Housing repossessions, evictions and common mental illness in the UK: results from a household panel study

Background: The numbers of housing repossessions and evictions in the UK are increasing. This study investigates whether repossessions and evictions increase the likelihood of common mental illness and examine patterns over time. Methods: Data come from the core longitudinal panel of the British Household Panel Survey (N=12 390) of adults living in private households. Multivariate fixed-effects regression models are used with weighted data. Common mental illness is measured by the 12-item General Health Questionnaire. Results: Housing repossession is associated with an increased risk of common mental illness (adjusted odds ratio 1.61, 95% confidence interval 1.10 to 2.36), whereas eviction from rented property shows no increased risk (0.97, 0.76 to 1.20). The pattern over time shows a clear increase in the years before repossession. Conclusions: Repossession of owned property, although a relatively rare event in the panel, significantly increases the risk of common mental illness immediately after the event. In contrast, eviction from rented property is a more common event but is not associated with an increased risk of common mental illness. This difference in association may be due to losing the security of owned housing and the often transitory nature of the rented housing population

Psychometric Properties of the Perceived Social Support from Family and Friends Scale: Data from an Adolescent Sample in Ghana

Several studies have found that perceived social support plays a crucial role in the psychological and physical wellbeing of young people. A number of instruments measuring perceived social support have been developed and validated, including the Perceived Social Support from Family and Friends subscales. The psychometric properties of the Perceived Social Support from Family and Friends subscales have been demonstrated in a range of samples, although not in Ghana. The purpose of this study is to investigate the psychometric properties of the Perceived Social Support from Family and Friends subscales in Ghanaian adolescents using data from a school-based survey (N = 770; 14–21 years). Participants completed a self-report questionnaire containing the Perceived Social Support from Family and Friends subscales, the Adolescent Stress Questionnaire, and the 12-item General Health Questionnaire. An exploratory factor analysis in addition to simultaneous confirmatory factor analyses with structural equation modelling were performed to evaluate the factor structure and factorial validity of the subscales along with Cronbach’s α and intercorrelations. Three factors and two factors were extracted for the Friends and Family subscales respectively. While the unidimensional model of the friends subscale had a better fit with the data than the three-factor model, the two-factor model of the family subscale had a better fit than the unidimensional model, even though the unidimensional models of both subscales produced higher internal consistency coefficients. With respect to construct validity, the family subscale demonstrated some evidence of convergent and discriminant validity, but the friends subscale demonstrated some evidence of only discriminant validity, in terms of the association between social support and common mental illness and perceived stress. It appears that the Perceived Social Support subscales are useful instruments for assessing social support from family and friends and could therefore be used to further our understanding about the role of social support in stressful life events and psychological functioning of Ghanaian adolescents, although further research is required for the friends subscale

Using the Principle Based Model to Improve Well-Being in School: A Mixed-Methods Pilot Study

The contemporary school environment in England has been identified as stressful for both staff and pupils. School-based interventions aimed at improving well-being and mental health have shown mixed results. The Principle Based Model (PBM) of Mind, Consciousness, and Thought is an untried intervention in English schools and as a working model there is a paucity of research into its potential. The aim of this mixed-methods pilot study was to investigate the effectiveness of the PBM as a means of increasing the psychological well-being of staff and pupils. The study was a 16-week pre, post, and follow-up study using the Friedman Well-Being Scale (FWBS) as a measure of psychological well-being, and analyzed using matched sample t tests and repeated measures ANOVA. The study was carried out in a high school in the east of England with 10 staff and nine pupils. The staff and pupils involved received the PBM as a psychoeducational program. During the follow-up period, six members of staff and one pupil were interviewed and the transcripts analyzed using Thematic Analysis. The pre to post total FWBS scores showed an increase in psychological well-being for both staff and pupils but only the change for pupils was statistically significant. Post to follow-up total FWBS scores for both staff and pupils showed no significant change. This study provides some initial evidence to suggest that the PBM may be a useful tool for schools to utilize in attempting to increase psychological well-being

Is Housing a Health Insult?

In seeking to understand the relationship between housing and health, research attention is often focussed on separate components of people?s whole housing ?bundles?. We propose in this paper that such conceptual and methodological abstraction of elements of the housing and health relationship limits our ability to understand the scale of the accumulated effect of housing on health and thereby contributes to the under-recognition of adequate housing as a social policy tool and powerful health intervention. In this paper, we propose and describe an index to capture the means by which housing bundles influence health. We conceptualise the index as reflecting accumulated housing ?insults to health??an Index of Housing Insults (IHI). We apply the index to a sample of 1000 low-income households in Australia. The analysis shows a graded association between housing insults and health on all outcome measures. Further, after controlling for possible confounders, the IHI is shown to provide additional predictive power to the explanation of levels of mental health, general health and clinical depression beyond more traditional proxy measures. Overall, this paper reinforces the need to look not just at separate housing components but to embrace a broader understanding of the relationship between housing and health

The impact of persistent poor housing on mental health: A longitudinal population-based study

Living with housing problems increases the risk of mental ill health. Housing problems tend to persist over time but little is known about the mental health consequences of living with persistent housing problems. We investigated if persistence of poor housing affects mental health over and above the effect of current housing conditions. We used data from 13 annual waves of the British Household Panel Survey (1996 to 2008) (81,745 person/year observations from 16,234 individuals) and measured the persistence of housing problems by the number of years in the previous four that a household experienced housing problems. OLS regression models and lagged-change regression models were used to estimate the effects of past and current housing conditions on mental health, as measured by the General Health Questionnaire. Interaction terms tested if tenure type modified the impact of persistent poor housing on mental health. In fully adjusted models, mental health worsened as the persistence of housing problems increased. Adjustment for current housing conditions attenuated, but did not explain, the findings. Tenure type moderated the effects of persistent poor housing on mental health, suggesting that those who own their homes outright and those who live in social housing are most negatively affected. Persistence of poor housing was predictive of worse mental health, irrespective of current housing conditions, which added to the weight of evidence that demonstrates that living in poor quality housing for extended periods of time has negative consequences for mental health

Psychological distress among Bam earthquake survivors in Iran: a population-based study

BACKGROUND: An earthquake measuring 6.3 on the Richter scale struck the city of Bam in Iran on the 26th of December 2003 at 5.26 A.M. It was devastating, and left over 40,000 dead and around 30,000 injured. The profound tragedy of thousands killed has caused emotional and psychological trauma for tens of thousands of people who have survived. A study was carried out to assess psychological distress among Bam earthquake survivors and factors associated with severe mental health in those who survived the tragedy. METHODS: This was a population-based study measuring psychological distress among the survivors of Bam earthquake in Iran. Using a multi-stage stratified sampling method a random sample of individuals aged 15 years and over living in Bam were interviewed. Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12). RESULTS: In all 916 survivors were interviewed. The mean age of the respondents was 32.9 years (SD = 12.4), mostly were males (53%), married (66%) and had secondary school education (50%). Forty-one percent reported they lost 3 to 5 members of their family in the earthquake. In addition the findings showed that 58% of the respondents suffered from severe mental health as measured by the GHQ-12 and this was three times higher than reported psychological distress among the general population. There were significant differences between sub-groups of the study sample with regard to their psychological distress. The results of the logistic regression analysis also indicated that female gender; lower education, unemployment, and loss of family members were associated with severe psychological distress among earthquake victims. CONCLUSION: The study findings indicated that the amount of psychological distress among earthquake survivors was high and there is an urgent need to deliver mental health care to disaster victims in local medical settings and to reduce negative health impacts of the earthquake adequate psychological counseling is needed for those who survived the tragedy

Psychosocial impact of the summer 2007 floods in England

Background The summer of 2007 was the wettest in the UK since records began in 1914 and resulted in severe flooding in several regions. We carried out a health impact assessment using population-based surveys to assess the prevalence of and risk factors for the psychosocial consequences of this flooding in the United Kingdom. Methods Surveys were conducted in two regions using postal, online, telephone questionnaires and face-to-face interviews. Exposure variables included the presence of flood water in the home, evacuation and disruption to essential services (incident management variables), perceived impact of the floods on finances, house values and perceived health concerns. Validated tools were used to assess psychosocial outcome (mental health symptoms): psychological distress (GHQ-12), anxiety (GAD-7), depression (PHQ-9) and probable post-traumatic stress disorder (PTSD checklist-shortform). Multivariable logistic regression was used to describe the association between water level in the home, psychological exposure variables and incident management variables, and each mental health symptom, adjusted for age, sex, presence of an existing medical condition, employment status, area and data collection method. Results The prevalence of all mental health symptoms was two to five-fold higher among individuals affected by flood water in the home. People who perceived negative impact on finances were more likely to report psychological distress (OR 2.5, 1.8-3.4), probable anxiety (OR 1.8, 1.3-2.7) probable depression (OR 2.0, 1.3-2.9) and probable PTSD (OR 3.2, 2.0-5.2). Disruption to essential services increased adverse psychological outcomes by two to three-fold. Evacuation was associated with some increase in psychological distress but not significantly for the other three measures. Conclusion The psychosocial and mental health impact of flooding is a growing public health concern and improved strategies for minimising disruption to essential services and financial worries need to be built in to emergency preparedness and response systems. Public Health Agencies should address the underlying predictors of adverse psychosocial and mental health when providing information and advice to people who are or are likely to be affected by flooding

A multicentre non-blinded randomised controlled trial to assess the impact of regular early specialist symptom control treatment on quality of life in malignant mesothelioma (RESPECT-MESO): Study protocol for a randomised controlled trial

Background: Malignant pleural mesothelioma is an incurable cancer caused by exposure to asbestos. The United Kingdom has the highest death rate from mesothelioma in the world and this figure is increasing. Median survival is 8 to 12 months, and most patients have symptoms at diagnosis. The fittest patients may be offered chemotherapy with palliative intent. For patients not fit for systemic anticancer treatment, best supportive care remains the mainstay of management. A study from the United States examining advanced lung cancer showed that early specialist palliative care input improved patient health related quality of life and depression symptoms 12 weeks after diagnosis. While mesothelioma and advanced lung cancer share many symptoms and have a poor prognosis, oncology and palliative care services in the United Kingdom, and many other countries, vary considerably compared to the United States. The aim of this trial is to assess whether regular early symptom control treatment provided by palliative care specialists can improve health related quality of life in patients newly diagnosed with mesothelioma. Methods: This multicentre study is an non-blinded, randomised controlled, parallel group trial. A total of 174 patients with a new diagnosis of malignant pleural mesothelioma will be minimised with a random element in a 1:1 ratio to receive either 4weekly regular early specialist symptom control care, or standard care. The primary outcome is health related quality of life for patients at 12 weeks. Secondary outcomes include health related quality of life for patients at 24 weeks, carer health related quality of life at 12 and 24 weeks, patient and carer mood at 12 and 24 weeks, overall survival and analysis of healthcare utilisation and cost. Discussion: Current practice in the United Kingdom is to involve specialist palliative care towards the final weeks or months of a life-limiting illness. This study aims to investigate whether early, regular specialist care input can result in significant health related quality of life gains for patients with mesothelioma and if this change in treatment model is cost-effective. The results will be widely applicable to many institutions and patients both in the United Kingdom and internationally. Trial registration: Current controlled trials ISRCTN18955704.Date ISRCTN assigned: 31 January 2014