Transition-age youth with mental health conditions experience adverse employment and educational outcomes and little is known about strategies for improving their outcomes. The purpose of this study was to review education and employment intervention programs that targeted transition-age youth with mental health conditions, to highlight the components, efficacy of the interventions, and predictors of better outcomes. Eighteen studies published between 1990 and 2017 met the inclusion criteria. Results indicate that interventions led to improvement in employment or education outcomes. Common intervention components included: mental health services, career counseling, career development, cognitive adaptation training, interagency collaboration, peer mentoring, functional skills assessment, individualized or person-centered counseling, social skill, and independent living skills training. Being married, active participation in vocational intervention, social support, prior work experience, high score on Social and Occupational Functioning Assessment Scale were found to be associated with better education and employment outcomes. Implications for research, and practice are discussed.

Depression and anxiety are relatively common among college students and research suggests that risk perceptions may be modulated by these mental health conditions. In addition, studies have demonstrated that higher perception of risk predicts more frequent practice of preventative health behaviors, and this relationship may also be modulated by depression and anxiety. The present study examined the relationship between these factors in the context of COVID-19. Using survey data from undergraduate students, risk perceptions about COVID-19, self-reported practice of COVID-19 preventative behaviors, and their relationship were compared between those with and without the common mental health conditions of Major Depressive Disorder and Generalized Anxiety Disorder. Results indicated that risk perceptions predicted self-reported use of preventative health behaviors across groups, and those with MDD and/or GAD had relatively greater affective than cognitive risk perceptions related to COVID-19. Critically, however, those with MDD and/or GAD did not show enhanced self-reported use of preventative health behaviors to avoid contracting or spreading COVID-19. In addition, mental health condition status did not modulate the relationship between risk perception and preventative health behaviors. Together, these findings suggest that while affective risk perceptions related to COVID-19 may be elevated in college students with common mental health conditions, perceived risk does not translate into behaviors that will reduce their risk of contracting or spreading COVID-19.

Employee mental health claims have become a costly burden for Canadian workplaces, therefore many organizations are seeking to adopt progressive disability management strategies to support employees with mental health conditions who are either returning to work or trying to remain at work. Developing and implementing effective workplace accommodation practices is one such strategy to support employees. Negotiating workplace accommodations has been recommended in the literature to be an interactive process between the employee and workplace stakeholders. However, there is very limited knowledge regarding the ways in which discussing and negotiating accommodations unfolds, or how employees and stakeholders experience the process of negotiating accommodations. This thesis includes the results of a qualitative study exploring how negotiating accommodations unfolds between employees with mental health conditions and workplace stakeholders, and a sub-analysis of the larger study data exploring how social capital can impact the negotiation process. In order to capture varied perspectives, in depth interviews were conducted with employees in diverse roles who self-identified as having a mental health condition that required accommodation, and stakeholders who were experienced in negotiating accommodations. A qualitative descriptive design was used to iteratively collect and analyze data. Constructive and interpretive strategies including initial and focused coding, memo writing and clustering were used to identify themes about negotiating accommodations. The negotiation process, as reported by participants in this study, was found to be a non-linear, social and political process that unfolded as a combination of micro formal and informal sub-processes, in contrast to the concrete, formal accommodation process mandated by some organizational policies. In addition, there were a number of factors that were experienced as either helpful or challenging in the process of negotiating accommodations. Social capital arose as an important element influencing how employees with mental health conditions accessed accommodations. The findings of a qualitative sub-analysis of the original data set focused on the ways in which workplace social capital impacted the experience of requesting and negotiating accommodations. Some elements of social capital were found to be dynamic, with workers able to accumulate, rebuild and spend social capital in the course of their employment. Employee reputation, employee self-confidence and likeability with coworkers and managerial staff arose as key elements of social capital. Other elements of social capital were external perceptions constructed by coworkers and workplace stakeholders, such as return-on-investment of accommodating and judgements of value to the organization. Overall, workplace social capital appeared to impact how employees experienced the process of requesting and negotiating accommodations, but it was not the determining factor of whether accommodation requests were granted. / Thesis / Master of Science (MSc) / This Master’s thesis focused on the process of discussing and negotiating workplace accommodations between workers with mental health conditions and workplace stakeholders. Six workers with mental health conditions and 6 other workplace stakeholders who had experience negotiating accommodations shared their experiences in interviews. Study findings highlighted that the negotiation process can be complex and non-linear, and is impacted by social and political factors. Workplace social capital had an impact when workers with mental health conditions requested and negotiated accommodations. For example, employee self-confidence, “likeability” (as perceived by coworkers and management), reputation as a good performer and perceived value to the organization appeared to shape how workers experienced the process of negotiating accommodations. Worker status and position also reportedly had an impact on access to supports. It should be noted, however, that social capital was only one of the factors that workers needed to be successfully accommodated, and their social capital could be at risk of being exhausted due to behavior or performance issues. This thesis expands our understanding of the accommodation negotiation process, and the impact of social and political forces on disability management strategies.

Yes / Introduction The role of digital health in providing psychological treatment and support for the prevention of suicide is well documented. Particular emphasis has been placed on digital health technologies during the COVID-19 pandemic. Providing psychological support reduces the burden of mental health conditions. The challenge is to provide support in the context of patient isolation, which highlights the role of digital technology (video conferencing, smartphone apps and social media). There is, however, a dearth of literature where experts by experience have been involved in the end-to-end process of developing digital health tools for suicide prevention. Methods and analysis This study aims to codesign a digital health tool for suicide prevention focusing on the enablers and barriers. The scoping review protocol is phase I within a three-phase study. The protocol will inform the second phase of the study which is the scoping review. The results of the review will inform a funding application to National Institute for Health and Care Research to codesign a digital health tool for suicide prevention (the third phase). The search strategy will follow the Joanna Briggs Institute Reviewer’s Manual for Scoping Reviews and incorporates the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist to ensure reporting standards are maintained. The methodology will be supplemented by frameworks by Arksey and O’Malley and Levac et al. The search strategy dates for screening are from November 2022 to March 2023. Five databases will be searched: Medline, Scopus, CINAHL, PsycInfo and Cochrane Database of Systematic Reviews. Grey literature searches include government and non-government health websites, Google and Google Scholar. The data will be extracted and organised into relevant categories. The results will be synthesised into themes and inform phase II of the study. Ethics and dissemination Ethics granted by the University of Bradford on 15 August 2022, reference E995. The project team will design a digital health tool, results will be published in a peer-review journal and disseminated through conferences. Study registration number Safety (Mental Health) Innovation Challenge Fund 2022–2023 Protocol RM0223/42079 Ver 0.1. / This research was funded by the National Institute for Health and Care Research (NIHR) Yorkshire and Humber Patient Safety Translational Research Centre (NIHR Yorkshire and Humber PSTRC). Project Reference: SICF 2022-02.

Long Term Conditions (LTCs) with co-morbid common mental health conditions of anxiety and depression present a significant challenge for UK health and social care services. Depression and anxiety are common in heart failure (HF) patient populations and research suggests depression has a detrimental effect on a range of health outcomes, including Health related Quality of Life (HRQoL). The impact of anxiety is relatively under-researched in this patient group. In this doctoral study a systematic review was conducted to consolidate the evidence base for the prevalence and variance of rates of anxiety in HF patients. Importantly, the relative contribution of anxiety symptoms, measured using the Hospital Anxiety and Depression Scale (HADS), to reported HRQoL , measured using the Kansas City Cardiomyopathy Questionnarie (KCCQ) was examined in a cross-sectional survey of 158 HF patients attending specialist HF outpatient clinics. The systematic review identified 72 studies, with reported rates of anxiety varying dramatically, ranging from 6.2% to 72.3%. The random effects pooled prevalence estimate for anxiety disorders was 13.01% (95% CI 9.3% - 16.9%), for probable clinically significant anxiety was 28.8% (95% CI 23.3% - 34.3%) and the random effects pooled prevalence estimate for elevated symptoms of anxiety was 55.5% (95% CI 48.1% - 62.8%). Not all tools used to assess anxiety were population appropriate. In the survey multivariate analysis found that anxiety symptoms, did not account for a significant proportion of unique variance in HRQoL scores. Higher levels of physical symptom burden, depression and an increased number of physical co-morbidities predominantly account for 69% of the variance in HRQoL (F13,125 = p <0.0005). The findings highlight the need for accurate and valid measurement of anxiety and depression within the context of a physical LTC. Anxiety and depression are common in HF patients and the evidence suggests depression in particular predicts reported HRQoL. Further research is required to understand more about the role of anxiety in influencing patient’s health outcomes.

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