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BackgroundMany people are accessing digital self-help for mental health problems, often with little evidence of effectiveness. Social anxiety is one of the most common sources of mental distress in the population, and many people with symptoms do not seek help for what represents a significant public health problem. ObjectiveThis study aimed to evaluate the effectiveness of a self-guided cognitive behavioral internet intervention for people with social anxiety symptoms in the general population. MethodsWe conducted a two-group randomized controlled trial in England between May 11, 2016, and June 27, 2018. Adults with social anxiety symptoms who were not receiving treatment for social anxiety were recruited using online advertisements. All participants had unrestricted access to usual care and were randomized in a 1:1 ratio to either a Web-based unguided self-help intervention based on cognitive behavioral principles or a waiting list control group. All outcomes were collected through self-report online questionnaires. The primary outcome was the change in 17-item Social Phobia Inventory (SPIN-17) score from baseline to 6 weeks using a linear mixed-effect model that used data from all time points (6 weeks, 3 months, 6 months, and 12 months). ResultsA total of 2122 participants were randomized, and 6 were excluded from analyses because they were ineligible. Of the 2116 eligible randomized participants (mean age 37 years; 80.24%, 1698/2116 women), 70.13% (1484/2116) had follow-up data available for analysis, and 56.95% (1205/2116) had data on the primary outcome, although attrition was higher in the intervention arm. At 6 weeks, the mean (95% CI) adjusted difference in change in SPIN-17 score in the intervention group compared with control was −1.94 (−3.13 to −0.75; P=.001), a standardized mean difference effect size of 0.2. The improvement was maintained at 12 months. Given the high dropout rate, sensitivity analyses explored missing data assumptions, with results that were consistent with those of the primary analysis. The economic evaluation demonstrated cost-effectiveness with a small health status benefit and a reduction in health service utilization. ConclusionsFor people with social anxiety symptoms who are not receiving other forms of help, this study suggests that the use of an online self-help tool based on cognitive behavioral principles can provide a small improvement in social anxiety symptoms compared with no intervention, although dropout rates were high. Trial RegistrationClinicalTrials.gov NCT02451878; https://clinicaltrials.gov/ct2/show/NCT02451878

A parallel system of inclusive and special education persists in Ireland despite attempts to move towards integrated provision for students with Special Educational Needs and Disabilities (SEND) along a flexible continuum of support. Even in mainstream schools, duality exists and discrete delivery of special education continues to create 'siloed' approaches to education for some students. This paper outlines a research and knowledge exchange initiative involving a higher education institution and a management body for post-primary schools in Ireland attempting to develop integrated, school-wide, systematic and collaborative approaches to inclusive and special education. Theoretically underpinned by Hornby's model of Inclusive Special Education (2015) and a conceptualisation of the SENCO role in the Irish context, a pilot process was implemented to support the development of an integrated response to a continuum of need. A year after initial implementation a review was undertaken. Focus group and individual interviews with SENCOs, Curriculum Leaders and Principals in six schools indicate that the initiative, while still in its infancy, raised awareness about inclusive special education amongst staff and provided data-informed approaches to education. The centrality of leadership in promoting school-wide approaches to inclusive special education also emerged. Finally, the importance of situated community of practice approaches to professional learning were identified as critical to leading change in schools.

Background: Decreasing suicide mortality has become an overarching goal for societies worldwide. Suicide registers and other monitoring systems are a valuable source of information that can be used for addressing the suicide phenomenon and evaluating preventative interventions. Aims: This scoping review provides an overview of literature published in the last decade that has focussed on the operations (functioning) and characteristics of suicide registers and other suicide monitoring systems. Methods: Four electronic databases were searched in 2020 for identifying published material from January 2010 to October 2020. The searches were updated in October 2023 to include material from 2020 to date. Grey literature through Google searches and mental health commissions websites and the reference lists of selected documents were also searched. Results: Twenty-five articles were included in this review. Nearly half the articles were from the United States, followed by Australia. Nine countries were identified as having used suicide registers or suicide-specific monitoring systems to inform suicide prevention. Monitoring mechanisms varied across the countries examined. No article provided evidence that definitively linked suicide registers or other monitoring systems for suicide with the prevention of suicide or reduction in suicide rates. However, a variety of benefits of suicide monitoring for preventative and public health interventions were identified. Conclusions: The number of nations with surveillance systems for suicide prevention is low. Further, there is a lack of consistency in the systematic collection, analysis and interpretation of suicide-related information across the countries examined. Efforts to establish high-quality suicide surveillance systems that can be accessed in a timely and easy manner are needed to inform tailored strategies for suicide prevention. [ABSTRACT FROM AUTHOR]