scholarly journals Ngā Whakāwhitinga (standing at the crossroads): How Māori understand what Western psychiatry calls “schizophrenia”

2018 ◽  
Vol 55 (2) ◽  
pp. 153-177 ◽  
Author(s):  
Melissa Taitimu ◽  
John Read ◽  
Tracey McIntosh
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Qualitative Methodology ◽  
Cultural Beliefs ◽  
Historical Trauma ◽  
Traditional Healers ◽  
Explanatory Models ◽  
Personal Construct ◽  
Structured Interviews

This project explored how Māori understand experiences commonly labelled “schizophrenic” or “psychotic”. Semi-structured interviews were conducted with 57 Māori participants who had either personal experiences labelled as “psychosis” or “schizophrenia”, or who work with people with such experiences; including tangata whaiora (users of mental health services), tohunga (traditional healers), kaumatua/kuia (elders), Māori clinicians, cultural support workers and students. Kaupapa Māori Theory and Personal Construct Theory guided the research within a qualitative methodology. The research found that participants held multiple explanatory models for experiences commonly labelled “psychotic” or “schizophrenic”. The predominant explanations were spiritual and cultural. It seems that cultural beliefs and practices related to mental health within Māori communities remain resilient, despite over a century of contact with mainstream education and health services. Other explanations included psychosocial constructions (interpersonal trauma and drug abuse), historical trauma (colonisation) and biomedical constructions (chemical brain imbalance). Participants (both tangata whaiora and health professionals) reported they were apprehensive about sharing their spiritual/cultural constructions within mainstream mental health settings due to fear of being ignored or pathologised. This study highlights the importance of asking users of mental health services about the meaning they place on their experiences and recognising that individuals can hold multiple explanatory models. Māori may hold both Māori and Pākehā (European) ways of understanding their experiences and meaningful recognition should be afforded to both throughout assessment and treatment planning in mental health services. Clinicians need to be aware that important personal and cultural meanings of experiences labelled psychotic may be withheld due to fear of judgement or stigmatisation.

The transition between mental health services in Scotland

2018 ◽  
Vol 23 (1) ◽  
pp. 12-24 ◽  
Author(s):  
Juliette van der Kamp
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Transition Period ◽  
Organisational Development ◽  
Structured Interviews ◽  
Content Type ◽  
Experience Difficulty

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved. Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development. Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development. Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services.

scholarly journals Influences on participation in a programme addressing loneliness among people with depression and anxiety: findings from the Community Navigator Study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Johanna Frerichs ◽  
Jo Billings ◽  
Nick Barber ◽  
Anjie Chhapia ◽  
Beverley Chipp ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Thematic Analysis ◽  
Narrative Analysis ◽  
Mental Health Problems ◽  
Severe Depression ◽  
Feasibility Trial ◽  
Structural Level ◽  
Structured Interviews

Abstract Background Loneliness is associated with negative outcomes, including increased mortality and is common among people with mental health problems. This qualitative study, which was carried out as part of a feasibility trial, aimed to understand what enables and hinders people with severe depression and/or anxiety under the care of secondary mental health services in the United Kingdom to participate in the Community Navigator programme, and make progress with feelings of depression, anxiety and loneliness. The programme consisted of up to ten meetings with a Community Navigator and three optional group sessions. Methods Semi-structured interviews were carried out with participants (n = 19) shortly after programme completion. A co-produced two-stage qualitative approach, involving narrative and reflexive thematic analysis, was undertaken by members of the study’s working group, which included experts by experience, clinicians and researchers. Results The narrative analysis showed that individuals have varied goals, hold mixed feelings about meeting other people and define progress differently. From the thematic analysis, six themes were identified that explained facilitators and challenges to participating in the programme: desire to connect with others; individual social confidence; finding something meaningful to do; the accessibility of resources locally; the timing of the programme; and the participant’s relationship with the Community Navigator. Conclusions We found that people with severe depression and/or anxiety supported by secondary mental health services may want to address feelings of loneliness but find it emotionally effortful to do so and a major personal challenge. This emotional effort, which manifests in individuals differently, can make it hard for participants to engage with a loneliness programme, though it was through facing personal challenges that a significant sense of achievement was felt. Factors at the individual, interpersonal and structural level, that enable or hinder an individual’s participation should be identified early, so that people are able to make the best use out of the Community Navigator or other similar programmes.

Wellbeing and experiences of Chinese and Vietnamese carers of people with mental illness in Australia

2020 ◽  
pp. 136346152095262
Author(s):  
Abner Weng Cheong Poon ◽  
Maria Cassaniti ◽  
Michele Sapucci ◽  
Rosaleen Ow
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Support Groups ◽  
Negative Impact ◽  
Cultural Safety ◽  
Structured Interviews ◽  
People With Mental Illness ◽  
Qualitative Thematic Analysis

Many studies show that carers of people with mental illness experience a negative impact on their wellbeing. Given the growing number of people relocating to Australia every year, there are limited studies examining the experience of carers of people with mental illness from culturally and linguistically diverse communities in Australia. Using cultural safety as a conceptual framework, this exploratory study recruited 14 carers of Chinese and Vietnamese heritage who were attending culturally and linguistically oriented support groups in Sydney, Australia. Standardised, validated scales were administered to measure carers’ wellbeing and knowledge of recovery. Structured interviews were conducted to understand carers’ perceived needs. Descriptive statistical and qualitative thematic analysis were used. Findings show that carers experienced social isolation and psychological distress, had multiple diverse needs and had a reasonably good understanding of recovery. Six themes were identified: i) obtaining information in own language; ii) attaining emotional support from support groups; iii) needing respite services to cope with caregiving responsibilities; iv) involvement in planning of treatment and care; v) migration process influencing caregiving, and; vi) cultural and transcultural factors influencing caregiving experience. Findings indicate that some carers might be experiencing some level of culturally unsafe practices in mainstream mental health services. Implications for support groups and mental health services are discussed.

Mental Health Service Needs of Commercially Sexually Exploited Youth: Voices of Survivors and Stakeholders

2020 ◽  
Vol 35 (3) ◽  
pp. 354-362
Author(s):  
Rachel Robitz ◽  
Emilio C. Ulloa ◽  
Marissa Salazar ◽  
Monica D. Ulibarri
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Sexual Exploitation ◽  
Individual Therapy ◽  
Service Needs ◽  
Structured Interviews ◽  
Community Stakeholders ◽  
Self Worth ◽  
Level Of Understanding

Youth who experience commercial sexual exploitation (CSE) have complex mental health needs. This study describes what CSE survivors and stakeholders who work with them desire in mental health services. We conducted semi-structured interviews with 10 CSE survivors 16–20 years old, and 15 community experts on CSE (n = 25). Thematic analyses indicated CSE survivors value mental health services including individual therapy and coping skills, and they wanted providers who are nonjudgmental, and exhibit some level of understanding of CSE. Community stakeholders described skills important for CSE survivors to gain from mental health services including recognition of patterns of victimization, self-worth, and emotion regulation. Both stakeholders and CSE youth desired services that give survivors some control over their treatment and recovery utilizing a trauma-informed approach.

Young service users from refugee backgrounds: their perspectives on barriers to accessing Australian mental health services

2017 ◽  
Vol 10 (1) ◽  
pp. 68-80 ◽  
Author(s):  
Madeleine Claire Valibhoy ◽  
Josef Szwarc ◽  
Ida Kaplan
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Health Professionals ◽  
Mental Health Problems ◽  
Health Problems ◽  
Explanatory Models ◽  
Service Users ◽  
Content Type

Purpose The purpose of this paper is to examine barriers to accessing mental health services, from the perspective of young people of refugee background who have been service users, and to suggest strategies to improve access to mental health services. Design/methodology/approach A qualitative study was conducted with 16 young people (aged 18-25), who had been refugees and who had attended mental health professionals in Australia. Interview transcripts were analysed thematically to examine participants’ perspectives on what hinders initial access to mental health services. Findings Stigma about mental health problems was particularly prominent. Many believed a high level of disturbance was the threshold for entering services, and for some there was no knowledge of such services’ existence. Options for assistance other than mental health services were often preferred, according to young people’s explanatory models. Apprehension was expressed that sessions would be uncomfortable, distressing or ineffective. The desire to be self-reliant functioned as a further barrier. Finally, structural obstacles and social exclusion deterred some young refugees from accessing services. Practical implications Implications include the need for service providers to be equipped to provide culturally sensitive, responsive services that ideally offer both practical and psychological assistance. Potential referrers, including health professionals and community leaders, could facilitate increased access if trained to recognise and address barriers. Finally, findings indicate potential content for awareness-raising initiatives for young refugees about mental health problems and services. Originality/value This paper is original in its sample, method, topic and findings; being drawn from the first known qualitative research exploring views of young mental health service users who have been refugees about barriers to accessing mental health services.

scholarly journals Wellness Centre: An Evidence-Guided Approach to Delivering Culturally Relevant Community Psychogeriatric Services for Chinese Elders

2012 ◽  
Vol 2012 ◽  
pp. 1-7
Author(s):  
Kar C. Chan ◽  
Joel Sadavoy
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Cultural Beliefs ◽  
Cultural Groups ◽  
Course Of Illness ◽  
Ethnic Populations ◽  
Problem Detection

Ethnic elders are commonly reluctant to access mental health services and their mental health problems are often overlooked and detected late in the course of illness. Prior studies identified major barriers to ethnic seniors accessing appropriate mental health care demonstrating that language and cultural beliefs cannot be ignored if effective mental health services are to be provided to patients from diverse cultural groups. These are particularly important when care is needed by less acculturated immigrant ethnic seniors for whom language barriers are often greatest. Differences in conceptions of mental distress affect ethnic seniors' choice of help-seeking and often discourage or divert aged persons from utilizing mainstream conventional psychiatric care. Despite the extensive need for appropriate service models for ethnic populations, there have been limited data and models to illustrate how these programs can be systematically and effectively integrated within the mainstream mental health service framework. This paper describes an innovative, mainstream, community-based psychogeriatric service delivery model developed for Chinese seniors in Toronto, Canada, aiming at improving their access to care and enhancing earlier mental health problem detection. The important concepts and strategies of designing and operating a culturally acceptable program are illustrated supported by program data and the challenges analyzed.

scholarly journals Screening and Referral is Not Enough: A Qualitative Exploration of Barriers to Access and Uptake of Mental Health Services in Patients With Cardiovascular Diseases

2020 ◽  
Author(s):  
Catherine M Collopy ◽  
Suzanne M Cosh ◽  
Phillip J Tully
Keyword(s):  
Mental Health ◽  
Cardiovascular Diseases ◽  
Mental Health Services ◽  
Health Services ◽  
Peer Support ◽  
Service Use ◽  
Information Provision ◽  
Cardiac Events ◽  
Structured Interviews

Abstract Background: Cardiovascular diseases (CVD) are commonly comorbid with mental health disorders, portending poorer cardiac prognosis. Despite the high prevalence of depression and anxiety, and guidelines recommending routine depression screening and referral, uptake of mental healthcare in CVD populations remains low. Reasons for the underutilisation of mental health and psychological services for this population remain largely unknown.Methods: Thirteen CVD patients with clinically significant psychological symptoms (depression, anxiety and/or stress) participated in one-on-one in-depth semi-structured interviews. Data were analysed using inductive thematic analysis.Results: Barriers to uptake included the timing of referral and screening, with patients reporting a need for longer term follow-up. A lack of information provision and understanding around mental health and services, especially following cardiac-events were further barriers. A reluctance to report mental health or engage in services was also identified, with patients indicating a preference for informal peer support networks. A range of practical barriers such as mobility, transport and cost were also reported. Conclusions: Longer term follow-up and routine mental health assessment may be beneficial to facilitate use of mental health services. Upskilling of practitioners around mental health may be a further avenue to promote information provision and enhance service use. Further focus on enhancing informal peer support may be a valuable initial approach for the CVD population. The implications for improving services and enhancing service use are discussed.

‘Maybe a Maverick, Maybe a Parent, but Definitely Not an Honorary Nurse’: Social Worker Perspectives on the Role and Nature of Social Work in Mental Health Care

2020 ◽  
Author(s):  
Laura Tucker ◽  
Martin Webber
Keyword(s):  
Mental Health ◽  
Social Work ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Social Workers ◽  
Geographical Area ◽  
Health Service Delivery ◽  
Structured Interviews ◽  
The Uk

Abstract In many places in the UK, social work is integral to mental health service delivery. Significant role erosion, however, has left the profession unclear about where it fits within modern mental health services. The 2016 Social Work for Better Mental Health initiative outlines five key mental health roles and has been adopted into national policy in England to combat this uncertainty, but the influence of this has not been explored. This study aimed to develop an understanding of how mental health social workers perceive and explain their role. Semi-structured interviews were undertaken with seven social workers based within one English National Health Service mental health trust covering a large geographical area and their responses analysed using Ritchie, Spencer and O’Connor’s Framework thematic model. Findings indicated that social workers only superficially engaged with the aspirational policy roles, instead presenting their own framework for what makes mental health social work distinctive. This was constructed around the context and intentions of practice, rather than around proscribed tasks and responsibilities. This study has significance for individual social workers and for organisations providing and planning mental health services in the UK and beyond, given the influence that practitioner perceptions can have on how they undertake their roles.

scholarly journals Social prescribing for patients of secondary mental health services: emotional, psychological and social well-being outcomes

2020 ◽  
Vol 19 (4) ◽  
pp. 271-279
Author(s):  
Chris Dayson ◽  
Jo Painter ◽  
Ellen Bennett
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Well Being ◽  
Positive Contribution ◽  
Structured Interviews ◽  
Content Type ◽  
Social Prescribing

Purpose This paper aims to identify the well-being outcomes of a social prescribing model set within a secondary mental health service recovery pathway and understand the key characteristics of a social prescribing referral for producing these outcomes. Design/methodology/approach A qualitative case study of one mental health social prescribing service with three nested case studies of social prescribing providers. Semi-structured interviews were undertaken with commissioners, providers and patients (n = 20) and analysed thematically. Findings Social prescribing makes a positive contribution to emotional, psychological and social well-being for patients of secondary mental health services. A key enabling mechanism of the social prescribing model was the supportive discharge pathway which provided opportunities for sustained engagement in community activities, including participation in peer-to-peer support networks and volunteering. Research limitations/implications More in-depth research is required to fully understand when, for whom and in what circumstances social prescribing is effective for patients of secondary mental health services. Practical implications A supported social prescribing referral, embedded within a recovery focussed secondary mental health service pathway, offers a valuable accompaniment to traditional approaches. Current social prescribing policy is focussed on increasing the number of link workers in primary care, but this study highlights the importance models embedded within secondary care and of funding VCSE organisations to receive referrals and provide pathways for long-term engagement, enabling positive outcomes to be sustained. Originality/value Social prescribing is widely advocated in policy and practice but there are few examples of social prescribing models having been developed in secondary mental health services, and no published academic studies that everybody are aware of.

Russian Speaking Immigrants from the Commonwealth of Independent States in the United States: Implications for Mental Health Counselors

2007 ◽  
Vol 29 (3) ◽  
pp. 242-258 ◽  
Author(s):  
Gulnora Hundley ◽  
Glenn Lambie
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Cultural Beliefs ◽  
The United States ◽  
Mental Health Counselors ◽  
Health Issues ◽  
Commonwealth Of Independent States ◽  
Treatment Services ◽  
Independent States

In this article, we present common mental health issues facing Russian speaking immigrants from the Commonwealth of Independent States (CIS), highlighting the necessity for counselors to have an understanding and appreciation of these issues in order to provide effective treatment services. An introduction to CIS mental health services and a historical description of the influence of the communist government on health care in the CIS are provided. Additionally, we review the cultural beliefs and values of CIS immigrants regarding mental health services and their underutilization. Finally, a series of practical suggestions for mental health counselors providing services to Russian speaking immigrants are offered.

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