2004年世界精神卫生日

2004年年初，世界精神卫生协会为本年度的世界精神卫生日的活动选择了一个新的主题：躯体健康和精神健康的关系，强调的概念是：“完整的健康不能缺少心理的健康”，鼓励在卫生保健和医疗过程中推行“全面的健康促进”。     

健康干预对慢性病人健康素养的作用

健康素养(health literacy)是近年来公共卫生研究的一个新领域,它既是健康教育和健康促进的目标,也是衡量健康教育和健康促进工作结果的指标.美国<2010年健康国民>中对健康素养的定义:个体获取、处理、理解基础保健知识和服务,并运用其做出适宜健康决策的能力.由此可见,人们健康素养的高低,直接影响个体和社会的健康状况.     

精神健康复元的研究进展

精神健康复元是国际精神卫生领域的重要理念,重视精神障碍亲历者的亲身经历,关注 精神障碍亲历者是否超越精神障碍的限制,过上有意义、有希望、有目标的生活。目前,我国有关精神 健康复元的研究相对较少,本综述从精神健康复元的概念、评估及干预措施 3 个角度对精神健康复元的 研究进展进行介绍。     

全生命周期健康与儿童精神医学北大核心CSCD

＂加快推进健康中国建设,努力全方位、全周期保障人民健康＂是习近平总书记在2016年召开的全国卫生与健康大会上的号召,标志着＂全生命周期的整体健康观＂首次写入国家战略.近几年,尽管我们也谈儿童心理健康对成人健康的影响,以及重视成人精神科与儿童精神科的衔接,强调关注成人中的＂儿童精神障碍＂,但并未引起足够的重视.总书记的讲话意味着全生命周期健康不仅被提升到国家战略高度,而且被赋予了更为深刻和广泛的内涵.     

澳大利亚的精神健康服务

澳大利亚的精神健康服务（MENTAL HEALTH SERVICE）和中国的结构有很大的不同，以下我以维省为例，简单地介绍一下。     

严重精神障碍患者直接监护人精神卫生知识知晓率 现状调查

目的 初步调查严重精神障碍患者直接监护人精神卫生知识知晓率现状。方法 2017年 12 月—2018 年6 月在重庆市招募选取严重精神障碍患者家属279 人，使用自编一般情况调查表和精神 卫生知识问卷进行调查。结果 （1）279 名监护人监护240 例严重精神障碍患者，39 例患者有2 名监护人 （16.2%）。监护人年龄（54.70±15.26）岁；文化程度：小学及以下144 人，占51.6%，初中89 人，占31.9%， 高中及中专33 人，占11.8%，大专及以上13 人，占4.6%；照料时间为（156.29±61.77）个月。（2）监护人精 神卫生知识知晓率为76.2%。（3）不同文化程度的监护人在不同条目精神卫生知识知晓率上存在差异， 部分条目回答正确与否与照料时间不同和监护人年龄有关。结论 严重精神障碍患者直接监护人呈现 出监护人数量少、年龄偏大、文化程度偏低、照料时间较长的特点，其文化程度、年龄、照料时间3 个因 素对精神卫生知识知晓率有影响。     

重症肌无力患者和家属的健康素养对健康教育的影响

目的通过测评重症肌无力(MG)患者及家属的健康素养,分析影响健康素养的因素以及健康素养对患者和家属掌握MG健康教育内容的意义。方法纳入106例MG患者及101名家属,采用国际公认的健康素养问卷测评他们的健康素养。采用自行设计的MG健康教育内容,随机对被调查者采用医生讲述或患者自行阅读的宣教方式,采用相应的问卷评价患者和家属对健康教育内容的掌握情况。采用独立样本t检验、秩和检验和卡方检验进行单因素分析,采用Logistic回归进行多因素分析。结果患者和家属健康素养为优的比例无统计学差异(P>0.05)。患者和家属健康素养优者中教育程度高者比例均高于健康素养差者(P<0.05,P<0.01)。患者中健康教育得分高的比例高于家属(P<0.01)。患者健康教育得分高者中年轻者比例,家属健康教育得分高者中年轻者和教育程度高者比例均高于健康教育得分低者(均P<0.01)。多因素分析发现,教育程度是影响患者(OR=3.12,P=0.045)和家属(OR=8.82,P=0.001)健康素养的独立影响因素,患者中年龄(OR=7.68,P=0.001)而家属中教育程度(OR=3.25,P=0.013)是健康教育得分的独立影响因素。结论教育程度既是MG患者和家属健康素养的决定因素又是健康教育效果的重要影响因素,年龄也是健康教育效果的重要影响因素,在制定个体化的MG教育方案时需要考虑。     

谈谈老年精神健康服务

澳洲人的寿命越来越长。从1999年～2011年．70岁以上的人口将增加55％．80岁以上的人口增长率将是社会中最高的。待到2020年后．战后出生的人们将进入老年;那时的老年健康问题将会更加引人注目。老年人是健康服务的最大应用,生命的普遍延长．增加了晚年残疾及慢性疾病的人口．增加了生活孤独和多种并发残疾的可能性．据最新     

长沙市普通人群的精神卫生知晓情况

目的评定长沙市公众精神卫生和精神疾病预防知识的知晓情况。方法采用多阶段整群随机抽样方法,选取长沙市辖区随机抽取的2个城市社区和2个农村社区的1660户家庭。从15岁及以上的家庭成员中随机抽取1人进行访谈,完成卫生部推荐的精神卫生知晓率标准问卷（20项）调查。结果1563人完成有效问卷调查,其中男性676人,女性887人,平均年龄（标准差）为41．9（15,9）岁。平均（标准差）应答正确率为68．5％（46．4％）,城市社区平均（标准差）应答正确率[70．5％（13．6％）]高于农村社区应答正确率[66．2％13．5％）]（t=6．18,P〈0．001）。正确应答率与年龄负相关（r=一0．21,P〈0．001）,与文化程度正相关（r=0．28,P〈0．001）,与职业和婚姻状态的差异呈多样相关性。采用逐步回归分析发现文化程度、年龄和职业（农民或工人与其他职业比较）为精神卫生知晓率的独立相关因素。问卷20个条目总体内部一致性及4个分量表的内部一致性偏低（alpha=0．27～0．57）。结论长沙市普通居民精神卫生知识总体知晓率相对较高,但有些方面仍需提高,特别是对于精神疾病病因的认识。公众精神卫生知识的知晓能力随人口学特征不同而有较大差异,因此对不同人群进行特定的精神卫生教育可有效地提高社区居民的精神卫生知识知晓率。今后需修订调查问卷,提高信、效度和内部一致性。     

Investigating the impact of masculinity on the relationship between anxiety specific mental health literacy and mental health help-seeking in adolescent males

BackgroundPoor mental health literacy and greater alignment with norms of hegemonic masculinity are established barriers to mental health help-seeking in men. However, little is known about how these variables influence adolescent male help-seeking and in particular, help-seeking for anxiety disorders. This study investigated the relationship between i) anxiety mental health literacy, ii) alignment with traditional masculinity norms and iii) help-seeking attitudes, intentions and behaviour in a sample of adolescent males.Methods1732 adolescent males (aged 12–18 years) participated online whilst at school.ResultsParticipant attitudes towards formal help-seeking, intentions to seek help from a family member and from an online source were found to predict professional help-seeking behaviour by the adolescent and/or by their parents on the adolescents’ behalf. In adolescents with a low or average personal alignment with norms of hegemonic masculinity, greater anxiety mental health literacy was positively associated with more favourable attitudes towards formal and informal help-seeking. However, this relationship was not found in adolescent males with a greater alignment with norms of hegemonic masculinity.LimitationsThe study had a correlational research design and used self-report measures.ConclusionsMental health initiatives which consider the impact of masculinity and gender stereotypes have the potential to significantly improve help-seeking in this population.     

Tensions along the path toward mental health literacy for new immigrant mothers: perspectives on mental health and mental illness

This study explored how mothers approach their own mental health literacy and that of their teenage children. The research used focus groups and questions based on the messaging of a community-based mental health awareness program called ‘Talking about Mental Illness’ (TAMI) to investigate the nature of mental health perceptions and attitudes of new immigrant mothers and illustrate how the program’s messaging can contribute to or build upon their levels of mental health literacy. A qualitative thematic assessment of the knowledge and perceptions of the study participants, all recent immigrants to Canada from India, Bangladesh, Iran, and Romania within the last three years and mothers of high school students, was undertaken. The findings show that participants appreciate the importance of fostering mental health understanding and discussion with their children at the same time that they encounter obstacles to the advancement of their mental health literacy.     

Psychiatric literacy and the conduct disorders

Past research regarding mental health literacy has indicated that public knowledge is lamentably poor. This study aimed to examine the effect of demographics, experience and personality, as predictors for understanding conduct disorders. An opportunistic sample of 125 participants with a mean age of 24.29 years completed an online questionnaire in which they were asked to describe and evaluate vignettes of 4 conduct disorders. They were asked for their view of what the diagnosis may be: “What is the main problem”, confidence in their diagnosis, and how the person could be helped. The correct diagnosis was given by 42% of the participants in one case but only 8% in another. A content analysis suggested that five types of diagnosis were given: psychological/psychiatric, behavioural, parenting, socio-emotional and lifestyle.There were significant differences in what treatments were thought to be useful between the cases though psychotherapy was thought to be most useful. Limitations of this study are considered.     

Helping older adults to help themselves: the role of mental health literacy in family members

Objectives: Family members may play an important role in the health and well-being of older adults. However, little is known about the factors that influence the likelihood of family members supporting older relatives to seek help from mental health professionals for mental health concerns. Mental health literacy is associated with people's help-seeking intentions regarding their own mental health concerns, and some studies have suggested it may play a role in help-seeking on behalf of others. The purpose of this study was to investigate whether mental health literacy is associated with adults’ likelihood of supporting an older relative to seek professional help for mental health concerns.

Method: Two hundred and sixty-three participants completed a measure of mental health literacy and responded to a hypothetical scenario by indicating their likelihood of supporting an older relative experiencing mental health problems to seek help from various sources.

Results: Mental health literacy was positively associated with intentions to support older relative's help-seeking.

Conclusions: Interventions to increase the mental health literacy of the relatives of older adults may lead to additional support for older adults’ help-seeking for mental health concerns.     

Measuring and predicting mental health literacy for depression

This study investigated if mental health literacy for depression is a multidimensional construct, and sought to identify its components and to construct empirically derived questionnaire subscales. Following a literature review, items were generated to produce five conceptual subscales. These were administered to 228 respondents (136 females, 92 males), along with others measuring psychological constructs of theoretical relevance, specifically assessing: emotional intelligence, mindfulness, interdependence and independence, rebelliousness, and depressive symptomatology. Principal components analysis of the 38-item pool confirmed a 3-factor solution: (1) Knowledge and belief in psychological strategies for reducing depression, (2) Ability to recognise depression, and (3) Knowledge and beliefs in positive self-care habits for reducing depression. These components comprise the Public Understanding of Depression Questionnaire (PUDQ). Interdependence, emotional intelligence, sex of respondent and previous history of medication for mental health difficulties were found to be independently predictive of scores on the PUDQ subscales, supporting their construct validity, with Cronbach’s Alpha coefficients indicating their internal reliability. The PUDQ is a novel multidimensional tool which can be used in the delivery and assessment of strategies for promoting the understanding of depression amongst at-risk groups.     

Effects of a classroom-based educational resource on adolescent mental health literacy: A cluster randomised controlled trial

Evidence suggests that poor mental health literacy is a key barrier to help-seeking for mental health difficulties in adolescence. Educational programs have shown positive effects on literacy, however, the evidence base remains limited and available studies have many methodological limitations. Using cluster Randomised Control Trial (RCT) methodology, the current study examines the impact of ‘HeadStrong’, a school-based educational intervention, on mental health literacy, stigma, help-seeking, psychological distress and suicidal ideation. A total of 380 students in 22 classes (clusters) from 10 non-government secondary schools was randomised to receive either HeadStrong or Personal Development, Health and Physical Education (PDHPE) classes. Participants were assessed pre- and post-intervention, and at 6-month follow-up. Literacy improved and stigma reduced in both groups at post-intervention and follow-up, relative to baseline. However, these effects were significantly greater in the HeadStrong condition. The study demonstrates the potential of HeadStrong to improve mental health literacy and reduce stigma.     

Differences in community mental health literacy in older and younger Australians

BACKGROUND: Depression has been traditionally considered to increase with age, although that may be due to sampling of those who have presented with depressive conditions. It is now recognised that patients' understanding of depression and beliefs about its appropriate treatment, mental health literacy, influences treatment-seeking behaviour. OBJECTIVES: This study delineates depression, recent use of health services and mental health literacy in a random and representative community sample of younger and older South Australians. METHODS: Depression, health service utilisation and mental health literacy were assessed in a random and representative sample of 2010 South Australians. Results for those aged between 65 and 74 years (n=300) and those aged 15 to 24 years (n=521) were compared. RESULTS: Compared with the younger group, older subjects did not report greater levels of current depression although they were more likely to have seen a medical practitioner in the last 12 months and be taking antidepressants. However, their mental health literacy in terms of recognition of a mental health problem in a vignette was somewhat poorer and fewer recommended treatment from a counsellor, telephone service or psychologist and more considered that a psychiatrist would be harmful. They also more often perceived the clergy as helpful. CONCLUSIONS: Depression was not more common among older than younger members of the community. Despite recognising depression in a vignette less often and perceiving less likelihood of help from several different mental health professionals, those in the older group were more likely to receive antidepressant medication and to have recently consulted a medical practitioner.