Major Depressive Disorder and Cardiovascular Disease in African-American Women

Major depression is a risk factor for cardiovascular disease (CVD). This study used the National Survey of American Life (NSAL) to examine the co-occurrence of major depressive disorder (MDD) and CVD in a nationally representative sample of African American women (n = 2,216). Results from a series of logistic regression models indicated high rates of MDD and CVD in the sample, and the African American women with MDD were 1.59 times more likely to have CVD compared to those without MDD. High rates of MDD/CVD co-morbidity appeared across those living in and not living in poverty. These individuals demonstrated greater functional impairment and were high users of mental health services. Our findings validate that MDD and CVD co-occur and the need for more holistic interventions are warranted. The interface of co-morbid health conditions is critical to developing integrated models of care. Integrated health care systems are central for improving physical and mental health outcomes. These findings facilitate developing targeted assessment procedures and culturally appropriate treatment interventions. Increased knowledge regarding the role of gender, chronic health conditions, and the burden of mental illness in African American Women provides the opportunity to examine other chronic health conditions co-occurring with MDD.     

Exploring perceptions of mental health clients and professionals about Buddhism‐based therapies at mental health hospitals in Vietnam

With 80% of Vietnamese people holding key Buddhist beliefs, Buddhism has great impact on the thoughts, emotions, and behavior of Vietnamese people. However, almost no Buddhism‐based psychosocial interventions are offered at formal psychiatric hospitals across Vietnam, nor is there any plan to incorporate these interventions into mental health care. This exploratory study examines the perceptions of mental health clients and staff regarding the effectiveness of Buddhism‐based therapies (BBTs) in mental health treatment in Vietnam, using ethnographic observation and in‐depth interviews with 24 patients and eight professionals at the only psychiatric hospital employing BBT. Participants strongly believed in the positive impact of BBT to help clients manage or improve their symptoms. However, clients and staff advised that BBT should not be used alone; rather it should be used in combination with medication and was best employed for stress‐related disorders. They unanimously supported incorporating BBT into the formal mental health system, especially if the therapies were well developed through collaboration between Buddhist monastics and mental health professionals. Results of the paper suggest that Vietnam should think strategically about developing and incorporating BBT into the formal mental health care system.     

Getting affairs in order: influences of social support and religious coping on end-of-life planning among open-heart surgery patients

Despite growing interest in end-of-life issues, little research has been done concerning end-of-life plans made by patients with cardiovascular disease (CVD), a disease that constitutes the highest mortality in the United States. Even less information is available on patients who undergo major cardiac surgery, a life-altering procedure with some risk of death, in terms of their engagement in end-of-life planning (EOLP). This prospective study enabled the contributors to explore EOLP among 309 middle-aged and older open-heart surgery patients, using survey data from three sequential interviews. A hierarchical logistic regression model shows that older age, higher education, greater social support, and negative religious coping were positively related to the likelihood of engaging in EOLP. Minority race was inversely related to EOLP. Findings suggest the potential role for social workers in helping cardiac patients to access social spiritual resources, and to consider engagement in EOLP.     

Familial caregivers of older adults

Caregivers of older adults face many obstacles as they balance family, career, and caregiving demands. Caregivers are at an increased risk for burden, stress, depression, and a variety of other mental and physical health complications. It is not uncommon for caregivers to receive some form of pharmacological therapy to treat the physical and mental health changes that may occur throughout their caregiving career. However, while pharmacological forms of treatment are invaluable, medications only may not be sufficient to treat the needs of caregivers. As such, geriatric professionals also have a responsibility to intervene with caregivers through psychosocial interventions. This paper provides an overview of caring, a summary of evidence-based psychosocial interventions for family caregivers of older adults, and recommendations for future interventions.     

Context and Scope of Social Work Interventions in Perinatal Mental Health Settings in India

The perinatal period may not be a happy time for all mothers. During this period, some may develop psychiatric complications, which have both biological and psychosocial etiology, and such illness may affect the whole family. Psychosocial aspects may trigger the illness and act as risk and maintaining factors. Social workers need to intervene in this context for optimal functioning of women with perinatal mental health issues and her family. A biopsychosocial framework may be adopted for social work assessment and intervention. Individual, familial, group, and community level intervention is required to address this complex issue, along with other mental health clinicians.     

Providing mental health services to older people living in rural communities

Rural dwelling elders who experience mental health problems often have difficulty finding help since rural communities often lack adequate mental health service providers. This paper reports on the initial phase of a 5-year, interdisciplinary clinical research study that is testing the effectiveness of providing a home delivered, therapeutic psychosocial intervention, aimed at improving the emotional wellbeing and the quality of life of medically frail elders who live in rural communities. In the early phases of this study, the clinical research team encountered a number of interesting and often unanticipated challenges as it attempted to recruit study participants and provide services to them. In this article, we examine these challenges and share what we have learned so far about providing mental health services to elderly persons living in rural environments.     

Adolescents at risk of mental health problems in the COVID-19 pandemic: A prospective population-based study of the effects of government mandates and school closures

There is increasing evidence that the COVID-19 pandemic has had substantial mental health impacts for adolescents. Yet, few definitive studies have investigated which adolescents were at higher risk of poor mental health and well-being during the pandemic. Data were drawn from the Childhood to Adolescence Transition Study, a prospective cohort study of students in Australia (N = 1211). Prevalence of mental health outcomes (depressive symptoms, anxiety symptoms, self-harm and good subjective well-being) was estimated in school Years 5–12, where Years 11 (2020) and 12 (2021) coincided with the pandemic. The age- and sex-adjusted relative risk of each mental health outcome for each priority group during the pandemic were estimated. During the pandemic, over 50% of study participants reported depressive symptoms, and one quarter reported anxiety symptoms. There was a decrease in good subjective well-being compared with pre-pandemic years, while self-harm prevalence remained similar. History of mental health problems, school disengagement and frequent peer victimisation increased the risk of experiencing mental health problems during the pandemic. Schools play a central role in maintaining the mental health and good subjective well-being of students, and this is particularly important during periods of social disruption, such as the COVID-19 pandemic.     

Evidence-based interventions with older adults: concluding thoughts

Taken collectively, the articles in this volume provide a method to assess psychosocial outcome research in aging. Although the outcome literature on effective interventions with older adults is uneven across condition and treatment approaches, there are some particular intervention methods that have received consistent research support. This article condenses the rich analyses presented by the volume authors and summarizes the interventions for which some evidence base exists by life issue/condition (health, mental health/cognitive and social rules) and outcomes achieved.     

Providing Mental Health Services to Older People Living in Rural Communities

Summary

Rural dwelling elders who experience mental health problems often have difficulty finding help since rural communities often lack adequate mental health service providers. This paper reports on the initial phase of a 5-year, interdisciplinary clinical research study that is testing the effectiveness of providing a home delivered, therapeutic psychosocial intervention, aimed at improving the emotional well-being and the quality of life of medically frail elders who live in rural communities. In the early phases of this study, the clinical research team encountered a number of interesting and often unanticipated challenges as it attempted to recruit study participants and provide services to them. In this article, we examine these challenges and share what we have learned so far about providing mental health services to elderly persons living in rural environments.     

Somatic illness and psychosocial risk among military Amerasian adolescents and young adults in Luzon,the Philippines

There are very few empirical mental health studies of military Filipino Amerasians, progeny of United States servicemen and Filipina national mothers abandoned during overseas duty. A preliminary finding in a 3-year, multiple-case study focusing primarily on stigmatization-related psychosocial risk and stress and their relationship to core mental health symptomatology showed elevated prevalence (56%) of somatic illness and probable somatization disorder among the sample (N = 16). Somatic complaints were categorized as a mental stress factor in the overall study showing (62.5%) scoring severe levels of anxiety, depression or stress using the Depression, Anxiety Stress Scales (DASS-21). The unexpected presence of somatic illness is noteworthy and with palliative implications for medical and clinical social workers and allied health professionals. Such practitioners are likely to encounter Amerasian clients who apparently number well over 50,000 throughout the archipelago, and treat Amerasians having experienced racial stigmatization and presenting psychosomatic physical ailments possibly masking somatization complications and psychopathological disorder.     

Unemployment and mental health among white‐collar workers – a question of work involvement and financial situation?

We examine whether it is a psychosocial or an economic need for employment that affects mental health among the unemployed. The relevance of both aspects are examined, concentrating on two measures of each dimension. Two perspectives of work involvement – the degree of connection to working life and the perceived employment commitment – and two perspectives on financial situation – economic security and perceived economic concern – have been analysed, using empirical data collected by means of a cross-sectional survey of 1297 unemployed white-collar workers from the public sector in Sweden. The degree of connection to working life was not significantly linked to the mental health of the unemployed, although there was a strong link between the perceived employment commitment and mental health among this group. The stronger the perceived employment commitment, the poorer the state of the person's mental health. Perceived economic concern was also tightly linked to mental health: the greater the economic concern, the poorer the mental health. Economic security also played – at least, partly – a moderate but significant role. The results provide strong support for the existence of both a psychosocial need and an economic need for employment. The analysis demonstrates that it is the perceived assessed measures of work involvement and financial situation that are linked to mental health.     

Relationships Among Caregiving,Income, Gender,and Health: A Cross-Sectional Examination of a Representative Sample of Older Americans

Although there is substantial evidence to support the effect of burden on caregivers, few studies have compared caregivers to their noncaregiving counterparts on the basis of health and well-being outcomes. This study examines the relationship between caregiving and health and whether other factors may have stronger influence on well-being measures. Using a nationally representative sample of older adults in the United States (N = 3,005), this study examines relationships between caregiving status, gender, and income, and 9 outcomes (self-rated physical and mental health, time since seeing a doctor, time since most recent pap smear or prostate-specific antigen [PSA] test, depression, loneliness, stress, anxiety), using logistic and linear regression models. Results support that paradoxically, caregiving was associated with increased likelihood of PSA test in male caregivers, although data also indicated higher levels of anxiety and stress, as might be expected. Income was associated with 8 of 9 outcomes, and gender predicted depression, anxiety, stress, and self-rated mental health. The study highlighted the importance of psychosocial stressors, such as income and gender, on the health outcomes of older adults who may be caregiving. Considering complexity of unique experience is necessary to accurately assess vulnerability to poor mental health or health-related outcomes.     

Negative Feelings and Help Seeking Among Older Adults With Chronic Conditions

Older adults with chronic conditions are at greater risk of negative affect, though few studies have focused on older adults’ perspectives on how chronic conditions affect their mental well-being. This study involved in-depth interviews that explored how older adults describe their feelings about chronic conditions, the context within which they experience these feelings, and their experiences with help-seeking for negative feelings. Participants reported that older adults experience a range of negative feelings related to their conditions and are only comfortable talking to people who understand their everyday experiences with managing chronic conditions. The findings have implications for health self-management.     

Psychological distress among women who were sexually abused as children

One of the aims of the study was to investigate how participants in self‐help groups (SHG) for women (n = 87) who had been sexually abused in childhood rated their mental health and to what extent they were at risk of developing posttraumatic stress disorder (PTSD). A further aim was to investigate the relationship between the ratings of mental health, occurrence of PTSD, women's interpersonal relationships, reasons for participating in an SHG and characteristics of the childhood sexual abuse (CSA). The participants completed questionnaires regarding their personal relationships, reasons for joining a group, abuse characteristics, mental health (Symptom Checklist‐90‐Revised) and PTSD (Impact of Event Scale‐Revised). The women showed poor mental health, and more than half of them were at risk of developing PTSD. Lack of social support and feelings of shame correlated with poor mental health, whereas guilt did not. Relationships with female friends had a positive association. Further research is needed to determine whether participating in an SHG could provide adequate social support and reduce feelings of shame, thereby contributing to the healing process in the aftermath of CSA. Key Practitioner Message: ? Child abuse is a significant component of the global burden of disease; ? Both social workers and public health care providers meet sexually abused girls and it is important that they have knowledge about the subject; ? An important clinical implication for adequate treatment would be to assess and recognise childhood sexual abuse and to link diagnosis to trauma.     

Intergenerational pathways leading to foster care placement of foster care alumni's children

This study examined a path model that postulated intergenerational relationships between biological parent psychosocial functioning and foster care alumni mental health, economic status and social support; and from these to the likelihood of children of foster care alumni being placed in foster care. The sample included 742 adults who spent time in foster care as children with a private foster care agency and who reported having at least one biological child. A full pathway was found between poorer father's functioning to greater alumni depression, which was in turn associated with negative social support, and then a greater likelihood of child out‐of‐home placement. Other parent to alumni paths were that poorer father functioning was associated with alumni anxiety and post‐traumatic stress disorder (PTSD), and poorer mother's mental health was associated with PTSD; however, anxiety and PTSD were not implicated as precursors of foster care placement of the child. Findings support the need for increased practice and policy support to address the mental health needs of parents of children in or at risk of foster care, as well as the children themselves, as family history may have a lasting influence on quality of life, even when children are raised apart from biological parents.     

Household stress and adolescent behaviours in urban families: the mediating roles of parent mental health and social supports

Using exploratory data analysis techniques, we propose a model of parent psychosocial well‐being that links financial strains and household stressors to adolescents' pro‐social behaviours and vulnerability through parent mental health and social supports. Parents of urban youth (n = 781) who planned to attend a summer camp for at‐risk youth responded to questions surveying household, parent and child factors related to early adolescent development. We expected that the relationship of household stressors – including financial strain and household difficulties – with adolescent behaviours would be mediated by parent depression and anxiety. We also anticipated that parent social supports would have both direct and indirect effects (via parent mental health) on adolescents' pro‐social behaviours. Study findings are consistent with our hypotheses and the model performed similarly for both adolescent males and females. Implications for practice and policy in the context of programmes for urban youth are discussed.     

Can Psychosocial Intervention Improve Peer and Sibling Relations Among War‐affected Children? Impact and Mediating Analyses in a Randomized Controlled Trial

Social resources are considered important protectors in traumatic conditions, but few studies have analyzed their role in psychosocial interventions among war‐affected children. We examined (1) whether a psychosocial intervention (teaching recovery techniques, TRT) is effective in improving peer and sibling relations, and (2) whether these potentially improved relations mediate the intervention's impacts on children's mental health. Participants were 428 Palestinian children [10–13 (mean = 11.29, standard deviation SD = .68)‐year‐old girls (49.4 percent) and boys (50.6 percent)], who were cluster‐randomized into the TRT and wait‐list control groups. They reported the quality of peer (friendship and loneliness) and sibling (intimacy, warmth, conflict, and rivalry) relations, and posttraumatic stress, depressive and psychological distress symptoms, as well as psychosocial well‐being at baseline (T1), postintervention (T2), and six month follow‐up (T3). Results showed gender‐specific TRT intervention effects: Loneliness in peer relations reduced among boys and sibling rivalry reduced among girls. The TRT prevented the increase in sibling conflict that happened in the control group. The mediating hypothesis was partially substantiated for improved peer relations, and beneficial changes in sibling relations were generally associated with improved mental health.     

Co‐production in the epidemiological clinic: A decentred analysis of the tensions in community‐based,client‐facing risk work

Public health policies to prevent disease within populations are giving rise to shifting patterns of healthcare delivery in the late modern era. There is an inherent tension in modern medicine between evidence‐based standardisation, on the one hand, and patient‐centred specificity on the other. This tension manifests in recent policy narratives regarding public health risk (which we have characterised in terms of the epidemiological clinic) and co‐production. Drawing on co‐produced data with health trainers (lay health workers tasked with supporting behavioural change in patients at high risk of cardiovascular disease) in a deprived post‐industrial region of England, our decentred analysis focuses on three extended narratives from this data set. Our analysis builds on and develops emerging theories of risk work, informed by Habermas, and we explore the extent to which elite narratives of public health risk are resisted, absorbed, or bracketed off by client‐facing health workers—emphasising the heterogeneity of responses—and locate these responses within the context of the workers' employment conditions, their embodied experiences, and their wider beliefs and traditions. We argue that co‐production—albeit in a highly constrained form—is possible while delivering public health interventions. However, in the context of a community where health is so adversely affected by wider social problems and where task shifting has drawn lower status healthcare workers into these client‐facing roles, workers must find their own ways to negotiate and attempt to reconcile this context with the risk‐framed practices they are required to carry out.     

Socio‐Economic Factors and Mental Health of Young People in India and China: An Elusive Link with Globalization

Globalization and its related social, cultural, and economic changes have significant mental health outcomes for young people. However, mental health disorders among youth are seldom included in the range of problems linked to globalization. It is imperative that these multifaceted associations are considered in light of the substantial and increasing burden of disease caused by mental illness, particularly in Asian countries, which are comparatively young and in next few decades will be the major sources of the growth of world’s young population. The evidence reviewed in this study makes an argument that globalization has increased [relative] poverty and deprivation, social and income inequality, migration, occupational stress, educational competition, and educated unemployment in India and China. Simultaneously there is evidence which shows that these variables are causally linked with mental health of young people. Altogether, these phenomena are accompanied by higher rates of suicide among lower class, migrant, and student youth. This substantiates the proposition that globalization has significant consequences for the mental health of young people. Some interventions for debate and discussion are considered.     

An exploration of mental health literacy among African American clergy

The purpose of this qualitative study was to explore African American clergy's mental health literacy with older congregants 60 years of age and older. Using a grounded theory approach, we recruited a purposive sample of 9 African American clergy representing diverse ages, denominations, locales, and educational levels. Data was coded and classified according to Kevin's (1976) typology of pastoral counseling and Jorm et al.'s (1997) conceptual model of mental health literacy. Findings from data analysis revealed study respondents were adherents of Kevin's Religious-Community (R-C) model. Additionally, the following themes emerged: loss of cognitive functioning, psychosocial stressors, religiosity, and appreciation for professional assistance, cultural barriers, and key informants/familiarity with formal mental health providers which partially maps onto Jorm et al.'s conceptual model of mental health literacy.