Formative Evaluation of Home Visitors' Role in Addressing Poor Mental Health, Domestic Violence, and Substance Abuse Among Low-Income Pregnant and Parenting Women

Objective This descriptive study compares rates of high psychological distress and mental disorders between low-income and non-low-income populations in Canada. Methods Data were collected through the Canadian Community Health Survey – Mental Health and Well-being (CCHS 1.2), which surveyed 36 984 Canadians aged 15 or over; 17.9% (n = 6620) was classified within the low-income population using the Low Income Measure. The K-10 was used to measure psychological distress and the CIDI for assessing mental disorders. Results One out of 5 Canadians reported high psychological distress, and 1 out of 10 reported at least one of the five mental disorders surveyed or substance abuse. Women, single, separated or divorced respondents, non-immigrants and Aboriginal Canadians were more likely to report suffering from psychological distress or from mental disorders and substance abuse. Rates of reported psychological distress and of mental disorders and substance abuse were much higher in low-income populations, and these differences were statistically consistent in most of the sociodemographic strata. Conclusion This study helps determine the vulnerable groups in mental health for which prevention and promotion programs could be designed.

Download Full-text

Intimate Partner Violence

The Canadian Journal of Psychiatry ◽

10.1177/0706743713058006001 ◽

2013 ◽

Vol 58 (6) ◽

pp. E1-E15 ◽

Cited By ~ 27

Author(s):

Donna E Stewart ◽

Harriet MacMillan ◽

Nadine Wathen

Keyword(s):

Mental Health ◽

Substance Abuse ◽

Chronic Pain ◽

Personality Disorders ◽

Mental Health Professionals ◽

Low Income ◽

Well Being ◽

Health Problems ◽

Pain Syndromes ◽

Chronic Pain Syndromes

• IPV is an underrecognized problem that occurs in all countries, cultures, and socioeconomic groups. • IPV has an enormous impact on personal health, and economic and social well-being. • IPV may occur in heterosexual and LGBTQ relationships and may be perpetrated by either sex. • Canadian data from 1999 show about equal proportions of men and women had been victims of physical (seven and eight per cent, respectively) and psychological (18 and 19 per cent, respectively) IPV in the previous five years. • Exposure to IPV has deleterious effects on children and other family members. • Some populations are at greater risk or have special needs for IPV. These include immigrant women, Aboriginal women, LGBTQ communities, people with ALs, pregnant women, dating adolescents, older people, alcohol and other substance abusing people, low-income people, and those without a current partner (that is, IPV perpetrated by a former partner). • Mental health problems associated with IPV include depression, anxiety disorders, chronic pain syndromes, eating disorders, sleep disorders, psychosomatic disorders, alcohol and other substance abuse, suicidal and self-harm behaviours, nonaffective psychosis, some personality disorders, and harmful health behaviours, such as risk taking and smoking. As IPV is a major determinant of mental health, it is of vital importance to mental health professionals. • Physical health problems associated with IPV include death, a broad range of injuries, reproductive disorders, gastrointestinal disorders, chronic pain syndromes, fibromyalgia, poor physical functioning, and lower health-related quality of life. Sexually transmitted diseases, unwanted pregnancies and physical inactivity are also increased. • Children's exposure to IPV may have short- and long-term health impacts on the child, especially mental health effects. • Perpetrators of IPV most frequently have personality disorders, but substance abuse and other types of mental illness or brain dysfunction may also occur.

Download Full-text

Mental and self-rated health of bakery workers in Lebanon: A national study

SAGE Open Medicine ◽

10.1177/2050312120962345 ◽

2020 ◽

Vol 8 ◽

pp. 205031212096234

Author(s):

Rima R Habib ◽

Nataly W El-Haddad ◽

Kareem Elzein ◽

Safa Hojeij

Keyword(s):

Mental Health ◽

Chronic Illness ◽

Occupational Health ◽

Musculoskeletal Pain ◽

Low Income ◽

Health Workers ◽

Poor Mental Health ◽

National Study ◽

Socioeconomic Indicators ◽

Self Rated Health

Objectives: The relationship between poverty and health has been well addressed in public health research. The health effects of social and economic inequalities on working groups have also drawn the attention of occupational health scholars. Research addressing workers in low-paying jobs showed increased risks for poor health. This research examined the psychosocial factors associated with poor mental health and self-rated health among low-income bakery workers performing demanding tasks. Methods: Face-to-face interviews in 504 randomly selected bakeries in Lebanon provided data on socio-demographics, perception of the workplace environment, job security, job satisfaction, general health, and mental health. Results: In total, 16.5% of bakery workers reported poor self-rated health, and 45% reported poor mental health. Workers with a chronic illness were almost three times more likely to report poor self-rated health (OR = 2.86; 95% CI = 1.44–5.67), and those with musculoskeletal pain reported poor self-rated health five times as often (OR = 5.34; 95% CI = 2.9–9.80). Those with a chronic illness and musculoskeletal pain were twice as likely to report poor mental health (OR = 1.94; 95% CI = 1.07–3.50 and OR = 2.07; 95% CI = 1.32–3.23, respectively); and those dissatisfied with their job reported poorer self-rated health (OR = 2.18; 95% CI = 1.12–4.23) and mental health (OR = 2.57; 95% CI = 1.54–4.26). In addition, workers reporting job insecurity had poor mental health twice as often (OR = 1.93; 95% CI = 1.24–2.99). Low socioeconomic indicators showed a gradient association with both poor self-rated health and mental health. Conclusion: Reporting job dissatisfaction and insecurity, musculoskeletal pain, and chronic illness were associated with poor mental and self-rated health among bakery workers. Interventions to improve the working conditions of bakery workers are timely and essential. This research provided evidence for policy to guide occupational health practice and safeguard the health of bakery workers.

Download Full-text

Exploring the relationship between housing concerns, mental health and wellbeing: a qualitative study of social housing tenants

Journal of Public Health ◽

10.1093/pubmed/fdz076 ◽

2019 ◽

Vol 42 (3) ◽

pp. e231-e238 ◽

Cited By ~ 1

Author(s):

Eleanor Holding ◽

Lindsay Blank ◽

Mary Crowder ◽

Edward Ferrari ◽

Elizabeth Goyder

Keyword(s):

Mental Health ◽

Low Income ◽

Social Housing ◽

Mental Health Problems ◽

Poor Mental Health ◽

Housing Quality ◽

Community Safety ◽

Public Health Issue ◽

Health And Wellbeing ◽

The Impact

Abstract Background The rising prevalence of mental health problems is a growing public health issue. Poor mental health is not equally distributed across social groups and is associated with poverty and insecure housing. An evaluation of a social housing intervention provided an opportunity to explore the connections between housing and wider determinants of health and wellbeing. Methods We undertook 44 interviews with social housing tenants over a two-year period to explore their views on housing, health and wellbeing. Results Poor mental health was common. The results suggest that perceptions of housing quality, service responsiveness, community safety, benefit changes and low income all have a detrimental effect on tenants’ mental health. Conclusions Social housing providers who wish to have a positive impact on the mental health of their tenants need to consider how to best support or mitigate the impact of these stresses. Addressing traditional housing officer functions such as reporting or monitoring home repairs alongside holistic support remains an important area where social housing departments can have substantial health impact. Tackling the complex nature of mental health requires a joined up approach between housing and a number of services.

Download Full-text

Comparing the Effectiveness of Clinicians and Paraprofessionals to Reduce Disparities in Perinatal Depression via the Mothers and Babies Course: Protocol for a Cluster-Randomized Controlled Trial (Preprint)

10.2196/preprints.11624 ◽

2018 ◽

Author(s):

Jessica K Jensen ◽

Jody D Ciolino ◽

Alicia Diebold ◽

Melissa Segovia ◽

Aria Degillio ◽

...

Keyword(s):

Mental Health ◽

United States ◽

Postpartum Depression ◽

Low Income ◽

Health Professionals ◽

Group Intervention ◽

Cluster Randomized Trial ◽

The United States ◽

Home Visitors ◽

Cluster Randomized

BACKGROUND Postpartum depression is highly prevalent in low-income women and has significant health and mental health effects on mother and child. Home visiting (HV) programs provide services to large numbers of perinatal women in the United States and are a logical setting for delivering mental health services. Although there are interventions that reduce the risk of developing postpartum depression among low-income women, none have used nonhealth or nonmental health professionals as interventionists. OBJECTIVE This study aimed to outline the protocol of a cluster randomized trial funded by the Patient-Centered Outcomes Research Institute that evaluates whether the Mothers and Babies (MB) group intervention, when led by paraprofessional home visitors, is more efficacious than usual care. It will also examine if MB, when led by home visitors, is not inferior to MB delivered by mental health professionals (MHPs). MB has previously demonstrated efficacy when delivered by MHPs, and pilot work indicated promising results using home visitors to deliver the intervention. METHODS A cluster randomized trial is being conducted with 38 HV programs. Sixteen HV programs will deliver MB using MHPs, 16 will deliver MB using paraprofessional home visitors, and 6 will deliver usual HV services. The study employs a modified covariate-constrained randomization design at the site level. We anticipate recruiting 933 women aged ≥16 years enrolled in HV programs, who are 33 or more weeks’ gestation and speak either English or Spanish. Women in the 2 intervention arms will receive the 6-session MB group intervention. Baseline, postintervention, 12-week postpartum, and 24-week postpartum assessments will be conducted to assess client outcomes. The primary outcome will be the change in Quick Inventory of Depressive Symptomatology Self-Report 16 scores from baseline to 24-week follow-up. Secondary outcomes associated with core MB content will also be examined. Semistructured interviews will be conducted with home visitors and MHPs who are group facilitators and 90 study participants to gain data on intervention successes and challenges. Analyses will proceed at the participant level. Primary analyses for depressive symptoms score at 24 weeks postpartum will involve a linear mixed model, controlling for baseline symptoms and other covariates, and random effects to account for clustering. RESULTS We have recruited 838 women through the end of August 2018. Recruitment will be completed at the end of September 2018. CONCLUSIONS There is considerable potential to disseminate MB to HV programs throughout the United States. Should our results demonstrate home visitor efficacy when compared with usual care and/ noninferiority between home visitors and MHPs in improving mental health outcomes, no additional financial resources would be required for the existing HV staff to implement MB. Should this study determine that home visitors are less effective than MHPs, we will generate more wide-scale evidence on MB effectiveness when led by MHPs. CLINICALTRIAL ClinicalTrials.gov NCT02979444; https://clinicaltrials.gov/ct2/show/NCT02979444 (Archived by Webcite at http://www.webcitation.org/archive.php) INTERNATIONAL REGISTERED REPOR PRR1-10.2196/11624

Download Full-text

Not Enough Money and Too Many Thoughts: Exploring Perceptions of Mental Health in Two Ugandan Districts Through the Mental Health Literacy Framework

Qualitative Health Research ◽

10.1177/1049732320986164 ◽

2021 ◽

pp. 104973232098616

Author(s):

Amanda P. Miller ◽

Leo Ziegel ◽

Stephen Mugamba ◽

Emmanuel Kyasanku ◽

Jennifer A. Wagman ◽

...

Keyword(s):

Mental Health ◽

Health Literacy ◽

Low Income ◽

Mental Health Literacy ◽

Health Resources ◽

Poor Mental Health ◽

Care Seeking ◽

Care Seeking Behavior ◽

Qualitative Work ◽

Literacy Framework

Mental health disorders account for a heavy disease burden in Uganda. In order to provide culturally appropriate mental health prevention and treatment approaches, it is necessary to understand how mental health is conceptualized in the population. Three focus group discussions (FGDs) and 31 in-depth interviews (IDIs) were conducted with men and women aged 14 to 62 years residing in rural, urban, and semi-urban low-income communities in central and western Uganda to explore perceptions and knowledge of mental health. Interpretive thematic analysis was undertaken; results were organized through the lens of the mental health literacy framework. Environmental and societal stressors were identified as primary underlying causes of poor mental health. While participants recognized symptoms of poor mental health, gaps in mental health literacy also emerged. Mental health resources are needed in this setting and additional qualitative work assessing knowledge and attitudes toward mental health care seeking behavior can inform the development of acceptable integrated services.

Download Full-text

Impact of Changed Use of Greenspace during COVID-19 Pandemic on Depression and Anxiety

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115842 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5842

Author(s):

Seulkee Heo ◽

Miraj U. Desai ◽

Sarah R. Lowe ◽

Michelle L. Bell

Keyword(s):

Mental Health ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Low Income ◽

Online Survey ◽

Psychological Symptoms ◽

Poor Mental Health ◽

Generalized Anxiety ◽

Patient Health ◽

Financial Issues

The COVID-19 pandemic has had devastating consequences for health, social, and economic domains, but what has received far less focus is the effect on people’s relationship to vital ecological supports, including access to greenspace. We assessed patterns of greenspace use in relation to individual and environmental factors and their relationship with experiencing psychological symptoms under the pandemic. We conducted an online survey recruiting participants from social media for adults in Korea for September–December 2020. The survey collected data on demographics, patterns of using greenspace during the pandemic, and major depression (MD) and generalized anxiety disorder (GAD) symptoms. The Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 2-item (GAD-2) were applied to identify probable cases of MD and GAD. A logistic regression model assessed the association decreased visits to greenspace after the outbreak compared to 2019 and probable MD and GAD. Among the 322 survey participants, prevalence of probable MD and GAD were 19.3% and 14.9%, respectively. High rates of probable MD (23.3%) and GAD (19.4%) were found among persons currently having job-related and financial issues. Of the total participants, 64.9% reported decreased visits to greenspace after the COVID-19 outbreak. Persons with decreased visits to greenspace had 2.06 higher odds (95% CI: 0.91, 4.67, significant at p < 0.10) of probable MD at the time of the survey than persons whose visits to greenspace increased or did not change. Decreased visits to greenspace were not significantly associated with GAD (OR = 1.45, 95% CI: 0.63, 3.34). Findings suggest that barriers to greenspace use could deprive people of mental health benefits and affect mental health during pandemic; an alternative explanation is that those experiencing poor mental health may be less likely to visit greenspaces during pandemic. This implies the need of adequate interventions on greenspace uses under an outbreak especially focusing on how low-income populations may be more adversely affected by a pandemic and its policy responses.

Download Full-text

Food insecurity, low dietary diversity, and poor mental health among Syrian refugee mothers living in vulnerable areas of Greater Beirut, Lebanon

British Journal Of Nutrition ◽

10.1017/s0007114521004724 ◽

2021 ◽

pp. 1-47

Author(s):

Joana Abou-Rizk ◽

Theresa Jeremias ◽

Georgiana Cocuz ◽

Lara Nasreddine ◽

Lamis Jomaa ◽

...

Keyword(s):

Mental Health ◽

Health Status ◽

Nutritional Status ◽

Food Insecurity ◽

Low Income ◽

Dietary Diversity ◽

Poor Mental Health ◽

Mental Health Status ◽

Reproductive Age ◽

Syrian Refugee

Abstract Syrian refugees in Lebanon are facing vulnerabilities that are affecting their food insecurity levels. The objectives of this study were to measure dietary diversity, food insecurity (FI), and mental health status of Syrian refugee mothers in Lebanon and to explore its associations with their anemia and nutritional status. A cross-sectional study was conducted among mothers with children under 5 years (n=433) in Greater Beirut, Lebanon. Dietary diversity was measured using the Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) and FI using the global Food Insecurity Experience Scale (FIES) at the individual level. Depression and post-traumatic stress disorder (PTSD) were measured to assess the maternal mental health status. Data on socio-economic characteristics, anthropometric measurements, and hemoglobin concentrations were collected. Overall, 63.3% of the mothers had a low dietary diversity (LDD) and 34.4% were moderately to severely food insecure, with 12.5% being severely food insecure. The prevalence of PTSD, moderate depression, and severe depression were 13.2%, 11.1%, and 9.9%, respectively. A significant correlation was found between LDD and FI (P<0.001). A low-income was significantly associated with LDD and FI. Poor mental health was significantly associated with FI. LDD and FI were not associated with anemia and nutritional status of mothers. Low-income households had significantly higher intakes of grains and refined starchy staples, whereas high-income households consumed more nutritious foods and sweets. Evidence of inadequate diet quality, FI, and poor mental health among Syrian refugee mothers in Lebanon are presented. Multifaceted actions are needed to reduce FI and improve dietary diversity.

Download Full-text