Experience Of Mental Disorders Research Articles

The Experience of Disclosure and Concealment of One’s Mental Disorder

Although disclosure of one’s experience of mental disorders is an important factor in the recovery process, this topic is not well understood or studied in scientific research. This study seeks to describe and analyse the experience of disclosing and concealing information about mental disorders. The participants were 5 men and 5 women (age 24–53) experiencing a form of mental disorder and receiving treatment for at least one year. Data was collected through semi–structured interviews and analysed using thematic analysis. The results showed that the decision to disclose information about one’s mental disorder is motivated by the desire to make oneself feel better, the need to justify oneself, and as a way to educate others. In contrast, concealment is used as a way to avoid stigmatising reactions and inflicting discomfort in other people. Our study results reflect a tendency among the participants to be selective about the information disclosed as well as the people it is disclosed to; however, the latter aspects of disclosure are open to change throughout time. Finally, participants in the study reported the positive value of both disclosing and concealing information about their mental disorder. The results of this study contribute to a better understanding of disclosure and concealment of one’s mental disorder and may be useful for those who interact with or provide support to people with mental disorders.

Reform of the mental health care system in the Republic of Croatia

Abstract Issue/problem The pandemic and earthquakes that hit Croatia have increased the need to develop an effective community based mental health care system. Description of the problem In Croatia, the hospitalization rate for depression has doubled in the last 20 years, and the growing needs are mainly related to the mental health of children and young people. The average length of hospital stay due to mental disorders is higher than the EU average, as is the suicide rate. Due to insufficient recognition at the primary level of health care, inadequate treatment and stigma, people with mental disorders rarely seek help. Results Croatia is in the process of adopting the Strategic Framework for Mental Health 2022-2030. The Action Plan for community based mental health service and the Action Plan for mental health promotion, the early detection and treatment of mental disorders are being developed. Emphasis is on intersectoral cooperation, reorientation of the mental health system to community-based care, empowerment, especially of young people, through social emotional learning in school programs, peer support and involvement of young people in decision-making processes. Increasing the mental health literacy, destigmatization, empowering people with mental health disorders to participate in designing interventions, establishing multidisciplinary mobile teams to provide community services and the cooperation of all sectors in mental health care are emphasized. The national program for improvement mental health literacy of educational staff was launched. Telemedicine services have been developed, and the pilot project Providing psychosocial services by mobile multidisciplinary teams have been implemented. Lessons Comprehensive, multidisciplinary and multisectoral action is needed to effectively address the problems in the mental health care system. Key messages • Community based mental health care is client oriented care. • People with experience of mental disorder and their families must be involved in the decision-making process.

Mental Disorder, Meaning-making, and Religious Cognition

Meaning-making plays a central role in how we deal with experiences of suffering, including those due to mental disorder. And for many, religious beliefs, experiences, and practices (hereafter, religious engagement) play a central role in informing this meaning-making. However, a crucial facet of the relationship between experiences of mental disorder and religious engagement remains underexplored—namely the potentially positive effects of mental disorder on religious engagement (e.g. experiences of bipolar disorder increasing sense of God’s presence). In what follows, I will present empirical findings from two recent studies of mine which shed light on the extent to which participants experienced these positive effects, specific components of these effects, and how they fit into their understanding of their mental disorder and its relationship to their religious identity. In doing so, I will draw on and expand Tasia Scrutton’s Potentially Transformative view (2015a, 2015b, 2020) according to which mental disorders may provide opportunities for spiritual growth. My empirical results align with and help deepen an account according to which mental disorders are potentially spiritually transformative by providing further insight into such instances: specifically, which symptoms and internal and external factors are often involved, as well as which religious beliefs, experiences, and/or practices are often affected. After presenting these results and articulating their relevance for a potentially transformative view of mental disorder, I will then address some potential objections to the theoretical account as well as some limitations of the empirical work, before sketching possible promising directions for future research.

Sources of biographical failures of foster children and the primary task of their carers

The article considers the sources of biographical failures of foster children, which are widely described in the literature on the subject and commonly known to practitioners. Based on research reports and own experiences from practice within the foster care system, several theses have been formulated, the main of which concerns the role of the relationship between the foster carer and the foster child to prevent its unfavourable biographical trajectory. Since the most important factors protecting the foster children against the experience of mental disorders and against the course of biography marked by social exclusion are located in the quality of the me–you relationship with the carer, and care for the reflective approach to this relationship should be treated as the primary task of foster carers.

A town without pity? Three stories of public exposure, print media, and family histories of madness in Western Australia

It is sometimes easier to understand the chimeric experience of mental disorder by accessing individual episodes and incidents. This paper will review the lives of three strong-willed, charismatic individuals who all had influential and very public brushes with mental disorder in the small outpost city of Perth, Western Australia, between the late nineteenth and mid-twentieth centuries. This opens up questions of retrospective diagnosis, the challenges of being mad in a small town, how print media has preserved these precarious individual narratives, and how individual histories of mental disorders can help to cast light on other aspects of mainstream Australian histories.

The experiences and perceptions of mental health service provision at a primary health centre in the Eastern Cape.

BackgroundSince 1994, the South African healthcare system has undergone several changes to meet the needs of contemporary South Africa. Yet the state of mental healthcare, especially in low-resource areas, remains in a precarious state.AimThis study aimed to explore how persons diagnosed with a mental disorder experience and perceive mental health services in a low-resource community in the Eastern Cape, South Africa.SettingThe study was conducted at a primary care clinic in a low resource community setting in the Eastern Cape, South Africa.MethodSemi-structured interviews were conducted with eight participants diagnosed with mental illness who had been accessing treatment for at least the past 6 months from a primary health clinic. Thematic analysis was used to analyse and identify pertinent themes.ResultsThe following themes emerged from the data: (1) perceptions of mental disorders – role of culture, (2) experiences of having mental disorders – loss of employment, (3) problem of stigma – social rejection and labelling, (4) experience of distress – sadness and frustration and (5) challenges in accessing treatment – transport fee and shortage of staff.ConclusionThis study yielded several lived experiences and perceptions in relation to participants’ feelings, opinions and interpretations of persons living with mental disorders and accessing mental health treatment in their local context. Future interventions should consider provision of more extensive professional help in the form of counsellors and social workers at the clinics, more efficient service delivery and future interventions regarding stigma should incorporate community members into the learning process.

An exploration of psychopathology for clinical practice

SUMMARYPsychopathology is an integral part of the theory and practice of psychiatry. This commentary explores the importance of psychopathology, especially with regard to clinical practice. The concept of lifeworld is introduced as an important component of attributing meaning to a person's experience of mental disorder. It is also argued that the advance of neuroscience does not preclude the importance of psychopathology.

Creation of consensus recommendations for collaborative practice in the Malaysian psychiatric system: a modified Delphi study

BackgroundThere is strong evidence that collaborative practice in mental healthcare improves outcomes for patients. The concept of collaborative practice can include collaboration between healthcare workers of different professional backgrounds and collaboration with patients, families and communities. Most models of collaborative practice were developed in Western and high-income countries and are not easily translatable to settings which are culturally diverse and lower in resources. This project aimed to develop a set of recommendations to improve collaborative practice in Malaysia.MethodsIn the first phase, qualitative research was conducted to better understand collaboration in a psychiatric hospital (previously published). In the second phase a local hospital level committee from the same hospital was created to act on the qualitative research and create a set of recommendations to improve collaborative practice at the hospital for the hospital. Some of these recommendations were implemented, where feasible and the outcomes discussed. These recommendations were then sent to a nationwide Delphi panel. These committees consisted of healthcare staff of various professions, patients and carers.ResultsThe Delphi panel reached consensus after three rounds. The recommendations include ways to improve collaborative problem solving and decision making in the hospital, ways to improve the autonomy and relatedness of patients, carers and staff and ways to improve the levels of resources (e.g. skills training in staff, allowing people with lived experience of mental disorder to contribute).ConclusionsThis study showed that the Delphi method is a feasible method of developing recommendations and guidelines in Malaysia and allowed a wider range of stakeholders to contribute than traditional methods of developing guidelines and recommendations.Trial registration Registered in the National Medical Research Register, Malaysia, NMRR-13-308-14792

Protocol: A grounded theory of ‘recovery’—perspectives of adolescent users of mental health services

IntroductionPolicies internationally endorse the recovery paradigm as the appropriate foundation for youth mental health services. However, given that this paradigm is grounded in the views of adults with severe mental...

Un « alien » dans le cerveau. Expérience sociale de la maladie mentale et idiome naturaliste des neurosciences

Dans cet article, j’interroge les enjeux anthropologiques souleves par la diffusion du discours naturaliste des neurosciences dans les societes contemporaines et l’idee qu’il offrirait aux individus une nouvelle maniere de se penser et de se definir selon le cerveau et son fonctionnement. Pour cela, je decris les logiques selon lesquelles des personnes souffrant d’un trouble obsessionnel compulsif s’approprient des explications cognitives ou biologiques pour rendre compte de leur experience de la maladie. J’avance l’idee que ces explications sont un idiome que les personnes mobilisent pour les registres d’action qu’il leur offre afin de reprendre le controle de leur trajectoire, d’agir sur leur environnement et de negocier les contraintes de la maladie. Plus que la construction d’une forme de vie fondee sur le biologique, ce langage s’inscrit dans des dispositifs qui le diffusent en echo des ideaux politiques et ethiques de la democratie sanitaire et de l’empowerment. L’ensemble participe a construire la figure d’un individu souffrant d’un trouble psychiatrique qui pourrait agir sur son cerveau pour redevenir acteur de sa sante et rejoindre la communaute des citoyens.

Using social media for support and feedback by mental health service users: thematic analysis of a twitter conversation.

BackgroundInternet based social media websites represent a growing space for interpersonal interaction. Research has been conducted in relation to the potential role of social media in the support of individuals with physical health conditions. However, limited research exists exploring such utilisation by individuals with experience of mental health problems. It could be proposed that access to wider support networks and knowledge could be beneficial for all users, although this positive interpretation has been challenged. The present study focusses on a specific discussion as a case study to assess the role of the website www.twitter.com as a medium for interpersonal communication by individuals with experience of mental disorder and possible source of feedback to mental health service providers.MethodAn electronic search was performed to identify material contributing to an online conversation entitled #dearmentalhealthprofessionals. Output from the search strategy was combined in such a way that repeated material was eliminated and all individual material anonymised. The remaining textual material was reviewed and combined in a thematic analysis to identify common themes of discussion.Results515 unique communications were identified relating to the specified conversation. The majority of the material related to four overarching thematic headings: The impact of diagnosis on personal identity and as a facilitator for accessing care; Balance of power between professional and service user; Therapeutic relationship and developing professional communication; and Support provision through medication, crisis planning, service provision and the wider society. Remaining material was identified as being direct expression of thanks, self-referential in its content relating to the on-going conversation or providing a link to external resources and further discussion.ConclusionsThe present study demonstrates the utility of online social media as both a discursive space in which individuals with experience of mental disorder may share information and develop understanding, and a medium of feedback to mental health service providers. Further research is required to establish potential individual benefit from the utilisation of such networks, its suitability as a means of service provision feedback and the potential role for, and user acceptability of, mental health service providers operating within the space.

Recognition rights, mental health consumers and reconstructive cultural semantics

IntroductionThose in mental health-related consumer movements have made clear their demands for humane treatment and basic civil rights, an end to stigma and discrimination, and a chance to participate in their own recovery. But theorizing about the politics of recognition, 'recognition rights' and epistemic justice, suggests that they also have a stake in the broad cultural meanings associated with conceptions of mental health and illness.ResultsFirst person accounts of psychiatric diagnosis and mental health care (shown here to represent 'counter stories' to the powerful 'master narrative' of biomedical psychiatry), offer indications about how experiences of mental disorder might be reframed and redefined as part of efforts to acknowledge and honor recognition rights and epistemic justice. However, the task of cultural semantics is one for the entire culture, not merely consumers. These new meanings must be negotiated. When they are not the result of negotiation, group-wrought definitions risk imposing a revision no less constraining than the mis-recognizing one it aims to replace. Contested realities make this a challenging task when it comes to cultural meanings about mental disorder. Examples from mental illness memoirs about two contested realities related to psychosis are examined here: the meaninglessness of symptoms, and the role of insight into illness. They show the magnitude of the challenge involved - for consumers, practitioners, and the general public - in the reconstruction of these new meanings and realities.ConclusionTo honor recognition rights and epistemic justice acknowledgement must be made of the heterogeneity of the effects of, and of responses to, psychiatric diagnosis and care, and the extent of the challenge of the reconstructive cultural semantics involved.

P01-253 - Meanings of life experiences during manic episodes as reported by outpatients in remission in the Southeast Brazil: A clinical-qualitative study

BackgroundPsychosocial representations about the manic episode may constitute personal difficulty factors in dealing with the disorder, to relate socially and compromise satisfactory adherence to clinical treatments. It was elected to recall the experiences of manic episode due to its social and individual stigma.PurposeTo discuss the meanings of life experiences regarding manic episodes as reported by outpatients with bipolar affective disorder in remission.MethodResearch methodology from the Humanities employed to health settings, using clinical-qualitative method, with the technique of semi-directed interview with open-ended questions. The sample was closed by the criterion of theoretical saturation of information. Eight interviews were conducted in a university psychiatric clinic. Data were treated through the qualitative content analysis, with free-floating readings of the corpus - the set of the transcribed interviews - in order to categorization in core's discussion.ResultsPatients whom experienced manic episodes use unique adaptive mechanisms to deal with their psychosocial experiences and emotions. The highlights were the recognized strategies of bargaining, denial, rationalization and escaping when facing the experienced problems.ConclusionThe recognition of the management of patients’ experiences of mental disorder by the healthcare team can better harmonize the professional-patient relationship and develop strategies for greater adherence to the therapeutic and preventive measures for recurrence of the episodes.

Experience of mental disorder in the context of basic service reforms: The impact on caregiving environments in South Africa

The integration of mental health services into primary health care and the shift towards community- and family-based care for chronic mental disorders has been associated with increased burden on households. At the same time, research investigating the impact of policies of cost recovery for basic services such as water and electricity has also indicated an increased burden on households. This study aimed to investigate the impact of these basic service reforms on households caring for a family member with a chronic mental disorder in Cape Town, South Africa. The findings indicate that factors associated with service reforms may increase the stress and burden experienced by households and in turn impact on the primary environment in which care is received.

Quality of Life of Spouses of Mentally Ill People

Spouses of people with mental disorder experience various forms of objective and subjective burden. This should negatively affect their quality of life. However, until now no single study has addressed this question. To investigate the quality of life of spouses of people with schizophrenia, depression or anxiety disorders. Spouses of patients suffering from schizophrenia (n = 45), depression (n = 49) and anxiety disorders (n = 39) were consecutively recruited from outpatient services in the city of Leipzig. Quality of life was assessed by means of the WHOQOL-BREF, a self-administered questionnaire developed by the World Health Organisation. Compared with the general population, the quality of life of the spouses of mentally ill people was lower in the domains 'psychological well-being' and 'social relationships'. There was a significant association between the patient's functional level and the spouse's quality of life. Better treatment, professional support and participation in self-help and advocacy groups may help to improve the quality of life of spouses of mentally ill people.

Reading about

This article focuses on books offering information or self-help programmes and memoirs of women’s experiences of mental disorder and the help they have received. We are a psychiatrist with an interest in women’s mental health and a health professional who experienced severe mental illness

Interior Landscapes of Mental Disorder: Visual Representations of the Experience of Madness.

The authors surveyed 38 textbooks of abnormal psychology and found 673 pictures of the inner experience of mental disorder. Textbook authors use these pictures to demonstrate diagnostic features of individuals and groups, to make a connection between mental disorder and artistic talent, and to suggest what it is like to experience mental disorder. To fulfill these functions, many of the pictures in the sample use the incongruities and distortions of expressionist, surrealist, and naive techniques.