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Mental Health in Times of Crisis: New Trends in Diagnosis and Treatment

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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Environmental Factors and Global Health".

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 17470

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Special Issue Editors

Dr. Argyroula Kalaitzaki

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Guest Editor

Social Work Department and Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life, School of Health Sciences, Hellenic Mediterranean University, Heraklion, Crete, Greece
Interests: aging; dementia; Alzheimer’s disease; psychological consequences (e.g., trauma, stress, mental disorders, etc.) caused by crises (health, economic, social, etc., e.g., COVID-19, war, earthquake etc.) and coping; interpersonal relationships; social networks/ social capital; aggression and violence (domestic, social etc.); social networks and misuse; positive psychology (resilience, well-being, etc.)
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Dr. Vasiliki Yotsidi

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Guest Editor

Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
Interests: mental disorders/psychopathology; psychotherapy process and outcome; wellbeing; positive psychology; mental health prevention; psychodynamic psychotherapy; cross-cultural psychology; addictions

Special Issue Information

Dear Colleagues,

Various current global crises, such as the COVID-19 pandemic, the war in Ukraine, climate change, the economic crisis, and refugee crisis, comprise additional risk factors for developing mental health problems or deteriorating pre-existing ones, with potentially long-term effects on both the individual and community level. Global collaboration on giving prominence to emerging mental health needs during the current crises and new trends in assessment, diagnosis, treatment, and psychosocial care are urgently needed.

This Special Issue seeks to publish innovative studies (original investigations, review articles, and short papers) in relation to people’s mental health and well-being during current crises. Studies may include, but are not limited to, the investigation of the risk and protective factors, new diagnostic and treatment approaches, technological advances in clinical research and practice, proactive strategies, specialized mental health interventions, and innovative good practices that increase resilience and post-traumatic growth and promote mental health and well-being. Papers on specific populations such as healthcare workers, users of mental healthcare services, older people, people with disabilities, minorities, refugees, and immigrants are also welcome.

Dr. Argyroula Kalaitzaki
Dr. Vasiliki Yotsidi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

mental disorders
mental health
well-being
resilience
post-traumatic growth
crisis intervention
global crises
online mental health services
telehealth
diagnosis
treatment
clinical community psychology

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Published Papers (8 papers)

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Research

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21 pages, 305 KiB

Open AccessArticle

Burnout and Professional Quality of Life Amongst Crisis Hotline Responders: A Cross-Sectional Survey in Canada During COVID-19

by Stephen Lee-Cheong, Mariam Alaverdashvili, Mackenzie Jardine, Vidhi Shivani Maharaj and Nathan Kolla

Healthcare 2025, 13(9), 1025; https://doi.org/10.3390/healthcare13091025 - 29 Apr 2025

Viewed by 227

Abstract

Background/Objectives: There is a significant gap in accessibility to mental healthcare in Canada. This study aims to examine the population of Canadian crisis hotline responders and investigate the variables that contributed to burnout and professional quality of life during COVID-19. Crisis hotline responders are hypothesized to be affected by burnout and poor professional quality of life, due to the inherent nature of the job and the widespread negative mental health effects of COVID-19, which are expected to continue even after the pandemic. Methods: An online, cross-sectional, mixed-methods survey assessed sociodemographic information, shift-related variables, burnout and related factors, and current support methods utilized by crisis hotline responders across Canada. The open-ended questions helped to more personally reflect participants’ experiences. Data were analyzed using chi-square tests, an analysis of variance, and a regression analysis. Results: The survey was completed by 136 participants (78.7% female) with an average age of 39.68. Participants reported relatively high levels of burnout/stress on both the Copenhagen Burnout Inventory and professional quality of life survey. Younger age, less work experience, and working overnight shifts emerged as possible predictors of worse mental wellbeing. Conclusions: Findings suggest that Canadian crisis hotline responders require greater support to manage workplace burnout/stress. Nevertheless, conducting comprehensive studies during times when there are no public health emergencies are warranted to understand the full scope of burnout in this population. We offer five recommendations to support the mental wellbeing of responders and improve access to this important public health resource. Full article

(This article belongs to the Special Issue Mental Health in Times of Crisis: New Trends in Diagnosis and Treatment)

12 pages, 627 KiB

Open AccessArticle

Depression, Anxiety, Resilience, and Family Functioning Among Different Age Groups During the COVID-19 Pandemic: A One-Year Longitudinal Study

by Vasiliki Efstathiou, Athanasia Papadopoulou, Valeria Pomini, Katerina Chatzimichail, Ioannis Michopoulos, Eleni Vousoura, Pilios-Dimitris Stavrou, Adamantia Kaparoudaki, Marianna Papadopoulou, Nikolaos Smyrnis, Athanasios Douzenis and Rossetos Gournellis

Healthcare 2025, 13(3), 237; https://doi.org/10.3390/healthcare13030237 - 24 Jan 2025

Viewed by 801

Abstract

Background/Objectives: The COVID-19 pandemic has profoundly disrupted mental health globally, affecting individuals across all age groups. Understanding its long-term impact is crucial for identifying age-specific vulnerabilities and informing targeted mental health interventions. This longitudinal study aimed to investigate the within-person changes in mental health across different age groups in Greece from the first to the third pandemic wave of coronavirus disease 2019 (COVID-19) (i.e., one year later) during nationwide lockdowns. It further compared the mental health outcomes of three distinct age groups, stratified based on their vulnerability to COVID-19—younger adults (18–29 years), adults (30–59 years), and older adults (60–84 years)—and examined correlates of depression and anxiety during the third pandemic wave. Methods: A total of 720 participants—92 younger adults, 543 adults, and 85 older adults—completed the same set of questionnaires during the first (April–May 2020) and third (March–May 2021) pandemic-related lockdowns. At both time points, participants provided data on the Generalized Anxiety Disorder-2, Patient Health Questionnaire-2, Systemic Clinical Outcome and Routine Evaluation-15, Connor–Davidson Resilience Scale-2, and demographic information. Results: Results indicated a within-individual increase in depression and a decrease in resilience for all participants, irrespective of age. Anxiety increased only among younger adults and adults, whereas family functioning remained stable across all age groups one year post-pandemic onset. Furthermore, younger adults reported higher levels of depression and anxiety, lower resilience, and more impaired family functioning compared to the older age groups in both lockdowns. Among the different age groups, factors independently associated with depression and anxiety were identified through stepwise regression analyses. Conclusions: The present study provides evidence for mental health deterioration during the pandemic across all age groups, with younger adults exhibiting heightened vulnerability. Full article

(This article belongs to the Special Issue Mental Health in Times of Crisis: New Trends in Diagnosis and Treatment)

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16 pages, 253 KiB

Open AccessArticle

Translation and Cultural Adaptation of an E-Health Program to Promote Positive Mental Health Among Family Caregivers in Portugal

by Sandra Carreira, Núria Albacar-Riobóo, Carme Ferré-Grau, Carlos Sequeira, Carmen Andrade and Odete Araújo

Healthcare 2025, 13(1), 31; https://doi.org/10.3390/healthcare13010031 - 27 Dec 2024

Viewed by 1789

Abstract

Introduction: Caring for a dependent individual, particularly over an extended period, places significant strain on family caregivers, often leading to adverse physical, mental, emotional, social, and economic outcomes for both caregivers and those they care for. Common challenges include anxiety, depression, loneliness, and diminished overall well-being. E-health applications have emerged as effective tools to support family caregivers by promoting positive mental health through online interventions, enhancing problem-solving skills, autonomy, interpersonal relationships, self-control, and a prosocial attitude. Methods: This study aimed to translate and culturally adapt the Spanish “Program to Promote Positive Mental Health through the Cuidadoras Crónicos Manual” into the Portuguese context, supporting its implementation as a smartphone application. The process involved translation, back-translation by two native experts, and refinement through a focus group with eight participants. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: The translation and back-translation processes identified several adjustments, which informed discussions in the focus group. Three key themes emerged: (i) conceptual and semantic equivalence, (ii) optimisation of content, and (iii) relevance and timeliness of the manual. Conclusions: The Spanish manual for promoting positive mental health among family caregivers was successfully translated and culturally adapted into European Portuguese. Validated through expert input, this marks the first version of the manual tailored to Portuguese caregivers, using Positive Mental Health models to support caregivers of individuals with chronic conditions. Full article

(This article belongs to the Special Issue Mental Health in Times of Crisis: New Trends in Diagnosis and Treatment)

12 pages, 233 KiB

Open AccessArticle

“I Felt a Sense of Mission during Moments of Crisis”: Mental Health Professionals’ Perspectives on Their Initial Treatment of Evacuees during the Israel–Hamas Conflict

by Inbar Levkovich and Michal Labes

Healthcare 2024, 12(11), 1098; https://doi.org/10.3390/healthcare12111098 - 27 May 2024

Cited by 3 | Viewed by 1493

Abstract

This study examines mental health service providers who provided care to evacuees during the Israel–Hamas conflict. Utilizing a phenomenological qualitative method, the research delves into the psychological impact on the participants’ lived experiences. The sample included 25 mental health providers (13 female, age range 28–63, mean 42.4, SD 7.3; 15 psychologists and 10 social worker, average seniority 10.8 years, SD 5.2, range 2–18 years). Data were collected through semi-structured interviews conducted between December 2023 and March 2024. The data analysis revealed a dual narrative: Participants paid a major personal price and experienced secondary traumatization manifesting in emotional detachment, physical symptoms, and heightened arousal. They also derived a profound sense of meaning and fulfillment from their work, contributing to personal and professional growth. These findings underscore the complexity of their experiences, which were marked by the challenges of secondary trauma and the resilience fostered through their work. This study emphasizes the importance of support systems, including social and familial networks and professional supervision, in navigating these challenges. This study has several limitations, including small sample size and the use of virtual interviews, suggesting the need for further research with a broader participant base and in different contexts. Full article

(This article belongs to the Special Issue Mental Health in Times of Crisis: New Trends in Diagnosis and Treatment)

15 pages, 603 KiB

Open AccessArticle

The Silver Lining of Posttraumatic Growth around the Dark Side of the COVID-19 Pandemic: A School-Based Intervention with Mindfulness and Character Strengths Practices among Children

by Alexandra Tamiolaki, Argyroula Kalaitzaki, Maria Papadakaki and Elias Kourkoutas

Healthcare 2024, 12(2), 283; https://doi.org/10.3390/healthcare12020283 - 22 Jan 2024

Cited by 4 | Viewed by 2123

Abstract

The theory of posttraumatic growth (PTG) proposes that from life difficulties positive changes can happen, such as deepened personal relationships and an awareness of new possibilities in life. PTG can occur naturally or can be facilitated. This study aimed to promote PTG through a school-based intervention of eight sessions of 45 min each with mindfulness and character strengths practices (the so-called “The exploration of happiness during the COVID-19 pandemic”). The study conducted assessments at baseline, post-intervention, and follow-up (i.e., one month after the intervention). The post-intervention results showed that the participants in the intervention group experienced an improvement in PTG, well-being, mindfulness, strengths use, and PTS symptoms compared to the children in the control group. Furthermore, these positive changes were sustained at follow-up. The findings of this study highlight that mindfulness-based strengths practices can increase positive outcomes (i.e., well-being, posttraumatic growth) and reduce negative psychological symptoms (PTS) among children. The implications for theory and practice are discussed, and detailed appendices for practitioners are provided. Full article

(This article belongs to the Special Issue Mental Health in Times of Crisis: New Trends in Diagnosis and Treatment)

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11 pages, 233 KiB

Open AccessArticle

Empathy and Violence in Schizophrenia and Antisocial Personality Disorder

by Konstantinos Tasios, Athanasios Douzenis, Rossetos Gournellis and Ioannis Michopoulos

Healthcare 2024, 12(1), 89; https://doi.org/10.3390/healthcare12010089 - 30 Dec 2023

Cited by 2 | Viewed by 3346

Abstract

A paucity of cognitive and affective features of empathy can be correlated with violent behavior. We aimed to identify differences in empathy among four groups in a sample of 100 male participants: (1) 27 violent offenders with schizophrenia, (2) 23 nonviolent patients with schizophrenia, (3) 25 patients with antisocial personality disorder, and (4) 25 subjects from the general population, who formed the control group. Schizophrenia symptoms were quantified with the Positive and Negative Syndrome Scale. Empathy was measured with the empathy quotient. Theory of mind was evaluated using (a) the first-order false-belief task, (b) the hinting task, (c) the faux pas recognition test and (d) the “reading the mind in the eyes” test (revised). Differences noted among the groups were age (controls were younger) and educational status (antisocials were less educated). The empathy quotient scoring (p < 0.001) and theory-of-mind tests (p < 0.001) were distinct between the control group and the three other groups of participants, but not among the three patient groups. Patients with antisocial personality disorder, violent psychotic offenders and psychotic nonviolent patients show no remarkable differences in affective or cognitive empathy tests, but they all present deficits in empathy and theory of mind when compared to controls. Full article

(This article belongs to the Special Issue Mental Health in Times of Crisis: New Trends in Diagnosis and Treatment)

16 pages, 477 KiB

Open AccessArticle

Group Belonging and Social Identities in the Transition of Asylum-Seekers in Greece: Longitudinal Pathways to Adjustment

by Angelos Panagiotopoulos and Vassilis Pavlopoulos

Healthcare 2024, 12(1), 55; https://doi.org/10.3390/healthcare12010055 - 26 Dec 2023

Viewed by 1435

Abstract

Millions of forced migrants settling in host countries often struggle to adjust to their new life. As their inclusion and adjustment within receiving societies has become a global social challenge, studying the factors that support their successful transition is an important topic of research inquiry. The present three-wave longitudinal study examined the role of group belonging and social identification in facilitating the transition of 60 sub-Saharan African asylum-seekers to Greece. Drawing upon the Social Identity Model of Identity Change (SIMIC), we investigated how multiple group memberships before migration, social identity continuity, and social identity gain related to their adjustment over 8 months. On the between-person level, multiple group belonging before migration indirectly contributed to better person-average levels of sociocultural adjustment, physical health functioning and satisfaction, psychological distress, and life satisfaction, by way of higher person-average levels of social identity continuity and/or social identity gain. However, multiple groups before migration also had a direct negative effect on the overall levels of psychological distress. On the within-person level, positive changes in social identity continuity and gain were related to positive changes in different adjustment-related outcomes over time. Our findings are consistent with SIMIC and highlight the importance of group belonging and associated social identities in forced migrants’ transition, in ways that may pave the way for the development of social identity interventions to promote their health, well-being, and successful integration. Future longitudinal and experimental evidence with larger and more diverse samples of forced migrants is needed to establish the generalizability and causality of the observed associations. Full article

(This article belongs to the Special Issue Mental Health in Times of Crisis: New Trends in Diagnosis and Treatment)

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Review

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20 pages, 759 KiB

Open AccessReview

Psychotherapeutic and Psychosocial Interventions with Unaccompanied Minors: A Scoping Review

by Irene Moutsou, Eugenie Georgaca and Theofilos Varaklis

Healthcare 2023, 11(6), 918; https://doi.org/10.3390/healthcare11060918 - 22 Mar 2023

Cited by 2 | Viewed by 3574

Abstract

Unaccompanied minors (UAMs) are considered a particularly vulnerable population, facing severe threats regarding their physical and mental health. As their number has increased in recent years worldwide, research on mental health interventions has become necessary. The implementation of psychotherapeutic interventions has been documented, but psychosocial interventions seem to not have been consistently studied. In this review, we summarize the psychotherapeutic and psychosocial interventions with UAMs that have been studied up to now. Following the PRISMA guidelines for scoping reviews, we searched four databases and included studies and practice papers; there were no restrictions on publication date, geographical region, language, or method. We identified 46 studies on psychotherapeutic interventions and 16 studies on psychosocial interventions that met the inclusion criteria. Psychotherapeutic interventions were mainly based on cognitive behavioural, psychodynamic, narrative, art and transcultural approaches and aimed at improving UAMs’ trauma, mental health and wellbeing, as well as professionals’ skills and therapeutic protocols. Several studies showed promising results, with the cognitive behavioural approaches being the most researched. However, more research is needed in order to draw conclusions in terms of effectiveness. Psychosocial interventions followed various approaches and aimed at UAMs’ empowerment, wellbeing, support and integration, as well as at improving caregivers’ skills. Nonetheless, they seem not only very heterogeneous but also understudied, and we believe that a focus on them would be very useful. Methodological limitations and their implications for future research are discussed. Full article

(This article belongs to the Special Issue Mental Health in Times of Crisis: New Trends in Diagnosis and Treatment)

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