scholarly journals Work experiences, resources, and beliefs among vulnerable subgroups of mental health care users

Work ◽  
2021 ◽  
pp. 1-10
Author(s):  
Mona Eklund ◽  
Jan-Åke Jansson ◽  
Lisa Eklund ◽  
Parvin Pooremamali ◽  
A. Birgitta Gunnarsson
Keyword(s):  
Mental Illness ◽  
Work Experience ◽  
Psychiatric Symptoms ◽  
Well Being ◽  
Activity Level ◽  
Work Experiences ◽  
Related Factors ◽  
Everyday Activity ◽  
Level Of Functioning ◽  
Work And Employment

BACKGROUND: People with mental illness may have difficulties related to work and employment, especially if they experience additional difficult life situations. OBJECTIVE: To explore how subgroups with mental illness and additional adversities perceived their situation with respect to work and employment prospects. METHODS: Three subgroups were included, exposed to an additional difficult life situation: i) psychosis interrupting their career development at young age (n = 46), ii) having a history of substance use disorder (SUD) (= 57) or iii) having recently immigrated (n = 39). They responded to questionnaires addressing sociodemographics, work-related factors, everyday activity, and well-being. A professional assessed their level of functioning and symptom severity. RESULTS: The young people with psychosis had a low education level, little work experience, the poorest worker role resources, and a low level of functioning, but a high quality of life. The SUD group had the fewest work experiences, were the least satisfied with work experiences, and had the lowest activity level, but had the least severe psychiatric symptoms. The immigrant group had severe psychiatric symptoms, but high ratings on work experiences, work resources, and activity level. CONCLUSIONS: Each group presented unique assets and limitations pertaining to work and employment, suggesting that they also needed unique support measures.

scholarly journals A cross-sectional study addressing the importance of work and other everyday activities for well-being among people with mental illness: does additional vulnerability matter?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa Eklund ◽  
A. Birgitta Gunnarsson ◽  
Jan-Åke Jansson ◽  
Parvin Pooremamali ◽  
Mona Eklund
Keyword(s):  
Quality Of Life ◽  
Mental Illness ◽  
Psychosocial Functioning ◽  
Work Experience ◽  
Well Being ◽  
Activity Level ◽  
Environmental Aspects ◽  
People With Mental Illness ◽  
History Of

Abstract Background Work and other everyday activities are beneficial for well-being among people with mental illness, but poor circumstances can create detrimental effects, possibly aggravated by additional vulnerabilities linked with their mental illness. This study aimed to investigate how activity factors were related to well-being and functioning among three vulnerable groups using outpatient mental health care – young people with psychosis, people with a history of substance use disorder (SUD), and immigrants with post-traumatic stress disorder (PTSD) – while controlling for vulnerability group, age and gender. Methods Participants represented the three types of vulnerability (n = 46/57/39). Data collection, using self-report and interviewer-rated questionnaires, concerned aspects of everyday activity (work experiences; views of the worker role; satisfaction with everyday occupations; activity level), well-being (quality of life: life and health; quality of life: environmental aspects; recovery) and functioning (psychosocial functioning; symptom severity). Spearman correlations and General Linear Modelling were used. Results Activity satisfaction was positive (p < 0.001) but recent work experience negative (p = 0.015) for the life and health aspect of quality of life. Activity satisfaction was positive for the environmental aspects of quality of life (p < 0.001). Resources for having a worker role (p < 0.001) and belief in having a future worker role (p = 0.007) were positively associated with better recovery. Activity level (p = 0.001) and resources for having a worker role (p = 0.004) showed positive associations with psychosocial functioning. Belief in a future worker role (p = 0.011) was related with symptom level. Women had less severe symptoms in the young group with psychosis. Regarding vulnerability group, young people with psychosis perceived better quality of life; those with a history of SUD had less severe psychiatric symptoms; and the recent immigrants with PTSD had the highest level of psychosocial functioning. Conclusion Work experience may not be conducive to well-being in itself; it is satisfaction with work and other activities that matters, and worker and employer expectations need alignment. No vulnerability group seemed consistently more disadvantaged regarding well-being and functioning, but the fact that differences existed is vital to acknowledge in activity-based rehabilitation. Inquiring about meaningful activities and providing opportunities for executing them would be a fruitful way of support.

Relationships between Occupational Factors and Health and Well-Being in Individuals with Persistent Mental Illness Living in the Community

2007 ◽  
Vol 74 (4) ◽  
pp. 303-313 ◽  
Author(s):  
Mona Eklund ◽  
Christel Leufstadius
Keyword(s):  
Mental Illness ◽  
Occupational Therapy ◽  
Psychiatric Symptoms ◽  
Well Being ◽  
Activity Level ◽  
Occupational Factors ◽  
Self Rated Health ◽  
Persistent Mental Illness ◽  
Health Related ◽  
Health And Well Being

Purpose. This study identified relationships between occupational factors and health and well-being among individuals with persistent mental illness. Methods. There were 103 subjects assessed in regards to time spent in different occupations, activity level, satisfaction with daily occupations, and experienced occupational value. The health-related variables were self-rated health, quality of life, self-esteem, sense of coherence, self-mastery, psychosocial functioning, and psychiatric symptoms. Results. Subjective perceptions of occupational performance were consistently related to both self-rated and interviewer-rated aspects of health and functioning. While variables pertaining to actual doing showed weak or no associations with self-rated health-related variables, they exhibited moderate relationships to interviewer-rated health and functioning. Implications. The health-promoting ingredients in occupations were determined by the way occupations were perceived, rather than the doing per se. The findings indicate that perceived meaning and satisfaction ought to be prioritized when setting goals in occupational therapy practice, and, besides, that existing occupational therapy theory needs to be updated.

scholarly journals Women, Younger Clinicians’, and Caregivers’ Experiences of Burnout and Well-being During COVID-19 in a US Healthcare System

2021 ◽  
Author(s):  
Ellis C. Dillon ◽  
Cheryl D. Stults ◽  
Sien Deng ◽  
Meghan Martinez ◽  
Nina Szwerinski ◽  
...  
Keyword(s):  
Healthcare System ◽  
Work Experience ◽  
Well Being ◽  
Work Experiences ◽  
Personal Lives ◽  
Weighted Estimates ◽  
Statistical Inferences ◽  
System Improvement ◽  
And Gender ◽  
Large Survey

Abstract Background The COVID-19 pandemic brought rapid changes to the work and personal lives of clinicians. Objective To assess clinician burnout and well-being during the COVID-19 pandemic and guide healthcare system improvement efforts. Design A survey asking about clinician burnout, well-being, and work experiences. Participants Surveys distributed to 8141 clinicians from June to August 2020 in 9 medical groups and 17 hospitals at Sutter Health, a large healthcare system in Northern California. Main Measures Burnout was the primary outcome, and other indicators of well-being and work experience were also measured. Descriptive statistics and multivariate logistic regression analyses were performed. All statistical inferences were based on weighted estimates adjusting for response bias. Key Results A total of 3176 clinicians (39.0%) responded to the survey. Weighted results showed 29.2% reported burnout, and burnout was more common among women than among men (39.0% vs. 22.7%, p<0.01). In multivariate models, being a woman was associated with increased odds of reporting burnout (OR=2.19, 95% CI: 1.51–3.17) and being 55+ years old with lower odds (OR=0.54, 95% CI: 0.34–0.87). More women than men reported that childcare/caregiving was impacting work (32.9% vs. 19.0%, p<0.01). Even after controlling for age and gender, clinicians who reported childcare/caregiving responsibilities impacted their work had substantially higher odds of reporting burnout (OR=2.19, 95% CI: 1.54–3.11). Other factors associated with higher burnout included worrying about safety at work, being given additional work tasks, concern about losing one’s job, and working in emergency medicine or radiology. Protective factors included believing one’s concerns will be acted upon and feeling highly valued. Conclusions This large survey found the pandemic disproportionally impacted women, younger clinicians, and those whose caregiving responsibilities impacted their work. These results highlight the need for a holistic and targeted strategy for improving clinician well-being that addresses the needs of women, younger clinicians, and those with caregiving responsibilities.

Toward a Science of Mental Health

2009 ◽  
pp. 88-96 ◽  
Author(s):  
Corey L. M. Keyes
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorder ◽  
Psychosocial Functioning ◽  
Well Being ◽  
Care Utilization ◽  
Subjective Well Being ◽  
Level Of Functioning ◽  
Population Mental Health ◽  
Better Than

This chapter summarizes the research on the dual-continua model of mental health and mental illness. Studies supported this model and therefore the view that the presence of mental health is more than the absence of mental illness. Mental health is conceived of as a constellation of dimensions of subjective well-being, specifically hedonic and eudaemonic measures of subjective well-being. Specifically, the mental health continuum ranges from languishing, moderate, to flourishing mental health. These classifications are important for distinguishing and predicting level of functioning for individuals with and without a current mental disorder. Among individuals free of a mental disorder, flourishing individuals report the fewest missed days of work, the fewest half-day or greater work cutbacks, the healthiest psychosocial functioning, high resilience, and high intimacy), the lowest risk of cardiovascular disease, the lowest number of chronic physical diseases at all ages, the fewest health limitations of activities of daily living, and lower health-care utilization. Even among adults with a mental disorder during the past 12 months, those who are flourishing functioned better than those with moderate mental health, who in turn functioned better than those who were languishing. The findings strongly support the adoption of a more positive paradigm to treatment, prevention, and promotion of population mental health.

scholarly journals Impact of the COVID-19 pandemic on the mental health and well-being of UK healthcare workers

BJPsych Open ◽  
2021 ◽  
Vol 7 (3) ◽  
Author(s):  
James Gilleen ◽  
Aida Santaolalla ◽  
Lorena Valdearenas ◽  
Clara Salice ◽  
Montserrat Fusté
Keyword(s):  
Mental Health ◽  
Healthcare Workers ◽  
Psychiatric Symptoms ◽  
Well Being ◽  
Post Traumatic Stress ◽  
Front Line ◽  
Related Factors ◽  
Factors Associated ◽  
Controllable Factors ◽  
Mental Well Being

Background The coronavirus disease 2019 (COVID-19) pandemic has had a significant psychological impact on healthcare workers (HCWs). Aims There is an urgent need to understand the risk and protective factors associated with poor mental well-being of UK HCWs working during the COVID-19 pandemic. Method Shortly after the April 2020 UK COVID-19 peak 2773 HCWs completed a survey containing measures of anxiety, depression, post-traumatic stress disorder and stress, as well as questions around potential predictors such as roles, COVID-19 risk perception and workplace-related factors. Respondents were classified as high or low symptomatic on each scale and logistic regression revealed factors associated with severe psychiatric symptoms. Change in well-being from pre- to during COVID-19 was also quantified. Results Nearlya third of HCWs reported moderate to severe levels of anxiety and depression, and the number reporting very high symptoms was more than quadruple that pre-COVID-19. Several controllable factors were associated with the most severe level of psychiatric symptoms: insufficient personal protective equipment availability, workplace preparation, training and communication, and higher workload. Being female, ‘front line’, previous psychiatric diagnoses, traumatic events, and being an allied HCW or manager were also significantly associated with severe psychiatric symptoms. Sharing stress, resilience and ethical support for treatment decisions were significantly associated with low psychiatric symptoms. Front-line workers showed greater worsening of mental health compared with non-front-line HCWs. Conclusions Poor mental well-being was prevalent during the COVID-19 response, however, controllable factors associated with severe psychiatric symptoms are available to be targeted to reduce the detrimental impact of COVID-19 and other pandemics on HCW mental health.

scholarly journals Subjective mental health and need for care among psychiatric outpatients during the COVID-19 pandemic: results from an outreach initiative in Sweden

2020 ◽  
Author(s):  
Oskar Flygare ◽  
Volen Z. Ivanov ◽  
Roland Säll ◽  
Henrik Malaise ◽  
Christian Rück ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Respiratory Symptoms ◽  
Psychiatric Symptoms ◽  
Well Being ◽  
Psychiatric Clinic ◽  
Cross Sectional ◽  
Management Plans ◽  
Subjective Mental Health

AbstractImportanceThe ongoing COVID-19 pandemic restricts access to care for psychiatric patients. The physical and mental well-being of patients with severe mental illness in the current circumstances is unknown.ObjectiveTo evaluate physical and mental well-being, subjective mental health, and need for updated psychiatric management plans in a sample of patients with severe mental illness during the early stages of the COVID-19 pandemic.DesignCross-sectional study of structured telephone assessments conducted between April 23 and June 30, 2020.SettingRegional psychiatric outpatient care centre in Stockholm, Sweden.ParticipantsPatients who had not been in contact with their psychiatric clinic between April 9 and April 23, 2020. A total of 1071 patients were contacted by phone.ExposuresOccurrence of respiratory symptoms, changes in psychiatric symptoms, and the need for updated psychiatric management plans, as determined by the telephone assessors. Subjective mental health rated 0-100 by patients.Main Outcomes and MeasuresSelf-rated physical, respiratory and psychiatric symptoms according to a semi-structured interview. Subjective mental health rated on a scale from 0-100.ResultsPatients (n = 1071) were on average 45 years old (SD = 16.9), of which 570 (53%) were female. Neurodevelopmental disorders, psychotic disorders, and bipolar disorder were the most common diagnostic categories. The majority of respondents reported no respiratory symptoms (86%), and few reported light (10%) or severe (4%) respiratory symptoms. Similarly, most patients reported no worsening in psychiatric symptoms (81%). For those who reported a worsening of psychiatric symptoms (19%), the psychiatric management plans that were already in place were deemed appropriate in most cases (16.5%), whereas 22 patients (2.5%) reported a worsening of psychiatric symptoms that warranted an earlier or immediate follow-up by their psychiatric clinic. Patients rated their subjective mental health on a 0-100 scale as 70.5 [95% CI 69 - 71.9] on average (n = 841). Response rates to the questions of the structured assessment varied from 79% - 82%.Conclusions and RelevanceThe majority of patients reported no respiratory symptoms, no change in psychiatric symptoms and a rather high subjective well-being. Patients in psychiatric care with a mental health care plan experienced stability in the management of their psychiatric symptoms and general well-being, and only a minority were in need of acute support during the early pandemic phase in Stockholm, Sweden.Key PointsQuestionWhat is the physical and mental health of patients with severe mental illness during the early phase of the COVID-19 pandemic?FindingsIn this cross-sectional study that included 1071 patients at a psychiatric outpatient clinic, the proportion of patients reporting respiratory symptoms were 4%. In addition, 19% of patients reported a worsening of psychiatric symptoms, with 2.5% needing an earlier follow-up than was planned.MeaningPatients with severe mental illness experienced stability in the management of their psychiatric symptoms during the early pandemic phase in Sweden.

Wealth accumulation and retirement preparedness in cross-national perspective: A gendered analysis of outcomes among single adults

2021 ◽  
Vol 31 (5) ◽  
pp. 549-564
Author(s):  
Janet C Gornick ◽  
Eva Sierminska
Keyword(s):  
Work Experience ◽  
Well Being ◽  
Single Women ◽  
Wealth Accumulation ◽  
Women's Employment ◽  
Women’S Employment ◽  
Related Factors ◽  
Retirement Preparedness ◽  
Cross National ◽  
Single Men

Wealth is an increasingly important dimension of economic well-being and is attracting rising attention in discussions of social inequality. In this article, we compare – within and across countries – wealth outcomes, and link those to both employment-related factors and policy solutions that have the potential to improve wealth creation and retirement security for women. By constructing country-specific portraits of wealth outcomes and ‘retirement preparedness’, we reveal extensive cross-national variation in multiple facets of wealth. Our regression analysis finds a statistically significant and positive effect of work experience on wealth, with that effect, in general, increasing over time. The effect of work experience for single women is greater than for single men, suggesting that, among men, other, stronger forces are at work in creating wealth. The retirement preparedness outcomes indicate that single women in all three countries are in a precarious position at retirement, with much lower expected annual wealth levels than single men. The second preparedness indicator, which links expected annual wealth to income, demonstrates that men have the potential to cover larger shares of their income at retirement – and thus are more able, than their female counterparts, to maintain standards of living achieved earlier in life. Our policy discussion indicates that employment remains a viable option for ultimately bolstering women’s wealth accumulation. Many scholars, gender equality advocates and policymakers have argued for raising women’s employment rates – for a multitude of reasons – but few, if any, have made the case for strengthening women’s employment in order to ultimately bolster women’s wealth building. We hope to help reduce the gap in the literature on policy supports for women’s employment and re-open the discussion on how women can create more wealth.

Crisis Occurrence and Resolution in Patients with Severe and Persistent Mental Illness

Crisis ◽  
2005 ◽  
Vol 26 (4) ◽  
pp. 160-169 ◽  
Author(s):  
Paul S. Links ◽  
Rahel Eynan ◽  
Jeffrey S. Ball ◽  
Aiala Barr ◽  
Sean Rourke
Keyword(s):  
Mental Illness ◽  
Suicide Ideation ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Self Report ◽  
Community Treatment ◽  
Persistent Mental Illness ◽  
Crisis Events ◽  
Symptom Distress Scale ◽  
Distress Scale

Abstract. Assertive community treatment appears to have limited impact on the risk of suicide in persons with severe and persistent mental illness (SPMI). This exploratory prospective study attempts to understand this observation by studying the contribution of suicidality to the occurrence of crisis events in patients with SPMI. Specifically, an observer-rated measure of the need for hospitalization, the Crisis Triage Rating Scale, was completed at baseline, crisis occurrence, and resolution to determine how much the level of suicidality contributed to the deemed level of crisis. Second, observer-ratings of suicidal ideation, the Modified Scale for Suicide Ideation, and psychopathology and suicidality, Brief Psychiatric Rating Scale, were measured at baseline, crisis occurrence, and resolution. A self-report measure of distress, the Symptom Distress Scale, was completed at baseline, crisis occurrence, and resolution. Finally, the patients' crisis experiences were recorded qualitatively to compare with quantitative measures of suicidality. Almost 40% of the subjects experienced crisis events and more than a quarter of these events were judged to be severe enough to warrant the need for hospitalization. Our findings suggest that elevation of psychiatric symptoms is a major contributor to the crisis occurrences of individuals with SPMI; although the risk of suicide may have to be conceived as somewhat separate from crisis occurrence.

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