In order to maximize human performance, defence forces continue to explore, develop, and apply human performance enhancement (HPE) methods, ranging from pharmaceuticals to (bio)technological enhancement. This raises ethical, legal, and societal concerns and requires organizing a careful reflection and deliberation process, with relevant stakeholders. We discuss a range of ethical, legal, and societal aspects (ELSA), which people involved in the development and deployment of HPE can use for such reflection and deliberation. A realistic military scenario with proposed HPE application can (...) serve as a starting point for such an iterative and participatory process. Stakeholders can discuss this application, modify its features, and design appropriate processes around it – for instance, procedures for informed consent. We propose that organizing aspects into these three categories – ethical, legal, and societal – can help involve appropriate interlocutors at different moments: legal aspects with people in strategy or management roles, from the start of a project; ethical aspects with people in operations and medical roles, during development; and societal aspects with people in communication and personnel roles, during deployment. Notably, we developed and discussed this framework and the three aspects in close collaboration with personnel from the military. (shrink)

In the wake of the Covid-19 pandemic we are witnessing a significant rise in mental illness diagnosis and corresponding anti-depressant prescription uptake. The drug response to this situation is unsurprising and reinforces the dominant role (neuro)biology continues to undertake within modern psychiatry. In contrast to this biologically informed, medicalised approach, the World Health Organisation (WHO) issued a statement stressing the causal role of psychological and social factors.Using the concept of ontological insecurity, contextualised within the WHO guidance, the interrelation (...) of psychological and social factors is illuminated, and a psychosocial framework is produced as a means of understanding the mental health consequence of the post-Covid-19 fallout.The psychosocial framework generated provides a rationale to revise and reprioritise how we engage with the biopsychosocial model that is intended to underpin modern psychiatry. This framework establishes a connection between psychological and social theory which are too often addressed as disparate terrains within mental health services and policy creation. (shrink)

Our premise is that ethics is the essence of good forensic practice and that mental health professionals must adhere to the ethical principles, standards, and guidelines of their professional bodies when they communicate their findings and opinions. We demonstrate that adhering to ethical principles can improve the quality of forensic reports and communications. We demonstrate this by focusing on the most basic principles that underlie professional ethical standards and guidelines, namely, Fidelity and Responsibility, Integrity, Respecting Rights and Dignity (...) of Persons, and Justice and Fairness. For each principle we offer a brief definition and explain its demands. Then we identify ways in which the principle can guide the organization, content, or style of forensic mental health report writing, offering illustrative examples that demonstrate or abuse the principle. (shrink)

This study was part of a larger cross-national research project at the Norway’s University of Bergen, which involved participants from over 30 countries. This undertaking delves into developmental assets, creativity, and thriving, and the part they play in determining mental health. Thus, this study examined the developmental assets, creativity, thriving, and their importance to mental health in a sample of Malaysian emerging adults. This study was based on a sample of 394 undergraduate students, comprising 264 females (...) and 130 males, ranging between the ages of 18 and 26 years. Two subscales of the Reisman diagnostic creativity assessment were used to measure creativity. Meanwhile, thriving indicators of Search Institute were used to measure thriving while the short form of the mental health continuum for adolescents was used to measure mental health. An online Google form was used to collect data from university students enrolled in both public and private universities. The correlation analysis results revealed that all the variables were positively correlated to each other and that the relationship between development assets, creativity, thriving, and mental health ranged from weak to moderate. Multiple regression analysis produced four models that indicated that positive identity, support, creativity, and thriving have a significant influence on mental health among emerging adults. Further, analyses using the PROCESS procedure demonstrated significant indirect effects of positive identity and support on mental health through its effects on creativity and thriving. As such, it is our recommendation that mental health practitioners tailor their treatment approach to include positive identity, support, creativity, and thriving in their sessions with Malaysian emerging adults. (shrink)

As mental health nursing roles expand, is education expanding mental health nurses? an emotionally intelligent view towards preparation for psychological therapies and relatedness Mental health nurses (MHN) in the UK currently occupy a challenging position. This positioning is one that offers a view of expanding roles and responsibilities in both mental health act legislation and the delivery of psychological therapies, while simultaneously generic pre‐registration training is being considered. Clearly, the view from this (...) position, although not without challenge and internal discipline dispute, can also offer growing professional prestige, influence and respect from other health disciplines, as well as the wider public. Conversely, if the training, education and strategic enactment for new MHN roles is formulated and delivered from predominantly non‐MHN axiomatic and epistemological stances, MHN identity can be seriously and potentially permanently diminished. This paper offers the construct of emotional intelligence as a framework to respond to these future challenges through making individual MHN enablement a primacy. This enablement of MHNs through enhanced emotional intelligence competencies is argued as requiring priority over the standard approach of enhancing strategies alone. (shrink)

With the recent expansion of child mental health research, more attention is being paid to the process of informed consent for research participation. For the consent to be truly informed, it is necessary that the relevant information be both disclosed and actually understood. Traditionally, much effort has gone to ensuring the comprehensiveness of consent/assent documents, which have progressively increased in length and complexity, whereas less attention has been paid to the comprehensibility of these documents. Available data indicate that (...) many parent and children have difficulties appreciating the research nature of treatment studies and that a higher level of formal education among the parents is associated with a greater degree of understanding. Promising approaches to achieving truly informed research participation have emerged, such as additional time for parents to meet with the researchers and using postexplanation questionnaires for identifying issues in need of further clarification. Research is needed to develop and test strategies for improving the effectiveness of the informed consent process in child mental health. (shrink)

RESUMEN Introducción: Son escasos los servicios en salud mental dentro del contexto escolar que permitan una integración intersectorial para superar la brecha de falta de asistencia en salud mental en la población infanto - juvenil, aun cuando, es en la escuela donde se detectan mayoritariamente los problemas de salud mental. Objetivo: Comentar el uso de servicios de salud mental en el ambiente escolar en relación con los trastornos mentales y trastornos subumbrales. Método: El presente resultado se (...) obtiene a partir del “Estudio de Prevalencia Comunitaria de Trastornos Psiquiátricos y Utilización de Servicios de la Población Infanto-Juvenil Chilena”. La muestra estuvo representada por sujetos entre 4 y 18 años. La información sobre el uso de servicio de salud mental se recogió con una versión modificada de la Escala Service Assesment for Children and Adolescent. Se realizó un modelo de regresión logística para analizar cinco áreas del uso de servicios en el ambiente escolar, las cuales se correlacionaron con diagnósticos de trastorno mentales y trastorno subumbral de ansiedad, disruptivo y depresión en el último año. Resultados: Las escuelas se enfrentan a grandes desafíos sobre cómo proporcionar apoyo efectivo de salud mental para los estudiantes, que presentan algún tipo de trastorno mental o trastorno subumbral. Discussión: Las instituciones educativas requieren ser visualizadas como una entidad que podría satisfacer las necesidades que se advierten de manera urgente en atención, prevención y promoción de problemas mentales en la población infanto- juvenil, si se vinculan de forma más directa con los servicios de salud mental. ABSTRACT Introduction: Mental health services are scarce within the school context that allow intersectoral integration to overcome the gap in mental health care in the child and adolescent population, being the school where mental health problems are mostly detected. Objective: to know the use of mental health services in the school environment in relation to mental disorders and subthreshold disorders. Method: The present secondary study is carried out from the "Study of Community Prevalence of Psychiatric Disorders and Utilization of Services of the Chilean Child-Youth Population". The sample was represented by subjects between 4 and 18 years old. Information on the use of mental health service was collected with a modified version of the Service Assessment Scale for Children and Adolescents. A logistic regression model was performed to analyze five areas of the use of services in the school environment, which were correlated with diagnoses of mental disorders and subthreshold anxiety, disruptive and depression disorder in the last year. Results: Schools face great challenges on how to provide effective mental health support for students, who present some type of mental disorder or subthreshold disorder. Discusion: Educational institutions need to be visualized as an entity that could meet the needs that are urgently noticed in attention, prevention and promotion of mental problems in the child and adolescent population, if it is linked more directly with health services. (shrink)

Although there have been numerous studies on mental wellbeing impairment or other negative consequences of Workplace Violence (WPV) against healthcare professionals, however, the effects of WPV are not limited to those who experience WPV in person, but those who exposed to WPV information indirectly. In the aftermath of “death of Dr. Yang Wen,” a cross-sectional study was conducted to explore the psychological status of healthcare professionals. A total of 965 healthcare professionals from 32 provinces in China participated in our (...) research. The prevalence rates of Post-Traumatic Stress Disorder (PTSD) symptoms, depression, anxiety among healthcare professional in the current study were 25.60, 46.01, and 27.88%, respectively. Moreover, our research suggested that the awareness of WPV-incident had a significant association with PTSD symptoms. In addition, risk perception was shown to mediate the effect of WPV awareness on PTSD symptoms. Furthermore, the present research also found a U-shaped relationship between issue salience and PTSD symptoms, and the relationship between issue salience and anxiety, indicating that higher awareness of WPV issue was negatively related to mental health status (including PTSD and anxiety) but only to the points at which there were no additional effects of more issue salience. This study highlighted that more protective measures for healthcare professionals need to be implemented in response to potential WPV events. More importantly, risk perception was found to mediate the effect of WPV issue salience on PTSD symptoms, it is critical to reduce the mental health burden through intervening in risk perception. (shrink)

Mental health has become a domain of professional and scientific endeavor, distinguished in the modern mind from spirituality, which is understood as a more subjective, transcendent, and private concern. This sharp separation has been challenged in recent decades by scientific research, which demonstrates the positive benefits of spirituality/religion (S/R) for mental health. Increasing scientific interest in the topic is to be welcomed, but the contribution of theology to the debate has been neglected. It is proposed here (...) that Jesus’ life and teaching are presented in the synoptic Gospels as fundamentally concerned with what we now call mental health. Jesus’ teaching on worry, for example, offers various psychological strategies for dealing with anxiety. Moreover, it presents prayer as an effective and constructive response to worry, involving disciplined attention rather than avoidance. Critical interdisciplinary conversations between science and theology on matters such as worry offer a constructive approach to understanding the human condition in the context of adversity. (shrink)

Central to ethical debates in contemporary mental health research are the rhetoric of parity of esteem, challenges underpinned by the social construct of vulnerability and the tendency to homogenis...

Volume 35, Issue 2, April-June 2020, Page 130-138.

What is it to be mentally healthy? In the ongoing movement to promote mental health, to reduce stigma, and to establish parity between mental and physical health, there is a clear enthusiasm about this concept and a recognition of its value in human life. However, it is often unclear what mental health means in all these efforts and whether there is a single concept underlying them. Sometimes, the initiatives for the sake of mental (...) health are aimed just at reducing mental illness, thus implicitly identifying mental health with the absence of diagnosable psychiatric disease. More ambitiously, there are high-profile proposals to adopt a positive definition, identifying mental health with psychic or even overall well-being. We argue against both: a definition of mental health as mere absence of mental illness is too thin, too undemanding, and too closely linked to psychiatric value judgments, while the definition in terms of well-being is too demanding and potentially oppressive. As a compromise, we sketch out a middle position. On this view, mental health is a primary good, that is, the psychological preconditions of pursuing any conception of the good life, including well-being, without being identical to well-being. (shrink)

Shortly following the Second World War, and under the medical direction of ex-army psychiatrist T. F. Main, the Cassel Hospital for Functional Nervous Disorders emerged as a pioneering democratic ‘therapeutic community’ in the treatment of mental illness. This definitive movement away from conventional ‘custodial’ assumptions about the function of the psychiatric hospital initially grew out of a commitment to sharing therapeutic responsibility between patients and staff and to preserving patients’ pre-admission responsibilities and social identities. However, by the mid-1950s, hospital (...) practices had come to focus pre-eminently on patients’ relationships with family members, and staff had developed a social model of mental health that focused on the family as the irreducible unit of mental treatment. By the late 1950s, this culminated in the in-patient admission of entire families for mental treatment, even when only one family member was exhibiting symptoms. At the heart of this growing post-war social-psychiatric preoccupation with the family was a new emphasis on the close relationship between mental health and individuals’ successful development toward mature responsible adulthood. The family came to be conceived as the quintessential space where both were forged. This article examines the process through which the Cassel’s social-psychiatric commitment to ‘therapeutic community’ became focused on the family as a key therapeutic site. While the family had become a central point of focus in social, political and psychological discussions of the foundation for stable democratic culture and political peace in post-war Britain, the Cassel Hospital actively experimented with these connections in therapeutic practice. This article thus illuminates the important, but frequently overlooked, role of psychiatric practices in the development of a post-war psychopolitics that established important links between the nuclear family, mental health and democratic social life. (shrink)

The provision of mental health services to women has come sharply into focus for providers of secure psychiatric services in the UK. Women's services are being developed in response to the known risks of mixed-sex provision, and a growing appreciation of the ways that women in secure services can be further disadvantaged by their minority status. Our intention here is to present evidence and reflections to help inform this development. The evidence is drawn from our recent work in (...) this field, which includes carrying out a review of local mental health services for ‘difficult’ women, and developing and piloting a national training programme for staff working with women in secure services. The reflections we offer are informed by the conviction that taking social inequalities into account is central to making sense of women's mental health difficulties, and improving service responses to women's needs. While there are signs that many mental health workers in secure services are beginning to share these convictions, the challenge now is to provide the necessary authorization, training and support that will enable them to translate these understandings into empowerment practice with women. (shrink)

BackgroundThe positive component of Mental Health Literacy refers to a person’s awareness of how to achieve and maintain good mental health. Although explored recently, the term still lacks a clear definition among healthcare practitioners.AimTo identify the attributes and characteristics of PMeHL, as well as its theoretical and practical applications.MethodsLiterature search and review, covering the last 21 years, followed by concept analysis according to the steps described by Walker and Avant approach.ResultsPositive component of Mental Health (...) Literacy is considered one component of MHL, integrating positive mental health. The concept’s attributes include: competence in problem-solving and self-actualization; personal satisfaction; autonomy; relatedness and interpersonal relationship skills; self-control; and prosocial attitude. Four case scenarios were used to clarify the antecedents and consequences of PMeHL.ConclusionPositive component of Mental Health Literacy is considered a component of MHL, which deserves attention throughout the lifespan, in different contexts and intervention levels. Considering PMeHL as a multi-faceted and dynamic construct will help understand the mechanisms that improve mental health and promote healthy behaviors. Priority should be given to robust primary research focused on nursing interventions that enhance and sustain PMeHL in people and families. (shrink)

My life during those three months looks a lot like the public mental health system. Local Community Mental Health agencies (CMHs) are required, on a daily basis, to meet the needs of people with mental illness in a system that everyone knows is tragically under funded. The system does what it can with the resources it has and looks towards the next fiscal year, with fingers crossed, hoping for some relief. Some in the system have (...) given up hope, and consider it a "success" if their funding isn�t cut or eliminated. (shrink)

Scholarship in neuroethics and related disciplines has long reflected on the value of different conceptual models of disability and impairment. While this theoretical work is valuable, centering the voices of people with mental health conditions in neuroethics research can help us better understand how such models apply in everyday people’s lives. Drawing on qualitative data from a study on mental health peer providers’ lived experiences of recovery, this paper will demonstrate that peers borrow from both a (...) neurodiversity framework and the medical model of disability, though their feelings toward the two models were often complex and ambivalent. These findings advance neuroethics by indicating that future research and clinical practice should take a nuanced approach to responding to the needs of people with mental health conditions and turn to peers as experts, honoring their values and recognizing both the promise and pitfalls of living with a mental health condition. (shrink)

This article positions ‘safety’ and ‘risk’ as key public health problems in mental health. I demonstrate that discourse about safety occurs extensively in relation to mental health, but it does not occur in a way where the mental health system gets any safer for the key actors involved. Ongoing unproductive discourse occurs because the different actors involved are speaking at cross purposes and about different things against the background of a ‘public’ discourse focused (...) on safety crises. I map the general interests of the main set of actors to demonstrate the conflicted and complex nature of discourse around mental health safety. In response I outline a dialogical approach to safety and risk based on the work of Habermas and values of recovery. This is presented as a framework from which to assess whether discourse is occurring effectively to develop shared meanings. Shared understandings of safety will mean that the safety needs of relevant actors can be understood and negotiated rather than giving way to an actuarial process which does not take into consideration the context of a person’s life. (shrink)

High quality monitoring of mental health and well-being over an extended period is essential to understand how communities respond to the COVID-19 pandemic and how to best tailor interventions. Multiple community threats may also have cumulative impact on mental health, so examination across several contexts is important. The objective of this study is to report on changes in mental health and well-being in response to the Australian bushfires and COVID-19 pandemic. This study utilized an (...) Experience-Sampling-Method, using the smartphone-based mood monitoring application, MoodPrism. Participants were prompted once a day to complete a brief survey inquiring about symptoms of depression and anxiety, and several well-being indices, including arousal, emotional valence, self-esteem, motivation, social connectedness, meaning and purpose, and control. Participants were N = 755 Australians who downloaded and used MoodPrism, between 2018 and 2020. Results showed that anxiety symptoms significantly increased during the COVID-19 pandemic, but not during the bushfires. This may be explained by concurrent feelings of social connectedness maintained during the bushfires but not during the pandemic. In contrast, depressive symptoms increased significantly during the bushfires, which maintained during the pandemic. Most indices of well-being decreased significantly during the bushfires, and further again during the pandemic. Study findings highlight the unique responses to the bushfire and COVID-19 crises, revealing specific areas of resilience and vulnerability. Such information can help inform the development of public health interventions or individual clinical treatment, to improve treatment approaches and preparedness for potential future community disasters. (shrink)

IntroductionDuring the COVID-19 pandemic, healthcare workers in Italy have been exposed to an unprecedented pressure and traumatic events. However, no direct comparison with the general population is available so far. The aim of this study is to detail mental health outcomes in healthcare workers compared to the general population.Methods24050 respondents completed an on-line questionnaire during the contagion peak, 21342 general population, 1295 second-line healthcare workers, and 1411 front-line healthcare workers. Depressive, anxious, post-traumatic symptoms and insomnia were assessed. Specific (...) COVID-19 related potential risk factors were also considered in healthcare workers.ResultsDepressive symptoms were more frequent in the general population and front-line healthcare workers compared to the second-line healthcare workers groups. Anxiety symptoms showed a prevalence of 21.25% in the general population, 18.05% for second-line healthcare workers, and 20.55% for front-line healthcare workers. Insomnia showed a prevalence of 7.82, 6.58, and 9.92% for the general population, second-line healthcare workers, and front-line healthcare workers, respectively. Compared to the general population, front-line healthcare workers had higher odds of endorsing total trauma-related symptoms. Both second-line healthcare workers and front-line healthcare workers had higher odds of endorsing core post-traumatic symptoms compared to the general population, while second-line healthcare workers had lower odds of endorsing negative affect and dissociative symptoms. Higher total traumatic symptom score was associated with being a front-line healthcare worker, having a colleague infected, hospitalized, or deceased, being a nurse, female gender, and younger age.ConclusionThis study suggests a significant psychological impact of the COVID-19 pandemic on the Italian general population and healthcare workers. Front-line healthcare workers represent a specific at-risk population for post-traumatic symptoms. These findings underline the importance of monitoring and intervention strategies. (shrink)

Many classical approaches in the area of phenomenological pscyhopathology focus on structures of lived experience of mental illness and overlook the role social context plays in the formation of lived experiences. The paper addresses this issue and contributes to recent research which has pointed out that there is a need for an approach to mental health which investigates the role of context in shaping lived experiences. We propose a conception of contextuality (or situatedness) which we develop in (...) terms of two main characteristics: intersectionality and social relationality of the human condition. We take context to be shaped by social interdependence and by the intersection of multiple factors including gender, race, ethnicity, class, socio-economic status and power relations. We develop this analysis in relation to substance misuse, refer to, and compare, certain case studies and perspectives from Brazil to illustrate our approach which can, however, be applied to other areas of mental health. We suggest that the proposed contextual approach is crucial for an in-depth understanding of psychopathology from a phenomenological perspective and in relation to contemporary ethico-political issues concerning social differences and inequalities in mental health. (shrink)

Recent policy debates in the US over access to mental health care have raised several philosophically complex ethical and conceptual issues. The defeat of mental health parity legislation in the US Congress has brought new urgency and relevance to theoretical and empirical investigations into the nature of mental illness and its relation to other forms of sickness and disability. Manifold, nebulous, and often competing conceptions of mental illness make the creation of coherent public policy (...) exceedingly difficult. Referencing a variety of approaches to ethical reflection on health care, and drawing from the empirical literature on therapeutic efficacy and economic efficiency, we argue that differential rationing, ‘disparity,’ is unjustifiable. (shrink)

This essay challenges the notion of avoiding uncomfortable thoughts and emotions in mental health. It argues that accepting these experiences, as supported by therapies like Exposure and Response Prevention for Pure OCD, promotes greater wellbeing. By cultivating a compassionate relationship with inner experiences, individuals can foster resilience amidst challenges.

Objectives: Initially, we analyzed relations between the challenging working conditions of flight attendants with symptoms of depression, anxiety and stress. As the COVID-19 pandemic plunged airlines into an unprecedented crisis, its impact on the mental health of flying cabin crews became the focus of a second survey.Methods: Flight attendants were surveyed online with DASS-21 in May 2019 and April 2020, complemented with questions about working conditions and existential fears and fear of job loss.Results: Sample 1 revealed that symptoms (...) of depression, anxiety and stress highly correlated with the subjective assessment of working conditions, but not with objectifiable parameters. Sample 2 showed significant positive correlations between existential fears and fear of job loss with depression, anxiety and stress. Crew members, grounded in April 2020, showed significantly higher scores in depression and stress, while still flying individuals had more clinically relevant symptoms of anxiety. Mean value comparisons between sample 1 and 2 in DASS-21 revealed a significant increase in symptoms at the time of crisis with effect sizes of d = 0.63 for depression, d = 0.26 for anxiety, and d = 0.52 for stress. The incidence of clinically relevant symptoms among the respondents increased from 8 to 23%, from 6 to 14%, and from 8 to 24%.Conclusion: The COVID-19 pandemic and associated work restrictions coincide with severe impairment of mental health of flying cabin crews, consistent with a mental health protecting function of labor. (shrink)

ConclusionA map of mental health is admittedly the vaguest of speculations at the moment. It is nowhere near as precise as anything presently seen through the mental health microscope. Indeed it may well turn out to offer nothing at all. On the other hand, the truth remains that unless we beat our addiction to microscopes we will never get even a glimpse of mental health: you can’t read a map with a microscope.

Brussen, Kerri Anne Adolescence and young adulthood are a time of change. It is also a time where there is an increased chance of being diagnosed with a mental illness. Professor Patrick McGorry has driven the agenda to transform the approach to youth mental health. This article is a review of the recommendations of McGorry and others within the mental health field on how best to care for our youth with a mental illness. We (...) also briefly look at some of the services offered by a Catholic agency. (shrink)

IntroductionThe COVID-19 pandemic has forced changes in patient care in Mental Health Day Hospitals.ObjectivesTo study the interventions performed in MHDHs during the pandemic in comparison with those performed in other facilities and to analyze the new hospital admissions in both groups.MethodA retrospective multicenter cohort study comparing the interventions received by a group of 161 patients admitted in MHDHs during the lockdown period in Spain with the interventions of another group of 109 patients who were treated at other facilities (...) during lockdown.ResultsMHDHs reduced their face-to-face interventions during lockdown just as much as other facilities but implemented telematic intervention methods to a greater extent. Patients attached to MHDHs during lockdown were admitted significantly less and presented fewer urgent consultations in the following 6 months.ConclusionThe use of telepsychiatry made it feasible to adapt MHDHs to periods of lockdown, being useful to improve the continuity of care during the pandemic. In addition, it was possible to maintain a reduction in hospital admissions in patients treated at MHDHs. (shrink)

Transcultural comparisons taking the differences and commonalities into consideration in the fields of mental health and ill mental health have always been a focus of scientific interest. The ‘East’ and ‘West’ comparisons in this regard, could be the one most widely deliberated. ‘East and West’, as a human-made conceptual construct, has evolved to signify many social, cultural, political, economic and psychological realities and meanings, beyond its geographical references. Such conceptualizations both reflect and re-construct our realities. -/- (...) Beyond the inequalities and discrepancies in resources, the ‘East and West’ dualism has an impact on mental health theory and praxis in a many different ways. The range, content, patterns and expression of psychopathology and psychiatric symptomatology; the explanatory models of mental disorders; the diagnostic and classification systems; the psychopharmacological and psychotherapeutical interventions; the role of family and psychosocial support systems; basic conceptualizations of mental health and disease are some of the main areas of diversity. -/- This chapter, after briefly discussing the historical roots of the conceptualization of ‘East and West’, will be focused on the relations of mental health and ill mental health with this and related conceptualizations. It is concluded that, in this day of globalization, to improve the quality of psychiatric theory and praxis within a framework of high ethical standards, a paradigm focusing on the unity in diversity and embracing a non-dualistic, non-categorical, and non-hierarchical humanistic approach to cultural differences would bring all the colours of humanity and therefore psychiatry onto the canvas. (shrink)

Global mental health in a changing world -- Contemporary humanitarianism -- Humanitarian ethics -- Professional and personal challenges in humanitarian work -- Managing ethical challenges in global mental health -- Aspirational guidance : principles of humanitarian assistance -- Operational guidance : IASC guidelines -- Ethical dilemmas : damned if you do and damned if you don't -- Ethically questionable practices -- Safety imperative and self-care -- Values-based ethical framework and core competencies in global mental (...) class='Hi'>health -- Ethical considerations for refugee mental health providers in the United States -- Conclusion and future directions. (shrink)

Spirituality and spiritual care have long been kept separate from patient care in mental health, primarily because it has been associated with psycho-pathology. Nursing has provided limited spiritual care competency training for staff in mental health due to fears that psychoses may be activated or exacerbated if religion and spirituality are addressed. However, spirituality is broader than simply religion, including more existential issues such as providing non-judgmental presence, attentive listening, respect, and kindness. Unfortunately, healthcare personnel working (...) in mental health institutions are not well prepared to address spiritual concerns or resources of their patients. Therefore, a mixed-method pilot study was conducted using a self-assessment survey tool to examine spiritual care competencies of mental health staff in Norway and to understand the perspectives of mental health staff in the Scandinavian context. Five questions and comments related to survey items provided rich qualitative data. While only a small pilot with 24 participants, this study revealed a need for spiritual care educational materials targeted specifically for those who work in mental health, materials that address the approach of improving attitudes, enhancing skills, and increasing knowledge related to spirituality and spiritual care of patients. (shrink)

Over the past few years, the number of Christian projects and charities working in the mental health sector in the United Kingdom has increased dramatically. At the same time, scientific and medical understandings of mental health have been advancing rapidly. These parallel trends beg a serious question: is the Christian Church's response to mental health authentically engaging with a changing scientific picture? Are theological questions like responsibility, sin, redemption, and reconciliation taking account of a (...) changing landscape? This is not a theoretical question, but has major practical consequences for developing practical pastoral responses. (shrink)

In this chapter we outline ethical issues raised by the application of public health approaches to the field of mental health. We first set out some of the basics of public health ethics that are particularly relevant to mental health, with special attention to the ongoing debate over the traditional presumption of non-infringement, increased recognition of the social determinants of health, and the concept of prevention. Then we turn to the moral particularities of (...) mental health, focusing on questions concerning coercion and treatment pressure, personal identity and sociocultural factors (including stigma), and unresolved conceptual and methodological issues in psychiatry that complicate its extension into the domain of public health. (shrink)

I argue in this essay that the phenomena we classify as "mental illness" result largely from the refusal of socially authorized "experts" to recognize - and thus to constitute - the Other as a subject. I suggest that Institutional Mental Health refuses to do this not merely because it seeks to aggrandize its own power but also because it fears to acknowledge that we are all participants in a process of historical development. It denies this because it (...) is historically conditioned by its own moment of origin in the project of the Enlightenment, It is conseqently wed to an ethos of rationalized order that does not accomodate, much less support, the unpredictable creative power of the Other and that sustains instead the project of mastery, of domination, of disovering eternal laws that will enable Reason to master history and to master the Other. For this reason Institutional Mental Health and its diverse ideologies, ranging from the pyschoanalytic to genetic defect models, constitute a major obstacle to the evolution of humanity. (shrink)

(1996). Designing mental health services to improve ethnic relations. World Futures: Vol. 47, Unity and Diversity in Contemporary Systems Tinking: Systematic Pictures at an Exhibition, pp. 15-23.

A significant number of inmates with mental illness reside within the New York State Department of Corrections (NYSDOCS). New York State has taken the initiative to provide mentally ill inmates with necessary services through a collaboration of the New York State Department of Correctional Services and the New York State Office of Mental Health (NYSOMH). The collaboration results in a mental health delivery system that provides many essential services to mentally ill inmates. This paper focuses (...) on the organization of mental health services within NYSDOCS, best practices, past and current litigation, and staff responsibilities. As the population of mentally ill inmates continues to grow, implications for the Human Services professions of OMH and DOCS needs to continue to address and provide adequate mental health care and resources for this special population. (shrink)

Postdisciplinarity in mental health‐care: an Australian viewpointThis paper outlines some of the powerful forces progressively undermining the conceptual and practical foundations upon which the major disciplines have been established, and dissolving the boundaries which have traditionally distinguished them from each other, particularly those disciplines involved in the healthcare enterprise. It discusses some of the implications of these processes for mental health nursing, and champions a new cadre of ‘postdisciplinary’ staff, comprising a graduate generic mental healthcare (...) worker and a postgraduate clinical specialist. It is argued that such a specialist — a ‘Generic Mental Health Worker’— should be welcomed by all those who want to see improved quality of care in mental health services rather than defend a failing system. (shrink)

The knowledge and skills of employees could play a valuable role in organizational success. Organizations seek practices to create a knowledge-sharing culture to take full advantage of individual competencies. However, the knowledge-hiding behavior of individuals is a hurdle in the internal dissemination of knowledge and expertise. It becomes more critical in the case of teaching institutions, where the students are taught and trained. Scholars are now putting their efforts into seeking the antecedents and consequences of knowledge-hiding behavior. This study also (...) attempts to determine the role of interpersonal distrust as an antecedent of knowledge hiding behavior of music education students. Based on the social exchange theory, the present study attempts to check the association of interpersonal distrust with emotional exhaustion and knowledge hiding. For empirical investigation, this study assumes that interpersonal distrust positively enhances knowledge hiding and emotional exhaustion, respectively. Moreover, the present study also attempts to check the association of emotional exhaustion with knowledge hiding. This study also assessed the mediating role of emotional exhaustion in the relationship between interpersonal distrust and knowledge hiding. This current study also aims to check the moderating role of mental health self-efficacy in the relationship between emotional exhaustion and knowledge hiding. For empirical investigation, the present study collected the data from 310 music learning students of various Chinese universities through a structured questionnaire method using a convenient sampling technique. This study applied partial least square structural equation modeling for empirical analyses using Smart PLS software. The findings of this study revealed that interpersonal distrust does not directly influence knowledge hiding; however, interpersonal distrust has a positive association with emotional exhaustion. The findings also acknowledged that emotional exhaustion positively correlates with knowledge hiding. The results also confirmed that emotional exhaustion positively mediates the relationship between interpersonal distrust and knowledge hiding. Further, the outcomes depicted that mental health self-efficacy negatively moderates the relationship between emotional exhaustion and knowledge hiding. In addition, this study’s findings also serve the literature of knowledge hiding by providing important theoretical and practical implications. (shrink)

In addressing the question of what mental health is we might proceed as if there is a single phenomenon – mental health – denoted by a single overarching concept. The task, then, is to provide an informative analysis of this concept which applies to all and only instances of mental health, and which illuminates what it is to be mentally healthy. In contrast, mental health pluralism is the idea that there are multiple (...) mental health phenomena denoted by multiple concepts of mental health. Analysis and illumination of mental health may still be possible, but there isn’t a single phenomenon or concept to be analysed in addressing the question of what mental health is. The question of pluralism has been overlooked in the philosophy of mental health. The discussion to follow is an attempt to get us to take mental health pluralism seriously. To that end, in this essay I have three primary goals: (1) to give a precise account of what mental health pluralism is, (2) to show that the question of pluralism should not be neglected in debate about what mental health is, and (3) to argue for mental health pluralism. I also draw out some implications of this discussion for philosophy, science, and psychotherapy. (shrink)

The concept 'health' is ambiguous [18,9, 11]. The concept 'mental health' is even more so. 'Health' compasses senses of well-being, wholeness, and sound ness that mean more than the simple freedom from illness - a fact appreci ated in the World Health Organization's definition of health as more than the absence of disease or infirmity [7]. The wide range of viewpoints of the con tributors to this volume attests to the scope of issues placed (...) under the rubric 'mental health. ' These papers, presented at the Fourth Symposium on Philos ophy and Medicine, were written and discussed within a broad context of interests concerning mental health. Moreover, in their diversity these papers point to the many descriptive, evaluative, and, in fact, performative functions of statements concerning mental health. Before introducing the substance of these papers in any detail, I want to indicate the profound commerce between philosophical and psychological ideas in theories of mental health and disease. This will be done in part by a consideration of some conceptual developments in the history of psychiatry, as well as through an analysis of some of the functions of the notions of mental illness and health. 'Mental health' lays a special stress on the wholeness of human intuition, emotion, thought, and action. (shrink)

Cancer, a terminal illness, has long been a focus of attention due to its fatal nature. Its diagnosis results in distress not only to the patients and physicians, but also the families and caregivers involved. This distress is of a multifaceted nature, including psychological, financial and physical distress. The present paper aims to explore mental health issues that specifically influence cancer patients’ caregivers. However, in a country like Pakistan literature is not very rich regarding the mentioned issue. Therefore, (...) giving rise to the immense need to create awareness concerning this pressing issue. In this paper, an effort has been made to identify the types of mental health problems and variables which could potentially affect the mental health of a cancer patient caregiver. An analysis on the type of issues and associated determining variables reveals various patients’ variable, situational variable or the caregiver’s own personality which makes them susceptible to poor mental health. Furthermore, the paper tries to answer the different question regarding the prevalence rate, current status of, and awareness on the above mentioned aspect. In the end some possible recommendations have also been made in the context of the mental health issues regarding the caregivers of cancer patients discussed in the paper. (shrink)

The aim of this chapter is to describe a type of law governing involuntary treatment that is based on decision-making capability and not on risk of harm to self or others. It is consistent with the legal and ethical principles followed in general medicine, and non-discriminatory against people with a mental illness. The rationale behind the proposal is outlined, as well as its principles and main features. It is argued that this type of law could be adapted to the (...) needs of low and middle-income countries without sacrificing its underlying principles, and that it lends itself to such adaptation much better than traditional mental health legislation. (shrink)

How are we to make sense of madness and psychosis? For most of us the words conjure up images from television and newspapers of seemingly random, meaningless violence. It is something to be feared, something to be left to the experts. But is madness best thought of as a medical condition? Psychiatrists and the drug industry maintain that psychoses are brain disorders amenable to treatment with drugs, but is this actually so? There is no convincing evidence that the brain is (...) disordered in psychosis, yet governments across the world are investing huge sums of money on mental health services that take for granted the idea that psychosis is an illness to be treated with medication. Although some people who use mental health services find medication helpful, many do not, and resist the idea that their experiences are symptoms of illnesses like schizophrenia. Consequently they are forced into having treatment against their wishes. So, how do we make sense of this situation? Postpsychiatry addresses these questions. It involves an attempt to rethink some of the fundamental assumptions of mental health work, showing how recent developments in philosophy and ethics can help us to clarify some of the dilemmas and conflicts around different understandings of madness. Throughout, the authors examine the conflicting ways in which politicians, academics, and mental health professionals appear to understand madness, and contrast this with voices and experiences that are usually excluded - those of the people who use mental health services. They then examine the power of psychiatry to shape how we understand ourselves and our emotions, before considering some of the basic limitations of psychiatry as science to make madness meaningful. In the final section of the book they draw on evidence from service users and survivors, the humanities and anthropology, to point out a new direction for mental health practice. This new direction emphasises the importance of cultural contexts in understanding madness, placing ethics before technology in responding to madness, and minimising 'therapeutic' coercion. (shrink)