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This research examines the mental health inequalities between employed and unemployed individuals among the fluctuations over the business cycle. To analyze whether a recession affects self-evaluated mental health and consequently increases the demand for mental health care, I exploit the sudden increase of the unemployment rate in Spain during the period 2007-2009. First, I analyze the impairment of self-evaluated mental health as a consequence of the Great Recession and if it prevails during the economic recovery. In addition, I estimate if the effect on self-reported mental health is reflected in demand for mental health care. The results from an event study design show that the economic downturn increases the differences between employed and unemployed individuals in self-evaluated mental health. However, and despite the continuous improvement in unemployment, the mental health gap remained unchanged between 2014 and 2017, which could imply the persistence of some lasting impacts of the Great Recession on mental health. Nonetheless, I find a reduction in the differences of using drugs related to mental health during the period 2011-2012, when I estimate the largest inequalities in self-evaluated mental health., (© 2023 Walter de Gruyter GmbH, Berlin/Boston.)

Objective: This review summarizes evidence pertaining to the impact of the COVID-19 pandemic on the psychological health of children and adolescents with autism spectrum disorder (ASD). Materials and Methods: An electronic search was conducted using four major databases--PubMed, ScienceDirect, Web of Science, and Google Scholar. Using an umbrella methodology, the reference lists of relevant papers were reviewed, and citation searches were conducted. The study included articles written in English between January 2020 and March 2021 that focused on the psychological health of autistic children and adolescents. Results: All eight studies included in the final review were cross-sectional. Three of the eight studies were conducted in Italy, two in Turkey, and one study each in Portugal, Spain, and the United Kingdom, with a total of 1,407 participants. All studies used a mixture of standardized and non-standardized questionnaires to collect data. The total number of patients were 1407 at a mean age of 9.53 (SD = 2.96) years. Seven studies report gender; male 74.7% (657/880) and female 25.3% (223/880). The finding showed that behavioral issues in children and adolescents with ASD have significantly increased; 521 (51.9 percent) of the 1004 individuals with ASD presented with behavioral changes, including conduct problems, emotional problems, aggression, and hyperactivity. Some studies also found increased anxiety and difficulties managing emotions. Only one study reported clinical stabilization in children with ASD during COVID-19. Finally, 82.7% of families and caregivers of children with ASD (544 out of 658) faced challenges during COVID-19. Conclusion: Although the studies in this review suggest a general worsening of ASD children's clinical status, it remains difficult to draw definitive conclusions at this moment, with newer COVID-19 variants on the rise worldwide. During this difficult pandemic period, caregivers, families, and healthcare professionals are recommended to pay more attention to the ASD patients' health and care needs.

Evidence suggests that school-age Latino immigrants from low socioeconomic backgrounds are at risk of multiple victimization with serious implications for their mental health and academic competence. This theory-oriented paper proposes that the overlapping of certain characteristics in the status of immigrant have been somehow overlooked or not properly addressed when dealing with immigrants' academic underachievement in Spain. Further, it considers Latino immigrant students susceptible to suffer more than one form of violence and describes how the acculturation process and social inequality clash with the host country's values. All this seem to exert too much stress on the family, bringing about patterns of victimization of children and youth that hinder competence in several domains. The inclusion in this paper of some American and Canadian neuroscience studies on attentional deficits are relevant to understand immigrants that struggle in Spanish schools. Finally, it discusses the pernicious effects of poly-victimization and the potential benefits of prevention and intervention programs.

Background: Adolescent depression has been recognized as a complex problem that presents a global public health challenge. Left undetected and untreated, depression can significantly reduce quality of life. Objective: The main purpose of this paper is to re-visit risk and protective factors for depression in adolescents with a specific focus on exploring the individual, familial, and social contexts of depression (especially high and very high depression levels) in a multi-country sample of youth in order to see if these factors are mitigated by cultural location. Methods: Questionnaire data from a cross-sectional study of a randomly selected sample of 5149 middle-school students from four EU-countries (Austria, Germany, Slovenia, and Spain) was used. Applying variance analysis, we examined the prediction strength for the observed risk and protective factors. Results: In all participating countries we show that in for both male and female adolescents, depression is linked to a broad range of interactive individual, and social protective and risk factors, such that even if the contribution of a single factor is low but still significant and this factor's prediction strength is low or moderate, taken together, the cumulative prediction strength of these factors yields a remarkably similar coefficient of determination of 42-49% in all samples. Conclusions: We have established a significant and relevant combination of the individual and social multifactorial risk and protective factors that characterize depression in adolescents of both genders, no matter their country of location and with that, we call for a multifaceted and comprehensive approach to mental health assessment, prevention and intervention.

Objective: Several studies stated greater impact on mental health among psychiatric population during the first wave of the COVID-19 pandemic. The aim of this paper was to study the pandemic effects more than a year after its outbreak on the mental state of adult patients with pre-existing psychopathology attending a Mental Health Center in Madrid (Spain)., Methods: A cross-sectional observational study was carried out with a sample of fifty-eight patients using a questionnaire that collected different descriptive variables. Results of the PHQ-9 Depression Scale, the GAD-7 Anxiety Scale, the IES-R Impact of Event Scale-Revised, the Clinical Global Impression scale CGI-GI, and the assessment of the professionals responsible for the patients about their clinical state were also collected. A descriptive analysis and binary logistic regression models were performed., Results: There was a prevalence of 70% anxiety, 76% depression and 57% stress due to a stressful event more than one year after the start of the pandemic. Likewise, associations were found between the symptoms and certain clinical, mediating variables and gender., Conclusions: The psychological state of patients with pre-existing psychopathology attended at the Mental Health Center is negatively affected by the COVID-19 pandemic up to a year and a half after its onset., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

This paper contributes to the literature on the impact of the COVID-19 outbreak on mental health by providing novel evidence of its interaction with labor market conditions and the long-term persistence of these effects. We run four waves of a large-scale representative survey in Spain between April 2020 and April 2022, and benchmark our data against a decade of pre-pandemic information. We document an increase in the share of individuals reporting depressive feelings from 16% prior to the pandemic to 46% in April 2020. We show that this effect is more pronounced for women, younger individuals and those with unstable incomes. We apply machine learning techniques, mediation analysis and event studies to document the role of the labor market as an important driver of these effects. Our results are crucial for the design of targeted policies that proof useful in overcoming the long lasting consequences of the pandemic., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

The Philippines is a source of labor for many countries. Roughly 10 million overseas Filipinos are working and living outside of the Philippines. This paper examines the association between sociodemographic characteristics (sex, age, educational level, and income) and self-rated physical and mental health, access to healthcare, and health habits among immigrant Filipinos living in Santa Cruz de Tenerife, Spain. Through convenience sampling, Filipino migrants (n = 103) aged 18 years and above participated in the online survey between October 2022 and March 2023. The data were analyzed using descriptive statistical analysis and chi-square. Almost all respondents self-rated their health as excellent and very good. Female respondents are more affected by mental health. Most are enrolled in the Universal Health System of Spain (public insurance). There is more utilization of private health insurance among respondents aged 60 years and above and high-wage earners. Cigarette smoking and alcohol drinking are associated with males. More than half of the respondents perform weekly exercise occasionally or never. These findings suggest a potential need for targeted interventions with an emphasis on the practice of preventive health and the promotion of healthy lifestyles, especially among financially disadvantaged migrants with lesser health access. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Home treatment teams help people in a mental health crisis to recover. The staff goes to the person's home, avoiding the need to go to the hospital and providing care in the person's environment.The teams have been created in our country in recent years, becoming part of the mental health care network. What this paper adds to existing knowledge?: The paper presents the functioning of a CRHTT, the type of care it provides, and the coordination with the rest of the care network. It also shows the clinical results obtained in the first two years since its creation, supporting the CRHTT's effectiveness in accompanying people with mental health crises and reducing the need for hospital care.The outstanding factors in the team operation were coordination fluidity with referral services (facilitating accessibility), a prolonged care time (about two months), and continuity of care during the CRHTT intervention (the same CRHTT professionals visited the user and the family at home) and upon discharge (CRHTT staff organized joint visits with the professionals who would care for the user and the family after home treatment).The CRHTT followed a person‐centered orientation based on horizontality and dialogue. The CRHTT fostered the inclusion of the family and social network in the treatment and a deep understanding of the crisis considering social determinants. What are the implications for practice?: Flexibility, approach to the person's environment, dialogue, shared decision‐making, and the inclusion of the family and social network in the treatment are central factors in CRHTT functioning. It helps the person regain control over their life and enhance their resources to face possible future crises.Training in crisis management, community mental health and family care, and teamwork (which implies joint home visits and co‐responsibility with the rest of the staff, user, and the family) are relevant for CRHTT professionals. Introduction: Crisis resolution and home treatment teams (CRHTTs) provide intensive home care to people in a mental health crisis, becoming an increasingly widespread alternative to hospital admissions. However, there are wide variations in service delivery, organization, and outcomes, and little literature on how these teams work in clinical practice and different settings. Aim: To share the organizational functioning, the therapeutic approach, and the outcomes obtained in a CRHTT in Catalonia, Spain. Method: A descriptive analysis of the functioning of a home treatment team, the characteristics of the people served, and the clinical results from November 2017 to December 2019 are presented. Results: One hundred and five people were served, with an average stay of 57 days. And 55.24% were women, and the mean age was 41. Most people could overcome the crisis at home, and 5.71% required hospital admission during home care. A statistically significant improvement was observed in the results of the GAF and HoNOS scales at admission and discharge. Discussion: Despite reduced staff, home care was an alternative to hospital admission for most people treated. Implications for Practice: Flexibility, teamwork, and collaboration with the social network are relevant factors when accompanying the recovery process at home. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of the present research is aimed at studying the relationship between emotional intelligence as an ability and emotional intelligence as a trait and mental health of a sample of school counsellors. Method: The sample has been made up of 203 school counsellors. The instruments used have been: Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), Trait Emotional Intelligence Questionnaire Short Form (TEIQUE-SF) and the Mental Health Scale (MH-5). In the first place, the correlations among the scoring corresponding to all of the variables were analysed. Subsequently, the differences in average (t of Student) were studied according to the educational stage in which the school counsellors are working and according to their sex. Finally, with the aim of exploring the variables that predict mental health, an analysis of multiple lineal regression was carried out, step by step. Results: The results show that the existing relationships between EI as a trait and mental health are higher than those existing between EI as an ability and mental health. On the other hand, scorings significantly higher were registered in the school counsellors in Secondary School in the variable of emotional intelligence as an ability in emotional comprehension. Scorings significantly higher are also registered in the variable of mental health of school counsellors in Primary Education. Likewise, scorings significantly higher are also registered in women in their score of emotional intelligence as an ability in emotional regulation, and scorings significantly higher in the score of emotional intelligence as a personality trait in men. Finally, the analysis of multiple regression has allowed for identifying emotional intelligence as a trait as a predictor variable of mental health. Discussion: The present study represents one of the first research papers carried out in a sample of school counsellors in which the influence on mental health of emotional intelligence as a trait and as an ability is analysed. Furthermore, it provides evidence about the predictive validity of EI as a trait over an indicator of mental health.

Purpose: This study aims to investigate how institutional and organisational factors affect case management of patients with mental disorders by GPs in Italy and Spain. The paper highlights the importance of improving the effectiveness of primary care to ensure easy access to mental health services, which is crucial in responding to the increasing incidence of mental disorders and preventing negative outcomes. Design/methodology/approach: This article details a qualitative research study that examines the management of patients with mental disorders by general practitioners (GPs) in Italy and Spain, using cross-national comparison and in-depth interviews with GPs as research methods. Findings: The study revealed that Italian self-employed GPs have more scheduling autonomy than Spanish Health Centre GPs. Both face high work pressure and resource scarcity, highlighting the need for targeted training. The COVID-19 pandemic led to a rise in phone consultations. Originality/value: This study provides novel insights into mental health management by examining the case management of patients with mental disorders by GPs in Italy and Spain, with a focus on the impact of institutional and organisational factors. The cross-national comparison and in-depth interviews enhance the originality of the study, offering a nuanced understanding of the constraints faced by GPs in their work context. Furthermore, the comparison of the similar primary care frameworks of Italy and Spain may offer insight into their evolution. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper was to explore the health of trafficking survivors in Spain, which is relatively unstudied (Sweileh, 2018). Therefore, the objectives of this study are to describe the health conditions, access to health-care facilities, COVID-19 protection and health challenges in relation to the COVID-19 pandemic reported by women survivors of human trafficking in Spain. Design/methodology/approach: Due to the pandemic situation, limited research and the complexity of the issue, the authors took a qualitative approach. A cross-sectional study was carried out through interviews with women survivors of human trafficking for sexual exploitation in Spain. Prior to the interviews, the researchers conducted written interviews with social workers to understand the most important challenges that the women survivors were experiencing during confinement. As a result of these written interviews, the interview script for the survivors was modified. Findings: To sum up, the COVID-19 situation poses several challenges, including social difficulties (food insecurity; violence; terrible housing conditions; working pressure; poor sleeping habits; and cultural, linguistic and religious challenges), medical insecurity (due to lockdowns, negative experiences in care, lack of official documents, collapse of hospitals, telephone monitoring and fear of contagion), great emotional distress reported by women (anxiety, fear, sadness, post-traumatic stress disorder, stigma and substance use) and physical health problems (serious weight loss, muscle pains, dental problems and sexual and reproductive health-care limitations). Research limitations/implications: As is usual in qualitative research, rather than obtain generalizable results, the main objective was to delve deeper into under-researched or complex issues (Polit and Beck, 2010). While this report provides a timely overview marked by COVID-19 of an important population, there are some limitations. The major limitation of this research was the sample representativity, because the sample was conducted with only one non-governmental organization and only individuals who voluntarily agreed to make the interview; as such, other victim profiles may not be represented. Practical implications: The findings can provide information for detecting victims of human trafficking for sexual exploitation and contribute to understanding the pandemic's impact. Furthermore, the paper emphasizes the need to adopt measures for the recovery of victims, such as medical and psychological assistance, in accordance with the Palermo Protocol. As people transition out of the pandemic, it is crucial for Spain, along with other European countries, to guarantee that all residents, particularly the victims of human trafficking, have access to social and health-care protections during times of crisis. Social implications: As already mentioned, further investigation should be done to fill the gaps on health of human trafficking (Sweileh, 2018) and improve the recovery of victims of trafficking (García-Vázquez and Meneses-Falcón, 2023 0; Sweileh, 2018). The paper acknowledges the existing research gap in the field and emphasizes the importance of future studies to delve deeper into the challenges faced by victims, calling for a more nuanced understanding of health. Originality/value: The Coronavirus pandemic has increased and reinforced the vulnerability of sex-trafficked victims, especially creating different mental health problems. One of the biggest concerns for this group has been the difficulty of access to basic goods such as food. Furthermore, psychological distress impacted the well-being of trafficking victims, and many suffered from eating disorders. Less than half of the women who were forced to continue in prostitution did not have the means to protect themselves against COVID-19 and did not have easy situations to overcome illness. [ABSTRACT FROM AUTHOR]

WHAT IS KNOWN ON THE SUBJECT?: Coercive measures represent an ethical conflict because they limit the person's freedom, compromising their personal autonomy, self-determination and fundamental rights. The reduction of the use of coercive measures implies not only regulations and mental health systems, but also cultural aspects, such as societal beliefs, attitudes, and values. There is evidence about the professionals' views on coercion in acute mental health care units and community settings, but they remain unexplored in inpatient rehabilitation units. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The knowledge about coercion varied from not knowing at all the meaning of the word, to a proper description of the phenomenon. Coercive measures are considered a necessary evil or normalized in mental health care and considered implicit to daily practice. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The perceptions and attitudes towards coercion might be influenced by the knowledge about the phenomenon. Training of mental health nursing staff in non-coercive practice could help professionals to detect, be conscious towards, and question coercive measures, thus orienting them to the effective implementation of interventions or programmes with evidenced effectiveness to reduce them., Abstract: INTRODUCTION: Creating a therapeutic and safe milieu with the minimum coercive measures requires knowing professionals' perceptions and attitudes towards coercion, but they remain unexplored in medium and long-stay inpatient psychiatric rehabilitation units., Aim: To explore the knowledge, perception and experience of coercion among nursing staff at a rehabilitation medium-stay mental health unit (MSMHU) in Eastern Spain., Method: Qualitative phenomenological study including 28 face-to-face, semi-structured interviews based on a script. Data were analysed using content analysis., Results: Two main themes were found: (1) therapeutic relationship and treatment in the MSMHU, which included three subthemes: qualities of the professionals for building the therapeutic relationship; perceptions about the persons admitted to the MSMHU; views of the therapeutic relationship and treatment in the MSMHU; (2) Coercion at the MSMHU, comprising five subthemes: professional knowledge; general aspects; emotional impact of coercion; opinions; alternatives., Discussion: Coercive measures are often normalized in mental health care and considered implicit to daily practice. A proportion of participants who did not know what coercion is., Implications for Practice: Knowledge about coercion might influence attitudes towards coercion. Mental health nursing staff could benefit from formal training in non-coercive practice, facilitating the operative implementation of effective interventions or programmes., (© 2023 The Authors. Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.)

Purpose: This paper aims to study the influence of leisure-time physical activity on depression crises and the difficulty in performing light household tasks. Design/methodology/approach: A population-based cross-sectional study was conducted using data from the 2020 European Health Survey in Spain. A total of 1,076 individuals diagnosed with depression were selected. ANOVA, chi-square, Fisher's exact test and Mann–Whitney U test were applied, and a simple moderation analysis was conducted using the SPSS PROCESS 4.0 macro. Findings: Women had higher percentages of some or much difficulty in performing domestic activities (p = 0.007). Differences were found between experiencing a crisis in the past 12 months versus not having one (p < 0.001): less physical activity was performed, perceived health was worse and difficulty in performing domestic activities increased. The moderation analysis confirmed the moderating effect of physical activity on the relationship between experiencing a crisis and having difficulty with domestic activities (p = 0.017). Research limitations/implications: The usual limitation of descriptive cross-sectional studies, which cannot establish causal relationships, must be added to low sample sizes in some categories. Practical implications: The analysis with gender differentiation, promoting gender-specific adapted practices, considering age and personal circumstances of the patient, appropriate exercise prescription, as well as its evaluation and follow-up, are areas where specialist nurses need to delve deeper to enhance the quality of care. Originality/value: Leisure-time physical activity moderates the relationship between experiencing a crisis and having difficulty with light household tasks: those who engage in occasional physical activity have less difficulty compared to those who do not engage in it. [ABSTRACT FROM AUTHOR]

The Spanish KIDSCREEN follow-up study reassessed the Spanish baseline sample (n = 840) of the European KIDSCREEN study 3 years later (2006). The aims of this paper were to describe the KIDSCREEN follow-up study and the pilot test, and to analyze participation rates and representativeness. Instruments included the KIDSCREEN-52 HRQoL measure and a set of scales including the possible explanatory variables. Focus groups and individual interviews were carried out in a pilot test. Participants were compared with non-participants at baseline, and also with Eurostat census data. Twenty-two out of 24 subjects were interviewed in the pilot test. Fifteen items needed to be modified after the pilot test. Participation rate reached 54% (n = 454). Participants (mean age = 12.71 years old) were on average 6 months younger than non-participants (p = 0.03), and from more educated families. KIDSCREEN follow-up instrumentation seems adequate for collecting factors with potential influence on HRQoL. Follow-up respondents' representativeness seems to be acceptable. (Contains 2 tables.)

One of the main drawbacks of computer-assisted psychology tools developed up to now is related to the real time customisation and adaptation of the content to each patient depending on his/her activity. In this paper we propose a new approach for mental e-health treatments named Intelligent e-Therapy (eIT) with capabilities for ambient intelligence and ubiquitous computing. From a technical point of view, an eIT system is based on four fundamental axes: ambient intelligence for capturing physiological, psychological and contextual information of the patient; persuasive computing for changing/reinforcing behaviours; ubiquitous computing for using the system at any place, and at any time; and multiple technological platforms support. (Contains 1 figure.)

Most studies on the benefits of late life civic engagement have focused exclusively on formal volunteering. Older adults' political participation is much more overlooked. The current paper explores the benefits of long-term participation in political organizations as described by actively engaged Spanish older people. We used an adaptation of McAdams' life-story interview with 40 participants from three types of political organizations who occupy a responsible position within the organization. We identified three main themes in participants' answers: personal benefits, relational benefits, and community benefits. Overall, our results showed that the benefits arising from long-term political participation go far beyond the well-studied individual benefits that research on late-life volunteering has typically identified, and spread to relational and community areas. Social work practitioners should consider these benefits when they implement plans and programmes to promote healthy, active ways of aging, fostering age-friendly communities or reducing old-age social exclusion. [ABSTRACT FROM AUTHOR]

The prevalence of depression related to precarious employment (PE) has become a significant public health concern, given the declining trend of the standard employment relationship. Research has focused on the mental health detrimental effects of employment conditions, whereas there is scarce evidence concerning the burden of depression that could be prevented by targeting precariousness. This paper estimates the impact of PE on the risk of depression and the attributable fraction within the active and working salaried population in Spain. Observational cross-sectional on data drawn from the Spanish portion of European Health Survey 2020. After applying selection criteria and descriptives, binary logistic regression models stratified by sex are used to examine the associations between a 9-categories combination of employment precariousness and occupational social class, and depressive symptoms. There is a higher risk of depression among individuals in PE and among those who are unemployed, with a notable gradient based on occupational social class for women. Adjusting by sex, age and foreign-born origin, we estimate that approximately 15.0% (95% confidence interval [CI]: 1.0%–26.2%) of depression cases among the working population and 33.3% (95% CI: 23.2%-43.2) among the active population can be attributed to PE. These findings highlight the public health impact of PE on mental health, provide evidence to estimate the economic burden linked to employment-related mental health, and underscore the need for policy changes and interventions at the level of labour markets and workplaces to mitigate the detrimental effects of PE. [ABSTRACT FROM AUTHOR]

Objective: One in one hundred minors has some mental health problem. Symptomatology varies according to gender. Most research has been conducted with the general population. The objective of this paper was to analyze the moderating role of sex in the presence of internalizing (emotional disorders, anxiety and depression) and externalizing symptomatology (behavioral disorders and hyperactivity) in childhood, as well as to compare the general population with the clinical population., Methods: A descriptive cross-sectional study was conducted with 552 boys and girls between ten and twelve years of age, 94 mental health patients and 458 schoolchildren. Participants completed self-report measures: Strengths and Difficulties Questionnaire (SDQ-Cas), Modified Depression Scale (MDS) and a sociodemographic information questionnaire. For data analysis, descriptive statistics and multivariate and univariate mean comparisons were performed by parametric and re-sampling procedures., Results: Statistically significant differences were observed between clinical and school population groups in externalizing, internalizing and depressive symptomatology (p<0.001). No sex differences were found in externalizing and depressive symptomatology. Sex differences were found in internalizing symptoms (p<0.001, p boot <0.001) as well as group interaction effects (p=0.016), girls had higher scores than boys, with greater differences in the clinical group (p<0.001, p boot =0.003)., Conclusions: Research with mental health patients is essential to verify the existence or not of differences with the general population as well as differences by sex, which will allow adapting preventive and intervention strategies to each case., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Much has been said about the harm children of migrants experience as a consequence of sequential family migration. Most of this literature discusses the case of children left behind. By contrast, this paper measures the cost in mental wellbeing (proxied by a composite index of non-specific psychological wellbeing) that children of migrant and native families suffer as a consequence of long periods of physical separation from their parents after family reunification. To do so, we use a unique dataset produced in the Municipality of Madrid in 2011, covering children in the 3rd and 4th grades (aged 13 to 15) of obligatory secondary education. Our evidence suggests that children who, as a consequence of family migration, have been separated from their parents from a period of at least three months, suffer a loss of mental wellbeing of a similar magnitude to that of native children upon parental divorce. In line with recent evidence from other European countries, we also find that the impact of parental divorce is almost negligible on immigrant origin children. Theoretical and policy implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to evaluate the feasibility and effectiveness of a training course »Living e-Motions« for people living with mental health challenges in the context of their recovery. The course was developed in the joint project of partners from Spain, Estonia, Slovenia and the UK. The curriculum of the course is focused on emotional education. It uses a narrative approach as a practical way for participants to explore and regulate their emotions and consequently take charge of their recovery. Design/methodology/approach: Seventeen participants were included in the pilot training in Spain and Estonia. Impact of the training was assessed on measures of life satisfaction, emotion regulation, positive and negative affect and recovery at baseline and directly after training. Findings: The analysis revealed that participants reported higher life satisfaction, emotion regulation skills, positive affect and recovery after the training. However, because of the small sample size, the mean differences did not reach statistical significance. Further studies on larger samples are needed to test the effectiveness of the training course. Practical implications: Pilot study findings are encouraging and show that the developed training course has a potential for improving key competencies and abilities needed in daily life, concretely in emotion regulation, positive and negative affect, life satisfaction and recovery. Originality/value: This paper presents a novel training course that uses a narrative approach and focuses on recovery and improvement of key competencies and abilities of individuals with mental health issues. [ABSTRACT FROM AUTHOR]

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although the detrimental health effects of tobacco, there has been scant research into determining comprehensive profiles to characterize individuals with a higher risk of smoking. This paper identifies such profiles and probabilistically quantifies the effects of certain traits on the decision to smoke in the Canary Islands. This characterization is approached from a broad and novel point of view for the region studied, given that the analysis not only studies sociodemographic characteristics, lifestyle and health, but also incorporates mental health. The results show that suffering from some type of psychopathology leads to a higher probability of tobacco consumption. Moreover, just as the promotion of a healthy lifestyle has a direct impact on tobacco consumption, the implementation of public policies that reduce the risks of suffering from a mental illness could also reduce the prevalence of smoking in the region and contribute to the design of more effective prevention strategies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Nieto-González, Rodríguez-Donate and Guirao-Pérez.)

The COVID-19 pandemic has exacerbated health inequalities worldwide, having a disproportionately harsh impact on unprivileged populations such as migrants and refugees. These populations are often more exposed to the virus, but less protected, while at the same time being at higher risk of suffering from poor living and working conditions, limited access to healthcare, and discrimination by the host society, all of which is challenging to their mental health. Empirical evidence on how the COVID-19 pandemic is affecting migrants and refugees is required to design effective actions aimed at ensuring health equity. Therefore, this paper aims to analyse how the pandemic has impacted the psychological well-being of migrants and refugees living in Spain. This study was carried out within the framework of the ApartTogether study sponsored by the World Health Organization. Data collection was carried out during March-November 2020, through an online survey completed by 241 participants (age: M = 37 years; 129 women). The results indicate that 78.7% of participants had suffered a decrease in their psychological well-being since the onset of the COVID-19 pandemic, with number of difficulties and worries experienced being the best individual predictors of this outcome. Enjoying social connections and perceiving positive treatment from the host society were positively associated with psychological well-being at a relational and community level, respectively. Based on these findings, we outline priority areas of psychosocial interventions aimed at guaranteeing the mental health of migrants and refugees in the face of the pandemic in Spain. [ABSTRACT FROM AUTHOR]

Copyright of Revista Espanola de Investigacion Criminologica is the property of Revista Espanola de Investigacion Criminologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Accessible Summary: What is known on the subject?: Risk factors associated with prolonged episodes of mechanical restraint and other coercive measures are understudied.There have been no studies of this phenomenon in the context of the Andalusian public health system.Knowledge about factors associated with prolonged episodes is essential to increase the understanding of this phenomenon and develop strategies to reduce its occurrence. What does this paper add to existing knowledge?: In Andalusia, prolonged restraint is still frequent and varies depending on the unit.It is associated with less time since admission, male gender, diagnosis, reason for restraint and the shift on which it was initiated. What are the implications for practice?: Interventions at the level of the units could be necessary to prevent prolonged episodes of mechanical restraint.The results suggest the need for stricter control during the shifts on which restraint starts, especially in the first days after the patient's admission.Preventive risk assessment considering clinical and sociodemographic risk factors could help to reduce prolonged restraint. Introduction: Factors associated with prolonged episodes of mechanical restraint and other coercive interventions are not clearly established and have been not studied in Andalusia (Spain). Aim: To study factors associated with prolonged episodes of mechanical restraint. Method: We analysed retrospectively episodes of mechanical restraint (N = 6267, prolonged episode >9.5 hours) in all public mental health hospitalization units (N = 20, 535 beds) that offer health coverage for the autonomous community of Andalusia. The data came from clinical records. A multivariable mixed logistic regression was used. Results: In Andalusia, prolonged restraint is still frequent and varies depending on the unit. It is associated with less time since admission, male gender, diagnosis, reason for restraint and the shift on which it was initiated. Discussion: The results provide evidence that prolonged episodes largely depend on the unit where they occur and that stricter control and regulation are necessary to prevent prolonged episodes. Implications for practice: Interventions at the level of the unit are necessary. Stricter control in the shifts during which there is more risk of prolonged restraint may be necessary, especially in the first days following admission. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sedentary tasks contribute to the deterioration of health and the appearance of chronic diseases. Physical exercise can contribute to the development of health, although the characteristics of the most appropriate program are unknown. OBJECTIVES: This is the second paper of the PRODET® intervention trial evaluating the effect of a supervised group exercise intervention in the worksite based on aerobic capacity and strength lasting 12 weeks. METHODS: The sample was composed of 67 subjects (N = 67, mean age 34.31 years) and the study investigated a 12-week group physical exercise program in the workplace, two days per week with 50-minute sessions, which was supervised and based on aerobic endurance and strength. The 67 subjects were working-age office workers, deemed as sedentary and randomized into an intervention (N = 40) or control (N = 27) group. Outcomes work ability, depression, anxiety and job satisfaction were assessed with questionnaires pre-and post-test in both groups. RESULTS: The program showed effects on the mental factor of work ability (Z = 2.36, P = 0.019, η2 = 0.09). However, there were no significant differences in the rest of the results. CONCLUSIONS: The intervention had an impact on the mental factor of work ability in the workers whose occupations were based on sedentary tasks, and reinforcing this variable with an exercise program in the workplace could contribute to reducing the mental factor of work ability. [ABSTRACT FROM AUTHOR]

The COVID-19 health crisis brought changes to people´s lives that affected them both physically and psychologically. The aim of this paper is to identify the key socio-psychological factors involved in the main changes to the mental health of the Spanish population, and to determine whether they had the same impact across genders. The survey data from the Spanish Centre for Sociological Research entitled "CIS Survey 3324 Effects and Consequences of Coronavirus IV" (specifically, question 14) were used to this end. Question variables were recoded into dummy variables for analysis of variance (ANOVA) and Exploratory Factor Analysis (EFA). The study found five key factors that have changed the mental health of the Spanish population: "being more empathic", "enjoying leisure more", "discovering new leisure activities", "being more religious or spiritual" and "being more interested in the future". All of these affected women more than men. [ABSTRACT FROM AUTHOR]

The access to public information is a democratic right that is not just for people who can communicate effectively within their dominant culture but for all citizens, thus it must be available and accessible to all. However, linguistic and cultural difficulties regarding the access and use of public services, as well as communication facilitation at all levels are problems which have not yet been tackled by authorities in Spain. The services currently used to tend to communication-related needs between the non-Spanish speaking population and healthcare professionals are not completely effective in Spanish hospitals, and most medical professionals will explain that, in their consultations with migrants who do not speak Spanish, they ask them to bring along a family member or friend who speaks Spanish. Concerning mental health--an area in which communication is of the utmost importance and treatment very frequently involves therapy and, thus, communication between the health provider and the patient--, language and cultural barriers often create further obstacles for an adequate treatment. This paper will present the results of a narrative inquiry of a sample of mental health clinicians on their perceptions and experiences when working with non-Spanish speaking patients. [ABSTRACT FROM AUTHOR]

Copyright of Clinica y Salud is the property of Colegio Oficial de Psicologos de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Periods of financial crisis are associated with higher psychological stress in the population and greater use of mental health services. This paper analyses the individual and contextual factors associated with mental health in the Spanish population in 2006, 2012 and 2017., Method: This was a cross-sectional, descriptive study at three timepoints: before (2006), during (2012) and after the recession (2017). The study population comprised individuals aged 16+ years old, polled for the National Health Survey. Dependent variable: psychiatric morbidity (PM)., Independent Variables: 1) Individual socio-economic variables: (socio-demographic and psycho-social variables) and 2) contextual socio-economic variables (financial, public welfare services and labour market indicators). Multilevel logistic regression models with mixed effects were constructed to determine changes in PM in relation to the variables studied., Results: Among women, the risk of PM increased when per capita health spending decreased and the percentage of temporary workers increased. The risk for men and women was lower when the employment rate decreased and the unemployment rate increased., Conclusions: It is possible that not only unemployment but also insecure employment entails a risk to mental health and that much of the employment created no longer guarantees basic levels of security it had achieved in previous decades.

Aim/Purpose This paper explores an intervention approach (in the form of workshops) focusing on doctoral progress, to address the problems of low emotional well-being experienced by many doctoral candidates. Background Doctoral education suffers from two severe overlapping problems: high dropout rates and widespread low emotional well-being (e.g., depression or anxiety symptoms). Yet, there are few interventional approaches specifically designed to address them in the doctoral student population. Among structural, psychosocial, and demographic factors influencing these problems, the self-perception of progress has emerged recently as a crucial motivational factor in doctoral persistence. Methodology This paper reports on an iterative design-based research study of workshop interventions to foster such perception of progress in doctoral students' everyday practice. We gathered mixed data over four iterations, with a total of 82 doctoral students from multiple disciplines in Spain and Estonia. Contribution An approach to preventive interventions that combines research-backed education about mental health and productivity, peer sharing and discussion of experiences, and indicators of progress, as well as self-tracking, analysis, and reflection upon everyday evidence of their own progress. The paper provides initial evidence of the effectiveness of the proposed interventions, across two institutions in two different countries. Further, our data confirms emergent research on the relationships among progress, emotional well-being, and dropout ideation in two new contexts. Finally, the paper also distills design knowledge about doctoral interventions that focus on progress, relevant for doctoral trainers, institutions, and researchers. Findings Our quantitative and qualitative results confirm previous findings on the relationships among progress, burnout, and dropout ideation. Our iterative evaluation of the workshops also revealed a large positive effect in students' positive psychological capital after the workshops (Cohen's d=0.83). Our quantitative and qualitative analyses also started teasing out individual factors in the variance of these benefits. Recommendations for Practitioners Intervention design guidelines for doctoral trainers include focusing on actionable productivity and mental health practices, the use of activities targeting perception biases and taboos, or the use of active practices and real (anonymous) data from the participants to make progress visible and encourage reflection. Recommendations for Researchers The construct of progress, its components, and its relationships with both emotional well-being and doctoral dropout need to be more deeply studied, using multiple methods of data collection, especially from more frequent, ecologically valid data sources (e.g., diaries). Impact on Society The proposed interventions (and focusing on doctoral progress more generally) hold promise to address the current emotional well-being and dropout challenges facing hundreds of thousands of doctoral students worldwide, ultimately helping increase the research and innovation potential of society as a whole. Future Research More rigorous evaluative studies of the proposed approach need to be conducted, with larger samples and in other countries/contexts. Aside from the proposed one-shot training events, complementary longitudinal interventions focusing on supporting everyday progress and reflection throughout the doctoral process should be trialed. [ABSTRACT FROM AUTHOR]

Copyright of Anuario de Psicología Jurídica is the property of Colegio Oficial de Psicologos de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Investigaciones Feministas is the property of Universidad Complutense de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The present study aimed to review the research literature on aquatic exercise for health promotion using bibliometric methods and CiteSpace software. The number of studies related to this topic are constantly expanding, with the USA, Brazil, and Australia the centers of this research. Most published papers fall within Sports Science, but the disciplines of Physiology, Psychology, and Rehabilitation were also found to be dominant domains for this literature. The seven most prolific authors were from Brazil or Spain. The most frequently cited references focused on sub-topics of physiology, biochemistry, physical fitness, psychological health, cardiovascular disease, and joint disease. New research trends have shifted to the promotion of cardiovascular health in clinical populations (stroke, overweight, hypertension, endothelium dysfunctional, obese, inflammation, antioxidant, heart failure). Overall, this review found that research hot spots and trends in this realm have focused on improving cardiovascular health with aquatic exercise. [ABSTRACT FROM AUTHOR]

Introduction: Regular moderate-to-vigorous physical activity (MVPA) is associated with improved mental health, but the evidence for the effect of reducing sedentary behavior (SB) or increasing light PA (LPA) in older adults is lacking. Using isotemporal substitution (IS) models, the aim of this paper was to investigate the effect of substituting SB with LPA or MVPA on associations with mental health in older adults., Methods: Data from 1360 older adults (mean age 75.18 years) in four countries were utilized. PA and SB was measured using ActiGraph wGT3X-BT + accelerometers worn for 7 days. Self-rated mental health was measured using the Hospital and Anxiety Depression Scale (HADS). IS models estimated cross-sectional associations when 30 minutes of one behavior was substituted with another. Models were adjusted for age, sex, marital status, and educational attainment., Results: Substituting 30 minutes of SB with LPA (β -.37; 95% CI -0.42, -0.32) or MVPA (β -.14; 95% CI -0.21, -0.07) and substituting LPA with MVPA (β -.11; 95% CI -0.18, -0.04) were associated with improvements in anxiety. However, substituting 30 minutes of SB with LPA (β .55; 95% CI 0.49, 0.62) was associated with increased depression., Conclusion: Replacing 30 minutes of SB with LPA or MVPA was associated with improved anxiety symptoms in older adults. Greater benefits were observed when shifting SB and LPA to MVPA., (© 2020 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

Our aim in this paper is to understand the impact of macroeconomic fluctuations on mental health and psychotropic medicine consumption. In order to do that we exploit differences in the fluctuations of business cycle conditions across regional units in Catalonia. Our findings suggest that, in general, economic fluctuations at the local level had no significant effect on the consumption of psychotropic medicines. However, we show that a deterioration in local labour market conditions is associated with a reduction in the consumption of anxiolytics medicines. We also report an increase in the consumption of anxiolytics in regions with a softer deterioration in the economic situation. Although we report mild improvements in both mental and physical health for some sub-groups of the population, we also find significant reductions on the probability of sleeping 6 h or more. Thus, these elements point towards potential negative effects of local labour market conditions on health in the medium/long term.

This study examines how confinement measures established during the COVID-19 pandemic crisis affected the emotions of the population. For this purpose, public sentiment on social media and digital ecosystems in Spain is analyzed. We identified affective tones towards media and citizens published on social media focusing on six basic emotions: anger, fear, joy, sadness, disgust and uncertainty. The main contribution of this work is the evidence of contagious sentiments and, consequently, the possibility of using this new dimension of social media as a form of a "collective therapy". This paper contributes to understanding the impact of confinement measures in a pandemic from the point of view of emotional health. This analysis provides a set of practical implications that can guide conceptual and empirical work in health crisis management with an alternative approach, especially useful for decision-making processes facing emergency responses and health crises, even in an unprecedented global health crisis such as the traumatic events caused by the COVID-19 disease.

Background: Mental health disorders are highly prevalent across countries. They increase over time and impose a severe burden on individuals and societies., Objective: This paper examines the evolution of mental health over a period of 15 years, paying special attention on the impact of the most recent economic downturn and subsequent recovery, in Spain., Method: We use data coming from the National Health Surveys of 2006/2007, 2011/2012 and 2016/2017. Mental health is proxied by two measures, doctor-diagnosed mental disorder and psychological distress (based on the 12-item General Health Questionnaire). To account for the relationship between the two mental health indicators, we estimate a bivariate probit model. The potential endogeneity of unemployment status is considered., Results: We observe different patterns of the two mental health indicators over time. Psychological distress in men increased during recession years, but slightly decreased among women. Diagnosed mental disorders declined during the peak years of the crisis. Unemployment is a major risk factor for mental distress. Irrespective of the economic conditions, belonging to a higher social class acts as a buffer against psychological distress for women, but not for men. The remaining determinants acted as expected. Women declared worse psychological health than men, and were also more often diagnosed with mental disorders. Having a partner had a protective impact, while providing intensive care to a dependent relative exerted the opposite effect. Education acted as buffer against the onset of psychological distress in women., Conclusion: Even though the need for mental healthcare increased during the recession, the fact that fewer people were diagnosed suggests that barriers to accessing mental healthcare may be aggravated during the crisis. Policies aiming to tackle the challenges posed by the high prevalence of mental disorders have to be particularly attentive to changes in individuals' socioeconomic situation, including education, unemployment and social class.

The objective of this article is to identify the effects of the Great Recession on the mental health of people residing in Spain. After presenting a conceptual framework on the mechanisms through which economic crises affect mental health, we describe the main results of 45 papers identified in our search. Studies indicate a worsening of mental health in Spain in the years of economic crisis, especially in men. Working conditions (unemployment, low wages, instability, precariousness) emerge as one of the main channels through which mental health is put at risk or deteriorates. This deterioration occurs with intensity in particularly vulnerable groups, such as immigrant population and families with economic burdens. In the case of suicides, the results were inconclusive. Regarding the use of health care services, an increase in the consumption of certain drugs seems to be identified, although the conclusions of all the studies are not coincidental. Social inequalities in mental health do not seem to have remitted. We conclude that Spain needs to improve information systems to a better understanding of the health effects of economic crises. In terms of public policies, together with the reinforcement of health services aimed at addressing mental health problems, an income guarantee network for people in vulnerable situations should be promoted, as well as the development of policies aimed at the labour market., (Copyright © 2020 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Purpose: This paper analyses the effects of temporary employment on work stress and mental health before (2006/2007) and during the economic recession (2011/2012), and examines whether the economic recession worsened these two health outcomes., Methods: To control for selection bias, propensity scores (PS) are computed separately for salaried men and women using microdata from two cross-sectional health surveys in Spain, considering temporary (treatment group) versus permanent employment (control group). Next, we use difference-in-difference estimators stratifying by age, education level, and regional unemployment differences using PS as weights., Results: Our results indicate that salaried worker with a temporary labour contract tends to have similar levels of high work stress and poorer mental health (only for men) than permanent ones for both periods. The economic recession does not appear to worsen both outcomes. However, when stratifying the sample, the economic recession is responsible for increasing stress among older temporary workers and male university graduates, without affecting women. Regarding mental health, we only find evidence of a negative impact of the economic recession on male temporary workers with university education., Conclusion: The economic recession has not affected poor mental health, but it has accentuated the adverse effects of work stress among some specific subgroups of male workers. These subgroups require specific preventive and support actions as the Spanish firms have not substantially changed their hiring practices after the recession.

Purpose The purpose of this paper is to determine the relation between quality of life (QoL), mental illness, challenging behaviour and institutionalisation in an adult population with intellectual disabilities (ID).Design/methodology/approach The study assessed the QoL and its conditioning factors in 142 subjects with different degrees of ID. The GENCAT and Quality of Life in Late Stage Dementia scale were used to evaluate QoL, the Psychiatric Assessment Schedule for Adults with Developmental Disability and Diagnostic Assessment for the Severely Handicapped-II scale to assess mental illness and the Inventory for Client and aetiology Planning scale to assess challenging behaviour.Findings Individuals who live in residential care homes were found to have significantly impaired QoL (<0.001). Individuals with challenging behaviour presented significantly lower QoL, regardless of ID aethiology and degree, while psychiatric disorders did not seem to have a direct influence on individual QoL.Originality/value This paper provides new insight into the importance of challenging behaviour and psychiatric disorders in the QoL of individuals with ID. [ABSTRACT FROM AUTHOR]

Copyright of Clinica y Salud is the property of Colegio Oficial de Psicologos de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Accessible summary: What is known on the subject?: AHDs in mental health are fundamental tools in advance care planning processes. It is an important method for involving mental healthcare users in clinical decisions and in providing effective healthcare based around user preferences.AHDs can be applied in situations in which the person may forfeit their legal capacity, according to the Convention on the Rights of Persons with Disabilities.However, the use of AHDs as described above is not yet a reality in Spain. What the paper adds to existing knowledge?: The present study surveys the knowledge and attitudes of mental healthcare providers towards AHDs in clinical practice.Although providers had a moderate–low level of knowledge about AHDs, they presented positive attitudes towards them. What are the implications for practice?: The use of AHDs in mental healthcare practice poses challenges to the Spanish mental healthcare system. Acquiring up‐to‐date data on the knowledge and attitudes of providers towards AHDs allows organizations to address aspects of their service that require reinforcement. This data could also be used by other countries just starting to use AHDs, as an initial step towards supporting the implementation of a multistage intervention process.More in‐depth training for providers would help improve their competence to implement or honour the statements set out in AHDs, the related legal and ethical issues, and liability issues related to their implementation.The Spanish mental healthcare system requires structural changes so that providers can embrace new ways of relating to users and to organize partnerships and a continuity of care centred on user preferences. Introduction: Advance healthcare directives (AHDs) in mental health offer important information regarding service users' preferences. However, whether AHDs are truly understood by providers is questionable. Aim: To survey the knowledge and attitudes of mental health professionals towards AHDs and examine any associations with sociodemographic and occupational variables. Method: We cross‐sectionally surveyed the knowledge and attitudes of 113 mental health professionals by using two validated questionnaires. Results: Participants showed very positive attitudes and high levels of knowledge about the conceptual definition and application of AHDs in clinical practice but their knowledge of the legalities, procedure and registration of AHDs was poor. Working in a community, having a career specializing in mental health or having personally signed an AHD was associated with enhanced knowledge about them. Moreover, female sex or employment as an auxiliary nursing‐care technician was associated with stronger positive attitudes. Discussion: Legal and structural changes will be needed to implement AHDs in Spain and to promote competence among healthcare providers in order to include AHDs in everyday practice. Implications for practice: The Spanish mental healthcare system requires legal and structural changes and must improve healthcare providers' competence in AHDs before they are implemented. [ABSTRACT FROM AUTHOR]

Several studies have revealed that homeless people suffering from mental health problems are more vulnerable than homeless without those mental health problems. Nevertheless, there is a lack of evidence describing the real circumstances of homeless women. This paper explores the differences between homeless women at high risk of mental ill-health compared with those who do not present this risk. The sample consisted of a group of 120 homeless women in Madrid (Spain). For this study, we collected data on background information (trajectory of homelessness and stressful life events experienced) and current aspects (living conditions, physical health, and social support). The risk of mental ill-health has been measured by the short version of the General Health Questionnaire (GHQ-28). The results showed that homeless women with higher risk of mental ill-health had become homeless at a younger age, had experienced more stressful life events in their lives, had a poorer physical health, felt less happy, had less social support, and a greater feeling of loneliness when compared with homeless women who did not present risk of mental ill-health. Improving knowledge about the risk of mental ill-health among homeless women is essential for the design of specific psychological interventions within this population. [ABSTRACT FROM AUTHOR]

Evidence-informed strategic planning is a top priority in Mental Health (MH) due to the burden associated with this group of disorders and its societal costs. However, MH systems are highly complex, and decision support tools should follow a systems thinking approach that incorporates expert knowledge. The aim of this paper is to introduce a new Decision Support System (DSS) to improve knowledge on the health ecosystem, resource allocation and management in regional MH planning. The Efficient Decision Support-Mental Health (EDeS-MH) is a DSS that integrates an operational model to assess the Relative Technical Efficiency (RTE) of small health areas, a Monte-Carlo simulation engine (that carries out the Monte-Carlo simulation technique), a fuzzy inference engine prototype and basic statistics as well as system stability and entropy indicators. The stability indicator assesses the sensitivity of the model results due to data variations (derived from structural changes). The entropy indicator assesses the inner uncertainty of the results. RTE is multidimensional, that is, it was evaluated by using 15 variable combinations called scenarios. Each scenario, designed by experts in MH planning, has its own meaning based on different types of care. Three management interventions on the MH system in Bizkaia were analysed using key performance indicators of the service availability, placement capacity in day care, health care workforce capacity, and resource utilisation data of hospital and community care. The potential impact of these interventions has been assessed at both local and system levels. The system reacts positively to the proposals by a slight increase in its efficiency and stability (and its corresponding decrease in the entropy). However, depending on the analysed scenario, RTE, stability and entropy statistics can have a positive, neutral or negative behaviour. Using this information, decision makers can design new specific interventions/policies. EDeS-MH has been tested and face-validated in a real management situation in the Bizkaia MH system., Competing Interests: The authors have declared that no competing interests exist.

This paper shows how the community of Latin-American and Spanish psychiatry represents a solid platform for the so-called 'continental thought' to meet the analytical Anglo-Saxon thought. It reviews what both Latin America and the Spanish and Portuguese languages represent in the American continent; the relation between Spanish psychiatry and Spanish-speaking psychiatry in America during the twentieth century; the reality of psychiatric research and profession in Latin America; the evolution of Spanish psychiatry in the twentieth century from the post civil war diaspora to the beginning of the twenty-first century, and research on mental health in Spain and the foreseeable future. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The mental health of health professionals is affected by their own work. Nurses and nursing students face high levels of stress, which results in anxiety, burnout, and depression.There are scales that allow the measurement of specific stress levels of nursing students, especially when they first attend their clinical practices in real settings such as hospitals. What this paper adds to existing knowledge?: Our study consists of validating an existing scale (the Stressors in Nursing Students Scale, SINS) that measures these stress levels in Spanish.Stress is an issue for nursing students and is related to the specific stressors they encounter in the process of their professional work and study. What are the implications for practice?: The validation and adaptation of this scale to Spain will allow us to adequately assess the stress levels of our students to give them adequate tools for the emotional control of their anxiety and stress.Once we have a reliable and appropriate tool for measuring the factors of greater impact in the generation of stress, we can implement preventive measures which may be very useful for the control of anxiety. Introduction: Nursing professionals and students suffer a greater number of stressors with negative health consequences. Aim: To translate and test a Spanish version of the Stressors in Nursing Students Scale (SINS‐S), with a cohort of nursing students in Spain. Also, we sought to examine the factor structure of this test and explore the psychometric structure of stress among this population. Method: The SINS scale was translated into Spanish and administered to a cohort (n = 398) of male and female Spanish nursing students in the final three years of their nursing program. Data were analyzed using exploratory factor analysis. Results: Exploratory factor analysis revealed four factors: "Clinical," "Financial," "Confidence," and "Education." Discussion: There were similarities between the perception of stressors by nursing students in Spain compared with the original version of the SINS from the United Kingdom. Stress is an issue for nursing students and is related to the specific stressors they encounter in the process of their professional work and study. [ABSTRACT FROM AUTHOR]

Background and aims: The focus of this paper is on the improvement of substance use disorder (SUD) screening and measurement. Using a multi‐dimensional item response theory model, the bifactor model, we provide a psychometric harmonization between SUD, depression, anxiety, trauma, social isolation, functional impairment and risk‐taking behavior symptom domains, providing a more balanced view of SUD. The aims are to (1) develop the item‐bank, (2) calibrate the item‐bank using a bifactor model that includes a primary dimension and symptom‐specific subdomains, (3) administer using computerized adaptive testing (CAT) and (4) validate the CAT‐SUD in Spanish and English in the United States and Spain. Design Item bank construction, item calibration phase, CAT‐SUD validation phase. Setting: Primary care, community clinics, emergency departments and patient‐to‐patient referrals in Spain (Barcelona and Madrid) and the United States (Boston and Los Angeles). Participants/cases: Calibration phase: the CAT‐SUD was developed via simulation from complete item responses in 513 participants. Validation phase: 297 participants received the Composite International Diagnostic Interview (CIDI) and the CAT‐SUD. Measurements A total of 252 items from five subdomains: (1) SUD, (2) psychological disorders, (3) risky behavior, (4) functional impairment and (5) social support. CAT‐SUD scale scores and CIDI SUD diagnosis. Findings Calibration: the bifactor model provided excellent fit to the multi‐dimensional item bank; 168 items had high loadings (> 0.4 with the majority > 0.6) on the primary SUD dimension. Using an average of 11 items (four to 26), which represents a 94% reduction in respondent burden (average administration time of approximately 2 minutes), we found a correlation of 0.91 with the 168‐item scale (precision of 5 points on a 100‐point scale). Validation: strong agreement was found between the primary CAT‐SUD dimension estimate and the results of a structured clinical interview. There was a 20‐fold increase in the likelihood of a CIDI SUD diagnosis across the range of the CAT‐SUD (AUC = 0.85). Conclusions: We have developed a new approach for the screening and measurement of SUD and related severity based on multi‐dimensional item response theory. The bifactor model harmonized information from mental health, trauma, social support and traditional SUD items to provide a more complete characterization of SUD. The CAT‐SUD is highly predictive of a current SUD diagnosis based on a structured clinical interview, and may be predictive of the development of SUD in the future. [ABSTRACT FROM AUTHOR]