“Heaven and Hell on Earth” A critical discourse analysis of religious terms in Norwegian autobiographies describing personal experience of mental health problems

This article explores the use of religious terms in six Norwegian autobiographies written between 1925 and 2005 by people who themselves have been patients in the mental health services. Through a critical discourse analysis, we discuss the functions of religious discourse in the texts and its position in contrast to the medical discourse predominant in today's mental health services. It was found that religious (predominantly Christian) terms were used to varying degrees in all autobiographies as a means to capture the immensity and inherent ambivalence characteristic of mental health problems. Despite the “medical turn” in professional mental health discourse, there is no clear evidence of a decrease in the use of religious terms from the oldest to the most recent text. We propose that professional mental health workers to a larger extent take into account the religious dimension in therapy, and reflect on its larger historical and sociocultural context.     

Community Psychology in Zimbabwe: Past,Present and Future

The study describes and evaluates community psychology in Zimbabwe. We distinguish between a professional with the title ‘community psychologist’ and the practice of the field of community psychology in Zimbabwe. Community psychology services in Zimbabwe include the provision of education to all school- going age children, and free health services and housing for all. We also consider community psychology applications in the context of the HIV and AIDS pandemic, rising unemployment, homelessness, child abuse, disabilities, disasters and other hardships from urbanization, economics, and other challenges. Psychologists and other professionals offer community psychology services in the context of these challenges.     

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.     

Private selves and shared meanings: Or forgive us our projections as we forgive those who project into us

Abstract

This paper explores the difficulty university counselling services experience in finding common purpose with their institutions at the present time. It draws on a review of the relevant literature and personal experience to argue that it is extremely difficult to sustain depressive-position functioning in the current organizational culture, which, the author suggests, is dominated by fears about survival. The paper examines some defensive strategies counsellors may use to protect themselves against prevailing anxieties and argues for the importance of recognizing and working with these.     

False dawns,bleak sunset: the Coalition Government's policies on career guidance

ABSTRACT

The Coalition Government's policies on career guidance are analysed. Its rhetorical concern for career guidance provision is based largely on its support for social mobility, and its recognition of the role of career guidance in moving towards a demand-led skills system. Initial policy statements affirmed its intention to establish an all-age careers service, to revitalise the professional status of career guidance and to safeguard the partnership between schools and external provision. But these policies have been undermined by its commitment to school autonomy and to public expenditure cuts, exacerbated by indecision and delays due to difficulties in resolving the tensions within its policies. The result is a significant erosion of the all-age vision, and a likely major reduction in the extent and quality of careers help for young people.     

Gender differences in the construction and experience of cancer care: The consequences of the gendered positioning of carers

The experience and construction of caring in 50 informal cancer carers, 35 women and 15 men, was examined using a critical realist approach and a mixed method design. Women reported higher rates of depression, anxiety, unmet needs and burden of care than men. No gender differences were found in time spent care-giving, suggesting that gendered roles are implicated in distress and coping. Semi-structured interviews with 13 carers were used to identify gender differences in caring, analysed using positioning theory. Women described being positioned as all encompassing expert carers, expected to be competent at decision-making, a range of physical caring tasks, and provision of emotional support for the person with cancer. The consequences of this positioning were over-responsibility and self-sacrifice, physical costs and overwhelming emotions, which were self-silenced. In contrast, men carers positioned caring as a competency task which they had mastered, and which provided them with satisfaction, with the emotions of the person with cancer, or their own emotions, being negative aspects of caring. It is concluded that cancer caring is tied to gendered constructions and expectations, with considerable implications for psychological well-being and coping, and for carer support services, which need to take gender issues on board.     

Informal care in social context: A social psychological analysis of participation,impact and intervention in care of the elderly

Abstract

Concern about the provision and effects of care to elderly people by unpaid family, relatives and friends has arisen in the contexts of changing demographic structures of populations and, in Britain at least, explicit policy by Government which seeks to promote familial responsibility for the financial, physical and emotional needs of elderly populations. The present review examines the extent and nature of informal care to elderly people, assesses the evidence to support sociological models of care work participation and the extent to which such models are reflected in beliefs concerning care of elderly people and intentions to cease direct provision of care. Studies of the psychological impacts of care work and of interventions to modify carer wellbeing are critically reviewed. It is suggested that future psychological research should focus on modeling the modifiable psychological processes which explain variance in care work participation, impact and uptake of services, and on the impacts of changing social policy on social perception and wellbeing of elderly people.     

Using the theory of planned behaviour to predict screening uptake in two contexts

Given current policy that decisions about screening should be based on informed choice, such decisions should reflect people's values and attitudes. This prospective study compares the attitudes and other cognitive predictors of screening uptake in two contexts: when conducted as part of a routine visit and when it is conducted at a separate, test-specific visit. It was conducted in two hospitals in England, differing in method of screening organisation. 1499 pregnant women offered serum screening for Down Syndrome completed a questionnaire assessing theory of planned behaviour constructs: attitude towards undergoing the test, subjective norms of others, perceived behavioural control and intention to undergo the test.

Intention predicted screening uptake in both screening settings, but more strongly when screening was part of a routine visit. Perceived behavioural control was not predictive of uptake, and only weakly predictive of intention in both settings. Subjective norm predicted intention more strongly when it referred to partner and friends than when it referred to health professionals, in both settings.

Attitude was more strongly predictive of intention to attend screening when screening was organised as a part of routine screening, rather than requiring a separate visit. These results suggest that offering a screening test at a routine visit compared with a separate visit is more likely to facilitated uninformed choices, given the stronger association between attitudes and intention and the absence of an association with the perceived influence of health professionals.     

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.