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.     

Predicting positive mental health in internally displaced persons in Indonesia: the roles of economic improvement and exposure to violent conflict

Positive mental health, rather than just the absence of mental illness, is rarely investigated among the internally displaced persons (IDPs) affected by violent conflict in low-income countries. The purpose of this study was to investigate a model that could explain the interrelationship between factors contributing to positive mental health in displaced populations. In a longitudinal study we examine poverty, exposure to traumatic events and the change of material well-being after one year. We collected data in two consecutive years (2005 and 2006) from a community-based sample of IDPs in Ambon, Indonesia, through face-to-face structured interviews with consenting adults. Participants of this study were IDPs lived in Ambon during the violent conflict period. We interviewed 471 IDPs in the first year and reinterviewed 399 (85%) of the same subjects in the second year. The IDPs possessed good sense of coherence and subjective well-being. Our final model, which was generated by the use of structural equation modeling, fits the data well (χ² = 52.51, df = 45, p = .21, CFI = .99, RMSEA = .019). Exposure to violent conflict had a negative impact on IDPs’ mental health initially and better economic conditions improved it (r = ?.30 and .29 respectively). Mental health status one year previously was a strong predictor of future mental health, followed by individual economic growth in the past year (r = .43 and .29 respectively). On a group level the IDPs were resilient and adaptive to survive in adverse living conditions after devastating violent conflict, and the economic improvement contributed to it.     

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 intersubjectivity of spiritual experience in the art practice of people with histories of mental distress: a phenomenological study

The therapeutic outcomes gained through engaging with the art making process are well documented. Somewhat less probed are the auxiliary and sometimes enigmatic experiences of art making that impact on the sense of mental wellbeing; experiences which, by their nature, can be difficult to capture. This paper discusses such experiences, described by a group of art makers with histories of mental illness, as being spiritual in nature. A phenomenological approach using Interpretative Phenomenological Analysis (IPA) methodology was used, with Heideggerian concepts of ‘Dasein’ (There-being) and ‘Mitsein’ (With-being) informing an interpretation of the intersubjective. Such experiences were felt to be profound, and were often claimed to be accessible exclusively through an art practice that was sustained over a number of years of regular activity. The paper concludes by pointing out the difficulty in capturing evidence of sustained, non-clinical strategies for wellbeing such as those developed as an inherent part of the experiences reported here, due to their nuanced nature and the reluctance with which they may be narrated.     

“God loves me no matter how I am”: a phenomenological analysis of the religious and spiritual experiences of HIV-infected African-American women with depression

Depression is associated with increased HIV morbidity and mortality, particularly among African-American women (AAW) in the United States. The purpose of this qualitative study was to explore religious practices, spiritual beliefs, and experiences among AAW with co-occurring HIV infection and depression. A transcendental phenomenological study design was used to explore the experiences of AAW's religion and spirituality after an HIV diagnosis and living with depression. The four themes that were identified included: Religious Conflict and Return to Religious Practices; Religious Fortitude Broken and Feeling Judged; Spiritual Connection is More Powerful than Attending Church Services; and Spiritual Healing and Re-Connecting with Spirituality. These findings suggest that the distinction between internal and external manifestations of spirituality is important and that given the current religious climate, interventions that focus on supporting internal spiritual practice may be a more important and effective approach for AAW with co-occurring HIV infection and depression.     

Relational spirituality and depression among married couples in Antigua

The World Health Organization indicates depression is the leading cause of disability worldwide. At the same time researchers have found religion/spirituality is inversely associated with depression. However, the mechanisms by which spirituality/religion impacts mental health have not been clearly identified particularly in non-western populations. Relational spirituality is a concept that focuses attention on the ways people relate to the sacred. This study examines whether different ways of relating to the sacred are implicated in levels of depression and whether marital partners affect each other’s level of relational spirituality and depression. Ninety-one (n?=?91) married heterosexual couples in the Caribbean Island of Antigua completed measures of relational spirituality and depression. Data were analysed using path analysis and through Actor Partner Interdependence Model methods. Results of the analysis showed wives’ and husbands’ depression scores covaried (COV?=?6.59, Pearson r?=?.28, p?β?=??.24, unstandardised B?=??3.23, se?=?1.30), and higher instability scores (β?=?.49, unstandardised B?=?5.46, se?=?.96). The husbands’ disappointment (β?=?.21, unstandardised B?=?2.17, se?=?.95) and instability (β?=?.54, unstandardised B?=?4.65, se?=?.72) were positively related to their depression scores. The results demonstrate relational spirituality is a useful framework for addressing depression in individuals as well as married couples.     

Évaluation de la formation,auto-efficacité et bien-être affectif au travail chez les magistrats de l’ordre judiciaire : le rôle médiateur du sentiment d’appartenance sociale

Within the context of research evaluating magistrate-training programs, a questionnaire was sent electronically to three generations of French judges each from a different graduating class of the École nationale de magistrature (n = 147). The present study explores relationships between evaluation of initial training, perceived self-efficacy, feeling of relatedness in the workplace and emotional well-being at work. Our results show that feeling of relatedness in the workplace completely mediates the relationship between training evaluation and perceived self-efficacy as well as between training evaluation and well-being at work. In conclusion, practical applications of this study as well as future research in the field are discussed.     

Workplace ethics culture and work engagement: The mediating effect of ethical leadership in a developing world context

This study examined the mediating effect of ethical leadership on the relationship between workplace ethics culture and work engagement among employees in a railway transport organisation in the Democratic Republic of the Congo (DRC). The sample consisted of permanently employed staff in a railway organisation in the DRC (n = 839; females = 32%). The employees were required to complete the Ethical Leadership Scale (ELS), the Ethical Corporate Virtue model (ECV) and the Utrecht Work Engagement Scale (UWES). Mediating regression analyses were conducted to predict work engagement from workplace ethics culture, partialling out ethical leadership. The results show that workplace ethics culture had a significantly positive effect on work engagement. The results further indicated that workplace ethics culture, through the mediation of perceived ethical leadership, had a significantly positive effect on the work engagement dimensions of vigour, dedication and absorption. The findings provide evidence that ethical leadership plays a crucial role in shaping workplace ethics culture and employees’ level of work engagement in an emerging country work setting.     

Developing a critically reflexive practice for art therapists using external perceptions of art therapy

This critical inquiry explored external perceptions of art therapy. By focusing on the organizational contexts and structures that art therapy practices are typically situated within, the purpose of the study was to understand: How the values that art therapists intrinsically hold within practice transmitted, translated, and interpreted by other mental health professionals. To gain rich and detailed views, nine mental health professionals were interviewed. Through analysis of the findings, a critically reflexive form of practice was developed to assist art therapists in substantiating their role, while strengthening a team mentality to provide better services to their clients. Study implications involve the need to further explore how art therapists can develop professionally, as well as expand on strategies for how art therapy can be further valued within mental health systems.