Researching the geography of mental wellbeing

Geopsychiatry and geography: A response

BACKGROUND

This contribution responds to three articles (we refer to all three as 'editorials') concerning something called 'geopsychiatry'.

AIMS

To evaluate claims made in these editorials for 'geopsychiatry' as a new field of inquiry at the interface between geography and psychiatry.

METHOD

Close critical reading of two editorials in the International Journal of Social Psychiatry - entitled 'Geographical determinants of mental health' and 'Political determinants of mental health' - and one in the International Review of Psychiatry - entitled 'What is geopsychiatry?'

RESULTS

While this geopsychiatry initiative is to be applauded, disquiet can be expressed about the almost complete neglect of a pre-existing domain of inquiry - 'mental health geography' or 'the geography of mental health' - that has long been researched by academic geographers and cognate scholars. Key trajectories in this field can be identified and related to the proposed foci for geopsychiatry.

CONCLUSIONS

The hope is voiced that future developments in geopsychiatry will proceed in dialogue with the literature and practitioners of mental health geography.

COVID-19 and Mental Health: An Examination of 911 Calls for Service

The purpose of this study was to explore the rate and geographic distribution of 911 calls for service related to mental health issues during the Coronavirus Disease 2019 (COVID-19) pandemic in the City of Detroit, MI, USA. The results suggest that the total number of calls for mental health issues was at the lowest level when compared with the same time period for the previous 3 years. Furthermore, as both the daily reported COVID-19 cases and related deaths increased over time, there was a significant decline in both suicide threats and suicides in progress. Significant hot spots were found for the total calls as well as for threats of suicide. These hot spots did not coincide with the spatial distribution of reported cases of COVID-19 by ZIP code. While higher and lower areas of reported cases were found, these differences by ZIP code were not found to be significant. When compared with the previous 3 years of data, the hot spot area was much smaller in 2020, implying that the mental health-related calls for service were more evenly spread throughout the city.

'This is the place where I can be alone, no tension:' Photovoice evidence for adolescent perceptions of their microsystem and psychological adjustment

Adolescents experience myriad emotions which occur in relation to their immediate social space which may shape their perceptions of members within the microsystem. The photovoice method uniquely provides participants with the means to capture their life through the lens of a camera while also enabling them to express emotions and meanings they attach to their particular life situations. We explore the various emotions adolescents attach to the spaces they occupy and how they link them to socialization in the context of the microsystem. This study was conducted in rural and urban areas of Udupi taluk, southern India. A total of 21 participants, ranging from early to late adolescence participated and provided multiple forms of data with 112 photographs, 21 journals on their daily interactions and one-on-one interviews facilitated using the SHOWeD model. The analytical method involved compiling visual data from photographs, journal content and interview data pertaining to each participant as a single data file, developing codes using ATLAS.ti, version 8, and further developing sub-themes and themes as they emerged into narratives. Our study was able to elicit emotions and meanings that adolescents attached to social interactions with gendered nuances specific to the Indian cultural setting. Future applications of the photovoice methodology on research among adolescents have also been discussed.

Exploring the geography of suicide threats and suicide attempts: An application of Risk Terrain Modeling

The purpose of this research is twofold: first, the spatial distribution of 911 emergency calls for service to the police for suicides in progress and threats of suicide in the City of Detroit, Michigan will be explored to determine whether these events exhibit different patterns of spatial clustering. Second, this research will explore the utility of Risk Terrain Modeling (RTM) to assist in our understanding of the locations of calls for service to the police related to suicide threats and suicides in progress. The results suggest that these events are different social phenomenon, both with respect to the spatial clustering of these events as well as qualitative differences in the environmental factors that may contribute to their occurrence.

Disparities in the geography of mental health: implications for social work

This article reviews recent theory and research on geographic disparities in mental health and their implications for social work. It focuses on work emerging from the fields of mental health geography, psychiatric epidemiology, and social work, arguing that a wide range of spatial disparities in mental health are important to understand but that of greatest relevance are inequities, or disparities, that violate fundamental norms of fairness and social justice. Research is reviewed on geographic variations in subjective well-being and mental health, on personality (using the five-factor model), and on psychopathology as well as several studies on the disparate implementation of mental health policy and services. Critical is the need to simultaneously assess, on the one hand, differential patterns of mental health conditions and, on the other, the services and policies designed to address them--the fact that considering only one dimension often leads to unintended consequences. Many of the most outstanding disparities have been found to exist at the local level, between towns and neighborhoods, and are based on socioeconomic conditions. This review concludes by discussing the implications of geographic disparities in mental health for allocation decisions and for social work practice, including decisions about the most efficacious mix of services at both the community and clinical practice levels.