Understanding and addressing the stigma of mental illness with ethnic minority communities

Higher income societies have moved from institutional to community-based care for people experiencing mental illness. However, stigma and discrimination persists and undermines help-seeking, recovery and life chances. Mental illness prevalence is higher amongst communities that face multiple prejudices and disadvantages within society, including black and minority ethnic communities who may experience migration trauma, racism, acculturation and adverse social circumstances. This study examines beliefs, stigma and the effectiveness of existing national mental health campaigns with Pakistani, Indian and Chinese heritage communities in Scotland, UK, using community based participatory research. Community organisers were trained and supported to co-facilitate focus groups with eighty seven people using a range of languages. Whilst diversity within and between communities was apparent, important trends emerged. People with mental illness experience high levels of stigma from communities. Families experience significant associated stigma. This shame combines with culturally inappropriate services to reduce help seeking from mental health services, friends and families. Existing anti-stigma campaigns have failed to reach or engage with communities due to a combination of practical issues such as the use of inappropriate language, imagery and media, but also due to assuming western medical concepts of illness. Participants suggested a new model for national campaigns placing greater emphasis upon community development, cultural events, positive contact and dialogue with families, faith leaders and youth groups. National anti-stigma programmes must develop more effective partnerships with communities or risk magnifying existing inequalities

Mosaics of Meaning Handbook : a guide for health improvement practitioners to tackle stigma of mental health with BME communities

Mosaics of Meaning was launched in 2005 to research and address the stigma associated with mental health problems in partnership with Scotland’s largest black and ethnic minority communities. Its unique programme of research and community action has involved training community workers in research skills and mental health issues, and using community development principles to address stigma and raise awareness at ground level. In the process, a powerful, evidence-based model of community engagement has been developed, a model which can be confidently applied in many other community settings

Promoting recovery and addressing stigma: mental health awareness through community development in a low-income area

One in four Scots will experience mental ill-health at some point in their lives, with increased prevalence in low-income communities. The associated stigma increases the negative impact on an individual's life. This paper outlines the development of a local anti-stigma programme that can be replicated in other areas, and presents key findings from the evaluation. This innovative model, which promotes recovery and addresses stigma, draws on a broad coalition of community support, and enables service users to lead its design and delivery. The paper argues that local initiatives, when complemented by a national programme, can achieve a positive additional impact on attitudes and behaviours; that multiple and flexible approaches are needed for different target groups; that the personal narrative about recovery has a particularly strong impact on participants; and that it may be desirable to tackle stigma in the context of addressing positive mental health. Refinements to the model are discussed

Prison health in NHS Greater Glasgow & Clyde : A health needs assessment 2012

Scotland has one of the highest rates of imprisonment in Western Europe and the prison population is rising [1]. In the last decade the average daily prison population in Scotland increased by 27% [1]. The burden of physical and mental illness in the prison population is high; disproportionately so when compared to the general population [2]. This has variably been attributed to socioeconomic disadvantage and lifestyle and behavioural factors such as substance misuse, smoking and poor nutrition which are common in the prison population [2,3]. Prisoners suffer from multiple deprivation [2,3]. Many are a product of the care system, have experienced physical, emotional or sexual abuse and have difficulties forming and maintaining relationships. Levels of educational attainment are low and unemployment high. Homelessness is common. Prior to incarceration prisoners rarely engage with health care services in the community; during imprisonment demand for health care services is high [3,6,7]. Traditionally health care services in Scottish prisons were provided by the Scottish Prisons Service (SPS). On 1st November 2011 responsibility for the provision of health care to prisoners was transferred from SPS to the National Health Service (NHS). The aim of the transfer was to ensure that prisoners received the same standard of care and range of services as offered to the general population according to need. The guiding principle is that of ‘equivalence’ of care. The aim of this Health Needs Assessment (HNA) was to provide a systematic baseline assessment of the health and health care needs of prisoners in NHS Greater Glasgow and Clyde (NHSGGC) and to identify gaps in the current service provision to inform service future planning and development. It focuses on the two operational publicly owned prisons within NHSGGC: HMP Barlinnie and HMP Greenock. A third prison, HMP Low Moss, falls under the remit of NHSGGC but it was under renovation at the time of this HNA. Information about the prison population was drawn from published literature and reports provided by staff from the Justice and Communities Directorate of the Scottish Government. Information about the prisons from HMP Inspectorate reports, direct observation and interviews with members of staff in each prison. To fully understand the level and nature of existing services a service mapping was undertaken jointly with nominated staff from the prison health teams using direct observation and extensive staff and prisoner interviews and focus groups. Overall the findings are in line with other national and international studies on prison health. Despite characteristic differences between the prisons within NHSGGC there was a high level of consensus amongst both prisoners and staff groups about health needs and priorities. The report acknowledges the thoughtful contribution of prison staff and the positive approach to improving health services that they expressed. This has impacted on the formation of recommendations that both validate existing approaches and identify opportunities and 10 priorities for health gain. In addition to more fundamental changes they identify opportunities for quick wins that do not require significant financial outlay

Poverty and mental health : policy, practice and research implications

This article examines the relationship between poverty and mental health problems. We draw on the experience of Glasgow, our home city, which contains some of Western Europe's areas of greatest concentrated poverty and poorest health outcomes. We highlight how mental health problems are related directly to poverty, which in turn underlies wider health inequalities. We then outline implications for psychiatry

Mental health literacy and adolescent help-seeking: the mediating and moderating effects of personal and perceived stigmas

No abstract available

Depression and anxiety among people living with and beyond cancer: a growing clinical and research priority

Background: A cancer diagnosis can have a substantial impact on mental health and wellbeing. Depression and anxiety may hinder cancer treatment and recovery, as well as quality of life and survival. We argue that more research is needed to prevent and treat co-morbid depression and anxiety among people with cancer and that it requires greater clinical priority. For background and to support our argument, we synthesise existing systematic reviews relating to cancer and common mental disorders, focusing on depression and anxiety. We searched several electronic databases for relevant reviews on cancer, depression and anxiety from 2012 to 2019. Several areas are covered: factors that may contribute to the development of common mental disorders among people with cancer; the prevalence of depression and anxiety; and potential care and treatment options. We also make several recommendations for future research. Numerous individual, psychological, social and contextual factors potentially contribute to the development of depression and anxiety among people with cancer, as well as characteristics related to the cancer and treatment received. Compared to the general population, the prevalence of depression and anxiety is often found to be higher among people with cancer, but estimates vary due to several factors, such as the treatment setting, type of cancer and time since diagnosis. Overall, there are a lack of high-quality studies into the mental health of people with cancer following treatment and among long-term survivors, particularly for the less prevalent cancer types and younger people. Studies that focus on prevention are minimal and research covering low- and middle-income populations is limited. Conclusion: Research is urgently needed into the possible impacts of long-term and late effects of cancer treatment on mental health and how these may be prevented, as increasing numbers of people live with and beyond cancer

Associations between dimensions of Mental Health Literacy and adolescent help-seeking intentions

Background: The majority of long‐term mental health problems begin during adolescence. Low mental health literacy (MHL) may impede help‐seeking for these problems. Although MHL is a multidimensional construct and adolescent help‐seeking can be through formal and informal means, little is known about how dimensions of MHL influence these help‐seeking intentions. This study examines associations between dimensions of MHL and formal and informal help‐seeking intentions among adolescents. It also investigates whether informal help‐seeking mediates the association between dimensions of MHL and formal help‐seeking, and whether these associations are moderated by gender. Methods: A cross‐sectional survey including measures of MHL, and help‐seeking intentions was distributed to participants in 10 schools (12–17 years) across Scotland (n = 734). Data were analysed using Confirmatory Factor Analyses (CFA) and Structural Equation Modelling (SEM). Results: Confirmatory Factor Analyses identified two distinct dimensions of MHL: ability to identify a mental health problem, and knowledge of treatment efficacy. Only knowledge of treatment efficacy was associated with increased intention to seek formal and informal help. Ability to identify a mental health problem was negatively associated with both forms of help‐seeking intentions. Informal help‐seeking mediated the association between both forms of MHL and formal help‐seeking. Gender did not moderate the associations between MHL and help‐seeking. Conclusions: Care should be taken when providing MHL interventions to ensure that adaptive forms of MHL are promoted. Future research should investigate possible mechanisms by which discrete forms of MHL influence adolescent help‐seeking as well as investigating other potential moderators of MHL and help‐seeking, such as stigma

Lessons from a national mental health arts festival

The Scottish Mental Health Arts and Film Festival has evolved over the last 10 years into one of the world’s largest mental health events, engaging more than 30,000 people each year. The model of the festival will be outlined and the evolution traced over three distinct phases: from its inception as an anti-stigma campaign, to a broad-based social movement harnessing grassroots activism, and finally, to achieving international reach and artistic recognition. The first phase details the inception and early incarnations of the festival, building upon Allport’s contact theory model that the most effective way to reduce stigma is through positive personal contact with someone in a valued social role. The learning demonstrated that the festival could achieve large-scale reach among the most marginalized communities and increase positive perceptions and intentions among audience members. As the festival evolved into its second phase, artists and activists began to develop events and grassroots partnerships throughout Scotland. A feature of the festival at this stage, as people with and without mental health diagnoses worked together, was that many events explored "mental health identities" in a broader sense, and this led many of those involved to reframe their ideas of mental health and illness. The third phase explores the impact of the festival at a broader social level