Objectives: The objectives of this study were to identify demographic, work-related and other predictors for clinically significant psychological distress, including PTSD, depression, and/or anxiety during the COVID-19 pandemic in UK frontline health and social care workers (HSCWs), and to compare rates of PTSD, depression and anxiety across different groups of HCSWs. Design: An online survey was conducted in the weeks following the initial peak in cases (27 May to 23 July 2020). Setting: The participants worked in a variety of healthcare roles UK hospitals, nursing or care homes and community settings. Participants: A convenience sample (n=1194) of frontline UK health and social care workers completed the survey (including allied healthcare professionals, carers, clinical support staff, nurses and midwives, and other health and social care roles). Main outcome measures: PTSD was assessed using the PTSD subscale of the International Trauma Questionnaire (ITQ); Depression assessed using the Patient Health Questionnaire-9 (PHQ-9); Anxiety was assessed using the Generalized Anxiety Disorder Scale (GAD-7). Results: Logistic regression analyses examined predictors for depression, anxiety and PTSD separately, and also investigated the predictors of meeting the criteria for at least one of the three conditions. Over 57% of respondents met the threshold for clinically significant PTSD, anxiety or depression, and symptom levels were reasonably high and comparable across occupational groups. Participants who were more concerned about infecting others, who felt they could not talk with their managers, who reported feeling stigmatised due to their role and who had not had reliable access to personal protective equipment (PPE) were more likely to meet criteria for a clinically significant mental disorder. Being redeployed during the pandemic, and having had COVID were associated with a higher likelihood of meeting criteria for PTSD. Higher household income was associated with reduced odds for a mental disorder. Conclusions: This study identifies predictors of clinically significant distress during COVID-19 and highlights the need for reliable access to PPE. Further research should investigate mental disorders in under-represented HSCW groups and examine barriers to communication between managers and staff. Identifying risk factors for PTSD, depression and anxiety among HSCWs, and providing treatment for those who need it, is critical given that subsequent waves of COVID-19 and other healthcare crises are inevitable.

Background: Increasing rates of mental health problems among adolescents are of concern. Teens who are most in need of mental health attention are reluctant to seek help. A better understanding of the help-seeking in this population is needed to overcome this gap. Methods: Five databases were searched to identify the principal barriers, facilitators and interventions targeting help-seeking for common mental health problems in adolescents aged 10-19 years. The search was performed in June 2018 and updated in March 2019. Two independent screening processes were made using the eligibility criteria. Quality assessment of each study was performed and findings summarised using a narrative synthesis. Results: 90 studies meet the inclusion criteria for this review for barrier and facilitators (n=54) and interventions (n=36). Stigma and negative beliefs towards mental health services and professionals were the most cited barriers. Facilitators included previous positive experience with health services and mental health literacy. Most interventions were based on psychoeducation, which focused on general mental health knowledge, suicide and self-harm, stigma and depression. Other types of interventions included the use of multimedia and online tools, peer training and outreach initiatives. Overall, the quality of studies was low to medium and there was no general agreement regarding help-seeking definition and measurements. Conclusion: Most of interventions took place in an educational setting however, it is important to consider adolescents outside the educational system. Encouraging help-seeking should come with the increased availability of mental health support for all adolescents in need, but this is still a major challenge for Child and Adolescent Mental Health Services. There is also a need to develop shared definitions, theoretical frameworks and higher methodological standards in research regarding help-seeking behaviours in adolescents. This will allow more consistency and generalisability of findings, improving the development of help-seeking interventions and ensuring timely access to mental health treatments.

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We aimed to conduct the first systematic narrative review and quality appraisal of existing evidence on the psychological consequences of crime in older victims in the community and psychological interventions. We searched five databases to identify all peer-reviewed literature published in English on psychological impact and/or interventions for older crime victims and quality appraised these using the Mixed-Methods Appraisal Tool, following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (Prospero: CRD42019140137). Evidence from included studies were narratively synthesized, along with their strengths and limitations. We found 20 studies on psychological distress in older victims, four of which included interventions. From these, we identified 30 different impacts including symptoms of anxiety, depression, post-traumatic stress disorder, emotions including humiliation and self-blame, and behavioral changes. Only feasibility interventions have been published, although promising results were reported for cognitive-behavioral informed treatments for depression and anxiety. Studies were wide-ranging in aims, crimes included, and outcomes used. Recommendations for improving the evidence-base and to raise the profile of this neglected population have been provided.

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