Mental health and the media: From illness to wellbeing

The media are a main source of information about mental health for many people, and an ever‐growing body of literature is evaluating their coverage of the topic. To help keep track of such research, several comprehensive but now dated literature reviews have been published. We assess more recent studies (2007–2017) and suggest future directions by integrating (a) the “circuit of mass communication” model from media and communication studies which posits that production, content, and reception need to be analysed for an in‐depth understanding of the media, (b) the holistic view of mental health as comprising both illness and wellbeing, and (3) the critical psychiatry literature questioning the assumptions underlying psychiatric knowledge and practice. We find that recent studies have focused on content and “the illness side” of mental health by examining the representation of particular mental disorders and events involving individuals with specific diagnoses. We identify as a promising development the growing interest in “the wellbeing side” of mental health whereby authors have started to analyse recovery messages. We invite more production and reception research and more critical content studies which use diagnostic labels cautiously and analyse the representation of people with mental health problems as the victims of violence.     

“Let’s Talk About Children” resource: A parallel mixed method evaluation

Psycho-education interventions for families affected by parental mental illness have been found to be effective. This study aimed to assess the feasibility of a psycho-educational resource for parents, designed to initiate family discussions about parental mental illness and educate parents about the impact of their illness on children. In a mixed methods design, 19 parents read the “Let’s Talk About Children” psycho-educational resource and completed pre-and-post questionnaires measuring their perspectives of mental illness and awareness of the impact of mental illness on their children and family. 18 of these participated in a follow-up, one hour, individual interview to obtain further feedback on the resource. After viewing the resource, changes in parents’ attitudes and/or behavior in relation to mental illness and parenting were recorded. Interview findings indicate that the resource gave parents an awareness of the skills and knowledge needed for initiating family discussions about parental mental illness. The results of this study can be used to inform future interventions targeting parents who experience mental illness.     

Exploring Epistemologies: The Debate Continues

ABSTRACT

Stigma is a significant barrier to recovery and full community inclusion for people with mental illnesses. Social work educators can play critical roles in addressing this stigma, yet little is known about their attitudes. Social work educators were surveyed about their general attitudes about people with mental illnesses, attitudes about practice with people with mental illnesses, and attitudes about students with mental illnesses. On average, educators’ general and practice attitudes were not negative. However, respondents did view a student with a mental illness differently from a “typical social work student.” Findings suggest that we, as social work educators, must raise our awareness and address our own attitudes to support students and uphold our social work values.     

From past trauma to post-traumatic growth: The role of self in participants with serious mental illnesses

Studies have shown that people with serious mental illness are more likely to have experienced trauma compared to the general population. This qualitative study employed a grounded theory approach to explore how trauma histories influenced the process of triggering, developing, and recovering from serious mental illness. Findings based on in-depth interviews with 15 participants illustrated the intersection of trauma, serious mental illness, and post-traumatic growth. Experiencing trauma compromised participants’ self-functioning, causing issues such as affect dysregulation, distorted self- and other- concepts and relationship difficulties, meaninglessness, and existential fears, all of which negatively impacted participants’ mental health and behavior. At the same time, participants with serious mental illness were able to achieve post-traumatic growth with the “transformed-self” via self-acceptance, self-exploration, self-worth, and self-fulfillment. Findings of this study have useful implications for trauma-informed care in mental health treatment. Mental health professionals should address clients’ trauma histories to prevent re-traumatization and design trauma-informed programs that use and build clients’ inner resources and strengths to promote post-traumatic growth.     

The Importance of “Empty Gestures” in Recovery: Being Human Together

What do clients/patients want or value from their encounters with healthcare providers? Based on ethnographic research conducted with individuals suffering from drug addiction and mental health issues, this article argues that clients/patients treasure “everyday” or “human” interaction with medical staff. Everydayness is accomplished through three generic social processes: **co‐silence, inclusion in back‐stage activity, and physical dramatizations of authenticity. These processes and other ordinary interactional strategies for “being human together” should be seen as vital tools for recovery.     

The Social Process Behind Inequalities in Children's Mental Health: Incorporating an Illness Career Framework

More advantaged children (both in terms of social class and racial/ethnic membership) appear protected from symptoms of mental health problem, but a pattern has emerged in which these children who tend to have better mental health are more likely to be diagnosed with certain mental health disorders. These patterns have led some researchers and professionals to wonder if the qualifications for diagnosis are culturally biased or might unfairly favor the mental health needs of more advantaged individuals in society. Evidence that White and middle‐class children are more likely to be diagnosed with certain mental health disorders raises important and legitimate concerns about the mental health profession, but this problem of social advantage leading to mental health diagnosis has often overlooked the role of social process in how children become diagnosed. Mental health diagnoses represent the culmination of a process that involves several stages and requires initiation and (often times) persistence on the part of the individual being diagnosed. This idea of process has previously been referred to as the “illness career,” and applying this logic to the study of children opens the door for renewed inquiry into understanding who is and who is not diagnosed with a mental health problem.     

Community mental health and mass media preventive education: the alternatives project.

An innovative mental health preventive education and public information program employing mass media was conducted in the Louisville, Kentucky, metropolitan area. Social work and mental health concepts of prevention were applied as a framework for developing project goals. Systematic evaluation, based on data from client-initiated telephone contacts and surveys of the community, demonstrated project success in increasing awareness and utilization of community mental health resources. The overall impact on assessment attitudes was positive; changes in resolution attitudes were not statistically significant. Implications for mass media utilization in mental health prevention are discussed.     

Mental illness etiology beliefs among African American men with serious mental illness and their social support networks

Semi-structured qualitative interviews were conducted with 26 African American men with serious mental illness who were consumers of community mental health services and 26 members of their social support networks. All participants were asked what they believed had caused the consumers’ mental illness. Consumer participants most commonly identified chronic life stressors as a causal factor, while social supports most often identified intrinsic factors such as genetics or biology as causes of mental illness. Some support participants believed that unintentional drug use had precipitated the onset of mental illness or had no causal theories. The fact that some support participants could not identify a causal explanation may indicate failure on the part of mental health care systems to engage with consumers’ social support networks and provide education about mental illness and its causes. The implications of etiology beliefs on mental health service utilization are discussed.     

Further comment on the homosexual role: A reply to goode

The Herpes Attitudes Scale (HAS) and the Herpes Knowledge Scale (HKS) were developed as research instruments to investigate knowledge and attitudes among college students about herpes. The HAS is a 40‐item Likert‐type scale with an internal consistency reliability coefficient of .91, based on a sample of 148 students. The HKS is a 54‐item true‐false test with a reliability coefficient of .88, with the same sample. Content validity of both scales was evaluated by a panel of judges knowledgeable about herpes and/or instrument construction. Since the scales are designed to detect unfavorable attitudes and general misconceptions about herpes, they can function in research applications and as both needs assessment and evaluative tools in herpes education programs.     

Introduction

ABSTRACT

Conceptualizations of mental health and mental illness continue to be an important influence in shaping social work practice and education. By critically analyzing the emergence of the current concepts of “brain disease” and “behavioral health,” we are able to better understand the stakeholders in this renaming process. The inherent assumptions and the sociopolitical aspects of these two concepts are analyzed. Recommendations for social work practitioners and educators in preparing for a future in which they will participate more fully in the professional dialog about changes in the vocabulary of mental illness and thus more meaningfully shape the service delivery system in general, and the social work domain, in particular, are offered.     

Work,Family, and Mental Health: Testing Different Models of Work‐Family Fit

Using family resilience theory, this study examined the effects of work‐family conflict and work‐family facilitation on mental health among working adults to gain a better understanding of work‐family fit. Data from the National Survey of Midlife Development in the United States (MIDUS) were used to compare different combinations of work‐family conflict and work‐family facilitation. Results suggest that family to work facilitation is a family protective factor that offsets and buffers the deleterious effects of work‐family conflict on mental health. The results across these outcomes suggest that work‐family conflict and facilitation must be considered separately, and that adult mental health is optimized when family to work facilitation is high and family to work and work to family conflict is low.     

“A Geography of Disparate Spirits”: Pathology as Oppression in “A Woman is Talking to Death” and “Mental”

This article foregrounds Judy Grahn's commitment to social justice and chiefly considers her nine-part poems: “A Woman is Talking to Death” and “Mental.” These poems illuminate the socially constructed nature of mental illness and challenge readers to consider how and why the characters within them are deemed mentally ill. Little, if any, scholarship has been devoted to using Grahn's poetry, and particularly “Mental,” as a framework for analyzing the pathologization of people, especially women, relative to the system of mental health. Her work remains relevant to critical conversations that illuminate contemporary issues of oppression that still haunt us today.     

Medicalization of Social Problems: Rising Depression-related Absenteeism in Japan

Increasing numbers of people are absent from work with a diagnosis of depression, and this has become a social problem in Japan. This study examines the hypothesis that this rise of depression-related absenteeism in Japan is influenced by social factors that contribute to the medicalization of social problems. Here, “social factors” are corporate systems that affect workers' psychology and mental health, media coverage and disease awareness campaigns by pharmaceutical companies, the intentions of patients' physicians, as well as psychopathological factors such as increased workplace stress. Data were obtained from semi-structured interviews conducted with 50 workers who had a history of taking depression-related leaves of absence, and a re-diagnosis by six physicians of 10 representative cases derived from categorizations based on data from the interviews. The data were analyzed to identify social factors underlying the rise in depression-related absenteeism and the mechanisms of medicalization of social problems. Social factors found to affect the rise of depression-related absenteeism include mentalities whereby patients, seeking to escape from harsh work environments, may wish to receive a diagnosis of depression to take a leave of absence; and the intention of participants' physicians to provide the diagnosis out of sympathy even when official diagnostic criteria are not met. Thus, it would seem that work-related social problems that should normally be addressed by public policy measures are in fact being medicalized. Moreover, this study considers how “self-medicalization” by patients renders the solution to social problems more complex by contributing to the further medicalization of social problems.     

Talking or Keeping Silent About Parental Mental Health Problems—A Grounded Theory of Parents' Decision Making and Experiences with Their Children

This grounded theory study explored parents' experiences of responding to their children's need for understanding parental mental health concerns. Fifteen parents with severe and enduring mental health difficulties participated in the study. The findings suggest four main social processes that influence parents' talk with their children about parental mental health issues, namely “Protecting and being protected,” “Responding to children's search for understanding,” “Prioritizing family life,” and “Relating to others.” Implications of the findings for clinical practice and future research are considered. In particular, the need for more family‐orientated services where parents experience parental mental health problems is highlighted.     

The construction of fear: Americans' preferences for social distance from children and adolescents with mental health problems

Debates about children's mental health problems have raised questions about the reliability and validity of diagnosis and treatment. However, little research has focused on social reactions to children with mental health problems. This gap in research raises questions about competing theories of stigma, as well as specific factors shaping prejudice and discrimination toward those children. Here, we organize a general model of stigma that synthesizes previous research. We apply a reduced version of this model to data from a nationally representative sample responding to vignettes depicting several stigmatizing scenarios, including attention-deficit/hyperactivity disorder (ADHD), depression, asthma, or "normal troubles." Results from the National Stigma Study-Children suggest a gradient of rejection from highest to lowest, as follows: ADHD, depression, "normal troubles," and physical illness. Stigmatizing reactions are highest toward adolescents. Importantly, respondents who label the vignette child's situation as a mental illness compared to those who label the problem as a physical illness or a "normal" situation report greater preferences for social distance, a pattern that appears to result from perceptions that the child is dangerous.     

Healthcare Use in the Heartland: How Health Care Selection Varies Between Rural,Retirement‐Age Migrants and Long‐Term Residents

One increasingly important problem affecting rural health care selection is the tendency of older residents to bypass local health care providers. This research investigates how the effects of community characteristics and attachment on health care bypass behavior vary between rural retirement‐age migrants and retirement‐age long‐term residents. Non‐health‐related behaviors, such as purchasing goods and services outside one's community during a health care trip, that is, “outshopping,” could influence bypass if individuals combine trips for their medical care with other consumer needs. Basing our work on the outshopping theory, we argue that bypass behavior is one facet of consumer consumption patterns for both rural retirement‐age migrants and long‐term residents. In addition, dissatisfaction with local health care and services like shopping can “push” rural residents to bypass local health care and travel greater distances for primary health care. We further contend that strong community attachment has an opposite “pull” effect that can help to negate the push of outshopping and reduce the likelihood of bypass. Our results reveal retirement‐age migrants are significantly more likely to bypass local primary health care providers than retirement‐age long‐term residents. Furthermore, our analysis bridges the rural health care and retirement community development literature to suggest that outshopping theory can now be applied to rural primary health care bypass behavior.