Illness Perception and Explanatory Models Involved in Health Services for Addictive Disorders and Dual Disorders in Mexico

Author(s):  
Christian G. Toledo-Lozano ◽  
Elia N. Arganis-Juárez ◽  
Marcela A. Tiburcio-Sainz ◽  
Asunción Álvarez-del-Río ◽  
Ingrid Vargas-Huicochea
1993 ◽  
Vol 17 (4) ◽  
pp. 233-234 ◽  
Author(s):  
Rachel Perkins ◽  
Parimala Moodley

People's beliefs about illness, distress and disability profoundly influence their experience of, and responses to, such problems. Medical anthropologists have long recognised the importance of explanatory models of physical illness and the impact of these on the provision and use of health services. Similarly, psychological models of physical illness and related behaviour stress the importance of the ways in which people conceptualise or understand their difficulties. These are central in determining emotional responses to illness, help-seeking and illness-related behaviours, attitudes towards and compliance with treatment. Eisenbruch (1990) argues that, “the culturally constructed ideas held by the patient about the cause and nature of disease” are as important in relation to mental distress and disturbance. Help-seeking behaviour, attitudes towards and compliance with treatment are of central concern in psychiatry and all of these are influenced by people's understandings of their difficulties. Yet relatively little attention has been paid to the ways in which people conceptualise their mental distress.


1988 ◽  
Vol 3 (2) ◽  
pp. 141-151 ◽  
Author(s):  
AXEL KROEGER ◽  
ALFREDO ZURITA ◽  
CARMEN PEREZ-SAMANIEGO ◽  
HEINRICH BERG

2017 ◽  
Vol 10 (1) ◽  
pp. 68-80 ◽  
Author(s):  
Madeleine Claire Valibhoy ◽  
Josef Szwarc ◽  
Ida Kaplan

Purpose The purpose of this paper is to examine barriers to accessing mental health services, from the perspective of young people of refugee background who have been service users, and to suggest strategies to improve access to mental health services. Design/methodology/approach A qualitative study was conducted with 16 young people (aged 18-25), who had been refugees and who had attended mental health professionals in Australia. Interview transcripts were analysed thematically to examine participants’ perspectives on what hinders initial access to mental health services. Findings Stigma about mental health problems was particularly prominent. Many believed a high level of disturbance was the threshold for entering services, and for some there was no knowledge of such services’ existence. Options for assistance other than mental health services were often preferred, according to young people’s explanatory models. Apprehension was expressed that sessions would be uncomfortable, distressing or ineffective. The desire to be self-reliant functioned as a further barrier. Finally, structural obstacles and social exclusion deterred some young refugees from accessing services. Practical implications Implications include the need for service providers to be equipped to provide culturally sensitive, responsive services that ideally offer both practical and psychological assistance. Potential referrers, including health professionals and community leaders, could facilitate increased access if trained to recognise and address barriers. Finally, findings indicate potential content for awareness-raising initiatives for young refugees about mental health problems and services. Originality/value This paper is original in its sample, method, topic and findings; being drawn from the first known qualitative research exploring views of young mental health service users who have been refugees about barriers to accessing mental health services.


2008 ◽  
Vol 23 (S1) ◽  
pp. s36-s42 ◽  
Author(s):  
S. Penka ◽  
H. Heimann ◽  
A. Heinz ◽  
M. Schouler-Ocak

AbstractIn Germany, the public system of addiction treatment is used less by migrants with addictive disorders than by their non-migrant counterparts. To date, the literature has focused primarily on language, sociocultural factors, and residence status when discussing access barriers to this part of the health care system. However, little attention has been paid to cultural differences in explanatory models of addictive behaviour. This is surprising when we consider the important role played by popular knowledge in a population's perceptions of and responses to illnesses, including their causes, symptoms, and treatment.In the present study, we examined explanatory models of addictive behaviour and of mental disorders in 124 native German und Russian-German youth and compared these models to those observed in an earlier study of 144 German and Turkish youth. We employed the free listing technique German and to compile the terms that participating subjects used to describe addictive behaviour. Subsequently, we examined how a subset of our study population assigned these terms to the respective disorders by means of the pile sort method.Although the explanatory models used by the German and Russian-German youth in our study were surprisingly similar, those employed by Turkish youth did not make any fundamental distinction between illegal and legal drugs (e.g. alcohol and nicotine). German and Russian-German youth regarded eating disorders as “embarrassing” or “disgraceful”, but Turkish youth did not. Unlike our German and Russian-German subjects, the Turkish youth did not classify eating disorders as being addictive in nature. Moreover, medical concepts crucial to a proper understanding of dependence disorders (e.g. the term “physical dependence”) were characterised by almost half of our Turkish subjects as useless in describing addictions.These findings show that it is impossible to translate medical or everyday concepts of disease and treatment properly into a different language without considering the connotations and implications of each term as it relates to the respective culture. Terms that are central to Western medical models of disease may otherwise be misunderstood, misinterpreted, or simply rejected.


PEDIATRICS ◽  
1999 ◽  
Vol 103 (Supplement_1) ◽  
pp. 902-909 ◽  
Author(s):  
Kathi J. Kemper ◽  
Barrie Cassileth ◽  
Timothy Ferris

Increasing numbers of American families seek complementary and alternative medical care (CAM) for their children; at the same time health care organization and financing are undergoing radical changes. The combination of these factors provides a powerful incentive for research on the effectiveness and safety of CAM therapies and their role in treating children. This article describes a rationale, spectrum, priorities, and methodologies for a research agenda in holistic pediatrics. The top priorities are clinical research projects addressing the safety and effectiveness of alternative therapies used for vulnerable children suffering from serious illnesses. Additionally, major research questions involve the impact of the various definitions such as “alternative,” “complementary,” “folk,” “integrative,” and “holistic” medicine on perceptions of health care, professional education, and funding of products and services. Research efforts in alternative therapies need to address explicitly the tremendous heterogeneity between and among the practices, beliefs, and providers of professional and lay services. Qualitative ethnographic research is needed to understand the consequences of diverse explanatory models and meanings of health and illness for patient-provider communication, adherence with professional recommendations, and satisfaction with care. Health services researchers need to address questions related to the epidemiology of CAM practices, health manpower issues, practice characteristics and the process and content of health care and how discoveries about CAM care may enhance the quality of mainstream health services. A rationale is provided for prioritizing certain conditions and therapies within these efforts.


1993 ◽  
Vol 9 (3) ◽  
pp. 283-299 ◽  
Author(s):  
Sarah J. Atkinson

Current crisis in the health sector has increased research directed towards quality of health services. Public health research on quality of services commonly assessed adherence to predefined criteria for building structure, equipment and technical procedures. The paper explores the contribution anthropology can make to health services research by including a lay perspective in quality evaluation. Rapid approaches to the lay perspective assume that conflict between the providers and users of health services result only from the different explanatory models and are thus resolvable through training and education. The holistic approach of anthropology demonstrates that service quality must be located in the wider contexts of health service structure, and the socio-economic circumstances of user's lives as well as differences between medical and lay models of health.


2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697121
Author(s):  
Michael Creed ◽  
Harry Gijbels

BackgroundTo analyse and understand the illness experience of depression in rural Irish males. Secondary objectives are to identify their explanatory models of depression, inform mental health service provision in rural areas, and identify suitable interventions for future research.AimIsolation and rural masculinities are thought to predispose rural Irish males to depression. Despite high levels of depressive symptoms among men in rural areas, lack of awareness and a different language around depression, coupled with stoicism, social isolation, and feminized mental health services, results in reduced help-seeking, under-reporting and under-treatment of depression in this population.MethodA purposive sample, selected through the West Cork and Galway/Roscommon Mental Health Services, and General Practitioners, of fourteen men, aged between 25 and 64 years of age, were interviewed in their homes. Data was collected through face-to-face interviews, using the McGill Illness Narrative Interview schedule. These interviews were recorded, transcribed to text, and analysed using a thematic content analysis. Results were integrated using the model of qualitative description.ResultsMost of the fourteen men reported alcohol and social isolation as precipitating factors of their depression. Suicidal intent and a stubborn attitude were common. Recovery-promoting behaviours included good social and family support, peer-support groups, religious practice and, universally, physical work.ConclusionRural Irish men view their depression as a disconnection from community, masculinity can be engaged in a positive way to improve mental health, and a sense of belonging is key to recovery. Future research should focus on the development of interventions incorporating these findings, such as community farming initiatives.


2006 ◽  
Vol 40 (4) ◽  
pp. 347-354 ◽  
Author(s):  
Zachary Steel ◽  
Robert Mcdonald ◽  
Derrick Silove ◽  
Adrian Bauman ◽  
Phil Sandford ◽  
...  

Objective: To examine the pathways to mental health care followed by patients presenting for the first time to community- and hospital-based services and the degree to which individual characteristics, cultural background, illness type, severity and service-related variables influence the time and pathways taken to reach care. Method: One hundred and forty-six consecutive Australian-born, Asian and Arabicspeaking patients making their first lifetime contact with mental health services in two area health regions were included. Symptom severity was assessed using the Health of the Nations Outcome Scales. Illness explanatory models, social support, English-language proficiency and acculturation were also assessed. Results: An average of three professional consultations were made prior to first contact with public mental health services. Family physicians occupied a pivotal role in the helpseeking pathway with 53% of patients consulting a general practitioner. The median time taken to reach specialist mental health services was 6 months, with significantly shorter time for patients with psychotic disorders. Individual variables such as gender, social support, ethnicity and English flency were not associated with delays in receiving public mental health care. Ethnicity was associated with lower utilization of allied health professionals. Conclusions: The data suggest that social and cultural factors influence the range of professionals consulted by those with a mental illness but do not delay their presentation to public mental health services.


2018 ◽  
Vol 55 (2) ◽  
pp. 153-177 ◽  
Author(s):  
Melissa Taitimu ◽  
John Read ◽  
Tracey McIntosh

This project explored how Māori understand experiences commonly labelled “schizophrenic” or “psychotic”. Semi-structured interviews were conducted with 57 Māori participants who had either personal experiences labelled as “psychosis” or “schizophrenia”, or who work with people with such experiences; including tangata whaiora (users of mental health services), tohunga (traditional healers), kaumatua/kuia (elders), Māori clinicians, cultural support workers and students. Kaupapa Māori Theory and Personal Construct Theory guided the research within a qualitative methodology. The research found that participants held multiple explanatory models for experiences commonly labelled “psychotic” or “schizophrenic”. The predominant explanations were spiritual and cultural. It seems that cultural beliefs and practices related to mental health within Māori communities remain resilient, despite over a century of contact with mainstream education and health services. Other explanations included psychosocial constructions (interpersonal trauma and drug abuse), historical trauma (colonisation) and biomedical constructions (chemical brain imbalance). Participants (both tangata whaiora and health professionals) reported they were apprehensive about sharing their spiritual/cultural constructions within mainstream mental health settings due to fear of being ignored or pathologised. This study highlights the importance of asking users of mental health services about the meaning they place on their experiences and recognising that individuals can hold multiple explanatory models. Māori may hold both Māori and Pākehā (European) ways of understanding their experiences and meaningful recognition should be afforded to both throughout assessment and treatment planning in mental health services. Clinicians need to be aware that important personal and cultural meanings of experiences labelled psychotic may be withheld due to fear of judgement or stigmatisation.


2019 ◽  
Vol 6 (2) ◽  
pp. 129-138
Author(s):  
Arwyn W Nusawakan ◽  
Sanfia Tesabela Messakh ◽  
Sevnat Jambormias

Background: Health is one of the important aspects in human life that will be maintained. The effort to maintain includes the right of decision-making to use health services provided in the community. Data on access to health services and facilities shows low number of visits to these facilities and it arises the question of the reason behind the low number of access. Objective: The purpose is to identify factors affecting the decision-making in the use of health services by the community of Hative Besar Village, Ambon-Maluku. Method: The approach used in this study is qualitative descriptive. Data is collected through semi-structured, in-depth interview. 8 natives of Hative Besar Village, Ambon-Maluku are involved as research participants. Result: Decision making in the use of health services by the community influenced by health-illness perception, professional services and the experience of using health care services are major factors that influence the Hative Besar village perception and later cause the emergence of factors decision in family and the cost. Conclusion: Factors that influence the decision-making by the community of Hative Besar Village in the use of health care facilities are health-illness perception, the experience of using health care services, professional services, decision in family and the cost. Keywords: Health, decision, community, health care


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