The Political Economy of the Mental Health System: A Marxist Analysis

The present paper analyses the functions of the mental health system in relation to the economic organisation of society, using concepts derived from Marx’s work on political economy and building on previous critiques. The analysis starts from the position that mental health problems are not equivalent to physical, medical conditions and are more fruitfully viewed as problems of communities or societies. Using the example of the United Kingdom, it traces how a public mental health system evolved alongside capitalism in order to manage the problems posed by people whose behaviour was too chaotic, disruptive or inefficient to participate in a labour market based on exploitation. The system provided a mixture of care and control, and under recent, Neoliberal regimes, these functions have been increasingly transferred to the private sector and provided in a capitalistic manner. Welfare payments are also part of the system and support those less seriously affected but unable to work productively enough to generate surplus value and profit. The increased intensity and precarity of work under Neoliberalism has driven up benefit claims at the same time as the Neoliberal state is trying to reduce them. These social responses are legitimised by the idea that mental disorders are medical conditions, and this idea also has a hegemonic function by construing the adverse consequences of social and economic structures as individual problems, an approach that has been particularly important during the rise of Neoliberalism. The concept of mental illness has a strategic role in modern societies, therefore, enabling certain contentious social activities by obscuring their political nature, and diverting attention from the failings of the underlying economic system. The analysis suggests the medical view is driven by political imperatives rather than science and reveals the need for a system that is more transparent and democratic. While the mental health system has some consistent functions across all modern societies, this account highlights one of the endemic contradictions of the capitalist system in the way that it marginalises large groups of people by narrowing the opportunities to make an economic contribution to society.

The Impact of the COVID-19 Pandemic on Those Supported in the Community with Long-Term Mental Health Problems: A Qualitative Analysis of Power, Threat, Meaning and Survival

Research suggests that the COVID-19 pandemic has had a significant impact on those already living with mental health problems, though there is also evidence of resilience. However, to date there has been limited in-depth qualitative investigation. We interviewed 15 people living with long-term mental health problems who, before the pandemic, were being supported by third sector organisations, to explore how they experienced lockdowns and accessing services remotely. Template analysis was informed by the Power Threat Meaning Framework and suggested that participants experienced significant threats to their mental wellbeing and recovery which were exacerbated by current or previous powerlessness and inequality. Although participants described positive coping strategies, several described a return of unhelpful behaviours that had contributed to the original difficulties. The findings illustrate the wider contributions of social and economic context to mental health problems and the importance of ensuring that people do not feel abandoned and are proactively supported.

Associations Between Physical Activity, Affect Regulation Difficulties, and Mental Health Among Canadian Adolescents at Two Different Points of the COVID-19 Pandemic

Although physical activity declined with social distancing measures and stay-at-home orders during the COVID-19 pandemic, youth who engaged in more physical activity experienced fewer mental health problems. If and how physical activity maintained its protective role throughout the ongoing pandemic remains unclear. This study models associations between three types of physical activity (indoor, outdoor, with parents), affect regulation, and anxious and depressive symptoms in two adolescent samples (W1: Summer 2020; W2: Winter 2020/21).

Educational Anomaly Analytics: Features, Methods, and Challenges

Anomalies in education affect the personal careers of students and universities' retention rates. Understanding the laws behind educational anomalies promotes the development of individual students and improves the overall quality of education. However, the inaccessibility of educational data hinders the development of the field. Previous research in this field used questionnaires, which are time- and cost-consuming and hardly applicable to large-scale student cohorts. With the popularity of educational management systems and the rise of online education during the prevalence of COVID-19, a large amount of educational data is available online and offline, providing an unprecedented opportunity to explore educational anomalies from a data-driven perspective. As an emerging field, educational anomaly analytics rapidly attracts scholars from a variety of fields, including education, psychology, sociology, and computer science. This paper intends to provide a comprehensive review of data-driven analytics of educational anomalies from a methodological standpoint. We focus on the following five types of research that received the most attention: course failure prediction, dropout prediction, mental health problems detection, prediction of difficulty in graduation, and prediction of difficulty in employment. Then, we discuss the challenges of current related research. This study aims to provide references for educational policymaking while promoting the development of educational anomaly analytics as a growing field.

Socioeconomic and sex inequalities in parent-reported adolescent mental ill-health: Time trends in four British birth cohorts

BackgroundStudies using symptom-based screeners have suggested that mental health problems have increased in adolescents in recent decades, however, few studies have explicitly tested the equivalence of their instruments, which is critical for inferring changes in prevalence. In addition, few studies have explored whether changes in socioeconomic position (SEP) and sex inequalities across generations have impacted trends in adolescent mental health. MethodsUsing structural equation modelling, we explore sex differences in harmonised parent-reports of emotional and behavioural problems, using data from four UK birth cohorts: the 1958 National Child Development Study (NCDS’58; N= 11,398), the 1970 British Cohort Study (BCS’70; N= 8,161), the 1991-92 Avon Longitudinal Study of Parents and Children (ALSPAC’91; N= 5,304), and the 2001 Millennium Cohort Study (MCS’01; N= 10,384). We also delineate associations between four harmonised indicators of childhood SEP and adolescent mental health, and test whether changes in SEP account for increases in mental ill-health over time. Results We found an increase in the latent means of parent-reported emotional and behavioural problems across time in both males and females in more recent cohorts, with the exception of ALSPAC’91. Sex-inequalities did not change over time, with females having consistently higher emotional problems. The associations between the four indicators of SEP and emotional problems were strongest in the MCS’01, with housing tenure having the strongest association. All four SEP indicators were associated with behavioural problems in all of the cohorts, with housing tenure again more strongly associated with problems in the MCS’01. Inconsistent mediation (i.e. regression suppression) suggested that the increases in mental health problems occurred despite broadly improving average socio-economic conditions. ConclusionsOur findings suggest that parent-reported adolescent mental health problems have risen in recent generations and that this trend is not due solely to reporting styles. A failure to address widening inequalities may result in further increases in mental ill-health amongst disadvantaged young people.

An Explainable Machine Learning Approach for COVID-19’s Impact on Mood States of Children and Adolescents during the First Lockdown in Greece

The global spread of COVID-19 led the World Health Organization to declare a pandemic on 11 March 2020. To decelerate this spread, countries have taken strict measures that have affected the lifestyles and economies. Various studies have focused on the identification of COVID-19’s impact on the mental health of children and adolescents via traditional statistical approaches. However, a machine learning methodology must be developed to explain the main factors that contribute to the changes in the mood state of children and adolescents during the first lockdown. Therefore, in this study an explainable machine learning pipeline is presented focusing on children and adolescents in Greece, where a strict lockdown was imposed. The target group consists of children and adolescents, recruited from children and adolescent mental health services, who present mental health problems diagnosed before the pandemic. The proposed methodology imposes: (i) data collection via questionnaires; (ii) a clustering process to identify the groups of subjects with amelioration, deterioration and stability to their mood state; (iii) a feature selection process to identify the most informative features that contribute to mood state prediction; (iv) a decision-making process based on an experimental evaluation among classifiers; (v) calibration of the best-performing model; and (vi) a post hoc interpretation of the features’ impact on the best-performing model. The results showed that a blend of heterogeneous features from almost all feature categories is necessary to increase our understanding regarding the effect of the COVID-19 pandemic on the mood state of children and adolescents.

General Measurement Tools for Assessing Mental Health Problems Among Children and Adolescents with an Intellectual Disability: A Systematic Review

There is a need for more knowledge of valid and standardized measures of mental health problems among children and adolescents with intellectual disability (ID). In this study, we systematically reviewed and evaluated the psychometric properties of instruments used to assess general mental health problems in this population. Following PRISMA guidelines, we reviewed empirical research published from 1980 through February 2020 with an updated search in March 2021 in Medline, Embase, PsycINFO, Health and Psychological Instruments, CINAHL, ERIC, and Web of Science databases. Forty-nine empirical articles were included in this review. Overall, the review indicated consistently better documentation of the reliability and validity of instruments designed for the ID population compared to instruments developed for the general child population.

Refugees’ Agency: On Resistance, Resilience, and Resources

This study set out to answer the question ‘Which kinds of agency do refugees perform when dealing with mental health problems of themselves and their children?’. Aiming to gain more insight in why it seems harder for refugee parents and minors than for the native population to talk to health professionals about their mental health and wellbeing, we combined two theoretical notions of agency to investigate a broad spectrum of informants’ behaviour. We conducted 25 interviews with 30 refugees from 8 countries (Syria, Yemen, Iran, Afghanistan, Armenia, Eritrea, Turkish Kurdistan, Vietnam), whose Dutch residence permit varied from 26 years to less than one year. Data were analysed through open and axial coding, followed by pattern analyses. Although sometimes refugees seek (mental) healthcare, at other times they show agency by doing ‘nothing’ or by deliberately using distracting activities to deal with severe stress. Making use of resources available to them, oftentimes refugees show agency in ways that are less visible to healthcare professionals, by surviving, showing resilience, and suffering. In these cases, we think healthcare for refugees should intervene in a non-medical way, e.g., by supporting them to obtain resources that help refugees to (re)gain agency.