1. In this meta-ethnography, basic human needs, psycho-emotional factors, and external social determinants demonstrated a role in the unmet mental health needs of homeless individuals.
2. Furthermore, stable housing was found to be foundational in improving all domains of mental health needs.
Evidence Rating Level: 2 (Good)
Over 200,000 individuals experience homelessness in Canada – many of which face significant barriers to basic human needs, as well as mental health needs. Currently, meta-ethnography studies have not focused specifically on the mental health needs of this population. As a result, the objective of the present meta-ethnography study was to elucidate the ways in which mental health needs are unmet for homeless individuals across a variety of settings.
Of 913 screened records across 2011 to 2021, 35 studies (n=1511) were included in the final analysis. Studies were included if they were conducted in Canada, used qualitative methods, and reported the subjective mental health needs of homeless individuals. Studies were excluded if they focused on service providers’ perspectives. Studies were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Research Checklist and followed PRISMA guidelines. The thematic analysis framework was followed. Themes were interpreted by comparing and contrasting findings across a variety of settings.
Results demonstrated six themes that characterized the mental health needs of the homeless population: autonomy, ontological security, hope and purpose, social connection and belonging, empowerment, and access to services. Unmet health needs were revealed through personal narratives of trauma, stigmatization, victimization, and a lack of necessities. Stable housing was identified as a potential avenue to improve all domains of health needs; however, it did not always create a sense of home and community, or improve a sense of mental well-being. Despite these results, the study was limited by the restrictive search strategy which may have excluded additional articles, as well as generalizing findings from a subpopulation. Nonetheless, this study was significant in providing important implications for the development of social programs and on-site mental health support for people in Canada who are homeless or recently housed.
1. In this literature review, heart rate variability measurements were able to detect mild mental stress, despite some gaps in data.
2. Furthermore, accelerometer-based sleep monitoring had a high accuracy and sensitivity in detecting sleep.
Evidence Rating Level: 2 (Good)
The Apple Watch has continually advanced the capabilities of smartwatches and are now able to gather various physiological parameters such as heart rate, respiration rate, and rhythm detection. Currently, their application to mental health monitoring and diagnosis is unknown. As a result, the objective of the present study was to identify current and potential physiological monitoring capabilities of the Apple Watch, relevant to mental health monitoring. Furthermore, this study sought to examine the accuracy and validation status of these measures and their implications for mental health treatment.
Of 5583 identified records from both published and gray literature, 19 were included in the analysis from 2015 to July 2021. Studies were included if they used the Apple Watch for either physiological data validation or psychology of mental health studies. Particular monitoring data points included sleep tracking, heart rate monitoring, respiratory monitoring, and energy expenditure. Data synthesis was performed using Clarivate analytics in EndNote.
Results demonstrated that the Apple Watch performed reasonably well at measuring heart rate, heart rate variability, and step counting. Furthermore, heart rate variability was able to detect mild mental stress. However, atrial fibrillation detection showed mixed results and no studies recorded validation of the Sleep app feature. Despite these results, the present study was limited by the lack of a risk of bias assessment for the studies. Nonetheless, this study demonstrated that more objective measures obtained passively may aid in assisting clinicians in monitoring mental health disorders.
1. In this systematic review, majority of included studies showed a significant association between telemedicine and mental health improvement.
2. Furthermore, the most common telehealth methods included online apps and videoconference.
Evidence Rating Level: 2 (Good)
Telehealth has been a frequently used method of healthcare delivery during the COVID-19 pandemic, due to its efficiency and ability to provide long-distance care. This has been of particular relevance for those who have been isolated such as those who suffer from mental health disorders. Mental health issues have risen since the pandemic, but have not been studied in relation to telehealth. As a result, the objective of the present systematic review was to investigate the association of telemedicine and the improvement of mental health outcomes.
Of 538 identified records, 12 studies (n=1900) were included from database inception to February 2022. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Studies were included if they studied the mental health outcomes of telehealth on patients who were susceptible to mood and anxiety disorders. The primary outcome was the improvement of psychological and mental problems. The study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Results demonstrated that 11 of 12 studies demonstrated a significant effect of telemedicine on various aspects of mental health, with anxiety and depression being the most prevalent measured outcomes. Furthermore, the most common online telecommunication methods included online applications and videoconference. Despite these results, the study was limited by the fact that the overall heterogeneity was not examined. However, these findings suggest that telemedicine may be an efficacious medium to improve mental health disorders during the COVID-19 pandemic.
1. In this systematic review and meta-analysis, women reported worsening anxiety during the COVID-19 pandemic compared to pre-pandemic times.
2. Furthermore, rates of depression were higher during the COVID-19 pandemic but did not reach statistical significance, compared to pre-pandemic times.
Evidence Rating Level: 1 (Excellent)
Depression and anxiety affect a significant proportion of women during both the perinatal period and pregnancy, making them a vulnerable high-risk group. Unfortunately, there is a lack of understanding of the impact that the COVID-19 pandemic has on this population. As a result, the objective of the present systematic review and meta-analysis was to assess the influence of the COVID-19 pandemic on measures on women’s health outcomes during pregnancy and the perinatal period.
Of 108 identified records, 8 studies (n=7750) were included in the final analysis from database inception up to July 2020. Studies were included if they measured depression and anxiety using the Edinburgh Postnatal Depression Scale (EDPS) and State-Trait Anxiety Inventory (STAI) scores, respectively. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Statistical analysis was performed using random-effects models.
Results demonstrated that compared to the pre-pandemic period, the EDPS score was higher amongst subjects during the COVID-19 pandemic, although this was not statistically significant. On the other hand, the STAI anxiety score was significantly higher during the pandemic when compared with pre-pandemic time. Despite these results, the study was limited by the inclusion of only studies using the EDPS and STAI which may not be widely used by the general population. Nonetheless, these findings suggest that clinicians should be aware of the increased vulnerability of this population with respect to mental health outcomes, particularly during the pandemic.
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