Older adults' perceptions of mentally ill older adults

Mental health awareness of secondary schools students: Mediating roles of knowledge on mental health, knowledge on professional help, and attitude towards mental health

Purpose

The mental health situation among adolescents in Malaysia has reached a worrying state with the rising number of cases. Despite a significant increase in the literature on mental health, there is a lack of studies that focused on mental health awareness. Therefore, this study aimed to investigate the factors affecting Malaysian youth's mental health awareness as well as the mediating roles of knowledge on mental health, knowledge on professional help, and attitude towards mental health.

Methods

Self-administered questionnaires were distributed to 450 secondary school students aged 15-19 years old in Kuala Lumpur and Melaka who were recruited via purposive sampling. Data analysis was performed using SPSS and SmartPLS to obtain the descriptive analysis, measurement model, and structural model.

Results

The results indicated that mental health awareness was influenced by knowledge on mental health and attitude towards mental health. The findings also revealed that familiarity and media exposure were important determinants of knowledge on mental health, knowledge on professional help, and attitude towards mental health. Moreover, the results indicated that knowledge on mental health positively mediated the relationship between media exposure and mental health awareness. Besides, attitude towards mental health also found to play mediating roles between familiarity and mental health awareness, as well as between media exposure and mental health awareness.

Conclusion

This study contributed important knowledge to the limited literature in this contemporary domain. An effective public mental health campaign is needed to reduce the burden of disease and the cost of mental illness.

Is it normal to be depressed in old age? Needs assessors' conceptions of older people's mental illness

The article contributes to the research on older people's mental illness through its focus on how needs assessors conceive mental illness amongst older people and their strategies for dealing with mental illness within existing organisational frameworks. The contribution is based on an empirical study of the needs assessment in eldercare in Sweden. The article aims to explore needs assessors' conceptions of mental illness amongst older people in relation to intertwining processes of normalisation and organisational and legal constraints. The normalisation principle (NP) proposes that individuals with a disability should have access to the same living conditions as 'others'. The NP can be described as a strategy that highlights equal rights for individuals regardless of their life situation. The main findings are that mental illness is defined by needs assessors on a spectrum of diagnoses from schizophrenia and borderline personality disorder to anxiety and depression. The successful normalisation of mental illness is linked to structural context, attitudes to older people's mental illnesses and ageing, the practise established on a unit and whether needs assessors reproduce ageism or challenge it through the NP by attempting to secure the rights of older people.

Socially desirable responding in geriatric outpatients with and without mild cognitive impairment and its association with the assessment of self-reported mental health

Background

Socially desirable responding is a potentially relevant issue in older adults and can be evaluated with the Marlowe-Crowne Social Desirability Scale (MCSDS). However, the eight-item MCSDS has never been specifically administered to geriatric subjects, and there is a dearth of literature on the relationship between social desirability and cognitive impairment. Also, the connection between social desirability and subjective measures of psychological well-being is a matter of controversy. This study has three main aims. First, to determine the psychometric properties of the eight-item MCSDS in geriatric outpatients without dementia (i.e. with normal cognition (NC) or mild cognitive impairment (MCI)). Second, to investigate the link between social desirability and cognitive functioning. Third, to determine the association between social desirability and the assessment of self-reported mental health.

Methods

Community-dwelling outpatients (aged ≥ 65) were consecutively recruited and neuropsychologically tested to diagnose NC or MCI (n = 299). Social desirability was assessed with the eight-item MCSDS. Depressive and anxiety symptoms were measured with the short Geriatric Depression (GDS-s) and the State-Trait Personality Inventory Trait Anxiety (STPI-TA) scales.

Results

On principal components analysis, the eight-item MCSDS was found to have a multidimensional structure. Of the initial three-component solution, only two subscales had acceptable internal consistency (Cronbach’s alpha > 0.6): “Acceptance of responsibility” and “Integrity”. The third subscale (“Kindness towards others”) appeared to gauge two distinct constructs of formal (i.e. politeness) versus substantive (i.e. forgiveness) compassion. On binary logistic regression, only higher income was a significant predictor of formal compassion. Test-retest reliability was substantial to excellent (Gwet’s AC2 ≥ 0.8). There were no meaningful differences in social desirability between the NC and MCI groups. Likewise, negative Spearman’s correlations between social desirability and cognitive Z-scores across the whole sample were weak (r_s < |0.3|) and confined to one MCSDS item. Although social desirability was an independent predictor of the STPI-TA score in multiple linear regression, it explained only a marginal amount of incremental variance in anxiety symptoms (less than 2%).

Conclusions

Our results suggest that social desirability need not be a major concern when using questionnaires to assess mental health in geriatric outpatients without dementia.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02435-z.

Characteristics of help-seeking behavior among bipolar disorder patients: A study in Hunan, China

To analyze the factors that affecting the help-seeking behavior of bipolar disorder (BD) patients by conducting interviews BD individuals in Hunan province of China.In 2015, 72,999 people from 123 counties of Hunan province of China were interviewed through multistage stratified random sampling. Twelve items of general health questionnaire (GHQ-12) and abnormal behavioral clue questionnaire were used as screening tools. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) (SCID) was used as a diagnostic tool.Among the 75 BD patients, 36% (27/75) sought help. Compared with help-seekers, non-help-seekers were more likely to be older, divorced, or widowed, mostly illiterate or elementary education, family monthly income at least 3000 ¥, more physically consulted in the past year, able to effective work or study, at a stable illness status. 70.4% help-seekers firstly sought help from a medical institution. The main reasons that patients did not seek help were economic problem, did not know where to seek help, unsatisfied with medical services, afraid of mental health stigma, and other problems, such as traffic inconvenience.Non-help-seekers were faced with more difficulties in their social functions and social interactions.

Association of generalized anxiety symptoms and panic with health care costs in older age-Results from the ESTHER cohort study

BACKGROUND

Little is known specifically about the association between generalized anxiety symptoms or panic and health care costs in older age. The aim of this study was to examine the association between generalized anxiety symptoms, panic and health care costs in people aged 65 and over.

METHODS

Cross-sectional data from the 8-year follow-up of a large, prospective cohort study, the ESTHER study, was used. Individuals aged 65 and over, who participated in the study's home assessment, were included in this analysis (n = 2348). Total and sectoral costs were analyzed as a function of either anxiety symptoms, probable panic disorder, or a panic attack, while controlling for selected covariates, using Two Part and Generalized Linear Models. Covariates were chosen based on Andersen's Behavioral Model of Health Care Use.

RESULTS

There was no significant association between either of the anxiety or panic measures and total health care costs. Stratified by health care sectors, only the occurrence of a panic attack was significantly associated with incurring costs for outpatient non-physician services (OR: 1.99; 95% CI: 1.15-3.45) and inpatient services (OR: 2.14; 95% CI: 1.07-4.28). Other illness-related factors, such as comorbidities and depressive symptoms, were associated with health care costs in several models.

LIMITATIONS

This was a cross-sectional study relying on self-reported data.

CONCLUSION

This study points to an association between a panic attack and sector-specific health care costs in people aged 65 and over. Further research, especially using longitudinal data, is needed.

An examination of perceptions of individuals with an intellectual disability, with and without co-morbid schizophrenia: effects of labels on stigma

BACKGROUND

Research demonstrates negative perceptions of individuals with intellectual disabilities (ID) and individuals with schizophrenia, but no study has examined ID with a co-morbid psychiatric disorder. The present study examined the social distance desired from and perceptions of dangerousness of ID, schizophrenia and co-morbid schizophrenia and ID and examined the impact of providing a label for the behaviours presented in a vignette.

METHODS

A total of 160 participants, all university students, were randomly assigned to one of six vignettes detailing a person with schizophrenia, ID, or a person with both presenting problems. Half of the participants were randomly assigned to read vignettes that had a label provided for the behaviours of the target.

RESULTS

Participants desired more social distance from the unlabelled than labelled targets. Presence of schizophrenia resulted in increased social distance, but co-morbid ID and schizophrenia elicited less desire for social distance than schizophrenia alone. Schizophrenia resulted in more perceived danger, but labelled co-morbid schizophrenia and ID resulted in little perceived danger.

CONCLUSIONS

Labels resulted in positive outcomes, particularly, when ID was co-morbid with schizophrenia. Schizophrenia stigma appears to be impacted by an ID label, indicating educating the public about the spectrum of co-morbidity may be useful.

Age-related self-stigma of people over 65 years old: adaptation of the Internalized Stigma of Mental Illness scale (ISMI) for use in age-related self-stigma (IS65+) in a Spanish sample

OBJECTIVES

To adapt the Internalized Stigma of Mental Illness scale (ISMI) to examine self-stigma associated with aging and to study the psychometric properties of this adapted version (IS65+). Finally, self-stigma associated with age in older people is studied.

METHOD

The IS65+ was administered to a random sample of 419 people over 65 years from Madrid (Spain) to study the psychometric properties of this adapted version. A regression model was estimated to identify the variables that best predict self-stigma associated with old age.

RESULTS

The IS65+ showed good internal consistency (α = .89) and a factorial structure of five factors. The data showed lower levels of self-stigma related to age in the sample than the levels of mental illness self-stigma in people with mental illness. The variables associated with age-related self-stigma are: high levels of perceived loneliness, low levels of coping strategies, gender (female), mental disorder, major depressive disorder, low levels of optimism and quality of life, and high levels of functional impairment.

CONCLUSION

A new version of ISMI (IS65+) with acceptable psychometric criteria has been developed for use in people over 65 years old.

Psychological interventions to improve psychological well-being in people with dementia or mild cognitive impairment: systematic review and meta-analysis protocol

INTRODUCTION

Dementia and mild cognitive impairment are associated with an increased risk of depression, anxiety, psychological distress and poor mental health-related quality of life. However, there is a lack of research examining the evidence base for psychological interventions targeting general psychological well-being within this population. Furthermore, there is little research relating to the design of randomised controlled trials examining psychological interventions for dementia and mild cognitive impairment, such as effective recruitment techniques, trial eligibility and appropriate comparators.

METHODS AND ANALYSIS

Systematic review of electronic databases (CINAHL; EMBASE; PsychInfo; MEDLINE; ASSIA and CENTRAL), supplemented by expert contact, reference and citation checking, and grey literature searches. Published and unpublished studies will be eligible for inclusion with no limitations placed on year of publication. Primary outcomes of interest will be standardised measurements of depression, anxiety, psychological distress or mental health-related quality of life. Eligibility and randomisation proportions will be calculated as secondary outcomes. If data permits, meta-analytical techniques will examine: (1) overall effectiveness of psychological interventions for people with dementia or mild cognitive impairment in relation to outcomes of depression, anxiety, psychological distress or mental health-related quality of life; (2) clinical and methodological moderators associated with effectiveness; (3) proportions eligible, recruited and randomised.

ETHICS AND DISSEMINATION

Ethical approval is not required for the present systematic review. Results will inform the design of a feasibility study examining a new psychological intervention for people with dementia and depression, with dissemination through publication in peer-reviewed journals and presentations at relevant conferences.

TRIAL REGISTRATION NUMBER

CRD42015025177.

'Individualism-collectivism' as an explanatory device for mental illness stigma

The aim of this study is investigate whether the cross-cultural value paradigm 'individualism-collectivism' is a useful explanatory model for mental illness stigma on a cultural level. Using snowball sampling, a quantitative questionnaire survey of 305 individuals from four UK-based cultural groups (white-English, American, Greek/Greek Cypriot, and Chinese) was carried out. The questionnaire included the 'Community Attitudes to Mental Illness scale' and the 'vertical-horizontal individualism-collectivism scale'. The results revealed that the more stigmatizing a culture's mental illness attitudes are, the more likely collectivism effectively explains these attitudes. In contrast, the more positive a culture's mental illness attitudes, the more likely individualism effectively explains attitudes. We conclude that a consideration of the individualism-collectivism paradigm should be included in any future research aiming to provide a holistic understanding of the causes of mental illness stigma, particularly when the cultures stigmatization levels are particularly high or low.

Belief in the dangerousness of people with mental disorders: a review

BACKGROUND

The scientific literature on stigma has been confused because there are multiple components of stigma with different correlates. In order to help make sense of this confusion, the present review focuses on research on one of the most commonly measured components - belief in dangerousness.

METHOD AND RESULTS

The review examines: measurement of belief in dangerousness; prevalence of belief in dangerousness; characteristics of people who believe in dangerousness; experiences associated with belief in dangerousness; characteristics of people that elicit belief in dangerousness; the effects of psychiatric labelling; the effects of causal explanations; interventions to reduce belief in dangerousness; and effects on help-seeking.

CONCLUSION

It is concluded that future research needs to focus on rigorous evaluation of interventions to reduce belief in dangerousness and the impact of this belief on people affected by mental disorders.

Access to mental health care among older adults

Many older adults experience common mental health problems that can have a negative impact on physiological health, functional status, and quality of life. Lack of access to mental health care for community-dwelling older adults is a significant problem. Busy primary care practices, few mental health professionals, inadequate problem recognition, and flaws in the health care system all contribute to restricted access to mental health care. As the population of adults 65 and older continues to grow, the need for mental health care for this group will increase. Strategies to improve access to mental health care must be targeted at the individual level, the provider level, and the system level.