Tanya Meade

Background: The global demand for mental health services has significantly increased over the past decade, exacerbated by the COVID-19 pandemic. Digital resources, particularly smartphone apps, offer a flexible and scalable means of addressing the research-to-practice gap in mental health care. Clinicians play a crucial role in integrating these apps into mental health care, although practitioner-guided digital interventions have traditionally been considered more effective than stand-alone apps. Objective: This scoping review explored mental health practitioners’ views on potential use or integration of smartphone apps into clinical practice. We asked, “What is known about how mental health practitioners view the integration of smartphone apps into their practice?” Further, this scoping review explored the factors that might influence integration of smartphone apps into practice, such as practitioner and client characteristics, app design and functionality, and practitioner views. Methods: We conducted a systematic search of 3 databases that yielded 38 studies published between 2018 and 2025, involving 1894 participants across various mental health disciplines, most predominantly psychologists and psychiatrists. Data were collected on practitioner and client characteristics, app functionality, and factors deemed important or influencing practitioners’ opinions about app integration. Results: The included studies were most likely to explore use of apps outside the clinical session and focused on self-management apps for mental health monitoring and tracking, and for collecting data from the patient. Fewer studies explored use of apps within-session, or practitioner-guided apps. Practitioners prioritized app features aligned with the American Psychological Association’s evaluation criteria, with practitioners prioritizing engagement and interoperability, but also noted the importance of training and resourcing to support integration. Conclusions: While practitioners recognize the potential of apps in mental health care, integration into clinical practice remains limited. This study highlights the need for further research on practical implementation, clinical effectiveness, and practitioner training to facilitate the transition from potential to actual use of apps in mental health care settings. Recommendations include evaluating effectiveness of app integration through experimental studies and developing training modules to develop practitioners’ digital competencies and confidence in app use.

Despite a wealth of research demonstrating the efficacy of exposure therapy for the anxiety and related disorders, research shows that few therapists use this technique in clinical practice. Negative beliefs about exposure therapy have been shown to be the most significant barrier to use or optimal use. A richer and more nuanced understanding of the relationship between negative beliefs and exposure use, and its implications for training and practice, is warranted. This research aimed to identify the specific negative beliefs about exposure held by Australian psychologists, and the association of these beliefs with the use of therapist-assisted and self-guided exposure (i.e. between-session exposure homework) of exposure therapy for anxiety, obsessive-compulsive, and post-traumatic stress disorders. One hundred registered psychologists participated in an online study. Results suggest that the most frequently endorsed negative belief is the need for arousal reduction techniques to tolerate distress associated with exposure therapy. Negative beliefs about exposure were negatively correlated with both therapist-supported and self-guided exposure of exposure therapy across all disorders, though largest correlations were found for therapist-supported techniques. Training implications of these findings are discussed.

The construction industry is undoubtedly one of the most significant global sectors that contributes to sustainable development across physical, social, environmental and economic objectives. Globally the value of the construction industry is USD 10 trillion annually. The robustness of the sector is in serious question with a crisis in mental health. The rebuilding of economies is often led by significant capital works programs and therefore in response to the global pandemic, it is anticipated that this problem will only be exacerbated. The construction sector has a unique project-based structure of numerous intersecting subsectors, which influence the behaviours and culminate in highly demanding work environments on a project-by-project basis. We propose that to institute transformational change to the mental health problem, we need to challenge current problematisations towards presenting a new conceptual framework. The aim of this paper is to analyse the industrial organisation and the structural and behavioural context of the industry and propose a new approach to understanding interactions at multiple levels in relation to root causes of the mental health problem. Aligned to the UN SDG that we are to ensure healthy lives and promote well-being for all, this paper responds to high rates of depression, anxiety and suicide in the construction industry. There is a need to generate new knowledge about the interactions between multi project supply chain, construction project supply chain environment and construction supply chain performance in relation to mental health outcomes. Literature indicates that there is a wealth of research on stressors, coping and interventions at an individual level, however very little from an ‘insider’ construction management perspective which contextualise mental health outcomes with the environmental stressors. Coupled with this, past research designs predominantly utilised quantitative approaches reliant on questionnaires. We critique past problematisations of the mental health problem and show how it has been represented to enable the development of a reframed conceptualisation. There is a need to identify contextual evidence-based stressors throughout the construction project supply chain. We present a transformational change model integrating construction industry specific context knowledge with psychosocial expertise to improve workers’ mental health. Future research could lead to outcomes including recommendations and guidelines to engage management actors who can influence positive change through preventative strategies leading to effective and measurable mental health and project performance improvements.

Individual associations between lifestyle behaviours and mental health have been established; however, evidence on the clustering of these behaviours and the subsequent impact on mental health is limited. The purpose of this study was to examine cross-sectional and longitudinal associations between combined unhealthy lifestyle behaviours (physical activity, sitting time, sleep duration, processed meat consumption, vegetable consumption, fruit consumption, smoking status, alcohol consumption) and the development of psychological distress (measured using the Kessler Psychological Distress Scale) in a large Australian sample. Participants were 163,707 Australian adults from the 45 and Up Study. Data from baseline (2006–2009) and follow-up wave 1 (2012) were analysed using binary logistic regression. The odds of reporting high or very high psychological distress at follow-up were significantly higher for those reporting five (AOR = 2.36; 95% CI 1.41–3.97, p = 0.001) or six or more (AOR = 3.04; 95% CI 1.62–5.69, p = 0.001) unhealthy lifestyle behaviours, in comparison to those reporting no unhealthy lifestyle behaviours at baseline. These findings suggest that a holistic, multi-faceted lifestyle approach addressing multiple behaviours may be required to support and promote positive mental health and to reduce the likelihood of psychological distress.

Objectives: Bipolar disorder research has primarily focused on clinical outcomes but there is increasing understanding of the importance of personal recovery. This study aimed to explore the relationship between functioning in key social roles including parenting and intimate relationships with personal recovery.Method: Participants with bipolar disorder (N = 393) were recruited to participate in an online survey. Participants provided clinical information and completed measures of personal recovery, parental and intimate relationship functioning.Results: Parental functioning and intimate relationship functioning were found to be significantly associated with recovery scores with higher scores being associated with greater recovery. Parental functioning was also found to have a predictive effect, with higher parental functioning predicting greater recovery scores.Conclusions: This study suggests that greater parental functioning may have an important role in the experience of personal recovery for people living with bipolar disorder. Future studies should further assess how supporting parenting may contribute recovery outcomes.

Background: The aim of this metasynthesis was to explore adult anorexia nervosa (AN) treatment experiences, including facilitators and barriers to treatment engagement and ways that questions of identity and personal agency were negotiated in treatment contexts. Methods: From 14 qualitative studies that met the search criteria, this thematic synthesis analyzed the sensitized concept of identity in the participants’ experiences of AN treatments, including their sense of personal agency, and implications for their recovery. The study was registered with Prospero (ID: CRD42018089259) and is reported according to PRISMA guidelines. Results: Three meta-themes were generated with the following key findings: grappling with identity, where collaborative and tailored interventions were positively experienced; the quality of the therapeutic relationship, which existed in a recursive relationship; and, rebuilding identity that included therapists standing with the person in recovering a sense of identity outside the anorexic identity. Importantly, interventions that failed to be negotiated with the person were experienced as disempowering however, where a two-way trust existed in the therapeutic relationship, it critically empowered and shaped participants’ sense of identity, and broadened the perception that they were valuable as a person. Conclusions: There was consensus across the range of treatment contexts that individuals with a lived AN experience preferred treatments where they experienced (1) a sense of personal agency through tailored interventions; and (2) therapists who treated them as a person who, in the face of their struggles, had skills and capacities in the processes of recovering and rebuilding sustainable and preferred identities outside the AN identity.

Background: Carers provide both practical and emotional support and often play an important role in coordination of care for recipients. The demands of caring may lead to increased levels of stress for the carer, which can affect mental health and quality of life. This study examined the relationship between being a carer and psychological distress (assessed using the Kessler Psychological Distress Scale [K10]), and explored the moderating effect of social support in that relationship using a large sample. Methods: The study used data from the 45 and Up study, a large cohort study of individuals aged 45 years and over in New South Wales, Australia, and applied multiple regression methods and moderation analysis. The sample for the current study comprised 267,041 participants drawn from the baseline dataset, with valid data on the primary outcome (carer status). Results: The mean age of participants was 62.73 (±11.18) years, and 4.23% and 7.13% were identified as full-time and part-time carers, respectively. Compared to non-carers, full-time carers had K10 scores that were on average, higher by 1.87, while part-time carers’ K10 scores were on average higher by 1.60 points. A perception of social support reduced the strength of the relationship between carer status and psychological distress by 40% for full-time carers and 60% for part-time carers. Conclusions: The findings have important implications, for both prevention and treatment of psychological problems among carers. In terms of prevention, they suggest that public health campaigns focused on increasing awareness regarding the psychological burden faced by carers would be useful. In terms of intervention, potential treatments that focus on improving social support networks may be helpful. The results are particularly important in the current context of an ageing population in Australian and other developed countries, where caregiving is likely to play an increasing role in the care and support services.

Background: Suicide is one of the most frequent causes of death in young people worldwide. Depression lies at the root of this issue, a condition that has a significant negative impact on the lives of those who experience it and on society more generally. However, 80% of affected young people do not obtain professional help for depression and other mental health issues. Therefore, a key challenge is to find innovative and appealing ways to engage young people in learning to manage their mental health. Research suggests that young people prefer to access anonymous Web-based programs rather than get face-to-face help, which has led to the development of numerous smartphone apps. However, the evidence indicates that not all of these apps are effective in engaging the interest of young people who are most in need of help. Objective: The study aimed to investigate young people’s response to six currently available smartphone apps for mental health and to identify features that young people like and dislike in such apps. Methods: Focus groups were conducted with 23 young people aged 13 to 25 years in which they viewed and used six smartphone apps for mental health. A general inductive approach following a realist paradigm guided data analysis. Results: The results revealed that young people value autonomy and the opportunity to personalize experiences with these apps above other things. Finding a balance between simplicity and informativeness is also an important factor. Conclusions: App developers need to consider using participant-design frameworks to ensure that smartphone apps are providing what young people want in a mental health app. Solutions to the need for personalization and increasing user engagement are also crucially needed.

Despite the increasing number of evidence-based research on relational spirituality (RS) and quality of life (QoL) in medical-health research, little is known about the links between RS and QoL outcomes and the mechanisms by which RS aspects are functionally tied to QoL. To determine how RS is perceived/positioned in relation to QoL, we (a) examined recent available data that identify and appraise the links between RS and QoL; (b) identified themes emerging from the association between RS and QoL, and (c) discussed the implications of the effects of RS on QoL outcomes. We conducted an integrative research review of English-language peer-reviewed articles published between 2007 to March 2017 which examined an association between RS and QoL, as identified from a search of three databases: PubMed, PsycINFO, and ScienceDirect. A total of 20 studies were analysed. Of these, twelve (60%) reported positive association between RS and QoL, three (15%) studies reported inverse associations, whereas five (25%) studies showed evidence of lack of association (with two out of the five studies showing an indirect association). Physical health and psychological functioning were the most researched domains of QoL, and some studies suggest an attachment-based model of RS in the last 10 years of RS and QoL research. Studies conducted with participants with serious illnesses ranging from dementia, cardiac arrest, and breast cancer reported no association between RS and physical health. Our review shows evidence of both the direct and/or indirect effects of RS on QoL as a possible spiritual coping model for complementary alternative health therapy, albeit occurring through several religious-related psychosocial conduits. RS appears to be associated with health benefits as indicated across QoL domains. General medical practitioners and other healthcare agencies could benefit from the understanding that a spiritual coping model could aid their patients, and therefore their clinical practices, in the healing process.