scholarly journals Connection Failure: Systemic Disadvantages Facing the LGBTQ+ Community in Therapy and how to Address them

Author(s):  
Erin Roach

This paper examines the experiences of members of the LGBTQ+ community in accessing mental health care in Ottawa, Canada, both positive and negative, and what might be done to improve outcomes. The paper includes a literature review of empirical studies and theoretical works about conducting therapy with LGBTQ+ clients, as well as the results of a pilot study conducted by the researcher to examine in depth the experience of a small sample of LGBTQ+ clients in Ottawa (N=4). Through semi-structured interviews, the researcher found that three out of four participants had experienced some dissatisfaction with how their identity was addressed in therapy, and as a result their overall well-being had suffered. This implies that therapists could be doing more to connect with their LGBTQ+ clients, potentially through better educating themselves on the issues affecting the community, as recommended by the participants. Increasing therapist knowledge would likely improve mental health outcomes for LGBTQ+ clients.

1993 ◽  
Vol 38 (10) ◽  
pp. 678-680 ◽  
Author(s):  
James Vanharen ◽  
Catherine Laroche ◽  
Marsha Heyman ◽  
Albert Massabki ◽  
Lois Colle

Over the past 30 years much information has been collected on children whose parents suffer from psychiatric illness. Research has shown that many of these children are at high risk for significant psychopathology but there have been few investigations examining whether or not they are being identified and are receiving mental health care. The purpose of this pilot study was to investigate to what extent the children of psychiatrically ill adult patients are identified and referred to the mental health services. Results of structured interviews with the patients indicate that a considerable number had school-aged children and that in many instances no inquiry had been made concerning the children's psychological health. Although some of the children were reported to have received treatment, few had been referred by their parents’ psychiatrists. Recommendations to improve the identification and treatment of such children are outlined in this study.


Author(s):  
Sus Corazon ◽  
Ulrik Sidenius ◽  
Katrine Vammen ◽  
Sabine Klinker ◽  
Ulrika Stigsdotter ◽  
...  

Binge eating disorder (BED), characterized by recurrent episodes of binge eating with a subjective experience of lack of control, is the world’s most common eating disorder. The aim of the present pilot study was to examine the feasibility of implementing nature-based therapy (NBT) in the treatment of BED. The NBT intervention was compared to Support Group Meetings (SGMs), which are the only publicly available form of support for people diagnosed with BED in Denmark. Twenty participants with a BED diagnosis were included in the study, which had a mixed-methods design including Eating Disorder Examination interviews, semi-structured interviews, and questionnaires measuring well-being (The Psychological General Well-Being Index) and self-esteem (Rosenberg’s Self-Esteem Scale). Both the NBT and the SGMs showed positive results on all outcome measures (decreases in binge eating episodes and increases in general psychological well-being and self-esteem). The interviews indicated that the NBT context made the psychotherapeutic content more accessible to the participants and further helped them transfer the therapeutic gains to daily life after completing treatment. However, these results should be interpreted with caution due to the small sample size—ideally, they would need to be tested on a larger, randomized sample.


2019 ◽  
Vol 44 (3) ◽  
pp. 149-155 ◽  
Author(s):  
Annie Snow ◽  
Julie Cerel ◽  
Diane N Loeffler ◽  
Chris Flaherty

AbstractContemporary research suggests that transgender and gender-nonconforming (TGNC) adults encounter formidable barriers to health care, including access to quality therapeutic interventions. This systematic review is one of the first to specifically explore obstacles to TGNC mental health care. A rigorous literature review identified eight relevant studies: six qualitative designs and two quantitative designs. Thematic synthesis revealed three major barriers to care and five corresponding subthemes: (1) personal concerns, involving fear of being pathologized or stereotyped and an objection to common therapeutic practices; (2) incompetent mental health professionals, including those who are unknowledgeable, unnuanced, and unsupportive; and (3) affordability factors. Results indicate an acute need for practitioner training to ensure the psychological well-being of TGNC clients.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Maren M. Hawkins ◽  
Marin E. Schmitt ◽  
Comfort Tosin Adebayo ◽  
Jennifer Weitzel ◽  
Oluwatoyin Olukotun ◽  
...  

AbstractThe health of refugee women after settlement in a new country, can be adversely or positively affected by individual, interpersonal, community, and organizational factors. While much of the previous literature highlights these factors individually, there is a lack of comprehensive synthesis regarding how the factors interact to influence the health of refugee women. We conducted a thematic analysis in our literature review to elucidate how providers can work with refugee women to prevent adverse health outcomes and intervene at multiple levels to improve their health outcomes after resettlement. We reviewed peer-reviewed literature from 2009 to 2019 from Google Scholar, JSTOR, Global Health, PubMed, CINAHL, Sociological Abstracts, and Social Service Abstracts, and also used citation chaining, to identify relevant information pertaining to refugee women’s health. The key terms used for our literature review were, health care, violence, social support, and mental health. In total, we included 52 articles, 3 books, and 8 other sources. We found that refugee women are vulnerable to violence during migration and typically have high rates of post-traumatic stress disorder. There were also concerns of secondary victimization by providers after resettlement. We also found that social support is an important factor for reducing isolation, and improving access to health care, as well as improving mental health outcomes. However, social support was often difficult to maintain, and was moderated by factors such as English language fluency. Health care was influenced by health literacy, cultural difference, communication concerns, and access issues. The findings suggest that at the individual and interpersonal levels there is a need to address language barriers, improve provider-patient communication, and provide appropriate medical and mental health screenings. At the organizational level, inter-organizational communication and awareness are vital. At the community level, providers can work with community leaders, to educate, create dialogue and collaboration, to help facilitate understanding and bolster community social support. Improved communication and knowledge about the unique needs and concerns of refugee women through an integrated, multi-system approach is necessary to improve their health outcomes.


2020 ◽  
Vol 35 (1) ◽  
pp. 88-107 ◽  
Author(s):  
Rosemary Ricciardelli ◽  
Nicole Gerarda Power

Internationally, researchers studying correctional officer (CO) work have examined CO self-presentation, staff-prisoner relationships, and emotional labor. We build on this research by drawing on occupational literature to examine officer mental health outcomes that result from correctional work. We examine the impact of working in prison on COs' well-being, paying particular attention to aspects of the work content (operational stressors) and context (organizational stressors). In conducting semi-structured interviews with COs in Atlantic Canada, we found that COs identified a number of operational stressors as impacting their mental health, specifically generalized violence among prisoners, direct and vicarious violence, and ongoing harassment. COs identified organizational stressors, including a work culture that discourages visible emotional responses to operational stressors, a lack of support from management, and inadequate procedures for dealing with workplace violence and harassment, as factors that exacerbate and contribute to negative mental health outcomes.


2007 ◽  
Vol 7 (2) ◽  
pp. 12-24 ◽  
Author(s):  
Fay Kohn ◽  
Jane Pirkis ◽  
Belinda Morley ◽  
Lucio Naccarella ◽  
Grant Blashki

Much has been written about evaluation utilisation from a theoretical perspective, but relatively less emphasis has been given to empirical studies that examine how the findings from given evaluations are utilised. The current study examined the nature and extent of utilisation of the findings from an ongoing evaluation of a key component of a major national primary mental health care initiative in Australia. The initiative is known as the Better Outcomes in Mental Health Care (BOiMHC) program, and the component involves 111 Access to Allied Psychological Services (ATAPS) projects, which provide mental health care to people who might otherwise have difficulty accessing such services. Nine reports have been produced during the evaluation of the ATAPS projects, and the current study explored how various stakeholders have used the first eight of these reports, via semi-structured interviews with 10 purposefully sampled respondents. The study revealed that the findings in the reports have been put to instrumental use (e.g. influencing decisions about program modification), conceptual use (e.g. furthering the knowledge base regarding the delivery of primary mental health care in general) and symbolic or legitimative use (e.g. confirming the original philosophy behind the BOiMHC program). Various reasons may account for this wide range of uses, including the fact that every effort has been made to identify all relevant stakeholders, garner their support for the evaluation from the outset, and communicate the evaluation findings to them in a relevant manner. The study provides empirical evidence that evaluation findings can be widely utilised, providing they are geared to the needs of the relevant stakeholders.


2017 ◽  
Vol 41 (3) ◽  
pp. 222-233 ◽  
Author(s):  
David J. Bumgarner ◽  
Elizabeth J. Polinsky ◽  
Katharine G. Herman ◽  
Joanne M. Fordiani ◽  
Carmen P. Lewis ◽  
...  

2021 ◽  
pp. 104420732110275
Author(s):  
Alex Nester Jiya ◽  
Maxwell Peprah Opoku ◽  
William Nketsia ◽  
Joslin Alexei Dogbe ◽  
Josephine Nkrumah Adusei

Deplorable living conditions among persons with disabilities and the need to improve their living conditions cannot be overemphasized. This has triggered international discussion on the need for deliberate social policies to bridge the poverty gap between persons with and without disabilities. In Malawi, expansion of financial services has been identified as an essential tool to accelerate economic and inclusive development. However, empirical studies are yet to explore the preparedness of financial institutions to extend their services to persons with disabilities. In this qualitative study, semi-structured interviews were conducted with managers from commercial banks in Malawi to understand their perspectives on extending financial services to persons with disabilities. Interviews were transcribed verbatim and a descriptive thematic analysis was performed. Although participants reiterated the need to provide persons with disabilities with financial services to improve their well-being, few initiatives have been undertaken to improve their participation. Particularly, participants stated that barriers, such as a lack of financial literacy and adaptive technologies, communication barriers, and high rates of unemployment, explained the reluctance of commercial banks to extend financial services to persons with disabilities. The limitations, recommendations for future research, and implications of the study for policymaking have been highlighted.


Author(s):  
Kris Vanhaecht ◽  
Deborah Seys ◽  
Luk Bruyneel ◽  
Bianca Cox ◽  
Gorik Kaesemans ◽  
...  

Abstract Background The coronavirus disease 2019 (COVID-19) may aggravate workplace conditions that impact health-care workers’ mental health. However, it can also place other stresses on workers outside of their work. This study determines the effect of COVID-19 on symptoms of negative and positive mental health and the workforce’s experience with various sources of support. Effect modification by demographic variables was also studied. Methods A cross-sectional survey study, conducted between 2 April and 4 May 2020 (two waves), led to a convenience sample of 4509 health-care workers in Flanders (Belgium), including paramedics (40.6%), nurses (33.4%), doctors (13.4%) and management staff (12.2%). About three in four were employed in university and acute hospitals (29.6%), primary care practices (25.7%), residential care centers (21.3%) or care sites for disabled and mental health care. In each of the two waves, participants were asked how frequently (on a scale of 0–10) they experienced positive and negative mental health symptoms during normal circumstances and during last week, referred to as before and during COVID-19, respectively. These symptoms were stress, hypervigilance, fatigue, difficulty sleeping, unable to relax, fear, irregular lifestyle, flashback, difficulty concentrating, feeling unhappy and dejected, failing to recognize their own emotional response, doubting knowledge and skills and feeling uncomfortable within the team. Associations between COVID-19 and mental health symptoms were estimated by cumulative logit models and reported as odds ratios. The needed support was our secondary outcome and was reported as the degree to which health-care workers relied on sources of support and how they experienced them. Results All symptoms were significantly more pronounced during versus before COVID-19. For hypervigilance, there was a 12-fold odds (odds ratio 12.24, 95% confidence interval 11.11–13.49) during versus before COVID-19. Positive professional symptoms such as the feeling that one can make a difference were less frequently experienced. The association between COVID-19 and mental health was generally strongest for the age group 30–49 years, females, nurses and residential care centers. Health-care workers reported to rely on support from relatives and peers. A considerable proportion, respectively, 18 and 27%, reported the need for professional guidance from psychologists and more support from their leadership. Conclusions The toll of the crisis has been heavy on health-care workers. Those who carry leadership positions at an organizational or system level should take this opportunity to develop targeted strategies to mitigate key stressors of health-care workers’ mental well-being.


Author(s):  
Tina Vilovic ◽  
Josko Bozic ◽  
Marino Vilovic ◽  
Doris Rusic ◽  
Sanja Zuzic Furlan ◽  
...  

During the coronavirus disease 2019 (COVID-19) outbreak, family physicians (FPs) are the backbone of the healthcare system with considerable impact on the general population, and their well-being is of great importance. The aim of this investigation was to assess FPs mental health, as well as knowledge, attitudes and practices (KAPs) regarding the pandemic, and opinions on non-communicable disease (NCD) health care provided to patients. A cross-sectional study was carried out with a sample of 613 FPs. Anxiety and depression levels were estimated with the Hospital Anxiety and Depression Scale, subjective perceived stress with the Perceived Stress Scale, while trauma-related symptoms were assessed using the Impact on Event Scale-COVID19. KAPs toward the pandemic and opinions regarding NCD patients were evaluated with questionnaires accordingly. Results have shown that age (β = −0.02, p = 0.013) and personal risk of COVID‑19 (β = 1.05, p < 0.001) were significant independent correlates of the knowledge score. A total of 87.7% FPs expressed moderate/high perceived stress, 45.2% moderate/severe trauma-related symptoms, 60.4% borderline/abnormal anxiety levels, and 52.4% borderline/abnormal depression levels. Knowledge score was an independent predictor of perceived stress (β = −0.33, p = 0.023) and anxiety (β = −0.31, p = 0.006) levels. Limited accessibility to healthcare services and decreased number of newly-diagnosed NCD cases were mostly agreed on. The pandemic puts a considerable strain on FPs mental health, as well as on public health measures, due to the decreased overall quality of NCD patient health care. Educational programs may bridge the gaps between FPs’ knowledge. Thus lowering anxiety and improving patient care.


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