Correlates of Suicidality Among A Community-Based Cohort of Women Sex Workers: The Protective Effect of Social Cohesion

2019 ◽  
pp. 088626051987016
Author(s):  
Elena Argento ◽  
Steffanie A. Strathdee ◽  
Jean A. Shoveller ◽  
Melissa Braschel ◽  
Kate Shannon
Keyword(s):  
Mental Health ◽  
Protective Effect ◽  
Social Cohesion ◽  
Sex Workers ◽  
Interpersonal Violence ◽  
Multivariable Analysis ◽  
Health Concern ◽  
Health Issues ◽  
Community Based ◽  
Mental Health Issues

Suicide is a critical public health concern globally. Sex workers experience a disproportionate burden of social and health inequities driven by forms of violence, stigma, and criminalization, yet empirical research on suicidality is limited. This study longitudinally investigated the burden and socio-structural correlates of recent suicidality among women sex workers in Vancouver, Canada. Data (2010-2017) were drawn from a community-based, prospective cohort of cis and trans women sex workers across Metro Vancouver. Women completed biannual interviewer-administered questionnaires, and correlates of suicidality in the last 6 months were analyzed using bivariate and multivariable logistic regression with generalized estimating equations (GEE). Of 867 women at baseline, 48% ( n = 413) reported lifetime suicidality, 16% (n = 141) reported suicidality in the last 6 months, and 29% reported suicidality at some point during the study. In multivariable analysis, factors independently associated with suicidality included physical/sexual childhood abuse (adjusted odds ratio [AOR]: 2.99; 95% confidence interval [CI] = [1.75, 5.10]), mental health issues (depression/anxiety/posttraumatic stress disorder; AOR = 2.19; 95% CI = [1.63, 2.95]), intimate partner violence (AOR: 2.11; 95% CI = [1.60, 2.80]), physical/sexual client violence (AOR: 1.82; 95% CI = [1.33, 2.50]), and homelessness (AOR: 1.44; 95% CI = [1.10, 1.89]). Older age (AOR: 0.97; 95% CI = [0.95, 0.99]) and higher social cohesion (AOR: 0.88; 95% CI = [0.78, 0.99]) were significantly associated with reduced odds of suicidality. Findings reveal key socio-structural correlates of suicidality among sex workers including experiences of historical and interpersonal violence, trauma/mental health issues, and homelessness. Strengthening social cohesion may have a protective effect on suicidality. Trauma-informed community-led structural interventions tailored to sex workers are urgently needed alongside a legal framework that enables collectivization and connectedness.

scholarly journals MENTAL HEALTH ISSUES AND RELEVANT LEGISLATION IN A DEVELOPING COUNTRY

1970 ◽  
Vol 7 (2) ◽  
pp. 122-126
Author(s):  
Shafquat Inayat
Keyword(s):  
Mental Health ◽  
Developing Country ◽  
Mental Health Policy ◽  
Fundamental Rights ◽  
Health Law ◽  
Health Issues ◽  
Community Based ◽  
Mental Health Issues ◽  
Mental Health Legislation ◽  
Health Legislation

Mental health legislation compiles and integrates fundamental doctrine, principles, goals, objectives and mental health policy. This legislation is required to assure that the self-respect and the dignity of patients is conserved and that their fundamental rights are protected. This article considers legislation in the Indo-Pak subcontinent, especially the Mental Health Act in Pakistan, and asserts that the act has limitation that serve as a barrier to mental health services currently provided in Pakistan. The purpose of this article is to identify the mental health legislation in a developing country like Pakistan. It also emphasizes the need of a modern mental health law that provides priority to protect the rights of patient with mental disorder to promote development of community based care and improves its access.

Discrimination and mental health among lesbian, gay and bisexual adults

2017 ◽  
Vol 41 (S1) ◽  
pp. S734-S734
Author(s):  
M.A. Dos Santos
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Public Health Problem ◽  
Health Concern ◽  
Health Issues ◽  
Care Providers ◽  
Mental Health Issues ◽  
And Bisexual

IntroductionMental health care is indispensable, has an essential role in development, but mental health issues are a major public health concern worldwide. Sexual minorities, lesbian, gay and bisexual, suffer from prejudice and it determines health inequities, especially for their mental health.ObjectiveTo show the relation between discrimination and mental health issues in lesbian, gay and bisexual (LGB) people and to increase understanding of this serious neglected public health problem.MethodsThe search was conducted using Science Direct and Scopus, using the following keywords: “discrimination” and “mental health” and “lesbian” and “gay” and “bisexual”. Using the review of literature, documents in English (articles, official documents, editorial, reviews, clinical trials).DiscussionNumerous studies have identified highest risk behavior, as illicit drug use, sexual risk-taking behaviors and mental health issues among LGB people. Some previous studies propose that health and risk disparities between heterosexual and LGB identifying or behaving people are due to minority stress–that is, that the stigma, discrimination, and violence experienced, leading to stress, thus predisposing illness, disease (worse mental and physical health outcomes) and potentially substance use, which may be used to relieve or escape stress.ConclusionHealth professionals and healthcare organizations must cover these unmet mental health needs if they move to more integrated, coordinated models of care. Health educators should attend to the unique needs of each sexual orientation group when presenting sexual health information and health care providers should undergo diversity and sensitivity training to work more effectively with those groups.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals Understanding mental health and wellbeing among aboriginal postsecondary students

2021 ◽  
Author(s):  
Caitlin Joy Davey
Keyword(s):  
Mental Health ◽  
Self Efficacy ◽  
Health Knowledge ◽  
Health Issues ◽  
Community Based ◽  
Post Secondary ◽  
Aboriginal Students ◽  
Mental Health Issues ◽  
Mental Health Knowledge

First Nations, Inuit and Métis youth in Canada report higher rates of mental health (i.e., depression, anxiety, addiction and suicide) issues than the non-Aboriginal population of youth, which impacts their ability to achieve their educational goals. Understanding mental health from an Aboriginal worldview and through culturally safe strategies designed to translate mental health information to Aboriginal people is lacking. The objectives of the present study were to develop, implement and evaluate a knowledge translation (KT) strategy to enhance wellbeing knowledge and self-efficacy in coping with mental health issues among Aboriginal postsecondary students using a community-based approach. The Tool Development Phase involved focus groups and interviews with Aboriginal post-secondary students (n=9) and community members (n=3) to develop a KT activity. The KT Phase involved a pre/post design where participants (n=4) were asked about their mental health knowledge and self-efficacy in improving their wellbeing prior to and after the KT activity. All students participated in an individual interview one month later about their knowledge and the helpfulness of activity. Key informants (n=4) were interviewed during a Follow-Up and Debriefing phase regarding the community-based approach. Mental health was defined wholistically, as related to community and as being impacted by identity, stigma, cultural connection, intergenerational trauma, and a clash between Aboriginal and positivist Western worldviews. KT preferences included incorporating traditional ceremonies; covering particular topics such as resources, traditional teachings and coping strategies; and incorporating active participation. The KT activity increased knowledge and self-efficacy related to mental health and some knowledge was retained and used at one-month follow-up. As well, participants appreciated the sense of community that the activity created and provided feedback regarding what could be changed (e.g., more active participation). Key informants thought the project addressed some community needs and that it was built on relationships. This study will contribute to increasing the wellbeing of Aboriginal students by expanding upon their mental health knowledge, and sense of self-efficacy in coping with their own mental health issues, with the aim of addressing mental health barriers to the completion of post-secondary education among Aboriginal students.

Program description and implementation findings of MyCare: enhancing community mental health care in Tasmania, Australia

2020 ◽  
Vol 26 (5) ◽  
pp. 374
Author(s):  
Renee O'Donnell ◽  
Darshini Ayton ◽  
Bengianni Pizzirani ◽  
Melissa Savaglio ◽  
Debra Fast ◽  
...  
Keyword(s):  
Mental Health ◽  
Implementation Strategy ◽  
Controlled Trial ◽  
Implementation Strategies ◽  
Health Programs ◽  
Successful Implementation ◽  
Health Issues ◽  
Community Based ◽  
Mental Health Issues ◽  
Mental Health Programs

Since 2014, Tasmania has experienced unprecedented rates of hospitalisations related to mental health issues. To address reliance on such acute-based care, government funding was invested to enhance community-based care, which, in turn, led to the development of MyCare. This paper represents the initial phase of a larger body of work (i.e. an effectiveness-controlled trial of MyCare) that describes the MyCare program and the successful implementation strategy underpinning the program. The implementation of MyCare was evaluated with 41 key stakeholders (staff, clients and senior executives) using semistructured interviews and focus groups, informed by the Consolidated Framework for Implementation Research (CFIR). According to stakeholders, three CFIR constructs that were directly addressed by the program, namely Tension for Change, Evidence Strength and Quality, and Available Resources for Implementation, facilitated the successful implementation of MyCare. In contrast, a feature of the program that impeded implementation was Patient Needs and Resources, which restricted program access to those with the most severe mental health issues. The reporting of implementation strategies underpinning mental health programs is rare. This study describes the implementation strategy underpinning a community-based mental health program that was successful in facilitating program uptake. We encourage other researchers to not only report on implementation findings, which may help avoid replication failure, but also to apply these innovative implementation processes (i.e. address the tension for change and ensure the program is evidence informed and that sufficient resources are available for implementation) within mental health programs to aid successful uptake.

The association between living in socially fragmented neighbourhoods and psychological distress among immigrant and non-immigrant people aged 45 and over in NSW, Australia

2020 ◽  
pp. 000486742098141
Author(s):  
Hossein Tabatabaei-Jafari ◽  
Tehzeeb Zulfiqar ◽  
Jennifer Welsh ◽  
Nasser Bagheri
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Economic Advantage ◽  
Socioeconomic Disadvantage ◽  
Health Concern ◽  
Health Issues ◽  
Cross Sectional ◽  
High Psychological Distress ◽  
Social Fragmentation ◽  
Mental Health Issues

Objective: Immigrants’ mental health is a growing public health concern. Neighbourhood characteristics in the host society may contribute to the poor mental health observed among immigrants. In this study, we aimed to investigate the association between neighbourhood-level social fragmentation and socioeconomic characteristics with psychological distress among immigrants and non-immigrants living in Australia. Methodology: We conducted cross-sectional secondary data analysis of 228,039 participants from the Sax Institute’s 45 and Up Study, with psychological distress measured with the Kessler 10 (K10) and area-level social fragmentation and economic advantage/disadvantage measured at the statistical area level 1 (areas containing approximately 400 people). Multilevel logistic models were used to examine the extent to which differences across the least and most fragmented and economic advantage/disadvantage neighbourhoods contributed to the prevalence of high psychological distress (K10 score ⩾ 22). Results: Immigrants accounted for about 23% of the sample. Slightly more immigrants (34.8%) compared to non-immigrants (32.9%) lived in fragmented areas. Although immigrants were over represented in areas with socioeconomic advantage (40% vs 33.9%), the prevalence of high psychological distress in neighbourhoods with higher social fragmentation and socioeconomic disadvantage was higher in immigrants than non-immigrants. Immigrants had 17% (95% confidence interval = [12%, 22%]) higher odds of having high psychological distress compared to non-immigrants. There was no evidence of an interaction between social fragmentation or socioeconomic disadvantage and immigrant status. Living in fragmented or socioeconomically disadvantaged areas was associated with higher psychological distress among immigrants and non-immigrants. English as a second language and low annual income were significant predictors of psychological distress in immigrants over and above area-level characteristics. Conclusion: Immigrants are vulnerable to mental health issues, but the characteristics of the area they live in are also important. Helping immigrants settle into well-integrated and economically advantaged areas may decrease the possibility of mental health issues.

scholarly journals Understanding mental health and wellbeing among aboriginal postsecondary students

2021 ◽  
Author(s):  
Caitlin Joy Davey
Keyword(s):  
Mental Health ◽  
Self Efficacy ◽  
Health Knowledge ◽  
Health Issues ◽  
Community Based ◽  
Post Secondary ◽  
Aboriginal Students ◽  
Mental Health Issues ◽  
Mental Health Knowledge

First Nations, Inuit and Métis youth in Canada report higher rates of mental health (i.e., depression, anxiety, addiction and suicide) issues than the non-Aboriginal population of youth, which impacts their ability to achieve their educational goals. Understanding mental health from an Aboriginal worldview and through culturally safe strategies designed to translate mental health information to Aboriginal people is lacking. The objectives of the present study were to develop, implement and evaluate a knowledge translation (KT) strategy to enhance wellbeing knowledge and self-efficacy in coping with mental health issues among Aboriginal postsecondary students using a community-based approach. The Tool Development Phase involved focus groups and interviews with Aboriginal post-secondary students (n=9) and community members (n=3) to develop a KT activity. The KT Phase involved a pre/post design where participants (n=4) were asked about their mental health knowledge and self-efficacy in improving their wellbeing prior to and after the KT activity. All students participated in an individual interview one month later about their knowledge and the helpfulness of activity. Key informants (n=4) were interviewed during a Follow-Up and Debriefing phase regarding the community-based approach. Mental health was defined wholistically, as related to community and as being impacted by identity, stigma, cultural connection, intergenerational trauma, and a clash between Aboriginal and positivist Western worldviews. KT preferences included incorporating traditional ceremonies; covering particular topics such as resources, traditional teachings and coping strategies; and incorporating active participation. The KT activity increased knowledge and self-efficacy related to mental health and some knowledge was retained and used at one-month follow-up. As well, participants appreciated the sense of community that the activity created and provided feedback regarding what could be changed (e.g., more active participation). Key informants thought the project addressed some community needs and that it was built on relationships. This study will contribute to increasing the wellbeing of Aboriginal students by expanding upon their mental health knowledge, and sense of self-efficacy in coping with their own mental health issues, with the aim of addressing mental health barriers to the completion of post-secondary education among Aboriginal students.

Psychiatric Consultation in the Eastern Canadian Arctic: III. Mental Health Issues in Inuit Women in the Eastern Arctic

1993 ◽  
Vol 38 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Susan E. Abbey ◽  
Eric Hood ◽  
L. Trevor Young ◽  
Samuel A. Malcolmson
Keyword(s):  
Mental Health ◽  
Cultural Change ◽  
Treatment Strategies ◽  
Canadian Arctic ◽  
Health Issues ◽  
Psychiatric Consultation ◽  
Community Based ◽  
Mental Health Issues ◽  
Patient Will ◽  
Eastern Canadian Arctic

This report describes mental health issues affecting Inuit women as seen in psychiatric consultation. Recent public and governmental attention has focused on the emotional and behavioural sequelae of rapid cultural change, spousal assault and sexual violence. The process of psychiatric consultant with the Inuit woman patient will be described. The need for innovative, community-based treatment strategies in this population will be emphasized.

scholarly journals PATTERNS AND DETERMINANTS OF POLYSUBSTANCE USE AMONG RETIRED POPULATION IN A U.S. NATIONALLY REPRESENTATIVE SAMPLE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S693-S693
Author(s):  
Tzung-Shiang Ou ◽  
Yi-Han Hu ◽  
Hsien-Chang Lin ◽  
Su-Wei Wong
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Mental Health Treatment ◽  
Health Concern ◽  
Health Issues ◽  
Health Treatment ◽  
The Past ◽  
Polysubstance Use ◽  
Mental Health Issues ◽  
The U.S

Abstract Polysubstance use in the U.S. has been a public health concern. The prevalence of substance use among middle-aged and older adults is predicted to increase by 50% by 2020. Previous studies revealed retirement could serve as a risk factor for substance use as this population was known to be more susceptible to mental health issues. However, patterns and determinants of polysubstance use among retired population remained understudied. The purpose of this study was to investigate the patterns and determinants of polysubstance use among retired adults aged 50 and older. This study extracted 3,019 retired participants from the 2017 National Survey on Drug Use and Health study. Polysubstance use was defined as the use of two or more substances, including alcohol, tobacco, marijuana, and painkiller misuse, in the past month. Weighted multinomial logistic regression model was conducted to examine the associations between utilization of mental health treatment and poly-use of substances. The findings suggested 52.0% of retired adults used at least one substance in the past month, where 17.0% used substances concurrently; 15% co-used alcohol, tobacco, and marijuana; 8.6% co-used tobacco and marijuana. Females were less likely to poly-use substances (RRR=0.37, p<.001) than males. Those who had received mental health treatment in the past year were more likely to co-use more than two substances in relative to substance non-users in the past month (RRR=1.71, p<.05). Retirement plan incorporating behavioral intervention and early detection of mental health issues are warranted to reduce polysubstance use among the retired population in the U.S.

scholarly journals An Exploration of Facilitators and Challenges to Young Adult Engagement in a Community-Based Program for Mental Health Promotion

2020 ◽  
Vol 7 ◽  
pp. 233339362092282
Author(s):  
Anne Marie Creamer ◽  
Jean Hughes ◽  
Nicole Snow
Keyword(s):  
Mental Health ◽  
Young Adulthood ◽  
Mental Health Center ◽  
Health Issues ◽  
Community Based ◽  
Health Concerns ◽  
Mental Health Issues ◽  
Canadian City ◽  
Trauma Informed ◽  
Adolescence And Young Adulthood

Adolescence and young adulthood can be particularly daunting for those with mental health concerns. In one Canadian city, a community-based drop-in psychosocial mental health center (Center) was designed specifically for youth who self-identified as struggling with mental health issues. The purpose of this study was to identify the features of the program that promoted or discouraged engagement. Narrative inquiry was used to guide the project. One-on-one interviews were conducted with 10 Center users. Four major categories were identified: (a) Reasons for Coming: Motivated to Work on Goals; (b) Facilitators of Engagement and Beyond; (c) Challenges to Engagement; and (d) Benefits of Engaging: Finding My Way. These categories were further delineated into themes. All participants had experienced trauma, and the Center assisted them in their coping. The researchers believe that to aid recovery, agencies working with this population need to use trauma-informed and healing-centered engagement.

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