The mental health of university students in the United Kingdom

ABSTRACT

There are increasing concerns globally about the mental health of students. In the UK, the actual incidence of mental disturbance is unknown, although university counselling services report increased referrals. This study assesses the levels of mental illness in undergraduate students to examine whether widening participation in education has resulted in increases as hypothesised by the UK Royal College of Psychiatrists. Patterns of disturbance across years are compared to identify where problems arise. Students (N=1197) completed the General Health Questionnaire-28 either on the first day at university or midway through the academic year for first, second and third year students. Rates of mental illness in students equalled those of the general population but only 5.1% were currently receiving treatment. Second year students reported the most significant increases in psychiatric symptoms. Factors contributing to the problem are discussed.     

Cultural aspects of mental health and mental health service delivery with a focus on Nigeria within a global community

With an endless range of subgroups and individual variations, culture bears upon what all people bring to the clinical setting. Culture could account for health-seeking behaviour, type of services and support system and variations in how people communicate their health concerns. Culture may underlie presentation of sets of symptoms that are peculiar to certain societies – culture-bound syndromes. Culture also influences the meanings that people impart to their illness and also stigma associated with such illnesses. Culture must be viewed from the patients, clinicians and health system dimensions. Changes in mental health service delivery in last few decades have yielded culturally competent mental health services. The aim of this paper was to discuss culture and mental health with a focus on Nigeria and from a global perspective.     

Activity during unemployment and mental health

The main purpose of this study was to investigate activity during unemployment and the relationship between such activity and mental health in a sample ( n = 213) of unemployed Norwegians. The results indicate that the unemployed are generally more passive than the average population, and that they are considerably less involved in social activities. However, the unemployed do not constitute a homogenous group in terms of activity level and activity profile. Women were somewhat more active that men, particularly in connection with domestic chores. Young people were more active than the other age groups, particularly in connection with extra-familial activities. Several significant relationships were found between different activity categories and mental health. The more active the unemployed were, the better their mental health. The results are discussed in relation to similar data for the average population, other unemployment research, subjective and objective factors which can be of importance to the activity level and profile of the unemployed, sex role issues, theoretical models developed to explain and understand the effects of unemployment, methodological considerations, and the possible functions of activity for mental health.     

Effect of Islamic psycho-spiritual therapy in managing craving,withdrawal symptoms,and mental health problems among cannabis users

ABSTRACT

The present study is an examination of Islamic psycho-spiritual therapy in managing craving, withdrawal symptoms, and mental health problems among cannabis users. Homogeneous purposive sampling was used in the selection of the sample. The therapy and administration of three scales (Marijuana Craving Scale Short Form; Cannabis Withdrawal Scale; Mental Health Inventory) were undertaken among 40 Muslim male cannabis users whose age ranged between 14 and 37 years on pre- and post-test analysis. The results highlighted the significant differences in the respective dimensions of the Craving and Withdrawal Scales and the Mental Health Inventory such as compulsivity, emotionality, expectancy and purposefulness, withdrawal intensity and negative impact of withdrawal symptoms, anxiety, depression, loss of behavioural/emotional control, emotional ties, life satisfaction, psychological distress, psychological well-being, and mental health index.     

Deliverance,demonic possession,and mental illness: some considerations for mental health professionals

This paper outlines an unconventional treatment for mental illness, the exorcism or deliverance ritual used by Pentecostals and some other charismatic Christians. Deliverance beliefs and practices are based on the assumption that both mental and physical ills result from possession of the sufferer by demons, and are to be treated by the expulsion of those demons. Deliverance practitioners claim to treat schizophrenia, ADHD, and Reactive Attachment Disorder, and believe that these problems are related to sins either of the person in treatment or of an ancestor. Clinicians and counsellors dealing with clients who partially or completely espouse deliverance beliefs may need to understand their worldviews and to discuss their belief system before managing to engage them in conventional mental health treatments. Unusual ethical problems may also be met in the course of such work.     

A narrative review: arguments for a collaborative approach in mental health between traditional healers and clinicians regarding spiritual beliefs

This review explores the possibility of a more collaborative approach between mental health clinicians and traditional healers, from a clinical psychology perspective, for clients with spiritual beliefs. Spiritual beliefs are incorporated into the identity and functioning of clients within a cultural context and prevalence rates reveal this is not uncommon. It is argued that working collaboratively would address many access difficulties to mental health services and support is generated through a number of studies and case reports in the United Kingdom, worldwide and across cultures. This approach appears to be in accordance with current theories of acculturation. The problems in the current system when working non-collaboratively are also explored. Counter arguments and pragmatic difficulties of collaboration have been discussed. Research in the United Kingdom is limited and it is suggested that more research is needed in the field. Pragmatic solutions are suggested to stimulate discussion.     

Repentance and seeking forgiveness: the effects of spiritual therapy based on Islamic tenets to improve mental health

For years, spirituality has been utilised by many as an asset to improve mental and physical health. This study creates a valid argument that Islamic teachings specifically can have a notable effect on students’ overall health. This particular therapy originates from the Islamic concept of soul purification/cleansing (otherwise known as: tazkiyah al-nafs). The reason behind this was to evaluate the impact of tawba (meaning repentance) and istighfar (forgiveness) therapy for improving mental health in a selected group of Muslim college students. Participants were expected to attend eight consecutive sessions exploring both tawba and istighfar therapy. Both before they trialled the treatment and once they had completed it, all participants were also required to complete the ‘Social Emotional Health Survey-Higher Education’ (SEHS-HE). We concluded that in general this programme was in fact successful in improving the overall mental and even physical health in our select group of Islam practising students.     

Survey of mental health of foreign students

The multifaceted nature of problems foreign students face have led some researchers to conclude that these students tend to suffer from poor health during their overseas sojourn. This assertion is examined among foreign students at the University of Bergen by means of a questionnaire survey. Loneliness, tiredness, sadness and worrying were reported as a frequent source of problem by nearly one in four of over 300 respondents. Students reported a decline in their general state of health as well as a rise in the occurrence of syndrome-like tendencies resembling paranoia, anxiety, depression and somatic complaints. These tendencies were attributed to certain psychosocial factors such as information received regarding study opportunities, social contacts with other tenants in the hall of residence and future job opportunities. Scandinavian students on the whole tended to have better mental health than students from the other countries. The implications of impaired health among foreign students is discussed.     

Associations between multiple health risk behaviors and mental health among Chinese college students

Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95%CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.     

Impact of maternal adverse childhood experiences on child socioemotional function in rural Kenya: Mediating role of maternal mental health

Mothers in low‐ and middle‐income countries (LMIC) suffer heightened vulnerability for adverse childhood experiences (ACEs), which is exacerbated by the multitude of risk factors associated with poverty and may lead to increased risk of psychiatric disorder. The constellation of complex, co‐occurring biological, environmental, social, economic and psychological risk factors are in turn transmitted to her child, conferring vulnerability for adverse development. This study examines the association between maternal intra‐ and extra‐familial ACEs, maternal education and the mental health of her child, mediated by maternal mental health. Mother‐child dyads (n = 121) in Machakos, Kenya were examined cross‐sectionally using self‐report measures of ACEs, maternal mental health and child internalizing and externalizing mental health problems. The four models proposed to examine the relationship between intra‐ and extra‐familial maternal ACEs and child internalizing and externalizing problems demonstrated indirect pathways through maternal mental health. These effects were found to be conditional on levels of maternal education, which served as a protective factor at lower levels of maternal ACEs. These models demonstrate how the impact of ACEs persists across the lifespan resulting in a negative impact on maternal mental health and conferring further risk to subsequent generations. Elucidating the association between ACEs and subsequent intergenerational sequelae, especially in LMIC where risk is heightened, may improve targeted caregiver mental health programs for prevention and intervention.     

Barriers to evidence-based treatment: developmental psychopathology and the interdisciplinary disconnect in school mental health practice

Reframing the role of school psychologists and related school professionals in a public health and primary prevention model represents a proactive antidote to their more traditional reactive stance to mental health problems. Two additional concepts, developmental psychopathology and complex comorbidity, are suggested as critical to complete this transition, and illustrations of these concepts for more effective school mental health services are provided.     

Media presentation of the mental health bill and representations of mental health problems

This paper discusses the findings of a study that examined the way in which the Mental Health Bill of June 2002 was presented in the British national and local media over a 3‐year period. A Lexis Nexis search yielded 256 articles, which were then analysed qualitatively and quantitatively. Overall, and perhaps contrary to what might have been expected given previous studies' conclusions regarding the media's negative portrayal of mental ill health, most articles tended to present a negative view of the Bill as unnecessarily repressive, and consequently were more sympathetic towards mental heath service clients, although this was not the case for tabloid articles. However, this paper then considers the more implicit representations found within the articles. It focuses particularly on the continued linking of mental ill health and violence, and also on the way in which the mental health service user might be portrayed as passive and rather pitiful as an alternative to violent and dangerous. It is suggested that the continued use of such images may stem from the fact that mental health problems have long been constructed as ‘Other’, and are therefore deeply engrained in our society. The implications of this for anti‐stigma campaigns are briefly discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

Knowledge and causal attributions for mental disorders in HIV-positive children and adolescents: results from rural and urban Uganda

Increasing availability of antiretroviral treatment (ART) has led HIV to be considered a chronic disease, shifting attention to focus on quality of life including mental wellbeing. We investigated knowledge and causal attributions for mental disorders in HIV-positive children and adolescents in rural and urban Uganda. This qualitative study was nested in an epidemiological mental health study among HIV-positive children and adolescents aged 5–17 years in rural and urban Uganda. In-depth interviews were conducted with caregivers of HIV-positive children (5–11 years) and adolescents (12–17 years) in HIV care. Interviews were audio recorded with permission from participants and written consent and assent sought before study procedures. Thirty eight participants (19 caregivers, 19 children/adolescents) were interviewed. Age range of caregivers was 28–69 years; majority were female (17). Caregivers had little knowledge on mental disorders ;only 3 related the vignette to a mental problem and attributed it to: improper upbringing, violence, poverty and bereavement. Five adolescents identified vignettes as portraying mental disorders caused by: ill-health of parents, bereavement, child abuse, discrimination, HIV and poverty. Caregivers are not knowledgeable about behavioural and emotional challenges in HIV-positive children/adolescents. Mental health literacy programmes at HIV care clinics are essential to enhance treatment-seeking for mental health.     

Implementation and evaluation of a juvenile mental health training for law enforcement in a medium-sized jurisdiction

The need for specialized training programs that are focused on youth mental health needs, awareness of community-based services, and de-escalation skills is growing across law enforcement agencies due to calls for service that involve youth in mental health crisis. The current study evaluates a juvenile mental health training for law enforcement that was developed based on agency needs. The training was completed by 159 officers and a pre-/post-test design was used. Findings suggest that officers were satisfied with the training and improvements were seen across several training constructs (confidence, preparedness, stigma, resource awareness, and de-escalation skills). Satisfaction with the training predicted change in confidence and preparedness. Recommendations for future research and the implementation of juvenile mental health trainings are discussed.     

Challenges and opportunities in moving toward a public health approach in school mental health

These three outstanding papers are important for the discipline of school psychology, the field of school-based mental health, and more generally for systems of education and mental health for children and adolescents. As the authors emphasize, there is an unprecedented focus on improving programs that remove barriers to learning and enhance development, health, and mental health in youth, in the most universal natural setting—the schools. The authors also correctly highlight that school psychology is uniquely positioned to play a leading role in this reform and change effort. Two interconnected themes of the public health approach—applying the evidence base and moving toward preventive and population-focused interventions—are emphasized in these papers, and while they focus on school psychology, the issues discussed are generalizable to the many disciplines that operate within educational and mental health systems. In the following discussion, I react to the papers' two major themes, discuss realities that should be addressed for progress to be made, and comment on their implications for school psychology.     

National attitudes towards mental health treatment: the importance of research evidence

Most conceptualizations of evidence-based practice view it as a “three legged stool” consisting of: the use of best available research evidence, clinical expertise, and client preferences. Although empirical evidence and clinical expertise have received greater empirical attention, relatively little research has systematically explored client preferences. The present study analyzed self-reported treatment preferences for various clinical and non-clinical presentations. Adult participants (n = 1262) residing in the United States were presented with diagnostic vignettes and rated their relative preferences among 5 treatment variables, including: use of an empirically supported treatment (EST), quality of the client–therapist relationship, therapist empathy, therapist experience, and client speaking for the majority of therapy sessions. Results indicated that participants endorsed significant preference for receiving an EST over other treatment variables for all clinical disorders, with effect sizes ranging from small to large depending on the diagnosis. There was slightly greater variability in treatment preferences for non-clinical issues, though participants generally reported greater preference for receiving an EST. Follow-up questions provided further evidence for EST preferences. The implications of these results are discussed.     

Relationship between positive mental health and appreciation in Korean individuals

Appreciation is a key component of subjective well‐being and may contribute to positive mental health. Few studies have examined relationships between specific aspects of appreciation and the 3 dimensions of positive mental health, and thus, the aim of this study was to identify associations between aspects of appreciation and positive mental health. Appreciation and positive mental health were measured in 266 Korean university students (50% females) using the Appreciation Inventory and the Mental Health Continuum‐Short Form. The results obtained showed that Have Focus significantly predicted Emotional Well‐being; Have Focus and Loss/Adversity significantly predicted Social Well‐being and Have Focus, Expression and Nature/Daily Life significantly predicted Psychological Well‐being. The implications of results that might enable positive mental health to be enhanced are discussed.     

Self-reported mental health problems and performance in mathematics and reading in children across Europe

ABSTRACT

The study examines the associations of specific self-reported internalizing and externalizing problems and performance in mathematics and reading in school-aged children across Europe. Data were drawn from 5,842 children between 6 and 13 years of age participating in the School Children Mental Health in Europe study and a large cross-sectional survey in France. Self-reported child mental health was assessed using the Dominic Interactive, academic performance was reported by teachers. Across Europe, controlling for key sociodemographic factors associated with achievement including maternal education, performance in mathematics was more often associated with the presence of externalizing and internalizing problems as compared to performance in reading. In addition, the findings point to significant sex differences in the associations of internalizing problems and academic achievement. Considering the impact of early academic difficulties in terms of later internalizing and externalizing problems and academic attainment, school-based interventions interrupting the cycle as early as possible are warranted.     

Emotional Intelligence and resilience in mental health professionals caring for patients with serious mental illness

Emotional Intelligence (EI) and resilience may be considered as prerequisites for mental health professionals caring for patients with serious mental illness (SMI), since they are often exposed to severe emotional stress during daily work. Accordingly, this cross-sectional study assessed both EI and resilience and their interrelationship in 61 individuals belonging to an assertive outreach team for patients suffering from SMI compared 61 control subjects without healthcare-related working conditions. EI was assessed by means of the German version of the Mayer-Salovey-Caruso-Emotional-Intelligence Test (MSCEIT), resilience was assessed using the German version of the Resilience Scale. Both groups showed an average level of EI in all categories of the MSCEIT and indicated high levels of resilience. They did not differ significantly from each other, neither in terms of EI nor resilience. Correlation analysis revealed a positive association between EI and resilience, albeit small in magnitude. Our results suggest that mental health professionals are not more resilient and therefore not more ‘protected’ from stressors than the general population. Though this finding warrants cautious interpretation, the positive correlation between EI and resilience suggests that EI may be a potential target for education and training in order to strengthen resilience even in healthy individuals and vice versa.