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The mental health of international students has become a concern, as they face high levels of psychological distress. We designed a five-week acceptance and commitment therapy (ACT) workshop with two additional individual assessment meetings. The intervention aimed at helping international students attending a Finnish university to reduce their symptoms of stress, depression, and anxiety, and enhance skills of psychological flexibility. The post-assessment was conducted seven weeks after the pre-measurement. Using data from 53 participants, an evaluation indicated that statistically and clinically significant reductions in symptoms were observed, and the workshop was well received. Regression analyses revealed that changes in psychological inflexibility, mindfulness, and value-based living acted as predictors of change in symptoms. Furthermore, changes in these psychological skills predicted changes in different kinds of distress. This study suggests that a brief group intervention might be a feasible alternative for enhancing the psychological well-being of international students. peerReviewed

Työn ja koulutuksen ulkopuolella olevien nuorten aikuisten tiedetään olevan moninainen ryhmä. Pitkittyneenä tilanne lisää riskiä syrjäytymiselle sekä ongelmien monimutkaistumiselle. Tämän katsauksen tavoitteena on kuvata työn ja koulutuksen ulkopuolella olleiden nuorten aikuisten taustatietoja, hyvinvointia ja palveluiden käyttöä sekä toimintakyvyn vahvistamista ja tulevaisuutta koskevia toiveita, joita kartoitettiin matalan kynnyksen ohjausjaksolle hakeutumisen yhteydessä tehdyssä alkuhaastattelussa. Katsauksen näytteenä olleen 46 nuoren aikuisen tilanteissa ilmeni erilaisia hyvinvointia, toimintakykyä ja ammatillisten suunnitelmien tekoa vaikeuttavia tekijöitä, kuten mielenterveysongelmia sekä aiempien opintojen keskeytymistä ja niissä ilmenneitä haasteita. Kuluneelta vuodelta kuvattiin erilaisten palveluiden käyttöä. Mielenterveyspalveluiden ja talous- ja velkaneuvonnan osalta ilmeni kokemuksia palvelun riittämättömyydestä tai vaikeasta saatavuudesta. Toimintakykyyn ja tulevaisuuteen liittyvät toiveet koskivat aineistossa yleisten haasteiden helpottumista, kuten työ- ja opintotilanteen parantumista sekä oman hyvinvoinnin, pärjäämisen tai arjen tilanteen kohentumista. Tulosten perusteella työn ja koulutuksen ulkopuolella olevien tukemisessa kattava tuen- ja palvelutarpeiden kartoitus on keskeistä. Tärkeää on myös varmistaa palveluiden piirissä olevien kokemuksia tuen riittävyydestä.

Objectives Participation in physical activity can improve mental health and well-being, but effects are mixed. This consensus statement from Sports Medicine Australia and the Australian Psychological Society aims to provide guidance to practitioners on the ways that physical activity can be promoted to maximise benefits to mental health. Method Following the Clinical Consensus Statement protocol, an expert group comprised of eight members with expertise in physical activity and mental health articulated recommendations regarding five physical activity contextual factors: type, physical environment, delivery, domain, and social environment. Results To optimise the mental health benefits of physical activity, we recommend: i) activity selection be guided by factors associated with adherence and enjoyment as opposed to any specific type (type); ii) facilitators (i.e., teachers, coaches, instructors, practitioners) deliver organised physical activity sessions using an instructional style that satisfies individuals' basic needs for autonomy, competence and social connection (delivery); iii) participation in physical activity with others who provide support, facilitate positive interactions, or make people feel valued, so long as it does not undermine a preference to be active alone (social environment); iv) where possible and appropriate, some physical activity should be undertaken outside in pleasant natural environments (physical environment); and, v) at least some physical activity be undertaken during leisure-time or via active travel, where possible prioritising activities one personally chooses to undertake (domain). Conclusions The type, domain, physical and social environment of physical activity, as well as the way in which it is delivered, will determine mental health outcomes. Practitioners can use these recommendations to optimise the effects of physical activity on mental health. peerReviewed

Kirja-arvio teoksesta Tomi Bergström, Mieletön häiriö. Psykiatrian ongelma ja sen ratkaisu. PS-Kustannus. 223 s.

Artikkeli perustuu tutkimukseen, jossa tarkastellaan seitsemän syrjäisellä maaseutualueella kasvaneen nuoren aikuistumista varjostaneita elämänongelmia: mielen ja minän pahoinvointiin liittyviä, ajan kuluessa vaikeutuvia konflikteja ja ahdistuksia, äkillisempiä uupumisen ja henkisen romahtamisen hetkiä sekä erilaisiin kontrolloimattomiin riskinottamisiin keskittyvää elämäntapaa. Tutkimuksen haastatteluaineisto on koottu laadullisessa pitkittäistutkimuksessa. Nyt 22-vuotiaiden nuorten aikuisten elämää seurattiin lähes seitsemän vuoden ajan. Aineisto on rikasta, luottamuksen sävyttämää kerrontaa, josta nuorten elämänongelmiin avautuu heidän omista kokemuksistaan käsin ongelmakenttä. Aineistoa analysoitiin temaattisina selontekoina eletystä elämästä. Analyysi osoittaa, että nuorten elämää hankaloittaneet ilmiöt kiinnittyvät ensisijaisesti heille läheisiin asioihin. Näihin kuuluu kamppailu perhe- ja rakkaussuhteita ja aikuistumista koskevia normatiivisia odotuksia vastaan. Joillakin nuorilla ongelmakenttä on monikerroksinen ja levittäytyy hallitsemaan elämää laajemmin kuin joillakin toisilla. Nuorten pyrkimykset selvitä ongelmista huolimatta eriävät.

Väestössä hyvin yleiset oppimisen ja mielenterveyden haasteet heikentävät nuorten ja aikuisten hyvinvointia ja mahdollisuuksia suoriutua opinnoista ja työllistyä. Tässä tutkimuksessa selvitettiin kehityksellisten oppimisen vaikeuksien ohella mahdollisesti esiintyvien mielenterveysongelmien yhteyttä koulupolun aikaiseen ja jälkeiseen elämään vertaamalla vain oppimisen vaikeuksia omaavien ja oppimisen vaikeuksien ohella mielenterveyden ongelmia raportoivien antamia tietoja opiskelusta ja hyvinvoinnista toisiinsa. Aineisto (n = 137) koostuu vuosina 2014–2017 NUTTU – Nuoret tuella työelämään -hankkeeseen ohjautuneista työttömistä tai työttömyysuhanalaisista nuorista ja aikuisista, joilla oli todettavissa kehityksellinen oppimisen vaikeus (esim. lukivaikeus). Arvioita opiskelusta ja hyvinvoinnista kartoitettiin strukturoidulla haastattelulla ja tuloksia vertailtiin sen mukaan, oliko henkilö raportoinut oppimisen vaikeuden ohella diagnosoidun mielenterveyden häiriön vai ei. Yhtäaikaisia oppimisen ja mielenterveyden haasteita kokevilla oli itsearvioiden mukaan enemmän ajankohtaista pitkäaikaistyöttömyyttä, jo ala-asteella koettuja vaikeuksia, toisen asteen opintojen keskeytymisiä, nukkumisen ongelmia, syömisen epäsäännöllisyyttä, huumekokeiluja ja itsetuhoisuutta kuin heillä, joilla tunnistettiin ainoastaan oppimisen vaikeuksia. Odotetusti vain oppimisen vaikeuksia omaavilla oli harvemmin säännöllinen lääkitys tai psykiatrinen hoitokontakti. Aiempiin tutkimuksiin sopien oppimisen vaikeuksien rinnalla esiintyvä mielenterveyden häiriö näyttäisi korostavan opinnoissa ja hyvinvoinnissa koettuja haasteita suhteessa tilanteeseen, jossa on pelkästään oppimisen vaikeuksia.

Alle 35-vuotiaiden työssä käyvien aikuisten mielenterveyden haasteet ovat kasvaneet voimakkaasti Suomessa ja muissa länsimaissa. Tutkimus on painottunut työelämän riskitekijälähtöiseen tarkasteluun, ja ratkaisujen etsinnässä on korostunut sekä lääketieteellinen että yksilölähtöinen viitekehys. Tässä artikkelissa tarkastellaan nuorten työntekijöiden työkykyä työelämän ja kulttuurisen muutoksen näkökulmasta. Lisäksi pyritään rakentamaan uudenlaista tutkimusperustaista näkökulmaa mielenterveyteen liittyvän työkyvyn tukemiseksi. Aineistona tutkimuksessa on käytetty Työterveyslaitoksen ”Mitä jos mielen hyvinvointia rakennettaisiin uudestaan?” -hankkeessa pääkaupunkiseudun kunta-alalta vuonna 2021 kerättyä haastatteluaineistoa (N = 70), jossa on haastateltu nuoria aikuisia, työterveyshuoltojen edustajia sekä esihenkilöitä. Tutkimusaineiston sisältöanalyysissä hyödynnetään Margaret Archerin teoriaa toimijuuden muodostumisesta refleksiivisen harkinnan kautta. Tuloksissa esitellään seitsemän erilaista nuorten työntekijöiden mielenterveyden toimijahahmoa. Kukin toimijahahmo pyrkii mielekkääseen toimintaan ja ratkaisuun omista arvoistaan, normeistaan ja moraalisista lähtökohdistaan käsin. Toimintaa raamittavat käytettävissä olevat resurssit. Hahmotypologia osoittaa, että mielenterveyskategorian alle on kertynyt joukko erilaisia yhteiskuntaan, työelämään ja yksilön elämänkulkuun kietoutuvia haasteita, joita ratkotaan työterveyshuollossa yksilötasolla. Hahmojen sosiaalisen ja rakenteellisen taustan moninaisuus korostaa sitä, kuinka mielenterveyteen liittyvä työkyky jäsentyy osaksi sosiaalista ja institutionaalista toimintaa. Tällöin on syytä myös kysyä, onko perusteltua pyrkiä ratkomaan nuorten työntekijöiden mielenterveyden haasteita pääsääntöisesti yksilötasolla diagnostisin käsittein ja hoitomuodoin. Abstract Social characters of mental health. A qualitative study of young employees in the municipal sector. The mental health challenges faced by working adults aged under 35 have grown rapidly in Finland and other Western countries. Studies have emphasized risk-based observation of work life, and the search for solutions has centered around two frameworks: medical and individual oriented. This article examines the work ability of young employees from the viewpoint of work life and cultural change. It also attempts to build a new kind of study-based viewpoint to support mental health-related work ability. The data used in this study were collected during the What if mental health could be constructed differently? project of the Finnish Institute of Occupational Health, in which young adults, occupational health service representatives, and supervisors (N=70) from the municipal sector in the capital area were interviewed in the year 2021. Content analysis of the study data used formation through reflexive deliberation from Margaret Archer’s theory of agency. Seven different social characters of young employee’s mental health are presented in the results. Every social character strives towards meaningful action and a solution based on their own values, norms, and moral starting points. Action takes place within the limits of available resources. The character typology shows that the mental health category has accumulated many different challenges, which are intertwined with society, work life and the individual life course, and are solved on an individual level by occupational health services. The diversity of a characters’ social and structural background highlights how mental health-related work ability is structured as part of social and institutional action. Thus, we may ask whether striving to resolve the mental health challenges of young employees on mainly an individual level, using diagnostic terms and types of treatment, is justified. Keywords: qualitative research, young adults, mental health, human agency, municipal sector

During this millennium, the survival of juvenile idiopathic arthritis (JIA) has greatly improved. However, chronic illness such as JIA appears to have an impact on the psychosocial development and mental health of children and adolescents. The aims of this thesis were to evaluate mortality, causes of death, mental and behavioural disorders and the use of psychotropic medications in patients with recent-onset juvenile idiopathic arthritis (JIA) patients compared to population controls. The research material of this case-control study was selected from national registers. The cases, JIA patients with the International Classification of Diseases (ICD-10) codes of M08.0–M08.9 or M09.0*L40.5, were collected from the national reimbursement register. For each case, the National Population Registry picked three controls matched for age, sex and residence. Mortality data were picked from Statistics Finland, psychiatric diagnoses (ICD-10 codes F10–98) from the Care Register of National Institute for Health and Welfare, and psychotropic medication was collected from the national prescription register. During the follow-up time, 4,180 JIA patients (62% females) received special reimbursement for JIA medications. Mean age at diagnosis was 8.3 years. The median follow-up time was 6.6 years (IQR 3.1–10.5). The patients were compared with 12,511 controls. The relative risk of death in the JIA group was not elevated compared to controls. However, the risk of psychiatric morbidity was higher among the JIA patients than the controls, especially in females. In addition, compared to controls, females with JIA purchased more antidepressants than males with JIA. In conclusion, this study provides novel information on the prognosis of JIA. Mortality in patients with JIA is the same as in controls, but psychiatric morbidity is increased among children, adolescents and young adults compared to controls. Tiivistelmä Lastenreuman eloonjäämisennuste on parantunut tämän vuosituhannen aikana. Kroonisella sairaudella kuten lastenreumalla on kuitenkin vaikutusta eri-ikäisten lasten ja nuorten psyykkiseen kehitykseen ja mielenterveyteen. Tämän tutkimuksen tarkoituksena oli kartoittaa lastenreumapotilaiden kuolleisuutta, kuolinsyitä, mielenterveyden- ja käyttäytymisen häiriöitä sekä psyykenlääkkeiden käyttöä verrokkiväestöön verrattuna. Tutkimusmateriaali tähän tapaus-verrokkitutkimukseen kerättiin kansallisista rekistereistä. Tapaukset eli lastenreumapotilaat (diagnoosikoodeilla M08.0–M08.9 tai M09.0*L40.5) kerättiin Kansaneläkelaitoksen (Kela) erityiskorvattavuusrekisteristä. Jokaista tapausta kohti Väestörekisterikeskus poimi kolme väestöverrokkia, jotka oli kaltaistettu iän, sukupuolen ja asuinpaikan suhteen. Kuolleisuusdata saatiin Tilastokeskuksesta. Kaikki seuranta-aikana ilmaantuneet psykiatriset diagnoosit (ICD-10-koodit F10–98) kerättiin Terveyden- ja hyvinvoinnin laitoksen hoitoilmoitusrekisteristä (Hilmo) ja psyykenlääkkeiden ostokerrat Kelan lääkeostorekisteristä. Seuranta-aikana 4180 lastenreumapotilasta (62% naisia) sai erityiskorvattavuuden reumalääkityksestä. Keski-ikä diagnoosihetkellä oli 8,3 vuotta. Keskimääräinen seuranta-aika oli 6,6 vuotta (IQR 3,1–10,5). Potilaita verrattiin 12 511 verrokkiin. Kuoleman riskissä ei ollut eroa verrokkeihin, mutta lastenreumapotilailla, erityisesti naispotilailla, oli verrokkeja suurempi riski sairastua psykiatriseen sairauteen. Verrokkeihin verrattuna naispotilaat ostivat lisäksi enemmän masennuslääkkeitä kuin miespotilaat. Tutkimus tarjoaa uutta tietoa lastenreumapotilaiden ennusteesta. Kuolleisuus ei ole lisääntynyt lastenreumapotilailla verrattuna verrokkiväestöön, mutta lapsilla, nuorilla ja nuorilla aikuisilla lastenreumapotilailla on enemmän psykiatrista sairastavuutta.

Background The COVID-19 pandemic has had implications for adolescents’ interpersonal relationships, communication patterns, education, recreational activities and well-being. An understanding of the impact of the pandemic on their mental health is crucial in measures to promote the post-pandemic recovery. Using a person-centered approach, the current study aimed to identify mental health profiles in two cross-sectional samples of Finnish adolescents before and after the peak of the pandemic, and to examine how socio-demographic and psychosocial factors, academic expectations, health literacy, and self-rated health are associated with the emerging profiles. Methods and findings Survey data from the Health Behaviour in School-aged Children (HBSC) study conducted in Finland in 2018 (N = 3498, age M = 13.44) and 2022 (N = 3838, age M = 13.21) were analyzed. A four-profile model using cluster analysis was selected for both samples. In Sample 1, the identified profiles were (1) “Good mental health”, (2) “Mixed psychosocial health”, (3) “Somatically challenged”, and (4) “Poor mental health”. In Sample 2, the identified profiles were (1) “Good mental health”, (2) “Mixed psychosomatic health”, (3) “Poor mental health and low loneliness”, and (4) “Poor mental health and high loneliness”. The results of the mixed effect multinomial logistic regression analysis showed that in both samples, being a girl and reporting lower maternal monitoring; lower family, peer, and teacher support; higher intensity of online communication; a less positive home atmosphere and school climate; and poor self-rated health were most strongly linked to belonging to a poorer mental health profile. In addition, in Sample 2, low subjective health literacy was a key factor associated with poorer mental health profiles, and teacher support was more important than before COVID. Conclusions The current study stresses the importance of identifying those vulnerable to developing poor mental health. To maximize post-pandemic recovery, the role of schools, especially teacher support and health literacy, along with the factors that remained important over time should be taken into account in public health and health promotion interventions.

Adolescence is a vulnerable age for emerging mental health problems. As schools are everyday environments for children and adolescents, mental health promotion interventions may be especially effective when delivered within them. The aim of this study was to generate knowledge on mental health promotion interventions in comprehensive schools in northern Finland. First, a mental health promotion model for comprehensive schools was developed by psychiatric nurses in collaboration with school professionals in workshops in Oulu, Finland. A review of the literature, which revealed that mental health promotion in schools includes indicated, selective and universal interventions, was used as a basis for the study, together with written reports from the workshops. Secondly, school professionals from comprehensive schools with or without interventions developed in the mental health promotion model in Oulu were included in the study, and their perceptions of student well-being and mental health promotion in school were queried. The study samples consisted of school professionals from 9 intervention schools and from 49 non-intervention schools. School professionals considered that student well-being has declined and that students show a general disregard for their own well-being. Mental health promotion was regarded as a ‘core business’ of schools. Thirdly, a universal psychoeducation intervention, including lectures and group work on mental health issues, was delivered to 14-years old students in eighth grade. Students from two comprehensive schools were included, 85 pupils in 8th grade forming an intervention group and 77 a non-intervention group. The psychoeducation intervention delivered in classroom settings increased boys’ recognition of conduct disorders and altered girls’ attitudes to regard mental health disorders more as real medical conditions than as personal traits. Students reported feeling more comfortable seeking help from family members and friends than from professionals. The least likely persons from whom to seek help were school personnel, especially teachers. The most common barriers to help-seeking were concerns that the person would respond negatively, seeking help would be too embarrassing or that the offered help would not be useful. Students regarded the psychoeducation intervention as a positive experience and reported gaining useful knowledge on mental health. School professionals regard mental health interventions to be an integral part of school activity, and they appreciate the need for support and help to deal with the increasing mental health needs of students. Short school-based psychoeducation interventions can be useful to change attitudes towards mental health disorders, and informal sources of help are highly regarded by students, but the barriers to accepting professional help are still high and we need ways to lower these barriers. Tiivistelmä Erilaiset mielenterveyteen liittyvät ongelmat ovat lapsilla ja nuorilla yleisiä ja suuri osa aikuisiän mielenterveyden häiriöistä alkaa lapsuudessa tai nuoruudessa. Koulut ovat lapsille ja nuorille yhteinen ja luonnollinen ympäristö edistää lasten ja nuorten mielenterveyttä, jonka vuoksi mielenterveyden edistämisen interventiot kouluympäristöissä voivat olla erityisen vaikuttavia. Tämän tutkimuksen tavoitteena oli tuottaa tietoa mielenterveyden edistämisestä peruskouluissa. Mielenterveyden edistämisen malli peruskouluihin kehitettiin Oulussa työpajoissa yhdessä psykiatristen sairaanhoitajien sekä eri yhteistyötahojen, koulun toimijoiden sekä vanhempien ja oppilaiden kanssa. Tutkimuksen pohjana toimi kirjallisuuskatsaus, jonka mukaan mielenterveyttä edistetään kouluissa yksilö-, ryhmä- ja yleistasolla sekä työpajojen raportit. Tutkimuksessa tarkasteltiin koulujen henkilökunnan kokemuksia oppilaiden hyvinvoinnista sekä mielenterveyden edistämisen toiminnasta kouluympäristössä. Tutkimukseen osallistui henkilökuntaa 9 koulusta, joissa toteutettiin työpajoissa kehitettyjä interventioita sekä 49 koulusta, joissa ei toteutettu työpajoissa kehitettyjä interventioita. Koulun henkilökunta koki, että oppilaiden hyvinvointi on heikentynyt ja oppilaat osoittavat välinpitämättömyyttä omaa hyvinvointia kohtaan. Koulujen henkilökunnan mielestä mielenterveyden edistäminen on osa koulun perustoimintaa. Yleistason psykoedukatiivinen interventio, johon kuului opetusta sekä ryhmätöitä mielenterveyden teemoista toteutettiin 8-luokan noin 14-vuotiaille oppilaille. Tutkimukseen osallistui oppilaita kahdesta peruskoulusta, 85 oppilasta interventiokoulusta sekä 77 ei-interventiokoulusta. Luokkaympäristössä toteutettu interventio lisäsi poikien osalta käytöshäiriöiden tunnistamista ja tyttöjen asenne muuttui mieltämään mielenterveyden häiriöitä enemmän lääketieteellisenä häiriönä eikä henkilökohtaisena ominaisuutena. Oppilaat raportoivat hakevansa mieluummin apua perheen jäseniltä ja kavereilta kuin ammattilaisilta. Epätodennäköisin avun hakemisen kohde olivat koulun henkilökunta, erityisesti opettajat. Yleisimmät avun hakemisen esteet olivat pelko negatiivisesta suhtautumisesta, pelko nolostumisesta tai että avun hakemisesta ei olisi hyötyä. Oppilaat kokivat psykoedukatiivisen intervention positiivisena kokemuksena, ja he saivat sen avulla hyödyllistä tietoa mielenterveydestä. Koulun henkilökunta kokee mielenterveyden edistämisen tärkeänä osana koulun tehtävää. He kokevat, että tarvitsevat apua ja tukea vastatakseen oppilaiden kasvaviin mielenterveyden haasteisiin. Lyhyet koulussa toteutettavat psykoedukatiiviset interventiot voivat muuttaa oppilaiden asenteita mielenterveyden häiriöitä kohtaan. Nuoret arvostavat enemmän epävirallisia avun lähteitä ja kokevat avun hakemisen ammattilaisilta vaikeaksi ja minkä vuoksi onkin tärkeä löytää keinoja madaltaa kynnystä avun hakemiseen.

Helsingin Sanomien julkaisemassa tietokirjassa Seitsemän miestä (2005) esitetään psykiatrisia diagnooseja Aleksis Kiven Seitsemässä veljeksessä (1870) kuvatuista henkilöistä. Tällainen diagnosoimisen tapa osallistuu kulttuurin diagnostisoitumisen prosessiin – siihen, että spesifit diagnoosinimikkeet saavat yhä keskeisemmän sijan kulttuurissa. Analysoin kulttuurisen mielenterveystutkimuksen näkökulmasta, miten Seitsemässä miehessä käytetään psykiatrisia diagnooseja. Tuloksinani esitän, että teoksessa luonnollistetaan ja arkipäiväistetään diagnooseja, varsinkin tietynlaisia, historiallisesta perspektiivistä uudempia ja ”lievempiin” mielenterveyden ongelmiin viittaavia diagnooseja, joita on tutkimuksessa käsitteellistetty tarttuvina diagnooseina. Samalla osoitan teoksen stigmatisoivan diagnosoimiaan henkilöhahmoja ja tiettyjä diagnoosinimikkeitä sekä kaventavan käsitystä siitä, millainen käyttäytyminen ja kokeminen voidaan katsoa normaaliksi ja terveeksi. Lähemmin tarkastelen koko veljesjoukkoon teoksessa liitettyä ADHD-diagnoosia. Osoitan teoksen välittävän kuvan ADHD:sta tarkkarajaisena, historiattomana entiteettinä. Mielenterveyden häiriöt ovat kuitenkin luonteeltaan tätä monimutkaisempia ilmiöitä. Lisäksi tuon esiin, että teoksessa esitetyt diagnoosit tarjotaan selityksiksi diagnosoitujen henkilöhahmojen ongelmille, mikä sivuuttaa ongelmia muotoilevat sosiaaliset syyt ja ympäristötekijät. Tämänkaltaisten huomioiden tekeminen on aiheellista aikana, jolloin yhä useampia elämän ja jopa fiktiivisesti kuvatun elämän osa-alueita lähestytään patologisoiden eli näkemällä ne sairauksina tai häiriöinä.

In this study, we explored whether satisfaction with government management, perception of risk, and gratitude influenced public anxiety during the COVID-19 pandemic in China. Using a cross-sectional, anonymous and confidential online survey, a nationwide sample of Chinese adults (N = 876) was targeted between March 25–March 30, 2020, a period in which newly confirmed cases significantly declined in China. The anxiety level was decreased as compared to that assessed during the peak period. Multiple parallel mediation modeling demonstrated that risk perception and gratitude partially mediated the relationship between satisfaction with government management and public anxiety. Increasing satisfaction and gratitude, as well as reducing risk perception contribute to the public’s mental health. The results may shed light on the positive factors for psychological well-being during the COVID-19 pandemic and may aid potential strategies for the policy maker, the public, and the clinic to regulate negative emotions or future emerging infectious diseases.

Numerous instruments have been developed to measure gaming-related health problems based on “internet gaming disorder” (IGD) in the third section of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) and “gaming disorder” (GD) in the International Classification of Diseases (11th rev.). However, the criteria in the manuals tend to be operationalized in numerous diverse ways, which can make screening outcomes incomparable. A content validity analysis is needed to reassess the relationships between the diagnostic criteria and the items that operationalize them. The IGD and GD criteria were divided into sematic components. A qualitative content validity analysis was carried out for all items employed by the 17 instruments that claim to measure either construct by their criteria in English. In all but one instrument, the operationalizations did not include all criterion components. There were two main reasons found for this: the components had simply been left out or had been alternatively modified into other components. Criteria that were vaguely described in the manuals were sources of lower content validity items. The study implies that many of the problems in IGD and GD measurement derive from criteria operationalization and original manual descriptions. The conclusion provides practical recommendations that researchers can apply to improve the content validity of their measurement. peerReviewed

nonPeerReviewed

Background/Objective Several factors associated with resilience as the maintenance of mental health despite stress exposure can be strengthened through participation in leisure time activities. Since many people listen to or make music in their leisure time, the aim of the present study was to provide insights into the architecture of how resilience relates to passive and active music engagement. Method 511 participants regularly listening to and/or making music completed an online survey on resilient outcomes (i.e., mental health and stressor recovery ability), different resilience factors (e.g., optimism, social support), quantitative music engagement (i.e., time spent with music listening/making) and qualitative music engagement (i.e., use of music listening/making for mood regulation). Results Bivariate correlations showed that subjects spending more time with music making reported better stressor recovery ability and less mental health problems, while partial correlational network analysis revealed no unique associations for quantitative music engagement. Regarding qualitative music engagement, people using music-based mood regulation reported lower mental health, mindfulness, and optimism, but also higher social support. A more heterogeneous pattern emerged for single music-based mood regulation strategies. Conclusions Our findings highlight the importance of the individual (mal-)adaptive use of music, painting a more nuanced picture of music engagement and resilience. peerReviewed

Sosiaalisessa mediassa viraalisti leviävissä huumorikuvissa eli meemeissä käsitellään yhä enenevässä määrin myös mielenterveyttä. Meemit heijastelevat ja tuottavat kulttuurisia käsityksiä mielenterveydestä, sen hoidosta ja merkityksistä. Tässä artikkelissa paneudutaan mielenterveysmeemien tutkimiseen liittyviin tutkimuseettisiin ja metodologisiin kysymyksiin erityisesti etnografian ja multimodaalisen diskurssianalyysin näkökulmasta. Erilaiset lähestymistavat tuottavat erilaista tietoa meemeistä ja niiden tekemiseen ja jakamiseen liittyvistä tekijöistä, ja asettavat erilaisia haasteita tutkimukselle ja aineistosta tehtäville tulkinnoille. Myös meemeissä viljelty usein mustakin huumori lisää niiden monitulkintaisuutta. Erilaisten tulkintojen mahdollisuuksien avaaminen tutkimuksen kontekstissa antaa myös laajemmalle yhteiskunnalle ja esimerkiksi sosiaalisen median ja terveydenhuollon toimijoille pohdittavaa mielenterveyteen liittyvien representaatioiden tulkinnan rajoista ja tavoista. peerReviewed

Background: Digital tools and interventions are being increasingly developed in response to the growing mental health crisis, and mental health professionals (MHPs) considerably influence their adoption in client practice. However, how MHPs use digital tools in client interaction is yet to be sufficiently understood, which poses challenges to their design, development, and implementation. Objective: This study aimed to create a contextual understanding of how MHPs use different digital tools in clinical client practice and what characterizes the use across tools. Methods: A total of 19 Finnish MHPs participated in semistructured interviews, and the data were transcribed, coded, and inductively analyzed. Results: We found that MHP digital tool use was characterized by 3 distinct functions: communication, diagnosis and evaluation, and facilitating therapeutic change. The functions were addressed using analog tools, digitized tools that mimic their analog counterparts, and digital tools that use the possibilities native to digital. The MHP-client communication included various media alongside face-to-face meetings, the MHPs increasingly used digitized tools in client evaluation, and the MHPs actively used digitized materials to facilitate therapeutic change. MHP tool use was generally characterized by adaptability—it was negotiated in client interactions. However, there was considerable variance in the breadth of MHPs’ digital toolbox. The existing clinical practices emphasized MHP-client interaction and invited incremental rather than radical developments, which challenged the achievement of the scalability benefits expected from digital tools. Conclusions: MHPs use digitized and digital tools in client practice. Our results contribute to the user-centered research, development, and implementation of new digital solutions in mental health care by classifying them according to their function and medium and describing how MHPs use and do not use them. peerReviewed

Introduction: Relatively little is known about individual differences in adolescent psychological flexibility and its associations with symptoms of stress and depression. This study examined different profiles of adolescent stress and depressive symptoms and their associations with developing psychological flexibility before the critical educational transition. Methods: The data were derived from a general sample of 740 Finnish ninth-grade adolescents (Mage = 15.7 years, 57% female) who were assessed twice during the final grade of their basic education. The data were analyzed using growth mixture modeling. Results: Four profiles of stress and depressive symptoms were identified during a school year: 1) no stress and no depressive symptoms (None; 69%); 2) mild and decreasing stress and depressive symptoms (Decreasing; 15%); 3) low but increasing stress and depressive symptoms (Increasing; 6%); and 4) high and stable levels of stress and depressive symptoms (High; 10%). The adolescents in these profiles differed from each other in their initial levels and changes of psychological flexibility. The initial level of psychological flexibility was highest in the no-symptom profile group. We observed simultaneous change trends in symptoms and psychological flexibility during a school year. When symptoms decreased, psychological flexibility increased, and when symptoms increased, psychological flexibility decreased. Conclusions: A bidirectional pattern of relationships between psychological flexibility and psychological symptoms was found. Despite initially high level of skills in psychological flexibility, some adolescents, unexpectedly, experienced increased symptoms of stress and depression during the school year. The results call for further studies to explore in-depth the developmental diversity in adolescents’ well-being and its antecedents. peerReviewed

Tässä julkaisussa esitän kokonaisvaltaisen mielen hyvinvoinnin määritelmän, jota olemme empiirisesti testanneet Lapsesta aikuiseksi -pitkittäistutkimuksen aikuisikäisillä osanottajilla (Kokko ym. 2013). Kokonaisvaltaisen mielen hyvinvoinnin määritelmässä huomioidaan mielen hyvinvoinnin myönteiset ulottuvuudet. nonPeerReviewed

COVID-19-era lockdown policies resulted in many older persons entering unemployment, facing financial difficulties and social restrictions, and experiencing declining health. Employing the Survey of Health, Ageing and Retirement in Europe's first COVID-19 module (summer 2020) (N = 11,231) and the Karlson-Holm-Breen method for decomposition of effects within non-linear probability models (logistic regression modelling), we examined associations of pandemic-era lost work with older Europeans' (50–80 years of age) self-assessed health, depressive symptoms, and anxiety symptoms, and mediation through households' difficulties making ends meet, loneliness, and curtailed face-to-face contact with non-relatives. We find that lost work was associated with detriments in all three health outcomes. Total mediation was 23% for worsened self-assessed health, 42% for depressive symptoms, and 23% for anxiety symptoms. In all cases, combined mediation through the two social activity variables was approximately twice the magnitude of mediation through household financial difficulties. This evidence highlights the extent of employment's value for friendship formation and sustenance, and social activity, during the pandemic-era social restrictions. This might be accentuated among older persons because of the social constrictions often concomitant to advancing age. These results emphasize that the social correlates of lost employment, beyond the financial concomitants, should receive thorough research and policy attention, perhaps especially for older adults during public health crises. peerReviewed

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Objectives To examine birth cohort differences in depressive symptoms and life satisfaction in older men and women and the mechanisms underpinning the possible cohort differences. Methods Two independent cohorts of Finnish men and women aged 75 and 80 were assessed in 1989–1990 ( n = 617) and 2017–2018 ( n = 794). They reported their depressive symptoms (CES-D), current life satisfaction, and evaluation of life until now. Results The later-born cohort reported fewer depressive symptoms (8.6 ± 7.1 vs. 13.9 ± 8.3) and the differences were similar for the subdomains of depressive symptoms. The later-born cohort was more often mostly satisfied with life until now (90 vs. 70%) but not with the current life than the earlier-born cohort. Better self-rated health and education of the later-born cohort partly explain the cohort differences. Discussion Older people in Finland report fewer depressive symptoms and they are more satisfied with their past life compared to their counterparts assessed 28 years ago.

Virtual reality (VR) offers new and flexible ways to provide psychological interventions. The aim of this study was to develop and investigate the effectiveness of a VR intervention based on acceptance and commitment therapy (ACT) for social and public speaking anxiety. ACT is a process-based approach that aims to (a) increase individuals’ abilities to handle difficult emotional and cognitive experiences and (b) develop the motivation required for change to occur. In this study, a sample of university students with social interaction or communication anxiety (N = 76; age M = 24.95, SD = 6.50, 69.7% females) was blindly randomized into a total of 2 h of VR ACT training (VRACT; n = 37) or a waiting list control (WLC; n = 39) group. The VRACT group was gradually exposed to social situations using a VR head-mounted display (HMD) and received audio-recorded ACT-based instructions aimed at increasing psychological flexibility. The outcome measurements included self-reported social and communication anxiety, well-being, psychological processes, and behavioral measures. At the final feedback meeting held one week after attending three VR sessions, we observed a significant decrease in social and communication anxiety (d = 0.55–0.61) and a significant improvement in psychological flexibility (d = 0.61), with moderate effect sizes. These findings contribute to advancing knowledge of how ACT can be efficaciously delivered using VR to improve mental health outcomes for university students with social anxiety. peerReviewed

Background Individuals with depression and depressive symptoms have a higher mortality rate than non-depressed individuals. The increased comorbidity and mortality associated with depression has remained largely unexplained. The underlying pathophysiological differences between depressive subtypes, melancholic and non-melancholic, may provide some explanation to this phenomenon. Methods 1995 participants (mean age 61 years) from the Helsinki Birth Cohort Study were recruited for this prospective study and followed up for a mean of 14.1 years. Information regarding medical history, lifestyle, and biochemical parameters were obtained. Depressive symptoms were assessed using the Beck Depression Inventory. Standardized mortality ratios were calculated. Results Participants were followed up for a total of 28 044 person-years. The melancholic depressive group had an increased adjusted risk of mortality [HR 1.49 (95% CI: 1.02-2.20)] when compared to the non-depressive group. Comparing mortality to the whole population of Finland using standardized mortality ratios (SMR) both the non-melancholic [1.11 (95% CI: 0.85-1.44)] and melancholic depressive [1.26 (95% CI: 0.87-1.81)] groups had higher mortality than the non-depressive group [ 0.82 (95% CI: 0.73-0.93)]. Conclusions Melancholic depressive symptoms are most strongly related to a higher mortality risk. peerReviewed

The article explores motivational and personality predictors of burnout syndrome in sports coaches. The study involved 183 sports coaches of 20–63 years old (86.9% women; M=41.34±10.56 years), with professional experience for 13.83±9.98 years. Three components of professional burnout ― Emotional exhaustion, Depersonification and Reduction of professional achievements ― were measured with the adapted Maslach professional burnout inventory (Vodopyanova, et al 2008). Motivational aspects were measured with the adapted Ryan and Connell Professional Motivation inventory (Osin et al, 2017). Personal resources ― stress resistance, authenticity and coping strategies ― were measured with the adapted Connor-Davidson Stress Resilience Scale (Nartova-Bochaver et al., 2021), the Moscow Authenticity Scale (Reznichenko et al., 2021) and the adapted Proactive Coping Questionnaire adapted (Belinskaya et al, 2018). The results showed that amotivation and external motives of professional activity are linked positively and internal motivation linked negatively to professional burnout. Furthermore, the links between the types of motivation and the components of burnout in different combinations are mediated by stress resistance, authenticity, and coping skills that prevent burnout. The strongest link of motivation and personal resources was revealed for the Reduction of professional achievements; the weakest link was in the context of Depersonification of a sports coach. Burnout was also positively linked to age and negatively to coaches' experience. The data obtained can be used to form preventive interventions that reduce the burnout of coaches and increase their professional performance, mental health and subjective well-being.

The group-level symptom-reduction model of mental health care emphasizes predetermined treatment guidelines for those mental and social difficulties that are diagnosable as mental health disorders on the basis of predetermined diagnostic criteria. The model have produced generalizable information to support medical decision-making for symptom reduction. However, it may have also increased the reification of diagnostic labels, and in so doing medicalized and stigmatized complex human-life experiences, with a lack of attention to a range of social determinants and existential factors associated with mental health. Since symptom-reduction model can easily lose sight of essential non-technical and contextual aspects of mental health care, including the quality of the interaction and other common factors needed to understand and treat mental health difficulties, there is doubts that the symptom-reduction model may actually decrease the effectiveness of mental health services, as compared to a holistic approach. Based on recent critiques of the group-level symptom-reduction model to mental health care, and research on common-factor perspectives on mental health treatments, holistic conceptions of humans, and naturalistic outcome studies from several holistic mental health services from different countries, I hypothesized that an ontological turn from the treatment of “mental disorders” to the treatment of “difficult life situations” will lead to a more personalized and comprehensive treatment approach, that mediates an improved effectiveness of mental health services. peerReviewed

Background: The COVID-19 pandemic is a massive health crisis that has exerted enormous physical and psychological pressure. Mental healthcare for healthcare workers (HCWs) should receive serious consideration. This study served to determine the mental-health outcomes of 1,556 HCWs from 45 countries who participated in the COVID-19 IMPACT project, and to examine the predictors of the outcomes during the first pandemic wave. Methods: Outcomes assessed were self-reported perceived stress, depression symptom, and sleep changes. The predictors examined included sociodemographic factors and perceived social support. Results: The results demonstrated that half of the HCWs had moderate levels of perceived stress and symptoms of depression. Half of the HCWs (n = 800, 51.4%) had similar sleeping patterns since the pandemic started, and one in four slept more or slept less. HCWs reported less perceived stress and depression symptoms and higher levels of perceived social support than the general population who participated in the same project. Predictors associated with higher perceived stress and symptoms of depression among HCWs included female sex, not having children, living with parents, lower educational level, and lower social support. Discussion: The need for establishing ways to mitigate mental-health risks and adjusting psychological interventions and support for HCWs seems to be significant as the pandemic continues.

Background The Symptom Checklist (SCL) developed by the Health Behaviour in School-aged Children (HBSC) study is a non-clinical measure of psychosomatic complaints (e.g., headache and feeling low) that has been used in numerous studies. Several studies have investigated the psychometric characteristics of this scale; however, some psychometric properties remain unclear, among them especially a) dimensionality, b) adequacy of the Graded Response Model (GRM), and c) measurement invariance across countries. Methods Data from 229,906 adolescents aged 11, 13 and 15 from 46 countries that participated in the 2018 HBSC survey were analyzed. Adolescents were selected using representative sampling and surveyed by questionnaire in the classroom. Dimensionality was investigated using exploratory graph analysis. In addition, we investigated whether the GRM provided an adequate description of the data. Reliability over the latent variable continuum and differential test functioning across countries were also examined. Results Exploratory graph analyses showed that SCL can be considered as one-dimensional in 16 countries. However, a comparison of the unidimensional with a post-hoc bifactor GRM showed that deviation from a hypothesized one-dimensional structure was negligible in most countries. Multigroup invariance analyses supported configural and metric invariance, but not scalar invariance across 32 countries. Alignment analysis showed non-invariance especially for the items irritability, feeling nervous/bad temper and feeling low. Conclusion HBSC-SCL appears to represent a consistent and reliable unidimensional instrument across most countries. This bodes well for population health analyses that rely on this scale as an early indicator of mental health status.

Korkeakouluopiskelijoiden oppimisvaikeuksia ja koettuja oppimisen ongelmia ei ole Suomessa juuri tutkittu. Tässä tutkimuksessa tavoitteena oli tarkastella korkeakouluopiskelijoiden todettujen ja koettujen oppimisvaikeuksien yleisyyttä sekä oppimisvaikeuksien yhteyttä elämän eri osa-alueisiin. Aineistona tutkimuksessa oli kaksi korkeakouluopiskelijoille suunnattua kyselyaineistoa: Opiskelijabarometri 2012 (N = 1649) sekä Korkeakouluopiskelijoiden terveystutkimus 2012 (N = 3 790). Tutkimusväestönä oli 20–29-vuotiaat korkeakouluopiskelijat. Menetelminä käytettiin ristiintaulukointia. Osuuksille laskettiin 95 prosentin luottamusvälit. Koettuja oppimisvaikeuksia oli Korkeakouluopiskelijoiden terveystutkimuksessa 6–8 prosentilla ja Opiskelijabarometrissa 9–11 prosentilla, todettuja puolestaan 2–4 prosentilla. Naiset raportoivat oppimisvaikeuksia miehiä useammin. Oppimisvaikeuksia kokeneilla naisista viidesosalla ja miehistä kymmenesosalla oli todettu oppimisvaikeus. Oppimisvaikeuksia kokeneilla oli muita yleisemmin todettuja ja koettuja mielenterveyden ongelmia sekä heikompi koettu terveys. Lisäksi heillä oli ongelmia sosiaalisessa kanssakäymisessä muita yleisemmin. Oppimisvaikeuksia kokevat tarvitsivat enemmän tukea opiskeluun kuin muut. He myös käyttivät muita yleisemmin terveyspalveluita ja olivat niihin muita tyytymättömämpiä. Lisäksi heillä oli muita opiskelijoita yleisemmin taloudellisia ongelmia.

• Koulu on otollinen ympäristö kaikille oppilaille kohdistetuille mielenterveyttä edistäville ­interventioille. • Opetushenkilöstö kaipaa lisää tietoa lasten ja nuorten mielenterveydestä sekä ­mielenterveysongelmien varhaisesta tunnistamisesta. • Kouluterveydenhoitajilla olisi valmiuksia oppilaiden mielenterveyden tukemiseen nykyistä ­laajemmin. • Kouluterveydenhoitajat toivovat koulutusta näyttöön perustuvista menetelmistä oppilaiden ­mielenterveyden arvioimiseen ja tukemiseen sekä aikaa menetelmien toteuttamiseen.

The worldwide outbreak of the novel coronavirus (COVID-19) and the likelihood of future pandemics has raised the attention to the effects of pandemics on the psychological well-being of individuals. Given their indispensable role in such situations, healthcare workers are at greater risk of mental health issues. This paper aimed to review the mediators of psychological well-being among healthcare workers responding to global pandemics. After registration on PROSPERO, a systematic review was performed in four databases. Following study selection (PRISMA guidelines), inclusion criteria and analysis methods were assessed. The quality of the included studies was assessed using the EPHPP criteria. Out of 1467 references, 39 studies were included in this review. In most studies, worse well-being outcomes, such as stress, depressive symptoms, anxiety, and burnout were related to demographic characteristics, direct contact with infected patients, and poor perceived support. In turn, self-efficacy, coping ability, altruism, and support from employers and organisations were found to be protective factors. Despite some limitations in the quality of the available evidence, this review highlights the prevalence of poor mental health outcomes in healthcare workers responding to global pandemics. Future interventions should target the identified mediators to promote psychological well-being among this population, particularly social and organisational support, which may improve workers’ mental health and reduce burnout and turnover.

Mielenterveyden häiriöiden merkityksen kasvaminen sekä haasteet mielenterveyspalveluiden järjestämisessä ovat tehneet sähköisten mielenterveyspalveluiden kehittämisestä ja tutkimuksesta ajankohtaista. Nyt COVID-19-pandemia on lisännyt sähköisten mielenterveyspalveluiden tarvetta mutta tuonut samalla näkyviksi organisaatioiden eriytyvät lähtökohdat sähköisten mielenterveyspalveluiden järjestämisessä. Tämän tutkimuksen tavoitteena oli kuvata sähköisten mielenterveyspalveluiden vaikutuksia palvelunkäyttäjien näkökulmasta sekä tunnistaa positiivisesti vaikuttavien sähköisten mielenterveyspalveluiden edellytyksiä. Tutkimus toteutettiin kansainvälisistä tutkimusartikkeleista (n = 27) tietoa kokoavana integroivana kirjallisuuskatsauksena. Analyysimenetelmänä sovellettiin teemoittelua ja tulkintakehyksenä toipumisorientaation (recovery) viitekehystä. Kirjallisuuskatsauksen perusteella sähköiset mielenterveyspalvelut tarjoavat mahdollisuuksia toipumiseen ja sen tukemiseen, mutta toipuminen ehdollistuu sähköisiin mielenterveyspalveluihin liittyvissä toimintakäytännöissä. Tulokset jäsennettiin yksilön laaja-alaista toipumista ja toipumista kokonaisvaltaisesti tukevia sähköisiä mielenterveyspalveluja ilmentävinä yläteemoina, joista edelliseen sisällytettiin alateemat kliininen toipuminen, henkilökohtainen toipuminen ja osallisuuden vahvistuminen ja jälkimmäiseen tietoperusteisuus, tilannekohtaisuus, tuen tarjoaminen, vuorovaikutteisuus, henkilökohtaisuus ja asiakaslähtöisyys. Kirjallisuuskatsaus osoittaa, että tutkimustarpeista huolimatta tiedämme jo paljon tekijöistä, jotka mahdollistavat toipumista edistävien sähköisten mielenterveyspalveluiden toteuttamista. Tätä tietoa on tarpeen hyödyntää myös COVID-19-pandemian muuttamassa toimintaympäristössä. Tulosten sovellettavuutta rajoittaa tutkimustiedon pirstaleisuus sekä se, että tutkimukset kohdistuivat vain henkilöihin, joilla oli pääsy, kyky ja halu sähköisten mielenterveyspalveluiden käyttöön.Abstract Digital mental health services and recovery. An Integrative literature review The increase of mental health disorders and the challenges of delivering mental health services have made the development and research of digital mental health services topical. Currently, the COVID-19 pandemic has increased the need for digital mental health services, but at the same time it has made visible the various potential of organizations for providing digital services. The aim of this study is to describe the effects of digital mental health services from the service users’ perspective and to identify the features of the services that make an impact. The study was conducted as an integrative literature review of international research articles (n = 27). The method used was thematic analysis and a recovery orientation was applied as the interpretation framework. Based on the review, digital mental health services offer opportunities for and support the recovery of service users, but the recovery is conditioned on digital mental health practices. The results were presented as two main-themes: a person’s extensive recovery and digital mental health services that support recovery holistically. The former includes the sub-themes of clinical recovery, personal recovery and participation, and the latter the sub-themes of knowledge orientation, situationality, provision of support, interactivity, personality and client orientation. The integrative literature review shows that despite the need for future research, we already know a great deal about the factors that enable the implementation of digital mental health services that promote recovery. This knowledge needs to be utilized in the operating environment of mental health services, which is currently changing because of the COVID-19 pandemic. The review has some limitations, because research on the subject is fragmentary and the studies involved in the review were only targeted at persons with access to digital mental health services and the ability and motivation to use them. Keywords: mental health, digital services, recovery, integrative literature review

Background There is growing evidence on positive effects of physical activity (PA) on mental health. However, the focus of previous research on this relationship has typically been on mental health from the perspective of mental health problems rather than from the perspective of mental wellbeing. Further, previous research has commonly focused rather on leisure time PA without evidence on the role of other domains of PA. The aim of the present cross-sectional study was to investigate the relationship between positive mental health (PMH) and different domains of PA in young Finnish men. The secondary aim was to examine the reasons for physical inactivity among individuals with a low level of PMH. Methods Positive mental health (measured with Short Warwick-Edinburgh Mental Wellbeing Scale, SWEMWBS), self-reported leisure time, occupational and commuting PA as well as reasons for physical inactivity were measured using questionnaires (n = 456, mean age 29 years) among young Finnish males. Logistic regression modelling was used to generate odds for low and high levels of positive mental health for different levels of PA and sociodemographic variables. Results A weak positive association between leisure time PA and PMH was found in men with a low level of PMH (OR = 0.33, 95% CI 0.13–0.86). No association was found in the domains of commuting and occupational PA. Multivariate logistic regression analysis showed lower level of leisure time PA, unemployment and being single independently predicting low level of PMH. No associations were found between any domains of PA and high level of PMH. The most common reasons for physical inactivity among men with a low level of PMH were lack of interest (28%) and unwillingness to practise sports alone (27%). Conclusions The relationship between physical activity and positive mental health seems to vary between different domains of physical activity. The findings highlight the important role of leisure time physical activity, particularly in men with a low level of positive mental health. Strategies aimed at increasing physical activity for mental health benefits should focus particularly on providing opportunities for leisure time physical activity involving social interactions for men with lower mental wellbeing.