Beyond Patient Characteristics: A Narrative Review of Contextual Factors Influencing Involuntary Admissions in Mental Health Care

Variations in the rates of involuntary admission (IA) reflect the influence of unexplained contextual variables that are typically too heterogeneous to be included in systematic reviews. This paper attempts to gather and analyze factors unrelated to the patients that have been linked to IA. The articles included in this review were selected by iteratively searching four electronic databases (PubMed, PsychINFO, EMBASE, and Web of Science). A total of 54 studies from 19 different countries and regions, including 14 European countries, the United States, Canada, China, Vietnam, and Taiwan, were selected. The factors were categorized as service-related factors, impactful events, seasonal and temporal factors, mental health legislation, staff factors, and public attitudes. The factors rarely act in isolation but rather interact and reinforce each other, causing a greater influence on IA. This paper explains how these factors present opportunities for robust and sustainable interventions to reduce IAs. The paper also identifies future directions for research, such as examining the effects of economic recessions. Enhancing global reporting standards is essential to validate future research and support further in-depth studies. The complexity of the factors influencing IA and the implicit role of society suggest that resolving it will require social change

A idade importa? : estatuto de emprego parental e a sua influência no bem-estar psicológico : resultados de um estudo nacional com crianças portuguesas em idade escolar

Revista de Psicologia da Criança e do Adolescente. - ISSN 1647-4120. - V. 5, n. 1 (Janeiro-Junho 2014). - p. 57-71.Portugal is facing an unprecedented economic recession and the highest unemployment rate ever recorded in the country (18%). Employment is a fundamental component of well-being and the main source of income for most people. When job loss hits home, families struggle with psychosocial stress which may influence the healthy development of adolescents. This paper aims to explore age-related differences of aspects of psychological wellbeing linked with parental employment status on a sample of 5050 Portuguese adolescents with a mean age of 14 years old (SD=1.85). We analysed data from the Portuguese Health Behaviour in School-aged Children study (HBSC/WHO) and performed qui-square tests and linear regression models regarding different parental employment status, controlling for gender and age. Results indicate that parental employment status is associated with psychological well-being of the adolescents and the effects differ with age and parent gender. Having both parents non-employed negatively influences low mood and irritability or bad temper of middle age adolescents (mean age 14). Secondly, having a non-employed father is statistically associated with low mood of younger and middle aged adolescents (mean age 12 and 14), and self-rated irritability or bad temper in all age cohorts (mean ages 12, 14 and 16 years old). Thirdly, having a non-employed mother was associated with low mood and irritability or bad temper in mid-adolescents. In conclusion the link between parental employment status and psychological well-being of adolescents varies with age and parental gender. Mid-age adolescents have higher rates of negative psychological wellbeing linked with parental non-employment

Burden on the families of patients with schizophrenia: Results of the BIOMED I study

The burden, the coping strategies and the social network of a sample of 236 relatives of patients with schizophrenia, living in five European countries, were explored by well-validated assessment instruments. In all centres, relatives experienced higher levels of burden when they had poor coping resources and reduced social support. Relatives in Mediterranean centres, who reported lower levels of social support, were more resigned, and more often used spiritual help as a coping strategy. These data indicate that family burden and coping strategies can be influenced by cultural factors, and suggest that family interventions should have also a social focus, aiming to increase the family social network and to reduce stigma

Migration and mental health in Europe (The state of the mental health in Europe working group: Appendix I)

Background: This paper is a part of the work of the group that carried out the report "The state of the mental health in Europe" (European Commission, DG Health and Consumer Protection, 2004) and deals with the mental health issues related to the migration in Europe. Methods: The paper tries to describe the social, demographical and political context of the emigration in Europe and tries to indicate the needs and (mental) health problems of immigrants. A review of the literature concerning mental health risk in immigrant is also carried out. The work also faces the problem of the health policy toward immigrants and the access to health care services in Europe. Results: Migration during the 1990s has been high and characterised by new migrations. Some countries in Europe, that have been traditionally exporters of migrants have shifted to become importers. Migration has been a key force in the demographic changes of the European population. The policy of closed borders do not stop migration, but rather seems to set up a new underclass of so-called "illegals" who are suppressed and highly exploited. In 2000 there were also 392.200 asylum applications. The reviewed literature among mental health risk in some immigrant groups in Europe concerns: I) highest rate of schizophrenia; suicide; alcohol and drug abuse; access of psychiatric facilities; risk of anxiety and depression; mental health of EU immigrants once they returned to their country; early EU immigrants in today disadvantaged countries; refugees and mental health. Due to the different condition of migration concerning variables as: motivation to migrations (e.g. settler, refugees, gastarbeiters); distance for the host culture; ability to develop mediating structures; legal residential status it is impossible to consider "migrants" as a homogeneous group concerning the risk for mental illness. In this sense, psychosocial studies should be undertaken to identify those factors which may under given conditions, imply an increased risk of psychiatric disorders and influence seeking for psychiatric care. Comments and remarks: Despite in the migrants some vulnerable groups were identified with respect to health problems, in many European countries there are migrants who fall outside the existing health and social services, something which is particularly true for asylum seekers and undocumented immigrants. In order to address these deficiencies, it is necessary to provide with an adequate financing and a continuity of the grants for research into the multicultural health demand. Finally, there is to highlight the importance of adopting an integrated approach to mental health care that moves away from psychiatric care only. © 2005 Carta et al; licensee BioMed Central. Ltd

Associations between DSM-IV mental disorders and subsequent COPD diagnosis

OBJECTIVES: COPD and mental disorder comorbidity is commonly reported, although findings are limited by substantive weaknesses. Moreover, few studies investigate mental disorder as a risk for COPD onset. This research aims to investigate associations between current (12-month) DSM-IV mental disorders and COPD, associations between temporally prior mental disorders and subsequent COPD diagnosis, and cumulative effect of multiple mental disorders. METHODS: Data were collected using population surveys of 19 countries (n=52,095). COPD diagnosis was assessed by self-report of physician's diagnosis. The World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) was used to retrospectively assess lifetime prevalence and age at onset of 16 DSM-IV disorders. Adjusting for age, gender, smoking, education, and country, survival analysis estimated associations between first onset of mental disorder and subsequent COPD diagnosis. RESULTS: COPD and several mental disorders were concurrently associated across the 12-month period (ORs 1.5-3.8). When examining associations between temporally prior disorders and COPD, all but two mental disorders were associated with COPD diagnosis (ORs 1.7-3.5). After comorbidity adjustment, depression, generalized anxiety disorder, and alcohol abuse were significantly associated with COPD (ORs 1.6-1.8). There was a substantive cumulative risk of COPD diagnosis following multiple mental disorders experienced over the lifetime. CONCLUSIONS: Mental disorder prevalence is higher in those with COPD than those without COPD. Over time, mental disorders are associated with subsequent diagnosis of COPD; further, the risk is cumulative for multiple diagnoses. Attention should be given to the role of mental disorders in the pathogenesis of COPD using prospective study designs.The World Health Organization World Mental Health (WMH) Survey Initiative is supported by the National Institute of Mental Health (NIMH; R01 MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13- MH066849, R01-MH069864, and R01 DA016558) and the Fogarty International Center (FIRCA R03-TW006481). The ESEMeD project is funded by the European Commission (Contracts QLG5-1999-01042; SANCO 2004123, and EAHC 20081308), the Piedmont Region (Italy)), Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF 2000- 158-CE), Departament de Salut, Generalitat de Catalunya, Spain and the Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP), Spai

Föräldraskap och neuropsykiatriskt funktionshinder : upplevelse och påverkan av diagnos

The aim in the study is to search for a deeper understanding of how parents experience a neurological diagnose of the child and how this affects the parenthood. Parenthood was seen in a systemtheoretical perspective as a social construction. The narrative method was used in two lifestory parentinterviews. The analysis was made from parenthood. The result formed stories about parenthood with children having neuropsyciatric functional disability who even came to be a woman’s struggle. Two stories became central, one about righteousness and commonship and one against diagnosis and network. The struggle for support and understanding from the surrounding network was central. There was also a fight between the network and the parent of the authority to decide the child’s normality. The parent and child early experience a segregation in society based on diagnose. Parents experienced insecurity and difficulties regarding dose and sideeffects in medication the child. The networks reception was central for the acceptance of diagnosis and for keeping the parentcompetence. The public debate of inherent or environment created doubt and insecurity. In the stories there was a tendency that the struggle went beside the child and parenthood and instead became a struggle for righteousness against society