BackgroundOne half of adults who develop any mental disorder do so during adolescence. Previous literature showed that Mental Health Literacy (MHL) interventions impact mental health knowledge, reduce the associated stigma, and promote help-seeking among the adolescent population. However, evidence for the effectiveness and cost-effectiveness of these programmes remains inconclusive. The aim of this paper is to present a study protocol that evaluates the effectiveness of the “EspaiJove.net” programme. “EspaiJove.net” consists of a universal MHL intervention designed to promote mental health knowledge, increase help-seeking, reduce the stigma associated with mental illness, and prevent mental disorders in Spanish school settings.MethodsA school-based clustered randomised controlled trial (cRCT) design with 12 months of follow-up. Subjects: At least 408 secondary school students who attend the 3rd year of E.S.O (Compulsory secondary education for 13- to 14-year- olds) will be recruited from 8 schools within Barcelona city, Catalonia (Spain). Intervention: A dose-response intervention will be delivered with 4 arms: 1) Sensitivity Programme (SP) in Mental Health (1 h); 2) Mental Health Literacy (MHL) Programme (6 h); 3) MHL plus first-person Stigma Reduction (MHL + SR) (7 h); 4) Control group: waiting list.Primary outcomes: 1) MHL: EspaiJove.net MHL Test (EMHLT); 2) Stigma: Reported and Intended Behaviour Scale (RIBS) and Community Attitudes toward the Mentally Ill (CAMI). Others outcomes: 1) Acceptability of intervention; 2) Mental health symptoms and emotional well-being (SDQ); 3) States of Change Scale (SCS); 4) Bullying and Cyberbullying; 5) Quality of life (EQ-5D); 6) Help seeking and use of treatment; 7) Health benefits.DiscussionResults would be informative for efforts to prevent mental disorders and promote mental wellbeing in secondary school students.Trial registrationNCT03215654 (date registration July 12, 2017).Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5855-1) contains supplementary material, which is available to authorized users.

BackgroundSince 1997, several tools based on the experiences of users and survivors of psychiatry have been developed with the goal of promoting self-determination in recovery, empowerment and well-being.ObjectivesThe aims of this study were to identify these tools and their distinctive features, and to know how they were created, implemented and evaluated.MethodThis work was conducted in accordance with a published Scoping Review protocol, following the Arksey and O’Malley approach and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Five search strategies were used, including contact with user and survivor networks, academic database searching (Cochrane, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PsycARTICLES, SCOPUS, PubMed and Web of Science), grey literature searching, Google Scholar searching and reference harvesting. We focused on tools, elaborated by users and survivors, and studies reporting the main applications of them. The searches were performed between 21 July and 22 September 2022. Two approaches were used to display the data: descriptive analysis and thematic analysis.ResultsSix tools and 35 studies were identified, most of them originating in the USA and UK. Thematic analysis identified six goals of the tools: improving wellness, navigating crisis, promoting recovery, promoting empowerment, facilitating mutual support and coping with oppression. Of the 35 studies identified, 34 corresponded to applications of the Wellness Recovery Action Plan (WRAP). All of them, but one, evaluated group workshops implementations. The most common objective was to evaluate symptom improvement. Only eight studies included users and survivors as part of the research team.ConclusionsOnly the WRAP has been widely disseminated and investigated. Despite the tools were designed to be implemented by peers, it seems they have been usually implemented without them as trainers. Even when these tools are not aimed to promote clinical recovery, in practice the most disseminated recovery tool is being used in this way.

In this article we hope to respond to the various questions that arise when one considers the way in which the media presents mental illness associated with violence. To do so, a literature review was undertaken, including 81 original studies or previous reviews, in an attempt to understand what are the meanings that the media attributes to mental illness and why the researchers consider these meanings to be inadequate and stigmatizing. At the same time, what the research says with respect to the existence, or non-existence, of this association outside of the media was also analyzed. And, finally, different studies were examined that explain the strategies used by the media to construct this association. The review allows us to conclude that the meanings attributed by the media, even if they contradict the opinions of professionals and experts, are effective and functional for commercial criteria...

IntroductionSince the emergence in 1997 of the Wellness Recovery Action Plan, a number of other tools developed by users and/or ex-users of mental health services have been published and implemented. All these tools aim to promote self-determination in mental health recovery processes. A scoping review will be carried out in order to (1) identify existing tools, (2) describe their distinctive characteristics and (3) examine how they have been implemented and evaluated.Methods and analysisThe scoping review will be guided by the methodological framework proposed by Arksey and O’Malley and expanded by Levac et al. It will involve, primarily, a literature search of the following electronic databases: Cochrane database, Cumulative Index to Nursing and Allied Health Literature, PsycInfo, PsycArticles, Scopus, PubMed and Web of Science. In addition, the search process will consider grey literature databases. Users, ex-users and survivors organisations and networks will be contacted in order to identify any relevant material. The reference lists of the articles identified through the literature search will be inspected. Finally, hand searches of journals will be conducted in order to increase the confidence in the search. Two main approaches will be used to present the charted data: a descriptive analysis and a thematic analysis. The study will be performed between April and December 2020. The results will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.Ethics and disseminationThis study does not require ethical approval because the data used are from publicly available materials. The study results will be disseminated through an article submitted for publication to a scientific journal and presented at relevant conferences. The results will also be shared in future workshops and seminars as part of continuing education programmes for mental health professionals.

Background Many countries today are undergoing a paradigm shift in mental health policies towards a recovery-oriented and rights-based approach. From this perspective, self-determination and self-management are fundamental factors for recovery. Despite this shift, there is still a lack of evidence on the effectiveness of training programmes aimed at promoting self-determination and self-management in recovery processes implemented in southern European or Spanish-speaking countries. The aim of this paper is to present a study protocol that evaluates the effectiveness of a 12-session recovery workshop implemented in community mental health services in Catalonia (Spain). Methods/design This is a 12-week follow-up multi-centre non-randomized controlled trial design. At least 160 users will be recruited from 13 Community Rehabilitation Services (CRS) in Catalonia. Eligible participants are adult (≥ 18 years old) users of a CRS, who sign a written consent to participate. The experimental group participates in a recovery workshop, in which people learn to develop and implement their own plan of personal recovery, which includes a Wellness Toolbox, a Maintenance Toolkit, a Personal Growth Plan, a Mirror of Relapses, a Crisis Plan, and a Learning Agenda. The control group participates in the usual activities of the CRS. Data is collected using a questionnaire of sociodemographic characteristics, personal recovery, empowerment, hope and perceived social support. The users’ measurements are taken at the baseline and one week after the end of the workshop. The primary outcome measures include the Self-Identified Stage of Recovery and the Maryland Assessment of Recovery in Serious Mental Illness Scale (short version). The secondary outcome measures include the Netherlands Empowerment List, Dispositional Hope Scale, and Multidimensional Scale of Perceived Social Support. Descriptive statistics for characterizing the sample size will be performed. Multivariate analyses for repeated measures designs will be used to evaluate the primary and secondary outcomes. Between-group and within-subject comparisons will be conducted. Discussion The results of the study will provide information on the usefulness of recovery workshops in a Mediterranean cultural context. Additionally, if this workshop is effective, it will be proposed for inclusion within the portfolio of community mental health services in Catalonia. Trial Registration ISRCTN11695542 (Registration date: 5 July 2022).

Resumen En este artículo se pretende responder a diversos interrogantes que surgen cuando se considera la manera como la enfermedad mental se presenta en los medios de comunicación asociada a la violencia. Para ello, se realizó una revisión de la literatura, incluyendo 81 investigaciones originales o revisiones previas, intentando comprender cuáles son las significaciones que los medios atribuyen a la enfermedad mental y porqué los/as investigadores/as consideran que estas significaciones son inadecuadas y estigmatizantes. A su vez, se analizó qué dicen las investigaciones respecto a la existencia o no de esta asociación fuera de los medios de comunicación. Y, finalmente, se examinaron diversos trabajos que explican las estrategias desplegadas por los medios para construir esta asociación. La revisión permite concluir que las significaciones atribuidas desde los medios, aunque contradicen las opiniones de profesionales y expertos, son efectivas y funcionales para los criterios comerciales.

Background The aim of this study is to evaluate the short- and long-term effects of the universal mental health literacy intervention “EspaiJove.net” in increasing mental health knowledge, help seeking and reducing stigma attitudes in the adolescent population. We also examine whether these effects depend on the intervention intensity.  Methods A clustered school-based randomised controlled trial (cRCT) design. Subjects: 1,298 secondary pupils aged 13 and 14 were recruited from 18 schools in Barcelona (Spain) between September 2016 and January 2018. Intervention: Three programmes were assessed: 1) Sensitivity Programme (SP; 1 h); 2) Mental Health Literacy (MHL; 6 h); 3) MHL plus a first-person Stigma Reduction Programme (MHL + SR; 7 h); 4) Control group (CG): waiting list. Outcome measures: 1) MHL: EspaiJove.net EMHL Test (First part and Second Part); 2) Stigma: RIBS and CAMI; 3) Help-seeking and use of treatment: GHSQ. Analysis: The data was collected at baseline, post-intervention and 6 and 12 months later. An intention-to-treat analysis and imputation method was used to analyse the missing data. Intervention effects were analysed using multilevel modelling. Results One thousand thirty-two students were included (SP = 225; MHL = 261; MHL + SR = 295 and CG = 251). The MHL and MHL + SR interventions showed short- and long-term an increase in knowledge compared to SP and CG, but no significant change post-intervention or over time (First part p = 0.52 and Second part p = 0.62) between intervention groups and CG. No significant changes were found in stigma scores post-intervention or over time (CAMI p = 0.61 and RIBS p = 0.98) or in help-seeking scores (parent p = 0.69; teacher p = 0.23 and healthcare professional p = 0.75). The MHL + SR intervention was the best valued and recommended (p < 0.005). Conclusions The three interventions of the EspaiJove.net programme (SP, MHL and MHL + SR) seem not to be effective in terms MHL, Stigma and help-seeking behaviours. The contact with a person who has experimented mental illness first-hand did not reduce stigma attitudes. Further research should deal with the heterogeneity of MHL interventions (concept, duration and measures) and identify which components of stigma interventions are effective. Trial registration ClinicalTrials.gov identifier: NCT03215654 (registration date 12 July 2017).

Following the guidelines of the United Nations (2006) and the World Health Organization (2013Organization ( , 2019e, 2021b, the mental health and addictions strategic plans in our country currently propose a person-centred, community-based, recovery-oriented, and rights-based care. On December 2, 2021, the Interterritorial Council approved the new Mental Health Strategy of the National Health System (ESM-SNS, for the Spanish acronym) for the period 2022-2026 (Ministerio de Sanidad, 2022). This document considers personal recovery as one of its principles and includes care based on the recovery model in the community as one of its strategic lines. This paradigm shift had already begun previously in the mental health and addiction strategic plans of some regions. Among them, we can find the regional governments of Andalusia (