1
|
Beukema L, de Winter AF, Korevaar EL, Hofstra J, Reijneveld SA. Investigating the use of support in secondary school: the role of self-reliance and stigma towards help-seeking. J Ment Health 2024; 33:227-235. [PMID: 35502838 DOI: 10.1080/09638237.2022.2069720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/29/2022] [Accepted: 04/19/2022] [Indexed: 10/18/2022]
Abstract
Purpose: Adolescents are the least likely to seek help for their mental health problems. School may be an important route to improve early recognition of adolescents with mental health problems in need for support, but little is known about the barriers to school support.Materials and methods: Data were collected in a longitudinal cohort study of Dutch adolescents (age 12-16) in secondary school (n = 956). We assessed the relation between level of psychosocial problems at the beginning of the school year (T1) and the support used in school at the end of that school year (T2), whether the willingness to talk to others (measured at T1) mediates this relation, and whether stigma towards help-seeking (T1) moderates this mediation.Results: Adolescents with more psychosocial problems were more likely to use support in school and were less willing to talk to others about their problems, but the willingness to talk to others was not a mediator. Stigma moderated the relationship between psychosocial problems and willingness to talk to others.Conclusions: Most adolescents with psychosocial problems get support in Dutch secondary school regardless of their willingness to talk to others about their problems. However, perceiving stigma towards help-seeking makes it less likely for someone to talk about their problems.
Collapse
Affiliation(s)
- L Beukema
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A F de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E L Korevaar
- Department of Rehabilitation, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - J Hofstra
- Department of Rehabilitation, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - S A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
2
|
Prizeman K, McCabe C, Weinstein N. Stigma and its impact on disclosure and mental health secrecy in young people with clinical depression symptoms: A qualitative analysis. PLoS One 2024; 19:e0296221. [PMID: 38180968 PMCID: PMC10769096 DOI: 10.1371/journal.pone.0296221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Clinical depression ranks as a leading cause of disease and disability in young people worldwide, but it is widely stigmatized. The aim of this qualitative research was to gather young people's experiences of depression stigma and its impact on loneliness, social isolation, and mental health disclosure and secrecy. This novel information can then be used to guide psychosocial interventions for young people with depression. METHODS This qualitative study included N = 28 young people aged 18-25 years (Mage = 21.30). Participants were recruited from the community who had high symptoms of depression (assessed through a pre-screen using the Mood and Feelings Questionnaire (MFQ) with a benchmark score > 27) or had been recently diagnosed with depression by a medical professional. Semi-structured interviews were based on conceptual model drawings created by participants and analyzed using thematic analysis. RESULTS Four main themes emerged: 1) Depression secrecy: positive and negative aspects; 2) Depression disclosure: positive and negative aspects; 3) The solution is selective disclosure; and 4) Participants' recommendations do not align with personal preferences. In particular, the young people described non-disclosure as a way to be in control, but that secrecy prevented authentic engagement with others. Young people also described disclosure as eliciting more stigma but as necessary to gain help. Finally, the young people described struggling with knowing how much to disclose in relation to their mental health and with whom they could disclose. CONCLUSIONS This study provides new evidence of how young people with depression experience stigma and its effects on disclosure and mental health secrecy. Knowing how young people struggle with these issues can allow us to develop interventions to encourage them to come forward and discuss their mental health in order to receive appropriate support and treatment. We recommend young people be signposted and have access to mental health champions or nominated teachers in their schools or universities.
Collapse
Affiliation(s)
- Katie Prizeman
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Ciara McCabe
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Netta Weinstein
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| |
Collapse
|
3
|
Prizeman K, Weinstein N, McCabe C. Effects of mental health stigma on loneliness, social isolation, and relationships in young people with depression symptoms. BMC Psychiatry 2023; 23:527. [PMID: 37479975 PMCID: PMC10362624 DOI: 10.1186/s12888-023-04991-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/30/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is the most prevalent affective disorder and the leading cause of illness and disability among young people worldwide. Besides being more susceptible to the onset of depression, young people have a higher risk of loneliness, and their personal and social development is impacted by social relationships during this time. It is thought that mental health stigma can undermine both help-seeking and longer-term outcomes for disorders like depression in young people. However, how stigma (i.e., related to depression) might affect young people's feelings of loneliness, social isolation, and relationships is unclear. Using qualitative research methods, this study aimed to explore the subjective experiences of public and internalized stigma and its effects on loneliness, social isolation, and relationship quality in young people with depression symptoms. METHODS We carried out in-depth, semi-structured interviews with N = 22 young people aged 17-25 (Mage = 22 years) who reported high symptoms of depression (Mood and Feelings Questionnaire (MFQ) score > 27) (i.e., community sample, N = 9) or had been previously diagnosed with depression by a medical professional (i.e., clinical sample, N = 13). Data were analysed using thematic analysis. We explored the subjective effects of depression stigma on loneliness, social isolation, and relationships. RESULTS Participants described both public stigma (i.e., initiated by others) and internalized stigma (i.e., self-imposed) as disrupting social relationships and eliciting loneliness, isolation, and depressive symptomology. Four main themes about young people's subjective experiences of stigma were identified: 1) Others' Misunderstanding of Mental Health Disorders and the Impact Misunderstanding has on Relationships; 2) Effects of Stigma on the Self and Wellbeing; 3) Stigma Fosters Secrecy Versus Disclosure; and 4) Stigma Increases Loneliness Driven by Avoidance of Social Contexts. CONCLUSIONS Young people's accounts revealed a wide range of consequences beyond their depression diagnosis. Participants often felt discriminated against, misunderstood, and judged by others as a result of public stigma; they discussed internalizing these attitudes. They suggested that a lack of understanding from others, for example from their partners, family, and peers, and unreliable and/or absent support systems resulted in increased feelings of loneliness and social isolation and reduced the quality and quantity of relationship formation, social bonds, and interactions. Stigma also reduced their self-esteem and confidence, which in turn fostered secrecy and a reluctance to disclose their depression. Despite depression's stigma, most participants reported having long-term goals and aspirations to reconnect with others. These goals stood in contrast to feeling hopeless and unmotivated during periods of depression. Overall, we reveal how stigma can impact feelings of loneliness, social isolation, and relationships among young people with depression, which could lead to targeted interventions to lessen the impact of stigma in this population.
Collapse
|
4
|
Migliorini C, Lam DSM, Harvey C. Supporting family and friends of young people with mental health issues using online technology: A rapid scoping literature review. Early Interv Psychiatry 2022; 16:935-957. [PMID: 34729912 DOI: 10.1111/eip.13230] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/20/2021] [Accepted: 10/19/2021] [Indexed: 12/25/2022]
Abstract
AIM Family and friends are often the first and/or only support options used by young people (12-25 years) struggling with mental health issues. The overarching aim of this literature review is to map current practice in online interventions specifically targeting family and friends of young people with mental health issues, especially relevant in light of the current worldwide COVID-19 pandemic. METHODS A rapid scoping literature review was conducted searching health and psychology databases for online interventions targeting family and friends supporting a young person (12-25 years) struggling with a mental health issue. The search strategy was comprehensive and expert librarian endorsed. The final synthesis comprised 13 articles. RESULTS Identified articles were few, reporting a disparate range of research aims, intervention content and delivery modes. Studies addressing caregivers of adolescents with a mental health diagnosis were small-scale, although suggested virtual modalities are positively received and viable alternatives to other delivery methods with potential for equivalent outcomes. Five randomized control trials involving caregivers of 'at-risk' adolescents reported improved parental knowledge, but mixed effects on family functioning. CONCLUSIONS Preliminary evidence suggests flexible online options including professional and peer support, to respond to carers' busy lives are needed to maximize benefits. Content that is sufficiently individualized and targeted to address the diverse needs of parents, as well as other caregivers, is also required. Well-being and self-care, in addition to parenting skills should be given more consideration in online interventions. Examination of the value of support from peers is also warranted.
Collapse
Affiliation(s)
- Christine Migliorini
- Psychosocial Research Centre, NorthWestern Mental Health Service, Coburg, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Carol Harvey
- Psychosocial Research Centre, NorthWestern Mental Health Service, Coburg, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
5
|
Dikeç G, Bilaç Ö, Kardelen C, Sapmaz ŞY, Kandemir H. Which factors affect internalized stigmatization in adolescents with mental disorders? JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2022; 35:362-371. [PMID: 35962770 DOI: 10.1111/jcap.12391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/20/2022] [Accepted: 08/01/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this descriptive study was to determine the factors affecting internalized stigmatization of adolescents with mental disorders. METHOD The study data were collected in a university hospital between August 1, 2020 and July 30, 2021 (n = 123), using a Personal information form and the Internalized Stigmatization of Mental Illness-Adolescent Form (ISMI-AF). RESULTS Gender and the number of hospitalizations were determined to be independent variables with explanatory power in the ISMI-AF, and in the model created with these variables, it was determined that these variables explained 18% of the change in the total points of the ISMI-AF. CONCLUSIONS It could be recommended that psychosocial programs are developed with the aim of decreasing internalized stigmatization and increasing the psychological resilience of adolescents.
Collapse
Affiliation(s)
- Gül Dikeç
- Department of Nursing, Faculty of Health Sciences, Fenerbahce University, Istanbul, Turkey
| | - Öznur Bilaç
- Department of Child and Adolescent Psychiatry, Hafsa Sultan Medical School Hospital, Celal Bayar University, Manisa, Turkey
| | - Cansın Kardelen
- Department of Child and Adolescent Psychiatry, Hafsa Sultan Medical School Hospital, Celal Bayar University, Manisa, Turkey
| | - Şermin Yalın Sapmaz
- Department of Child and Adolescent Psychiatry, Hafsa Sultan Medical School Hospital, Celal Bayar University, Manisa, Turkey
| | - Hasan Kandemir
- Department of Child and Adolescent Psychiatry, Hafsa Sultan Medical School Hospital, Celal Bayar University, Manisa, Turkey
| |
Collapse
|
6
|
Hancock K, Barrera M, Prasad S, Desjardins L, Shama W, Alexander S, Szatmari P. A qualitative examination of the benefits and challenges of a psychosocial screening intervention in pediatric oncology: "Support comes to us". Pediatr Blood Cancer 2022; 69:e29578. [PMID: 35084106 DOI: 10.1002/pbc.29578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/30/2021] [Accepted: 01/01/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pediatric cancer diagnosis and treatment can have detrimental mental health effects on parents (caregivers) and their children/adolescents (youth). Psychosocial screening and intervention have been recognized as standards of care in pediatric oncology. The most effective psychosocial interventions to support those in need post screening have not been determined. AIMS This qualitative study aimed to investigate the perceived benefits and challenges for caregiver and youth participants in the screening-intervention arm of an Enhanced Psychosocial Screening Intervention (EPSI) pilot study. METHODS EPSI consists of a psychosocial navigator (PSN) who shares screening results conducted near diagnosis (T1) and monthly for 1 year (T2) with treating teams and families. All 17 caregiver-youth dyads who had completed EPSI were invited to participate in a semi-structured interview. RESULTS Ten caregivers and nine youth participated. Identified themes were grouped into benefits and challenges of EPSI: feeling supported and cared for (support comes to us regularly, having someone to talk to); and feeling empowered through knowledge of resources and services were perceived as benefits. Caregivers were challenged by feeling overwhelmed, and youth by screening questions perceived as too repetitive. CONCLUSIONS Regular monthly contacts for a year by the PSN with screening results and recommendations were perceived as beneficial by youth newly diagnosed with cancer and their caregivers who participated in EPSI. Feeling that support came to them and they had someone to talk to was a critical component. While information about psychosocial resources was not always used right away, it did evoke feelings of being empowered.
Collapse
Affiliation(s)
- Kelly Hancock
- Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Maru Barrera
- Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Soni Prasad
- Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Leandra Desjardins
- Research Centre, Sainte-Justine University Health Center, Montreal, Quebec, Canada
| | - Wendy Shama
- Department of Social Work, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sarah Alexander
- Division of Haematology, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| |
Collapse
|
7
|
Rasmussen EE, Shannon KL, Pitchford B. Adolescents' Disclosure of Mental Illness to Parents: Preferences and Barriers. HEALTH COMMUNICATION 2022; 37:346-355. [PMID: 33106039 DOI: 10.1080/10410236.2020.1839201] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Adolescents with a diagnosable mental health disorder must often first disclose their mental health problems to a parent in order to obtain professional mental health treatment. The decision to disclose private, personal health information is the result of successful progression through disclosure decision-making processes fraught with barriers that can discourage disclosure; therefore, the current study explored adolescents' perceptions of factors that facilitate or discourage disclosure of mental health information to parents. Thematic analysis of a series of focus groups with adolescents with and without a mental health disorder discovered several themes that describe factors adolescents consider in the disclosure decision-making process. Several identified themes are consistent with past research related to health-related disclosure decisions, but some themes suggest that the mental health disclosure decision-making processes of adolescents may be different than the decision-making processes of adults in other health contexts. Results of the study have implications for interventions associated with adolescents' and parents' mental health literacy, mental health stigma and communication about mental health issues.
Collapse
|
8
|
Kaushik A, Papachristou E, Telesia L, Dima D, Fewings S, Kostaki E, Gaete J, Ploubidis GB, Kyriakopoulos M. Experience of stigmatization in children receiving inpatient and outpatient mental health treatment: a longitudinal study. Eur Child Adolesc Psychiatry 2021; 32:675-683. [PMID: 34751811 PMCID: PMC10115721 DOI: 10.1007/s00787-021-01904-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
Mental health-related stigma is poorly understood, and minimal research has focused on the experience of stigma from children's perspectives. We sought to investigate whether children treated as inpatients and outpatients had different experiences of stigma over time and whether stigma is linked to global functioning cross-sectionally and longitudinally. Children, aged 8-12 years, receiving treatment within a national specialist mental health inpatient unit were matched for age, gender and diagnosis with children receiving outpatient treatment (N = 64). Validated measures of stigma, global functioning and symptom severity were collected at the start of treatment and upon discharge from the ward for inpatients, and a similar timeframe for their individually matched outpatients. Latent change score models and partial correlation coefficients were employed to test our hypotheses. No differences in most aspects of stigma between children treated as inpatients and outpatients were observed, except for personal rejection at baseline and self-stigma at follow-up favouring outpatients. A reduction in stigma was observed in societal devaluation, personal rejection and secrecy for inpatients, and self-stigma and secrecy for outpatients between the two assessments. Societal devaluation declined at a higher rate among inpatients compared to outpatients, albeit reductions in stigma were comparable for all remaining measures. No association was found between the change in stigma and change in global functioning. Future research may offer further insights into the development and maintenance of stigma and identify key targets for anti-stigma interventions to reduce its long-term impact.
Collapse
Affiliation(s)
- Anya Kaushik
- National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK
| | - Efstathios Papachristou
- Department of Psychology and Human Development, UCL Institute of Education, University College London, London, UK
| | - Laurence Telesia
- National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (PO66), King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Danai Dima
- Department of Psychology, School of Arts and Social Sciences, City, University of London, London, UK.,Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sandra Fewings
- National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK
| | - Evgenia Kostaki
- National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK.,Learning Disability Specialist Health Services, Hertfordshire Partnership University NHS Foundation Trust, Braintree, Essex, UK
| | - Jorge Gaete
- Faculty of Education, Universidad de los Andes, Santiago, Chile.,Millennium Nucleus To Improve the Mental Health of Adolescents and Youths, Santiago, Chile
| | - George B Ploubidis
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
| | - Marinos Kyriakopoulos
- National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK. .,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (PO66), King's College London, De Crespigny Park, London, SE5 8AF, UK. .,First Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece.
| |
Collapse
|
9
|
Boege I, Corpus N, Weichard M, Schepker R, Young P, Fegert JM. Long-term outcome of intensive home treatment for children and adolescents with mental health problems - 4 years after a randomized controlled clinical trial. Child Adolesc Ment Health 2021; 26:310-319. [PMID: 34477291 DOI: 10.1111/camh.12500] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Admission rates to child and adolescent mental health inpatient units in Germany are substantial (58.831 admissions in 2019). Historically, different treatment pathways have not been available. The evidence suggests that home treatment could be an alternative. The objective of this study was to assess the long-term stability of treatment gains among children and adolescents treated for serious mental health problems with home treatment (HT) as compared with inpatient treatment-as-usual (TAU). METHODS Hundred patients were enrolled and randomized into an intervention (HT n = 54) and control group (TAU n = 46). Follow-up data were available after 8.4 months (n = 78) (T3) and after 4.3 years (n = 51) (T4). The primary outcome measured was overall level of functioning, for which the Children's Global Assessment Scale (CGAS) was used. Secondary outcomes included severity of patient impairment and parental competency in dealing with their child's symptoms, measured using the Health of the Nation Outcome Scales (HoNOSCA). A qualitative interview with parents was performed at T3 and T4. RESULTS Treatment effects remained stable for both groups at T3 and T4 (p < .001). After 4.3 years 70% of the parents in the intervention group stated satisfaction with the treatment received, while only 36.8% of the parents within the control group rated themselves as satisfied. 43.7% of parents in the home treatment group reported that the most helpful aspect of this pathway was the prompt and intensive professional help and advice they received as primary caregivers at home. CONCLUSIONS Home treatment may be considered a viable alternative to inpatient care.
Collapse
Affiliation(s)
- Isabel Boege
- CAP, ZfP Suedwuerttemberg, Ravensburg, Germany.,CAP, Universitaet Ulm, Ulm, Germany
| | | | | | | | | | | |
Collapse
|
10
|
Rüsch N, Kösters M. Honest, Open, Proud to support disclosure decisions and to decrease stigma's impact among people with mental illness: conceptual review and meta-analysis of program efficacy. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1513-1526. [PMID: 33893512 PMCID: PMC8429161 DOI: 10.1007/s00127-021-02076-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/07/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Honest, Open, Proud (HOP; formerly "Coming Out Proud"/COP) is a peer-led group program to support people with mental illness in their disclosure decisions and in their coping with stigma. The aims of this study were to provide (i) a conceptual review of HOP, including versions for different target groups and issues related to outcome measurement and implementation; and (ii) a meta-analysis of program efficacy. METHODS Conceptual and empirical literature on disclosure and the HOP program was reviewed. Controlled trials of HOP/COP were searched in literature databases. A meta-analysis of HOP efficacy in terms of key outcomes was conducted. RESULTS HOP program adaptations for different target groups (e.g. parents of children with mental illness; veterans or active soldiers with mental illness) exist and await evaluation. Recruitment for trials and program implementation may be challenging. A meta-analysis of five HOP RCTs for adults or adolescents with mental illness or adult survivors of suicide attempts found significant positive effects on stigma stress (smd = - 0.50) as well as smaller, statistically non-significant effects on self-stigma (smd = - 0.17) and depression (smd = - 0.11) at the end of the HOP program. At 3- to 4-week follow-up, there was a modest, not statistically significant effect on stigma stress (smd = - 0.40, 95%-CI -0.83 to 0.04), while effects for self-stigma were small and significant (smd = - 0.24). Long-term effects of the HOP program are unknown. CONCLUSION There is initial evidence that HOP effectively supports people with mental illness in their disclosure decisions and in their coping with stigma. Implementation issues, future developments and public health implications are discussed.
Collapse
Affiliation(s)
- Nicolas Rüsch
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm/Günzburg, Germany.
| | - Markus Kösters
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm/Günzburg, Germany
| |
Collapse
|
11
|
Abstract
PURPOSE OF REVIEW Children and adolescents with mental health difficulties, and people associated with them, can experience stigma as a result of these difficulties. This article aims to provide an update on the literature pertaining to mental health-related stigma in children and adolescents. RECENT FINDINGS Recent studies have investigated public stigma, self-stigma and affiliate stigma related to child and adolescent mental health difficulties. Research has typically employed a cross-sectional design. Significant variation was identified in both study methodology and study findings. Qualitative studies offer a unique perspective of stigma from the point of view of the stigmatized individual. Significantly, quantitative analysis has found different variables to be associated with stigma in different geographical locations, even when similar measures are used. SUMMARY Stigma can have a significant detrimental impact on the quality of life for those affected. Careful attention should therefore be paid to stigma in the assessment and treatment of children and adolescents with mental health difficulties. Furthermore, its impact on their caregivers should not be overlooked. Further research is needed to understand the role of social and cultural factors in the development and impact of stigma, and may aid production of antistigma interventions.
Collapse
|
12
|
McMillan SS, Stewart V, Wheeler AJ, Kelly F, Stapleton H. Medication management in the context of mental illness: an exploratory study of young people living in Australia. BMC Public Health 2020; 20:1188. [PMID: 32731858 PMCID: PMC7392659 DOI: 10.1186/s12889-020-09237-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 07/12/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Young people face significant challenges when managing a mental illness, such as acquiring treatment autonomy, being inexperienced users of the healthcare system and associated peer-related stigma. While medication use can be challenging in its own right, there is comparatively little information about the associated experiences and needs of young people with mental illness, particularly in the Australian context. This exploratory study will provide valuable insight into how this group is currently supported in relation to medication use. METHODS Young people (aged 14-25 years) who had used a prescription medication for any mental illness for a minimum of 2 months were eligible to participate in this qualitative exploratory study. Semi-structured interviews were conducted between October 2017-September 2018 in consultation rooms at two youth-focused mental health support organisations in Brisbane, Queensland. Interview questions explored how participants managed their medication and related experiences. Interviews were transcribed verbatim and descriptively analysed using thematic analysis. RESULTS Eighteen young people discussed their lived experience during interviews averaging 50 min in duration. Finding the right medication that reduced symptom severity with minimal side-effects was identified as a complex experience for many, particularly when there was a lack of information, support or reduced financial capacity. Young people described a range of strategies to manage medication side-effects, changes and to support routine medication use. CONCLUSIONS Young people persevered with taking medication to manage a mental illness within a healthcare system that does not adequately support this vulnerable population. There remains a clear directive for healthcare professionals to provide credible information that proactively engages young people as healthcare participants, and for policy makers to consider financial burden for this population with limited financial capacity.
Collapse
Affiliation(s)
- Sara S. McMillan
- School of Pharmacy and Pharmacology, Quality Use of Medicines Network, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Victoria Stewart
- School of Human Services and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Amanda J. Wheeler
- School of Human Services and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Fiona Kelly
- School of Pharmacy and Pharmacology, Quality Use of Medicines Network, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Helen Stapleton
- School of Human Services and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| |
Collapse
|
13
|
Byrne L, Wykes T. A role for lived experience mental health leadership in the age of Covid-19. J Ment Health 2020; 29:243-246. [DOI: 10.1080/09638237.2020.1766002] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Louise Byrne
- Fulbright Fellow, Lived Experience Researcher, School of Management, RMIT University, Melbourne, Australia
- Program for Recovery and Community Health, Department of Psychiatry, School of Medicine, Yale, New Haven, CT, USA
| | - Til Wykes
- Professor of Clinical Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| |
Collapse
|
14
|
Wykes T, Evans J. Gender diversity in the Journal of Mental Health - how are we doing and what do we need to do? J Ment Health 2020; 29:493-495. [PMID: 32191147 DOI: 10.1080/09638237.2020.1739254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jo Evans
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
15
|
Tuaf H, Orkibi H. Community-based rehabilitation programme for adolescents with mental health conditions in Israel: a qualitative study protocol. BMJ Open 2019; 9:e032809. [PMID: 31857314 PMCID: PMC6937008 DOI: 10.1136/bmjopen-2019-032809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION In Israel, 12% of adolescents have mental health conditions. Approximately 600 adolescents with mental health conditions are hospitalised each year and about 40% of them return to the hospital and are thus cut-off from their daily lives and peers in the community. In contrast to adults, adolescents with mental health conditions in Israel are not eligible by law for rehabilitation services. Thus, the overarching goal of this qualitative study is to identify best practices for the implementation of community-based psychosocial rehabilitation programme for this population, by examining the first such programme in Israel. Amitim for Youth, which was established in 2018 by the Israel Association of Community Centers in cooperation with the Ministry of Health, the Ministry of Education and the Special Projects Fund of the National Insurance Institute. METHODS AND ANALYSIS Qualitative data will be collected through in depth semi-structured interviews and focus groups. To identify themes and patterns in the data, a six-stage reflexive thematic analysis approach will be used. A triangulation procedure will be conducted to strengthen the validity of the findings collected by different methods and from various stakeholders in the programme: the programme's decision-makers, programme team members, the intended beneficiaries and referring mental health professionals. To insure the trustworthiness of the findings, three strategies will be employed: memo writing, reflexive journaling and member checking. ETHICS AND DISSEMINATION This study was approved by the Ethics Committee for Human Research in the Faculty of Social Welfare and Health Sciences at the University of Haifa (#455-18) and by the Chief Scientist in the Ministry of Education (#10566). All participants will sign an informed consent form and will be guaranteed confidentiality and anonymity. Data collection will be conducted in the next 2 years (2019 to 2020). After data analysis, the findings will be disseminated via publications.
Collapse
Affiliation(s)
- Hila Tuaf
- School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Hod Orkibi
- School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| |
Collapse
|
16
|
Mulfinger N, Rüsch N, Bayha P, Müller S, Böge I, Sakar V, Krumm S. Secrecy versus disclosure of mental illness among adolescents: II. The perspective of relevant stakeholders. J Ment Health 2019; 28:304-311. [DOI: 10.1080/09638237.2018.1487537] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Nadine Mulfinger
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany,
| | - Nicolas Rüsch
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany,
| | - Philipp Bayha
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany,
| | - Sabine Müller
- Department of Child and Adolescent Psychiatry, University Hospital Ulm, Ulm, Germany,
| | - Isabel Böge
- Department of Child and Adolescent Psychiatry, Centre for Psychiatry Ravensburg Weissenau, Ravensburg, Germany,
| | - Vehbi Sakar
- Department of Child and Adolescent Psychiatry, Josefinum, Augsburg, Germany
| | - Silvia Krumm
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany,
| |
Collapse
|
17
|
Mulfinger N, Rüsch N, Bayha P, Müller S, Böge I, Sakar V, Krumm S. Secrecy versus disclosure of mental illness among adolescents: I. The perspective of adolescents with mental illness. J Ment Health 2018; 28:296-303. [DOI: 10.1080/09638237.2018.1487535] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Nadine Mulfinger
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany,
| | - Nicolas Rüsch
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany,
| | - Philipp Bayha
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany,
| | - Sabine Müller
- Department of Child and Adolescent Psychiatry, University Hospital Ulm, Ulm, Germany,
| | - Isabel Böge
- Department of Child and Adolescent Psychiatry, Centre for Psychiatry Ravensburg Weissenau, Ravensburg, Germany, and
| | - Vehbi Sakar
- Department of Child and Adolescent Psychiatry, Josefinum, Augsburg, Germany
| | - Silvia Krumm
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany,
| |
Collapse
|