A public health approach to perinatal mental health: Improving health and wellbeing of mothers and babies

Abstract Background Over recent years there have been several major terror attacks in cities across Europe. These attacks result in deaths, physical injuries, and pose long-term threats to mental health and wellbeing of large populations. Despite this, the mental health and wellbeing impacts of such attacks have been comparatively less examined in academic literature than the acute health response to physical injuries. This paper reflects on Southwark Council’s pioneering public health response to the June 2017 terror attack at London Bridge and Borough Market. It aims to understand the mental health and wellbeing impact of the incident, and evaluate Council led efforts to minimise mental health and wellbeing sequelae following the attack. Methods A rapid qualitative evaluation informed by the logic underpinning Southwark Council’s response was conducted. Nineteen in-depth semi-structured interviews with consenting Southwark Council employees, residents and workers from the London Borough of Southwark affected by the 2017 terror attack were conducted. Seven interviews were with actors involved in developing and delivering the response to ascertain the logic that underpinned it. Twelve interviews were with residents, business owners and council employees to examine the mental health and wellbeing impacts of the attack and the effectiveness of the response. A thematic analysis of transcribed interviews was undertaken. Results When establishing a health and wellbeing response, public health expertise and capacity provides an opportunity to dynamically identify and respond to emerging mental health and wellbeing needs. A comprehensive systematic approach to health needs assessment which draws on knowledge and relationships of key Council workers and community stakeholders is imperative. This improves communication and working relationships between statutory organisations and community stakeholders, and ensures all groups in the community are reached and supported in a manner appropriate for them. It is also critical that mental health needs of Council staff involved in delivering such a response are met. Failure to do this risks extending the negative impacts of such events. Conclusions This article highlights the potential of taking a public health approach in the aftermath of terror attacks. This approach has already influenced the response to the Christchurch mosque shooting in 2019.

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A qualitative evaluation of Southwark Council’s public health approach for mitigating the mental health impact of the 2017 London Bridge and Borough Market terror attack

10.21203/rs.3.rs-27881/v2 ◽

2021 ◽

Author(s):

Sandra Jumbe ◽

Adrienne Milner ◽

Megan Clinch ◽

Jonathan Kennedy ◽

Richard J Pinder ◽

...

Keyword(s):

Public Health ◽

Mental Health ◽

Qualitative Evaluation ◽

Business Owners ◽

Public Health Approach ◽

Health And Wellbeing ◽

Terror Attacks ◽

Physical Injuries ◽

Community Stakeholders ◽

Health Response

Abstract BackgroundOver recent years there have been several major terror attacks in cities across Europe. These attacks result in deaths, physical injuries, and pose long-term threats to mental health and wellbeing of large populations. Although psychologists and psychiatrists have completed important work on mental health responses to disaster exposure including terrorist attacks, the mental health and wellbeing impacts of such attacks have been comparatively less examined in academic literature than the acute health response to physical injuries. This paper reflects on Southwark Council’s pioneering public health response to the June 2017 terror attack at London Bridge and Borough Market. It aims to explore the perceptions of mental health and wellbeing impact of the incident, and evaluate Council led efforts to minimise mental health and wellbeing sequelae following the attack.Methods A rapid qualitative evaluation informed by the logic underpinning Southwark Council’s response was conducted. Nineteen in-depth semi-structured interviews with consenting Southwark Council employees, residents, business owners, and workers from the London Borough of Southwark were conducted. Seven formative interviews were conducted with members of Southwark Council and other individuals directly involved in the planning and/or delivery of the mental health and wellbeing response. Twelve subsequent interviews were then conducted with residents, business owners and council employees to examine the mental health and wellbeing impacts of the attack and the effectiveness of the response. A thematic analysis of transcribed interviews was undertaken. Results The main theme found was that the attack had a wide-reaching negative impact and the main subthemes found that delivering the response was a challenge, that there was multifacted damage botha cross and within communities, and there was limited visibility of the response within the community. As such, when establishing a health and wellbeing response, public health expertise and capacity provides an opportunity to dynamically identify and respond to emerging mental health and wellbeing needs. A comprehensive systematic approach to health needs assessment which draws on knowledge and relationships of key Council workers and community stakeholders is imperative. This improves communication and working relationships between statutory organisations and community stakeholders, and ensures all groups in the community are reached and supported in a manner appropriate for them. It is also critical that mental health needs of Council staff involved in delivering such a response are met. Failure to do this risks extending the negative impacts of such events. Conclusions This article highlights the potential of taking a public health approach in the aftermath of terror attacks. This approach has already influenced the response to the Christchurch mosque shooting in 2019.

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Determinants of positive mental health: a path model

Mental Health Review Journal ◽

10.1108/mhrj-05-2013-0018 ◽

2014 ◽

Vol 19 (1) ◽

pp. 47-60 ◽

Cited By ~ 4

Author(s):

Nima S. Ganga ◽

V. Raman Kutty ◽

Immanuel Thomas

Keyword(s):

Public Health ◽

Mental Health ◽

Latent Variables ◽

Positive Mental Health ◽

Path Model ◽

Primary Data ◽

Outcome Variable ◽

Public Health Approach ◽

Cross Sectional Survey ◽

Content Type

Purpose – A public health approach for promoting mental health has become a major health policy agenda of many governments. Despite this worldwide attention on research addressing population mental health and general wellbeing, very little is heard on positive mental health from the low-and middle-income countries. This paper aims to present an attempt to develop a model of positive mental health among young people. This could be used for integrating the concept of positive mental health (PMH) into public health interventions. Design/methodology/approach – The study was conducted in the state of Kerala, India. The paper administered the “Achutha Menon Centre Positive Mental health Scale” to a sample of 453 (230 men and 223 women) in the age group 18-24, along with an interview schedule exploring the relationship of PMH with many explanatory variables such as sex, beliefs, religion, education, employment and social capital. The paper developed an input path model through a series of multiple regressions explaining the levels of PMH in the community, which was then tested statistically (using AMOS version 7.0). The input model was created by identifying the determinants and correlates of PMH based on their predictive power on the outcome variable, the PMH score. The input diagram was used to test the model fit of the data. Findings – The path model (Figure 1) clearly specified the determinants of PMH. Among them, the variables that have a direct determinant effect on PMH are: quality of home learning environment, employment status, education status, marital status, self-perception on possession of skills, happiness with life, membership in social organizations and socializing capability. Research limitations/implications – In this study, path model is used to confirm relationships among observed and latent variables. The path diagram assesses the comparative strength of the correlations between the variables and does not test the directionality. Or, the model itself cannot prove causation. Practical implications – Determinants of PMH those are amenable to interventions as well as those which help in recognizing characteristic groups for intervention could help to plan future intervention programs. Originality/value – Original paper based on primary data collected through a cross-sectional survey.

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