Change, psychosocial stress and health in an era of globalization

In the last decades, globalization has produced an acceleration of social, economic and political changes worldwide. These changes had a number of positive effects including enhancing political freedom, living standards and health conditions. However, many of them have also produced adverse health consequences, especially when they have been implemented in a sudden, rapid and unexpected way. This is especially true among those populations whose ability to adjust to the new circumstances generated by rapid change was limited. The aim of the present research project was to examine the health consequences of rapid social, economic and political change following globalization as well as to investigate the role of psychosocial factors in explaining these relationships. A theoretical framework proposing major psychosocial pathways connecting rapid change with health-related outcomes has been developed. A series of case studies from countries affected by rapid change supported the hypothesized relationships included in the framework. Countries of interest were the former Soviet Union nations, China, Japan, Micronesia Islands, New Zealand, Australia, Canada, and the United States. The limited ability of certain populations to adjust to rapid changes induced by globalization as well as the pace of change of social, economic and political reforms are discussed

Resilience and Coping for the Healthcare Community: A Post-disaster Group Work Intervention for Healthcare and Social Service Providers

Healthcare and social service providers play a critical role in supporting children, families and communities immediately after a disaster and throughout the recovery process. These providers, who may have also experienced the disaster and related losses, are among the least likely to receive mental health or psychological support which can result in burnout, secondary traumatic stress, depression and anxiety. Accessible psychosocial interventions designed for healthcare and social service providers in the aftermath of a disaster are therefore critical to recovery and to ensure providers are available to support families after future disasters. The purpose of this article is to describe Resilience and Coping for the Healthcare Community (RCHC), a manualized group work intervention for social service and health care providers who have provided care to children, families, and communities after a natural disaster. RCHC is currently being delivered in response to Hurricanes Harvey and Maria, storms that struck the gulf coast of the United States and the island of Puerto Rico in 2017. RCHC has also been used in the areas affected by Hurricane Sandy (New York and New Jersey), in Shreveport, Louisiana following severe flooding and in Saipan after a Typhoon devastated the island. Healthcare and social service providers who have received RCHC include the staff of Federally Qualified Health Centers and other community clinics, Disaster Case Managers, Child Care Providers, Mental Health Providers and First Responders. The health and wellbeing of these providers directly impacts their ability to provide quality care to families in their communities. This article presents the theoretical foundations of the RCHC intervention, describes the intervention in detail, provides a description of early and ongoing evaluation studies, and discusses the conditions for both implementation of RCHC and training of RCHC providers. The RCHC psychoeducational intervention provides education on, and strategies for, acute, chronic and post-traumatic stress, coping, and resilience, tailored for the needs of the helping professions. Through the use of individual and collective processing, healthcare and social service providers participating in RCHC develop both individual and collective coping plans. Considering the short and long-term impacts of disasters on communities’ essential healthcare and social service workforce, interventions like RCHC stand to provide essential benefits, including retention and wellbeing of providers of family services

Developing an Intervention Toolbox for the Common Health Problems in the Workplace

Development of the Health ↔ Work Toolbox is described. The toolbox aims to reduce the workplace impact of common health problems (musculoskeletal, mental health, and stress complaints) by focusing on tackling work-relevant symptoms. Based on biopsychosocial principles this toolbox supplements current approaches by occupying the zone between primary prevention and healthcare. It provides a set of evidence-informed principles and processes (knowledge + tools) for tackling work-relevant common health problems. The toolbox comprises a proactive element aimed at empowering line managers to create good jobs, and a ‘just in time’ responsive element for supporting individuals struggling with a work-relevant health problem. The key intention is helping people with common health problems to maintain work participation. The extensive conceptual and practical development process, including a comprehensive evidence review, produced a functional prototype toolbox that is evidence based and flexible in its use. End-user feedback was mostly positive. Moving the prototype to a fully-fledged internet resource requires specialist design expertise. The Health ↔ Work Toolbox appears to have potential to contribute to the goal of augmenting existing primary prevention strategies and healthcare delivery by providing a more comprehensive workplace approach to constraining sickness absence

Beacons of Excellence in Stress Prevention

NoThis report describes the work of Robertson Cooper Ltd and UMIST to identify good practice in stress prevention and then identify organisations within the UK that could be called beacons of excellence in comparison to this model. Part one of this report summarises and draws conclusions from all of the substantive academic studies on stress prevention over the last decade and uses this information, as well as advice gained from a panel of international experts, to develop a comprehensive stress prevention model. Part two of the report uses this model to describe examples of stress prevention practices that Robertson Cooper Ltd has identified within a wide range of UK organisations. Case studies are presented for each aspect of the good practice model. Examples of real documentation and organisational practice are presented.Health and Safety Executive (HSE

Management of Agitation During the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic caused by the coronavirus SARS-CoV-2 has radically altered delivery of care in emergency settings. Unprecedented hardship due to ongoing fears of exposure and threats to personal safety, along with societal measures enacted to curb disease transmission, have had broad psychosocial impact on patients and healthcare workers alike. These changes can significantly affect diagnosing and managing behavioral emergencies such as agitation in the emergency department. On behalf of the American Association for Emergency Psychiatry, we highlight unique considerations for patients with severe behavioral symptoms and staff members managing symptoms of agitation during COVID-19. Early detection and treatment of agitation, precautions to minimize staff hazards, coordination with security personnel and psychiatric services, and avoidance of coercive strategies that cause respiratory depression will help mitigate heightened risks to safety caused by this outbreak

Emergency department mental health nurses' perceptions of occupational stressors and utilization of coping strategies

Individuals in mental health crises can present to an emergency department 24 hours a day, seven days a week. Yet there is minimal literature discussing the function and importance of emergency department mental health services. This investigation seeks to answer the question: what is the lived experience of dealing with occupational stress as a mental health nurse working on an emergency department mental health team? This research is based on a qualitative descriptive approach where a narrative is derived from the lived experiences of several individuals involved with a common phenomenon. Eight participants from two emergency department mental health teams were interviewed to explore their perceptions of occupational stressors and resulting coping strategies. Findings were divided into two categories: stressors and coping strategies. The main themes of stressors were: feeling morally distressed, working in an acute and uncertain environment, and incivility in the workplace. The main themes of coping strategies were: learning to work together, a shift in perspective, and personal coping strategies. These findings are discussed alongside current literature and suggestions are made for future research, continuing education, and practice improvement.Includes bibliographical references (pages 87-93)."In partial fulfillment of the requirements for the degree of Master of Psychiatric Nursing.

Mental Health & Psychosocial Support Rapid Situational Analysis: Ukraine--Kyiv, Odessa & Lviv

The primary objectives of this rapid MHPSS situational analysis are to:understand the perceived and identified sources of psychosocial distress among community members affected by the war in Ukraine (with special focus on International Medical Corps' areas of operation);identify key needs for MHPSS services, traditional ways of coping, help-seeking behaviors and barriers to accessing support services;determine existing MHPSS actors and services, as well as gaps in services; andshare recommendations for MHPSS programming as a part of the humanitarian response, and advocate for increased investment in MHPSS activities and services in Ukraine

Clinicians’ Reports of the Impact of the 2008 Financial Crisis on Mental Health Clients

This study investigated the impact of the 2008 economic crisis on mental health clients. One hundred and three mental health providers (101 being psychologists) from California, Colorado, and Arizona completed an online survey. Following Lazarus’ stress theory, social identity theory, and the finances-shame model, several moderator variables were evaluated for impact of financial crisis: gender, age group, previous mental health, lifestyle threat, and sources for support. As predicted, male and female clients were generally described as equally stressed, but stress responses differed. Financial role responsibilities and previous mental health were noted as predictors of stress. Men—as well as clients earning a “moderate” income (i.e., $50–100,000 annually) and who faced greater instability in social identity/status—described finance shame. Implications for further research, clinical competence, and public health are discussed

"It Was as Though My Spirit Left, Like They Killed Me": The Disruptive Impact of an HIV-Positive Diagnosis among Women in the Dominican Republic.

An HIV diagnosis may be associated with severe emotional and psychological distress, which can contribute to delays in care or poor self-management. Few studies have explored the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in low-resource settings. We conducted in-depth interviews with 30 women living with HIV in the Dominican Republic. Interviews were audio-recorded, transcribed, and analyzed using the biographical disruption framework. Three disruption phases emerged (impacts of a diagnosis, postdiagnosis turning points, and integration). Nearly all respondents described the news as deeply distressful and feelings of depression and loss of self-worth were common. Several reported struggling with the decision to disclose-worrying about stigma. Postdiagnosis turning points consisted of a focus on survival and motherhood; social support (family members, friends, HIV community) promoted integration. The findings suggest a need for psychological resources and social support interventions to mitigate the negative impacts of an HIV diagnosis