Mental illness and suicide in British South Asian adults

South Asians make up about 5% of the UK population. Their rates for mental illness and suicide have been shown by some researchers to be rather lower than that of the total UK population, using a variety of measures, and considering many psychiatric conditions. This paper reviews the literature on the extent of mental illness among British South Asian adults, and explores aspects of their service use, and their attitudes to mental illness. Some distinguishing features of British South Asian mental health are identified, including areas justifying further research. Variations in the South Asian population including generation, country of origin, religion, class, wealth and geography, emphasise the growing need to disaggregate this population when presenting data about them.     

The effects of mental illness on families within faith communities

Associations between mysticism and madness have been made since earliest recorded history, and the striking resemblance between self-reports of both mystical and psychotic experience suggests that similar psychological processes may be involved in their occurrence. By exploring the similarities, and proposing a common element to mystical and psychotic experience (referred to here as the experience of “oneness”), this paper aims to place mysticism and madness onto the same experiential continuum. However, in contrast to much of the previous literature, the intention is not to pathologize mystical experience, but rather to normalize psychotic experience. The paper argues not only that the experience of oneness is entirely genuine and available to all humans, but also that it has an important psychological (and evolutionary) function. Using cognitive terminology, it then attempts to explain the processes determining whether an individual enjoys a fulfilling mystical experience, or suffers a debilitating psychotic breakdown (i.e., how “oneness” is experienced). Finally, this paper turns to look at some of the important implications such an approach might have for clinical practice and for the mental health of people in general.     

Attitudes Toward Professional Psychological Help Seeking in South Asian Students: Role of Stigma and Gender

This study examined (a) the roles of perceived and personal stigma on attitudes toward professional psychological help seeking and (b) the effects of these constructs across gender in South Asians. Personal stigma and being male was negatively associated with attitudes toward professional psychological help seeking; no difference in the association between personal and perceived stigma and attitudes across genders was found. These findings have implications for the engagement of South Asians in mental health services in the United States. Este estudio examinó (a) los roles de estigmas percibidos y personales en las actitudes hacia la búsqueda de ayuda psicológica profesional y (b) los efectos de estos constructos en indiviuos sudasiáticos según su sexo. El estigma personal y la identidad masculina se asociaron negativamente con las actitudes hacia la búsqueda de ayuda psicológica profesional; no se halló diferencia en la asociación entre estigmas personales y percibidos y las actitudes de los distintos sexos. Estos hallazgos tienen implicaciones para la participación de los individuos sudasiáticos en los servicios de salud mental en Estados Unidos.     

The shame of being undone by illness and the power of support through the body of Christ

This paper examines shame that arises from living with a body that has been undone by cancer or other serious illness. It draws on first-person narratives and social-scientific studies of cancer patients to explore how bodies undone by illness often cease to conform to cultural standards of health as well as gendered expectations of bodies, and how experiences of shame arise from those shifts in how sick bodies appear and perform. Analysis of narratives by and qualitative data about those who are seriously ill also reveals how the undoing of the body by illness often precipitates an undoing of one's sense of self that leads to experiences of shame over an inability to fill roles and expectations in ways that were possible in life before serious illness. The paper then utilizes biblical and theological resources to explore ways religious communities can make space for those living with serious illness to lament what it's like to be undone by illness, to hold them up amid their experiences of vulnerability through public lament and acts of accompaniment, and to affirm their worth in the eyes of God and in the body of Christ.     

Carers of adults with mental illness: Comparison of respite care users and non‐users

The aim of this study was to investigate the rate, type and duration of respite care use in carers of an adult with mental illness, and the differences between respite care users and non‐users on demographic, caregiving context and adjustment variables. A total of 106 carers completed a postal survey questionnaire. The majority (76%) of carers who accessed care used it weekly, fortnightly or monthly. The most common types of respite services were in‐home, day programs, and residential respite. The mean duration of respite care periods was 58.18 hr each time respite was used. Compared to respite care non‐users, carers who accessed respite care were more likely to live with their care‐recipient and provide more caregiving. They also reported more benefits associated with their caregiving. Findings suggest that respite care services need to be varied, available for carers on a weekly to monthly basis with a range in duration, but catering for higher use of 2‐day respite periods. Carers who are highly engaged in a range of caregiving tasks and who live with their care recipient are more likely to have a greater need for respite care. Future research should examine the effects of a range of respite care factors on carer adjustment outcomes.     

Internalized transphobia and mental health among transgender adults: A nationwide cross-sectional survey in South Korea

Abstract

Introduction: Transgender people are stigmatized in South Korea (hereafter Korea), where cultural expectations of a biologically-based, binary sex and gender system present fundamental challenges to those whose gender identity does not align with their birth-assigned sex. A growing international body of literature implicates gender minority stress as a key contributor to transgender mental health disparities, but little research has been conducted on this topic in Korea. As in other cultural settings, depression and suicidality are urgent public health concerns for transgender people in Korea, primarily for those who have not initiated gender affirming medical treatment (GAMT), such as cross-sex hormone therapy. In the current study, an international and interdisciplinary team of authors apply the lens of gender minority stress to elucidate the relationships between a key facet of gender minority stress, internalized transphobia (ITP), and outcomes of depressive symptoms and suicidality.

Methods: Based on a cross-sectional survey of 207 Korean transgender adults, the current study evaluates the relationships between ITP and depressive symptoms, suicidal ideation, and suicide attempts. ITP was measured with an eight-item, Korean-language questionnaire adapted from the Gender Minority Stress and Resilience Measure through a translation and back-translation process.

Results: Korean trans women and trans men mean (mean age?=?26.4) were included in the analysis, most of whom had at least one experience of any GAMT. The findings of this study show that Korean transgender adults face similar public health concerns such as high prevalence of depressive symptoms, suicidal ideation, and suicide attempts. As predicted, ITP was significantly related to depressive symptoms, suicidal ideation, and suicide attempts.

Conclusion: The authors suggest potential clinical, policy, and research applications, including institutional interventions, to address structural and cultural barriers to optimal mental health and GAMT as well as mental health interventions to reduce Korean transgender people’s internalized negative beliefs about their gender identity.     

The typology of parricide and the role of mental illness: Data-driven approach

Parricide is a rare type of homicide in which mental illness is often an important factor. The aims of this study were (a) to describe the characteristics of parricide offenders with a focus on mental illness and clinical care and (b) to examine Heide's widely used typology of parricide through a data-driven approach. We analyzed all homicides in England and Wales between 1997 and 2014. Parricide offenders in our sample were most often male, unmarried, and unemployed, with a third of offenders diagnosed with schizophrenia; 28% had been in contact with mental health services before the offense. The latent class analysis resulted in three types of parricide offenders: middle-aged with affective disorder, previously abused, and seriously mentally Ill, which confirmed, to an extent, Heide's typology. Health and social care services should actively engage with carers of people with mental illness and support to those caring for older relatives and victims of abuse.     

Family identity and severe mental illness: A thematic synthesis of qualitative studies

There is a growing amount of research showing that a shared social identity and the sense of belonging to a family have a potential effect on health. However, little is known about the effects of severe mental illness on family identity. The authors carried out this thematic synthesis based on a systematic review of literature on family narratives of severe mental illness and family identity. The main findings indicate that in many families (i) their identity—as a shared social identity—undergoes a transformation process by which the identity aspects of being a family are reinforced; (ii) family members often take on a caring role as their main family role; and finally, (iii) a cultural component shapes this transformation process. The authors describe implications for research and application in the mental health field. All in all, family identity is transformed by the experience of severe mental illness.     

Imagined contact and mental illness stigma in an Asian context: Bolstering the effect and examining the impact of factual information

Imagined contact can be effective at reducing social stigma. However, the effect may depend on the strength of the stigma held. We tested the robustness of imagined contact in an Asian setting where stigmatization of mental illness is stronger than in Western countries. In Experiment 1 (n = 167) with five conditions, only an enhanced version of positive imagined contact was able to decrease stigma towards people with schizophrenia through decreasing intergroup anxiety. Given the potential discrepancy between imaginations and reality about experiences with stigmatized groups, in Experiment 2 (n = 121), we tested the hypothesis that after presenting participants with factual information about a mental illness group, imagined contact might backfire, resulting in more negative perceptions. However, enhanced imagined contact alongside factual message about schizophrenia did not increase stigma. The backfiring hypothesis was therefore not supported. Nevertheless, providing realistic information did negate the positive effects of enhanced imagined contact on stigma reduction. In both experiments, we also showed that intergroup anxiety mediated the effect of enhanced imagined contact on various measures of stigma.     

Parental socialization of mental health in Chinese American families: What parents say and do,and how youth make meaning

Parental mental health socialization is a process by which parents shape how youth develop and maintain beliefs, attitudes, and behaviors regarding mental health and help-seeking behaviors. Although culture shapes parental mental health socialization, few studies have examined specific parental socialization practices regarding mental health and help-seeking, especially as a culturally anchored process. Using a qualitative approach, this study explores youth-reported parental socialization of mental health within Chinese American families by examining focus group data from 69 Chinese American high school and college students. Findings revealed that youth received parental messages that conveyed culturally anchored conceptualizations of mental health that included stigmatized views of mental illness and perceptions of mental distress as not a legitimate problem. Parents responded to youth distress in culturally consonant ways: by encouraging culturally specific coping methods, dismissing or minimizing distress, or responding with silence. Youth engaged in the active interpretation of parental messages through cultural brokering, bridging the gap between their parents’ messages and mainstream notions of mental health and help-seeking. Overall, our findings point to the significant role of culture in parental mental health socialization in Chinese American families and the need to integrate culturally specific understandings of mental health into future interventions for Asian American youth.     

The Cultural Closet: The South Asian American Experience of Keeping Romantic Relationships Secret

Many South Asian Americans face challenges when they are in romantic relationships outside of their racial, ethnic, or religious group. Because of values associated with dating and marriage, one challenge is disclosing the relationship to family. South Asian Americans often hide their relationships, and we propose that this experience has parallels to the closet for lesbian, gay, bisexual, transgender, and queer individuals. In this article, we name this experience the “cultural closet” and discuss the associated theory, context, consequences, and counseling implications. Muchos americanos surasiáticos afrontan desafíos cuando se encuentran en relaciones amorosas fuera de su grupo racial, étnico o religioso. Uno de los desafíos es revelar la relación a su familia, a causa de los valores asociados con las citas y el matrimonio. Con frecuencia, los americanos surasiáticos ocultan sus relaciones, y proponemos que esta experiencia tiene correspondencias con el armario para personas lesbianas, gais, bisexuales, transexuales y queer. En este artículo, denominamos esta experiencia el “armario cultural” y discutimos la teoría, el contexto, las consecuencias y las implicaciones para la consejería asociadas.     

Factors associated with perceived helpfulness and use of mental health websites by Australian young adults with a family history of mental illness

Young adults with a family history of mental illness may be vulnerable to develop mental health conditions based on genetic and environmental features. This study aimed to explore factors associated with the use of mental health websites for young adults aged 18–30 years who reported a family history of mental illness. Young adults (n = 469) who reported a family history of mental illness completed an online survey regarding their use of mental health websites, demographic questionnaires and the Depression, Anxiety and Stress Scales. In total, 194 (41%) participants reported using mental health websites, with the majority using these for their own mental well-being (n = 156; 33%). Having a previous history of a mental health condition was associated with mental health website use, along with having a prior history of drug use and having more than one family member diagnosed with a mental illness.     

Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking

The purpose of the present study was to examine the role of emotional and instrumental social support seeking in the quality of life (QOL) and mental health of women with ovarian cancer. Participants were recruited through the Pennsylvania Cancer Registry, and one hundred women took part in a mail questionnaire that collected information on their demographics, medical status, social support seeking, QOL and mental health including anxiety, depression and stress. Hierarchical linear regression analyses were conducted to assess the influence of emotional and instrumental social support seeking on QOL and mental health. After controlling for remission status, greater emotional social support seeking was predictive of higher overall QOL, social/family QOL, functional QOL and lower depression scores. Instrumental social support seeking was not significant in the models. The results illustrate that social support seeking as a coping mechanism is an important consideration in the QOL and mental health of women with ovarian cancer. Future studies should examine the psychological and behavioral mediators of the relationship to further understand the QOL and mental health of women with ovarian cancer.     

The relationship between violence and youth suicide indicators among Asian American and Pacific Islander youth

The literature documents a relationship between interpersonal violence and suicide. One tool used to understand interpersonal violence is the Power Wheel, developed from clinical experience and originally used in domestic violence education. We examine the relationship between Teen Power and Control Wheel domains and suicidal indicators (seriously considered suicide, made a suicide plan, and attempted suicide) among Asian American and Pacific Islander high school students, in terms of both victimization and perpetration. Data from a 2007 survey of two multi-ethnic high schools on the island of O'ahu, Hawai'i were used. The survey assessed interpersonal youth violence and a multitude of risk and protective factors. It found that females were significantly more likely to seriously consider suicide and attempt suicide, compared to males. There were no statistically significant differences in seriously considering suicide, making a suicide plan, and attempting suicide by ethnic group, employment status, or hours worked per week. Using the Wheel, we found that all dimensions for victimization and perpetration were associated with the three suicidal indicators. However, the magnitude of this association was dramatically higher for victims than for perpetrators. School- and healthcare-based prevention strategies should ensure that both suicide and violence intervention components are addressed. Professionals who work with youth should be trained to feel comfortable, confident, and competent in discussing suicide and violence, and be willing and capable to assess and intervene.     

The stigma of having a parent with mental illness: Genetic attributions and associative stigma

Children often report associative stigma because they are ‘contaminated’ by association with a parent who has a mental illness. An exploratory study was conducted to investigate the role of genetic attributions in the aetiology of associative stigma. The first hypothesis was that genetic attributions would predict associative stigma over and above the contribution of biochemical and stressful‐event attributions, while the second hypothesis was that the relationship between genetic attributions and associative stigma would be mediated by the perceived likelihood that children would develop the same disorder as their parents. Two‐hundred‐and‐two individuals were asked to read a hypothetical scenario describing a teenage girl whose mother had been diagnosed with either schizophrenia or depression. Both hypotheses were supported. The findings of the study have implications for a number of professions working in the community such as teachers and psychologists. Additional avenues for future research are also explored.     

The relationship between career adaptability, person and situation variables, and career concerns in young adults

We surveyed 245 first-year university students using measures of career concerns, career adaptability (career planning, career exploration, self-exploration, decision-making, self-regulation), goal-orientation (learning, performance-prove, performance-avoid) and social support (family, friends, significant others), and tested: (a) whether the career adaptability variables could be represented by a second-order factor of career adaptability; (b) whether career adaptability, goal-orientation and social support were associated with fewer career concerns; and (c) whether career adaptability mediated the relationship between goal-orientation and social support and career concerns. The study demonstrated that the career adaptability variables were inter-related and could be represented by a higher-order factor. Decision-making and self-exploration were negatively associated with career concerns, and decision-making mediated the relationship between goal-orientation and career concerns. Having more of a learning orientation was associated with more decision-making and fewer career concerns, whereas holding a performance-prove orientation was associated with poorer decision-making and more career concerns.