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Purpose: Previous research has shown that lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) individuals experience greater levels of bullying which may place them more at risk of mental health problems than their heterosexual or cisgender counterparts. Therefore, increasing their resilience may help them cope with the challenge of bullying and have a positive impact on their mental health. This study seeks to provide support for resilience factors that may promote increased well-being for bullied LGBTQ+ adolescents. Methodology: LGBTQ+ individuals aged 16-25 (N=287) completed questionnaires which measured their bullying status, mental well-being, perceived resilience, stigma-consciousness, and perceived social support, in order to compare the mental well-being of bullied and non-bullied young people and to determine protective resilience factors. Findings: Young people who had experienced bullying were found to have poorer mental wellbeing than their non-bullied counterparts. Perceived social support and self-belief predicted better mental wellbeing. Implications: Personal and social resilience was associated with better mental wellbeing outcomes for bullied LGBTQ+ young people. Perceived social support and self-belief, equipped individuals with the assets and resources necessary to mitigate the consequences of being bullied and being part of the LGBTQ+ community. [ABSTRACT FROM AUTHOR]

Objective: Self-harm remains a serious public health concern; however, identifying adolescents at risk is challenging. While self-harm has been linked with difficulties in emotional regulation postinjury, comparatively little is known about how such difficulties may impact on the future development of self-harm behavior.Methods: A total of 318 pupils aged 14-15 years completed measures on history of direct self-injurious behavior (D-SIB), emotional regulation, depression, and anxiety at two time points across a six-month period.Results: Of 13% (42) of participants reported their first episode of D-SIB over the six-month period and reported increased difficulties with emotional regulation prior to initial D-SIB. Regression analyses found significant associations for emotional regulation and specifically lack of emotional clarity prior to first episode of D-SIB. Lack of emotional awareness and difficulties with impulse control was significantly associated in those with ongoing D-SIB.Conclusions: Prior to first episode of D-SIB, young people may experience difficulty regulating emotions, a difficulty which appears less pronounced following their engagement with D-SIB. Our findings implicate difficulties in the early evaluation and understanding of emotions which may later impair attempts at emotion modulation and increase risk of D-SIB. Such findings might help inform early identification of adolescents at risk of initial D-SIB. [ABSTRACT FROM AUTHOR]

Introduction Non-suicidal self-injury (NSSI) and suicidal behaviour have been witnessed in children as young as 6-7 years of age, but while there are many reviews of preventative interventions for NSSI and suicide in adolescents, few have explored its prevalence in younger children and the potential impact of preventative interventions at this stage of life. NSSI and suicidal behaviour are an increasing concern in schools but schoolbased programmes can improve knowledge, attitudes and help-seeking behaviours and help prevent escalation of NSSI and later suicide. This scoping review will aim to explore the nature and extent of the evidence on the magnitude of NSSI and suicidal behaviour in primary school children, and to examine whether there are any primary school-based interventions available for the prevention of this phenomenon in 5 to 11-year-olds. Methods and analysis A scoping review will be conducted using established methodology by Arksey and O'Malley and the Joanna Briggs Institute. Multiple bibliographic and indexing databases and grey literature will be searched using a combination of text words and index terms relating to NSSI, suicide, primary schools, frequency and intervention. Two reviewers will independently screen eligible studies for study selection and extract relevant data from included studies. A narrative summary of evidence will be conducted for all included studies with results presented in tables and/or diagrams. Inductive content analysis will be used to understand any narrative findings within the included studies. Ethics and dissemination Ethical approval is not required for this scoping review. The results of this review will be disseminated though publication in a peer-reviewed journal and presented at relevant conferences. [ABSTRACT FROM AUTHOR]

Aim Delayed help-seeking can have serious consequences for young people with first-episode psychosis ( FEP), in terms of treatment response and outcome. Young people's narratives about help-seeking are important to understand why delays occur; however, as the majority of help-seeking is initiated by family members, through a general practitioner ( GP), family narratives are also of interest. The aim of this study was to explore help-seeking for FEP, including first contact with a GP. Method A semistructured interview was developed using a topic guide. Framework analysis was used to analyse data and a deductive qualitative method for applied research. The study was set in Birmingham, UK. Participants were interviewed separately by researchers. Joint coding and identification of 14 complete family dyads was then explored for emerging patterns within the family context. Results Family responses to FEP that had an impact on help-seeking behaviour included withdrawal, normalization, stigma, fear and guilt; poor knowledge of availability, and means of access to mental health services was also important. Help-seeking was usually instigated by a family member through a GP, although this was not the case for two of our families, and while contact with GP was generally described as a positive experience for several families, it was hindered by poor communication and lack of engagement. Conclusion Families play a key role in facilitating help-seeking for FEP, but attempts are often derailed by complex family responses to illness. Public mental health interventions should focus on increasing community awareness of psychosis and improving access and alternative routes to mental health services. However, improvements will have little impact unless primary care and other help-seeking sources engage in open and easy dialogue with the families and young people trying to access their specialist services. [ABSTRACT FROM AUTHOR]

Background: No evidence based approach to reduce duration of untreated psychosis (DUP) has been effective in the UK. Existing interventions have many components and have been difficult to replicate. The majority of DUP in Birmingham, UK is accounted for by delays within mental health services (MHS) followed by help-seeking delay and, we hypothesise, these require explicit targeting. This study examined the feasibility and impact of an intervention to reduce DUP, targeting help-seeking and MHSs delays. Methods: A dual-component intervention, comprising a direct care pathway, for 16-25 year olds, and a community psychosis awareness campaign, using our youth-friendly website as the central hub, was implemented, targeting the primary sources of care pathway delays experienced by those with long DUP. Evaluation, using a quasi-experimental, design compared DUP of cases in two areas of the city receiving early detection vs detection as usual, controlling for baseline DUP in each area. Results: DUP in the intervention area was reduced from a median 71 days (mean 285) to 39 days (mean 104) following the intervention, with no change in the control area. Relative risk for the reduction in DUP was 0.74 (95 % CI 0.35 to 0.89; p = .004). Delays in MHSs and help-seeking were also reduced. Conclusions: Our targeted approach appears to be successful in reducing DUP and could provide a generalizable methodology applicable in a variety of healthcare contexts with differing sources of delay. More research is needed, however, to establish whether our approach is truly effective. [ABSTRACT FROM AUTHOR]

Considerable focus has been given to the interpersonal nature of the voice-hearing relationship and how appraisals about voices may be linked with distress and depression (the 'cognitive model'). Research hitherto has focused on appraisals of voice power, but the supportive and affiliative quality of voices, which may act to mitigate distress, is not understood. We explored appraisals of voices' power and emotional support to determine their significance in predicting depression and suicidal thought. We adapted the concept of expressed emotion (EE) and applied it to measure voice hearers' perception of the relationship with their voice(s). In a sample of 74 voice hearers, 55.4% were moderately depressed. Seventy-eight who rated their voices as high in both power and EE had a large and significant elevation in depression, suggesting that co-occurrence of these appraisals impacts on depression. Analysis of the relationship between power and EE revealed that many voices perceived as low in power were, nevertheless, perceived as high in EE. Those rating their voices as emotionally supportive showed the lowest levels of depression and suicidal thinking. These findings highlight the protective role that the supportive dimension of the voice/voice-hearer relationship may have. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message Appraisals of social rank and EE impact on the depressive and suicidal status of voice-hearers., The emotionally supportive dimension of the voice-hearing relationship may have a protective role in the affective response of voice hearers., Therapeutic interventions should consider the emotionally supportive needs of voice-hearers [ABSTRACT FROM AUTHOR]

Abstract: Background: Approximately 80 000 children and young people in the UK suffer from depression, but many are untreated because of poor identification of early warning signs and risk factors. Aims: This study aimed to derive and to investigate discrimination characteristics of a prediction model for a first recorded diagnosis of depression in young people aged 15–24 years. Method: This study used a matched case–control method using electronic primary care records. Stepwise conditional logistic regression modelling investigated 42 potential predictors including symptoms, co‐morbidities, social factors and drug and alcohol misuse. Results: Of the socio‐economic and symptomatic predictors identified, the strongest associations were with depression symptoms and other psychological conditions. School problems and social services involvement were prominent predictors in men aged 15–18 years, work stress in women aged 19–24 years. Conclusion: Our model is a first step in the development of a predictive model identifying early warning signs of depression in young people in primary care. [ABSTRACT FROM AUTHOR]

Objective: To explore lay understanding and perceptions of schizophrenia in university students., Design: Qualitative study using semi-structured interviews and thematic analysis., Setting: The University of Birmingham, West Midlands., Participants: 20 UK home students of white British (n=5), Indian (n=5), Pakistani (n=5), African Caribbean (n=4) and dual white British and African Caribbean ethnicity (n=1)., Results: Findings revealed a lack of knowledge about schizophrenia, particularly the negative symptoms that were not mentioned. There were mixed ideas on the causes and sources of available help for schizophrenia; however, positively many said they would consult their general practitioner. While there was a general misconception among the students that schizophrenia caused multiple personalities and was a dangerous illness, there were some differences in perceptions and understanding between ethnic groups, with more Indian students perceiving upbringing as a causal factor in the development of the illness and more Pakistani students perceiving possession by a spirit as a cause., Conclusions: The university students interviewed lacked knowledge about schizophrenia and stigma was widespread, both of which may delay help-seeking. Public health campaigns educating young people about schizophrenia are required to improve early identification and intervention and improve outcomes. Further research exploring ways to effectively tackle stigma is also required., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Non-suicidal self-injury (NSSI) and suicidal behaviour have been witnessed in children as young as 6-7 years of age, but while there are many reviews of preventative interventions for NSSI and suicide in adolescents, few have explored its prevalence in younger children and the potential impact of preventative interventions at this stage of life. NSSI and suicidal behaviour are an increasing concern in schools but school-based programmes can improve knowledge, attitudes and help-seeking behaviours and help prevent escalation of NSSI and later suicide. This scoping review will aim to explore the nature and extent of the evidence on the magnitude of NSSI and suicidal behaviour in primary school children, and to examine whether there are any primary school-based interventions available for the prevention of this phenomenon in 5 to 11-year-olds., Methods and Analysis: A scoping review will be conducted using established methodology by Arksey and O'Malley and the Joanna Briggs Institute. Multiple bibliographic and indexing databases and grey literature will be searched using a combination of text words and index terms relating to NSSI, suicide, primary schools, frequency and intervention. Two reviewers will independently screen eligible studies for study selection and extract relevant data from included studies. A narrative summary of evidence will be conducted for all included studies with results presented in tables and/or diagrams. Inductive content analysis will be used to understand any narrative findings within the included studies., Ethics and Dissemination: Ethical approval is not required for this scoping review. The results of this review will be disseminated though publication in a peer-reviewed journal and presented at relevant conferences., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)