Search results for: community psychiatric mental health nursing

Authors: Sarah Elshahat, Tina Moffat

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Suboptimal mental health is a considerable global public health challenge that leads to considerable inequalities worldwide. Newcomers are at elevated risk for developing mental health issues as a result of social exclusion, stigmatization, racism, unequal employment opportunities, and discrimination. The problem can be especially serious amongst Arabic-speaking immigrants and refugees (ASIR) whose mental wellness may have already been affected by exposure to political violence, persecution, hunger or war in their countries of origin. A scoping review was conducted to investigate pre- and post-migration mental health determinants amongst ASIR in North America (the U.S. and Canada), who are a rapidly growing population in both regions. Pertinent peer-reviewed papers and grey literature were located through a systematic search of five electronic databases (Medline, Embase, PsycINFO, Anthropology Plus, and Sociology Database). A stakeholder consultation was implemented to validate the analyzed findings of the included 44 studies. About 80% of the studies were carried out in the US, underscoring a lack of Canadian ASIR-mental health research. A gap in qualitative, mixed-method, and longitudinal research was detected, where approximately two-thirds of the studies adopted a cross-sectional method. Pre-migration determinants of mental health were related to the political unrest, violence and armed conflict in the Arab world, increasing post-traumatic stress disorder and psychological distress levels among ASIR. English language illiteracy and generational variations in acculturation patterns were major post-migration mental health triggering factors. Exposure to domestic violence, stigmatization, poverty, racialization, and harassment were significant post-migration mental health determinants that stem from social inequalities, triggering depression, and distress amongst ASIR. Family conflicts linked to child-rearing and gendered norms were considered as both pre- and post-migration mental health triggering factors. Most post-migration mental health protective factors were socio-culturally related and included the maintenance of positive ethnic identity, faith, family support, and community cohesion. Individual resilience, articulated as self-esteem and hope, was a significant negative predictor of depression and psychological distress among ASIR. Community-engaged, mixed-methods, and longitudinal studies are required to address the current gap in mental health research among ASIR in North America. A more thorough determination of potential mental health triggers and protective factors would help inform the development of mental wellness and resilience-promoting programs that are culturally sensitive to ASIR. On the policy level, the Health in All Policies framework of the World Health Organization can be potentially useful for addressing social and health inequalities among ASIR, reducing mental health challenges.

Keywords: depression, post-traumatic stress disorder, psychological distress, resilience

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Authors: Inaam Khalaf, Nadin M. Abdel Razeq, Hamza Alduraidi, Suhaila Halasa, Omayyah S. Nassar, Eman Al-Horani, Jumana Shehadeh, Anna Talal

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Background: Nursing researchers are responsible for generating knowledge that corresponds to national and global research priorities in order to promote, restore, and maintain the health of individuals and societies. The objectives of this scoping review of Jordanian literature are to assess the existing research on pediatric nursing in terms of evolution, authorship and collaborations, funding sources, methodologies, topics of research, and pediatric subjects' age groups so as to identify gaps in research. Methodology: A search was conducted using related keywords obtained from national and international databases. The reviewed literature included pediatric health articles published through December 2019 in English and Arabic, authored by nursing researchers. The investigators assessed the retrieved studies and extracted data using a data-mining checklist. Results: The review included 265 articles authored by Jordanian nursing researchers concerning children's health, published between 1987 and 2019; 95% were published between 2009 and 2019. The most commonly applied research methodology was the descriptive non-experimental method (76%). The main generic topics were health promotion and disease prevention (23%), chronic physical conditions (19%), mental health, behavioral disorders, and forensic issues (16%). Conclusion: The review findings identified a grave shortage of evidence concerning nursing care issues for children below five years of age, especially those between ages two and five years. The research priorities identified in this review resonate with those identified in international reports. Implications: Nursing researchers are encouraged to conduct more research targeting topics of national-level importance in collaboration with clinically involved nurses and international scholars.

Keywords: Jordan, scoping review, children health nursing, pediatric, adolescents

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Authors: Jean Ross

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Rural nursing is not an identified professional identity in the UK, unlike the USA, Canada, and Australia which recognizes rural nursing as a specialty scope of practice. In New Zealand rural nursing is an underrepresented aspect of nursing practice, is misunderstood and does not fit easily within the wider nursing profession and policies governing practice. This study situated within the New Zealand context adds to the international studies’ aligned with rural nursing practice. The study addresses a gap in the literature by striving to identify and strengthen the awareness of and increase rural nurses’ understanding and articulation of their changing and adapting identity and furthermore an opportunity to appreciate their contribution to the delivery of rural health care. In addition, this study adds to the growing global rural nursing knowledge and theoretical base. This research is a continuation of the author’s academic involvement and ongoing relationships with the rural nursing sector, national policy analysts and health care planners since the 1990s. These relationships have led to awareness, that despite rural nurses’ efforts to explain the particular nuances which make up their practice, there has been little recognition by profession to establish rural nursing as a specialty. The research explored why nurses’ who practiced in the rural Otago region of New Zealand, between the 1990s and early 2000s moved away from the traditional identity as a district, practice or public health nurse and looked towards a more appropriate identity which reflected their emerging practice. This qualitative research situated within the interpretive paradigm embeds this retrospective study within the discipline of nursing and engages with the concepts of place and governmentality. National key informant and Otago regional rural nurse interviews generated data and were analyzed using thematic analysis. Stemming from the analyses, an analytical diagrammatic matrix was developed demonstrating rural nursing as a ‘place–based practice’ governed both from within and beyond location presenting how the nurse aligns the self in the rural community as a meaningful provider of health care. Promoting this matrix may encourage a focal discussion point within the international spectrum of nursing and likewise between rural and non-rural nurses which it is hoped will generate further debate in relation to the different nuances aligned with rural nursing practice. Further, insights from this paper may capture key aspects and issues related to identity formation in respect to rural nurses, from the UK, New Zealand, Canada, USA, and Australia.

Keywords: matrix, place, nursing, rural

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Authors: Vinay Kumar, M. Kishor, Sathyanarayana Rao Ts

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Background: Growth of elderly people in the general population in recent years is termed as ‘greying of the world’ where there is a shift from high mortality & fertility to low mortality and fertility, resulting in an increased proportion of older people as seen in India. Improved health care promises longevity but socio-economic factors like poverty, joint families and poor services pose a psychological threat. Epidemiological data regarding the prevalence of mental disorders in geriatric population with physical illness is required for proper health planning. Methods: Sixty consecutive elderly patients aged 60 years or above of both sexes, reporting with physical illness to general outpatient registration counter of JSS Medical College and Hospital, Mysore, India, were considered for the Study. With informed consent, they were screened with General Health Questionnaire (GHQ-12) and were further evaluated for diagnosing mental disorders according to WHO International Classification of Diseases (ICD-10) criteria. Results: Mental disorders were detected in 48.3%, predominantly depressive disorders, nicotine dependence, generalized anxiety disorder, alcohol dependence and least was dementia. Most common physical illness was cardiovascular disease followed by metabolic, respiratory and other diseases. Depressive disorders, substance dependence and dementia were more associated with cardiovascular disease compared to metabolic disease and respiratory diseases were more associated with nicotine dependence. Conclusions: Depression and Substance use disorders among elderly population is of concern, which needs to be further studied with larger population. Psychiatric morbidity will adversely have an impact on physical illness which needs proper assessment and management. This will enhance our understanding and prioritize our planning for future.

Keywords: Geriatric, mental disorders, physical illness, psychiatry

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Authors: Poornima Khadanga, Gaurav Pawar, Madhavi Rairikar

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Background: The COVID 19 pandemic, with its unparalleled mental health repercussions, has impacted people globally and has catalyzed a Mental Health pandemic among the youth. The detrimental effects on mental health needs to be pondered at the earliest. Aims: To study the behavioral problems among children and adolescents visiting Psychiatry Outpatient Department Tertiary Health Care during COVID pandemic and its correlation with socio-demographic profiles. Methods: A cross sectional study was conducted by interviewing 120 participants between 4 to 17 years of age and their parents, visiting Psychiatry OPD. Behavioral problems were assessed using the Strength and Difficulties Questionnaire and diagnosed by DSM-5. Statistical analysis was done by SPSS-21. Results: Male participants showed significant association with conduct (t=2.36, p=0.02) and hyperactive problems (t=5.07, p<0.05). Increase in screen time showed a positive correlation with conduct problems (r=0.22. p=0.02). Attention Deficit Hyperkinetic Disorder (18.3%) was the most commonly diagnosed psychiatric illness. Total difficulty score was significantly associated with difficult temperament (F=68.69, p<0.05). Conclusion: The study brings to light the pattern of behavioral problems that emerged during recent times of uncertainties among the young ones, including those with special needs. The increase in disruptive behaviors with increase screen time needs to be addressed at the earliest.

Keywords: behavioral problems, pandemic, screen time, temperament

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Authors: Alyaa Farouk Abdelfattah Ibrahim, Samah Mohamed, Huda Jrady, Mashail Alrashidi, Alaa Mohammad, Fatimah Alotaibi, Maram Almutiri

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Participation in volunteering was associated with better mental and physical health, self-esteem, and life satisfaction. The main motivator for students in particular is the chance to gain work-related experiences, improve skills, and build on qualifications that may help them achieve their educational goals and further their careers. This study aimed to assess the effect of summer training volunteering practices in healthcare on self-confidence of nursing students in Riyadh. In a crossectional study design, 150 nursing students at King Saud bin Abdul-Aziz University for health sciences in Riyadh were included in the study. Bio-socio-demographic, self-confidence, patients’ care and skills questionnaires were used for data collection. Results: Participants’ age ranged between 20 and 26 years. The majority were from the educational level seven (80%). 40.7 % of them reported volunteering in summer training programs; 70.37% of them volunteered at least once and for a duration of at least one month. Nursing students from level 6 were less likely to have self-confidence in their patients’ care skills than those in level 7. Students who volunteered were more likely to be more interested in becoming social, professional, and independent healthcare workers. There was no difference regarding experience in clinical skills and education by volunteering status. Clinical skills improved by a level of education in this group. Conclusion: Professional self-confidence and clinical performance are related in this group of nursing students. Monitoring, arranging, and encouraging volunteering activities for nursing students are important to help them broaden their interests, their self-confidence in their capabilities, and advancement in their chosen profession. Mostly, volunteering enhanced knowledge in patient safety and quality of care and attempts to secure volunteering opportunities should be a priority on the nursing education agenda.

Keywords: volunteering, health care volunteering, nursing students, summer training

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Authors: Ravan Samadov

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Mentally disabled people are the most discriminated against among other disabled people and face much stronger negative attitudes across many cultures. The most complex and severe form of exclusion of these people is deprivation of liberty on the grounds of their disability. This problem was for many years overlooked to a great extent by the core human rights instruments. However, the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD), adopted in 2006, is considered a potential tool to successfully fill the gap. It is especially vital for the developing countries with the vast majority of disabled people of the world and the CRPD is presumed to be able to trigger drastic positive changes. Article 14 of the mentioned human rights treaty has brought into the international forum a new notion, as prohibits deprivation of liberty on the grounds of disability. It is to be understood as an absolute prohibition of deprivation of liberty on the grounds of disability, including mental disability, which manifests in the form of non-consensual psychiatric hospitalisation. The interpretation by the CRPD Committee indicates that this prohibition well embraces all types of non-consensual psychiatric hospitalisation – whether it is based on illness, impairment or disability. This prohibition also extends to such justifications as ‘dangerousness’, ‘need for treatment’ and ‘diminished capacity’. Moreover, providing due substantive and/or procedural safeguards does not render any legitimacy to application of deprivation of liberty on the grounds of mental disability. Logically, this new prohibition form was to be duly considered by different UN human rights bodies, and was subsequently to bring changes to their practices. However, the analyses of post-CRPD work of those bodies allows for asserting the contrary, as they have continued displaying the position which recognises deprivation of liberty on the grounds of disability to be legitimate. While such a position could be justified in the pre-CRPD time as stemming from the silence of human rights documents about it, the continuation of this course after the CRPD entered into force may call the integrity and coherence of the UN human rights treaty system into question. The non-coherent approaches of different UN bodies to this novelty give grounds for misinterpretation thereof, and hinder its due implementation by the States Parties. The paper will discuss the nature of the mentioned new prohibition and the controversial approaches to that notion by different UN human rights bodies.

Keywords: CRPD, deprivation of liberty, mental disability, non-consensual psychiatric hospitalisation, UN bodies

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Authors: Sarah P. Wuebbolt, Ashlee N. Sawyer-Mays

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Non-medical prescription and other drug (NMPOD) use has been a significant public health issue for the last few decades, with problematic use increasing among university students more recently. The current study focused on associations between NMPOD use and mental health, well-being, and world beliefs among young adults. Young adults (N=513) completed online questionnaires assessing stress, demographic characteristics, self-esteem, NMPOD use, coping mechanisms, and anxiety. A substantial portion of participants reported using cannabis (48.5%, n=249), while smaller portions of participants reported using stimulants (26.7%, n = 137), sedatives (17.2%, n=88), opioids (10.8%, n=55), and hallucinogens (14.4%, n=74). Five hierarchical logistic regressions were performed to determine the independent relationships between mental health, well-being, and world belief factors and NMPOD use for the five classes of substances. After controlling for demographic factors (age, gender, race/ethnicity, sexual orientation, and religious affiliation), depression was associated with increased non-medical stimulant, opioid, and cannabis use; coping self-efficacy was associated with increased hallucinogen use, and attendance of worship services was associated with decreased non-medical cannabis and hallucinogen use. Results suggest that depression was strongly associated with non-medical stimulant, opioid, and cannabis use, and attendance of worship services was protective against cannabis and hallucinogen use. To the best of our knowledge, this is one of the first studies to investigate the relationships between mental health, well-being, world beliefs, and NMPOD use among young adults. The present study illuminates future targets for intervention, such as increased access to mental health diagnosis and treatment and the exploration of the roles of religion and shared community in the prevention of drug use among young adults.

Keywords: cannabis, mental health, non-medical prescription and other drug use, world beliefs

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Authors: Mohsen Shahbakhti

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The aim of this study was to examine the relationship between self-esteem, social support and mental health in a sample of government high school students in Eshtehard city in Alborz Province in Iran. Three hundred and eleven students (boys) were included in this study. All participants completed the General Health Questionnaire (GHQ 12), Multidimensional Scale of Perceived Social Support (MSPSS -12), and Self-Esteem Scale (SS-10). The results revealed that self-esteem was positively associated with social support. Self-esteem and social support negatively associated with psychological distress. Self-esteem and social support to influence on mental health.

Keywords: self-esteem, social support, mental health, high school students

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Authors: Samaneh Abedini, Diana Urajnik, Nicole Naccarato

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A high prevalence of mental health problems was observed in marginalized youth living in underserved regions of Ontario during the COVID-19 pandemic. To address this issue, a growing number of community-based traditional mental health services are offering digital mental health resources due to their accessibility, affordability, and scalability. The feasibility of providing these resources in underserved regions has been examined by researchers rather than by representatives of effective services within a mental health system. Indeed, digitalized mental health contents are not routinely embedded within local mental health organizations' services in Northern Ontario, where they can make a substantial impact. To date, many technology-based mental health initiatives have not been effectively implemented in this region. The obstacles associated with implementing digitalized mental health resources in Northern Ontario may be unique to that region. Thus, specific context-based considerations might need to be applied for developing and implementing digital resources by regional mental health organizations in Northern Ontario. The target population was child-serving organizations situated in northeastern Ontario, specifically within Greater Sudbury and the Sudbury District. A sample of six organizations were selected with representation from the mental health, social, and healthcare sectors. The project supervisor was in a unique position to access the organizations by virtue of existing relationships with the practice and lay communities at large. Thus, recruitment was conducted through professional outreach in partnership with the Center for Rural and Northern Health Research (CRaNHR). Semi-structured interviews were conducted with 1-2 key personnel (e.g., administrator, clinician) from participating organizations. Audio recordings from the semi-structured interviews were transcribed verbatim and thematically analyzed supported by NVivo. Thematic analysis of the data resulted in a total of 13 excerpts which were categorized into two major themes including 1) digital mental health services as a valuable resource for organizations both during and after the pandemic, and 2) barriers and facilitators to a successful implementation of digital mental health resources in northern Ontario. Four secondary themes were identified: 1) perceived barriers to implementation of digital mental health resources to the offered services by mental health agencies; 2) acceptability and feasibility of digital health sources for people living in northern Ontario; 3) data security, safety, and risk; and 4) connecting with clients. The employees of mental health organizations in northern Ontario considered digital mental health resources as generally acceptable to youth. However, they raised several concerns that may affect their implementation into routine practice and service delivery. The implementation of digital systems should be simple and straightforward and should enhance rather than hinder clinical workflows for staff. A clear plan for implementing technological services is also required for the successful adoption of digital systems. For successful adoption and implementation of digital systems, staff views must be considered.

Keywords: COVID-19 pandemic, digital mental health resources, Ontario, underserved

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Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Pedro Henrique Tertuliano Leoni, Carla Aparecida Arena Ventura, Ana Cristina de Oliveira e Silva, Renata Karina Reis

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Context and significance: Resilience is a protective agent for the physical and mental well-being of nursing professionals. Team members are constantly subjected to high levels of work stress that can negatively impact care performance and users of health services. Stress levels have been exacerbated with the COVID-19 pandemic. Objective: The aim of this study was to analyze the resilience of nursing professionals in Brazil during the COVID-19 pandemic. Method: Cross-sectional study with a quantitative approach carried out with professionals from nursing teams from all regions of Brazil. Data collection took place in the first year of the pandemic between October and December 2020. Data were obtained through an online questionnaire posted on social networks. The information collected included the sociodemographic characterization of the nursing professionals and the Brief Resilient Coping Scale was applied. Student's t-test for independent samples and analysis of variance (ANOVA) were used to compare resilience scores with sociodemographic variables. Results: 8,792 nursing professionals participated in the study, 5,767 (65.6%) were nurses, 7,437 (84.6%) were female and 2,643 (30.1%) were from the Northeast region of Brazil, 5,124 (58.8% ) had low levels of resilience. The results showed a statistically significant difference between the resilience score and the variables: professional category (p<0.001); sex (p = 0.003); age range (p<0.001); region of Brazil (p<0.001); marital status (p=0.029) and providing assistance in a field hospital (p<0.001). Conclusion: Participants in this study had, in general, low levels of resilience. There is an urgent need for actions aimed at promoting the psychological health of nursing professionals inserted in pandemic contexts. Descriptors: Psychological Resilience; Nursing professionals; COVID-19; SARSCoV-2.

Keywords: psychological resilience, nursing professionals, COVID-19, SARS-CoV-2

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Authors: Fenni Sim

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Background: The application of systemic family therapy approaches to community health cases have not gathered traction. In National Kidney Foundation, Singapore, the belief is that community support has great potential in helping End Stage Renal Failure (ESRF) patients manage the demands of their treatment regime, whether Hemodialysis (HD) or Peritoneal Dialysis(PD) and sustain them on the treatment. However, the current community support does not include family interventions and is largely nursing based. Although nursing support is well provided to patients, and their family members in issues related to treatment and compliance, complex family issues and dynamics arising from caregiver strain or pre-dialysis relationship strain might deter efforts in managing the challenges of the treatment. Objective: The objective of the study is to understand the potential scope of work provided by a social worker who is trained in systemic family therapy and the effects of these interventions. Methodology: 3 families on HD and 3 families on PD who have been receiving family intervention for the past 6 months would be chosen for the study. A qualitative interview would be conducted to review the effectiveness for the family. Scales such as SCORE-15, PHQ-9, and Zarit Burden were used to measure family functioning, depression, and caregiver’s burden for the families. Results: The research is still in preliminary phase. Conclusion: The study highlights the importance of family intervention for families with multiple stressors on different treatment modalities who might have different needs and challenges. Nursing support needs to be complemented with family-based support to manage complex family issues in order to achieve better health outcomes and improved family coping.

Keywords: complementing nursing support, end stage renal failure, healthcare, systemic approaches

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Authors: Lucksini Raveendran

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Introduction: This mixed-methods study focuses on the experiences of ethnocultural youth and families in Canada, identifying key barriers and opportunities to inform service programming and policies that can better meet their mental health needs during the COVID-19 pandemic and beyond. Methods: Mental Health Commission of Canada's Headstrong initiative administered the youth survey (April – June 2020) and family survey (June – August 2020) with a total sample size of 137 and 481 respondents, respectively. Thematic analysis was conducted to identify key challenges faced, coping strategies used, and help-seeking behaviours. A similar approach was also applied to the family survey data, but instead, a representative sample was collated to analyze geographically variable and ethnically diverse subgroups. Results and analysis: Multiple challenges have impacted families, including increased feelings of loneliness and distress from border travel restrictions, especially among those navigating pregnancy alone or managing children with developmental needs, which is often understudied. Also, marginalized groups were disproportionately affected by inequitable access to communication technologies, further deepening the digital divide. Some reported living in congregated homes with regular conflicts, thus leading to increased anxiety and exposure to violence. For many families, urbanicity and ethnicity played a key role in how families reported coping with feelings of uncertainty while managing work commitments, navigating community resources, fulfilling care responsibilities, and homeschooling children of all ages. Despite these challenges, there was evidence of post-traumatic growth and building community resiliency. Conclusions and implications for policy, practice, or additional research: There is a need to foster opportunities to promote and sustain mental health, wellness, and resilience for families through social connections. Also, intersectionality must be embedded in the collection, analysis, and application of data to improve equitable access to evidence-based and recovery-oriented mental health supports among diverse families in Canada. Lastly, address future research on the long-term COVID-19 impacts of travel border restrictions on family wellness.

Keywords: mental health, youth mental health, family wellness, health equity

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Authors: Deshar Bashu Dev

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In this modern age, most people in developed and developing countries are affected by mental illness. There are many mental illnesses, and their differing symptoms impact peoples’ lives in different ways. These illnesses affect the way people think and feel, as well as how they behave with others. Mental illness results from compound interactions between the mind, body, and environment. New technologies and sciences make the world a better place. These technologies are becoming smarter and are being developed every day to help make daily life easier However, people suffer from mental illness in every part of the world. The philosophy propounded by the Buddha, Buddhism, teaches that all life is connected, from the microcosm to macrocosm. In the 2,500 years that elapsed since the death of the Buddha, his disciples have spread his teachings and developed sophisticated psycho-therapeutic methodologies. We can find many examples in Buddhist texts and in the modern age where Buddhist philosophy modern science could not solve. The Noble Eightfold Path, which is one of the main philosophies of Buddhism; it eradicates hatred and ill will and cultivates good deeds, kindness, and compassion. Buddhism, as a practice of dialectic conversation and mindfulness training, is full of rich therapeutic tools that the mental health community has adopted to help people. Similarly, Buddhist meditation is very necessary; it purifies thoughts and avoids unnecessary thinking. This research aims to study different causes of mental illness; analyzes the different approaches to eradicate mental illness problems and provides conclusions and recommendations present solutions through Buddhism in this modern age.

Keywords: mental illness, Buddhism, mindfulness, Buddhist practices

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Authors: Maria T. Cruz, Scott N. Thompson

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In recent years, Canadian federal and provincial law enforcement organizations have implemented numerous mental health strategies in an attempt to address officers’ mental health and wellness needs. Despite these reforms, however, mental illness continues to persist in these populations. Whereas workplace stressors continue to be factored into the development of mental health initiatives, it is proposed that aspects of masculine culture have been overlooked as contributing to the prevalence of mental illness among Canadian officers. By drawing on Michel Foucault’s theory of discourse, this study was conducted to determine if elements of masculine discourse exist as a socio-cultural barrier for officers seeking mental health assistance. This research supported the above hypothesis, and furthermore, identified how masculine discourse works in competition with mental health-related help-seeking discourses. To answer the research question, semi-structured phone interviews with active and retired male officers from Western provincial and municipal policing organizations, and the Royal Canadian Mounted Police were employed. Through thematic analysis of the transcripts, the data revealed three themes: i) masculinity in law enforcement is a determinant of workplace competency; ii) the dominance of masculine culture in law enforcement is problematic for mental health, and iii) improved help-seeking policies complicate how masculinity is expressed in law enforcement organizations. These findings suggest that within the reviewed Canadian law enforcement organizations, aspects of masculinity act as a socio-cultural barrier to officers seeking mental health services, and that the two conflicting discourses of masculinity and mental health-related help-seeking appear to be in competition with each other.

Keywords: competing discourses, dominant discourses, Foucault’s theory of discourse, law enforcement, masculinity, mental health, police officers

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Authors: Huang Chiung Chiu

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This article is about the nursing experience of assisting an outpatient with premature menopause, osteoporosis and sarcopenia through a multi-discipline care model. The nursing period is from September 22nd, 2020, to December 7th, 2020, collecting data through interviews with the patient, observation, and physical assessment. It was found that the main health problems were insufficient nutrition, less physical need, insomnia, and potentially dangerous falls. As an outpatient nurse, the author observed that in recent years, the age group of women with premature menopause, osteoporosis and sarcopenia had shifted downward. Integrated multi-disciplinary interventions were provided upon the initial diagnosis of osteoporosis and sarcopenia. Under the outpatient care setting, the collaborative team works between the doctors, nutritionists, osteoporosis educators, rehabilitates, physical therapists and other specialized teams were applied to provide individualized, integrated multi-disciplinary care. Through empathy and the establishment of attentive care, companionship and trust, we discussed care plans and treatment guidelines with the case, providing accurate, complete disease information and feedback education to strengthen the patient’s knowledge and motivation for exercise. Nursing guidance regarding the dietary nutrition and adjustment of daily routine was provided to increase the self-care ability, improve the health problems of muscle weakness and insomnia, and prevent falls. For patients with postmenopausal osteoporosis and sarcopenia, it is recommended that the nurses coordinate the multi-discipline integrated care model, adjust patients’ lifestyle and diet, and establish a regular exercise plan so that the cases can be evaluated holistically to improve the quality of care and physical and mental comfort.

Keywords: multi-discipline care model, premature menopause, osteoporosis, sarcopenia, insomnia

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Authors: Soowon Park, Min-Ji Kim, Jun-Young Lee

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Motivation: The stigma of mental illness has been studied in many disciplines, including social psychology, counseling psychology, sociology, psychiatry, public health care, and related areas, because individuals labeled as ‘mentally ill’ are often deprived of their rights and their life opportunities. To understand the factors that deepen the stigma of mental illness, it is important to understand the influencing factors of the stigma. Problem statement: Depression is a common disorder in adults, but the incidence of help-seeking is low. Researchers have believed that this poor help-seeking behavior is related to the stigma of mental illness, which results from low mental health literacy. However, it is uncertain that increasing mental health literacy decreases mental health stigmatization. Furthermore, even though decreasing stigmatization is important, the stigma of mental illness is still a stable and long-lasting phenomenon. Thus, factors other than knowledge about mental disorders have the power to maintain the stigma. Investigating the influencing factors that facilitate the stigma of psychiatric disease could help lower the social stigmatization. Approach: Face-to-face interviews were conducted with a multi-clustering sample. A total of 700 Korean participants (38% male), ranging in age from 18 to 78 (M(SD)age= 48.5(15.7)) answered demographical questions, Korean version of Link’s Perceived Devaluation and Discrimination (PDD) scale for the assessment of social stigmatization against depression, and the Korean version of the WHO-Composite International Diagnostic Interview for the assessment of mental disorders. Multiple-regression was conducted to find the predicting factors of social stigmatization against depression. Ages, sex, years of education, income, living location, and experience of mental illness were used as the predictors. Results: Predictors accounted for 14% of the variance in the stigma of depressive disorders (F(6, 693) = 20.27, p < .001). Among those, only age, years of education, and experience of mental illness significantly predicted social stigmatization against depression. The standardized regression coefficient of age had a negative association with stigmatization (β = -.20, p < .001), but years of education (β = .20, p < .001) and experience of mental illness (β = .08, p < .05) positively predicted depression stigmatization. Conclusions: The present study clearly demonstrates the association between personal factors and depressive disorder stigmatization. Younger age, more education, and self-stigma appeared to increase the stigmatization. Young, highly educated, and mentally ill people tend to reject patients with depressive disorder as friends, teachers, or babysitters; they also tend to think that those patients have lower intelligence and abilities. These results suggest the possibility that people from a high social class, or highly educated people, who have the power to make decisions, help maintain the social stigma against mental illness patients. To increase the awareness that people from high social classes have more stigmatization against depressive disorders will help decrease the biased attitudes against mentally ill patients.

Keywords: depressive disorder stigmatization, age, education, self-stigma

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Authors: Eli Buchbinder

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Introduction. Language is the basis to our experience as human being. We use language in describing our experiences and construct meaning and narratives from experiences. Metaphors are a valuable linguistic tool commonly use. Metaphors link two domains that are ordinarily not related. Metaphors achieve simultaneously multi-level integration: abstract and concrete, rational and imaginative, familiar and the unfamiliar, conscious and preconscious/unconscious. As such, metaphors epistemological and ontological tool that are important in social work in every field and domain. Goals and Methods The presentation’s aim is to validate the value of metaphors through the first psychiatric breakdown is a traumatic for families. The presentation is based on two pooled qualitative studies. The first study focused on 12 spouses: 7 women and 5 men, between the ages of 22 and 57, regarding their experiences and meanings of the first psychiatric hospitalization of their partners diagnosed with affective disorders. The second study focused on 10 parents, between the ages of 47 and 62, regarding their experiences and meanings following their child's first psychotic breakdown during young adulthood. Results Two types of major metaphors evolved from the interviews in farming the trauma of the first mental breakdown. The first mode - orientation (spatial) metaphors, reflect symbolic expression of the loss of a secure base, represented in the physical environment, e.g., describing hospitalization as "falling into an abyss." The second mode- ontological metaphors, reflect how parents and spouses present their traumatic experiences of hospitalization in terms of discrete, powerful and coherent entities, e.g., describing the first hospitalization as "swimming against the tide." The two metaphors modes reflect the embodiment of the unpredictability, being mired in distress, shock, intense pain and the experience the collapse of continuity on the life course and cuts off the experience of control. Conclusions Metaphors are important and powerful guide in assessing individuals and families’ phenomenological reality. As such, metaphors are useful for understanding and orientated therapeutic intervening, in the studies above, with the first psychiatric hospitalization experienced, as well as in others social workers’ interventions.

Keywords: first mental breakdown, metaphors, family perspective, qualitative research

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Authors: Wondale Getinet Alemu, Lillian Mwanri, Clemence Due, Telake Azale, Anna Ziersch

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Background: Mental illness is one of the most severe, chronic, and disabling public health problems that affect patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023. Methods: A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total number of study participants who had a follow-up appointment during the data collection period (2400) by the total sample size of 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the QoL of people with mental illness. The domains and Health-Related Quality of Life (HRQoL) were identified. The indirect and direct effects of variables were calculated using structural equation modeling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance. Results: A total of 636 (99.7%) participants responded and completed the WHOQOL-BREF questionnaire. The mean score of overall HRQoL of people with mental illness in the outpatient clinic was (49.6 ± 10 Sd). The highest QoL was found in the physical health domain (50.67 ±9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41±10 Sd). Rural residents, drug nonadherence, suicidal ideation, not getting counseling, moderate or severe subjective severity, the family does not participate in patient care, and a family history of mental illness had an indirect negative effect on HRQoL. Alcohol use and psychological health domain had a direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having a history of mental illness in the family had both direct and indirect effects on QoL. Furthermore, sociodemographic factors (residence, educational status, marital status), social support-related factors (self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use,) and clinical factors (objective and subjective severity of illness, not getting counseling, suicidal ideation, number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL. Conclusions: In this study, the QoL of people with mental illness was poor, with the psychological health domain being the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors directly and indirectly, affect QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the scourge of mental health, including the development of policy and practice drivers that address the above-identified factors.

Keywords: quality of life, mental wellbeing, mental illness, mental disorder, Ethiopia

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Authors: Ying-Lun Tseng Chiu-Ying Chen

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Taiwan's Mental Health Act was amended at the end of 2022; they added regulations regarding refusing compulsory treatment by patients with mental illnesses. In addition, not only by an examination committee, the judge must also assess the patient's need for compulsory treatment. Additionally, the maximum of compulsory hospitalization has been reduced from an unlimited period to a maximum of 60 days. They aim to promote the healthcare autonomy of individuals with mental illnesses in Taiwan and prevent their silenced voice in medical decision-making while they still possess rationality. Furthermore, they plan to use community support and social care networks to replace the current practice of compulsory treatment in Taiwan. This study uses qualitative research methodology, utilizing interview guidelines to inquire about the experiences of Taiwanese who have undergone compulsory hospitalization, compulsory community treatment, and compulsory medical care. The interviews aimed to explore their feelings when they were subjected to compulsory medical intervention, the inside of their illness, their opinions after treatments, and whether alternative medical interventions proposed by them were considered. Additionally, participants also asked about their personal life history and their support networks in their lives. We collected 12 Taiwanese who had experienced compulsory medical interventions and were interviewed 14 times. The findings indicated that participants still possessed rationality during the onset of their illness. However, when they have other treatments to replace compulsory medical, they sometimes diverge from those of the doctors and their families. Finally, doctors prefer their professional judgment and patients' families' option. Therefore, Taiwanese mental health patients' power of decision-making still needs to improve. Because this research uses qualitative research, so difficult to find participants, and the sample size rate was smaller than Taiwan's population, it may have biases in the analysis. So, Taiwan still has significant progress in enhancing the decision-making rights of participants in the study.

Keywords: medical decision making, compulsory treatment, medical ethics, mental health act

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Authors: Shengdan Yang

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The outbreak of the COVID-19 pandemic in early 2020 has made public health issues to be re-examined. The value of green space configuration is an important measure of community health quality. By combining quantitative and qualitative methods, the structure and function of community green space can be better evaluated. This study selects Wuhan Kunhou Community as the site and proposes to analyze the daily health service function of the community's green infrastructure. Through GIS-based spatial analysis, case study, and field investigation, this study evaluates the accessibility of green infrastructure and discusses the ideal green space form based on health indicators. The findings show that Kunhou Community lacks access to green infrastructure and public space for daily activities. The research findings provide a bridge between public health indicators and community space planning and propose design suggestions for green infrastructure planning.

Keywords: accessibility, community health, GIS, green infrastructure

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Authors: Sh. Khoshemehry, M. E. Bahram, M. J. Pourvaghar

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Sport has found a special place as an effective phenomenon in all societies of the contemporary world. The relationship between physical activity and exercise with different sciences has provided new fields for human study. The range of issues related to exercise and physical education is such that it requires specialized sciences and special studies. In this article, the psychological and social sections of exercise have been investigated for children and adults. It can be used for anyone in different age groups. Exercise and regular physical movements have a great impact on the mental and social health of the individual in addition to body health. It affects the individual's adaptability in society and his/her personality. Exercise affects the treatment of diseases such as depression, anxiety, stress, body image, and memory. Exercise is a safe haven for young people to achieve the optimum human development in its shelter. The effects of sensorimotor skills on mental actions and mental development are such a way that many psychologists and sports science experts believe these activities should be included in training programs in the first place. Familiarity of students and scholars with different programs and methods of sensorimotor activities not only causes their mental actions; but also increases mental health and vitality, enhances self-confidence and, therefore, mental health.

Keywords: anxiety, mental health, physical activity, serotonin

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Authors: Mohammed-Hareef Asunramu, Sana Hashemi, Raja Ohri, Luc Worthington, Nadia Zaman, Junkai Zhu

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Background: The 2012 Health and Social Care Act committed to a ‘parity of esteem between mental and physical health services. Although this investment, aimed to both increase the quality of services and ensure the retention of mental health staff, questions remained regarding its ability to prevent mental health problems. One possible solution is a focus on the social determinants of health which have been shown to impact mental health. Aim: To examine the relationship between the index of multiple deprivations (IMD) and the prevalence of common mental health disorders (CMD) for CCGs in NHS England between 2019 and 2020. Design and setting: Cross-sectional analysis of 189 CCGs in NHS England. Methods: A multivariate linear regression model was utilized with CMD as outcome variable and IMD, age and ethnicity as explanatory variables. Datasets were obtained from Public Health England and the latest UK Census. Results: CCG IMD was found to have a significantly positive relationship with CMD. For every 1-point increase in IMD, CMD increases by 0.25%. Ethnicity had a significantly positive relationship with CMD. For every 1% increase in the population that identifies as BME, there is a 0.03% increase in CMD. Age had a significantly negative relationship with CMD. For every 1% increase in the population aged 60+, there is a 0.11% decrease in CMD. Conclusion: This study demonstrates that addressing mental health issues may require a multi-pronged approach. Beyond budget increases, it is essential to prioritize health equity, with careful considerations towards ethnic minorities and different age brackets.

Keywords: deprivation, health inequality, mental health, social determinants

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Authors: Kay-Anne Haykal, Issack Biyong

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The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: post-traumatic stress disorder, co-morbidities, diagnosis, mental health disorders

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Authors: Billy Zou

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Statement of the Problem: The burden of mental illness and problem behaviors in adolescence has risen worldwide. While less than 50% of teens have access to traditional mental health care, more than 73% have smartphones. Internet-based interventions offer advantages such as cost-effectiveness, availability, and flexibility. Methodology & Theoretical Orientation: A literature review was done using a PubMed search with the words mental health app yielding 2113 results. 103 articles that met inclusion criteria were reviewed, and findings were then described and synthesized. Findings: 1. Computer-based CBT was found to be effective for OCD, depression, social phobia, and panic disorder. 2. Web-based psychoeducation reduced problem behavior and improved parental well-being. 3. There is limited evidence for mobile-phone-based apps, but preliminary results suggest computer-based interventions are transferrable to mobile apps. 4. Adherence to app-based treatment was correlated with impressions about the user interface Conclusion & Significance: There is evidence for the effectiveness of computer-based programs in filling the significant gaps that currently exist in mental health delivery in the United States and internationally. There is also potential and theoretical validity for mobile-based apps to do the same, though more data is needed.

Keywords: children's mental health, mental health app, child and adolecent psychiatry, digital therapy

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Authors: Amanda Kenny, Virginia Dickson-Swift, Jane Farmer, Sarah Larkins, Karen Carlisle, Helen Hickson

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Rural ECOH (Engaging Communities in Oral Health) is a collaborative project that connects policy makers, service providers and community members. The aim of the project is to empower community members to determine what is important for their community and to design the services that they need. This three-year project is currently underway in six rural communities across Australia. This study is specifically focused on Remote Services Futures (RSF), an evidence-based method of community participation that was developed in Scotland. The findings highlight the complexities of community participation in health service planning. We assumed that people living in rural communities would welcome participation in oral health planning and engage with their community to discuss these issues. We found that to understand the relationships between community members and health service providers, it was essential to identify the formal and informal community leaders and to engage stakeholders from the various community governance structures. Our study highlights the sometimes ‘messiness’ of decision making in rural communities as well as ways to ensure that community members have the training and practical skills necessary to participate in community decision making.

Keywords: community participation, health planning, rural ECOH, Remote Services Futures

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Authors: Mohsen Amiri

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This study aimed at investigating the relationship between familial functioning, child characteristics, demographic variables and parenting stress and mental health among parents of children with mental disabilities. 200 parents (130 mothers and 70 fathers) were studied and they completed the Parenting Stress Index, General Health Questionnaire, Family Assessment Device and demographic questionnaires for parents and children. Data were analyzed using correlation and regression analysis. Regression analysis showed that child characteristics, familial functioning and parents demographic factors could predict 8, 4 and 17 percent of variance in parental stress and 3.6, 16 and 10 percent of variance in mental health, respectively. Familial functioning, child characteristics and parental demographic variables correlated with mental health and parental stress and could predict them.

Keywords: parenting stress, mental health, mentally disabled children, familial functioning, demographic variables

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Authors: Jirapan Khruesarn, Wimwipa Boonklin

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Background: Currently, Thailand has an aging population. In 2017, the elderly population was over 11.14 million. There will be an increase in the number of elderly people, 8.39 million, some people grumble to themselves and have conflicts with their offspring or those close to them. It is a source of stress. Mental health promotion should be given to the elderly in order to cope with these changes. Due to the family characteristics of Thai society, these family members will act as caregivers for the elderly. Therefore, a group-counseling program based on Personnel-Centered Theory for Elderly Caregivers in Mental Health Promotion for Older People in Na Kaeo Municipality, Kau Ka District, Lampang Province, has been developed to compare the elderly care behavior before and after the participation. Methods: This research was study for 20 elderly' caregiver: Those aimed to compare the before and after use of group program for caregiver to promoting for the elderly by the following methods: Step 1 Establish a framework for evaluating elderly care behaviors and develop a group counseling program for promote mental health for elderly on: 1) Body 2) Willpower 3) Social and community management and 4) Organizing learning process. Step 2 Assessing an Elderly Care Behaviors by using "The behavior assessment on caring for the elderly" and assessing the mental health power level of the elderly and follow the counseling program 9 times and compare of the elderly care behaviors before and after joined a group program, and compare of mental health level of caregiver attends a group program. Results: This study is developing a group counseling program to promoting for the resilience quotient in elderly people that the results of the study could be summarized as follows: 1) Before the elderly's caregivers join a group counseling program: Mental health promotion behaviors of the elderly were at the high level of (3.32), and after: were at the high level of (3.44). 2) Before the elderly's caregiver attends a group counseling program: the mental health level of the elderly the mean score was (47.85 percent), and the standard deviation was (0.21 percent) and after. The elderly had a higher score of (51.45 percent) In summary, after the elderly caregivers joined the group, the elderly are higher in all aspects promote mental health for elderly and the statistically significance at the 0.05, It shows that programs are fit for personal and community condition in promoting the mental health of the elderly because this theory has the idea that: Humans have the ability to use their intelligence to solve problems or make decisions effectively, And member of group counseling program have ventured and express grievances that the counselor is a facilitator who focuses on personal development by building relationships among people. In other words, the factors contributing to higher levels of elderly care behaviors is group counseling, that isn't a hypothetical process but focus on building relationships that are based on mutual trust and Unconditional acceptance.

Keywords: group counseling base on person-centered theory, elderly person, resilience quotient: RQ, caregiver

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Authors: Patricia Portugal Marques de Carvalho Lourenco

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Money, status, beauty, popularity, widespread public adulation, glitz and glamour portray a perfumed stress-free existence yet not every rock that glitters is a gold nugget and mental disorders are not an exclusivity of middle/low societal classes. Mental illnesses do not discriminate, and behind the superficial visual wealth of the upper-class, there are human beings who experience the ups and downs of life like any other person, except that publicly rather than privately and with an array of fingers pointing at them instead of a mere few. Sammi Cheung, Carina Lau, Fiona Sit, Kara Hui and Louis Cheung are a number of Hong Kong artists that have battled mental disorders, overcame them and used the process to openly discuss the still existing taboo.

Keywords: mental disorders, mental health, public communication, depression, hong kong artists

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Authors: Vered Shenaar-Golan, Nava Wald, Uri Yatzkar

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Background: Parenting children with mental health problems poses multiple challenges, including coping with difficult behavior and negative child emotions. The impact on parents includes financial strain, negative social stigma, and negative feelings of guilt or blame, resulting in significant stress and lower levels of well-being. Given findings that self-compassion plays a significant role in reducing stress and improving well-being, the current study examined the role of self-compassion in the experience of parents raising a child with mental health problems. The study tested (1) whether child behavioral/emotional problem severity is associated with higher parental stress and lower parental well-being; (2) whether self-compassion is associated with lower parental stress and higher parental well-being; and (3) whether self-compassion is a stronger predictor of parental stress and well-being than child behavioral/emotional problem severity. Methods: Three hundred and six mothers and two hundred and fifty-six fathers of children attending a hospital child and adolescent psychiatric center were assessed at admission. Consenting parents completed four questionnaires: Child Strength and Difficulty – parent version, Self-compassion, Parent Feeling Inventory, and Well-Being. Results: Child behavioral/emotional problem severity was associated with higher parental stress and lower parental well-being, and self-compassion was a stronger predictor of parental stress and well-being levels than child behavioral/emotional problem severity. For children with internalizing but not externalizing behavioral/emotional problems, parental self-compassion was the only predictor of parental well-being beyond the severity of child behavioral/emotional problems. Conclusions: Cultivating self-compassion is important in reducing parental stress and increasing parental well-being, particularly with internalizing presentations, and should be considered when designing therapeutic interventions for parents.

Keywords: parenting children with mental health problems, self-compassion, parental stress, feelings, well-being

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