International Journal of Social Psychiatry

This study describes barriers to accessing mental health services among men currently experiencing a mental health concern.

Mental health help-seeking survey data from 778 male respondents who self-reported experiencing a mental health concern were analyzed.

Of these men, 65% (n = 513) wanted treatment and 35% (n = 265) did not want treatment. The most frequently endorsed barriers to mental health treatment were believing that a lot of people feel sad and down (80%; n = 620), not knowing what to look for in a psychotherapist (counselor; 80%; n = 618) and needing to solve one’s own problems (73%; n = 569). Compared with men who wanted help for their mental health concern, those men who did not want help were significantly more likely to be unsure if psychotherapy (counseling) really works or is effective, not tell their physician if they were feeling down or depressed and prefer to solve their own problems.

The high endorsement of both structural (e.g., cost) and attitudinal (e.g., beliefs) barriers by respondents suggests that service delivery must adapt to better respond to dominant masculine ideals while also improving men’s ease of access into a transparent treatment process.

There is a dearth of studies on functioning in patients with psychotic disorders in rural areas.

The objective of this study was to assess functioning in a population-based sample of patients with psychotic disorders who live in rural, remote and deprived areas in Greece, and to explore the differences in functioning across ages.

The sample consisted of 61 patients with psychotic disorders that were engaged to treatment with a community mental health service. The mean age of patients was 54.2 years, and the mean illness duration was 26.5 years.

A total of 23 patients (37.7%) had score in the Global Assessment of Functioning scale >60, and were rated as adequately functioning, and 18 patients (29.5%) had score in Clinical Global Impression scale-Schizophrenia ⩽3 and could be rated as mildly or minimally ill. Functioning was found to be inversely related to the patients’ symptomatology. No correlation with age was found.

This study suggests that a large proportion of patients with psychotic disorders in rural Greece may achieve a satisfactory level of functioning in the long-term, across the whole age range despite the not completely remitted symptomatology. More research is needed to clarify the factors associated with rural residency that may account for patients’ functioning.

Understanding the concept of recovery in severe mental illnesses such as schizophrenia from the social and cultural aspects is important as it will help in developing models of recovery and appropriate interventions. Client and caregiver perspectives on recovery play a significant role in shaping these models and interventions. Hence, the aim of this study was to understand how clients with schizophrenia and their caregivers perceive recovery and to examine the differences between male and female clients with schizophrenia.

A total of 100 clients with schizophrenia and 80 caregivers of clients with schizophrenia were included in the study after written informed consent. A semi-structured proforma was used to collect the sociodemographic profile and illness variables. A questionnaire was developed to assess the indicators of recovery from mental illness and was administered to study participants. Descriptive statistics including frequency and percentages were used along with the chi-square test for analysis.

The most common indicators of recovery for the clients with schizophrenia were absence of symptoms (88%), no relapse (70%) and going back to work (70%), while for the caregivers were absence of symptoms (100%), becoming independent (92.5%) and no relapse (91%). Indicators of recovery were similar between male and female clients with schizophrenia except for the need to stop medication as an indicator of recovery observed significantly more in females (p = .006). Most clients used internal validation of indicators to assess their recovery (79%).

Results indicate that clients and caregivers from India perceive recovery as being symptom free, able to go back to work and being independent. Clients with schizophrenia use internal validation to assess recovery. Gender does not play a role in the perceptions toward recovery in schizophrenia. These results will help in developing models of recovery for severe mental illness in Indian context leading to tailored interventions.

Suicide cases have psychological, socio-economic and cultural aspects, and such cases may have catastrophic impacts in societies due to their outcomes.

This study was aimed to reflect the effect of psychological, behavioral, socio-demographic and economic determinants on suicide.

The Ordinary Least Square (OLS) Regression Analysis was utilized for the purposes of this study. Five models were established. In this contex, the first model includes the variables on psychological determinants; the second model with the variables on behavioral determinants; the third model with the variables on socio-demographic determinants; the fourth model with the variables on economic determinants and finally the fifth model with all of the independent variables.

According to the results, the variables of depression prevalence, alcohol consumption and unemployment rates had statistically significant effect on the suicide cases (p < .05). The study’s outcomes are considered to contribute on the evidence-based policy development process.

Little is known about mental health and resettlement difficulties of Chinese asylum seekers fleeing China due to religious persecutions.

This study explores main post-migration living difficulties (PMLD) in this population, with a focus on their role in post-traumatic stress disorder (PTSD).

A total of 67 patients (95.52% women, mean age 34.75 ± 7.63) were included in the study. The Harvard Trauma Questionnaire (HTQ) was used to assess PTSD, the List of Migration Experiences (LiMEs) was used for pre-migration and post-migration experiences (potentially traumatic events as well as living difficulties). The t-test was used to examine the differences in pre-migration and post-migration mean scores. Logistic regression was used to test the effect of pre-migration traumatic experiences (PMTE) and most frequent PMLD on having a PTSD.

A total of 49 patients scored above the HTQ cut-off score for PTSD. As expected, traumatic experiences were concentrated in the pre-migration phase, while living difficulties were present in both phases but more frequently in the post-migration period. PMTE were significantly related to PTSD (OR 1.29, p = .01). However, three PMLD (‘Feeling that you do not know where you will lend up tomorrow’, ‘Loneliness and boredom’ and ‘Not being able to find work’) showed a significant interaction with PMTE, suggesting that their presence in the post-migration phase has a modulation effect by increasing the likelihood of PTSD.

This study extends to Chinese asylum seekers the previous evidence that PMLD have a significant role in the likelihood to have a PTSD after landing in the host country.

There have been cases of suicide following the Work Capability Assessment (WCA), a questionnaire and interview for those claiming benefits due to ill health or disability in the United Kingdom.

To examine whether experiencing problems with welfare benefits, including WCA, among people with pre-existing mental health conditions was associated with poorer mental health and wellbeing and increased health service use and costs.

A prospective cohort study of an exposed group (n = 42) currently seeking help from a Benefits Advice Service in London and a control group (n = 45) who had recently received advice from the same service. Questionnaires at baseline and 3-, 6- and 12-month follow-ups.

The exposed group had higher mean scores for anxiety (p = .008) and depression (p = .016) at baseline and the control group higher mean scores for wellbeing at baseline (p = .034) and 12 months (p = .035). However, loss to follow-up makes overall results difficult to interpret. The control group had higher incomes throughout the study, particularly at the 12-month follow-up (p = .004), but the differences could have been accounted for by other factors. Health service costs were skewed by a few participants who used day-care services intensively or had inpatient stays. Over the study period the proportion of exposed participants engaged in benefits reassessment ranged from 50% to 88%, and 40% to 76% of controls.

The hardship of living with financial insecurity and a mental health condition made it difficult for our participants to sustain involvement in a 12-month study and the frequency of benefit reviews meant that the experiences of our controls were similar to our exposed group. These limitations limit interpretation but confirm the relevance of our research. The control data raise the question of whether people with mental health conditions are being disproportionately reassessed.

Racial and ethnic minorities (such as Chinese-speaking (CS)) are known to have less equitable access to mental health services than Caucasians. These disparities have a powerful influence on minority groups that already endure a greater burden from mental health needs.

The aim was to identify perceived provider barriers to care for CS patients.

The study involved an 11-item web-based survey to multidisciplinary health professionals in the department of psychiatry at a 75-bed teaching community mental health center.

More than half the respondents agreed that there are disparities in the management of CS versus non-CS patients primarily due to the language barrier (46%). However, older participants and participants who worked fewer hours per week in patient care were less likely to agree (rho = −.27, p = .05 and rho = .33, p = .015, respectively) that these perceived difficulties prevented them from caring for these patients.

The study revealed that certain modifiable factors like the limited availability of interpreters and culturally appropriate services, rendering psychoeducation and forming therapeutic alliances with CS patients, posed the greatest challenges on inpatient units. In light of these findings, we aim to make recommendations to remediate concerns of limited provider availability by proposing ways to efficiently utilize current resources and advocate for better staffing to improve the overall well-being of this challenging patient subset.

User involvement, based on respect and carried out through dialogue, has been shown to lead to increased self-respect, self-confidence and positive identity. In Sweden, the Social Service Act requires that interventions be designed and implemented together with the individual concerned. The basic criterion for social support is prolonged severe mental illness (usually at least 6 months), with no criteria for specific diagnosis or institutional history. The most common form of social support is ‘support in daily living’, a community care intervention for people aged 18 years or older who have their own homes and living arrangements.

This article aims to deepen our understanding of user involvement at the individual level in the provision of an ongoing social work intervention. What elements of user involvement can be found in users’ and support workers’ descriptions of helpful support in daily living?

Qualitative interviews were conducted with 18 users, who had experienced support in daily living as helpful, and 16 interviews with the users’ support workers.

Three major, interconnected themes emerged: Constant dialogue; Framing the flexibility, in relation to formalized intervention plans and regulations; The importance of ‘small things’, decisions concerning daily life.

Both users and support workers described user involvement at the individual, micro-level to be an integral part of helpful support in daily living. It was possible to create a space for dialogue and co-creation in which users were involved in formulating and deciding the contents of their support at an informal level, to influence their own everyday lives. While a formal framework of rules, restrictions and plans surrounds meetings between users and professionals, a facilitating factor may be the absence of too detailed plans and regulations, leaving trust to users and professionals and their capacity to manage most of the choices they have to make.

Perceived justice after man-made disaster bereavement may involve as a protective factor in the recovery process. However, perceived justice related to posttraumatic stress disorder (PTSD) or complicated grief (CG) after disaster bereavement has not been sufficiently discussed in previous studies.

This study aims to assess PTSD and CG in bereaved parents of Sewol disaster and to explore whether perceived justice is related with the diagnostic groups.

Bereaved parents of Sewol disaster (N = 122) were interviewed approximately 2 years after the incident. Structured interviews for PTSD and CG were assessed, and perceived institutional justice surrounding the incident was measured. Symptom groups were identified, and multinomial logistic regression was conducted to find whether perceived justice was related with PTSD or CG.

Participants showed high rates of CG and PTSD, and were classified into the both PTSD and CG group, the CG-only group and the resilient group. The analysis revealed that less perceived justice and being a mother increased the likelihood of having both PTSD and CG. Less perceived justice also showed a tendency to be associated with having CG without PTSD.

Parents bereaved by the Sewol disaster had high PTSD and CG related to lower levels of perceived justice surrounding the post-disaster period. Post-disaster environment seeking justice may facilitate the natural grieving process or encourage access to effective individual interventions.

The present study addressed the effects of child abuse in early adulthood.

The purpose of the study was to determine the direct and indirect effects of child abuse on self-esteem, depression, anxiety and stress levels.

The participants of the study were 636 students (477 females and 159 males) studying at three different state universities in Turkey. Data were collected through ‘Childhood Trauma Questionnaire’, ‘Depression Anxiety Stress Scale (DASS)’, ‘Two-Dimensional Self-Esteem Scale (Self-Liking/Self-Competence)’ and ‘Demographic Information Form’. The obtained data were analyzed with Pearson product-moment correlation coefficient and path analysis techniques via SPSS 23 and AMOS 22.

Considering the relationship between the variables, child abuse was found to be negatively correlated with self-esteem, while it was positively correlated with depression, anxiety and stress. As a result of the path analysis, it was observed that child abuse affected self-esteem directly in the negative way. Throughout the analysis, self-esteem was found to have a direct and negative effect on depression, anxiety and stress, respectively. Child abuse was also found to have an indirect effect on depression, anxiety and stress.

Self-esteem had full mediation effect between child abuse, and depression, anxiety and stress.

Schizophrenia has been described as the most disabling mental disorder, and patients with schizophrenia have been said to be disabled mostly in self-care, occupation, sexual relation and social relationship domains. Previous authors have studied disability among this study population. However, the limitations of these previous works include non-report of the prevalence rates of disability, report on disability limited to only a particular domain of life and the utilization of disability instruments fraught with significant weaknesses.

To determine the prevalence, severity, domains and correlates of disability among outpatients with schizophrenia at the Neuropsychiatric Hospital, Aro, Abeokuta in Ogun State, Nigeria.

It was a cross-sectional study conducted among three hundred consenting adult outpatients with schizophrenia attending the Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State. Each participant was interviewed with the sociodemographic questionnaire, Mini International Neuropsychiatric Interview, Positive and Negative Syndrome Scale (PANSS) and the 36-item World Health Organization Disability Assessment Schedule.

The prevalence of disability was 78% (with 22% having no disability in any of the domains). Most were disabled in the mild to moderate range. Seventy-seven percent (77%) had mild to moderate disability while only 1% had severe disability. Excluding those free of disability, 98.7% of those with disability had mild to moderate form while only 1.3% had severe form. Highest prevalence rates for disability were reported in the ‘participation in society’ and ‘getting along’ domains while the lowest rates were reported in the ‘activities’ (household, work, school) and ‘self-care’ domains. Of all the sociodemographic and clinical variables explored, only the PANSS positive, negative and total scores demonstrated significant relationships with disability.

Consistent with existing literature, disability is very prevalent among patients with schizophrenia and it is associated with higher levels of illness severity. Clinicians have a role in limiting disability by focusing on early and comprehensive treatment approaches.

In China, because of the growth of economically driven rural-to-urban migration, there are lots of children in rural area who are separating or have separation experience with their parents. Until now, few studies focused on solely maternal separation and no research studied whether its pattern will affect children’s later psychological status.

The aim of this study was to determine whether early or late maternal separation affects depression and dysfunctional attitude in middle school students and what is the role of cumulative duration and meeting frequency.

Maternal separation experience was obtained by using questionnaires. We got early maternal separation group first. Then, late maternal separation and control group were obtained with the same number by matching grade, sex and family socioeconomic status. All the students in the three groups completed the scales of Children’s Depression Inventory (CDI) and Dysfunctional Attitude Scale (DAS).

Both CDI and DAS scores of early separation group are higher than the other two groups. When we split the data by sex, only females presented the same results. When cumulative duration is short, there is significant difference in both scores of CDI and DAS among the three groups, which showed the scores of early separation group are higher than the other two groups. When the cumulative duration is long, there is no significant difference among the three groups. When meeting frequency is high, there is no significant difference among the three groups. When it is low, there is significant difference among the three groups, which showed the CDI and DAS scores of early separation group are higher than the other two groups. Furthermore, the same results are also found in females.

Early maternal separation may exert negative influence on student’s depression and dysfunctional attitude. The sex, cumulative duration and meeting frequency may also play important roles in the effect.

To identify, through the conscientious, explicit and judicious use, the evidence about health behaviors and situations included in the decision making on individuals belonging to the lesbian, gay, bisexual and transgender (LGBT) group in the context of ethnic disparities and sexual minorities.

A systematic review with meta-analysis meta-synthesis from searches in electronic databases SCOPUS and Virtual Health Library (VHL), portal that hosts databases such as MEDLINE, using the following descriptors MeSH (Medical Subject Headings): ‘Sexual Minorities’, ‘Health’, ‘African Continental Ancestry Group’ and ‘Brazil’. To achieve safe and reproducible research, the authors decided to gather the descriptors using Boolean operators AND and OR, in the following manner: in the VHL, Sexual Minorities AND Health AND African Continental Ancestry Group OR Brazil; in SCOPUS, Sexual Minorities AND Health AND African Continental Ancestry Group. The selection of articles occurred in two stages.

Of the 52 results found, this study included 14 articles, according to the stages of screening and eligibility criteria. The research carried out proved to be scarce when related to Brazil, so that the review was constructed from studies carried out in international environment.

The scarcity of studies in this area suggested lack of knowledge on the health profiles of the LGBT Afro Population. The individualized attention proved to be insufficient and reveals the need for training health professionals aware of the aspects and health care for this population, with a view to implementing integral health policies that already exist.