Finding Strength in the Struggle

Author(s):  
Loni Crumb ◽  
Madeline Clark ◽  
Susan M. Long

Poverty is an intersectional issue, as children; women; men; people of color; people who identify as lesbian, gay, or transgender; and immigrant groups are all prone to experience the multifaceted impact of poverty. People who live in rural poverty are likely to experience more severe and persistent mental health disorders. This chapter provides an overview of how rural poverty impacts the mental health and wellbeing of diverse children and families. The authors discuss issues faced by residents living in rural poverty and provide multiple strength-based strategies that behavioral service providers can use to provide culturally relevant mental healthcare in impoverished rural communities. Lastly, the authors offer suggestions for future research.

Author(s):  
Loni Crumb ◽  
Madeline Clark ◽  
Susan M. Long

Poverty is an intersectional issue, as children; women; men; people of color; people who identify as lesbian, gay, or transgender; and immigrant groups are all prone to experience the multifaceted impact of poverty. People who live in rural poverty are likely to experience more severe and persistent mental health disorders. This chapter provides an overview of how rural poverty impacts the mental health and wellbeing of diverse children and families. The authors discuss issues faced by residents living in rural poverty and provide multiple strength-based strategies that behavioral service providers can use to provide culturally relevant mental healthcare in impoverished rural communities. Lastly, the authors offer suggestions for future research.


2021 ◽  
Author(s):  
Stephanie Nicole Fraser

An increase of ongoing armed conflicts has resulted in substantial numbers of refugees around the world. The traumatic experiences refugees face can be detrimental to their mental health, further compounded by resettlement stressors upon arrival in Canada. This qualitative study incorporates an intersectional social determinants of health framework in order to understand the changes in mental health of refugees at different stages of a lifelong (re)settlement process. The findings of this study are informed by interviews with five service providers. Results indicated a number of salient post-migration factors that influence mental health in both the short and over the longer term for refugees and further elucidated the effects of a mutually-reinforcing relationship between resettlement stressors and trauma in mental health changes. Implications of the study findings reveal a critical need for a more psychosocial approach to be taken regarding refugee mental healthcare in future research as well as psychological interventions.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Anna Humphreys ◽  
Elizabeth G. Walker ◽  
Gregory N. Bratman ◽  
Nicole A. Errett

Abstract Background Extreme, prolonged wildfire smoke (WFS) events are becoming increasingly frequent phenomena across the Western United States. Rural communities, dependent on contributions of nature to people’s quality of life, are particularly hard hit. While prior research has explored the physical health impacts of WFS exposure, little work has been done to assess WFS impacts on mental health and wellbeing, or potential adaptation solutions. Methods Using qualitative methods, we explore the mental health and wellbeing impacts experienced by community members in a rural Washington State community that has been particularly hard hit by WFS in recent years, as well as individual, family, and community adaptation solutions. We conducted focus groups with residents and key informant interviews with local health and social service providers. Results Participants identified a variety of negative mental health and wellbeing impacts of WFS events, including heightened anxiety, depression, isolation, and a lack of motivation, as well as physical health impacts (e.g., respiratory issues and lack of exercise). Both positive and negative economic and social impacts, as well as temporary or permanent relocation impacts, were also described. The impacts were not equitably distributed; differential experiences based on income level, outdoor occupations, age (child or elderly), preexisting health conditions, housing status, and social isolation were described as making some residents more vulnerable to WFS-induced physical and mental health and wellbeing challenges than others. Proposed solutions included stress reduction (e.g., meditation and relaxation lessons), increased distribution of air filters, development of community clean air spaces, enhancing community response capacity, hosting social gatherings, increasing education, expanding and coordination risk communications, and identifying opportunities for volunteering. Findings were incorporated into a pamphlet for community distribution. We present a template version herein for adaptation and use in other communities. Conclusions Wildfire smoke events present significant mental health and wellbeing impacts for rural communities. Community-led solutions that promote stress reduction, physical protection, and community cohesion have the opportunity to bolster resilience amid this growing public health crisis.


2021 ◽  
Author(s):  
Stephanie Nicole Fraser

An increase of ongoing armed conflicts has resulted in substantial numbers of refugees around the world. The traumatic experiences refugees face can be detrimental to their mental health, further compounded by resettlement stressors upon arrival in Canada. This qualitative study incorporates an intersectional social determinants of health framework in order to understand the changes in mental health of refugees at different stages of a lifelong (re)settlement process. The findings of this study are informed by interviews with five service providers. Results indicated a number of salient post-migration factors that influence mental health in both the short and over the longer term for refugees and further elucidated the effects of a mutually-reinforcing relationship between resettlement stressors and trauma in mental health changes. Implications of the study findings reveal a critical need for a more psychosocial approach to be taken regarding refugee mental healthcare in future research as well as psychological interventions.


Author(s):  
Adina S Kazan ◽  
Laura M Perry ◽  
Wasef F Atiya ◽  
Hallie M Voss ◽  
Seowoo Kim ◽  
...  

Abstract Tobacco use is a leading preventable cause of early mortality and is prevalent among adults with mental health diagnoses, especially in the southern USA. Increasing cessation resources in outpatient mental health care and targeting individuals most receptive to changing their behavior may improve cessation. Drawing on the transtheoretical model, our goals were to develop an educational video about the Louisiana Tobacco Quitline and evaluate its acceptability. We designed the video with knowledge derived from Louisiana-specific data (2016 Louisiana Adult Tobacco Survey, N = 6,469) and stakeholder feedback. Bivariate associations between demographic/tobacco-use characteristics and participants’ stage of quitting (preparation phase vs. nonpreparation phase) were conducted, which informed design elements of the video. Four stakeholder advisory board meetings involving current smokers, mental health clinicians, and public health advocates convened to provide iterative feedback on the intervention. Our stakeholder advisory board (n = 10) and external stakeholders (n = 20) evaluated intervention acceptability. We found that 17.9% of Louisiana adults were current smokers, with 46.9% of them in the preparation phase of quitting. Using insights from data and stakeholders, we succeeded in producing a 2-min video about the Louisiana Tobacco Quitline which incorporated three themes identified as important by stakeholders: positivity, relatability, and approachability. Supporting acceptability, 96.7% of stakeholders rated the video as helpful and engaging. This study demonstrates the acceptability of combining theory, existing data, and iterative stakeholder feedback to develop a quitline educational video. Future research should examine whether the video can be used to reduce tobacco use.


2021 ◽  
Vol 2 (3) ◽  
pp. 1-15
Author(s):  
Colm Sweeney ◽  
Courtney Potts ◽  
Edel Ennis ◽  
Raymond Bond ◽  
Maurice D. Mulvenna ◽  
...  

The objective of this study was to understand the attitudes of professionals who work in mental health regarding the use of conversational user interfaces, or chatbots, to support people’s mental health and wellbeing. This study involves an online survey to measure the awareness and attitudes of mental healthcare professionals and experts. The findings from this survey show that more than half of the participants in the survey agreed that there are benefits associated with mental healthcare chatbots (65%, p < 0.01). The perceived importance of chatbots was also relatively high (74%, p < 0.01), with more than three-quarters (79%, p < 0.01) of respondents agreeing that mental healthcare chatbots could help their clients better manage their own health, yet chatbots are overwhelmingly perceived as not adequately understanding or displaying human emotion (86%, p < 0.01). Even though the level of personal experience with chatbots among professionals and experts in mental health has been quite low, this study shows that where they have been used, the experience has been mostly satisfactory. This study has found that as years of experience increased, there was a corresponding increase in the belief that healthcare chatbots could help clients better manage their own mental health.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 358-358
Author(s):  
Hyojin Choi ◽  
Kristin Litzelman ◽  
Molly Maher ◽  
Autumn Harnish

Abstract Spouses of cancer survivors are 33% less likely to receive guideline-concordant depression treatment than other married adults. However, depression is only one of many manifestations of psychological distress for caregivers. This exploratory study sought to assess the paths by which caregivers access mental health-related treatment. Using nationally representative data from the Medical Expenditures Panel Survey, we assessed the proportion of caregivers who received a mental health-related prescription or psychotherapy visit across care settings (office based versus outpatient hospital, emergency room, or inpatient visit), provider type (psychiatric, primary care, other specialty, or other), and visit purpose (regular checkup, diagnosis and treatment, follow-up, psychotherapy, other). In addition, we assessed the health condition(s) associated with the treatment. The findings indicate that a plurality of caregivers accessed mental health-related treatment through an office-based visit (90%) with a primary care provider (47%). A minority accessed this care through a psychologist or psychiatrist (11%) or a physician with another specialty (12%) or other provider types. Nearly a third accessed treatment as part of a regular check-up (32%). These patterns did not differ from the general population after controlling for sociodemographic characteristics. Interestingly, mental health-related treatments were associated with a mental health diagnosis in only a minority of caregivers. The findings confirm the importance of regular primary care as a door way to mental healthcare, and highlight the range of potential paths to care. Future research will examine the correlates of accessing care across path types.


2020 ◽  
Author(s):  
Roshini Peiris-John ◽  
Lovely Dizon ◽  
Kylie Sutcliffe ◽  
Kristy Kang ◽  
Theresa Fleming

Aim This paper describes how we engaged with adolescents and health providers to integrate access to digital health interventions as part of a large-scale secondary school health and wellbeing survey in New Zealand. Methods We conducted nine participatory, iterative co-design sessions involving 29 adolescents, and two workshops with young people (n = 11), digital and health service providers (n = 11) and researchers (n = 9) to gain insights into end-user perspectives on the concept and how best to integrate digital interventions in to the survey. Results Students’ perceived integrating access to digital health interventions into a large-scale youth health survey as acceptable and highly beneficial. They did not want personalized/normative feedback, but thought that every student should be offered all the help options. Participants identified key principles: assurance of confidentiality, usability, participant choice and control, and language. They highlighted wording as important for ease and comfort, and emphasised the importance of user control. Participants expressed that it would be useful and acceptable for survey respondents to receive information about digital help options addressing a range of health and wellbeing topics. Conclusion The methodology of adolescent-practitioner-researcher collaboration and partnership was central to this research and provided useful insights for the development and delivery of adolescent health surveys integrated with digital help options. The results from the ongoing study will provide useful data on the impact of digital health interventions integrated in large-scale surveys, as a novel methodology. Future research on engaging with adolescents once interventions are delivered will be useful to explore benefits over time.


Author(s):  
Kelly Clarke ◽  
Sílvia Shikanai Yasuda ◽  
Atif Rahman

Adolescent mental health disorders have serious health and socioeconomic consequences and may persist into adulthood and affect future generations. They account for four of the top ten causes of DALYs among young people, with suicide as the main cause of adolescent mortality. New threats are constantly emerging and changing with urbanisation, social media, and armed conflicts. As a neglected area of public health, resources are needed to improve awareness and develop global research, policies and training. Stakeholder involvement and government commitment are also essential to address the gap between burden and resource allocation. Promotion and prevention at a community level, coordinated between different sectors, could help to foster youth resilience. Non-specialist mental healthcare provision is a promising approach in low-resource settings but must be adapted to local needs.


BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e021361 ◽  
Author(s):  
Lindsay H Dewa ◽  
Kevin Murray ◽  
Bethan Thibaut ◽  
Sonny Christian Ramtale ◽  
Sheila Adam ◽  
...  

ObjectivePhysical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health.DesignSemistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements.Setting and participantsAcademic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included.Main outcome measuresAgreement in research priorities on a five-point scale.ResultsSeventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important.ConclusionsThis is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this.


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