Mental Barriers Research Articles

Sodalism as Open Worldview: Conspiring to Dismantle the White Franchise

Sodalism as Open Worldview: Conspiring to Dismantle the White Franchise

Rural Community Pharmacists' Perceptions of Implementing Mental Health Interventions to Reach Underserved Populations.

Mental illness and suicide are significant public health problems. Limited resources put individuals at greater risk, particularly in rural areas with fewer health providers. Community pharmacists are the most accessible health professionals in rural communities and are interested in addressing mental health concerns. Research is limited on how to implement mental health interventions in community pharmacy settings. The objectives of this study were to assess community pharmacists' perceptions of mental health interventions and barriers and facilitators to implementation and prioritize interventions to be pilot tested. Qualitative interviews were conducted with community pharmacists (N=17). Interviews focused on perceptions of mental health interventions in pharmacy settings. Data were analyzed using template analysis. A stakeholder meeting reviewed data and prioritized interventions to be pilot tested. Pharmacists viewed implementing mental health interventions positively. Barriers included lack of mental health knowledge, time, diagnosis, and concerns about workflow. Facilitators included accessible settings, knowing the community, and seeing patients frequently. The most common needs for implementation were education and payment. Pharmacists preferred progress monitoring in collaboration with a prescriber and mental health first aid training. Further research is needed to gather feedback from prescribers to inform implementation.

243 Why are Somali refugees not utilizing mental healthcare? Identifying barriers impacting mental healthcare utilization among Somali Refugees

OBJECTIVES/GOALS: We seek to describe the challenges to mental healthcare access and utilization among Somali refugees in Minnesota. The objectives of this study are 1) to characterize beliefs and attitudes about mental illness and 2) identify barriers, either personally experienced or perceived, to utilizing mental health services among Somali refugees. METHODS/STUDY POPULATION: Mental health challenges are of particular concern among Somali refugees, who have been found to have rates of PTSD as high as 50%. However, Somali refugees are reported to underutilize mental healthcare. We will recruit 20-25 Somali refugee women and men, who are 18 years or older and reside in the Twin Cities, to participate in one on one interviews. Participants will be asked about their perception of barriers to mental healthcare services, and their beliefs about mental illness and treatment. We will transcribe the interviews, code them, and identify key themes. A community advisory board will be directly involved in the research design, recruitment, interview instrument development, interpretation of findings, and dissemination of project materials as part of our community engagement protocol. RESULTS/ANTICIPATED RESULTS: When completed we expect to identify mental health beliefs and barriers to mental healthcare utilization. The long-term goal of this work is to reduce the substantial mental health morbidity among Somali refugees. Common barriers to research participation that we expect are mistrust, financial constraints, fear of unintended outcomes, stigma about participating in research, and fear of deportation or concern of immigration status. We plan to address these barriers by hiring bilingual Somali recruiter/interviewer, translating study materials, reassuring confidentiality of participant’s information, providing a $50 incentive, and implementing community advisory board’s input on study design and recruitment sites. DISCUSSION/SIGNIFICANCE: Translational Impact: Findings from interviews will be disseminated and evaluated by members of the community and providers. Recommendations based on our findings can be applied in mental healthcare practice to reduce identified barriers. Community dissemination can also promote the destigmatization of mental healthcare in the Somali community.

Correlates of sedentary behavior in people with fibromyalgia: A systematic review.

Understanding the correlates of sedentary behavior (SB) is important in the development of interventions which reduce and interrupt SB in people with fibromyalgia (PwF). This systematic review aimed to investigate the correlates of SB in PwF using the socio-ecological model. Three databases (Embase, CINAHL and PubMed) were search from inception until July 21, 2022 using "sedentary" or different types of SB and "fibromyalgia" or "fibrositis" as keywords. The data collected was then analyzed using summary coding. Out of 23 SB correlates retrieved from 7 reports (n= 1698), no correlates were consistently reported (ie, reported in 4 or more studies). Higher pain intensity was the most commonly reported barrier for reducing/interrupting SB (reported in 3 reports). Other reported barriers to reducing/interrupting SB were experiencing physical and mental fatigue, a more severe disease impact, and a lack of motivation to be physically active (all reported in 1 study). A better experienced social and physical functioning and more vitality were facilitators for reducing/interrupting SB (all reported in 1 study). To date, in PwF no correlates of SB at the interpersonal, environmental and policy levels have been explored. Research on correlates of SB in PwF is still in its infancy. The current preliminary evidence suggests that clinicians should consider physical and mental barriers when aiming to reduce or interrupt SB in PwF. Further research on modifiable correlates at all levels of the socio-ecological model is required to inform future trials aiming to modify SB in this vulnerable population.

Asian Healthcare Workers and Their Experiences of Racism in North America: A Scoping Review.

The rising rates of anti-Asian sentiments has recently been called into question by several community activists and scholars. While this collective work has heightened awareness to address anti-Asian racism, the experiences of Asian healthcare workers in particular remains limited. To map the existing literature on anti-Asian racism experienced by Asian healthcare workers in North American healthcare settings, identify gaps in the current literature base, and inform future areas of anti-Asian racism research. A scoping review following Arksey and O'Malley's (2005) methodology with updated guidance by Levac et al. (2010) and Peters et al. (2020) was undertaken. A total of 3565 articles from database searches were identified from eight databases, with 64 full text articles screened and 15 articles included in this review. Anti-Asian racism amongst healthcare workers has been conceptualized, studied, and understood in three broad categories: levels of racism, descriptions of anti-Asian racism, and the impact of racism. In 60% of the included articles, interpersonal level of racism was solely studied, while 40% articles simultaneously studied interpersonal and institutional levels of racism. Anti-Asian racism was described through three key perspectives: otherness, inferior professional status, and general racial discrimination. Lastly, the impact of Asian healthcare workers' experiences of anti-Asian racism was studied by exploring the impact on mental health and barriers to career advancement. Despite the presence of anti-Asian racism, the limited literature examining the complexities of the experiences of anti-Asian racism for Asian healthcare workers is concerning. Future scholarship requires further investigation that comprehensively explores the multiple pathways of anti-Asian racism, the contestation of monolithic stereotypes, and how Asian healthcare workers negotiate both hypervisibility and invisibility within healthcare spaces.

Changes in physical activity, diet, sleep, and mental well-being when starting university: A qualitative exploration of Australian student experiences

Objective: To explore young adult’s experiences of how starting university influenced their physical activity, diet, sleep, and mental well-being, and barriers and enablers to health behavior change. Participants: University students aged 18–25 years. Methods: Three focus groups were conducted in November 2019. Inductive thematic approach was utilized to identify themes. Results: Students (female: n = 13, male: n = 2, other gender identity: n = 1, 21.2 (1.6) years) reported mental well-being, physical activity levels, diet quality and sleep health were negatively affected. Stress, study demands, university timetabling, not prioritizing physical activity, cost and availability of healthy foods, and difficulty falling asleep were key barriers. Health behavior change interventions aiming to support mental well-being need to include both information and support features. Conclusions: There is a significant opportunity to improve the transition to university for young adults. Findings highlight areas to target in future interventions to improve physical activity, diet, and sleep of university students.

Functional, communicative, and hybrid barriers to accessing mental health care in LGBTQ+ communities

ABSTRACT Understanding how LGBTQ+ populations experience common mental health care barriers reveals uncommon ways these barriers interact, layer, and compound to increase health disparities. This mixed methods study organised 250 open ended responses into 30 codes situated along a functional to communicative spectrum. The codes revealed sub-categories and relationships between barrier groupings which highlight ways mental health care obstacles for sexual and gender minorities span categories and are operationalised in unique ways that compound constraints. Organizing LGBTQ+ mental health care access obstacles along a continuum that spans functional barriers (i.e. time, money, transportation) to communicative ones (i.e. stigma, trust) revealed a hybrid category (i.e. providers, bureaucracy) where functional and communicative barriers overlap, mesh and operate simultaneously. Lack of access to trained mental health care providers who offer affirming, appropriate care sits at the centre of this web of constraints and as such is influential in a wide array of mental health care issues. Prioritising mental health care workforce training in LGBTQ+ specific competencies has the potential to create a ‘ripple effect’ that mitigates interconnected mental health care barriers throughout this spectrum.

Mental health, functional impairment, and barriers to mental health access among cancer patients in Vietnam.

This study evaluated the prevalence and severity of depression and anxiety symptomatology, barriers to mental health access, and correlates of functional impairment among cancer inpatients. This cross-sectional study recruited adult cancer patients (N=300) in June and July 2022 at the largest oncological hospital in Vietnam. Multivariable linear regression analyses examined the association between demographics, clinical characteristics, and patients' functional impairment. Approximately 46.3% and 27.0% showed some depression and anxiety symptomatology, while 8.0% and 3.0% experienced major depressive and anxiety symptoms, respectively. Patients reported the most impairment in mobility and capacity for life activities. More functional impairment was identified in patients with gastrointestinal cancers, those receiving radiation therapy alone, and those scoring higher on depression and anxiety than in those with cancers originating in the head, neck, or lung or those receiving chemotherapy alone. Reports of better overall health status were negatively associated with functional impairment. Patients reported extensive perceived barriers to seeking psychiatric care, including not knowing where to get mental health support (86.7%), wanting to manage mental health independently (73.7%), and thinking mental health will resolve on its own (73.7%), and denying mental health concerns (61.0%). High frequency and severity of depression and anxiety symptomatology underscore the importance of integrating mental health services into existing oncological treatment protocols. Increasing mental health literacy and provision of psychoeducation is critical to addressing barriers to mental health service access. Integration of functional impairment evaluations into hospital admission and discharge planning is also needed.

Development and Psychometric Validation of the Mental Health-Related Barriers and Benefits to EXercise (MEX) Scale in Healthy Adults

BackgroundPhysical exercise has been shown to reduce anxiety and depression symptoms, the most common mental health disorders globally. Despite the benefits of exercise in anxiety and depression, the symptoms of these disorders may directly contribute to a lack of engagement with exercise. However, mental health-related barriers and benefits to exercise engagement have not been addressed in quantitative research. We introduce the development and psychometric validation of the Mental health-related barriers and benefits to EXercise (MEX) scale.MethodsThree samples were collected online prospectively (sample 1 n = 492; sample 2 n = 302; sample 3 n = 303) for scale refinement and validation with exploratory and confirmatory factor analysis. All participants were generally healthy adults, aged 18–45, and had no history of severe mental illness requiring hospitalization and no physical disability impacting over 50% of daily function.ResultsWe identified a 30-item, two-factor model comprising 15 barrier and 15 benefit items. Overall model fit was excellent for an item-level scale across the three samples (Comparative Fit Index = 0.935–0.951; Root-Mean-Square Error of Approximation = 0.037–0.039). Internal consistency was also excellent across the three samples (α = 0.900–0.951). The barriers subscale was positively correlated with symptoms of anxiety, depression and stress, and negatively correlated with measures of physical activity and exercise engagement. The benefits subscale was negatively correlated with symptoms of anxiety, depression and stress, and positively correlated with measures of physical activity and exercise engagement.ConclusionThe MEX is a novel, psychometrically robust scale, which is appropriate for research and for clinical use to ascertain individual and/or group level mental health-related barriers and benefits to exercise.

Use of participatory action research to support Syrian refugee mothers in the resettlement period in Canada: A longitudinal study.

Research has shown that refugees in a foreign country often experience physical and mental health challenges upon resettlement (Ahmad et al., 2021; Salam et al., 2022). In Canada, refugee women experience a range of physical and mental barriers, including poor access to interpreter services and transportation, and a lack of accessible childcare, all of which can negatively affect their successful integration (Stirling Cameron et al., 2022). Social factors that support Syrian refugees to settle successfully in Canada have been unexplored systematically. This study examines these factors from the perspectives of Syrian refugee mothers living in the province of British Columbia (BC). Framed by principles of intersectionality and community-based participatory action research (PAR), the study draws on Syrian mothers' perspectives of social support in early, middle, and later phases of resettlement. A qualitative longitudinal design consisting of a sociodemographic survey, personal diaries, and in-depth interviews was used to gather information. Descriptive data were coded, and theme categories were assigned. Six themes emerged from data analysis: (1) Steps in the Migration Journey; (2) Pathways to Integrated Care; (3) Social Determinants of Refugee Health; (4) COVID-19 Pandemic Impacts and Ongoing Resettlement; (5) Strength-Based Capabilities of Syrian mothers; (6) Peer Research Assistant's Research (PRAs) Experience. Results from themes 5 and 6 are published separately. Data obtained in this study contribute to the development of support services that are culturally appropriate and accessible to refugee women living in BC. Our objectives are to promote the mental health and improve the quality of life of this female population, and to enable it to access healthcare services and resources in a timely manner.

Personalized Help-Seeking Web Application for Chinese-Speaking International University Students: Development and Usability Study.

The mental health of international students is a growing concern for education providers, students, and their families. Chinese international students have low rates of help seeking owing to language, stigma, and mental health literacy barriers. Web-based help-seeking interventions may improve the rate of help seeking among Chinese international students. This study aimed to describe the development of a mental well-being web app providing personalized feedback and tailored psychoeducation and resources to support help seeking among international university students whose first language is Chinese and test the web application's uptake and engagement. The bilingual MindYourHead web application contains 6 in-app assessments for various areas of mental health, and users are provided with personalized feedback on symptom severity, psychoeducation tailored to the person's symptoms and information about relevant interventions, and tailored links to external resources and mental health services. A feasibility study was conducted within a school at the University of Sydney to examine the uptake and engagement of the web application among Chinese international students and any demographic characteristics or help-seeking attitudes or intentions that were associated with its engagement. A total of 130 Chinese international students signed up on the web application. There was an uptake of 13.4% (122/908) in the schools' Chinese student enrollment. Most participants (76/130, 58.5%) preferred to use the web application in Chinese and used informal but not formal help for their mental health. There was considerable attrition owing to a design issue, and only 46 students gained access to the full content of the web application. Of these, 67% (31/46) of participants completed 1 or more of the in-app mental well-being assessments. The most commonly engaged in-app assessments were distress (23/31, 74%), stress (17/31, 55%), and sleep (15/31, 48%), with the majority scoring within the moderate- or high-risk level of the score range. In total, 10% (9/81) of the completed in-app assessments led to clicks to external resources or services. No demographic or help-seeking intentions or attitudes were associated with web-application engagement. There were promising levels of demand, uptake, and engagement with the MindYourHead web application. The web application appears to attract students who wished to access mental health information in their native language, those who had poor mental health in the past but relied on informal support, and those who were at moderate or high risk of poor mental well-being. Further research is required to explore ways to improve uptake and engagement and to test the efficacy of the web application on Chinese international students' mental health literacy, stigma, and help seeking.

Women's attitudes towards pessary self-care: a qualitative study.

Patients with vaginal pessaries can learn to care for their pessary by themselves or they can have provider-led care, which requires more frequent follow-up visits. We aimed to understand motivations for and barriers to learning self-care of a pessary to inform strategies to promote pessary self-care. In this qualitative study, we recruited patients recently fitted with a pessary for stress incontinence or pelvic organ prolapse, and providers who perform pessary fittings. Semi-structured, one-on-one interviews were completed to data saturation. A constructivist approach to thematic analysis using the constant comparison method was used to analyze interviews. A coding frame was created following independent review of a subset of interviews by three members of the research team and this frame was used to code interviews and develop themes through interpretive engagement with the data. Ten pessary users and four health care providers (physicians and nurses) participated. Three major themes were identified: motivators, benefits, and barriers. There were several motivators for learning self-care, including care provider advice, personal hygiene, and ease of care. Benefits of learning self-care included autonomy, convenience, facilitation of sexual relations, avoidance of complications, and decreased burden on the health care system. Barriers to self-care included physical, structural, mental, and emotional barriers; lack of knowledge; lack of time; and social taboo. Promotion of pessary self-care should focus on patient education about benefits and ways of mitigating common barriers while focusing on normalizing patient engagement in pessary self-care.

Perceptions from the British Pakistani Muslim community towards mental health

ABSTRACT Mental health issues are worldwide, impacting people from all backgrounds, ethnicities, and religious denominations. The current study aims to explore the perceptions of the British Pakistani Muslim community towards mental health and barriers towards seeking treatment. Semi-structured interviews with seven Muslim participants of Pakistani origin (four female) explore how they perceive and understand mental health in the Muslim community. Reflexive thematic analysis identified four themes: (a) culture vs religion, (b) religion as a protective factor, (c) fear of public opinion, and (d) integration of religious and professional services. Participants discussed a negative cultural perception and positive religious perception towards mental health. Services that integrate both a religious and western psychological model to effectively treat mental health issues are suggested. The results indicate towards a tailored framework to tackle mental health and can be used in addressing issues and concerns of the Muslim community concerning mental health.

Bridging the ‘instruction gap’: how ICT instructors help older adults with the acquisition of digital skills

ABSTRACT Existing research on digital inclusion has shown that older adults (65+) are, in general, less digitally skilled than other age groups. While older adults can gain digital skills through ‘cold’ (formal) training by ICT instructors or through ‘warm’ (informal) support from family and friends, studies have suggested that formal training is more effective. Drawing on qualitative interview data of 26 ICT instructors, we 1) examine how their support contributes to the acquisition of digital skills in later life, and 2) explore the ICT instructors’ role in the digital inclusion of older adults. The instructors in our study identify specific strategies to address the mental and ageing-related barriers faced by older adults in acquiring digital skills. The ‘warm’ support provided by family and friends is a double-edged reason behind the need for ‘cold’ training. On the one hand, they gift devices, encourage uptake, and shape learning desires. On the other hand, participants turn to ICT training due to the limitations of informal support in terms of time, patience, and expertise. Drawing on the instructors’ descriptions and existing literature, we argue that ICT instructors play a necessary role in the digital inclusion of older adults as they close the ‘instruction gap’ left by warm experts.

The Relationship Sexual Satisfaction and the Marital burnout in Married Women of Yasouj City

Background & Aims Sexual dissatisfaction in women has several consequences. Due to the cultural factors and the traditional context of Iranian cities, there are limitations for women to talk about sexual issues and do not express their sexual satisfaction during the necessary care in reproductive age. This study aims to determine the relationship between sexual satisfaction and marital burnout of women living in Yasuj, Iran. Materials & Methods This cross-sectional study was conducted on 300 married women referred to four comprehensive health centers in Yasuj. Data was collected using a demographic form, the Married Women’s Sexual Satisfaction Questionnaire (MWSSQ), and the Couple Burnout Measure (CBM). The data was analyzed using the Pearson correlation test in SPSS software, version 22. Results The component of mental and physical barriers to sexual satisfaction had a significant positive correlation with the total score of CBM (r=0.488, P<0.001). Other three components of MWSSQ, including antecedents (r=-0.624, P<0.001), husband-related factors (r=-0.662, P<0.001), and dominant cultural values (r=-0.447, P<0.001) had a significant negative correlation with the total score of CBM. Conclusion Higher mental and physical barriers to sexual satisfaction can cause higher marital burnout in women, while lower antecedents, husband-related factors, and cultural values related to sexual performance can reduce marital burnout. Healthcare workers working in health centers should check women's sexual satisfaction status and, if necessary, remove their mental and physical barriers to sexual satisfaction and improve their physical, mental, and emotional conditions and relationships with husbands by providing training and counseling to them.

"It's Been a Game Changer": Examining Treadmill Desk Use When Working from Home.

The online version contains supplementary material available at 10.1007/s41542-023-00144-0.

Healthcare worker's understanding of perinatal depression and maternal mental health service needs in rural Kenya

BackgroundPerinatal depression is a significant maternal mental health issue in sub-Saharan Africa. Because of the severe shortage of mental health specialists in this region, healthcare workers can be trained to deliver mental health services. Yet, little research has examined their views about maternal mental health. AimsTo help inform the development of a perinatal depression screening program, the aim of this pilot study was to explore the knowledge and understanding of perinatal depression among healthcare workers in rural Kenya. MethodsFourteen healthcare workers participated in focus group interviews. ResultsContent analysis of interview data yielded three primary themes: 1) healthcare workers’ knowledge and understanding of perinatal depression, 2) symptoms of perinatal depression, and 3) identification of perinatal mental health help-seeking resources and barriers in a rural community. Additionally, healthcare workers used a hierarchical approach to manage perinatal depressive symptoms, first by using available resources at the clinic, followed by psychiatric referral as indicated. ConclusionsHealthcare professionals may use study findings to enhance awareness of barriers and stigma associated with perinatal depression and to create a culturally sensitive mental health program for women in this rural community.

Kurdish Refugee Beliefs about Mental Health and Help-Seeking: A Community-Engaged Research Study in Tennessee.

Refugee populations exhibit high rates of PTSD, anxiety, depression, and psychological distress, but are less likely to receive care than the general population. Perceptions among the Kurdish refugee community about causes and consequences of mental illness symptoms and perceived barriers to help-seeking are understudied. This community-engaged research study conducted in-depth interviews with Kurdish refugees from Iraq to explore their beliefs about drivers of mental illness and seeking help for mental health. Iterative thematic analysis of transcripts from ten participants indicated four key themes: (1) social network loss due to resettlement causes poor mental health; (2) socioeconomic status loss due to unrecognized professional qualifications puts strain on mental health; (3) social stigma about mental health and fears about disclosure of mental health issues within community and subsequent negative gossip prevent help-seeking; and (4) social interaction may alleviate mental illness symptoms. Overall, Kurdish refugees perceived social factors as major drivers of mental illness symptoms and barriers to help-seeking in their community. However, while participants believed that the general community attitude was against help-seeking, most participants personally expressed support of anyone in their community needing to see a mental health professional. Future research should assess the extent to which perceived community norms differ from aggregated personal help-seeking attitudes and behaviors among Kurdish refugees from Iraq in the United States.

Utilization of and barriers to a telemedicine system at a rural general hospital in Japan: a mixed methods study.

The initial and operational costs of telemedicine are major barriers to its adoption. We aimed to investigate and identify the barriers to adopting a telemedicine system in a Japanese rural general hospital without incurring setup and operational costs. Our study was conducted between May and August 2018, and included six general practitioners working at a rural general hospital. We extracted data collected from messages (date and time, sender and recipient, and counts and contents of messages) and conducted semi-structured interviews, which were then analyzed using quantitative and qualitative methods. We quantitatively analyzed the total counted of the 179 messages. The total counts recorded for each physician were 56 (A), 20 (B), 3 (C), 74 (D), 5 (E), and 21 (F). The mean monthly counts were 2.17 (May), 8.50 (June), 11.50 (July), and 7.67 (August). Interview data from the six physicians yielded 13 codes that included various points of dissatisfaction acting as barriers to using our system, which we grouped into mental and physical barriers. Mental barriers included suspicion of carrying, feelings of isolation, and loss, whereas physical barriers included portability, user authentication, internet speed, group chat system, notice, search image, typing, chat system, print facility, and limited function. The representative barriers to introducing a telemedicine system at a rural general hospital in Japan without initial and running costs could be classified as feelings of isolation and suspicion of carrying (mental barriers); and notice, portability, and user authentication (physical barriers). Continued investigation in this area is warranted, and solutions to these barriers could improve the shortage of medical staff in the context of declining birth rates and aging populations in Japan.

Mental health resources, barriers, and intervention needs among women in rural Maharashtra, India: A qualitative study.

This research paper focuses on the mental health needs, the need for mental health interventions and barriers in mental healthcare of women living in rural Maharashtra, India. Using a mixed-methods approach, the study has collected data from a sample of women living in the rural areas of Maharashtra through in-depth interviews. The data collected has been analyzed to identify the barriers and obstacles in mental healthcare, how the existing community support serves as a resource as well as the desire for potential mental healthcare interventions among participants. The findings of the study are expected to contribute to the development of effective mental health interventions tailored to the specific needs of women living in the rural areas of Maharashtra. Overall, this research paper aims to improve the understanding of the mental health needs of women in rural Maharashtra and provide insights for policymakers and mental health practitioners to develop effective interventions to promote their mental well-being.