“In our community, a friend is a psychologist”: An ethnographic study of informal care in two Bhutanese refugee communities

2017 ◽  
Vol 54 (3) ◽  
pp. 400-422 ◽  
Author(s):  
Liana Chase ◽  
Ram P. Sapkota
Keyword(s):  
Mental Health ◽  
Social Networks ◽  
Informal Care ◽  
Help Seeking ◽  
Participant Observation ◽  
Health Resources ◽  
Ethnographic Study ◽  
Care Systems ◽  
And Behavior ◽  
Bhutanese Refugee

The recent rise in suicide among Bhutanese refugees has been linked to the erosion of social networks and community supports in the ongoing resettlement process. This paper presents ethnographic findings on the role of informal care practiced by relatives, friends, and neighbors in the prevention and alleviation of mental distress in two Bhutanese refugee communities: the refugee camps of eastern Nepal and the resettled community of Burlington, Vermont, US. Data gathered through interviews ( n = 40, camp community; n = 22, resettled community), focus groups (four, camp community), and participant observation (both sites) suggest that family members, friends, and neighbors were intimately involved in the recognition and management of individual distress, often responding proactively to perceived vulnerability rather than reactively to help-seeking. They engaged practices of care that attended to the root causes of distress, including pragmatic, social, and spiritual interventions, alongside those which targeted feelings in the “heart-mind” and behavior. In line with other studies, we found that the possibilities for care in this domain had been substantially constrained by resettlement. Initiatives that create opportunities for strengthening or extending social networks or provide direct support in meeting perceived needs may represent fruitful starting points for suicide prevention and mental health promotion in this population. We close by offering some reflections on how to better understand and account for informal care systems in the growing area of research concerned with identifying and addressing disparities in mental health resources across diverse contexts.

Acceptance of Mental Illness Among Men

2016 ◽  
pp. 102-114
Author(s):  
Lauren Mizock ◽  
Zlatka Russinova
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Help Seeking ◽  
Health Resources ◽  
Health Conditions ◽  
Self Medication ◽  
Supportive Relationships ◽  
Clinical Strategies ◽  
Traditional Masculinity ◽  
The Impact

This chapter explores the unique barriers and facilitators to acceptance that men with serious mental illness may experience. The values associated with traditional masculinity are discussed as they pertain to the process of accepting mental illness. Barriers specific to men in our research studies are detailed, including avoidance of help-seeking and self-medication with substance abuse. In addition, the literature on misdiagnosis and underdiagnosis of mental health conditions among men is presented. Facilitators to the process of acceptance for men in the present research are discussed, including accessing supportive relationships and other mental health resources. Several participant case narratives are provided in order to demonstrate the impact of various masculinities on the process of acceptance. A clinical strategies list, discussion questions, activities, the “Men’s Acceptance of Mental Health Worksheet,” and an explanatory table are included at the close of the chapter.

Understanding Parents’ Approaches to Care and Treatment of Children With Cancer When Standard Therapy Has Failed

2007 ◽  
Vol 25 (17) ◽  
pp. 2414-2419 ◽  
Author(s):  
Myra Bluebond-Langner ◽  
Jean Bello Belasco ◽  
Ann Goldman ◽  
Carmen Belasco
Keyword(s):  
Pediatric Oncology ◽  
Standard Therapy ◽  
Participant Observation ◽  
Health Care Systems ◽  
Ethnographic Study ◽  
Semistructured Interviews ◽  
The Us ◽  
Care Models ◽  
Care Systems ◽  
Care And Treatment

Purpose To examine US and United Kingdom (UK) parents’ approaches to care and treatment when standard therapy has failed and consider implications for clinical practice. Methods We conducted a prospective, ethnographic study of parents, patients, and staff, including participant-observation; open-ended, semistructured interviews; and review of medical records at a US and UK pediatric oncology center. Thirty-four children (n = 17 US, 17 UK), whose disease had recurred with less than 30% chance of cure, were enrolled between March 2001 and June 2002 and followed until death (n = 11 US, 14 UK) or close of study in December 2005 (n = 6 US, 3 UK). Results There were no major differences between parents’ approaches in the US and UK despite differences in health care systems, institutions, and parents’ religion or ethnicity. All parents continued to have or request meetings with the oncologist and investigative procedures. No parent initiated discontinuation of cancer- or symptom-directed interventions. In 28 of 34 cases (13 US, 15 UK), parents continued to pursue cancer-directed therapies; in 16 of 28 cases (seven US, nine UK), parents initiated inquires beyond what was offered. Conclusion Understanding parents’ behavior requires attention to the reason and emotion they bring to decision making and their children's care, their unique responsibilities as parents, and what they learn throughout the illness. Parents do not see cancer-directed therapy and symptom-directed care as mutually exclusive, alternative approaches. Parents will not be constrained by what the oncologist offers. Physicians and parents discuss and negotiate care and treatment throughout the illness. Our findings suggest developing integrative care models incorporating cancer-directed, symptom-directed, and supportive care throughout the illness; they are most consistent with parents’ approaches and advances in pediatric oncology.

scholarly journals Stigmatising Attitudes Towards Depression and Alcohol Misuse in Young People: Relationships with Help-Seeking Intentions and Behavior

2019 ◽  
Vol 9 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Ali Cheetham ◽  
Anthony F. Jorm ◽  
Coralie Wilson ◽  
Bonita J. Berridge ◽  
Fiona Blee ◽  
...  
Keyword(s):  
Mental Health ◽  
High School Students ◽  
Young People ◽  
Help Seeking ◽  
Alcohol Misuse ◽  
Mental Health Problems ◽  
Helping Behavior ◽  
Adverse Outcomes ◽  
School Students ◽  
And Behavior

Background and Objective: Adolescents experiencing mental health problems often approach their peers rather than seeking professional help. A better understanding of adolescents’ stigmatising attitudes towards mental illness will help inform interventions that aim to improve the quality of advice that young people provide to their peers. In particular, there is a need for research examining adolescents’ attitudes towards alcohol misuse, given it’s increase in prevalence during this period as well as the adverse outcomes that are associated with untreated early drinking problems. Methods: High-school students (n=2447) were recruited as part of an intervention focussed on overcoming barriers to accessing help for mental health and substance use problems. Participants were presented with two vignettes that described a peer experiencing depression and alcohol misuse, respectively, and completed the General Help-Seeking Questionnaire as well as a 10-item scale measuring stigmatising attitudes. Past helping behavior was also assessed. Results: Compared to depression, a peer experiencing alcohol misuse was more likely to be considered “weak” rather than sick, and was perceived as more dangerous and unpredictable. The “weak-not-sick” and “dangerousness” dimensions of stigma predicted weaker intentions to encourage help-seeking from informal sources, while ‘dangerousness’ predicted stronger intentions to encourage formal help-seeking. Both dimensions were associated with fewer instances of past helping behavior. Conclusion: Young people stigmatise alcohol misuse more severely than depression. Overall, stigma was associated with weaker intentions to encourage peers to seek help. While perceptions of ‘dangerousness’ were associated with stronger intentions to seek help from formal sources, this association may not translate into actual helping behavior.

scholarly journals Differences in Mental Health, Help-Seeking and Barriers to Care Between Civilians and Sworn Members Working in Law Enforcement: A Research Note

2021 ◽  
Author(s):  
Krystle Martin ◽  
Alifa Siddiqui ◽  
Rosemary Ricciardelli ◽  
Liana Lentz ◽  
R. Nicholas Carleton
Keyword(s):  
Mental Health ◽  
Law Enforcement ◽  
Mental Disorders ◽  
Police Officers ◽  
Help Seeking ◽  
Barriers To Care ◽  
Health Resources ◽  
Self Report ◽  
Public Safety Personnel ◽  
Mental Wellness

Abstract Recent Canadian research indicates 44.5% of public safety personnel (PSP) self-report symptoms consistent with at least one type of mental disorder; however, researchers have typically not focused on the mental wellness of civilians working within PSP sectors. Given that the number of civilians working in Canadian law enforcement organizations has doubled since 2003, with more than 30% of all police personnel in Canada being civilians, more research is needed to support this understudied sub-population within law enforcement. The current study used a survey to compare civilian members (n = 80) and sworn (n = 112) police officers working within a law enforcement organization on issues regarding mental disorders, perceived barriers to care and help-seeking behaviours. Results indicate that civilian members self-report a high prevalence of mental disorders and lower resilience compared with police officers in the same organization. Civilians reported similar barriers to accessing mental health compared with police officers but were less likely to indicate willingness to access supports within their place of employment. Our results support the need for equitable access to mental health resources for civilian staff working within law enforcement organizations.

scholarly journals Website Analytics of a Google Ads Campaign for a Men’s Mental Health Website: Comparative Analysis

10.2196/12428 ◽  
2018 ◽  
Vol 5 (4) ◽  
pp. e12428 ◽  
Author(s):  
Andrea Lynn Murphy ◽  
Sophie Peltekian ◽  
David M Gardner
Keyword(s):  
Mental Health ◽  
Service Providers ◽  
Health Resources ◽  
Community Support ◽  
Self Help ◽  
Session Duration ◽  
Health Service Providers ◽  
Health Promotion Initiative ◽  
And Behavior ◽  
Common Device

Background Men with mental health and addictions problems seek information and help from health service providers and community support less often than women with such problems. Online health resources offer men rapid access to self-care recommendations and resources and anonymity; however, only a few websites are specifically developed for men. Headstrong - Taking Things Head-On was a community pharmacy and online health promotion initiative for men living with mental health and addictions problems. The Headstrong website was developed to offer a curated collection of print and online recommended resources (primarily self-help oriented) for depression, anxiety, insomnia, tobacco and alcohol use problems, and suicide. To increase awareness of the initiative and use of the website’s content and resource recommendations, a Google Ads campaign was developed. Objective This study aimed to compare user acquisition and behavior on the Headstrong website during and after a Google Ads campaign. Methods The Google Ads campaign was launched on December 21, 2017, and run until February 28, 2018. Website analytics (acquisition of new users, behavior in terms of at-website actions and duration, devices used, and conversions [link-outs to recommended resources]) in a 30-day period during the campaign (January 26, 2018 to February 24, 2018) were compared to a similar 30-day period after the campaign (March 23, 2018 to April 21, 2018). A cost analysis of the ad campaign was also performed. Results The ad campaign generated 3011 clicks and 4.5 million impressions in total. In addition, the campaign received 1311 website users during the 30-day period of the ad campaign as compared to 241 users during the 30-day period after the ad campaign (P<.001). Return visitor (17.7% vs 27.8%) and nonbounce (19.5% vs 39.8%) user rates as well as session duration (42 vs 102 seconds) and page views per session (1.4 vs 2.1) were lower during the ad campaign than after the campaign (P<.01 for all). The 30-day period of the ad campaign included 9 sessions with conversions initiated by an ad click. Paid and display ads accounted for 63% of the site traffic during the ad campaign, most of which came from mobile phone users. Desktops were the most-common device used after the ad campaign acquired the website via direct and organic searches primarily (92%). The estimated cost per session with one or more conversions was Can $54.69 and cost per conversion was Can $32.81. Conclusions A Google Ads campaign designed to direct men to the Headstrong website increased the number of user visits by more than five-fold. However, engagement by users responding to the ad campaign was substantially lower than that by users who visited the website via other acquisition methods, possibly reflecting the nonspecific online targeting of men by the ad campaign. General targeting of men online to promote men’s mental health appears to have limited value.

Under- or Overtreatment of Mental Distress? Practices, Consequences, and Resistance in the Field of Mental Health Care

2020 ◽  
Vol 30 (10) ◽  
pp. 1503-1516
Author(s):  
Sigita Doblytė
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Providers ◽  
Help Seeking ◽  
Mental Distress ◽  
Health Care Systems ◽  
Care Providers ◽  
Care Systems ◽  
The Media

The economic, social, and health costs of mental distress are increasingly burdening individuals and societies in Europe. Yet, overmedicalization of mild symptoms is also well documented. This accumulates in more pressures and demands on health care systems. In this article, I explore how the process of help seeking in mental distress might be shaped by health system design and functioning in one of the South European societies—Spain. Employing Bourdieu’s theoretical lens, in-depth interviews with health care providers and users of services are analyzed. I reveal how the logic of the mental health care field, which is reinforced by the market, the state, and the media, may result in medicalization of mild distress while severe mental illness remains undertreated. I also show how mental help-seeking practices could gradually influence the functioning of the treatment system. Nevertheless, points of resistance to medicalization can also be identified.

Friends as Informal Educators: The Role of Peer Relationships in Promotion of Sexual Health Services among College Students

2021 ◽  
pp. 0272684X2110346
Author(s):  
Veena Muraleetharan ◽  
Marie A. Brault
Keyword(s):  
Health Promotion ◽  
Sexual Health ◽  
Peer Relationships ◽  
Participant Observation ◽  
Health Resources ◽  
Ethnographic Study ◽  
Structured Interviews ◽  
Informal Educators ◽  
The Impact

This ethnographic study of one United States university’s sexual health resources explores the role of peer relationships in sexual health promotion to understand how these relationships shaped students’ interactions with campus sexual health resources. Through analysis of seventeen semi-structured interviews with students, five policy interviews with providers and university personnel, and participant-observation of peer health educator training, the authors examine how trust in peer relationships can serve as a form of social capital to influence sexual health information sharing. The article introduces the term “peer administrator” to describe student actors who sit at the intersection of friend and official resource and explores the importance of these mentoring relationships for sexual health promotion. The analysis also considers how more individualistic models of public health promotion limit the impact of peer relationships and concludes with a discussion of how universities might imagine new forms of sexual health promotion among students.

scholarly journals Young people, the internet and mental health

2017 ◽  
Vol 35 (1) ◽  
pp. 1-4 ◽  
Author(s):  
D. Chambers ◽  
K. Cairns ◽  
L. Ivancic
Keyword(s):  
Mental Health ◽  
Young People ◽  
Help Seeking ◽  
Health Resources ◽  
Research Area ◽  
Policy Framework ◽  
The Internet ◽  
Original Research ◽  
Online Content ◽  
The Impact

The original research by Mullen et al. in this issue is a welcome contribution to the increasingly important research area concerned with mental health and internet use. There is a persistent and growing tension between harmful online content and the potential to support vulnerable people online. Although current research has established both negative and positive influences of the internet on mental health, a policy framework to guide the development of online mental health resources is lacking. Based on 20 years of online service provision (in Australia originally and now in Ireland), ReachOut.com has gained important insights into young people’s online behaviour and help-seeking preferences. Given that young people have expressed concerns about the impact of the internet and social media on their mental health, yet they will go online for support, there is a clear need for leadership and the resourcing of quality assured, engaging online mental health supports. Such an approach will be the most effective way of mitigating the threat posed by harmful online content.

scholarly journals Facilitating Help-Seeking Behavior Among Medical Trainees and Physicians Using the Interactive Screening Program

2018 ◽  
Vol 104 (2) ◽  
pp. 27-36 ◽  
Author(s):  
Maggie Mortali ◽  
Christine Moutier
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Medical Students ◽  
Mental Health Treatment ◽  
Help Seeking ◽  
Screening Program ◽  
Health Care Systems ◽  
Medical Schools ◽  
Chi Square ◽  
Care Systems

Physician and trainee distress, from burnout and depression to suicide risk, has been recognized as a serious threat to physicians, health care systems and to the optimal delivery of health care. To address this problem, the American Foundation for Suicide Prevention (AFSP) adapted the Interactive Screening Program (ISP) for use by medical schools nationwide. Much is known about the problem, but less is known about the effectiveness of programs and solutions. This program evaluation utilized data from six medical schools' implementation of ISP over a seven-year period (2007–2013) to quantify openness to help-seeking and engagement with each step of program outreach. Descriptive statistics were used to quantify participants' engagement: reviewing the counselor's response; exchanging dialogue messages with the counselor; requesting to meet with the counselor in person; and requesting referral for mental health treatment. Chi-square distribution tests were used to determine differences in level of risk and rates of engagement among medical students, residents and fellows, and faculty physicians. A total of 1,449 individuals, including medical students, residents and faculty physicians, completed the questionnaire; 1,413 (97.5%) were designated as having high or moderate distress and only 5.3% were receiving any type of counseling or therapy. Among program participants, prevalence rates of high distress were higher among medical students and residents versus faculty physicians. The rate of program engagement was high overall with 81.2% reviewing the counselor's response; further engagement was highest among those most distressed, with 32.2% engaging in online dialogue with a program counselor. ISP was a feasible tool for engaging at-risk medical students, residents and physicians who were not currently utilizing mental health services.

scholarly journals The cultural dialogue on the domestic dimension of care to immigrant caregivers in Spain

2015 ◽  
Vol 23 (5) ◽  
pp. 821-828 ◽  
Author(s):  
Isabel Morales-Moreno ◽  
Maravillas Giménez-Fernández ◽  
Paloma Echevarría-Pérez
Keyword(s):  
Informal Care ◽  
Participant Observation ◽  
Ethnographic Study ◽  
Cultural Integration ◽  
Structured Interviews ◽  
Cultural Hybridization ◽  
Traditional Medicines ◽  
Home Group ◽  
Health Care Practices ◽  
Cultural Dialogue

Objectives: to determine how the immigration phenomenon influences the response to informal care in the domestic level through the caregiver activity, and to analyze the cultural dialogue established in the residential area of Murcia (Spain).Method: This is an ethnographic study, conducted in 26 informal immigrant caregivers. As data collection instruments, semi-structured interviews and participant observation were employed. MAXQDA-2 assisted content analysis was also applied.Results: the immigrant caregiver is the main consumer of traditional medicines, extending these health practices to her home group. A cultural dialogue is established on informal care, characterized by interculturalism and mutual adaptation.Conclusions: cultural hybridization was identified for informal caregivers, immigrants and cultural integration: new health care practices and cultural behaviors in informal systems. There is a transformation in the roles of family members attended in domestic environments, increasing quality of life and self care. They represent an alternative to medicalization, promoting self-management of health.

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