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Intolerance of uncertainty has been proposed as a transdiagnostic factor in emotional disorders. Despite comprehensive empirical evidence demonstrating the association between intolerance of uncertainty and emotional disorders, the underlying mechanism remains elusive. Drawing on theoretical frameworks and empirical studies, the current study proposed that emotion regulation emerges as a potential mechanism. We explored the connections among intolerance of uncertainty, eight emotion regulation strategies (both adaptive and maladaptive), and emotional difficulties (specifically anxiety and depression) using a three-wave longitudinal approach (N = 341). Our findings revealed that heightened intolerance of uncertainty predicted increased anxiety but not depression over time. Greater intolerance of uncertainty significantly predicted elevated levels of maladaptive emotion regulation strategies including experiential avoidance, thought suppression, rumination, and reassurance-seeking. Adaptive strategies (i.e., mindfulness, cognitive reappraisal, problem-solving) predicted lower anxiety and/or depression whereas maladaptive emotion regulation strategy rumination predicted greater levels of anxiety and depression. Surprisingly, thought suppression predicted lower levels of anxiety and depression. More importantly, our analysis showed that both rumination and thought suppression served as significant mediators in the relationship between intolerance of uncertainty and both anxiety and depression. These results hold implications for future interventions, emphasising rumination and thought suppression as potential targets for interventions aimed at alleviating emotional difficulties in individuals with intolerance of uncertainty., Competing Interests: Declaration of competing interest All authors declare that they have no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Objectives: Young people attending university for the first time may be at heightened risk of experiencing mental health problems. However, limited research has examined the mental health experiences of this cohort using longitudinal methods. This study aimed to examine mental health symptoms prior to commencing university, estimate changes in symptoms over the course of the first semester of study, and identify factors associated with initial symptom levels and changes. Methods: Australian first-year undergraduate students ( N = 340) were recruited via social media and participated in a four-wave online longitudinal study conducted between February and June 2021. Symptoms of depression, anxiety, and psychological distress were assessed at each wave, along with psychosocial and lifestyle factors. Demographic characteristics were assessed at baseline. Results: Latent growth curve models indicated no significant linear change over time for depression ( p = .26) or anxiety ( p = .83) symptoms. However, a significant effect of time was observed for psychological distress ( p = .03), indicating higher distress levels at wave 3 compared to baseline ( p = .004). Financial stress, pressure to succeed, difficulty coping, greater loneliness, and more negative social interactions were each significantly associated with higher baseline depression, anxiety, and distress scores. Only greater loneliness and more negative social interactions were found to be associated with a greater increase in depression over time. Conclusion: The findings indicate that transition to university was not generally associated with an increase in poor mental health. However, several factors were associated with poorer mental health immediately prior to university commencement. Assisting students to manage financial distress, facilitating the development of social connections among students with limited social networks and skills training targeting coping and the development of realistic academic expectations may help support student mental health and promote improved wellbeing during transition to university., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Digital interventions can be effective in preventing and treating common mental health conditions among university students. Incorporating student experiences and perspectives in the design and implementation of these programmes may improve uptake and engagement. This qualitative study explored university students' perspectives of a low-intensity video-based mental health intervention, their recommendations for implementing the programme in university settings, and their views and recommendations to address barriers to engagement., Methods: Participants (N = 115) were students (mean = 20.63 years, SD = 2.10) with elevated distress from 31 Australian universities drawn from a randomised controlled trial of the Uni Virtual Clinic-Lite (UVC-Lite). Data from students randomised to the intervention condition were collected via semi-structured interviews (n = 12) and open-ended questions during post-intervention surveys (n = 103). Data were analysed using content analysis., Results: Participants generally reported positive views of the intervention, and most felt it should be offered to students as a universal intervention. Multiple methods of disseminating the intervention were suggested, including through university counselling, official platforms (e.g. student support services) and informal channels (e.g. word-of-mouth promotion). Difficulty integrating the programme into everyday life, pre-existing beliefs about mental health and technology-related factors were highlighted as barriers to engagement., Conclusion: A low-intensity video-based mental health intervention was generally considered to be acceptable and appropriate for students with mild to moderate distress. Participants provided several suggestions to encourage uptake of the intervention and possible pathways to disseminate the intervention to students. The effectiveness of these should be examined in future trials., Competing Interests: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: AG, PH, LL, PJB, ALC and LMF are co-developers of the UVC-Lite intervention. AG and LMF were involved in the development of the original Uni Virtual Clinic intervention., (© The Author(s) 2024.)

Background: Mental health problems are common among university students, yet many students do not seek professional help. Digital mental health interventions can increase students' access to support and have been shown to be effective in preventing and treating mental health problems. However, little is known about the extent to which students implement therapeutic skills from these programs in everyday life (ie, skill enactment) or about the impact of skill enactment on outcomes., Objective: This study aims to assess the effects of a low-intensity video-based intervention, Uni Virtual Clinic Lite (UVC-Lite), in improving skill enactment relative to an attention-control program (primary aim) and examine whether skill enactment influences symptoms of depression and anxiety (secondary aim). The study also qualitatively explored participants' experiences of, and motivations for, engaging with the therapeutic techniques., Methods: We analyzed data from a randomized controlled trial testing the effectiveness of UVC-Lite for symptoms of depression and anxiety among university students with mild to moderate levels of psychological distress. Participants were recruited from universities across Australia and randomly assigned to 6 weeks of self-guided use of UVC-Lite (243/487, 49.9%) or an attention-control program (244/487, 50.1%). Quantitative data on skill enactment, depression, and anxiety were collected through baseline, postintervention, and 3- and 6-month follow-up surveys. Qualitative data were obtained from 29 intervention-group participants through open-ended questions during postintervention surveys (n=17, 59%) and semistructured interviews (n=12, 41%) after the intervention period concluded., Results: Mixed model repeated measures ANOVA demonstrated that the intervention did not significantly improve skill enactment (F 3,215.36 =0.50; P=.68). Skill enactment was also not found to influence change in symptoms of depression (F 3,241.10 =1.69; P=.17) or anxiety (F 3,233.71 =1.11; P=.35). However, higher levels of skill enactment were associated with lower symptom levels among both intervention and control group participants across time points (depression: F 1,541.87 =134.61; P<.001; anxiety: F 1,535.11 =73.08; P<.001). Inductive content analysis confirmed low levels of skill enactment among intervention group participants. Participants were motivated to use techniques and skills that were perceived to be personally relevant, easily integrated into daily life, and that were novel or had worked for them in the past., Conclusions: The intervention did not improve skill enactment or mental health among students with mild to moderate psychological distress. Low adherence impacted our ability to draw robust conclusions regarding the intervention's impact on outcomes. Factors influencing skill enactment differed across individuals, suggesting that it may be necessary to tailor therapeutic skills and engagement strategies to the individual user. Theoretically informed research involving collaboration with end users is needed to understand the processes underlying skill enactment in digital mental health interventions., Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12621000375853; https://tinyurl.com/7b9ar54r., (©Hayley M Jackson, Philip J Batterham, Alison L Calear, Jeneva L Ohan, Louise M Farrer. Originally published in JMIR Mental Health (https://mental.jmir.org), 21.08.2024.)

Background: Numerous studies have demonstrated the effectiveness of digital interventions for improving the mental health of university students. However, low rates of engagement with these interventions are an ongoing challenge and can compromise effectiveness. Brief, transdiagnostic, web-based video interventions are capable of targeting key mental health and related issues affecting university students and may be more engaging and accessible for this population., Objective: This study used a 2-arm randomized controlled trial to evaluate the effectiveness of Uni Virtual Clinic-Lite (UVC-Lite), a fully automated, transdiagnostic, web-based video intervention, relative to an attention-control condition. The primary outcomes were symptoms of depression and generalized anxiety disorder. The secondary outcomes included psychological distress, social anxiety symptoms, body appreciation, quality of life, well-being, functioning, general self-efficacy, academic self-efficacy, and help seeking. Program use (intervention uptake and engagement) and satisfaction were also assessed., Methods: University students (n=487) with mild to moderate symptoms of distress were recruited from universities across Australia and randomly allocated to receive access to the UVC-Lite intervention or an attention-control condition targeting general health for a period of 6 weeks. UVC-Lite includes 12 modules, each comprising a brief animated video and an accompanying exercise. Of the 12 modules, 7 also included a brief symptom screening quiz. Outcomes were assessed at baseline, postintervention, and 3- and 6-months postintervention., Results: The primary and secondary outcomes were analyzed on an intention-to-treat basis using mixed models repeated measures ANOVA. The intervention was not found to be effective relative to the control condition on any of the primary or secondary outcomes. While 67.9% (114/168) of participants accessed at least 1 module of the intervention, module completion was extremely low. Subgroup analyses among those who engaged with the program (completed at least 1 video) and those with higher baseline distress (Distress Questionnaire-5 score ≥15) did not reveal any differences between the conditions over time. However, uptake (accessing at least 1 video) and engagement (completing at least 1 video) were higher among those with higher baseline symptoms. Satisfaction with the intervention was high., Conclusions: The UVC-Lite intervention was not effective relative to a control program, although it was associated with high satisfaction among students and was not associated with symptom deterioration. Given the challenges faced by universities in meeting demand for mental health services, flexible and accessible interventions such as UVC-Lite have the potential to assist students to manage symptoms of mental health problems. However, low uptake and engagement (particularly among students with lower levels of symptomatology) are significant challenges that require further attention. Future studies should examine the effectiveness of the intervention in a more highly symptomatic sample, as well as implementation pathways to optimize effective engagement with the intervention., Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12621000375853; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380146., (©Louise M Farrer, Hayley M Jackson, Amelia Gulliver, Alison L Calear, Liana Leach, Penelope Hasking, Natasha Katruss, Philip J Batterham. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 13.08.2024.)

Background: The acquisition of knowledge and use of skills from digital mental health interventions (DMHIs) are considered important for effectiveness. However, our understanding of user experiences implementing skills learned from these interventions is limited, particularly outside of research trials. This qualitative study aimed to investigate how community users learn and apply knowledge and skills from DMHIs based on cognitive behavioural therapy (CBT) in daily life. The study also examined factors influencing the selection and use of skills and explored perceived changes in mental health resulting from the intervention., Methods: Thirteen adults aged 26 to 66 years (10 females) were recruited using social media advertising and participated in semi-structured interviews by telephone or videoconference. All participants were living in Australia and had used a digital CBT program within the past 3 months. Interviews lasted on average 45 min. Transcripts were analysed using theoretical thematic analysis., Results: Participants demonstrated high levels of program engagement. Findings were organised into three topics with six major themes. Participants reported that their chosen intervention reinforced existing knowledge and fostered new skills and insights (Topic 1, Theme 1: knowledge consolidation). Most described actively applying skills (Topic 1, Theme 2: active approach to skill enactment), although the extent of learning and range of skills enacted varied across participants. Influences on skill selection included the perceived relevance of intervention strategies to the user's needs and personal characteristics (Topic 2, Theme 1: relevance of intervention strategies), as well as the perceived or experienced effectiveness of those strategies (Topic 2, Theme 2: perceived and experienced benefit). Challenges to ongoing skill enactment included time scarcity, prioritisation difficulties, and lack of motivation (Topic 2, Theme 3: navigating time constraints and low motivation). Improvements in mental health were generally modest and attributed mainly to participants' proactive efforts (Topic 3, Theme 1: perceived changes)., Conclusions: DMHIs may reinforce existing understanding of psychotherapeutic strategies, offer new knowledge, and encourage the application of skills in everyday life among community users who actively engage with these interventions. Future research should prioritise personalising DMHIs and investigating methods to optimise the acquisition, retention, and sustained application of knowledge and skills., (© 2024. The Author(s).)

Background: There is emerging literature regarding the efficacy of trauma-focussed writing therapies (TF-WTs) for posttraumatic stress. Such therapies have the potential to reduce posttraumatic stress symptoms (PTSS) in a brief time frame and can be delivered remotely. There remains a need for further research assessing the efficacy of different types of TF-WTs, as well comparing them to alternative control conditions not previously assessed. The present study assessed two TF-WTs that had differing writing instructions in comparison to an intervention that involved writing about positive experiences., Methods: Adult community participants (n = 83) with subthreshold or clinical PTSD symptoms were randomized to one of three conditions (two of which involved trauma-focussed writing, and the other involved writing about positive experiences). All conditions involved three weekly telehealth-delivered writing appointments. Outcomes were measured using the PTSD Checklist (PCL-5) and the Depression, Anxiety and Stress Scales (DASS-21), and were evaluated at baseline, one-week post-intervention, and five-weeks post-intervention. This trial was registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR Protocol 12620001065987)., Results: There was no evidence that the two TF-WTs were more efficacious in reducing PTSS or producing clinically meaningful change in comparison to positive experiences writing. Instead, a significant reduction from baseline to follow-up in PTSS, depression, anxiety and stress was observed in all three conditions., Limitations: The results should be interpreted with consideration of the modest sample size and absence of longer-term follow-up., Conclusions: Three-session trauma-focussed writing delivered via telehealth may not be superior to writing about positive experiences., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: Rates of help-seeking for mental disorders and suicide are low among children and adolescents. Parents are viewed as gatekeepers for their care, yet they may lack the knowledge and skills to identify needs or facilitate service access. The primary aim is to test the effect of a new gatekeeper resource for parents and caregivers on their self-efficacy to recognise, respond and access support for mental health problems and suicide risk in their child., Methods and Analysis: A two-arm randomised controlled trial will compare an online mental health and suicide gatekeeper resource for parents and caregivers to a waitlist control. Australian parents of children aged 5-17 years recruited through social media and community advertising will participate in an online trial. Participants randomised to the intervention condition will be emailed the resource to work through at their own pace. The resource consists of three sections providing parents and caregivers with confidence, knowledge and skills to recognise and respond to mental health problems and suicide risk in their child, as well as support them in accessing professional help. The primary outcome measure is self-efficacy to recognise, respond and provide support for mental health problems and suicide risk, while secondary outcomes include perceived knowledge, stigma, literacy, help-seeking attitudes, intentions and barriers. Data will be collected at preintervention, postintervention (4 weeks after accessing the resource) and 12-week follow-up. Primary analyses will compare changes in self-efficacy in the intervention condition relative to the waitlist control using mixed-model repeated measures analyses., Ethics and Dissemination: The ethical aspects of the study were approved by the Australian National University Human Research Ethics Committee (Protocol 2023/195). If effective, the resource will fill an important gap in resources for parents, with the potential for dissemination through school groups, community organisations and clinical settings., Trial Registration Number: Australian New Zealand Clinical Trials Registry, ACTRN12623000933651., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Introduction: This study aimed to investigate the mechanisms of the development of suicidal ideation and its moderating and protective factors. Drawing on the Interpersonal-psychological theory of suicide, we proposed that disruptions to belongingness, in conjunction with tolerance of health risk, may influence the development of suicidal ideation above and beyond psychosocial changes such as disruptions to finances and work., Methods: The study involved a longitudinal investigation of an Australian representative sample reporting suicidal ideation fortnightly for 12 weeks between March and June 2020., Results: The results indicated that participants who reported higher levels of belongingness, mastery, and intolerance of health risk were less likely to experience suicidal ideation and had lower severity of suicidal ideation. Mastery significantly strengthened the negative link between belongingness and the incidence of suicidal ideation, while agreeableness significantly strengthened the negative link between belongingness and the severity of suicidal ideation over time., Conclusion: The findings suggest that supporting effective social connectedness during times of isolation and promoting self-efficacy, mastery, and regulation of risk tolerance, may be crucial for suicide prevention and therapeutic intervention., (© 2024 The Authors. Suicide and Life‐Threatening Behavior published by Wiley Periodicals LLC on behalf of American Association of Suicidology.)

Background: Two of the most common modifiable barriers to help-seeking for mental health problems during adolescence are stigma and poor mental health literacy. However, relatively little is known about stigma as it relates to suicide, and knowledge about suicidality in this age group., Aims: To assess levels of suicide literacy and suicide attitudes in an adolescent sample, and to identify correlates of these constructs., Methods: Data were drawn from the pre-intervention survey of the Sources of Strength Australia Project. A total of 1019 adolescents aged between 11 and 17 years participated. Suicide literacy and attitudes were measured alongside potential correlates including psychological distress, suicidal ideation, mastery, previous exposure to suicidal thinking and behaviour, and demographics., Results: Participants more strongly endorsed attitudes attributing suicide to isolation/depression, compared to attitudes glorifying or stigmatising suicide. Gaps in knowledge about suicide included the risk factors, signs and symptoms. Key correlates of suicide attitudes and literacy included age, gender and cultural background., Conclusion: Findings highlight the need for further education activities in schools and public awareness campaigns that address the gaps in suicide knowledge and attitudes. Such activities would assist in the identification of suicide risk among young people and improve help-seeking in this population.

Purpose: As environmental disasters become more common and severe due to climate change, there is a growing need for strategies to bolster recovery that are proactive, cost-effective, and which mobilise community resources., Aims: We propose that building social group connections is a particularly promising strategy for supporting mental health in communities affected by environmental disasters., Methods: We tested the social identity model of identity change in a disaster context among 627 people substantially affected by the 2019-2020 Australian fires., Results: We found high levels of post-traumatic stress, strongly related to severity of disaster exposure, but also evidence of psychological resilience. Distress and resilience were weakly positively correlated. Having stronger social group connections pre-disaster was associated with less distress and more resilience 12-18 months after the disaster, via three pathways: greater social identification with the disaster-affected community, greater continuity of social group ties, and greater formation of new social group ties. New group ties were a mixed blessing, positively predicting both resilience and distress., Conclusions: We conclude that investment in social resources is key to supporting mental health outcomes, not just reactively in the aftermath of disasters, but also proactively in communities most at risk., (© 2023. The Author(s).)

Background: Most people with mental health problems do not seek help, with delays of even decades in seeking professional help. Lack of engagement with professional mental health services can lead to poor outcomes and functional impairment. However, few effective interventions have been identified to improve help-seeking in adults, and those that exist are not widely implemented to deliver public health impact. Co-designing interventions with people with lived experience of mental ill-health and other relevant stakeholders is critical to increase the likelihood of uptake and engagement with these programs., Objective: This study aims to (1) test the effectiveness of a co-designed help-seeking program on increasing professional help-seeking intentions in employees in a workplace setting; (2) determine whether the program reduces mental illness stigma and improves help-seeking intentions and behavior, mental health literacy, mental health symptoms, and work and activity functioning relative to the control condition; (3) explore factors that facilitate broader implementation of the co-designed program; and (4) explore the cost-effectiveness of the co-designed program compared to the control condition over 6 months., Methods: A 2-arm cluster randomized controlled trial will be conducted (target sample: N=900 from 30 to 36 workplaces, with n=25 to 35 participants per workplace). The trial will compare the relative effectiveness of an enhanced interactive program (intervention condition) with a standard psychoeducation-alone program (active control condition) on the primary outcome of professional help-seeking intentions as measured by the General Help-Seeking Questionnaire. Secondary outcomes include the impact on mental illness stigma; mental health literacy; help-seeking attitudes and behavior; work and activity functioning; quality of life; and symptoms of mental ill-health including depression, anxiety, and general psychological distress., Results: Facilitators of and risks to the trial are identified and addressed in this protocol. Recruitment of workplaces is scheduled to commence in the first quarter of 2024., Conclusions: If effective, the program has the potential to be ready for rapid dissemination throughout Australia, with the potential to increase appropriate and efficient service use across the spectrum of evidence-based services., Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12623000270617p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385376., International Registered Report Identifier (irrid): PRR1-10.2196/55529., (©Philip J Batterham, Amelia Gulliver, Cassandra Heffernan, Alison L Calear, Aliza Werner-Seidler, Alyna Turner, Louise M Farrer, Mary Lou Chatterton, Cathrine Mihalopoulos, Michael Berk. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 24.05.2024.)

Background: Body satisfaction is associated with mental health and well-being in adults. However, prospective studies are needed to better understand its protective effects, and in whom these are most beneficial. This study investigated body satisfaction as a predictor of depressive symptoms, generalised anxiety, and well-being in a representative Australian sample collected during the initial COVID-19 lockdown. Two emotion regulation strategies - cognitive reappraisal and expressive suppression - were also tested as moderating variables., Methods: The sample comprised 684 adults aged 19 to 87 years who completed three primary waves of data spanning two months [Wave 3 (W3), W4 and W7] from the Australian National COVID-19 Mental Health, Behaviour and Risk Communication Survey., Results: Hierarchical multiple regression models controlling for demographic and COVID-19 risk factors, as well as W3 for each outcome variable, indicated that W3 body satisfaction predicted greater W7 well-being, and fewer W7 depressive symptoms and greater W7 well-being in participants reporting low levels of W4 cognitive reappraisal. No moderation for W4 expressive suppression was observed, nor predictive relationships between W3 body satisfaction and W7 anxiety., Limitations: The two-month follow-up period precludes conclusions relating to the longer-term protective effects of body satisfaction within and beyond the pandemic context. Examination of focal relationships in clinical samples, and inclusion of broader indices of body image, emotion regulation and mental health, is needed in future studies., Conclusions: Findings suggest body satisfaction warrants attention in community well-being promotion in adults, and may be particularly beneficial for those lack adaptive emotion regulation strategies., Competing Interests: Declaration of competing interest None to declare., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Mental disorders are common in childhood, but many young people do not receive adequate professional support. Help-seeking interventions may bridge this treatment gap, however, there is limited research on interventions for primary-school children. This study aims to evaluate the effectiveness of an emotion literacy program at increasing literacy, reducing stigma, and promoting help-seeking in children aged 8-10 years., Methods and Analysis: A two-arm pragmatic cluster-controlled trial will compare Thriving Minds, an emotion literacy program for middle primary school children, to a wait-list control condition. Children aged 8-10 years will be recruited from approximately 12 schools (6 intervention schools/6 wait-list control) to participate in Thriving Minds via direct invitation by the program delivery service. Allocation to the intervention condition will be pragmatically, by school. Children will receive the intervention over two 50-minute sessions, across two weeks. Using story books and interactive discussion, the program aims to develop children's knowledge of their own and other's emotional experiences and emotion regulation strategies (self-care and help-seeking). The primary outcome is help-seeking intentions. Secondary outcomes include help-seeking knowledge, attitudes, and behaviours, emotion knowledge and attitudes, and stigma. Children will complete surveys at pre-intervention, post-intervention (one week after the program) and 12-week follow-up. Additional satisfaction data will be collected from teachers in intervention schools via surveys (post-intervention and 3-month follow-up) and semi-structured interviews (after follow-up), and selected children via focus groups (12-week follow-up). Analyses will compare changes in help-seeking intentions relative to the waitlist control condition using mixed-model repeated-measures analyses to account for clustering within schools., Discussion: With demonstrated effectiveness, this universal emotion literacy program for promoting help-seeking for mental health could be more widely delivered in Australian primary schools, providing a valuable new resource, contributing to the mental health of young people by improving help-seeking for early mental health difficulties., Trial Registration: Australian New Zealand Clinical Trials Registry, ACTRN12623000910606 Registered on 24 August 2023., (© 2024. The Author(s).)

Background: Internet interventions for common mental disorders are widely available, effective, and economical, yet community uptake remains low. One consistently cited reason for not engaging in mental health interventions is lack of time., Aims: This research examined whether lack of time as a rationale for not using online interventions reflects real time scarcity, and whether time availability impacts intention to use interventions., Methods: A nationally representative sample ( N  = 1094, 51% women) reported their time use in activity categories for a typical week. Participants rated their acceptance and likelihood of use of mental health internet interventions, and completed mental health symptom, help-seeking and stigma measures., Results: Amount of leisure time reported by participants was not associated with acceptance or likelihood of use of internet interventions for mental health. However, respondents who worked longer hours ranked time and effort factors as more influential in their intention to use internet-based mental health programs. Younger respondents and those with greater help-seeking attitudes reported higher acceptance of use., Conclusion: These findings suggest lack of time is not a direct barrier to use of internet interventions, and that perceived time scarcity may be masking real barriers to uptake.

Witnessing degradation and loss to one's home environment can cause the negative emotional experience of solastalgia. We review the psychometric properties of the 9-item Solastalgia subscale from the Environmental Distress Scale (Higginbotham et al. (EcoHealth 3:245-254, 2006)). Using data collected from three large, independent, adult samples (N = 4229), who were surveyed soon after the 2019/20 Australian bushfires, factor analyses confirmed the scale's unidimensionality, while analyses derived from Item Response Theory highlighted the poor psychometric performance and redundant content of specific items. Consequently, we recommend a short-form scale consisting of five items. This Brief Solastalgia Scale (BSS) yielded excellent model fit and internal consistency in both the initial and cross-validation samples. The BSS and its parent version provide very similar patterns of associations with demographic, health, life satisfaction, climate emotion, and nature connectedness variables. Finally, multi-group confirmatory factor analysis demonstrated comparable construct architecture (i.e. configural, metric, and scalar invariance) across validation samples, gender categories, and age. As individuals and communities increasingly confront and cope with climate change and its consequences, understanding related emotional impacts is crucial. The BSS promises to aid researchers, decision makers, and practitioners to understand and support those affected by negative environmental change., (© 2024. The Author(s).)

Objective: There is limited evidence of the direct effects of COVID-19 infection on mental health, and whether these are influenced by vaccination or physical health symptoms. We aimed to investigate the relationships of COVID-19 infection, current symptom presentation, and vaccination status with mental health symptoms in adults., Study Design and Setting: A cross-sectional sample of the Australian adult population that was representative by age, gender, and location was recruited through market research panels (N = 1407, 51.3% female, mean age 47.9 years). Hierarchical regression analyses were used to examine the associations of COVID-19 infection history and current COVID-19 symptoms with symptoms of depression (Patient Health Questionnaire-9), generalized anxiety (Generalized Anxiety Disorder-7) and social anxiety (Mini-Social Phobia Inventory)., Results: COVID-19 infection was associated with significantly higher depression and anxiety symptoms, but only in those who were not fully vaccinated. Current experience of COVID-related symptoms was associated with significantly higher depression and anxiety symptoms, and attenuated the direct effect of infection on mental health outcomes to non-significance., Conclusion: COVID-19 infection may be associated with increased mental health symptoms. However, the effects of infection on mental health were primarily evident in those who were not fully vaccinated and were explained by greater physical health problems associated with COVID-19 infection. The findings reinforce the efficacy of vaccination for reducing physical and mental health symptoms following infection., Competing Interests: Declaration of competing interest The authors have no competing interests to report., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Many young people with mental health problems do not readily seek help or receive treatment and support. One way to address low help-seeking behavior is to improve access to information on mental health services and how to navigate the mental health system via a web-based tool. Seeking input from the end users (young people and parents or caregivers) on key features of the tool is imperative to ensure that it is relevant, engaging, and likely to meet their needs and expectations., Objective: This study aims to investigate young person and parent or caregiver views on the design, content, functioning, and user experience of a web-based mental health navigation tool to support connection to mental health services for children and young people aged up to 25 years., Methods: A total of 4 online focus groups were conducted: 2 with young people aged 16 years and older (total n=15) and 2 with parents or caregivers (total n=13). Focus groups were structured around a series of guiding questions to explore participants' views on content, features, user experience, and design of a mental health navigation website. Focus groups were audio recorded with detailed notes taken. In addition, 53 young people aged 16-25 years and 97 parents or caregivers completed an online survey, comprising closed- and open-ended questions; open-ended responses were included with the focus group data in the qualitative analysis. All qualitative data were analyzed using thematic analysis., Results: A total of 2 topic areas and 7 themes were developed. The first topic area covered the types of information needs of young people and parents. Identified themes concerned the scope of the navigation website, as well as the provision of up-to-date and practical information on how to navigate the whole help-seeking process. The second topic area covered website features that would be beneficial and included the consideration of the website design; search engines; supported navigation; and forums, reviews, and user accounts., Conclusions: This study provides important insights into the navigation needs of young people and parents or caregivers in seeking mental health services. Key findings identified through this research have directly informed the development of MindMap, a web-based youth navigation tool providing a searchable database of local services, including a clear description, their location, and potential wait times. The website can be navigated independently or with support., (©Alison L Calear, Philip J Batterham, Sonia M McCallum, Michelle Banfield, Elizabeth Moore, Natalie Johnson, Alyssa R Morse. Originally published in JMIR Formative Research (https://formative.jmir.org), 18.01.2024.)

Aims: We assessed the mental health effects of Australia's 2019-2020 bushfires 12-18 months later, predicting psychological distress and positive psychological outcomes from bushfire exposure and a range of demographic variables, and seeking insights to enhance disaster preparedness and resilience planning for different profiles of people., Methods: We surveyed 3083 bushfire-affected and non-affected Australian residents about their experiences of bushfire, COVID-19, psychological distress (depression, anxiety, stress, post-traumatic stress disorder) and positive psychological outcomes (resilient coping, wellbeing)., Results: We found high rates of distress across all participants, exacerbated by severity of bushfire exposure. For people who were bushfire-affected, being older, having less financial stress, and having no or fewer pre-existing mental disorders predicted both lower distress and higher positive outcomes. Being male or having less income loss also predicted positive outcomes. Severity of exposure, higher education and higher COVID-19-related stressors predicted both higher distress and higher positive outcomes. Pre-existing physical health diagnosis and previous bushfire experience did not significantly predict distress or positive outcomes., Recommendations: To promote disaster resilience, we recommend investment in mental health, particularly for younger adults and for those in rural and remote areas. We also recommend investment in mechanisms to protect against financial distress and the development of a broader definition of bushfire-related impacts than is currently used to capture brushfires' far-reaching effects., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Screening for psychological distress may assist in identifying at-risk adolescents. While several measures of adolescent psychological distress have been used, most have limited or suboptimal psychometric properties. This study aimed to assess the psychometric properties of the Distress Questionnaire-5 (DQ5), a brief measure of psychological distress, in a large community-based sample of adolescents. Data for the study (n = 3117) were drawn from the baseline and 6-week follow-up assessments of the Future Proofing Study, which collected data from three cohorts of Year 8 students (M = 13.9 years; 48% female) between August 2019 and May 2022. Participants completed the DQ5 at each measurement occasion, as well as measures of depression, generalised and social anxiety, and suicidal ideation. The DQ5 had good fit to a unidimensional construct, with standardised factor loadings ranging between 0.69 and 0.90. The scale had strong criterion (AUC ranged from 0.84 to 0.93) and predictive (AUC ranged from 0.81 to 0.87) validity when compared against indicators for depression, generalised anxiety, social anxiety and suicidal ideation. The DQ5 cut-point of ≥14 had 80% sensitivity and 90% specificity for identifying adolescents meeting symptom thresholds for any of the assessed mental health conditions. Changes in DQ5 scores over 6 weeks had moderate associations with changes in other symptom scales, suggesting sensitivity to change. In conclusion, the DQ5 demonstrates strong psychometric properties and is a reliable measure of psychological distress in adolescents. Given its brevity and ease of interpretation, the DQ5 could be readily used in schools to screen for psychological distress in students., Competing Interests: Declaration of competing interest None., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)