Meeting the mental health needs of older women: taking social inequality into account

2000 ◽  
Vol 20 (6) ◽  
pp. 699-723 ◽  
Author(s):  
ALISOUN MILNE ◽  
JENNIE WILLIAMS

Whilst there is increasing acceptance that social inequalities have implications for mental health, there is minimal acknowledgement of their effects on the development and treatment of mental ill health in older people. This paper focuses on older women, as they are the majority sufferers of mental illness in later life, and are particularly vulnerable to the cumulative effects of lifelong and age-related inequalities. The authors, who draw upon literature from the fields of gerontology and mental health, argue that for effective care to be developed, older women's mental ill health needs to be seen within the context of their past and present experience of social inequalities. Evidence particularly relates to socio-economic disadvantages as well as to the consequences of discrimination. It is argued that psychological vulnerability is further compounded by the gendered effects of social policy, and by a care system which constructs mental health needs as unrelated to oppression, and dislocated from their economic, social and historical roots. Finally, the authors outline the key components of a care and service system which takes account of social inequalities, and which accords centrality to the experiences, views and opinions of older women with mental health problems.

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033317
Author(s):  
Rachel M Hiller ◽  
Sarah L Halligan ◽  
Richard Meiser-Stedman ◽  
Elizabeth Elliott ◽  
Emily Rutter-Eley

ObjectivesYoung people who have been removed from their family home and placed in care have often experienced maltreatment and there is well-developed evidence of poor psychological outcomes. Once in care, foster carers often become the adult who provides day-to-day support, yet we know little about how they provide this support or the challenges to and facilitators of promoting better quality carer–child relationships. The aim of this study was to understand how carers support the emotional needs of the young people in their care and their views on barriers and opportunities for support.Design and participantsParticipants were 21 UK foster carers, recruited from a local authority in England. They were predominantly female (86%), aged 42–65 years old and ranged from those who were relatively new to the profession (<12 months’ experience) to those with over 30 years of experience as a carer. We ran three qualitative focus groups to gather in-depth information about their views on supporting their foster children’s emotional well-being. Participants also completed short questionnaires about their training experiences and sense of competence.ResultsOnly half of the sample strongly endorsed feeling competent in managing the emotional needs of their foster children. While all had completed extensive training, especially on attachment, diagnosis-specific training for mental health problems (eg, trauma-related distress, depression) was less common. Thematic analysis showed consistent themes around the significant barriers carers faced navigating social care and mental health systems, and mixed views around the best way to support young people, particularly those with complex mental health needs and in relation to reminders of their early experiences.ConclusionsFindings have important implications for practice and policy around carer training and support, as well as for how services support the mental health needs of young people in care.


Author(s):  
Foteini Tseliou ◽  
Michael Rosato ◽  
Dermot O'Reilly

BackgroundHigh levels of mental ill-health have resulted in increasing delays in the receipt of appropriate care. However, the size of the gap between mental health needs and the likelihood of receiving treatment has not been thoroughly investigated on a population-level within Northern Ireland. ObjectivesTo that end we investigated the link between self-reported mental ill-health and likelihood of being in receipt of treatment in a population cohort. MethodsThe 2011 Northern Ireland Census was linked to a population-wide prescribing database. The presence of a chronic mental health condition, as assessed through the Census self-reported mental health question, was compared to regular psychotropic medication use in the six and twelve months following the Census. Of the 23,803 individuals (aged 25 to 74) who reported chronic mental ill-health at the Census, 22% were not in receipt of medication over the following six months, with this being reduced down to 18.5% by the twelve month mark. FindingsAfter adjusting logistic regression models for socio-demographic factors, men (OR=0.56: 95%CI=0.52-0.60), those of non-white ethnicity (OR=0.38: 95%CI=0.26-0.54), never married (OR=0.67: 95%CI=0.61-0.82), unemployed (OR=0.65: 95%CI=0.53-0.81) and living in a rural area (OR=0.88: 95%CI=0.79-0.98) were less likely to receive regular medication, indicating mental health unmet need. ConclusionsA level of discord was observed between mental-ill health and medication receipt on a population level. Further focus on mental health needs and the impact of low prescribing rates on mental health patients could help ameliorate the current inequalities and reduce potential gaps in mental health treatment.


2019 ◽  
Vol 11 (10) ◽  
pp. 434-439
Author(s):  
Trudy Hutchison ◽  
Carolyn Lees ◽  
Robyn Lotto ◽  
Alison White ◽  
Ron Harris

The paramedic service responds to emergency calls for a variety of reasons, many relating to mental health concerns. This qualitative study aims to explore the views and experiences of student paramedics in relation to clinical decision making for mental health calls. Focus groups were used to investigate the participants' perspectives. Thematic analysis was used to organise data and identify key issues. Findings suggested some disparity between what paramedic students were prepared for and the reality of public need. Clinical decision making in relation to those with mental health problems was significantly influenced by the current provision of mental health services and the lack of mental health-specific education for student paramedics. Current changes to the paramedic programme make this an opportune time for a review of curriculum content.


2017 ◽  
Vol 42 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Josh Fergeus ◽  
Cathy Humphreys ◽  
Carol Harvey ◽  
Helen Herrman

Across the developed world, efforts are being made to identify and develop effective interventions that will reduce the prevalence and severity of mental health problems among children and young people in out-of-home care. Foster and kinship carers have been identified as critically important in this process. In order to develop an understanding of what interventions and/or supports assist carers in responding effectively to the mental health needs of the children and young people in their care, a scoping review was undertaken. Using the scoping study method, 1064 publications were identified, and 82 publications were selected for further analysis. The review shows that promising interventions that aim to improve the mental health of children and young people living in out-of-home care have been developed and trialled both in Australia and internationally. However, the review also highlights the lack of research specifically focused on the role of the carer.


Author(s):  
Alisoun Milne

Focusing on mental health rather than mental illness, this book adopts a life course approach to understanding mental health and wellbeing in later life. Drawing together material from the fields of sociology, psychology, critical social gerontology, the mental health field, and life course studies, it analyses the meaning and determinants of mental health amongst older populations and offers a critical review of existing discourse. The book explores the intersecting influences of lifecourse experiences, social and structural inequalities, socio-political context, history, gender and age-related factors and demands an approach to prevention and resolution that appreciates the embedded, complex and multi-faceted nature of threats to mental health and ways to protect it. It foregrounds engagement with the perspectives and lived experiences of older people, including people living with dementia, and makes the case for a paradigmatic shift in conceptualising, exploring and researching mental health issues and supporting older people with mental health problems. The book is essential reading for policy makers, health and social care professionals and students, third sector agencies, researchers and all of those concerned to more effectively and collaboratively address mental health issues in later life.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Stephane Shepherd ◽  
Cieran Harries ◽  
Benjamin Spivak ◽  
Anne-Sophie Pichler ◽  
Rosemary Purcell

Abstract Background Mental ill-health can impact an individual’s capacity to interact with others, make decisions, and cope with social challenges. This is of particular importance for many Culturally and linguistically diverse (CALD) individuals who may be at various stages of the acculturation process. The increasing diversity of the Australian population necessitates informed and culturally relevant services that meet the needs of a changing demographic. However the extant research on the mental health needs of CALD Australians is limited. This study aimed to further our understanding of the mental health needs of young CALD Australians by exploring the mental health concerns and social factors exhibited by CALD individuals accessing community based youth mental health services in two major cities. Methods We performed a series of logistic regression models to ascertain if a concert of factors (i.e., clinical, socio-economic, criminal justice system involvement, child maltreatment, social support) were associated with CALD status Results Comparisons across factors revealed no significant differences between groups. A small number of correlates differentiated between CALD and non-CALD participants (mental illness diagnosis during childhood, family history of mental illness/suicide, sensation seeking, sensitivity to punishment, maternal overprotection) however these factors were no longer meaningful after adjustment for multiple comparisons. Conclusions In help-seeking mainstream youth populations, cultural differences across clinical and environmental factors appear to be minimal.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Li Bao ◽  
Wen-Tian Li ◽  
Bao-Liang Zhong

Abstract Background Due to the implementation of social distancing and quarantine measures, loneliness has been a major public health concern during the COVID-19 pandemic. However, few studies have examined loneliness in Chinese residents during the COVID-19 epidemic, as well as its associations with mental health needs and services utilization. Methods The present study was a cross-sectional survey during the COVID-19 outbreak in China. A total of 7741 adults were invited and completed an online self-administered questionnaire. The Chinese 12-item General Health Questionnaire was used to screen for common mental health problems, loneliness was measured with a single-item self-report question (“How often do you feel lonely in recent days?”), and two standardized questions were used to assess perceived needs for and use of mental health services. Results In total, 24.2 % of the participants felt lonely in recent days. Age of 16–29 years (OR = 1.36, P = 0.020), marital status of never-married (OR = 1.47, P < 0.001), marital status of “others” (re-married, co-habiting, separated, divorced, and widowed) (OR = 1.72, P < 0.001), having infected family members or close relatives (OR = 1.64, P = 0.026), and having infected colleagues, friends, or classmates (OR = 1.62, P < 0.001) were significant correlates of loneliness. Rates of mental health needs (17.4 % vs. 4.9 %, P < 0.001) and services utilization (2.7 % vs. 1.0 %, P < 0.001) were significantly higher in lonely than not lonely participants. After adjusting for socio-demographic and epidemic characteristics and common mental health problems, loneliness was still significantly associated with mental health needs (OR = 2.50, P < 0.001) and services utilization (OR = 1.62, P = 0.020). Conclusions Feelings of loneliness are prevalent among Chinese residents affected by the COVID-19 epidemic and the presence of loneliness is associated with high levels of mental health needs and greater services utilization. Effective measures aiming at preventing or reducing loneliness are potentially beneficial for the mental wellbeing of COVID-19-affected population and reducing the use of the limited mental health service resources during the COVID-19 pandemic.


Author(s):  
Daniel W. Klyce ◽  
James C. Jackson

Survivors of critical illness frequently have significant and persistent mental health problems, which may develop or worsen following intensive care unit (ICU) admission. Chief among these problems is depression, which occurs in approximately a third of all individuals after critical illness and is associated with a wide array of untoward outcomes. Depression is manifest in a diversity of ways and risk factors may contribute to significant depressive symptoms after critical. Questions persist about whether treatment of depression after critical illness is most effective using conventional approaches or whether the depressive symptoms observed in ICU survivors may be clinically distinct and may optimally respond to carefully tailored innovative approaches. One promising strategy for managing the mental health needs of patients after critical illness involves ICU recovery clinics, which target the unique constellation of cognitive, psychiatric, and functional challenges common to survivors of critical illness.


1995 ◽  
Vol 19 (5) ◽  
pp. 317-317 ◽  
Author(s):  
Andrew Clark

Diagnosis and treatment of mental health problems in individuals suffering from deafness or severe hearing impairment poses particular challenges. This is recognised for adults by the provision of specialised services based in London, Birmingham and Manchester but for children and adolescents there is only a specialised out-patient service based at Springfield Hospital in London which has itself only been in existence two years. This day conference of invited hearing and non-hearing professionals held in Birmingham in October 1994 considered how appropriate services might further develop.


2014 ◽  
Vol 8 (6) ◽  
pp. 381-389 ◽  
Author(s):  
Nancy J. Razza ◽  
Laura Schwartz Dayan ◽  
Daniel Tomasulo ◽  
Michelle S. Ballan

Purpose – The purpose of this paper is threefold: to document the relationship between intellectual disability (ID) and psychopathology; to raise awareness of the ongoing lag in professional training for psychologists in the area of mental health treatment for people with intellectual disabilities; and, to provide recommendations for advancing professional education and, ultimately, adequate mental health treatment availability for people with intellectual disabilities. Design/methodology/approach – The paper reviews the literature on prevalence of mental health problems in people with intellectual disabilities. At the same time, the paper reviews the training of psychologists relative to the burgeoning growth in awareness of the mental health needs of people with intellectual disabilities. Findings – The paper concludes that ID is a significant risk factor for psychopathology. In addition, the paper concludes that the education of psychologists regarding the mental health needs of people with intellectual disabilities is insufficient. The authors document the need for incorporating research and treatment advances related to intellectual disabilities and mental health into to the professional training of psychologists. The paper also describe the potential this training holds for improving both the lives of people with intellectual disabilities and the overall competence of psychologists. Practical implications – This paper provides a literature-based rationale for the need to include education in the mental health needs of people with intellectual disabilities into the general training of mental health professionals. In addition, it provides specific recommendations for how such training can be incorporated into graduate psychology programs. Originality/value – This paper provides mental health professionals with a review of the growth in understanding of the enormous, unmet mental health needs of people intellectual disabilities, and of the critical role of ID in development of mental health problems. Moreover, this paper builds the case for an important revision in the training of psychologists to include competence in understanding and treating mental health problems across the full spectrum of intellectual functioning.


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