Rural Women Veterans' Use and Perception of Mental Health Services.

Science.gov (United States)

Ingelse, Kathy; Messecar, Deborah

2016-04-01

While the total number of veterans in the U.S. is decreasing overall, the number of women veterans is significantly increasing. There are numerous barriers which keep women veterans from accessing mental health care. One barrier which can impact receiving care is living in a rural area. Veterans in rural areas have access to fewer mental health services than do urban residing veterans, and women veterans in general have less access to mental health care than do their male colleagues. Little is known about rural women veterans and their mental health service needs. Women, who have served in the military, have unique problems related to their service compared to their male colleagues including higher rates of post-traumatic stress disorder (PTSD) and military sexual trauma (MST). This qualitative study investigated use of and barriers to receiving mental health care for rural women veterans. In-depth interviews were conducted with ten women veterans who have reported experiencing problems with either MST, PTSD, or combat trauma. All ten women had utilized mental health services during active-duty military service, and post service, in Veterans Administration (VA) community based-outpatient clinics. Several recurring themes in the women's experience were identified. For all of the women interviewed, a sentinel precipitating event led to seeking mental health services. These precipitating events included episodes of chronic sexual harassment and ridicule, traumatic sexual assaults, and difficult combat experiences. Efforts to report mistreatment were unsuccessful or met with punishment. All the women interviewed reported that they would not have sought services without the help of a supportive peer who encouraged seeking care. Barriers to seeking care included feeling like they were not really a combat veteran (in spite of serving in a combat unit in Iraq); feeling stigmatized by providers and other military personnel, being treated as crazy; and a lack of interest

Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Programme for providing innovative mental health care in rural communities in India.

Science.gov (United States)

Maulik, P K; Devarapalli, S; Kallakuri, S; Praveen, D; Jha, V; Patel, A

2015-01-01

India has few mental health professionals to treat the large number of people suffering from mental disorders. Rural areas are particularly disadvantaged due to lack of trained health workers. Ways to improve care could be by training village health workers in basic mental health care, and by using innovative methods of service delivery. The ongoing Systematic Medical Appraisal, Referral and Treatment Mental Health Programme will assess the acceptability, feasibility and preliminary effectiveness of a task-shifting mobile-based intervention using mixed methods, in rural Andhra Pradesh, India. The key components of the study are an anti-stigma campaign followed by a mobile-based mental health services intervention. The study will be done across two sites in rural areas, with intervention periods of 1 year and 3 months, respectively. The programme uses a mobile-based clinical decision support tool to be used by non-physician health workers and primary care physicians to screen, diagnose and manage individuals suffering from depression, suicidal risk and emotional stress. The key aim of the study will be to assess any changes in mental health services use among those screened positive following the intervention. A number of other outcomes will also be assessed using mixed methods, specifically focussed on reduction of stigma, increase in mental health awareness and other process indicators. This project addresses a number of objectives as outlined in the Mental Health Action Plan of World Health Organization and India's National Mental Health Programme and Policy. If successful, the next phase will involve design and conduct of a cluster randomised controlled trial.

Recruiting and retaining mental health professionals to rural communities: an interdisciplinary course in Appalachia.

Science.gov (United States)

Meyer, Deborah; Hamel-Lambert, Jane; Tice, Carolyn; Safran, Steven; Bolon, Douglas; Rose-Grippa, Kathleen

2005-01-01

Faculty from 5 disciplines (health administration, nursing, psychology, social work, and special education) collaborated to develop and teach a distance-learning course designed to encourage undergraduate and graduate students to seek mental health services employment in rural areas and to provide the skills, experience, and knowledge necessary for successful rural practice. The primary objectives of the course, developed after thorough review of the rural retention and recruitment literature, were to (1) enhance interdisciplinary team skills, (2) employ technology as a tool for mental health practitioners, and (3) enhance student understanding of Appalachian culture and rural mental health. Didactic instruction emphasized Appalachian culture, rural mental health, teamwork and communication, professional ethics, and technology. Students were introduced to videoconferencing, asynchronous and synchronous communication, and Internet search tools. Working in teams of 3 or 4, students grappled with professional and cultural issues plus team process as they worked through a hypothetical case of a sexually abused youngster. The course required participants to engage in a nontraditional manner by immersing students in Web-based teams. Student evaluations suggested that teaching facts or "content" about rural mental health and Appalachian culture was much easier than the "process" of using new technologies or working in teams. Given that the delivery of mental health care demands collaboration and teamwork and that rural practice relies increasingly more on the use of technology, our experience suggests that more team-based, technology-driven courses are needed to better prepare students for clinical practice.

Rural and urban married Asian immigrants in Taiwan: determinants of their physical and mental health.

Science.gov (United States)

Chen, Walter; Shiao, Wen-Been; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh

2013-12-01

Different geographical areas with unique social cultures or societies might influence immigrant health. This study examines whether health inequities and different social factors exist regarding the health of rural and urban married Asian immigrants. A survey was conducted on 419 rural and 582 urban married Asian immigrants in Taiwan in 2009. Whereas the descriptive results indicate a worse mental health status between rural and urban married Asian immigrants, rural married immigrants were as mentally healthy as urban ones when considering different social variables. An analysis of regional stratification found different social-determinant patterns on rural and urban married immigrants. Whereas social support is key for rural immigrant physical and mental health, acculturation (i.e., language proficiency), socioeconomics (i.e., working status), and family structure (the number of family members and children living in the family) are key to the mental health of urban married immigrants in addition to social support. This study verifies the key roles of social determinants on the subjective health of married Asian immigrants. Area-differential patterns on immigrant health might act as a reference for national authorities to (re)focus their attention toward more area-specific approaches for married Asian immigrants.

Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Programme for providing innovative mental health care in rural communities in India

OpenAIRE

Maulik, P. K.; Devarapalli, S.; Kallakuri, S.; Praveen, D.; Jha, V.; Patel, A.

2015-01-01

Background. India has few mental health professionals to treat the large number of people suffering from mental disorders. Rural areas are particularly disadvantaged due to lack of trained health workers. Ways to improve care could be by training village health workers in basic mental health care, and by using innovative methods of service delivery. The ongoing Systematic Medical Appraisal, Referral and Treatment Mental Health Programme will assess the acceptability, feasibility and prelimina...

Mental health in remote rural developing areas: concepts and cases

National Research Council Canada - National Science Library

1995-01-01

"In this book, we illustrate some of the social and environmental incluences that shape health and mental health care, using examples from rural villages in Alaska as well as other developing areas of the world...

Discrimination, perceived social inequity, and mental health among rural-to-urban migrants in China.

Science.gov (United States)

Lin, Danhua; Li, Xiaoming; Wang, Bo; Hong, Yan; Fang, Xiaoyi; Qin, Xiong; Stanton, Bonita

2011-04-01

Status-based discrimination and inequity have been associated with the process of migration, especially with economics-driven internal migration. However, their association with mental health among economy-driven internal migrants in developing countries is rarely assessed. This study examines discriminatory experiences and perceived social inequity in relation to mental health status among rural-to-urban migrants in China. Cross-sectional data were collected from 1,006 rural-to-urban migrants in 2004-2005 in Beijing, China. Participants reported their perceptions and experiences of being discriminated in daily life in urban destination and perceived social inequity. Mental health was measured using the symptom checklist-90 (SCL-90). Multivariate analyses using general linear model were performed to test the effect of discriminatory experience and perceived social inequity on mental health. Experience of discrimination was positively associated with male gender, being married at least once, poorer health status, shorter duration of migration, and middle range of personal income. Likewise, perceived social inequity was associated with poorer health status, higher education attainment, and lower personal income. Multivariate analyses indicate that both experience of discrimination and perceived social inequity were strongly associated with mental health problems of rural-to-urban migrants. Experience of discrimination in daily life and perceived social inequity have a significant influence on mental health among rural-to-urban migrants. The findings underscore the needs to reduce public or societal discrimination against rural-to-urban migrants, to eliminate structural barriers (i.e., dual household registrations) for migrants to fully benefit from the urban economic development, and to create a positive atmosphere to improve migrant's psychological well-being.

Utilization of Mental Health Services by Veterans Living in Rural Areas.

Science.gov (United States)

Teich, Judith; Ali, Mir M; Lynch, Sean; Mutter, Ryan

2017-06-01

There is concern that veterans living in rural areas may not be receiving the mental health (MH) treatment they need. This study uses recent national survey data to examine the utilization of MH treatment among military veterans with a MH condition living in rural areas, providing comparisons with estimates of veterans living in urban areas. Multivariable logistic regression is utilized to examine differences in MH service use by urban/rural residence, controlling for other factors. Rates of utilization of inpatient and outpatient treatment, psychotropic medication, any MH treatment, and perceived unmet need for MH care are examined. There were significant differences in MH treatment utilization among veterans by rural/urban residence. Multivariate estimates indicate that compared to veterans with a MH condition living in urban areas, veterans in rural areas had 70% lower odds of receiving any MH treatment. Veterans with a MH condition in rural areas have approximately 52% and 64% lower odds of receiving outpatient treatment and prescription medications, respectively, compared to those living in urban areas. Differences in perceived unmet need for mental health treatment were not statistically significant. While research indicates that recent efforts to improve MH service delivery have resulted in improved access to services, this study found that veterans' rates of MH treatment are lower in rural areas, compared to urban areas. Continued efforts to support the provision of behavioral health services to rural veterans are needed. Telemedicine, using rural providers to their maximum potential, and engagement with community stakeholder groups are promising approaches. © 2016 National Rural Health Association.

Expanding rural access to mental health care through online postgraduate nurse practitioner education.

Science.gov (United States)

Kverno, Karan; Kozeniewski, Kate

2016-12-01

Workforce shortages in mental health care are especially relevant to rural communities. People often turn to their primary care providers for mental healthcare services, yet primary care providers indicate that more education is needed to fill this role. Rural primary care nurse practitioners (NPs) are ideal candidates for educational enhancement. Online programs allow NPs to continue living and working in their communities while developing the competencies to provide comprehensive and integrated mental healthcare services. This article presents a review of current online postgraduate psychiatric mental health NP (PMHNP) options. Website descriptions of online PMHNP programs were located using keywords: PMHNP or psychiatric nurse practitioner, postgraduate or post-master's, and distance or online. Across the United States, 15 online postgraduate certificate programs were located that are designed for primary care NPs seeking additional PMHNP specialization. For rural primary care NPs who are ready, willing, and able, a postgraduate PMHNP specialty certificate can be obtained online in as few as three to four semesters. The expected outcome is a cadre of dually credentialed NPs capable of functioning in an integrated role and of increasing rural access to comprehensive mental healthcare services. ©2016 American Association of Nurse Practitioners.

Characteristics of HIV-infected adults in the Deep South and their utilization of mental health services: A rural vs. urban comparison.

Science.gov (United States)

Reif, Susan; Whetten, Kathryn; Ostermann, Jan; Raper, James L

2006-01-01

Insufficient utilization of mental health services has been described among HIV-infected individuals in urban areas; however, little is known about utilization of mental health services among rural-living HIV-infected individuals. This article examines use of mental health services by HIV-infected adults in the Southern U.S., where approximately two-thirds of rural HIV cases reside, and compares mental health services use between those in rural and urban areas. Data were obtained from surveys of HIV-infected individuals receiving care at tertiary Infectious Diseases clinics in the Southern U.S. (n = 474). Study findings indicated that participants living in areas with a higher proportion of rural-living individuals were less likely to report seeing a mental health provider (p mental health visits in the previous month (p = .025). Furthermore, rural living was significantly associated with being African-American, heterosexual, less educated, and having minor children in the home. Due to differences in characteristics and mental health services use by degree of rurality, efforts are needed to assess and address the specific mental health and other needs of HIV-infected individuals in rural areas.

Prevalence of Mental Health Problems and Associated Risk Factors among Rural-to-Urban Migrant Children in Guangzhou, China.

Science.gov (United States)

Wang, Jun; Liu, Ke; Zheng, Jing; Liu, Jiali; You, Liming

2017-11-14

Rural-to-urban migration, which has achieved a huge scale during China's economic reform, is a potential risk factor for the mental health of migrant children. To test this hypothesis, this study assessed the mental health status of rural-to-urban migrant children. Guided by Andersen's behavioral model, the study explored the risk factors associated with mental health. The study recruited 1182 fifth/sixth-grade children from four private and four public primary schools in Guangzhou in 2014 in a descriptive cross-sectional design. Mental health status was measured by the strengths and difficulties questionnaire. Predisposing characteristics including demographics (e.g., age, gender), social structure (e.g., education, occupation) and health beliefs (health attitude) were recorded. Enabling characteristics including family and community resources and the need for health services were analyzed to explore the risk factors. The results indicate that more rural-to-urban migrant children were classified in the abnormal (21.0%) or borderline (18.8%) categories based on the total difficulties scores, the proportions of which were much higher than those of local children (9.8% abnormal, 13.8% borderline). Factors associated with a greater likelihood of mental health problems included single-parent families, seeking health information actively, family income cannot meet basic needs and poor perceived health status. Compared with the local children, the rural-to-urban migrant children had relatively poor mental health, hence monitoring and supporting mental health for rural-urban migrant children is critical.

Caring for clients with dual diagnosis in rural communities in Australia: the experience of mental health professionals.

Science.gov (United States)

Deans, C; Soar, R

2005-06-01

This paper identifies and describes the experiences of 13 rural mental health professionals who care for clients diagnosed with a mental illness and a coexisting alcohol and other drug disorder (dual diagnosis). Dual diagnosis is a common problem which is often poorly understood and managed by mental health professionals. The effect of excessive substance use on a person's mental well-being can present as a diagnostic challenge as each condition may mask symptoms of the other. The authors utilized a phenomenological approach to discover the experiences of a group of mental health professionals working in rural communities in Victoria, Australia. Caring for clients diagnosed with dual diagnosis was found to be a complex and stressful role that involved high levels of skill and knowledge. Despite the fact that health professionals in rural areas are expected to deliver the most appropriate care to individuals with a dual diagnosis, a number of these rural health professionals have limited preparation and experience in dealing with arising clinical diagnosis issues. Clinicians experience frustration, resentment and powerlessness in their attempt to understand their clients' drug misuse whilst simultaneously endeavouring to provide a quality mental health service.

Increasing use of mental health services in remote areas using mobile technology: a pre-post evaluation of the SMART Mental Health project in rural India.

OpenAIRE

Maulik, PK; Kallakuri, S; Devarapalli, S; Vadlamani, VK; Jha, V; Patel, A

2017-01-01

BACKGROUND: About 25% of the Indian population experience common mental disorders (CMD) but only 15-25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile-technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence-based mental health care for stress,...

Effect of Air Pollution and Rural-Urban Difference on Mental Health of the Elderly in China.

Science.gov (United States)

Tian, Tao; Chen, Yuhuai; Zhu, Jing; Liu, Pengling

2015-08-01

China has become an aging society, and the mental health problem of the elderly is increasingly becoming prominent. This paper aimed to analyze the effect of air pollution and rural-urban difference on mental health of the elderly in China. Using the data from the China Health and Retirement Longitudinal Survey (CHARLS, 2013), after controlling the social demography variable via Tobit and Probit, a regression analysis of the effect of air pollution and rural-urban difference on mental health and psychological disorder was conducted on 6,630 old people (≧60 yr old) of China from February to April 2015. Mental health and psychological disorder of the elderly were measured by the CES-D score of respondents. Air pollution degree of counties and cities (n=123) were measured by SO2 emission. 27.8% of old people had psychological disorders. Air pollution significantly influenced the mental health of the elderly, showing a positive "U-shaped" curve (Phealth problems. Marriage, education, and social activities had positive effects on the mental health of the elderly. China's local governments should consider the influence of air pollution on the mental health of the elderly during economic development. This paper recommends paying attention to the difference in mental health between the urban and rural elderly when making public health policies. Governments could improve the mental health of the elderly by enriching social activities and increasing employment opportunities of the elderly.

Task-Sharing Approaches to Improve Mental Health Care in Rural and Other Low-Resource Settings: A Systematic Review.

Science.gov (United States)

Hoeft, Theresa J; Fortney, John C; Patel, Vikram; Unützer, Jürgen

2018-12-01

Rural areas persistently face a shortage of mental health specialists. Task shifting, or task sharing, is an approach in global mental health that may help address unmet mental health needs in rural and other low-resource areas. This review focuses on task-shifting approaches and highlights future directions for research in this area. Systematic review on task sharing of mental health care in rural areas of high-income countries included: (1) PubMed, (2) gray literature for innovations not yet published in peer-reviewed journals, and (3) outreach to experts for additional articles. We included English language articles published before August 31, 2013, on interventions sharing mental health care tasks across a team in rural settings. We excluded literature: (1) from low- and middle-income countries, (2) involving direct transfer of care to another provider, and (3) describing clinical guidelines and shared decision-making tools. The review identified approaches to task sharing focused mainly on community health workers and primary care providers. Technology was identified as a way to leverage mental health specialists to support care across settings both within primary care and out in the community. The review also highlighted how provider education, supervision, and partnerships with local communities can support task sharing. Challenges, such as confidentiality, are often not addressed in the literature. Approaches to task sharing may improve reach and effectiveness of mental health care in rural and other low-resource settings, though important questions remain. We recommend promising research directions to address these questions. © 2017 National Rural Health Association.

Relationships among sense of coherence, resources, and mental health in urban and rural residents in Japan

Directory of Open Access Journals (Sweden)

Tsuno Yoko Sumikawa

2012-12-01

Full Text Available Abstract Background The salutogenic model states that coping resources are defined within sociocultural and historical contexts and that various social and historical factors influence the availability of such resources. Though previous studies have suggested the need for an interregional comparison of psychological and social resources, few studies have undertaken such an investigation. The aim of this study is to investigate the associations among coping resources, sense of coherence (SOC, and health status in a comparison of urban and rural residents. Methods General residents (aged 30–69 years in two areas were targeted for the current study. Through a random sampling selection, 1,000 residents from each area were picked, and an anonymous questionnaire was mailed to each resident. Ultimately, 269 and 363 valid responses from the urban and rural areas, respectively, were analyzed. SOC, both social and psychological resources, and mental health were assessed. To examine relationships between SOC and resources associated with mental health, mental health was defined as a dependent variable. Hierarchical multiple regression was conducted with variables entered from sociodemographic characteristics, social and psychological resources, and SOC. Results Regarding regional characteristics, social capital and participation in community activities were significantly greater in the rural area than in the urban area. Urban residents reported significantly higher self-esteem and optimism than rural residents. SOC showed the most significant association with mental health in both areas. Mental health was significantly associated with physical activity limitations and life stressors in both areas. However, the associations were weakened when social and psychological resources and SOC were added, which demonstrated their buffering effect on the negative influence of life stressors on health. When SOC was added, the association of self-esteem with mental

Development and Evaluation of Training for Rural LGBTQ Mental Health Peer Advocates.

Science.gov (United States)

Israel, Tania; Willging, Cathleen; Ley, David

2016-01-01

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) people in rural areas experience negative mental health consequences of minority stress, and encounter multiple barriers to accessing mental health and substance use treatment services. As part of a larger intervention study, we developed and piloted a unique training program to prepare peer advocates for roles as paraprofessionals who assist rural LGBTQ people with mental health needs. Thirty-seven people in New Mexico took part in either the initial training or a second revised training to improve their knowledge and skills to address LGBTQ mental health needs. Evaluation of this training consisted of self-administered structured assessments, focus groups, and open-ended interviews. Results for the initial training showed no significant increases from pre- and post-test scores on knowledge about LGBTQ people and their mental health issues, whereas significant increases were detected for the revised training. There also were significant increases in self-efficacy to perform tasks associated with the peer advocate role for all but a subset of tasks for the revised training. Qualitative data reveal that participants appreciated the opportunity to increase information and skills, especially concerning bisexual and transgender persons, and the opportunity to connect with others in the community who want to support LGBTQ people.

Impact and management of dual relationships in metropolitan, regional and rural mental health practice.

Science.gov (United States)

Endacott, Ruth; Wood, Anita; Judd, Fiona; Hulbert, Carol; Thomas, Ben; Grigg, Margaret

2006-01-01

To explore the extent and impact of professional boundary crossings in metropolitan, regional and rural mental health practice in Victoria and identify strategies mental health clinicians use to manage dual relationships. Nine geographically located focus groups consisting of mental health clinicians: four focus groups in rural settings; three in a regional city and two in a metropolitan mental health service. A total of 52 participants were interviewed. Data revealed that professional boundaries were frequently breached in regional and rural settings and on occasions these breaches had a significantly negative impact. Factors influencing the impact were: longevity of the clinician's relationship with the community, expectations of the community, exposure to community 'gossip' and size of the community. Participants reported greater stress when the boundary crossing affected their partner and/or children. Clinicians used a range of proactive and reactive strategies, such as private telephone number, avoidance of social community activities, when faced with a potential boundary crossing. The feasibility of reactive strategies depended on the service configuration: availability of an alternative case manager, requirement for either patient or clinician to travel. The greater challenges faced by rural and regional clinicians were validated by metropolitan participants with rural experience and rural participants with metropolitan experience. No single strategy is used or appropriate for managing dual relationships in rural settings. Employers and professional bodies should provide clearer guidance for clinicians both in the management of dual relationships and the distinction between boundary crossings and boundary violation. Clinicians are clearly seeking to represent and protect the patients' interests; consideration should be given by consumer groups to steps that can be taken by patients to reciprocate.

Adaptation of intensive mental health intensive case management to rural communities in the Veterans Health Administration.

Science.gov (United States)

Mohamed, Somaia

2013-03-01

There has been increasing concern in recent years about the availability of mental health services for people with serious mental illness in rural areas. To meet these needs the Department of Veterans Affairs (VA) implemented the Rural Access Networks for Growth Enhancement (RANGE) program, in 2007, modeled on the Assertive Community Treatment (ACT) model. This study uses VA administrative data from the RANGE program (N = 343) to compare client characteristics at program entry, patterns of service delivery, and outcomes with those of Veterans who received services from the general VA ACT-like program (Mental Health Intensive Case Management (MHICM) (N = 3,077). Veterans in the rural program entered treatment with similar symptom severity, less likelihood of being diagnosed with schizophrenia and having had long-term hospitalization, but significantly higher suicidality index scores and greater likelihood of being dually diagnosed compared with those in the general program. RANGE Veterans live further away from their treatment teams but did not differ significantly in measures of face-to-face treatment intensity. Similar proportions of RANGE and MHICM Veterans were reported to have received rehabilitation services, crisis intervention and substance abuse treatment. The rural programs had higher scores on overall satisfaction with VA mental health care than general programs, slightly poorer outcomes on quality of life and on the suicidality index but no significant difference on other outcomes. These data demonstrate the clinical need, practical feasibility and potential effectiveness of providing intensive case management through small specialized case management teams in rural areas.

An exploratory study of mental health and HIV risk behavior among drug-using rural women in jail.

Science.gov (United States)

Staton-Tindall, Michele; Harp, Kathi L H; Minieri, Alexandra; Oser, Carrie; Webster, J Matthew; Havens, Jennifer; Leukefeld, Carl

2015-03-01

Rural women, particularly those in the criminal justice system, are at risk for HIV related to the increasing prevalence of injection drug use as well as limited services. Research on HIV risk correlates, including drug use and mental health, has primarily focused on urban women incarcerated in prisons. The purpose of this exploratory study is to examine dual HIV risk by 3 different mental health problems (depression, anxiety, and posttraumatic stress disorder [PTSD]) among drug-using women in rural jails. This study involved random selection, screening, and face-to-face interviews with 136 women in 1 Appalachian state. Analyses focused on the relationship between mental health and HIV risk. Nearly 80% of women self-reported symptoms of depression, and more than 60% endorsed symptoms consistent with anxiety and PTSD symptoms. Mental health significantly correlated with severity of certain types of drug use, as well as risky sexual activity. In addition, for women experiencing anxiety and PTSD, injection drug use moderated the relationship between mental health and risky sexual activity. Based on these rates of drug use, mental health problems, and the emergence of injection drug use in rural Appalachia, the need to explore the relationships between these issues among vulnerable and understudied populations, such as rural women, is critical. Because of service limitations in rural communities, criminal justice venues such as jails provide opportune settings for screening, assessment, and intervention for drug use, mental health, and HIV education and prevention. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Mental health status and related characteristics of Chinese male rural-urban migrant workers.

Science.gov (United States)

Yang, Tingzhong; Xu, Xiaochao; Li, Mu; Rockett, Ian R H; Zhu, Waner; Ellison-Barnes, Alejandra

2012-06-01

To explore mental health status and related characteristics in a sample of Chinese male rural-urban migrants. Subjects were 1,595 male rural-urban migrant workers selected though a multi-stage sample survey conducted in two cities (Hangzhou and Guangzhou). Data were collected by means of a self-administered questionnaire. Both life and work stressors were examined. Stress and mental health status were measured by the Chinese Perceived Stress Scale (CPSS) and the Chinese Health Questionnaire (CHQ), respectively. Unconditional logistic regression analysis was performed to identify factors associated with probable mental disorders. There are approximately 120 million rural-urban migrants in China. The prevalence of probable mental disorders in the sample population was 24.4% (95% CI: 23.3-25.5%), which was higher than among urban residents (20.2%, 95% CI: 18.8-21.7%). Logistic regression analysis revealed that five characteristics were positively associated with risk for probable mental disorders: originating in the South (OR = 2.00; 95% CI = 1.02, 4.00), higher life stress (OR = 7.63; 95% CI = 5.88, 10.00), staying in the city for 5-9 months each year (OR = 2.56; 95% CI = 1.67, 3.85), higher work stress (OR = 2.56; 95% CI = 1.96, 3.33), and separation from wife (OR = 2.43; 95% CI = 1.61, 3.57). Employment in machinery and transportation (OR = 0.54; 95% CI = 0.36, 0.81) and higher self-worth (OR = 0.42; 95% CI = 0.28, 0.62) were negatively associated. Findings support an urgent need to develop specific policies and programs to address mental health problems among Chinese rural-urban migrants.

Stigma-related mental health knowledge and attitudes among primary health workers and community health volunteers in rural Kenya

NARCIS (Netherlands)

Mutiso, Victoria N.; Musyimi, Christine W.; Nayak, Sameera S.; Musau, Abednego M.; Rebello, Tahilia; Nandoya, Erick; Tele, Albert K.; Pike, Kathleen; Ndetei, David M.

2017-01-01

Background: The study was conducted in rural Kenya and assessed stigma in health workers from primary health facilities. Aims: This study compared variations in stigma-related mental health knowledge and attitudes between primary health workers (HWs) and community health volunteers (CHVs). Methods:

Factors affecting job satisfaction of Aboriginal mental health workers working in community mental health in rural and remote New South Wales.

Science.gov (United States)

Cosgrave, Catherine; Maple, Myfanwy; Hussain, Rafat

2017-12-01

Objective The aim of the present study was to identify factors affecting the job satisfaction and subsequent retention of Aboriginal mental health workers (AMHWs). Methods Five AMHWs working in New South Wales (NSW) for NSW Health in rural and remote community mental health (CMH) services participated in in-depth, semi-structured interviews to understand how employment and rural living factors affected workers' decisions to stay or leave their CMH positions. Results Using a constructivist grounded theory analysis, three aspects negatively impacting the job satisfaction of AMHWs were identified: (1) difficulties being accepted into the team and organisation; (2) culturally specific work challenges; and (3) professional differences and inequality. Conclusions Policy and procedural changes to the AMHW training program may address the lower remuneration and limited career opportunities identified with regard to the Bachelor Health Sciences (Mental Health) qualification. Delivering training to increase levels of understanding about the AMHW training program, and cultural awareness generally, to CMH staff and NSW Health management may assist in addressing the negative team, organisational and cultural issues identified. What is known about the topic? The Bachelor Health Sciences (Mental Health) qualification and traineeship pathway undertaken by AMHWs differs significantly from that of other health professionals working in NSW Health's CMH services. The health workforce literature identifies that each health professional group has its own culture and specific values and that forming and maintaining a profession-specific identity is an extremely important aspect of job satisfaction for health workers. What does the paper add? AMHWs working in rural and remote NSW CMH services commonly experience low levels of job satisfaction, especially while undertaking the embedded training program. Of particular concern is the health sciences qualification not translating into NSW

Family Perspectives on Pathways to Mental Health Care for Children and Youth in Rural Communities

Science.gov (United States)

Boydell, Katherine M.; Pong, Raymond; Volpe, Tiziana; Tilleczek, Kate; Wilson, Elizabeth; Lemieux, Sandy

2006-01-01

Context: There is insufficient literature documenting the mental health experiences and needs of rural communities, and a lack of focus on children in particular. This is of concern given that up to 20% of children and youth suffer from a diagnosable mental health problem. Purpose: This study examines issues of access to mental health care for…

Community-based mental health intervention for underprivileged women in rural India: an experiential report.

Science.gov (United States)

Rao, Kiran; Vanguri, Prameela; Premchander, Smita

2011-01-01

Objective. To share experiences from a project that integrates a mental health intervention within a developmental framework of microcredit activity for economically underprivileged women in rural India. Method. The mental health intervention had two components: group counseling and stress management. The former comprised of ventilation and reassurance and the latter strengthening of coping skills and a relaxation technique. Focus group discussions were used to understand women's perception of how microcredit economic activity and the mental health intervention had affected their lives. Results. Women in the mental health intervention group reported reduction in psychological distress and bodily aches and pains. Majority (86%) reported that the quality of their sleep had improved with regular practice of relaxation and that sharing their problems in the group had helped them to unburden. The social support extended by the members to each other, made them feel that they were not alone and could face any life situation. Conclusion. The study provided qualitative evidence that adding the mental health intervention to the ongoing economic activity had made a positive difference in the lives of the women. Addressing mental health concerns along with livelihood initiatives can help to enhance both economic and social capital in rural poor women.

Attitude about mental illness of health care providers and community leaders in rural Haryana, North India

Directory of Open Access Journals (Sweden)

Harshal Ramesh Salve

2014-12-01

Full Text Available Background: Attitude about mental illness determines health seeking of the people. Success of National Mental Health Programme (NMHP is dependent on attitude about mental illness of various stakeholders in the programme. Material & Methods: A community based cross-sectional study was carried out in Ballabgarh block of Faridabad district in Haryana. We aimed to study attitude about mental illness of various stakeholders of health care providers (HCP, community leaders in rural area of Haryana, north India. Study area consisting of five Primary Health Centers (PHCs serving 2,12,000 rural population. All HCP working at PHCs, Accredited Social Health Activist (ASHA and community leaders in study area were approached for participation. Hindi version of Opinion about Mental illness Scale for Chinese Community (OMICC was used to study attitude. Results: In total, 467 participants were participated in the study. Of which, HCP, ASHAs and community leaders were 81 (17.4%, 145 (31.0% and 241 (51.6% respectively. Community members reported socially restrictive, pessimistic and stereotyping attitude towards mentally ill person. ASHA and HCP reported stereotyping attitude about person with mental illness. None of the stakeholders reported stigmatizing attitude. Conclusion: Training programme focusing on spectrum of mental illness for HCP and ASHA working in rural area under NMHP programme is needed. Awareness generation of community leaders about bio-medical concept of mental illness is cornerstone of NMHP success in India.

Process evaluation of the systematic medical appraisal, referral and treatment (SMART) mental health project in rural India

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Tewari, Abha; Kallakuri, Sudha; Devarapalli, Siddhardha; Jha, Vivekanand; Patel, Anushka; Maulik, Pallab K.

2017-01-01

Background Availability of basic mental health services is limited in rural areas of India. Health system and individual level factors such as lack of mental health professionals and infrastructure, poor awareness about mental health, stigma related to help seeking, are responsible for poor awareness and use of mental health services. We implemented a mental health services delivery model that leveraged technology and task sharing to facilitate identification and treatment of common mental di...

Partnering with Communities to Address the Mental Health Needs of Rural Veterans

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Kirchner, JoAnn E.; Farmer, Mary Sue; Shue, Valorie M.; Blevins, Dean; Sullivan, Greer

2011-01-01

Purpose: Many veterans who face mental illness and live in rural areas never obtain the mental health care they need. To address these needs, it is important to reach out to community stakeholders who are likely to have frequent interactions with veterans, particularly those returning from Operations Enduring and Iraqi Freedom (OEF/OIF). Methods:…

Physical and mental health perspectives of first year undergraduate rural university students.

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Hussain, Rafat; Guppy, Michelle; Robertson, Suzanne; Temple, Elizabeth

2013-09-15

University students are often perceived to have a privileged position in society and considered immune to ill-health and disability. There is growing evidence that a sizeable proportion experience poor physical health, and that the prevalence of psychological disorders is higher in university students than their community peers. This study examined the physical and mental health issues for first year Australian rural university students and their perception of access to available health and support services. Cross-sectional study design using an online survey form based on the Adolescent Screening Questionnaire modeled on the internationally recognised HEADSS survey tool. The target audience was all first-year undergraduate students enrolled in an on-campus degree program. The response rate was 41% comprising 355 students (244 females, 111 males). Data was analysed using standard statistical techniques including descriptive and inferential statistics; and thematic analysis of the open-ended responses. The mean age of the respondents was 20.2 years (SD 4.8). The majority of the students lived in on-campus residential college style accommodation, and a third combined part-time paid work with full-time study. Most students reported being in good physical health. However, on average two health conditions were reported over the past six months, with the most common being fatigue (56%), frequent headaches (26%) and allergies (24%). Mental health problems included anxiety (25%), coping difficulties (19.7%) and diagnosed depression (8%). Most respondents reported adequate access to medical doctors and support services for themselves (82%) and friends (78%). However the qualitative comments highlighted concerns about stigma, privacy and anonymity in seeking counselling. The present study adds to the limited literature of physical and mental health issues as well as barriers to service utilization by rural university students. It provides useful baseline data for the

Mental health in primary health care in a rural district of Cambodia: a situational analysis.

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Olofsson, Sofia; Sebastian, Miguel San; Jegannathan, Bhoomikumar

2018-01-01

While mental and substance use disorders are common worldwide, the treatment gap is enormous in low and middle income countries. Primary health care is considered to be the most important way for people to get mental health care. Cambodia is a country with a long history of war and has poor mental health and limited resources for care. The aim of this study was to conduct a situational analysis of the mental health services in the rural district of Lvea Em, Kandal Province, Cambodia. A cross-sectional situational analysis was done to understand the mental health situation in Lvea Em District comparing it with the national one. The Programme for improving mental health care (PRIME) tool was used to collect systematic information about mental health care from 14 key informants in Cambodia. In addition, a separate questionnaire based on the PRIME tool was developed for the district health care centres (12 respondents). Ethical approval was obtained from the National Ethics Committee for Health Research in Cambodia. Mental health care is limited both in Lvea Em District and the country. Though national documents containing guidelines for mental health care exist, the resources available and health care infrastructure are below what is recommended. There is no budget allocated for mental health in the district; there are no mental health specialists and the mental health training of health care workers is insufficient. Based on the limited knowledge from the respondents in the district, mental health disorders do exist but no documentation of these patients is available. Respondents discussed how community aspects such as culture, history and religion were related to mental health. Though there have been improvements in understanding mental health, discrimination and abuse against people with mental health disorders seems still to be present. There are very limited mental health care services with hardly any budget allocated to them in Lvea Em District and Cambodia

Rural Mental Health

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... social networks While there are drawbacks to small communities when it comes to mental health, there are positives as well. The close-knit ... to refer patients to facilities outside of the community. The Substance Abuse and Mental ... Administration (SAMHSA) maintains the 2016 National Directory ...

Medical-legal partnerships: the role of mental health providers and legal authorities in the development of a coordinated approach to supporting mental health clients' legal needs in regional and rural settings.

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Speldewinde, Christopher A; Parsons, Ian

2015-01-01

Medical-legal partnerships (MLP) are a model in which medical and legal practitioners are co-located and work together to support the health and wellbeing of individuals by identifying and resolving legal issues that impact patients' health and wellbeing. The aim of this article is to analyse the benefits of this model, which has proliferated in the USA, and its applicability in the context of rural and remote Australia. This review was undertaken with three research questions in mind: What is an MLP? Is service provision for individuals with mental health concerns being adequately addressed by current service models particularly in the rural context? Are MLPs a service delivery channel that would benefit individuals experiencing mental health issues? The combined searches from all EBSCO Host databases resulted in 462 citations. This search aggregated academic journals, newspapers, book reviews, magazines and trade publications. After several reviews 38 papers were selected for the final review based on their relevance to this review question: How do MLPs support mental health providers and legal service providers in the development of a coordinated approach to supporting mental health clients' legal needs in regional and rural Australia? There is considerable merit in pursuing the development of MLPs in rural and remote Australia particularly as individuals living in rural and remote areas have far fewer opportunities to access support services than those people living in regional and metropolitan locations. MLPS are important channels of service delivery to assist in early invention of legal problems that can exacerbate mental health problems.

Women living with AIDS in rural Southern India: Perspectives on mental health and lay health care worker support

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Srivastava, Neha; Nyamathi, Adeline M.; Sinha, Sanjeev; Carpenter, Catherine; Satyanarayana, Veena; Ramakrishna, Padma; Ekstrand, Maria

2017-01-01

In this study, focus groups were conducted with 16 rural Women Living with AIDS (WLA) from Andhra Pradesh, India who had previously participated in a clinical trial wherein 68 WLA were randomized into either an Accredited Social Health Activists (ASHA) – Life (AL) intervention or a Usual Care program. Findings are discussed in terms of: a) mental health issues, b) perceived stressors, c) individual resources for coping with mental health issues, and d) role of Asha support in coping with mental health issues. These findings highlight the salience of mental health issues in the lives of WLA and the role played by Asha in addressing some of these issues. The discussion section makes a case for increased emphasis on mental health care in future community-based interventions for this population. PMID:29056879

Value of mental health first aid training of advisory and extension agents in supporting farmers in rural Queensland.

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Hossain, D; Gorman, D; Eley, R; Coutts, J

2010-01-01

This study was a pilot project responding to the increasing levels of stress, depression and other mental health issues in Australian rural areas resulting from prolonged drought and a changing economic and social environment. Thirty-two Advisory and Extension Agents (AEAs) attended a training course held in 2007 and 2008 in Queensland, Australia. A year after the training, data was collected to determine its value. Interviews were conducted with course participants and their supervisors and focus groups were held with stakeholders (farmers, agency staff and health professionals). The findings show that Mental Health First Aid training improved the participants' confidence level and their knowledge of mental health issues and increased their empathy toward persons with mental health problems. Furthermore, providing training on mental health issues to AEAs was perceived by stakeholders to be beneficial to both farmers and AEAs. This study demonstrated that stakeholders and course participants see this type of training as very much needed and highly beneficial. Further, providing training in mental health issues to rural service providers can be very beneficial to their farmer clients and their social network.

A comparison of barriers to accessing services for mental and physical health conditions in a sample of rural Australian adults.

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Fennell, Kate; Hull, Melissa; Jones, Martin; Dollman, James

2018-02-01

The prevalence of chronic disease, mortality and suicide rates is higher in rural Australia than in urban centres. Understanding rural Australians' barriers to accessing health services requires urgent attention. The purpose of this study was to compare barriers to help-seeking for physical and mental health issues among rural South Australian adults. A total of 409 people from three rural and remote regions in South Australia completed a computer-assisted telephone interview. They were presented a physical or mental health scenario and rated the extent to which barriers would prevent them from seeking help for that condition. Responses ranged from 1 ('strongly disagree') to 5 ('strongly agree') and were averaged to form domain scores (higher scores representing stronger barriers to seeking support), in addition to being examined at the item level. Men reported higher barriers for the mental compared with physical health scenario across four domains ('need for control and self-reliance', 'minimising the problem, resignation and normalisation', 'privacy' and 'emotional control'). Women reported higher barriers for the mental compared to physical health scenario in two domains ('need for control and self-reliance' and 'privacy'). Both men and women endorsed many items in the mental health context (eg 'I don't like feeling controlled by other people', 'I wouldn't want to overreact to a problem that wasn't serious', 'Problems like this are part of life; they're just something you have to deal with', 'I'd prefer just to put up with it rather than dwell on my problems', 'Privacy is important to me, and I don't want other people to know about my problems' and 'I don't like to get emotional about things') but in the physical health context, barriers were endorsed only by men (eg 'I wouldn't want to overreact to a problem that wasn't serious',' I'd prefer just to put up with it rather than dwell on my problems', 'Problems like this are part of life; they're just something

Perinatal mental health care in a rural African district, Uganda: a qualitative study of barriers, facilitators and needs.

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Nakku, Juliet E M; Okello, Elialilia S; Kizza, Dorothy; Honikman, Simone; Ssebunnya, Joshua; Ndyanabangi, Sheila; Hanlon, Charlotte; Kigozi, Fred

2016-07-22

Perinatal mental illness is a common and important public health problem, especially in low and middle-income countries (LMICs). This study aims to explore the barriers and facilitators, as well as perceptions about the feasibility and acceptability of plans to deliver perinatal mental health care in primary care settings in a low income, rural district in Uganda. Six focus group discussions comprising separate groups of pregnant and postpartum women and village health teams as well as eight key informant interviews were conducted in the local language using a topic guide. Transcribed data were translated into English, analyzed, and coded. Key themes were identified using a thematic analysis approach. Participants perceived that there was an important unmet need for perinatal mental health care in the district. There was evidence of significant gaps in knowledge about mental health problems as well as negative attitudes amongst mothers and health care providers towards sufferers. Poverty and inability to afford transport to services, poor partner support and stigma were thought to add to the difficulties of perinatal women accessing care. There was an awareness of the need for interventions to respond to this neglected public health problem and a willingness of both community- and facility-based health care providers to provide care for mothers with mental health problems if equipped to do so by adequate training. This study highlights the acceptability and relevance of perinatal mental health care in a rural, low-income country community. It also underscores some of the key barriers and potential facilitators to delivery of such care in primary care settings. The results of this study have implications for mental health service planning and development for perinatal populations in Uganda and will be useful in informing the development of integrated maternal mental health care in this rural district and in similar settings in other low and middle income countries.

Local suffering and the global discourse of mental health and human rights: an ethnographic study of responses to mental illness in rural Ghana.

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Read, Ursula M; Adiibokah, Edward; Nyame, Solomon

2009-10-14

The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families. This research forms part of a longitudinal anthropological study of people with severe mental illness in rural Ghana. Visits were made to over 40 households with a family member with mental illness, as well as churches, shrines, hospitals and clinics. Ethnographic methods included observation, conversation, semi-structured interviews and focus group discussions with people with mental illness, carers, healers, health workers and community members. Chaining and beating of the mentally ill was found to be commonplace in homes and treatment centres in the communities studied, as well as with-holding of food ('fasting'). However responses to mental illness were embedded within spiritual and moral perspectives and such treatment provoked little sanction at the local level. Families struggled to provide care for severely mentally ill relatives with very little support from formal health services. Psychiatric services were difficult to access, particularly in rural communities, and also seen to have limitations in their effectiveness. Traditional and faith healers remained highly popular despite the routine maltreatment of the mentally ill in their facilities. Efforts to promote the human rights of those with mental illness must engage with the experiences of mental illness within communities affected in order to grasp how these may underpin the use of practices such as mechanical

Recruiting and Retaining Mental Health Professionals to Rural Communities: An Interdisciplinary Course In Appalachia

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Meyer, Deborah; Hamel-Lambert, Jane; Tice, Carolyn; Safran, Steven; Bolon, Douglas; Rose-Grippa, Kathleen

2005-01-01

Faculty from 5 disciplines (health administration, nursing, psychology, social work, and special education) collaborated to develop and teach a distance-learning course designed to encourage undergraduate and graduate students to seek mental health services employment in rural areas and to provide the skills, experience, and knowledge necessary…

Service providers' experiences of using a telehealth network 12 months after digitisation of a large Australian rural mental health service.

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Newman, Lareen; Bidargaddi, Niranjan; Schrader, Geoffrey

2016-10-01

Despite evidence of benefits of telehealth networks in increasing access to, or providing, previously unavailable mental health services, care providers still prefer traditional approaches. For psychiatric assessment, digital technology can offer improvements over analog systems for the technical and, subsequently, the social quality of provider-client interaction. This is in turn expected to support greater provider uptake and enhanced patient benefits. Within the framework of Innovation Diffusion Theory, to study service providers' experiences of an existing regional telehealth network for mental health care practice twelve months after digitisation in order to identify the benefits of digital telehealth over an analog system for mental health care purposes in rural Australia. Qualitative interviews and focus groups were conducted with over 40 service providers from June to September 2013 in South Australia, ranging from the metropolitan central operations to health providers located up to 600km away in rural and remote areas of the same state. Participants included rural mental health teams, directors of nursing at rural hospitals, metropolitan-based psychiatrists and registrars, the metropolitan-based mental health team dedicated to rural provider support, rural GPs, administrative staff, and the executive group of the state rural health department. Fieldwork was conducted 12 months after the analog system was digitised. The interview and focus group data were analysed using thematic analysis, focusing on three key areas of innovation diffusion theory: relative advantage, technical complexity and technical compatibility. Five themes with 11 sub-themes were identified: (1) "Existing Uses", with three sub-themes: current mental health use, use by GPs, and use for staff support; (2) "Relative Advantage", with four sub-themes: improved technical quality, improved clinical practice, time and cost benefits for providers, and improved patient care; (3) "Technical

Local suffering and the global discourse of mental health and human rights: An ethnographic study of responses to mental illness in rural Ghana

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Adiibokah Edward

2009-10-01

Full Text Available Abstract Background The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families. Methods This research forms part of a longitudinal anthropological study of people with severe mental illness in rural Ghana. Visits were made to over 40 households with a family member with mental illness, as well as churches, shrines, hospitals and clinics. Ethnographic methods included observation, conversation, semi-structured interviews and focus group discussions with people with mental illness, carers, healers, health workers and community members. Results Chaining and beating of the mentally ill was found to be commonplace in homes and treatment centres in the communities studied, as well as with-holding of food ('fasting'. However responses to mental illness were embedded within spiritual and moral perspectives and such treatment provoked little sanction at the local level. Families struggled to provide care for severely mentally ill relatives with very little support from formal health services. Psychiatric services were difficult to access, particularly in rural communities, and also seen to have limitations in their effectiveness. Traditional and faith healers remained highly popular despite the routine maltreatment of the mentally ill in their facilities. Conclusion Efforts to promote the human rights of those with mental illness must engage with the experiences of mental illness within communities affected in order to

Operational challenges in conducting a community-based technology-enabled mental health services delivery model for rural India: Experiences from the SMART Mental Health Project.

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Maulik, Pallab K; Kallakuri, Sudha; Devarapalli, Siddhardha

2018-01-01

Background: There are large gaps in the delivery of mental health care in low- and middle-income countries such as India, and the problems are even more acute in rural settings due to lack of resources, remoteness, and lack of infrastructure, amongst other factors. The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health Project was conceived as a mental health services delivery model using technology-based solutions for rural India. This paper reports on the operational strategies used to facilitate the implementation of the intervention. Method: Key components of the SMART Mental Health Project included delivering an anti-stigma campaign, training of primary health workers in screening, diagnosing and managing stress, depression and increased suicide risk and task sharing of responsibilities in delivering care; and using mobile technology based electronic decision support systems to support delivery of algorithm based care for such disorders. The intervention was conducted in 42 villages across two sites in the state of Andhra Pradesh in south India. A pre-post mixed methods evaluation was done, and in this paper operational challenges are reported. Results: Both quantitative and qualitative results from the evaluation from one site covering about 5000 adults showed that the intervention was feasible and acceptable, and initial results indicated that it was beneficial in increasing access to mental health care and reducing depression and anxiety symptoms. A number of strategies were initiated in response to operational challenges to ensure smoother conduct of the project and facilitated the project to be delivered as envisaged. Conclusions: The operational strategies initiated for this project were successful in ensuring the delivery of the intervention. Those, coupled with other more systematic processes have informed the researchers to understand key processes that need to be in place to develop a more robust study, that could eventually be

Empowerment of women and mental health promotion: a qualitative study in rural Maharashtra, India.

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Kermode, Michelle; Herrman, Helen; Arole, Rajanikant; White, Joshua; Premkumar, Ramaswamy; Patel, Vikram

2007-08-31

The global burden of mental illness is high and opportunities for promoting mental health are neglected in most parts of the world. Many people affected by mental illness live in developing countries, where treatment and care options are limited. In this context, primary health care (PHC) programs can indirectly promote mental health by addressing its determinants i.e. by enhancing social unity, minimising discrimination and generating income opportunities. The objectives of this study were to: 1. Describe concepts of mental health and beliefs about determinants of mental health and illness among women involved with a PHC project in rural Maharashtra, India; 2. Identify perceived mental health problems in this community, specifically depression, suicide and violence, their perceived causes, and existing and potential community strategies to respond to them and; 3. Investigate the impact of the PHC program on individual and community factors associated with mental health We undertook qualitative in-depth interviews with 32 women associated with the PHC project regarding: their concepts of mental health and its determinants; suicide, depression and violence; and the perceived impact of the PHC project on the determinants of mental health. The interviews were taped, transcribed, translated and thematically analysed. Mental health and illness were understood by these women to be the product of cultural and socio-economic factors. Mental health was commonly conceptualised as an absence of stress and the commonest stressors were conflict with husbands and mother-in-laws, domestic violence and poverty. Links between empowerment of women through income generation and education, reduction of discrimination based on caste and sex, and promotion of individual and community mental health were recognised. However, mental health problems such as suicide and violence were well-described by participants. While it is essential that affordable, accessible, appropriate treatments and

Beyond the biomedical: community resources for mental health care in rural Ethiopia.

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Selamu, Medhin; Asher, Laura; Hanlon, Charlotte; Medhin, Girmay; Hailemariam, Maji; Patel, Vikram; Thornicroft, Graham; Fekadu, Abebaw

2015-01-01

The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources. We employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered. The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities. The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be used to support

Beyond the biomedical: community resources for mental health care in rural Ethiopia.

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Medhin Selamu

Full Text Available The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources.We employed resource mapping within the Programme for Improving Mental Health Care (PRIME, to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered.The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs represented all the biomedical health services in the district. In addition the Health Development Army (HDA are community volunteers who support health promotion and prevention activities.The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be

The effects of positive and negative parenting practices on adolescent mental health outcomes in a multicultural sample of rural youth.

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Smokowski, Paul R; Bacallao, Martica L; Cotter, Katie L; Evans, Caroline B R

2015-06-01

The quality of parent-child relationships has a significant impact on adolescent developmental outcomes, especially mental health. Given the lack of research on rural adolescent mental health in general and rural parent-child relationships in particular, the current longitudinal study explores how rural adolescents' (N = 2,617) perceptions of parenting practices effect their mental health (i.e., anxiety, depression, aggression, self-esteem, future optimism, and school satisfaction) over a 1 year period. Regression models showed that current parenting practices (i.e., in Year 2) were strongly associated with current adolescent mental health outcomes. Negative current parenting, manifesting in parent-adolescent conflict, was related to higher adolescent anxiety, depression, and aggression and lower self-esteem, and school satisfaction. Past parent-adolescent conflict (i.e., in Year 1) also positively predicted adolescent aggression in the present. Current positive parenting (i.e., parent support, parent-child future orientation, and parent education support) was significantly associated with less depression and higher self-esteem, future optimism, and school satisfaction. Past parent education support was also related to current adolescent future optimism. Implications for practice and limitations were discussed.

A comparison of barriers to mental health support-seeking among farming and non-farming adults in rural South Australia.

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Hull, Melissa J; Fennell, Kate M; Vallury, Kari; Jones, Martin; Dollman, James

2017-12-01

To assess the differences between farming and non-farming rural adults in perceived barriers to mental health service use. A cross-sectional survey, modified from the Barriers to Help-Seeking Scale (BHSS), was conducted using a computer-assisted telephone interview. Respondents (age 52.6 ± 11.6 years) were recruited from three rural regions of South Australia. Approximately, 78 non-farmers and 45 farmers were included in analyses. 78 retired and two unemployed participants were excluded from the analyses. Farmers and non-farmers were compared on domain scores and individual item responses from the adapted BHSS that represent 'agrarian' attitudes to support-seeking for mental health: stoicism, self-reliance, minimisation of the problem, stigma and distrust of health professionals. In the analysis of domain scores, 'Need for Control and Self-Reliance' was a stronger barrier for farmers than non-farmers (P = 0.009) with a trend (P = 0.07) towards stronger barriers among farmers in the 'Minimising Problem and Resignation' domain. In the analysis of item-level responses, there was a difference (P = 0.03) between farmers and non-farmers in responses to 'I find it difficult to understand my doctor/health professional', with 24.4% of the farmers agreeing that this is a barrier compared with 15.3% of the non-farmers. Long-held stereotypes of stoicism and self-reliance among farmers were somewhat supported, in the context of mental health. Mental health services and professionals in rural Australia might need to adapt their practices to successfully engage this population. © 2017 National Rural Health Alliance Inc.

Pakistan mental health country profile.

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Karim, Salman; Saeed, Khalid; Rana, Mowaddat Hussain; Mubbashar, Malik Hussain; Jenkins, Rachel

2004-01-01

The Republic of Pakistan is a South East Asian country with a population of over 140.7 million. Its population is fast growing and the majority (70%) live in rural areas with a feudal or tribal value system. The economy is dependent on agriculture and 35% of the population live below the poverty line. Islam is the main religion and 'mental illnesses' are stigmatized and widely perceived to have supernatural causes. The traditional healers along with psychiatric services are the main mental health service providers. The number of trained mental health professionals is small as compared to the population demands and specialist services are virtually non-existent. Lack of data on prevalence of various mental illnesses and monitory constraints are the major hurdles in the development of mental health services. A number of innovative programmes to develop indigenous models of care like the 'Community Mental Health Programme' and 'Schools Mental Health Programme' have been developed. These programmes have been found effective in reducing stigma and increase awareness of mental illness amongst the adults and children living in rural areas. Efforts by the government and mental health professionals have led to the implementation of a 'National Mental Health Policy' and 'Mental Health Act' in 2001. These aim at integrating mental health services with the existing health services, improving mental health care delivery and safeguarding the rights of mentally ill people. A favourable political will and the help of international institutions like the World Health Organization are required to achieve these aims.

Migrant Farmworker Stress: Mental Health Implications

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Hiott, Ann E.; Grzywacz, Joseph G.; Davis, Stephen W.; Quandt, Sara A.; Arcury, Thomas A.

2008-01-01

Context: The number of Latinos in rural regions of the United States is increasing. Little is known about factors that undermine the mental health of this segment of the rural population. Purpose: The goal of this study is to determine which stressors inherent in farmwork and the farmworker lifestyle contribute to poor mental health. Methods: An…

Maternal mental health and the persistence of food insecurity in poor rural families.

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Lent, Megan D; Petrovic, Lindsay E; Swanson, Josephine A; Olson, Christine M

2009-08-01

Little is known about the causal relationship between and the mechanisms linking depression and food insecurity. Our purpose was to examine these knowledge gaps. Chi-squared analysis of longitudinal data from 29 rural upstate New York families followed for three years and qualitative analysis of interviews were used to identify associations and mechanisms. Depressive symptoms (p=.009) and poor mental health (p=.01) in mothers limited the likelihood families would leave food insecurity. This relationship was mediated through limiting the employment of adult family members and operated in three ways: preventing the depressed household member from working, preventing a different household member from working, and limiting access to childcare for depressed children so adults could work. Poor mental health is associated with keeping families food-insecure by limiting their employment. High-quality, accessible mental health care is needed for poverty-associated food insecurity to be alleviated.

Empowerment of women and mental health promotion: a qualitative study in rural Maharashtra, India

Directory of Open Access Journals (Sweden)

White Joshua

2007-08-01

Full Text Available Abstract Background The global burden of mental illness is high and opportunities for promoting mental health are neglected in most parts of the world. Many people affected by mental illness live in developing countries, where treatment and care options are limited. In this context, primary health care (PHC programs can indirectly promote mental health by addressing its determinants i.e. by enhancing social unity, minimising discrimination and generating income opportunities. The objectives of this study were to: 1. Describe concepts of mental health and beliefs about determinants of mental health and illness among women involved with a PHC project in rural Maharashtra, India; 2. Identify perceived mental health problems in this community, specifically depression, suicide and violence, their perceived causes, and existing and potential community strategies to respond to them and; 3. Investigate the impact of the PHC program on individual and community factors associated with mental health Method We undertook qualitative in-depth interviews with 32 women associated with the PHC project regarding: their concepts of mental health and its determinants; suicide, depression and violence; and the perceived impact of the PHC project on the determinants of mental health. The interviews were taped, transcribed, translated and thematically analysed. Results Mental health and illness were understood by these women to be the product of cultural and socio-economic factors. Mental health was commonly conceptualised as an absence of stress and the commonest stressors were conflict with husbands and mother-in-laws, domestic violence and poverty. Links between empowerment of women through income generation and education, reduction of discrimination based on caste and sex, and promotion of individual and community mental health were recognised. However, mental health problems such as suicide and violence were well-described by participants. Conclusion While it is

Medicaid managed care for mental health services: the survival of safety net institutions in rural settings.

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Willging, Cathleen E; Waitzkin, Howard; Nicdao, Ethel

2008-09-01

Few accounts document the rural context of mental health safety net institutions (SNIs), especially as they respond to changing public policies. Embedded in wider processes of welfare state restructuring, privatization has transformed state Medicaid systems nationwide. We carried out an ethnographic study in two rural, culturally distinct regions of New Mexico to assess the effects of Medicaid managed care (MMC) and the implications for future reform. After 160 interviews and participant observation at SNIs, we analyzed data through iterative coding procedures. SNIs responded to MMC by nonparticipation, partnering, downsizing, and tapping into alternative funding sources. Numerous barriers impaired access under MMC: service fragmentation, transportation, lack of cultural and linguistic competency, Medicaid enrollment, stigma, and immigration status. By privatizing Medicaid and contracting with for-profit managed care organizations, the state placed additional responsibilities on "disciplined" providers and clients. Managed care models might compromise the rural mental health safety net unless the serious gaps and limitations are addressed in existing services and funding.

Lack of association between drought and mental health in a cohort of 45-61 year old rural Australian women.

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Powers, Jennifer R; Dobson, Annette J; Berry, Helen L; Graves, Anna M; Hanigan, Ivan C; Loxton, Deborah

2015-12-01

To evaluate the impact of drought on the mental health of rural Australian women and those in vulnerable sub-populations: women who were more isolated, poorer and less educated; and women who had histories of chronic disease or poor mental health. Surveys were mailed in 1996, 1998, 2001, 2004 and 2008 to 6,664 women born between 1946 and1951 who were participating in the Australian Longitudinal Study on Women's Health. The surveys included the Mental Health Index of the Medical Outcomes Study Short-Form 36 (MHI). Drought was assessed by linking the latitude and longitude of women's place of residence at each survey to the Hutchinson Drought Index. Associations between MHI and drought were assessed using linear mixed-models. While 31% of the women experienced drought in 1998 and 50% experienced drought in 2007; experience of droughts was less common in the other years. Although drought varied from survey year to survey year, mental health did not vary with drought conditions for rural women or vulnerable sub-populations. These findings are contrary to the long-held assumption that droughts increase mental health problems in Australia. While similar results may not be true for men, empirical evidence (rather than assumptions) is required on associations between drought and mental health. © 2015 Public Health Association of Australia.

EARLY CHILDHOOD MENTAL HEALTH CONSULTATION: AN EVALUATION OF EFFECTIVENESS IN A RURAL COMMUNITY.

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Vuyk, M Alexandra; Sprague-Jones, Jessica; Reed, Christie

2016-01-01

Little research has been done to evaluate the effectiveness of early childhood mental health consultation (ECMHC) in rural, applied settings. In this mixed-methods study, we evaluated an approach to ECMHC used in rural Southwest Kansas with individualized services for childcare providers. Twenty-nine home-based and center-based childcare providers completed measures on provider growth, perceptions of child outcomes, and satisfaction with sessions. In total, 162 data points were collected and analyzed using multilevel growth models. In addition, 16 providers participated in qualitative interviews. Both home-based and center-based providers reported very high satisfaction with consultation sessions which increased with time, although home-based providers showed significantly higher satisfaction than did center-based providers. Provider growth, encompassing personal well-being, scheduling and transitions, connections with parents, and positive discipline strategies increased significantly over time. Child outcomes, encompassing prosocial behavior, resilience, and overall well-being also improved significantly in providers' perception. ECMHC as conducted in Southwest Kansas appears to have a positive effect on childcare providers and the children in their care. © 2015 Michigan Association for Infant Mental Health.

Process evaluation of the systematic medical appraisal, referral and treatment (SMART) mental health project in rural India.

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Tewari, Abha; Kallakuri, Sudha; Devarapalli, Siddhardha; Jha, Vivekanand; Patel, Anushka; Maulik, Pallab K

2017-12-04

Availability of basic mental health services is limited in rural areas of India. Health system and individual level factors such as lack of mental health professionals and infrastructure, poor awareness about mental health, stigma related to help seeking, are responsible for poor awareness and use of mental health services. We implemented a mental health services delivery model that leveraged technology and task sharing to facilitate identification and treatment of common mental disorders (CMDs) such as stress, depression, anxiety and suicide risk in rural areas of the state of Andhra Pradesh, India. The intervention was delivered by lay village health workers (Accredited Social Health Activists - ASHAs) and primary care doctors. An anti-stigma campaign was implemented prior to this activity. This paper reports the process evaluation of the intervention using mixed methods. A mixed methods pre-post evaluation assessed the intervention using quantitative service usage analytics from the server, and qualitative interviews with different stakeholders. Barriers and facilitators in implementing the intervention were identified. Health service use increased significantly at post-intervention, ASHAs could followup 78.6% of those who had screened positive, and 78.6% of the 1243 Interactive Voice Response System calls made, were successful. Most respondents were aware of the intervention. They indicated that knowledge received through the intervention empowered them to approach ASHAs and share their mental health symptoms. ASHAs and doctors opined that EDSS was useful and easy to use. Medical camps organized in villages to increase access to the doctor were received positively by all. However, some aspects or facilitators of the intervention need to be improved, including network connectivity, booster training, anti-stigma campaigns, quality of mental health services provided by doctors, provision of psychotropic medications at primary health centers and frequency of health

India mental health country profile.

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Khandelwal, Sudhir K; Jhingan, Harsh P; Ramesh, S; Gupta, Rajesh K; Srivastava, Vinay K

2004-01-01

India, the second most populated country of the world with a population of 1.027 billion, is a country of contrasts. It is characterized as one of the world's largest industrial nations, yet most of the negative characteristics of poor and developing countries define India too. The population is predominantly rural, and 36% of people still live below poverty line. There is a continuous migration of rural people into urban slums creating major health and economic problems. India is one of the pioneer countries in health services planning with a focus on primary health care. Improvement in the health status of the population has been one of the major thrust areas for social development programmes in the country. However, only a small percentage of the total annual budget is spent on health. Mental health is part of the general health services, and carries no separate budget. The National Mental Health Programme serves practically as the mental health policy. Recently, there was an eight-fold increase in budget allocation for the National Mental Health Programme for the Tenth Five-Year Plan (2002-2007). India is a multicultural traditional society where people visit religious and traditional healers for general and mental health related problems. However, wherever modern health services are available, people do come forward. India has a number of public policy and judicial enactments, which may impact on mental health. These have tried to address the issues of stigma attached to the mental illnesses and the rights of mentally ill people in society. A large number of epidemiological surveys done in India on mental disorders have demonstrated the prevalence of mental morbidity in rural and urban areas of the country; these rates are comparable to global rates. Although India is well placed as far as trained manpower in general health services is concerned, the mental health trained personnel are quite limited, and these are mostly based in urban areas. Considering this

Mental health, well-being, and poverty: A study in urban and rural communities in Northeastern Brazil.

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Nepomuceno, Bárbara Barbosa; Cardoso, Antonio Alan Vieira; Ximenes, Verônica Morais; Barros, João Paulo Pereira; Leite, Jáder Ferreira

2016-01-01

This article analyzes the relations between mental health and well-being in urban and rural contexts marked by poverty. The analysis takes as its basis a quantitative research conducted with 417 adult inhabitants of two communities, one rural and the other urban, in Northeastern Brazil. The data were constructed using questionnaires composed of sociodemographic data, the Personal Wellbeing Index and Self Report Questionnaire (SRQ-20) scales. We found significant differences between the inhabitants of the rural and urban communities regarding well-being and the prevalence of common mental disorders (CMD), with a higher average well-being score in the rural context; the urban sample had a higher average regarding the prevalence of CMD. The variable income significantly influenced the SRQ-20 average scores; the same was not observed with well-being scores. Besides, it was observed that there is a negative correlation with well-being and CMD.

Common mental health problems in historically disadvantaged urban and rural communities in South Africa: prevalence and risk factors

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Havenaar, Juhan; Geerlings, Mirjan; Vivian, Lauraine; Collinson, Marh; Robertson, Brian

2007-01-01

This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were

Community beliefs about causes and risks for mental disorders: a mental health literacy survey in a rural area of Maharashtra, India.

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Kermode, Michelle; Bowen, Kathryn; Arole, Shoba; Joag, Kaustubh; Jorm, Anthony F

2010-11-01

Explanations for mental disorders in India can be influenced by biomedicine, systems of traditional medicine and supernatural beliefs. Community beliefs about causes of mental distress influence help-seeking behaviours. This study aimed to assess local knowledge and understanding of causes and risks for mental disorders in a rural area of Maharashtra, and to assess the prevalence of possible common mental disorders. A cross-sectional mental health literacy survey was undertaken in late 2007. A questionnaire was administered to 240 systematically sampled community members and 60 village health workers (VHWs). Participants were presented with two vignettes describing people experiencing symptoms of mental disorders (depression, psychosis); they were asked about the causes of the problems and the vulnerabilities of community sub-groups. Additionally, the General Health Questionnaire (GHQ12) was administered to assess prevalence of possible common mental disorders. The most commonly acknowledged causes of the problems were a range of socioeconomic factors. Supernatural and biological explanations were not widely endorsed. Women, the unemployed and the poor were judged as more likely to develop mental disorders, while both young and older people were perceived to be less vulnerable. Results of the GHQ12 indicated that 27% had a possible common mental disorder and that the elderly were at increased risk, contrary to community perceptions. Enhancing mental health literacy of both VHWs and community members using approaches that are sensitive to local conceptualizations of mental health and illness will contribute to improved treatment and care for people with mental disorders. Further investigation of mental health among the elderly in this community is indicated.

Undergraduate Nursing Students' Attitudes toward Mental Illness and Mental Health Nursing

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Konzelman, Lois

2017-01-01

Historically, nurses have lacked recognition for the work they do, especially in the area of mental health. There is a shortage of qualified mental health nurses to meet the demand for services. Many rural areas in the United States have few or no mental health services to offer communities. Encouraging positive attitudes toward mental health…

Common mental health problems in historically disadvantaged urban and rural communities in South Africa: prevalence and risk factors

NARCIS (Netherlands)

Havenaar, J.M.; Geerlings, M.I.; Vivian, L.; Collinson, M.; Robertson, B.

2008-01-01

This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were used

Common mental health problems in historically disadvantaged urban and rural communities in South Africa : prevalence and risk factors

NARCIS (Netherlands)

Havenaar, Juhan M.; Geerlings, Mirjan I.; Vivian, Lauraine; Collinson, Marh; Robertson, Brian

This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were used

Innovations on a shoestring: a study of a collaborative community-based Aboriginal mental health service model in rural Canada

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Graham Douglas

2009-12-01

Full Text Available Abstract Background Collaborative, culturally safe services that integrate clinical approaches with traditional Aboriginal healing have been hailed as promising approaches to ameliorate the high rates of mental health problems in Aboriginal communities in Canada. Overcoming significant financial and human resources barriers, a mental health team in northern Ontario is beginning to realize this ideal. We studied the strategies, strengths and challenges related to collaborative Aboriginal mental health care. Methods A participatory action research approach was employed to evaluate the Knaw Chi Ge Win services and their place in the broader mental health system. Qualitative methods were used as the primary source of data collection and included document review, ethnographic interviews with 15 providers and 23 clients; and 3 focus groups with community workers and managers. Results The Knaw Chi Ge Win model is an innovative, community-based Aboriginal mental health care model that has led to various improvements in care in a challenging rural, high needs environment. Formal opportunities to share information, shared protocols and ongoing education support this model of collaborative care. Positive outcomes associated with this model include improved quality of care, cultural safety, and integration of traditional Aboriginal healing with clinical approaches. Ongoing challenges include chronic lack of resources, health information and the still cursory understanding of Aboriginal healing and outcomes. Conclusions This model can serve to inform collaborative care in other rural and Indigenous mental health systems. Further research into traditional Aboriginal approaches to mental health is needed to continue advances in collaborative practice in a clinical setting.

An experiment in using open-text comments from the Australian Rural Mental Health Study on health service priorities.

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Rich, Jane; Handley, Tonelle; Inder, Kerry; Perkins, David

2018-02-01

Conducting research in rural and remote areas is compounded by challenges associated with accessing relatively small populations spread over large geographical areas. Open-ended questions provided in a postal survey format are an advantageous way of including rural and remote residents in research studies. This method means that it is possible to ask for in-depth perspectives, from a large sample, in a relatively resource-efficient way. Such questions are frequently included in population-based surveys; however, they are rarely analysed. The aim of this article is to explore word cloud analysis, to evaluate the utility of automated programs to supplement the analysis of open-ended survey responses. Participants from the Australian Rural Mental Health Study completed the open-ended question 'What health services would you like to see the local health district providing that are currently not available in your area?' A word cloud analysis was then undertaken using the program Wordle; the size of the word in the cloud illustrates how many times, in proportion to other words, a word has appeared in responses, and provides an easily interpretable visual illustration of research results. In total, 388 participants provided a response to the free-text question. Using the word cloud as a visual guide, key words were identified and used to locate relevant quotes from the full open-text responses. \\'Mental health\\' was the most frequent request, cited by 81 people (20.8%). Following mental health, requests for more \\'specialists\\' (n=59) and \\'services\\' (n=53) were the second and third most frequent responses respectively. Visiting specialists were requested by multiple respondents (n=14). Less frequent requests illustrated in the word cloud are important when considering representatives from smaller population groups such as those with specific health needs or conditions including \\'maternity\\' services (n=13), \\'cancer\\' (n=10), \\'drug and alcohol\\' services

Association between adverse mental health and an unhealthy lifestyle in rural-to-urban migrant workers in Shanghai

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Hua Yang

2017-02-01

Conclusion: Lifestyle behaviors were significantly associated with mental health in rural-to-urban migrant workers, and these findings indicate the need to develop targeted psychological interventions to foster healthy lifestyles in migrants.

Increasing use of mental health services in remote areas using mobile technology: a pre-post evaluation of the SMART Mental Health project in rural India.

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Maulik, Pallab K; Kallakuri, Sudha; Devarapalli, Siddhardha; Vadlamani, Vamsi Krishna; Jha, Vivekanand; Patel, Anushka

2017-06-01

About 25% of the Indian population experience common mental disorders (CMD) but only 15-25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile-technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence-based mental health care for stress, depression, and suicidal risk in 30 remote villages in the state of Andhra Pradesh, India. The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health project between May 2014 and April 2016 trained lay village health workers (Accredited Social Health Activists - ASHAs) and primary care doctors to screen, diagnose and manage individuals with common mental disorders using an electronic decision support system. An anti-stigma campaign using multi-media approaches was conducted across the villages at the outset of the project. A pre-post evaluation using mixed methods assessed the change in mental health service utilization by screen positive individuals. This paper reports on the quantitative aspects of that evaluation. Training was imparted to 21 ASHAs and 2 primary care doctors. 5007 of 5167 eligible individuals were screened, and 238 were identified as being positive for common mental disorders and referred to the primary care doctors for further management. Out of them, 2 (0.8%) had previously utilized mental health services. During the intervention period, 30 (12.6%) visited the primary care doctor for further diagnosis and treatment, as advised. There was a significant reduction in the depression and anxiety scores between start and end of the intervention among those who had screened positive at the beginning. Stigma and mental health awareness in the broader community improved during the project. The intervention led to individuals being screened for common mental

Increasing use of mental health services in remote areas using mobile technology: a pre–post evaluation of the SMART Mental Health project in rural India

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Maulik, Pallab K; Kallakuri, Sudha; Devarapalli, Siddhardha; Vadlamani, Vamsi Krishna; Jha, Vivekanand; Patel, Anushka

2017-01-01

Background About 25% of the Indian population experience common mental disorders (CMD) but only 15–25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile–technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence–based mental health care for stress, depression, and suicidal risk in 30 remote villages in the state of Andhra Pradesh, India. Methods The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health project between May 2014 and April 2016 trained lay village health workers (Accredited Social Health Activists – ASHAs) and primary care doctors to screen, diagnose and manage individuals with common mental disorders using an electronic decision support system. An anti–stigma campaign using multi–media approaches was conducted across the villages at the outset of the project. A pre–post evaluation using mixed methods assessed the change in mental health service utilization by screen positive individuals. This paper reports on the quantitative aspects of that evaluation. Results Training was imparted to 21 ASHAs and 2 primary care doctors. 5007 of 5167 eligible individuals were screened, and 238 were identified as being positive for common mental disorders and referred to the primary care doctors for further management. Out of them, 2 (0.8%) had previously utilized mental health services. During the intervention period, 30 (12.6%) visited the primary care doctor for further diagnosis and treatment, as advised. There was a significant reduction in the depression and anxiety scores between start and end of the intervention among those who had screened positive at the beginning. Stigma and mental health awareness in the broader community improved during the project. Conclusions The intervention

Prospective Study of the Mental Health Consequences of Sexual Violence Among Women Living With HIV in Rural Uganda.

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Tsai, Alexander C; Wolfe, William R; Kumbakumba, Elias; Kawuma, Annet; Hunt, Peter W; Martin, Jeffrey N; Bangsberg, David R; Weiser, Sheri D

2016-05-01

The association between sexual violence and depression is well known, but the temporal aspects of the association have not been well established. We analyzed data from a cohort of 173 HIV-positive women in rural Uganda who were interviewed every 3 months for a median of 1.8 years of follow-up. The method of generalized estimating equations (GEE) was used to model the marginal expectation of depression symptom severity (Hopkins Symptom Checklist for Depression), mental health-related quality of life (MOS-HIV Mental Health Summary), and heavy drinking (Alcohol Use Disorders Identification Test) as a function of self-reported forced-sex victimization in the 3 months prior to interview. Estimates were adjusted for variables known to confound the association between victimization and mental health status. To assess any potential reciprocal relationships, we reversed the temporal ordering of the exposures and outcomes and refitted similar GEE models. In multivariable analyses, victimization was associated with greater depression symptom severity (b = 0.17; 95% CI = [0.02, 0.33]) and lower mental health-related quality of life (b = -5.65; 95% CI = [-9.34, -1.96]), as well as increased risks for probable depression (adjusted relative risk [ARR] = 1.58; 95% CI = [1.01, 2.49) and heavy drinking (ARR = 3.99; 95% CI = [1.84, 8.63]). We did not find strong evidence of a reciprocal relationship. Our findings suggest that forced sex is associated with adverse mental health outcomes among HIV-positive women in rural Uganda. Given the substantial mental health-related impacts of victimization, effective health sector responses are needed. © The Author(s) 2015.

Obstacles to the take-up of mental health-care provision by adult males in rural and remote areas of Australia: A systematic review protocol.

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Stroud, Peter; Lockwood, Craig

The objective is to identify and synthesise the best available evidence on the obstacles to the take-up of health-care provision by adult rural and remote dwelling males in Australia seeking mental health services. Men's health, in general health-care practice, is defined as the global management of mental, emotional, and physical health conditions, and related risk factors, that are specific to men in order to promote and generate optimal health.Research and practice tends to suggest that health-care and mental-health care practitioners seem to be confronted with obstacles such as distance clients need to travel and rurality in delivering care to adult rural males. Possible issues might be whether, or to what extent, care providers are conscious of these obstacles. Another issue might be how care providers work with these obstacles in practice, and whether or not they may, also to some extent, share some of the responsibility for the existence of these obstacles, on their own, or in conjunction with other factors which might be said to exist purely in the rural context. There is also a need to explore the contributions to obstacles from the adult rural male side as well. There may also be factors at work in the particular unique nature of rural and remote health-care and mental-health care as well, which could also be involved in the creation of obstacles.The structure and functioning of rural care available to adult males of all cultural backgrounds and the obstacles to the take-up of that care represents an area which warrants further exploration and understanding. A foundation paper in this field by Karoski suggests that obstacles exist in health-care provision, particularly in the field of mental-health care to adult males. Other research suggests that, while obstacles in service provision are common to all areas, some obstacles are more significant for rural and remote areas.The reasons for framing this review in terms of the adult rural and remote male (ARRM

Association between adverse mental health and an unhealthy lifestyle in rural-to-urban migrant workers in Shanghai.

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Yang, Hua; Gao, Jian; Wang, Tianhao; Yang, Lihong; Liu, Yao; Shen, Yao; Gong, Jian; Dai, Wei; Zhou, Jing; Gu, Jie; Pan, Zhigang; Zhu, Shanzhu

2017-02-01

The association between adverse mental health and unhealthy lifestyle behaviors in migrant workers remains poorly defined in Chinese rural-to-urban migrants. A cross-sectional study was conducted regarding health-related behaviors in 5484 migrants (51.3% males) employed in Shanghai for at least 6 months. The Chinese version of the Symptom Checklist-90-Revised (SCL-90-R) was used to assess migrant mental health status. Logistic regression was applied to determine the contribution of adverse mental health to lifestyle behaviors. Of the 5484 migrants, 21.1% had potential mental health problems and 63.1% had an unhealthy lifestyle. The three most prevalent mental disorders were obsessions-compulsions (O-C; 13.7%; 751/5484), interpersonal sensitivity (I-S; 11.0%; 603/5484), and hostility (HOS; 10.8%; 590/5484). Compared with the male participants, the female participants exhibited significantly increased mean scores for phobic anxiety (PHOB) and anxiety (ANX) (p unhealthy lifestyle score was significantly associated with all nine subscales of the SCL-90-R. The male participants with psychoticism [PSY; odds ratio (OR) = 4.908, 95% confidence interval (CI) 2.474-9.735], ANX (OR = 4.022, 95% CI 2.151-7.518), or depression (DEP; OR = 3.378, 95% CI 2.079-5.487) were the most likely to have an unhealthy lifestyle. In the female participants, an unhealthy lifestyle was most associated with HOS (OR = 2.868, 95% CI 2.155-3.819), PSY (OR = 2.783, 95% CI 1.870-4.141), or DEP (OR = 2.650, 95% CI 1.960-3.582). Lifestyle behaviors were significantly associated with mental health in rural-to-urban migrant workers, and these findings indicate the need to develop targeted psychological interventions to foster healthy lifestyles in migrants. Copyright © 2016. Published by Elsevier B.V.

Rural health service managers' perspectives on preparing rural health services for climate change.

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Purcell, Rachael; McGirr, Joe

2018-02-01

To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

Terrorism and mental health in the rural Midwest.

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Hawley, Suzanne R; Ablah, Elizabeth; Hawley, Gary C; Cook, David J; Orr, Shirley A; Molgaard, Craig A

2006-01-01

Since the terrorist attacks of 11 September 2001, the amount of terrorism preparedness training has increased substantially. However, gaps continue to exist in training for the mental health casualties that result from such events. Responders must be aware of the mental health effects of terrorism and how to prepare for and buffer these effects. However, the degree to which responders possess or value this knowledge has not been studied. Multi-disciplinary terrorism preparedness training for healthcare professionals was conducted in Kansas in 2003. In order to assess knowledge and attitudes related to mental health preparedness training, post-test surveys were provided to 314 respondents 10 months after completion of the training. Respondents returned 197 completed surveys for an analysis response rate of 63%. In general, the results indicated that respondents have knowledge of and value the importance of mental health preparedness issues. The respondents who reported greater knowledge or value of mental health preparedness also indicated significantly higher ability levels in nationally recognized bioterrorism competencies (p mental health components to be incorporated into terrorism preparedness training. Further studies to determine the most effective mental health preparedness training content and instruction modalities are needed.

Making strides in women’s mental health care delivery in rural Ethiopia: demographics of a female outpatient psychiatric cohort at Jimma University Specialized Hospital (2006–2008

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Chemali ZN

2013-07-01

Full Text Available Zeina N Chemali,1,2 Christina PC Borba,1,2 Tanya E Henderson,3 Markos Tesfaye41Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; 2Harvard Medical School, Boston, MA, USA; 3International and Human Rights Law Consultants, Cambridge, MA, USA; 4Department of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, EthiopiaAbstract: This paper presents the delivery of mental health care to a sample of women living in Jimma, rural Ethiopia, and their access to mental health services. A total of 226 psychiatric charts were reviewed for women seen at Jimma University Specialized Hospital. The mental health charts included documentation ranging from one paragraph to a full note. No psychiatric chart recorded medication status, detailed substance abuse history, or a history of violence. Rendering appropriate mental health care for women requires concerted efforts by multiple stake holders. Using our results, we advance concrete and practical suggestions for improving women's mental health in rural Ethiopia. We point out that the health care system needs to be responsive, allowing for change starting with gender rights, so that rural women have access to basic mental health services.Keywords: global mental health, low income country, Africa, gender differences

Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment.

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Nduwimana, Estella; Mukunzi, Sylvere; Ng, Lauren C; Kirk, Catherine M; Bizimana, Justin I; Betancourt, Theresa S

2017-06-01

Fostering children is common in sub-Saharan Africa, but few studies examine these children's mental health needs. This study investigated the impact of living in a foster family on the mental health of HIV-positive, HIV-affected and HIV-unaffected children (n = 681 aged 10-17) in rural Rwanda. Regression analyses assessed the impact of living in a foster family on mental health, parenting, and daily hardships; multiple mediation analyses assessed whether family factors mediated the association between foster status and mental health. HIV-positive children were eight times more likely to live in foster families than HIV-unaffected children. Being HIV-affected was predictive of depression and irritability symptoms after controlling for family factors. Controlling for HIV-status, foster children had more symptoms of depression, anxiety, and irritability than non-fostered children. Positive parenting fully mediated the association between foster status and mental health. Mental health and parenting interventions for foster children and HIV-affected children may improve child outcomes.

Studying the association between musculoskeletal disorders, quality of life and mental health. A primary care pilot study in rural Crete, Greece

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Hadjipavlou Alexander G

2009-11-01

Full Text Available Abstract Background The burden of musculoskeletal disorders (MSD on the general health and well-being of the population has been documented in various studies. The objective of this study was to explore the association between MSD and the quality of life and mental health of patients and to discuss issues concerning care seeking patterns in rural Greece. Methods Patients registered at one rural Primary Care Centre (PCC in Crete were invited to complete the Nordic Musculoskeletal Questionnaire (NMQ for the analysis of musculoskeletal symptoms, together with validated instruments for measuring health related quality of life (SF-36 and mental distress (GHQ-28. Results The prevalence rate of MSD was found to be 71.2%, with low back and knee pain being the most common symptoms. Most conditions significantly impaired the quality of life, especially the physical dimensions of SF-36. Depression was strongly correlated to most MSD (p Conclusion Musculoskeletal disorders were common in patients attending the rural PCC of this study and were associated with a poor quality of life and mental distress that affected their consultation behaviour.

Comparing the mental health of rural-to-urban migrant children and their counterparts in china: Protocol for a systematic review and meta-analysis.

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Zhang, Jun-Hua; Yan, Li-Xia; Yuan, Yang

2018-04-01

In recent years, the issue of migrant children with peasant parents working in cities has attracted widespread attention in recent years because of the sheer number and the benefits bundled in China's household. The focus has gradually extended from early education opportunities to all aspects of physical and mental development, especially the social adaptation and mental health of migrant children. The negative impact of environment changes on migrant children' mental health is very worrying for parents and the society. Some studies have found that immigrant children's mental health is significantly lower than their peers, but there are also studies that hold the opposite view. Thus, the mental health status of migrant children is still a controversial issue, which may have a certain relationship with the potential differences in the specific problems of mental health, regions, comparison objects, and researchers. The objective of this protocol is to investigate whether mental health and subdimensions differ between rural-to-urban migrant children and their counterparts living in China and examine study characteristics that might result in differences among studies. We will search PubMed, Embase, OVID, ERIC, Web of Science, and Chinese databases including CNKI, Chongqing VIP, and Wan Fang data from start to April 2018. Cross-sectional studies with a comparison of migrant children and their counterparts will be included. The primary outcome will be the mean and standard deviation of mental health and its sub-dimensions. Standardized mean difference is used as the main effect value. Subgroup analyses will be carried out by the location of studies and school type of. Sensitivity analyses will be conducted to assess the robustness of the findings. Analyses will be performed with RevMan and Stata software. This systematic review and meta-analysis will compare the mental health status of rural-to-urban migrant children and their counterparts living in China. The results

Operational challenges in conducting a community-based technology-enabled mental health services delivery model for rural India: Experiences from the SMART Mental Health Project [version 1; referees: 2 approved

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Pallab K. Maulik

2018-04-01

Full Text Available Background: There are large gaps in the delivery of mental health care in low- and middle-income countries such as India, and the problems are even more acute in rural settings due to lack of resources, remoteness, and lack of infrastructure, amongst other factors. The Systematic Medical Appraisal Referral and Treatment (SMART Mental Health Project was conceived as a mental health services delivery model using technology-based solutions for rural India. This paper reports on the operational strategies used to facilitate the implementation of the intervention. Method: Key components of the SMART Mental Health Project included delivering an anti-stigma campaign, training of primary health workers in screening, diagnosing and managing stress, depression and increased suicide risk and task sharing of responsibilities in delivering care; and using mobile technology based electronic decision support systems to support delivery of algorithm based care for such disorders. The intervention was conducted in 42 villages across two sites in the state of Andhra Pradesh in south India. A pre-post mixed methods evaluation was done, and in this paper operational challenges are reported. Results: Both quantitative and qualitative results from the evaluation from one site covering about 5000 adults showed that the intervention was feasible and acceptable, and initial results indicated that it was beneficial in increasing access to mental health care and reducing depression and anxiety symptoms. A number of strategies were initiated in response to operational challenges to ensure smoother conduct of the project and facilitated the project to be delivered as envisaged. Conclusions: The operational strategies initiated for this project were successful in ensuring the delivery of the intervention. Those, coupled with other more systematic processes have informed the researchers to understand key processes that need to be in place to develop a more robust study, that

Service network analysis for agricultural mental health

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Fuller Jeffrey D

2009-05-01

Full Text Available Abstract Background Farmers represent a subgroup of rural and remote communities at higher risk of suicide attributed to insecure economic futures, self-reliant cultures and poor access to health services. Early intervention models are required that tap into existing farming networks. This study describes service networks in rural shires that relate to the mental health needs of farming families. This serves as a baseline to inform service network improvements. Methods A network survey of mental health related links between agricultural support, health and other human services in four drought declared shires in comparable districts in rural New South Wales, Australia. Mental health links covered information exchange, referral recommendations and program development. Results 87 agencies from 111 (78% completed a survey. 79% indicated that two thirds of their clients needed assistance for mental health related problems. The highest mean number of interagency links concerned information exchange and the frequency of these links between sectors was monthly to three monthly. The effectiveness of agricultural support and health sector links were rated as less effective by the agricultural support sector than by the health sector (p Conclusion Aligning with agricultural agencies is important to build effective mental health service pathways to address the needs of farming populations. Work is required to ensure that these agricultural support agencies have operational and effective links to primary mental health care services. Network analysis provides a baseline to inform this work. With interventions such as local mental health training and joint service planning to promote network development we would expect to see over time an increase in the mean number of links, the frequency in which these links are used and the rated effectiveness of these links.

Impact of Mental Poverty on Rural Economic Development

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Zhao, Lan-xiang

2011-01-01

This paper introduces the definition of mental poverty and the status quo of mental poverty in China's rural areas. Mental poverty in China's rural areas embodies the following aspects: the sense of parochialism is serious; the small farmer consciousness is strong; there is misgiving about identity. This paper analyses the reason of Mental poverty influencing farmers' behavior model and rural economic development. Mental poverty influences the farmers' changing current situation; Mental pover...

A Continuing Educational Initiative to Develop Nurses' Mental Health Knowledge and Skills in Rural and Remote Areas.

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Chang, Esther; Daly, John; Bell, Pamela; Brown, Tracey; Allan, Jan; Hancock, Karen

2002-01-01

Australian nurses (n=202) participated in mental health continuing education delivered via distance methods and regional workshops in rural areas. The majority increased content knowledge and thought audio- and videotapes were effective despite technical difficulties; 90% felt the experiential learning workshops and distance modules integrated…

The Role of Hopelessness in the Health of Low-Class Rural Chinese Residents.

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Zhang, Huiping; Wu, Lei; Cheng, Mingming

2018-03-12

It is well known that health inequality has been happening between rural and urban Chinese populations, however, the health differences among rural Chinese residents remain unclear. This study aims to assess the physical and mental health of rural Chinese residents in different social classes, and then to examine the mediating role of hopelessness between social class and health-related quality of life (HRQOL). A stratified multi-stage sampling was used to recruit 2003 rural residents responding to the 12-item Short Form Health Survey (SF-12). The results showed that lower-class rural Chinese residents reported lower physical and mental health as well as a higher level of hopelessness. Furthermore, hopelessness could fully mediate the association between social class and physical and mental health. These findings will generate significant implications for identifying those at particular risk for lower quality of life and designing social work intervention programs in rural China's context.

Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study.

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M Rizal Abdul Manaf

Full Text Available Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress and their associated factors among the Malay elderly in a rural community of Perak, Malaysia.It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21 was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed.The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44, living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10, and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36. Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57. There was no significant factor for stress.Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made.

Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study.

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Abdul Manaf, M Rizal; Mustafa, Madihah; Abdul Rahman, Mohd Rizam; Yusof, Khairul Hazdi; Abd Aziz, Noor Azah

2016-01-01

Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress) and their associated factors among the Malay elderly in a rural community of Perak, Malaysia. It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed. The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44), living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10), and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36). Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57). There was no significant factor for stress. Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made.

Differential impacts of social support on mental health: A comparison study of Chinese rural-to-urban migrant adolescents and their urban counterparts in Beijing, China.

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Zhuang, Xiao Yu; Wong, Daniel Fu Keung

2017-02-01

The number of internal migrant children in China has reached 35.8 million by the end of 2010. Previous studies revealed inconsistent findings regarding the mental health status of rural-to-urban migrant adolescents, as well as the impact of peer, teacher and parental support on the mental health of Chinese adolescent migrants. Using a comparative approach, this study attempted to compare the mental health status between migrant and urban-born adolescents and to clarify the specific roles of different sources of social support in the mental health of migrant and urban adolescents. A cross-sectional survey using a cluster convenience sampling strategy was performed in Beijing, China. A structured questionnaire was filled out by 368 rural-to-urban migrant adolescents and 325 urban-born adolescents. A significant difference was found only for positive affect (PA) but not for negative affect (NA) between the two groups, favouring the urban-born adolescents. Social support from all the three sources were all predictive of PA among rural-to-urban migrant adolescents, while only peer support contributed to PA among urban-born adolescents. Unexpectedly, teachers' support contributed to an increase in NA among urban-born adolescents. The findings contribute to understanding of the mental health status of migrant adolescents in China and the differential impact of the various sources of social support on migrant and urban-born adolescents. Also the findings may inform the development of mental health services and programmes that can potentially benefit a large number of internal migrant adolescents in China.

Health-Related Quality of Life of Rural Clients Seeking Telepsychology Services

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Kevin R. Tarlow

2014-01-01

Full Text Available Sixty million US residents live in rural areas, but health policies and interventions developed from an urban mindset often fail to address the significant barriers to health experienced by these local communities. Telepsychology, or psychological services delivered by distance via technology, is an emerging treatment modality with special implications for underserved rural areas. This study found that a sample of rural residents seeking telepsychology services (n=94 had low health-related quality of life (HRQOL, often due to cooccurring physical and mental health diagnoses including high rates of depression. However, a brief telepsychology treatment delivered to rural clients (n=40 was associated with an improvement in mental health-related quality of life (d = 0.70,  P<.001. These results indicate that despite the complex health needs of these underserved communities, telepsychology interventions may help offset the disparities in health service access in rural areas.

Earthquakes in El Salvador: a descriptive study of health concerns in a rural community and the clinical implications: Part III--Mental health and psychosocial effects.

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Woersching, Joanna C; Snyder, Audrey E

2004-01-01

In 2001, the mountain town of San Sebastian, El Salvador experienced a series of earthquakes that affected the livelihood of its people. A convenience sample of 100 households of 594 inhabitants of San Sebastian and the surrounding rural farming areas was completed. One study participant for each household was evaluated for mental health and psychosocial changes after the earthquakes. The participant's questionnaire was used to investigate the relationship between physical health, access to health care, housing, food and water, and the occurrence of negative mental health markers six months after the disasters. Findings indicate that the majority (67%) of respondents experienced 6 or more mental health complaints. Risk factors associated with multiple negative mental health symptoms included change in household income and loss of job, a new illness or a new injury in the household, reliance on healthcare services since the earthquake, and managing a chronic illness. Findings indicate a need for rapid, acute mental health screening with at-risk groups and the need to educate the entire community regarding what medical and mental health treatments are available to reduce barriers to treatment and increase public awareness.

Food Insecurity and Rural Adolescent Personal Health, Home, and Academic Environments

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Shanafelt, Amy; Hearst, Mary O.; Wang, Qi; Nanney, Marilyn S.

2016-01-01

Background: Food-insecure (FIS) adolescents struggle in school and with health and mental health more often than food-secure (FS) adolescents. Rural communities experience important disparities in health, but little is known about rural FIS adolescents. This study aims to describe select characteristics of rural adolescents by food-security…

Disparities in Alcohol, Drug Use, and Mental Health Condition Prevalence and Access to Care in Rural, Isolated, and Reservation Areas: Findings From the South Dakota Health Survey.

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Davis, Melinda M; Spurlock, Margaret; Dulacki, Kristen; Meath, Thomas; Li, Hsin-Fang Grace; McCarty, Dennis; Warne, Donald; Wright, Bill; McConnell, K John

2016-06-01

Research on urban/rural disparities in alcohol, drug use, and mental health (ADM) conditions is inconsistent. This study describes ADM condition prevalence and access to care across diverse geographies in a predominantly rural state. Multimodal cross-sectional survey in South Dakota from November 2013 to October 2014, with oversampling in rural areas and American Indian reservations. Measures assessed demographic characteristics, ADM condition prevalence using clinical screenings and participant self-report, perceived need for treatment, health service usage, and barriers to obtaining care. We tested for differences among urban, rural, isolated, and reservation geographic areas, controlling for participant age and gender. We analyzed 7,675 surveys (48% response rate). Generally, ADM condition prevalence rates were not significantly different across geographies. However, respondents in isolated and reservation areas were significantly less likely to have access to primary care. Knowledge of treatment options was significantly lower in isolated regions and individuals in reservation areas had significantly lower odds of reporting receipt of all needed care. Across the sample there was substantial discordance between ADM clinical screenings and participant self-reported need; 98.1% of respondents who screened positive for alcohol or drug misuse and 63.8% of respondents who screened positive for a mental health condition did not perceive a need for care. In a predominantly rural state, geographic disparities in ADM conditions are related to differences in access as opposed to prevalence, particularly for individuals in isolated and reservation areas. Educational interventions about ADM condition characteristics may be as important as improving access to care. © 2015 National Rural Health Association.

Education Mitigates the Relationship of Stress and Mental Disorders Among Rural Indian Women.

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Fahey, Nisha; Soni, Apurv; Allison, Jeroan; Vankar, Jagdish; Prabhakaran, Anusha; Moore Simas, Tiffany A; Byatt, Nancy; Phatak, Ajay; O'Keefe, Eileen; Nimbalkar, Somashekhar

Common mental disorders (CMD) are a constellation of mental health conditions that include depression, anxiety, and other related nonpsychotic affective disorders. Qualitative explanatory models of mental health among reproductive-aged women in India reveal that distress is strongly associated with CMD. The relationship of perceived stress and CMD might be attenuated or exacerbated based on an individual's sociodemographic characteristics. To screen for Common Mental Disorders (CMD) among reproductive-aged women from rural western India and explore how the relationship between perceived stress and CMD screening status varies by sociodemographic characteristics. Cross-sectional survey of 700 women from rural Gujarat, India. CMD screening status was assessed using Self-Reported Questionnaire 20 (SRQ-20). Factors associated with CMD screening status were evaluated using multivariable logistic regression. Effect modification for the relationship of perceived stress and CMD screening status was assessed using interaction terms and interpreted in terms of predicted probabilities. The analytic cohort included 663 women, with roughly 1 in 4 screening positive for CMD (157, 23.7%). Poor income, low education, food insecurity, and recurrent thoughts after traumatic events were associated with increased risk of positive CMD screen. Perceived stress was closely associated with CMD screening status. Higher education attenuated the relationship between high levels of stress and CMD screening status (82.3%, 88.8%, 32.9%; P value for trend: 0.03). Increasing income and age attenuated the link between moderate stress and CMD. Our findings suggest a high burden of possible CMD among reproductive-aged women from rural western India. Higher education might mitigate the association between elevated stress and CMD. Future efforts to improve mental health in rural India should focus on preventing CMD by enhancing rural women's self-efficacy and problem-solving capabilities to overcome

Factors associated with reported service use for mental health problems by residents of rural and remote communities: cross-sectional findings from a baseline survey

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2013-01-01

Background The patterns of health service use by rural and remote residents are poorly understood and under-represented in national surveys. This paper examines professional and non-professional service use for mental health problems in rural and remote communities in Australia. Methods A stratified random sample of adults was drawn from non-metropolitan regions of New South Wales, Australia as part of a longitudinal population-based cohort. One-quarter (27.7%) of the respondents were from remote or very remote regions. The socio-demographic, health status and service utilization (professional and non-professional) characteristics of 2150 community dwelling residents are described. Hierarchical logistic regressions were used to identify cross-sectional associations between socio-demographic, health status and professional and non-professional health service utilization variables. Results The overall rate of professional contacts for mental health problems during the previous 12 months (17%) in this rural population exceeded the national rate (11.9%). Rates for psychologists and psychiatrists were similar but rates for GPs were higher (12% vs. 8.1%). Non-professional contact rates were 12%. Higher levels of help seeking were associated with the absence of a partner, poorer finances, severity of mental health problems, and higher levels of adversity. Remoteness was associated with lower utilization of non-professional support. A Provisional Service Need Index was devised, and it demonstrated a broad dose–response relationship between severity of mental health problems and the likelihood of seeking any professional or non-professional help. Nevertheless, 47% of those with estimated high service need had no contact with professional services. Conclusions An examination of self-reported patterns of professional and non-professional service use for mental health problems in a rural community cohort revealed relatively higher rates of general practitioner attendance for

Factors associated with reported service use for mental health problems by residents of rural and remote communities: cross-sectional findings from a baseline survey.

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Perkins, David; Fuller, Jeffrey; Kelly, Brian J; Lewin, Terry J; Fitzgerald, Michael; Coleman, Clare; Inder, Kerry J; Allan, John; Arya, Dinesh; Roberts, Russell; Buss, Richard

2013-04-30

The patterns of health service use by rural and remote residents are poorly understood and under-represented in national surveys. This paper examines professional and non-professional service use for mental health problems in rural and remote communities in Australia. A stratified random sample of adults was drawn from non-metropolitan regions of New South Wales, Australia as part of a longitudinal population-based cohort. One-quarter (27.7%) of the respondents were from remote or very remote regions. The socio-demographic, health status and service utilization (professional and non-professional) characteristics of 2150 community dwelling residents are described. Hierarchical logistic regressions were used to identify cross-sectional associations between socio-demographic, health status and professional and non-professional health service utilization variables. The overall rate of professional contacts for mental health problems during the previous 12 months (17%) in this rural population exceeded the national rate (11.9%). Rates for psychologists and psychiatrists were similar but rates for GPs were higher (12% vs. 8.1%). Non-professional contact rates were 12%. Higher levels of help seeking were associated with the absence of a partner, poorer finances, severity of mental health problems, and higher levels of adversity. Remoteness was associated with lower utilization of non-professional support. A Provisional Service Need Index was devised, and it demonstrated a broad dose-response relationship between severity of mental health problems and the likelihood of seeking any professional or non-professional help. Nevertheless, 47% of those with estimated high service need had no contact with professional services. An examination of self-reported patterns of professional and non-professional service use for mental health problems in a rural community cohort revealed relatively higher rates of general practitioner attendance for such problems compared with data from

Association between visual status and mental health status in Thai rural elderly: a community-based study

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Pear Pongsachareonnont

2018-05-01

Full Text Available AIM: To evaluate the association between visual impairment (VI and mental health or social engagement in older adults living in rural Thailand. METHODS: Data for this cross-sectional study were drawn from a community survey conducted in 2015 in Saraburi Province, Thailand. Participants were 327 adults aged ≥50y. VI was assessed using presenting distance visual acuity. Mental health and social engagement were evaluated in face-to-face interviews using validated questionnaires. After determining the prevalence of VI and relevant sociodemographic characteristics, multivariate regression analysis was used to evaluate the impact of VI on mental health and social engagement. RESULTS: The prevalence of VI was 18.3%. Major causes were refractive error (58.3% and cataract (35%. Factors associated with VI in the crude analysis were: older age [odds ratio (OR 8.08], unemployment (OR 2.72, widowhood (OR 2.47, being divorced/separated (OR 3.27, smoking (OR 2.09 and disability in activities of daily living (OR 2.35. Protective factors were undergoing eye screening at least once a year (P=0.029 and obesity (P=0.005. VI was significantly associated with low social engagement (adjusted OR 4.13 but not with poor mental health (P>0.05. CONCLUSION: Although VI older adults reported less participation in social activities, there is no significant association between VI and poor mental health. Annual eye examinations may prevent VI in older adults. Information about employment and anti-smoking should be targeted to older adults with VI.

Service user involvement in mental health system strengthening in a rural African setting: qualitative study

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Abayneh, Sisay; Lempp, Heidi; Alem, Atalay; Alemayehu, Daniel; Eshetu, Tigist; Lund, Crick; Semrau, Maya; Thornicroft, Graham; Hanlon, Charlotte

2017-01-01

Background It is essential to involve service users in efforts to expand access to mental health care in integrated primary care settings in low- and middle-income countries (LMICs). However, there is little evidence from LMICs to guide this process. The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach. Methods Thirty nine semi-structured interviews were carried out with pur...

Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach.

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Shields-Zeeman, Laura; Pathare, Soumitra; Walters, Bethany Hipple; Kapadia-Kundu, Nandita; Joag, Kaustubh

2017-01-01

There are limited accounts of community-based interventions for reducing distress or providing support for people with common mental disorders (CMDs) in low and middle-income countries. The recently implemented Atmiyata programme is one such community-based mental health intervention focused on promoting wellness and reducing distress through community volunteers in a rural area in the state of Maharashtra, India. This case study describes the content and the process of implementation of Atmiyata and how community volunteers were trained to become Atmiyata champions and mitras ( friends ). The Atmiyata programme trained Atmiyata champions to provide support and basic counselling to community members with common mental health disorders, facilitate access to mental health care and social benefits, improve community awareness of mental health issues, and to promote well-being. Challenges to implementation included logistical challenges (difficult terrain and weather conditions at the implementation site), content-related challenges (securing social welfare benefits for people with CMDs), and partnership challenges (turnover of public health workers involved in referral chain, resistance from public sector mental health specialists). The case study serves as an example for how such a model can be sustained over time at low cost. The next steps of the programme include evaluation of the impact of the Atmiyata intervention through a pre-post study and adapting the intervention for further scale-up in other settings in India.

People, processes, and systems: An observational study of the role of technology in rural youth mental health services.

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Orlowski, Simone; Lawn, Sharon; Matthews, Ben; Venning, Anthony; Jones, Gabrielle; Winsall, Megan; Antezana, Gaston; Bidargaddi, Niranjan; Musiat, Peter

2017-06-01

The merits of technology-based mental health service reform have been widely debated among academics, practitioners, and policy makers. The design of new technologies must first be predicated on a detailed appreciation of how the mental health system works before it can be improved or changed through the introduction of new products and services. Further work is required to better understand the nature of face-to-face mental health work and to translate this knowledge to computer scientists and system designers responsible for creating technology-based solutions. Intensive observation of day-to-day work within two rural youth mental health services in South Australia, Australia, was undertaken to understand how technology could be designed and implemented to enhance young people's engagement with services and improve their experience of help seeking. Data were analysed through a lens of complexity theory. Results highlight the variety of professional roles and services that can comprise the mental health system. The level of interconnectedness evident in the system contrasted with high levels of service self-organization and disjointed information flow. A mental health professional's work was guided by two main constructs: risk and engagement. Most clients presented with a profile of disability, disadvantage, and isolation, so complex client presentations and decision-making were core practices. Clients (and frequently, their families) engaged with services in a crisis-dependent manner, characterized by multiple disengagements and re-engagements over time. While significant opportunities exist to integrate technology into existing youth mental health services, technologies for this space must be usable for a broad range of medical, psychological and cognitive disability, social disadvantage, and accommodate repeat cycles of engagement/disengagement over time. © 2016 Australian College of Mental Health Nurses Inc.

Making mental health services accessible for rural Kenyans | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

New research from the Africa Mental Health Foundation (AMHF), funded by the Global ... In 2004 he founded AMHF to address this gap in services. ... in an informal urban settlement to determine whether this strategy for mental health service ...

[Perceptions on healthcare in people with self-identified mental health problems in the rural areas of Peru].

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Saavedra, Javier E; Uchofen-Herrera, Verousckha

2016-01-01

Person-centered health and community health perspectives on its needs and resources are mandatory in healthcare policies in highly cultural diverse contexts. From this point of view, epidemiology needs to be centered not only on the disease, but also on the health diagnosis and its context, including the points of view of people and the community about their problems and needs. This article describes and qualitatively analyzes the views of adults with self-identified mental health disorders (MHD) in rural regions on the coast, highlands, and jungle of Peru, as causal factors, personal resources, and healthcare expectations from health facilities, using the narrative approach of ideographic formulation proposed by the World Psychiatric Association. The database of mental health epidemiological studies from the National Mental Health Institute was used. The qualitative analysis on answers from 235 people reveals that a large part of MHD is linked to the dynamics of troubled families and to the loss of loved ones. The presence of scarce community resources that help overcome these problems is noted. Counseling is stressed among the expectations of healthcare at facilities; nevertheless, many people do not know what to expect from such healthcare. We believe that the narrative approach is an important tool as regards to community- and person-centered medicine and intervention strategy planning.

Mental Health Condition of the Only-Child: A Study of Urban and Rural High School Students in China

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Liu, Chenying; Munakata, Tsunetsugu; Onuoha, Francis N.

2005-01-01

The mental health of the only-child continues to generate interest in research literature. The present study examines the issue in China, where the one-child phenomenon is highest due to deliberate government policy. Subjects are 299 and 333 students in two high-rank high schools in urban Harebin and rural Qing an Xian, respectively (mean age =…

Service user involvement in mental health system strengthening in a rural African setting: qualitative study.

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Abayneh, Sisay; Lempp, Heidi; Alem, Atalay; Alemayehu, Daniel; Eshetu, Tigist; Lund, Crick; Semrau, Maya; Thornicroft, Graham; Hanlon, Charlotte

2017-05-18

It is essential to involve service users in efforts to expand access to mental health care in integrated primary care settings in low- and middle-income countries (LMICs). However, there is little evidence from LMICs to guide this process. The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach. Thirty nine semi-structured interviews were carried out with purposively selected mental health service users (n = 13), caregivers (n = 10), heads of primary care facilities (n = 8) and policy makers/planners/service developers (n = 8). The interviews were audio-recorded and transcribed in Amharic, and translated into English. Thematic analysis was applied. All groups of participants supported service user and caregiver involvement in mental health system strengthening. Potential benefits were identified as (i) improved appropriateness and quality of services, and (ii) greater protection against mistreatment and promotion of respect for service users. However, hardly any respondents had prior experience of service user involvement. Stigma was considered to be a pervasive barrier, operating within the health system, the local community and individuals. Competing priorities of service users included the need to obtain adequate individual care and to work for survival. Low recognition of the potential contribution of service users seemed linked to limited empowerment and mobilization of service users. Potential health system facilitators included a culture of community oversight of primary care services. All groups of respondents identified a need for awareness-raising and training to equip service users, caregivers, service providers and local community for involvement. Empowerment at the level of individual service users (information about mental health conditions, care and rights) and the group level (for advocacy and representation) were considered

Body Mass Index and Rural Status on Self-Reported Health in Older Adults: 2004-2013 Medicare Expenditure Panel Survey.

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Batsis, John A; Whiteman, Karen L; Lohman, Matthew C; Scherer, Emily A; Bartels, Stephen J

2018-02-01

To ascertain whether rural status impacts self-reported health and whether the effect of rural status on self-reported health differs by obesity status. We identified 22,307 subjects aged ≥60 from the Medical Expenditure Panel Survey 2004-2013. Body mass index (BMI) was categorized as underweight, normal, overweight, or obese. Physical and mental component scores of the Short Form-12 assessed self-reported health status. Rural/urban status was defined using metropolitan statistical area. Weighted regression models ascertained the relative contribution of predictors (including rural and BMI) on each subscale. Mean age was 70.7 years. Rural settings had higher proportions classified as obese (30.7 vs 27.6%; P rural residents had lower physical health status (41.7 ± 0.3) than urban (43.4 ± 0.1; P rural/urban by BMI. Individuals classified as underweight or obese had lower physical health compared to normal, while the differences were less pronounced for mental health. No differences in mental health existed between rural/urban status. A BMI * rural interaction was significant for physical but not mental health. Rural residents report lower self-reported physical health status compared to urban residents, particularly older adults who are obese or underweight. No interaction was observed between BMI and rural status. © 2017 National Rural Health Association.

Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

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Toyama, Mauricio; Castillo, Humberto; Galea, Jerome T.; Brandt, Lena R.; Mendoza, María; Herrera, Vanessa; Mitrani, Martha; Cutipé, Yuri; Cavero, Victoria; Diez-Canseco, Francisco; Miranda, J. Jaime

2017-01-01

Background: Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods: Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results: Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion: Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru has achieved a

Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

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Mauricio Toyama

2017-09-01

Full Text Available Background Mental, neurological, and substance (MNS use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru

Dusukasi-The Heart That Cries: An Idiom of Mental Distress Among Perinatal Women in Rural Mali.

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Lasater, Molly E; Beebe, Madeleine; Warren, Nicole E; Souko, Fatoumata; Keita, Mariam; Murray, Sarah E; Bass, Judith K; Surkan, Pamela J; Winch, Peter J

2018-04-25

Perinatal mental health problems such as depression and anxiety are prevalent in low and middle-income countries. In Mali, the lack of mental health care is compounded by few studies on mental health needs, including in the perinatal period. This paper examines the ways in which perinatal women experience and express mental distress in rural Mali. We describe a process, relying on several different qualitative research methods, to identify understandings of mental distress specific to the Malian context. Participants included perinatal women, maternal health providers, and community health workers in rural southwest Mali. Participants articulated several idioms of distress, including gèlèya (difficulties), tôôrô (pain, suffering), hamin (worries, concerns), and dusukasi (crying heart), that occur within a context of poverty, interpersonal conflict, and gender inequality. These idioms of distress were described as sharing many key features and operating on a continuum of severity that could progress over time, both within and across idioms. Our findings highlight the context dependent nature of experiences and expressions of distress among perinatal women in Mali.

Rural Parents’ Perceived Stigma of Seeking Mental Health Services for their Children: Development and Evaluation of a New Instrument

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Williams, Stacey L.; Polaha, Jodi

2014-01-01

The purpose of this paper was to examine the validity of score interpretations of an instrument developed to measure parents’ perceptions of stigma about seeking mental health services for their children. The validity of the score interpretations of the instrument was tested in two studies. Study 1 examined confirmatory factor analysis (CFA) employing a split half approach, and construct and criterion validity using the entire sample of parents in rural Appalachia whose children were experiencing psychosocial concerns (N=347), while Study 2 further examined CFA, construct and criterion validity, as well as predictive validity of the scores on the new scale using a general sample of parents in rural Appalachia (N=184). Results of exploratory and confirmatory factor analyses revealed support for a two factor model of parents’ perceived stigma, which represented both self and public forms of stigma associated with seeking mental health services for their children, and correlated with existing measures of stigma and other psychosocial variables. Further, the new self and public stigma scale significantly predicted parents’ willingness to seek services for children. PMID:24749752

Overcoming Barriers to Rural Children's Mental Health: An Interconnected Systems Public Health Model

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Huber, Brenda J.; Austen, Julie M.; Tobin, Renée M.; Meyers, Adena B.; Shelvin, Kristal H.; Wells, Michael

2016-01-01

A large, Midwestern county implemented a four-tiered public health model of children's mental health with an interconnected systems approach involving education, health care, juvenile justice and community mental health sectors. The community sought to promote protective factors in the lives of all youth, while improving the capacity,…

Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2-8 Years in Rural and Urban Areas - United States, 2011-2012.

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Robinson, Lara R; Holbrook, Joseph R; Bitsko, Rebecca H; Hartwig, Sophie A; Kaminski, Jennifer W; Ghandour, Reem M; Peacock, Georgina; Heggs, Akilah; Boyle, Coleen A

2017-03-17

Mental, behavioral, and developmental disorders (MBDDs) begin in early childhood and often affect lifelong health and well-being. Persons who live in rural areas report more health-related disparities than those in urban areas, including poorer health, more health risk behaviors, and less access to health resources. 2011-2012. The National Survey of Children's Health (NSCH) is a cross-sectional, random-digit-dial telephone survey of parents or guardians that collects information on noninstitutionalized children aged health and well-being, health care access, and family and community characteristics. Using data from the 2011-2012 NSCH, this report examines variations in health care, family, and community factors among children aged 2-8 years with and without MBDDs in rural and urban settings. Restricting the data to U.S. children aged 2-8 years with valid responses for child age and sex, each MBDD, and zip code resulted in an analytic sample of 34,535 children; MBDD diagnosis was determined by parent report and was not validated with health care providers or medical records. A higher percentage of all children in small rural and large rural areas compared with all children in urban areas had parents who reported experiencing financial difficulties (i.e., difficulties meeting basic needs such as food and housing). Children in all rural areas more often lacked amenities and lived in a neighborhood in poor condition. However, a lower percentage of children in small rural and isolated areas had parents who reported living in an unsafe neighborhood, and children in isolated areas less often lived in a neighborhood lacking social support, less often lacked a medical home, and less often had a parent with fair or poor mental health. Across rural subtypes, approximately one in six young children had a parent-reported MBDD diagnosis. A higher prevalence was found among children in small rural areas (18.6%) than in urban areas (15.2%). In urban and the majority of rural

Impulsivity, Mental Disorder, and Suicide in Rural China.

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Lin, Lin; Zhang, Jie

2017-01-02

The purpose of this study was to investigate the relationship among impulsivity, mental disorder, and suicide with a sample of rural young Chinese. Subjects were 392 consecutively recruited male and female suicides aged 15-34 years and 416 community male and female controls of the same age range sampled in rural China. The case-control data were obtained using psychological autopsy with structured and semi-structured instruments. Dysfunctional impulsivity was a significant risk factor regardless of mental disorder in rural China. Dysfunctional impulsivity is a potential area for further study of suicidal behavior. The suicide prevention efforts in rural China may address impulsivity.

Salud mental en médicos que realizan el servicio rural, urbano-marginal en salud en el Perú: Un estudio de línea base Mental health in physicians doing the rural and suburban health service in Peru: a baseline study

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Edén Galán-Rodas

2011-06-01

Full Text Available Las condiciones poco favorables que el médico joven encara durante el Servicio Rural, Urbano Marginal en Salud (SERUMS pueden incrementar el riesgo de enfermedades mentales. El objetivo del estudio es establecer la línea base sobre niveles de depresión y uso problemático de alcohol en aquellos médicos que realizarán dicho servicio durante el periodo 2011-2012. Se aplicó como herramientas de tamizaje la escala del Centro de Estudios Epidemiológicos para depresión y el Test para la Identificación de Trastornos por Uso de Alcohol, a 493 médicos. Se encontró que 26% de las mujeres y 14,5% de los varones puntuaron en el rango de depresión; 22% de mujeres y 26% de varones lo hicieron para uso problemático de alcohol. 39% puntuó para cualquiera de ambas entidades. Los problemas de salud mental son comunes entre los médicos que se disponen a migrar para realizar el SERUMS, lo cual debe ser atendido para evitar mayores riesgos.The disadvantageous conditions in which young physicians have to do their rural and sub-urban health service (SERUMS may put them in a high risk for mental disorders. This study aims to establish the baseline levels of depression and alcohol use problems among those physicians scheduled to complete their SERUMS during the period 2011-2012. The Center for Epidemiologic Studies Depression Scale (CES-D and the Alcohol Use Disorders Identification Test (AUDIT were administered as screening tests to 493 physicians. Depression scores were met by 26% females and 14.5% males, and alcohol use problem scores were met by 22% females and 26% males. Overall, 39% persons scored for either of both mental health entities. Mental health problems seem to be common among young physicians scheduled to migrate to their SERUMS. These problems must be addressed to avoid greater risks.

Experience from mental health clinics held during medical service camps in Fiji.

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Sivakumaran, Hemalatha; George, Kuruvilla; Naker, Gunu; Nadanachandran, Kathir

2015-12-01

We aim to describe the experience and findings of mental health clinics held during medical service camps in the rural settings of Fiji. Descriptive data collated at the end of the medical camps across 2011-2014 are used to highlight the main findings. The exposure to mental health assessments and brief interventions at these camps was a validating experience for both individuals and medical students attending the clinics. The most common presentations can be categorised under symptoms of depression, anxiety and relationship problems. The accessibility of mental health support services is a challenge in Fiji. Medical service camps can form an important pathway in promoting mental health awareness, especially amongst the rural communities of Fiji, and a useful platform for medical students to acquire some clinical exposure. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Themes of rural health and aging from a program of research.

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Congdon, J G; Magilvy, J K

2001-01-01

The culture and diversity of rural life and limitations of rural health systems to meet the changing health needs of an aging population lead to problems of obtaining appropriate care in rural America. In a program of nursing research involving three ethnographic studies in rural Colorado, transitions of older adults across differing levels of heath care were explored. The sample totaled 425 participants, of whom 25% were Hispanic. Five major themes emerged: circles of formal and informal care; integration of faith, spirituality, and family with health status; crisis nature of health care transitions; nursing homes as a housing option; and changing spirit of traditional rural nursing. Recommendations for providers included making their practices congruent with rural culture, being fully informed of available resources, facilitating acceptable health care decisions, and integrating physical, mental, and spiritual health care for elders and their families.

Mental Health in Cypriot Citizens of the Rural Health Centre Kofinou

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Georgios Stavrou

2016-11-01

Full Text Available Objective: The main purpose of this study was to investigate the mental health of Cypriot citizens living in the current difficult period of economic recession. The specific objective was to investigate the different factors (gender, age, socio-economic factors, etc. that may affect the levels of emotional distress, anxiety, and depression in patients attending the Rural Health Centre of Kofinou. Materials and Methods: The sample consisted of a total of 300 Cypriots who visited Kofinou Health Centre in the period between July and September 2015. For the middle-aged citizens, the Greek version of the Hospital Anxiety Depression Scale (HADS was applied to 150 persons [1], while for the visiting senior citizens (aged over 65 years, the Greek version of the Geriatric Depression Scale (GDS was used [2]. Results: HADS: A total of 150 people of average age 47 ± 11.5 years (min 23–max 64 participated in the study. Fifty-six percent were women. Seventy-seven percent stated they had a reduction in income (mean reduction 35% ± 25% and 46.7% suffered from chronic disease. The 36.6% and 28.7% of the visitors showed moderate or severe forms of anxiety and depression, accordingly. Higher emotional distress is associated with lower educational level (b = −2.63, p < 0.001, lower income (b = −1.07, p = 0.017, and the presence of a chronic disease (b = 5.45, p < 0.001. The same factors are significantly associated with higher anxiety (Education: b = −1.20, p = 0.003; Income: b = −0.64, p = 0.01; Chronic disease: b = 2.82, p = 0.001. Additionally, a reduction in income (>35% is associated with increased depression (p = 0.028. GDS: 150 patients out of which 77 were women (51.3%. The average age of participants was 72 ± 5.5 years. Ninety-three (62% participants declared a reduction in income due to the financial crisis (mean reduction 20% ± 8%, while 139 (92.7% stated that they had chronic disease. Fifty-three participants (35.3% thought they had

Evaluation of the Mental Healthiness Aging Initiative: community program to promote awareness about mental health and aging issues.

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Zanjani, Faika; Kruger, Tina; Murray, Deborah

2012-04-01

The objective of this study is to evaluate the Mental Healthiness Aging Initiative, designed to promote community awareness and knowledge about mental health and aging issues. This study occurred during 2007-2009 in 67 of 120 counties in Kentucky. A rural region (11 counties) received the intervention, consisting of focus groups, Extension Agent training, and television-based social marketing campaign. Partial-intervention counties (29 counties) received only the television-based social marketing campaign. The control counties (27 counties) received no intervention activities. Results indicated that the intervention counties agreed more with being able to assist elder adults with a potential mental illness. Also, the intervention counties understood the risk of consuming alcohol and medications better, but had a poorer recognition of drinking problems in elder adults. These findings need to be considered within study limitations, such as measurement error, degree of intervention exposure, and regional differences across intervention groups. The study demonstrates that community interventions on mental health awareness and knowledge are feasible within majority rural regions, with Extension Agents being gatekeepers, for promoting positive messages about mental health and aging issues.

Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2–8 Years in Rural and Urban Areas — United States, 2011–2012

Science.gov (United States)

Holbrook, Joseph R.; Bitsko, Rebecca H.; Hartwig, Sophie A.; Kaminski, Jennifer W.; Ghandour, Reem M.; Peacock, Georgina; Heggs, Akilah; Boyle, Coleen A.

2017-01-01

Problem/Condition Mental, behavioral, and developmental disorders (MBDDs) begin in early childhood and often affect lifelong health and well-being. Persons who live in rural areas report more health-related disparities than those in urban areas, including poorer health, more health risk behaviors, and less access to health resources. Reporting Period 2011–2012. Description of System The National Survey of Children’s Health (NSCH) is a cross-sectional, random-digit–dial telephone survey of parents or guardians that collects information on noninstitutionalized children aged health and well-being, health care access, and family and community characteristics. Using data from the 2011–2012 NSCH, this report examines variations in health care, family, and community factors among children aged 2–8 years with and without MBDDs in rural and urban settings. Restricting the data to U.S. children aged 2–8 years with valid responses for child age and sex, each MBDD, and zip code resulted in an analytic sample of 34,535 children; MBDD diagnosis was determined by parent report and was not validated with health care providers or medical records. Results A higher percentage of all children in small rural and large rural areas compared with all children in urban areas had parents who reported experiencing financial difficulties (i.e., difficulties meeting basic needs such as food and housing). Children in all rural areas more often lacked amenities and lived in a neighborhood in poor condition. However, a lower percentage of children in small rural and isolated areas had parents who reported living in an unsafe neighborhood, and children in isolated areas less often lived in a neighborhood lacking social support, less often lacked a medical home, and less often had a parent with fair or poor mental health. Across rural subtypes, approximately one in six young children had a parent-reported MBDD diagnosis. A higher prevalence was found among children in small rural areas

Bringing Mental Health Needs into Focus through School Counseling Program Transformation

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Gruman, Diana H.; Marston, Toby; Koon, Holly

2013-01-01

Professional school counselors are educational leaders with training and expertise to address the mental health concerns of students. Unfortunately, work conditions at some schools can create barriers to the delivery of effective mental health services. This article presents a case of one rural, diverse high school that transformed its school…

Assessing Program Efficiency: A Time and Motion Study of the Mental Health Emergency Care — Rural Access Program in NSW Australia

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Emily Saurman

2014-07-01

Full Text Available The Mental Health Emergency Care-Rural Access Program (MHEC-RAP is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time is spent completing clinical paperwork. This finding emphasizes the importance of these services to program efficiency and the need to address variability of service provision to impact capacity. Currently, there is no efficiency benchmark for emergency telepsychiatry programs. Findings suggest that MHEC-RAP could increase its activity without affecting program responsiveness. T&M studies not only determine activity and time expenditure, but have a wider application assessing program efficiency by understanding, defining, and calculating capacity. T&M studies can inform future program development of MHEC-RAP and similar telehealth programs, both in Australia and overseas.

Journal of Child and Adolescent Mental Health - Vol 26, No 3 (2014)

African Journals Online (AJOL)

Eating attitudes, body image satisfaction and self-esteem of South African ... The impact of a mental health teaching programme on rural and urban ... in assessing children's mental health in primary care: Finnish parents', ... Attachment, parenting styles and bullying during pubertal years · EMAIL ... OTHER RESOURCES.

Socioeconomic Inequalities in Mental Health of Adult Population: Serbian National Health Survey.

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Santric-Milicevic, Milena; Jankovic, Janko; Trajkovic, Goran; Terzic-Supic, Zorica; Babic, Uros; Petrovic, Marija

2016-01-01

The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement. To explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements. Cross-sectional study. This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households - 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5), and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index). The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at pinequalities contributed by differences in age, education, employment, marriage and the wealth status of the adult population.

Challenges of connectedness in personal recovery for rural mothers with mental illness.

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Hine, Rochelle Helena; Maybery, Darryl; Goodyear, Melinda Jane

2018-04-01

Social connection is a fundamental human need, but challenging for individuals with characteristics that are socially stigmatized. Parenting with mental illness presents obstacles, as well as opportunities, for connection. In the present study, we examined connectedness within a personal recovery paradigm for rural mothers with a mental illness. In-depth interviews with 17 mothers with a mental illness, utilizing constructivist grounded theory, resulted in six categories of meaning, including 'yearning for connection', 'connecting intensely', 'encountering rejection and exclusion', 'choosing isolation', 'being known', and 'finding peers/helping others'. Women expressed a strong desire for connection, but for many, prior experiences of trauma and rejection created barriers to the development of trust, preventing some women from seeking opportunities for connection. Connectedness to self and significant others, and a broader life meaning and purpose can support and expedite personal recovery from mental illness for rural women. However the factors that contribute to the mental illness might also inhibit the development of trust needed to attain social connection. Increasing connectedness in mothers with mental illness is a complex endeavour requiring concerted focus as distinct from other service-delivery goals. The perinatal period could be a key time for intervention. © 2017 Australian College of Mental Health Nurses Inc.

Enhancing client welfare through better communication of private mental health data between rural service providers

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Oliver Kisalay Burmeister

2015-11-01

Full Text Available Client welfare is detrimentally affected by poor communication of data between rural service providers, which in part is complicated by privacy legislation. A study of service provision involving interviews with mental health professionals, found challenges in communicative processes between agencies were exacerbated by the heavy workloads. Dependence on individual interpretations of legislation, and on manual handling, led to delays that detrimentally affected client welfare. The main recommendation arising from this article is the creation of an ehealth system that is able to negotiate differing levels of access to client data through centralised controls, where the administration of that system ensures that it stays current with changing legislative requirements. The main contribution of the proposed model is to combine two well-known concepts: data integration and generalisation. People with mental illness are amongst the most vulnerable members of society, and current ehealth systems that provide access to medical records inadequately cater to their needs.

Common mental disorders and associated factors: a study of women from a rural area.

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Parreira, Bibiane Dias Miranda; Goulart, Bethania Ferreira; Haas, Vanderlei José; Silva, Sueli Riul da; Monteiro, Juliana Cristina Dos Santos; Gomes-Sponholz, Flávia Azevedo; Parreira, Bibiane Dias Miranda; Goulart, Bethania Ferreira; Haas, Vanderlei José; Silva, Sueli Riul da; Monteiro, Juliana Cristina Dos Santos; Gomes-Sponholz, Flávia Azevedo

2017-05-25

Identifying the prevalence of Common Mental Disorders and analyzing the influence of sociodemographic, economic, behavioral and reproductive health variables on Common Mental Disorders in women of childbearing age living in the rural area of Uberaba-MG, Brazil. An observational and cross-sectional study. Socio-demographic, economic, behavioral and reproductive health instruments were used, along with the Self-Reporting Questionnaire (SRQ-20) to identify common mental disorders. Multiple logistic regression was used for multivariate data analysis. 280 women participated in the study. The prevalence of Common Mental Disorders was 35.7%. In the logistic regression analysis, the variables of living with a partner and education level were associated with Common Mental Disorders, even after adjusting for the other variables. Our findings evidenced an association of social and behavioral factors with Common Mental Disorders among rural women. Identification and individualized care in primary health care are essential for the quality of life of these women. Identificar a prevalência do transtorno mental comum e analisar a influência de variáveis sociodemográficas, econômicas, comportamentais e de saúde reprodutiva sobre o transtorno mental comum em mulheres em idade fértil, residentes na zona rural do município de Uberaba-MG, Brasil. Estudo observacional e transversal. Foram utilizados instrumentos de caracterização sociodemográfica, econômica, comportamental e de saúde reprodutiva, e o Self-Reporting Questionnaire (SRQ-20) para identificar os transtornos mentais comuns. Na análise multivariada dos dados, foi utilizada a regressão logística múltipla. Participaram do estudo 280 mulheres. A prevalência do transtorno mental comum foi de 35,7%. Na análise de regressão logística, as variáveis convivência com o companheiro e escolaridade, associaram-se ao transtorno mental comum, mesmo após o ajuste para as demais variáveis. Os achados evidenciaram a

Positive future orientation as a mediator between traumatic events and mental health among children affected by HIV/AIDS in rural China.

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Zhang, Jintao; Zhao, Guoxiang; Li, Xiaoming; Hong, Yan; Fang, Xiaoyi; Barnett, Douglas; Lin, Xiuyun; Zhao, Junfeng; Zhang, Liying

2009-12-01

The current study was designed to explore the effect of future orientation in mediating the relationship between traumatic events and mental health in children affected by HIV/AIDS in rural China. Cross-sectional data were collected from 1221 children affected by HIV/AIDS (755 AIDS orphans and 466 vulnerable children). Future orientation among children was measured using three indicators (future expectation, hopefulness toward the future, and perceived control over the future). Measures of mental health consisted of depression, loneliness, and self-esteem. Children's experience of any traumatic events was measured using a modified version of the Life Incidence of Traumatic Events-Student Form. Mediation analysis was conducted using structural equation modeling (SEM) methods. Among the children surveyed, most of the traumatic indicators were negatively associated with future expectation, hopefulness, perceived control, and self-esteem, and positively associated with depression and loneliness. The SEM of mediation analysis demonstrated an adequate fit. Future orientation fully mediated the relationship between traumatic events and mental health and accounted for 67.9% of the total effect of traumatic events on mental health. Results of this study support the positive effect of future expectation in mediating the relationship between traumatic events and mental health among children affected by HIV/AIDS in China. Future mental health promotion and intervention efforts targeting children affected by HIV/AIDS should include components that can mitigate the negative impact of traumatic events on their lives. These components may aim to develop children's positive future expectations, increase their hopefulness toward the future, and improve their perceived control over the future.

COMMUNITY MENTAL HEALTH SERVICES FOR LATINOS AND LATINAS IN THE RURAL U.S.

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Sergio Cristancho

2016-01-01

Full Text Available El aumento de la población Latina rural en EEUU representa un reto para la provisión de servicios de salud mental adecuados. B arreras de acceso como el aislamiento geográfico , limitaciones en el transporte público , escasez de proveedores /as de servicios y su limitada competencia cultural son particularmente marcadas . La psicología comunitaria puede hacer contribuciones significat ivas para resolver este grave problema de salud pública. En este artículo , nos basamos en nuestra experiencia investigativa y de extensión con inmigrantes Latinos y Latinas en áreas rurales de la región centr o - occidental de los EEUU para ilustrar percepcio nes sobre su situación de salud mental y su necesidad de servicios. También hacemos recomendaciones acerca de los cambios necesarios para aumentar la capacidad técnica de provisión de servicios en salud mental que respondan a las necesidades de esta poblac ión. Esto incluye el desarrollo de nuevos programas para responder a las prioridades comunitarias, el entrenamiento de promotores de salud o enlaces comunitarios para facilitar el acceso y la navegación en el sistema de salud, y realizar abogacía.

Psychological health among Chinese college students: a rural/urban ...

African Journals Online (AJOL)

Journal of Child and Adolescent Mental Health ... higher scores than their rural counterparts on self-esteem and social support. However, there was no statistically significant difference between the groups on ... AJOL African Journals Online.

Institutional Policy Changes Aimed at Addressing Obesity Among Mental Health Clients

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Knol, Linda L.; Pritchett, Kelly; Dunkin, Jeri

2010-01-01

Background People with mental illness often experience unique barriers to healthy eating and physical activity. For these clients, interventions should focus on changes in the immediate environment to change behaviors. The purpose of this project was to implement and evaluate policy changes that would limit calorie intake and increase calorie expenditure of clients receiving mental health services. Context This intervention was implemented in a rural mental health system in the southeastern U...

Partnerships to promote mental health of NSW farmers: the New South Wales Farmers Blueprint for Mental Health.

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Fragar, Lyn; Kelly, Brian; Peters, Mal; Henderson, Amanda; Tonna, Anne

2008-06-01

To describe the process and outcome of development of a framework for planning and implementation of a range of interventions aimed at improving the mental health and wellbeing of farmers and farm families in New South Wales (NSW). In response to a major drought in New South Wales (NSW), key agencies were invited to participate in a longer-term collaborative program aimed at improving the mental health and well-being of the people on NSW farms. These agencies became the NSW Farmers Mental Health Network. The Australian National Action Plan for Promotion, Prevention & Early Intervention for Mental Health 2000 proposed a population health approach base encompassing the range of risk and protective factors that determine mental health at the individual, family and community and society levels. It incorporated three traditional areas of health activity into programs aimed at achieving improved mental health for the Australian population - mental health promotion, prevention activities and early intervention. Although the farming population was not identified as a priority population, research has identified this population to be at high risk of suicide, and of having difficulty in coping with the range of pressures associated with life and work in this industry. Participants were agencies providing services across rural NSW in the fields of farmer and country women's organisations, financial counselling services, government departments of primary industries and health, mental health advisory and support services, charitable organisations and others. The NSW Farmers Blueprint for Mental Health (http://www.aghealth.org.au/blueprint) was developed to be 'a simplified summary of key issues that need to be addressed, and the major actions that we can be confident will be effective in achieving our purpose'. It has identified 'steps' along 'pathways to breakdown' from the range of known mental health and suicide risk factors that are relevant to the NSW farming population

Socioeconomic Inequalities in Mental Health of Adult Population: Serbian National Health Survey

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Milena Santric Milicevic

2016-02-01

Full Text Available Background: The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement. Aims: То explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements. Study Design: Cross-sectional study. Methods: This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households – 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5, and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index. The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at p<0.05. Results: Chronic anxiety or depression was seen in 4.9% of the respondents, and poor MHI-5 in 47% of respondents. Low education (Odds Ratios 1.32; 95% confidence intervals=1.16-1.51, unemployment (1.36; 1.18-1.56, single status (1.34; 1.23-1.45, and Wealth Index middle class (1.20; 1.08-1.32 or poor (1.33; 1.21-1.47 were significantly related with poor MHI-5. Unemployed persons in urban settlements had higher odds for poormMHI-5 than unemployed in rural areas (0.73; 0.59-0.89. Single (1.50; 1.26-1.78, unemployed (1.39; 1.07-1.80 and inactive respondents (1.42; 1.10-1.83 had a higher odds of chronic anxiety or depression than married individuals, or

Randomized Trial of Supported Employment Integrated With Assertive Community Treatment for Rural Adults With Severe Mental Illness

Science.gov (United States)

Gold, Paul B; Meisler, Neil; Santos, Alberto B; Carnemolla, Mark A; Williams, Olivia H; Keleher, Jennie

2006-01-01

Urban-based randomized clinical trials of integrated supported employment (SE) and mental health services in the United States on average have doubled the employment rates of adults with severe mental illness (SMI) compared to traditional vocational rehabilitation. However, studies have not yet explored if the service integrative functions of SE will be effective in coordinating rural-based services that are limited, loosely linked, and geographically dispersed. In addition, SE's ability to replicate the work outcomes of urban programs in rural economies with scarce and less diverse job opportunities remains unknown. In a rural South Carolina county, we designed and implemented a program blending Assertive Community Treatment (ACT) with an SE model, Individual Placement and Support (IPS). The ACT-IPS program operated with ACT and IPS subteams that tightly integrated vocational with mental health services within each self-contained team. In a 24-month randomized clinical trial, we compared ACT-IPS to a traditional program providing parallel vocational and mental health services on competitive work outcomes for adults with SMI (N = 143; 69% schizophrenia, 77% African American). More ACT-IPS participants held competitive jobs (64 versus 26%; p < .001, effect size [ES] = 0.38) and earned more income (median [Mdn] = $549, interquartile range [IQR] = $0–$5,145, versus Mdn = $0, IQR = $0–$40; p < .001, ES = 0.70) than comparison participants. The competitive work outcomes of this rural ACT-IPS program closely resemble those of urban SE programs. However, achieving economic self-sufficiently and developing careers probably require increasing access to higher education and jobs imparting marketable technical skills. PMID:16177278

Young Malawians on the interaction between mental health and HIV ...

African Journals Online (AJOL)

... teenage mothers, and out-of-school youths, in both rural and urban settings. ... They showed awareness of a two-way interaction between HIV/AIDS and mental ... that the latter can increase thoughts of suicide and HIV risk-taking behaviour. ... of mental health provision within HIV prevention, education and care initiatives.

Critical health infrastructure for refugee resettlement in rural Australia: case study of four rural towns.

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Sypek, Scott; Clugston, Gregory; Phillips, Christine

2008-12-01

To explore the reported impact of regional resettlement of refugees on rural health services, and identify critical health infrastructure for refugee resettlement. Comparative case study, using interviews and situational analysis. Four rural communities in New South Wales, which had been the focus of regional resettlement of refugees since 1999. Refugees, general practitioners, practice managers and volunteer support workers in each town (n = 24). The capacity of health care workers to provide comprehensive care is threatened by low numbers of practitioners, and high levels of turnover of health care staff, which results in attrition of specialised knowledge among health care workers treating refugees. Critical health infrastructure includes general practices with interest and surge capacity, subsidised dental services, mental health support services; clinical support services for rural practitioners; care coordination in the early settlement period; and a supported volunteer network. The need for intensive medical support is greatest in the early resettlement period for 'catch-up' primary health care. The difficulties experienced by rural Australia in securing equitable access to health services are amplified for refugees. While there are economic arguments about resettlement of refugees in regional Australia, the fragility of health services in regional Australia should also be factored into considerations about which towns are best suited to regional resettlement.

The Station Community Mental Health Centre Inc: nurturing and empowering.

Science.gov (United States)

Taylor, Judy; Jones, Rosalind M; O'Reilly, Peta; Oldfield, Wayne; Blackburn, Anne

2010-01-01

Consumer-driven community mental health services play an important role in rehabilitation, recovery, and advocacy in rural and remote Australia. The origins of services often lie in the need to provide options for people with mental illness and their carers when there is a lack of on-the-ground support. This article adds to the information about the strengths and limitations of consumer-driven mental health services by presenting the findings of an evaluation of The Station Inc. in rural South Australia. This consumer-driven mental health service provides a safe and supportive environment, social connections, and activities for its members (those with a lived experience of mental illness). Using a realist evaluation approach, the evaluation identified the contextual factors and the program mechanisms that produce positive outcomes for members. The evaluation was conducted as participatory action research with The Station members, volunteers, management committee members, and staff involved in all phases of the research process. Because of the complexity of The Station's functioning a realist evaluation using qualitative data was conducted to identify how the program worked, for whom, and in what circumstances. Twenty-five in-depth interviews were conducted with participants who were randomly selected from within the groups identified above. Interviews focused on The Station's role in assisting recovery from mental illness, the limitations and strengths of the program, and relationships with the mental health system. The Station's goals, policies and procedures, and the role of stakeholders were analysed in order to identify any links among these contextual factors, program mechanisms, and program outcomes. Qualitative data were entered into descriptive categories in N6 software (QSR; international.com" target="_blank">www.qsr.international.com). Data from the stakeholder analysis were entered into Microsoft Excel. Using an iterative approach to include the three

A task shifting approach to primary mental health care for adults in South Africa: human resource requirements and costs for rural settings.

Science.gov (United States)

Petersen, Inge; Lund, Crick; Bhana, Arvin; Flisher, Alan J

2012-01-01

BACKGROUND A recent situational analysis suggests that post-apartheid South Africa has made some gains with respect to the decentralization and integration of mental health into primary health care. However, service gaps within and between provinces remain, with rural areas particularly underserved. Aim This study aims to calculate and cost a hypothetical human resource mix required to populate a framework for district adult mental health services. This framework embraces the concept of task shifting, where dedicated low cost mental health workers at the community and clinic levels supplement integrated care. METHOD The expected number and cost of human resources was based on: (a) assumptions of service provision derived from existing services in a sub-district demonstration site and a literature review of evidence-based packages of care in low- and middle-income countries; and (b) assumptions of service needs derived from other studies. RESULTS For a nominal population of 100 000, minimal service coverage estimates of 50% for schizophrenia, bipolar affective disorder, major depressive disorder and 30% for post-traumatic stress disorder and maternal depression would require that the primary health care staffing package include one post for a mental health counsellor or equivalent and 7.2 community mental health worker posts. The cost of these personnel amounts to £28 457 per 100 000 population. This cost can be offset by a reduction in the number of other specialist and non-specialist health personnel required to close service gaps at primary care level. CONCLUSION The adoption of the concept of task shifting can substantially reduce the expected number of health care providers otherwise needed to close mental health service gaps at primary health care level in South Africa at minimal cost and may serve as a model for other middle-income countries.

Mental health service delivery following health system reform in Colombia.

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Romero-González, Mauricio; González, Gerardo; Rosenheck, Robert A

2003-12-01

change in the pattern of mental health service delivery from a reliance on costly inpatient care to more efficient outpatient services. Health reform in Colombia improved access to health services for the general medical services, but not for specialized mental health services. Although the primary goal of the health reform was to provide universal medical coverage, by not including mental health services in the standardized benefits package, inequities in the delivery of mental health services appear to have been perpetuated or even exacerbated. IMPLICATIONS FOR HEALTH CARE AND POLICY FORMULATION: If health reform in Colombia and elsewhere is to provide universal coverage and adequate access to comprehensive health care, mental health services must be added to the standardized package of health benefits and efforts to develop accessible and effective mental health treatment at the primary care level should continue. Mental health services research in Colombia should focus future studies on the differential impact of health reform on access to mental health services across regions, and between urban and rural areas.

The Use of Telemental Health to Meet the Mental Health Needs of Women Using Department of Veterans Affairs Services.

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Moreau, Jessica L; Cordasco, Kristina M; Young, Alexander S; Oishi, Sabine M; Rose, Danielle E; Canelo, Ismelda; Yano, Elizabeth M; Haskell, Sally G; Hamilton, Alison B

Women veterans are a growing segment of Department of Veterans Affairs (VA) users with distinct mental health needs and well-documented barriers to care. Telemental health holds much promise for reducing barriers to mental health care. We assessed VA stakeholders' perceptions of telemental health's appropriateness and potential to address the mental health needs of women veteran VA users. We conducted semistructured qualitative interviews with 40 key leadership and clinical stakeholders at VA medical centers and associated outpatient clinics. Transcripts were summarized in a template of key domains developed based on the interview guide, and coded for topics relevant to women's mental health needs and telehealth services. Telemental health was perceived to increase access to mental health care, including same-gender care and access to providers with specialized training, especially for rural women and those with other limiting circumstances. Respondents saw women veterans as being particularly poised to benefit from telemental health, owing to responsibilities associated with childcare, spousal care, and elder caregiving. Interviewees expressed enthusiasm for telemental health's potential and were eager to expand services, including women-only mental health groups. Implementation challenges were also noted. Overall, our stakeholders saw telemental health as a good fit for helping to address the perceived needs of women veterans, especially in addressing the geographical barriers experienced by rural women and those with a limited ability to travel. These findings can help to inform gender-tailored expansion of telemental health within and outside of the VA. Published by Elsevier Inc.

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

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Nalukenge, W; Martin, F; Seeley, J; Kinyanda, E

2018-05-02

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.

The mental health status of ethnocultural minorities in Ontario and their mental health care.

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Grace, Sherry L; Tan, Yongyao; Cribbie, Robert A; Nguyen, Han; Ritvo, Paul; Irvine, Jane

2016-02-26

Mental disorders are a leading cause of disability and early mortality. The objective of this study was to describe and compare psychosocial indicators and mental health service use among ethnoculturally-diverse Ontarians. This is a cross-sectional analysis of the Ontario Health Study pilot investigation. Residents were mailed an invitation to one of 3 assessment centres (urban, rural and northern sites) from March 2009 to July 2010. Participants had an interview with a nurse and completed a questionnaire on a touchscreen kiosk. The questionnaire included sociodemographic items, and scales assessing symptoms of depressive symptoms (CES-D) and anxiety (GAD-7), social support (Lubben Social Network Scale), stressful life events, and mental health service use. Eight thousand two hundred thirty-five residents participated, among whom 6652 (82.4 %) self-reported their ethnocultural background as White, 225 (2.8 %) as South Asian, 222 (2.8 %) East Asian, 214 (2.7 %) Southeast Asian, 197 (2.4 %) Black, and 28 (0.3 %) as Aboriginal. Based on their sociodemographic characteristics, participants from these ethnocultural minority groups were matched to White participants. Black participants reported significantly greater stressful life events than White participants (p = .04), particularly death (p divorce (p = .002) and financial difficulties (p < .001). East Asian participants reported significantly less social support than their White counterparts (p < .001), and this was not confounded by measurement variance. Mental health service use was significantly lower in all ethnocultural minorities except Aboriginals, when compared to White participants (p = .001). There is a high burden of psychosocial distress in several preponderant ethnocultural minorities in Ontario; many of whom are not accessing available mental health services.

Narratives of Violence, Pathology, and Empowerment: Mental Health Needs Assessment of Home-Based Female Sex Workers in Rural India.

Science.gov (United States)

Sardana, Srishti; Marcus, Marina; Verdeli, Helen

2016-08-01

This study explores the narratives of psychological distress and resilience among a group of female sex workers who use residential spaces to attend to clients in rural India. The narratives reflect the lived experiences of these women. They describe the women's reasons for opting into sex work; guilt, shame, and stigma related to their sex worker status; experiences with intimate partner and domestic violence; health-related problems; communication with their family members about their sex worker status; mental health referral practices among the women; and elements of resilience and strength that they experience within themselves and within their community of fellow sex workers. The article also offers elements of our own experiences of recruiting the women to participate in the focus group, training local outreach workers in conducting focus group discussions, and forging a collaboration with a local community-based organization to highlight important barriers, challenges, and strategies for planning a group-based discussion to explore the mental health needs of home-based sex workers. © 2016 Wiley Periodicals, Inc.

Psychological health among Chinese college students: a rural/urban comparison.

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Zhang, Jie; Qi, Qing; Delprino, Robert P

2017-09-01

The literature on suicide among the Chinese indicates that younger individuals from rural areas are at higher risk of suicide than their urban counterparts. While earlier studies have investigated the relationship between psychological health and major demographic variables, the relationship of psychological health as it relates to suicide by those from urban and rural areas have been rare. Studying the psychological health of college students from rural China in comparison with students who originate from urban areas may shed light on the mental health disparities of the two populations. This study examined the relationship of psychological health and rural/urban origins of college students in China. Data was obtained from 2 400 college students who completed a survey questionnaire while in attendance at a key university in Beijing China in 2013. Four standardised psychological health scales were administered to obtain measures of participants' self-esteem, depression, social support, and suicide ideation. Findings indicated that urban students had significantly higher scores than their rural counterparts on self-esteem and social support. However, there was no statistically significant difference between the groups on measures of depression and suicide ideation.

Mental health literacy as a function of remoteness of residence: an Australian national study.

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Griffiths, Kathleen M; Christensen, Helen; Jorm, Anthony F

2009-03-27

Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional, remote, and very remote) regions were compared using data from a 2003-04 Australian national survey of the mental health literacy of 3998 adults. Measures included the perceived helpfulness of a range of professionals, non-professionals and interventions, and the causes, prognosis, and outcomes after treatment for four case vignettes describing depression, depression with suicidal ideation, early schizophrenia and chronic schizophrenia. Participant awareness of Australia's national depression initiative and depression in the media, their symptoms of depression and exposure to the conditions depicted in the vignettes were also compared. Mental health literacy was similar across remoteness categories. However, inner regional residents showed superior identification of the disorders depicted in the suicidal ideation and chronic schizophrenia vignettes. They were also more likely to report having heard of Australia's national depression health promotion campaign. Conversely, they were less likely than major city residents to rate the evidence-based treatment of psychotherapy helpful for depression. Both inner regional and outer-remote residents were less likely to rate psychologists as helpful for depression alone. The rural groups were more likely to rate the non-evidence based interventions of drinking and painkillers as helpful for a depression vignette. In addition, outer-remote residents were more likely to identify the evidence based treatment of antipsychotics as harmful for early schizophrenia and less likely to endorse psychiatrists, psychologists, social workers and general

Mental health literacy as a function of remoteness of residence: an Australian national study

Directory of Open Access Journals (Sweden)

Jorm Anthony F

2009-03-01

Full Text Available Abstract Background Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. Methods The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional, remote, and very remote regions were compared using data from a 2003–04 Australian national survey of the mental health literacy of 3998 adults. Measures included the perceived helpfulness of a range of professionals, non-professionals and interventions, and the causes, prognosis, and outcomes after treatment for four case vignettes describing depression, depression with suicidal ideation, early schizophrenia and chronic schizophrenia. Participant awareness of Australia's national depression initiative and depression in the media, their symptoms of depression and exposure to the conditions depicted in the vignettes were also compared. Results Mental health literacy was similar across remoteness categories. However, inner regional residents showed superior identification of the disorders depicted in the suicidal ideation and chronic schizophrenia vignettes. They were also more likely to report having heard of Australia's national depression health promotion campaign. Conversely, they were less likely than major city residents to rate the evidence-based treatment of psychotherapy helpful for depression. Both inner regional and outer-remote residents were less likely to rate psychologists as helpful for depression alone. The rural groups were more likely to rate the non-evidence based interventions of drinking and painkillers as helpful for a depression vignette. In addition, outer-remote residents were more likely to identify the evidence based treatment of antipsychotics as harmful for early schizophrenia and less likely to endorse

Mental health literacy as a function of remoteness of residence: an Australian national study

Science.gov (United States)

Griffiths, Kathleen M; Christensen, Helen; Jorm, Anthony F

2009-01-01

Background Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. Methods The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional, remote, and very remote) regions were compared using data from a 2003–04 Australian national survey of the mental health literacy of 3998 adults. Measures included the perceived helpfulness of a range of professionals, non-professionals and interventions, and the causes, prognosis, and outcomes after treatment for four case vignettes describing depression, depression with suicidal ideation, early schizophrenia and chronic schizophrenia. Participant awareness of Australia's national depression initiative and depression in the media, their symptoms of depression and exposure to the conditions depicted in the vignettes were also compared. Results Mental health literacy was similar across remoteness categories. However, inner regional residents showed superior identification of the disorders depicted in the suicidal ideation and chronic schizophrenia vignettes. They were also more likely to report having heard of Australia's national depression health promotion campaign. Conversely, they were less likely than major city residents to rate the evidence-based treatment of psychotherapy helpful for depression. Both inner regional and outer-remote residents were less likely to rate psychologists as helpful for depression alone. The rural groups were more likely to rate the non-evidence based interventions of drinking and painkillers as helpful for a depression vignette. In addition, outer-remote residents were more likely to identify the evidence based treatment of antipsychotics as harmful for early schizophrenia and less likely to endorse psychiatrists, psychologists

Influencing factors of mental health of medical students in China.

Science.gov (United States)

Yang, Fan; Meng, Heng; Chen, Hui; Xu, Xin-hao; Liu, Zhuo; Luo, Ai; Feng, Zhan-chun

2014-06-01

This study investigated the mental health status of medical students in China, and analyzed the influencing factors in order to provide evidence for mental health education for medical students. A stratified cluster sampling method was used to recruit medical students from Huazhong University of Science and Technology, China. The questionnaire survey on general information and Symptom Checklist 90 (SCL-90) were used for investigation and analysis. The results showed among the 1137 valid questionnaires, 278 (24.45%) participants had SCL-90 score ≥ 160. The top three mental problems of medical students were obsessive-compulsive disorder, interpersonal sensitivity and depression in terms of the factor score ≥ 2.5 and the number of participants who reflected on the diseases. The third-year medical students had the worst mental health status, and fifth-year medical students had the best mental health status. Students from rural area had more psychological problems than those from urban area; furthermore, students with high professional satisfaction, those who were the single child of the family, non-poor students, and those whose parents had high education level had better mental health status. It was concluded that the mental health of medical students is not optimistic in China. Medical students have some mental health problems of different degrees. Factors that influence the mental health of medical students include academic pressure, professional satisfaction level and family environment.

Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme

Science.gov (United States)

2017-01-01

Objectives To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. Background A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Methods Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Results Qualitative thematic analysis revealed two major themes: (1) belief that any given patient’s metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. Conclusion As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness. PMID:29041798

Mental health literacy as a function of remoteness of residence: an Australian national study

OpenAIRE

Jorm Anthony F; Christensen Helen; Griffiths Kathleen M

2009-01-01

Abstract Background Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. Methods The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional, remote, and very remote) regions were compared using data from a 2003–04 Australi...

Epidemiological survey of mental health in adolescent school children of Gujarat, India.

Science.gov (United States)

Nair, Sandhya; Ganjiwale, Jaishree; Kharod, Nikhil; Varma, Jagdish; Nimbalkar, Somashekhar Marutirao

2017-01-01

Mental health problems in adolescents are inadequately researched in low-resource settings. We aimed in this study to assess the prevalence of mental health problems and correlates in school children aged 13-17 years and compare differences between urban and rural schools in Anand District, Gujarat. A cross-sectional study was conducted in five Gujarati medium higher secondary schools in Anand, Gujarat. Six hundred and ninety-three students with equal distribution of boys and girls belonging to 9th to 12th grades were included in the study. Strengths and Difficulties Questionnaire (SDQ) was used to assess the mental health status of the students, and total difficulties scoring was used to categorise participants into normal (0-15) and high (borderline (16-19) and abnormal (20-40)). Socio-demographic data and Teenage Screening Questionnaire-Trivandrum (TSQ) were used to assess associated medical and psychosocial factors. Clearance was obtained from the institutional ethics committee before conducting the study. 15% participants had a high SDQ score. Girls had more emotional problems, while the rest of the mental health problems were more prevalent in boys. Rural children were found to have more mental health issues. Having an eye problem, scoring parents increased odds of high SDQ score, while having friends and after-school entertainment like watching movies decreased odds of high SDQ score. At least one in eight adolescents in this study was at risk of mental health problems. SDQ self-report questionnaire and TSQ survey may be used as a screening modality to identify at-risk students.

Social networks and mental health among a farming population.

Science.gov (United States)

Stain, Helen J; Kelly, Brian; Lewin, Terry J; Higginbotham, Nick; Beard, John R; Hourihan, Fleur

2008-10-01

The study investigated the associations between mental health and measures of community support, social support networks, sense of place, adversity, and perceived problems in a rural Australian population. There was a specific focus on farming communities due to previous qualitative research by the authors indicating distress by farmers in response to drought (Sartore et al. Aust Fam Phys 36(12), 990-993, 2007). A survey was mailed to adults randomly selected from the Australian Electoral Roll and residing within four local government areas (LGAs) of varying remoteness in rural New South Wales (NSW). Survey measures included: support networks and community attachment; recent stressors (including drought-related stress); and measures of health and related functioning. The Kessler-10 provided an index of current psychological distress. The sample (n = 449; response rate 24%) was predominantly female (58.4%) and 18.9% were farmers or farm workers. Moderate to very high psychological distress was reported for 20.7% of the sample. Half (56.1%) of all respondents, and specifically 71.8% of farmers or farm workers, reported high levels of perceived stress due to drought. Psychological distress was associated with recent adverse life events, increased alcohol use and functional impairment. Hierarchical regression analysis demonstrated an independent effect of the number of stressful life events including drought related stress, perceived social support (community and individual), alcohol use and physical functioning ability on levels of psychological distress. This model accounted for 43% of the variance in current levels of distress. Lower community support had a more marked impact on distress levels for non-farming than farming participants. This study has highlighted the association between unique rural community characteristics and rural stressors (such as drought) and measures of mental health, suggesting the important mediating role of social factors and community

U-Shaped Relationship between Years of Residence and Negative Mental Health Outcomes among Rural-to-Urban Children in Migrant Schools in Beijing, China: The Moderating Effects of Socioeconomic Factors.

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Cheng, Jin; Wang, Ri-Chu; Yin, Xing; Fu, Lin; Liu, Zheng-Kui

2017-01-01

This study aimed to test the relationship between length of residence and mental health in a school-based sample of migrant children who studied in migrant schools. A total of 7,296 rural-to-urban migrant children were recruited from 58 schools in Beijing and assessed by the State-Trait Anxiety Inventory and Children's Depression Inventory. A quadratic relationship was found between mental health and length of residence. The results suggested that the scores for anxiety and depression were high during the initial resettlement after migrating and then decreased. However, after approximately 8 years, the scores increased. Our findings also showed a significant moderating effect of family socioeconomic status on the relation between mental health and length of residence. This study provided empirical evidence for a better understanding of psychosocial factors on the mental health of migrant children during the process of urbanization in China.

[Colombia 2015 National Mental Health Survey. Study Protocol].

Science.gov (United States)

Gómez-Restrepo, Carlos; de Santacruz, Cecilia; Rodriguez, María Nelcy; Rodriguez, Viviana; Tamayo Martínez, Nathalie; Matallana, Diana; Gonzalez, Lina M

2016-12-01

The 2015 National Mental Health Survey (NMHS) is the fourth mental survey conducted in Colombia, and is part of the National System of Surveys and Population Studies for health. A narrative description is used to explain the background, references, the preparation, and characteristics of the 2015 NMHS. The 2015 NMHS and its protocol emerge from the requirements that support the national and international policies related to mental health. Together with the Ministry of Health and Social Protection, the objectives, the collection tools, the sample, and the operational plan are defined. The main objective was to obtain updated information about the mental health, mental problems and disorders, accessibility to health services, and an evaluation of health conditions. Participants were inhabitants from both urban and rural areas, over 7 years old, and in whom the comprehension of social determinants and equity were privileged. An observational cross-sectional design with national, regional and age group representativity, was used. The age groups selected were 7-11, 12-17, and over 18 years old. The regions considered were Central, Orient, Atlantic, Pacific, and Bogota. The calculated sample had a minimum of 12,080 and a maximum of 14,496 participants. A brief summary of the protocol of the 2015 NMHS is presented. The full document with all the collection tools can be consulted on the Health Ministry webpage. Copyright © 2016. Publicado por Elsevier España.

Perceptions of traditional healing for mental illness in rural Gujarat.

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Schoonover, Julie; Lipkin, Samuel; Javid, Munazza; Rosen, Anna; Solanki, Mehul; Shah, Sandip; Katz, Craig L

2014-01-01

Despite the significant toll of mental illness on the Indian population, resources for patients often are scarce, especially in rural areas. Traditional healing has a long history in India and is still widely used, including for mental illnesses. However, its use has rarely been studied systematically. The aim of this study was to determine the perspective of patients, their families, and healthy community members toward faith healing for mental illness, including the type of interventions received, perceptions of its efficacy, and overall satisfaction with the process. We also sought to explore the range of care received in the community and investigate possibilities for enhancing mental health treatment in rural Gujarat. We interviewed 49 individuals in July 2013 at Dhiraj General Hospital and in 8 villages surrounding Vadodara. A structured qualitative interview elicited attitudes toward faith healing for mental illnesses and other diseases. Qualitative analysis was performed on the completed data set using grounded theory methodology. Subjects treated by both a doctor and a healer reported they overwhelmingly would recommend a doctor over a healer. Almost all who were treated with medication recognized an improvement in their condition. Many subjects felt that traditional healing can be beneficial and believed that patients should initially go to a healer for their problems. Many also felt that healers are not effective for mental illness or are dishonest and should not be used. Subjects were largely dissatisfied with their experiences with traditional healers, but healing is still an incredibly common first-line practice in Gujarat. Because healers are such integral parts of their communities and so commonly sought out, collaboration between faith healers and medical practitioners would hold significant promise as a means to benefit patients. This partnership could improve access to care and decrease the burden of mental illness experienced by patients and

Parenting Style, Individuation, and Mental Health of Egyptian Adolescents

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Dwairy, Marwan; Menshar, Kariman E.

2006-01-01

Three questionnaires that measure parenting style, adolescent-family connectedness, and mental health were administered to 351 Egyptian adolescents. Results show that in rural communities the authoritarian style is more predominant in the parenting of male adolescents, while the authoritative style is more predominant in the parenting of female…

School Mental Health Resources and Adolescent Mental Health Service Use

Science.gov (United States)

Green, Jennifer Greif; McLaughlin, Katie A.; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A,; Kessler, Ronald C.

2014-01-01

Objective Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This paper examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources-policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use. Results Roughly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students-to-mental health providers was not associated with overall service use, but was associated with sector of service use. Conclusions School mental health resources, particularly those related to early identification, may facilitate mental health service use and influence sector of service use for youths with DSM disorders. PMID:23622851

Large-scale mHealth professional support for health workers in rural Maharashtra, India.

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Hegde, Shailendra Kumar B; Saride, Sriranga Prasad; Kuruganty, Sudha; Banker, Niraja; Patil, Chetan; Phanse, Vishal

2018-04-01

Expanding mobile telephony in India has prompted interest in the potential of mobile-telephone health (mHealth) in linking health workers in rural areas with specialist medical advice and other professional services. In 2012, a toll-free helpline offering specialist medical advice to community-based health workers throughout Maharashtra was launched. Calls are handled via a 24 h centre in Pune, staffed by health advisory officers and medical specialists. Health advisory officers handle general queries, which include medical advice via validated algorithms; blood on-call services; grievance issues; and mental health support - the latter calls are transferred to a qualified counsellor. Calls requiring more specialist advice are transferred to the appropriate medical specialist. This paper describes the experience of the first 4 years of this helpline, in terms of the services used, callers, nature of calls, types of queries serviced and lessons learnt. In the first 4 years of the helpline, 669 265 calls were serviced. Of these calls, 453 373 (67.74%) needed medical advice and were handled by health advisory officers. Specialist services were required to address 199 226 (29.77%) calls. Blood-bank-related services accounted for 7919 (1.18%) calls, while 2462 (0.37%) were grievance calls. Counselling for mental health issues accounted for 6285 (0.94%) calls. The large-scale mHealth professional support provided by this helpline in Maharashtra has reached many health workers serving rural communities. Future work is required to explore ways to expand the reach of the helpline further and to measure its effectiveness in improving health outcomes.

Use of Veterans Health Administration Mental Health and Substance Use Disorder Treatment After Exiting Prison: The Health Care for Reentry Veterans Program.

Science.gov (United States)

Finlay, Andrea K; Stimmel, Matthew; Blue-Howells, Jessica; Rosenthal, Joel; McGuire, Jim; Binswanger, Ingrid; Smelson, David; Harris, Alex H S; Frayne, Susan M; Bowe, Tom; Timko, Christine

2017-03-01

The Veterans Health Administration (VA) Health Care for Reentry Veterans (HCRV) program links veterans exiting prison with treatment. Among veterans served by HCRV, national VA clinical data were used to describe contact with VA health care, and mental health and substance use disorder diagnoses and treatment use. Of veterans seen for an HCRV outreach visit, 56 % had contact with VA health care. Prevalence of mental health disorders was 57 %; of whom 77 % entered mental health treatment within a month of diagnosis. Prevalence of substance use disorders was 49 %; of whom 37 % entered substance use disorder treatment within a month of diagnosis. For veterans exiting prison, increasing access to VA health care, especially for rural veterans, and for substance use disorder treatment, are important quality improvement targets.

Functional impairment and mental health functioning among Vietnamese children.

Science.gov (United States)

Dang, Hoang-Minh; Weiss, Bahr; Trung, Lam T

2016-01-01

Functional impairment is a key indicator of need for mental health services among children and adolescents, often a stronger predictor of service usage than mental health symptoms themselves. Functional impairment may be of particular importance in low- and middle-income countries (LMIC) because of its potential to focus policy on treatment of child mental health problems which is generally given low priority in LMIC. However, few studies have assessed functional impairment in LMIC. The present study assessed rates of functional impairment among children in Vietnam, as a case example of an LMIC, as well as effects of other risk/protective factors of particular relevance to LMIC (e.g., whether the family lived in an urban or rural area; family structure variables such as grandparents living with the family). 1314 parents of children 6-16 years old from 10 Vietnamese provinces were interviewed. The overall rate of functional impairment among Vietnamese children was 20 %, similar to rates in high-income countries such as Germany and the United States, suggesting that LMIC status may not be associated with dramatic increases in functional impairment in children. Functional impairment was significantly greater among mental health cases than non-cases, with increases of over 550 % associated with mental health caseness. A number of other risk factors (e.g., marital status) had smaller but significant effects. Mental health problems are a major but not the sole contributor to functional impairment among Vietnamese children. The pragmatic significance of this research lies in its potential to affect public awareness and policy related to child mental health in LMIC.

Exposure to Neighborhood Green Space and Mental Health: Evidence from the Survey of the Health of Wisconsin

Directory of Open Access Journals (Sweden)

Kirsten M. M. Beyer

2014-03-01

Full Text Available Green space is now widely viewed as a health-promoting characteristic of residential environments, and has been linked to mental health benefits such as recovery from mental fatigue and reduced stress, particularly through experimental work in environmental psychology. Few population level studies have examined the relationships between green space and mental health. Further, few studies have considered the role of green space in non-urban settings. This study contributes a population-level perspective from the United States to examine the relationship between environmental green space and mental health outcomes in a study area that includes a spectrum of urban to rural environments. Multivariate survey regression analyses examine the association between green space and mental health using the unique, population-based Survey of the Health of Wisconsin database. Analyses were adjusted for length of residence in the neighborhood to reduce the impact of neighborhood selection bias. Higher levels of neighborhood green space were associated with significantly lower levels of symptomology for depression, anxiety and stress, after controlling for a wide range of confounding factors. Results suggest that “greening” could be a potential population mental health improvement strategy in the United States.

Significance of mental health legislation for successful primary care for mental health and community mental health services: A review.

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Ayano, Getinet

2018-03-29

 Mental health legislation (MHL) is required to ensure a regulatory framework for mental health services and other providers of treatment and care, and to ensure that the public and people with a mental illness are afforded protection from the often-devastating consequences of mental illness.  To provide an overview of evidence on the significance of MHL for successful primary care for mental health and community mental health servicesMethod: A qualitative review of the literature on the significance of MHL for successful primary care for mental health and community mental health services was conducted.  In many countries, especially in those who have no MHL, people do not have access to basic mental health care and treatment they require. One of the major aims of MHL is that all people with mental disorders should be provided with treatment based on the integration of mental health care services into the primary healthcare (PHC). In addition, MHL plays a crucial role in community integration of persons with mental disorders, the provision of care of high quality, the improvement of access to care at community level. Community-based mental health care further improves access to mental healthcare within the city, to have better health and mental health outcomes, and better quality of life, increase acceptability, reduce associated social stigma and human rights abuse, prevent chronicity and physical health comorbidity will likely to be detected early and managed.  Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

Self-reported confidence and skills of general practitioners in management of mental health disorders.

Science.gov (United States)

Oakley Browne, Mark; Lee, Adeline; Prabhu, Radha

2007-10-01

To identify the predictors of self-reported confidence and skills of GPs in management of patients with mental health problems. Cross-sectional survey, with questionnaire presented to 246 GPs working in 62 practices throughout Gippsland. Rural general practices in Gippsland. One hundred and thirty-four GPs across Gippsland. GPs completed a questionnaire assessing self-perception of knowledge and skills in recognition and management of common mental health problems. Of 134 GPs, 45% reported that they have a specific interest in mental health, and 39% of GPs reported that they had previous mental health training. Only 22% of GPs describe having both an interest and prior training in mental health care. Age and years since graduation are not significantly related to self-reported confidence and skills. The results of this study highlight that self-professed interest and prior training in mental health are associated. Self-professed interest in mental health care predicts confidence and self-perceived skills in recognition, assessment and management of common mental health disorders. Similarly, prior training in mental health care predicts confidence and self-perceived skills in recognition, assessment and management of common mental health problems. Self-professed interest in mental health issues is also associated with hours of participation in continuing medical education related to mental health care. Unfortunately, only a minority described having both interest and prior training in mental health care.

Teacher Candidate Mental Health and Mental Health Literacy

Science.gov (United States)

Dods, Jennifer

2016-01-01

Providing teacher candidates with a strong foundation in mental health literacy during their teacher education program is crucial in ensuring novice teachers are prepared to support the mental health needs of their students. In addition to responding to students, teacher candidates are typically at an age when mental health disorders are common…

Culture and rural health.

Science.gov (United States)

Farmer, Jane; Bourke, Lisa; Taylor, Judy; Marley, Julia V; Reid, John; Bracksley, Stacey; Johnson, Nicole

2012-10-01

This paper considers the role of culture in rural health, suggesting that the concept and its impacts are insufficiently understood and studied. It reviews some of the ways that culture has been considered in (rural) health, and states that culture is either used ambiguously and broadly - for example, suggesting that there is a rural culture, or narrowly - indeed perhaps interchangeably with ethnicity, for example Aboriginal culture as a unity. The paper notes that, although culture is a dynamic social concept, it has been adopted into a biomedical research paradigm as though it is fixed. Culture is often treated as though it is something that can be addressed simplistically, for example, through cultural sensitivity education. Authors suggest that culture is an unaddressed 'elephant in the room' in rural health, and that exploring cultural differences and beliefs and facing up to cultural differences are vital in understanding and addressing rural health and health system challenges. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Food Insecurity and Rural Adolescent Personal Health, Home, and Academic Environments.

Science.gov (United States)

Shanafelt, Amy; Hearst, Mary O; Wang, Qi; Nanney, Marilyn S

2016-06-01

Food-insecure (FIS) adolescents struggle in school and with health and mental health more often than food-secure (FS) adolescents. Rural communities experience important disparities in health, but little is known about rural FIS adolescents. This study aims to describe select characteristics of rural adolescents by food-security status. Baseline analysis using data from a randomized trial to increase school breakfast participation (SBP) in rural Minnesota high schools. Students completed a survey regarding food security, characteristics, and home and school environments. Schools provided academic data and staff measured height and weight. Food security was dichotomized as FS vs FIS. Bivariate analysis, multivariate linear/logistic regression, and testing for interaction of food security and sex were performed. Food-insecure adolescents reported poorer health, less exercise, had lower grades, and higher SBP (p breakfast (p = .05). All associations except reported benefits remained significant after adjustment. Interactions were identified with girls' grade point average and with boys' caloric and added sugar intake. Negative associations among food insecurity and positive youth development are identified in our sample. Policy and environmental strategies should address the complexities of these associations, including exploration of the role of school meals. © 2016, American School Health Association.

Young Malawians on the interaction between mental health and HIV/AIDS.

Science.gov (United States)

Wright, Jerome; Lubben, Fred; Mkandawire, Mac Bain

2007-11-01

Previous research has identified high levels of mental health problems among people affected by HIV. This study surveys specifically adolescents in southern Malawi on their experience of the impacts of living with HIV or AIDS on one's mental health. At the same time, the study explores the link between mental health problems and subsequent HIV-risk behaviour. Short texts relating everyday scenarios that depicted symptoms of three mental health problems (i.e.depression, anxiety and HIV-related brain impairment) formed the basis of in-depth discussions in 12 existing groups of secondary school students, orphans and vulnerable children, teenage mothers, and out-of-school youths, in both rural and urban settings. The responses show that these young people recognised the mental health sequelae of HIV/AIDS as impacting upon many aspects of one's life. The young people traced these 'interruptions' and 'disruptions' through deteriorating psychological and socio-economic conditions. They showed awareness of a two-way interaction between HIV/AIDS and mental illness, indicating that the latter can increase thoughts of suicide and HIV risk-taking behaviour. More importantly, they identified a number of locally derived community interventions, which if supported by statutory health and education services, can significantly ameliorate their situations. The findings provide avenues for practical integration of mental health provision within HIV prevention, education and care initiatives.

Rural Latinos' mental wellbeing: a mixed-methods pilot study of family, environment and social isolation factors.

Science.gov (United States)

Stacciarini, Jeanne-Marie R; Smith, Rebekah; Garvan, Cynthia Wilson; Wiens, Brenda; Cottler, Linda B

2015-05-01

Upon immigration to the rural areas in the US, Latino families may experience cultural, geographic, linguistic and social isolation, which can detrimentally affect their wellbeing by acting as chronic stressors. Using a community engagement approach, this is a pilot mixed-method study with an embedded design using concurrent qualitative and quantitative data. The purpose of this study is to evaluate family and social environments in terms of protective factors and modifiable risks associated with mental well-being in Latino immigrants living in rural areas of Florida. Latino immigrant mother and adolescent dyads were interviewed by using in-depth ethnographic semistructured interviews and subsequent quantitative assessments, including a demographic questionnaire and three structured instruments: the Family Environment Scale Real Form, the SF-12v2™ Health Survey and the short version (eight items) of PROMIS Health Organization Social Isolation. This mixed-method pilot study highlighted how family, rural, and social environments can protect or impair wellbeing in rural Latino immigrant mother and adolescent dyads.

Functional impairment and mental health functioning among Vietnamese children

Science.gov (United States)

Dang, Hoang-Minh; Weiss, Bahr; Trung, Lam T.

2015-01-01

Purpose Functional impairment is a key indicator of need for mental health services among children and adolescents, often a stronger predictor of service usage than mental health symptoms themselves. Functional impairment may be of particular importance in low and middle income countries (LMIC) because of its potential to focus policy on treatment of child mental health problems which is generally given low priority in LMIC. However, few studies have assessed functional impairment in LMIC. The present study assessed rates of functional impairment among children in Vietnam, as a case example of an LMIC, as well as effects of other risk/protective factors of particular relevance to LMIC (e.g., whether the family lived in an urban or rural area; family structure variables such as grandparents living with the family). Methods 1,314 parents of children 6–16 years old from 10 Vietnamese provinces were interviewed. Results The overall rate of functional impairment among Vietnamese children was 20%, similar to rates in high income countries such as Germany and the United States, suggesting that LMIC status may not be associated with dramatic increases in functional impairment in children. Functional impairment was significantly greater among mental health cases than non-cases, with increases of over 550% associated with mental health caseness. A number of other risk factors (e.g., marital status) had smaller but significant effects. Conclusions Mental health problems are a major but not the sole contributor to functional impairment among Vietnamese children. The pragmatic significance of this research lies in its potential to affect public awareness and policy related to child mental health in LMIC. PMID:26315942

Journal of Child and Adolescent Mental Health - Vol 19, No 1 (2007)

African Journals Online (AJOL)

Journal of Child and Adolescent Mental Health. ... for analysis and activism in response to HIV and AIDS stigmatisation in a rural KwaZulu-Natal school ... Home-based care for parents with AIDS: impact on children's psychological functioning.

Journal of Child and Adolescent Mental Health - Vol 12, No 2 (2000)

African Journals Online (AJOL)

Journal of Child and Adolescent Mental Health. ... GENDER, URBAN/RURAL AND SOCIAL CLASS DIFFERENCES · EMAIL FULL TEXT EMAIL FULL TEXT ... CLINICAL PERSPECTIVES'CROSS-CULTURAL' ISSUES IN CHILD DEVELOPMENT ... HYPERBARIC OXYGEN THERAPY IN BRAIN INJURED CHILDREN BOCA ...

Latino Mental Health

Science.gov (United States)

... How Do Mental Health Conditions Affect the Latino Community? Common mental health disorders among Latinos are generalized anxiety disorder , major ... quality care. Lack of Information and Misunderstanding about Mental Health Overall, the Latino community does not talk about mental health issues. There ...

Worker Preferences for a Mental Health App Within Male-Dominated Industries: Participatory Study.

Science.gov (United States)

Peters, Dorian; Deady, Mark; Glozier, Nick; Harvey, Samuel; Calvo, Rafael A

2018-04-25

Men are less likely to seek help for mental health problems, possibly because of stigma imposed by cultural masculine norms. These tendencies may be amplified within male-dominated workplaces such as the emergency services or transport industries. Mobile apps present a promising way to provide access to mental health support. However, little is known about the kinds of mental health technologies men would be willing to engage with, and no app can be effective if the intended users do not engage with it. The goal of this participatory user research study was to explore the perceptions, preferences, and ideas of workers in male-dominated workplaces to define requirements for a mental health app that would be engaging and effective at improving psychological well-being. Workers from male-dominated workplaces in rural, suburban, and urban locations took part in an exploratory qualitative study involving participatory workshops designed to elicit their perspectives and preferences for mental health support and the design of an app for mental health. Participants generated a number of artifacts (including draft screen designs and promotional material) designed to reify their perceptions, tacit knowledge, and ideas. A total of 60 workers aged between 26 and 65 years, 92% (55/60) male, from male-dominated workplaces in rural (16/60, 27%), suburban (14/60, 23%), and urban (30/60, 50%) locations participated in one of the 6 workshops, resulting in 49 unique feature ideas and 81 participant-generated artifacts. Thematic analysis resulted in a set of feature, language, and style preferences, as well as characteristics considered important by participants for a mental health app. The term "mental health" was highly stigmatized and disliked by participants. Tools including a mood tracker, self-assessment, and mood-fix tool were highly valued, and app characteristics such as brevity of interactions, minimal on-screen text, and a solutions-oriented approach were considered

Mental health concerns among Canadian physicians: results from the 2007-2008 Canadian Physician Health Study.

Science.gov (United States)

Compton, Michael T; Frank, Erica

2011-01-01

In light of prior reports on the prevalence of stress, depression, and other mental health problems among physicians in training and practice, we examined the mental health concerns of Canadian physicians using data from the 2007-2008 Canadian Physician Health Study. Among 3213 respondents, 5 variables (depressive symptoms during the past year, anhedonia in the past year, mental health concerns making it difficult to handle one's workload in the past month, problems with work-life balance, and poor awareness of resources for mental health problems) were examined in relation to sex, specialty, practice type (solo practice vs group or other practice settings), and practice setting (inner city, urban/suburban, or rural/small town/remote). Nearly one quarter of physicians reported a 2-week period of depressed mood, and depression was more common among female physicians and general practitioners/family physicians. Anhedonia was reported by one fifth; anesthesiologists were most likely to report anhedonia, followed by general practitioners/family physicians. More than one quarter reported mental health concerns making it difficult to handle their workload, which was more common among female physicians and general practitioners/family physicians and psychiatrists. Nearly one quarter reported poor work-life balance. Lack of familiarity with mental health resources was problematic, which was more prominent among female physicians and specialists outside of general practice/family medicine or psychiatry. Mental health concerns are relatively common among Canadian physicians. Training programs and programmatic/policy enhancements should redouble efforts to address depression and other mental health concerns among physicians for the benefit of the workforce and patients served by Canadian physicians. Copyright © 2011 Elsevier Inc. All rights reserved.

Transformation of children's mental health services: the role of school mental health.

Science.gov (United States)

Stephan, Sharon Hoover; Weist, Mark; Kataoka, Sheryl; Adelsheim, Steven; Mills, Carrie

2007-10-01

The New Freedom Commission has called for a transformation in the delivery of mental health services in this country. The commission's report and recommendations have highlighted the role of school mental health services in transforming mental health care for children and adolescents. This article examines the intersection of school mental health programs and the commission's recommendations in order to highlight the role of school mental health in the transformation of the child and adolescent mental health system. Schools are uniquely positioned to play a central role in improving access to child mental health services and in supporting mental health and wellness as well as academic functioning of youths. The New Freedom Commission report articulated several goals related to school mental health: reducing stigma, preventing suicide, improving screening and treating co-occurring disorders, and expanding school mental health programs. The authors suggest strategies for change, including demonstrating relevance to schools, developing consensus among stakeholders, enhancing community mental health-school connections, building quality assessment and improvement, and considering the organizational context of schools.

Mental Health: Keeping Your Emotional Health

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... Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth ... PPD) Home Prevention and Wellness Emotional Well-Being Mental Health Mental Health: Keeping Your Emotional Health Mental Health: ...

Epidemiological patterns of mental disorders and stigma in a community household survey in urban slum and rural settings in Kenya.

Science.gov (United States)

Mutiso, Victoria N; Musyimi, Christine W; Tomita, Andrew; Loeffen, Lianne; Burns, Jonathan K; Ndetei, David M

2018-03-01

This study investigated the epidemiological patterns of mental illness and stigma in community households in Kenya using a cross-sectional community household survey among 846 participants. A cross-sectional community household survey was conducted around urban slum (Kangemi) and rural (Kibwezi) selected health facilities in Kenya. All households within the two sites served by the selected health facilities were included in the study. To select the main respondent in the household, the oldest adult who could speak English, Kiswahili or both (the official languages in Kenya) was selected to participate in the interview. The Opinion about Mental Illness in Chinese Community (OMICC) questionnaire and the MINI-International Neuropsychiatric Interview-Plus Version 5 (MINI) tools were administered to the participants. Pearson's chi-square test was used to compare prevalence according to gender, while adjusted regression models examined the association between mental illness and views about mental illness, stratified by gender. The overall prevalence of mental illness was 45%, showing gender differences regarding common types of illness. The opinions about mental illness were similar for men and women, while rural respondents were more positively opinionated than urban participants. Overall, suffering from mental illness was associated with more positive opinions among women and more negative opinions among men. More research is needed into the factors explaining the observed differences in opinion about mental illness between the subgroups, and the impact of mental illness on stigma in Kenya in order to create an evidence-based approach against stigma.

Rural Health Concerns

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People in rural areas face some different health issues than people who live in towns and cities. Getting health care can ... long distances to get routine checkups and screenings. Rural areas often have fewer doctors and dentists, and ...

What Is Mental Health?

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... Myths and Facts Recovery Is Possible What Is Mental Health? Mental health includes our emotional, psychological, and social ... mental health problems and where to find help . Mental Health and Wellness Positive mental health allows people to: ...

A Survey on Mental Health Status of Adult Population Aged 15 and above in the Province of Qazvin, Iran.

Science.gov (United States)

Noorbala, Ahmad Ali; Bagheri Yazdi, Seyed Abbas; Faghihzadeh, Soghrat; Kamali, Koorosh; Faghihzadeh, Elham; Hajebi, Ahmad; Akhondzadeh, Shahin; Jafarinia, Morteza; Mohammadizadeh, Lalah

2017-11-01

This research aims to determine the mental health status of population aged 15 and over in the province of Qazvin in 2015. The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Qazvin in Iran. An estimated sample size of 1200 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Qazvin, Alvand, Mohammadieh and Abhar cities. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. Data analysis in the current study was carried out using the SPSS-18 software. Using GHQ traditional scoring method, 25.8% of the subjects were shown to be at risk of mental disorders (29.5% of females and 22.1% of males). Urban areas (27%) were more at risk of mental disorders compared with rural residents (23.3%). Anxiety and somatization symptoms were more frequent than depression and social dysfunction among respondents. The obtained data revealed that the prevalence of mental disorders increased with age. These disorders were more common in females, age group of 65 and above, people living in rural areas, divorced and widowed, illiterate and unemployed individuals compared with the other groups. The results of this study showed that about a fourth of the people in the province were suspected to have mental disorders. Therefore, it is mandatory for the provincial public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

MENTAL HEALTH: ISLAMIC PERSPECTIVE

OpenAIRE

Muzdalifah M. Rahman

2015-01-01

The purpose of this paper was to explain the concept of mental health perspective Contemporary Psychology, describes the mental health of an Islamic perspective and describes how mental health recovery. The theory used is the concept of mental health perspective Contemporary Psychology, and the concept of mental health perspective Islamic Psychology Writing is writing method using qualitative research methods. Mental health is avoiding an Islamic perspective of all symptoms, complaints and...

Applying Strengths Model principles to build a rural community-based mental health support service and achieve recovery outcomes.

Science.gov (United States)

Dunstan, Debra; Anderson, Donnah

2018-02-01

, and taking a strengths-based rather than a deficit approach to the human and other resources that were available, the PHaMs service was established and is maintained by applying Strengths Model principles and being committed to teamwork and interagency respect. Caseworker ratings of participants who had completed an Individual Recovery Plan indicated significant gains in adaptive functioning, including improvements in physical health and wellbeing, management of symptoms, accommodation, vocational skills development and increased community involvement. Strengths-based recovery services offered by a rural PHaMs service can assist Australians with severe mental illness to achieve meaningful gains towards recovery. Furthermore, a Strengths Model approach to service development and operations – one that recognises individual abilities and prizes interpersonal relationships and teamwork – can maximise the potential of local human and other resources, and serve as a solution to resolving apparent service gaps and perceived deficits in rural and regional areas.

Trends of Mental Health Status in Iranian Population Aged 15 and above between 1999 and 2015.

Science.gov (United States)

Noorbala, Ahmad Ali; Bagheri Yazdi, Seyed Abbas; Faghihzadeh, Soghrat; Kamali, Koorosh; Faghihzadeh, Elham; Hajebi, Ahmad; Akhondzadeh, Shahin; Esalatmanesh, Sophia; Bagheri Yazdi, HanihalSadat; Abbasinejad, Maryam; Asadi, Ali

2017-11-01

The main objective of this study was to compare the results of mental health surveys on adult populations of all provinces in Iran, between 1999 and 2015. This study was an overview of two cross-sectional, descriptive studies that were performed in 1999 and 2015. The study population of these two studies consisted of urban and rural residents of all provinces in Iran. Samples were recruited by systematic random cluster sampling. In both studies, the General Health Questionnaire (GHQ-28) was used to assess mental health status of respondents. Trained psychologists completed questionnaires, and data were analyzed using SPSS software-18. The results showed that in the survey of 1999, 21% of participants suffered from mental disorders (25.9% of females and 14.9% of males). In the survey of 2015, 23.4% of samples were suspected of having mental disorders (27.6% of females and 19.3% of males). The prevalence of mental disorders increased from 1999 to 2014 by about 1.12 fold (1.06 fold in females and 1.3 fold in males). In the survey of 1999, rural residents were more at risk of mental disorders, while in the survey of 2015, urban residents were more prone to mental disorders. In both studies, the risk of suspicion for mental disorders increased with increasing age, and was higher in people aged 65 and above, as well as widowed, divorced and illiterate individuals. The results of this study showed an increase in suspected cases of mental disorders in Iran from 1999 to 2015. Therefore, it is vital for policymakers and health officials to take action in order to improve and maintain mental health status of the people who are at risk in the country.

Undergraduate mental health nursing education in Australia: More than Mental Health First Aid.

Science.gov (United States)

Happell, Brenda; Wilson, Rhonda; McNamara, Paul

2015-01-01

Mental Health First Aid training is designed to equip people with the skills to help others who may be developing mental health problems or experiencing mental health crises. This training has consistently been shown to increase: (1) the recognition of mental health problems; (2) the extent to which course trainees' beliefs about treatment align with those of mental health professionals; (3) their intentions to help others; and (4) their confidence in their abilities to assist others. This paper presents a discussion of the potential role of Mental Health First Aid training in undergraduate mental health nursing education. Three databases (CINAHL, Medline, and PsycINFO) were searched to identify literature on Mental Health First Aid. Although Mental Health First Aid training has strong benefits, this first responder level of education is insufficient for nurses, from whom people expect to receive professional care. It is recommended that: (1) Mental Health First Aid training be made a prerequisite of preregistration nurse education, (2) registered nurses make a larger contribution to addressing the mental health needs of Australians requiring care, and (3) current registered nurses take responsibility for ensuring that they can provided basic mental health care, including undertaking training to rectify gaps in their knowledge.

Food insecurity among people with severe mental disorder in a rural Ethiopian setting: a comparative, population-based study.

Science.gov (United States)

Tirfessa, K; Lund, C; Medhin, G; Hailemichael, Y; Fekadu, A; Hanlon, C

2017-11-16

In low-income African countries, ensuring food security for all segments of the population is a high priority. Mental illness is associated consistently with poverty, but there is little evidence regarding the association with food insecurity. The aim of this study was to compare the levels of food insecurity in people with severe mental disorders (SMD) with the general population in a rural African setting with a high burden of food insecurity. Households of 292 community-ascertained people with a specialist-confirmed diagnosis of SMD (including schizophrenia and bipolar disorder) were compared with 284 households without a person with SMD in a rural district in south Ethiopia. At the time of the study, no mental health services were available within the district. Food insecurity was measured using a validated version of the Household Food Insecurity Access Scale. Disability was measured using the World Health Organisation Disability Assessment Schedule 2.0. Severe household food insecurity was reported by 32.5% of people with SMD and 15.9% of respondents from comparison households: adjusted odds ratio 2.82 (95% confidence interval 1.62 to 4.91). Higher annual income was associated independently with lower odds of severe food insecurity. When total disability scores were added into the model, the association between SMD and food insecurity became non-significant, indicating a possible mediating role of disability. Efforts to alleviate food insecurity need to target people with SMD as a vulnerable group. Addressing the disabling effects of SMD would also be expected to reduce food insecurity. Access to mental health care integrated into primary care is being expanded in this district as part of the Programme for Improving Mental health carE (PRIME). The impact of treatment on disability and food insecurity will be evaluated.

Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System.

Science.gov (United States)

East, Marlene Lynette; Havard, Byron C

2015-01-01

The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can promote cognitive learning, personal growth, and mental health enhancement. As key influencers in the mental health social system, counselor educators and professional associations may either help or hinder diffusion of beneficial mHealth technologies. As mental health mobile apps move towards ubiquity, research will continue to be conducted. The studies published thus far, combined with the potential of mental health mobile apps for learning and personal growth, offer enough evidence to compel mental health professionals to infuse these technologies into education and practice. Counselor educators and professional associations must use their influential leadership roles to train students and practitioners in how to research, evaluate, and integrate mental health mobile apps into practice. The objectives of this article are to (1) increase awareness of mHealth and mental health mobile apps, (2) demonstrate the potential for continued growth in mental health mobile apps based on technology use and acceptance theory, mHealth organizational initiatives, and evidence about how humans learn, (3) discuss evidence-based benefits of mental health mobile apps, (4) examine the current state of mHealth diffusion in the mental health profession, and (5) offer solutions for impelling innovation diffusion by infusing mental health mobile apps into education, training, and clinical settings. This discussion has implications for counselor educators, mental health practitioners, associations

[Determining Factors in the Access to Mental Health Services by the Adult Colombian Population].

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González, Lina María; Peñaloza, Rolando Enrique; Matallana, María Alexandra; Gil, Fabián; Gómez-Restrepo, Carlos; Landaeta, Angela Patricia Vega

2016-12-01

Access to mental health services by people with mental disorders has traditionally been limited, and is associated with attitudinal, social, and structural variables. To analyse the factors that determine access to mental health services by the adult population (18-44 years old) in Colombia, from the results obtained in the 2015 National Mental Health Survey. Analysis of variables of access to attention in mental health care for adults. The reasons for not consulting were classified as barriers of behavioural supply and demand. To analyse the factors associated with access to mental health services in the Colombian adult population, the use of health services in the last 12 months for emotional, nervous or mental health problems was taken into account, as well as associated variables such as demographic characteristics, occupational activity, affiliation to social security, and health status variables. The relationships between these variables were estimated using bivariate multinomial logistic regression models. Rural residence, being married, and having a chronic disease were associated with the decision to consult or not to consult the doctor. Further studies should be conducted to evaluate the situation as regards mental health care access, as well as to determine the potential factors associated with these limitations. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Community perceptions of mental health needs: a qualitative study in the Solomon Islands

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Silove Derrick

2009-03-01

Full Text Available Abstract Background Psychosocial and mental health needs in the aftermath of conflict and disaster have attracted substantial attention. In the Solomon Islands, the conceptualisation of mental health, for several decades regarded by policy makers as primarily a health issue, has broadened and been incorporated into the national development and social policy agendas, reflecting recognition of the impact of conflict and rapid social change on the psychosocial wellbeing of the community as a whole. We sought to understand how mental health and psychosocial wellbeing were seen at the community level, the extent to which these issues were identified as being associated with periods of 'tension', violence and instability, and the availability of traditional approaches and Ministry of Health services to address these problems. Methods This article reports the findings of qualitative research conducted in a rural district on the island of Guadalcanal in the Solomon Islands. Key informant interviews were conducted with community leaders, and focus groups were held with women, men and young people. Wellbeing was defined broadly. Results Problems of common concern included excessive alcohol and marijuana use, interpersonal violence and abuse, teenage pregnancy, and lack of respect and cooperation. Troubled individuals and their families sought help for mental problems from various sources including chiefs, church leaders and traditional healers and, less often, trauma support workers, health clinic staff and police. Substance-related problems presented special challenges, as there were no traditional solutions at the individual or community level. Severe mental illness was also a challenge, with few aware that a community mental health service existed. Contrary to our expectations, conflict-related trauma was not identified as a major problem by the community who were more concerned about the economic and social sequelae of the conflict. Conclusion

Mental Health and Drivers of Need in Emergent and Non-Emergent Emergency Department (ED) Use: Do Living Location and Non-Emergent Care Sources Matter?

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McManus, Moira C; Cramer, Robert J; Boshier, Maureen; Akpinar-Elci, Muge; Van Lunen, Bonnie

2018-01-13

Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations. Concerning moderating effects, Spanish/Hispanic origin was associated with increased likelihood for emergent ED use in the rural living location model, and non-emergent ED use for the no non-emergent source model. 'Other' ethnic origin increased the likelihood of emergent ED use for rural living location and no non-emergent source models. The findings reveal 'need', including mental health admissions, as the largest driver for ED use. This may be due to mental healthcare access, or patients with mental health emergencies being transported via first responders to the ED, as in the case of suicide, self-harm, manic episodes or psychotic episodes. Further educating ED staff on this patient population through gatekeeper training may ensure patients receive the best treatment and aid in driving access to mental healthcare delivery changes.

Pedagogy for rural health.

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Reid, Stephen J

2011-04-01

As the body of literature on rural health has grown, the need to develop a unifying theoretical framework has become more apparent. There are many different ways of seeing the same phenomenon, depending on the assumptions we make and the perspective we choose. A conceptual and theoretical basis for the education of health professionals in rural health has not yet been described. This paper examines a number of theoretical frameworks that have been used in the rural health discourse and aims to identify relevant theory that originates from an educational paradigm. The experience of students in rural health is described phenomenologically in terms of two complementary perspectives, using a geographic basis on the one hand, and a developmental viewpoint on the other. The educational features and implications of these perspectives are drawn out. The concept of a 'pedagogy of place' recognizes the importance of the context of learning and allows the uniqueness of a local community to integrate learning at all levels. The theory of critical pedagogy is also found relevant to education for rural health, which would ideally produce 'transformative' graduates who understand the privilege of their position, and who are capable of and committed to engaging in the struggles for equity and justice, both within their practices as well as in the wider society. It is proposed that a 'critical pedagogy of place,' which gives due acknowledgement to local peculiarities and strengths, while situating this within a wider framework of the political, social and economic disparities that impact on the health of rural people, is an appropriate theoretical basis for a distinct rural pedagogy in the health sciences.

A Survey on Mental Health Status of Adult Population Aged 15 and above in the Province of Ardebil, Iran.

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Noorbala, Ahmad Ali; Bagheri Yazdi, Seyed Abbas; Faghihzadeh, Soghrat; Kamali, Koorosh; Faghihzadeh, Elham; Hajebi, Ahmad; Akhondzadeh, Shahin; Sedighnia, Azadeh; Azimi, Ahmad

2017-11-01

The main objective of this study was to determine the mental health status of population aged 15 and over in the province of Ardebil in 2015. The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Ardebil province in Iran. An estimated sample size of 1200 people were chosen using systematic random cluster sampling. Access was provided by the contribution of Geographical Post Office of Ardebil, Pars abad and Germi cities. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. Data analysis in the current study was carried out using the SPSS-18 software. Using GHQ traditional scoring method, the results showed that 21.4% of individuals (26.3% of females and 16.5% of males) were suspected of mental disorders. The prevalence of suspected cases of mental disorders was 20.8% in urban and 22.8% in rural areas. The results also showed that somatization and anxiety symptoms were more prevalent than social dysfunction and depression symptoms, and were more common in women than men. The results of this research also showed that the prevalence of suspected cases of mental disorders increased with aging. Such disorders were more common in females, age group of 65 and above, people living in rural areas, divorced and widowed, illiterate and unemployed individuals compared with other groups. The results of this study showed that about one fifth of people in the province were suspected of mental disorders. Therefore, it is mandatory for the provincial public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

Public and Private Responsibility for Mental Health: Mental Health's Fourth Revolution.

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Dokecki, Paul R.

Three revolutions in the history of mental health were identified by Nicholas Hobbs: the humane revolution, the scientific and therapeutic revolution, and the public health revolution. The shift of responsibilities for mental health and substance abuse services from the public to the private sector may constitute a fourth mental health revolution.…

Conversations on telemental health: listening to remote and rural First Nations communities.

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Gibson, Kerri L; Coulson, Heather; Miles, Roseanne; Kakekakekung, Christal; Daniels, Elizabeth; O'Donnell, Susan

2011-01-01

Telemental health involves technologies such as videoconferencing to deliver mental health services and education, and to connect individuals and communities for healing and health. In remote and rural First Nations communities there are often challenges to obtaining mental healthcare in the community and to working with external mental health workers. Telemental health is a service approach and tool that can address some of these challenges and potentially support First Nations communities in their goal of improving mental health and wellbeing. Community members' perspectives on the usefulness and appropriateness of telemental health can greatly influence the level of engagement with the service. It appears that no research or literature exists on First Nations community members' perspectives on telemental health, or even on community perspectives on the broader area of technologies for mental health services. Therefore, this article explores the perspectives on telemental health of community members living in two rural and remote First Nations communities in Ontario, Canada. METHODS; This study was part of the VideoCom project, a collaborative research project exploring how remote and rural First Nations communities are using ICTs. This current exploration was conducted with the support of Keewaytinook Okimakanak (KO), our partner in Northwestern Ontario. With the full collaboration of the communities' leadership, a team involving KO staff and VideoCom researchers visited the two communities in the spring of 2010. Using a participatory research design, we interviewed 59 community members, asking about their experiences with and thoughts on using technologies and their attitudes toward telemental health, specifically. A thematic analysis of this qualitative data and a descriptive quantitative analysis of the information revealed the diversity of attitudes among community members. Finally, based on a discussion with the community telehealth staff, a 'ways forward

The magnitude of and health system responses to the mental health treatment gap in adults in India and China.

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Patel, Vikram; Xiao, Shuiyuan; Chen, Hanhui; Hanna, Fahmy; Jotheeswaran, A T; Luo, Dan; Parikh, Rachana; Sharma, Eesha; Usmani, Shamaila; Yu, Yu; Druss, Benjamin G; Saxena, Shekhar

2016-12-17

This Series paper describes the first systematic effort to review the unmet mental health needs of adults in China and India. The evidence shows that contact coverage for the most common mental and substance use disorders is very low. Effective coverage is even lower, even for severe disorders such as psychotic disorders and epilepsy. There are vast variations across the regions of both countries, with the highest treatment gaps in rural regions because of inequities in the distribution of mental health resources, and variable implementation of mental health policies across states and provinces. Human and financial resources for mental health are grossly inadequate with less than 1% of the national health-care budget allocated to mental health in either country. Although China and India have both shown renewed commitment through national programmes for community-oriented mental health care, progress in achieving coverage is far more substantial in China. Improvement of coverage will need to address both supply-side barriers and demand-side barriers related to stigma and varying explanatory models of mental disorders. Sharing tasks with community-based workers in a collaborative stepped-care framework is an approach that is ripe to be scaled up, in particular through integration within national priority health programmes. India and China need to invest in increasing demand for services through active engagement with the community, to strengthen service user leadership and ensure that the content and delivery of mental health programmes are culturally and contextually appropriate. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mental Health

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Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel and act as ... stress, relate to others, and make choices. Mental health is important at every stage of life, from ...

[Study on the psychological-health status and its relationship with social capital among left behind children in rural area, Macheng, Hubei province].

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Hu, Yue; Han, Juan; Chen, Xinguang; Yang, Senbei; Xu, Yanghuan; Xie, Shu; Liu, Weiwei

2014-01-01

To understand the status of mental health among left-behind children in rural area and to explore its relationship with social capital. A sample of 1 031 left behind children, aged 10-18 years, was randomly selected from six schools of two townships in Macheng city of Hubei province where large number of rural parents were working in the urban area. Data from a cross-sectional survey was collected among the sampled students from primary, middle and high schools, using self-designed questionnaires which targeting the 'left-behind' condition and social capital Mental Health Inventory of Middle-School Students (MMHI-60). Chi-square test was used to compare the differences in mental health among different groups. Spearman correlation and logistical regression analysis were applied to assess the relationship between social capital and mental health. The prevalence of mental problems was 54.12%. Results from linear χ² test indicated that the detection rates of mental problems were parallel with the monthly pocket money and the reduction in the frequency of contacting migrant father/mother (P < 0.01). Results from the multiple logistic regression analysis indicated that students who were senior(OR = 2.410-2.682, P < 0.001), and who reported not caring about their parents (OR = 2.048-2.420, P < 0.001)were at increased risks for mental health problems. After controlling the demographic characteristics and conditions of staying relevant factors, family social capital(OR = 0.845, 95%CI:0.801-0.891), neighborhood social capital (OR = 0.867, 95%CI:0.826-0.910)and school social capital(OR = 0.893, 95%CI:0.863-0.923) were all associated with declined risks of mental health problems, in which the family social capital was the most important one. The prevalence of mental health problems was high among the left-behind children in rural area. Much attention should be paid to assist these children in improving their mental health status. One promising approach appeared to be

Observation of influences of mental health promotion and mental intervention on mental health status of professionals

OpenAIRE

Jiang, Shu-Qiang; Zhang, Jian-Ling

2015-01-01

Objective: To observe the influences of mental health promotion and mental intervention on mental health status of professionals. Method: 2878 professionals for physical examination were selected and randomly divided into treatment group and control group, with 1443 professionals and 1435 professionals, respectively. Then, the difference of mental health status before and after mental intervention between two groups was compared. Results: In treatment group, the proportion of people with heal...

Common perinatal mental disorders in northern Viet Nam: community prevalence and health care use

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Tran, Thach; La, Buoi thi; Kriitmaa, Kelsi; Rosenthal, Doreen; Tran, Tuan

2010-01-01

Abstract Objective To establish the prevalence of common perinatal mental disorders their determinants, and their association with preventive health care use among women in one rural and one urban province in northern Viet Nam. Methods We conducted a cross-sectional survey of cohorts of pregnant women and mothers of infants recruited systematically in 10 randomly-selected communes. The women participated in psychiatrist-administered structured clinical interviews and separate structured interviews to assess sociodemographic factors, reproductive health, the intimate partner relationship, family violence and the use of preventive and psychiatric health care. Associations between these variables and perinatal mental disorders were explored through univariate analyses and multivariable logistic regression. Findings Among women eligible for the study (392), 364 (93%) were recruited. Of these, 29.9% (95% confidence interval, CI: 25.20–34.70) were diagnosed with a common perinatal mental disorder (CPMD). The frequency of such disorders during pregnancy and in the postpartum period was the same. Their prevalence was higher among women in rural provinces (odds ratio, OR: 2.17; 95% CI: 1.19–3.93); exposed to intimate partner violence (OR: 2.11; 95% CI: 1.12–3.96); fearful of other family members (OR: 3.36; 95% CI: 1.05–10.71) or exposed to coincidental life adversity (OR: 4.40; 95% CI: 2.44–7.93). Fewer women with a CPMD used iron supplements than women without a CPMD, but the results were not statistically significant (P = 0.05). None of the women studied had ever received mental health care. Conclusion Perinatal depression and anxiety are prevalent in women in northern Viet Nam. These conditions are predominantly determined by social factors, including rural residence, poverty and exposure to family violence. At present the needs of women with common perinatal mental disorders are unrecognized and not attended to and their participation in essential

Modelo de integración de recursos para la atención de la salud mental en la población rural de México A model for integrating mental healthcare resources in the rural population of Mexico

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V Nelly Salgado-de Snyder

2003-01-01

. CONCLUSIONES: Para llevar a cabo con éxito programas de intervención culturalmente sensibles en el medio rural se requiere contar con información detallada, derivada de la investigación y de la participación activa de todos los recursos humanos e institucionales disponibles, desde profesionales e investigadores auténticamente multidisciplinarios, hasta educadores, líderes sociales, religiosos, políticos, miembros de la comunidad e instituciones de esas localidades. El modelo propuesto de integración de recursos personales y comunitarios para la atención de la salud contempla la creación de programas de sensibilización, información y capacitación para los pobladores de la comunidad y los prestadores de servicios; el sistema etnomédico y el sistema formal de salud se proponen como indispensables.OBJECTIVE: The purpose of this project was to identify behaviors of health service utilization to solve mental health-related problems among rural inhabitants of Mexico. A model of pathways to mental health services was built. Based on this model, an integration- intervention model is proposed to help improve access to mental health services and their quality. MATERIAL AND METHODS: In 1997, in-depth interviews were conducted among 21 adults (9 men and 12 women and seven healthcare providers, in a rural community in Jalisco, Mexico. Women's age ranged from 23 to 44 years; ten were married and two single. Men were between 30 and 74 years old; eight were married and one was a widower. Healthcare providers in the same community were: a priest, a general physician, a pharmacy clerk, two nurses, and two traditional healers. RESULTS: The pathways models suggest that the first attempt a person does to solve a symptom is self-care. When such strategies are not sufficient to relief the symptom, the person turns to the members of his/her social network for help, who in addition to providing information about remedies, offer their emotional and instrumental support. If after

Health concerns associated with unconventional gas mining in rural Australia.

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Haswell, Melissa R; Bethmont, Anna

2016-01-01

Many governments globally are investigating the benefits and risks associated with unconventional gas mining for shale, tight and coal seam gas (coalbed methane) to determine whether the industry should proceed in their jurisdiction. Most locations likely to be developed are in rural areas, with potential impact on farmers and small communities. Despite significant health concerns, public health knowledge and growing evidence are often overlooked in decision-making. It is difficult to gain a broad but accurate understanding of the health concerns for rural communities because the evidence has grown very recently and rapidly, is complex and largely based in the USA, where the industry is advanced. In 2016, a concerned South Australian beef and lamb farmer in an area targeted for potential unconventional gas development organised visits to homes in developed unconventional gas areas of Pennsylvania and forums with leading researchers and lawyers in Pennsylvania and New York. Guided by priorities identified during this trip, this communication concisely distils the research evidence on these key concerns, highlighting the Australian situation where evidence exists. It summarises key information of particular concern to rural regions, using Australia as an example, to assist rural health professionals to be better prepared to engage in decision-making and address the challenges associated with this new industry. Discussions with communities and experts, supported by the expanding research from the USA and Australia, revealed increasing health concerns in six key areas. These are absence of a safe solution to the toxic wastewater management problems, air pollution, land and water competition, mental health and psychosocial wellbeing risks, fugitive methane emissions and lack of proven regulatory regimes. Emerging epidemiological studies suggesting interference with foetal development and birth outcomes, and exacerbation of asthma conditions, are particularly concerning

How does maternal oxytocin influence children's mental health problem and maternal mental health problem?

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Tse, Wai S; Siu, Angela F Y; Wong, Tracy K Y

2017-12-01

This study aims to explore the interrelationship among maternal oxytocin (OT) responsiveness, maternal mental health, maternal parenting behavior, and mental health of children under a free-play interaction. 61 mother-child dyads were recruited for the study. Maternal mental health problem and parenting self-efficacy were measured using self-reported questionnaires. The mental health problems of children were also evaluated using a mother-reported questionnaire. Furthermore, salivary OT was collected before and after a standardized 10min free-play interaction. Parenting behaviors, including eye gaze and touch, were measured during the free-play interaction. Maternal OT responsiveness was significantly associated with less maternal mental health problem, touch frequency, and mental health problem of children but not with parenting self-efficacy. In the multivariate linear regression analysis that considers maternal OT responsiveness and maternal and children's mental health problems, maternal OT responsiveness was not associated with the mental health problems of children. This result suggested that maternal mental health problem played a mediational role between maternal OT responsiveness and the mental health problem of children. Results supported the assertion that maternal OT responsiveness contributed to the increased risk of maternal mental health problems and, subsequently, the risk of mental health problems of their children. Copyright © 2017 Elsevier B.V. All rights reserved.

Common mental health problems in rural-to-urban migrant workers in Shenzhen, China: prevalence and risk factors.

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Zhong, B L; Liu, T B; Chan, S S M; Jin, D; Hu, C Y; Dai, J; Chiu, H F K

2018-06-01

Rural-to-urban migrant workers are a large marginalised population in urban China. Prevalence estimates of common mental health problems (CMHPs) in previous studies varied widely and very few studies have investigated migration-related factors of CMHPs in migrant workers. The objective of this study was to determine the prevalence and risk factors of CMHPs among Chinese migrant workers. A random sample of 3031 migrant workers of ten manufacturing factories in Shenzhen, China, completed a standardised questionnaire containing socio-demographic and migration-related variables and the Chinese 12-item General Health Questionnaire (GHQ-12). A GHQ-12 score of three or higher was used to denote the presence of CMHPs. The prevalence of CMHPs was 34.4% in Chinese migrant workers. In multiple logistic regression, risk factors for CMHPs included being 16-25 years old (odd ratio [OR] 1.65, 95% confidence interval [CI] 1.28, 2.12), being 26-35 years old (OR 1.36, 95% CI: 1.05, 1.75), low monthly income (OR 1.42, 95% CI 1.04, 1.92), poor living condition (OR: 1.76, 95% CI: 1.22, 2.54), physical illness in the past 2 weeks (OR 1.72, 95% CI 1.43, 2.05), having worked in many cities (OR 1.34, 95% CI 1.03, 1.74), infrequently visiting hometown (OR 1.56, 95% CI 1.22, 1.99), poor Mandarin proficiency (OR 1.51, 95%CI 1.13, 2.01), a low level of perceived benefits of migration (OR 1.33, 95% CI 1.14, 1.55) and working more than 8 h/day (OR 1.39, 95% CI 1.14, 1.70). CMHPs are very prevalent among Chinese migrant workers. Given the large number of Chinese migrant workers, there is an urgent need to address the mental health burden of China's migrant worker population.

Migration, mental health and costs consequences in Romania.

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Miclutia, Ioana; Junjan, Veronica; Popescu, Codruta Alina; Tigan, Stefan

2007-03-01

Legal and illegal circulatory migration from Romania reached huge proportions after 2000, following the lifting of the visa requirements for EU Shengen countries. So far, the impact of migration on health has received scarce attention from Romanian authorities. To describe the socio-demographic and clinical profile of the migrants who have developed mental illness, estimate their services use in terms of hospitalization and to analyze the cost impact on the Romanian health system and on the migrants' co-payments, to discuss the possible relationships between migration and mental health. A semi-structured interview, designed by the authors, has been administered to 50 migrants admitted to the Second Psychiatric Clinic Cluj-Napoca, Romania, to investigate the following areas: immigration status, working conditions, income, housing, insurance and social bonds. The clinical symptomatology of these patients was assessed using the Brief Psychiatric Rating Scale (BPRS). The average cost of hospitalization per day per patient, the total costs of hospitalization and the migrants' co-payment through personal contribution to the insurance system were estimated. Most of the patients were young, single, with no previous experience abroad and with few social ties in the host country, with unqualified and insecure jobs. In this group, 45 out of 50 had schizophrenia spectrum disorders diagnoses. The hospitalization length of these patients was slightly shorter than the hospitalization of non-migrant patients with the same diagnosis. Individuals from rural areas had longer hospitalisation than those coming from urban areas. Those who left the country illegally and those who worked illegally had shorter hospitalisations. The average costs of hospitalization per day per patient were Euro 15.56; and the total costs were Euro 14,054.92. In order to cover the costs of hospitalization in the native country due to an illness with the onset abroad, a patient should work and contribute 4

Co-morbidity and cannabis use in a mental health trust in South East England.

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Trathen, Bruce; O'gara, Colin; Sarkhel, Arghya; Sessay, Mohammed; Rao, Harish; Luty, Jason

2007-10-01

The prevalence of co-morbidity (severe mental illness and substance) may be less in rural and semi-rural areas than inner cities. The aims were therefore to measure the prevalence of co-morbidity among patients of attending a mental health service in a semi-rural area South East England. Cross-sectional prevalence survey of 1,808 patients with detailed assessments from a representative sample of 373 patients identified as having a combination of severe mental illness and substance misuse. Interviews with key workers were performed using validated methods from the COSMIC study. The response rates equalled or exceeded 90% for the various parts of the study. One-tenth of patients attending the Community Mental Health Teams (CMHTs) reported problematic use of illicit drugs and 17% reported alcohol problems in the past year. 22% of Community Drug and Alcohol Service (CDAS) clients reported a severe mental illness and 46% reported some other form of psychiatric disorder. Of patients with a combined diagnosis of mental illness and substance misuse, cannabis use was 4-fold more common amongst patients attending the CMHT than CDAS (33% vs. 8%) while use of amphetamine was five-fold higher in the CMHT group (10% vs. 2%). Patients with concurrent psychiatric and substance misuse problems represent a similar proportion of the aggregate caseload of both treatment services with observed prevalence amongst the CDAS and CMHT patients with a diagnosis for anxiety disorder (18% vs. 26%), minor depression (42% vs. 32%), personality disorders (32% vs. 36%), histories of self-harm (52% vs. 46%) and violence (33% vs. 30%) respectively. Co-morbidity is common in clients amongst CMHT and CDAS clients although use of cannabis was significantly more common in CMHT clients than in CDAS clients.

Are work demands associated with mental distress? Evidence from women in rural India.

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Richardson, Robin A; Nandi, Arijit; Jaswal, Surinder; Harper, Sam

2017-12-01

High work demands might be a determinant of poor mental health among women in low- and middle-income countries, especially in rural settings where women experience greater amounts of labor-intensive unpaid work. Research originating from such settings is lacking. We estimated the cross-sectional association between work demands and mental distress among 3177 women living in 160 predominantly tribal communities in southern Rajasthan, India. A structured questionnaire captured the number of minutes women spent on various activities in the last 24 h, and we used this information to measure women's work demands, including the total work amount, nature of work (e.g., housework), and type of work (e.g., cooking). Mental distress was measured with the Hindi version of the 12-item General Health Questionnaire. We used negative binomial regression models to estimate the association between work demands (amount, nature, and type) and mental distress. On average, women spent more than 9.5 h a day on work activities. The most time, intensive work activity was caring for children, the elderly, or disabled (149 min). In adjusted models, we found a U-shaped association between work amount and mental distress. High amounts of housework were associated with higher distress, whereas paid work and farmwork amount were not. Certain types of housework, including collecting water and cleaning, were associated with increased distress scores. We found an association between aspects of work demands and mental distress. Research in other contexts where women perform high amounts of unpaid work, particularly within the home or farm, is warranted.

Perceptions of the mental health impact of intimate partner violence and health service responses in Malawi

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Lignet Chepuka

2014-09-01

Full Text Available Background and objectives: This study explores the perceptions of a wide range of stakeholders in Malawi towards the mental health impact of intimate partner violence (IPV and the capacity of health services for addressing these. Design: In-depth interviews (IDIs and focus group discussions (FGDs were conducted in three areas of Blantyre district, and in two additional districts. A total of 10 FGDs, 1 small group, and 14 IDIs with health care providers; 18 FGDs and 1 small group with male and female, urban and rural community members; 7 IDIs with female survivors; and 26 key informant interviews and 1 small group with government ministry staff, donors, gender-based violence service providers, religious institutions, and police were conducted. A thematic framework analysis method was applied to emerging themes. Results: The significant mental health impact of IPV was mentioned by all participants and formal care seeking was thought to be impeded by social pressures to resolve conflict, and fear of judgemental attitudes. Providers felt inadequately prepared to handle the psychosocial and mental health consequences of IPV; this was complicated by staff shortages, a lack of clarity on the mandate of the health sector, as well as confusion over the definition and need for ‘counselling’. Referral options to other sectors for mental health support were perceived as limited but the restructuring of the Ministry of Health to cover violence prevention, mental health, and alcohol and drug misuse under a single unit provides an opportunity. Conclusion: Despite widespread recognition of the burden of IPV-associated mental health problems in Malawi, there is limited capacity to support affected individuals at community or health sector level. Participants highlighted potential entry points to health services as well as local and national opportunities for interventions that are culturally appropriate and are built on local structures and resilience.

School Mental Health Resources and Adolescent Mental Health Service Use

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Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.

2013-01-01

Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…

Deployment, Mental Health Problems, Suicidality, and Use of Mental Health Services Among Military Personnel.

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Chu, Carol; Stanley, Ian H; Hom, Melanie A; Lim, Ingrid C; Joiner, Thomas E

2016-01-01

Following deployment, soldiers may struggle to cope with the after-effects of combat service and experience increased suicidality. Therefore, connection to mental health services is vital. Research regarding the relationship between deployment, suicidality, and mental health connections has been equivocal, with some studies finding a link between deployment history and mental health outcomes, and others not. The purpose of this study was to examine the effects of military deployment on mental health and service utilization outcomes using a longitudinal design. Deployment history, mental health visits, symptoms of suicidality, and various mental health outcomes were assessed in a sample of 1,566 Army recruiters at study entry and 18-months follow-up. Deployment history was positively associated with mental health visits, number of major depressive episodes, and acquired capability for suicide at baseline; however, no significant relationship between deployment, mental health visits, and any other suicide or mental health-related outcomes emerged at baseline or follow-up. Findings suggest a disconnection from mental health services among military personnel. Implications for treatment and suicide prevention efforts among military personnel are discussed.

Significance of mental health legislation for successful primary care for mental health and community mental health services: A review

Directory of Open Access Journals (Sweden)

Getinet Ayano

2018-03-01

Conclusion: Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

A Survey on Mental Health Status of Adult Population Aged 15 and above in the Province of Razavi Khorasan, Iran.

Science.gov (United States)

Noorbala, Ahmad Ali; Bagheri Yazdi, Seyed Abbas; Faghihzadeh, Soghrat; Kamali, Koorosh; Faghihzadeh, Elham; Hajebi, Ahmad; Akhondzadeh, Shahin; Ghazizadeh Hashemi, Fatemah; Okhravi, Neda

2017-11-01

This research aims to determine the mental health status of population aged 15 and over in the province of Razavi Khorasan in 2015. The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Razavi Khorasan in Iran. An estimated sample size of 1200 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Mashhad, Torbate Jam and Sabzavar cities. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. Data analysis in the current study was carried out using the SPSS-18 software. Using GHQ traditional scoring method, the results showed that 23.7% of individuals (26.9% of females and 20.6% of males) were suspected of mental disorders. The prevalence of suspected cases of mental disorders was 23.6% in urban and 23.8% in rural areas. It was also shown that somatization and anxiety symptoms were more prevalent than social dysfunction and depression symptoms, and were more common in women than men. The results of this research also showed that the prevalence of suspected cases of mental disorders increased with aging. Such disorders were more common in females, people living in rural areas, divorced and widowed, illiterate, housewives and retired individuals compared with the other groups. The results of this study showed that about a fourth of the people in the province were suspected to have mental disorders and the prevalence rate of mental disorders increased from 7.7% in 1999 to 23.7% in 2015. Therefore, it is mandatory for the provincial public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

MENTAL HEALTH: ISLAMIC PERSPECTIVE

Directory of Open Access Journals (Sweden)

Muzdalifah M. Rahman

2015-02-01

of mental health, especially mental health needs to be developed with an Islamic perspective various studies and research, especially the development of mental health recovery means Islamic perspective.

The effects of family structure and function on mental health during China's transition: a cross-sectional analysis.

Science.gov (United States)

Cheng, Yao; Zhang, Liuyi; Wang, Fang; Zhang, Ping; Ye, Beizhu; Liang, Yuan

2017-05-05

Social change, intensified by industrialization and globalization, has not only changed people's work lives but also their personal lives, especially in developing countries. The aim of this study was to provide evidence and recommendations regarding family structure, function, and mental health to actively respond to rapid social change. A cross-sectional survey was conducted face-to-face and door-to-door from July 2011 to September 2012 in Hubei Province, central China. Family structure comprised alone, couple, nuclear family, and extended family; family function was measured using the family APGAR (Adaptation, Partnership, Growth, Affection, and Resolve) scale, and mental health was measured using the Chinese version of the 12-item General Health Questionnaire (GHQ-12). The urban-vs-rural difference of family structure among alone, couple, nuclear family, and extended family was statistically significant (5.21% vs 4.62%; 27.36% vs 13.14%; 33.22% vs 27.74%; 34.20% vs 54.50%, respectively; p family function was not statistically significant (8.11 ± 2.13 vs 8.09 ± 2.27, p = 0.9372). The general linear regression showed that the effect of family structure on mental health, whether urban or rural, was not significant, however, the effect of family function was significant, especially regarding better family functioning with better mental health. Combined the effects of family structure and function on mental health, the external form of family (family structure) may not be important; while the internal quality of role (family function) might be key. Improving the residents' family function would be a priority strategy for family practice with their mental health.

Medicaid and Rural Health

Science.gov (United States)

... State Guides Rural Data Visualizations Rural Data Explorer Chart Gallery Maps Case Studies & Conversations Rural Health Models & ... services provided by state Medicaid programs might include dental care, physical therapy, home and community-based services, ...

Urbanization and mental health: psychiatric morbidity, suicide and violence in the State of Victoria.

Science.gov (United States)

Krupinski, J

1979-06-01

Australia is one of the most urbanized countries in the world with over 85% of the population living in metropolitan and other urban areas. More important, the change from a predominantly rural society to an urbanized society has occurred within the last 100 years. To assess the effects of urbanization on mental health, rates of admissions to psychiatric institutions, suicides and violent crime in Victoria have been analysed for the last hundred years. Data on admissions to psychiatric facilities in Victoria from metropolitan, other urban and rural areas, as well as results of community health surveys carried out in metropolitan and rural areas were compared to examine for evidence of urban-rural differences in psychiatric morbidity. The findings do not support the notion that the level of psychiatric and psychosocial disorders in Victoria are related to urbanization or to urban living.

Disaster mental health

DEFF Research Database (Denmark)

Henderson, Silja; Berliner, Peter; Elsass, Peter

2015-01-01

In this chapter we focus on disaster mental health, particularly theoretical and research-based implications for intervention. The field of disaster mental health research is vast and impossible to cover in a single chapter, but we will visit central research, concepts, and understandings within...... disaster mental health and intervention, and refer to further literature where meaningful. We conclude the chapter with recommendations for further research....

Health status of rural population in Ialomita county

Directory of Open Access Journals (Sweden)

ANA-MARIA TALOS

2014-10-01

Full Text Available Health is an issue that manages to provide many top ics in various fields (medicine, geography, sociology, psychology. This study aims to highlight the territorial disparities in health status of Ialomi ţ a county, to identify the health determinants and to make a preliminary analysis of the relationships between the lifestyle and the health status, using an objective assessment (statistics and a subjective evaluation (health surveys. There were analyzed elements such as mortality and morbidity, using health indic ators (mortality rate, infant mortality rate, specific mortality rate and specific morbidity rate and an aggregate index (health index. Combining statistic analysis and spatial analysis, t he study offers the possibility of comparing the rural areas with urban area, and it can be a base f or further studies. The health services, ageing and the characteristics of lifestyle could explain the territorial disparities in health status. A health study can reveal important details about eco nomic features, social behavior, mentality and social environment.

Strengthening rural health placements for medical students ...

African Journals Online (AJOL)

Strengthening rural health placements for medical students: Lessons for South Africa ... rural health, primary healthcare and National Health Insurance strategies. ... preferential selection of students with a rural background, positioning rural ...

Linking Returning Veterans in Rural Community Colleges to Mental Health Care

Science.gov (United States)

2015-01-01

post - traumatic stress disorder ( PTSD ), depression, or traumatic brain...a 4-item screener for post - traumatic stress ( PTSD ). Forty-Four percent of the student Veterans screened positive on at least one mental health...administered screeners for depression (PHQ-9), generalized anxiety (GAD-7), posttraumatic stress disorder (PC- PTSD ), non-lethal self-injury,

Consumer attitudes towards evidence based mental health services among American mental health consumers.

Science.gov (United States)

Teh, Lisa B; Hayashi, Kentaro; Latner, Janet; Mueller, Charles W

2016-10-01

The Consumer Attitudes towards Evidence Based Services (CAEBS) scale is a 29-item questionnaire designed to assess public views on the role of science in helping to guide mental health treatment. The aim of the current study was to assess the Factor structure the CAEBS in an online sample of adults seeking information about mental health services. The CAEBS was administered to a nationwide sample of participants from websites offering classified advertisements for mental health related study participation (n = 312). An Exploratory Factor Analysis (EFA) suggested four factors based on 26 of the items: Beliefs Regarding Therapists' Practices, Attitudes about Mental Health Policy, Negative Personal-Level Attitudes toward EBPs, and Negative Societal-Level Attitudes towards EBPs. In order to increase consumer empowerment within the mental health-care system and develop policies supporting EBP usage, mental health professionals need to increase communication with the public to address these concerns and leverage positive attitudes. © 2016 Australian College of Mental Health Nurses Inc.

Health-related lifestyle behaviors among male and female rural-to-urban migrant workers in Shanghai, China.

Science.gov (United States)

Yang, Hua; He, Fang; Wang, Tianhao; Liu, Yao; Shen, Yao; Gong, Jian; Dai, Wei; Zhou, Jing; Gu, Jie; Tu, Yimin; Wang, Tianying; Shen, Lei; Wu, Yumiao; Xia, Xiuping; Xu, Donghao; Pan, Zhigang; Zhu, Shanzhu

2015-01-01

Lifestyle behaviors significantly impact health, yet remain poorly defined in Chinese rural-to-urban migrants. In a cross-sectional study of health-related behaviors of 5484 rural-to-urban migrants who had worked in Shanghai for at least six months, we assessed the contribution of demographics and physical and mental health to lifestyle behaviors in male and female participants by multiple stepwise cumulative odds logistic regression. Respondents were 51.3% male. 9.9% exhibited abnormal blood pressure; 27.0% were overweight or obese; 11.2% reported abnormal mental health; 36.9% reported healthy lifestyle. Multiple stepwise cumulative odds logistic regression indicated that men working in manufacturing reported less unhealthy lifestyle than those in hospitality (cumulative odds ratio (COR) = 1.806, 95%CI 1.275-2.559) or recreation/leisure (COR = 3.248, 95%CI 2.379-4.435); and women working in manufacturing and construction reported less unhealthy lifestyle than those in all other sectors. Unhealthy lifestyle was associated with small workplaces for men (COR = 1.422, 95%CI 1.154-1.752), working more than 8 or 11 hours per day for women and men, respectively, and earning over 3500 RMB in women (COR = 1.618, 95%CI 1.137-2.303). Single women and women who had previously resided in three or more cities were more likely to report unhealthy lifestyle (COR = 2.023, 95%CI 1.664-2.461, and COR = 1.311, 95%CI 1.072-1.602, respectively). Abnormal mental status was also correlated with unhealthy lifestyle in men (COR = 3.105, 95%CI 2.454-3.930) and women (COR = 2.566, 95%CI 2.024-3.252). There were different risk factors of unhealthy lifestyle score in male and female rural-to-urban migrants, especially in number of cities experienced, salary, marital status, work place scale. Several demographic groups: employment sectors (e.g. hospitality and recreation/leisure), working conditions (e.g. long hours) and abnormal mental status were associated with unhealthy lifestyle behaviors

Health-related lifestyle behaviors among male and female rural-to-urban migrant workers in Shanghai, China.

Directory of Open Access Journals (Sweden)

Hua Yang

Full Text Available Lifestyle behaviors significantly impact health, yet remain poorly defined in Chinese rural-to-urban migrants.In a cross-sectional study of health-related behaviors of 5484 rural-to-urban migrants who had worked in Shanghai for at least six months, we assessed the contribution of demographics and physical and mental health to lifestyle behaviors in male and female participants by multiple stepwise cumulative odds logistic regression.Respondents were 51.3% male. 9.9% exhibited abnormal blood pressure; 27.0% were overweight or obese; 11.2% reported abnormal mental health; 36.9% reported healthy lifestyle. Multiple stepwise cumulative odds logistic regression indicated that men working in manufacturing reported less unhealthy lifestyle than those in hospitality (cumulative odds ratio (COR = 1.806, 95%CI 1.275-2.559 or recreation/leisure (COR = 3.248, 95%CI 2.379-4.435; and women working in manufacturing and construction reported less unhealthy lifestyle than those in all other sectors. Unhealthy lifestyle was associated with small workplaces for men (COR = 1.422, 95%CI 1.154-1.752, working more than 8 or 11 hours per day for women and men, respectively, and earning over 3500 RMB in women (COR = 1.618, 95%CI 1.137-2.303. Single women and women who had previously resided in three or more cities were more likely to report unhealthy lifestyle (COR = 2.023, 95%CI 1.664-2.461, and COR = 1.311, 95%CI 1.072-1.602, respectively. Abnormal mental status was also correlated with unhealthy lifestyle in men (COR = 3.105, 95%CI 2.454-3.930 and women (COR = 2.566, 95%CI 2.024-3.252.There were different risk factors of unhealthy lifestyle score in male and female rural-to-urban migrants, especially in number of cities experienced, salary, marital status, work place scale. Several demographic groups: employment sectors (e.g. hospitality and recreation/leisure, working conditions (e.g. long hours and abnormal mental status were associated with unhealthy lifestyle

Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System

OpenAIRE

East, Marlene Lynette; Havard, Byron C

2015-01-01

The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can pro...

Livestock/animal assets buffer the impact of conflict-related traumatic events on mental health symptoms for rural women.

Directory of Open Access Journals (Sweden)

Nancy Glass

Full Text Available In the context of multiple adversities, women are demonstrating resilience in rebuilding their futures, through participation in microfinance programs. In addition to the economic benefits of microfinance, there is evidence to suggest that it is an effective vehicle for improving health.The parent study is a community-based trial to evaluate the effectiveness of a livestock microfinance intervention, Pigs for Peace (PFP, on health and economic outcomes with households in 10 villages in eastern Democratic Republic of Congo. The analysis for this manuscript includes only baseline data from female participants enrolled in the ongoing parent study. Multiple regression analysis was used to examine if livestock/animal asset value moderates the relationship between conflict-related traumatic events and current mental health symptoms.The majority of women are 25 years or older, married, have on average 4 children in the home and have never attended school. Nearly 50% of women report having at least one livestock/animal asset at baseline. Over the past 10 years, women report on average more than 4 (M = 4.31, SD 3·64 traumatic events (range 0-18. Women reported symptoms consistent with PTSD with a mean score of ·2.30 (SD = 0·66 range 0-4 and depression with a mean score of 1.86 (SD = 0·49, range 0-3.47. The livestock/animal asset value by conflict-related traumatic events interaction was significant for both the PTSD (p = 0·021 and depression (p = 0·002 symptom models.The study provides evidence of the moderating affect of livestock/animal assets on mental health symptoms for women who have experienced conflict. The findings supports evidence about the importance of livestock/animal assets to economics in rural households but expands on previous research by demonstrating the psychosocial effects of these assets on women's health.clinicaltrials.gov NCT02008708.

[Mental Health: Concepts, Measures, Determinants].

Science.gov (United States)

Doré, Isabelle; Caron, Jean

Objectives This article aims to situate the concept of mental health in a historical perspective. This article presents the most commonly used measurement tools in Canada and elsewhere in the world to assess specific and multiple dimensions of mental health; when available, psychometric properties are discussed. Finally, research findings on quality of life and mental health determinants are presented.Methods A literature review of concepts, measurement and determinants of mental health is presented in this paper. The selection of measurement scales presented is based on the findings of the research reports conducted by the second author, an expert on mental health measures, for Health Canada and Statistics Canada.Results Mental health is more than the absence of mental illness; rather it is a state of complete well-being, which refers to our ability to enjoy life and deal with the challenges we face. Accordingly, mental health and mental illness are not extremes of the same continuum, but distinct yet correlated concepts. The traditional conceptualization suggesting that mental health represents simply the absence of mental illness has been replaced, in the last few decades, by a more holistic characterization, which directly concerns public health. The components of mental health include emotional well-being/quality of life (QOL) and psychological and social well-being. Mental health influences the personal and social functioning of individuals, justifying the importance of intervening upstream to promote mental health. Specific scales are relevant for obtaining a detailed measure of one aspect of well-being in particular (emotional/quality of life, psychological or social well-being); however, to account for the global mental health status, measurement tools that integrate all three forms of well-being (emotional, psychological and social) should be privileged. A diversity of determinants at the individual, social and neighbourhood levels influence quality of

Mental Health and African Americans

Science.gov (United States)

... Minority Population Profiles > Black/African American > Mental Health Mental Health and African Americans Poverty level affects mental health ... compared to 120% of non-Hispanic whites. 1 MENTAL HEALTH STATUS Serious psychological distress among adults 18 years ...

Mental Health Nurse Incentive Program: facilitating physical health care for people with mental illness?

Science.gov (United States)

Happell, Brenda; Platania-Phung, Chris; Scott, David

2013-10-01

People with serious mental illness have increased rates of physical ill-health and reduced contact with primary care services. In Australia, the Mental Health Nurse Incentive Program (MHNIP) was developed to facilitate access to mental health services. However, as a primary care service, the contribution to physical health care is worthy of consideration. Thirty-eight nurses who were part of the MHNIP participated in a national survey of nurses working in mental health about physical health care. The survey invited nurses to report their views on the physical health of consumers and the regularity of physical health care they provide. Physical health-care provision in collaboration with general practitioners (GPs) and other health-care professionals was reported as common. The findings suggest that the MHNIP provides integrated care, where nurses and GPs work in collaboration, allowing enough time to discuss physical health or share physical health activities. Consumers of this service appeared to have good access to physical and mental health services, and nurses had access to primary care professionals to discuss consumers' physical health and develop their clinical skills in the physical domain. The MHNIP has an important role in addressing physical health concerns, in addition to the mental health issues of people accessing this service. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Mental Health and Antiretroviral Adherence Among Youth Living With HIV in Rwanda.

Science.gov (United States)

Smith Fawzi, Mary C; Ng, Lauren; Kanyanganzi, Fredrick; Kirk, Catherine; Bizimana, Justin; Cyamatare, Felix; Mushashi, Christina; Kim, Taehoon; Kayiteshonga, Yvonne; Binagwaho, Agnes; Betancourt, Theresa S

2016-10-01

In Rwanda, significant progress has been made in advancing access to antiretroviral therapy (ART) among youth. As availability of ART increases, adherence is critical for preventing poor clinical outcomes and transmission of HIV. The goals of the study are to (1) describe ART adherence and mental health problems among youth living with HIV aged 10 to 17; and (2) examine the association between these factors among this population in rural Rwanda. A cross-sectional analysis was conducted that examined the association of mental health status and ART adherence among youth (n = 193). ART adherence, mental health status, and related variables were examined based on caregiver and youth report. Nonadherence was defined as ever missing or refusing a dose of ART within the past month. Multivariate modeling was performed to examine the association between mental health status and ART adherence. Approximately 37% of youth missed or refused ART in the past month. In addition, a high level of depressive symptoms (26%) and attempt to hurt or kill oneself (12%) was observed in this population of youth living with HIV in Rwanda. In multivariate analysis, nonadherence was significantly associated with some mental health outcomes, including conduct problems (odds ratio 2.90, 95% confidence interval 1.55-5.43) and depression (odds ratio 1.02, 95% confidence interval 1.01-1.04), according to caregiver report. A marginally significant association was observed for youth report of depressive symptoms. The findings suggest that mental health should be considered among the factors related to ART nonadherence in HIV services for youth, particularly for mental health outcomes, such as conduct problems and depression. Copyright © 2016 by the American Academy of Pediatrics.

Micro-scale environment and mental health in later life: Results from the Cognitive Function and Ageing Study II (CFAS II).

Science.gov (United States)

Wu, Yu-Tzu; Prina, A Matthew; Jones, Andy; Barnes, Linda E; Matthews, Fiona E; Brayne, Carol

2017-08-15

Poor micro-scale environmental features, such as graffiti and broken windows, have been associated with crime and signs of social disorder with a potential impact on mental health. The aim of this study is to investigate the association between micro-scale environment and mental health problems in later life, including cognitive (cognitive impairment and dementia) and common mental disorders (depressive and anxiety symptoms). The method of visual image audits was used to collect micro-scale environmental data for 3590 participants in the Cognitive Function and Ageing Study II, a population-based multicentre cohort of people aged 65 or above in England. Multilevel logistic regression was used to examine the associations between the quality of micro-scale environment and mental health problems taking into account urban/rural difference. Poor quality of micro-scale environment was associated with nearly 20% increased odds of depressive (OR: 1.19; 95% CI: 0.99, 1.44) and anxiety symptoms (OR: 1.17; 95% CI: 0.99, 1.38) while the direction of association for cognitive disorders differed across urban and rural settings. Although higher odds of cognitive disorders were found in rural settings, living in a poor quality environment was associated with nearly twice higher odds of cognitive impairment (OR: 1.88; 95% CI: 1.18, 2.97) in urban conurbations but 20% lower odds in rural areas (OR: 0.80; 95% CI: 0.57, 1.11). The causal direction could not be fully determined due to the cross-sectional nature of the data. The visual nature of the environmental assessment tool means it likely does not fully capture features related to the availability of local support services, or opportunities for social participation and interaction. The quality of micro-scale environment appears to be important to mental health in older people. Interventions may incorporate the environmental aspect to reduce cognitive and common mental disorders. Copyright © 2017 The Authors. Published by

Information in mental health: qualitative study of mental health service users

OpenAIRE

Powell, John; Clarke, Aileen

2006-01-01

Background  Despite the widespread proliferation of consumer health information provision, little is known about information needs or information‐seeking behaviour in mental health. A qualitative study was therefore undertaken to explore these issues for mental health service users.

Population mental health: evidence, policy, and public health practice

National Research Council Canada - National Science Library

Cohen, Neal L; Galea, Sandro

2011-01-01

... on population mental health with public mental health policy and practice. Issues covered in the book include the influence of mental health policies on the care and well-­ being of individuals with mental illness, the interconnectedness of physical and mental disorders, the obstacles to adopting a public health orientation to mental health/mental ill...

Romantic relationships and mental health.

Science.gov (United States)

Braithwaite, Scott; Holt-Lunstad, Julianne

2017-02-01

This paper reviews the research on relationships and mental health. Individuals who are more mentally healthy are more likely to select into relationships, but relationships are also demonstrably associated with mental health. The type of relationship matters - evidence suggests that more established, committed relationships, such as marriage, are associated with greater benefits than less committed unions such as cohabitation. The association between relationships and mental health is clearly bidirectional, however, stronger effects are observed when mental health is the outcome and relationships are the predictor, suggesting that the causal arrow flows more strongly from relationships to mental health than vice versa. Moreover, improving relationships improves mental health, but improving mental health does not reliably improve relationships. Our review of research corroborates the view that relationships are a keystone component of human functioning that have the potential to influence a broad array of mental health outcomes. Copyright © 2016. Published by Elsevier Ltd.

Parenting style, individuation, and mental health of Egyptian adolescents.

Science.gov (United States)

Dwairy, Marwan; Menshar, Kariman E

2006-02-01

Three questionnaires that measure parenting style, adolescent-family connectedness, and mental health were administered to 351 Egyptian adolescents. Results show that in rural communities the authoritarian style is more predominant in the parenting of male adolescents, while the authoritative style is more predominant in the parenting of female adolescents. In urban communities, on the other hand, the authoritarian style was more predominant in the parenting of female adolescents. The connectedness of all female adolescents with their family was stronger than that of male adolescents. The connectedness of girls was found to be more emotional and financial in villages and to be more functional in town. Female adolescents reported a higher frequency of psychological disorders. Mental health was associated with authoritative parenting, but not with authoritarian parenting. It seems that authoritarian parenting within an authoritarian culture is not as harmful as within a liberal culture.

The association between socioeconomic status and health-related quality of life among Polish postmenopausal women from urban and rural communities.

Science.gov (United States)

Kaczmarek, M; Pacholska-Bogalska, J; Kwaśniewski, W; Kotarski, J; Halerz-Nowakowska, B; Goździcka-Józefiak, A

2017-01-01

In recent years, more scholarly attention has been paid to a growing range of geographic characteristics as antecedents of inequalities in women's health and well-being. The purpose of this study was to evaluate differences in health-related quality of life between rural and urban Polish postmenopausal women. Using a data set from a reproductive health preventive screening of 660 postmenopausal women aged 48-60 years, inhabitants of Wielkopolska and Lublin provinces, the association of place of residence, socioeconomic status and lifestyle factors with health-related quality of life (the SF-36 instrument) was evaluated using ANCOVA models and multiple logistic regression analysis with backward elimination steps. A consistent rural-to-urban gradient was found in all indices of physical health functioning and well-being but not in vitality, social functioning, emotional role and mental health scales with women in large cities being likely to enjoy the highest and those in villages the lowest quality of life. The rural-urban disparities in health-related quality of life were mediated by women's socioeconomic status. The likelihood of worse physical and mental functioning and well-being was 2-3 times greater for the low socioeconomic status rural women than their counterparts from more affluent urban areas. The educational attainment and employment status were the most powerful independent risk factors for health-related quality of life in both rural and urban women. Better understanding of the role of socioeconomic status that acts as a mediator in the association between area of residence and health-related quality of life may be useful in developing public health policies on health inequalities among women at midlife. Copyright © 2016. Published by Elsevier GmbH.

Acute mental health care according to recent mental health ...

African Journals Online (AJOL)

Objective: This is the third of three reports on the follow-up review of mental health care at Helen Joseph Hospital (HJH). The study reviewed existing South African standards for mental health care facilities. Architectural principles and implications for the use of space were deducted from recent legislation. Objectives were to ...

Child Mental Health: MedlinePlus Health Topic

Science.gov (United States)

... events and children (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Child Mental Health ... in childhood Traumatic events and children Related Health Topics Bullying Child Behavior Disorders Mental Disorders Mental Health ...

Sociodemographic disparities associated with perceived causes of unmet need for mental health care.

Science.gov (United States)

Alang, Sirry M

2015-12-01

Mental disorders are among the leading causes of disability in the United States. In 2011, over 10 million adults felt that even though they needed treatment for mental health problems, they received insufficient or no mental health care and reported unmet need. This article assesses associations between sociodemographic characteristics and perceived causes of unmet needs for mental health care. A sample of 2,564 adults with unmet mental health need was obtained from the National Survey on Drug Use and Health. Outcome variables were 5 main reasons for unmet need: cost, stigma, minimization, low perceived treatment effectiveness, and structural barriers. Each cause of unmet need was regressed on sociodemographic, health, and service use characteristics. Women had higher odds of cost-related reasons for unmet need than men. Odds of stigma and structural barriers were greater among Blacks than Whites, and among rural than metropolitan residents. Compared with the uninsured, insured persons were less likely to report cost barriers. However, insured persons had higher odds of stigma and minimization of mental disorders. Insurance alone is unlikely to resolve the problem of unmet need. Understanding the social epidemiology of perceived unmet need will help identify populations at risk of not receiving mental health care or insufficient care. Focusing on specific programs and services that are designed to address the causes of perceived unmet need in particular populations is important. Future research should explore how intersecting social statuses affect the likelihood of perceived unmet need. (c) 2015 APA, all rights reserved).

Physical health monitoring in mental health settings: a study exploring mental health nurses' views of their role.

Science.gov (United States)

Mwebe, Herbert

2017-10-01

To explore nurses' views of their role in the screening and monitoring of the physical care needs of people with serious mental illness in a mental health service provider. There is increasing awareness through research that people with serious mental illness disproportionately experience and die early from physical health conditions. Mental health nurses are best placed as front-line workers to offer screening, monitoring and interventions; however, their views on physical care interventions are not studied often. Qualitative exploratory study. The study was carried out in a mental health inpatient centre in England. Volunteer sampling was adopted for the study with a total target sample of (n = 20) nurses from three inpatient wards. Semistructured interviews were conducted with (n = 10) registered mental health nurses who had consented to take part in the study. Inductive data analysis and theme development were guided by a thematic analytic framework. Participants shared a clear commitment regarding their role regarding physical health screening and monitoring in mental health settings. Four themes emerged as follows: features of current practice and physical health monitoring; perceived barriers to physical health monitoring; education and training needs; and strategies to improve physical health monitoring. Nurses were unequivocal in their resolve to ensure good standard physical health monitoring and screening interventions in practice. However, identified obstacles have to be addressed to ensure that physical health screening and monitoring is integrated adequately in everyday clinical activities. Achieving this would require improvements in nurses' training, and an integrated multiservice and team-working approach. Attending to the physical health needs of people with serious mental illness has been associated with multiple improvements in both mental and physical health; nurses have a vital role to play in identifying and addressing causes of poor

Workplace Violence in Mental Health: A Victorian Mental Health Workforce Survey.

Science.gov (United States)

Tonso, Michael A; Prematunga, Roshani Kanchana; Norris, Stephen J; Williams, Lloyd; Sands, Natisha; Elsom, Stephen J

2016-10-01

The international literature suggests workplace violence in mental health settings is a significant issue, yet little is known about the frequency, nature, severity and health consequences of staff exposure to violence in Australian mental health services. To address this gap, we examined these aspects of workplace violence as reported by mental health services employees in Victoria, Australia. The project used a cross-sectional, exploratory descriptive design. A random sample of 1600 Health and Community Services Union members were invited to complete a survey investigating exposure to violence in the workplace, and related psychological health outcomes. Participants comprised employees from multiple disciplines including nursing, social work, occupational therapy, psychology and administration staff. A total of 411 members responded to the survey (26% response rate). Of the total sample, 83% reported exposure to at least one form of violence in the previous 12 months. The most frequently reported form of violence was verbal abuse (80%) followed by physical violence (34%) and then bullying/mobbing (30%). Almost one in three victims of violence (33%) rated themselves as being in psychological distress, 54% of whom reported being in severe psychological distress. The more forms of violence to which victims were exposed, the greater the frequency of reports of psychological distress. Workplace violence is prevalent in mental health facilities in Victoria. The nature, severity and health impact of this violence represents a serious safety concern for mental health employees. Strategies must be considered and implemented by healthcare management and policy makers to reduce and prevent violence. © 2016 Australian College of Mental Health Nurses Inc.

Rural migration and health care

DEFF Research Database (Denmark)

Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn

This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role......, or no role at all? First, the paper reports on key findings from rural migration studies, in order to shed light on two migration trends: urbanization and counter-urbanization. Then we take a closer look on settlement preferences in rural areas, including the impact of health care facilities. Finally, we end...... up with a more deepgoing review of the relatively small number of studies, which explicitly deal with settlement preferences related to access to health care....

Parent-reported Mental Health Problems and Mental Health Services Use in South Australian School-aged Children

Directory of Open Access Journals (Sweden)

Jing Wu

2016-09-01

Full Text Available Background:Monitoring and reporting childhood mental health problems and mental health services utilization over time provide important information to identify mental health related issues and to guide early intervention. This paper aims to describe the recent prevalence of parent-reported mental health problems among South Australian (SA children; to identify mental health problems associated characteristics; and to describe mental health services utilization and its related characteristics among this population. Methods:Parent-reported mental health problems were assessed against the first item of the Strength and Difficulties Questionnaire. School-aged children were randomly sampled monthly and data were collected using a surveillance system between 2005 and 2015. Associations between mental health problems and various factors were analysed using univariable analysis and multivariable logistic regression modelling. Results:Prevalence of parent-reported mental health problems among children was 9.1% and 9.3% for children aged 5 to 11 years and children aged 12 to 15 years, respectively. No change in prevalence was observed during the past decade. Mental health problems were associated with male sex, long-term illness or pain, negative school experiences, not living with biological parents, and living in a rental dwelling. Less than half (48.7% of the children with mental health problems received professional help. An increasing trend was found in mental health services utilisation among children aged 5 to 15 years. Utilization of mental health services was associated with male sex, older age, long-term illness or pain, and feeling unhappy at school. Conclusion:This study reports the prevalence of parent-reported mental and mental health services utilisation among SA school-aged children. Identified characteristics associated with mental health problems and mental health services utilisation provide useful information for the planning of

Community mental health nurses’ experience of decentralised and integrated psychiatric-mental health care services in the Southern mental health region of Botswana (part 1

Directory of Open Access Journals (Sweden)

M.K. Maphorisa

2002-09-01

Full Text Available Since the inception of the decentralisation and integration of psychiatric mental health care services into the general health care delivery system in Botswana, there has never been a study to investigate what community mental health nurses are experiencing due to the policy. Many of these nurses have been leaving the scantily staffed mental health care services in increasing numbers to join other sectors of health or elsewhere since the beginning of the implementation of the policy. During the research study, phenomenological in-depth interviews were conducted with three groups of 12 community mental health nurses altogether. An open central question was posed to each group followed by probing questions to explore and describe these nurses’ experience of the decentralisation and integration of psychiatric-mental health care services. After the data was analysed, related literature was incorporated and guidelines for advanced psychiatric nurses were formulated and described to assist these nurses to cope with the decentralisation and integration of psychiatric-mental health care services. The guidelines were set up for the management of the community mental health nurses who are experiencing obstacles in the quest for mental health which also interfere with their capabilities as mental health care providers.

Quebec mental health services networks: models and implementation

Directory of Open Access Journals (Sweden)

Marie-Josée Fleury

2005-06-01

Full Text Available Purpose: In the transformation of health care systems, the introduction of integrated service networks is considered to be one of the main solutions for enhancing efficiency. In the last few years, a wealth of literature has emerged on the topic of services integration. However, the question of how integrated service networks should be modelled to suit different implementation contexts has barely been touched. To fill that gap, this article presents four models for the organization of mental health integrated networks. Data sources: The proposed models are drawn from three recently published studies on mental health integrated services in the province of Quebec (Canada with the author as principal investigator. Description: Following an explanation of the concept of integrated service network and a description of the Quebec context for mental health networks, the models, applicable in all settings: rural, urban or semi-urban, and metropolitan, and summarized in four figures, are presented. Discussion and conclusion: To apply the models successfully, the necessity of rallying all the actors of a system, from the strategic, tactical and operational levels, according to the type of integration involved: functional/administrative, clinical and physician-system is highlighted. The importance of formalizing activities among organizations and actors in a network and reinforcing the governing mechanisms at the local level is also underlined. Finally, a number of integration strategies and key conditions of success to operationalize integrated service networks are suggested.

Local suffering and the global discourse of mental health and human rights: An ethnographic study of responses to mental illness in rural Ghana

OpenAIRE

Read, Ursula M; Adiibokah, Edward; Nyame, Solomon

2009-01-01

Abstract Background The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting...

Mental Health and Mental Disorder Recommendation Programs.

Science.gov (United States)

Ruchiwit, Manyat

2017-12-01

The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and target groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

Meeting Recommended Levels of Physical Activity and Health-Related Quality of Life in Rural Adults.

Science.gov (United States)

Hart, Peter D

2016-03-01

Little is known about physical activity (PA) and health-related quality of life (HRQOL) among rural adults. The purpose of this study was to investigate the relationship between meeting recommended levels of PA and HRQOL in a rural adult population. This study analyzed data from 6,103 rural adults 18 years of age and older participating in a 2013 survey. Respondents reporting at least 150 minutes a week of moderate-intensity (or moderate-vigorous combination) PA during the past month were categorized as meeting PA guidelines. Five health variables were used to assess HRQOL. A continuous HRQOL ability score was also created using item response theory (IRT). Rural adults who met recommended levels of PA were significantly more likely to report good HRQOL in adjusted models of physical health (OR: 1.99; 95% CI: 1.54-2.56), mental health (OR: 1.96; 95% CI: 1.46-2.64), inactivity health (OR: 2.14; 95% CI: 1.54-2.97), general health (OR: 1.69; 95% CI: 1.35-2.13), and healthy days (OR: 1.98; 95% CI: 1.58-2.47), compared to those who did not meet recommended levels. Furthermore, rural adults meeting recommended levels of PA also had a significantly greater HRQOL ability score (51.7 ± 0.23, Mean ± SE), compared to those not meeting recommended levels (48.4 ± 0.33, p meeting recommended levels of PA increases the likelihood of reporting good HRQOL in rural adults. These results should be used to promote the current PA guidelines for improved HRQOL in rural populations.

Mental Health staff views on improving burnout and mental toughness

OpenAIRE

Posner, Zoe; Janssen, Jessica; Roddam, Hazel

2017-01-01

Purpose- Burnout in mental health staff is acknowledged as a major problem. The purpose of this paper is to gain an understanding of mental health staff views on improving burnout and mental toughness in mental health staff.\\ud Design/methodology/approach-Ten participants from two mental health rehabilitation units across the North West of England took part in a Nominal Group Technique (NGT). Participants consisted of mental health workers from varied roles in order to\\ud capture views from a...

Impact of rural health development programme in the Islamic Republic of Iran on rural-urban disparities in health indicators.

Science.gov (United States)

Aghajanian, A; Mehryar, A H; Ahmadnia, S; Kazemipour, S

2007-01-01

By 1979 50 years of uneven development and modernization by governments prior to the Islamic Revolution had left rural parts of the Islamic Republic of Iran with extremely low economic and health status. This paper reports on the impact of the rural health development programme implemented as an effective and inexpensive way to improve the heath of the rural population, especially mothers and children. It describes the system of rural health centres, health houses and community health workers (behvarz) and demonstrates the effectiveness of the programme through declining measures of rural-urban disparities in health indicators. The implications of inexpensive rural health policies for other countries in the region such as Afghanistan and Central Asian countries with a similar sociocultural structure are discussed.

Atopic conditions and mental health problems: a 3-year follow-up study.

Science.gov (United States)

Lien, Lars; Green, Kristian; Thoresen, Magne; Bjertness, Espen

2010-09-01

The aim of this study was to test the hypothesis that atopic conditions at 15/16 years of age affect both internalized and externalized mental health problems 3 years later. Combined school and postal survey was conducted in urban and rural settings. A total of 3,674 adolescents (70.1% response rate) were followed at two time points and interviewed with similar questionnaires at baseline and follow-up. Hopkins Symptoms Checklist (HSCL-10) was used to assess internalized problems, and two subscales (conduct problems and hyperactivity) from the Strength and Difficulties Questionnaire to measure externalized mental health problems. The atopic conditions investigated were asthma, hay fever and eczema by asking the adolescents whether these conditions were present or not. There was an increase in the prevalence of internalized mental health problems from about 17-25% and a decrease in externalized mental health problems and number of atopic conditions in the follow-up period. Of the atopic conditions, hay fever was most prevalent with about 34% at 15 years of age and 20% at 18. The asthma prevalence was at 10 and 5% and eczema at 25 and 10%, respectively. Internalized mental health problems among girls were significantly associated with atopic conditions 3 years earlier, also after controlling for confounding variables. To live with atopic conditions seem to affect the mood and level of anxiety among adolescent girls. This should be kept in mind by health professionals treating young girls with atopic conditions.

Malaysian mental health law.

Science.gov (United States)

Khan, Nusrat N; Yahya, Badi'ah; Abu Bakar, Abd Kadir; Ho, Roger C

2015-05-01

The Malaysian Mental Health Act 2001 did not come into effect until the Mental Health Regulations 2010 came into force. The Act provides a framework for the delivery of comprehensive care, treatment, control, protection and rehabilitation of those with mental disorders. The Act governs the establishment of private and government psychiatric hospitals, psychiatric nursing homes and community mental health centres. This paper outlines the provisions of the Act and the Regulations.

Stigma and Mental Illness: Investigating Attitudes of Mental Health and Non-Mental-Health Professionals and Trainees

Science.gov (United States)

Smith, Allison L.; Cashwell, Craig S.

2010-01-01

The authors explored attitudes toward adults with mental illness. Results suggest that mental health trainees and professionals had less stigmatizing attitudes than did non-mental-health trainees and professionals. Professionals receiving supervision had higher mean scores on the Benevolence subscale than did professionals who were not receiving…

The interplay of rural issues, mental illness, substance use and housing problems.

Science.gov (United States)

Jones, Rebecca; Reupert, Andrea; Sutton, Keith; Maybery, Darryl

2014-12-01

People with mental illness and substance use problems form a significant subgroup of the homeless population. International research has begun to document the complex experiences of this vulnerable group; however, less attention has focused on those living in rural areas. This study sought to determine the experiences of people with mental illness and/or substance use issues, experiencing significant housing problems in rural areas. Within a qualitative framework, individual interviews were conducted with 40 respondents in Australia. Themes generated a discussion around three main areas; (1) current housing problems, (2) pathways into unsuitable housing, and (3) factors contributing to appropriate accommodation. The need for agency staff to identify and assist with the housing issues of their clients is underscored.

Mental health in prisons: A public health agenda.

Science.gov (United States)

Fraser, A

2009-01-01

Mental illness affects the majority of prisoners. Mental health issues are beginning to take a central position in the development of prison health services, reflecting this burden of disease. This change in focus is not before time. But prison mental health services cannot exist in isolation. Public health systems should lead provision of care for patients with acute and severe illness. A whole prison approach to health and, specifically, mental health will offer the greatest likelihood that offenders will thrive, benefit from imprisonment, and lead law-abiding lives after release. Public awareness of the scale and commitment of prisons to mental health and illness, and understanding of prisons' role in society, are necessary developments that would protect and enhance public mental health, as well as creating a healthier and safer society. This article draws on recent reviews, information and statements to set out a public health agenda for mental health in prisons.

Current State of Child Health in Rural America: How Context Shapes Children's Health.

Science.gov (United States)

Probst, Janice C; Barker, Judith C; Enders, Alexandra; Gardiner, Paula

2018-02-01

Children's health is influenced by the context in which they live. We provide a descriptive essay on the status of children in rural America to highlight features of the rural environment that may affect health. We compiled information concerning components of the rural environment that may contribute to health outcomes. Areas addressed include the economic characteristics, provider availability, uniquely rural health risks, health services use, and health outcomes among rural children. Nearly 12 million children live in the rural United States. Rural counties are economically disadvantaged, leading to higher rates of poverty among rural versus urban children. Rural and urban children are approximately equally likely to be insured, but Medicaid insures a higher proportion of children in rural areas. While generally similar in health, rural children are more likely to be overweight or obese than urban children. Rural parents are less likely to report that their children received preventive medical or oral health visits than urban parents. Rural children are more likely to die than their urban peers, largely due to unintentional injury. Improving rural children's health will require both increased public health surveillance and research that creates solutions appropriate for rural environments, where health care professionals may be in short supply. Most importantly, solutions must be multisectoral, engaging education, economic development, and other community perspectives as well as health care. © 2016 National Rural Health Association.

Rural women's health

National Research Council Canada - National Science Library

Thurston, Wilfreda E; Leach, Belinda; Leipert, Beverly

2012-01-01

... about reduction of government funding and access to health care, and about the shortage of new volunteers to replace them when they burn out. These are a few of the stories told in the chapters of this book. This ground-breaking collection of essays identifies priority issues that must be addressed to ensure rural women's well-being, and offers innovative ideas for improvement and further research. Rural women play a critical role within their families and communities, and the health of these wome...

Prevalence of Common Mental Disorders in a Rural District of Kenya, and Socio-Demographic Risk Factors

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David Kiima

2012-05-01

Full Text Available Association between common mental disorders (CMDs, equity, poverty and socio-economic functioning are relatively well explored in high income countries, but there have been fewer studies in low and middle income countries, despite the considerable burden posed by mental disorders, especially in Africa, and their potential impact on development. This paper reports a population-based epidemiological survey of a rural area in Kenya. A random sample of 2% of all adults living in private households in Maseno, Kisumu District of Nyanza Province, Kenya (50,000 population, were studied. The Clinical Interview Schedule-Revised (CIS-R was used to determine the prevalence of common mental disorders (CMDs. Associations with socio-demographic and economic characteristics were explored. A CMD prevalence of 10.8% was found, with no gender difference. Higher rates of illness were found in those who were of older age and those in poor physical health. We conclude that CMDs are common in Kenya and rates are elevated among people who are older, and those in poor health.

National Institute of Mental Health

Science.gov (United States)

... to content Home Health Information Health Information Home Mental Health Information Statistics Consumer Health Publications Help for Mental ... signs and symptoms of depression in men. More Mental Health Services Research Conference Register now for the nation’s ...

"We Are Not Really Marketing Mental Health": Mental Health Advocacy in Zimbabwe.

Directory of Open Access Journals (Sweden)

Reuben Hendler

Full Text Available Few people with mental disorders in low and middle-income countries (LMICs receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs.We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country's mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions.Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy's importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate ("targets", what they advocate for ("asks", how advocates reach their targets ("access", how they make their asks ("arguments", and the results of their advocacy ("outcomes".Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

"We Are Not Really Marketing Mental Health": Mental Health Advocacy in Zimbabwe.

Science.gov (United States)

Hendler, Reuben; Kidia, Khameer; Machando, Debra; Crooks, Megan; Mangezi, Walter; Abas, Melanie; Katz, Craig; Thornicroft, Graham; Semrau, Maya; Jack, Helen

2016-01-01

Few people with mental disorders in low and middle-income countries (LMICs) receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs. We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country's mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions. Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy's importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate ("targets"), what they advocate for ("asks"), how advocates reach their targets ("access"), how they make their asks ("arguments"), and the results of their advocacy ("outcomes"). Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

Mental health in schools and public health

OpenAIRE

Adelman, Howard S; Taylor, Linda

2006-01-01

Health policy and practice call for health and mental health parity and for a greater focus on universal interventions to promote, prevent, and intervene as early after problem onset as is feasible. Those in the public health field are uniquely positioned to help promote the mental health of young people and to reshape how the nation thinks about and addresses mental health. And schools are essential partners for doing the work.

Contradictions In Mental Health: Stigma, Mental Health Literacy And Disclosure (Or Not Of A Mental Disorder Diagnosis.

Directory of Open Access Journals (Sweden)

manuel torres cubeiro

2018-05-01

Full Text Available Mental illnesses affect 25% of any given population. The literacy of human population about mental health doesn’t not much the scientific knowledge available about Mental disorders (MDs. Developed countries invest in mental health less than their 9% of their GDPs. There is a contradiction, or discrepancy, between the incidence of MD in human population and how human societies react about them. This discrepancy has long been evident in the literature of medical sociology. In this article we analyze three medical sociology related concepts that have been coined to understand this contradiction: first, mental health literacy; second, stigma of mental ailments; and finally, the disclosure (or not of the diagnosis of a mental illness. With this article we try to solve short use of these concepts in medical sociology in Spanish.

Role of the police in linking individuals experiencing mental health crises with mental health services

Science.gov (United States)

2012-01-01

Background The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact. Methods Police records were searched for calls regarding individuals with acute mental health needs and police handling of these calls. Mental healthcare contact data were retrieved from a Psychiatric Case Register. Results The police were called upon for mental health crisis situations 492 times within the study year, involving 336 individuals (i.e. 1.7 per 1000 inhabitants per year). Half of these individuals (N=162) were disengaged from mental health services, lacking regular care contact in the year prior to the crisis (apart from contact for crisis intervention). In the month following the crisis, 21% of those who were previously disengaged from services had regular care contact, and this was more frequent (49%) if the police had contacted the mental health services during the crisis. The influence of police referral to the services was still present the following year. However, for the majority (58%) of disengaged individuals police did not contact the mental health services at the time of crisis. Conclusions The police deal with a substantial number of individuals experiencing a mental health crisis, half of whom are out of contact with mental health services, and police play an important role in linking these individuals to services. Training police officers to recognise and handle mental health crises, and implementing practical models of cooperation between the police and mental health services in dealing with such crises may further improve police referral of individuals disengaged from mental health services. PMID:23072687

The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Project: Development and Testing of Electronic Decision Support System and Formative Research to Understand Perceptions about Mental Health in Rural India.

Science.gov (United States)

Maulik, Pallab K; Tewari, Abha; Devarapalli, Siddhardha; Kallakuri, Sudha; Patel, Anushka

2016-01-01

Common mental disorders (CMD) such as depression, suicidal risk and emotional/medically unexplained complaints affect a large number of people in India, but few receive appropriate care. Key reasons for this include few trained mental health professionals and stigma associated with mental health. A potential approach to address poor access to care is by training village healthcare workers in providing basic mental health care, and harnessing India's vast mobile network to support such workers using mobile-based applications. We propose an intervention to implement such an approach that incorporates the use of mobile-based electronic decision support systems (EDSS) to provide mental health services for CMD, combined with a community-based anti-stigma campaign. This will be implemented and evaluated across 42 villages in Andhra Pradesh, a south Indian state. This paper discusses the development and testing of the EDSS, and the formative research that informed the anti-stigma campaign. The development of the EDSS used an iterative process that was validated against clinical diagnosis. A mixed methods approach tested the user acceptability of the EDSS. Focus group discussions and in-depth interviews provided community-level perceptions about mental health. This study involved 3 villages and one primary health centre. The EDSS application was found to be acceptable, but some modifications were needed. The community lacked adequate knowledge about CMD and its treatment and there was stigma associated with mental illness. Faith and traditional healers were considered to be important mental health service providers. A number of barriers and facilitators were identified in implementing the intervention analysed in a framework using Andersen's behavioural model of health services use. The findings assisted with refining the intervention prior to large-scale implementation and evaluation.

The Systematic Medical Appraisal, Referral and Treatment (SMART Mental Health Project: Development and Testing of Electronic Decision Support System and Formative Research to Understand Perceptions about Mental Health in Rural India.

Directory of Open Access Journals (Sweden)

Pallab K Maulik

Full Text Available Common mental disorders (CMD such as depression, suicidal risk and emotional/medically unexplained complaints affect a large number of people in India, but few receive appropriate care. Key reasons for this include few trained mental health professionals and stigma associated with mental health. A potential approach to address poor access to care is by training village healthcare workers in providing basic mental health care, and harnessing India's vast mobile network to support such workers using mobile-based applications. We propose an intervention to implement such an approach that incorporates the use of mobile-based electronic decision support systems (EDSS to provide mental health services for CMD, combined with a community-based anti-stigma campaign. This will be implemented and evaluated across 42 villages in Andhra Pradesh, a south Indian state. This paper discusses the development and testing of the EDSS, and the formative research that informed the anti-stigma campaign.The development of the EDSS used an iterative process that was validated against clinical diagnosis. A mixed methods approach tested the user acceptability of the EDSS. Focus group discussions and in-depth interviews provided community-level perceptions about mental health. This study involved 3 villages and one primary health centre.The EDSS application was found to be acceptable, but some modifications were needed. The community lacked adequate knowledge about CMD and its treatment and there was stigma associated with mental illness. Faith and traditional healers were considered to be important mental health service providers.A number of barriers and facilitators were identified in implementing the intervention analysed in a framework using Andersen's behavioural model of health services use.The findings assisted with refining the intervention prior to large-scale implementation and evaluation.

Public mental health.

Science.gov (United States)

Lindert, Jutta; Bilsen, Johan; Jakubauskiene, Marija

2017-10-01

Public mental health (PMH) is a major challenge for public health research and practice. This article is organized in six parts. First, we will highlight the significance of PMH; second, we will define mental health and mental disorders; third, we identify and describe determinants of mental health and mental disorders on which we worked in the past 10 years since the establishment of the PMH section such as social determinants and violence. Fourth, we will describe the development of the EUPHA PMH section and provide details on vulnerable groups in the field of PMH, on violence as a main determinant and on suicide as an outcome which affects all countries in the European region. Fifth, we describe policy and practice implications of the development of PMH and highlight the European dimension of PMH. We will conclude this article by providing an outlook on potential further development of PMH as regards research and policy and practice. Finally, we hope that the EUPHA PMH section will contribute to public health in the next 25 years and we can contribute to improvement of PMH in Europe. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Survey on the use of mental health services and help-seeking behaviors in a community population in Northwestern China.

Science.gov (United States)

Liu, Li; Chen, Xiao-Li; Ni, Chun-Ping; Yang, Ping; Huang, Yue-Qin; Liu, Zhao-Rui; Wang, Bo; Yan, Yong-Ping

2018-04-01

There is little research into the patterns of mental health services use, related factors, and barriers in help-seeking behaviors among the community population in northwestern China. We conducted a community-based survey among the general population in Xi'an City with the stratified two-stage systematic selection scheme using the World Health Organization Composite International Diagnostic Interview version 3.0 computer-assisted personal interview (CIDI-CAPI 3.0). We interviewed 2447 individuals aged 16 years or older. The lifetime prevalence estimate of mental disorders was 21%. However, the lifetime use rate of mental health services of the 2447 responding subjects was 2.45% and 4.67% among those subjects who reported a mental disorder. Several variables were associated with lower use of mental health services: rural residence and divorced or unmarried. Among the group with mental disorders, 15/21 sought help from non-mental health specialty services such as a general physician (13/21). The high prevalence rate of mental disorders but low rate of mental health services use raises a significant public health issue in northwestern China. Reduction in the resource gap and encouraging people to seek treatment remain a challenge to the mental health services system. Copyright © 2018 Elsevier B.V. All rights reserved.

Common Mental Health Issues

Science.gov (United States)

Stock, Susan R.; Levine, Heidi

2016-01-01

This chapter provides an overview of common student mental health issues and approaches for student affairs practitioners who are working with students with mental illness, and ways to support the overall mental health of students on campus.

The Impact of System Level Factors on Treatment Timeliness: Utilizing the Toyota Production System to Implement Direct Intake Scheduling in a Semi-Rural Community Mental Health Clinic

Science.gov (United States)

Weaver, A.; Greeno, C.G.; Goughler, D.H.; Yarzebinski, K.; Zimmerman, T.; Anderson, C.

2013-01-01

This study examined the effect of using the Toyota Production System (TPS) to change intake procedures on treatment timeliness within a semi-rural community mental health clinic. One hundred randomly selected cases opened the year before the change and one hundred randomly selected cases opened the year after the change were reviewed. An analysis of covariance (ANCOVA) demonstrated that changing intake procedures significantly decreased the number of days consumers waited for appointments (F(1,160)=4.9; p=.03) from an average of 11 days to 8 days. The pattern of difference on treatment timeliness was significantly different between adult and child programs (F(1,160)=4.2; p=.04), with children waiting an average of 4 days longer than adults for appointments. Findings suggest that small system level changes may elicit important changes and that TPS offers a valuable model to improve processes within community mental health settings. Results also indicate that different factors drive adult and children’s treatment timeliness. PMID:23576137

The impact of system level factors on treatment timeliness: utilizing the Toyota Production System to implement direct intake scheduling in a semi-rural community mental health clinic.

Science.gov (United States)

Weaver, Addie; Greeno, Catherine G; Goughler, Donald H; Yarzebinski, Kathleen; Zimmerman, Tina; Anderson, Carol

2013-07-01

This study examined the effect of using the Toyota Production System (TPS) to change intake procedures on treatment timeliness within a semi-rural community mental health clinic. One hundred randomly selected cases opened the year before the change and 100 randomly selected cases opened the year after the change were reviewed. An analysis of covariance demonstrated that changing intake procedures significantly decreased the number of days consumers waited for appointments (F(1,160) = 4.9; p = .03) from an average of 11 to 8 days. The pattern of difference on treatment timeliness was significantly different between adult and child programs (F(1,160) = 4.2; p = .04), with children waiting an average of 4 days longer than adults for appointments. Findings suggest that small system level changes may elicit important changes and that TPS offers a valuable model to improve processes within community mental health settings. Results also indicate that different factors drive adult and children's treatment timeliness.

Acute mental health care and South African mental health legislation

African Journals Online (AJOL)

information on mental health care outcome, to do a cost analysis and to establish a quality assurance cycle that may facilitate a cost ... clinical record reviews of mental health service delivery, training ... (d) describe the demographic and clinical profile of HIV positive ..... accommodate the differentiated but integrated care of.

Holistic Health: Does It Really Include Mental Health?

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Kimberly K. McClanahan

2006-01-01

Full Text Available Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S. over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

Holistic health: does it really include mental health?

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McClanahan, Kimberly K; Huff, Marlene B; Omar, Hatim A

2006-03-14

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

Mental health policy and development in Egypt - integrating mental health into health sector reforms 2001-9

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Siekkonen Inkeri

2010-06-01

Full Text Available Abstract Background Following a situation appraisal in 2001, a six year mental health reform programme (Egymen 2002-7 was initiated by an Egyptian-Finnish bilateral aid project at the request of a former Egyptian minister of health, and the work was incorporated directly into the Ministry of Health and Population from 2007 onwards. This paper describes the aims, methodology and implementation of the mental health reforms and mental health policy in Egypt 2002-2009. Methods A multi-faceted and comprehensive programme which combined situation appraisal to inform planning; establishment of a health sector system for coordination, supervision and training of each level (national, governorate, district and primary care; development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at each level; integration of mental health into health management systems; and dedicated efforts to improve forensic services, rehabilitation services, and child psychiatry services. Results The project has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, mental health masterplan (policy guidelines to accompany the general health policy, updated Egyptian mental health legislation, Code of Practice, adaptation of the WHO primary care guidelines, primary care training, construction of a quality system of roles and responsibilities, availability of medicines at primary care level, public education about mental health, and a research programme to inform future developments. Intersectoral liaison with education, social welfare, police and prisons at national level is underway, but has not yet been established for governorate and district levels, nor mental health training for police, prison staff and teachers. Conclusions The bilateral collaboration programme

Good Mental Health Status of Medical Students: Is There A Role for Physical Activity?

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Deepthi R

2015-01-01

Full Text Available Background: Mental health problems are more commonly seen in youth, more so in medical students. Physical activity though known to improve mental health is difficult to follow among medical students. Aims & Objectives: This study aimed to investigate self-reported levels of anxiety and depression and compare these with self-reported physical activity among medical students in an institution of India. Material & Methods: A Cross sectional study was done among 430 medical students and interns of a medical college of rural Karnataka, India. Hospital Anxiety and Depression Scale (HADS and International Physical Activity Questionnaire (IPAQ were administered to assess mental health status and physical activity levels respectively. Results: The prevalence of anxiety (65.1%, depression (39.5% and anxiety with depression (34.4% was high among medical students. Only 18.1% of students were highly active while 35.9% were inactive when physical activity levels were measured. Students who were highly active and minimally active in physical activity showed lower levels of depression and anxiety compared to low physical activity group. Conclusion: Mental health problems are high and physical activity levels are low among medical undergraduate students. Engagement in physical activity can be an important contributory factor in positive mental health of future doctors.

Children's Mental Health

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... Español (Spanish) Recommend on Facebook Tweet Share Compartir Mental health in childhood means reaching developmental and emotional milestones, ... is doing to improve access to care. Children’s Mental Health: What's New Article: U.S. Children with Diagnosed Anxiety ...

Institutional policy changes aimed at addressing obesity among mental health clients.

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Knol, Linda L; Pritchett, Kelly; Dunkin, Jeri

2010-05-01

People with mental illness often experience unique barriers to healthy eating and physical activity. For these clients, interventions should focus on changes in the immediate environment to change behaviors. The purpose of this project was to implement and evaluate policy changes that would limit calorie intake and increase calorie expenditure of clients receiving mental health services. This intervention was implemented in a rural mental health system in the southeastern United States. Clients live in small group homes, where they are served breakfast, dinner, and a snack, and attend outpatient day treatment programs, where they are served lunch and can purchase snacks from vending machines. This intervention included institutional policy changes that altered menus and vending machine options and implemented group walking programs. Primary outcome measures were changes in clients' weight at 3 and 6 months after policy implementation. At the 3-month follow-up, the median weight loss for overweight/obese clients (n = 45) was 1.4 kg. The 33 overweight/obese clients who were still in the group homes at the 6-month follow-up either maintained or continued to lose weight. Institutional policy changes aimed at improving dietary intake and physical activity levels among clients receiving mental health services can promote weight loss in overweight clients.

Development of Mental Health Indicators in Korea

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Han, Hyeree; Ahn, Dong Hyun; Song, Jinhee; Hwang, Tae Yeon

2012-01-01

Objective Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea. Methods This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries. Results We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders. Conclusion Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation. PMID:23251193

Mental Health, Racism, and Sexism.

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Willie, Charles V., Ed.; And Others

This volume, successor to the 1973 volume "Racism and Mental Health," presents a range of perspectives on mental health, prejudice, and discrimination. Contributors are of multiracial, multiethnic, and gender-diverse backgrounds. They use their existential experiences to analyze pressing mental health and mental illness issues. Contributions…

Experiencing racism in health care: the mental health impacts for Victorian Aboriginal communities.