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Mental health reform processes in Great Britain and Italy have been discussed. Recent publications permit a comparative reflection. In England, the reform started earlier and ran continuously, with its focus changing from deinstitutionalisation and community care to (also) user involvement, managerialism, evidence-based medicine, guidelines and budget cuts. Government policies can be identified. In Italy, the reform process started later and was more disruptive. It was influenced by Basaglia und the political-historical context. The reform process has been continuous, deficits are discussed, it has stood the test of time. Similarities and differences (GB vs I) are highlighted, a social history framework is proposed to understand mental health reform processes as one aspect of societal development. This research process could help identify and shape alliances for further reforms of mental health care., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

This article casts light on informal caregiving, an essential aspect of the international postgraduate researcher (PGR) experience, but which is often invisible in literature and discourses on international education. Drawing from qualitative semi-structured interviews with international PGRs in a British university, it highlights their dual role as care recipients and lesser known caregivers across transnational and local spaces. It gives insights into the forms and dynamics of care that they give to and receive from family, friends and others, uncovering the emotional and affective aspects of undertaking a postgraduate research degree overseas which impact on their mental wellbeing. The findings have implications for the improvement of university support for international PGRs which has relevance for the wider international student community.

In addition to improving quality of life, higher subjective wellbeing leads to fewer health problems and higher productivity, making subjective wellbeing a focal issue among researchers and governments. However, it is difficult to estimate how happy people were during previous centuries. Here we show that a method based on the quantitative analysis of natural language published over the past 200 years captures reliable patterns in historical subjective wellbeing. Using sentiment analysis on the basis of psychological valence norms, we compute a national valence index for the United Kingdom, the United States, Germany and Italy, indicating relative happiness in response to national and international wars and in comparison to historical trends in longevity and gross domestic product. We validate our method using Eurobarometer survey data from the 1970s and demonstrate robustness using words with stable historical meanings, diverse corpora (newspapers, magazines and books) and additional word norms. By providing a window on quantitative historical psychology, this approach could inform policy and economic history.

COVID-19 presented a range of challenges to the delivery of school psychology services in countries around the world. The current study aimed to investigate the practices of school psychologists from the United States of America, Australia, Germany, Canada, and the United Kingdom, including changes to practice and exploration of the factors that supported the delivery of school psychology services during the pandemic. Quantitative and qualitative data were collected from 1,030 school psychologists and analyzed using a mixed methods, multiple case study design. Differing impacts of the pandemic on the working hours of school psychologists were reported across countries. Participants in all countries reported a shift to online working, with an increased focus on consultation and intervention and a reduction in psychoeducational assessments. School psychologists from all nations emphazised the importance of self-care strategies, social connections and physical activity and the role of support via supervision or professional networks. Access to appropriate technology and responsive workplace policies and procedures were also identified as important. Results have implications for the internationalization of the school psychology profession and can inform international school psychology planning in response to future crises.

The UK government identified 'improving support within the criminal justice systems' as a priority for autistic people. There is a lack of quantitative research to enable policymakers to make evidence-based decisions on how to improve access to justice for autistic people. This study used a case-comparison design to compare the experiences of 145 autistic and 116 non-autistic adults who had been arrested at some point in their life. Autistic participants were nearly five times more likely to state that they were not given an appropriate adult even though they believed they needed one and felt less able to communicate with the police. Autistic participants felt less able to cope with stress, twice as likely to have experienced meltdowns and five times more likely to have experienced shutdowns because of their criminal justice involvement. We conclude that there are inequalities that autistic people face when navigating the criminal justice system and the degree to which they can participate effectively in the justice process. This has an impact on their mental health. Policy recommendations are discussed based on this evidence.

An important, yet unsettled, question in public health policy is the extent to which unemployment causally impacts mental health. The recent literature yields varying findings, which are likely due to differences in data, methods, samples, and institutional settings. Taking a more general approach, we provide comparable evidence for four countries with different institutional settings-Australia, Germany, the UK, and the United States-using a nonparametric bounds analysis. Relying on fairly weak and partially testable assumptions, our paper shows that unemployment has a significant negative effect on mental health in all countries. Our results rule out effects larger than a quarter of a standard deviation for Germany and half a standard deviation for the Anglo-Saxon countries. The effect is significant for both men and women and materialises already for short periods of unemployment. Public policy should hence focus on early prevention of mental health problems among the unemployed., (Copyright © 2017 John Wiley & Sons, Ltd.)

Occupational stress has been constantly rising among academics in universities globally, which affects their health and well-being. Although some studies reviewed occupational stress in academics, there has been less systematic evidence reviewed occupational stress of academic staff through the lens of the Transactional Model of Stress and Coping (TTSC). This integrative review aims to search, extract, appraise and synthesise recent evidence relating to occupational stress, coping strategies, health, and well-being of university academic staff. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) methodology provides a structure for searching and reporting the search outcomes. Primary studies relating to occupational stress, coping strategies, health, and well-being of academics in university published from 2010 onwards were selected from five databases, CINAHL, ERIC, PsycINFO, SCOPUS, and Web of Science in June 2020. Keywords included "stress", "coping strategy", "health", "well-being", "academics" and "university" in various combinations. The boolean operators "AND" and "OR" were also used. 17 out of 682 articles were included in this review. Most studies reported academics experienced moderate to high level of stress, and the heavy workload was one of the main stressors. Both positive and negative coping methods were used by academics to cope with stress. Occupational stress can contribute to poor mental health and decreased well-being of academics. This review can help to understand the work phenomenon of university academics and improve their health and well-being, which in turn can contribute to satisfaction and productivity within the educational institutes.

Mental health literacy (MHL) encompasses understanding mental health and learning how to obtain and maintain good mental health. Increasing MHL may increase help-seeking behaviors and positive mental health. This study aimed to identify school-based MHL interventions for children/youth using a scoping review methodology following the Johanna Briggs Model. The interventions were assessed for quality of evidence using the National Institutes of Health Study Quality Assessment Tools. Six databases were searched: Scopus, APA PsycInfo, Cochrane Library, ERIC, PubMed, and ProQuest Psychology. Search terms included "mental health literacy," "intervention," and "children." The search yielded 27 studies after applying inclusion criteria. Eight of these studies were assessed as "poor" quality, twelve as "fair" quality, and seven as "good" quality. The results highlight the need for more research to implement and evaluate interventions to sustainably and feasibly incorporate school-based MHL interventions for children and youth into practice.

Purpose: To explore employment as a social determinant of health through examining the relationship between employment status and mental health. Method: The authors conducted a systematic review of 48 longitudinal studies conducted in Australia, Canada, Croatia, Germany, Ireland, Israel, the Netherlands, Norway, United Kingdom, and United States to explore the causal relationship between employment status and mental health. Results: Five common trajectories were identified as employment, unemployment, job loss, reemployment, and retired. Employment and reemployment were associated with better mental health (e.g., lower psychological distress, lower depression, lower anxiety), whereas unemployment and job loss were correlated with poorer mental health (e.g., higher depression, higher psychological distress). Conclusion: To enhance employment outcomes, service providers must acknowledge the relationship between employment status and mental health. The trajectories of employment and reemployment should be further explored by category (e.g., temporary, adequacy, income, skill level, hours, status). Additional research is needed to further elucidate the relationship between employment status and mental health.

Flashbulb memories (FBMs) refer to vivid and long-lasting autobiographical memories for the circumstances in which people learned of a shocking and consequential public event. A cross-national study across eleven countries aimed to investigate FBM formation following the first COVID-19 case news in each country and test the effect of pandemic-related variables on FBM. Participants had detailed memories of the date and others present when they heard the news, and had partially detailed memories of the place, activity, and news source. China had the highest FBM specificity. All countries considered the COVID-19 emergency as highly significant at both the individual and global level. The Classification and Regression Tree Analysis revealed that FBM specificity might be influenced by participants' age, subjective severity (assessment of COVID-19 impact in each country and relative to others), residing in an area with stringent COVID-19 protection measures, and expecting the pandemic effects. Hierarchical regression models demonstrated that age and subjective severity negatively predicted FBM specificity, whereas sex, pandemic impact expectedness, and rehearsal showed positive associations in the total sample. Subjective severity negatively affected FBM specificity in Turkey, whereas pandemic impact expectedness positively influenced FBM specificity in China and negatively in Denmark. [ABSTRACT FROM AUTHOR]

Especially in young and middle adulthood, the integration of working and private life can be challenging. The current study showed a significant association between anxiety, stress, depressive symptoms and WLB in a sample of Generation Z. Thus, WLB can be considered a significant factor in mental health among Generation Z. Objective: Mental health can be negatively affected if work and private life demands are not balanced. This study proposes exploring work-life balance (WLB) as a predictor of Generation Z's mental health outcomes. Methods: A cross-sectional online study was conducted to collect data on mental health outcomes and WLB from a sample of Generation Z (N = 134). Three regression models were calculated to examine the predictive effect of WLB on stress, anxiety, and depressive symptoms. Results: The results show a strong statistically significant association between all three mental health outcomes. The regression model suggests work-life balance as a predictor of stress (β =.−0.404 P = 0.001, R2 = 0.16) and anxiety (β =.−256 P = 0.001, R2 = 0.06). Conclusion: WLB must be considered a significant factor in mental health problems among Generation Z. [ABSTRACT FROM AUTHOR]

Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners. [ABSTRACT FROM AUTHOR]

Objectives: Masculinity is sometimes presumed to be a cause of mental health problems and antisocial behavior in men. This study sought to identify the predictors of men’s mental well-being, including their attitudes to masculinity. Methods: 4,025 men from the UK and Germany (GDR) were asked about their core values, which areas of their life they felt were important, and their opinions about masculinity., Their mental well-being was measured using the Positive Mindset Index (PMI). Multiple linear regression assessed the degree to which their answers were linked to their mental well-being. Results: The results in both countries were similar. The main predictors of higher PMI scores were Personal Growth Satisfaction (UK β = 0.211; t = 6.146; P < 0.0000005; GDR β = 0.160; t = 5.023; P < 0.000001), Age (being older) (UK β = 0.150; t = 4.725; P < 0.00001; GDR β =0.125; t = 4.075; P < 0.00005), not taking a Negative view of Masculinity (UK β = 0.101; t = −3.458; P < 0.001; GDR β = −0.118; t = −4.014; P < 0.0001), and Health Satisfaction (UK β = 0.124; t = 3.785; P < 0.0001; GDR β = 0.118; t = 3.897; P < 0.0001). In addition, in the UK, Education Satisfaction was the fourth strongest predictor of PMI (β = 0.105; t = 3.578; P < 0.0005), and in Germany, Having a Positive View of Masculinity was the fifth strongest predictor of PMI (β = 0.097; t = 3.647; P < 0.0005). Conclusions: These findings are discussed in relation to whether the negative view of masculinity often cited in the media and elsewhere is having a negative impact on men’s mental health. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

The aim of the present study was to examine parental experiences of homeschooling during the COVID-19 pandemic in families with or without a child with a mental health condition across Europe. The study included 6720 parents recruited through schools, patient organizations and social media platforms (2002 parents with a child with a mental health condition and 4718 without) from seven European countries: the UK (n = 508), Sweden (n = 1436), Spain (n = 1491), Belgium (n = 508), the Netherlands (n = 324), Germany (n = 1662) and Italy (n = 794). Many parents reported negative effects of homeschooling for themselves and their child, and many found homeschooling to be of poor quality, with insufficient support from schools. In most countries, contact with teachers was limited, leaving parents with primary responsibility for managing homeschooling. Parents also reported increased levels of stress, worry, social isolation, and domestic conflict. A small number of parents reported increased parental alcohol/drug use. Some differences were found between countries and some negative experiences were more common in families with a child with a mental health condition. However, differences between countries and between families with and without a mental health condition were generally small, indicating that many parents across countries reported negative experiences. Some parents also reported positive experiences of homeschooling. The adverse effects of homeschooling will likely have a long-term impact and contribute to increased inequalities. Given that school closures may be less effective than other interventions, policymakers need to carefully consider the negative consequences of homeschooling during additional waves of the COVID-19 pandemic and future pandemics. [ABSTRACT FROM AUTHOR]

Research to date suggests older adults prefer a passive involvement in the clinical decision-making process; however, the empirical evidence underlying this claim in the mental health context is yet to be reviewed systematically. To understand whether older adults desire involvement in mental health-related clinical decisions. A systematic review was conducted to identify primary research that explored mental-health decision-making preferences of people with a mean age of over 55 from January 1990 through to December 2018. Three independent studies of varying design and quality were included. Study settings were in the USA, Germany, and the UK. A preference for shared decision-making was seen in two studies, while a preference for active decision-making was identified in one. In contrast to other reviews on clinical decision-making, this review focused on mental health-related decisions of older adults. The evidence suggests older adults desire involvement in mental health-related clinical decisions. Given the political drive to empower patients and the need to ensure evidence-based clinical practice, more high-quality research regarding the shared decision-making preferences and outcomes of older adults with mental ill-health is needed. Systematic Review Registration PROSPERO: CRD42018102009 [ABSTRACT FROM AUTHOR]

Studies reported a strong impact on mental health during the first wave of the COVID-19 pandemic in March–June, 2020. In this study, we assessed the impact of the pandemic on mental health in general and on schizotypal traits in two independent general population samples of the United Kingdom (May sample N: 239, October sample N: 126; participation at both timepoints: 21) and in two independent general population samples of Germany (May sample N: 543, October sample N: 401; participation at both timepoints: 100) using online surveys. Whereas general psychological symptoms (global symptom index, GSI) and percentage of responders above clinical cut-off for further psychological investigation were higher in the May sample compared to the October sample, schizotypy scores (Schizotypal Personality Questionnaire) were higher in the October sample. We investigated potential associations, using general linear regression models (GLM). For schizotypy scores, we found that loneliness, use of drugs, and financial burden were more strongly corrected with schizotypy in the October compared to the May sample. We identified similar associations for GSI, as for schizotypy scores, in the May and October samples. We furthermore found that living in the United Kingdom was related to higher schizotypal scores or GSI. However, individual estimates of the GLM are highly comparable between the two countries. In conclusion, this study shows that while the general psychological impact is lower in the October than the May sample, potentially showing a normative response to an exceptional situation; schizotypy scores are higher at the second timepoint, which may be due to a stronger impact of estimates of loneliness, drug use, and financial burden. The ongoing, exceptional circumstances within this pandemic might increase the risk for developing psychosis in some individuals. The development of general psychological symptoms and schizotypy scores over time requires further attention and investigation. [ABSTRACT FROM AUTHOR]

As the population of the world gets older, cognitive and mental health decline in older adults has become one of the most pressing scientific problems of the 21st century. It has been well-established that multiple pathways exist that can lead to future cognitive decline and the development of age-related mental health conditions. Making matters more complicated is the fact that aging is not a homogenous or simple process; rather, each person brings a diverse set of circumstances to the table, leading to differences in biologically aging. Research is needed to identify how the intersection of environmental and biological factors may protect older adults or put them at future risk for cognitive decline and the development of age-related mental health conditions. Furthermore, each potential factor may impact different domains of cognition and mental health or may impact individuals differentially based on genetic, environmental, social, emotional, and behavioral factors. Neuroimaging is one key tool that can be used to discover and assess markers of cognitive and mental health. The goal of this special issue is to expand the science on how biological markers can aid the understanding of aging and mental health through the lens of the individual from an international perspective, representing Germany, Taiwan, Thailand, the United Kingdom, and the United States. Common themes from these articles are used to support the new Seed and Soil Model of Neurocognitive Disorders. [ABSTRACT FROM AUTHOR]

The global economic crisis of the previous decade has accelerated internal mobility in the European Union. The main objective was to analyse perceived stress and mental health among Spanish immigrants and non-immigrants, as well as gender differences, and to examine the mediation role of perceived stress in the relationship between migration protective factors and mental health. A convenience sample (N = 941) was obtained by snowball sampling, contacting with social networks during 2014 and 2015. Spanish immigrants (n = 719) living in Germany or United Kingdom and non-immigrants (n = 222) living in Spain answered an online survey with a questionnaire about socio-demographic and migration variables (immigrants) as well as PSS-14 and GQH-28. The low level of perceived stress and mental health symptoms found were similar in Spanish immigrants and non-immigrants. Women immigrants presented slightly higher rates of prevalence of somatisation and anxiety/insomnia and higher perceived stress. A parsimonious structural equation model with two protective migration factors was obtained (R2 =.58), which had direct and indirect effects on mental health through perceived stress. The migration process was not related to poorer mental health in the European context, and gender differences were small. These findings could be explained by the privileged migration conditions of Spanish immigrants. [ABSTRACT FROM AUTHOR]

In cases of suspected violations of rules, regulations or the law by armed forces personnel, investigations are invariably mandatory. Military investigations differ from well-researched civilian criminal investigations. Differing from civilian police detectives, most military investigators – as disciplinary supervisors and military police personnel – have a number of tasks to accomplish, which include leading in combat and ensuring military readiness. Military investigations can lead to substantive negative or positive consequences for military readiness, including mental health, unit cohesion and subjective legal certainty. This impact on unit cohesion and mental health is influenced by any prior history of distress or trauma; military investigations are often preceded by contravention of internal disciplinary acts, complaints and traumatic events. This study explores factors in the differing military and legal systems of Germany and the United Kingdom (UK) that might help military personnel to successfully conduct investigations while ensuring deployment readiness and maintaining human rights. [ABSTRACT FROM AUTHOR]

Many European mental health systems are undergoing change as community-centred care replaces large-scale institutions. We review empirical evidence from three countries (UK, Germany, Italy) that have made good progress with this rebalancing of care. We focus particularly on the economic consequences of deinstitutionalisation. A systematic literature review was conducted using a broad search strategy in accordance with established guidelines. We searched the International Bibliography of the Social Sciences, Health Management Information Consortium, British Nursing Index and PUBMED/Medline to 2008. The on-line search was supplemented by advice and assistance from contacts with government departments, European Commission, professional networks and known local experts. Community-based models of care are not inherently more costly than institutions, once account is taken of individuals' needs and the quality of care. New community-based care arrangements could be more expensive than long-stay hospital care but may still be seen as more cost-effective because, when properly set up and managed, they deliver better outcomes. Understanding the economic consequences of deinstitutionalisation is fundamental to success. Local stakeholders and budget controllers need to be aware of the underlying policy and operational plan. Joint planning and commissioning or devolving certain powers and responsibilities to care managers may aid development of effective and cost-effective care. People's needs, preferences and circumstances vary, and so their service requirements and support costs also vary, opening up the possibility for purposive targeting of services on needs to improve the ability of a care system to improve well-being from constrained resources. As the institutional/community balance shifts, strategic planning should also ensure that the new care arrangements address the specific contexts of different patient groups. Decision-makers have to plan a dynamic community-based system to match the needs of people moving from institutions, and must take the long view. [ABSTRACT FROM AUTHOR]

There is accumulating evidence that individual differences in stress reactivity contribute to the risk for stress-related disease. However, the assessment of stress reactivity remains challenging, and there is a relative lack of questionnaires reliably assessing this construct. We here present the Perceived Stress Reactivity Scale (PSRS), a 23-item questionnaire with 5 subscales and 1 overall scale, based on an existing German-language instrument. Perceived stress reactivity and related constructs were assessed in N = 2,040 participants from the United Kingdom, the United States, and Germany. The 5-factor structure of the PSRS was found to be similar in the 3 countries. In the U.S. sample the questionnaire was applied using 2 modes of administration (paper-pencil and computerized), and measures were repeated after 4 weeks. Measurement invariance analyses demonstrated full invariance across mode of administration and partial invariance across gender and countries. Scale scores differed between countries and genders, with women scoring higher on most scales. Overall, reliability analysis suggested good stability of PSRS scores over a 4-week period, and validation analysis showed expected associations with related constructs such as self-efficacy, neuroticism, chronic stress, and perceived stress. Perceived stress reactivity was also associated with depressive symptoms and sleep. These associations were particularly strong when individuals scoring high on perceived stress reactivity were exposed to chronic stress. In sum, our findings suggest that the PSRS is a useful and easy-to-administer instrument to assess perceived stress reactivity. [ABSTRACT FROM AUTHOR]

Background: Disparities in access to primary care (PC) have been demonstrated within and between health systems. However, few studies have assessed the factors associated with multiple barriers to access occurring along the care-seeking process in different healthcare systems. Methods: In this secondary analysis of the 2016 Commonwealth Fund International Health Policy Survey of Adults, access was represented through participant responses to questions relating to access barriers either before or after reaching the PC practice in 11 countries (Australia, Canada, France, Germany, Norway, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom, and United States). The number of respondents in each country ranged from 1000 to 7000 and the response rates ranged from 11% to 47%. We used multivariable logistic regression models within each of eleven countries to identify disparities in response to the access barriers by age, sex, immigrant status, income and the presence of chronic conditions. Results: Overall, one in five adults (21%) experienced multiple barriers before reaching PC practices. After reaching care, an average of 16% of adults had two or more barriers. There was a sixfold difference between nations in the experience of these barriers to access. Vulnerable groups experiencing multiple barriers were relatively consistent across countries. People with lower income were more likely to experience multiple barriers, particularly before reaching primary care practices. Respondents with mental health problems and those born outside the country displayed substantial vulnerability in terms of barriers after reaching care. Conclusion: A greater understanding of the multiple barriers to access to PC across the stages of the care-seeking process may help to inform planning and performance monitoring of disparities in access. Variation across countries may reveal organisational and system drivers of access, and inform efforts to improve access to PC for vulnerable groups. The cumulative nature of these barriers remains to be assessed. [ABSTRACT FROM AUTHOR]