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Article: Re: investigating the impact of financial concerns on symptoms of depression in UK healthcare workers: data from the UK REACH nationwide cohort study.

Croak, Bethany / Lamb, Danielle / Stevelink, Sharon A M

2024 Volume 10, Issue 3, Page(s) e74

Abstract: This editorial comments on the paper by Martin McBride and the UK REACH team (published in 2023) investigating financial concerns in UK healthcare workers and depressive symptoms. The research concludes that reporting future financial concerns at ... ...

Abstract	This editorial comments on the paper by Martin McBride and the UK REACH team (published in 2023) investigating financial concerns in UK healthcare workers and depressive symptoms. The research concludes that reporting future financial concerns at baseline increased the odds of depressive symptoms at follow-up around 18 months later. We discuss these findings in the context of the cost-of-living crisis and pay disputes within the NHS, important policy implications and directions for future research.
Language	English
Publishing date	2024-04-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2829557-2
ISSN	2056-4724
ISSN	2056-4724
DOI	10.1192/bjo.2024.30
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Risk and protective factors for self-harm and suicide behaviours among serving and ex-serving personnel of the UK Armed Forces, Canadian Armed Forces, Australian Defence Force and New Zealand Defence Force: A systematic review.

Williamson, Charlotte / Croak, Bethany / Simms, Amos / Fear, Nicola T / Sharp, Marie-Louise / Stevelink, Sharon A M

PloS one

2024 Volume 19, Issue 4, Page(s) e0299239

Abstract: Background: Self-harm and suicide behaviours are a major public health concern. Several factors are associated with these behaviours among military communities. Identifying these factors may have important implications for policy and clinical services. ... ...

Abstract	Background: Self-harm and suicide behaviours are a major public health concern. Several factors are associated with these behaviours among military communities. Identifying these factors may have important implications for policy and clinical services. The aim of this review was to identify the risk and protective factors associated with self-harm and suicide behaviours among serving and ex-serving personnel of the United Kingdom Armed Forces, Canadian Armed Forces, Australian Defence Force and New Zealand Defence Force. Methods: A systematic search of seven online databases (PubMed, Web of Science, Embase, Global Health, PsycINFO, PTSDpubs and CINAHL) was conducted alongside cross-referencing, in October 2022. Following an a priori PROSPERO approved protocol (CRD42022348867), papers were independently screened and assessed for quality. Data were synthesised using a narrative approach. Results: Overall, 28 papers were included: 13 from Canada, 10 from the United Kingdom, five from Australia and none from New Zealand. Identified risk factors included being single/ex-relationship, early service leavers, shorter length of service (but not necessarily early service leavers), junior ranks, exposure to deployment-related traumatic events, physical and mental health diagnoses, and experience of childhood adversity. Protective factors included being married/in a relationship, higher educational attainment, employment, senior ranks, and higher levels of perceived social support. Conclusion: Adequate care and support are a necessity for the military community. Prevention and intervention strategies for self-harm and suicide behaviours may be introduced early and may promote social networks as a key source of support. This review found a paucity of peer-reviewed research within some populations. More peer-reviewed research is needed, particularly among these populations where current work is limited, and regarding modifiable risk and protective factors.
MeSH term(s)	Humans ; Military Personnel/psychology ; Self-Injurious Behavior/epidemiology ; Self-Injurious Behavior/prevention & control ; Self-Injurious Behavior/psychology ; Australia/epidemiology ; United Kingdom/epidemiology ; Risk Factors ; Canada/epidemiology ; Protective Factors ; Suicide/psychology ; Suicide/statistics & numerical data ; New Zealand/epidemiology
Language	English
Publishing date	2024-04-26
Publishing country	United States
Document type	Journal Article ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0299239
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Does it matter if there are errors in GHQ-12 response items?

Croak, Bethany / Greenberg, Neil / Lamb, Danielle / Stevelink, Sharon A M / Wessely, Simon

The lancet. Psychiatry

2024

Language	English
Publishing date	2024-04-19
Publishing country	England
Document type	Letter
ISSN	2215-0374
ISSN (online)	2215-0374
DOI	10.1016/S2215-0366(24)00109-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Evaluation of Community Reinforcement and Family Therapy in the UK military community.

Croak, Bethany / Archer, Marc / Harwood, Hannah / Stevelink, Sharon A M / Greenberg, Neil / Rafferty, Laura

European journal of psychotraumatology

2023 Volume 14, Issue 2, Page(s) 2282904

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Humans ; Family Therapy ; Military Personnel ; Alcoholism/therapy ; Patient Acceptance of Health Care ; United Kingdom
Language	English
Publishing date	2023-11-27
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2586642-4
ISSN	2000-8066 ; 2000-8066
ISSN (online)	2000-8066
ISSN	2000-8066
DOI	10.1080/20008066.2023.2282904
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Adjustment disorder in the Armed Forces: a systematic review.

McKenzie, Amber / Burdett, Howard / Croak, Bethany / Rafferty, Laura / Greenberg, Neil / Stevelink, Sharon A M

Journal of mental health (Abingdon, England)

2022 Volume 32, Issue 5, Page(s) 962–984

Abstract: Background: In the UK military, adjustment disorder (AjD) is reported as one of the most diagnosed mental disorders, alongside depression, in personnel presenting to mental health services. Despite this, little is understood about what may predict AjD, ... ...

Abstract	Background: In the UK military, adjustment disorder (AjD) is reported as one of the most diagnosed mental disorders, alongside depression, in personnel presenting to mental health services. Despite this, little is understood about what may predict AjD, common treatment or outcomes for this population. Aim: The systematic review aimed to summarise existing research for AjD in Armed Forces (AF) populations, including prevalence and risk factors, and to outline clinical and occupational outcomes. Method: A literature search was conducted in December 2020 to identify research that investigated AjD within an AF population (serving or veteran) following the PRISMA guidelines. Results: Eighty-three studies were included in the review. The AjD prevalence estimates in AF populations with a mental disorder was considerably higher for serving AF personnel (34.9%) compared to veterans (12.8%). Childhood adversities were identified as a risk factor for AjD. AjD was found to increase the risk of suicidal ideation, with one study reporting a risk ratio of 4.70 (95% Confidence Interval: 3.50-6.20). Talking therapies were the most common treatment for AjD, however none reported on treatment effectiveness. Conclusion: This review found that AjD was commonly reported across international AF. Despite heterogeneity in the results, the review identifies several literature gaps.
MeSH term(s)	Humans ; Child ; Adjustment Disorders/epidemiology ; Military Personnel/psychology ; Veterans/psychology ; Mental Health Services ; Suicidal Ideation
Language	English
Publishing date	2022-11-04
Publishing country	England
Document type	Systematic Review
ZDB-ID	1145439-8
ISSN	1360-0567 ; 0963-8237
ISSN (online)	1360-0567
ISSN	0963-8237
DOI	10.1080/09638237.2022.2140792
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Evaluating a Smartphone App (MeT4VeT) to Support the Mental Health of UK Armed Forces Veterans: Feasibility Randomized Controlled Trial.

Parkes, Steven / Croak, Bethany / Brooks, Samantha K / Stevelink, Sharon A M / Leightley, Daniel / Fear, Nicola T / Rafferty, Laura / Greenberg, Neil

JMIR mental health

2023 Volume 10, Page(s) e46508

Abstract: Background: Previous research demonstrates that less than 50% of military veterans experiencing mental health difficulties seek formal support. Veterans often struggle to identify problems as mental health difficulties. In addition, they may fail to ... ...

Abstract	Background: Previous research demonstrates that less than 50% of military veterans experiencing mental health difficulties seek formal support. Veterans often struggle to identify problems as mental health difficulties. In addition, they may fail to recognize the need for support before reaching a crisis point and face difficulties navigating care pathways to access support. Objective: A feasibility trial was conducted to assess a novel digital smartphone app (Mental Health Toolkit for Veterans Project [MeT4VeT]) for UK Armed Forces (UKAF) veterans experiencing mental health difficulties. The trial aimed to explore the feasibility and acceptability of trial procedures for a later randomized controlled trial (RCT) and to assess the acceptability of the MeT4VeT app. Methods: Participants were recruited at UK military medical centers, by advertising on social media, and through veteran third-sector organizations between February and November 2021, and assessed for eligibility (male, owned a smartphone, served at least 2 years in the UKAF, left the UKAF within the last 2 years, not undertaking formal mental health treatment). Eligible participants were assigned, on a 1:1 ratio, to either the intervention group (full app) or a control group (noninteractive app with signposting information). Three key objectives were determined a priori to assess the practicality of running an RCT including an assessment of recruitment and retention, evaluation of the technical app delivery and measurement processes, and acceptability and usability of the intervention. Results: In total, 791 individuals completed the participant information sheet, of which 261 (33%) were ineligible, 377 (48%) declined or were unable to be contacted for consent, and 103 (13%) did not download the app or complete the baseline measures. Of this, 50 participants completed baseline measures and were randomly assigned to the intervention group (n=24) or the control group (n=26). The trial was effective at enabling both the technical delivery of the intervention and collection of outcome measures, with improvements in mental health demonstrated for the intervention group from baseline to the 3-month follow-up. Recruitment and retention challenges were highlighted with only 50 out of the 530 eligible participants enrolled in the trial. The acceptability and usability of the MeT4VeT app were generally supported, and it was reported to be a useful, accessible way for veterans to monitor and manage their mental health. Conclusions: The results highlighted that further work is needed to refine recruitment processes and maintain engagement with the app. Following this, an RCT can be considered to robustly assess the ability of the app to positively affect mental health outcomes indicated within this trial. Trial registration: ClinicalTrials.gov NCT05993676; https://clinicaltrials.gov/ct2/show/NCT05993676.
Language	English
Publishing date	2023-08-28
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2798262-2
ISSN	2368-7959
ISSN	2368-7959
DOI	10.2196/46508
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Article ; Online: A Service Evaluation of the Military HeadFIT Initiative: An Implementation Study.

McKenzie, Amber / Croak, Bethany / Rafferty, Laura / Greenberg, Neil / Stevelink, Sharon A M

International journal of environmental research and public health

2021 Volume 18, Issue 14

Abstract: 1) Background: UK Armed Forces personnel provide first response, support and protection during national and international disasters and conflicts. They thus have a psychologically challenging role which requires them to maintain a good state of mental ... ...

Abstract	(1) Background: UK Armed Forces personnel provide first response, support and protection during national and international disasters and conflicts. They thus have a psychologically challenging role which requires them to maintain a good state of mental health and wellbeing. HeadFIT is a preventative initiative developed to help foster mental fitness through various self-help tools and resources online including techniques to de-stress and increase drive. This paper reports on an independent service evaluation of HeadFIT to examine feasibility and acceptability among Ministry of Defence (MOD) personnel. (2) Methods: Qualitative interviews were held with the HeadFIT beneficiaries, including military personnel and civil servants. The beneficiaries provided feedback on HeadFIT through questionnaires and interviews, and website traffic data were also collected. Qualitative data were analysed using framework analysis. (3) Results: Beneficiaries generally reported positive views on the HeadFIT initiative, with most agreeing that the tools could support them to foster their mental fitness. However, concerns were raised around the uptake of HeadFIT and participants suggested methods to improve usability. (4) Conclusions: Several recommendations were made to improve the resources, usability, uptake, and implementation and communication of HeadFIT.
MeSH term(s)	Drive ; Humans ; Mental Health ; Mental Health Services ; Military Personnel ; Surveys and Questionnaires ; United Kingdom
Language	English
Publishing date	2021-07-09
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph18147375
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Capturing the experiences of UK healthcare workers during the COVID-19 pandemic: A structural topic modelling analysis of 7,412 free-text survey responses.

Lamb, Danielle / Wright, Liam / Scott, Hannah / Croak, Bethany / Gnanapragasam, Sam / Docherty, Mary / Greenberg, Neil / Hotopf, Matthew / Stevelink, Sharon A M / Raine, Rosalind / Wessely, Simon

PloS one

2022 Volume 17, Issue 10, Page(s) e0275720

Abstract: Background: Healthcare workers (HCWs) have provided vital services during the COVID-19 pandemic, but existing research consists of quantitative surveys (lacking in depth or context) or qualitative interviews (with limited generalisability). Structural ... ...

Abstract	Background: Healthcare workers (HCWs) have provided vital services during the COVID-19 pandemic, but existing research consists of quantitative surveys (lacking in depth or context) or qualitative interviews (with limited generalisability). Structural Topic Modelling (STM) of large-scale free-text survey data offers a way of capturing the perspectives of a wide range of HCWs in their own words about their experiences of the pandemic. Methods: In an online survey distributed to all staff at 18 geographically dispersed NHS Trusts, we asked respondents, "Is there anything else you think we should know about your experiences of the COVID-19 pandemic?". We used STM on 7,412 responses to identify topics, and thematic analysis on the resultant topics and text excerpts. Results: We identified 33 topics, grouped into two domains, each containing four themes. Our findings emphasise: the deleterious effect of increased workloads, lack of PPE, inconsistent advice/guidance, and lack of autonomy; differing experiences of home working as negative/positive; and the benefits of supportive leadership and peers in ameliorating challenges. Themes varied by demographics and time: discussion of home working decreasing over time, while discussion of workplace challenges increased. Discussion of mental health was lowest between September-November 2020, between the first and second waves of COVID-19 in the UK. Discussion: Our findings represent the most salient experiences of HCWs through the pandemic. STM enabled statistical examination of how the qualitative themes raised differed according to participant characteristics. This relatively underutilised methodology in healthcare research can provide more nuanced, yet generalisable, evidence than that available via surveys or small interview studies, and should be used in future research.
MeSH term(s)	COVID-19/epidemiology ; Health Personnel ; Humans ; Pandemics ; Surveys and Questionnaires ; United Kingdom/epidemiology
Language	English
Publishing date	2022-10-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0275720
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Capturing the experiences of UK healthcare workers during the COVID-19 pandemic: A structural topic modelling analysis of 7,412 free-text survey responses

Lamb, Danielle / Wright, Liam / Scott, Hannah / Croak, Bethany / Gnanapragasam, Sam / Docherty, Mary Jane / Greenberg, Neil / Hotopf, Matthew / Stevelink, Sharon / Raine, Rosalind / Wessely, Simon

medRxiv

Abstract: Background Healthcare workers (HCWs) have provided vital services during the COVID-19 pandemic, but existing research consists of quantitative surveys (lacking in depth or context) or qualitative interviews (with limited generalisability). Structural ... ...

Abstract	Background Healthcare workers (HCWs) have provided vital services during the COVID-19 pandemic, but existing research consists of quantitative surveys (lacking in depth or context) or qualitative interviews (with limited generalisability). Structural Topic Modelling (STM) of large-scale free-text survey data offers a way of capturing the perspectives of a wide range of HCWs in their own words about their experiences of the pandemic. Methods In an online survey distributed to all staff at 18 geographically dispersed NHS Trusts, we asked respondents, Is there anything else you think we should know about your experiences of the COVID-19 pandemic?. We used STM on 7,412 responses to identify topics, and thematic analysis on the resultant topics and text excerpts. Results We identified 33 topics, grouped into two domains, each containing four themes. Our findings emphasise: the deleterious effect of increased workloads, lack of PPE, inconsistent advice/guidance, and lack of autonomy; differing experiences of home working as negative/positive; and the benefits of supportive leadership and peers in ameliorating challenges. Themes varied by demographics and time: discussion of home working decreasing over time, while discussion of workplace challenges increased. Discussion of mental health was lowest between September-November 2020, between the first and second waves of COVID-19 in the UK. Discussion Our findings represent the most salient experiences of HCWs through the pandemic. STM enabled statistical examination of how the qualitative themes raised differed according to participant characteristics. This relatively underutilised methodology in healthcare research can provide more nuanced, yet generalisable, evidence than that available via surveys or small interview studies, and should be used in future research.
Keywords	covid19
Language	English
Publishing date	2022-06-16
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2022.06.16.22276487
Database	COVID19

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