Resort to faith-healing practices in the pathway to care for mental illness: a study on psychiatric inpatients in Orissa

Belief in supernatural causation of mental illnesses and resort to faith healing as the method of intervention continue in many parts of the world. This study intended to find out the belief and utilisation of faith-healing, its implications, and associated socio-cultural factors in a sample of psychiatric inpatients in Orissa, an eastern state of India. It was found that the majority (85.5%) of the patients believed in supernatural causation, 75% attended faith healing before seeking medical help, and a considerable proportion had related psychopathology and continued to believe in the therapeutic efficacy of the faith healing, even while continuing medicinal treatment. Resort to faith-healing effectively delayed medical intervention to an extent in many patients and some of the faith-healing methods were traumatising. These observations raised concern. A considerable proportion of patients and families found faith healing supportive, reassuring, and more acceptable in the community. Sensitivity to these belief systems and faith healing practices is important for practising mental-health professionals.     

Student Nurses' Experiences of The Clinical Psychiatric Learning Environment in an Education Institution

This study investigated lived experiences of student nurses working in a clinical psychiatric learning environment in South Africa. Participants were 29 fourth-year student nurses in the clinical psychiatric learning environment at a nursing education institution (females = 27; males =2). They engaged in focus group discussion on their experiences of the clinical psychiatric learning environment. The data were thematically analyzed using Tesch's method of open coding. The student nurses experienced the environment as growth enhancing on a professional and personal level.     

Concept Shift and the Development of the Concept of Class in Children

The authors compared parent-related perceptions by hospitalized adolescents (i.e., who were admitted to a specialized psychiatric unit; n = 50) and delinquent adolescents (i.e., who were placed at a juvenile treatment institution; n = 51) with adolescents from the general population (n = 51). All adolescents completed a broad set of measures of attachment, perceived parenting, and separation–individuation. Contrary to initial expectations, hospitalized adolescents scored higher than controls on indices of excessive autonomy. Ambivalence regarding issues of interpersonal closeness and distance was found among delinquent adolescents. In addition, hospitalized and delinquent adolescents were found to be struggling, each in their specific way, with attachment-related experiences of trauma. Finally, delinquent adolescents also showed a stage-appropriate form of potentially adaptive narcissism. These findings add to the growing consensus in the literature that associations between adolescent psychopathology and parent-related perceptions are typically complex and somewhat counterintuitive.     

Participatory Action Research

Abstract

Traditionally, mental health research has been conducted exclusively by professionals with little input and participation from individuals with mental illness themselves. Participatory action research (PAR) provides a more dynamic method of research, giving individuals the opportunity to become activists and advocates by influencing the direction of mental health research. This paper outlines important differences between PAR methodology and traditional research, with an emphasis on the differing roles of persons with mental illness in the two models. PAR is consistent with the recovery movement in several ways: both approaches value self-definition, empowerment, and experiential knowledge. As an example, this paper describes one project that incorporates principles of the participatory action research paradigm.     

“It Would Be a Shame to Lose Them”: A Critical Historical,Scoping, and Expert Review on the Use of Projective Assessments in Occupational Therapy,Part I

Projective assessments have a long history in occupational therapy, yet their relevance may be questioned. This first article reviews the clinical utility of projective assessments by providing a critical history of their development, followed by a scoping review of the current evidence. The second article outlines the opinions of nine experts in this field. Through this comprehensive process, conceptual and methodological issues are articulated in order to suggest educational and clinical guidelines, and future research avenues. The place of projective assessments in occupational therapy is demonstrated as a salient specialty area of practice in the current evolving landscape of mental health.     

Personalized Occupational Transformations: Narratives from Two Occupational Therapists’ Experiences with Complex Therapeutic Processes

Recovery and occupation-centered practices with persons with severe psychiatric disabilities involve many dynamic issues and processes. This study aimed to develop an understanding of how the therapeutic process unfolds in occupational therapy among persons with severe psychiatric disabilities living in sheltered or supported housing. Repeated interviews were conducted with two occupational therapists working in sheltered and supported housing facilities. Narrative analysis was used to analyze their stories. The findings reveal “personalized occupational transformations” describing significant events of interaction establishing therapeutic processes to promote personal agency and social recovery while targeting meaningful activities based on each resident’s wishes.     

Morningness-eveningness, use of stimulants, and minor psychiatric disorders among undergraduate students

Morningness–eveningness dimension in humans have been indicated to influence social behavior and individual health. The aim of the present study was to investigate the association of the morningness–eveningness dimension with behavioral and health aspects in a sample of undergraduate students. We assessed demographic data; the Pittsburgh Sleep Quality Index was used to evaluate sleep quality; the Morningness/Eveningness Questionnaire to determine morningness–eveningness, and the Self‐Reporting Questionnaire to assess minor psychiatric disorders. A total of 372 students (66.7% females), on average 21.6 years old, participated in this study. Among them, 92.2% did not smoke, 58.9% engaged in physical activities, and 19.7% were night‐shift workers. In regard to morningness–eveningness, 55.9% of the participants were intermediate between evening (39.5%) and morning (4.6%) types. Poor sleep quality (OR = 1.89), minor psychiatric disorders (OR = 1.92), and tobacco consumption (OR = 3.65) predominated among evening types. Evening types were predominantly males (OR = 1.72). This study suggests that evening types are more vulnerable to sleep and psychiatric disturbances, and tend to smoke more than morning types.     

Knowledge and causal attributions for mental disorders in HIV-positive children and adolescents: results from rural and urban Uganda

Increasing availability of antiretroviral treatment (ART) has led HIV to be considered a chronic disease, shifting attention to focus on quality of life including mental wellbeing. We investigated knowledge and causal attributions for mental disorders in HIV-positive children and adolescents in rural and urban Uganda. This qualitative study was nested in an epidemiological mental health study among HIV-positive children and adolescents aged 5–17 years in rural and urban Uganda. In-depth interviews were conducted with caregivers of HIV-positive children (5–11 years) and adolescents (12–17 years) in HIV care. Interviews were audio recorded with permission from participants and written consent and assent sought before study procedures. Thirty eight participants (19 caregivers, 19 children/adolescents) were interviewed. Age range of caregivers was 28–69 years; majority were female (17). Caregivers had little knowledge on mental disorders ;only 3 related the vignette to a mental problem and attributed it to: improper upbringing, violence, poverty and bereavement. Five adolescents identified vignettes as portraying mental disorders caused by: ill-health of parents, bereavement, child abuse, discrimination, HIV and poverty. Caregivers are not knowledgeable about behavioural and emotional challenges in HIV-positive children/adolescents. Mental health literacy programmes at HIV care clinics are essential to enhance treatment-seeking for mental health.     

Psychiatric Hospitalization and School and Community Adjustment of Children and Adolescents with Acquired Brain Injury

There is a high prevalence of psychiatric disorders in children and adolescents who have acquired brain injury (ABI). We examined the records of 82 students with ABI who were admitted to a community-based school for education and neurorehabilitation over a three-year period to determine how many experienced one or more psychiatric hospitalizations before admission, and whether hospitalization status was related to positive school and community adjustment. Results were that 30.4% of the students had a documented history of one or more psychiatric hospitalizations. Of this group, 60.0% were able to be maintained in the community-based school program and 40.0% were discharged to other settings. When discharged, 70.0% of students entered more restrictive treatment programs (e.g., psychiatric hospital, secure residential facility, residential school). The number of psychiatric hospitalizations did not predict discharge from the community-based school and was unrelated to the type of discharge setting. Clinical and research issues concerning psychiatric disorders in children and adolescents with ABI in relation to post-acute adjustment are discussed.