similar strategies can be employed in both the European and global contexts. Promotion of mental well-being can prevent mental disorder but is also important in the recovery from mental disorder. This guidance should be read in conjunction with the EPA Guidance on Mental Health Promotion. This guidance draws on preparatory work for the development of England policy on prevention of mental disorder which used a wide range of sources., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Objective: The aim of this paper is to describe the introduction, trial and termination of a smoke-free policy in an acute mental health unit of a regional hospital, and to consider factors that may contribute to the success of such policies in other settings., Methods: This analysis is based on key informant interviews and review of correspondence related to the trial, and examination of the relevant incident-reporting database., Results: Planning for implementation is described. The trial itself was terminated after 6 weeks due to perceived increases in aggression by patients towards staff working in the high dependency unit. Staff perceived that these episodes were directly related to these patients not being allowed to smoke. While there was an increase in events during the trial relating to two seriously ill individuals, examination of formal incident reports over a period of 2 years suggests little change in the overall number of incidents., Conclusions: Despite clear public health benefits, implementation of a smoke-free policy may have untoward behavioural effects in institutional mental health settings. In addition, staff expectations and perceptions are critical. Salient factors appear to be preparation of staff and patients, appropriate training, avoidance of exceptions and inconsistency, considering alternatives to smoking to fill the gap created by the policy, and a culture of critical evaluation in practice. Such processes will facilitate understanding and cooperation so that mental health services are able to participate in important policy processes with implications for the health of patients and staff.

The effects of three strategies for changing stigmatizing attitudes--education (which replaces myths about mental illness with accurate conceptions), contact (which challenges public attitudes about mental illness through direct interactions with persons who have these disorders), and protest (which seeks to suppress stigmatizing attitudes about mental illness)--were examined on attributions about schizophrenia and other severe mental illnesses. One hundred and fifty-two students at a community college were randomly assigned to one of the three strategies or a control condition. They completed a questionnaire about attributions toward six groups--depression, psychosis, cocaine addiction, mental retardation, cancer, and AIDS--prior to and after completing the assigned condition. As expected, results showed that education had no effect on attributions about physical disabilities but led to improved attributions in all four psychiatric groups. Contact produced positive changes that exceeded education effects in attributions about targeted psychiatric disabilities: depression and psychosis. Protest yielded no significant changes in attributions about any group. This study also examined the effects of these strategies on processing information about mental illness.

Objective: The purpose of this study was to determine the association between leadership styles of leaders of mental health treatment teams and consumers' ratings of satisfaction with the program and their quality of life., Methods: A multifactor model has distinguished three factors relevant to leadership of mental health teams: transformational leadership, in which a leader's primary goal is to lead the team to evolving better programs; transactional leadership, in which the leader strives to maintain effective programs through feedback and reinforcement; and laissez-faire leadership, an ineffective, hands-off leadership style. Research has shown transformational leadership to be positively associated with measures of the team's functioning, but the effects of leadership style on consumers is not well known. A total of 143 leaders and 473 subordinates from 31 clinical teams rated the leadership style of the team leader. In addition, 184 consumers served by these teams rated their satisfaction with the treatment program and their quality of life., Results: Consumers' satisfaction and quality of life were inversely associated with laissez-faire approaches to leadership and positively associated with both transformational and transactional leadership. Moreover, leaders' and subordinates' ratings of team leadership accounted for independent variance in satisfaction ratings-up to 40 percent of the total variance., Conclusions: Leadership seems to be an important variable for understanding a team's impact on its consumers.

A survey was carried out over a 3-month period to determine experiences of religious healing in a group of 198 consecutive psychiatric patients attending a hospital in Tamil Nadu, South India. Of these, 89 (45%) had sought between 1 and 15 sessions from either Hindu, Muslim of Christian healers. The number of patients visiting healers was linked significantly with their income, while a significantly higher number under the age of 17 years had received such help compared with older age groups. A significantly higher consultation rate was observed in those patients with schizophrenia and delusional disorders when compared with other mental illness. An average of 30% of patients claimed some benefit from healer consultation, although the majority (91%) had discontinued such treatment at the time of the hospital attendance. The role of social support, methods of traditional healing and the underlying implications for service delivery are discussed. The implications for service providers to ethnic minorities need to be taken into account while planning services.

Twelve filicidal men were examined on a forensic psychiatric service. The majority suffered from severe mental impairments due to psychosis, neurological disorders, substance abuse, or mental retardation. Most of the filicidal acts committed by these chronically impaired men resulted from isolated explosive behavior.

The authors studied 15 men who committed matricide. The majority were diagnosed as having chronic schizophrenia and had been living alone with their mothers. Other diagnoses included substance-induced psychosis and impulse disorders. Specific psychodynamic and environmental factors can be identified for each diagnostic category. The authors conclude that the matricidal impulse evolves through successive stages of psychological development; therefore, the motives for matricide are varied and correlate with the level of psychological development or regression.