Gaps and Links Between Religious Institutions and Mental Health Practitioners in Indonesia

Objective: COVID-19 restrictions precipitated rapid work practice changes for family and mental health practitioners, including care via telehealth and secondary exposures to COVID-19 induced violence in client. This descriptive study aimed to examine stress and health among practitioners during COVID-19 restrictions. Method: Participants, recruited via professional networks, were 320 maternal and child health (MCH), child and youth mental health (CYMH) and adult mental health (AMH) practitioners from Victoria, Australia. Participants reported family violence among cases, workplace stress, and mental and physical health problems during COVID-19 restrictions, via an online survey. Results: Rising family violence incidence, including emotional abuse and serious threats against a woman (>25%), child emotional abuse/neglect, and child exposure to family violence were reported. Higher violence was reported by CYMH and AMH than MCH practitioners. We found increases in practitioner stress due to workplace practice changes and exposure to family violence. Highest stress was among CYMH and AHM practitioners. Participants reported worsening mental (63.2%) and physical (51.2%) health. Negative affect was higher among CYMH than MCH participants. Conclusion: Findings demonstrate pressure on family and mental health workforces during COVID-19. Provision of training and support to manage secondary stress from exposures to trauma and changing workplace practices is indicated. KEY POINTS What is already known about this topic: (1) Family and mental health practitioners’ mental health is below normative levels due to exposure to secondary traumatic stress exposure and associated compassion fatigue. (2) Periods of natural and community disaster elevate pressure and distress among mental health professionals and contribute to risk for workforce attrition and among client families are also associated with increased risks for intimate partner violence due to financial pressures and inadequate and confined housing. (3) Concerns about family violence during COVID-19 lockdown restrictions have arisen from publicly available reports of increases in emergency department domestic violence-related injuries and urgent applications to the Family Courts, but research data pertaining to levels of family violence during COVID-19 are scarce. What this study adds: (1) Family and mental health practitioners, especially those in child/youth and adult mental health sectors, reported increased proportions of caseloads in which incidents of family violence occurred during stage-3 COVID-19 lockdown restrictions in Victoria, Australia, contributing to exposure of practitioners to secondary trauma. (2) Practitioners reported higher workplace stress (due to changed work practices and family violence) during COVID-19 restrictions and greater stress was related to greater negative affect, sleep problems, headaches, and gastrointestinal problems. (3) Urgent attention to training and support of family and mental health workers providing care to distressed families during periods of community and natural disaster is indicated.

In multicultural and multilingual Australia, mental health practitioners (MHPs) are increasingly attending to the psychological needs of culturally and linguistically diverse (CALD) people. Most clinical interactions occur in English, which is the CALD clients’ non-native language, making it a challenging task for clients and practitioners. Language is the main vehicle of assessment, diagnosis, and treatment in most Western models of mental health care. Even so, minimal attention has been paid in policy, research, and practice to MHPs’ language diversity related competence to work effectively with CALD clients. To address this gap, this research aimed to conceptualise, define, and operationalise the novel construct of cross-lingual competence and to develop a reliable and valid psychometric instrument to measure it - the Cross-lingual Competence Scale (CLCS). This research was conceptually and theoretically grounded on Sue et al.’s (1996; 1982) metatheory of multicultural therapy and counselling and their tripartite model, and on research findings from the fields of multicultural psychotherapy and psycholinguistic. On these bases, the domains of awareness, knowledge and skills were argued to be central to the cross-lingual competence construct. Study 1 generated the initial set of items for the CLCS and explored its factor structure through exploratory factor analysis (EFA). Data was collected from in-training and fully registered MHPs (n = 155) in Australia through an online survey containing 61 items and additional measures of MHPs’ multicultural and general competence. Exploratory Factor Analysis did not support the hypothesised structure based on the tripartite conceptualisation; instead, a novel factorial structure representing three distinct concepts emerged: a. MHPs’ Self-perceptions of Competence (SPC); b. MHPs’ Knowledge of Barriers for Clients (KBC); and c. MHPs’ Knowledge of Barriers for MHPs (KBP). The emergent factor structure of the CLCS provided evidence of a new and strong organising concept for self-assessments of competence: self-perceptions of competence and factual knowledge. Importantly, the KBC and KBP subscales were positively associated to one another but unrelated to the SPC subscale, suggesting that the two overarching domains (perceptions and factual knowledge) are unrelated. Thus MHPs’ estimates of their own cross-lingual competence to effectively work with CALD clients were discrepant from their demonstrable knowledge necessary for competent work. The initial assessment of validity further highlighted this discrepancy showing that the SPC subscale converged with all criterion measures of competence reporting MHPs’ self-perceptions, while the KBC and KBP subscales did not. Study 2 aimed to confirm the factor structure of the CLCS and further assess its reliability and convergent validity in a new sample of Australian MHPs (n = 257). Through CFA competing models were tested. The findings from Study 2 closely replicated those of Study 1, supporting the hypothesis that the 3-factor structure would be the best fit for the data. This outcome lent support to the overarching distinction between self-perceptions and factual knowledge. The final version of the CLCS had 23 items and each subscale had good reliability and validity. Study 3 sought to identify predictors of MHPs’ cross-lingual competence as measured by the three subscales of the CLCS exploring the following individual characteristics: ethnic status, language status, professional status, exposure to work with CALD clients, and multicultural training. Based on the combined samples from studies 1 and 2 (n = 412) data was analysed through t-tests and hierarchical multiple regression. Study 3 results showed that MHPs who belonged to an ethnic minority, were bilingual, worked with CALD clients frequently, were fully registered, and had multicultural training reported higher levels of self-perceived competence than their counterparts. When analysed collectively, all these individual characteristics except for ethnic status, predicted MHPs’ self-perceptions of competence. On the other hand, knowledge of barriers for clients was only predicted by engagement with CALD clients, while knowledge of barriers for MHPs was predicted by engagement with CALD clients and language status. Indeed, engagement with CALD clients was the only significant predictor across all three subscales. Overall this research contributes to theory, research and practice of multicultural psychotherapy in several ways. First, it has contributed an innovative construct to the field of cross--cultural psychotherapy, cross--lingual competence. Second, it has developed a reliable and valid measure of MHPs’ cross-lingual competence composed of three subscales each one with good psychometric properties to be used for various purposes. Third, it has established cross-lingual competence as a construct that is related but distinct from multicultural competence requiring specific attention and assessment. Finally, it has shed light into individual characteristics that predict cross-lingual competence and potential means to promote cross-lingual competence among CALD and non-CALD MHPs. Theoretical and practical implications for future research into development and assessment of cross-lingual competence are discussed.

Purpose – The purpose of this paper is to raise mental health practitioner awareness of the opportunities and risks afforded by social media in day-to-day practice. Design/methodology/approach – The paper provides case studies of people experiencing mental health problems who are using social media as part of their recovery, to live well and to challenge stigma. Findings – It was found that, whilst there are risks, many people are using social media for peer support, shared learning and to decrease isolation. Practical implications – It is argued that mental health practitioners will increasingly need to have an understanding of social media so they can offer support to people they care for in their online as well as offline lives. As the use of social media expands, this will become increasingly important. Social implications – the paper has implications for practice and policy for both mental health. Originality/value – For the first time, the paper pulls together lived experience of social media from people with mental health problems and make recommendations for practitioners. The paper will be valuable to people experiencing mental health problems, practitioners, health and social care organisations and policy makers.

The loss of a patient to suicide is a common experience among mental health practitioners and trainees. Research suggests that younger, less experienced clinicians are often most keenly affected by the experience. Given the prevalence of patient loss to suicide and the subsequent emotional aftermath, our goal in creating a multidisciplinary suicide symposium was to provide a safe, structured environment where trainees and mental health practitioners could obtain collegial support and education to reduce the stigma surrounding patient suicide. Mental health trainees and practitioners (including medical students, nurse practitioner students, psychiatry residents, psychology interns, and practicing psychologists and psychiatrists) were invited to a 4-hour symposium. The curriculum focused on assessment of risk and possible interventions, as well as addressing the loss of a patient to suicide. Teaching methods included a PowerPoint lecture; case-based, small-group discussion; and role-play. Attendees completed numbered, anonymous surveys looking at attitudes about loss and suicide before and after the symposium. Of 35 total attendees, 22 completed both pre- and postsymposium surveys. Paired t tests revealed several statistically significant increases, including increases in comfort seeking support from a colleague after losing a patient to suicide (p = .043) and comfort seeking support from a professional after losing a patient to suicide (p = .030). The symposium appears to have had the desired effect of increasing attendees' comfort working with patients at risk for suicide, as well as their comfort reaching out for support from others following the loss of a patient to suicide.

Many mental health practitioners in the United States are trained to cure or change autistic people. Some of these mental health practitioners may show anti-autistic bias when working with autistic clients. Anti-autistic bias is any kind of bias that degrades, devalues, or others autistic people or autistic traits. Anti-autistic bias is especially problematic when mental health practitioners and clients are engaged in the therapeutic alliance, which is the collaborative relationship between a therapist and client. The therapeutic alliance is one of most important parts of an effective therapeutic relationship. Our interview-based study examined 14 autistic adults' experiences with anti-autistic bias in the therapeutic alliance and the relationship they felt it has on their self-esteem. Results from this research showed that some mental health practitioners expressed hidden and unrealized bias when working with autistic clients, such as making assumptions about what it means to be autistic. Results also showed that some mental health practitioners were intentionally biased and openly harmful to their autistic clients. Both forms of bias negatively affected participant self-esteem. Based on the findings of this study, we offer recommendations to help mental health practitioners and mental health practitioner training programs better serve autistic clients. This study addresses a significant gap in current research on anti-autistic bias in the mental health field and the overall well-being of autistic individuals.

Objective Despite the importance of spoken language in psychotherapy processes with clients whose native language is distinct from the language of therapy, there is a dearth of research on mental health practitioners (MHPs) language competence. This research aimed to develop the Perceptions of Cross-lingual Practice (PCLP) scale designed to aid MHPs’ cross-lingual practice. Method Study 1 developed items and collected data from Australian MHPs (n = 155) to test the scale’s factor structure through exploratory factor analysis. Study 2 (n = 257) confirmed the emergent factor structure of the scale through confirmatory factor analysis and further assessed its reliability and convergent validity. Results The final 23-item measure had good reliability and validity. Three factors emerged; MHPs’ perceptions of self-competence, MHPs’ perceptions of difficulties faced by clients, and MHPs’ perceptions of barriers for themselves imposed by language. The perceptions of self-competence subscale was weakly related to the other subscales highlighting a disconnect between MHPs’ self-perceptions and perceptions of contextual factors. Conclusion The PCLP is a reliable and valid measure of MHPs’ perceptions of cross-lingual practice composed of three subscales each with good psychometric properties that can be used for various purposes in the evaluation and development of MHPs in post-graduate and professional settings.

Mental health literacy of Indonesian health practitioners and implications for mental health system development.

Millions of individuals around the globe have been displaced from their countries due to disasters, including persecution, war, disease, famine, and weather events. Many forced migrants (FMs) experience mental health concerns that warrant treatment but often face significant barriers to care, including a limited pool of mental health practitioners (MHPs) who are competent, willing, and able to serve them. In Alaska, the Working Alongside Refugees in Mental Health (WARM) program was developed to address this need. After conducting the first WARM workshop, our team sought to understand how MHPs in Alaska are recruited and retained in working with forced migrants to further develop and maintain our program. We examined MHPs’ motivations to work with FMs through 13 qualitative semi-structured interviews with MHPs who engage in such work. Experiences with FMs and awareness of FMs in their communities, competence, and connections with other practitioners increased MHPs’ motivation and led to service delivery. Community psychology is well positioned to enhance services for FMs through both practitioner-level interventions and systemic interventions. Strategies for increasing and sustaining MHPs’ motivations to work with FMs include: forming connections with other MHPs and trusted individuals and organizations, increasing competence to work with FMs via specialized training networks, integrating experiences working with FMs into training programs, and engaging in advocacy to address systems-level barriers to care.

Source of information about mental illness among medical students in a tertiary care centre of North India.

Implementation of the evidence-based paradigm in mental health practice is an idea of enormous merit but, as we all know, an idea's merit does not guarantee its acceptance. Indeed, it...

Mental health practitioners (MHPs), including occupational therapists (OTs), need support to adopt a truly recovery-oriented practice. Like other practitioners, if OTs often embrace the principles of recovery as a philosophical foundation for their practice, these principles may not always reflect in their attitudes, behaviors or in their interventions. While further research is needed to demonstrate the positive effects of recovery-oriented training programs on MHPs' attitudes and practice, there is a need to explore novel training programs. The Recovery College (RC) model is one of the interventions that are designed to facilitate these changes in practice, through co-production and co-delivery of recovery-focused courses curriculum. Although the perceived benefits and outcomes of RC courses are widely documented, very few studies focus specifically on what MHPs gain from them or on their global experience. The aim of this article is to describe the experience of MHPs learners in RC courses and the perceived benefits on their practice. An exploratory descriptive qualitative study was conducted. Data were collected through semi-structured interviews and analyzed using Miles and Huberman's stepwise qualitative analysis method. Participants were 13 MHPs working in community organizations or healthcare institutions and who participated as learners in a RC, in the province of Quebec, Canada. Ten themes emerged from the qualitative analysis. Participants expressed their perspectives on the format of the courses, their initial expectations and their recommendations. They also identified the types of knowledge they shared during the courses. Participants reported changes in their practice, raised awareness on their clinical and personal issues, improved well-being and recovery. Group composition, interactions within the group, complementarity of the different types of knowledge, and pedagogical design and learning activities were identified as key ingredients of RC. This study highlighted RCs' role in enriching MHPs clinically and personally. RC curriculum and courses drive changes in practice and attitudes towards service users. RCs may assist MHPs reflect on practice and improve their clinical reasoning. This study advances understanding of a promising, accessible training program for adopting a recovery-oriented practice amid a paradigm shift among MHPs and OTs.

ObjectivesTo understand complaint risk among mental health practitioners compared with physical health practitioners.DesignRetrospective cohort study, using incidence rate ratios (IRRs) to analyse complaint risk and a multivariate regression model to...

Introduction: The Coronavirus disease pandemic of 2019 (COVID-19) has had psychological implications and altered the public’s well-being. In response to the pandemic, mental health practitioners play an essential role in mitigating the adverse psychological effects among the public. However, as the demand for mental health services increases, the responsibilities of mental health professionals are far stretched from what they can handle. Therefore, this research is aimed to explore the psychological impact of the pandemic on the mental health practitioners in Selangor and their coping strategies. Method: A total of 10 mental health practitioners who are clinical psychologists and counselors participated in the one-to-one interview. The collected data were analysed using thematic analysis. Result: The higher client loads, the transition to virtual therapy, burnout, and anxiety were found to have an impact on the mental health practitioners’ well-being. Despite the challenging psychological impact, the mental health practitioners expressed a high level of satisfaction with their jobs, which they attributed to the supportive organisational culture and their intrinsic drive for selecting this profession. The mental health practitioners have reported that perceived organisational support, social support, and self-care approaches are effective coping mechanisms. Mindfulness skills such as breathing techniques and meditation are often practiced by the participants to calm the mind and body from a long day of work. Conclusion: The implication of the study contributes to breaking the stigmatisation of help seeking behaviour among the helping professions, as well as urging the policy makers, governments, and foundations to play a part in providing accessible and quality mental healthcare to the society.

This article summarizes key findings from the national evaluation of the Safe Start Demonstration Project. As part of Safe Start, local mental health systems and practitioners played essential roles in protecting young children from the impact of exposure to violence. Both crisis circumstances (e.g., a domestic violence incident) and noncrisis circumstances (e.g., ongoing mental health treatment) are opportunities for mental health practitioners to access children exposed to violence and address the negative consequences often associated with exposure. One Safe Start grantee found that family and child functioning improved and violence ended when families participated in a crisis intervention provided by clinicians. Three grantees found evidence that therapeutic and family support services reduced the impact of exposure to violence on children. Community partnerships were a critical component of the Safe Start services that demonstrated positive mental health outcomes for children who have been exposed to violence and their families. Furthermore, successful mental health interventions incorporated cross-disciplinary strategies and practices that integrated and sequenced services so that all family members and their multiple needs were supported. In addressing the needs of families experiencing violence, mental health practitioners need to consider the potential value of partnering with other service providers in the community and providing their services within the context of more comprehensive interventions.

When therapy is not therapy