title: Group interventions to promote mental health in health professional education: a systematic review and meta-analysis of randomised controlled trials.
abstract: Effects of interventions for improving mental health of health professional students has not been established. This review analysed interventions to support mental health of health professional students and their effects. The full holdings of Medline, PsycINFO, EBM Reviews, Cinahl Plus, ERIC and EMBASE were searched until 15th April 2016. Inclusion criteria were randomised controlled trials of undergraduate and post graduate health professional students, group interventions to support mental health compared to alternative education, usual curriculum or no intervention; and post-intervention measurements for intervention and control participants of mindfulness, anxiety, depression, stress/distress or burnout. Studies were limited to English and short term effects. Studies were appraised using the PEDro scale. Data were synthesised using meta-analysis. Four comparisons were identified: psychoeducation or cognitive-behavioural interventions compared to alternative education, and mindfulness or relaxation compared to control conditions. Cognitive-behavioural interventions reduced anxiety (-0.26; -0.5 to -0.02), depression (-0.29; -0.52 to -0.05) and stress (0.37; -0.61 to -0.13). Mindfulness strategies reduced stress (-0.60; -0.97 to -0.22) but not anxiety (95% CI -0.21 to 0.18), depression (95% CI -0.36 to 0.03) or burnout (95% CI -0.36 to 0.10). Relaxation strategies reduced anxiety (SMD -0.80; 95% CI -1.03 to -0.58), depression (-0.49; -0.88 to -0.11) and stress (-0.34; -0.67 to -0.01). Method quality was generally poor. Evidence suggests that cognitive-behavioural, relaxation and mindfulness interventions may support health professional student mental health. Further high quality research is warranted.
authors.affiliation: Department of Physiotherapy, Monash University, Monash University Peninsula Campus Building B, McMahons Road Frankston, Melbourne, VIC, 3199, Australia. Kristin.Lo@monash.edu.
authors.forename: Kristin
authors.initials: K
authors.lastname: Lo
authors.affiliation: Department of Physiotherapy, Monash University, Monash University Peninsula Campus Building B, McMahons Road Frankston, Melbourne, VIC, 3199, Australia.
authors.forename: Jamie
authors.initials: J
authors.lastname: Waterland
authors.affiliation: Subject Librarian, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
authors.forename: Paula
authors.initials: P
authors.lastname: Todd
authors.affiliation: South Eastern Private Hospital, Melbourne, Australia.
authors.forename: Tanvi
authors.initials: T
authors.lastname: Gupta
authors.affiliation: HealthPEER Monash University, Melbourne, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Bearman
authors.affiliation: Department of General Practice, Monash University, Melbourne, Australia.
authors.forename: Craig
authors.initials: C
authors.lastname: Hassed
authors.affiliation: Department of Physiotherapy, Monash University, Monash University Peninsula Campus Building B, McMahons Road Frankston, Melbourne, VIC, 3199, Australia.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Keating
mesh_terms: D001007:Anxiety / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003863:Depression / Q000628:therapy; D006281:Health Occupations / Q000193:education*; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008603:Mental Health; D064866:Mindfulness / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012064:Relaxation Therapy / Q000379:methods; D013315:Stress, Psychological / Q000628:therapy; D013336:Students, Health Occupations / Q000523:psychology*
keywords: Cognitive-behavioural; Health professional student; Mental health; Meta-analysis; Mindfulness; Psychoeducation; Relaxation; Systematic review