Zero tolerance approach to aggression and its impact upon mental health staff attitudes

OBJECTIVE: A natural study design provided an opportunity to investigate the effect of zero tolerance to aggression policy on health staff attitudes. METHOD: This study compared a training programme used to train health service staff in aggression minimization (group 1) with a highly similar training programme that differed in that it emphasized a zero tolerance approach to aggression minimization in the health workplace (group 2). Prior to training and at follow up 117 health staff (57 from group 1, and 60 from group 2) completed a series of evaluations examining rigid attitudes toward managing aggression, tolerance for aggression and confidence and skills in dealing with aggression. RESULTS: The groups were equivalent with respect to age, sex and occupation. Prior to training the two groups did not differ with regard to rigidity, tolerance, confidence and skills. Both training interventions were effective in increasing confidence and skills. However, group 1 significantly decreased rigid attitudes toward the management of aggression, whereas group 2 significantly evidenced increased rigid attitudes and decreased tolerance toward aggression. CONCLUSION: Zero tolerance for aggression had a negative impact on health staff attitudes in relation to managing aggression in the health workplace.     

The impact of mental health literacy,stigma, and social support on attitudes toward mental health help-seeking

Guided by the theory of reasoned action, this study built a model to examine the ways in which mental health literacy (MHL), personal stigma, self-stigma, and social support collectively influence attitudes toward mental health help-seeking. A sample of 211 participants (age range 22–64; 67.62% females) from a cross-sectional survey that examined MHL of local public housing staffs in Texas were included in a structural equation modeling analysis. MHL directly influenced attitudes. Personal and self-stigma did not mediate the relationship between MHL and attitudes. Yet, self-stigma was significantly associated with attitudes. Social support positively predicted attitudes. Findings suggest the need for improving MHL and strengthening social support to promote positive attitudes toward mental health help-seeking. Mental health education to those who are at risk for mental illness and to families who are likely to influence help-seeking attitudes of those with mental illness could be useful.     

Taoism and its impact on mental health of the Chinese communities

Spirituality and religious coping is an important and rapidly expanding field in recent years. For the Chinese, traditional Taoism may still have a strong impact on the mental health of Chinese people. Taoistic concepts of mental health stress the transcendence from self and secularity, the dynamic revertism of nature, integration with nature and the pursuit of the infinite. Compared with western concepts of mental health, Taoism advocates self-transcendence, integration with the Law of Nature, inaction and infinite frame of reference instead of social attainment, self-development, progressive endeavor and personal interpretation. By means of a case illustration, the writer tries to describe its impacts on help-seeking, stress and coping, and the meaning of life of a Chinese family. Its generalization to different types of Chinese communities is also discussed.     

A mental health training program for community health workers in India: impact on knowledge and attitudes

Background

Unmet needs for mental health treatment in low income countries are pervasive. If mental health is to be effectively integrated into primary health care in low income countries like India then grass-roots workers need to acquire relevant knowledge and skills to be able to recognise, refer and support people experiencing mental disorders in their own communities. This study aims to provide a mental health training intervention to community health workers in Bangalore Rural District, Karnataka, India, and to evaluate the impact of this training on mental health literacy.

Methods

A pre-test post-test study design was undertaken with assessment of mental health literacy at three time points; baseline, completion of the training, and three month follow-up. Mental health literacy was assessed using the interviewer-administered Mental Health Literacy Survey. The training intervention was a four day course based on a facilitator's manual developed specifically for community health workers in India.

Results

70 community health workers from Doddaballapur, Bangalore Rural District were recuited for the study. The training course improved participants' ability to recognize a mental disorder in a vignette, and reduced participants' faith in unhelpful and potentially harmful pharmacological interventions. There was evidence of a minor reduction in stigmatizing attitudes, and it was unclear if the training resulted in a change in participants' faith in recovery following treatment.

Conclusion

The findings from this study indicate that the training course demonstrated potential to be an effective way to improve some aspects of mental health literacy, and highlights strategies for strengthening the training course.     

Post-war mental health promotion in Bosnia-Herzegovina

After the war in Bosnia-Herzegovina, mental illness is very prevalent. With little knowledge about mental health, the stigma of mental illness is still pervasive in many communities. To combat this prejudice, we describe mental health promotion strategies which can empower individuals and educate the communities in which they live.     

Youth mental health promotion in the Hunter region

OBJECTIVE: To describe the work of the Hunter Institute of Mental Health, with special emphasis on its role in mental health promotion and prevention with adolescents. METHOD AND RESULTS: The Ottawa Charter for Health Promotion is used as a framework to describe the varied functions of this organisation. Four youth mental health promotion programs are given as examples of the Institute's work. Results of preliminary evaluation of the Youth Suicide Prevention - National University Curriculum Project are provided. CONCLUSION: The Hunter Institute of Mental Health, a self-funding unit of the Hunter Area Health Service, provides innovative health promotion programs as part of its role as a provider of mental health education and training. The model may be particularly applicable to mental health services in regional Australia.     

The study of attitudes about mental health in the community mental health center

The assumption that a common ideology is shared by the staff of a community mental health center was tested using the Community Mental Health Ideology Scale. The scores of three groups were analyzed—service directors, line staff, and student aides. Marked discrepancies or lack of consensus in beliefs were found to exist among professional disciplines, between service units, and within each category. The implications of these findings on center functioning are discussed, and recommendations for additional studies are suggested.     

The need for mental health promotion

OBJECTIVE: To examine the concept and evidence for mental health promotion, within an understanding of mental health and mental illness and their determinants. METHOD: A selective review of literature and opinion in the fields of public health and mental health. RESULTS: Mental health and mental illness are often given a low priority, despite growing evidence of the burden of disease and costs to the economy. Improving mental health and reducing mental illness will improve quality of life, public health and productivity. The needs for mental health promotion are complementary to the needs for prevention and treatment of mental illness. The required activities are different. Mental health professionals have a necessary but not sufficient role in mental health promotion. CONCLUSIONS: An understanding that mental illnesses are treatable can encourage early entry to care, improve outcomes and lessen the stigma and discrimination related to mental illness. In primary health care there is some evidence that preventive interventions with groups at high risk of depression can prevent episodes of ill health. However, mental health promotion involves another dimension. Better understanding of the nature of mental health and mental illness is the key to changing the priorities, policies and practices in education, law, social services, housing and health critical in turn to the conditions conducive to mental health.     

Triple jeopardy: impact of partner violence perpetration,mental health and substance use on perceived unmet need for mental health care among men

Objectives  

To examine the relationship between intimate partner violence (IPV) perpetration, serious mental illness, and substance use and perceived unmet need for mental health treatment in the past year among men in the general population using the behavioral model for health-care use (Aday and Anderson in Health Serv Res 9:208–220, 1974; Andersen in A behavioral model of families’ use of health services, 1968; Andersen in Med Care 46:647–653, 2008).     

Authoritarianism and attitudes toward mental health services

Right-wing authoritarians have been shown to resist change and to demonstrate hostility toward out-groups and social movements that may advocate change from traditional and conventional beliefs. Using data from the Louisville Metropolitan Survey, an omnibus survey of 771 adults interviewed by telephone, the authors investigated the relationship between right-wing authoritarianism (RWA) and attitudes toward mental health services. The findings of the bivariate and regression analyses indicated that high scorers on a version of B. Altemeyer's (1988) RWA index were more likely to hold negative attitudes on mental health services. In particular, the Submissive Authoritarianism scale predicted negative attitudes toward mental health services; however, scores on the Conventionality subscale were not related to attitudes toward mental health services.     

Community attitudes about mental health services

Community attitudes toward a new mental health center were surveyed by calling 110 randomly selected residences. Drugs and alcohol were seen as the community's most pressing social problem. Respondents were favorable to mental health centers and public funding and had accurate information about many aspects of mental health problems, although misinformation about types of services, professional staffing, and length of treatment was present. The favorable community altitude is seen as providing a base for increased public education in areas of misinformation and more consultation and preventive programs in areas of community concern.     

Review of mental health promotion interventions in schools

Purpose

The prevalence of mental disorders amongst children and adolescents is an increasing global problem. Schools have been positioned at the forefront of promoting positive mental health and well-being through implementing evidence-based interventions. The aim of this paper is to review current evidence-based research of mental health promotion interventions in schools and examine the reported effectiveness to identify those interventions that can support current policy and ensure that limited resources are appropriately used.

Methods

The authors reviewed the current state of knowledge on school mental health promotion interventions globally. Two major databases, SCOPUS and ERIC were utilised to capture the social science, health, arts and humanities, and education literature.

Results

Initial searches identified 25 articles reporting on mental health promotion interventions in schools. When mapped against the inclusion and exclusion criteria, 10 studies were included and explored. Three of these were qualitative and seven were quantitative.

Conclusions

A range of interventions have been tested for mental health promotion in schools in the last decade with variable degrees of success. Our review demonstrates that there is still a need for a stronger and broader evidence base in the field of mental health promotion, which should focus on both universal work and targeted approaches to fully address mental health in our young populations.

     

Child mental health services: cultural diversity training and its impact on practice

We are supportive of the desire to ensure that CAMHS staff provide appropriate care that is tailor made for each child and family they encounter, and would argue that this is a benchmark for quality. It is important to qualify that this is not just a case of giving the consumer what they want, but rather helping families think about the issues they present with, and then arriving collaboratively at a management plan that is coherent to all parties. However, we would be more cautious about what can be achieved through individual strategies such as cultural competence or diversity training, that are not linked to other strategies. There is a need to reflect on what we are doing rather than responding in a knee jerk fashion. We also need to consider the evidence we use to frame our interventions. Sometimes there is no evidence available and action is needed. In these situations we need to be transparent about our approaches and be prepared to change them in light of emerging evidence. Delivering appropriate services to diverse populations is so much more than having a checklist and sending the workforce to be superficially trained. Before we embark on training, we should ask what we anticipate the training to achieve. This has to be set within an educational rather than political -framework, if educational objectives are to be met. It is also inexcusable to fund or support any kind of intervention without building in evaluation processes. Finally, we need to find out what kind of training improves the patient experience and health care outcomes. Unless we take all these factors into account, paying attention to diverse populations may end up being nothing more than a passing fad.     

PSRO-future impact on community mental health centers

In November 1972 Congress passed P.L. 92-603 creating Professional Standards Review Organizations (PSROs) to involve practicing physicians and other health care professionals in the ongoing review and evaluation of health care services funded through Medicare, Medicaid, and maternal and child health programs. This paper examines the requirements and components of the PSRO program, the mandate for nonphysician peer review, and future implications for mental health facilities including community mental health centers. With the eventual review of community mental health centers by PSRO's, centers must begin plans for implementing review programs that evaluate the necessity, the quality, and the cost of services.     

A systematic concept analysis of mental health promotion

This study explored and clarified the nature and characteristics of the concept of mental health promotion. The study also investigated how these characteristics appear in current policies and strategies. A total of 30 scientific articles and policy documents were identified and analysed using Rodgers’s systematic evolutionary concept analysis method. The analysis provided valuable information on the attributes, related concepts, antecedents, consequences and references of mental health promotion, indicating that the concept is a distinct concept comprising a unique set of attributes and characteristics. A concept mapping of mental health promotion was subsequently developed. The analysis and the concept mapping provide health professionals, policy-makers and researchers with a framework, upon which well-grounded mental health promotion practice and evaluation research can be based.