Promoting Self-Care Management among Persons with Serious Mental Illness and HIV

Reprint of: Elemental dysregulation in psychotic spectrum disorders: A review and research synthesis

Accumulating evidence from observational studies, genetic research, and animal models suggests a relationship between toxic and nutritive elements and psychotic spectrum disorders (PSD). This review systematically evaluates the current research evidence for two hypotheses: 1) that exposures to abnormal levels of toxic and nutritive elements early in life contributes to the subsequent development of PSD, and 2) that an imbalance of element levels is linked to psychotic illness and clinical severity. We focused on the extant literature on five elements, lead (Pb), copper (Cu), magnesium (Mg), manganese (Mn), and zinc (Zn), because of their previously documented associations with psychiatric problems and the availability of pertinent literature. The review identified 38 studies of which 11 measured Pb, 27 measured Cu, 16 measured Mg, 15 measured Mn, and 25 measured Zn concentrations in PSD patients and controls. A majority of research has been conducted on nutritive element imbalance, and findings are largely mixed. While it is biologically plausible that element dysregulation is an important modifiable risk factor for PSD, more research into exposure in early life is needed to better characterize this relationship.

Elemental dysregulation in psychotic spectrum disorders: A review and research synthesis

Accumulating evidence from observational studies, genetic research, and animal models suggests a relationship between toxic and nutritive elements and psychotic spectrum disorders (PSD). This review systematically evaluates the current research evidence for two hypotheses: 1) that exposures to abnormal levels of toxic and nutritive elements early in life contributes to the subsequent development of PSD, and 2) that an imbalance of element levels is linked to psychotic illness and clinical severity. We focused on the extant literature on five elements, lead (Pb), copper (Cu), magnesium (Mg), manganese (Mn), and zinc (Zn), because of their previously documented associations with psychiatric problems and the availability of pertinent literature. The review identified 38 studies of which 11 measured Pb, 27 measured Cu, 16 measured Mg, 15 measured Mn, and 25 measured Zn concentrations in PSD patients and controls. A majority of research has been conducted on nutritive element imbalance, and findings are largely mixed. While it is biologically plausible that element dysregulation is an important modifiable risk factor for PSD, more research into exposure in early life is needed to better characterize this relationship.

Learning to manage a mental health condition: Caring for the self and ‘normalizing’ identity at work

This article examines the internal and external pressures to ‘normalize’ identity in relation to individuals experiencing mental health conditions (MHCs) at work. The data takes the form of three vignettes extracted from a larger empirical study of 60 interviews. These explore the tensions surrounding identity for individuals experiencing MHCs as well as their interventions to suppress exhibiting the condition. The analysis captures a number of competing meanings surrounding identity in relation to learning to care for the self and managing MHCs. Our contribution is to explore the relationships between learning to care for the self and the performativity of ‘normalizing’ identity in managing MHCs at work. It also provides a potential means of integrating Foucault’s ethics of caring for the self with the literature on identity in ways that can be illuminating for those who manage their MHCs and the demands of work through processes of ‘normalization’. This analysis offers theoretical insights regarding how identity work may be self-defeating in exacerbating MHCs and therefore is of some practical benefit for managers, health professionals and those experiencing MHCs since they often leave individuals with little choice but to intensify their attempts to ‘normalize’ their identities.

Modeling Health Disparities and Outcomes in Disenfranchised Populations

The Health Disparities and Outcomes (HDO) model originally created to explain the complexity of obtaining healthcare in rural settings has been revised and updated using emerging theoretical models of adversity and inequity and two decades of empirical work by the authors. With a strong orientation to explaining population-based health inequities, the HDO is applied to individuals with Serious Mental Illness (SMI), to explain their high rates of morbidity and mortality compared to the general population. Individual-, community-, and system-level factors that reflect an understanding of life-long risk, accrued hazards associated with multiple and intersecting disadvantages, and difficulty obtaining healthcare that meets accepted standards are described. The revised HDO can be applied to populations with disproportionate health challenges to identify multi-level factors that affect illness trajectory and overall health outcomes.