Community membership and social networks in mental health self-help agencies

This article explores community membership among self-help agency (SHA) participants. It is suggested that SHAs foster the enhancement of peer-oriented social networks, leading to the experience of shared community. Social network analysis was used to examine the structure of support mechanisms, and to assess levels of community membership through peer inclusion. Results indicate that both individual and organizational characteristics play roles in predicting peer presence in social networks. Organizational empowerment is a key factor, with the SHA emerging as a promising locus for peer support development through enhanced social networks. Implications for the organization of consumer-based services are discussed.     

The effect of social networks and social support on common mental disorders following specific life events

Maulik PK, Eaton WW, Bradshaw CP. The effect of social networks and social support on common mental disorders following specific life events. Objective: This study examined the association between life events and common mental disorders while accounting for social networks and social supports. Method: Participants included 1920 adults in the Baltimore Epidemiologic Catchment Area Cohort who were interviewed in 1993–1996, of whom 1071 were re‐interviewed in 2004–2005. Generalized estimating equations were used to analyze the data. Results: Social support from friends, spouse or relatives was associated with significantly reduced odds of panic disorder and psychological distress, after experiencing specific life events. Social networks or social support had no significant stress‐buffering effect. Social networks and social support had almost no direct or buffering effect on major depressive disorder, and no effect on generalized anxiety disorder and alcohol abuse or dependence disorder. Conclusion: The significant association between social support and psychological distress, rather than diagnosable mental disorders, highlights the importance of social support, especially when the severity of a mental health related problem is low.     

抑郁症患者家属心理健康水平、应对方式及社会支持的现状

目的:探讨抑郁症患者家属的心理健康水平、应对方式及社会支持水平。方法:对与抑郁症患者同住的150名家属进行症状自评量表(SCL-90)、简易应对方式问卷(SCSQ)和社会支持评定量表(SSRS)评估,并与全国常模的数据比较。结果:抑郁症患者家属SCL-90总分及躯体化、抑郁、焦虑、精神病性因子分明显高于全国常模(P均0.05);SCSQ中积极的应对方式得分明显低于全国常模,而消极方式得分明显高于全国常模(P均0.05);SSRS中男性家属客观支持、主观支持、支持利用评分及女性家属客观支持评分明显低于全国常模(P均0.05)。结论:抑郁症患者家属心理健康水平较差,社会支持少,多采取消极的应对方式;他们需要心理干预。     

Associations between the mental health and social networks of children and parents in single-parent families

The parents and children in single-parent families were studied. A group of 39 children ages 9–16 years who had been patients at a child and adolescent psychiatric clinic and a control group with an equal number of children were interviewed together with their single parent regarding social network and mental health. The networks of children and parents in the control group were more similar to each other than the networks of parents and children in the patient group. The crosswise influence of parents’ mental health, children's behavioural disturbances and social networks showed associations between parents’ mental health and children's behavioural disturbances, between parents's social networks and children's behavioural disturbances and between parents’ mental health and their social networks. There was, on the other hand, no association between parents’ mental health and the social networks of their children.     

Social networks among users of mental health day care--predictors of social contacts and confiding relationships

AbstractBackground The social networks of people with mental illness have received much attention, but users of day care services have rarely been considered.Methods Users of day hospitals and day centres were surveyed cross-sectionally. Demographic and illness factors were tested for associations with network size, while intrinsic relationship factors were tested for association with confiding in a network member.Results There was some evidence that a longer duration of contact with services, more unmet needs, working, living in supported accommodation and needing help with psychotic symptoms were associated with having a larger network, while a longer duration of contact was associated with having more confidantes. Day centre users confided in people who were more likely to be friends or neighbours than professionals, and who were more likely to be the same sex.Conclusion For people in day care, the stereotype that people with longer-term mental health problems are socially isolated is contradicted by this study. The limited role of professionals in providing confiding relationships is striking.     

The stigma of mental illness: patients' anticipations and experiences

BACKGROUND: There are studies that either deal with the stigmatization patients anticipate or with patients' concrete stigmatization experiences. Up until now, however, research is short of studies that investigate both aspects of subjective stigmatization simultaneously. AIMS: This study aims at investigating to what extent patients with schizophrenia or depression anticipate and experience stigmatization and how this is influenced by the type of mental disorder and the social environment. METHOD: A total of 210 patients with schizophrenia or a depressive episode were interviewed, one half living in a city and the other in a small town. RESULTS: Most of the patients expect negative reactions from the environment, particularly as concerns the access to work. Concrete stigmatization experiences were most frequently reported in the domain of interpersonal interaction. Even though schizophrenia patients and patients with depression anticipated stigmatization similarly frequently, the former reported concrete stigmatization experiences more frequently than the latter. Conversely, patients living in a small town anticipated stigmatization more frequently than patients from the city, even though both had actually experienced stigmatization at a similar rate. CONCLUSION: The results underline the necessity to differentiate between anticipated and experienced stigmatization. This is highly relevant for planning interventions aimed at reducing the stigma of mental disorder.     

Social services and health services day care in mental health: the social networks and care needs of their users

BACKGROUND: In view of the increasing integration of health and social care, there is an urgent need to know how health service day hospitals and social service day centres are being used, and by whom. AIMS: We aimed to compare users of day hospitals and centres in terms of their social networks, needs for care and demographics. METHODS: A cross-sectional, comparative study of service users at two day hospitals and four day centres compared their social networks, needs and characteristics. RESULTS: Day centre clients had much larger social networks, including a three-fold difference in total contacts and two-fold difference in confidants, but had more needs for care, particularly relating to psychological distress. They were also older on average than day hospital patients and were a more long-term group. CONCLUSION: It is vital to understand differences between health service day hospitals and social service day centres given the increasing integration of health and social care. The present study shows that the two user groups are significantly different. It is unlikely that the needs of most day care users could be met by either service interchangeably.     

急诊外科患者心理紧张度调查及原因分析

目的 调查分析急诊外科就诊患者心理紧张的成因及影响因素.方法 对2009-01～2009-05我院急诊外科神志清楚、记录完整的1466例成年患者采用自行设计的问卷调查方式进行.结果 84.3%的患者存在不同程度的紧张与焦虑,患者紧张、焦虑程度在各种年龄、性别、文化程度、职业之间差别无统计学意义,引起患者紧张、焦虑的主要原因有医务人员态度、疾病痛苦程度、诊治水平、诊治费用、后遗症等.结论 紧张、焦虑是多因素综合的结果,其中医务人员因素的影响较大,与患者本身因素也有关系,缓解紧张、焦虑需医患共同来完成.     

Online social support networks

Abstract

Peer support groups have a long history and have been shown to improve health outcomes. With the increasing familiarity with online social networks like Facebook and ubiquitous access to the Internet, online social support networks are becoming popular. While studies have shown the benefit of these networks in providing emotional support or meeting informational needs, robust data on improving outcomes such as a decrease in health services utilization or reduction in adverse outcomes is lacking. These networks also pose unique challenges in the areas of patient privacy, funding models, quality of content, and research agendas. Addressing these concerns while creating patient-centred, patient-powered online support networks will help leverage these platforms to complement traditional healthcare delivery models in the current environment of value-based care.     

Effects of brief hospitalization on psychiatric patients' behaviour and social functioning

224 newly admitted inpatients were randomly allocated to two treatment groups: standard care (length of stay determined by the clinical team) and brief care (acute treatment aimed at effecting the patient's discharge after about a week). Using a new research instrument (the Patient Behaviour Assessment Schedule), information was gathered from the patient's closest relative or friend on a subsample of 99 patients (the “target group”), which actually showed shortened length of hospitalization for brief care patients. There were no significant differences between groups at the two follow-up evaluations on measures of behavioural disturbance and limited social functioning. Results for the whole “target” group reveal that although there was significant improvement in both behaviour and social functioning 2 weeks after admission, there was little subsequent change thereafter. Overall, individual patients demonstrated more improvement in behavioural disturbance than in social functioning at the follow-up interview.