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.     

现代社会需要心理健康教育——评《现代心理健康教育》

随着社会的发展,人们越来越重视心理健康教育。《现代心理健康教育》一书集中反映了俞国良教授及其课题组多年扎根于心理健康教育领域的工作特色:研究对象广泛,研究成果有创新,学术研究与普及工作齐头并进。     

中西方关于心理健康标准问题的探讨及对我们的启示

分析了国内外学者在制定心理健康标准时所作的探讨,提出了适应与发展应是心理健康考察的基本对象,对心理健康的评估应是对心理机能的评估,我国在制定心理健康标准时应借鉴西方的有关理论和经验。     

Dose response effects of cognitive-behavioral therapy in a school mental health program

ABSTRACT

School mental health (SMH) programs have been shown to be effective in providing evidence-based interventions to underserved youth. However, limitations of SMH programs are that they can entail holiday breaks, typically do not operate through summer, and often require pulling students from class to receive therapy. These limitations suggest that treatment must be expeditious and potent. Although researchers have investigated dose response to treatment, no studies were located that addressed dose response to treatment in SMH programs. The present study addressed this gap by evaluating the dose response to SMH treatment in a sample of 133 adolescents. Adolescents were assessed at baseline, post-treatment, and at multiple time points throughout treatment. An average treatment response of a 26.81-point decrease in Youth Outcome Questionnaire (YOQ-30) score was found across 14 sessions of cognitive-behavioral therapy (CBT). Further, adolescents exhibited reliable change in YOQ-30 score within an average of 2.91 sessions. Finally, it was found that baseline scores on the Depression and Hyperactivity subscales of the Behavior Assessment System for Children, 2nd Edition, along with YOQ-30 score, predicted treatment response. These findings advance our understanding of dose response to CBT in SMH settings, and create opportunities to better inform effective treatment strategies in similar contexts.     

目前国内常用心理健康量表的回顾与反思

对国内近10多年来常被用于评鉴心理健康的7大类量表的分析结果表明,我国常用心理健康评估工具具有逐年增加、从单纯引进转向创造性地自编、自编量表的内容从学习与人格向多领域延伸、自编量表的方法从不完全到完全的特点。已编制出一些信效度较高的量表,但是仍存在一些问题。存在的主要问题是量表的信效度较低、自编量表有低水平重复现象、测量积极心理的量表少。     

国外心理健康服务及其启示

在回顾了美国、瑞典等国家心理健康服务概况的基础上提出了以下启示：1．中国心理健康服务体系应以构建和谐社会理论为基础;2．在心理服务的教育与培训中,应当尽量兼顾普及知识与提高专业化水平两个目标;3．政府应当大力支持社区心理健康服务以及包含各种社区可用资源的综合性社区服务;4．中国心理健康服务必须从本国文化与国情出发,因此还需要更多这方面的文献总结与实际诃查工作;5．心理健康服务应当全面而有区别地实施予心理健康水平不同的人群。     

Making the grade: a pilot investigation of an e-intervention to increase mental health literacy and help-seeking intentions among international university students

ABSTRACT

International students may have less understanding and awareness of mental health issues and appear unlikely to seek help. The purpose of the current study was to construct and evaluate a brief online educational intervention designed to increase mental health literacy (MHL) and help-seeking among international tertiary students studying in Australia. The intervention was tested among 45 international tertiary students (undergraduate and postgraduate), who were randomly allocated to control and intervention conditions. The intervention led to significant improvements in help-seeking attitudes, particularly in stigmatising attitudes. No significant effects were found for MHL or help-seeking intentions. A brief educational intervention can improve help-seeking attitudes among international tertiary students. Future research may focus on establishing optimal intervention dosage.     

Pathways to mental health care by members of a rural community in South Africa

This study explored mental health help seeking pathways followed by Black South African rural community dwellers in the Limpopo province of South Africa. Ten participants (5 females and 5 males) aged between 18 and 59 years receiving services from a rural mental health care facility in the Limpopo province were the informants. They presented with psychotic disorders?=?50%, substance-use mental disorders?=?20%, mood disorders?=?20% and epilepsy?=?10%. They completed a semi-structured one-to-one interview on their pathways to mental health care services. Data were content analysed. The results showed that help seeking pathways for mental health involve several entry points. These include the utilisation of western medicine when experiencing acute symptoms, and a preference for traditional medicine when faced with chronic but manageable symptoms. The findings suggest that families and significant others are important facilitators for individuals navigating the mental health care pathways.     

Occupational Choices for People with Psychiatric Disabilities: Comparing Attendees and Non-Attendees at Community-Based Day Centers

Research has shown that people with psychiatric disabilities who attend a day center rate their satisfaction with daily occupations equally in comparison with non-attendees. The current study investigates which occupations the target group performs and also differences in occupational choices between attendees and non-attendees. Reported occupations were analyzed with content analysis. Day center attendees reported more productive occupations, while non-attendees reported more recreational occupations and a greater breadth of occupations. This implies that non-attendees might compensate a lack of work-like occupations at a day center with satisfying recreational occupations. The results can guide development of psychiatric occupational-based rehabilitation.     

Mental health counselling in the Black American Church: reflections and recommendations from counsellors serving in a counselling ministry

The goal of this study was to examine the relationship between “The Black Church”, the mental health needs of its members, and addressing those needs from the perspective of counsellors within the church. Four in-depth interviews were conducted with members of the mental health counselling team at one large, African American-serving church in the Midwest to explore their thoughts about their church pastor’s desire to expand their current ministry to a fully operating counselling centre. The findings suggest that “the Black Church” not only has a role and responsibility in addressing the mental health needs of African Americans within and outside of the church but can also use religiosity as a facilitator rather than a barrier to mental health service use among African Americans.     

Mapping Men's Mental Health

The central theme of this paper is that men are at one and the same time both damaged and damage-doing. The process of being damaged through the agency of masculinity predisposes men to exploit, dominate and abuse—not only as boys, as partners and fathers, but as priests, teachers, therapists, lawyers, nurses, psychologists and psychiatrists. Mental health services need to see both aspects of this male equation: a focus on male abuse alone leads to punishment, containment and, very likely, the continuation of abuse; a focus on male damagedness alone preserves the ideology of male unaccountability. However, evidence reviewed here suggests that most traditional psychiatric services fail to acknowledge the impact of inequalities on men's mental health as comprehensively as they fail to acknowledge the impact of these inequalities on the mental health of women. This is a significant problem, and we suggest ways that a gendered analysis of masculinity can be used to help address this deficit. This analysis is used to develop a map of men's mental health that not only accommodates traditional categories of mental health difficulty, but other important consequences of the close association between masculinity and sexuality inequality, especially the use of violence and the capacity to do harm. This analytical framework also invites consideration of the invisibility of male distress, the disallowing and desensitizing of ‘vulnerability, and their submersion in a kind of psychology of entitlement. Finally, we consider the implications of this mapping exercise for mental health services and for working with men.     

Validation of the WHOQOL-BREF in a Sample of Male Treatment-Seeking Veterans

We examined the psychometric properties of a quality of life measure, the WHOQOL-BREF, in male treatment-seeking veterans. A sample of 131 veterans at an outpatient clinic completed a mail-in survey that included the WHOQOL-BREF as well as measures of posttraumatic stress, depression, anxiety symptoms, and functional health status. The WHOQOL-BREF showed evidence of good internal consistency and strong test-retest reliability. In addition, analysis of results demonstrated evidence of construct, convergent, and discriminant validity. The results suggest that the WHOQOL-BREF is a reliable and valid measure that can be used in the planning of psychological services provided to veterans with mental health problems.     

心理异常中“一般心理问题“的判别标准与临床表现

心理异常是相对于心理健康而言的。心理异常不仅是指心理障碍、心理疾病以及心身障碍和心身疾病,而且也包括一般心理问题。人们通常认为的所谓“心理障碍”以及心理辅导和心理咨询中常见的心理异常,大量的还是指一般心理问题。本文就一般心理问题的判别标准以及各种主要一般心理问题的临床表现与鉴别诊断作了有益的探索,为心理辅导和心理咨询工作提供了心理学依据。     

大学新生心理健康水平调查

采用国家教育部中国大学生心理健康测评系统(CSPA)中的《中国大学生心理健康量表》对天津某高校3826名2013年入学的大学新生进行问卷调查,并分析大学新生心理健康水平的人口学差异。结果 :(1)大学新生整体心理健康状况较好;(2)女生的整体心理健康水平要好于男生,但女生比男生表现出更多的自卑;(3)汉族学生比少数民族学生表现出更高的焦虑;(4)独生子女的心理健康水平显著好于非独生子女;(5)理工类、文史类、文体艺术类大学新生的心理健康水平存在差异,理工类大学生的整体心理健康水平要好于文体艺术类大学新生。     

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.     

Forgiveness and Health: Age Differences in a U.S. Probability Sample

Forgiveness is a variable closely related to religiousness and spirituality that has been hypothesized to be protective of mental and physical health. However, we do not clearly understand which aspects of forgiveness are most clearly associated with health outcomes, and the conditions under which these relationships occur. This study used national probability data to systematically examine age differences in the association between forgiveness, religiousness/ spirituality, and respondent reports of mental and physical health. Results showed age differences in the levels of forgiveness of others and feeling forgiven by God. In both cases, middle and old age adults showed higher levels of these forms of forgiveness than young adults. Furthermore, the relationship between forgiveness of others and respondent reports of mental and physical health varies by age. Forgiveness of others was more strongly related to self-reported mental and physical health for middle and old age adults than for young adults.     

Relationships Between Treatment Attitudes,Psychological Symptoms,Emotional Competence,and Help‐Seeking Intentions

The authors examined whether emotional competence (i.e., awareness, coping strategies) predicted help‐seeking intentions above and beyond previously identified factors (i.e., attitudes and perceived stigma toward professional help, psychological symptom severity) in an undergraduate sample (N = 531). Emotional awareness predicted help‐seeking intentions for personal/emotional problems and suicidal thoughts. Emotional coping strategies predicted help‐seeking intentions for suicidal thoughts and moderated the relationship between symptom severity and help‐seeking intentions for suicidal thoughts. Efforts to increase help‐seeking should address students' emotional competence.     

Advocacy processes in mental health: a qualitative study

Advocates perform an important role in representing the rights of mental health consumers, especially since mental health consumers are often marginalized. Little is known about the processes advocates use to assist mental health consumers in navigating the health care system. This study details the manner in which advocates work together with mental health consumers and health professionals through presenting a qualitative synthesis of 60 case records. Four main themes emerged: negotiating on behalf of consumers during meetings with health professionals; liaising between consumers and health professionals outside of meetings; supporting consumer decision making without the involvement of health professionals; and involvement in legal processes. The findings of this study demonstrated that advocates were primarily oriented toward the protection of negative rights, but they also promoted positive rights.     

Poverty and Serious Mental Illness: Toward Action on a Seemingly Intractable Problem

This paper examines the issue of poverty among people with serious mental illness (SMI), positioning it as a key issue to be confronted by community mental health systems and practitioners. The paper reviews three perspectives on poverty, considering how each sheds light on poverty among people with SMI, and their implications for action: (a) monetary resources, (b) basic needs, and (c) capabilities. The paper argues that community mental health programs and systems are currently unable to address poverty as they are overly focused on individual‐level interventions that, on their own, cannot raise people out of poverty. The paper calls for a social justice value, informed by the concept of citizenship, as a necessary complement to the recovery concept that has informed community mental health practice for almost 25 years. Finally, the paper argues that community psychologists, with their concepts, methods, and values, are well positioned to contribute to this important issue. However, it also contends that addressing poverty requires collaboration from community psychologists with researchers and practitioners from other fields and domains of expertise to begin to make progress.     

Emotional and behavioral problems in children of depressed mothers: a school-based study in Southern Brazil

The present study aimed to verify the association between maternal depression and emotional and behavioral problems in school children in Pelotas, Southern Brazil, considering that maternal depression increases children’s vulnerability for developing psychiatric disorders. This is a cross-sectional study with a school-based sample conducted between August 2015 and November 2016 and it is part of a major project entitled ‘Healthy Childhood in Context: A Multidisciplinary Investigation’. Schoolchildren aged between 7 and 8 years and one of their respective parents or a primary caregiver were included in the study. Maternal depression was assessed using the Mini International Neuropsychiatric Interview (MINI). The presence of emotional and behavioral problems in children was verified by the Strengths and Difficulties Questionnaire (SDQ) – parents version. Children of depressed mothers exhibited higher mean scores in all SDQ domains and in the total score when compared to children of non-depressed mothers. Lower socio-economic status was also associated with higher SDQ scores. Our results showed the effects of both maternal depression and poverty on children emotional and behavioral problems, which evidence the need for child mental health preventive care, and free quality assistance for both mothers and their children.