Stigma of mental illness and cultural factors in Pacific Rim region: a systematic review

Development and Validation of the Spiritual and Religious Needs Inventory for Muslim Psychiatric Inpatients: A Study in the Indonesian Context

Spirituality care plays an important role in holistic healthcare. Our previous study found Muslim psychiatric inpatients encounter significant obstacles that hinder their ability to engage in a formal prayer practice in the hospital. To address this gap, we aimed to develop a spirituality and religious needs inventory specifically for Muslim psychiatric inpatients. Findings from our previous study informed the construction of the inventory items. The developed inventory underwent rigorous validation, including expert appraisal, factor analysis, and reliability testing. The results indicate that our Islamic Spirituality and Religious Needs Inventory possesses robust validity and reliability metrics. We recommend that healthcare professionals employ this inventory as a resource for bedside evaluations and a foundation for future research endeavors within spiritual care for Muslim inpatients.

Recovery Notion of Individuals With Schizophrenia and Their Families in Eastern Turkey: A Qualitative Study

PURPOSE

To determine the recovery notion among individuals with schizophrenia and their families in Eastern Turkey.

METHOD

A descriptive phenomenological study was performed. Individual in-depth interviews were conducted, and data were analyzed using Braun and Clarke's thematic analysis.

RESULTS

Three themes were revealed-Meaning of Recovery, which emphasizes a multifaceted definition of recovery based on the individual's and family's experiences; Necessities of Recovery, emphasizing the requirements of recovery from the individual's and family's perspectives (e.g., treatment adherence, support of health care professionals); and Recovery Journey, which emphasizes the dynamic aspect of the recovery process from the individual's perspective.

CONCLUSION

Individuals with schizophrenia are able to define their own recovery and self-determined recovery goals, which will enable them to evaluate treatment outcomes. [Journal of Psychosocial Nursing and Mental Health Services, 63(4), 34-42.].

How Educators' Self-Construal Shapes Teacher Training: Navigating from Autism Awareness to Stigma

This study examined how self-construal, a key aspect of cultural structure, influences teacher training to improve autism awareness and reduce stigma. It explored autism awareness, self-construal, and stigma levels among potential educators, as well as the relationships between these factors. The study also investigated the mediating role of self-construal in the link between autism awareness and stigma. The study included 1031 potential educators-individuals with no teaching experience with students with ASD but likely to work with them in the future. Participants were selected through purposeful sampling. Data were collected using a demographic form, Autism Awareness Scale, Self-Construal Scale, and Stigma Scale. The study found that both autonomous and relational self-construals significantly impacted autism awareness and stigma. These cultural factors influenced how potential educators perceive and respond to ASD. The analysis highlighted the mediating role of self-construal between autism awareness and stigma. The study concluded that self-construal, as a cultural element, plays a significant role in shaping potential educators' approaches to autism awareness and stigma reduction. It is recommended that teacher training programs incorporate cultural factors like self-construal to complement efforts in enhancing autism awareness and reducing stigma, ensuring that potential educators' cultural structures do not outweigh their professional qualifications in interactions with students with ASD.

Effectiveness of OH card-based group mental health education in improving mood and behavior in breast cancer patients

Purpose

Psychological disorders and different coping styles often occur after breast cancer (BC) diagnosis. The purpose of this study was to explore the effect of OH card on psychological status and coping styles of individuals with breast cancer.

Methods

This was a non-randomized trial in which 54 outpatients or inpatients with BC who were willing to be assessed using psychological scales, allocated to either the OH card intervention group (OHG) or the usual care group (CG). The OHG received 1 session of OH card therapy over 2 h. Participants completed assessments of anxiety and depressive symptoms and coping styles using the Hospital Anxiety and Depression Scale (HADS) and Simplified Coping Style Questionnaire (SCSQ) scales at baseline, month 1, 3 and 6 post-intervention. Data were analyzed using descriptive statistics, chi-squared test and repeated measures ANOVA.

Results

The HADS score in the intervention group was lower than that of the control group by 2.296 (p<0.05) at 1 month post-intervention. The SCSQ-positive coping aspect of usual care group scores showed a downward trend, while the OH card intervention group scores showed an upward trend, with a significant difference between the two groups (p = 0.040), and the difference between the two groups was significant at 1, 3 and 6 months after the intervention (all p < 0.05).

Conclusion

The results of our study suggest that OH card intervention may improve symptomatology of anxiety and depression among people with BC at month1, and promote positive behavior within 6 months. The OH card intervention has a potential role in the psychological rehabilitation of individuals with breast cancer and warrants further research.

Barriers to maintaining dignity for patients with schizophrenia: A qualitative study

BACKGROUND

Since dignity is one of the fundamental rights of each patient, maintaining patients' dignity is essential. Unfortunately, in many cases, particularly among patients with schizophrenia (SCZ), dignity is not fully respected. Nonetheless, there is limited knowledge regarding this matter in Middle Eastern Nations.

RESEARCH OBJECTIVE

This study aimed to identify the barriers to maintaining dignity for patients with schizophrenia from the perspective of patients with schizophrenia, their family caregivers, and healthcare personnel.

RESEARCH DESIGN

This qualitative study was conducted with patients (n = 16), family caregivers (n = 4), and healthcare personnel (n = 6) who were selected using a purposeful sampling method. The data were collected through semi-structured, in-depth face-to-face interviews until the data reached saturation. Data were analyzed using the Graneheim and Lundman method.

ETHICAL CONSIDERATIONS

The Research Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1401.099).

FINDINGS

Analysis of the interviews revealed two main themes and five subthemes as the barriers to maintaining dignity for patients with schizophrenia. The main themes included "Black shadow of stigma" (three subthemes: "Facing the fear and discrimination of others," "Misconceptions in society," and "Social rejection") and "Facing violations" (two subthemes: "Basic human rights violation" and "Negative emotional responses").

CONCLUSION

Patients' dignity with schizophrenia was at a low level due to the negative attitude of society toward these patients. In this respect, the basic human rights violations, social rejection, and misconceptions were abundant in society and care centers. An in-depth comprehension of the threatening factors affecting dignity can assist policymakers in safeguarding their dignity through effective programs.

Mental Health Literacy and Professional Psychological Help-Seeking Attitudes Among Primary Healthcare Workers: The Mediating Role of Social Support and Mental Illness Stigma

Background

Research highlights poor mental health among healthcare workers, but limited attention has been given to the mental health literacy and professional psychological help-seeking attitudes of primary healthcare workers.This study investigates the relationship between primary healthcare workers' mental health literacy and their attitudes toward professional psychological help-seeking. It also explores the chain mediating roles of social support and mental illness stigma in this relationship.

Methods

We conducted the study among primary healthcare workers in Shapingba District, Chongqing, China. The study utilized demographic questionnaires, the Multiple Mental Health Literacy Scale, Social Support Rating Scale, Perceived Devaluation-Discrimination Scale, and Attitudes Toward Seeking Professional Psychological Help Scale. We applied Pearson correlation, multiple linear regression, and structural equation modeling (SEM) for data analysis.

Results

Correlation analysis revealed positive associations between mental health literacy and help-seeking attitudes, while stigma negatively impacted these attitudes. The regression analysis demonstrated that mental health literacy, social support, and mental illness stigma significantly influenced attitudes toward professional psychological help-seeking, with the adjusted R square being 0.402. Specifically, social support and stigma acted as partial mediators in the relationship between mental health literacy and help-seeking attitudes. SEM confirmed a significant chain mediation effect, with social support and stigma jointly mediating the link between mental health literacy and help-seeking attitudes, explaining 27.46% of the variance.

Conclusion

This study underscores the critical role of mental health literacy, social support, and mental illness stigma in shaping primary healthcare workers' attitudes toward professional psychological help-seeking. Strengthening these factors can enhance their mental health outcomes and encourage more proactive help-seeking behavior. Implementing targeted interventions in training programs to reduce stigma and promote social support could improve help-seeking behaviors and overall mental health within healthcare settings.

Will tomorrow be better? The moral experiments of three women with mental illness

Based on 16 months of fieldwork in a Chinese psychiatric hospital from 2017 to 2019, this study applies Myers's concept of moral agency to explore the efforts of three women with mental illness in their pursuits of a better life, examining their actions and interactions with social workers throughout the process. It enriches our understanding of moral agency by demonstrating that its actualization requires not only freedom, intention, and access to their life plans, but also patients' reflections on the relationships between themselves and the others. The study provides an example to comprehend the recovery of moral agency within a family-centered context, where patients' aspirations for a better life may be constrained by cultural expectations. This study also suggests that hospital social workers should establish trusting relationships with patients to accurately assess their genuine understanding of a good life and navigate the institutional constraints with the patients.

Factors Associated with Stigma and Beliefs About Psychotropics Among the Japanese Ancestry Population Diagnosed with Depression in Brazil

To analyze stigma related to depression, beliefs about psychotropics, and associated factors in a population of Japanese ancestry in Brazil. This cross-sectional study was conducted between March and June, 2022. Beliefs about psychotropics (BMQ-specific) and depression-related stigma (The Stigma Scale) were collected through an online questionnaire. Multiple linear regression analysis was performed to identify the factors associated with these dependent variables. Ninety-three respondents of Japanese ancestry completed the questionnaire. Participants were more focused on the necessity of the prescribed psychotropics than on possible adverse effects. Married individuals (β=-4.68 [95%CI -8.74, -0.63]; p = 0.024) were less concerned with their psychotropics than single individuals, while those undergoing treatment for longer years (β = 6.23 [95%CI 1.35, 11.11]; p = 0.013) perceive a greater necessity for treatment than those who started it recently. In addition, older individuals perceived less necessity for treatment (β=-5.83 [95%CI -10.76, -0.90]; p = 0.021) than younger individuals. Unemployed people (β = 12.09 [95%CI 0.47, 23.70]; p = 0.042) perceived more depression-related stigma than those employed. Aspects of Japanese cultural heritage related to depression and its treatment are still prevalent among people of Japanese ancestry in Brazil. Factors such as age, treatment duration, and marital status affects the perception of beliefs about psychotropics, whereas occupation affects the perception of stigma.

Multiple approaches to advance health equity in nursing science: Recruitment, data, and dissemination

Ensuring equitable care and health outcomes for all populations is essential in nursing science. However, achieving health equity in nursing science necessitates a multifaceted approach to address the complex factors influencing health disparities. This paper presented the keynote address delivered at the Advanced Methods Conference hosted by the Council for Advancement of Nursing Science in 2023. We identified critical gaps in health equity within nursing science, emphasizing the need for innovative recruitment strategies, comprehensive data analysis, and targeted dissemination efforts. This paper underscores the importance of equity in artificial intelligence research, highlighting issues such as biases in machine learning models and the underrepresentation of minoritized groups. Bridging the current gaps in health equity research within nursing science requires a systematic and forward-thinking approach.

Examining the challenges encountered by community health workers and empowering them to address mental health disorders: A qualitative study in Indonesia

Objectives

Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia's healthcare professionals. This study aimed to explore the challenges that community health workers (CHWs) encounter while providing mental health services in the community.

Methods

Forty CHWs were selected to participate in the study by purposive sampling method from July to August 2023 in seven primary health centers (PHCs) among three cites of Indonesia. Focus group discussions were used to collect data. All of data were analyzed using the interpretive phenomenological analysis method.

Results

Considering the participants' voluntary CHW role, the results were organized into five themes. These comprised two themes of challenges-family stigma and limited understanding of mental disorders, and three themes regarding efforts to overcome the challenges-maintaining self-motivation, fostering self-efficacy, and using communication skills when approaching families and patients.

Conclusions

Upskilling and empowering CHWs helps to enhance community mental health. Thus, it is crucial to support CHWs through training programs that aim to improve mental health literacy and communication skills and diminish family stigma.

Translation, cross-cultural adaptation and validation of the Chinese version of the IBD-Control questionnaire: A patient-reported outcome measure in inflammatory bowel disease

BACKGROUND

A demand exists for user-friendly patient-reported outcome measures for patients with inflammatory bowel disease (IBD). The IBD-Control Questionnaire has been recently developed to assess overall disease control from the patient's view but has not been available in China.

METHODS

Translation and cultural adaption of the IBD-Control into Chinese was conducted through four steps (forward translation, backward translation, expert panel, and pilot testing). Afterwards, a prospective validation study was conducted from February 2022 to February 2023. The translated IBD-Control, Short Health Scale, EQ-5D-5L, and disease activity measurements using either the Physician Global Assessment and Simple Clinical Colitis Activity Index or the Crohn's Disease Activity Index were used. Acceptability, test-retest reliability, internal consistency, content validity, convergent validity, structural validity, discriminant ability, and receiver operating characteristic curves were analyzed.

RESULTS

Questionnaires were completed by 150 participants with IBD (31 with Crohn's disease [CD] and 119 with ulcerative colitis [UC]). The Cronbach's alpha coefficient was 0.823 for the IBD-Control-8 scale. The correlations between individual item and total score varied from 0.485 to 0.892 among CD patients and from 0.588 to 0.712 among UC patients. The S-CVI/Ave was 0.98. Convergent validity analyses exhibited moderate to strong correlations between other measurements and IBD-Control-8-subscore (0.555-0.675) or IBD-Control VAS (0.503-0.671). Test-retest analysis showed that the mean scores were 75.23±17.33 versus 72.10±14.99 (r = 0.894, p<0.01) for VAS scores and 12.75±3.49versus 12.80±3.29 for IBD-Control-8 subscore (r = 0.963, p<0.01), respectively. The IBD-Control-8-subscore and IBD-Control-VAS exhibited significant discriminative capability among the PGA categories (ANOVA, p < .001). The ROC analysis revealed an optimal cut-off point for the IBD-Control-8 subscore of 14 points (sensitivity: 70.9%, specificity 83.5%), versus a cut-off of 70 on the IBD-Control VAS score (sensitivity: 84.4%, specificity 69.3%).

CONCLUSION

The Chinese IBD-Control proves to be a disease-specific, reliable, and valid tool for revealing overall disease control from the patient's viewpoint. Both healthcare professionals and patients may find it to be a useful patient-reported outcome measurement for triaging IBD patients in China or complementing routine care.

Experiences of Growing Up with Mothers with Schizophrenia in South Korea: A Qualitative Study

PURPOSE

The purpose of this study was to explore the experience of living with mothers with schizophrenia from childhood to the present from the perspective of their now-adult child.

METHODS

Individual interviews were conducted with 10 adult children of mothers with schizophrenia. The data were collected in South Korea from July 2017 to March 2018 and thematic analysis was employed. Purposive sampling was used.

RESULTS

Four themes were identified: (1) Navigating Childhood Confusion and Isolation Due to Maternal Schizophrenia, (2) Journey Through Loneliness, Resentment, and Emerging Responsibility, (3) Facing real-life difficulties as an adult child with vulnerability, and (4) Satisfaction in well-grown self.

CONCLUSIONS

Notwithstanding the real-life difficulties due to the unstable life with their mothers with schizophrenia, the children still had faith and confidence in themselves as well-grown thus far. Reflection on memories with their mothers served as a basis for continued maternal-child relationship and for taking on the role of guardians despite the negative experiences of their mothers' psychotic symptoms. Mental health nurses and school health professionals should pay attention to the children of mothers with schizophrenia and their difficulties in providing appropriate mental health services.

Conceptualizing mental health stigma in organizational settings: a sociolinguistic perspective

BACKGROUND

Sociolinguistic research on workplace mental health stigma is scarce and consequently, there are a lack of relevant conceptual models. Drawing on Goffman's notion of stigma as a 'language of relationships', and Heller's concept of 'discursive space', this paper offers a conceptual model of how stigma is produced and reinforced in workplace settings. Specifically, the model maps the complex discursive processes of mental health stigmatization through workplace discursive practices.

METHODS

The model is empirically grounded and draws on 23 in-depth participant interviews with professional services employees in Hong Kong. Through a meta-discursive analysis of the employees' experience in the workplace, the paper investigates how mental health stigma is produced in the workplace.

RESULTS

Conceiving the workplace as a discursive space, the model demonstrates that mental health stigma unfolds across three discursive layers, namely immediate encounters, organizational practices, and societal ideologies. Mediated by discursive practices, such as identity management, stigma is both produced and perpetuated across the three layers.

CONCLUSIONS

The paper provides a model for analyzing the production of mental health stigma through dynamic discursive activities in the workplace. By doing so, it offers a way to systematically map how stigma, brought about through discourse in organizational settings, can regulate both interpersonal relationships and resource allocation (such as career prospects).

Global mental health solidarity: strategies and solutions

Mental health is deteriorating far and fast globally post-COVID. Though there were already over one billion people living with mental disorders pre-pandemic, in the first year of COVID-19 alone, the prevalence of anxiety and depression soared by 25% worldwide. In light of the chronic shortages of mental health resources and talents, along with disruptions of available health services caused by pandemic-related restrictions, technology is widely believed to hold the key to addressing the rising mental health crises. However, hurdles such as fragmented and oftentimes suboptimal patient protection measures substantially undermine technology's potential to address the global mental health crises reliably and at scale. To shed light on these issues, this paper aims to discuss the post-pandemic mental health challenges and opportunities, and the strategies and solutions the global mental health community could leverage to protect and elevate society's mental health in the long run.

The community health worker experience and perception toward mental illness: A multi-settings cross-sectional study in Indonesia

BACKGROUND

The experiences and perceptions of Community Health Workers toward mental illness are vital for tailoring interventions, reducing stigma, improving access to services, and fostering community engagement in mental health initiatives.

AIMS

This study investigates the experiences of community health worker and their perception of mental illness.

METHODS

A multi-settings cross-sectional study was conducted among 487 Community Health Workers. Their experience and perception toward mental illness were studied with questionnaires, which examined their general perception, religious-related perception, cause, treatment, and expectation for mental treatment.

RESULTS

Most participants concurred that serving as a community health worker enhances their communication abilities (90.4%), strengthens connections with community health center staff (84.8%), boosts self-confidence (84.6%), and refines their capacity to identify signs of mental disorders (77%). Most notably, they consider their fellow community health workers essential to their extended family. Furthermore, a notable proportion associates' mental illness with religious elements, with 19.5% believing it can result from a lack of religious worship and a minority attributing it to witchcraft or black magic (3.5%). In terms of treatment, 14.2% think Ruqyah can cure mental illness, 6.4% believe in treatment by religious scholars, and a similar percentage (6.4%) think no medication or treatment is necessary for mental problems.

CONCLUSION

Participants overwhelmingly recognize the positive impact of serving as community health workers, citing improvements in communication, relationships with health center staff, self-confidence, and mental disorder identification. The strong bond among community health workers, likened to an extended family, emphasizes their collective importance. Additionally, the majority advocates for compassionate treatment of individuals with mental illness. These findings underscore the complex interplay of professional, communal, and cultural elements in addressing community mental health.

Chinese College Students' Stigmatization towards People with Mental Illness: Familiarity, Perceived Dangerousness, Fear, and Social Distance

BACKGROUND

Attribution models have been examined in Western countries. However, little is known about the applicability of the attitude-emotion-behavior model within Chinese culture. This study aimed to examine the association between familiarity, perceived dangerousness, fear, and social distance towards persons with mental illness (PMI) in the Chinese context.

METHODS

An online cross-sectional survey was conducted from October to November 2022 in mainland China. A total of 1493 college students completed a questionnaire evaluating familiarity, perception of dangerousness, fear, and social distance regarding PMI. Path analysis was employed to validate the model proposed in this study.

RESULTS

Participants expressed moderate to high levels of stigma towards PMI. Familiarity was negatively associated with social distance (p < 0.01). Participants who perceived PMI as dangerous were more prone to exhibit a reaction of fear (p < 0.001), consequently leading to social distance (p < 0.01). However, the mediating effect of perceived dangerousness and fear on the relationship between familiarity and social distance was not significant (p > 0.05).

CONCLUSIONS

The results of this study provide support for Corrigan's attributional model of stigma in the Chinese context. Contact-based interventions for stigma reduction should emphasize multiple elements of contact, including the quality of contact, rather than familiarity.

Structure, network analysis, psychometric properties and clinical utility of the self-absorption scale in China

BACKGROUND

Self-absorption refers an excessive, persistent, and rigid preoccupation with information regarding the self. This study aims to introduce the Self-Absorption Scale (SAS) into China with an assessment of its latent variable structure, network structure, psychometric properties, and clinical utility in a nonclinical Chinese sample.

METHODS

209 participants completed the translated SAS as well as the Short General Health Questionnaire (GHQ-12), rumination subscale of the Rumination-Reflection Questionnaire (RRQ), the Mindful Attention Awareness Scale (MAAS), the Private Self-Consciousness Scale (PrSCS), the Obsessive-Compulsive Inventory-Revised (OCI-R) and the Dissociative Experiences Scale (DES-II). In addition, 30 respondents completed the Chinese version of the SAS and retested it 2 weeks later.

RESULTS

The Chinese version of the SAS (CH-SAS) had a desirable two-correlated-factor structure with the reverse scored item removed, which was invariant across different genders. The core items in the network structure of the CH-SAS were related to excessive self-immersion, uncontrollability and anxiety aspects of self-absorption. The Cronbach's alpha coefficient for the CH-SAS was 0.903 while the McDonald's omega coefficient was 0.916 and the test-retest reliability was 0.908. The CH-SAS and its two subscales had moderate positive correlations with the rumination subscale of the RRQ (ranging from 0.474 to 0.616; p < .001) and the GHQ-12 (ranging from 0.479 to 0.538; p < .001), and moderate negative correlations with the MAAS (ranging from - 0.413 to - 0.360; p < .001). The PrSCS has almost no correlation with the CH-SAS and PrSAS (p > .05), and its correlation with the PubSAS was significant at the 0.05 level, with a remarkably low correlation coefficient (r = .157). The hierarchical regression analysis suggested that the CH-SAS can significantly predict the severity of OCD beyond factors such as depression, anxiety, rumination, dissociation, and mindful attention awareness.

CONCLUSIONS

The CH-SAS demonstrates excellent reliability, including internal consistency and test-retest reliability. Additionally, it exhibits favorable structural validity, as well as strong evidence of convergent and divergent validity. Furthermore, the self-absorption measured using the CH-SAS contributed significantly to the prediction of OCD beyond other relevant psychological factors, suggesting its clinical utility.

Attitudes of university students towards people with mental health disorders: a survey-based study

Background

Iraq and Iraqi Kurdistan face significant challenges regarding mental disorders. Individuals with mental health disorders often conceal their conditions, particularly in certain cultural contexts, due to the negative attitudes they face. This study aims to explore the attitudes of university students towards individuals with mental health disorders.

Methods

A sample of 294 university students from five distinct colleges within a public university in the Kurdistan region of Iraq was selected to participate in an attitudinal survey. The participants were chosen using convenience sampling. The survey encompassed 34 items, which were categorized into six overarching conceptual sub-scales: benevolence, separatism, stereotyping, restrictiveness, pessimistic prediction, and stigmatization. Descriptive and inferential statistics were employed to analyze the gathered data.

Results

The findings indicate that the majority of participants held negative attitudes towards individuals with mental health disorder. Furthermore, the study identified statistically significant associations between socio-demographic variables and students’ attitudes across most of the subscales.

Conclusion

The study highlights the prevalence of negative attitudes towards individuals with mental health disorder among university students. It suggests the establishment of a psychological and guidance counseling center at the university to promote awareness about mental health disorder and provide guidance and training to mitigate its severity, similar to physical illnesses.

Participatory Design in Suicide Prevention: A Qualitative Study of International Students' Experiences of Adapting the LivingWorks safeTALK Programme

BACKGROUND

Current suicide prevention approaches are not adapted to international student needs, and participatory design is a method that may facilitate the development or adaptation of appropriate programmes for this group.

METHODS

This qualitative study investigated the experiences of international university students studying in Australia who participated in a co-consultation process to adapt the LivingWorks safeTALK suicide prevention programme. Eight international students from the co-consultation workshop completed semi-structured interviews about their workshop experience. The data were analysed using reflexive thematic analysis.

RESULTS

The findings showed that participants found the co-consultation process empowering and engaging. They also reported that the experience promoted mutual learning and challenged simplistic views of suicide. No students reported experiencing distress. Suggestions for improving participatory design for international students focussed on enhancing participant interaction, supporting quiet voices to be heard and ensuring understanding of mental health and suicide through shared language.

CONCLUSIONS

This study underscores the value of participatory design in suicide prevention, emphasising its potential to empower international students and facilitate culturally sensitive programme adaptations.

PATIENT OR PUBLIC CONTRIBUTION

International students were involved in the co-consultation process to redevelop the training content and provided a series of recommendations for improving such processes for international students in the future. The two researchers who conducted the interviews and data analysis were former international students.

Understanding the factors related to how East and Southeast Asian immigrant youth and families access mental health and substance use services: A scoping review

The objective of the review is to identify factors related to how East and Southeast Asian immigrant youth aged 12-24 and their families access mental health and substance use (MHSU) services. To address how East and Southeast Asian youth and their families access mental health and substance use services, a scoping review was conducted to identify studies in these databases: PubMed, MEDLINE (Ovid), EMBASE (Ovid), PsychINFO, CINAHL, and Sociology Collection. Qualitative content analysis was used to deductively identify themes and was guided by Bronfenbrenner's Ecological Systems Theory, the process-person-context-time (PPCT) model, and the five dimensions of care accessibility (approachability, acceptability, availability and accommodation, appropriateness, affordability). Seventy-three studies met the inclusion criteria. The dimensions of healthcare accessibility shaped the following themes: 1) Acceptability; 2) Appropriateness; 3) Approachability; 4) Availability and Accommodation. Bronfenbrenner's Ecological Systems Theory and the PPCT model informed the development of the following themes: 1) Immediate Environment/Proximal Processes (Familial Factors, Relationships with Peers; 2) Context (School-Based Services/Community Resources, Discrimination, Prevention, Virtual Care); 3) Person (Engagement in Services/Treatment/Research, Self-management); 4) Time (Immigration Status). The study suggests that there is a growing body of research (21 studies) focused on identifying acceptability factors, including Asian cultural values and the model minority stereotype impacting how East and Southeast Asian immigrant youth access MHSU services. This review also highlighted familial factors (16 studies), including family conflict, lack of MHSU literacy, reliance on family as support, and family-based interventions, as factors affecting how East and Southeast Asian immigrant youth access MHSU care. However, the study also highlighted a dearth of research examining how East and Southeast Asian youth with diverse identities access MHSU services. This review emphasizes the factors related to the access to MHSU services by East and Southeast Asian immigrant youth and families while providing insights that will improve cultural safety.

Incidence of Panic Disorder Diagnoses After Celebrity Disclosures of Panic Disorder in South Korea

Importance

The persistent stigma associated with mental health conditions is a major challenge worldwide. Celebrities may improve this by openly discussing their own mental health issues, potentially influencing public attitudes and encouraging individuals to seek treatment for these conditions.

Objective

To evaluate the impact of celebrity mental health disclosures on the incidence and prevalence of panic disorder diagnosis in South Korea.

Design, Setting, and Participants

This cohort study included the entire South Korean population from January 2004 to December 2021, as reflected in the National Health Insurance Service data. Analysis was conducted from May 2022 through January 2024.

Exposure

Time periods analyzed included the timeframe before (from January 2004 to December 2010) and after the public disclosures of panic disorder by 3 high-profile Korean celebrities between December 2010 and January 2012 (from January 2011 to December 2021).

Main Outcomes and Measures

Monthly incidence and prevalence of panic disorder, defined by the presence of a clinical diagnosis of the condition. Trends were assessed using interrupted time series analysis with autoregressive integrated moving average models. To assess public interest in panic disorder, trends in search data were analyzed, examining the association between the timing of increased searches and changes in the incidence and prevalence of panic disorder. Data on obsessive-compulsive disorder (OCD) were included as a control.

Results

The study covered the entire population of South Korea, including 48 559 946 individuals in January 2004 and 52 593 886 individuals in December 2021. Before 2011, the mean (SD) annual prevalence of panic disorder was stable at 560 (140) persons per 100 000 persons per year. The celebrity disclosure in December 2010 was associated with higher monthly incidence rates of panic disorder, as measured by insurance claims data, changes that were observed in both the level (5.8 persons; 95% CI, 2.2-9.5 persons) and slope (0.78 persons per month; 95% CI, 0.19-1.40 persons per month) per 100 000 persons. By 2021, the observed annual prevalence per 100 000 persons reached 7530 persons, an increase of 775.6% compared with the 860 persons (95% CI, 330-1400 persons) estimated if the disclosures had not occurred. Internet searches anticipated changes in monthly prevalence with a lag of 2 or 3 months (F = 4.26, P = .02 and F = 3.11, P = .03, respectively). The celebrity disclosures had no significant association with the incidence or prevalence of OCD.

Conclusions and Relevance

In this observational cohort study, celebrity disclosure of mental health conditions was associated with a sustained reduction in stigma, as reflected in increased help-seeking behavior for the condition over more than a decade. This underscores the influential role celebrities can play in shaping public health perceptions and behaviors, offering valuable insights for the development of future mental health policies and public awareness campaigns.

Digital empowerment in mental health: A meta-analysis of internet-based interventions for enhancing mental health literacy

Background

Poor mental health literacy (MHL) in the global population significantly contributes to the treatment gap associated with mental disorders. In the digital age, leveraging Internet-based MHL interventions offers scalability and broader accessibility. This meta-analysis aimed to evaluate the effects of Internet-based interventions in improving MHL and mental health.

Method

Up to Feb 2024, seven databases were searched for Internet-based interventions on MHL (knowledge, stigma, help-seeking attitudes and intentions) and mental disorders (general distress, anxiety, and depressive symptoms). The random-effects meta-analyses at post-intervention and long-term follow-up assessments were performed.

Results

Twenty-nine eligible studies involving 11,582 participants were included. Significant positive effects were observed across various domains: knowledge increase (immediate: g = 0.459, 95 %CI: 0.285 to 0.634; follow-up: g = 0.487, 95 %CI: 0.348 to 0.626), immediate stigma reduction (g = -0.332, 95 %CI: -0.479 to -0.186), immediate enhancement of help-seeking attitudes (g = 0.168, 95 %CI: 0.046 to 0.3291) and help-seeking intentions (g = 0.135, 95 %CI: 0.072 to 0.198), as well as immediate mental health improvements (g = -0.074, 95 %CI: -0.115 to -0.033).

Conclusion

Overall, these findings underscore the promising effects of internet-based interventions in improving MHL and mental health, while maintaining these effects over time remains challenging, particularly in reducing stigma and promoting long-term help-seeking behaviors. Addressing methodological limitations, adopting a more interactive approach, and implementing targeted interventions are crucial to maximizing the effectiveness and advancing mental health care worldwide.

Mental Health Stigma and Mental Health Literacy in Russia: Their Prevalence and Associations with Somatic, Anxiety, and Depressive Symptoms

Background

Mental health stigma and mental health literacy can be potential targets of public education and health development. These areas are culturally specific and have so far been almost unexplored in Russia.

Objective

This study aimed at examining mental health stigma and mental health literacy in Russia, their prevalence, and their associations with somatic, anxiety, and depressive symptoms.

Design

The participants were 1,068 Russian adults. They completed the online questionnaire with measures assessing their mental health stigma (Perceived Devaluation and Discrimination Scale; Link et al., 2001); somatic symptoms (Somatic Symptom Scale-8; Gierk et al., 2014); anxiety symptoms (Generalized Anxiety Disorder-7; Spitzer et al., 2006); and depressive symptoms (Patient Health Questionnaire-9; Kroenke et al., 2001). To examine their mental health literacy, we used a series of questions exploring a person's awareness of mental health and mental health problems.

Results

Mental health stigma was found in 67% of the participants, who were less confident that most mental disorders can be prevented and more confident that mental disorders can be cured in most cases. Higher devaluation, discrimination, and mental health stigma were related to more severe somatic symptoms. Lower mental health literacy and higher devaluation, discrimination, and mental health stigma were associated with more severe anxiety and depressive symptoms. These associations were the same when adding covariates such as sex, age, partnership, parenthood, and educational background.

Conclusion

This study highlighted the obvious need for measures to reduce mental health stigma and improve mental health literacy in Russian society. In general, these measures can contribute to the promotion of better mental health in Russia.

Affiliate stigma and its association with family burden among family members of people living with schizophrenia in China

PURPOSE

Understanding affiliate stigma and its impact on family of people living with schizophrenia (PLS) in China is important for culturally informed intervention. This study aims to describe the pattern of affiliate stigma of family members of PLS in China and investigated the association between affiliate stigma and family burden.

METHODS

PLS and their family members dwelling in community were randomly recruited from four cities across China and completed measures of affiliate stigma and family burden. Linear regression analyses were used to determine the association between affiliate stigma and family burden.

RESULTS

A total of 493 dyads of family member and PLS were include in this study. The mean affiliate stigma in family members was 2.21 (SD = 0.61). The vast majority of family members reported the feeling of inferiority, helpless and sad because of their family members' schizophrenia, but few family members refusing to communicate or contact with the PLS. The mean score of overall family burden was 22.25 (SD = 14.90), with 98 % of participants reported moderate or severe burden. A higher level of affiliate stigma was associated with more family burden (b = 7.837, 95CI: 5.240 to 8.747). Affiliate stigma was significantly associated with family daily activities, entertainment activities, family relationship, physical health and mental health of family members, but not family economic burden.

CONCLUSION

A higher level of affiliate stigma was associated with more family burden among family with PLS. Anti-stigma intervention of mental illness should be consider not only PLS but also their family members.

Honest, Open, Proud (HOP) for people with mental illness in Hong Kong: a randomized controlled trial

BACKGROUND

Self-stigma among people with mental illness is negatively associated with personal and clinical recovery. Due to the concealable nature of mental illness, people with mental illness experience constant struggles between concealment and disclosure. Disclosure of mental health challenges can potentially minimize negative impacts of self-stigma and enhance self-esteem and sense of empowerment. Honest, Open, Proud (HOP) is a peer-led intervention that promotes autonomous and dignified decisions about disclosure.

PURPOSE

This study examined the effectiveness of HOP on concealment motivation, empowerment, self-stigma, stigma stress, and recovery among people with lived experience of mental illness in Hong Kong.

METHODOLOGY

A total of 162 participants with a mean age of 45.38 were recruited and randomized into intervention group and waitlist control group. Participants in the intervention group were invited to attend a 6-session HOP group intervention.

RESULTS

Significant improvement in optimism score from the empowerment scale was found in the intervention group compared to the waitlist control group and the effect was sustained at 1-month follow-up. However, significant changes were not found in other outcome variables.

CONCLUSION

Only improvement in optimism was observed in the current study. Future study needs to examine the effects of HOP with further modification to maximize the benefit for people with lived experience of mental illness in the local context.

Factors Related to the Willingness of People with Mental Health Illnesses Living in Group Homes to Disclose Their Illness to Supporters during Disaster Evacuation: A Cross-Sectional Study

Severe heavy rains caused by linear precipitation systems are occurring more frequently in Japan owing to climate change, and residents are being asked to evacuate more often. The purpose of this study was to identify factors associated with the willingness of people with mental health illness (PMHI) in group homes to disclose their illness when being evacuated. Participants were PMHI living in group homes in Japan. We conducted an original anonymous self-administered questionnaire based on previous research. Valid data from 119 people were analyzed. Factors associated with the willingness to disclose illness to supporters upon evacuation were "I can imagine living in a public shelter" (Odds Ratio [OR] 4.50, 95% Confidence Interval [CI]: 1.78-11.43), and "I socialize with neighbors" (OR 5.63, 95% CI: 1.74-18.22). Managers of group homes should encourage PMHI to imagine life in an evacuation zone by increasing opportunities for disaster training and for interaction with local residents. People who are less likely to socialize with neighbors should be especially careful, as they may not be able to disclose their illness, and those who support evacuees should pay special attention to these people.

Attitude toward patients with mental disorders: what is going on amongst Iranian pharmacies?

INTRODUCTION

As the incidence of mental disorders continues to rise, and pharmacy staff can significantly affect the willingness of patients with mental disorders to seek help; we aimed to evaluate the stigmatizing attitude of the pharmacy staff toward these patients in Iran.

METHODS

We conducted this cross-sectional study between April 2020 and December 2021 in Tehran, Iran, and included pharmacists, pharmacy technicians and pharmacy students, with the experience of working in a pharmacy for at least three months. The social distance scale (SDS) and dangerousness scale (DS) were used to measure the stigmatizing attitude of the participants. Higher scores indicated more stigmatizing attitudes.

RESULTS

We included a total of 186 participants with a mean age of 32.97 ± 9.41 years, of which 101 (54.3%) were male, and 75 (40.3%) were pharmacists, 101 (54.3%) were pharmacy technicians, and 8 (4.3%) were pharmacy students. The mean SDS score was 14.2 ± 4.13, and the mean DS score was 33.85 ± 8.92. The greatest tendency for social distance was reported for a patient with a mental disorder, 'being the caretaker of their children for an hour or two' and 'marrying their children.' The most perceived dangerousness was reported for a patient with a mental disorder 'owning a gun.' Positive personal history of psychopharmacological treatment was statistically correlated with lower DS (P = 0.001) and SDS (P = 0.007) scores. Positive family history of psychiatric inpatient admission was significantly correlated with higher DS (P = 0.05) and SDS (P = 0.03) scores. Higher rates of 'received psychiatric prescriptions per month' was associated with lower DS scores (P = 0.04).

CONCLUSION

Our participants did not have an overall positive attitude toward patients with mental disorders. Although, compared to previous studies, they held a more positive attitude. Positive personal history of psychopharmacological treatment predicted a more positive attitude and positive family history of psychiatric inpatient admission predicted a more negative attitude.

Mental health problems and help-seeking behaviours of Syrian refugee adolescents: mediating role of self-stigma

BACKGROUND

Although common mental health problems have been widely studied with self-stigma, few studies have focused on the mediating effect of self-stigma in the relationship between mental health problems and help-seeking behaviours of refugee adolescents. Therefore, the purpose of the present study was to examine whether self-stigma mitigates the adverse effects of stress, anxiety, and depression symptoms on the help-seeking behaviours of Syrian adolescents living in Turkey.

METHODS

The participants of this study included 488 Syrian refugee adolescents (boys, 63.73%; girls, 3627%) living in Turkey. Participants completed the Depression Anxiety Stress Scale and General Help-Seeking Scale and Self-Stigma of Seeking Psychology Help Scale.

RESULTS

The findings revealed that stress (β = 0.19, p < 0.01), anxiety (β = 0.12, p < 0.05), and depression (β = 0.17, p < 0.01) had significant and positive predictive effects on self-stigma, but not on help-seeking behaviours. Also, self-stigma (β = -0.12, p < 0.01) had a significant negative predictive effect on help-seeking behaviours. With regard to the indirect effects, the findings showed that self-stigma fully mediated the associations between stress - help-seeking [effect = -0.05, 95% confidence interval (CI) -0.11 to -0.01], anxiety - help-seeking (effect = -0.04, 95% CI -0.09 to -0.01)], and depression - help-seeking (effect = -0.05, 95% CI -0.12 to -0.01).

CONCLUSIONS

Our findings highlight the potential negative effects of self-stigma on the help-seeking behaviours of Syrian refugee adolescents, both directly and indirectly. These results can be used to develop and implement effective and efficient interventions to address the unmet mental health needs of refugee adolescents.

Cross-cultural perspectives on intelligent assistive technology in dementia care: comparing Israeli and German experts' attitudes

BACKGROUND

Despite the great benefits of intelligent assistive technology (IAT) for dementia care - for example, the enhanced safety and increased independence of people with dementia and their caregivers - its practical adoption is still limited. The social and ethical issues pertaining to IAT in dementia care, shaped by factors such as culture, may explain these limitations. However, most studies have focused on understanding these issues within one cultural setting only. Therefore, the aim of this study was to explore and compare the attitudes of Israeli and German dementia experts toward IAT in dementia care, to contribute to a more cultural-comparative perspective.

METHODS

Semi-structured interviews were conducted with 35 experts (15 Israelis and 20 Germans) in key roles in health and community services for people with dementia as well as in the fields of dementia and IAT (e.g., computer science, electrical/biomedical engineering, ethics, nursing, and gerontology). Thematic content analysis was used to analyze the data.

FINDINGS

Israeli and German experts identified the same social accelerators in the development and implementation of IAT in dementia care (i.e., changes in family structure and social digitization) and benefits of adopting IAT (e.g., enhancing the safety of people with dementia and increasing their independence). However, there were differences in inhibitor/risk assessments between the two groups. Namely, economic considerations and the cognitive capacity of people with dementia were identified by both groups as inhibitors, while Israeli experts additionally reported stigma and ageism. Whereas both groups agreed that IAT might reduce human connection, and that the technology is not yet reliable enough, German experts highlighted concerns regarding privacy; in contrast, Israeli experts prioritized safety over privacy.

CONCLUSIONS

Our research findings allow for the identification of relevant similarities but also important differences between German and Israeli experts' perspectives. As such, an important basis has been provided for a more in-depth discussion regarding where, why, and how culturally-sensitive technology development is needed.

A Constructivist Grounded Theory Study on Mental Health Recovery from a Lived Experience Perspective in Singapore

More contemporary personal recovery conceptualisation of mental health recovery emphasize the need to consider the perspectives of people who experience mental ill-health. Most lived experience research has been done in Western cultures with relatively few studies in Asian ones, creating a gap that needs to be addressed due to differences in cultural worldviews. This study explores the notion of recovery from the lens of people experiencing mental health challenges in Singapore. We adopted a constructivist grounded theory perspective to evaluate qualitative data from 21 participants. The core category which best represented what recovery meant was "reconciling and living with experiences of mental ill-health". Our findings suggest that a variety of societal aspects greatly influence perceptions of mental health recovery in Singapore, as participants often shared their desire to live a meaningful life within society but could only do so if they found a way to manage their symptoms more effectively.

Conventional or Alternative Mental Health Service Utilization According to English Proficiency Among Asians in the United States

After the onset of the COVID-19 pandemic in 2020, Asian Americans in the United States have experienced a surge in anti-Asian crimes, leading to heightened psychological distress among this community. Consequently, the mental well-being of Asian Americans demands greater attention than ever. Regrettably, Asians tend to underutilize or delayed mental health care treatments. This study examines the conventional and alternative mental health service utilization among Asians in the United States according to their English proficiency. From the 2015-2018 National Survey on Drug Use and Health, this study examined 3,424 self-identified non-Hispanic Asians aged 18-64 with Kessler score of at least 5. Stratified bivariate analysis and multivariable logistic regression analysis were conducted. Regardless of English proficiency, Asians did not utilize alternative mental health service more than conventional mental health service. However, those with limited English proficiency consistently utilize care less than those with English proficiency. Need factors, such as mental distress severity and self-rated health status, were significant factors associated with their mental health service utilization. English proficiency remains a structural factor in preventing Asians from utilizing mental health services regardless of the nature of services. Due to the COVID-19 pandemic, more Asians have been experiencing mental distress. This study demonstrates a particular need for mental health services that are culturally specific and Asian language friendly.

Medication non-adherence and its influencing factors in persons with schizophrenia in rural China

BACKGROUND

Few studies have been conducted to explore medication non-adherence in persons with schizophrenia (PWS) and its influencing factors in rural China. This study aimed to investigate the medication non-adherence and its influencing factors among PWS in rural China.

METHODS

A total of 269 PWS and their family caregivers in Xinjin district, Chengdu, China were investigated on medication adherence and related factors. Logistic regression was employed to identify the influencing factors.

RESULTS

The results showed that 37.6% of PWS had medication non-adherence. PWS living with family caregivers had significantly lower rate of medication non-adherence (34.7%) than those not living with family caregivers (60.0%) (p < 0.01). Family caregivers' affiliate stigma of mental illness, knowledge of mental illness and self-esteem were significantly related to patients' medication non-adherence (p < 0.05). PWS' employment status, living with family caregiver, present mental status and social support were significantly related to medication adherence.

CONCLUSION

This study shows medication non-adherence is severe among PWS in rural China. Both patient- and family-related factors affect patients' medication adherence seriously. Except improving patients' treatment and mental status, development of family caregiving, social support network and intervention on reducing stigma of mental illness should be crucial for enhancing PWS' medication adherence.

Trends and disparities in non-communicable diseases in the Western Pacific region

The WHO Western Pacific region bears disproportionate deaths from non-communicable diseases (NCDs), with increased overall NCD proportional mortality over the past two decades. The disease burden of mental health increased, resulting from rapid ageing, enhanced stress, and the COVID-19 pandemic, but it was largely neglected. The highly diverse cultures, religions, political systems, socioeconomic contexts, lifestyles, and environmental factors probably have led to massive disparities across countries in NCD mortality, risk factors, and NCD management. Geographically, East Asia had the lowest NCD mortality whilst Pacific islands had the highest. Economic booms, ageing, nutrition transition, social stress, prevalent tobacco use, and fast-increasing obesity and hyperglycaemia are important drivers of NCDs. Men tended to have more adverse behavioural and metabolic risk factors. Rural residents are catching up with their urban counterparts in metabolic risk factors and conditions. Sustainable strategies tailored to NCD patterns are needed to fight the NCD epidemic and related disparities.

Navigating the Shadows: A Comprehensive Review of Suicide in the Geriatric Population

This review critically examines the complex landscape of suicide within the geriatric population, defined as individuals aged 65 and older. By synthesizing existing research, we elucidate critical findings related to the prevalence, risk factors, and challenges associated with suicide in this demographic. Social isolation, mental health issues, and the intricate psychosocial dimensions of ageing emerge as pivotal factors contributing to the vulnerability of older individuals. The conclusion underscores a compelling call to action, urging collaborative efforts from healthcare professionals, policymakers, and communities to implement targeted prevention strategies. Our vision for the future involves building a supportive and resilient community for the geriatric population, emphasizing age-friendly policies, robust social support networks, and destigmatizing mental health discussions. Through this comprehensive exploration, we aim to contribute to a deeper understanding of suicide in the geriatric population and inspire effective interventions that prioritize the well-being and dignity of older individuals.

Relationship between mental health literacy and professional psychological help-seeking attitudes in China: a chain mediation model

BACKGROUND

Mental health literacy is considered an important factor in promoting professional psychological help-seeking attitudes. However, it is important to clarify the emotional and behavioral factors that underlie this association. Drawing from the ABC model of attitudes and the Health Disclosure Decision-Making Model, this study aimed to examine the mediating role of psychological help-seeking stigma and distress disclosure in the relationship between mental health literacy and professional psychological help-seeking attitudes.

METHODS

We collected data from 827 participants in seven regions of China (597 female; Mage = 26.019, SD = 5.592 years old) using self-report measures, including the Mental Health Literacy Scale, Questionnaire of Stigma for Seeking Professional Psychological Help, Distress Disclosure Index, and Attitudes Toward Seeking Professional Psychological Help-Short Form. A chain mediation model was built to examine the relationships among mental health literacy, psychological help-seeking stigma, distress disclosure, and professional psychological help-seeking attitudes.

RESULTS

The results of the analyses showed a positive association between mental health literacy and professional psychological help-seeking attitudes, with psychological help-seeking stigma and distress disclosure playing mediating roles in this relationship. Furthermore, even after controlling for participants' age, gender, and education, the chain mediation effect of psychological help-seeking stigma and distress disclosure on the relationship between mental health literacy and professional psychological help-seeking attitudes was observed among the Chinese population.

CONCLUSIONS

These findings underscore the significance of mental health literacy in shaping professional psychological help-seeking attitudes, while emphasizing the need to account for psychological help-seeking stigma and distress disclosure when examining this association. Additionally, the model proposed in this study provides a valuable framework for promoting the utilization of professional mental health services.

Attitudes towards people with mental health illness in the Kurdistan region of Iraq: a quantitative study

People with mental health illnesses are exposed to rejection by community members because of the negative attitudes from people towards them. This study assesses undergraduates' attitudes towards people with mental health illness in the Kurdistan region of Iraq and compares their attitudes with socio-demographic characteristics such as age, gender and academic field of study. A quantitative descriptive study design has been used for this research. A multistage cluster sampling was used for data collection between May to June 2019 from a sample of 361 undergraduate students. A modified version of the British Market Research Bureau (BMRB) questionnaire was used for data collection. Undergraduate students from various fields of study have had different attitudes towards people with mental illnesses. Medical students have better understanding and more positive attitudes than students of the other fields. Male students showed more negative attitudes compared to female students. Furthermore, younger students had more negative attitudes than older students.

Data-mining analysis of media frame effects on social perception of schizophrenia renaming in Korea

BACKGROUND

In 2011, Korean Neuropsychiatric Association renamed schizophrenia from 'mind split disorder' ('Jungshinbunyeolbyung' in Korean) to 'attunement disorder' ('Johyeonbyung' in Korean), in a strategic way to reduce social stigma toward people with schizophrenia. However, there remains an elusive consensus that how the renaming effort has contributed to changes in the social perception of schizophrenia in Korea.

METHODS

With this regard, we explored whether media frames alter the social perception, in ways of respecting or disrespecting schizophrenia patients before and after the renaming. This study extensively investigated media keywords related to schizophrenia across the time by applying both language and epidemiologic analyses.

RESULTS

In results, the media keywords have been negatively described for schizophrenia patients both before and after the renaming. Further, from an analysis using the regression model, a significant correlation was observed between the frequency of negative keywords and the hospitalization frequency of schizophrenia patients.

CONCLUSIONS

These findings suggest that the social perception of schizophrenia has been scarcely changed, but rather remained negatively biased against schizophrenia patients, in spite of the renaming effort. Notably, the biased media frames have been demonstrated to negatively impact on the social perception, and even on the medical use patterns of general schizophrenia patients. In conclusion, we suggest that the unbiased media frames along with the renaming effort may collectively help reduce the negative social perception of schizophrenia.

TRIAL REGISTRATION

This study was approved from the Institute of Review Board (IRB) of the Yoing-In Mental Hospital (IRB No. YIMH-IRB-2019-02).

Contradictions hindering the provision of mental healthcare and psychosocial services to women experiencing homelessness in Addis Ababa, Ethiopia: service providers' and programme coordinators' experiences and perspectives

BACKGROUND

Mental health conditions are among the health issues associated with homelessness, and providing mental healthcare to people experiencing homelessness is challenging. Despite the pressing issue of homelessness in Addis Ababa, Ethiopia, there is scant research on how service providers address women's mental health and psychosocial needs. Therefore, we explored service providers' and programme coordinators' perceptions and experiences regarding mental healthcare and psychosocial services delivery to women experiencing street homelessness in the city.

METHODS

We conducted a descriptive qualitative study with selected healthcare and social support providers and programme coordinators. The study involved 34 participants from governmental and non-governmental organisations in Addis Ababa, Ethiopia. Data were analysed using an inductive thematic approach.

RESULTS

Four themes were derived from the analysis. The first of these was "divergent intentions and actions". While service providers and programme coordinators showed empathy and compassion, they also objectified and blamed people for their own homelessness. They also expressed opposing views on mental health stigma and compassion for these people. The second theme addressed "problem-solution incompatibility", which focused on the daily challenges of women experiencing homelessness and the types of services participants prioritised. Service providers and programme coordinators proposed non-comprehensive support despite the situation's complexity. The participants did not emphasise the significance of gender-sensitive and trauma-informed care for women experiencing street homelessness in the third theme, "the lack of gendered and trauma-informed care despite an acknowledgement that women face unique challenges". The fourth theme, "mismatched resources," indicated structural and systemic barriers to providing services to homeless women.

CONCLUSIONS

Conflicting attitudes and practices exist at the individual, organisational, and systemic levels, making it challenging to provide mental healthcare and psychosocial services to women experiencing homelessness. An integrated, gender-sensitive, and trauma-informed approach is necessary to assist women experiencing homelessness.

Comparison of attitudes to media representation of mental illness between journalists and mental health professionals in Russia with German-speaking countries of Switzerland, Germany, and Austria

BACKGROUND

The media are an important source of information on mental health. They are often implicit in reinforcing negative stereotypes of people with mental health problems. There are no studies in German-speaking countries or Russia on media attitudes to mental health and mental health professionals' (MHP) attitudes to the media.

AIMS

This study explored journalists and MHPs attitudes to mental health media reporting in the German speaking countries of Switzerland, Germany, and Austria and in Russia.

METHODS

A cross-sectional online internet survey, of ten Likert scale statements to ascertain perceptions of stigma, role, and training needs following the STROBE guidance was conducted among journalists and MHPs via their professional organizations. A non-discriminatory exponential snowballing technique leading to non-probability sampling was used. Descriptive statistics, Kruskal-Wallis, and a post hoc Dunn's multiple comparisons test using Bonferroni adjustment were used to analyze data.

RESULTS

A total of 106 German-speaking and 78 Russian journalists, 109 German-speaking, and 82 Russian MHPs fully answered the survey. Journalists felt the media were more balanced about mental health than MHPs, and MHPs were wary of engagement with the media. Small minorities of journalists had engaged with mental health training, similarly few MHPs had engaged with media training, but both groups were interested in doing so in the future. Significant differences between German and Russian speaking respondents were found on a range of issues (e.g. stigmatization, image about psychotherapy, the media/MHPs, and their own role in engaging with the media/MHPs). Russians were more likely to know specialized (media/mental health awareness) training compared to German-speaking MHPs and journalists.

CONCLUSION

There are potential opportunities to engage journalists and MHPs in training about each other's worlds and reducing stigma toward mental illness through engaging MHPs with the media.

Mental illness stigma among indigenous communities in Bangladesh: a cross-sectional study

BACKGROUND

Mental illnesses stigma is a universal and transcultural phenomenon. While mental illnesses stigma is pervasive in Bangladesh, very little research exists on stigma toward mental illnesses among indigenous communities. This study aimed to investigate the prevailing stigma and the risk factors among different indigenous communities in the Chattogram Hill Tracts (CHT) in Bangladesh.

METHODS

A cross-sectional survey was carried out and participants were recruited purposively from Rangamati, a South-Eastern district of Bangladesh in the CHT. Participants from various indigenous communities including Chakma, Marma, Rakhine, Tripura, and Pangkhua were recruited. The 28- item Bangla translated version of the Mental Illnesses Stigma Scale was used. Independent-samples t-test, ANOVA, and multiple regression were performed.

RESULTS

The results indicate evidence of a gender difference with females reporting more stigma than their male counterparts. Age, gender, socioeconomic status, and monthly income are associated with stigma among indigenous people. Further analyses of the subscales indicated significant differences among sociodemographic variables.

CONCLUSIONS

The results provide an insight into the prevailing stigma and associate risk factors among indigenous communities. The results may help inform anti-stigma interventions targeting indigenous communities in Bangladesh.

Comparison of stigmatizing views towards COVID-19 and mental disorders among adolescent and young adult students in China

Objective

Infectious diseases including COVID-19 and mental disorders are two of the most common health conditions associated with stigma. However, the comparative stigma of these two conditions has received less attention in research. This study aimed to compare the prevalence of stigmatizing views toward people with COVID-19 and mental disorders and the factors associated with these views, among a large sample of adolescent and young adult students in China.

Methods

A total of 9,749 adolescents and young adults aged 15-24 years completed a survey on stigmatizing attitudes toward COVID-19 and mental disorders, as well as mental health-related factors, including general mental health status and symptoms of depression, anxiety, insomnia, and post-traumatic stress disorder (PTSD). Multivariable linear regression analyses were conducted to identify factors associated with stigmatizing views.

Findings

The prevalence of COVID-19 and mental disorders-related stigma was 17.2% and 40.7%, respectively. COVID-19-related stigma scores were significantly higher among male students (β = 0.025, p < 0.05), those without quarantine experience (β = 0.035, p < 0.001), those with lower educational level (p < 0.001), those with lower family income (p < 0.01), and those with higher PTSD symptoms (β = 0.045, p < 0.05). Mental disorder-related stigma scores were significantly higher among individuals with average and lower-than-average levels of family income (p < 0.01), depression symptoms (β = 0.056, p < 0.001), anxiety symptoms (β = 0.051, p < 0.001), and mental health problems (β = 0.027, p < 0.05).

Conclusion

The stigma of mental disorders is higher in the youth population than the stigma of COVID-19. Factors associated with stigmatizing attitudes toward people with COVID-19 and mental disorders varied across the youth. Stigma-reduction interventions among the youth should be targeted specifically to COVID-19 or mental disorders conditions.

Stigma management during reintegration of older incarcerated adults with mental health issues: A qualitative analysis

INTRODUCTION

The number of older prisoners with mental health issues released from prisons and forensic psychiatric institutions is rising. Their successful integration is important due to its implications for the public's safety and the individual's health and well-being. However, reintegration efforts are hampered due to the double stigma attached to 'mental illness' and 'incarceration history'. To alleviate the burden of such stigma, affected persons and their social networks employ stigma management strategies. This study sought to investigate the stigma management strategies of mental health professionals supporting older incarcerated adults with mental health issues in their reintegration process.

METHODS

Semi-structured interviews with 63 mental health professionals from Canada and Switzerland were carried out as part of the overall project. To address the reintegration topic, data from 18 interviews were used. Data analysis followed the thematic analysis approach.

RESULTS

Mental health professionals emphasized the double stigmatization of their patients which impaired their quest for housing. Lengthy searches for placement frequently resulted in patients' unnecessary long stays in forensic programs. Nevertheless, participants outlined that they were at times successful in finding appropriate housing for their patients due to the use of certain stigma management strategies. They stated that they, first, established initial contacts with outside institutions, second, educated them about stigmatizing labels and, third, provided ongoing collaboration with public institutions.

DISCUSSION

Incarcerated persons with mental health issues face double stigmatization that affects their reentry process. Our findings are interesting as they illustrate ways in which stigma can be reduced, and how the reentry process can be streamlined. Future research should include the perspectives of incarcerated adults with mental health issues to shed more light on the various options that they seek for successful reintegration after imprisonment.

Psychiatrists’ occupational stigma conceptualization, measurement, and intervention: A literature review

Psychiatrists require frequent contact with and treatment of patients with mental illnesses. Due to the influence of associative stigma, psychiatrists may also be targets of stigma. Occupational stigma warrants special consideration because it significantly affects psychiatrists' career advancement, well-being, and their patients’ health. Given that there is no complete summary of this issue, this study reviewed the existing literature on psychiatrists' occupational stigma to clearly synthesize its concepts, measurement tools, and intervention strategies. Herein, we emphasize that psychiatrists’ occupational stigma is a multifaceted concept that simultaneously encompasses physically, socially, and morally tainted aspects. Currently, standardized methods to specifically measure psychiatrists’ occupational stigma are lacking. Interventions for psychiatrists’ occupational stigma may consider the use of protest, contact, education, comprehensive and systematic methods, as well as the use of psychotherapeutic approaches. This review provides a theoretical basis for the development of relevant measurement tools and intervention practices. Overall, this review seeks to raise public awareness of psychiatrists' occupational stigma, thereby promoting psychiatric professionalism and reducing its stigma.

Latent characteristics and influencing factors of stigma in rheumatoid arthritis: A latent class analysis

To explore the latent classes of stigma in patients with rheumatoid arthritis, we analyzed the characteristics of the different categories. Adopting a convenient sampling method, socio-demographic and disease-related information from the outpatient clinics and wards of 3 tertiary care hospitals in China was collected. The Chinese version of the Internalized Stigma of Mental Illness scale-Rheumatoid Arthritis was used in this survey. Rheumatoid arthritis stigma was divided into 3 potential categories: Low Stigma-Strong Resistance (83, 41.5%), Medium Stigma-Strong Alienation (78, 39.0%), and High Stigma-Weak Resistance (39, 19.5%). Unordered multinomial logistic regression analysis showed that pain (OR = 1.540, P = .005; OR = 1.797, P < .001), elementary school education and below (OR = 4.051, P = .037), and duration of morning stiffness (OR = 0.267, P = .032) were risk factors for stigma, whereas family history was a protective factor against stigma (OR = 0.321, P = .046). Patients with longer morning stiffness, more severe pain, and less education have a greater risk of heavier stigma. Strong alienation is an early warning of heavy stigma. Resistance to stigma and family support can help patients overcome their psychological obstacles. More attention should be paid to constructing family centered support systems to help resist stigma.

Affiliate stigma and caregiving burden among family caregivers of persons with schizophrenia in rural China

BACKGROUND

Although stigma and caregiving burden are important in relation to mental health recovery, few studies have been conducted on affiliate stigma and caregiving burden among family caregivers of persons with schizophrenia (FCPWS) in rural China.

AIMS

This study aimed to examine the severity level of affiliate stigma and caregiving burden, and identify the correlates among FCPWS in rural China.

METHODS

A mental health survey was conducted (N = 253 FCPWS) in Xinjin county, Sichuan province, China. Affiliate Self-Stigma Scale and Zarit Burden Interview Short Form were used. The regression analysis was performed to explore the correlates of stigma and burden.

RESULTS

Most FCPWS reported experiencing high and severe level of affiliate stigma (78.66%) and caregiving burden (95.26%). Family caregivers who were middle aged, unemployed, with high caregiving burden and low quality of life (QoL), showed more severe affiliate stigma. Family caregivers who were female, older, with low income, high affiliate stigma and low QoL, experienced greater caregiving burden.

CONCLUSIONS

The large majority of FCPWS in rural China experienced severe affiliate stigma, caregiving burden and poor QoL. It is crucial to develop culture-specific anti-stigma interventions to reduce caregivers' stigma and caregiving burden, and improve QoL. Specific risk factors of family caregivers' affiliate stigma and caregiving burden should be considered for development of health policy and community-based mental health services.

Stigma and Suicide From the Perspective of Balinese Adults

Research on stigma toward suicide has grown dramatically but limited is studying in Bali, Indonesia. This qualitative research conducted to explore the stigma and suicide from Balinese perspective. Eighty-four Balinese Hindus participated in this study, which 27.38% of them had a history of suicidal thoughts or attempted suicide. Our research found that the cultural belief of Balinese view suicide as an act of ulah pati, which means taking death inappropriately and for an inappropriate reason, which carries the consequence that the suicidal person and the family will incur bad karma. Public stigma and self-stigma toward suicide exist among Balinese, i.e. the act of suicide due to a mental disorder and people who die by suicide are weak. The findings of this study suggest mental health professionals and local governments to pay attention to Balinese cultural belief and Hinduism religious teaching to prevent suicide.

The experience of stigma in family caregivers of people with schizophrenia spectrum disorders: A meta-synthesis study

Introduction

Schizophrenia is a chronic disabling and the most stigmatizing mental disorder worldwide. The stigma experienced by family caregivers impacts their lives in different ways. This study reports the results of qualitative synthesis to understand the perceptions and experiences of stigma in families of people with schizophrenia spectrum disorders across various socio-cultural contexts.

Methods

An initial comprehensive search was performed in databases like Web of Science, PsycINFO, CINAHL, Scopus, and Ovid-based MEDLINE. By searching, 3560 studies were found, of which 16 articles were included in the present study. A meta-synthesis was done according to the meta-ethnographic approach.

Result

Three themes were generated: perpetuated stigma by general misunderstandings about schizophrenia, mental health inequality contributes to structural stigma, and long-term family caregiving stigmas, attitudes, and coping strategies. These themes indicated the essential experiences of stigma in families of people with schizophrenia, which appeared due to unknown and socio-cultural misconceptions of schizophrenia that led to emotional challenges for family caregivers.

Conclusion

This study addresses stigma-related issues, and coping strategies used almost exclusively by family caregivers. Health policymakers and healthcare professionals working in mental health institutions should consider this data. Substantial steps must be taken to combat stigma, with education initiatives topping the list.

Barriers and facilitators to accessing inpatient and community substance use treatment and harm reduction services for people who use drugs in the Muslim communities: A systematic narrative review of studies on the experiences of people who receive services and service providers

BACKGROUND

The prevalence of drug use in Muslim communities is difficult to estimate due to religious, social, and cultural prohibition toward drug use. With Islam affecting all aspects of life in the Muslim world, people who use drugs do it clandestinely to avoid stigma and exclusion from the community, leading to a low number of them seeking treatment for their drug use. This review explored the barriers and facilitators to accessing inpatient and community substance use treatment and harm reduction services for people who use drugs in Muslim communities.

METHODS

This review was in accordance with PRISMA. Seven databases were systematically searched for qualitative, quantitative, and mixed methods studies conducted in countries where at least 70% of the population were Muslim or where data were presented separately for Muslim communities in other countries. Eligible articles were reviewed, and key qualitative themes were abstracted and compared across studies and settings.

RESULTS

Twenty-four studies were included from Iran, Bangladesh, Afghanistan, Tajikistan, Kazakhstan, Kyrgyzstan, Egypt, Lebanon, and UAE. Two themes were identified: a psychosocial theme included denial of the problem severity, lack of trust in the treatment system, fear of breach in confidentiality and privacy, the need for community support, religion and women who use drugs. Additionally, an organizational theme included affordability, treatment Service characteristics, lack of Awareness, service providers' Attitudes, drug use registration and fear of legal consequences of drug use. Stigma was also identified as an over-arching theme. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included studies with where 12 of the studies met all 5 the quality criteria. No studies were excluded for having lower quality scores.

CONCLUSION

This review reflected how diverse the Muslim world is in drug use. It is important to use mosques to raise awareness on people who use drugs and reduce stigma. Providing holistic services for people who use drugs specially women will improve their access to treatment and harm reduction services in the Muslim world.