The development of the Short Explanatory Model Interview (SEMI) and its use among primary-care attenders with common mental disorders

1998 ◽  
Vol 28 (5) ◽  
pp. 1231-1237 ◽  
Author(s):  
K. R. LLOYD ◽  
K. S. JACOB ◽  
V. PATEL ◽  
L. St. LOUIS ◽  
D. BHUGRA ◽  
...  
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Help Seeking ◽  
Common Mental Disorders ◽  
Field Work ◽  
Field Studies ◽  
Epidemiological Studies ◽  
Explanatory Models ◽  
African Caribbean ◽  
Help Seeking Behaviour

Background. Recent anthropological studies have documented the importance of understanding the relation of culture to the experience of mental illness. The use of interviews that elicit explanatory models has facilitated such research, but currently available interviews are lengthy and impractical for epidemiological studies. This paper is a preliminary report on the development of a brief instrument to elicit explanatory models for use in field work.Method. The development of the SEMI, a short interview to elicit explanatory models is described. The interview explores the subject's cultural background, nature of presenting problem, help-seeking behaviour, interaction with physician/healer and beliefs related to mental illness.Results. The SEMI was employed to study the explanatory models of subjects with common mental disorders among Whites, African-Caribbean and Asians living in London and was also used in Harare, Zimbabwe. Data from its use in four different ethnic groups is presented with the aim of demonstrating its capacity to show up differences in these varied settings.Conclusions. The simplicity and brevity of the SEMI allow for its use in field studies in different cultures, data can be used to provide variables for use in quantitative analysis and provide qualitative descriptions.

Qualitative Analysis of Cultural Formulation Interview: Findings and Implications for Revising the Outline for Cultural Formulation

2019 ◽  
Vol 57 (4) ◽  
pp. 525-541 ◽  
Author(s):  
Vasudeo P. Paralikar ◽  
Ankita Deshmukh ◽  
Mitchell G. Weiss
Keyword(s):  
Mental Disorders ◽  
Qualitative Analysis ◽  
Help Seeking ◽  
Common Mental Disorders ◽  
Explanatory Models ◽  
Dimensional Structure ◽  
Cultural Formulation ◽  
Dsm 5 ◽  
The Impact ◽  
Cultural Formulation Interview

The DSM-IV Outline for Cultural Formulation (OCF) was a framework for assessment based on principles of cultural psychiatry. The Cultural Formulation Interview (CFI) for DSM-5 provided a tool enabling wider use of cultural formulation in clinical cultural assessment. Validation to justify the inclusion of the CFI in DSM-5 involved quantitative analysis of debriefing interviews of patients and clinicians for feasibility, acceptability and clinical utility. We now further examine qualitative field trial data from the CFI interviews and the debriefing interviews in Pune, India. Administration of the CFI was followed by routine diagnostic assessment of 36 psychiatric outpatients—11 found to have severe mental disorders (SMD) and 25 with common mental disorders (CMD). Domain-wise thematic analyses of the CFI and debriefing interviews identified recurrent themes based on cultural identity, illness explanatory models, stressful and supportive social relationships, and the impact of political, economic, and cultural contexts. A tendency to elaborate accounts, rather than simply name their problem, and more diverse past help-seeking distinguished CMD from SMD groups. Patients valued the CFI more than clinicians did, and most patients did not consider cultural background differences of clinician-patient relationships to be relevant. Qualitative analysis of CFI data and critical analysis of domain mapping of CFI content to the structure of OCF domains indicated the value of revising the dimensional structure of the OCF. A proposed revision (OCF-R) is expected to better facilitate clinical use and research on cultural formulation and use of the CFI.

Clients and carers perception of mental illness and factors that influence help-seeking: Where they go first and why

2017 ◽  
Vol 63 (5) ◽  
pp. 418-425 ◽  
Author(s):  
Harris K Chilale ◽  
Ndumanene Devlin Silungwe ◽  
Saulos Gondwe ◽  
Charles Masulani-Mwale
Keyword(s):  
Health Care ◽  
Mental Illness ◽  
Health Care Providers ◽  
Help Seeking ◽  
Spirit Possession ◽  
Explanatory Models ◽  
Hospital Treatment ◽  
Care Providers ◽  
Care Giving ◽  
Help Seeking Behaviour

Objective: In Northern Malawi, the duration of untreated psychosis (DUP) is longer than that in high-income countries. The reasons for the delay in help-seeking are not known, although studies show multiple reasons. This research was conducted to establish health care help-seeking behaviours and identify barriers that exist between service users and health care providers. The study also intended to establish the beliefs that clients and family members have regarding the causes of mental illness which profoundly shape help-seeking, care giving process and outcomes. Methodology: The study employed the exploratory phenomenological method, utilizing focus group discussions (FGDs) in the sampled population. The Health Belief Model and Disease Explanatory Models were conveniently chosen a priori by researchers to develop guide questions to explore clients’ and carers’ perceptions of the illness and their health care help-seeking behaviours. Results: Results show a bio-psycho-social inclination of disease causation and help-seeking behaviour. Causes of mental illness are understood in three categories, namely: physical/biological, psychological and socio-cultural. The majority of participants attributed mental illness to socio-cultural factors, with witchcraft, spirit possession and curses as main determinants. Causal perceptions also influenced help-seeking pathways. Many participants reported consulting traditional healers first, for diagnosis and to know who was responsible. Conclusion: In this study, it has been found that help-seeking is influenced by the understanding of the source of the illness – which has a bio-psychosocial inclination. The socio-cultural explanation of witchcraft and spirit possession is dominant and a determinant of help-seeking behaviour. While participants noted benefits to hospital treatment, barriers and bio-psychosocial in nature were also noted. Guardians and not clients hold the key to choice of treatment modality and therefore a potential ally in all treatment interventions promotive, preventive and curative. There is need for strengthening of a bio-psychosocial intervention model in the treatment of mental illness.

Stigma and its impact on help-seeking for mental disorders: what do we know?

2008 ◽  
Vol 17 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Georg Schomerus ◽  
Matthias C. Angermeyer
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Help Seeking ◽  
Public Attitudes ◽  
Population Based ◽  
Professional Help ◽  
Promising Target ◽  
Individual Discrimination ◽  
Stigma Of Mental Illness ◽  
Seeking Help

SummaryAims – Many people suffering from serious mental illness do not seek appropriate medical help. The stigma of mental illness has often been considered a potential cause for reluctance in seeking help. We review recent evidence on this topic. Methods – Narrative review of the recent literature on stigma and helpseeking for psychiatric disorders. Results – There is proof of a particular stigma attached to seeking help for a mental problem. Anticipated individual discrimination and discrimination qua self-stigmatisation are associated with a reduced readiness to seek professional help for mental disorders. Intervention studies show that destigmatisation may lead to increased readiness to seek professional help, but other aspects like knowledge about mental diseases seem to be at least as important. The belief that seeking help for a mental health problem is actually helpful has been shown to be at the core of help-seeking intentions and thus offers a promising target for information programmes. Population based time-trend studies show that public attitudes towards help-seeking have improved over the last decade. Discussion – The relationship between help-seeking intentions and actual help-seeking needs further exploration. While many studies have been able to relate attitudes to intentions, predicting actual help-seeking has proved more difficult.Declaration of Interest: None.

scholarly journals Associations between common mental disorders and the Mental Illness Needs Index in community settings

2007 ◽  
Vol 191 (2) ◽  
pp. 158-163 ◽  
Author(s):  
David L. Fone ◽  
Frank Dunstan ◽  
Ann John ◽  
Keith Lloyd
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Small Area ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Service Planning ◽  
Individual Risk ◽  
Community Settings

BackgroundThe relationship between the Mental Illness Needs Index (MINI) and the common mental disorders is not known.AimsTo investigate associations between the small-area MINI score and common mental disorder at individual level.MethodMental health status was measured using the Mental Health Inventory of the Short Form 36 instrument (SF-36). Data from the Caerphilly Health and Social Needs population survey were analysed in multilevel models of 10 653 individuals aged 18–74 years nested within the 2001 UK census geographies of 110 lower super output areas and 33 wards.ResultsThe MINI score was significantly associated with common mental disorder after adjusting for individual risk factors. This association was stronger at the smaller spatial scale of the lower super output area and for individuals who were permanently sick or disabled.ConclusionsThe MINI is potentially useful for small-area needs assessment and service planning for common mental disorder in community settings.

scholarly journals Help Seeking Behaviour of Chinese Living in Belfast, Northern Ireland

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
Y.-W. Yeung
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Northern Ireland ◽  
Help Seeking ◽  
Psychological Problem ◽  
Mental Illness Stigma ◽  
Covering Letter ◽  
Language Difficulty ◽  
Help Seeking Behaviour ◽  
Chinese And English

Aims:British Chinese have a low uptake of mental health servcies. Poor symptom recognition, language difficulty and mental illness stigma are the key barriers to accessing services. This study aims to explore their help seeking behaviours when they experience mental illness.Methods:About 96% of Chinese in Northern Ireland worked in catering business. Questionnaires (both in Chinese and English) were sent to ninety-one addresses occupied by catering businesses in Belfast. A bilingual covering letter was enclosed to encourage recipients to ask their families and friends to return the questionnaires.Results:Twenty-four questionnaires were returned. 66.6% reported that they visited their GP within the year prior to the study. Only one person visited the GP becasue of a mental / psychological problem. All others visited their GP for their physical illness. Racism (58.3%), physical ill health (50%) and lack of social support (41.7%) were the key stressors. 21% would visit their GP if they had a mental health problem and 45.8% would contact the GP if someone they knew became mentally unwell. Poor recognition of mental illness (41.7%) and mental illness stigma (25%) were the reasons for not seeking medical advice.Conclusion:Findings revealed that the Chinese do seek help from their GP. However, little evidence suggests that the community will approach their GP when they or someone they know actually become mentally unwell. Further investigation is needed to explore diifferent ways to provide information about mental illness symptoms and mental health services for the community.

A Study of Patient's Perspective of Schizophrenia Using Emic Perspective

2017 ◽  
Vol 41 (S1) ◽  
pp. s249-s249
Author(s):  
D. Sanyal ◽  
D. Das
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Help Seeking ◽  
Cultural Perspective ◽  
Faith Healer ◽  
Mental Health Specialist ◽  
Health Specialist ◽  
Help Seeking Behaviour ◽  
Competing Interest ◽  
Emic Perspective

IntroductionKnowledge about how patients perceive mental illness and how it possibly influences help seeking behaviour is important in development of proper plan for mental health reform.ObjectiveThis study planned to study disease related perception, first help seeking behaviour and stigma among schizophrenia patients admitted at a hospital.Aims(1) To know about patient's view regarding the problems; (2) attempt to predict help seeking behaviour.MethodsFifty-one patients suffering from schizophrenia according to DSM-5 and fit to be interviewed were assessed using EMIC (Explanatory Model Interview Catalogue) to get emic (insider or person's own cultural) perspective of disease related perception, help seeking behaviour and stigma.ResultsTerms used to describe their illness included “depression” (21.6%), “mental” (17.6%) “matha kharap” (9.8%). Most common perceived cause was stress (25.5%) and sorcery (23.5). Mental health specialist was visited by 27.5% Faith healer consultation was high (29.4%). Stigma score was higher with marriage related issues and social isolation. Using exhaustive CHAID analysis, it was found that patients with negative themes as disease name like “matha kharap” (loosely meaning crazy) are more likely to visit faith healers, while patients naming the condition with some medical related term like depression were more likely to visit mental health specialist.ConclusionClearly perception of patients regarding mental illness and its causation varies greatly from the way psychiatrists’ viewpoint and this perception is likely to influence help seeking behaviour. Understanding these issues is likely to enable better patient awareness and proper formulation of plans to address mental health issues.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Value Orientations and Mental Health: A Theoretical Review

2019 ◽  
Vol 56 (3) ◽  
pp. 449-470 ◽  
Author(s):  
Eva Heim ◽  
Andreas Maercker ◽  
Diana Boer
Keyword(s):  
Mental Disorders ◽  
Cultural Values ◽  
Cultural Context ◽  
Common Mental Disorders ◽  
Personal Values ◽  
Epidemiological Studies ◽  
Value Theory ◽  
Value Orientations ◽  
Cultural Groups ◽  
The Relationship

Cross-national epidemiological studies show that prevalence rates of common mental disorders (i.e. depression, anxiety disorders, and PTSD) vary considerably between countries, suggesting cultural differences. In order to gather evidence on how culture relates to the aetiology and phenomenology of mental disorders, finding meaningful empirical instruments for capturing the latent (i.e. non-visible) construct of ‘culture’ is vital. In this review, we suggest using value orientations for this purpose. We focus on Schwartz's value theory, which includes two levels of values: cultural and personal. We identified nine studies on personal values and four studies on cultural values and their relationship with common mental disorders. This relationship was assessed among very heterogeneous cultural groups; however, no consistent correlational pattern occurred. The most compelling evidence suggests that the relationship between personal values and mental disorders is moderated by the cultural context. Hence, assessing mere correlations between personal value orientations and self-reported symptoms of psychopathology, without taking into account the cultural context, does not yield meaningful results. This theoretical review reveals important research gaps: Most studies aimed to explain how values relate to the aetiology of mental disorders, whereas the question of phenomenology was largely neglected. Moreover, all included studies used Western instruments for assessing mental disorders, which may not capture culturally-specific phenomena of mental distress. Finding systematic relationships between values and mental disorders may contribute to making more informed hypotheses about how psychopathology is expressed under different cultural circumstances, and how to culturally adapt psychological interventions.

scholarly journals The arrogance of insight?

1993 ◽  
Vol 17 (4) ◽  
pp. 233-234 ◽  
Author(s):  
Rachel Perkins ◽  
Parimala Moodley
Keyword(s):  
Health Services ◽  
Help Seeking ◽  
Mental Distress ◽  
Emotional Responses ◽  
Explanatory Models ◽  
Physical Illness ◽  
Psychological Models ◽  
Help Seeking Behaviour ◽  
The Impact ◽  
Use Of Health Services

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.

Treatment gap in common mental disorders: the Singapore perspective

2012 ◽  
Vol 21 (2) ◽  
pp. 195-202 ◽  
Author(s):  
S. A. Chong ◽  
E. Abdin ◽  
C. Sherbourne ◽  
J. Vaingankar ◽  
D. Heng ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Help Seeking ◽  
Age Of Onset ◽  
Common Mental Disorders ◽  
Treatment Gap ◽  
Help Seeking Behavior ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Treatment Gaps ◽  
Seeking Behavior

Aims.The problem of wide treatment gaps in mental disorders is endemic world wide. The study aims to establish the treatment gap of common mental disorders in Singapore.Methods.A national sample of 6616 persons aged 18 years and above was surveyed with the World Mental Health Composite International Diagnostic Interview in which for each diagnostic module, respondents were asked a series of questions regarding treatment contact.Results.Treatment gap varied considerably between disorders; alcohol abuse had the largest treatment gap (96.2%), followed by obsessive compulsive disorder (89.8%) and alcohol dependence (88.3%). The disorder for which people were most likely to seek help was major depressive disorder. Women with dysthmia were more likely than men to seek help but this help seeking behavior was reversed among those with alcohol abuse and dependence. Age of onset was significantly associated with treatment contact with those who had an earlier age of onset less likely to have treatment contact than those with late age of onset for all disorders except obsessive compulsive disorder.Conclusions.Our findings suggest that treatment gaps are wide even in an economically developed country like Singapore and other than sociodemographic factors, cultural influences might play an important role in help seeking behavior.

scholarly journals Help-seeking and receipt of treatment among UK service personnel

2010 ◽  
Vol 197 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Amy C. Iversen ◽  
Lauren van Staden ◽  
Jamie Hacker Hughes ◽  
Tess Browne ◽  
Neil Greenberg ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Help Seeking ◽  
Service Use ◽  
Common Mental Disorders ◽  
Armed Forces ◽  
Service Utilisation ◽  
Professional Help ◽  
Military Health ◽  
The Uk

BackgroundFor armed forces personnel, data on help-seeking behaviour and receipt of treatment for mental disorders are important for both research and policy.AimsTo examine mental healthcare service use and receipt of treatment in a sample of the UK military.MethodParticipants were drawn from an existing UK military health cohort. The sample was stratified by reserve status and by participation in the main war-fighting period of the Iraq War. Participants completed a telephone-based structured diagnostic interview comprising the Patient Health Questionnaire and Primary Care Post-Traumatic Stress Disorder Screen (PC–PTSD), and a series of questions about service utilisation and treatment receipt.ResultsOnly 23% of those with common mental disorders and still serving in the military were receiving any form of medical professional help. Non-medical sources of help such as chaplains were more widely used. Among regular personnel in receipt of professional help, most were seen in primary care (79%) and the most common treatment was medication or counselling/psychotherapy. Few regular personnel were receiving cognitive–behavioural therapy (CBT). These findings are comparable with those reported for the general population.ConclusionsIn the UK armed forces, the majority of those with mental disorders are not currently seeking medical help for their symptoms. Further work to understand barriers to care is important and timely given that this is a group at risk of occupational psychiatric injury.

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