The Association Between Deaf Identity and Emotional Distress Among Adolescents

The sociocultural approach regards being deaf as a cultural characteristic in the identity of a deaf/hard-of-hearing (D/HH) person. The degree to which one integrates the hearing and Deaf cultures ( acculturation ) is an important factor for the well-being of deaf adolescents. We examined the relationship between acculturation patterns and emotional distress among D/HH (n = 69) compared to hearing (n = 60) adolescents in Israel. We used culturally and linguistically accessible measures. Our findings showed no significant differences in emotional distress between D/HH and their hearing counterparts. Acculturation played an important role predicting emotional distress. Identification with both the Deaf and hearing cultures was associated with reduced somatization. Exposure to discrimination and social support was also associated with emotional distress in predictable ways. Findings are interpreted within the specific context of Israeli society and highlight the importance of using adaptive linguistic and cultural assessment tools with D/HH populations

Presenting Problems and Treatment Expectations Among Service Users Accessing Psychiatric Outpatient Care: Are There Gender Differences?

Background: Community-based studies have documented gender differences in mental health problems and service utilization. This mixed methods study explored gender differences in severity of emotional distress, referral paths, presenting problems and care expectations among service users upon accessing outpatient psychiatric care. Methods: Consecutive service users (N=284, 64% women) who presented for a new or repeated episode of care in adult outpatient clinics completed questionnaires on a measure of emotional distress, treatment history and referral path. These variables were quantitatively analyzed. Also, users completed two open-ended questionnaires on reasons for seeking care and expectations from the services. These variables were qualitatively analyzed using thematic analyses. Results: No significant gender differences emerged on any of the variables examined among new and repeated users. The main reasons for seeking care were psychiatric symptoms as well as non-specific psychopathology. The most frequent expectations from the services were receiving psychotherapy and specific tools to better manage life problems. Limitations: The sample of new male service users was relatively small. Conclusions: Once care is initiated, men and women showed similar clinical presentation and care expectations

Cancer and Common Mental Disorders in the Community: Results of the Israel-World Mental Health Survey

Background and Objectives: To study common mental disorders (CMD) and other mental health-related variables among community residents with active cancer, cancer survivors and cancer-free respondents. Methods: Data were extracted from the Israeli component of the 28-country World Mental Health Survey. The sample included 165 respondents who reported ever having cancer and 2,282 cancer-free respondents, all aged 39 years and older. The WHO/Composite International Diagnostic Interview (CIDI) was used to determine the prevalence rate of CMD. Emotional distress (ED) was ascertained with the GHQ-12. Also, respondents were asked about sleep disturbances and mental health service utilization. Results: Respondents with active cancer were more likely to endorse CMD in the past year than cancer-free respondents, 22.1% SE = 6.1 and 7.2% SE = 2.5, respectively (adjusted odds ratio = 2.6, 95% CI 1.2-5.6); to have higher ED scores, M = 27.1 SE = 1.3 and M = 19.8 SE = 0.3, respectively (Wald F = 16.7, p \u3c 0.001); and higher prevalence rates of sleep disturbances, 64.7% SE = 6.5% and 31.5% SE = 4.6%, respectively (adjusted odds ratio = 2.1, 95% CI 1.1-3.9). Cancer survivors did not significantly differ from cancer-free respondents on the study variables. Despite the emotional toll, there were no differences in mental health service utilization among the three cancer groups. Conclusions: Respondents with active cancer residing in the community show enhanced psychopathology. Study findings highlight a double need: to adequately assess mental health problems in persons with cancer and to bridge the treatment gap

A Qualitative Study Examining the Quality of Working Alliance as a Function of the Social Identifies of Clients and Therapists During the Mental Health Intake

Therapists are faced with the challenge of developing effective ways to advance cross-cultural engagement with a rapidly growing diverse client population. In this qualitative study, we characterized the way clients and therapists described the quality of working alliance during the mental health intake and examined whether these descriptions vary as a function of their social identities. We conducted in-depth interviews with Ashkenazi (socially advantaged group; n = 22) therapists and their Mizrahi (socially disadvantaged group n = 29) or Ashkenazi (n = 26) clients immediately following their intake session in four mental health clinics in Israel. We performed a thematic analysis. Overall, interrater reliability among three raters who coded the narratives was high (kappa = 0.72, therapist; 0.70, client). Across all client and therapist interviews, we identified eight central themes detailing different qualities of the working alliance: (1) feeling understood, (2) feeling comfortable, (3) openness and cooperation, (4) trust, (5) empathy and identification, (6) frustration and disappointment, (7) anger and hostility, and (8) emotional disengagement. On average, clients reported 2.56 (standard deviation = 1.17) and therapists described 2.65 (standard deviation = 1.45) themes in each session. Overall, concordant and discordant dyads described similar themes with few exceptions. In particular, being part of a discordant dyad may affect the client’s interpretation of non-verbal communication as well as the therapist’s evaluation of the client’s openness and trustworthiness. Although less frequent, when anger and hostility were described by therapists, these characterized the interaction with Mizrahi clients. We discuss implications to care including the need to promote a culturally humble approach to providing care for minorities

Psychological Factors Associated with Emotional Distress Among Palestinian Arabs from East Jerusalem Accessing Psychiatric Care in Israel

Background: The Palestinian population residing in East Jerusalem is characterized by high rates of poverty and unemployment and is subject to discrimination in various forms, including infrastructure of mental health services. Little is known about the help seeking needs and practices of East Jerusalem residents. Method: We examined socio-demographic and clinical characteristics of a consecutive sample Palestinian residents from East Jerusalem (N=50) who accessed a specially assigned psychiatric clinic in Israel. In addition, we examined the psychological factors associated with emotional distress among these service-users upon entry to care. Participants completed a survey in Arabic that included a socio-demographic questionnaire and measures assessing emotional distress, perceived exposure to discrimination and social support, and mental health stigma. Results: Participants reported high levels of emotional distress. Female gender, low socioeconomic status, higher perceived exposure to discrimination and higher perceived social support were associated with increased emotional distress. Conclusions: Findings add to the scarce body of knowledge on specific mental health characteristics of East Jerusalem Palestinian residents

“Degrees of Freedom”: Comparing Mental Distress of Populations with Different Levels of Access to Care-Prisoners, Psychiatric Patients and General Population

Objectives: The study presents an analysis of the risk for common mental disorders (CMDs) in populations with different levels of access to mental health care. Methods: We merged and statistically compared the representative data of prisoners to data collected from psychiatric clinics and the general population. Participants across all samples completed the General Health Questionnaire. Results: More than half of the inmates met the criteria for CMDs, while rates were 25% in the general population and 80% among psychiatric patients. The odds of prisoners being five times more likely to meet the criteria for CMDs were five times higher than the odds of the general population while controlling for demographic variables. Conclusions: The study highlights the need for prisoners for mental health services. Prisoners face stressful life conditions before and during incarceration while having limited access to medical and psychological treatment stresses the need for systemic interventions

Appendix_interview_guides – Supplemental material for “Why Come for Treatment?” Clients’ and Therapists’ Accounts of the Presenting Problems When Seeking Mental Health Care

<p>Supplemental material, Appendix_interview_guides for “Why Come for Treatment?” Clients’ and Therapists’ Accounts of the Presenting Problems When Seeking Mental Health Care by Ora Nakash, Michal Cohen, and Maayan Nagar in Qualitative Health Research</p