Social justice, health equity, and mental health

There is considerable evidence to indicate that stigma and discrimination against people with mental illnesses are widely prevalent across nations. Research also shows that individuals with mental illnesses are likely to die 15–20 years younger than those who do not have these illnesses. In addition, they are more likely to experience delays in help-seeking leading to poor outcomes and are more likely to experience physical illnesses. Stigma and discrimination appear to play a major role in depriving people with mental illnesses of their basic rights. Their economic, political, social, and human rights are often ignored. In this article, we describe the capability to be healthy and basic principles of social justice related to mental health. We discuss findings of discrimination often embedded in laws of countries around the world in the context of basic human rights. We believe that clinicians have a key role as advocates for their patients. Clinicians and policymakers need to work together to bring about social and health equity.

Adjustment and socioeconomic status: how do these factors influence the intention to dropout of university?

This study investigated the effects of adjustment and socioeconomic status on the intention by undergraduate students to dropout of university. The sample comprises 955 students from a university in South Africa and a quantitative research approach was used to test the hypotheses. Regression analyses results showed that social adjustment and institutional attachment significantly predicted the intention to dropout, whereas academic adjustment and personal-emotional adjustment could not predict the intention to dropout. In addition, the results showed that socioeconomic status significantly moderated the relationship between academic adjustment and the intention to dropout of university; however, socioeconomic status could not moderate the relationship between institutional attachment and the intention to dropout of university. The results highlight the need for students to be supported in dealing with adjustment challenges during the transition to university. Furthermore, the results encourage universities to consider various academic needs of students from different socioeconomic backgrounds to improve their academic experiences.

Cancer coping self-efficacy mediates the relationship between mental adjustment to cancer and health-related quality of life in persons with cancer

Individuals with cancer experience significant levels of distress. Improving health-related quality of life of persons with cancer is a major focus in cancer treatment. This study investigated the mediating role of self-efficacy for coping with cancer in the relationship between mental adjustment to cancer and health-related quality of life among individuals with cancer. Two hundred and fourteen persons with cancer (male = 74, female = 140, mean age = 50.57) were recruited from a University Teaching Hospital, in South-West Nigeria. Participants responded to the measures of psychological responses to cancer (mental adjustment to cancer), self-efficacy for coping with cancer (Cancer Behaviour Inventory [CBI]), and health-related quality of life (Functional Assessment of Cancer Therapy–General). Mediation analysis and structural equation modelling were carried out using IBM AMOS software version 23. Domains of mental adjustment to cancer significantly predicted health-related quality of life, helplessness/hopelessness, and anxious preoccupation had a negative association with health-related quality of life; whereas fighting spirit, cognitive avoidance, and fatalism were positively associated with health-related quality of life. Self-efficacy had a positive association with health-related quality of life. Mediation analysis showed that self-efficacy for coping with cancer partially mediated the association between four domains of mental adjustment to cancer (helplessness/hopelessness, fighting spirit, cognitive avoidance, and fatalism) and health-related quality of life. The findings demonstrated the need for improved coping mechanisms while undergoing cancer treatment. The study has important clinical implications for psycho-oncology practice, particularly with respect to self-efficacy for coping with cancer. Psychosocial therapies aimed at enhancing the self-efficacy of persons with cancer should be incorporated as part of cancer treatment to improve their health-related quality of life.

Assessing sources of resilience in orphans and vulnerable children in Amajuba District schools

The main aim of the study was to assess the sources of resilience in orphans and vulnerable children in district schools in the local communities of Amajuba. The study has drawn insight from the social ecological theory of Bronfenbrenner. Being a mixed-method research approach, its design is grounded within the post-positivism paradigm. A self-administered questionnaire and individual interviews were used to collect data from 303 orphans and vulnerable children purposively sampled from schools within the Amajuba district KwaZulu-Natal for the quantitative phase, while eight orphans and vulnerable children were interviewed for the qualitative phase. Frequency distributions and a thematic analysis were employed to analyse the data. The findings establish that apart from HIV/Aids related deaths of parents, poverty, disabilities, abandonment or neglect, and COVID-19 are found to be other causes of vulnerability among the participants. Conversely, future expectations, religion or spirituality, and an extraverted personality type were found to be the sources of resilience in the participants. The inclusion of resilience in the education/school curriculum across all levels as well as resilience booster interventions are recommended for African children.

Significance as component of meaning in career narratives of unemployed graduates

Youth unemployment is a continuing concern in South Africa, and, in the context of growing economic volatility, an increasing number of young adult graduates will find themselves without work. Given the negative effect of unemployment on psychological well-being, research is required to enhance insight into how unemployed graduates can negotiate times of unemployment. Although multiple studies have investigated the influence of unemployment on hedonic well-being, less research is available on how eudaimonic well-being is impacted by unemployment. Significance is a component of meaning, and refers to a sense of mattering in one’s social context. The aim of the current study was to explore how young adult graduates experience a sense of significance during unemployment. Semi-structured interviews were conducted to gain insights into participants’ career narrative, which were then analysed to find meaning plots that relate to significance. The results showed that threads of significance are present throughout the participant’s career narratives, and that the lack of significance during unemployment resulted in great distress, but also a need to restore significance. The value of the study lies in uncovering significance as an important resource during unemployment, which could be a focal point to address in psychological interventions.

Managing the Covid-19 pandemic in South African Schools: turning challenge into opportunity

This article reports on challenges faced today by the South African schooling system due to the Covid-19 pandemic, with the emphasis on the public school system. Its aim is to show the extent and nature of these challenges and how they exacerbate existing challenges and impact the quality of post-matric study and tertiary education. A number of specific challenges are focused on such as large class sizes, physical distancing requirements, and the use of online and digital learning platforms to facilitate education, and how this style of teaching and training is not practical for most of the South African school population. The discrepancy between the real situation in schools and the applicability of Covid-19 protocols is also examined. In addition, I discuss the problems posed by the schooling time that has been lost, the effect of curriculum trimming, and the long-term price post-Grade 12 study and tertiary teaching and learning may have to pay. Finally, looking through a positive, future-oriented lens, I endeavour to place the overall situation in South African education in perspective.

Depressive symptoms and socio-demographic correlates among adolescents in Kampala: a cross-sectional study

The aim of this study was to investigate the prevalence of depressive symptoms in secondary school students in Kampala, Uganda, and assess associations with demographic characteristics and living arrangements. In this cross-sectional study, 14- to 17-year-olds were recruited from six randomly selected schools in Kampala. Participants completed a questionnaire, covering demographic questions and the affective problems subscale of the Youth Self-Report (YSR) – a depression screening tool for minors. Scores range from 0 to 26; a minimum score of 9 and 8 for female and male participants, respectively, suggests depressive symptoms in the clinical range, according to standard (non-local) norms. Unadjusted logistic regressions were used to assess demographic (e.g., age, gender, religion, parental education) and family-related characteristics (e.g., living arrangements, household size) associated with symptoms of depression in the clinical range. In total, 503 participants were recruited, of which 26.6% had depressive symptoms in the clinical range (female: 32.5%, male: 18.1%; risk ratio [RR] = 1.79, 95% confidence interval [CI] [1.28, 2.51]). Those who reported living with only one parent (RR = 1.62, 95% CI [1.14, 2.30]) or another family member/friend (RR = 1.98, 95% CI [1.14, 2.30]) were at increased risk of depressive symptoms above clinical threshold compared with participants living with both parents. A quarter of urban low-risk school-going adolescents had depressive symptoms in the clinical range in Kampala; girls and adolescents not living with their parents were particularly vulnerable. It recommended that school staff be equipped with skills to identify students who may be at risk for depression and make appropriate referrals.

Adherence to antiretroviral therapy mediates the link between posttraumatic stress disorder symptoms and health-related quality of life

Human immunodeficiency virus is one of the trauma-inducing chronic illnesses with attendant-negative impact on health-related quality of life. Substantial literature exists on the association of posttraumatic stress disorder symptoms and health-related quality of life among people living with human immunodeficiency virus, but little is known about the pathways explaining this link. This study therefore examined the mediating role of adherence to antiretroviral therapy in the association between posttraumatic stress disorder symptoms and health-related quality of life among people living with human immunodeficiency virus. Nine hundred and sixty-nine people living with human immunodeficiency virus in Nigeria who were on antiretroviral therapy completed measures of posttraumatic stress disorder symptoms, adherence to antiretroviral therapy, and health-related quality of life. Hayes PROCESS macro for SPSS was used to analyse the data. Adherence to antiretroviral therapy mediated the association between posttraumatic stress disorder symptoms and health-related quality of life in the relationship and treatment impact domains, implying that poor adherence to antiretroviral therapy is a pathway through which posttraumatic stress disorder symptoms exert negative influence on health-related quality of life of people living with human immunodeficiency virus. Interventions aimed at reducing the impact of posttraumatic stress disorder symptoms on quality of life of people living with human immunodeficiency virus should focus on improving clients’ level of adherence to antiretroviral therapy treatment.