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The dual-continua model of mental health suggests that mental illness and positive mental health reflect distinct continua, rather than the extreme ends of a single spectrum. The aim of this review was to scope the literature surrounding the dual-continua model of mental health, to summarise the evidence, highlight the areas of focus for individual studies and discuss the wider implications of the model. A search was conducted in PsycINFO (n = 233), PsycARTICLES (n = 25), Scopus (n = 137) and PubMed (n = 47), after which a snowballing approach was used to scope the remaining literature. The current scoping review identified 83 peer-reviewed empirical articles, including cross-sectional, longitudinal and intervention studies, which found overall support for superior explanatory power of dual-continua models of mental health over the traditional bipolar model. These studies were performed in clinical and non-clinical populations, over the entire life-course and in Western and non-Western populations. This review summarised the evidence suggesting that positive mental health and mental illness are two distinct but interrelated domains of mental health; each having shared and unique predictors, influencing each other via complex interrelationships. The results presented here have implications for policy, practice and research for mental health assessment, intervention design, and mental health care design and reform.

Background The coronavirus disease (COVID-19) is expected to have widespread and pervasive implications for mental health in terms of deteriorating outcomes and increased health service use, leading to calls for empirical research on mental health during the pandemic. Internet-based psychological measurement can play an important role in collecting imperative data, assisting to guide evidence-based decision making in practice and policy, and subsequently facilitating immediate reporting of measurement results to participants. Objective The aim of this study is to use an internet-based mental health measurement platform to compare the mental health profile of community members during COVID-19 with community members assessed before the pandemic. Methods This study uses an internet-based self-assessment tool to collect data on psychological distress, mental well-being, and resilience in community cohorts during (n=673) and prior to the pandemic (two cohorts, n=1264 and n=340). Results Our findings demonstrate significantly worse outcomes on all mental health measures for participants measured during COVID-19 compared to those measured before (P<.001 for all outcomes, effect sizes ranging between Cohen d=0.32 to Cohen d=0.81. Participants who demonstrated problematic scores for at least one of the mental health outcomes increased from 58% (n=197/340) before COVID-19 to 79% (n=532/673) during COVID-19, leading to only 21% (n=141) of measured participants displaying good mental health during the pandemic. Conclusions The results clearly demonstrate deterioration in mental health outcomes during COVID-19. Although further research is needed, our findings support the serious mental health implications of the pandemic and highlight the utility of internet-based data collection tools in providing evidence to innovate and strengthen practice and policy during and after the pandemic.

Background Smoking rates of Australians with severe mental illness (SMI) are disproportionately higher than the general population. Despite the rapid growth in mobile health (mHealth) apps, limited evidence exists to inform their design for SMI populations. Objective This study aimed to explore the feasibility, acceptability, and utility of adapting a novel smoking cessation app (Kick.it) to assist smokers with SMI to prevent smoking relapse and quit. Methods Using co-design, two in-depth interviews with 12 adult smokers and ex-smokers with SMI were conducted in this qualitative study. Stage 1 interviews explored participants’ smoking-related experiences and perceptions of social support for smoking cessation, informed the development of the stage 2 interview schedule, and provided context for participants’ responses to the second interview. Stage 2 interviews explored participants’ perceptions of the feasibility, utility, and acceptability of the app features for SMI populations. Results People with SMI perceived mHealth interventions to support their quit smoking attempts as feasible, acceptable, and useful. Key emerging themes included personalization of the app to users’ psychosocial needs, a caring app to mediate self-esteem and self-efficacy, an app that normalizes smoking relapse and multiple quit attempts, a strong focus on user experience to improve usability, and a social network to enhance social support for smoking cessation. Conclusions This study gained an in-depth understanding of the lived experiences of smoking and quitting among people with SMI and their perception of the Kick.it app features to help inform the tailoring of the app. Specific program tailoring is required to assist them in navigating the complex interactions between mental illness and smoking in relation to their psychosocial well-being and capacity to quit. This study describes the adaptations required for the Kick.it app to meet the specific needs and preferences of people with SMI. Results of this study will guide the tailoring of the Kick.it app for SMI populations. The study findings can also inform a co-design process for the future development and design of smoking cessation apps for SMI populations.