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Article ; Online: Evaluation of anti-stigma social marketing campaigns in Ghana and Kenya: Time to Change Global.

Potts, Laura C / Henderson, Claire

BMC public health

2021 Volume 21, Issue 1, Page(s) 886

Abstract: Background: Launched in 2018, Time to Change Global is a new anti-stigma programme to tackle stigma and discrimination towards people with mental health problems in low- and middle-income countries. Our aim was to evaluate pre-post changes in stigma ... ...

Abstract	Background: Launched in 2018, Time to Change Global is a new anti-stigma programme to tackle stigma and discrimination towards people with mental health problems in low- and middle-income countries. Our aim was to evaluate pre-post changes in stigma within the target populations for the social marketing campaigns ran in Ghana and Kenya carried out as components of the wider Time to Change Global programme. Methods: Using data collected before and after each campaign in Accra and Nairobi, we investigated pre-post differences in stigma-related outcome measures: mental health-related knowledge (MAKS), mental health-related attitudes (CAMI), and desire for social distance (RIBS), with regression analyses. Other covariates were included in the models to control for differences in participant demographics. Results: A significant positive change in a stigma related outcome was found at each site. Reported in standard deviation units, desire for social distance from people with mental health problems in Accra was lower after the launch of the campaign, measured as an increase in intended contact (β = 0.29, 95% CI = 0.14 to 0.43, p < 0.001). In Nairobi, the stigma related knowledge score was higher in the post campaign sample (β = 0.21, 95% CI = 0.07 to 0.34, p = 0.003). Conclusion: The increase in intended contact in the absence of other changes seen in Ghana, is consistent with the early results for Time to Change England. The estimate for the magnitude of this change is the same as Time to Change England for the general population between 2009 and 19, a very promising result for a short term public mental health campaign. The different results observed between sites may be due to campaign as well as population differences.
MeSH term(s)	England ; Ghana ; Health Knowledge, Attitudes, Practice ; Humans ; Kenya ; Mental Disorders ; Social Marketing ; Social Stigma
Language	English
Publishing date	2021-05-08
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1471-2458
ISSN (online)	1471-2458
DOI	10.1186/s12889-021-10966-8
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Article: Moderation by socioeconomic status of the relationship between familiarity with mental illness and stigma outcomes.

Potts, Laura C / Henderson, Claire

SSM - population health

2020 Volume 11, Page(s) 100611

Abstract: Purpose: Multiple studies suggest response to mental health treatment is worse for people of lower socioeconomic status, a group who also express more mental illness stigma. Worse response to treatment may lead to greater therapeutic pessimism, an ... ...

Abstract	Purpose: Multiple studies suggest response to mental health treatment is worse for people of lower socioeconomic status, a group who also express more mental illness stigma. Worse response to treatment may lead to greater therapeutic pessimism, an important component of stigma. However, familiarity with mental illness is associated with lower levels of stigma. This study therefore examines whether, among the general public, socioeconomic status moderates the relationships between familiarity and stigma related outcomes: knowledge; attitudes; and desire for social distance. Methods: We carried out secondary analysis of data from the Attitudes to Mental Illness survey, collected annually from different general population samples from 2009-17, and every two years from 2017-19. Three separate multiple linear regression models examined factors associated with each outcome, with interaction tests between socioeconomic status and familiarity. Stigma related knowledge was measured using the Mental Health Knowledge Schedule (MAKS), which includes items on treatment effectiveness and recovery, thus addressing aspects of therapeutic pessimism. Attitudes were measured using the Community Attitudes towards the Mentally Ill Scale; and desire for social distance using the Reported and Intended Behaviour scale. Results: In lower socioeconomic groups, personal experience was more frequent, while familiarity with someone else was less frequent. Interaction tests were significant for stigma related knowledge (p<0.0001) and desire for social distance (p=0.0118), but not for attitudes (p=0.057). The direction of the interaction differed between knowledge and the other outcomes. In lower socioeconomic groups the positive effect of familiarity on knowledge was weaker, as hypothesised, but for attitudes and desire for social distance, its effect was stronger. Conclusions: Our results support the promotion of familiarity through encouraging discussion of mental health problems within social networks. However, lower stigma related knowledge among people with personal experience in lower socioeconomic groups suggests different responses to mental illness among these groups are needed.
Language	English
Publishing date	2020-06-12
Publishing country	England
Document type	Journal Article
ISSN	2352-8273
ISSN	2352-8273
DOI	10.1016/j.ssmph.2020.100611
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Article ; Online: Mental illness stigma after a decade of Time to Change England: inequalities as targets for further improvement.

Henderson, Claire / Potts, Laura / Robinson, Emily J

European journal of public health

2020 Volume 30, Issue 3, Page(s) 526–532

Abstract: Background: England's Time to Change programme to reduce mental health-related stigma and discrimination included a social marketing campaign using traditional and social media, and targeted middle-income groups aged 25-45 between 2009 and 2016. From ... ...

Abstract	Background: England's Time to Change programme to reduce mental health-related stigma and discrimination included a social marketing campaign using traditional and social media, and targeted middle-income groups aged 25-45 between 2009 and 2016. From 2017, the same age group on low to middle incomes were targeted, and the content focused on men's mental health, by changing the advertising and adapting the 'key messages'. This study investigates changes in stigma-related public knowledge, attitudes and desire for social distance in England since Time to Change began in 2008-19 and for 2017-19. Methods: Using data from a face-to-face survey of a nationally representative quota sample of adults for England, we evaluated longitudinal trends in outcomes with regression analyses and made assumptions based on a simple random sample. The pre-existing survey used a measure of attitudes; measures of knowledge and desire for social distance were added in 2009. Results: Reported in standard deviation units (95% CI), the improvement for knowledge for 2009-19 was 0.25 (0.19, 0.32); for attitudes, 2008-19, 0.32 (0.26, 0.39) and for desire for social distance, 2009-19 0.29 (0.23, 0.36). Significant interactions between year and both region and age suggest greater improvements in London, where stigma is higher, and narrowing of age differences. There were significant improvements between 2017 and 2019 in knowledge [0.09 (0.02, 0.16)] and attitudes [0.08 (0.02, 0.14)] but not social distance. Conclusion: The positive changes support the effectiveness of Time to Change but cannot be definitively attributed to it. Inequalities in stigma by demographic characteristics present targets for research and intervention.
MeSH term(s)	Adult ; England ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Mental Disorders/epidemiology ; Social Marketing ; Social Stigma
Language	English
Publishing date	2020-06-09
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1129243-x
ISSN	1464-360X ; 1101-1262
ISSN (online)	1464-360X
ISSN	1101-1262
DOI	10.1093/eurpub/ckaa013
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Article ; Online: Factors associated with re-admission in the year after acute postpartum psychiatric treatment.

Taylor, Billie Lever / Sweeney, Angela / Potts, Laura C / Trevillion, Kylee / Howard, Louise M

Archives of women's mental health

2022 Volume 25, Issue 5, Page(s) 975–983

Abstract: Purpose: To examine factors associated with being re-admitted in the year after discharge from acute postpartum psychiatric treatment.: Methods: Secondary data analysis of information collected from mothers who were admitted to acute psychiatric ... ...

Abstract	Purpose: To examine factors associated with being re-admitted in the year after discharge from acute postpartum psychiatric treatment. Methods: Secondary data analysis of information collected from mothers who were admitted to acute psychiatric services in the year after childbirth between 2013 and 2017. We carried out univariable analyses and multivariable hierarchical logistic regression to examine risk factors for women's re-admission to acute psychiatric care (inpatient or community crisis care) in the year following discharge. Results: Sixty-seven (24.1%) of 278 women were re-admitted in the year after discharge from acute care; the median number of days to re-admission was 86 (IQR 35-214), and women who were re-admitted accessed a median of two further acute services (IQR 1-3). In adjusted analyses, reporting a history of childhood trauma (aOR 1.02; 95% CI 1.00- 1.03, p = 0.036), a higher level of difficulties in the mother-infant bond (aOR 1.03; 95% CI 1.01-1.06, p = 0.009) and younger age (aOR 0.95; 95% CI 0.90-1.00, p = 0.066) were associated with re-admission. Conclusion: This study confirms that the role of childhood adverse experiences on mental health is relevant for outcomes in women experiencing acute postpartum psychiatric episodes. Ongoing parent-infant bonding difficulties are also independently associated with re-admission. Perinatal mental health services therefore need to offer evidence-based interventions to address histories of trauma and to support parent-infant bonding to optimise mental health in women following discharge from acute psychiatric services. However, further research is needed to explore what other factors, not measured in our study, are also influential to re-admission.
MeSH term(s)	Female ; Hospitalization ; Humans ; Infant ; Mental Health ; Mental Health Services ; Mothers/psychology ; Postpartum Period/psychology ; Pregnancy
Language	English
Publishing date	2022-08-25
Publishing country	Austria
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1463529-X
ISSN	1435-1102 ; 1434-1816
ISSN (online)	1435-1102
ISSN	1434-1816
DOI	10.1007/s00737-022-01255-3
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Article ; Online: Caregiving and mental health needs in the significant others of women receiving inpatient and home treatment for acute severe postpartum mental illness.

Atmore, Katie H / Taylor, Billie Lever / Potts, Laura C / Trevillion, Kylee / Howard, Louise M

Archives of women's mental health

2022 Volume 26, Issue 1, Page(s) 49–56

Abstract: To examine the mental health and caregiving needs of significant others (including partners, parents, friends) to women who received acute psychiatric care either as inpatients or at home during the perinatal period. Cross-sectional survey of 98 ... ...

Abstract	To examine the mental health and caregiving needs of significant others (including partners, parents, friends) to women who received acute psychiatric care either as inpatients or at home during the perinatal period. Cross-sectional survey of 98 significant others of 279 women who participated in a quasi-experimental cohort study of services for mothers with acute severe postpartum mental health diagnoses. Significant others completed an adapted General Health Questionnaire-12 (GHQ) and Involvement Evaluation Questionnaire (IEQ) to indicate their mental health needs and service use as well as caregiving activities. The mean age of significant others was 38.9 years (range 24-69). 81.6% were male and 81.6% were intimate partners to the women. High levels of unmet mental health needs were detected in significant others, with a majority (51.0%) having a score > 2 on the GHQ-12 indicating caseness for a psychiatric disorder. In those with GHQ-12 caseness indicated, few were receiving help for their difficulties: 22.5% received support from their general practitioner, and 14.3% received help from a social worker, psychologist, psychiatrist or outpatient department. 18.4% received medication for GHQ-12 symptoms. The median sumscore of IEQ surveying caregiving activities in significant others was 18/108. We did not find evidence of differences in GHQ-12 or IEQ scores for significant others to women who received inpatient care versus care at home. Significant others to women with acute severe postpartum psychiatric illness have high levels of unmet mental health needs during the weeks after women are discharged from acute care. Services need to address these needs to optimise outcomes for the whole family.
MeSH term(s)	Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Pregnancy ; Young Adult ; Cohort Studies ; Cross-Sectional Studies ; Inpatients ; Mental Disorders/psychology ; Mental Health ; Postpartum Period ; Sexual Partners ; Spouses ; Depression, Postpartum
Language	English
Publishing date	2022-12-24
Publishing country	Austria
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1463529-X
ISSN	1435-1102 ; 1434-1816
ISSN (online)	1435-1102
ISSN	1434-1816
DOI	10.1007/s00737-022-01286-w
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Article: Patient and therapist experiences of exposure therapy for anxiety-related disorders in pregnancy: qualitative analysis of a feasibility trial of intensive versus weekly CBT.

Challacombe, Fiona L / Sabin, Katherine / Jacobson, Samantha / Tinch-Taylor, Rose / Potts, Laura / Carter, Ben / Lawrence, Vanessa

BJPsych open

2023 Volume 9, Issue 6, Page(s) e189

Abstract: Background: Approximately 15% of pregnant women experience anxiety disorders. Effective treatments exist but their acceptability during pregnancy, particularly exposure therapy, is not known.: Aims: To understand patient and therapist experiences of ... ...

Abstract	Background: Approximately 15% of pregnant women experience anxiety disorders. Effective treatments exist but their acceptability during pregnancy, particularly exposure therapy, is not known. Aims: To understand patient and therapist experiences of time-intensive and weekly exposure-based therapy for anxiety disorders delivered during pregnancy. Trial registration: ISRCTN81203286. Method: In-depth interviews were conducted with patients and therapists who had taken part in a feasibility trial of predominantly online time-intensive versus weekly cognitive-behavioural therapy in pregnancy in a primary care setting in the UK. Data were analysed using reflexive thematic analysis. Results: In total, 45 women participating in the trial and 6 therapists who had delivered the treatments were interviewed. Five themes were developed from the data that showed convergence from therapist and patient perspectives: 'Acquiring tools to navigate the perinatal period'; 'Motivated yet constrained by pregnancy'; 'Having the confidence to face fears and tolerate uncertainty'; 'Momentum with the need for flexibility'; 'Being removed from the face-to-face world'. Conclusions: Exposure therapy is acceptable and helpful in pregnancy and can lead to lasting gains. Exposure is a key element of treatment and needs to be confidently conducted by therapists with perinatal knowledge and expertise. Treatments need to consider the unfolding context of pregnancy. The momentum of intensive therapy can lead to rapid improvements, but is demanding for both patients and therapists, especially fitting round other commitments. Online treatments can work well and are a good fit for perinatal women, but this needs to be balanced with the need for social connection, suggesting a hybrid model is the ideal.
Language	English
Publishing date	2023-10-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2829557-2
ISSN	2056-4724
ISSN	2056-4724
DOI	10.1192/bjo.2023.585
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Article ; Online: Experience and perpetration of intimate partner violence and abuse by gender of respondent and their current partner before and during COVID-19 restrictions in 2020: a cross-sectional study in 13 countries.

Gilchrist, Gail / Potts, Laura C / Connolly, Dean J / Winstock, Adam / Barratt, Monica J / Ferris, Jason / Gilchrist, Elizabeth / Davies, Emma

BMC public health

2023 Volume 23, Issue 1, Page(s) 316

Abstract: Background: Intimate partner violence and abuse (IPVA) includes controlling behaviours, psychological, physical, sexual and financial abuse. Globally, surveys and emergency services have recorded an increase in IPVA since restrictions were imposed to ... ...

Abstract	Background: Intimate partner violence and abuse (IPVA) includes controlling behaviours, psychological, physical, sexual and financial abuse. Globally, surveys and emergency services have recorded an increase in IPVA since restrictions were imposed to limit COVID-19 transmission. Most studies have only included heterosexual women. Methods: Data from the Global Drug Survey (an annual, anonymous, online survey collecting data on drug use) Special Edition were analysed to explore the impact of COVID-19 on people's lives, including their intimate relationships. Five relationship groupings were created using respondents' lived gender identity: women partnered with men (46.9%), women partnered with women (2.1%), men partnered with men (2.9%), men partnered with women (47.2%), and partnerships where one or both partners were non-binary (1%). Self-reported experience and perpetration of IPVA in the past 30 days before (February) and during COVID-19 restrictions (May or June) in 2020 (N = 35,854) was described and compared for different relationship groupings using Fishers Exact Tests. Changes in IPVA during restrictions were assessed using multivariable logistic regression. Results: During restrictions, 17.8 and 16.6% of respondents had experienced or perpetrated IPVA respectively; 38.2% of survivors and 37.6% of perpetrators reported this had increased during restrictions. Greater proportions of non-binary respondents or respondents with a non-binary partner reported experiencing or perpetrating IPVA (p < .001) than other relationship groupings. 22.0% of respondents who were non-binary or had a non-binary partner, 19.5% of men partnered with men, 18.9% of men partnered with women, 17.1% of women partnered with women and 16.6% of women partnered with men reported experiencing IPVA. Respondents with higher psychological distress, poor coping with pandemic-related changes, relationship tension and changes (increases or increases and decreases) in alcohol consumption reported increased experience of IPVA during restrictions. Conclusions: This study confirmed that IPVA can occur in all intimate relationships, regardless of gender of the perpetrator or survivor. Non-binary respondents or respondents with non-binary partners reported the highest use and experience of IPVA. Most IPVA victim support services have been designed for heterosexual, cisgender women. IPVA support services and perpetrator programmes must be tailored to support all perpetrators and survivors during the pandemic and beyond, regardless of their sexual or gender identity.
MeSH term(s)	Humans ; Male ; Female ; Cross-Sectional Studies ; Gender Identity ; COVID-19/epidemiology ; Intimate Partner Violence ; Sexual Partners/psychology ; Surveys and Questionnaires ; Risk Factors
Language	English
Publishing date	2023-02-13
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-022-14635-2
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Article ; Online: Exposure-based cognitive-behaviour therapy for anxiety-related disorders in pregnancy (ADEPT): Results of a feasibility randomised controlled trial of time-intensive versus weekly CBT.

Challacombe, Fiona L / Tinch-Taylor, Rose / Sabin, Katherine / Potts, Laura / Lawrence, Vanessa / Howard, Louise / Carter, Ben

Journal of affective disorders

2023 Volume 344, Page(s) 414–422

Abstract: Background: Exposure-based cognitive-behaviour therapies (CBT) are effective but their acceptability in pregnancy is untested. Time-intensive delivery of CBT (INT-CBT) may accelerate treatment response. This feasibility trial aimed to explore this.: ... ...

Abstract	Background: Exposure-based cognitive-behaviour therapies (CBT) are effective but their acceptability in pregnancy is untested. Time-intensive delivery of CBT (INT-CBT) may accelerate treatment response. This feasibility trial aimed to explore this. Methods: This multi-centre parallel-group trial recruited pregnant women with anxiety-related disorders via maternity and mental health settings and randomised (1:1) to INT-CBT (8-10 treatment hours over two weeks) or standard weekly one-hour CBT sessions (WCBT). Both groups also received late pregnancy and postpartum follow-ups. Participants received 10-12 total hours of individual therapy using remote delivery (95 %). Outcomes were assessed: at baseline; after two weeks of treatment, late pregnancy, at 1 and 3 months postpartum (by blinded assessors), alongside a qualitative interview. Pre-specified primary feasibility outcomes regarding acceptability, recruitment and retention were evaluated. The secondary outcome of adjusted mean difference was estimated for the proposed primary outcome. Results: All feasibility outcomes were met. Of 135 screened, 59 women were randomised into the trial (29 INT-CBT:30 WCBT). 93 % completed treatment and 81 % provided data at 3 m postpartum. No adverse effects were attributable to treatment. Women receiving INT-CBT showed a reduction in anxiety (GAD-7) after two weeks of treatment compared to WCBT (aMD = -4.17, 95%CI -6.03 to -2.31) with narrower difference at 3-month postpartum aMD = -0.11 (95%CI -3.23, 3.00). Women described the momentum of INT-CBT as helpful to drive change. Conclusions: Exposure-based therapies are acceptable to pregnant women. INT-CBT may reduce anxiety quickly and should be tested in a confirmatory trial examining longer term outcomes. There may be limitations to generalisability from sampling and COVID. Trial registration: doi:https://doi.org/10.1186/ISRCTN81203286 prospectively registered 27/6/2019.
MeSH term(s)	Humans ; Female ; Pregnancy ; Feasibility Studies ; Cognitive Behavioral Therapy/methods ; Psychotherapy ; Anxiety/therapy ; Cognition ; Treatment Outcome
Language	English
Publishing date	2023-10-15
Publishing country	Netherlands
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2023.10.070
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Article: Optimising psychological treatment for Anxiety DisordErs in Pregnancy (ADEPT): study protocol for a feasibility trial of time-intensive CBT versus weekly CBT.

Challacombe, Fiona L / Potts, Laura / Carter, Ben / Lawrence, Vanessa / Husbands, Alaina / Howard, Louise M

Pilot and feasibility studies

2021 Volume 7, Issue 1, Page(s) 101

Abstract: Background: Moderate to severe anxiety disorders such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social phobia and panic disorder are common, and affect approximately 11-16% of women in pregnancy. Psychological ... ...

Abstract	Background: Moderate to severe anxiety disorders such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social phobia and panic disorder are common, and affect approximately 11-16% of women in pregnancy. Psychological treatments for anxiety disorders, primarily cognitive behaviour therapy (CBT), have a substantial evidence base and recently time-intensive versions have been found as effective as weekly treatments. However, this has not been trialled in women who are pregnant, where a shorter intervention may be desirable. Methods: The ADEPT study is a feasibility randomised controlled trial with two parallel intervention groups. Time-intensive one-to-one CBT and standard weekly one-to-one CBT delivered during pregnancy will be compared. Feasibility outcomes including participation and follow-up rates will be assessed, alongside the acceptability of the interventions using qualitative methods. Discussion: The study will provide preliminary data to inform the design of a full-scale randomised controlled trial of a time-intensive intervention for anxiety during pregnancy. This will include information on the acceptability of time-intensive interventions for pregnant women with anxiety disorders. Trial registration: https://doi.org/10.1186/ISRCTN81203286 prospectively registered 27/6/2019.
Language	English
Publishing date	2021-04-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2809935-7
ISSN	2055-5784
ISSN	2055-5784
DOI	10.1186/s40814-021-00838-8
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Article ; Online: Factors Affecting Infant Feeding Practices Among Women With Severe Mental Illness.

Baker, Natasha / Potts, Laura / Jennings, Stacey / Trevillion, Kylee / Howard, Louise M

Frontiers in global women's health

2021 Volume 2, Page(s) 624485

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2021-04-09
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-5059
ISSN (online)	2673-5059
DOI	10.3389/fgwh.2021.624485
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