Causes Of Mental Distress Research Articles

“Nothing's changed, baby”: How the mental health narratives of people with multiple and complex needs disrupt the recovery framework

The dominant narrative in mental health policy and practice has shifted in the 21st century from one of chronic ill health to a ‘recovery’ orientation. Knowledge of recovery is based on narratives of people with lived experience of mental distress. However the narratives of people experiencing structural inequalities are under-represented in recovery research. Meanwhile, uses of recovery narratives have been critiqued by survivor-researchers as a co-option of lived experience to serve neoliberal agendas.To address these twin concerns, we undertook a performative narrative analysis of two ‘recovery narratives’ of people with multiple and complex needs, analysing their co-construction at immediate/micro and structural/macro levels. We found two contrasting responses to the invitation to tell a recovery story: a narrative of personal lack and a narrative of resistance. We demonstrate through reflexive worked examples how the genre of recovery narrative, focused on personal transformation, may function to occlude structural causes of mental distress and reinforce personal responsibility in the face of unchanging living conditions. We conclude that unacknowledged epistemological assumptions may contribute to co-constructing individualist accounts of recovery. A critical, reflexive approach, together with transparent researcher positionality, is imperative to avoid the epistemic injustice of a decontextualised form of recovery narrative.

How identity is produced and experienced in the context of mandated community-based mental health care: An application of the theories of Grosz and Foucault.

Despite changes to research and practice, that, to some degree, acknowledge that people are shaped by their contexts, the treatment of mental illness remains largely focused on interventions that take place at the level of the individual. Conceptualizing mental illness as something that resides in individuals can lead to reliance on neurobiological and psychotherapeutic solutions, and away from conversations about not only contextual causes of mental distress, but also sociopolitical solutions to mental distress. Further, it can lead to the use of mental health interventions that focus on the biology of an individual without a consideration for how those interventions themselves may have psychological, social, or political consequences that act to shape an individual's identity, agency, and relationship to their community. This paper examines one medicolegal intervention, the community treatment order, using the philosophical work of Grosz and Foucault to consider how this intervention affects the experience and construction of identity, and the impact of this on an individual's sense of agential membership in a community. This discussion aims to increase understanding of the individual and social implications of interventions for mental illness, and provide a conceptualization of the relationship between identity, agency, and ethics which can inform critical research and nursing practice more broadly.

Mental Health, Food Insecurity, and Economic Hardship among College Students during the COVID-19 Pandemic.

The mental health crisis among college students has become one of the most pressing issues, especially during the pandemic. Researchers discuss food insecurity as one of the leading causes of mental distress. The onset and continued impacts of the COVID-19 pandemic appear to compound food insecurity, economic hardship, and mental health. This study aims to understand the mental health of college students in relation to food insecurity and financial struggles to meet basic living expenses and debts during the pandemic. Authors collected survey data from college students in a public urban university in 2020 and conducted a multiple regression (N = 375). Evidence indicated that mental health became significantly worse after the pandemic onset. Mental health was significantly associated with food insecurity and multiple economic hardships, controlling for prepandemic mental health and other characteristics. The findings affirm that food insecurity and dire levels of economic hardship have devastating effects on the mental health of young adults. The article highlights the long-term implications of mental health affected by basic needs insecurity and the emergent need for integrated services and university-community partnerships.

Patients’ priorities around drug-resistant tuberculosis treatment: A multi-national qualitative study from Mongolia, South Africa and Georgia

ABSTRACT We conducted qualitative research exploring the treatment experience of people with DR-TB. We held nine focus group discussions with 57 adults undergoing/recently completed treatment for DR-TB in Georgia, Mongolia and South Africa. Translated transcripts were analysed using thematic analysis. We identified three higher order themes: (1) Treatment experience and the role of good relationships with healthcare providers: Treatment duration, pill burden and side-effects were challenging aspects of treatment. Side-effects/symptoms that were visible signs of illness were particularly troubling. Good relations with clinical staff helped combat fear and uncertainty regarding treatment. (2) Mental distress and opportunities for wellbeing: The shame, stigma and isolation people experienced as a result of their DR-TB diagnosis was an important cause of mental distress. No longer being infectious enabled people to resume work and socialising. Positive emotions emerged with good treatment outcomes. (3) Fear and worry along the treatment journey: Participants expressed fears about TB: infecting others; whether they would be able to endure treatment; side-effects; health consequences of treatment. Worries mostly disappeared with successful treatment. Alongside measuring side-effects, time to culture conversion and cure rates, future trials of DR-TB treatments should capture how quickly visible symptoms resolve, quality of life measures, and mental health outcomes.

Can news with positive or negative content affect and a relaxation pause improve the emotional state of health care professionals? A randomized online experiment during COVID-19 pandemic

A cause of mental distress during the COVID-19 pandemic is media exposure, which can impact health care professionals (HCPs) who must keep up to date with the statistics and procedures to fight the outbreak. This study aimed to evaluate the effects of listening to negative and positive news about COVID-19 pandemic and a relaxation pause audio. For that, we measured the emotional state through Likert items in a scale developed to assess how anxious, stressed, hopeful, conscious about emotions, irritated, despondent, joyful, optimistic, and preoccupied, he or she was feeling in the moment of evaluation. In an online experiment, an HCPs sample of 245 participants were randomly assigned to either listen to negative or positive news contents about COVID-19. After that, both groups were guided by a relaxation pause activity in which they paid attention to the body and breath. They were assessed before and after listening to each audio. After listening to negative news, participants entered in a more negative emotional state than at baseline (p < 0.001) and compared with participants who listened to positive news (p < 0.001). Both groups improved their emotional state after performing the proposed brief relaxation (p < 0.001). These results show the importance of HCPs being aware and controlling the content of consumed news. A brief relaxation practice can mitigate the negative effects of consuming information with negative content.

Daily experiences and strategies for psychological survival during the 2014 assaults in Gaza: a retrospective analysis of chronological diaries

BackgroundPublic health research suggests that multiple factors contribute to the mental health sequalae of political violence, but the daily experiences and ongoing strategies of psychological survival during active warfare are not clearly understood. We analysed retrospective chronological diaries from Palestinian women in Gaza, occupied Palestinian territory, to explore their lives during Operation Protective Edge in 2014, when a series of aerial bombardments killed over 2000 Palestinians and left around 500 000 displaced from their homes. Methods20 Palestinian female teachers in Gaza were recruited via an intervention for trauma recovery 1 month after the end of Operation Protective Edge, in September, 2014. Following the experience sampling method, women were asked to chronicle specific memories and affective responses associated with their experiences. Data were imported into qualitative data analysis software, coded line by line, and analysed using content analysis, with special attention to the causes of mental distress associated with political violence. FindingsThe women's narratives included memories of exposure to bombings, injuries, death, and destruction of vital infrastructure and systems. Their experiences of flight were described as exhausting and demoralising. Their temporary shelters lacked their basic needs for sanitation, food, and privacy. These experiences resulted in intense terror, grief, exhaustion, hopelessness, and isolation. Strategies of psychological survival included reframing; trying to appreciate “being able to escape death”, a sense of solidarity within families and neighbourhoods, and pride and satisfaction found in a context of resistance and global attention to the suffering in Gaza. InterpretationOur results reveal the importance of tracing the events of warfare, its psychosocial consequences, and the distinct patterns of emotional and logistical survival in Gaza. This study was limited by the representativeness of our study population and the small sample size. Future studies should explore this topic in larger populations. Limitations notwithstanding, in drawing out the unique contribution of reflective narratives of women survivors of war, our study highlights the need to solicit and analyse reflective and chronologically grounded narratives within global mental health epidemiology. FundingNone.

Analysis of the impact of COVID-19 pandemic on house-staff in the USA: addressing the ripple effects

ABSTRACT Background: The novel corona virus has changed the way individuals interact with each other and society. In the medical sector, this has affected the residents and fellows who spend the majority of their time on the front lines. Methods: We conducted a cross-sectional survey to assess the impact of the COVID-19 pandemic on the lives and training of house-staff across the USA. Respondents in our survey reported feeling significantly overwhelmed by the ongoing pandemic. Results: The majority of house-staff were significantly concerned about the lack of protective equipment, inability to safeguard themselves from infection and inability to look after their families. Concerns regarding contracting the infection and transmitting it to their loved ones were reported as a cause of mental distress among resident physicians. Increasing patient load, lack of protective equipment, and disruption of educational and academic activities during the COVID-19 pandemic have all reportedly affected the training and overall well-being of resident physicians. Conslusion: Our study adds further support for measures to safeguard house-staff with proper protective equipment and ensure adequate support for both mental and physical well-being during these challenging times.

Depression, Anxiety, and Stress among Private Health Care Practitioners in Delhi NCR Region During Covid-19 Pandemic: A Cross-Sectional Study

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a globally prevalent public health pandemic due to a viral COVID-19 infection. This cross-sectional observational study aimed at evaluating the depression, anxiety, and stress levels among private health care practitioners in the Delhi NCR region during the COVID-19 pandemic. The questionnaire included sociodemographic characteristics and Depression, Anxiety, and Stress Scale (DASS)-21. Dentists exhibited the highest level of depression (83.89%), anxiety (89.3%), and stress (89.95%), followed by medical personnel and AYUSH workers. Most of the study cohort showed moderate levels of DASS scale. Fear of contracting the infection and fear of infection transmission to family/friends were the most common causes of mental distress. COVID-19 pandemic has imparted adverse effects on the mental health status of health professionals. The risk factors should be acknowledged, and necessary interventions should be implemented to maintain psychological well-being.

Impact of polycystic ovary syndrome on quality of life of women in correlation to age, basal metabolic index, education and marriage.

Polycystic ovary syndrome (PCOS) is the major endocrine related disorder in young age women. Physical appearance, menstrual irregularity as well as infertility are considered as a sole cause of mental distress affecting health-related quality of life (HRQOL). This prospective case-control study was conducted among 100 PCOS and 200 healthy control cases attending tertiary care set up of AIIMS, Patna during year 2017 and 2018. Pre-validated questionnaires like Short Form Health survey-36 were used for evaluating impact of PCOS in women. Multivariate analysis was applied for statistical analysis. In PCOS cases, socioeconomic status was comparable in comparison to healthy control. But, PCOS cases showed significantly decreased HRQOL. The higher age of menarche, irregular/delayed menstrual history, absence of child, were significantly altered in PCOS cases than control. Number of child, frequency of pregnancy, and miscarriage were also observed higher in PCOS cases. Furthermore, in various category of age, BMI, educational status and marital status, significant differences were observed in the different domain of SF-36 between PCOS and healthy control. Altogether, increased BMI, menstrual irregularities, educational status and marital status play a major role in altering HRQOL in PCOS cases and psychological care must be given during patient care.

Transforming Therapy: Mental Health Practice and Cultural Change in Mexico

Transforming Therapy: Mental Health Practice and Cultural Change in Mexico

A Qualitative Study On Mental Distress Of Vietnamese Students In The U.S.A. In The Covid-19 Era

Objective: This paper aims to examine how the COVID-19 pandemic affects the mental distress of the Vietnamese students in the USA. We explore different root causes of mental distress among international students who are away from their home country, their loved ones, and being isolated from school and community due to this outbreak.&#x0D; Design: In-depth interviews were conducted to probe the reasons for mental stress during the pandemic and the narrative textual analysis was subsequently performed to analyze the results. This research includes the interviews of 20 Vietnamese students in the USA during the COVID-19 era.&#x0D; Results: The textual analysis showed that the mental distress of these Vietnamese students were caused by limited access to on-campus facilities and activities, limited access to public services including grocery shopping, transportations, clinics, the possibility of being infected, isolated living condition due to the lockdown order, and inability to go back to the home country when wanted.&#x0D; Conclusions: We found that both physical attributes (e.g., living condition, internet difficulty, overwhelmed healthcare system, restricted traveling, lack of personal interaction, limited access to public services) and psychological factors (e.g., anxiety of unfamiliar teaching modality, fear of viral infection, uncertain career aspects, cultural barrier and prejudice) directly led to the mental distress of these students. Moreover, other factors such as turbulent future job markets and potential racism toward Asians in relation with “Chinese virus” may cause the mental distress of these students.

Symptoms and Experience of Depression Among Chinese Communities in the West: A Scoping Review.

Despite the increasing presence of Chinese communities in the West, their experiences of depression and the variations in symptoms or presentation are not well understood. Using Arksey and O'Malley's methodical framework, we conducted a scoping review of the published literature, using electronic databases MEDLINE and PsycINFO, and searched for articles published since 1999. Out of 1177 articles identified, 21 met the inclusion criteria. Thematic synthesis revealed valuable scholarly work on (1) depression rates, migration, and contextual determinants, (2) causation beliefs and help seeking, (3) acculturation and symptoms, (4) presenting symptoms and somatization, and (5) culturally sensitive assessment and care. Overall, this review has identified the importance of contextual determinants in the development of depression, low rates of seeking of professional help, subtle variations in somatization, and knowledge gaps in culturally sensitive care. The findings suggest that, rather than treating migration as a cause of mental distress, the accompanying conditions and events need to be further examined and addressed as potential risk or protective factors. Subtle variations in somatization are also evident, and future scholarly work should examine the notion of cultural scripts-namely, that people attend and react to particular experiences in culturally based ways. For this reason (among others), practice models need to develop strategies for culturally sensitive care, such as co-construction of illness narratives and finding common ground. Given the stigma of mental illness and the low level of seeking professional help, the role of primary care should be expanded. Further studies investigating mental health issues beyond depression are also warranted in the studied community.

Popular television and public mental health: creating media entertainment from mental distress

This paper explores how tensions and power differentials within public mental health interact with the practices of media production in entertainment television. I present the findings of a qualitative study involving semi-structured interviews with story consultants from mental health organisations and Senior Executives, Producers and script-writers from UK television series (n = 14). Story advisors welcome the opportunity to reach larger and younger audiences in distinct ways and to share the ‘lived experience’ of mental distress through well-researched characters. They accept their relative lack of power to negotiate dramatic storylines which conflate mental distress with criminality and may undermine their anti-stigma ideals. The ‘medical model’ is prioritised in mainstream television drama and the causes of mental distress framed in biomedical terms. Storylines tend to emphasise the certain benefits of medication and marginalise self-management of conditions. Television industry professionals recognise their anti-stigma public service role and are receptive to working with programme consultants to help create authentic characters. Perceptions of the nature of drama as requiring resolution may help to explain the principal focus on biomedical conceptualisations of mental distress. Medication provides a relatively simple on-screen solution to resolve complex stories. Entertainment television operates within limited ideological frames. Mental distress and stigma are addressed at an individual, not collective level. Debates within the survivor movement and public mental health concerning medication, treatment and recovery tend to be obscured. These might provide a productive alternative vein of storytelling that could broaden our understanding of the social meaning of suffering and thus help challenge stigma.

Web based health surveys: Using a Two Step Heckman model to examine their potential for population health analysis

In June 2011 the BBC Lab UK carried out a web-based survey on the causes of mental distress. The ‘Stress Test’ was launched on ‘All in the Mind’ a BBC Radio 4 programme and the test’s URL was publicised on radio and TV broadcasts, and made available via BBC web pages and social media. Given the large amount of data created, over 32,800 participants, with corresponding diagnosis, demographic and socioeconomic characteristics; the dataset are potentially an important source of data for population based research on depression and anxiety. However, as respondents self-selected to participate in the online survey, the survey may comprise a non-random sample. It may be only individuals that listen to BBC Radio 4 and/or use their website that participated in the survey. In this instance using the Stress Test data for wider population based research may create sample selection bias. Focusing on the depression component of the Stress Test, this paper presents an easy-to-use method, the Two Step Probit Selection Model, to detect and statistically correct selection bias in the Stress Test. Using a Two Step Probit Selection Model; this paper did not find a statistically significant selection on unobserved factors for participants of the Stress Test. That is, survey participants who accessed and completed an online survey are not systematically different from non-participants on the variables of substantive interest.

A critical engagement with the DSM-5 and psychiatric diagnosis

Classifications in psychiatry can result in the reification of hypothetical approaches, arbitrary categorisation and social injustice. This article applies a social constructivist approach to critique the DSM-5 as a neurobiological model of psychiatric diagnosis which ignores psychosocial factors such as poverty, unemployment and trauma as causes of mental distress. It challenges the universality of psychiatric diagnosis and proposes that cultural psychiatry's framing of ‘culture-bound syndromes,’ or ‘cultural case formulation’ guidelines, is oversimplified. Use of the DSM in the South African context risks perpetuating injustice by labelling and stigmatising people who have in the past been racially stigmatised by apartheid. In culturally diverse South Africa, psychiatric diagnosis should take into account alternative explanatory models that provide a more balanced view of the complex and dynamic relationship between biological and sociocultural forces in the manifestation of psychopathology.

Mexican-American Perceptions of the Causes of Mental Distress

This article reports South Texas Rio Grande Valley Mexican-American perspectives on the causes of mental distress. Very little has been published about Mexican-American perspectives on this topic. Mexican Americans as a population exhibit strong mental health care disparities in the United States; therefore their perspective on the causes of mental distress is an important area to investigate. An exploratory descriptive design with 82 interviews resulted in three overarching themes: Individual Causes of Mental Distress; External Aspects; and How Mental Distress Develops. The results of this study have implications for mental health practitioners regarding family problems, experiences of loss, and money problems of clients, as well as for employers regarding stress experienced by employees at work. They also highlight the importance of using a collaborative interdisciplinary approach in treating Mexican-American clients and supporting clients in their perceptions while providing clients with important skills such as problem solving, self-awareness, and coping. Mexican Americans living in different geographical locations within the United States may have different perceptions of causes of mental distress. This is important for mental health professionals to understand when working with Mexican-American clients.

Models of care delivery in mental health nursing practice: a mixed method study

The aim of this study was to identify the conceptual models that underpin mental health nursing care in clinical settings. This study is a modification of a previous study which evaluated the influence of implicit models of mental disorder on processes of decision making within community-based teams. Participants completed questionnaires in response to a scenario. A range of explanatory conceptual models were identified in respect to aetiology, treatment and recovery. In a forced choice the participants ranked a medical model of care above other models as underpinning care delivery. The content analysis found that the participants used a psychodynamic framework for understanding the causes of mental distress but described the nursing interventions in terms of supporting a medical model of care. Nursing care is dominated by a medical model which constrains mental health nursing. This potentially creates tension between what nurses believe to be the problem and the responses available for nurses in their clinical setting. A range of psychosocial approaches to mental health care delivery have been developed, but there seems to be problems with their implementation in practice. Further research is required to explore how broader therapeutic interventions can be implemented by nurses within multidisciplinary systems of mental health care delivery.

Why cause matters

Recently, some commentators have suggested, for either pragmatic or philosophical reasons, that the cause of mental distress is irrelevant. In this paper it is suggested that downplaying the role of cause leads to ignoring the link between abuse and mental health difficulties which is disempowering for individuals, short-sighted for service provision and fails to challenge the social structures, inequalities, conditions, practices, values and attitudes that allow abuse to happen. Acknowledging the causal link between abuse and mental health difficulties implies that in addition to building recovery focused therapeutic relationships with individuals, as mental health nurses we need to take seriously our role in mental health promotion from infancy onwards and to acknowledge the importance of being politically aware and involved.

Professional and service-user perceptions of self-help in primary care mental health services

Self-help is becoming an increasingly accessible option for addressing mental health problems. Despite this, self-help is subject to a variety of interpretations, little is known about how professionals and service-users conceptualise self-help, or how service-users engage in self-help activities. This study aimed to explore the views of self-help by service-users and health professionals in one area of Scotland, including the perceptions of what constitutes self-help and how it might be used to address mental health problems in primary care. The research involved semistructured interviews with 31 primary care mental health professionals, and in-depth interviews with 34 service-users. We found that professionals and service-users describe self-help in different ways, which has great implications for referral to and implementation of self-help in primary care settings. It also emerged that self-help was not necessarily perceived to be able to address the causes of mental distress, which could leave some professionals defaulting to offering no interventions despite the fairly positive attitude service-users show to self-help strategies. Finally, professionals need to be convinced that interventions are useful, effective and accessible as there are significant barriers in professionals using self-help; if they are not convinced, such approaches will support their therapeutic approach. The research supports the need to develop methods of delivery that offer self-help as part of a broad package of care that also considers social causes of distress.

Job Satisfaction and Mental Distress among Japanese Farmers

Objective: Job satisfaction and mental distress may contribute to mental illness, particularly in regard to depression and even suicide. The aim of this study was to investigate the level of job satisfaction and its relationship to the level of mental distress among farmers in comparison to non-farming rural residents. Materials and Methods: A cross-sectional questionnaire survey of 7,000 rural residents was performed to assess the level of job satisfaction and mental distress. Mental distress was measured using the 12-item General Health Questionnaire (GHQ-12). The adjusted odds ratios and their 95% confidence intervals were calculated by means of multivariate logistic regression models. Results: A total of 5,364 rural residents (1,888 farmers and 3,476 non-farmers) responded, therefore yielding a response rate of 76.6%. Twenty-five percent of the farmers and 24 percent of non-farmers were either very dissatisfied or somewhat dissatisfied with their jobs. Twenty-five percent of the farmers and 29 percent of non-farmers had mental distress (GHQ score of 4 or above). The crude odds ratio of mental distress among dissatisfied farmers in comparison to satisfied farmers was 4.38 (95% CI = 3.49-5.51). Similarly, the crude odds ratio of mental distress among dissatisfied non-farmers in comparison to satisfied non-farmers was 5.01 (95% CI = 4.19-5.98). These statistically significant odds ratios remained even after controlling for age, gender and family structure. The most important cause of mental distress among farmers was related to family finances. Among non-farmers, however, the most important cause of mental distress tended to be human relations in the workplace. Conclusion: Although farmers experienced similar levels of job satisfaction and mental distress in comparison to non-farmers, the most important cause of mental distress differed between farmers and non-farmers. As the underlying risks for this level of job satisfaction, family finances are therefore considered to be a potentially hazardous factor in regard to mental distress for farmers.