Community Mental Health Project Research Articles

Moderating effects of age on associations between exercise self-efficacy and physical activity in women with psychosis in Hong Kong.

Physical activity (PA) can improve the clinical symptoms, physical health, and functional outcomes of patients with psychosis. This study aimed to investigate the moderating effects of age on the associations between exercise self-efficacy (ESE) and PA in women with psychosis. Data from 38 women with psychosis (mean age, 37.5±13.2 years) who participated in a community mental health project in Hong Kong were analysed. Psychotic symptoms were evaluated using the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms. Levels of PA were determined using the self-report International Physical Activity Questionnaire-Long Form. ESE was assessed using a self-report instrument. The moderating effects of age on associations between ESE domains and physical activity levels were assessed. Age was correlated with moderate-intensity PA (r = 0.51, p = 0.007) and total PA (r = 0.52, p = 0.002). The ESE 'must exercise alone' domain was correlated with moderate-intensity PA (r = 0.17, p = 0.009) and total PA (r = 0.15, p = 0.04). The ESE 'resistance from others' domain was correlated with moderate-intensity PA (r = 0.0003, p = 0.03). No significant correlations were observed between other PA variables and other ESE domains. Among women with psychosis, age was a moderating factor in the association between moderate-intensity PA and ESE, particularly in domains of 'must exercise alone', 'inconvenience to exercise', and 'resistance from others'. Among women with psychosis, ESE domains of 'must exercise alone', 'inconvenience to exercise', and 'resistance from others' as well as overall ESE were significantly associated with moderate-intensity PA in older age group only. Age-specific strategies should be applied when designing interventions to increase PA levels in this population.

Prevalence and correlates of anxiety symptoms among Black people in Canada: A significant role for everyday racial discrimination and racial microaggressions

ObjectiveAnxiety disorders are highly prevalent worldwide but vary significantly by country and ethnoracial background. Minimal published data exist on the prevalence of clinically significant anxiety among Black people in Canada and none using validated measures. Therefore, this study sought to establish the frequency of clinically significant anxiety symptoms among a sample of Black people living in Canada as well as examine the association with two forms of racism (racial discrimination and racial microaggressions). MethodsData collected from the Black Community Mental Health project in Canada was analyzed. Participants provided (N= 845) sociodemographic information and completed measures assessing anxiety symptomology (GAD-7), everyday racial discrimination, racial microaggressions, and resilience. Prevalence of anxiety symptomatology was determined across sociodemographic variables as well as categories of everyday racial discrimination and racial microaggressions. Two regression models were conducted to examine the relationship between anxiety symptoms and the two forms of racism controlling for sociodemographic factors. ResultsOverall, nearly a third of participants endorsed clinically significant levels of anxiety symptoms, with higher rates observed among men, unemployed people, those with higher education, people who are separated, and those with no reported family history of mental health problems. Logistic regression models demonstrated that, except for those reporting the greatest frequency of racial discrimination, there is a general linear trend such that those experiencing higher levels of racial discrimination or racial microaggressions are increasingly more likely to present with anxiety symptoms when compared to those reporting low levels of discrimination or microaggressions. Psychological resilience afforded nominal protection but only against exposure to racial microaggressions. ConclusionsRates of clinically significant anxiety are higher among Black people in Canada than reported previously. Both racial discrimination and racial microaggressions predicted higher rates of anxiety symptoms. The results are discussed in relation to previous findings from the US that report similar findings.

Prevalence and correlates of depression among Black individuals in Canada: The major role of everyday racial discrimination

Depression is a common mental health problem causing significant disability globally, including in Canada. Prevalence estimates for depression within Black communities in Canada are unknown. This study determined the prevalence of depression in a sample of Black Canadians and the association between everyday racial discrimination experiences and depression. We analyzed data collected from the Black Community Mental Health project in Canada. Participants provided sociodemographic information and completed measures assessing depressive symptomology, everyday racial discrimination, and social support. The prevalence of depressive symptomatology was computed across sociodemographic variables and categories of everyday racial discrimination. Different regression models were conducted to examine the relationship between depressive symptoms and everyday racism controlling for sociodemographic factors. In total, 65.87% of participants reported severe depressive symptoms, with higher rates among women, those who are employed, and those born in Canada. The linear regression models showed that everyday racial discrimination is the best predictor of depressive symptoms, with a final model explaining 25% of the variance. A logistic regression model demonstrated that those experiencing a high level of racial discrimination are 36.4 more likely to present severe depressive symptoms when compared to those reporting a low level of discrimination. Rates of depressive symptoms among Black individuals are nearly six times the 12-month prevalence reported for the general population in Canada. Racial discrimination, which significantly predicts greater depressive symptomatology, is consistent with earlier studies in the United States and suggests that Canadian colorblind policies may inadvertently reinforce racial discrimination with detrimental effects on mental health.

A time motion study of community mental health workers in rural India

BackgroundCommunity Health Workers (CHWs) are critical to providing healthcare services in countries such as India which face a severe shortage of skilled healthcare personnel especially in rural areas. The aim of this study is to understand the work flow of CHWs in a rural Community Mental Health Project (CMHP) in India and identify inefficiencies which impede their service delivery. This will aid in formulating a targeted policy approach, improving efficiency and supporting appropriate work allocation as the roles and responsibilities of the CHWs evolve.MethodsA continuous observation Time Motion study was conducted on Community Health Workers selected through purposive sampling. The CHWs were observed for the duration of an entire working day (9 am- 3 pm) for 5 days each, staggered during a period of 1 month. The 14 different activities performed by the CHWs were identified and the time duration was recorded. Activities were then classified as value added, non-value added but necessary and non-value-added to determine their time allocation.ResultsHome visits occupied the CHWs for the maximum number of hours followed by Documentation, and Traveling. Documentation, Administrative work and Review of work process are the non-value-added but necessary activities which consumed a significant proportion of their time. The CHWs spent approximately 40% of their time on value added, 58.5% of their time on non-value added but necessary and 1.5% of their time on non-value added activities. The CHWs worked for 0.7 h beyond the stipulated time daily.ConclusionThe CHW’s are “dedicated” mental health workers as opposed to being “generalists” and their activities involve a significant investment of their time due to the specialized nature of the services offered such as counselling, screening and home visits. The CHWs are stretched beyond their standard work hours. Non-value added but necessary activities consumed a significant proportion of their time at the expense of value-added activities. Work flow redesign and implementation of Health Management Information Systems (HMIS) can mitigate inefficiencies.

Rethinking Resilience for Children and Youth in Conflict Zones: The Case of Palestine

Approximately one in four children lives in conflict-affected areas around the world and this results in many consequences for their physical and mental health. This paper first provides a brief history of the specific contexts of violence and resistance that children and youth engage with, and in, on a daily basis in Palestine. It then outlines the efforts of one functioning program in the West Bank, the United Nations Community Mental Health Project, which was designed not only to respond to, but mitigate, child and youth mental health problems in the midst of decades of such political violence.

Women’s Participation in a Postconflict Community in Peru

The impact of the internal armed conflict in Peru (1980–2000) was felt in many regions in this South American country, and especially in rural regions such as the Southern Andean province of Cotabambas in the Apurímac department. This article describes and analyzes the actions and results of a community mental health project in this area that aimed to address the conflict’s aftermath. The intervention used participatory strategies to identify the communities’ prioritized problems, established actions appropriate to the cultural characteristics of the population, and implemented creative and recreational initiatives that responded to communities’ needs. Based on democratic dialogue, horizontal relations, and reciprocity, the targeted communities became protagonists in the process of psychosocial transformation that fostered individual and collective exercise of rights, individual human development, and democratic community building.

It’s a Goal!: basing a community psychiatric nursing service in a local football stadium

This paper describes the development of a community mental health project in a local football stadium. Funded for three years by the Laureus Foundation's 'Sport for Good' initiative, the project provides mental health promotion and mental health awareness input targeted initially at young men, a group who are often very difficult to engage in this type work. Using group interventions and utilising football as a metaphor, the project helps young men address issues around depression, self-esteem and inclusion, and addresses the subject of suicide which remains the second biggest cause of death in young men in Britain. The paper describes the development of the project, the structure of the groups and the evaluation of the first two groups to complete the process. The work takes place in the Moss Rose stadium, home of Macclesfield Town, a team in the English Football League.

Mental health: the missing link in primary care? Health for All by the Year 2000 revisited

The effects on the uptake of services offered in primary health care of a demonstration community mental health project in Pakistan were assessed. A subdistrict with the project was compared with a matched area without the project over 7 years. Routinely collected information on service use was used, including the detection and treatment of mental disorders. Compared with the comparison subdistrict, the index subdistrict showed an increase in use of primary care by men, reduction in pregnancy rate, increased use of antenatal care, reduced maternal mortality, increased immunization coverage, and increased detection and treatment of mental disorders.

The Community Mental Health Project of Kyonggi Province

The Community Mental Health Project of Kyonggi Province

Traces of Khmer Women's Imaginary:

This paper presents the voices and reflections of two women who worked together in a community mental health project with Cambodian women. The first person narrative of Sokhany Sieng recollects her story of migration to the United States and her insights into the lives of refugee women in America. The discussion by Janice Thompson examines the ethics of feminist practice with refugee women and explores questions of colonialism in the use of feminist scholarship in multicultural work with refugee women.

Vision to Reality: Case Study of a Unique Community Mental Health Project

The history of a multi-disciplinary child mental health team funded under the Mental Health and Related Services Act 1973 (Commonwealth) is traced from its inception until the end of 1988 using a developmental organisational framework. Many of the problems which beset the group can be attributed, in part at least, to the combination of poorly defined guidelines, positions at base-grade classification and no provision for formal leadership. That the group ultimately became a team, succeeded in establishing a role and developing skills (initially in mental health consultation and later in other processes) is a tribute to its members' perseverance, dedication and enthusiasm, as well as the length of time it was ‘allowed’ to create a niche for itself. If it had been subjected to the current practice of being reviewed after one or two years of operation, it would not have survived and a useful contribution to preventive mental health would have been lost.

Peer Counseling in the Secondary Schools: A Community Mental Health Project for Youth

Click to increase image sizeClick to decrease image size Additional informationNotes on contributorsBeatrix A. HamburgBeatrix A. Hamburg is Clinical Associate Professor of Psychiatry at Stanford University School of Medicine, Palo Alto, CaliforniaBarbara B. VarenhorstBarbara B. Varenhorst is Consulting Psychologist, Palo Alto Unified School District. Condensed from American Journal of Orthopsychiatry, 1972, 42 (4), 566–581.

Peer counseling in the secondary schools: a community mental health project for youth.

The Peer Counseling Program trains high school and junior high school students to help other students with personal problems or situational stress. Training is carried out in small groups in weekly sessions, and it includes behavioral principles, issues of relevance to adolescents, and supervised practical experience. Criteria are suggested for judging the suitability and effectiveness of students in the counseling role.

Urban Challenges to Psychiatry: The Case History of A Response

Medical centers often function as though the phrase, service to the belongs only public health and preventive medicine textbooks. The problems of community mental health programs involve defining the characteristics and needs of a given community, and then devising methods for actual delivery of health care services. This edited volume collates research material from a 12-year study of the Columbia-Washington Heights Community Mental Health Project that began 1957. The book describes successful attempts to improve mental health services offered by Columbia University's New York State Psychiatric Institute to the surrounding Washington Heights area. Major objectives of this social psychiatric research were to define a specific urban area in terms of such questions as the prevalence of mental illness and emotional maladjustment, the availability and adequacy of mental health resources, and the attitudes within the community towards mental health and mental health programs. An additional goal was applying

A Few Facts about the Residents of Washington Heights

The Washington Heights Health District, a geographically demarcated area in upper Manhattan, can scarcely be called a community. Yet it is important to know something about the kinds of people who live in the area. The facts and figures presented here about the residents of Washington Heights were gleaned from the findings of a household sample survey carried out between November, 1960, and April, 1961.1 It should be borne in mind, accordingly, that these data reflect only the characteristics of the district's population at that time and are accurate only within the limits of sampling error as well as nonsampling error to which interview data are inevitably subject. For both descriptive and administrative purposes, the district has been arbitrarily divided into three zones.2 The central zone was designated at the outset by the Columbia-Washington Heights Community Mental Health Project as a possible catchment area for future service programs. About half of the district's total land area is contained in the north zone; the central zone contains about a third and the south only a sixth. Yet the population count by the 1960 Census shows the north zone with 115,000 persons, or 42 per cent of the total; the central zone with 99,000, or 37 per cent; and the south zone with 55,000, or 21 per cent. A density index of proportion of population divided by proportion of area yields relative density measures of 0.8, 1.1 and 1.6, respectively. In other words, the south zone is half again as densely populated as the central zone and twice as densely populated as the north zone. Another measure of crowding, housing density index, reveals that the proportion of dwelling units in the south zone with one

The role of the social worker in an experimental community mental health clinic: Experiences and future implications

This paper discusses the role of the social worker in an experimental community mental health project designed to evaluate the treatment of schizophrenics in a home-care setting as compared to a hospital setting. The clinic utilized throughout this project served both as a medium of research and as a source of direct services to the patients and families involved. In this paper the role of the psychiatric social worker is evaluated and described showing both its traditional as well as innovated aspects in hopes of offering a possible prototype of the social worker's role in future community mental health programs.

A Community Mental Health Project in New York State

A Community Mental Health Project in New York State