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Mental health is an emerging health policy priority globally. The emphasis on closing the treatment gap in psychiatric services is now being complemented by an increasing focus on prevention and health promotion. The purpose of this paper is to describe the programmes and delivery of public mental health in England led by Public Health England (PHE), an arms-length body of the Department of Health and Social Care.

This technical paper outlines the general approach PHE has taken in delivering national work in public mental health and describes several key areas of work: children and young people, suicide prevention, workplace and workforce, strategic engagement with stakeholders, data and information and evidence synthesis.

A description of the various programmes and guidance documents that PHE have produced are described and referenced, which form a substantial body of work in public mental health.

The outputs from PHE may assist in informing the approach to public mental health that other government agencies could consider adopting. The resources described and signposted within this technical paper are publicly available for readers.

England is one of a small group of countries that have a track record in delivering public mental health at a national level. This paper gives a unique and detailed insight into this work.

Hand foot mouth disease (HFMD) is an emerging disease caused by Enterovirus. HFMD usually occurs in South-East Asian countries including Thailand. Thailand has been indicated as one of the countries having high epidemic rate in children less than five years of age, particularly in the northern regions. The paper aims to discuss this issue.

A qualitative method was used to extract information from 48 informants from two different areas; high and low epidemic areas of HFMD. Question guidelines were developed from literature review and viewed by three external experts in the field before use. Interviews took place in a private and confidential room. Each interview lasted approximately 50 minutes.

There are no policies regarding HFMD control in both high and low epidemic areas of HFMD. The staff at sub-district local government level did not have the necessary qualifications for HFMD control. Additionally, staff were not stable, and there was a lack of a disease control team. Antiseptics for cleaning day care centers (DCC) were not effective for disease control; most DCC use Dettol®, soap, dishwashing liquid, detergent and water for cleaning the environment. These antiseptics do not include chlorine making it ineffective in destroying the virus.

The sub-district local government should be concerned about HFMD control; the staff should have the necessary qualifications suitable for disease control. Standard and practical HFMD control guideline should be set up and used in DCC.

This discursive paper presents a lived experience leadership model as developed as part of the Activating Lived Experience Leadership (ALEL) project to increase the recognition and understanding of lived experience leadership in mental health and social sectors. The model of lived experience leadership was formulated through a collaboration between the South Australian Lived Experience Leadership & Advocacy Network and the Mental Health and Suicide Prevention Research and Education Group.

As one of the outcomes of the ALEL research project, this model incorporates findings from a two-year research project in South Australia using participatory action research methodology and cocreation methodology. Focus groups with lived experience leaders, interviews with sector leaders and a national survey of lived experience leaders provided the basis of qualitative data, which was interpreted via an iterative and shared analysis. This work identified intersecting lived experience values, actions, qualities and skills as characteristics of effective lived experience leadership and was visioned and led by lived experience leaders.

The resulting model frames lived experience leadership as a social movement for recognition, inclusion and justice and is composed of six leadership actions: centres lived experience; stands up and speaks out; champions justice; nurtures connected and collective spaces; mobilises strategically; and leads change. Leadership is also guided by the values of integrity, authenticity, mutuality and intersectionality, and the key positionings of staying peer and sharing power.

This model is based on innovative primary research, which has been developed to encourage understanding across mental health and social sectors on the work of lived experience leaders in seeking change and the value that they offer for systems transformation. It also offers unique insights to guide reflective learning for the lived experience and consumer movement, workers, clinicians, policymakers and communities.

Mental well-being is associated with positive outcomes throughout the life course. This study aims to examine interventions delivered by allied health professionals (AHPs) to alleviate community stressors adversely impacting public mental health and well-being.

Review inclusion criteria comprised experimental and qualitative process evaluations of public mental health interventions delivered by AHPs. Electronic searches in Cinahl, Embase, Medline, PsycINFO and the Cochrane Library, were combined with grey literature searches of National Institute for Health and Care Excellence public health guidance. A narrative synthesis and the Effective Public Health Practice Project appraisal tool were used to evaluate the evidence.

A total of 45-articles were included in the review describing AHP-delivered interventions addressing social disadvantage, trauma, bullying, loneliness, work-related stress, transitional stress, intersectionality, pain and bereavement. No articles were identified evaluating interventions delivered by operating department practitioners or orthoptists. A conceptual map was developed summarising the stressors, and a typology of public mental health interventions defined including: place-based interventions, discrete/one-off interventions, multi-component lifestyle and social connector interventions and interventions targeting groups at risk of mental health conditions.

Many mental health conditions begin in childhood, and a strength of the review is the life course perspective. A further strength is compiling a compendium of public mental health outcome measures used by AHPs to inform future research. The authors excluded many articles focussed on clinical interventions/populations, which did not meet review inclusion criteria. While playing a key role in delivering public mental health interventions, clinical psychologists are not defined as AHPs and were excluded from the review, and this may be construed a limitation. Given heterogeneity of study designs and interventions evaluated numerical analyses of pooled findings was not appropriate.

The review highlights the breadth of community stressors on which AHPs can intervene and contribute in public mental health contexts, stressors which correspond to those identified in UK Government guidance as currently important and relevant to address. The findings can inform developing community public mental health pathways that align with the UK National Health Service (NHS) Long Term Plan, on prevention and early intervention to protect community mental health and well-being. Further can inform the NHS strategic direction for AHPs including informing ways of increasing utilisation of core AHP skills to optimise contributions in public mental health agendas.

It is surprising there were not more AHP delivered evaluations of interventions for other stressors important to address in public mental health settings, for example gambling, domestic violence or that used digital technology, and these are areas for future research. Future research should identify the most active/effective dimensions of multi-component interventions which could be informed by frameworks to guide complex intervention development. The relative paucity of research identified, highlights the predominant focus of research to date on interventions for clinical mental health conditions and populations. The lack of preventative approaches is evident, and an important area for future research to align with UK health and social care priorities.

The review highlights AHP-delivered interventions impacting diverse community stressors across the life course. The findings can inform developing public mental health pathways aligned with government health service priorities to protect mental health and well-being, prioritise prevention and early intervention and increase utilisation of AHP skills across public mental health settings.

Early identification of persons at risk is essential in suicide prevention. Undocumented migrants (UM) live under limited conditions and are to a high degree invisible, both in research and in suicide prevention programmes. The aim of this study was to investigate prevalence rates of suicidal thoughts among UM in Sweden.

This cross-sectional study was part of the Swedish Health Research on Undocumented Migrants project (SHERUM). The study population consisted of 104 UM over 18 years of age recruited through informal networks. Data on 112 multiple choice questions was collected via trained interviewers in Gothenburg, Stockholm and Malmö during 2014–2016. To assess suicidal thoughts (the last two weeks) one item asking about suicidal thought in the Beck Depression Inventory scale (BDI-II) was used. Logistic regression and chi-square analyses were made to identify risk and protective factors.

Suicidal thoughts were found in 43.2% of the 88 UM that answered the question on suicidal thoughts. Being a parent had some protective influence on the prevalence of suicidal thoughts while the housing situation, having been exposed to crime and having mental illness were all statistically significant risk factors for suicidal thoughts. However, due to low sample size, few variables presented statistically significant differences.

This study presents an alarmingly high prevalence of suicidal thoughts among undocumented migrants in Sweden, a difficult-to reach, vulnerable and rarely studied group. Targeted strategies are imperative to include undocumented migrants in suicidal prevention programmes.

This research study included an examination into the extent that a comprehensive wellness program affects employees' job satisfaction levels. As the leaders of more hospitality organizations implement wellness programs in the workplace, they will want to understand what factors, besides the employees' health, the wellness programs can impact. Survey participants were self-identified employees of the hospitality organization who did or did not participate in the wellness program. Research findings indicated there was a significant difference in extrinsic and intrinsic job satisfaction levels between employees who participated and employees who were nonparticipating in the wellness program.

The population for this study was from a contract foodservice organization that provides facility services to higher education organizations, from their northeast regional location that consisted of approximately 200 employees. The employees of the organization ranged from entry-level positions, up to and including senior-level management. The researcher solicited employees in all departments in the organization to participate in the survey. The company offers a comprehensive wellness program, and all employees in the organization had a choice to participate in the wellness program.

The intent of the study was to determine if participating in a wellness program affected the employee's job satisfaction levels. Securing a hospitality organization to survey was a challenge, possibly because the survey included questions about job satisfaction. The purpose of the study was to identify whether participation in the wellness program affected employees' extrinsic and intrinsic job satisfaction levels. Hospitality organizations continue to allocate resources to implement and improve existing wellness programs in the workplace. Researchers had not specifically focused on the potential impact a wellness program might have on employee job satisfaction levels. Cyboran and Goldsmith (2012) concluded organization leaders should take steps to create an effective workplace. The study showed that even though hospitality organization leaders are dedicating resources to the development and implementation of wellness programs, participating in the wellness program has an effect on increasing or maintaining current employees' extrinsic and intrinsic job satisfaction levels throughout the organization.

This is the author’s research that was conducted for a dissertation that has been turned into a research article for publication.

This paper aims to provide an estimation of the costs of the coronavirus (COVID-19) pandemic with a special focus on Spain. Costs include macroeconomic costs of foregone gross domestic product (GDP) attributable to the pandemic and the direct and indirect costs of prevention, treatment and lost productivity. This study also analyzes the cost-effectiveness of the test-tracking-quarantine (TTQ) strategy in Spain.

The macroeconomic costs of foregone GDP attributable to the pandemic are estimated for different countries and areas by comparing the present GDP forecasts for 2020 and 2021 with counterfactuals estimated before the COVID-19 crisis aftermath. The total cost of the COVID-19 for Spain in 2020 was obtained using the cost of illness approach with a bottom-up process. A cost-effectiveness analysis of the TTQ strategy in Spain is based on the estimation of the total costs of TTQ and the health gains and avoided health-care costs associated with the TTQ strategy. A sensitivity analysis explores the consequences of uncertainty in key parameters.

The GDP cost of the COVID-19 is by far larger than all the other components of the cost. The global cost of the Covid-19 crisis in 2020–2021 is estimated at 14% of 2019 GDP (around 12,206 mm$). In the specific case of Spain, it amounts to 24% of the 2019 GDP; which is 397.3 m €. Spain is and will be by far the European country most economically affected by the pandemic. In Spain 2020, the GDP cost accounts for 94.7% of the total cost of the COVID-19 and health-care direct costs are only 2.14%. TTQ is a dominant strategy in Spain. For each euro spent on it, 7 euros will be recovered only in terms of saved health-care resources.

Given the large degree of uncertainty and the fast-evolving nature of the epidemic, a number of assumptions are required to arrive at the estimates provided in this study. The results were found to be robust to the assumptions applied.

TTQ is a key strategy for the contention of the epidemy and it is justified from the economic perspective.

This is the first estimation of the cost of the COVID-19 and the cost-effectiveness of the TTQ strategy for Spain.

Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.

The purpose of this study is to develop a reliable test metric that can ascertain health literacy as it relates to hypertension in the population of Thailand.

One thousand five hundred patients from hypertension clinics in hospitals under the Ministry of Public Health, Thailand were recruited to this study. The test was developed and divided into three latent variables and four observed variables for health literacy concepts. Indexes of Item-Objective Congruence (IOC) from seven experts and Cronbach’s alpha coefficient of the entire questionnaire were evaluated for content validity and reliability. The Confirmatory Factor Analysis with LISREL also analyzed for construct validity.

The result illustrates that the Item-Objective Congruence was 0.68, and Cronbach’s alpha coefficient was 0.87. The result also shows that Barlett’s Test of Sphericity was 3129.31 (p < 0.01), and the Kaiser-Meyer-Olkin measure of sampling adequacy was 0.83. The model was fit to empirical data (Chi-square = 0.02).

This study concludes that the Thai Hypertension Health Literacy Assessment Tool (THHLA) created as a result of the study is valid and reliable. The test can be used to evaluate health literacy for hypertension patients in Thailand.

The role of health promoters and educators in the current and future response to COVID-19 is critical, but, to date, under explored. This opinion paper offers a number of important contributions that this professional group may offer both in the immediate and future strategy of global public health. While the importance of a medical model of health cannot be underplayed, the social model of health suggests that some groups in society are being more disproportionately impacted than others. Health promotion has been committed to reducing inequalities and therefore offers “a voice” to those most marginalised. The paper suggests that bottom-up approaches focusing on building individual and community control is essential and, moreover, the concepts of a settings approach in health promotion, the fostering of critical health literacy and “salutogenesis” may be worthy of further debate and discussion.