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A growing body of evidence suggests that experiences of discrimination may affect physical and mental health through multiple pathways. This paper aims to characterize the extent of everyday perceived discrimination among Brazilian and Cape Verdean immigrant adults in Portugal, to identify its forms and analyze its association with mental health.

This study draws on data from the EQUALS4COVID19 (Equity in health in times of pandemic) project that implemented a cross-sectional survey combining online and face-to-face questionnaires for data collection between February and November 2022.

Women were less likely than men to report no discrimination experiences and more likely to report combined bases of discrimination. While Brazilian women were more likely than Cape Verdean counterparts to report gender and nationality-based discrimination, Cape Verdean women and men were more likely to report experiencing race-based discrimination. Gender (being identified as a woman) and length of stay in Portugal were the main predictors of depression, while resilience and perceived social support were protective factors. Participants with higher levels of resilience showed a significantly diminished association between perceived discrimination and depressive symptoms.

This study highlights the need for further research on the interlocking influences of gender, race, nationality and other structures of power, on health and illness to increase our understanding of what would help meet the specific needs of migrants’ mental health and improve equitable health care.

The findings on the multiple and intersectional discrimination perceived by the Brazilian and Cape Verdean populations in Portugal illustrated the ways mental health can be affected by social structures, such as gender and ethnic hierarchies, and can be used to inform the relevance to design and implement programs on combating individual and institutional discrimination and improving the rights of all people.

This chapter introduces the topic of mental health and wellbeing in schools and the overarching theoretical framework for the book. The evolving role of schools from nurturing environments to frontline support for pupils’ mental health and wellbeing is scrutinised in the context of demand, capacity and constraints in a post-pandemic world. Alongside this is a critical consideration of schools’ and education staff’s role, responsibilities and boundaries. The disparate mental health needs of pupils within the school population are discussed, as well as key risk and protective factors to help facilitate timely identification and appropriate support pathways for vulnerable pupils. Key topics and case studies which comprise the remainder of the book are introduced to navigate the reader, and this concludes the chapter.

Poor mental health in men and women is attributable to disparities in physical traits, social roles, power and health-seeking behaviours. This study aims to examine the gender differences in mental health among Pakistan and German university students and focuses on their right to seek mental health care.

Data on depression, anxiety and stress symptoms, as well as positive mental health (PMH), resilience, social support and life satisfaction, were gathered from Pakistani and German students.

In contrast to the Pakistani group, where no such gender differences were seen, women in Germany reported higher degrees of stress, anxiety and depression, as well as a lower level of overall good mental health. In comparison to German men and women, Pakistani women scored equally high on resilience. While gender had no bearing on life happiness in either Pakistan or Germany, women in both countries perceived more social support than men did.

The study’s strengths include its large sample size and battery of mental health measures. The results of partial weak measurement Invariance (MI) on the stress subscale underlined the importance of using MI in cross-cultural studies. The validity of a direct comparisons on sum score between different language versions or country samples shall be cautious. Still, there are limitations. Firstly, the authors did not differentiate gender and biological sex, and there was no group of non-binary gender. Pakistani (N = 1,840) and German (N = 7,890) students were in unequal numbers. Again, only university students were sampled, so the results cannot be generalised to older (probably less educated) populations. Self-reported data that mainly obtained via online survey were the third limitation. This design is cost-effective and easy to administer for cross-cultural survey research. However, social desirability and memory bias are common in self-report inventories. Fourthly, although English is an official language in Pakistan and the medium of instruction in education, the authors recommend future study to use questionnaires that have been translated and validated into Urdu (Pakistan’s national language) and investigate gender differences in a general population. Fifthly, this is a cross-sectional survey; the authors were not able to explore the causality or risk factors that contribute to the poor mental well-being in Pakistan students in general or the relatively worse mental health in German women. Future studies may investigate the mechanism behind the phenomena observed in this study with longitudinal or experimental design. Last but not least, Germany and Pakistan differ in so many different aspects from culture, religions and history to social structure and economic status, which make it hard to claim whether the observed differences were due to national differences, cultural differences, economic differences, gender inequality differences or other effects. It would be helpful for future studies to include more country samples with clear definitions of different “culture” aspects for a better understanding of gender differences in other countries and in different mental well-being constructs.

The current study is the first attempt to compare the gender difference patterns in positive and negative mental health between European and South Asian counties and focuses on gender-specific approaches. Although Pakistani university students reported in general worse mental well-being, the differences between the two genders in mental health (e.g. depression, anxiety, general PMH) were not as pronounced as in the German student sample. Gender comparisons in these mental health constructs would help to improve protective factors against mental illness and to develop appropriate management programmes based on cultural differences. The results suggest that the gender differences found in western countries cannot always be directly translated into the South Asian cultural framework. Our results also highlight the importance of improving the general situation of Pakistan (students) instead of focusing on one gender. At the same time, in Germany, prevention and intervention plans are more warranted for women. It could be that once the general situation in Pakistan is improved, the gender-related differences in mental health will be clearly observed.

These findings imply the significance of cultural context when inferring gender variations in mental health. Moreover, it supports the advancement of comprehensive policies to reduce gender-related mental health inequalities and focuses on the equal rights of men and women to get mental health care.

Organizational scholars studying compensation often place an emphasis on certain employee groups (e.g., executives). Missing from this discussion is research on the compensation systems for low-wage jobs. In this review, the authors argue that workers in low-wage jobs represent a unique employment group in their understanding of rent allocation in organizations. The authors address the design of compensation strategies in organizations that lead to different outcomes for workers in low-wage jobs versus other workers. Drawing on and integrating human resource management (HRM), inequality, and worker literatures with compensation literature, the authors describe and explain compensation systems for low-wage work. The authors start by examining workers in low-wage work to identify aspects of these workers’ jobs and lives that can influence their health, performance, and other organizationally relevant outcomes. Next, the authors explore the compensation systems common for this type of work, building on the compensation literature, by identifying the low-wage work compensation designs, proposing the likely explanations for why organizations craft these designs, and describing the worker and organizational outcomes of these designs. The authors conclude with suggestions for future research in this growing field and explore how organizations may benefit by rethinking their approach to compensation for low-wage work. In sum, the authors hope that this review will be a foundational work for those interested in investigating organizational compensation issues at the intersection of inequality and worker and organizational outcomes.

This final chapter draws together the key findings presented in the preceding pages and considers emergent conclusions and implications for mental health and wellbeing in schools. The author draws upon the evidence presented by the book’s eclectic range of contributors and the health promoting schools’ (HPSs) framework to provide a road map of what an effective whole school approach (WSA) might look like moving forward. Crucially, lessons from recent crises in education, including COVID-19-driven changes in pathways to support, are highlighted as pivotal factors in a future vision which sees schools as an effective and sustainable frontline force to help tackle the global burden of child and adolescent mental health through a proactive, preventive stance. With this future focus in mind, next steps are considered in terms of developing effective and sustainable mental health and wellbeing support for all within healthy school settings.

This study aims to explore how people with concurrent mental health and substance use disorders and lived experience of deep social marginalization perceived barriers and facilitators to mainstream social participation. The purpose of this study is to identify meaningful and relevant learning content for a virtual reality-based intervention to promote social participation in this group.

This formative qualitative study was conducted in Norway during Autumn 2022. Nine in-depth individual interviews with adults recovering from dual diagnosis were conducted, audiotaped, transcribed and analysed using reflexive thematic analysis in a collaborative analysis process.

Results indicated that social alienation, poor social skills, stigma, low self-esteem and social anxiety were key barriers to social participation in this group. This study suggests a need to learn appropriate social behaviour in mainstream society, in addition to better employability skills, civic literacy and health literacy to improve utilization of social opportunities.

This study implies that virtual reality-based interventions for promoting social participation in people with dual diagnosis should primarily focus on learning and practising appropriate social behaviour in shared public spaces before practising advanced social skills such as employability skills in simulated work environments. Learning and practising social skills appears decisive for using more complex social opportunities, such as in education, health, social services and work.

This research provides suggestions for the content of a novel virtual reality-based intervention to promote social participation among people in recovery from dual diagnosis.

This paper aims to highlight the factors influencing the conceptualisation of return on investment (ROI) from healthcare quality improvement (QI) programmes.

In their previous work, the authors found that the concept of ROI from QI is broad and includes numerous internal and external benefits for organisations. In this paper, the authors developed a framework outlining the factors that influence this conceptualisation of QI-ROI from an institutional theory perspective. The framework is based on the synthesis of their serial studies on the determinants of the concept of ROI from QI. The research was performed from 2020–2023 and involved a global multidisciplinary systematic literature review (N = 68), qualitative interviews (N = 16) and a Delphi study (N = 23). The qualitative and Delphi studies were based on the publicly-funded mental healthcare in UK. Participants included board members, clinical and service directors, as well as QI leaders.

The authors outline a framework of internal and external institutional forces that influence the conceptualisation of ROI from QI programmes in mental healthcare and similar organisations. Based on these factors, the authors state several conjectures. In doing this, the authors highlight the ambiguities and uncertainties surrounding QI-ROI conceptualisation. These challenge leaders to balance various monetary and non-monetary benefits for organisations and health systems. This explains the broadness of the QI-ROI concept.

The authors developed a framework highlighting the forces underpinning the broad, ambiguous and sometimes uncertain nature of the QI-ROI concept. They raise awareness about dilemmas to be confronted in developing or applying any tool to evaluate the value for money of QI programmes. Specifically, the work highlights the limitations of the ROI methodology as a primary tool in the QI context and the need for a more comprehensive tool.

The second chapter of this text provides an introduction to policy relating to mental health, addiction and dual diagnosis from three jurisdictions [Ireland, UK and Australia], chosen because of their close links to Irish people and mental health service provision. The chapter begins with an introduction, reflecting on key points raised in Chapter 1 and how they are relevant to this present chapter. A critical exploration of the policies within these three jurisdictional areas is then presented to highlight the strategic direction of mental health and addiction service provision within the three jurisdictions. This includes the acknowledgement that mental health and addiction services need to be integrated as the presence of dual diagnosis in modern society increases at an alarming rate. Finally, this chapter concludes with a link to each of the policies mentioned herein for those who wish to explore these issues further.