research on mental health

August 20, 2024

Climate & mental health: A roadmap to global heat resilience

The Wellcome Trust and The Physiological Society share their plans to help tackle mental health effects of climate change

Image credit: Environmental, by Pete Linforth from Pixabay

Very early onset dementias: Importance of differentiating from schizophrenia spectrum disorders

In our first Essay, McCormick and colleagues explain the importance of accurately differentiating between very early onset dementia and psychosis 

Image credit: Medical, by Darko Stojanovic from Pixabay

Bridging the gap between tradition and innovation in psychotherapy: The promise of awareness integration theory

Psychotherapist Foojan Zeine outlines a new, holistic psychotherapy framework - AIT

Image credit: Stones, by Alexa from Pixabay

Is it time to change mental health crisis responses?

Psychiatrist Rupinder Legha advocates for change to mental health crisis management

Image credit: Police, Max from Pixabay

Equipping the next generation of clinicians for addressing conflict mental health: A role for Geopsychiatry

Section Editor Joseph El-Khoury and colleagues share recommendations for training mental health professionals in conflict medicine

Image credit: War, by Alexa from Pixabay

public mental health & policy

Psychological support for older crime victims - understanding barriers using Metropolitan Police data

Researchers at UCL collaborate with the Metropolitan police to understand help-seeking behavior in older victims of crime

Image credit: Hands, by Sabine van Erp, Pixabay

socio-economics & political approaches

The role of social determinants of health in mental health: An examination of the moderating effects of race, ethnicity, and gender on depression through the all of us research program dataset

Researchers from University of Austin, including Section Editor Craig Watkins, demonstrate the need for deliberate sampling plans to examine the needs of marginalized communities

Image credit: Line, by Peggy from Pixabay

Supporting our community

Introducing ' PLOS Mental Health : The Bigger Picture'

A new quarterly seminar series led by our Senior Editorial Board and Executive Editor, which highlights work in our journal authored by early career researchers and those from underrepresented regions

Image credit: Eye, by Gerd Altmann from Pixabay

community mental health

The mental health of parent versus non-parent post-secondary students

Image credit: Notebook, by Pexels from Pixabay

public mental health and policy

Psychosocial interventions for persons affected by Leprosy: A systematic review

Image credit: Holding hands, by Aldren Gamalo from Pixabay

neurodiversity and mental health

“Actually, even me I wouldn’t think that it is there” exploring the knowledge and attitudes of health professionals towards autism spectrum disorders in Uganda

Image credit: Children, by Vicki Hamilton from Pixabay

Mental health psychology

Psychopathy, psychological distress, and treatment history among perpetrators of intimate partner femicide, homicide, and other violent crimes in Buenos Aires, Argentina

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Community Case Studies - NTDs

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Why the reliance on data? Findings and statistics from research studies can impact us emotionally, add credibility to an article, and ground us in the real world. However, the importance of research findings reaches far beyond providing knowledge to the general population. Research and evaluation studies — those studies that assess a program’s impact — are integral to promoting mental health and reducing the burden of mental illness in different populations.

Mental health research identifies biopsychosocial factors — how biological, psychological and social functioning are interacting — detecting trends and social determinants in population health. That data greatly informs the current state of mental health in the U.S. and around the world. Findings from such studies also influence fields such as public health, health care and education. For example, mental health research and evaluation can impact public health policies by assisting public health professionals in strategizing policies to improve population mental health.

Research helps us understand how to best promote mental health in different populations. From its definition to how it discussed, mental health is seen differently in every community. Thus, mental health research and evaluation not only reveals mental health trends but also informs us about how to best promote mental health in different racial and ethnic populations. What does mental health look like in this community? Is there stigma associated with mental health challenges? How do individuals in the community view those with mental illness? These are the types of questions mental health research can answer.

Data aids us in understanding whether the mental health services and resources that are available meet mental health needs. Many times the communities where needs are the greatest are the ones where there are limited services and resources available. Mental health research and evaluation informs public health professionals and other relevant stakeholders of the gaps that currently exist so they can prioritize policies and strategies for communities where gaps are the greatest.

Research establishes evidence for the effectiveness of public health policies and programs. Mental health research and evaluation help develop evidence for the effectiveness of healthcare policies and strategies as well as mental health promotion programs. This evidence is crucial for showcasing the value and return on investment for programs and policies, which can justify local, state and federal expenditures. For example, mental health research studies evaluating the impact of Mental Health First Aid (MHFA) have revealed that individuals taking the course show increases in knowledge about mental health, greater confidence to assist others in distress, and improvements in their own mental wellbeing. They have been fundamental in assisting organizations and instructors in securing grant funding to bring MHFA to their communities.

The findings from mental health research and evaluation studies provide crucial information about the specific needs within communities and the impacts of public education programs like MHFA. These studies provide guidance on how best to improve mental health in different contexts and ensure financial investments go towards programs proven to improve population mental health and reduce the burden of mental illness in the U.S.

In 2021, in a reaffirmation of its dedication and commitment to mental health and substance use research and community impact, Mental Health First Aid USA introduced MHFA Research Advisors. The group advises and assists Mental Health First Aid USA on ongoing research and future opportunities related to individual MHFA programs, including Youth MHFA, teen MHFA and MHFA at Work.

Through this advisory group and evaluation efforts at large, Mental Health First Aid USA will #BeTheDifference for mental health research and evaluation across communities in the US.

Learn more about MHFA Research Advisors and how you can share your research with us.

Get the latest MHFA blogs, news and updates delivered directly to your inbox so you never miss a post.

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Mental health

• Affordable, effective and feasible strategies exist to promote, protect and restore mental health.
• The need for action on mental health is indisputable and urgent.
• Mental health has intrinsic and instrumental value and is integral to our well-being.
• Mental health is determined by a complex interplay of individual, social and structural stresses and vulnerabilities.

Concepts in mental health

Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community. It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in. Mental health is a basic human right. And it is crucial to personal, community and socio-economic development.

Mental health is more than the absence of mental disorders. It exists on a complex continuum, which is experienced differently from one person to the next, with varying degrees of difficulty and distress and potentially very different social and clinical outcomes.

Mental health conditions include mental disorders and psychosocial disabilities as well as other mental states associated with significant distress, impairment in functioning, or risk of self-harm. People with mental health conditions are more likely to experience lower levels of mental well-being, but this is not always or necessarily the case.

Determinants of mental health

Throughout our lives, multiple individual, social and structural determinants may combine to protect or undermine our mental health and shift our position on the mental health continuum.

Individual psychological and biological factors such as emotional skills, substance use and genetics can make people more vulnerable to mental health problems.

Exposure to unfavourable social, economic, geopolitical and environmental circumstances – including poverty, violence, inequality and environmental deprivation – also increases people’s risk of experiencing mental health conditions.

Risks can manifest themselves at all stages of life, but those that occur during developmentally sensitive periods, especially early childhood, are particularly detrimental. For example, harsh parenting and physical punishment is known to undermine child health and bullying is a leading risk factor for mental health conditions.

Protective factors similarly occur throughout our lives and serve to strengthen resilience. They include our individual social and emotional skills and attributes as well as positive social interactions, quality education, decent work, safe neighbourhoods and community cohesion, among others.

Mental health risks and protective factors can be found in society at different scales. Local threats heighten risk for individuals, families and communities. Global threats heighten risk for whole populations and include economic downturns, disease outbreaks, humanitarian emergencies and forced displacement and the growing climate crisis.

Each single risk and protective factor has only limited predictive strength. Most people do not develop a mental health condition despite exposure to a risk factor and many people with no known risk factor still develop a mental health condition. Nonetheless, the interacting determinants of mental health serve to enhance or undermine mental health.

Mental health promotion and prevention

Promotion and prevention interventions work by identifying the individual, social and structural determinants of mental health, and then intervening to reduce risks, build resilience and establish supportive environments for mental health. Interventions can be designed for individuals, specific groups or whole populations.

Reshaping the determinants of mental health often requires action beyond the health sector and so promotion and prevention programmes should involve the education, labour, justice, transport, environment, housing, and welfare sectors. The health sector can contribute significantly by embedding promotion and prevention efforts within health services; and by advocating, initiating and, where appropriate, facilitating multisectoral collaboration and coordination.

Suicide prevention is a global priority and included in the Sustainable Development Goals. Much progress can be achieved by limiting access to means, responsible media reporting, social and emotional learning for adolescents and early intervention. Banning highly hazardous pesticides is a particularly inexpensive and cost–effective intervention for reducing suicide rates.

Promoting child and adolescent mental health is another priority and can be achieved by policies and laws that promote and protect mental health, supporting caregivers to provide nurturing care, implementing school-based programmes and improving the quality of community and online environments. School-based social and emotional learning programmes are among the most effective promotion strategies for countries at all income levels.

Promoting and protecting mental health at work is a growing area of interest and can be supported through legislation and regulation, organizational strategies, manager training and interventions for workers.

Mental health care and treatment

In the context of national efforts to strengthen mental health, it is vital to not only protect and promote the mental well-being of all, but also to address the needs of people with mental health conditions.

This should be done through community-based mental health care, which is more accessible and acceptable than institutional care, helps prevent human rights violations and delivers better recovery outcomes for people with mental health conditions. Community-based mental health care should be provided through a network of interrelated services that comprise:

• mental health services that are integrated in general health care, typically in general hospitals and through task-sharing with non-specialist care providers in primary health care;
• community mental health services that may involve community mental health centers and teams, psychosocial rehabilitation, peer support services and supported living services; and
• services that deliver mental health care in social services and non-health settings, such as child protection, school health services, and prisons.

The vast care gap for common mental health conditions such as depression and anxiety means countries must also find innovative ways to diversify and scale up care for these conditions, for example through non-specialist psychological counselling or digital self-help.

WHO response

All WHO Member States are committed to implementing the “Comprehensive mental health action plan 2013–2030" , which aims to improve mental health by strengthening effective leadership and governance, providing comprehensive, integrated and responsive community-based care, implementing promotion and prevention strategies, and strengthening information systems, evidence and research. In 2020, WHO’s “Mental health atlas 2020” analysis of country performance against the action plan showed insufficient advances against the targets of the agreed action plan.

WHO’s “World mental health report: transforming mental health for all” calls on all countries to accelerate implementation of the action plan. It argues that all countries can achieve meaningful progress towards better mental health for their populations by focusing on three “paths to transformation”:

• deepen the value given to mental health by individuals, communities and governments; and matching that value with commitment, engagement and investment by all stakeholders, across all sectors;
• reshape the physical, social and economic characteristics of environments – in homes, schools, workplaces and the wider community – to better protect mental health and prevent mental health conditions; and
• strengthen mental health care so that the full spectrum of mental health needs is met through a community-based network of accessible, affordable and quality services and supports.

WHO gives particular emphasis to protecting and promoting human rights, empowering people with lived experience and ensuring a multisectoral and multistakeholder approach.

WHO continues to work nationally and internationally – including in humanitarian settings – to provide governments and partners with the strategic leadership, evidence, tools and technical support to strengthen a collective response to mental health and enable a transformation towards better mental health for all. 

• World mental health report: transforming mental health for all
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• Mental health atlas 2020

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Mental health and the pandemic: What U.S. surveys have found

The coronavirus pandemic has been associated with worsening mental health among people in the United States and around the world . In the U.S, the COVID-19 outbreak in early 2020 caused widespread lockdowns and disruptions in daily life while triggering a short but severe economic recession that resulted in widespread unemployment. Three years later, Americans have largely returned to normal activities, but challenges with mental health remain.

Here’s a look at what surveys by Pew Research Center and other organizations have found about Americans’ mental health during the pandemic. These findings reflect a snapshot in time, and it’s possible that attitudes and experiences may have changed since these surveys were fielded. It’s also important to note that concerns about mental health were common in the U.S. long before the arrival of COVID-19 .

Three years into the COVID-19 outbreak in the United States , Pew Research Center published this collection of survey findings about Americans’ challenges with mental health during the pandemic. All findings are previously published. Methodological information about each survey cited here, including the sample sizes and field dates, can be found by following the links in the text.

The research behind the first item in this analysis, examining Americans’ experiences with psychological distress, benefited from the advice and counsel of the COVID-19 and mental health measurement group at Johns Hopkins Bloomberg School of Public Health.

At least four-in-ten U.S. adults (41%) have experienced high levels of psychological distress at some point during the pandemic, according to four Pew Research Center surveys conducted between March 2020 and September 2022.

Young adults are especially likely to have faced high levels of psychological distress since the COVID-19 outbreak began: 58% of Americans ages 18 to 29 fall into this category, based on their answers in at least one of these four surveys.

Women are much more likely than men to have experienced high psychological distress (48% vs. 32%), as are people in lower-income households (53%) when compared with those in middle-income (38%) or upper-income (30%) households.

In addition, roughly two-thirds (66%) of adults who have a disability or health condition that prevents them from participating fully in work, school, housework or other activities have experienced a high level of distress during the pandemic.

The Center measured Americans’ psychological distress by asking them a series of five questions on subjects including loneliness, anxiety and trouble sleeping in the past week. The questions are not a clinical measure, nor a diagnostic tool. Instead, they describe people’s emotional experiences during the week before being surveyed.

While these questions did not ask specifically about the pandemic, a sixth question did, inquiring whether respondents had “had physical reactions, such as sweating, trouble breathing, nausea, or a pounding heart” when thinking about their experience with the coronavirus outbreak. In September 2022, the most recent time this question was asked, 14% of Americans said they’d experienced this at least some or a little of the time in the past seven days.

More than a third of high school students have reported mental health challenges during the pandemic. In a survey conducted by the Centers for Disease Control and Prevention from January to June 2021, 37% of students at public and private high schools said their mental health was not good most or all of the time during the pandemic. That included roughly half of girls (49%) and about a quarter of boys (24%).

In the same survey, an even larger share of high school students (44%) said that at some point during the previous 12 months, they had felt sad or hopeless almost every day for two or more weeks in a row – to the point where they had stopped doing some usual activities. Roughly six-in-ten high school girls (57%) said this, as did 31% of boys.

On both questions, high school students who identify as lesbian, gay, bisexual, other or questioning were far more likely than heterosexual students to report negative experiences related to their mental health.

Mental health tops the list of worries that U.S. parents express about their kids’ well-being, according to a fall 2022 Pew Research Center survey of parents with children younger than 18. In that survey, four-in-ten U.S. parents said they’re extremely or very worried about their children struggling with anxiety or depression. That was greater than the share of parents who expressed high levels of concern over seven other dangers asked about.

While the fall 2022 survey was fielded amid the coronavirus outbreak, it did not ask about parental worries in the specific context of the pandemic. It’s also important to note that parental concerns about their kids struggling with anxiety and depression were common long before the pandemic, too . (Due to changes in question wording, the results from the fall 2022 survey of parents are not directly comparable with those from an earlier Center survey of parents, conducted in 2015.)

Among parents of teenagers, roughly three-in-ten (28%) are extremely or very worried that their teen’s use of social media could lead to problems with anxiety or depression, according to a spring 2022 survey of parents with children ages 13 to 17 . Parents of teen girls were more likely than parents of teen boys to be extremely or very worried on this front (32% vs. 24%). And Hispanic parents (37%) were more likely than those who are Black or White (26% each) to express a great deal of concern about this. (There were not enough Asian American parents in the sample to analyze separately. This survey also did not ask about parental concerns specifically in the context of the pandemic.)

Looking back, many K-12 parents say the first year of the coronavirus pandemic had a negative effect on their children’s emotional health. In a fall 2022 survey of parents with K-12 children , 48% said the first year of the pandemic had a very or somewhat negative impact on their children’s emotional well-being, while 39% said it had neither a positive nor negative effect. A small share of parents (7%) said the first year of the pandemic had a very or somewhat positive effect in this regard.

White parents and those from upper-income households were especially likely to say the first year of the pandemic had a negative emotional impact on their K-12 children.

While around half of K-12 parents said the first year of the pandemic had a negative emotional impact on their kids, a larger share (61%) said it had a negative effect on their children’s education.

• Coronavirus (COVID-19)
• Happiness & Life Satisfaction
• Medicine & Health
• Teens & Youth

John Gramlich is an associate director at Pew Research Center .

How Americans View the Coronavirus, COVID-19 Vaccines Amid Declining Levels of Concern

Online religious services appeal to many americans, but going in person remains more popular, about a third of u.s. workers who can work from home now do so all the time, how the pandemic has affected attendance at u.s. religious services, economy remains the public’s top policy priority; covid-19 concerns decline again, most popular.

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A rapid narrative review of the clinical evolution of psychedelic treatment in clinical trials

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Disability rights and experiential use of psychedelics in clinical research and practice

Given the renewed interest in the use of psychedelics for the treatment of mental and substance use disorders in recent decades, there has also been renewed discussion and debate about whether it is necessary or beneficial for those who study and deliver psychedelic-assisted psychotherapy (PAP) to have had personal experience of using psychedelics. This paper provides a brief history of this debate and brings a disability-rights perspective to the discussion, given increasing efforts to dismantle ableism in medical training, practice, and research. Many psychiatric conditions and psychotropic medications, including ones as commonly prescribed as antidepressants, may preclude one from being able to safely and/or effectively use psychedelics. As such, we argue explicitly mandating or even implying the necessity of experiential training for psychedelic researchers and clinicians can perpetuate ableism in medicine by excluding those who cannot safely use psychedelics because of their personal medical histories. As PAP research and practice rapidly grow, we must ensure the field grows with disability inclusion amongst researchers and clinicians.

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Research Topics & Ideas: Mental Health

100+ Mental Health Research Topic Ideas To Fast-Track Your Project

If you’re just starting out exploring mental health topics for your dissertation, thesis or research project, you’ve come to the right place. In this post, we’ll help kickstart your research topic ideation process by providing a hearty list of mental health-related research topics and ideas.

PS – This is just the start…

We know it’s exciting to run through a list of research topics, but please keep in mind that this list is just a starting point . To develop a suitable education-related research topic, you’ll need to identify a clear and convincing research gap , and a viable plan of action to fill that gap.

If this sounds foreign to you, check out our free research topic webinar that explores how to find and refine a high-quality research topic, from scratch. Alternatively, if you’d like hands-on help, consider our 1-on-1 coaching service .

Overview: Mental Health Topic Ideas

• Mood disorders
• Anxiety disorders
• Psychotic disorders
• Personality disorders
• Obsessive-compulsive disorders
• Post-traumatic stress disorder (PTSD)
• Neurodevelopmental disorders
• Eating disorders
• Substance-related disorders

Mood Disorders

Research in mood disorders can help understand their causes and improve treatment methods. Here are a few ideas to get you started.

• The impact of genetics on the susceptibility to depression
• Efficacy of antidepressants vs. cognitive behavioural therapy
• The role of gut microbiota in mood regulation
• Cultural variations in the experience and diagnosis of bipolar disorder
• Seasonal Affective Disorder: Environmental factors and treatment
• The link between depression and chronic illnesses
• Exercise as an adjunct treatment for mood disorders
• Hormonal changes and mood swings in postpartum women
• Stigma around mood disorders in the workplace
• Suicidal tendencies among patients with severe mood disorders

Anxiety Disorders

Research topics in this category can potentially explore the triggers, coping mechanisms, or treatment efficacy for anxiety disorders.

• The relationship between social media and anxiety
• Exposure therapy effectiveness in treating phobias
• Generalised Anxiety Disorder in children: Early signs and interventions
• The role of mindfulness in treating anxiety
• Genetics and heritability of anxiety disorders
• The link between anxiety disorders and heart disease
• Anxiety prevalence in LGBTQ+ communities
• Caffeine consumption and its impact on anxiety levels
• The economic cost of untreated anxiety disorders
• Virtual Reality as a treatment method for anxiety disorders

Psychotic Disorders

Within this space, your research topic could potentially aim to investigate the underlying factors and treatment possibilities for psychotic disorders.

• Early signs and interventions in adolescent psychosis
• Brain imaging techniques for diagnosing psychotic disorders
• The efficacy of antipsychotic medication
• The role of family history in psychotic disorders
• Misdiagnosis and delayed treatment of psychotic disorders
• Co-morbidity of psychotic and mood disorders
• The relationship between substance abuse and psychotic disorders
• Art therapy as a treatment for schizophrenia
• Public perception and stigma around psychotic disorders
• Hospital vs. community-based care for psychotic disorders

Personality Disorders

Research topics within in this area could delve into the identification, management, and social implications of personality disorders.

• Long-term outcomes of borderline personality disorder
• Antisocial personality disorder and criminal behaviour
• The role of early life experiences in developing personality disorders
• Narcissistic personality disorder in corporate leaders
• Gender differences in personality disorders
• Diagnosis challenges for Cluster A personality disorders
• Emotional intelligence and its role in treating personality disorders
• Psychotherapy methods for treating personality disorders
• Personality disorders in the elderly population
• Stigma and misconceptions about personality disorders

Obsessive-Compulsive Disorders

Within this space, research topics could focus on the causes, symptoms, or treatment of disorders like OCD and hoarding.

• OCD and its relationship with anxiety disorders
• Cognitive mechanisms behind hoarding behaviour
• Deep Brain Stimulation as a treatment for severe OCD
• The impact of OCD on academic performance in students
• Role of family and social networks in treating OCD
• Alternative treatments for hoarding disorder
• Childhood onset OCD: Diagnosis and treatment
• OCD and religious obsessions
• The impact of OCD on family dynamics
• Body Dysmorphic Disorder: Causes and treatment

Post-Traumatic Stress Disorder (PTSD)

Research topics in this area could explore the triggers, symptoms, and treatments for PTSD. Here are some thought starters to get you moving.

• PTSD in military veterans: Coping mechanisms and treatment
• Childhood trauma and adult onset PTSD
• Eye Movement Desensitisation and Reprocessing (EMDR) efficacy
• Role of emotional support animals in treating PTSD
• Gender differences in PTSD occurrence and treatment
• Effectiveness of group therapy for PTSD patients
• PTSD and substance abuse: A dual diagnosis
• First responders and rates of PTSD
• Domestic violence as a cause of PTSD
• The neurobiology of PTSD

Neurodevelopmental Disorders

This category of mental health aims to better understand disorders like Autism and ADHD and their impact on day-to-day life.

• Early diagnosis and interventions for Autism Spectrum Disorder
• ADHD medication and its impact on academic performance
• Parental coping strategies for children with neurodevelopmental disorders
• Autism and gender: Diagnosis disparities
• The role of diet in managing ADHD symptoms
• Neurodevelopmental disorders in the criminal justice system
• Genetic factors influencing Autism
• ADHD and its relationship with sleep disorders
• Educational adaptations for children with neurodevelopmental disorders
• Neurodevelopmental disorders and stigma in schools

Eating Disorders

Research topics within this space can explore the psychological, social, and biological aspects of eating disorders.

• The role of social media in promoting eating disorders
• Family dynamics and their impact on anorexia
• Biological basis of binge-eating disorder
• Treatment outcomes for bulimia nervosa
• Eating disorders in athletes
• Media portrayal of body image and its impact
• Eating disorders and gender: Are men underdiagnosed?
• Cultural variations in eating disorders
• The relationship between obesity and eating disorders
• Eating disorders in the LGBTQ+ community

Substance-Related Disorders

Research topics in this category can focus on addiction mechanisms, treatment options, and social implications.

• Efficacy of rehabilitation centres for alcohol addiction
• The role of genetics in substance abuse
• Substance abuse and its impact on family dynamics
• Prescription drug abuse among the elderly
• Legalisation of marijuana and its impact on substance abuse rates
• Alcoholism and its relationship with liver diseases
• Opioid crisis: Causes and solutions
• Substance abuse education in schools: Is it effective?
• Harm reduction strategies for drug abuse
• Co-occurring mental health disorders in substance abusers

Choosing A Research Topic

These research topic ideas we’ve covered here serve as thought starters to help you explore different areas within mental health. They are intentionally very broad and open-ended. By engaging with the currently literature in your field of interest, you’ll be able to narrow down your focus to a specific research gap .

It’s important to consider a variety of factors when choosing a topic for your dissertation or thesis . Think about the relevance of the topic, its feasibility , and the resources available to you, including time, data, and academic guidance. Also, consider your own interest and expertise in the subject, as this will sustain you through the research process.

Always consult with your academic advisor to ensure that your chosen topic aligns with academic requirements and offers a meaningful contribution to the field. If you need help choosing a topic, consider our private coaching service.

Good morning everyone. This are very patent topics for research in neuroscience. Thank you for guidance

What if everything is important, original and intresting? as in Neuroscience. I find myself overwhelmd with tens of relveant areas and within each area many optional topics. I ask myself if importance (for example – able to treat people suffering) is more relevant than what intrest me, and on the other hand if what advance me further in my career should not also be a consideration?

This information is really helpful and have learnt alot

Phd research topics on implementation of mental health policy in Nigeria :the prospects, challenges and way forward.

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Children’s Mental Health Research

• Mental health in the community
• Different data sources
• National data sets

Research on children’s mental health in the community

Project to learn about youth – mental health.

The Project to Learn About Youth – Mental Health (PLAY-MH) analyzed information collected from four communities. The focus was to study attention-deficit/hyperactivity disorder (ADHD)  and other  externalizing and internalizing  disorders, as well as  tic disorders  in school-aged children. The purpose was to learn more about public health prevention and intervention strategies to support children’s health and development.

Read about the results of the Play-MH study

Study questions included:

• What percentage of children in the community had one or more externalizing, internalizing, or tic disorders?
• How frequently did these disorders appear together?
• What types of treatment were children receiving in their communities?

This project used the same methodology as the original Project to Learn about ADHD in Youth (PLAY) project.  Read more about the original study approach here .

Other research

Read more about research on

• Tourette syndrome

CDC and partner agencies are working to understand the prevalence of mental disorders in children and how they impact their lives. Currently, it is not known exactly how many children have any mental disorder, or how often different disorders occur together, because no national dataset is available that looks at all mental, emotional, or behavioral disorders together.

Research on prevalence

What is It and Why is It Important?

Using different data sources

Healthcare providers, public health researchers, educators, and policy makers can get information about the prevalence of children’s mental health disorders from a variety of sources. Data sources, such as national surveys, community-based studies, and administrative claims data (like healthcare insurance claims), use different study methods and provide different types of information, each with advantages and disadvantages. Advantages and disadvantages for different data sources include the following:

• National surveys have large sample sizes that are needed to create estimates at the national and state levels. However, they also generally use a parent’s report of the child’s diagnosis, which means that the healthcare provider has to give an accurate diagnosis and the parent has to accurately remember what it was.
• Community-based studies offer the opportunity to observe children’s symptoms, which means that even children who have not been diagnosed or do not have the right diagnosis could be found. However, these studies are typically done in small geographic areas, so findings are not necessarily the same in other communities.
• Administrative claims are typically very large datasets with information on diagnosis and treatment directly from the providers, which allows tracking changes over time. Because they are recorded for billing purposes, diagnoses or services that would not be reimbursed from the specific health insurance might not be recorded in the data.

Using different sources of data together provides more information because it is possible to describe the following:

• Children with a diagnosed condition compared to children who have the same symptoms, but are not diagnosed
• Differences between populations with or without health insurance
• How estimates for mental health disorders change over time

Read more about using different data sources.

National data on children’s mental health

A comprehensive report from the Centers for Disease Control and Prevention (CDC), Mental Health Surveillance Among Children — United States, 2013 – 2019 , described federal efforts on monitoring mental disorders, and presented estimates of the number of children with specific mental disorders as well as for positive indicators of mental health. The report was developed in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA ), the National Institute of Mental Health (NIMH ), and the Health Resources and Services Administration (HRSA ). It represents an update to the first ever cross-agency children’s mental health surveillance report in 2013.

Read a summary of the findings for the current report using data from 2012-2019

Read a summary of the findings for the first report using data from 2005-2011 .

The goal is now to build on the strengths of federal agencies serving children with mental disorders to:

• Develop better ways to document how many children have these disorders,
• Better understand the impacts of mental disorders,
• Inform needs for treatment and intervention strategies, and
• Promote the mental health of children.

This report is an important step on the road to recognizing the impact of childhood mental disorders and developing a public health approach to address children’s mental health.

Holbrook JR, Bitsko RB, Danielson ML, Visser SN. Interpreting the Prevalence of Mental Disorders in Children: Tribulation and Triangulation. Health Promotion Practice. Published online November 15, 2016 https://www.ncbi.nlm.nih.gov/pubmed/27852820 .

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Understanding mental health in the research environment

Short abstract.

This study aimed to establish what is known about the mental health of researchers based on the existing literature. The literature identified focuses mainly on stress in the academic workforce and contributory factors in the academic workplace.

This study aimed to establish what is known about the mental health of researchers based on the existing literature. There is limited published evidence on the prevalence of specific mental health conditions among researchers. The majority of the identified literature on prevalence relates to work-related stress among academic staff and postgraduate students in university settings.

Survey data indicate that the majority of university staff find their job stressful. Levels of burnout appear higher among university staff than in general working populations and are comparable to “high-risk” groups such as healthcare workers. The proportions of both university staff and postgraduate students with a risk of having or developing a mental health problem, based on self-reported evidence, were generally higher than for other working populations. Large proportions (>40 per cent) of postgraduate students report symptoms of depression, emotion or stress-related problems, or high levels of stress.

Factors including increased job autonomy, involvement in decision making and supportive management were linked to greater job satisfaction among academics, as was the amount of time spent on research. Opportunities for professional development were also associated with reduced stress. UK higher education (HE) and research staff report worse wellbeing, as compared to staff in other sectors, in most aspects of work that can affect workers' stress levels.

The evidence around the effectiveness of interventions to support the mental health of researchers specifically is thin. Few interventions are described in the literature and even fewer of those have been evaluated.

The Royal Society and Wellcome Trust are interested in better understanding the mental health needs of researchers, and what interventions could be used to support them. This reflects the recent focus on mental health among undergraduate students in the UK, and the concern that others in the academic and wider research environment may have mental health needs that have not been as well explored and considered. This study aims to establish what is currently known about the mental health of researchers based on the existing literature.

Over 6 million working-age people in England have a mental health condition at a given time. The most common diagnosable difficulties among working age adults are anxiety and depression, each of which includes a number of different conditions. Less common but still widespread mental health diagnoses include personality disorders and psychoses such as bipolar disorder and schizophrenia. Many people will have more than one diagnosis at a time, or receive different diagnoses over time.

The causes and triggers of poor mental health are complex and not fully understood. There is evidence that the vast majority of people who experience poor mental health in adulthood first experienced difficulties as children, often from a young age. Risk factors for poor mental health include having a parent with mental health difficulties, growing up in prolonged poverty and housing insecurity, experiences of abuse, neglect and bullying, and traumatic experiences during childhood. Some groups of people have a heightened risk of poor mental health, including some black and ethnic minority communities, people with long-term physical conditions, lesbian, gay, bisexual and transgender people, and people with disabilities.

There is mixed evidence about the extent to which a person's experiences of work contribute to their having a mental health difficulty. Survey evidence suggests that workplace factors such as bullying, insecurity and a lack of control are major causes of mental ill health among staff. On the other hand, there is also evidence that work helps many people to recover from an episode of poor mental health, and there is clear evidence that unemployment is a major risk factor for mental and physical ill health.

Mental ill health and work-related stress are key issues for the labour market as they affect productivity through absenteeism and presenteeism, and are associated with high economic costs for individuals, employers and the economy at large. It has been estimated that poor mental health costs employers in the UK £26 billion nationwide each year, equivalent to £1,035 for every employee in the workforce ( Centre for Mental Health, 2007 ).

Little is known about how mental health needs vary across working environments, or about how to tailor interventions to address different working populations.

The aim of this study was to assess what is known about mental health in research environments through a literature review, and it focused on the UK and comparable research systems. A better understanding of researchers' mental health needs will enable the design of more effective interventions to address them, while a better understanding of evidence gaps can also help guide future research efforts in this area. The following research questions guided the study:

• How are “mental health” and “wellbeing” understood in the context of research environments?
• What is currently known about researchers' mental health and wellbeing, and does it differ from that of other populations?
• What interventions are used to support researchers, and what evidence is there of their effectiveness?
• What are the strengths and limitations of the evidence base in this area?

How Are “Mental Health” and “Wellbeing” Understood in Research Environments?

Overall, the existing literature offers little insight into what sets the research environment apart from other workplaces, or into how mental health, stress, and wellbeing are defined in these contexts. Rather, the majority of the literature identified focuses on describing the levels of stress amongst the academic workforce and, in particular, identifying contributory factors within the workplace. There is little available evidence based on objective clinical assessment about the prevalence of clinically defined mental health conditions and their treatment in this context. The focus on wellbeing raises the issue that although the presence of common mental health conditions does correlate with some of the wellbeing scales used commonly in the literature, more serious (e.g. psychotic) mental illnesses are not necessarily aligned with measurement of wellbeing.

The literature is also almost exclusively focused on universities, with many studies covering all university staff, which will include both researchers and non-research staff. Some studies focused more specifically on researchers, and a more limited group within that looked at particular groups of researchers—most commonly PhD students, reflecting the wider focus on (typically undergraduate) students in the literature around this topic. The majority of the existing research is based on survey data, which is subject to sampling biases, relies on self-reporting, and was not triangulated with other objective indicators, such as absence data.

What Is Currently Known About Researchers' Mental Health and Wellbeing, and How It Differs from Other Populations?

Evidence on the prevalence of work-related stress and mental health problems.

Despite widely reported anecdotal evidence and press coverage of a “mental health crisis” in academia, there is limited published evidence regarding the prevalence of specific mental health conditions among researchers. The majority of the literature on prevalence identified through this review relates to the experience of work-related stress (and arguably the risk of developing a mental health condition as a result of exposure to identified stressors) among academic staff and postgraduate students in university settings.

• Survey data indicate that the majority of university staff find their job stressful. Levels of burnout appear higher among university staff than in general working populations and are comparable to “high-risk” groups such as healthcare workers.
• The proportions of both university staff and postgraduate students with a risk of having or developing a mental health problem, based on self-reported evidence, were generally higher than for other working populations.
• Large proportions (>40 per cent) of postgraduate students report symptoms of depression, emotion or stress-related problems, or high levels of stress.

UK national statistics indicate that only 6.2 per cent of staff disclosed a mental health condition to their university, though academics have been found to be among the occupational groups with the highest levels of common mental disorders with prevalence around 37 per cent. It should be noted, however, that prevalence may generally be over-reported in surveys of occupational groups.

Personal Factors That Contribute to Mental Health Outcomes in the Research Workplace

Gender was the key personal factor that emerged as a determinant for mental health (or its reporting), with women reporting more exposure to stress than men, as well as greater challenges around work-life balance. There was also evidence that personality and perceived competence affect mental health as self-critical personalities are more susceptible to stress, though it is also possible that they are more aware of it or more willing to report it. However, it was unclear whether stress was a result of working conditions in the research environment, or whether research settings attracted particular types of individuals. The results on whether age affects mental health were inconclusive, partly as age is often difficult to disentangle from discussions about rank and seniority. Other factors such as disability, sexuality and minority status were mentioned in a small number of articles in the sample, and these articles indicated that these personal factors generally increase stress.

Environmental Factors Commonly Considered in Surveys of Mental Health and Wellbeing in Workplaces

Based on the Health and Safety Executive's framework, and evidence from the wider literature, we identify six key aspects of work that can affect workers' stress levels: work demands, job control, change management, work relationships, support provided by managers and colleagues, and clarity about one's role.

• These aspects of the work environment can be sources of stress or they can help counteract it.
• Findings from studies of university staff and researchers were consistent with the wider understanding of factors that contribute to stress in workplaces.
• Factors including increased job autonomy, involvement in decision making and supportive management were linked to greater job satisfaction among academics, as was the amount of time spent on research. Opportunities for professional development were also associated with reduced stress.

UK higher education (HE) and research staff report worse wellbeing in most of the six aspects, as compared to staff in other sectors.

• In large-scale surveys, UK higher education staff have reported worse wellbeing than staff in other types of employment (including education, and health and social work) in the areas of work demands, change management, support provided by managers and clarity about one's role.
• The only area where higher education staff have reported higher wellbeing in large-scale surveys is in job control, though even here results are mixed across studies. Wide variability was seen among respondents in relation to the level of support provided by managers and colleagues.
• Job insecurity (real and perceived) appears to be an important issue for those working in the research environment, and particularly for early-career researchers, who are often employed on successive short-term contracts.

PhD students face similar challenges to other researchers and higher education staff.

• The main factors associated with development of depression and other common mental health problems in PhD students are high levels of work demands and work-life conflict, low job control, poor support from the supervisor and exclusion from decision making.
• Believing that PhD work is valuable for one's future career helps reduce stress, as does confidence in one's own research abilities.

Some studies suggested that changes to the UK higher education system had brought increased job stress.

• These studies discussed changes that had occurred in the UK higher education system from the 1990s onwards, and had resulted in increased emphasis on accountability, efficiency and performance management. Study authors suggested that these changes could have brought about increases in job stress for staff working in this system.
• However, data explicitly linking the changes to an increase in stress are limited, partly due to a lack of comparable data from before the 1990s.

Staff who can devote a large proportion of their working time to research have better wellbeing.

• Studies found that spending a larger percentage of one's time on research was associated with reduced stress, and that research-only staff reported lower levels of work-life conflict and had better wellbeing than other higher education institution (HEI) staff. However, this may be to some extent confounded by other characteristics of such researchers (e.g. they may be more senior).

Research on emotionally challenging topics can put staff wellbeing at risk.

• Studies showed that staff involved in research on sensitive topics, such as trauma or abuse, may be emotionally affected by the material they encounter in their work and should receive greater support to mitigate the negative impacts of this work.

Outcomes Related to Poor Mental Health and Wellbeing

In addition to considering the extent to which individuals in research environments suffer from mental health issues, it is important for employers and institutions to recognise that these issues have further implications:

• Job stress and poor workplace wellbeing can contribute to reduced productivity—both through absence and, more importantly, through presenteeism, where researchers attend work and are less productive.
• They can also lead to lower levels of commitment to their research and to institutions—which can be seen in high levels of turnover and through negative attitudes in the workplace.
• Effects on job satisfaction are less clear because of the satisfaction researchers gain from intrinsic factors such as the intellectual stimulation of their work. Several studies note that high levels of job-related stress can coexist with high levels of job satisfaction.
• Effects can also spill over into personal and family life.

The overall effects of these negative outcomes on the sector have not been fully quantified, but estimates drawing on broader experience suggest that the costs could be high. An estimate from Shutler-Jones et al (2008) which has several caveats and assumptions, suggests that the costs to the UK HE sector could be more than £500 million per year (c. 5 per cent of the sector's total annual income). Costs to the economy and the country more widely could also be significant due to the lost potential for scientific advances and due to impacts on the availability of research talent if PhD students fail to complete their studies or choose to leave research subsequently.

What Interventions Are Used to Support Researchers, and What Evidence Is There of Their Effectiveness?

Though poor mental health at work is often related to difficulties that are not caused by work (e.g. childhood adversity, family life and other stressors), support in the workplace can offer benefits. However, the evidence around the effectiveness of interventions to support the mental health of researchers specifically is thin. Few interventions are described in the literature and even fewer of those have been evaluated. Where evaluations have been conducted, they are often of limited utility, either because of the evaluation design or the length of follow-up.

Interventions typically focus on stress and wellbeing rather than clinical mental health conditions, reflecting the wider focus in the literature as described above. In addition, the majority of interventions identified aim to support researchers to deal with workplace stress, but they may not be effective in addressing the root causes of that stress or stresses relating to life outside work. The interventions identified can be broadly classified into four groups: policy changes, communication activities, training, and health-promotion activities.

Focusing specifically on the UK, a range of interventions were piloted and evaluated (to a limited extent) as part of a wellbeing initiative by the Higher Education Funding Council for England (HEFCE) around 2009–2011. These offer scope for further investigation and potentially evaluation now that more time has elapsed. Additionally, the project, though completed in 2011, has spawned a network that is now managed by the Universities and Colleges Employers Association (UCEA), which may offer a route to identify further ongoing initiatives and potentially a space to pursue and evaluate efforts to address these issues in the HE sector.

What Are the Strengths and Limitations of the Evidence Base in This Area?

The existing evidence base is limited, meaning it is not possible to draw robust conclusions about the mental health status and needs of researchers, and how researchers may differ from other populations in this regard. More work is needed to understand both the mental health needs of researchers and how they can be addressed. Particular gaps include the effectiveness of interventions, prevalence of specific mental health needs (rather than stress) among researchers, and any evidence about researchers outside the academic setting. There are also limitations to the quality and design of many of the studies conducted, such as lack of long-term follow-up and absence of control groups.

Based on the evidence gaps identified and the information available, we suggest the following avenues for further research on this topic:

• Study the prevalence of mental health conditions amongst postdoctoral researchers: Further work on prevalence could use a targeted approach building on the recent work by Levecque et al. (2017) , who used a survey to assess the presence of psychological distress and potential psychiatric disorders in a sample of PhD students and compared the results to those of three other sample populations, and Eisenberg et al. (2007) , who surveyed a sample of undergraduate and postgraduate university students to assess prevalence of depressive and anxiety disorders and took steps to address the issue of non-response bias. In particular, we suggest a similar study focusing on postdoctoral researchers, a group that is particularly poorly addressed in the existing literature.
• Map mental health policies and procedures at UK HEIs: The current standard of mental health policies and procedures in UK research institutions is not well understood. We suggest that a mapping of the current policies in place across institutions could be valuable, and could build on standards such as those set out in the Mindful Employer Charter ( Mindful Employer, 2017 ).
• Evaluate the interventions introduced through the HEFCE wellbeing and engagement initiative: The wellbeing initiative established by the HEFCE and subsequently maintained as a network by UCEA offers a range of interventions for evaluation. In the project reporting in 2011, many of the institutions noted that it was too soon to tell whether their interventions had been effective. Though these initiatives generally focus on wellbeing rather than clinical mental health conditions, there is scope to explore with the relevant institutions whether those interventions have developed over the years, and whether data are now available (or could be collected) to provide more useful evaluation of the interventions introduced.
• Investigate and develop the HSE management standards as a framework for workplace mental health management in research environments: As well as providing a framework for workplace stress used in several important surveys, the Health and Safety Executive (HSE) have also set out management standards that describe an approach to identifying sources of workplace stress and addressing them at an organisational level. It could be useful to work through that approach with a university or a research organisation to identify the mechanisms at play in those environments. Doing so could establish the relevance of the approach in this context, and potentially provide a model that could be used more widely in the sector.
• Conduct more and higher-quality evaluations of mental health interventions and publish their results: Broadly, better-quality evaluations are needed to identify what works in this area. There is a need for high-quality studies to test the effectiveness of interventions.

The research described in this article was prepared for the Royal Society and the Wellcome Trust and conducted by RAND Europe.

• Centre for Mental Health. Mental health at work: Developing the business case. 2007. 2017. http://www.centreformentalhealth.org.uk/Handlers/Download.ashx?IDMF=4c278a50-8bd6-4aff-9cf3-7667c0770288 As of May 30.
• Eisenberg D., Gollust S. E., Golbertstein E., Hefner J. L. “Prevalence and correlates of depression, anxiety, and suicidality among university students.” American Journal of Orthopsychiatry. 2007; 77 (4):534–542. [ PubMed ] [ Google Scholar ]
• Levecque K., Anseel F., De Beuckelaer A., Van der Heydan J. and Gisle L. “Work organization and mental health problems in PhD students.” Research Policy. 2017; 46 (4):868–879. [ Google Scholar ]
• Mindful Employer. “Charter for employers”. 2017. http://www.mindfulemployer.net/charter/ As of June 10, 2017.
• Shutler-Jones K. Improving performance through well-being and engagement. 2011. 2017. http://www.qub.ac.uk/safety-reps/sr_webpages/safety_downloads/wellbeing-final-report-2011-web.pdf As of June 10.

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New Center Provides Resources for HIV-Related Stigma Research

The National Institute of Mental Health has awarded Stefan Baral, MD , professor of Epidemiology , a $2.8 million, four-year P30 Center Core grant for the creation of the Center for HIV and Mental Health Stigma Elimination Strategies (CHIMES). The Center will provide resources to researchers whose focus is measuring and reducing HIV-related stigma and its impact on mental health.

“We are excited about the opportunities that CHIMES will bring to students and faculty in the Department of Epidemiology and other departments across the school in supporting pilot projects, grant writing support, and even open-access fees for papers for stigma-related projects,” said Baral.

A collaboration between the Bloomberg School of Public Health and Emory University Rollins School of Public Health, CHIMES is comprised of four cores, each with a specific aim:

Administrative Core: Build local and global capacity to measure and respond to stigma as a risk for suboptimal mental health and HIV outcomes.

Measurement Core: Improve the measurement of attribute-specific and intersectional stigmas on mental health and HIV.

Intervention Core: Increase the quantity and quality of interventions addressing stigma and structural determinants of risk.

Development Core: Support the proliferation of science in measuring and responding to stigma and structural determinants.

Sheree Schwartz, PhD , associate scientist in Epidemiology, is the Development Core director for the Center. Kalai Robinson, senior research program manager in Epidemiology, will serve as CHIMES manager supporting faculty and students with grant reviews, conference travel, and research paper support.

Together, these cores provide a wide range of free services to researchers, including analytical data access; mentorship for early-stage investigators; consulting services; technical support in research design, program development, and grant writing. Through CHIMES, investigators are welcome to contribute to collaborative, community-engaged conversations enabling pathways for idea generation; disseminate findings; and facilitate partnerships.

An online form highlights specific services available across CHIMES and provides the option to sign up for CHIMES updates. 

Questions about the Center can be sent to [email protected]

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Opinion Guest Essay

How Psychedelic Research Got High on Its Own Supply

Credit... Illustration by Pablo Delcan; images by londoneye and SimoneN/Getty Images

Supported by

By Caty Enders

Ms. Enders is a science writer.

• Aug. 23, 2024

T hings weren’t supposed to go this way. The drug company Lykos Therapeutics had spent much of this year expecting to vault to meteoric heights. It had sent an application to the Food and Drug Administration seeking approval to use MDMA to treat post-traumatic stress disorder. Lykos expected F.D.A. approval; it was banking on it.

And then on Aug. 9, the F.D.A.’s decision came through: rejection. It was the capstone to months of increasingly loud concerns being voiced over the quality of Lykos’s clinical trials. And in the wake of the F.D.A. decision, the journal Psychopharmacology retracted three papers related to research on MDMA, citing “ unethical conduct ,” an apparent reference to allegations of sexual abuse on the part of an unlicensed therapist at one of the trial sites. Several of the authors of the retracted papers were affiliated with Lykos.

It is a shocking decrescendo for a drug that had been promoted for years as best positioned to lead a psychedelic mental health revolution. The F.D.A.’s rejection signals greater uncertainty for the future of psychedelic medicine. And it will take more than just additional clinical trials for advocates to get back on track — it might require changing the culture of the research community from within.

First synthesized by the drug company Merck in 1912, MDMA, also known as the party drug Ecstasy or molly, has both stimulant and hallucinogenic properties. It also has the ability to foster feelings of connectedness and to seemingly dissolve a person’s mental boundaries, which advocates say can help patients revisit their trauma more comfortably during psychotherapy sessions in order to heal from it. Lykos has spent years conducting clinical trials testing whether MDMA-assisted psychotherapy could alleviate the symptoms of PTSD. Its most recent drug trial showed that more than 86 percent of people treated had a measurable reduction in symptom severity. Even more impressive, the effect seemed to be lasting. Had the therapy been approved, it would have become the first new treatment for PTSD in decades, and would have handed over administration and control of prescription MDMA to Lykos for at least five years.

More broadly, proponents hoped a green light from the F.D.A. would open the door to regulatory approval for other psychedelics in mental health treatment, an area of medicine that has been desperate for innovation. Mental health disorders are surging , with rates of depression, anxiety and PTSD all on the rise, and current drugs don’t work terribly well. The majority of patients diagnosed with depression do not benefit from the first medications they are given. Conditions like PTSD are challenging to treat, and veterans groups have been especially supportive of the potential for psychedelics to address the mental trauma suffered during combat. Amid growing enthusiasm, drug companies, clinicians and patients had enormous hope that psychedelics could relieve the symptoms of millions.

But that hope began to fray in June, when an advisory panel to the F.D.A. voted almost unanimously against recommending Lykos’s MDMA treatment. With what seemed to be audible irritation, the chair of the F.D.A. review panel, Dr. Rajesh Narendran, called Lykos’s study so poorly conducted as to be “meaningless,” adding that he was “not convinced at all” that MDMA could effectively treat PTSD.

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Declining senses can impact mental health and loneliness in aging adults

by University of Chicago Medical Center

Up to 94% of U.S. adults adults experience at least some dulling of their senses with age, finding themselves squinting at screens, craving stronger flavors, and missing snatches of conversations more and more frequently. Researchers at the University of Chicago Medicine are looking into how these changes can go beyond mere inconvenience and actually worsen overall mental health in older adults.

"When your senses decline, you can't experience the world as well," said Jayant Pinto, MD, a physician and expert in olfactory dysfunction at UChicago Medicine.

"You can't hear colleagues or friends at the dinner table; you can't discern what's going on in your environment; you may have a hard time reading or making things out when you're in your neighborhood. It makes all your cognitive burdens a little harder, and that probably wears you down over time and causes mental health problems."

Along with Alexander Wang, a medical student at the UChicago Pritzker School of Medicine, Pinto recently led a study examining the prevalence and impact of sensory impairments among older adults.

They found that people with sensory disabilities tend to have worse mental health, and that different types of sensory disability were associated with different aspects of mental health. The findings are published in the Journal of the American Geriatrics Society .

Revealing associations between perception and emotion

The UChicago researchers analyzed data on sensory function (vision, hearing and sense of smell) and self-reported mental health from nearly 4,000 older adults, collected over 10 years of follow-up as part of the National Social Life, Health & Aging Project .

They found that people who had multiple senses impaired experienced more loneliness and had significantly worse self-reported mental health overall, and people with three sensory disabilities were more likely to experience frequent depressive episodes.

In analyses that differentiated between the senses, vision impairment was most strongly associated with both loneliness and poor self-rated mental health.

Scientists are still exploring how changes in all five senses can impact people, but the UChicago researchers can already point to many ways sensory decline contributes directly to feelings of loneliness, sadness and boredom.

Older people with vision impairment may have trouble getting out of the house or seeing the faces of their friends and family, and hearing loss can make conversations stilted and frustrating. Even loss of smell can affect someone's ability to find joy in familiar scents—like a favorite home-cooked meal or a loved one's signature perfume—and perceive pheromones, which (though not registered consciously) contribute to social dynamics.

"We saw that hearing and vision disability tended to be associated with lower self-rated mental health and feelings of loneliness, but olfactory disability had a weaker association," Wang said. "This stood out to me because hearing and vision disabilities tend to be much more stigmatized than olfactory disability. This made me reflect on the ways in which social stigma may be driving this worse mental health."

Caring for one another in an aging society

In the face of that stigma, the researchers say their results highlight the importance of improving access to mental health services and increasing awareness of the connection between sensory loss and mental distress.

In particular, understanding how different sensory disabilities impact the long-term mental health of older adults could help health care professionals—especially primary care providers , otolaryngologists and ophthalmologists—screen for mental health conditions when they identify sensory loss in their patients, providing opportunities for personalized and timely interventions.

In addition to proactively treating older adults' mental health, the researchers pointed to steps that can be taken to directly lessen the day-to-day effects of sensory difficulties, which would in turn lessen their negative mental health implications.

"We have an aging society; everybody has a relative who's getting older and having a harder time in life. It's a burden for us all to share," Pinto said. "Lessening the burdens of your aging relatives and friends can have a huge impact on people's lives, their productivity and their quality of life."

On a personal level, family members and friends can help by being patient and finding ways to communicate more effectively, such as speaking clearly or using written notes. On a societal level, public policies and community programs can ensure accessibility in public spaces and provide resources that improve quality of life.

Pinto also highlighted a wide range of technologies and medical interventions are available that can help compensate for sensory impairment. For hearing loss, there are cochlear implants , hearing aids and other hearing-assistive devices—which research has indicated could slow cognitive decline in addition to improving quality of life.

For vision loss, there are glasses, contacts, cataract surgery and LASIK surgery, along with accommodations like text-to-speech computer programs. Even for the sense of smell , health experts can sometimes help by reducing sinus inflammation or conducting smell training exercises.

"In many cases, we can mitigate sensory difficulties in ways that might actually improve people's lives, mental health and sense of loneliness—which is a huge epidemic," Pinto said. "These are simple ways we can intervene to help people and potentially have a huge impact on society."

Recognizing and destigmatizing sensory disability

The researchers said they intentionally used the word "disability" throughout the paper to underscore the significant impact of sensory impairments on individuals' lives. This terminology also aligns with efforts to destigmatize these conditions and promote a more inclusive approach to health care.

"To some extent, our society already considers decreased sensory function to be a disability: think of the blind and d/Deaf communities," Wang said.

"Like many marginalized communities, the disabled community has historically had a very contentious relationship with the medical field, which can cause distress and limit access to mental health services. With better understanding and compassion, we can strive to improve the care we provide to older adults and disabled patients."

He said that by framing the data this way, he hopes to encourage more health care providers to move away from thinking in terms of the Medical Model of Disability and move towards the Social Model of Disability.

"My understanding is that the Medical Model characterizes disability as something that is 'deficient' with a person, thus requiring some sort of 'fixing' of the individual," he explained. "The Social Model characterizes disability as more of an identity, so limitations relating to disability stem from a society's lack of accessibility and accommodation for disabled people."

Recognizing sensory impairments as disabilities and acknowledging their impact on mental health are important steps toward more comprehensive and compassionate care.

By addressing the medical, social and environmental barriers that exacerbate these impairments, clinicians—and society as a whole—can better support older adults in maintaining their independence.

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Number of Iowa mental health facilities has declined in past 15 years, report finds

New research has found more health care facilities have closed in Iowa than have opened in the past 15 years, with mental health centers closing at the highest rate.

The finding was part of a report on Iowa's health care landscape published Aug. 22 by Common Sense Institute Iowa, a nonpartisan, free enterprise-oriented economic research and policy think tank. The nonprofit studied the economic climate of the state's health care sector, including health care expenditures, insurance rates and its workforce.

“Even while we might be better off than some other states, there's still some really big hurdles that we need to improve going forward in order to improve our economy and to improve our health," said Chelsea Lensing, the health and wellness fellow at Common Sense Institute Iowa and lead researcher on the report.

More: This Des Moines hospital was rated 5 stars by CMS. How do the others compare?

According to the report, more than 600 health care facilities closed from 2008 to 2023. That includes hospitals, home health agencies, clinics, elderly care facilities and other health care centers overseen by the Iowa Department of Inspections and Appeals.

During that period, fewer than 450 facilities opened, resulting in a net closure of 250 health care centers in Iowa.

“It’s definitely an area of concern moving forward, especially in trying to understand how we can help this part of the population who's most affected by these net closures,” said Lensing, who is also a professor at Coe College.

Mental health centers saw a whopping 94% overall decrease since 2008. Researchers found a total of 180 facilities closed, including 92 centers that shut down from 2020 to 2023. Since 2008, only 11 mental health centers opened their doors.

The report found elderly care facilities — which include nursing homes, assisted living and residential care — saw the most openings and closures from 2008 to 2023. Researchers counted 262 closures in total, including 88 that occurred in the past three years, as well as 219 openings across the state.

Report points to financial, workforce challenges facing health care industry

The Common Sense Institute Iowa report also found Iowa's hospitals are facing increasing financial vulnerability, with more than half of all hospitals in the state operating at a loss in 2022. That comes as average hospital expenses increased 66% from 2009 to 2022.

“Hospitals across the state, starting in 2022, are now for the first time operating at a net loss,” said Ben Murrey, director of policy and research at Common Sense Institute Iowa.

The report points to data from the Center for Healthcare Quality and Payment Reform, which estimates 28 Iowa hospitals have only enough financial reserves to cover their losses for six to seven years. Ten hospitals lack the resources to cover their losses for more than three years.

More: An Iowa woman blames nursing home staff shortages for her mom's death. Will new rules help?

In addition, the report found current health care workforce trends "indicate a significant shortage will emerge in upcoming years" as the demand for workers continues to outpace the supply. Researchers found that a major factor driving this shortage are providers who are aging out of the workforce.

"Though Iowa’s healthcare workforce has strengths, policymakers and the industry should continue to seek ways to fill the healthcare workforce pipeline so younger workers can help meet current demand and fill the gap left by retiring professionals," the Common Sense Institute Iowa report says.

Institute says recent legislation could serve as solutions

Even with the challenges laid out in the report, Common Sense Institute Iowa researchers say they believe state lawmakers have passed a number of policies that help address them.

The report points to a number of policies passed in recent state legislative sessions, including a law that caps damage awards in medical malpractice cases as well as a law that extends Medicaid coverage for postpartum women in Iowa.

Both measures drew criticism when the Republican-controlled Legislature passed them. Some Republicans opposed the malpractice caps, saying they amounted to putting an arbitrary limit on the value of a person's life. Democrats said the law will infringe on Iowans' right to a jury trial while doing nothing to protect patient safety.

While the Medicaid measure will extend coverage for low-income new mothers and their babies from 60 days to a year beginning in January, it also will tighten eligibility, which is expected to cause an estimated 1,700 women and babies to lose coverage each month, according to the nonpartisan  Legislative Services Agency . Democrats supported extending Medicaid coverage to new mothers for a full year, but opposed lowering the income threshold. 

More: Most oppose allowing health care workers to opt out of providing services based on beliefs

Murrey noted new laws will take time to have an impact on the health care sector. He said Common Sense Iowa plans to continue evaluating the sector, with the latest report serving as a benchmark to measure any successes from future legislation.

“Policymakers have done a good deal to address some of these issues, and we’re going to have to see if these things are affected by continuing to monitor the data,” he said.

Michaela Ramm covers health care for the Des Moines Register. She can be reached at  [email protected] , at (319) 339-7354 or on Twitter at  @Michaela_Ramm .

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State Laws Strongly Affect Mental Health of Trans People, Study Finds

Key takeaways.

There's been a recent wave of state legislation that either supports or denies the rights of transgender people, depending on the state

New research out of Washington state suggests that once trans people understand their rights are protected, anxiety and depression levels drop

The findings are another example of the huge impact state legislation can have on the well-being of trans people

THURSDAY, Aug. 22, 2024 (HeathDay News) -- There's a strong association between a state's policies and laws around the rights of transgender people and the mental health of transgender residents, a new study shows.

"Trans individuals who were worried about having their rights taken away had significantly higher odds of experiencing depression and anxiety symptoms," the study authors reported Aug. 22 in the journal JAMA Network Open.

"Contrarily, those who knew about the state-level protective legislation, specifically protections against hate crimes, had lower odds of depression and anxiety symptoms," said a team led by Arjee Restar , an assistant professor of epidemiology at the University of Washington in Seattle.

As Restar's team noted, there's been a vigorous movement in recent years to either restrict or preserve a trans person's access to health care and other services, depending on the state they live in.

"In the last few years, states within the U.S. have advanced a record number of bills targeting the restriction of lesbian, gay, bisexual, trans and other queer protections and rights; as of June 2024, more than 598 bills across 43 states had been introduced, with 43 passed specific to targeting trans people’s rights," the research team noted.

Not all states have enacted such laws.

In Washington state, for example, "several measures have been taken to protect trans rights," Restar and her team pointed out. Those measures include legislation that bars discrimination against trans people in the workplace, schools and housing, as well as measures barring the denial of health insurance coverage for treatments specific to trans people.

Does knowing about these measures make a difference for the day-to-day mental well-being of transgender people?

To find out, the Seattle team surveyed almost 800 trans adults living in Washington state in March and April of 2023.

Most (about 86%) did say they currently did have some level of depression -- a figure that's much higher than was found in earlier studies.

"This was likely because data from those studies may capture the prevalence of mental health outcomes with a dataset that predates 2021, when anti-trans legislation in the U.S. first started escalating," the researchers said.

Overall, trans people who said that they worried about their rights being taken away were 66% more likely to be battling depression, and almost three times as likely to suffer from anxiety, compared to those who said they weren't worried, the study found.

Whether or not they knew about Washington state's efforts to protect their rights was key, however.

Participants who said they were aware of Washington's efforts to safeguard trans people's rights had a 56% lower odds for current depression and an 89% lower odds for anxiety, compared to those who weren't aware, the researchers found.

"Those who knew about the state-level protective legislation, specifically protections against hate crimes, had lower odds of depression and anxiety symptoms," Restar's group said. "Trans individuals who correctly knew about the protective policy and were not worried about having their rights taken away reported the lowest odds of depression and anxiety."

All of this highlights the "crucial role" legal protection plays in safeguarding the mental well-being of trans people, the authors concluded.

More information

There's more the impact of local legislation on transgender mental health at the American Psychological Association .

SOURCE: JAMA Network Open , Aug. 22, 2024

What This Means For You

Knowing that their state supports or denies transgender rights has a strong association with an individual trans person's mental wellbeing

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What are the mental health benefits of exercise?

Other mental health benefits of exercise, reaping the mental health benefits of exercise is easier than you think, overcoming obstacles to exercise, getting started with exercise when you have a mental health issue.

• Easy ways to move more that don't involve the gym

The Mental Health Benefits of Exercise

You already know that exercise is good for your body. But did you know it can also boost your mood, improve your sleep, and help you deal with depression, anxiety, stress, and more?

Exercise is not just about aerobic capacity and muscle size. Sure, exercise can improve your physical health and your physique, trim your waistline, improve your sex life, and even add years to your life. But that’s not what motivates most people to stay active.

People who exercise regularly tend to do so because it gives them an enormous sense of well-being. They feel more energetic throughout the day, sleep better at night, have sharper memories, and feel more relaxed and positive about themselves and their lives. And it’s also a powerful medicine for many common mental health challenges.

Regular exercise can have a profoundly positive impact on depression, anxiety, and ADHD. It also relieves stress, improves memory, helps you sleep better, and boosts your overall mood. And you don’t have to be a fitness fanatic to reap the benefits. Research indicates that modest amounts of exercise can make a real difference. No matter your age or fitness level, you can learn to use exercise as a powerful tool to deal with mental health problems, improve your energy and outlook, and get more out of life.

Exercise and depression

Studies show that exercise can treat mild to moderate depression as effectively as antidepressant medication—but without the side-effects, of course. As one example, a recent study done by the Harvard T.H. Chan School of Public Health found that running for 15 minutes a day or walking for an hour reduces the risk of major depression by 26%. In addition to relieving depression symptoms , research also shows that maintaining an exercise schedule can prevent you from relapsing.

Exercise is a powerful depression fighter for several reasons. Most importantly, it promotes all kinds of changes in the brain, including neural growth, reduced inflammation, and new activity patterns that promote feelings of calm and well-being. It also releases endorphins, powerful chemicals in your brain that energize your spirits and make you feel good. Finally, exercise can also serve as a distraction, allowing you to find some quiet time to break out of the cycle of negative thoughts that feed depression.

Exercise and anxiety

Exercise is a natural and effective anti-anxiety treatment . It relieves tension and stress, boosts physical and mental energy, and enhances well-being through the release of endorphins. Anything that gets you moving can help, but you’ll get a bigger benefit if you pay attention instead of zoning out.

Try to notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of the wind on your skin. By adding this mindfulness element—really focusing on your body and how it feels as you exercise—you’ll not only improve your physical condition faster, but you may also be able to interrupt the flow of constant worries running through your head.

Exercise and stress

Ever noticed how your body feels when you’re under stress ? Your muscles may be tense, especially in your face, neck, and shoulders, leaving you with back or neck pain, or painful headaches. You may feel a tightness in your chest, a pounding pulse, or muscle cramps. You may also experience problems such as insomnia, heartburn, stomachache, diarrhea, or frequent urination. The worry and discomfort of all these physical symptoms can in turn lead to even more stress, creating a vicious cycle between your mind and body.

Exercising is an effective way to break this cycle. As well as releasing endorphins in the brain, physical activity helps to relax the muscles and relieve tension in the body. Since the body and mind are so closely linked, when your body feels better so, too, will your mind.

Exercise and ADHD

Exercising regularly is one of the easiest and most effective ways to reduce the symptoms of ADHD and improve concentration, motivation, memory, and mood. Physical activity immediately boosts the brain’s dopamine, norepinephrine, and serotonin levels—all of which affect focus and attention. In this way, exercise works in much the same way as ADHD medications such as Ritalin and Adderall.

Exercise and PTSD and trauma

Evidence suggests that by really focusing on your body and how it feels as you exercise, you can actually help your nervous system become “unstuck” and begin to move out of the immobilization stress response that characterizes PTSD or trauma. Instead of allowing your mind to wander, pay close attention to the physical sensations in your joints and muscles, even your insides as your body moves. Exercises that involve cross movement and that engage both arms and legs—such as walking (especially in sand), running, swimming, weight training, or dancing—are some of your best choices.

Outdoor activities like hiking, sailing, mountain biking, rock climbing, whitewater rafting, and skiing (downhill and cross-country) have also been shown to reduce the symptoms of PTSD.

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Even if you’re not suffering from a mental health problem, regular physical activity can still offer a welcome boost to your mood, outlook, and mental well-being.

Exercise can help provide:

Sharper memory and thinking. The same endorphins that make you feel better also help you concentrate and feel mentally sharp for tasks at hand. Exercise also stimulates the growth of new brain cells and helps prevent age-related decline .

Higher self-esteem. Regular activity is an investment in your mind, body, and soul. When it becomes habit, it can foster your sense of self-worth and make you feel strong and powerful. You’ll feel better about your appearance and, by meeting even small exercise goals, you’ll feel a sense of achievement.

Better sleep. Even short bursts of exercise in the morning or afternoon can help regulate your sleep patterns . If you prefer to exercise at night, relaxing exercises such as yoga or gentle stretching can help promote sleep.

More energy. Increasing your heart rate several times a week will give you more get-up-and-go. Start off with just a few minutes of exercise per day, and increase your workout as you feel more energized.

Stronger resilience. When faced with mental or emotional challenges in life, exercise can help you build resilience and cope in a healthy way, instead of resorting to alcohol, drugs, or other negative behaviors that ultimately only make your symptoms worse. Regular exercise can also help boost your immune system and reduce the impact of stress.

You don’t need to devote hours out of your busy day to train at the gym, sweat buckets, or run mile after monotonous mile to reap all the physical and mental health benefits of exercise. Just 30-minutes of moderate exercise five times a week is enough. And even that can be broken down into two 15-minute or even three 10-minute exercise sessions if that’s easier.

Even a little bit of activity is better than nothing

If you don’t have time for 15 or 30 minutes of exercise, or if your body tells you to take a break after 5 or 10 minutes, for example, that’s okay, too. Start with 5- or 10-minute sessions and slowly increase your time. The more you exercise, the more energy you’ll have, so eventually you’ll feel ready for a little more. The key is to commit to some moderate physical activity—however little—on most days. As exercising becomes a habit, you can slowly add extra minutes or try different types of activities. If you keep at it, the benefits of exercise will begin to pay off.

You don’t have to suffer to get results

Research shows that moderate levels of exercise are best for most people . Moderate means:

• That you breathe a little heavier than normal, but are not out of breath. For example, you should be able to chat with your walking partner, but not easily sing a song.
• That your body feels warmer as you move, but not overheated or very sweaty.

Can’t find time to exercise during the week? Be a weekend warrior

A recent study in the United Kingdom found that people who squeeze their exercise routines into one or two sessions during the weekend experience almost as many health benefits as those who work out more often. So don’t let a busy schedule at work, home, or school be an excuse to avoid activity. Get moving whenever you can find the time—your mind and body will thank you!

Even when you know that exercise will help you feel better, taking that first step is still easier said than done. Obstacles to exercising are very real—particularly when you’re also struggling with a mental health issue.

Here are some common barriers and how you can get past them.

Feeling exhausted. When you’re tired, depressed, or stressed, it seems that working out will just make you feel worse. But the truth is that physical activity is a powerful energizer. Studies show that regular exercise can dramatically reduce fatigue and increase your energy levels. If you are really feeling tired, promise yourself a quick, 5-minute walk. Chances are, once you get moving you’ll have more energy and be able to walk for longer.

Feeling overwhelmed. When you’re stressed or depressed, the thought of adding another obligation to your busy daily schedule can seem overwhelming. Working out just doesn’t seem practical. If you have children, finding childcare while you exercise can also be a big hurdle. However, if you begin thinking of physical activity as a priority (a necessity for your mental well-being), you’ll soon find ways to fit small amounts of exercise into even the busiest schedule.

Feeling hopeless. Even if you’ve never exercised before, you can still find ways to comfortably get active. Start slow with easy, low-impact activities a few minutes each day, such as walking or dancing.

Feeling bad about yourself. Are you your own worst critic? It’s time to try a new way of thinking about your body. No matter your weight, age or fitness level, there are plenty of others in the same boat. Ask a friend to exercise with you. Accomplishing even the smallest fitness goals will help you gain body confidence and improve how you think about yourself.

Feeling pain. If you have a disability, severe weight problem, arthritis, or any injury or illness that limits your mobility, talk to your doctor about ways to safely exercise . You shouldn’t ignore pain, but rather do what you can, when you can. Divide your exercise into shorter, more frequent chunks of time if that helps, or try exercising in water to reduce joint or muscle discomfort.

Many of us find it hard enough to motivate ourselves to exercise at the best of times. But when you feel depressed, anxious, stressed or have another mental health problem, it can seem doubly difficult. This is especially true of depression and anxiety, which can leave you feeling trapped in a catch-22 situation. You know exercise will make you feel better, but depression has robbed you of the energy and motivation you need to work out, or your social anxiety means you can’t bear the thought of being seen at an exercise class or running through the park.

Start small. When you’re under the cloud of anxiety or depression and haven’t exercised for a long time, setting extravagant goals like completing a marathon or working out for an hour every morning will only leave you more despondent if you fall short. Better to set achievable goals and build up from there.

Schedule workouts when your energy is highest. Perhaps you have most energy first thing in the morning before work or school or at lunchtime before the mid-afternoon lull hits? Or maybe you do better exercising for longer at the weekends. If depression or anxiety has you feeling tired and unmotivated all day long, try dancing to some music or simply going for a walk. Even a short, 15-minute walk can help clear your mind, improve your mood, and boost your energy level. As you move and start to feel a little better, you’ll often boost your energy enough to exercise more vigorously—by walking further, breaking into a run, or adding a bike ride, for example.

Focus on activities you enjoy. Any activity that gets you moving counts. That could include throwing a Frisbee with a dog or friend, walking laps of a mall window shopping, or cycling to the grocery store. If you’ve never exercised before or don’t know what you might enjoy, try a few different things. Activities such as gardening or tackling a home improvement project can be great ways to start moving more when you have a mood disorder—as well as helping you become more active, they can also leave you with a sense of purpose and accomplishment.

Be comfortable. Wear clothing that’s comfortable and choose a setting that you find calming or energizing. That may be a quiet corner of your home, a scenic path, or your favorite city park.

Reward yourself. Part of the reward of completing an activity is how much better you’ll feel afterwards, but it always helps your motivation to promise yourself an extra treat for exercising. Reward yourself with a hot bubble bath after a workout, a delicious smoothie, or with an extra episode of your favorite TV show, for example.

Make exercise a social activity. Exercising with a friend or loved one, or even your kids, will not only make exercising more fun and enjoyable, it can also help motivate you to stick to a workout routine. You’ll also feel better than if you were exercising alone. In fact, when you’re suffering from a mood disorder such as depression, the companionship can be just as important as the exercise.

Easy ways to move more that don’t involve the gym

Don’t have a 30-minute block of time to dedicate to yoga or a bike ride? Don’t worry. Think about physical activity as a lifestyle rather than just a single task to check off your to-do list. Look at your daily routine and consider ways to sneak in activity here, there, and everywhere.

Move in and around your home. Clean the house, wash the car, tend to the yard and garden, mow the lawn with a push mower, sweep the sidewalk or patio with a broom.

Sneak activity in at work or on the go. Bike or walk to an appointment rather than drive, use stairs instead of elevators, briskly walk to the bus stop then get off one stop early, park at the back of the lot and walk into the store or office, or take a vigorous walk during your coffee break.

Get active with the family. Jog around the soccer field during your kid’s practice, make a neighborhood bike ride part of your weekend routine, play tag with your children in the yard, go canoeing at a lake, walk the dog in a new place.

Get creative with exercise ideas. Pick fruit at an orchard, boogie to music, go to the beach or take a hike, gently stretch while watching television, organize an office bowling team, take a class in martial arts, dance, or yoga.

Make exercise a fun part of your everyday life

You don’t have to spend hours in a gym or force yourself into long, monotonous workouts to experience the many benefits of exercise. These tips can help you find activities you enjoy and start to feel better, look better, and get more out of life.

More Information

• Greer, T. L., Trombello, J. M., Rethorst, C. D., Carmody, T. J., Jha, M. K., Liao, A., Grannemann, B. D., Chambliss, H. O., Church, T. S., & Trivedi, M. H. (2016). Improvements in psychosocial functioning and health-related quality of life following exercise augmentation in patients with treatment response but non-remitted major depressive disorder: Results from the TREAD study. Depression and Anxiety, 33(9), 870–881. Link
• Kandola, A., Vancampfort, D., Herring, M., Rebar, A., Hallgren, M., Firth, J., & Stubbs, B. (2018). Moving to Beat Anxiety: Epidemiology and Therapeutic Issues with Physical Activity for Anxiety. Current Psychiatry Reports, 20(8), 63. Link
• Aylett, E., Small, N., & Bower, P. (2018). Exercise in the treatment of clinical anxiety in general practice – a systematic review and meta-analysis. BMC Health Services Research, 18(1), 559. Link
• Stubbs, B., Vancampfort, D., Rosenbaum, S., Firth, J., Cosco, T., Veronese, N., Salum, G. A., & Schuch, F. B. (2017). An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry Research, 249, 102–108. Link
• Kandola, A. A., Osborn, D. P. J., Stubbs, B., Choi, K. W., & Hayes, J. F. (2020). Individual and combined associations between cardiorespiratory fitness and grip strength with common mental disorders: A prospective cohort study in the UK Biobank. BMC Medicine, 18(1), 303. Link

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