Into the looking glass on cultural and religious competent care: optimizing healthcare for Haredi individuals with mental illness

Previous research has shown that minority groups tend to underuse healthcare services. One community whose experiences remain particularly under-researched in the Western world is Haredi Jews- a diverse group of individuals committed to traditional Talmudic and Halakhah teachings and observances.  This presentation aims to enhance participants' understanding of mental health-seeking behaviours and challenges faced by Haredi individuals. We conducted a qualitative study that involved in-depth interviews with 24 adults who identified as Haredi and used mental health services, as well as informal consultations with local rabbis and community leaders. Interviews were transcribed and analyzed using thematic analysis techniques. Analysis revealed several important themes, including:   (1) Strength of religious practices, community, and relationship with God as a factor determining mental well-being.   (2) Implications of devotion to religion within the patient-physician encounter.   (3) Stigma and acknowledged lack of awareness surrounding mental health in Haredi communities. These themes will be explored in the presentation, which will aim to bring light to participants’ lived experiences. We hope to address the proverbial "elephant in the room" often ignored or overlooked, as encountered by Haredi community members and their interactions with the healthcare system. We will present the unique strengths and challenges related to mental health encountered by Haredi Jews in our study, while discussing potential measures that can produce better health outcomes and culturally sensitive care for Haredi individuals. &nbsp

Postnatal mental distress in relation to the sociocultural practices of childbirth:An exploratory qualitative study from Ethiopia

AbstractSociocultural patterning of the postnatal period in non-Western settings has been hypothesised to protect against postnatal depression. In 2004, in a predominantly rural area of Ethiopia, we conducted 25 in-depth interviews and five focus group discussions with purposively selected participants including perinatal women, fathers, grandmothers, traditional and religious leaders, birth attendants and community leaders. Our main objectives were (1) to examine societal recognition of problematic distress states in the postnatal period and relate this to Western conceptualisations of postnatal depression and (2) to relate the occurrence of distress states to sociocultural patterning of the postnatal period. Inductive analysis was employed to identify salient themes. Participants spontaneously described culturally problematic distress states occurring in the postnatal period, although did not consider them to be illness. Vulnerability and danger of the postnatal period was emphasised, with risk of supernatural attack and physical harm leading to distress states. Participants also spoke of how gender disadvantage and economic strain intersect with cultural patterning of the postnatal period, threatening mental health due to the resulting disappointed expectations and exclusion, as well as exacerbation of pre-existing problems. Cultural dissonance, where a person's beliefs or actions are out of kilter with strong prevailing cultural norms, may be an important risk factor for postnatal distress in rural Ethiopia, where the postnatal period is extensively culturally elaborated

Culture et santé mentale en Haïti : une revue de littérature

Cet article passe en revue et résume l’ensemble de la littérature sur la santé mentale et les services de santé mentale en Haïti. Ce compte rendu a été rédigé à la suite du tremblement de terre qui a frappé Haïti en janvier 2010. Nous avons effectué des recherches dans Medline, Google Scholar et d’autres bases de données disponibles en vue de recueillir la littérature scientifique pertinente sur la santé mentale en Haïti. La consultation d’ouvrages de référence et de la littérature grise sur Haïti a complété les recherches. La première partie décrit les principales données historiques, économiques, sociologiques et anthropologiques qui permettent de comprendre sommairement Haïti et sa population. La démographie, la structure familiale, l’économie haïtienne et la religion y sont abordées. La deuxième partie est axée sur la santé mentale et les services de santé mentale. L’épidémiologie élémentaire des maladies mentales, les croyances au sujet des maladies mentales, les modèles explicatifs, les idiomes de détresse, les comportements de recherche d’aide, la configuration des services de santé mentale et l’étude des relations entre la religion et la santé mentale y sont examinés.This paper reviews and summarizes the available literature on Haitian mental health and mental health services. This review was conducted in light of the Haitian earthquake in January 2010. We searched Medline, Google Scholar and other available databases to gather scholarly literature relevant to mental health in Haiti. This was supplemented by consultation of key books and grey literature relevant to Haiti. The first part of the review describes historical, economic, sociological and anthropological factors essential to a basic understanding of Haiti and its people. This includes discussion of demography, family structure, Haitian economics and religion. The second part of the review focuses on mental health and mental health services. This includes a review of factors such as basic epidemiology of mental illness, common beliefs about mental illness, explanatory models, idioms of distress, help-seeking behavior, configuration of mental health services and the relationship between religion and mental health.Este artículo revisa y resume la literatura sobre la salud mental y los servicios de salud mental en Haití. Este informe fue redactado después del terremoto que sacudió a Haití en enero de 2010. Realizamos búsquedas en Medline, Google Scholar y otras bases de datos disponibles a fin de recopilar la literatura científica pertinente acerca de la salud mental en Haití. La investigación fue completada con obras de referencia y literatura gris acerca de Haití. La primera parte describe los principales datos históricos, económicos, sociológicos y antropológicos que permiten comprender someramente a Haití y a su población. Se abordan la demografía, la estructura familiar, la economía haitiana y la religión. La segunda parte se centra en la salud mental y los servicios de salud mental. Se examinan la epidemiología elemental de las enfermedades mentales, las creencias con respecto a las enfermedades mentales, los modelos explicativos, las expresiones de angustia, los comportamientos de búsqueda de ayuda, la configuración de los servicios de salud mental y el estudio de las relaciones entre la religión y la salud mental.Este artigo passa em revista e resume a literatura sobre a saúde mental e os serviços de saúde mental no Haiti. Este resumo foi redigido após o tremor de terra que atingiu o Haiti em janeiro de 2010. Realizamos pesquisas no Medline, no Google Scholar e em outros bancos de dados disponíveis visando reunir a literatura científica pertinente sobre a saúde mental no Haiti. A consulta de obras de referência e da literatura “cinzenta” sobre o Haiti completou as pesquisas. A primeira parte descreve os principais dados históricos, econômicos, sociológicos e antropológicos que permitem entender sumariamente o Haiti e sua população. São abordadas a demografia, a estrutura familiar, a economia haitiana e a religião. A segunda parte trata da saúde mental e dos serviços de saúde mental. São examinados: a epidemiologia elementar das doenças mentais, as crenças sobre as doenças mentais, os modelos explicativos, as demonstrações de desespero, os comportamentos de busca de auxílio, a configuração dos serviços de saúde mental e o estudo das relações entre a religião e a saúde mental

Uses of strength-based interventions for people with serious mental illness: a critical review

Background: For the past 3 decades, mental health practitioners have increasingly adopted aspects and tools of strength-based approaches. Providing strength-based intervention and amplifying strengths relies heavily on effective interpersonal processes. Aim: This article is a critical review of research regarding the use of strength-based approaches in mental health service settings. The aim is to discuss strength-based interventions within broader research on recovery, focussing on effectiveness and advances in practice where applicable. Method: A systematic search for peer-reviewed intervention studies published between 2001 and December 2014 yielded 55 articles of potential relevance to the review. Results: Seven studies met the inclusion criteria and were included in the analysis. The Quality Assessment Tool for Quantitative Studies was used to appraise the quality of the studies. Our review found emerging evidence that the utilisation of a strength-based approach improves outcomes including hospitalisation rates, employment/educational attainment, and intrapersonal outcomes such as self-efficacy and sense of hope. Conclusion: Recent studies confirm the feasibility of implementing a high-fidelity strength-based approach in clinical settings and its relevance for practitioners in health care. More high-quality studies are needed to further examine the effectiveness of strength-based approaches

The relationship between clinical and recovery dimensions of outcome in mental health

Background: Little is known about the empirical relationship between clinical and personal recovery. Aims: To examine whether there are separate constructs of clinical recovery and personal recovery dimensions of outcome, how they change over time and how they can be assessed. Method: Standardised outcome measures were administered at baseline and one-year follow-up to participants in the REFOCUS Trial (ISRCTN02507940). An exploratory factor analysis was conducted and a confirmatory factor analysis assessed change across time. Results: We identified three factors: patient-rated personal recovery, patient-rated clinical recovery and staff-rated clinical recovery. Only the personal recovery factor improved after one year. HHI, CANSAS-P and HoNOS were the best measures for research and practice. Conclusions: The identification of three rather than two factors was unexpected. Our findings support the value of concurrently assessing staff and patient perceptions of outcome. Only the personal recovery factor changed over time, this desynchrony between clinical and recovery outcomes providing empirical evidence that clinical recovery and personal recovery are not the same. We did not find evidence of a trade-off between clinical recovery and personal recovery outcomes. Optimal assessment based on our data would involve assessment of hope, social disability and patient-rated unmet need

Between life and death: exploring the sociocultural context of antenatal mental distress in rural Ethiopia

The high prevalence of antenatal common mental disorders in sub-Saharan Africa compared to high-income countries is poorly understood. This qualitative study explored the sociocultural context of antenatal mental distress in a rural Ethiopian community. Five focus group discussions and 25 in-depth interviews were conducted with purposively sampled community stakeholders. Inductive analysis was used to develop final themes. Worry about forthcoming delivery and fears for the woman’s survival were prominent concerns of all participants, but only rarely perceived to be pathological in intensity. Sociocultural practices such as continuing physical labour, dietary restriction, prayer and rituals to protect against supernatural attack were geared towards safe delivery and managing vulnerability. Despite strong cultural norms to celebrate pregnancy, participants emphasised that many pregnancies were unwanted and an additional burden on top of pre-existing economic and marital difficulties. Short birth interval and pregnancy out of wedlock were both seen as shameful and potent sources of mental distress. The notion that pregnancy in traditional societies is uniformly a time of joy and happiness is misplaced. Although antenatal mental distress may be self-limiting for many women, in those with enduring life difficulties, including poverty and abusive relationships, poor maternal mental health may persist

Suicide portrayal in the Canadian media: examining newspaper coverage of the popular Netflix series ‘13 Reasons Why’

Abstract Background Evidence suggests that the media can influence societal attitudes and beliefs to various social issues. This influence is especially strong for mental health issues, particularly suicide. As such, the aim of this study is to systematically examine Canadian newspaper coverage of the popular fictional Netflix series 13 Reasons Why, wherein the lead character dies by suicide in the final episode. Methods Articles mentioning the series were systematically collected from best-selling Canadian newspapers in the three-month period following series release (April–June 2017). Articles were coded for adherence to key best practice recommendations on how to sensitively report suicide. Frequency counts and proportions were produced. An inductive qualitative thematic analysis was then undertaken to identify common themes within the articles. Results A total of 71 articles met study inclusion criteria. The majority of articles did not mention the suicide method (88.7%) and did not use stigmatizing language such as ‘commit suicide’ (84.5%). Almost half of the articles linked suicide to wider social issues (43.7%) or quoted a mental health professional (45.1%). 25% included information telling others considering suicide where to get help. Our qualitative analysis indicated that articles simultaneously praised and criticized the series. It was praised for (i) promoting dialogue and discussion about youth suicide; (ii) raising awareness of youth suicide issues; (iii) shining a spotlight on wider social issues that may affect suicide. It was criticized for (i) glorifying suicide, (ii) harmfully impacting young viewers; (iii) prompting pushback from educators and schools. Conclusions Newspaper coverage of ‘13 Reasons Why’ generally adhered to core best practice media recommendations, and sensitively discussed suicide from various angles, prompting productive discussion and dialogue about youth suicide. These findings suggest that the media can be an ally in promoting dialogue and raising awareness of important public health issues such as suicide

Clueless: An ethnographic study of young men who participate in the seduction community with a focus on their psychosocial well-being and mental health.

In the last decade, a cross-national community of like-minded young men has emerged, commonly known as 'the seduction community'. This community is led by professional 'pick-up artists' who teach these young men a variety of techniques and mindsets with the stated aim of improving their success with women, or 'game'. There has been little research on the men who participate in this community, and none from a mental health angle. As such, this study is propelled by two specific objectives, namely documenting and understanding (i) the reasons why young men join the seduction community; and (ii) the impacts of community involvement on participants' lives. To meet these aims, we used an inductive qualitative methodology giving ample scope for bottom-up understandings to emerge. Specifically, we recruited young men participating in the seduction community for an in-depth qualitative interview (N = 34) to explore self-reported motives and impacts. Interviews were augmented by lengthy participant observation, and data was analyzed by content analysis techniques. The results reveal that men often join the community to address a range of psychosocial deficits, and that community involvement successfully equips participants with numerous valued social and communication skills. The community appears to fill a void in providing a place of hope, fellowship and learning for young (often immigrant) men. The findings are summarized in five themes (i) loneliness and social inclusion; (ii) lack of male role models and need for guidance; (iii) mental health and well-being issues; (iv) skill acquisition and personal development; and (v) the dark side of pick-up. Interestingly, some of the practices commonly taught and utilized within the community resemble aspects of Cognitive Behavioral Therapy and mental health peer support. This may explain its evident appeal. We conclude by reflecting on the implications of the findings for official mental health service provision for young men