Category: Mental health

Well established treatments are those that have supporting research evidence. The supporting evidence comes from different studies that are well designed and conducted by independent investigators. On the other hand, a probably efficacious treatment is one that has study support, which is well designed. Meanwhile, treatments can also be controversial because there are studies of the given treatment yielding conflicting results. In other cases, treatment becomes controversial because it is efficacious, yet claims of why it works do not follow research evidence (Hajcak & Starr, 2013).

Efficacious treatment examples are prolonged exposure, present-centered therapy, and cognitive processing therapy. Another example is seeking safety (for PSTD with co-morbid substance use disorder), while the treatment that has a rating of probably efficacious is stress inoculation therapy. The efficacious status of psychological debriefing remains unknown while eye movement desensitization and reprocessing treatment are efficacious, but probably damaging (Hajcak & Starr, 2013).

Article 1

The study by Garske (2011) examines the rehabilitation treatments offered to a new generation of veterans who are at risk of chronic mental health problems.

Summary of treatment

The study reviews literature that shows the symptoms of PSTD and then analyzes other studies on the treatment of PTSD. The paper covers the main PTSD treatment options like CBT and EMDR. It discusses each treatment separately based on the available literature.

Summary of methodology

Part of the discussion is the link of eye movement desensitization and reprocessing (EMDR) treatment done to veterans as a practical alternative to behavioral exposure treatments. At the same time, it highlights controversies that exist with the treatment, but it confirms that there have been many randomized trials that support the method’s effectiveness. The authors mentioned the meta-analysis that indicated 50 percent of the participants had a complete and successful PSTD therapy that employed EMDR (Garske, 2011).

Article 2

Griffith (2013) confirmed that 92 percent of the respondents in his study found the training as helpful with their resilience competencies. The participants were able to use the skills and capabilities in military and civilian jobs. The study provides evidence for the use of stress inoculation therapy as a way of supporting recovery from PTSD.

Summary of treatment

The study used soldiers as the focus of a study with the stressors of military life and the use of the Master Resilience Training (MRT) course as the conditions considered. The study looked at whether program participants were able to resist or cope with harmful effects and stressful events after the training session. Emphasis was on the self-reported change in resilience competencies and stress-buffering, with results showing that the course was helpful.

Summary of methodology

The researcher aimed to determine whether the training was meeting its objective and formulated a study that uses a survey approach with questionnaires delivered to Army National Guard soldiers online. With a target sample population of 611, the study was able to get a 72 percent completion rate. The questionnaire used in the study was in two parts. Part one had information about the MRT course, such as the time taken to complete, the perceived helpfulness, and the transferability of skills. The second part included individual training experience, with a focus on six core competencies of the resilience training based on the MRT curriculum and automated literature review.

Article 3

In another study, Kok, de Haan, van der Meer, Najavits, and DeJong (2013) give a preliminary report on the efficacy of seeking safety as a treatment for PTSD. Following a Dutch population, they test the treatment of traumatized substance-use people.

Summary of treatment

With 12 group sessions, the researchers sought to evaluate each treatment. They mainly sought to determine how severe substance use was. Besides, the researchers also planned to use secondary outcome measures as PTSD and trauma symptoms. Others were functioning, cognition, and coping skills.

Summary of methodology

The report used a randomized control trial. With the design, the findings would describe the study’s hypothesis, which was that the intervention group to have a significant improvement when compared to the control group. The positive outcomes were expected at the end of treatment and the follow-up stage. The research is still taking place and it seeks to determine how efficacious it is to seek safety than to have CBT. CBT is another treatment offered to PTSD patients. The patients must have experienced a traumatic event and show trauma-related symptoms while meeting the DSM-IV criteria for substance dependence or abuse. Participants for the study are both male and female aged 18 and above, who are fluent in speaking Dutch. Also, participants had active substance use at least 30 days before the study.

Article 4

Gros et al. (2012) conducted a study to show how comorbid disorders can influence the effectiveness of exposure therapy for PTSD. There were notable improvements in PTSD after the study. However, there was no marked improvement in non-overlapping symptoms of depression.

Summary of treatment

Participants had two sessions for behavioral activation and therapeutic exposure. The behavioral activation session also had two sessions and on this aspect of the study, the participants engaged in activities with two main aims. One was situational exposures image exposures.

Summary of methodology

The study was a survey for a controlled population trial. It was part of the prolonged exposure treatment for PSTD. The study used 117 combat veterans who had PTSD, who were taken through eight sessions of behavioral activation (BA) and therapeutic exposure (TE). Recruitment happened through referrals and it was concentrated on the southeastern Veteran Affairs Medical Center, which is considered a central point for participant engagement.

Article 5

Dowd and McGuire (2011) reviewed recent literature as at the time of their study on psychological treatments for childhood PTSD. After the literature review, the researchers concluded that there was strong evidence for TF-CBT applied to patients of different ages and suffering from different traumas.

Summary of treatment

The researchers evaluated the treatment options once. The focus was on the evidence available about the supported usefulness of particular treatments. The treatments observed were Trauma-Focused Cognitive-Behavioral Treatments (TF-CBT), eye movement desensitization and reprocessing, and Group-Delivered Cognitive Behavioral Therapies (GD-CBT).

Summary of methodology

The researchers reviewed the literature on TF-CBT, CBT, GD-CBT, and EMDR did from 2005 to 2010 to show strong support respective methods through a meta-analysis approach. The analysis was based on accepted peer-reviewed findings. The study confirmed the harmful effects of clinical stress debriefing.

Answer to questions

Based on the five scholarly sources that used or reviewed the different treatment options for PTSD, this paper concludes with an argument that CBT is the most effective treatment. The main reason is the support provided by Dowd and McGuire (2011). Besides, the ability to modify CBT to match different groups in individual cases makes it appropriate compared to other treatments. The use of non-empirically validated treatment could be considered in cases where other treatments are not effective or the resources required are unavailable. Even in such cases, there will be a need to explain the potential consequences of the treatment to the patients and require the patients to agree to the treatment. Finally, processing actual trauma with clients ensures that all factors are considered before a particular treatment is chosen.

Rationale for answers

The reason for choosing to process actual trauma with clients is that they are going to bear the emotional burden and they happen to be the closest to the actual danger. Predicting individual reactions to the trauma news and the treatment is difficult because of different expected reactions. Therefore a standard approach is not good; instead, individualized approaches should be encouraged. Trauma often becomes a negative experience in a person’s life; hence the need for involvement of the client.

References

Dowd, H., & McGuire, B. E. (2011). Psychological treatment of PSTD in children: an evidence-based review. The Irish Journal of Psychology, 32(1-2), 25-39.

Garske, G. G. (2011). Military-related PSTD: a focus on the symptomatology and treatment approaches. Journal of Rehabilitation, 77(4), 31-36.

Griffith, J. (2013). Master resilience training and its relationship to individual well-being and stress-buffering among army National Guard soldiers. Journal of Health and Behavioral Health Services & Research, 40(2), 140-155.

Gros, D. F., Price, M., Strachaan, M., Yuen, E. K., Milanak, M. E., & Acierno, R. (2012). Behavioral activation and therapeutic exposure: an investigation of relative symptoms changes in PSTD and depression during the course of integrated behavioral activation, situational exposure, and imaginal exposure techniques. Behavior Modification, 36(4), 580-599.

Hajcak, G., & Starr, L. (2013). Posttraumatic stress disorder: Description. Web.

Kok, T., de Haan, H. A., van der Meer, M., Najavits, L. M., & DeJong, C. A. (2013). Efficacy of “seeking safety” in a Dutch population of traumatized substance-use disorder outpatients: study protocol of a randomized control trial.BMC Psychiatry, 13(162). Web.

Introduction

Research has been carried out to understand the factors that elicit disparities in mental health. Some mentally handicapped persons including ethnic and racial groups, women, children, and individuals living in rural and urban dwellings constitute the category of minorities affected by such disparities. In this regard, the research process for the evaluation of the complex issues that account for the differences in living conditions, public perspectives, and medical care requires valid research methodologies. Therefore, the collection and analysis of data need to be effective to arrive at valid and reliable results. Various government departments have been committed to uncovering the factors for disparities, but the findings leave out some critical data domains. Efficient data collection would facilitate the implementation of policies that enhance mental health parity in various settings, thus improving the government’s medical services. This paper will focus on the issues that evoke mental health disparities. Additionally, the paper explores ways in which the data collection process on mental health research can be improved.

Ethnic Disparities in Mental Health Treatment

Despite the extensive research on the topic of mental health disparities, the medical and health fraternity tends to disagree on the meaning of inequalities in the field. In this case, ethnic mental health disparities seem to induce conflicts due to the cultural diversity aspects of mental health patients. Ethnic disparities associated with mental health are characterized by differences in the quality of health care due to racial or cultural factors. Ethnic minorities in various societies experience poor health conditions and treatment due to the cultural and social constructions that include stereotyping and social exclusion (Nguyen-Feng, Beydoun, McShane, & Blando, 2014). Gaps in mental health care based on ethnicity are ascribed to the health status of the patients, hence the need for creating parity. For instance, in the US, African Americans are perceived to have poor health conditions and outcomes as compared to their white counterparts. Therefore, the treatment of mental disorders affecting African Americans tends to be compromised due to their ethnic affiliations and the perspectives of other social groups that may induce stigmatization (Nguyen-Feng et al., 2014).

The collection of data requires the researcher to reflect on identifying the issues responsible for mental health disparities. The following issues based on ethnicity or race need to be considered for improved data management systems when researching mental health disparities based on ethnic origin.

Bias and discrimination from the health care provider cause unfair treatment due to ethnic or race differences. Moreover, statistical discrimination is a cause for mental health treatment disparities whereby clinicians treat patients differently based on statistics attributed to disparate ethnic groups. Geographical differences may affect the quality of mental health care negatively due to resource allocation and the social exclusion of minority groups. Differences in health insurance cover among different ethnic groups are also attributed to inequalities in the provision of mental health services since minority communities lack adequate access to health policies (Safran et al., 2010). Therefore, it is essential for research on the topic to consider the responsible factors for the disparities in a bid to employ the appropriate data collection techniques that would enhance the realization of mental health parity.

How Government Officials can Improve Data Collection in Mental Health Disparities Research

To arrive at solutions that solve the health issues affecting citizens, government agencies ought to conduct comprehensive research on the problem. Regarding mental health problems, the collection of significant data domains based on the potential causes is essential. The National Institute of Mental Health (NIMH) in the US has initiated various research programs to investigate the aspects of mental health disparities. The agency leads in its efforts towards the alleviation of the suffering caused by mental illnesses among diverse groups in the US. For example, the NHIM Strategic Plan for Research seeks to facilitate effective data management systems that would enhance purposeful and efficient research in the health area (Nguyen-Feng et al., 2014). The following research methodologies or strategies could be implemented for better data collection and management systems in mental health disparity research.

Community-Based Participatory Research Approach

This research approach would facilitate the collection of data from respondents of different ethnic backgrounds. The improvement of the findings from qualitative research techniques would be fostered through the enhancement of the research problem when the relevant parties are engaged actively. In this case, surveys would be conducted in various regions that constitute the mental illness through the administration of well-structured questionnaires. The collection of robust data, in this case, would be facilitated by engaging faith-based organizations (FBOs), community-based organizations (CBOs), communities, mental health practitioners, and other relevant parties in the community. The identification of ethnic and social issues like residential clustering, religion, and stereotyping after interviewing the participants would enrich the data collected to realize valid results and conclusions (Safran et al., 2010). The methodology ensures the collection of data from small and understudied ethnic populations, thus facilitating the understanding of the reasons for the mental health status and treatment disparities.

Focus Group Discussions

Government officials could also adopt research methods that embrace focus group discussions that seek to elucidate the underlying causes of mental health disparities. In this regard, the focus groups would comprise ethnic minorities that have been affected by mental disorders. The strategy facilitates the collection of significant data from the subjects in various groups. The interaction in the discussions should be guided by topical questions administered through group interviews. In this regard, the definition of the complexity associated with mental health disparities would be achieved through purposeful interactions that unveil areas that need to be addressed (Nguyen-Feng et al., 2014). Therefore, data based on issues like access to health insurance, the providers’ bias, and discrimination would be collected for government institutions to formulate policies that would restore parity in mental health conditions.

Supporting and Training Researchers to Conduct Adequate Research on Mental Health Disparities

Government agencies should be committed to the provision of support and training programs that aim at enhancing data management systems on mental health status and treatment across different ethnic groups. Communication with the stakeholders regarding the science of mental health issues needs to be delivered for the process to adopt objectivity, thus avoiding bias or prejudice. In this regard, cases of statistics discrimination would be curtailed, thus resulting in inequality of treatment due to findings that come from efficient data collection mechanisms.

Studying Diverse Populations

To enhance the data collection processes when studying aspects of mental health disparities, studying diverse cultures would be strategic for the collection of comprehensive data. The approach facilitates the collection of data representing different ethnic groups, thus providing information that fosters equity. Various sampling methods should be considered depending on the distribution of the subjects in the society that constitutes different races and ethnic groups. The approach enhances the understanding of the risks associated with mental health disparities to the public since policymakers strive for the attainment of equality in the administration of services. Additionally, data management systems would be facilitated by identifying the prevention and response to treatment across diverse cultures that constitute the ethnic minorities and majorities.

Furthermore, relevant domains of data would be gathered from studying diverse populations. Data based on age, gender, and economic background would facilitate a better understanding of the ethnic and racial issues regarding mental health differences. Therefore, the diverse populations would streamline the provision of data, which is essential for the development of personalized interventions and precision medicine in the delivery of mental health care services.

Interdisciplinary Collaborations and Partnerships

Research on mental health disparities could embrace the collaborations and partnerships from different stakeholders in the field. The data collection process would be improved by incorporating researchers from disciplines like biological, behavioral, medical, environmental, and social sciences. The interdisciplinary approach allows the application of different perspectives on the study thereby boosting the quality of data gathered, thus leading to better data management systems (Nguyen-Feng et al., 2014). The assessment of qualitative and quantitative data from various researchers facilitates the attainment of valid and reliable outcomes. Despite the effectiveness of a single disciplinary approach in the exploration of a particular problem, mental health disparity issues based on ethnicity and race require comprehensiveness that could be achieved through an interdisciplinary approach. Therefore, policymakers would adopt innovative solutions that would lead to the realization of mental health parity among the public.

Conclusion

The issue of mental health disparities has been researched extensively to find solutions that would foster equality in status and treatment among various groups including race, ethnicity, gender, age, women, and children. However, loopholes in the data collection strategies have subjected the studies to the lack of comprehensiveness, thus failing to address the issue adequately. The adoption of research methodologies like focus group discussions, community-based participatory approaches, selection of a diversified population, and collaborations and partnerships would prove effective. The adoption of the data management strategies would enhance the formulation of policies that aim at solving the disparity issues in mental health, thus resulting in happier and healthier citizens.

References

Nguyen-Feng, N., Beydoun, A., McShane, K., & Blando, J. (2014). Disparities in-hospital services utilization among patients with mental health issues: a statewide example examining insurance status and race factors from 1999-2010. Journal of Health Disparities Research and Practice, 8(2), 92-104.

Safran, A., Mays, R., Huang, N., McCuan, R., Pham, K., Fisher, K., & Trachtenberg, A. (2010). Mental health disparities. American Journal of Public Health, 99(11), 1962–66.

Introduction

In this paper, the discussion is about mental health concerning Canadians. The reason why this topic was chosen for discussion because it is a fact that every Canadian is affected by mental health either directly or indirectly. This is because either one is suffering from mental illness or a family member or colleague does. It starts mostly when one is in adolescence or early adulthood (Public Health Agency of Canada, 2002). It costs a lot to manage and deal with it especially because 86% of the mental illnesses admissions occur in general hospitals.

Definition of mental illnesses

Mental illnesses can be described as the alterations that occur in an individual’s behavior, thinking, and mood. The extent of the effect is affected by the socio-economic environment, the individual, the family, and the type of illness that one is suffering from. There are several mental illnesses and this includes eating, mood, bipolar, anxiety and personality disorders, depression, and also schizophrenia. Although these disorders are said to affect all age groups and gender indiscriminately, it has been found that the the15-24, 25-44 year age groups are affected more than those who are more than 45 years old. Women also account for more hospitalizations than men.

Some illnesses affect the prevalence of mental illnesses. This may be due to the manifestation of the disease or the treatment used for that disease. Some diseases like cancer are a cause of chronic pain and this affects the mental stability of the sufferer. Others like Parkinson’s disease use some drugs in the treatment that may cause mental instability. Obesity is another disorder that can cause suffering from it to become extremely depressed when they are not able to be comfortable with their physical appearance. Apart from this, some diseases may lead to one developing an addiction to some drugs especially those that help in the management of pain.

Mental disorders can be caused by other factors apart from other physical illnesses. These causes may be genetic, personal, and also the environment the person is in. At least 20% of Canadians will at one point suffer from a mental illness. If in an individuals’ family there has been a case of mental illness, there is the possibility of the person suffering from an illness. The personality of an individual determines how well he or she can cope with everyday stress. Some succumb to incidences that others have handled quite well. This may even be as a result of taking care of a mentally ill family member; this is known as caregiver burnout (Public Health Agency of Canada, 2002).

The environment can affect a person’s mental health. There is a high prevalence of mental illness among prisoners especially due to the violence they face. Those who are very poor and homeless are also prone to suffering from mental illness. Trying to cope with the disadvantage of not having enough to get by while those around them seem to be living in luxury may lead to depression. Furthermore, when taking care of a mentally ill person, the family ends up spending so much such that they are left in economic crisis hence affecting the family members well being. The stigma associated with mental illness aggravates the situation for both the mentally ill and their family (Corrigan P. W., Edwards A.B., Green A., Diwan S. L & Penn D.L, 2001).

Impact of mental illnesses

The impact that the illnesses have on the Canadian economy is experienced in different sectors of the economy. In the labor force, there is a decrease in the number of laborers. This is because of two different factors. First, the mentally ill employee is constantly absent from work when searching for treatment or when overcome by symptoms. The second factor deals with those who take care of the ill person. If a family member is mentally ill, not only does the productivity of that person decrease but also that of the other family members. This is because their working hours are affected by the time required to take care of the ill person. Also at the workplace, they are unable to work at optimum levels because they are not mentally settled.

The financial crisis caused by spending on the treatment reduces the ability of the family to spend on consumption. It also depletes their savings and hence affects the level of investment. The loss of employment due to the ravages of the disease becomes a burden to the state and to those who are supporting the person. The impact on government revenue is also seen in the health sector. As mentioned earlier, 86% of mental illnesses admission cases take place in general hospitals. This then increases the amount spent on medical costs by the government. These illnesses may take a long time before treatment makes an impact and this affects the amount spent on an individual admitted to the hospital (Stephens T. & Joubert N, 2001).

Before carrying out this project, there was the assumption that the number of people suffering from mental illness was less than that which is statistically proven. Apart from this, there was also the assumption that the majority were found in the 65 years and over age group while this was found not to be true. The assumption that it affects the economy negatively was seen to be true. Some of the disorders that I had assumed were simply physical disorders turned out to be forms of mental illnesses. An example of this is obesity which I had always assumed was a physical disorder and not a psychological illness. Also, the assumption that most mentally ill people are poor was proved not to be entirely true. While a large percentage of mentally ill people are either directly or indirectly affected by poverty, the affluent also suffer from these illnesses.

Social problems caused by mental illnesses

The fact that most of the causes of mental illnesses are social and psychological means that some can be prevented. In the prevention, social cohesion at the individual level can be encouraged. This leads to the ability of a person to handle problems as they come. This can be improved by the family first whereby children get good parenting hence having a strong emotional foundation. A strong friendship is also very important because one is then able to discuss problems and this helps in coping with them. The availability of sustainable employment reduces poverty and consequently its effect on mental health. With meaningful employment, one can be able to get before the disease gets too far.

When it comes to the impact the medication for other illnesses has on mental health, one can give reports to the doctors on the effects the medication has on them and hence have it changed to one with fewer side effects. The people can be encouraged to involve themselves in various physical exercises that help them to manage their weight. This reduces cases of heart diseases and obesity which have been associated with cases of depression. If one is already ill, the rest of society should be taught how to deal with the illness and not shun the individual as this makes the situation worse. There should be a forum that allows people to develop personally and also air out their views so that the stigma associated with the illness may be reduced (Turner F.J, 2005).

Another social problem that causes mental illness is the abuse of people. This may be sexual or physical and causes a myriad of problems on those to who it occurs. A way should be developed on how to prevent such occurrences and when they have already occurred a way to deal with the fact. Stiffer punishments should be introduced for perpetrators of abuse but also from early childhood, there should be “teaching of cognitive-behavioral strategies can prevent or reduce the impact of anxiety disorders” (Public Health Agency of Canada, 2002). If this happens it reduces the incidences of abuse from already disturbed individuals and also helps those who are abused cope with what has happened to them.

In the medical field, it should be made mandatory for all physicians to learn about mental illness. This helps in the early and correct diagnosis of the illness. Instead of one being treated for physical illnesses when they are suffering from mental illnesses, the doctor can be able to refer them to a specialist if he or she recognizes the symptoms of a mental illness. This helps in getting the right treatment for the disease. When detected early before it progresses very far, there is a chance of reversing the effects of the illness. The treatment usually includes medication, psychotherapy, occupational therapy, cognitive behavioral therapy, and also social work. Using the right combination for the specific illness is important for the personal well-being of the sufferer.

The families and individuals should receive education on symptoms and signs of the illnesses so that they detect their onset early enough for intervention to occur. Networks of suffering individuals can be formal to help them look out for each other. The hospitals should also have a crisis response department for those suffering from mental illness. These are to be used for mental emergency cases. Apart from this, there should be community outreach programs that check on the mentally ill individuals even in their homes ensuring that they follow up on their treatment. In their workplaces where poor people are mostly found there should be support for those who suffer or have someone close to them suffering from mental illness (Canadian Alliance on Mental Illness and Mental Health, 2000).

Conclusion

In conclusion, I have found out a lot about mental illness. Some of the misconceptions I had about the causes of illness have been corrected with facts. There is also the realization that the problem is more than initially thought. It has also alerted me to the stigma that the sufferers and also their family members face at the hands of society and this will change the way I treat them from now on. The discovery of the numerous associations that have been put up to deal with mental illness has provided a place where I can get information in case I need to do further research on the topic.

References

1. Canadian Alliance on Mental Illness and Mental Health 2000. A Call for Action: Building Consensus for a National Plan on Mental Illness and Mental Health.
2. Corrigan P. W, Edwards A.B, Green A, Diwan S. L & Penn D.L 2001. Prejudice, Social Distance, and Familiarity with Mental Illness Oxford University Press and the Maryland Psychiatric Research Centre Schizophrenia Bulletin Vol. 27 No. 2
3. Public Health Agency of Canada 2002. A Report on Mental Illness in Canada. Ottawa Ontario, Public Health Agency of Canada
4. Stephens T. & Joubert N. 2001. The Economic Burden of Mental Health Problems in Canada Chronic Diseases in Canada.
5. Turner F.J 2005. Encyclopedia of Canadian Social Work Wilfred Laurier University Press Canada.
6. University of Edinburgh 2007, Study Of Damaged Gene Gives Insight Into Causes Of Mental Illness Sciencedaily. Web.

Introduction: Subjective Well-being (SWB)

Also recognized as self-reported Well-being

Introduced by Ed Diener, a psychologist in 1984

Components entails:

• Positive Affect (PA)
• Life Satisfaction (LS)
• Negative Affect (NA)

Relationship Between SWB and Physical Health

• Physical health is influenced by the satisfaction of life and enjoyment of life
• Positive affect (PA)

Associated with Reduced pain and symptoms:

• Life satisfaction (LS)

Higher life satisfaction results in better physical health:

• Negative Affect (NA)

Stable tendency associated with the frequent experience of negative emotions

Involves poor self-concept leading to conditions such as anorexia

Creates negative attitudes, chronic stress leading skins problems and hormonal imbalance

Associated with poor health leading to weak immune system

Relationship Between SWB and Mental Health

• SWB contributes through life satisfaction, determined by mental illness
• SWB as a measure of happiness and mental health
• Entails satisfaction and dissatisfaction
• Positive subjective Well-being leads to healthier mental health

Relationship Between SWB and Work

Job satisfaction influences Subjective Well-being

Negative state of mind or poor mental health leads to a lack of interest in work

Negative Affects (NA) can lead to poor physical health and hence negatively affects work

Work affects one’s life satisfaction

Relationship Between SWB and Intelligence

Age influences both emotional intelligence and SWB

Emotional intelligence leads to higher levels of subjective Well-being

Being emotionally unstable negatively affects both SWB and intelligence

SWB may negatively influence emotional intelligence

Through emotional factors one is able to control SWB

Relationship Between SWB and Race, Ethnicity

Whites report higher levels of SBW than the blacks

With the shifting racial inequality patterns

Individuals from ethnic groups considered inferior have low SWB

Relationship Between SWB and Stigma

• Stigmatization leads to low SWB
• Social support lows the degree that stigma has on SWB
• States that influence SWB include:
  • Body size
  • Type of disease
  • How individuals who are incompetent are treated

Relationship Between SWB and Religion

Religiosity and spirituality is recognized as a positive predictor of SWB (Villani et al., 2019)

Experience of closeness to the supreme being tends to positively affect SWB

Negative SWB results can be contributed by unstable religiosity

Conclusion

SWB is affected by both physical health, religious, work, stigma and race

Increased emotional intelligence leads to increased SWB

Increased rate of stigmatization results into low self satisfaction

Poor working conditions or nature of work leads to low SWB

Individuals who experience high racial disparity or racism are likely to be dissatisfied

References

Lombardo, P., Jones, W., Wang, L., Shen, X., & Goldner, E. M. (2018). The fundamental association between mental health and life satisfaction: results from successive waves of a Canadian national survey.BMC Public Health, 18(1), 1-9. Web.

Patel, J., & Patel, P. (2019).Consequences of repression of emotion: Physical health, mental health, and general well being. International Journal of Psychotherapy Practice and Research, 1(3), 16. Web.

Villani, D., Sorgente, A., Iannello, P., & Antonietti, A. (2019).The role of spirituality and religiosity in subjective well-being of individuals with different religious status. Frontiers in Psychology, (10), 1525. Web.

Introduction

Field practicum opportunities in mental health social work foster interactions between classroom knowledge and real-world examples of challenges theoretically described. Real field situations draw theories closer to practicality, such as the mental health diagnosis experience discussed in this paper. The case is a mental illness diagnosis and treatment procedure for a client with a history of mental illness who is currently showing more clinical symptoms diagnosable using reliable diagnostic manuals as described in the case. The key takeaway from Field Practicum I is that practitioners can accurately diagnose mental illnesses using physical exams and psychological evaluation without lab tests. Moreover, mental illnesses share many symptoms or exist with comorbidities, implying practitioners must address the main issue and all detected comorbidities. The direction taken in this paper is that reliable diagnostic manuals should inform the practitioner’s decision for evidence-based treatment approaches that stabilize a patient’s mental illness cases.

Client Description

Jenny is a young woman in her early 20s who lives with her family (mother, step-dad, and three other siblings) in a modest community. Jenny has a long history of abuse and neglect, having been through traumatic sexual abuse by her foster family; her biological mother physically abused her severely. The client also had an extensive history of mental health instability characterized by difficulty coping with stress, poor management of impulses, and poor self-care. Jenny’s dangerous and impulsive acts often put others at risk, especially the younger members of her family. She had a history of diminished ability to complete normal activities characteristic of daily living. Although the client reported these symptoms as historical challenges causing instability, most of them were still persistent, as explained in the client’s diagnosis next.

Presenting Issues: Diagnosis

The client has numerous persistent psychiatric symptoms that require immediate therapeutic intervention. They are anxiety, threats, impulsivity, and explosive reactions related to the reported inability to cope under stress. The client is easily frustrated and shows runaway behavior and mood swings. Moreover, she is reported to have challenges like disruption, sexual preoccupation, and manipulative behaviors. These issues reflect other reported symptoms such as binge eating, suicidal ideation, and physical aggression towards her peers and school staff. She engaged in sexualized chatrooms, scratched and cut herself when in distress, maintained poor boundaries, burned herself, or hid sharps for self-harm. Her sexual impulses have been historically dangerous as some reported behaviors are that she caused sexual harm to children or had inappropriate contact with younger children. The listed behaviors, self-reported and reported by close family, led to five diagnoses as follows:

The first diagnosis was F33.9 Major Depressive Disorder (MDD), a mental health illness affecting mood. According to the Kim and Jung (2022), a client has major depressive disorder if showing either a depressed mood or loss of interest or pleasure. The Diagnostic and Statistical Manual (DSM-5) outlines several symptoms associated with MDD. The symptoms observed in the client are recurrent thoughts of death, feelings of worthlessness, and a depressed mood that lasts most of the day (Kim & Jung, 2022). MDD is diagnosable if a client’s symptoms, as outlined above, result in clinically significant impairment in cognitive and social functions (Kim & Jung, 2022). Therefore, it is justifiable that Jenny has MDD, which requires immediate attention.

The secondary diagnosis is F40.10 Social Anxiety Disorder, a mental health case with a common comorbidity pattern with MDD. The DSM-5 describes the major symptom of social anxiety disorder as the marked fear of anxiety about an individual’s social situations (Kim & Jung, 2022). Specific symptoms observed in the client’s case are social situations avoidance because social situations provoke fear in the client. These symptoms are supported by the client’s avoidance of social activities (Kim & Jung, 2022). However, there were not many symptoms relatable with the client’s social anxiety disorder diagnosis other than the two marked behaviors.

The client’s symptoms also led to an F94.1 Reactive Attachment Disorder (RAD) diagnosis. The DSM-5 describes the major symptom associated with reactive attachment disorder as consistent emotionally withdrawn behavior, especially for adult caregivers (Kim & Jung, 2022). Persistent social and emotional disturbances indicate the presence of reactive attachment disorder, especially if the client shows behaviors such as diminished emotional responsiveness to social circles or irritability episodes even when there are no prevalent threats (Kim & Jung, 2022). The client showed, among many other behavioral characteristics, the behavioral symptoms associated with reactive attachment disorder.

The listed symptoms of reactive attachment disorder were observable in the client, including other symptoms of F84.0 autism spectrum disorder (ASD). The DSM-5 described the major symptom of ASD as the multiple patterns of deficit in social communication and interaction observed over multiple contexts (Kim & Jung, 2022). The observable characteristic of the client is deficits in developing or maintaining relationships or social interactions through non-verbal communicative behavior (Kim & Jung, 2022). Together with the fifth diagnosis, which is a personal history of self-harm, it is justifiable that the client is placed in a therapeutic group home for urgent support.

Theory Applied to Treatment

The psychodynamic theory of mental health counseling was the most appropriate model for the client’s diagnosed mental health illnesses. Crugnola et al. (2020) described the psychodynamic theory in mental health counseling as the clinical focus on the impacts of experiences on the onset of mental health symptoms. That implies the psychodynamic theory explains that mental health symptoms result from experiences encountered in an individual’s growth and developmental environment. Moreover, the psychodynamic theory best applies to the client’s case because the theory focuses on past experiences (Crugnola et al., 2020). The only alternative that would have applied to this case is the behaviorism theory, which has the exact definitions of the approach as the psychodynamic model, except that behaviorism does not focus on past experiences (Crugnola et al., 2020; Marþinko et al., 2020). Considering the client’s long history of experiences like sexual abuse and neglect, the psychodynamic model most appropriately applies in the diagnosis and therapy, drawing from past experiences to explain the persistent psychiatric symptoms in current diagnoses.

Specific Techniques Used

Techniques used with the client were brief therapies and stabilization efforts for regulating the observed mental health symptoms. The psychodynamic model of mental health counseling supports multiple brief intervention approaches for handling clinically observed mental health symptoms such as those associated with the client. The model promotes self-reflection and self-examination on the client’s side, making it easy to apply effective psychoanalysis and appropriate intervention (Cieri & Esposito, 2019). Therefore, the client’s self-examination and self-reflection techniques enabled the application of other interventions like brief psychodynamic and group psychodynamic therapy as a replacement for family therapy.

The brief psychodynamic therapy lasted only three sessions, as the technique was only useful for establishing a therapeutic connection for preparing the client for a group home intervention. According to Crugnola et al. (2020), brief psychodynamic therapy is useful in identifying circumstances leading to mental health illness and client briefing on temporary coping mechanisms. The reason for using a brief psychodynamic therapy is that the client had some acute symptoms associated with the diagnosed mental health illnesses, especially ASD and MDD. Therefore, the brief therapy was the onset of the therapy journey anticipated for the client once she joins the group home for counseling.

A specific technique used in the group home for structured support and therapeutic intervention was long-term cognitive-behavioral therapy (CBT). The CBT core principle for addressing the client’s challenges states that psychological challenges result from faulty ways of thinking or observed and acquired patterns of unhelpful behavior (Weiner et al., 2020). Therefore, the CBT approach helped restructure the client’s thinking patterns by replacing maladaptive techniques with confidence, resilience, and positive coping skills. According to Robinson et al. (2020), both high-intensity and low-intensity CBT calms a client’s mind either by making them resilient to their fears or by using role-playing to fend off problematic interactions with peers and colleagues. Therefore, the client needed close monitoring to ascertain the CBT efficacy identifiable from behavioral changes and improved coping mechanisms.

Client Response

The client showed responsiveness in the first few days of the visit and therapy, where the client was cooperative with a remarkable change in socialization behavior. Given the weight of the symptoms associated with the comorbid mental health illnesses, much of the recovery progress was to take place at the recommended group therapy home. Therefore, the only observable data obtained from the field practicum was the brief psychodynamic therapy given to the client before recommending the group home therapy. The reason is that the group therapy home professionals could not share client information without the client’s consent. However, since the client showed signs of positive behavioral change, it was anticipated that CBT under the psychodynamic model would promote positive outcomes.

Future Directions

The recommended therapy focused on cognitive behavioral therapy (CBT), evidence-based therapy for promoting positive adaptive behavior, resilience, and coping skills for patients experiencing mental illness symptoms. However, since interpersonal challenges were characterized by poor social behavior and tendencies to harm others on the path to fulfilling impulsive tendencies, the recommended future direction is that such a client undergo interpersonal therapy (IPT) alongside CBT. Moreover, mental health social workers treating clients using the IPT and CBT combined approaches should record and declare the recovery progress comparable to CBT alone.

Conclusion

The client’s history of mental health symptoms and persistent psychiatric symptoms led to the diagnosis of five mental illness conditions. They were major depressive disorder, social anxiety disorder, reactive attachment disorder, autism spectrum disorder, and personal history of self-harm. The DSM-5 manual’s explanation of the disorders matched most of the client’s reported and self-reported symptoms like impulsivity, anxiety, and explosive reactions. Therefore, the psychodynamic theory was the most suitable model for examining the client’s past experiences and their impacts on the persistent psychiatric symptoms. The model also informed two treatment approaches: brief psychodynamic therapy and CBT, though recommended for long-term therapy in a group home setting. The recommended future direction is that a client, such as the one in this case, should undergo interpersonal therapy combined with CBT to test changes in recovery duration and sustainability outcomes.

References

Cieri, F., & Esposito, R. (2019). Psychoanalysis and neuroscience: the bridge between mind and brain. Frontiers in Psychology, 10, 1-15.

Crugnola, C., Preti, E., Bottini, M., Rosaria Fontana, M., Sarno, I., Ierardi, E., & Madeddu, F. (2020). Effectiveness of a university counseling intervention based on a psychodynamic approach.Bulletin of the Menninger Clinic, 84(4), 373-398. Web.

Kim, K., & Jung, W. (2022). A Critical Review of the Definition of Mental Disorders in DSM (Diagnostic and Statistical Manual of Mental Disorders). Korean Journal of Philosophy, 150, 309-331. Web.

Marčinko, D., Jakovljević, M., Jakšić, N., Bjedov, S., & Mindoljević Drakulić, A. (2020). The importance of psychodynamic approach during COVID-19 pandemic. Psychiatria Danubina, 32(1), 15-21. Web.

Robinson, L., Kellett, S., & Delgadillo, J. (2020). Dose‐response patterns in low and high intensity cognitive behavioral therapy for common mental health problems.Depression and Anxiety, 37(3), 285-294. Web.

Weiner, L., Berna, F., Nourry, N., Severac, F., Vidailhet, P., & Mengin, A. C. (2020). Efficacy of an online cognitive behavioral therapy program developed for healthcare workers during the COVID-19 pandemic: The reduction of Stress (REST) study protocol for a randomized controlled trial.Trials, 21(1), 1-10. Web.

Past

Over the past several decades, the mental health of police officers and other first responders has been overlooked. Even though mental health illness has been found to be relatively widespread among Canadian police, which leads to adverse outcomes, including suicidal behavior. According to 2017 data, 52% of the surveyed police officers reported having moderate to severe stress, while 11% noted having extremely severe stress (Auditor General of Canada, 2017). In regard to anxiety, 88% of police officers reported having moderate to severe anxiety, while 12% said they had extremely severe anxiety (Auditor General of Canada, 2017). 87% of the surveyed police officers reported having moderate to severe depression, with 13% experiencing a severe level of depression (Auditor General of Canada, 2017). Thus, both depression and anxiety are somewhat on the same level in prevalence.

Finally, 29% of responders fell in the clinical diagnostic range for post-traumatic stress disorder (PTSD) even though the lifetime prevalence rate of PTSD among the general Canadian population was 9% (Auditor General of Canada, 2017). Even though the statistics indicate that mental health challenges have significantly affected the population under question, the problem has not yet been resolved effectively. It is notable that the symptoms of various mental health issues can occur throughout the lifetime and exacerbate with time, with conditions possibly getting worse if they remain unaddressed.

Present

Considering the history of mental health challenges among Canadian police officers, the current context indicates that the pressure will not alleviate any time soon. Specifically, the post-COVID-19 context is characterized by law enforcement officers having to deal with a larger scope of challenges when serving their communities in an environment of physical and psychological pressures (Tehrani, 2022). In contrast to many other incidents, the COVID-19 pandemic has been and remained a significant public health emergency that put a strain on police officers and their mental health.

As found in the study by Tehrani (2022), most police officers that worked during the pandemic have been emotionally affected by it, with the lowest indicators of mental health being strongly related to anxiety and depression and not compassion fatigue or PTSD. However, in individuals who have already been vulnerable to PTSD symptoms and reported experiencing compassion fatigue, the addition of anxiety and depression led to the deterioration of their mental health (Tehrani, 2022). If they remain unaddressed, the symptoms of mental health issues among law enforcement will build up, creating disengaged teams that will be less effective and productive in their everyday service.

Future

The exploration of the past and present challenges associated with the mental health of Canadian police officers calls for the development of a sustainable initiative targeting separate police departments across the country to identify their mental health needs and help address them. There is a lack of reports on how the Canadian police force receives care for their mental health challenges, which calls for the reconsideration of the current practices in the future. While the report of the Government of Canada (2019) provides evidence for an action plan on post-traumatic stress injuries experienced by police officers, there is not enough attention given to other mental health challenges. Besides, more research is needed to identify the pressing mental health needs of specifically Canadian police offers to recommend a plan of action that will allow for meeting them on both short- and long-term bases.

References

Auditor General of Canada. (2017). Report 4 – mental health support for members. Web.

Government of Canada. (2019). Supporting Canada’s public safety personnel: An action plan on post-traumatic stress injuries. Web.

Tehrani N. (2022). The psychological impact of COVID-19 on police officers. The Police Journal, 95(1), 73–87. Web.

Introduction

“The Ancient Greeks referred to stigma as a ‘bodily sign to expose something unusual and bad about the moral status of a person’. These marks were generally burnt or cut into the body to advertise the bearer was a slave, criminal or traitor, ‘a blemished person ritually polluted, to be avoided especially in public places’ (Goffman, 1963). Mental health in the United States has boiled down to the discovery of new diseases and medical issues. The social ramifications vary from drawing wrong conclusions about the state of mind, to the exclusion of social and health benefits. The development of stigmas in American society has created rampant generalizations about mental illness. The most prevalent of these is the association of mental illness and crime or imprisonment. Professionals believe there are solutions to the uneducated views of the public towards those people being diagnosed with a mental health issues. As a foundation, the general public must be more informed about the myths of mental health issues. The most efficient way for this to happen is through the media. The overall goal is for the general public to realize that psychology is part of daily lives, not the remedy for juvenile delinquency.

Main Issues

Mental illness affects many aspects of suffers’ life, the most important is that the diagnosis of mental illness comes with the additional burden of a negative label. The term stigma refers to any persistent trait of an individual or group which evokes negative or punitive responses. Goffman (1963) has made the salient point that it is not the functional limitations of impairment which constitute the greatest problems, but rather the perceptions of negative difference and their evocation of adverse social responses. He argues that a person is not a deviant until his acts or attributes are perceived as negatively different. Arboleda-Florez (2003) explains:

Stigma develops within a social matrix of relationships and interactions and has to be understood within a 3-dimensinal axis. The first of three dimensions is perspective; that is, the way stigma is perceived by the person who does the stigmatizing (perceiver) or by the person who is being stigmatized (target). The second dimension is identity, defined along a continuum from the entirely personal at one end to group-based identifications and group belongingness at the other. The third dimension is reactions; that is, the way the stigmatizer and the stigmatized react to the stigma and its consequences.

This stigma has become the standard, not the exception, with mental health cases in America. The psychological underpinning to this appears to be that so called normal people exaggerate the difference between those that are mentally ill and themselves, because disability symbolically represents fear of what could be. Corrigan (2004) adds, “Mental illness strikes with a two-edged sword. On one side is the psychological distress and psychiatric disabilities that prevent people from accomplishing and enjoying life goals. On the other hand, is the public’s reaction to mental illness; a plethora of prejudicial beliefs, emotions, and behaviors that cause the public to discriminate against those labeled mentally ill.”

Although the ability to refuse the internalization of negative societal attitudes exists, those with a mental illness often accept the premises and values which underlie their social identities. Vogel, Wade and Hackler (2007) contend that:

Despite the awareness of the relationship between perceived public stigma and the decision to seek treatment, the complex role that stigma plays in this decision-making process is not fully known…public stigma, is the perception held by others (i.e. by society) that an individual is socially unacceptable. The second, self stigma, is the perception held by the individual that he or she is socially unacceptable, which can lead to a reduction in self-esteem or self-worth if the person seeks psychological help.

Self stigma is also perpetuated through the views of individuals by mental health professionals. This is commonly referred to as disidentification. Servais and Saunders (2007) explain, “disidentification also occurs when one feature of an individual is used to define the totality of the individual’s existence, such as when mental health professionals refer to clients as their psychological disorder (e.g., “borderlines” and “schizophrenics”).”

In addition to the psychological perspective, researchers have also focused on the symbolic associations of medical labels and media images. Media portrayals are of great interest to researchers because they reflect and perpetuate stereotypical ways of thinking about mental health. Diefenbach and West (2007) explain, “Although media portrayals of mental illness have been predominantly negative, with factors such as ‘violence,’ ‘unpredictability,’ and ‘dangerousness’ cited as common characteristics of mentally disordered characters in the media, the question remains as to whether these portrayals are, indeed, inaccurate. The criminology literature supports the contention that media portrayals are sensationalized and exaggerated.” Television has always visualized violent and negative images of mental health issues. (Diefenbach and West, 2007).

The media has much to do with research into the social encounters between those with a mental illness and those without show there is a sense of being uncomfortable and uncertain when interacting with persons who are mentally ill. Corrigan, Larson and Kuwabara (2007) state the major form of discrimination against people with psychiatric disorders is represented in the belief that people with psychiatric disorders are dangerous or threats to society. In testing the hypothesis of disseminating more knowledge about mental illness, mental health professionals found it often leads to the increase in social distance. (Lauber, Nordt, Falcato & Rossler, 2004). As a result, many people choose to distance themselves from people with mental illness. Angermeyer and Matschinger (2005) stress, “regardless of whether people are familiar with mental illness or not, the beneficial effect of labeling on the stereotype, namely that there is less blaming for the occurrence of the illness, does not translate into a decrease for social distance.”

Social distance takes on a whole new meaning in America, in large part, due to the fact that so many people are still uninformed or, more likely, ill-informed about the course of mental illnesses. Arboleda-Florez (2003) simply tells us, “Prejudice often stems from ignorance or unwillingness to find the truth.” He continues:

For example, a study conducted by the Ontario Division of the Canadian Mental Health Association in 1993-1994 found that the most prevalent misconceptions about mental illness include the belief that mental patients are dangerous and violent (88%); that they have a low IQ or are developmentally handicapped (40%); that they cannot function, hold a job, or have anything to contribute (32%); that they lack willpower or are weak and lazy (24%); that they are unpredictable (20%); and finally, that they are to be blamed for their own condition and should just “shape up” (20%).

These myths and have not been substantiated through research. The misconceptions have constructed not only the common practice of social distance, but also the impression that people of all ages with mental illness have a stronger tendency for criminal activity.

After taking a closer look at the problem of stigma in mental illness, it becomes clearer that there are many layers to the association of mental illness and juvenile delinquency. Brett (2003) argues, “Arrest records have been used to examine patterns of offending in those with mental illness. Mentally disordered people have been found to be more likely to be arrested than those seemingly free of mental illness, even when the offending behaviors are the same.” To date, there is not a concise procedure for managing people with mental illness in regards to the justice system. Without the proper management of mental health cases, the justice system continues adding to the misconceptions.

Links between mental health and criminal activity have been closely associated, as well as increased attention to juvenile delinquency. Therefore, American children can be considered the difference in this equation. The connection between mental retardation and other disorders, especially autism, has become a growing debate. However, Edelson (2006) argues:

Research has shown that low scores on developmental scales do not predict subsequent development in children with autism as well as they predict the development in typical children and that adaptive scales can underestimate the intelligence of children with autism. Developmental and adaptive scales may be particularly problematic for higher functioning children with autism, who may have a discrepancy between their intelligence and what adaptive or developmental measures would predict.

The relationship between autism and juvenile delinquency has not been closely researched; however social behavior is very scrutinized. Edelson (n.d.) claims, “One of the most characteristic symptoms of autism is a dysfunction in social behavior.” Social avoidance, indifference and awkwardness are three classifications of social problems. Social avoidance is considered the complete evasion of any form of contact. Indifference takes place when the individual does not actively seek or avoid contact. Awkwardness occurs when individuals with autism might try extremely hard to create friendships, but continually struggle due to the fact that they often do not reciprocate the social interactions (Edelson, n.d.)

Even though these three classifications do not apply to all forms of mental illness, it is one of many examples the media uses to define mental illness to children. The media does this through animated films. Lawson & Fouts (2004) explain:

Understanding the presentation of mental illness in children’s movies is important for three reasons. First, numerous studies have shown that children’s exposure to TV and movies influence attitudes towards a wide range of social groups, that is, the elderly, persons with a mental disability and persons with obesity. Therefore, repeated exposure to depictions of mental illness in movies likely influences children’s attitudes towards persons with a mental illness.

Therefore, the media must be used to reverse this trend of misinformation and misconception.

Since this is a multidimensional problem, a multifaceted solution is required. Corrigan (2004) says, “Understanding stigma is only half of the battle; of equal importance is testing strategies that are… used in anti-stigma programs: protest, education and contact.” Arboleda-Florez (2003) adds:

Successful treatment and community management of mental illness relies heavily on the involvement of many levels of government, social institutions, clinicians, caregivers, the public at large, consumers and their families. Successful community reintegration of mental health patients and the acceptance of mental illness as an inescapable element of our social fabric can only be achieved by engaging the public in a true dialogue about the nature of mental illness, their devastating effects on individuals and communities, and the promise of better treatment and rehabilitation alternatives.

Furthermore, an important component of efforts to reduce stigma would be the dissemination of basic knowledge about mental illness to the general population. This would lead to the dissolution of fears and outrageous generalizations about mental illness and its parallel to violence and criminal activity; more importantly, juvenile delinquency. Since the media shapes the largest and most diverse audience, it stands to reason that the efficient method of dissemination is through the media. Defeinbach & West (2007) conclude, “Broadcast television is a unique medium because it uses the public airwaves. We have a vested interest in the content of broadcast television and the social effects of that content. Broadcasters must serve the public interest.” Newspapers could perhaps feature excerpts from memoirs of those who have written about their personal experiences of mental illness. Accounts of mental illness recovery would give positive and accurate portrayals of mental illness.

In addition to broadcast television, a very conducive alternative would be a program designed for the purpose of addressing mental health and stigmas. Goldberg (2006) explains her proposal for a talk show:

Therefore, to provide antidotes to tabloid talk shows, my program features licensed psychologists and descriptions of their professional credentials. The program’s interview format captures psychologists’ expertise and passion for their work. Programmers show respect for patient confidentiality by not exposing identities and problems.

These talk shows would need to find those mental health professionals that do not compound the stigmas of mental illness. This proposal could also branch off into an educational series designed for children, in order to correlate juvenile delinquency aspects of mental illness.

Moreover, mental health studies could expand on the areas of stigmatization effects, the relationship between the severity of illness and the perception of stigma. Mental health professionals could provide this information to develop a better understanding of the effects of stigmas on mental illness and approaches to weaken the stigma’s impact. (Corrigan, 2004). It would also be useful to get the public to articulate their beliefs and fears of mental illness, so that specific information could be provided to reduce negative beliefs about mental illness. These studies could be made available in either print or video publications to allow for wider audience dissemination. Also, mental health organizations can raise awareness by increasing the amount and scope of seminars and workshops, as well as open many of them to public audiences.

In addition to dissemination methods, judicial services could be provided to assist courts with cases involving mental health issues. Brett (2003) asserts, “In summary, mentally impaired defendants are an extremely stigmatized and marginalized group and good court liaison services can decrease the stigma and improve the management of these people. There are a large numbers of patients with mental illness in the justice system. As psychiatrists, we can help this group at many points, including ensuring that community services are comprehensive and community needs are addressed.” As part of the community, judiciary services can provide much needed assistance in reducing the affects of mental health stigmas in these cases and community issues at large.

Conclusion

Throughout mental health, the issues of stigma have plagued American society for a notable time. The idea that individuals must balance both a mental health issue and the social problem associated with it is quite overwhelming. Given that these cases also involve children, the affects are even more significant. The link between mental health issues such as autism and juvenile delinquency, as well as other violence, are a product of these common misconceptions by the general public. Through the use of a wide range of media, dissemination of material can not only inform and educate, but put to rest the stigma of mental illness. This will allow for the more important task of creating treatment and other services for those individuals diagnosed with a mental illness.

References

Angermeyer, M. C. & Matschinger, H. (2005) Labeling–stereotype–discrimination: An investigation of the stigma process. Social Psychiatry and Psychiatric Epidemiology, 40(5), 391-395.

Arboleda-Flórez, J. (2003). Considerations on the stigma of mental illness. The Canadian Journal of Psychiatry 48(10), 645-650.

Brett, A. (2003). Psychiatry, Stigma and Courts. Psychiatry, Psychology and Law, 10(2), 283-288.

Corrigan, P. W. (2004). Don’t call me nuts: An international perspective on the stigma of mental illness. Acta Psychiatrica Scandinavica, 109(6), 403-404.

Corrigan, P. W., Larson, J. E., & Kuwabara, S. A. (2007) Rehabilitation Mental illness stigma and the fundamental components of supported employment. Psychology, 52(4), 451-457.

Diefenbach, D. L., & West, M. D. (2007). Television and attitudes toward mental health issues: Cultivation analysis and the third-person effect. Journal of Community Psychology, 35(2), 181-195.

Edelson, M. G. (2006). Are the majority of children with autism mentally retarded? A systematic evaluation of the data. Focus on Autism and Other Developmental Disabilities, 21(2), 66-89. Web.

Edelson, M. S. (n.d.). Social Behavior in Autism. Web.

Feldman, D. B., & Crandall, C. S. (2007). Dimensions Of Mental Illness Stigma: What About Mental Illness Causes Social Rejection? Journal of Social and Clinical Psychology, 26(2), 137-155.

Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs: Penguin.

Goldberg, C. (2006). How to Make Psychology a Household Word Through Television: A Psychologist’s Experience as Host and Producer of a Weekly Program. Professional Psychology: Research and Practice, 37(2), 109-113.

Lauber, C., Nordt, C., Falcato, L., & Rossler, W. (2004). Factors Influencing Social Distance Toward People with Mental Illness. Community Mental Health Journal, 40(3), 265-274.

Lawson, A., & Fouts, G. (2004). Mental Illness in Disney Animated Films. The Canadian Journal of Psychiatry, 49(5), 310-314.

Servais, L. M., & Saunders, S. M. (2007). Clinical Psychologists’ Perceptions of Persons With Mental Illness. Professional Psychology: Research and Practice, 38(2), 214-219.

Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007). Perceived Public Stigma and the Willingness to Seek Counseling: The Mediating Roles of Self-Stigma and Attitudes Toward Counseling. Journal of Counseling Psychology, 54(1), 40-50.

Abstract

The fundamental principle of confidentiality is that information held for a certain objective may not be given without consent to a third party. Ethics codes and law recognize the mental health client right to confidentiality; however, there are exceptions and controversies. The aim of this thesis is to review in brief these ethical and legal commitments and give a case example on one issue on confidentiality in a mental health setting.

Introduction

Confidentiality is a commitment that restrains a body (psychologist, healthcare provider, or organization) from revealing information against the interest of the individual or body who gave it first. The fundamental principle of confidentiality is that information held for a certain objective may not be given without consent to a third party. Confidentiality is important to achieve the trust needed for the therapeutic bond between a client and a healthcare provider. Based on this definition, confidentiality is a commitment of a person towards another, while privacy is the information a person wants to keep and not to disclose to anyone else (New South Wales Consumer Advisory Group-Mental Health, 2004).

Ethical and legal confidentiality commitments in mental health

The Oath of Hippocrates states confidentiality, a principal confirmed by the UN Geneva Declaration in 1948. Ethically, confidentiality has two perspectives, the professional viewpoint, as it is an immediate precondition to ensure patient’s cooperation. Second is the duty viewpoint, since healthcare providers give a promise of confidentiality, either clearly or unspoken (implied), it is their duty to keep the promise. As the social scope is wider with competitive moral commitments; some suggest limits to confidentiality in one of two states of affairs, to achieve the patient’s best interest (rule of beneficence). Some suggest breaking confidentiality to achieve a public interest (rule of justice). In this state the question of decision making of what is in the best interest of the public is ambiguous (McClelland, and Thomas, 2002).

The report of the US Surgeon General (2000) summarized the confidentiality legal dilemma. It stated that law can either expand or submit confidentiality to the rule of beneficence or rule of justice. The US Supreme Court extended the principle of confidentiality based on providing psychotherapists with the best conditions to build trust and treat their patients is concisely in the public interest (psychotherapeutic privilege principle). On the other hand, states’ laws may differ as it is with the California Supreme Court ruling that psychotherapists had a commitment to protect third parties. There are areas of wider controversies especially with adolescents with alcohol or drug abuse combined with psychological problems. The report concluded that confidentiality is not absolute. This shows the importance of extending the discussions on the rules of beneficence and justice (US Department of Health and Human Services, Surgeon General Report, 2000).

The ambiguity of breaking confidentiality: An example case

The law recognizes the right of youth to make a decision about medical consultation (autonomy), and grants confidentiality in healthcare-related to them. Sanci and others (2005) presented a case for weighing confidentiality. A student welfare coordinator noticed the low academic performance of a 16 years old male student; during the discussion, he stated he hears a voice. On referral to the GP, the student requested that his mother not be informed, because of her illness and recent separation from the student father. That was the only condition the student made to see the GP, who succeeded to gain the student’s trust by explaining that exceptions to confidentiality will only be in case of risk of suicide, homicide, or abuse. On subsequent visits, the student described the impact of voices on his life; he had to quit school for days, he became socially isolated and stopped playing music which was his favourite hobby. The progressive course of his problems frightened him but still does not inform his mother. The GP judges a minimal risk of suicide; next, the GP expressed his appreciation for the student’s courage in discussing his problems and suggested referral to a psychologist. The GP advised the student to involve his mother as he may need her support, but the student agreed to see the psychologist on his own insisting that his mother should not know. The question is what the psychologist should do, he earned the student trust and managed successfully to manipulate the progress of his disorders, breaching confidentiality may reverse the whole procedure and make things worse for the psychologist to take over the case (Sanci and others, 2005).

Apart from legal consequences, the ethical controversy, in this case, is between the Deontological approaches that ethical principles governing an action are inherent rather than depending on its consequences. The second is the Utilitarianism approach where the concept involves all whatever good or bad consequences of an action. It looks that Deontological approaches are expressed in a healthcare organization’s written policies whereas discrepancies from written policies appear in the everyday practice of managing a case. When a client decides to seek advice, thus practising autonomy but giving up confidentiality as the client will show the personal self to the therapist. Further, for treatment to succeed, the client must change behaviour, thus giving up the right of autonomy. This is a part of the confidentiality issue to deal with in future research (Sweitzer, 2008).

Conclusion

Although the ethical and legal backgrounds of protecting confidentiality provide guidance to mental healthcare providers on when to breach confidentiality, yet terms are broad and general. Not all cases or situations are covered, and conflicts often emerge between commitment to confidentiality and breaking it. Further, look to the area of public interest and patient versus society benefits is needed for further clarification and precision.

References

1. McClelland, R., and Thomas, V. (2002). Confidentiality and security of clinical information in mental health practice. Advances in Psychiatric Treatment, 8, 291-296.
2. New South Wales Advisory Group-Mental Health Incorporated (2004). Issues Paper: Privacy and Confidentiality. Web.
3. Sanci, L., A., Sawyer, S., M., S-L Kang, M., Haller, D., M., and Patton, G., C. (2005). Confidential health care for adolescents: reconciling clinical evidence with famil values. MJA, 183(8), 410-414.
4. Sweitzer, E.M. (2008). Frontstage and Backstage Ethics in Mental Health: A Qualitative Case Study. Journal of Law, Ethics, and Intellectual Property, 2 (1), 1-11.
5. U.S. Department of Health and Human Services. (2000). Mental Health: A Report of the Surgeon General. Washington, DC: U.S. Government Printing Office.

Recent permutations within sociocultural, economic, and political contexts of the global community have created prerequisites for the development of anxiety in a substantial part of the global population. Therefore, concerns associated with a drop in the quality of life have become especially valid recently. By incorporating mindfulness into personal spiritual practices, social workers will be able to overcome stress and avoid mental health issues that it entails, thus, increasing clients’ quality of life.

The concept of mindfulness is fairly broad, yet it can be summarized succinctly as the awareness of emotional and mental health state, as well as the ability to maintain emotional balance and develop mechanisms for managing stress appropriately (Galante et al., 2021). Therefore, it is reasonable to assume that the focus on self-cognition and a thorough understanding of one’s emotional needs and mental health issues will guide one to building a strategy for resilience against adverse factors inducing stress (Galante et al., 2021). Thus, the integration of mindfulness as a skill of building strategic frameworks for addressing negative factors causing severe stress is vital for keeping the quality of life consistently high.

Furthermore, mindfulness allows people to introduce better control over their mental health and, therefore, their quality of life. Specifically, the integration of mindfulness techniques will inevitably lead to enhanced patient education (Galante et al., 2021). As a result, a range of ideas and perceptions that misalign with core goals of leading a healthy lifestyle will be dispelled among the target population. Most importantly, patients will be able to navigate the available plethora of information independently, distinguishing between useful and harmful ideas (Galante et al., 2021). The described change is expected to increase patients’ ability to avoid major risks to their heath, including the ones that stem from their currently misguided perceptions of their mental health (Galante et al., 2021). Namely, mindfulness will allow patients to prioritize their health and explore it, therefore, learning about their needs and the means of meeting them. Furthermore, the focus on mindfulness will help improve one’s perception of negative factors, allowing one to evaluate core risks to well-being properly and refrain from panicking in case of a threat (Galante et al., 2021). Overall, mindfulness should be regarded as a critical practice of mental health management and the resulting improvement in the quality of people’s lives.

The introduction of mindfulness techniques will allow minimizing people’s sensitivity toward negative factors that affect their mental health adversely, thus, avoiding multiple complications and disorders. As a result, patients’ quality of life will be improved to a substantial degree. With the incorporation of mindfulness into therapy, one will be able to reduce stress by promoting active health education and learning to a patient. As a result, opportunities for independent crisis management in patients can be discovered.

Reference

Galante, J., Friedrich, C., Dawson, A. F., Modrego-Alarcón, M., Gebbing, P., Delgado-Suárez, I., Gebbing, P., Delgado-Suárez, I., Gupta, T., Dean, L., Dalgleish, T., White, I. R., & Jones, P. B. (2021). Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: a systematic review and meta-analysis of randomised controlled trials. PLoS medicine, 18(1), 1-40. Web.

Introduction

The state of one’s mental health is an essential and fundamental component of overall health. People are said to be in a state of well-being when they can realize their capabilities, deal with the stresses of everyday life, work productively, and make positive contributions to society (Danneel et al., 2019). The case study focuses on a man in his 50s who has been divorced and has three children who are now adults. A general practitioner who treated Reg at a health facility he frequented observed that the patient appeared to be struggling with mental health disorders. Due to Reg’s inability to find work and continue his previous lifestyle, his mental health appears to have been impacted by mood disorders such as anxiety or depression. When asked how he is handling everything that life throws at him, Reg admits that he is experiencing a state of emotional overload. Aside from that, Reg’s mental health is a cause for concern because he is linked to social exclusion, failure to apply for more new jobs and an unhealthy lifestyle.

Reg gives the impression that he is depressed because he has trouble sleeping and needs to drink alcohol every night before bed. Aside from that, the depressive nature of his mental health status is visible through changes in appetite and a lack of grooming for himself. Despite his former status as a fitness expert, he has a scruffy appearance. Furthermore, the man’s depressive state gives him a strong desire to isolate himself from others. Although his friends are willing to stand by him and support him, he refuses to associate with them. He avoids parties because he fears his friends will mock him because of his social standing. He does not want other people to get involved in his life because he is lonely at home and does not want their attention.

In addition, Reg frequently finds himself in a state of emotional overwhelm due to his intense feelings, which he struggles to control. For example, although his children are willing to assist him, he is under the impression that they are only interested in their inheritance. He places the blame for his joblessness on everyone else and has given up hope of finding new employment because he is afraid of being rejected. Negative feelings flood him, and as a result, Reg has difficulty taking care of himself. He forgets to eat and has trouble falling asleep.

Predisposing, Precipitating, Perpetuating and Protective Factors

Depression, emotional overwhelm, and high anticipatory distress are the predisposing factors relevant to Reg’s case. Due to the above circumstances, he is at an elevated risk of developing a problem resulting from his temperament combined with his life experiences. He experiences feelings of exhaustion and isolation. In addition to this, he has a difficult time interacting with other people, and he does not want to go out. The precipitating factors that triggered his current mental health issues may be linked to the fact that he lost his job as a senior member at his place of employment and was unable to secure another job, even though he submitted numerous applications for jobs (Furukawa et al., 2021). One more component is the modification of his social status, which went from that of a respected man to that of an average person.

In the case of Reg, factors such as unpredictable sleep-wake patterns, interpersonal trauma, and depression are all factors that contribute to the condition’s persistence. He enjoyed the finer things in life, such as having a lovely home in a pleasant neighborhood, working out for at least an hour every day, and exercising daily. All of this, however, shifted after he was laid off from his job. Reg maintains a cordial relationship with his ex-wife, who is consistently concerned about his state of health and well-being, which is one of the protective factors relevant to Reg. Because of his tendency toward perfection and his firm belief in his abilities, he can avoid associating with his friends who still have successful jobs, thereby shielding himself from the ridicule that could be directed at him by insensitive friends.

Initial Treatment Options

Since managing depression is difficult, a person’s reserves of energy, optimism, and motivation to take steps that might improve their condition quickly deplete. Reg’s situation is best addressed through introspection and proactive measures. Before figuring out how to get back in the driver’s seat, he must pinpoint what makes him feel helpless. Cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy are all common treatments for depression (Danneel et al., 2019). Reg should try to contact and stay in touch with his friends because blended approaches are commonly used today. Reg is a prime example of how depressed people prefer to isolate themselves. It can be challenging to stay in touch with family and friends.

On the other hand, Reg needs to seek assistance from responsible and concerned parties, such as his ex-wife. Reg’s emotional overload makes him feel as if he is being engulfed and overtaken by feelings over which he has no control. Regular exercise may be as effective as medication in treating depression. Exercise increases happy-feeling chemicals in the brain, like serotonin and endorphins, and promotes new neural growth in the same way that antidepressants do. Strong social networks help combat social isolation, a risk factor for depression. Maintain regular contact with loved ones and consider joining a course or a club. Volunteering is an excellent way to meet new people, give back to the community, and better themselves.

Ongoing relapse prevention and support strategies

When conducting in-depth evaluations of their patients, mental health professionals frequently use the bio-psychosocial model as a guide. Relapse prevention encourages patients to reflect on their own experiences and guides how to deal with overt and hidden factors that may lead to a relapse. Reg’s biopsychosocial cultural needs can be met through relapse prevention and support strategies that consider her lifestyle. Reg’s situation necessitates biopsychosocial-cultural requirements such as learning how to deal with life’s stresses after losing a job and addressing potentially harmful behaviors such as excessive drinking. Reg needs to dispel myths about alcohol and its effects and the notion that his children care more about their inheritance than their father’s health. He needs to look on the bright side to be motivated to look for work.

Conclusion

Reg can reduce the likelihood of relapse by implementing specific intervention strategies such as recognizing and coping with high-risk situations, eliminating the effects of myths, and cognitively restructuring his thinking. Reg expresses his desire to stop drinking because he is overwhelmed. Furthermore, therapy may be the most effective way to deal with upsetting events. Reg is concerned that his friends are mocking him when they offer to buy him a cigar and provide social support to help him recover, and this is an example of how it has the potential to address sociocultural factors such as stigma.

References

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