org355: Are We Talking Too Much About Mental Health?

An interesting article from the New York Times, especially for those of you preparing for the final (Paper 2) exam.

As a member of the mental health group at LSHTM, I have an immediate answer to this question posed in the title. But as an epidemiologist, there's a lot in this article to consider.

For example,

- What are the (unexpected) mediating effects of the trial interventions?

- What do you make of "prevalence inflation" ? How would you test this hypothesis?

- Explain the distinction between efficacy and effectiveness, using an example from a trial in the article

- Should we continue to fund trials into school-level interventions? If so, what needs to change in the trial design?

Re: Are We Talking Too Much About Mental Health?

by | Feifei Martin - Tuesday, 7 May 2024, 5:56 PM

Hi Sujit, this is an interesting article!

- Mediating effects could be factors like personality type (anxious children potentially more prone to catastrophize).

- Prevalence inflation is possible because children and teachers are self-identifying a mental health issue, which is less objective than a clinical diagnosis. It might be interesting to find out the prevalence of self-identified mental health issues in schools with similar demographics without mental health interventions, and compare the prevalence to the schools with the mental health interventions.

- Efficacy is the ability to adhere to the intervention protocols to produce an effect, under ideal circumstances. Effectiveness is how well the intervention performs under real world circumstances. So, teachers training students to learn mindfulness using protocols to help reduce stress is efficacy. Effectiveness is how well that intervention does actually reduce stress for those students.

- We should only continue to fund school-level intervention, if RCT can prove that it's better than doing nothing.