Distressing encounters in the context of climate change: Idioms of distress, determinants, and responses to distress in Tuvalu

Across the globe there is a critical need for culturally informed and locally valid approaches to mental health assessment and intervention, particularly among disadvantaged and marginalized populations. To be optimally effective, such approaches must be informed by a sound understanding of locally relevant idioms of distress and its determinants, including those caused or exacerbated by global power disparities and structural inequities. Climate change, arising due to anthropogenic sources located predominantly in industrialized nations, is one potential determinant of distress having disproportionate adverse impacts on already marginalized populations. The present study formed part of a broader project examining the intersections of culture, climate change, and distress in the Polynesian nation of Tuvalu – a focal point of global concern over the human costs of climate change. The study explored determinants and idioms of distress and culturally prescribed responses to coping with distress. Results are based on fieldwork conducted in 2015 entailing semi-structured interviews with 16 key informants and 23 lay residents of Funafuti atoll, recruited using maximal variation purposive sampling. Findings are examined in consideration of the unfolding impacts of climate change and the threat it portends for the future, both of which were identified as salient determinants of distress, in keeping with theorized relationships between climate change and mental health. The study underscores the necessity of attending to the relationships between global forces, local cultures, and individual experiences of distress, as efforts to provide access to culturally informed social and mental health services expand globally.

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Improving the timeliness of mental health assessment for children and adolescents in a multidisciplinary team

International Practice Development Journal ◽

10.19043/ipdj.41.007 ◽

2014 ◽

Vol 4 (1) ◽

pp. 1-13

Author(s):

Nicola Evans ◽

Keyword(s):

Mental Health ◽

Action Research ◽

Children And Adolescents ◽

Health Assessment ◽

Organisational Change ◽

Waiting List ◽

Assessment Process ◽

Structured Interviews ◽

Mental Health Assessment ◽

Brief Assessment

Background: The waiting list for outpatient Child and Adolescent Mental Health Service (CAMHS) appointments exceeded 12 months. This paper discusses the development and implementation of a bespoke mental health assessment process that improved the timeliness of assessments for referred children and adolescents. Aim: To introduce a new system of managing referrals to reduce the waiting list for children and their families. Methods: Action research methodology was used as an approach to engage practitioners and facilitate change within a multidisciplinary CAMHS in the UK. The methods used to generate data about the intervention were semi structured interviews with families referred to the services and with practitioners working in the team, as well as an examination of waiting list data and a survey of referrers to the service. Findings: As a result of the implementation of a triage approach, the waiting time for a referred child to receive an initial CAMHS assessment was reduced from 12 months to all children being assessed within one month of referral. Referrers to the service and families involved valued the quick response from CAMHS. Conclusions: This was a bespoke process that combined a brief clinical interview, the use of psychometric measures and a team review meeting to create an effective mechanism for conducting brief, robust mental health assessments. Implications for practice: It was possible to glean sufficient detail about the nature of a child’s mental health difficulties from a brief assessment or triage process A brief assessment process might be useful in a number of mental health fields to enable screening, triage or a gateway assessment to be conducted Action research was a useful approach to engage practitioners as collaborating partners during organisational change in a way that promoted sustainability for that change

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Institutional Barriers to Climate Change Adaptation in Burkina Faso: How could We Go around Them?

Journal of Sustainable Development ◽

10.5539/jsd.v13n5p67 ◽

2020 ◽

Vol 13 (5) ◽

pp. 67

Author(s):

Fiacre Basson ◽

Djibril S. Dayamba ◽

Joel Korahire ◽

Jean M. Dipama ◽

Francois Zougmore ◽

...

Keyword(s):

Climate Change ◽

Burkina Faso ◽

Climate Change Adaptation ◽

Focal Point ◽

Monitoring And Evaluation ◽

Political Support ◽

Structured Interviews ◽

Institutional Barriers ◽

Strategic Objectives ◽

Key Stakeholders

Despite the existence of a National Adaptation Plan to climate change (NAP) in Burkina Faso, operationalizing adaptation still face a number of challenges. The current study focused on identifying institutional barriers to the strategic objectives of climate change adaptation (CCA) using a literature review and semi-structured interviews conducted with key stakeholders / resource persons involved in the implementation of the NAP. The results revealed a weak collaboration between the NAP steering institution and the ministerial departments covered by the NAP. This situation, first, hampers the implementation of adaptation actions and secondly, the monitoring reporting and verification of adaptation initiatives. Further, the analysis revealed that lack of financial resources poses constraints to many actions that were to be taken by the steering institution and therefore creates poor ownership of the NAP by the main stakeholders that should be actively involved in the NAP process. To cope with the various constraints, it is necessary to have strong political support in many aspects. For instance, it was judged that institutionalizing the role of climate change (CC) focal point within the ministries and embedding NAP monitoring and evaluation (M&E) objectives and indicators with existing functional M&E systems in the sectorial ministries will ease CCA actions integration in operational plans, their implementation and documentation. Moreover, it is relevant to have a continuous capacity building plan to keep stakeholders updated on climate change issues as this will support them in their mandate of mainstreaming CC into ministerial operational plans and lead to optimal CCA implementation and monitoring.

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Safe but isolated – an interview study with Iraqi refugees in Sweden about social networks, social support, and mental health

International Journal of Social Psychiatry ◽

10.1177/0020764020954257 ◽

2020 ◽

pp. 002076402095425 ◽

Cited By ~ 1

Author(s):

Maria Sundvall ◽

David Titelman ◽

Valerie DeMarinis ◽

Liubov Borisova ◽

Önver Çetrez

Keyword(s):

Mental Health ◽

Social Support ◽

Social Networks ◽

Mental Health Problems ◽

Health Assessment ◽

Well Being ◽

Health Problems ◽

Traumatic Experiences ◽

Iraqi Refugees ◽

Structured Interviews

Background: Problems with social networks and social support are known to be associated with mental ill-health in refugees. Social support after migration promotes resilience. Aim: To study how Iraqi refugees who arrived in Sweden after the year 2000 perceived their social networks and social support, and to relate the observed network characteristics and changes to the refugees’ mental health and well-being. Method: Semi-structured interviews with 31 refugees, including questions on background and migration experiences, a biographical network map, and three health assessment scales. The findings were analysed with descriptive statistics and content thematic analysis. Results: The respondents’ networks were diminished. Social support was continued to be provided mainly by family members and supplemented by support from authorities. The main themes of the refugee experience of post-migration challenges were weakened social networks, barriers to integration and challenges to cultural and religious belonging. Failed reunion and worrying about relatives was described as particularly painful. Negative contacts with authority persons were often seen as humiliating or discriminating. Acquiring a new cultural belonging was described as challenging. At the same time, changing family and gender roles made it more difficult to preserve and develop the culture of origin. Traumatic experiences and mental health problems were common in this group. Family issues were more often than integration difficulties associated with mental health problems. Conclusion: In order to strengthen post-migration well-being and adaptation, authorities should support the refugees’ social networks. Clinicians need to address post-migration problems and challenges, including the meaning and function of social networks.

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Tipping to Staying on the Ground: Internalized Knowledge of Climate Change Crucial for Transformed Air Travel Behavior

Sustainability ◽

10.3390/su12051994 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1994 ◽

Cited By ~ 2

Author(s):

Lisa Jacobson ◽

Jonas Åkerman ◽

Matteo Giusti ◽

Avit K. Bhowmik

Keyword(s):

Climate Change ◽

Travel Behavior ◽

Focal Point ◽

Policy Instruments ◽

Climate Impact ◽

Air Travel ◽

Structured Interviews ◽

The Media ◽

Effective Policy ◽

The Impact

Air travel accounts for a major share of individual greenhouse gas emissions, particularly for people in high-income countries. Until recently, few have reduced flying because of climate concerns, but currently, a movement for staying on the ground is rising. Sweden has been a focal point for this movement, particularly during 2018–2019, when a flight tax was introduced, and air travel reduction was intensely discussed in the media. We performed semi-structured interviews with Swedish residents, focusing primarily on individuals who have reduced flying because of its climate impact. We explore how such individual transformation of air travel behavior comes about, and the phases and components of this process. Applying a framework of sustainability transformation, we identify incentives and barriers in personal and political spheres. We show that internalized knowledge about climate change and the impact of air travel is crucial for instigating behavioral change. Awareness evokes negative emotions leading to a personal tipping point where a decision to reduce or quit flying is made. However, the process is often counteracted by both personal values and political structures promoting air travel. Even individuals with a strong drive to reduce flying feel trapped in social practices, norms and infrastructures. Hence, we argue that personal and political spheres interact complexly and to reduce flying at larger scales, interventions are needed across spheres, e.g., change of norms, effective policy instruments and better alternatives to air travel.

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Development of the South Sudan Mental Health Assessment Scale

Transcultural Psychiatry ◽

10.1177/13634615211059711 ◽

2021 ◽

pp. 136346152110597

Author(s):

Lauren C. Ng ◽

Jordan S. Solomon ◽

Maithri Ameresekere ◽

Judith Bass ◽

David C. Henderson ◽

...

Keyword(s):

Mental Health ◽

Concurrent Validity ◽

Convergent Validity ◽

Mental Health Problems ◽

South Sudan ◽

Health Assessment ◽

Assessment Scale ◽

Idioms Of Distress ◽

The South ◽

Mental Health Assessment

This study developed and validated a measure that captures variation in common local idioms of distress and mental health problems experienced by women in South Sudan, a country which has experienced over 50 years of violence, displacement, and political, social, and economic insecurity. This measure was developed during a randomized controlled trial of the Adolescent Girls Initiative (AGI) and used qualitative Free Listing (n = 102) and Key Informant interviews (n = 27). Internal reliability and convergent validity were assessed using data from 3,137 randomly selected women (ages 14–47) in 100 communities in South Sudan. Test-retest and inter-rater reliability were assessed using responses from 180 women (ages 15–58) who completed the measure once, and 129 of whom repeated the measure an average of 12 days (SD = 8.3) later. Concurrent validity was assessed through the ratings of 22 AGI leaders about the presence or absence of mental health symptoms in the 180 women in the test-retest sample. The study resulted in the development of the South Sudan Mental Health Assessment Scale, a 24-item measure assessing six idioms of distress. The scale consisted of one factor and had excellent internal, test-retest, and interrater reliability. The scale also demonstrated good convergent and concurrent validity and performed well psychometrically. Moreover, its development provides an example for other organizations, working in environments where mental health measures have not yet been developed and validated, to create and validate measures relevant to their populations. In this way, the role of mental health in development settings can be more rapidly assessed.

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