Male farmers with mental health disorders: A scoping review

The issue of male farmers' mental health raises many concerns including high rates of psychological distress and suicide amid the poor uptake of health services among this subgroup. Gender is an important social determinant of health, and this paper provides an overview of connections between farming and masculinities in the context of men's mental health disorders. This scoping review summarises findings drawn from 46 studies to discuss male farmers' mental health disorders, psychosocial interventions and barriers to help‐seeking. In providing the review, recommendations are made including the need for an array of study and intervention approaches to advance the mental health and well‐being of male farmers and their families.     

How rates of perinatal mental health screening in Australia have changed over time and which women are missing out

Objectives : To report rates of perinatal mental health screening from 2000 to 2017 and investigate factors associated with not being screened both antenatally and postnatally more recently (2013–2017). Methods : A longitudinal community‐based study of self‐reported perinatal mental health screening with a national sample of 7,566 mothers from the Australian Longitudinal Study on Women's Health reporting on 9,384 children. The main outcome measure was whether mothers were asked about their emotional wellbeing by a health professional, including completing a questionnaire. Results : From 2000 to 2017, the percentage of women not screened decreased from 40.6% to 1.7%. The percentage of women screened both antenatally and postnatally increased from 21.3% to 79.3%. From 2013 to 2017, women who were older (aOR, 0.65; 95%CI, 0.52–0.81) or had reported emotional distress (aOR, 0.77; 95%CI, 0.60–0.99) were less likely to have been screened both antenatally and postnatally. Conclusions : Despite improvements, perinatal mental health screening is not yet universal. One‐in‐five women are not screened both antenatally and postnatally, including women in high‐risk populations such as those who have reported emotional distress. Implications for public health : Women are in regular contact with health professionals in the perinatal period. This opportunity to detect women at risk of perinatal mental health issues is too important to be missed.     

Profile of consumers and their partners of a perinatal and infant mental health (PIMH) service in Australia

The perinatal period is a time of great vulnerability for many women, in particular those with a range of psychosocial vulnerabilities and mental health risk factors. This paper outlines the psychosocial and mental health profile of consumers and their partners of a perinatal and infant mental health (PIMH) service in Australia. To establish the consumer profile, we analysed client vulnerabilities and demographical information maintained over a 6‐year period for 406 consumers. Consumer information, including mental health problems, psychosocial vulnerabilities and demographical information, was entered into a standalone database by the allocated clinicians upon service allocation and throughout treatment. The women accepted by PIMH presented with an average of nine different vulnerabilities. Frequently endorsed risk factors included depression (72.66%), anxiety (71.43%), comorbid depression and anxiety (58.13%), self‐harm (past, 7.88%, present, 16.26%), a history of family mental health issues (39.66%), childhood trauma (57.88%), limited support (68.84%), relationship conflict with partners (38.92%) and financial stress (47.29%). The women's partners also presented with a range of vulnerabilities, in particular childhood trauma (34.11%) and mental health issues (30.81%). This study contributes to our understanding of the profile of vulnerable women in the perinatal period, and in particular contributes to the literature by highlighting that in addition to depression, anxiety, self‐harm and trauma are also significant in PIMH service delivery.     

Ethnicity and mental health encounters in primary care: help-seeking and help-giving for perinatal depression among Black Caribbean women in the UK

Background. Perinatal depression among Black Caribbean women in the UK remains an intriguingly under-researched topic. Despite high levels of known psychosocial risks, Black Caribbeans remain relatively invisible among those seeking/receiving help for depression during and after pregnancy.

Methods. In-depth interviews were undertaken with a purposive sample of twelve Black Caribbean women selected from a larger sample (n=101) to examine prevalence and psychosocial risks for perinatal depression among this ethnic group. The study also sought to explore women's models of help-seeking. During analysis, the context in which help-seeking/giving is mediated emerged as a key issue. We explore the nature of these encounters thereby opening up the possibility of finding common ground between service users and providers for enabling women to receive the care and support they need.

Findings. Whether or not women configure depressive feelings as ‘symptoms’ requiring external validation and intervention is a reflection both of the social embeddedness of those individuals and of how ‘help-givers’ perceive them and their particular needs. We suggest that the ways in which help-seeking/giving are commonly conceptualised might offer at least a partial explanation for apparently low levels of diagnosed perinatal depression among Black Caribbean women.

Conclusions. Popular approaches to health seeking behaviours within health promotion and practice focus on individuals as the fulcrum for change, tending to overlook their embeddedness within ‘reflexive communities’. This might serve to reinforce the invisibility of Black Caribbean women both in mainstream mental health services and associated research. Alternative approaches may be required to achieve government targets to reduce inequalities in access, care, and treatment and to deliver more responsive and culturally-appropriate mental health services.     

Challenges faced by general practitioners and allied mental health services in providing mental health services in rural Queensland

OBJECTIVE: To examine the views of rural practitioners concerning issues and challenges in mental health service delivery and possible solutions. DESIGN: A qualitative study using individual semi-structured interviews. SETTING: Eight general practices from eight rural Queensland towns, three rural mental health services and two non-government organisations, with interviews being conducted before recent changes in government-subsidised access to allied health practitioners. PARTICIPANTS: A sample of 37 GPs, 19 Queensland Health mental health staff and 18 participants from community organisations. MAIN OUTCOME MEASURES: Analysis of qualitative themes from questions about the key mental health issues facing the town, how they might be addressed and what challenges would be faced in addressing them. RESULTS: There was substantial consensus that there are significant problems with inter-service communication and liaison, and that improved collaboration and shared care will form a critical part of any effective solution. Differences between groups reflected differing organisational contexts and priorities, and limitations to the understanding each had of the challenges that other groups were facing. CONCLUSIONS: Improvements to mental health staffing and to access to allied health might increase the ability of GPs to meet the needs of less complex patients, but specific strategies to promote better integrated services are required to address the needs of rural and regional patients with complex mental health problems. The current study provides a baseline against which effects of recent initiatives to improve mental health care can be assessed.     

Trauma-informed care with women diagnosed with postpartum depression: a conceptual framework

Postpartum depression (PPD) is a mental health disorder that affects approximately 20% of all new mothers. PPD frequently co-occurs with and is exacerbated by trauma, particularly for women from vulnerable populations. Trauma-informed care (TIC) is a best practice that recognizes the importance of, and takes steps to promote recovery from, trauma while preventing retraumatization. Despite its potential utility, there is limited research published on TIC, including how TIC is operationalized across practice settings. Further, despite the prevalence and negative effects of untreated PPD, to date there have been limited articles published on TIC and PPD. The purpose of this article is to provide a TIC framework for service delivery for women diagnosed with PPD including explicit strategies for how TIC should be structured across roles, settings, and systems. Implications for health practice, policy, and future research are provided.     

Supporting family engagement with child and adolescent mental health services: A scoping review

A key challenge facing the mental health field is connecting children and families to services when symptoms first appear. Multiple barriers inhibit timely access to treatment, and interventions to resolve barriers to care are not common among health and social care organisations. To address this research‐to‐practice gap this study undertook a scoping review of the empirical literature aimed at identifying key factors in the social ecology of families which influence family engagement with child and adolescent mental health services, then identifying and describing models of intervention designed to help facilitate access to care. Forty studies published between 1 January 2000 and 28 February 2019 were reviewed. Key factors associated with child and adolescent mental health service engagement included family attitudes towards mental illness and help seeking, the flexibility and availability of needed services, community attitudes and stigma surrounding mental illness and mental health treatment, and the degree of coordination and integration across systems of health and social care. Models of intervention to facilitate engagement with mental health services included family outreach, telephone and digital health strategies, and integrated care approaches. Empirical support is strongest for family outreach and integrated care, although telephone and digital health strategies are underexplored with children and families and a potentially promising avenue for future research. To support family engagement with child and adolescent mental health services health and social care organisations should be prepared to identify barriers in their local practice settings and integrate efficacious engagement approaches into their continuum of available services.     

The psychological burden of waiting for procedures and patient‐centred strategies that could support the mental health of wait‐listed patients and caregivers during the COVID‐19 pandemic: A scoping review

BackgroundWaiting for procedures delayed by COVID‐19 may cause anxiety and related adverse consequences.ObjectiveTo synthesize research on the mental health impact of waiting and patient‐centred mitigation strategies that could be applied in the COVID‐19 context.MethodsUsing a scoping review approach, we searched 9 databases for studies on waiting lists and mental health and reported study characteristics, impacts and intervention attributes and outcomes.ResultsWe included 51 studies that focussed on organ transplant (60.8%), surgery (21.6%) or cancer management (13.7%). Most patients and caregivers reported anxiety, depression and poor quality of life, which deteriorated with increasing wait time. The impact of waiting on mental health was greater among women and new immigrants, and those of younger age, lower socio‐economic status, or with less‐positive coping ability. Six studies evaluated educational strategies to develop coping skills: 2 reduced depression (2 did not), 1 reduced anxiety (2 did not) and 2 improved quality of life (2 did not). In contrast, patients desired acknowledgement of concerns, peer support, and periodic communication about wait‐list position, prioritization criteria and anticipated procedure date.ConclusionsFindings revealed patient‐centred strategies to alleviate the mental health impact of waiting for procedures. Ongoing research should explore how to optimize the impact of those strategies for diverse patients and caregivers, particularly in the COVID‐19 context.Patient or Public ContributionSix patients and four caregivers waiting for COVID‐19‐delayed procedures helped to establish eligibility criteria, plan data extraction and review a draft and final report.     

Assessing care‐giving demands,resources and costs of family/friend caregivers for persons with mental health disorders: A scoping review

As mental health (MH) care has shifted from institutional settings to the community, families and friends are responsible for providing the majority of the care at home. The substantial literature on the adverse effects experienced by caregivers has focused mainly on psychological morbidity. Less attention has been paid to how caregivers for persons with MH disorders interact with larger social systems and the impacts of factors such as financial strain, lost time from leisure activities, and the availability of health and social services. We conducted a scoping review of MH and other caregiver questionnaires published between 1990 and 2016 to determine whether they addressed four key domains: caregiver work demands, resource needs, resource utilisation and costs. A range of health and social care databases were searched, including MEDLINE and Health and Psychosocial Instruments. After screening for relevance and quality, our search identified 14 instruments addressing elements related to one or more of our domains. Because these instruments covered only a small portion of our domains, we conducted a second targeted search of the general care‐giving literature and consulted with experts, identifying an additional 18 instruments. A total of 32 questionnaires were reviewed, 14 specific to care‐giving for mental health problems and 18 for other health conditions. Our search identified instruments or items within instruments that assess constructs in each of our domains, but no one instrument covered them completely. Additionally, some constructs were evaluated in detail and others only addressed by single items. While these instruments are helpful for moving measurement beyond the psychological impacts of care‐giving, our results serve only as an initial guide. Additional methodological work is needed to more comprehensively measure the impact of care‐giving for individuals with MH disorders and to contribute to the development of more meaningful and effective policies and programmes.     

医学生与非医学生情绪状况调查

目的:了解医学生与非医学生情绪状况,探讨影响医学生心理健康的因素。方法:采用Zung氏抑郁自评量表(SDS)和焦虑自评量表(SAS)对361名北京大学医学部八年制四年级学生和240名清华大学和北京大学同年级非医学专业学生进行测评。结果:医学生组SDS和SAS阳性结果检出率为10.38%和6.25%,显著低于非医学生组(P<0.05),性别间无显著差异(P>0.05)。SDS主要影响因素为晨重晚轻,决断困难和无用感;SAS为多汗,静坐不能和乏力。结论:长学制医学生心理状况良好,但仍然需要重视心理健康教育,注重前期预防,并注意应激引起的心理变化。     

Refugee mental health and the role of place in the Global North countries: A scoping review

Post-migration factors significantly influence refugee mental health. This scoping review looks at the role of place in refugee mental health. We included 34 studies in Global North high-income countries that elaborated on the place characteristics of facilities, neighbourhoods, urban and rural areas, and countries. While the role of place remains under-theorised, all studies reveal common characteristics that support a strong relationship between place of residence, refugee mental health and wellbeing outcomes in post-migration context. Given that refugees often have little or no choice of where they ultimately live, we suggest future research should focus on how characteristics of place co-constitute post-migration refugee mental health risks, protections, and outcomes.     

Experiences of social work intervention among mothers with perinatal mental health needs

Perinatal mental health difficulties are prevalent among women, and the vulnerability of young infants makes this a time when families experiencing multiple adversities may be particularly likely to attract state intervention. However, very little is known about how mothers experience social work intervention during the perinatal period. This study explored experiences of social work intervention among women with perinatal mental health difficulties. Qualitative semi‐structured interviews were carried out with 18 women with 6‐ to 9‐month‐old babies, who had been treated in England for a perinatal mental health difficulty and also had social services intervention. Interviews were analysed using thematic analysis. Findings suggested that mothers had a predominantly negative view of children's social services, especially when social workers had significant child protection concerns. The fear of being judged an unfit mother and having their babies taken away overshadowed their encounters. Mothers felt that social workers would not accept they could be good mothers in spite of their difficulties and set them up to fail. Some felt that social workers focused exclusively on the risks to the baby and did not acknowledge the mother's own needs or understand perinatal mental health. In some cases, social work intervention was described as intensifying pressure on mothers’ mental health, leading to escalating difficulties and increased likelihood of care proceedings. At the same time, our study also included examples of mothers forming positive relationships with social workers, and of ‘turning points’ where initially negative interactions stabilised and child protection concerns lessened. Women's accounts highlighted the importance of feeling ‘known’ by social workers who understood and respected them. The findings also suggested there may be value in improving collaboration between social workers and mental health professionals to create more space for representation of women's needs as well as those of their babies.     

四川省艾滋病高发区艾滋病病毒感染孕产妇卫生保健服务利用现状分析

目的了解艾滋病高发区艾滋病病毒(human immunodeficiency virus,HIV)感染孕产妇的卫生服务及围产保健服务利用现状。方法选取艾滋病高发区四川省凉山州为样本地区,对212名HIV感染孕产妇开展卫生服务利用的问卷调查。结果 HIV感染孕产妇两周患病率和两周就诊率分别为31.13%和27.27%,年住院率为1.42%,需住院未住院率为66.67%。产前检查的比例为72.17%,产后访视的比例为57.08%,住院分娩比例为82.55%。两周患病率在不同年龄、民族和是否务农间有差异,两周就诊率在不同年收入家庭间存在差异。结论 HIV感染孕产妇卫生服务需求和门诊服务利用较高,住院服务和围产保健服务利用不足。     

A review of mental health literacy in Singapore

ABSTRACT

Mental health is a major concern throughout the world. The lifetime prevalence of mental health problems in Singapore for those aged 18 years and above was reported to be 12%. However, studies on mental health literacy are relatively scarce in Singapore. The aim of this paper is to provide a topical review of local studies on mental health literacy, people’s knowledge of, and attitude toward mental illness, and beliefs about mental health treatment. A narrative review of studies on mental health literacy in Singapore covering the period from 1995 to 2016 highlights the findings from various local studies about attitudes toward mental illness, belief about the causes, and help-seeking behavior. Findings revealed that many lay people are unable to recognize different types of mental disorders. Negative attitudes toward mental illness that hinders individuals from seeking professional treatment, and help-seeking, are the common themes that emerge from the findings. Health professionals have differing views about the causes and treatment of mental disorders. Findings also revealed that treatment seeking and attitudes and beliefs toward mental illness are related to mental health literacy. Implications for promoting mental health literacy are provided.     

Exploring the impact of engagement in mental health and substance use research: A scoping review and thematic analysis

Background

There is growing evidence demonstrating the impact of engaging people with lived experience (PWLE) in health research. However, it remains unclear what evidence is available regarding the impact of engagement specific to mental health and substance use research.

Methods

A scoping review of three databases and thematic analysis were conducted. Sixty-one articles that described the impact of engagement in mental health and substance use research on either individual experiences or the research process were included.

Results

Key topics include (a) the impact of engagement on individual experiences; (b) the impact of engagement on the research process; and (c) facilitators and barriers to impactful engagement. Studies largely focused on the perceived positive impact of engagement on PWLE (e.g., personal and professional growth, empowering and rewarding experience, feeling heard and valued), researchers (e.g., rewarding experience, deeper understanding of research topic, changes to practice), and study participants (e.g., added value, fostered a safe space). Engagement activities were perceived to improve facets of the research process, such as improvements to research quality (e.g., rigour, trustworthiness, relevance to the community), research components (e.g., recruitment), and the research environment (e.g., shifted power dynamics). Facilitators and barriers were mapped onto the lived experience, researcher, team, and institutional levels. Commonly used terminologies for engagement and PWLE were discussed.

Conclusion

Engaging PWLE—from consultation to co-creation throughout the research cycle—is perceived as having a positive impact on both the research process and individual experiences. Future research is needed to bring consistency to engagement, leverage the facilitators to engagement, and address the barriers, and in turn generate research findings that have value not only to the scientific community, but also to the people impacted by the science.

Patient or Public Contribution

PWLE were engaged throughout the scoping review process, including the screening phase, analysis phase, and write-up phase.     

Working conditions,mental health and coping of staff in social work with refugees and homeless individuals: A scoping review

The refugee and homeless population has been increasing worldwide in recent years. Staff in social work provide practical help to these populations, but often struggle with high job demands. This scoping review aims to systematically map the job demands, resources, mental health problems, coping strategies and needs of staff in social work with refugees and homeless individuals. Relevant studies were identified by searching seven electronic databases from their inception until the end of May 2018, as well as Google Scholar and reference lists of included articles. The methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool. A thematic analysis was conducted. Twenty‐five studies were included in the review. Fourteen studies followed a quantitative approach, six a qualitative approach and five a mixed‐method approach. Most studies were conducted in the homeless sector (56%), in North America (52%) and published after the year 2009 (68%). Common job demands included the bureaucratic system, high caseloads, clients' suffering and little experience of success. Maintaining professional boundaries counted both as a job demand and a coping strategy. Deriving meaning from work and support from the team were identified as important job resources. The prevalence of mental health problems among staff was high, but difficult to compare due to the use of different instruments in studies. Staff expressed a need for ongoing training, external counselling and supervision. Further studies should examine the effectiveness of workplace health interventions.     

The effectiveness of positive mental health programs in adults: A systematic review

A systematic review was conducted. So, electronic database including CINAHL, Embase, MEDLINE, Pubmed, Scopus and Cochrane‐Central were explored in January 2017 and in October 2017. The aim of this systematic review is to identify, appraise and synthesize the best evidence for the effectiveness of programmes of positive mental health in adults. Mental health is regarded as an ideal functioning state of the human being, which emphasizes the relevance of promoting the person's qualities in the optimization of their potential. Mental health is not inert and definitive but a dynamic and variable state. Studies were reviewed and data extracted by two independent reviewers using Joanna Briggs Institute standardized critical appraisal and data extraction instruments. Six studies met the inclusion criteria for the analysis. However, a meta‐analysis could not be performed. The results suggest that positive mental health programmes improve adults’ mental condition, although there is neither evidence of content formalization nor of programme sessions criteria. The review findings indicate that interventions promoting positive mental health of young adults can be implemented effectively in community settings with various programmes and results.