Housing type,housing location and mental health

A number of studies have suggested a connection between the type of dwellings which people occupy and their mental health. People who live in flats are usually shown to be more prone to mental illness than those who live in houses. Those who live in high-rise accommodation are shown to be particularly vulnerable. These conclusions were examined by comparing rates on an indicator of psychological distress, in different dwelling types located in good and bad council housing areas. The results suggest that psychological distress is more closely associated with the location of a dwelling than with dwelling type. High-rise flats located on inner-city problem estates are associated with high levels of psychological distress, while low levels are found in similar dwelling types located in the suburbs. These findings are consistent when the effect of age, health, sex and household class are taken into consideration.     

Culture and urban mental health.

The previous panoramic view provides sufficient evidence that cultural understanding of urban realities and expressions of their impact on mental health are necessary for a successful approach to mental health in cities. The issues go beyond understanding how urban realties and cultural issues differ in New York from Jakarta; every city has a variety of unwritten cultural norms that permeate every aspect of its mental health. Unless these norms are understood within the dynamic structure of city living, any attempt to intervene on mental health programs will be doomed to failure. Understanding the cultural blueprint of a city, however, is only the first step, as we need to shed our cultural assumptions while we consider contextual socioeconomic and political factors for each city. Finally we need to adapt our western view of cultural values and how citizens function or do not function within the urban environments. Because each city in is its own culturally specific entity, the three steps outlined previously can help create an accurate portrait of what is needed to implement culturally sensitive changes. A paradigm shift, laid on a bicurcated foundation, on the one hand a locally attuned awareness of urban cultural dimensions and on the other educational programs based on extensive knowledge of worldwide problems such as stigma, gender-specific issues, disability, and the plight of vulnerable populations can potentially have far reaching implications on mental health policy changes addressing the cultural needs of cities. Urban mental health is poised to be one of the central issues for the next few decades, because of the size of the world urban population and because of the protean nature of its problems. Cultural factors interplay with urban dynamics in a unique, at times creative, other times destructive, fashion. Under conditions of socioeconomic disadvantage vulnerable individuals who lack adaptive mechanisms may become mentally ill or experience an exacerbation of their mental illness. Understanding how cultural dynamics articulate with adaptation to urban life may greatly enhance our ability to properly assess and treat mental disorders in cities. In the assessment and treatment of patients living in urban areas contextual cultural factors rather than being merely complementary assume a preeminent if not crucial role.     

The relationship between manual coordination and mental health

Motor coordination impairments frequently co-occur with other developmental disorders and mental health problems in clinically referred populations. But does this reflect a broader dimensional relationship within the general population? A clearer understanding of this relationship might inform improvements in mental health service provision. However, ascertainment and referral bias means that there is limited value in conducting further research with clinically referred samples. We, therefore, conducted a cross-sectional population-based study investigating children’s manual coordination using an objective computerised test. These measures were related to teacher-completed responses on a behavioural screening questionnaire [the Strength and Difficulties Questionnaire (SDQ)]. We sampled 298 children (4–11 years old; 136 males) recruited from the general population. Hierarchical (logistic and linear) regression modelling indicated significant categorical and continuous relationships between manual coordination and overall SDQ score (a dimensional measure of psychopathology). Even after controlling for gender and age, manual coordination explained 15 % of the variance in total SDQ score. This dropped to 9 % after exclusion of participants whose SDQ responses indicated potential mental health problems. These results: (1) indicate that there is a clear relationship between children’s motor and mental health development in community-based samples; (2) demonstrate the relationship’s dimensional nature; and (3) have implications for service provision.     

The relationship between mental health and drug use

The aim was to examine the relationship between mental health and use of different kinds of drugs. The study was a cross-sectional survey of a total population aged 45–69 years, conducted in 2 municipalities in southwestern Finland. Altogether 1821 people (80% of those invited), 815 men and 1006 women, took part in the screening. The subjects were examined by a questionnaire mailed beforehand and checked in a personal interview. The questionnaire contained questions about the currently used drugs and Goldberg's questionnaire on mental health. Half of the people examined used prescribed drugs currently, more women used drugs than men, and the use of drugs increased with age. Mental symptoms measured with the Goldberg Index appeared in one fifth of the subjects, showing a slight increase with age. Men with mental symptoms showed a fourfold psychotropic drug use compared with the men without mental symptoms. The women with mental symptoms showed a threefold use of psychotropic drugs compared with the women without mental symptoms. Similar differences were found also in other drug groups, for example cardiac glycosides, other cardiovascular drugs, analgesics and drugs for respiratory and digestive organs. Persons with mental disorders showed a high tendency to drug use, also when those drugs had no direct attachment to the mental problem. Men seemed more liable to somatization of mental problems than women.     

The relationship between public mental health admission rates,institutional constraints,and unemployment

Aggregate-level economic decline has been significantly related to utilization rates of public mental health services. Concomitant time-series methods related the monthly unemployment rate of the City of St. Louis to the institutional supply of public mental health services. Supply factors and unemployment were then related to monthly inpatient and outpatient group admission rates from January, 1976 through August, 1983. The results suggested a selection bias during bed shortages favoring first admissions over readmissions. Unemployment was found to be positively related to total first admissions, employed first admissions, and male first admissions.     

The relationship between sexual assault, religiosity, and mental health among male veterans

OBJECTIVES: We examine the association between sexual assault, religion and mental health among male veterans. METHODS: We used longitudinal data collected from 2,427 male veterans who received VA outpatient care. Sexual assault was self-reported in the questionnaire. Two dimensions of religiosity were used: organizational (frequency of religious service attendance) and subjective religiosity (the extent that religious beliefs are a source of strength or comfort). Mental health was measured by the mental component summary from the Veterans SF-36 and depression was measured by the Center for Epidemiologic Studies-Depression scale. A regression model that uses the generalized estimating equation approach for longitudinal repeated data analysis was used. RESULTS: Based on the baseline data, 96 (4%) patients reported ever experiencing sexual assault. These patients have significantly lower levels of mental health status and higher levels of depression (p < .001). The regression results show that this decrement in mental health and increment in depression associated with sexual assault are in lesser degrees for patients who attended religious service more frequently compared to those who never did (p < .05). Similarly, there is a smaller magnitude of increment in depression associated with sexual assault for those who have a higher level of subjective religiosity (p < .05). CONCLUSIONS: Although the prevalence of self reported sexual assault is low among male veterans, those who reported sexual assault experiences had lower levels of mental health status and higher levels of depression. Further, religion attenuates this association which highlights the important role religion might have in coping with this stressful life event.     

The relationship between body mass index and mental health

BACKGROUND: The association between atypical body weight and mental health remains poorly understood. We examined the relationship between body mass index and mental health in a population-based study of adults that included the full range of body weights, three disorder types, and three levels of mental illness severity. METHODS: Data came from the 2003 Alberta Mental Health Survey (n=5383), which included a validated, standard instrument for measurement of DSM-IV mental disorders as well as several indicators of psychiatric symptoms. Associations were examined using crosstabulation and chi squared statistics, and logistic regression adjusting for sociodemographic variables. RESULTS: Findings differed by type and severity of mental illness and by sex and age. For instance, anxiety disorders were elevated among underweight men compared to normal weight men and to women. Substance use disorders were elevated among obese men at younger compared to older ages. Mood disorders were elevated among obese women compared to normal weight women, and subclinical anxiety/depression was reduced among obese men compared to normal weight men and to women. CONCLUSIONS: These analyses highlight the importance of considering type of mental illness, level of severity, sex and age when examining the relationship between BMI and mental health. The diversity of patterns observed, detectable at the population level, warrant further examination and monitoring.     

Collaborative mental health care for the homeless: the role of psychiatry in positive housing and mental health outcomes.

OBJECTIVE: Factors associated with positive outcomes for homeless men referred to a shelter-based collaborative mental health care team were examined. METHOD: A chart review of 73 clients referred over 12 months was completed. Two outcome measures were examined, clinical status and housing status, 6 months after their referral to the program. RESULT: Among the referred clients, the prevalence of severe and persistent mental illness and substance use disorders was 76.5% and 48.5%, respectively. At 6 months, 24 clients (35.3%) had improved clinically, and 33 (48.5%) were housed. Logistic regression identified 2 factors associated with clinical improvement: the number of visits with a psychiatrist and treatment adherence. The same 2 factors were associated with higher odds of housing, and presence of substance use disorder was associated with lower odds of housing at 6-month follow-up. CONCLUSION: Care by a mental health specialist is positively associated with improved outcomes. Strategies to improve treatment adherence, access to mental health specialists, and innovative approaches to treatment of substance use disorders should be considered for this population. Having a psychiatrist as a member of a shelter-based collaborative care team is one possible way of addressing the complex physical and mental health needs of homeless individuals.     

Quality of housing among patients of an area mental health service

OBJECTIVES: The aims of the present study were to (i) assess the quality of housing for patients receiving treatment from an area mental health service; (ii) compare estimates of quality of housing using two different methods: housing type versus housing characteristics; (iii) determine whether either method for assessing quality is more useful that a combination; and (iv) examine the relationship between housing quality and case manager's assessment of the impact of the housing on the patient's mental disorder. METHODS: A survey was developed that included the demographics of the patient; housing type; living arrangements; housing characteristics as assessed by the patient's case manager; and an overall assessment by the case manager of the impact that the housing has on the patient's mental disorder. Case managers were asked to complete the housing survey on all patients they saw in the community during a 2 week period in 2003. The social worker for the inpatient unit completed the survey for all patients admitted to the inpatient unit over a 3 month period. RESULTS: Surveys were completed for a total of 362 patients. Just under 10% of patients were identified as homeless in that the person either had no housing or was living in a shelter or accommodation frequently associated with homeless persons. Almost half of the patients in the sample had housing that was either not affordable, not secure, not safe or not appropriate to their needs, that is, their housing met at least one of a range of criteria defining poor-quality housing. Sixty-one patients (16.9%) had housing that was considered by their case managers to have a substantial negative impact on their mental illness. CONCLUSIONS: Almost half of the patients treated by an area mental health service appeared to have poor-quality housing. Housing characteristics identified a higher proportion of people with poor-quality housing than did housing type. Case managers' assessments generally failed to identify a potential negative impact of poor quality housing on the person's mental disorder.     

The relationship between mercury from dental amalgam and mental health

The findings presented here suggest that mercury poisoning from dental amalgam may play a role in the etiology of mental illness. Comparisons between subjects with and without amalgam showed significant differences in subjective reports of mental health. Subjects who had amalgams removed reported that symptoms of mental illness lessened or disappeared after removal. The data suggest that inorganic mercury poisoning from dental amalgam does affect the mind and emotions.