Search results

1 – 10 of over 8000
To view the access options for this content please click here
Article
Publication date: 1 June 2007

Bridget Candy, Vicky Cattell, Charlotte Clark and Stephen Stansfeld

Those most socially disadvantaged are at a greater risk of common mental disorder (CMD). The need to evaluate the health impact of social policy interventions that aim to…

Abstract

Those most socially disadvantaged are at a greater risk of common mental disorder (CMD). The need to evaluate the health impact of social policy interventions that aim to reduce social inequalities between the disadvantaged and the better off is well recognised. This paper reports findings from a review to explore evidence on the health impact of UK policy interventions that aim to tackle the key social determinants of CMD. These were previously identified from the literature as cumulative socioeconomic deprivation, unemployment, psychosocial work characteristics, and poor social relationships. We identified some evidence of a positive impact on CMD of urban regeneration schemes, but evidence was sparse on interventions relating to the other determinants. The ability of research to inform policy designed to improve the lives of the disadvantaged could be assisted by a broader definition of what counts as evidence. This may include wider use of qualitative methodologies and a more deliberate focus on social processes known to be implicated in mental health.

Details

Journal of Public Mental Health, vol. 6 no. 2
Type: Research Article
ISSN: 1746-5729

Keywords

To view the access options for this content please click here
Article
Publication date: 29 November 2013

Patrick Larsson

The purpose of this paper is to establish that social determinants are vital contributing factors to mental health difficulties and that, similar to physical health, mental

Abstract

Purpose

The purpose of this paper is to establish that social determinants are vital contributing factors to mental health difficulties and that, similar to physical health, mental health follows a social gradient. Despite this acknowledgement, there is a rhetoric/reality gap found in social determinants of mental health (SDMH). It will be argued in this paper that this rhetoric/reality gap is located on a number of levels, including theoretical, methodological, practical, political and policy based, which are proposed here to be interrelated.

Design/methodology/approach

The approach is a conceptual analysis of the rhetoric/reality gap found in SDMH using a critical perspective. It draws on a wide variety of theories in order to provide an analysis of the issues outlined.

Findings

The paper's central finding is that there is a dissonance between the dominant ontological, epistemological and methodological, or axiomatic, focus in contemporary mental health theory and practice and SDMH. This dissonance has led to a form of “analysis paralysis” on all levels, and the initiatives required to tackle SDMH have been marginalised in favour of a narrow interpretation of evidence-based research and its accompanying ideology centring on the individual, which has established itself as a primary position on what constitutes valid knowledge to the detriment of other views.

Originality/value

The paper offers a critical perspective on an area of SDMH which is often alluded to but never explicitly explored, and questions the underlying assumptions inherent to mental health theory and practice. The paper's value is that it draws attention to this particular dilemma on a wider scale, including on a political and policy-based level, which is often neglected in mental health theory, and it makes some recommendations on how to move forward.

Details

Mental Health Review Journal, vol. 18 no. 4
Type: Research Article
ISSN: 1361-9322

Keywords

To view the access options for this content please click here
Article
Publication date: 30 August 2010

Robin Johnson

This paper is an account of the discussions and recommendations by the exper t advisory panel on potential metrics and ‘sentinel indicators’ for improved outcomes in…

Abstract

This paper is an account of the discussions and recommendations by the exper t advisory panel on potential metrics and ‘sentinel indicators’ for improved outcomes in housing and mental health, as par t of an inter‐agency seminar called to advise on the development of metrics and measures for community mental health, for Fair Society, Healthy Lives: The Marmot Review (Marmot, 2010). The seminar covered all aspects of mental health in both its broadest and narrower senses.Much of the background material for these discussions, therefore, cuts across familiar knowledge silos between the fields of health and housing. Where it is necessary to elucidate the text, references are included to relevant research and policy frameworks that may be unfamiliar to the general reader. This paper is not, however, intended as a general literature review nor is it an evaluation of the available research. A paper on this subject will feature in a future issue of the Journal.1The conclusions from the panel discussion are presented in four main areas, reflecting the need to specify metrics across the wide‐ranging interface between housing and mental health, while still keeping the task manageable. Five current or potential health service metrics were proposed as having par ticular value as signal indicators. Two of these (relating to primary care prevention and public health) have no precision as yet, par tly as new services and approaches are still evolving. Among existing health datasets, the Mental Health Minimum Dataset (MHMDS) (NHS Information Centre, 2009a), SITuation REPor ts (SITREPS) (Department of Health, 2003), and the Summary Care Record data were singled out, though each is thought to need more work to improve the current data categories as well as data collection.One rather more fundamental point made was that the identifying, assessing and encouraging of effective inter‐sector par tnership work will be the key to tackling health inequalities. The use of other, non‐health services data therefore holds great potential for a better recognition both of needs and of outcomes in successful par tnership work, especially where this can be interpreted at local level. These wider comments are elaborated in the context of housing, but may be applicable to all effor ts to evidence and work with the social determinants and the social outcomes of mental health. For the future, a combination of well‐crafted nationally sanctioned metrics and the ‘soft intelligence’ of locally identified meaning may be most effective.Subsequent developments confirm the potential in cross‐sector development work, and indicate the potential for fur ther collaboration via the local performance framework. As policy frameworks continue to evolve rapidly, the ar ticle ends with a Codex, updating the relevant policy frameworks context since the seminar (in Spring 2009) and especially in the context of a new coalition government with aspirations to ar ticulate and promote public health in the context of the local performance framework and the ‘new localism’ agenda. This final section and comments therein are therefore entirely the responsibility of the author.

Details

Journal of Public Mental Health, vol. 9 no. 3
Type: Research Article
ISSN: 1746-5729

Keywords

To view the access options for this content please click here
Article
Publication date: 30 August 2010

Bayard Roberts, Pamela Abbott and Martin McKee

Although it is well recognised that the collapse of the Soviet Union and the subsequent widespread social and economic changes impacted on the levels and distribution of

Abstract

Although it is well recognised that the collapse of the Soviet Union and the subsequent widespread social and economic changes impacted on the levels and distribution of physical health, there is very limited evidence on the social patterning of mental health in the countries that emerged. The aim of this paper is to assess levels of psychological distress and describe its demographic, social and economic correlates in eight former Soviet countries.Cross‐sectional surveys using multi‐stage random sampling were conducted in Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. A standardised questionnaire was used for all countries, including the main outcome for this study of psychological distress, which consisted of 12 items on symptoms of psychological distress. Respondents who repor ted 10‐12 of the symptoms were considered to have a high psychological distress score. Multivariate logistic regression analysis was then used to investigate how demographic, social and economic factors were associated with a high psychological distress score.High psychological distress in seven of the eight countries ranges from 3.8% in Kazakhstan to 10% in Ukraine but was substantially higher (21.7%) in Armenia. Factors associated with psychological distress in the multivariate analysis included: being female; increasing age; incomplete secondary education; being disabled; experiencing two or more stressful events in the past year; lack of trust in people; lack of personal suppor t in crisis; being unemployed; and poor household economic situation.The study contributes evidence on the association of impoverishment and social isolation on psychological distress in countries of the former Soviet Union and highlights the impor tance of exploring ways of improving mental health by addressing its social determinants.

Details

Journal of Public Mental Health, vol. 9 no. 3
Type: Research Article
ISSN: 1746-5729

Keywords

To view the access options for this content please click here
Article
Publication date: 2 February 2021

Viktoriia Gorbunova, Natalia Gusak, Vitalii Klymchuk, Zemfira Kondur, Paliy Valeriia, Viola Popenko and John Oates

The purpose of this study is to characterize the social and cultural context of the social construction of mental health (MH) by members of Romani communities in Ukraine.

Abstract

Purpose

The purpose of this study is to characterize the social and cultural context of the social construction of mental health (MH) by members of Romani communities in Ukraine.

Design/methodology/approach

The research collected qualitative data to gain a better understanding of how Romani communities in Ukraine view the social and cultural factors influencing mental health. This paper analyzes data from focus groups in Romani communities in Ukraine (from six different oblasts) from February to March 2020. A total of 49 persons 19–75 years of age participated in the research, including 17 men and 32 women.

Findings

This study identifies four clusters of perceived social determinants of Romani mental health, these being employment, financial difficulties, level of education and discrimination. The findings indicate specific cultural characteristics of the Romani community that are seen as helping to support mental health. Family values, mutually supporting and referring to other members of the community are seen as especially important. Such social cohesion is believed to have a positive effect on the mental health of members of the Romani community. This paper discusses the implications of the study and suggests possible avenues for future data-driven policymaking in the area of mental health that take account of the culturally-specific meanings of mental health for these communities.

Originality/value

Given the significant gaps, shortages and, in some cases, complete lack of data on Romani ethnic and cross-cultural psychology, research is urgently needed to fill this gap. Lack of understandings of how Romani construct mental health can lead to badly-matched, misplaced or ineffective actions and distrust. This paper aims to support better understandings of Romani among MH service providers and enhancing the mutual engagement of Romani and MH services, supporting the broader agenda of social inclusion of Romani people.

To view the access options for this content please click here
Article
Publication date: 5 March 2014

Nima S. Ganga, V. Raman Kutty and Immanuel Thomas

A public health approach for promoting mental health has become a major health policy agenda of many governments. Despite this worldwide attention on research addressing…

Abstract

Purpose

A public health approach for promoting mental health has become a major health policy agenda of many governments. Despite this worldwide attention on research addressing population mental health and general wellbeing, very little is heard on positive mental health from the low-and middle-income countries. This paper aims to present an attempt to develop a model of positive mental health among young people. This could be used for integrating the concept of positive mental health (PMH) into public health interventions.

Design/methodology/approach

The study was conducted in the state of Kerala, India. The paper administered the “Achutha Menon Centre Positive Mental health Scale” to a sample of 453 (230 men and 223 women) in the age group 18-24, along with an interview schedule exploring the relationship of PMH with many explanatory variables such as sex, beliefs, religion, education, employment and social capital. The paper developed an input path model through a series of multiple regressions explaining the levels of PMH in the community, which was then tested statistically (using AMOS version 7.0). The input model was created by identifying the determinants and correlates of PMH based on their predictive power on the outcome variable, the PMH score. The input diagram was used to test the model fit of the data.

Findings

The path model (Figure 1) clearly specified the determinants of PMH. Among them, the variables that have a direct determinant effect on PMH are: quality of home learning environment, employment status, education status, marital status, self-perception on possession of skills, happiness with life, membership in social organizations and socializing capability.

Research limitations/implications

In this study, path model is used to confirm relationships among observed and latent variables. The path diagram assesses the comparative strength of the correlations between the variables and does not test the directionality. Or, the model itself cannot prove causation.

Practical implications

Determinants of PMH those are amenable to interventions as well as those which help in recognizing characteristic groups for intervention could help to plan future intervention programs.

Originality/value

Original paper based on primary data collected through a cross-sectional survey.

Details

Mental Health Review Journal, vol. 19 no. 1
Type: Research Article
ISSN: 1361-9322

Keywords

To view the access options for this content please click here
Article
Publication date: 23 September 2013

Josephine Pui-Hing Wong, Alan Tai-Wai Li, Maurice Kwong-Lai Poon and Kenneth Po-Lun Fung

Canadian HIV/AIDS researchers, service providers and policy-makers are faced with new challenges of providing effective and inclusive care that meets the needs of the…

Abstract

Purpose

Canadian HIV/AIDS researchers, service providers and policy-makers are faced with new challenges of providing effective and inclusive care that meets the needs of the changing populations infected with and affected by HIV. Since 2005 immigrants and refugees from ethno-racial minority communities have comprised close to 20 percent of all new HIV infections in Canada. Anecdotes shared by PLWHAs and service providers indicated that mental health challenges faced by newcomer PLWHAs was a priority concern for HIV prevention, treatment and care. This paper reports on the results of an exploratory study, which examined the complex factors that influence the mental health of immigrants and refugees living with HIV/AIDS (IR-PLWHAs).

Design/methodology/approach

This exploratory study is informed by a critical social science paradigm, which acknowledges that the everyday reality is shaped by interlocking systems of social processes and unequal power relations. The paper used a qualitative interpretative design and focus groups to explore the intersecting effects of living with HIV/AIDS, migration and settlement, and HIV stigma and discrimination on the mental health of IR-PLWHAs.

Findings

The paper found that in addition to social and economic marginalization, IR-PLWHAs experienced multiple stressors associated with their HIV status: neurocognitive and physical impairments, HIV stigma and discrimination, and fear of deportation. The paper also found that the experiences of stigma and discrimination among IR-PLWHAs were complex and contextual, closely linked to their social positions defined by the intersecting dimensions of race, class, gender, citizenship, sexualities, body norms, and HIV status. The paper concludes that effective HIV prevention, treatment and care, and mental health promotion in newcomer and ethno-racial minority communities must consider the bio-psycho-social connections of different stressors and the interlocking systems of oppression faced by IR-PLWHAs.

Research limitations/implications

This study was exploratory in nature with a small number of participants who were recruited through AIDS organizations in Toronto. Consequently, the recruitment strategy may reach only those who were connected to the AIDS organizations. The paper believes that IR-PLWHAs who were not connected to the AIDS organizations might experience even more social exclusion and marginalization. These factors may limit the transferability of this study.

Originality/value

This is the first study that explores the bio-psycho-social connections and intersecting determinants of mental health among immigrants and refugees living with HIV and AIDS in Canada. The results of this study contribute to cross-sector dialogue among practitioners and researchers in the HIV/AIDS, mental health, and immigration and settlement services sectors.

Details

International Journal of Migration, Health and Social Care, vol. 9 no. 3
Type: Research Article
ISSN: 1747-9894

Keywords

To view the access options for this content please click here
Article
Publication date: 1 March 2007

Lynne Friedli

Abstract

Details

Journal of Public Mental Health, vol. 6 no. 1
Type: Research Article
ISSN: 1746-5729

To view the access options for this content please click here
Article
Publication date: 19 September 2016

Kelsey Lucyk, Kim Gilhuly, Ame-Lia Tamburrini and Bethany Rogerson

Health impact assessment (HIA) is a systematic research and public engagement tool used to elevate health and equity in public policies. However, HIA practitioners often…

Abstract

Purpose

Health impact assessment (HIA) is a systematic research and public engagement tool used to elevate health and equity in public policies. However, HIA practitioners often overlook potential mental health impacts. The purpose of this paper is to review the degree to which mental health is included in HIAs in the USA.

Design/methodology/approach

The authors conducted a systematic review of 156 HIAs that were completed between 1993 and 2013 for their inclusion of mental health. HIAs were subdivided to assess if mental health conditions or their determinants were measured, and if predictions or mitigation strategies were made in the scoping, assessment, or recommendations phases.

Findings

Overall, 73.1 percent of HIAs included mental health. Of the HIAs that included mental health (n=114), 85.1 percent also included the determinants of mental health and 67.6 percent included mental health outcomes. 37.7 percent of HIAs measured baseline mental health conditions and 64.0 percent predicted changes in mental health as the result of implementing the proposed policy, plan, or program. Among the HIAs that made predictions about mental health, 79.5 percent included recommendations for potential changes in mental health, while only 46.6 percent had measured mental health at baseline.

Research limitations/implications

Although many HIAs included mental health in some capacity, this paper quantifies that mental health is not included in a robust way in HIAs in the USA. This presents a difficulty for efforts to address the growing issues of mental health and mental health inequities in the populations.

Originality/value

This paper represents the first academic endeavor to systematically assess the state of the field of HIA for its inclusion of mental health.

Details

Journal of Public Mental Health, vol. 15 no. 3
Type: Research Article
ISSN: 1746-5729

Keywords

To view the access options for this content please click here
Book part
Publication date: 3 November 2005

Anthony Kouzis

To investigate the role of social factors, health status, and psychiatric disorders (DSM-III-R) on mental health services use, we utilized the National Comorbidity Survey…

Abstract

To investigate the role of social factors, health status, and psychiatric disorders (DSM-III-R) on mental health services use, we utilized the National Comorbidity Survey (NCS), a nationally representative household survey (1990–1992) of the US (n=5877). Multivariate logistic regression allowed estimation of the adjusted odds ratios and 95% confidence intervals on the likelihood of visiting the health or the specialty mental/addictive service sectors. Significant determinants included: gender, race, household income, work status, and quality of community-level health care resources. Those with greater socioeconomic resources or comorbid psychiatric disorders were more likely to visit the specialty mental health sector.

Details

Health Care Services, Racial and Ethnic Minorities and Underserved Populations: Patient and Provider Perspectives
Type: Book
ISBN: 978-0-76231-249-8

1 – 10 of over 8000