Involvement in mental health self-help groups and recovery

Empathy and redemption: Exploring the narrative transformation of online support for mental health across communities before and after Covid-19

This study examines the impact of the COVID-19 pandemic on individuals' mental health and their online interactions, particularly within Reddit's mental health communities. By analyzing data from 15 subreddits categorized into mental health and control groups from 2018 to 2022, we observed that forums dedicated to mental health exhibited higher levels of user engagement and received more supportive responses than those in other categories. However, as the pandemic evolved, a significant decrease in online support was noted, especially within these mental health groups. This decline hints at a risk of emotional burnout among users, which poses a particularly acute challenge for individuals grappling with mental health issues. Intimate relationships have also an impact on online expression of mental health. The research underscores the pandemic's effect on online support and interaction dynamics, signaling the necessity for a deeper understanding and the development of strategies to maintain support within online communities during times of crisis.

Personal recovery and socio-structural disadvantage: A critical conceptual review

Despite its seeming breadth and diversity, the bulk of the personal (mental health) recovery literature has remained strangely 'silent' about the impact of various socio-structural inequalities on the recovery process. Such an inadequacy of the empirical literature is not without consequences since the systematic omission or downplaying, at best, of the socio-structural conditions of living for persons with lived experience of mental health difficulties may inadvertently reinforce a reductionist view of recovery as an atomised, individualised phenomenon. Motivated by those limitations in extant scholarship, a critical literature review was conducted to identify and critique relevant research to problematise the notion of personal recovery in the context of socio-structural disadvantage such as poverty, homelessness, discrimination and inequalities. The review illuminates the scarcity of empirical research and the paucity of sociologically-informed theorisation regarding how recovery is shaped by the socio-structural conditions of living. Those inadequacies are especially pertinent to homelessness research, whereby empirical investigations of personal recovery have remained few and undertheorised. The gaps in the research and theorising about the relational, contextual and socio-structural embeddedness of recovery are distilled. The critical review concludes that personal recovery has remained underresearched, underproblematised and undertheorised, especially in the context of homelessness and other forms of socio-structural disadvantage. Understanding how exclusionary social arrangements affect individuals' recovery, and the coping strategies that they deploy to negotiate those, is likely to inform anti-oppressive interventions that could eventually remove the structural constraints to human emancipation and flourishing.

Use of unstructured intervention in a community-based mental health setting for the recovery of people with depression in Hong Kong: A qualitative assessment

This qualitative evaluation study examined the impact of unstructured intervention on people with depression in a community mental health centre in Hong Kong. In the intervention, service users initiated groups and designed group activities by themselves, with social workers as facilitators. Semi-structured interviews were conducted with service users enrolled in unstructured intervention, their family members, and service providers in 2019. Overall, 32 participants were recruited through purposive sampling. The results revealed that peer interactions helped participants to feel accepted and understood. Participants also acquired experience with emotional coping strategies and practised their interpersonal skills, and by learning new skills from peers, they were able to rebuild their self-esteem and improve their relationships with friends and family. To cater to clients' different needs and concerns, unstructured activities should be diversified. Family and social functioning should also be emphasised in the development of unstructured intervention because the generic skills and knowledge acquired from unstructured activities with peers could help to enhance family relationships, self-confidence, and the ability to manage issues related to working and socialising.

A cluster randomized trial for improving mental health and well-being of persons affected by leprosy or buruli ulcer in Nigeria: A study protocol

This protocol describes a study in which we would assess the effect of using community lay counselors, self-help groups (SHGs), and trained frontline health workers to reduce mental disorders and improve quality of life (QOL) of persons affected by leprosy or Buruli ulcer (BU). A cluster randomized controlled study design will be employed. The study will involve persons affected by leprosy or BU. Ten local government areas (clusters) with the highest number of notified leprosy or BU cases between 2014 and 2018 in Southern Nigeria will be purposively selected. The clusters will be randomized into intervention and control groups using a computer-generated list of random numbers. At baseline, data were collected using the following validated questionnaires, Patient Health Questionnaire, Generalized Anxiety Disorder questionnaire, Stigma Assessment and Reduction of Impact Scale, World Health Organization QOL BREF and Warwick-Edinburgh Mental Well-being scale among persons affected by leprosy or BU. The intervention will last for 2 years and will involve use of community lay counselors, SHGs, and appropriately trained frontline health workers in reducing mental disorders and improving QOL of persons affected by leprosy or BU. This project postulates that the reduction of burden of mental health problems and improved QOL among persons affected by leprosy or BU could be achieved through a holistic approach involving SHGs, appropriately trained community opinion leaders, and general health-care workers as well as a functional referral system. If successful, the model will be integrated into the activities of the National Tuberculosis and Leprosy Control Programme and scaled up nationwide. Trial registration: ISRCTN Registry: ISRCTN 83649248. https://trialsearch. who.int/Trial2.aspx? TrialID % ISRCTN83649248 Prospectively registered.

A systematic review and meta-analysis of group peer support interventions for people experiencing mental health conditions

BACKGROUND

Peer support is being integrated within mental health services to further the development of a recovery approach. However, the most effective models and formats of intervention delivery are unknown. We conducted this systematic review and meta-analysis to determine the effectiveness of peer support for improving outcomes for people with lived experience of mental health conditions, when delivered as group interventions.

METHODS

Studies reporting randomised controlled trials of group peer support interventions for people experiencing mental health conditions were identified by searching MEDLINE, PsycINFO, Embase and Cochrane CENTRAL, from inception until July 12th 2019 and undertaking supplementary searches. Included studies were assessed for risk of bias and meta-analyses were conducted if three or more trials provided usable data.

RESULTS

Eight trials met eligibility criteria, providing data from 2131 participants. Six trials had either high or unclear risk of bias. Interventions were categorised as mutual support groups, or peer support groups, sub-categorised as anti-stigma or self-management interventions. Meta-analyses were only possible for peer support groups and five outcomes. We found evidence that group peer support may make small improvements to overall recovery but not hope or empowerment individually, or to clinical symptoms. Evidence for effectiveness for outcomes which could not be meta-analysed was mixed.

CONCLUSIONS

Findings from the few eligible trials suggest group peer support interventions may be specifically effective for supporting personal recovery and have a limited impact on other outcomes, though there were some risks of bias to study findings. Interventions were heterogeneous and most social outcomes were absent in the literature, highlighting further limitations to the current evidence-base. There is insufficient evidence available from trials of group peer support torecommend the routine implementation of these interventions across mainstream mental health services at present. More high-quality trials of peer-developed, group peer support interventions are needed in order tomake firm conclusions about intervention effectiveness.

Assessing depressive symptoms among people living with HIV in Yangon city, Myanmar: Does being a member of self-help group matter?

Background

While self-help groups have been formed among people living with HIV, few studies have been conducted to assess the role of self-help groups in mitigating depressive symptoms. This study investigated the association between self-help group membership and depressive symptoms among people living with HIV in Yangon, Myanmar.

Methods

In this cross-sectional study, data were collected from people living with HIV at three antiretroviral therapy clinics in 2017. Multiple logistic regression analyses were carried out to examine the associations between having self-help group membership and depressive symptoms. Three ART clinics were purposively selected based on the recommendation from the National AIDS Program in Myanmar. At these clinics, people living with HIV were recruited by a convenience sampling method.

Results

Among people living with HIV recruited in this study (n = 464), 201 (43.3%) were members of a self-help group. The membership was not associated with having depressive symptoms (adjusted odds ratio [AOR] 1.59, 95% confidence interval [CI] 0.98–2.59). Factors associated with having depressive symptoms were female (AOR 3.70, 95% CI 1.54–8.88) and lack of social support (AOR 0.97, 95% CI 0.96–0.98) among self-help group members, and female (AOR 3.47, 95% CI 1.70–7.09), lack of social support (AOR 0.98, 95% CI 0.97–0.99), and internalized stigma (AOR 1.28, 95% 1.08–1.53) among non-members.

Conclusions

This study did not find evidence on the association between membership in self-help groups and depressive symptoms among people living with HIV. Social support was a protective factor against depressive symptoms both self-help group members and non-members, although the level of social support was lower among members than non-members. The activities of self-help groups and care provided by the ART clinics should be strengthened to address mental health problems among people living with HIV in the study site.

Measuring Development of Self-Help Organizations for Patients with Chronic Health Conditions in Hong Kong: Development and Validation of the Self-Help Organization Development Scale (SHODS)

Self-help organizations (SHOs) enable patients with chronic health conditions (PCHCs) to overcome common difficulties through the exchange of knowledge and mutual assistance, which serves as the basis for promoting the self-reliance and well-being of PCHCs. Nevertheless, practical challenges persist because little is known about what and how to evaluate for the developmental outcomes of SHOs. To address this knowledge gap, the present study seeks to develop and validate the Self-Help Organization Development Scale (SHODS). A total of 232 core members from 54 SHOs in Hong Kong participated in our study. The SHODS structure was validated by confirmatory factor analysis. This analysis derived five factors: citizen support, business support, member recovery and mutual aid, organizational health, and functional sustainability. The five-factor structure demonstrated stability across various types of SHOs, as validated by the subgroup analysis based on two criteria: duration of SHO establishment and organization affiliation. Good concurrent validity was supported by significant correlations between the SHODS factors and organizational variables, including staff supervision, staff understanding, networking, advocating, and educating the public and patients. The SHODS also showed excellent internal consistency. In conclusion, the SHODS is a psychometrically sound instrument for measuring the developmental outcomes of SHOs.

Psychosocial rehabilitation of people living with mental illness: Lessons learned from community-based psychiatric rehabilitation centres in Gujarat

Introduction:

Psychosocial rehabilitation is the process that facilitates opportunities for persons with chronic mental illness to reach their optimal level of independent functioning in society and for improving their quality of life. However, such psychosocial rehabilitation centers are limited in India.

Aims:

The present study assesses psychosocial rehabilitation centers (of urban day-care and rural residential rehabilitation center) operated by Ashadeep Charitable Foundation, a civil service organization and its effect on health outcomes of patients living with chronic mental illness.

Materials and Methods:

Records of 170 cases were retrieved for secondary analysis of demographic information, diagnosis, duration of stay, and health outcomes.

Results:

Rehabilitation activities included yoga, light physical exercises, group discussion, training for daily living skills, social skills, life skills, vocational training, individual, and family counseling. In addition, extensive outreach activities, mental health camps were also integral part of the rehabilitation activities. Patients who have accessed rehabilitation services were diagnosed with schizophrenia, psychosis, bipolar disorder, depression, and intellectual disability. The average duration of rehabilitation of patients (other than persons with intellectual disability) was ranged from three to four months. Out of those rehabilitated, 69% of them were successfully re-integrated with the family.

Conclusion:

Combination of pharmacological and psychosocial interventions are effective for re-integrate patients with mental illness to the family. This model of community-based rehabilitation has potential for scale-up.

Mental illness and recovery: an interpretative phenomenological analysis of the experiences of Black African service users in England

Background

Research conceptualising recovery is predominantly Eurocentric. This paper develops the conceptualisation of recovery by Black African service users.

Aims

Our aim was to explore Black African service users' experiences of recovery from mental illness and to understand how they conceptualise recovery.

Methods

Using a qualitative research approach and interpretative phenomenological analysis (IPA), semi-structured interviews were conducted with 12 Black African service users recovering from mental illness in England.

Results

Participants conceptualised recovery as a pragmatic and subjective concept distributed across a continuum of clinical, functional and spiritual dimensions, resilience, identity and their social and cultural backgrounds.

Conclusions

It seems critical for all stakeholders to ensure that these components are embedded in recovery-oriented services for Black African service users.

The "Own" and the "Wise": Does Stigma Status Buffer or Exacerbate Social Rejection of College Students with a Mental Illness?

Drawing on Goffman's stigma status framework, this study examines how being diagnosed with a mental illness or knowing someone close diagnosed with a mental illness affects responses towards persons exhibiting symptoms of various mental illnesses. Using data from a survey administered to a sample of college students (n = 556), we find that respondents who have been diagnosed with a mental illness (the "own") or who know a family member or friend with a mental illness diagnosis (the "wise") express lower desired social distance from persons with symptoms of a mental illness than other respondents ("normals"). Also, informally labeling symptoms as 'mental illness' reduced social distance among those similarly diagnosed. However, perceived dangerousness did not vary across stigma status, and the socially-distancing effects of perceived dangerousness were more pronounced among the "own," indicating that labels and stereotypes operate in countervailing ways.