Bullying victimization, especially cyberbullying, is associated with increased risk of suicidal ideation among adolescents referred for psychiatric risk assessment. The detailed history of the type and duration of bullying experienced by the victims should be considered when conducting a psychiatric risk assessment.

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Background: Borderline personality disorder is a debilitating and prevalent mental health disorder, with often inaccessible treatment options. Electronically delivered dialectical behavioral therapy could be an efficacious and more accessible intervention. Objective:We aimed to evaluate the efficacy of electronic delivery of dialectical behavioral therapy in the treatment of individuals with symptoms of borderline personality disorder.Methods: Study participants diagnosed with borderline personality disorder were offered either an email-based or in-person group format dialectical behavioral therapy skill-building program. During each session, participants were provided with both the material and feedback regarding their previous week's homework. Electronically delivered dialectical behavioral therapy protocol and content were designed to mirror in-person content. Participants were assessed using the Self-Assessment Questionnaire (SAQ) and Difficulties in Emotion Regulation Scale (DERS).Results: There were significant increases in SAQ scores from pre-to posttreatment in the electronic delivery group (F 1,92 =69.32, P<.001) and in-person group (F 1,92 =60.97, P<.001). There were no significant differences observed between the groups at preand posttreatment for SAQ scores (F 1,92 =.05, P=.83). There were significant decreases in DERS scores observed between preand posttreatment in the electronic delivery group (F 1,91 =30.15, P<.001) and the in-person group (F 1,91 =58.18, P<.001). There were no significant differences observed between the groups for DERS scores pre-and posttreatment (F 1,91 =.24, P=.63). There was no significant difference in treatment efficacy observed between the 2 treatment arms (P<.001).Conclusions: Despite the proven efficacy of in-person dialectical behavioral therapy in the treatment of borderline personality disorder, there are barriers to receiving this treatment. With the prevalence of internet access continuing to rise globally, delivering dialectical behavioral therapy with email may provide a more accessible alternative to treatment for individuals with borderline personality disorder without sacrificing the quality of care.

Online MFPGT may be an effective way to increase knowledge, provide resources and support and build on skills thus giving individuals more control and confidence when dealing with a mood or anxiety disorder while on a waitlist. MFPGT showed equal efficacy in live and online groups, indicating that the online program has the potential to be a more convenient and accessible program for families. More research is needed with a greater sample size.

Background The considerable rise of mental health challenges during the COVID-19 pandemic has had detrimental effects on the public health sector and economy. To meet the overwhelming and growing demand for mental health care, innovative approaches must be employed to significantly expand mental health care delivery capacity. Although it is not feasible to increase the number of mental health care providers or hours they work in the short term, improving their time efficiency may be a viable solution. Virtually and digitally delivering psychotherapy, which has been shown to be efficient and clinically effective, might be a good method for addressing this growing demand. Objective This research protocol aims to evaluate the feasibility and efficacy of using an online, digital, asynchronous care model to treat mental health issues that are started or aggravated by stressors associated with the COVID-19 pandemic. Methods This nonrandomized controlled trial intervention will be delivered through the Online Psychotherapy Tool, a secure, cloud-based, digital mental health platform. Participants will be offered a 9-week electronically delivered cognitive behavioral therapy program that is tailored to address mental health problems in the context of the COVID-19 pandemic. This program will involve weekly self-guided educational material that provides an overview of behavioral skills and weekly homework. Participants (N=80) will receive personalized feedback from and weekly interaction with a therapist throughout the course of the program. The efficacy of the program will be evaluated using clinically validated symptomology questionnaires, which are to be completed by participants at baseline, week 5, and posttreatment. Inclusion criteria includes the capacity to consent; a primary diagnosis of generalized anxiety disorder or major depressive disorder, with symptoms that started or worsened during the COVID-19 pandemic; the ability to speak and read English; and consistent and reliable access to the internet. Exclusion criteria includes active psychosis, acute mania, severe alcohol or substance use disorder, and active suicidal or homicidal ideation. Results This study received funding in May 2020. Ethics approval was received in June 2020. The recruitment of participants began in June 2020. Participant recruitment is being conducted via social media, web-based communities, and physician referrals. To date, 58 participants have been recruited (intervention group: n=35; control group: n=23). Data collection is expected to conclude by the end of 2020. Analyses (ie, linear regression analysis for continuous outcomes and binomial regression analysis for categorical outcomes) are expected to be completed by February 2021. Conclusions If proven feasible, this care delivery method could increase care capacity by up to fourfold. The findings from this study can potentially influence clinical practices and policies and increase accessibility to care during the COVID-19 pandemic, without sacrificing the quality of care. Trial Registration ClinicalTrials.gov NCT04476667; https://clinicaltrials.gov/ct2/show/NCT04476667 International Registered Report Identifier (IRRID) DERR1-10.2196/24913

Introduction:Suicidal behaviour is one of the most common reasons for presentation to the emergency rooms. Bullying is a universal public health concern that affects significant number of adolescents. Many children and adolescents are recurrently involved in school bullying. Research suggests that both bullies and victims are overrepresented amongst those seen by mental health professionals. Objectives: Understand the the relationship between bullying and suicidal behaviour, prevalence of different kinds of bullying in patients with mental health problems and prevalence of cyber bullying and it's affect on the victim Aim: Increase public awareness on importance of cyber bullying. We feel that many patients won't disclose that they had been or are being cyber bullied because the characteristics are unclear. Method:Charts of all patients who visited emergency room from 2011 to 2013 with a mental health complaint were reviewed. Variables understudy were gender, history of bullying, type of bullying (verbal, physical, emotional), DSM-IV-TR diagnosis and outcome following the assessment. Results: Our study shows significant association between bullying, and suicidal behaviours, although based on our study, this predictor was not commonly assessed. Conclusion:Our study showed that there was a significant link between bullying and future suicidal behaviour which is not commonly assessed. It is important that physicians identify these risk factor while assessing suicidality. Involvement in current cyber bullying was found to be less frequent than other forms of bullying such as verbal and physical. However, significant links were observed between cyber bullying and suicidal behaviour.

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Background Limited help-seeking behaviours, among adolescents with mental health concerns and many barriers to accessing mental health services, make innovative approaches to administering mental health therapies crucial. Therefore, this study evaluated the efficacy of e-CBT given via PowerPoint slides to treat adolescents with anxiety and/or depression. Method 15 adolescents referred to an outpatient adolescent psychiatry clinic to treat a primary DSM-IV diagnosis of anxiety and/or depression chose between 8 weeks of e-CBT (n=7) or 7 weeks of live CBT (n=8). The e-CBT modules were presented using PowerPoint delivered weekly through email by either a senior psychiatry resident or an attending physician. Within each session, participants in both groups had personalized feedback on their mandatory weekly homework assignment from the previous week's module. BYIs were completed before treatment and and after final treatment within both groups to assess changes in depression, anxiety, anger, disruption, and self-concept. Findings Before treatment, BYI scores did not sig. differ between groups. After treatment, e-CBT participants reported sig. improved depression, anger, anxiety, and self-concept BYI scores while live CBT participants did not report any sig. changes. Only the Beck Anxiety Inventory sig. differed between groups after CBT. Conclusion Despite the low sample size within this study, using email to deliver e-CBT PowerPoint slides and individualized homework feedback shows promise as an alternate method of CBT delivery that reduces barriers to receiving mental health treatment that occur internationally.