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The Targeted Mental Health in Schools (TaMHS) programme was a nationwide initiative that funded mental health provision in schools for pupils at risk of or already experiencing mental health problems. The implementation, impact and experience of this programme was evaluated using quantitative and qualitative methodology involving three main studies: (1) a 1-year RCT involving 8658 8-10 year olds and 6583 11-13 year olds, (2) a 3-year longitudinal study involving 3346 8-10 year olds and 2647 11-13 year olds and (3) qualitative interviews with 26 TaMHS workers, 31 school staff, 15 parents and 60 pupils. The RCT demonstrated that TaMHS led to reductions in behaviour problems but not emotional problems for 8-10 year olds. No impact was found for 11-13 year olds. The effects on behaviour problems in primary school were enhanced by the provision of evidence based self-help materials, but not by other area level support. The longitudinal study found information giving and good inter-agency working correlated with more positive outcomes for behavioural problems in secondary schools. The qualitative findings indicated that TaMHS was well received by all groups, though challenges to its implementation were noted. Overall, findings indicate the utility of targeted mental health provision in schools, particularly in primary settings. The implications for implementation are discussed. © 2013 Copyright SEBDA.

Shared decision making (SDM) is increasingly being suggested as an integral part of mental health provision. Yet, there is little research on what clinicians believe the barriers and facilitators around practice to be. At the same time, there is also increasing recognition of a theory–practice gap within the field, with calls for more pragmatic uses of theory to inform and improve clinical practice. Using the Theoretical Domains Framework (TDF), a comprehensive, theoretical-led framework, underpinned by 33 behaviour change theories and 128 constructs, clinician perceived barriers and facilitators to SDM are investigated. The sample comprised of 15 clinicians across two sites in England, who took part in qualitative semi-structured interviews and focus groups. Transcripts were analysed using a deductive thematic analysis, and themes were coded under each theoretical domain. Overall, 21 barriers and facilitators for SDM in child and youth mental health were identified across ten domains of the TDF. Under capability, barriers and facilitators were found for knowledge, skills, memory/attention/decision making processes, and behavioural regulation. For opportunity, barriers and facilitators were found for social influences, as well as environmental context and resources. Finally, for motivation, domains covered included: beliefs about consequences, beliefs about capabilities, emotions, and professional role and identity. Findings suggest that a range of barriers and facilitators affect clinicians' abilities to engage in SDM with young people and parents. Interventions which target different domains related to capability, opportunity and motivation should be developed to better facilitate young people and their families in care and treatment decisions. [ABSTRACT FROM AUTHOR]

Pakistani and Caucasian mothers were both highly accurate in the identification of child and adolescent mental health problems. In a community-based vignettes study, Caucasian mothers were more likely to identify all behaviours as problematic. However, Pakistani mothers who did identify behaviours as problematic then rated them as being as (or more) serious than the Caucasian mothers. Despite this, Pakistani mothers were less likely to seek treatment from local child and adolescent mental health services. [ABSTRACT FROM AUTHOR]

An NHS Trust set up groups to teach social skills to children and adolescents using a cognitive behavioural framework. One group of seven children (five boys and two girls) is described. Parents were invited to a parallel parents' group. Each group lasted for 90 minutes and ran weekly for 6 weeks. Extensive liaison with parents and teachers took place before, during and after the group. Analysis of pre- and post group questionnaires sent to parents and teachers indicated improved social functioning, outside the group, for most of the children. Parents valued the dialogue with professionals and often felt supported by them for the first time. Therapists' contact with teachers ensured full knowledge of children's behaviour and the transfer of skills to schools. Cognitive behavioural techniques with children under-going group work require intensive liaison to facilitate generalization of skills learnt. [ABSTRACT FROM AUTHOR]

During a one-year survey 283 corneal ulcers from 274 patients were seen at St John's Eye Unit of Baragwanath Hospital. Central bacterial ulcers constituted the largest problem, and the commonest isolate in this group was Streptococcus pneumoniae. Mycotic and dendritic keratitis were relatively uncommon, while marginal catarrhal ulceration secondary to chronic staphylococcal lid disease was frequently seen. The microbiology of the various ulcers is described, and the placing of organisms into classes is stressed in determining significance of isolates. Many of the patients were male Africans who were either manual labourers or unemployed. Half the patients had used topical antibiotics before presentation. [ABSTRACT FROM PUBLISHER]

This randomised, double-masked study on 45 black South Africans compares the effect of topical indomethacin pretreatment with that of placebo on the immediate postoperative increase or reduction in intraocular pressure one week and one month after argon laser trabeculoplasty. There was no significant difference in the incidence and the magnitude of the immediate postoperative intraocular pressure increase between the two groups, though they occurred significantly later in the indomethacin-treated group (p less than 0.01). Although no effect of indomethacin pretreatment on the intraocular pressure reduction was evident after one week, a significant adverse effect of the drug was demonstrated after one month (p less than 0.01). [ABSTRACT FROM PUBLISHER]

Mandarin Chinese is typologically unusual among the world's languages in having flexible word order despite a near absence of inflectional morphology. These features of Mandarin challenge conventional linguistic notions such as subject and object and the divide between syntax and semantics. In the present study, we tested monolingual processing of argument structure in Mandarin verb-final sentences, where word order alone is not a reliable cue. We collected participants' responses to a forced agent-assignment task while measuring their electroencephalography data to capture real-time processing throughout each sentence. We found that sentence interpretation was not informed by word order in the absence of other cues, and while the coverbs BA and BEI were strong signals for agent selection, comprehension was a result of multiple cues. These results challenge previous reports of a linear ranking of cue strength. Event-related potentials showed that BA and BEI impacted participants' processing even before the verb was read and that role reversal anomalies elicited an N400 effect without a subsequent semantic P600. This study demonstrates that Mandarin sentence comprehension requires online interaction among cues in a language-specific manner, consistent with models that predict crosslinguistic differences in core sentence processing mechanisms., (© 2024. The Author(s).)

Adjectives in English and Mandarin are typically prenominal, but the corresponding grammatical rules vary in subtle ways. Our event-related potential (ERP) study shows that native speakers of both languages rely on similar processing mechanisms when reading sentences with anomalous noun-adjective order (e.g., the vase *white) in their first language, reflected by a biphasic N400-P600 profile. Only Mandarin native speakers showed an additional N400 on grammatical adjectives (e.g., the white vase), potentially due to atypical word-by-word presentation of lexicalized compounds. English native speakers with advanced Mandarin proficiency were tested in both languages. They processed ungrammatical noun-adjective pairs in English like English monolinguals (N400-P600), but only exhibited an N400 in Mandarin. The absent P600 effect corresponded to their (surprisingly) low proficiency with noun-adjective violations in Mandarin, questioning simple rule transfer from English grammar., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

We face increasing demand for greater access to effective routine mental health services, including telehealth. However, treatment outcomes in routine clinical practice are only about half the size of those reported in controlled trials. Progress feedback, defined as the ongoing monitoring of patients' treatment response with standardized measures, is an evidence-based practice that continues to be under-utilized in routine care. The aim of the current review is to provide a summary of the current evidence base for the use of progress feedback, its mechanisms of action and considerations for successful implementation. We reviewed ten available meta-analyses, which report small to medium overall effect sizes. The results suggest that adding feedback to a wide range of psychological and psychiatric interventions (ranging from primary care to hospitalization and crisis care) tends to enhance the effectiveness of these interventions. The strongest evidence is for patients with common mental health problems compared to those with very severe disorders. Effect sizes for not-on-track cases, a subgroup of cases that are not progressing well, are found to be somewhat stronger, especially when clinical support tools are added to the feedback. Systematic reviews and recent studies suggest potential mechanisms of action for progress feedback include focusing the clinician's attention, altering clinician expectations, providing new information, and enhancing patient-centered communication. Promising approaches to strengthen progress feedback interventions include advanced systems with signaling technology, clinical problem-solving tools, and a broader spectrum of outcome and progress measures. An overview of methodological and implementation challenges is provided, as well as suggestions for addressing these issues in future studies. We conclude that while feedback has modest effects, it is a small and affordable intervention that can potentially improve outcomes in psychological interventions. Further research into mechanisms of action and effective implementation strategies is needed., (© 2024. The Author(s).)

Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health 1,2 . Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities 3 . Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories 4 . We invited a multidisciplinary, global group of researchers, practitioners, advocates and young people to complete sequential surveys to identify and prioritize the characteristics of a mental health-friendly city for young people. Here we show a set of ranked characteristic statements, grouped by personal, interpersonal, community, organizational, policy and environmental domains of intervention. Life skills for personal development, valuing and accepting young people's ideas and choices, providing safe public space for social connection, employment and job security, centring youth input in urban planning and design, and addressing adverse social determinants were priorities by domain. We report the adversities that COVID-19 generated and link relevant actions to these data. Our findings highlight the need for intersectoral, multilevel intervention and for inclusive, equitable, participatory design of cities that support youth mental health., (© 2024. The Author(s).)

Evidence-based and person-centred care requires the measurement of treatment outcomes that matter to youth and mental health practitioners. Priorities, however, may vary not just between but also within stakeholder groups. This study used Q-methodology to explore differences in outcome priorities among mental health practitioners from two countries in relation to youth depression. Practitioners from the United Kingdom (UK) (n = 27) and Chile (n = 15) sorted 35 outcome descriptions by importance and completed brief semi-structured interviews about their sorting rationale. By-person principal component analysis (PCA) served to identify distinct priority profiles within each country sample; second-order PCA examined whether these profiles could be further reduced into cross-cultural "super profiles". We identified three UK outcome priority profiles (Reduced symptoms and enhanced well-being; improved individual coping and self-management; improved family coping and support), and two Chilean profiles (Strengthened identity and enhanced insight; symptom reduction and self-management). These could be further reduced into two cross-cultural super profiles: one prioritized outcomes related to reduced depressive symptoms and enhanced well-being; the other prioritized outcomes related to improved resilience resources within youth and families. A practitioner focus on symptom reduction aligns with a long-standing focus on symptomatic change in youth depression treatment studies, and with recent measurement recommendations. Less data and guidance are available to those practitioners who prioritize resilience outcomes. To raise the chances that such practitioners will engage in evidence-based practice and measurement-based care, measurement guidance for a broader set of outcomes may be needed., (© 2023. The Author(s).)

The importance of shared research goals for a world in which no one is held back by mental health problems.

Despite the importance of prosodic processing in utterance parsing, a majority of studies investigating boundary localization in a second language focus on word segmentation. The goal of the present study was to investigate the parsing of phrase boundaries in first and second languages from different prosodic typologies (stress-timed vs. syllable-timed). Fifty English-French bilingual adults who varied in native language (French or English) and second language proficiency listened to English and French utterances with different prosodic structures while event-related brain potentials were recorded. The utterances were built around target words presented either in phrase-final position (bearing phrase-final lengthening) or in penultimate position. Each participant listened to both English and French stimuli, providing data in their native language (used as reference) and their second language. Target words in phrase-final position elicited closure positive shifts across listeners in both languages, regardless of the language-specific acoustic cues associated with phrase-final lengthening (shorter phrase-final lengthening in English compared to French). Interestingly, directional effects were observed, where learning to parse English as a second language in a native-like manner seemed to require a higher proficiency level than learning to parse French as a second language. This pattern of results supports the idea that L2 listeners need to learn to recognize L2-specific phrase-final lengthening regardless of the apparent similarity across languages and that some language combinations might present greater challenges than others., (© 2023 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

In anxiety, depression and psychosis, there has been frustratingly slow progress in developing novel therapies that make a substantial difference in practice, as well as in predicting which treatments will work for whom and in what contexts. To intervene early in the process and deliver optimal care to patients, we need to understand the underlying mechanisms of mental health conditions, develop safe and effective interventions that target these mechanisms, and improve our capabilities in timely diagnosis and reliable prediction of symptom trajectories. Better synthesis of existing evidence is one way to reduce waste and improve efficiency in research towards these ends. Living systematic reviews produce rigorous, up-to-date and informative evidence summaries that are particularly important where research is emerging rapidly, current evidence is uncertain and new findings might change policy or practice. Global Alliance for Living Evidence on aNxiety, depressiOn and pSychosis (GALENOS) aims to tackle the challenges of mental health science research by cataloguing and evaluating the full spectrum of relevant scientific research including both human and preclinical studies. GALENOS will also allow the mental health community-including patients, carers, clinicians, researchers and funders-to better identify the research questions that most urgently need to be answered. By creating open-access datasets and outputs in a state-of-the-art online resource, GALENOS will help identify promising signals early in the research process. This will accelerate translation from discovery science into effective new interventions for anxiety, depression and psychosis, ready to be translated in clinical practice across the world., Competing Interests: Competing interests: AC received research, educational and consultancy fees from the Italian Network for Paediatric Trials, CARIPLO Foundation, Lundbeck, and Angelini Pharma. RM received speaker/consultancy fees from Karuna, Janssen, Boehringer Ingelheim and Otsuka, and is director of a company that hosts psychotropic prescribing decision tools. TAF reports personal fees from Boehringer-Ingelheim, DT Axis, Kyoto University Original, Shionogi and SONY, and a grant from Shionogi outside the submitted work; in addition, TAF has patents 2020-548587 and 2022-082495 pending, and intellectual properties for Kokoro-app licensed to Mitsubishi-Tanabe. CM received honoraria as a consultant and/or advisor and/or for lectures from Angelini, Compass, Esteve, Exeltis Janssen, Lundbeck, Neuraxpharm, Nuvelution, Otsuka, Pfizer, Servier and Sunovion outside the submitted work. EGO has received research and consultancy fees from Angelini Pharma. In the last three years SL has received honoraria as a consultant and/or advisor and/or for lectures and/or for educational material from Alkermes, Angelini, Eisai, Gedeon Richter, Janssen, Lundbeck, Medichem, Medscape, Merck Sharpp and Dome, Mitshubishi, Neurotorium, NovoNordisk, Otsuka, Recordati, Roche, Rovi, Sanofi Aventis, TEVA., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Reviews around interventions to improve shared decision making (SDM) for child and youth mental health have produced inconclusive findings on what approaches increase participation. Importantly, the previous reviews did not explore the use of theory, as well as mechanisms of change (intervention functions) and active units of change (behaviour change techniques). The aim of this review was to explore these factors and ascertain how, if at all, these contribute to SDM. Five databases were searched up until April 2020. Studies met inclusion criteria if they were: (a) an intervention to facilitate SDM; (b) aimed at children, adolescence, or young people aged up to 25, with a mental health difficulty, or their parents/guardians; and (c) included a control group. Data were extracted on patient characteristics, study design, intervention, theoretical background, intervention functions, behaviour change techniques, and SDM. Quality assessment of the studies was undertaken using the Effective Public Health Practice Project (EPHPP) quality assessment tool. Eight different interventions met inclusion criteria. The role of theory to increase SDM remains unclear. Specific intervention functions, such as 'education' on SDM and treatment options and 'environmental restructuring' using decision aids, are being used in SDM interventions, as well as 'training' for clinicians. Similarly, behaviour change techniques linked to these, such as 'adding objects to the environment', 'discussing pros/cons', and clinicians engaging in 'behavioural practice/rehearsal'. However, as most studies scored low on the quality assessment criteria, as well as a small number of studies included and a low number of behaviour change techniques utilised, links between behaviour change techniques, intervention functions and increased participation remain tentative. Intervention developers and clinicians may wish to consider specific intervention functions and behaviour change techniques to facilitate SDM., (© 2021. Crown.)