“It’s only ‘madness’ that I know”: analysis of how mental illness is conceptualised by congregants of selected Charismatic churches in Ghana

In Ghana, many individuals employ traditional and faith healing for treating illnesses. Although attitudes and knowledge of laypeople on mental illness have been explored, little is known about Christians’ knowledge and how the church influences such knowledge. The present study explored knowledge on definition, types and symptoms of mental illness, church teachings on mental illness and the influence of such teachings on the mental well-being of 86 congregants of six Charismatic churches in Ghana. Through in-depth interviews, focus group discussions and observations, we found that knowledge surrounded psychotic disorders with a few citing other DSM/ICD categories. Regarding church teachings, some churches provided education and spiritual healing, and others emphasised non-existence of, and immunity from, mental illness. Findings showed the “double-edged” role of religion in enhancing and hindering congregants’ mental well-being. The paper concludes with an argument for psycho-education on mental illness and collaboration between churches and mental health practitioners.     

Early trauma and serious mental illness: what role does spirituality play?

For many who experience serious mental illness, spirituality and religion can be common vehicles that provide a sense of coherence and meaning to life. However, in the presence of early trauma, spiritual and religious beliefs may be enhanced or destroyed, or never develop. This paper explores the relationship between spirituality/religion, early trauma, and serious mental illness. Three case examples from a qualitative phenomenological study are presented to illustrate spiritual and religious struggles that can arise and how a person can work through these over time to use spirituality and religion as positive resources for recovery. Tentative implications for practice are offered.     

Utilizing Religious Schemas to Cope with Mental Illness

Recent Gallup Polls suggest that 96% of Americans polled believe in God or a universal supreme being (Gallup, 1995). In addition, large percentages of Americans polled report that they pray or believe in miracles. It appears then that religious belief might be a useful coping strategy for those experiencing significant distress or illness. Although much of the research regarding religious coping and illness has focused on physical illness, it seems likely that religious coping would also be useful to those who are experiencing a mental illness. Existing data regarding the use of religious coping and mental illness is discussed, and Daniel McIntosh's theory of religion as a cognitive schema is applied to those suffering severe mental illness.     

Mental health provision,religion, politics,and guns: college students express their concerns

The purpose of this study was to gather the opinions of college students regarding their concerns about guns and mental illness and how they differed by gender, race, religion, and political party. Four hundred and nineteen college students participated in an online survey. Eighty-one per cent believe increasing mental health services will prevent gun violence. A logistic regression analysis revealed that all agreed regardless of race, religion, gender, and political party that insurance companies should be required to offer benefits for mental health care that are similar to health care. Males were three times as likely to agree there should be laws prohibiting persons with a mental illness to carry a hand gun (3.8502 AOR). Overall, college students believe mental health care should be funded. It is less clear what the role of government should be in funding mental health services.     

Mental disorder among nonreligious adolescents

This study is the first of its kind to investigate mental disorder among nonreligious adolescents. In this paper, we report three main findings based on data from the National Comorbidity Survey of Adolescents. First, nonreligious adolescents on average have higher rates of mental disorder than adolescents who identify as religious. Second, there is variability in rates of mental disorder among the three types of nonreligious adolescents, with atheists/agnostics experiencing the highest rates, followed by those with no religion, and those with no religious preference. Indeed, after controlling for a host of sociodemographic characteristics, adolescents with no preference have levels of mental disorder that do not differ from the religiously affiliated. Third, the mental health disadvantage of nonreligiosity is strongest among nonreligious adolescents with two highly religious parents. Their rates of mental illness are almost twice that of religious adolescents raised in religious households. Moreover, neither nonreligious nor religious adolescents are negatively affected by being raised in nonreligious households.     

Changes in Attitudes Toward Religion Among Those with Mental Illness

Despite the increased attention given to the religious experiences of those with mental illness, the specific nature of the changes in religious attitudes that occur within this population remain yet unknown. In this study, 406 individuals with persistent mental illness who attended one of 13 Los Angeles County Mental Health facilities completed a demographic questionnaire, an adapted version of the Religious Coping Index, and the Symptom Checklist 90-R. Over 54% of the participants reported a change in their religious beliefs such that their faith became stronger or weaker as a result, and 66% perceived these changes to be positive in nature. Qualitative codings suggest that a constructive or destructive use of religion and the quality of one's self-image and relationship with God are the primary themes underlying these changes. Those changes that were predominantly positive were associated with less severe symptomatology and more religious coping when compared to predominantly negative changes. These findings suggest that religious attitudes may be an ongoing and dynamic part of the experience of mental illness that should be considered in the treatment and research afforded by mental health professionals.     

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.     

South African Hindu Psychologists’ Perceptions of Mental Illness

Conceptualisations of mental illness are not universally applicable, as culture shapes the expression, perceptions and treatment preferences thereof. By focusing on the perceptions of Hindu psychologists regarding mental illness, this study aimed to provide a deeper understanding of the impact that religious beliefs have on such conceptualisations. Semi-structured interviews were conducted with six Hindu psychologists around the Johannesburg area, South Africa. Responses were analysed using thematic content analysis. From the findings, it was evident that religion plays a critical role in the understanding and treatment of mental illness. Hindu beliefs around psychological disturbances were salient. Additionally, it was found that a tension existed between psychologists’ awareness of the influential function of religion, particularly amongst collectivistic communities such as the Hindu community, and their occupational understandings and practices, which are deeply rooted in Western thought. Furthermore, it was suggested that the fear of stigma prevented Hindu clients from reaping the benefits of seeking help from culturally competent psychologists.     

Pastoral theory and practice in the team approach to treatment of scrupulosity as a component of obsessive compulsive disorder

The statistical estimates of the prevalence of Obsessive Compulsive Disorder (OCD) in the general population have increased dramatically in recent years. "Blasphemous" obsessions and religious compulsions dominate the clinical picture of many sufferers of OCD. Freud proposed that religion might be a contributing factor for many patients with mental illness. He hedged, however, that observation--something that many of his followers have not done. Others have noted the pathoplasticity of strict religious upbringing and images of God as vindictive or otherwise harsh. Only recently--since the 1970s--has much clinical attention been focused on this disorder by the other disciplines within the mental health community. The church, however, is ahead of the curve in diagnosis and treatment of scrupulosity. It has long been a concern for pastoral counselors--particularly pre-Vatican II Roman Catholic priests. Pathological religion influences OCD and pastoral counseling, the author proposes, can contributes to recovery.     

“You have to be mental to jump off a board any way”: Elite divers' conceptualizations and perceptions of mental health

ObjectivesMental health research in elite sport focuses predominantly on mental illness prevalence rates and help-seeking behaviours. Diving has been identified as a sport that generates particular challenges for maintaining mental health, yet has received scant attention from researchers. Therefore, purpose this paper explores what mental health and mental health related behaviours mean for a group of young, elite athletes as conditioned by their peculiar social context as elite athletes.MethodSemi-structured interviews were conducted with purposely sampled eight elite divers aged between 14 and 24 years with between 5 and 16 years of diving experience who have competed in international level diving competitions including Olympic, Common Wealth and World Cup competitions. Interviews were recorded, transcribed verbatim, and analyzed using inductive thematic analysis.ResultsAnalysis identified mental health literacy, experiences of mental health, risk factors, and opportunities for support as themes. Mental health generated negative connotations for participants attributable to knowledge development occurring through personal and vicarious experience of mental illness. Limited knowledge of symptoms of mental illnesses was evident. Participants identified a range of risk-factors inherent in their sport performance and culture revealing a performative and gendered dimension to mental health.ConclusionsOur results indicate the need to recognize the performative nature of mental health for elite divers and therefore social and cultural influences alongside biophysical. Greater efforts need to be made to help improve the overall mental health literacy of elite divers so they may be able to seek the support and treatment they need.     

Using Systems of Care to Reduce Incarceration of Youth with Serious Mental Illness

Youth with serious mental illness come into contact with juvenile justice more than 3 times as often as other youth, obliging communities to expend substantial resources on adjudicating and incarcerating many who, with proper treatment, could remain in the community for a fraction of the cost. Incarceration is relatively ineffective at remediating behaviors associated with untreated serious mental illness and may worsen some youths' symptoms and long-term prognoses. Systems of care represent a useful model for creating systems change to reduce incarceration of these youth. This paper identifies the systemic factors that contribute to the inappropriate incarceration of youth with serious mental illness, including those who have committed non-violent offenses or were detained due to lack of available treatment. It describes the progress of on-going efforts to address this problem including wraparound and diversion programs and others utilizing elements of systems of care. The utility of systems of care principles for increasing access to community-based mental health care for youth with serious mental illness is illustrated and a number of recommendations for developing collaborations with juvenile justice to further reduce the inappropriate incarceration of these youth are offered.     

Spiritual Disposition and Understanding Illness

Although Dull and Skokan (1995) proposed a cognitive model of the effect of religion on health, they neglected to clearly identify the multi-dimensional nature of religion as a cognitive schema. The present paper identifies various aspects of spiritual disposition (defined as personality and beliefs) that can play a role in an individual’s adaptation to illness. Specifically, this paper reviews the factors of religious doctrine and affiliation, spiritual beliefs, religious orientation, God locus of control, faith and hope as aspects of a spiritual disposition and explores how they can function as resources and/or negative factors in the process of adjustment to illness. Implications for clinical health care (e.g., pastoral counsellors) are drawn from this review.     

音乐治疗在消化内镜室的应用研究

在精神科领域,精神病患者及家属对精神疾病的认识存在许多误区。诸如：对精神疾病诊断、治疗的认识误区,对精神疾病病因的认识误区;对人际关系与社会功能的认识误区;对仪器设备检查过度迷信的认识误区等。为了保证精神病患者的诊断、治疗、康复的顺利进行,必须消除对精神疾病的认识误区,必须重视与加强精神科医患之间全方位有效沟通。     

Religious delusions and filicide: a psychodynamic model

In this article, we present a psychodynamic explanation for the complex crime of filicide motivated by religious delusions. To begin, we provide an overview of filicide, including its typology and epidemiology. Second, we examine the psychoanalytic theories of Heinz Kohut and Otto Kernberg so as to better understand how family-of-origin experiences add to the ways in which psychotic disorders later take shape in filicide cases. Third, we offer an explication of the psychology of religion, including the role that religious defences and religious delusions play in cases involving filicide. Ultimately, we hypothesise that mothers with religious delusions commit acts of filicide due to the dynamic and reciprocal interaction between mental illness, psychological functioning, and the psychological role played by religion. We conclude our article with a case illustration to demonstrate our theoretical model.     

Religion and obsessive-compulsive disorder (OCD) among young Muslim women in Saudi Arabia

Fifteen young women suffering from OCD in Saudi Arabia were interviewed about their experience of the illness and the roles played by religion. Religion was not perceived as a cause of the illness, but the illness can show itself in religious symptoms – notably with respect to prayer, and in a phase in which the young women were very strict and literal-minded with themselves and their families, with respect to religious observance. Religious symptoms were reported as more upsetting than other symptoms – being seen as damaging to the sufferer's piety. Other facets of the importance of religion in the experience of OCD were shown in help-seeking, in choosing to go first to religious healers for treatment, and only when these were unsuccessful were mental health professionals consulted. At this point, it was very important that the professional should be seen as trustworthy, and the criterion of trustworthiness was religiosity, specifically the use of pious, Qura’anic quotations, and a covered face (for a woman)/long beard (for a man). The accounts of the roles of religion in the experiences of the young women interviewed suggest that religion is an arena – but not the sole arena – for the expression of OCD symptoms. Religion plays an important role in determining the acceptability of treatments and treatment providers.     

Perceptions of mental healthcare consumers regarding their conditions

Distress is experienced, understood and communicated differently across various cultures. The aim of the study was to investigate the role of culture, religion and spirituality in patients’ understanding of and coping with mental problems. A quantitative survey was done at a psychiatric institution. A questionnaire was designed to explore patients’ cultural and religious beliefs about mental illness, and how these beliefs and perceptions influenced their actions in search for recovery. Questionnaires were completed by 94 patients. The majority of participants were Christian (79.8%), followed by African traditionalists (17.0%). Seventy-two per cent believed that faith in God, and 34.4% that help from religious leaders, could contribute to mental wellness. Approximately a third (29.0%) believed that by keeping their ancestors happy, they would be protected from sickness and bad luck. Mental healthcare providers’ sensitivity to cultural and religious beliefs will translate into a more comprehensive management plan, ensuring a satisfying therapeutic relationship.     

Prime and prejudice: Brief stereotypical media representations can increase prejudicial attitudes and behaviour towards people with schizophrenia

Prejudice against people with mental illnesses remains a significant problem in the United Kingdom and in many other countries despite sustained efforts by governments and charities. This is particularly so for people with schizophrenia, who are seen as dangerous and unpredictable. The present study investigated the effect of brief, casual, stereotypical representations on prejudice and behavioural intentions towards people with schizophrenia. Participants viewed Halloween costumes in an online environment under the guise of product research. In the experimental condition, they were exposed to a “Psycho Ward” Halloween outfit identical to one sold online by a leading supermarket chain in the United Kingdom. Participants in the control condition saw a neutral “pumpkin” Halloween costume. Exposure to the Psycho Ward outfit resulted in more negative behavioural intentions towards people with schizophrenia, mediated by increased prejudice. These findings confirm and extend earlier research that implicates adverse media stereotypes in the persistence of prejudice against people with mental illness. More research is warranted on the relative effects of different influences on community attitudes to mental illness.     

Complexity of referrals to a specialist psychotherapy service

Consecutive referrals to a specialist psychotherapy service were analysed for complexity. Some 71% had a severe enduring mental illness or personality disorder. Two-thirds of the rest had added psychosocial or behavioural complexity. Only 9% had no severe enduring mental illness, personality disorder, or added complexity; nearly half of these had somatoform disorder. Only 2% of the patients had uncomplicated depression or anxiety disorders.

Patients treated in this psychotherapy service are substantially different from those on whom NICE bases its guidance for the treatment of depression and anxiety, and for whom IAPT was conceived, it functions as a de facto complex case service.