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.     

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.     

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.     

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.     

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.     

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.     

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.     

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.     

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.     

Who uses community mental health centres? A study of one health district

A caseload analysis was undertaken to investigate those clients seen by five community mental health centre teams within one healthcare district. The 985 clients are described in terms of demographic and clinical features and questions relating to service provision are discussed.     

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.     

The relationship between ethnicity,Christian orthodoxy,and mental health

Although researchers have noted differences in the role of religiosity in the lives of people from different ethnic backgrounds, the components of religion's influence (i.e., membership and orthodoxy) on mental health have not been previously examined. In the current study, Christian participants’ Christian Orthodox Scale (COS) scores were used to predict scores on mental health. As hypothesized, African Americans with higher COS scores exhibited fewer mental-health problems than did all ethnicities studied with lower COS scores. Implications and future directions for understanding the cultural influence of religion on African Americans are discussed.     

Relationship between job burnout and personal wellness in mental health professionals

This study aimed to determine the nature of the relationship between job burnout and personal wellness among mental health professionals. The authors performed intercorrelations and multivariate multiple regression analyses to identify the relationship between subscales of job burnout and personal wellness. Results showed that all subscales of job burnout, except for the Negative Work Environment subscale, significantly predicted a large amount of the variance in the collective personal wellness subscales. Implications for mental health professionals’ clinical practice, training, and supervision and limitations and prospects for future studies are discussed.     

Health care practitioners' perceptions of public mental health care in the Eastern Cape,South Africa

This qualitative study explored the perceptions of health care practitioners (HCPs) concerning public mental health care in the Eastern Cape Province of South Africa. Data were collected from thirteen purposively selected HCPs using in-depth unstructured interviews (males?=?6, females?=?7). Data were transcribed verbatim and later thematically analysed. The findings suggest that mental health professionals perceive mental health services to be both inadequate and of suboptimal quality. Specifically, they perceived public mental health care to have lower priority, to be poorly resourced and lacking in patient-oriented care qualities.     

Positive mental imagery and mental health amongst university students in Pakistan

Mental health problems amongst university students pose a major public health challenge, and this is particularly the case in Pakistan. Alongside broader societal and cultural pressures, cognitive factors likely also play a role in the development of and resilience to mental health problems and may provide a feasible target for interventions. The current study built on previous research in primarily European samples investigating the relationship between one cognitive factor, positive future-oriented mental imagery, and mental health, extending this to a sample of university students in Pakistan (N = 1838). In a cross-sectional design, higher vividness of positive future-oriented mental imagery was associated with lower levels of depressive symptoms and higher levels of positive mental health amongst participants completing questionnaire measures on paper (N = 1430) or online (N = 408). In the sample completing the measures on paper, these relationships remained statistically significant even when controlling for socio-demographic and mental health-related variables. The results provide a foundation for further investigating positive mental imagery as a potential mechanism of mental health and intervention target amongst university students in Pakistan.     

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.     

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.