Emerald | Journal of Public Mental Health | Table of Contents

Public health implications of spiritual healing practice, in conditions such as depression

literatinetwork@emeraldinsight.com (Charles J.M. Bell) — Fri, 15 Mar 2013 00:00:00 +0000

Abstract

Purpose – Patient-defined spiritual aspects of mental health care are an understudied and potentially important aspect to non-pharmaceutical treatments. A review of this area will lead to improved rigorous research and better patient outcomes. The purpose of this paper is to examine the public health implications of spiritual healing practice, in conditions such as depression. Design/methodology/approach – The current research into spiritual healing was reviewed, and in particular its use in depression. Scientific and anecdotal evidence was considered, and areas of improvement were identified. Findings – The attitudes of physicians and patients may affect the efficacy of patient-defined spiritual healing, which is currently lacking in rigorous academic research. A better scientific understanding may aid in a cost-benefit analysis of such treatments in the future. Originality/value – This paper should aid those involved in public health-care planning or who practice psychotherapeutic methods to ensure they utilise all possible methods, whilst working within a rigorous evidence-based framework.

Mental health law in Africa: analysis from a human rights perspective

Fri, 15 Mar 2013 00:00:00 +0000

Abstract

Purpose – The purpose of this paper is to provide detailed assessments of the mental health laws of Ghana, South Africa, Uganda and Zambia. Design/methodology/approach – The mental health laws of four countries were assessed both by country partners and staff of WHO, Geneva, using the World Health Organization (WHO) Checklist on Mental Health Legislation, which examines the level of coverage of key issues in mental health laws. Findings – The older laws of Ghana, Uganda and Zambia do not address fundamental human rights of people with mental health conditions. South Africa's more recent Mental Health Care Act (2002) incorporates critical human rights standards, though certain provisions fail to adequately safeguard against potential violations. For mental health legislation to maintain currency with human rights standards it must be regularly reviewed and updated. Originality/value – The findings highlight the urgent need to revise the mental health laws of Zambia, Uganda and Ghana, and to plan ways to address the gaps identified in the relatively new South African mental health law. The entry into force of the United Nations Convention on the Rights of Persons with Disabilities in 2008 signals a new era in how mental health legislation is to be drafted. The identification of gaps in national laws, as has been undertaken by the four countries, is an important first step towards putting in place legal frameworks to promote the rights of people with mental health conditions in line with current international human rights standards.

Mental health in the left-behind children in the Fujian Province of China

literatinetwork@emeraldinsight.com (Björn Albin, Jiang Qin, Zhang Hong) — Fri, 15 Mar 2013 00:00:00 +0000

Abstract

Purpose – An increasing number of people are migrating within the borders of China. Some migrants have to leave their children behind, and 58,000,000 children are estimated to be living as left-behind children. Earlier studies have found severe mental problems in left-behind children, but different factors could influence their mental health. The purpose of this paper is to investigate the mental health of these left-behind children and to determine possible influencing factors. Design/methodology/approach – Data for this study were collected in one province of the People's Republic of China with a validated instrument, the Strengths and Difficulties Questionnaire (SDQ), to investigate behavior in 13-to-15-year old children. Findings – No significant difference was found in total difficulty score and in any subscale score of SDQ when left-behind children were compared with children who were not left behind. A significant difference in emotional difficulty subscale score was found between girls who were left behind and girls who were not. Some socio-economic factors such as poor family economy and living with relatives, friends or grandparents, were identified as risk factors. Originality/value – When strategies for support of the mental health in left-behind children are developed, they will need to be individualized according to the gender, social and economic situation and focused on emotional and conduct problems.

Reducing antipsychotic prescriptions in primary care: a healthcare perspective

literatinetwork@emeraldinsight.com (Angelique Mavrodaris, Ian Philp) — Fri, 15 Mar 2013 00:00:00 +0000

Abstract

Purpose – One in 14 people over 65 years suffer from dementia in the UK. Over 25 per cent are receiving antipsychotics, which cause increases in mortality and cerebrovascular events. The need for a reduction and the use of alternative supportive strategies has been advocated. Risperidone at six-week intervals is the only antipsychotic licensed for treatment with regular review. The majority of management occurs at primary care level and in care homes. The purpose of this paper is to investigate antipsychotic prescribing practices and patient review in these settings. Design/methodology/approach – In total, two surveys comprising questions addressing prescribing practices were developed and distributed electronically to all GP practices and care homes in Coventry and Warwickshire, West Midlands, England. Findings – The majority of GPs (75 per cent) reported only “occasional” discontinuation of antipsychotics due to concerns at reducing drugs on their own, expectations of regulation from secondary care and resistance from care home staff. Poor reduction levels were reported in care homes, attributing low numbers to reluctance among GPs. History of cardiovascular risk factors did not appear to influence withdrawal. Only 40 per cent of GP practices maintained sole use of risperidone. At least six-monthly reviews were reported by 63 per cent of GPs and 64 per cent of care homes, with very few conducting reviews at least three-monthly. The importance of non-pharmacological alternatives was emphasized, yet access was limited and highly resource-dependent. Originality/value – This study reveals the perspectives of staff delivering healthcare for people with dementia and behavioural and psychological symptoms of dementia (BPSD). Potentially inappropriate antipsychotic principles were reported. A lack of communication and uncertainty of roles was evident. The development of understandable guidelines for healthcare workers and care home staff managing behavioural issues in patients with dementia is necessary.

Potential pathways from biopsychosocial risk factors to sleep loss due to worry: a population-based investigation

literatinetwork@emeraldinsight.com (Alex Dregan, Tea Lallukka, David Armstrong) — Fri, 15 Mar 2013 00:00:00 +0000

Abstract

Purpose – Typologies of sleep problems have usually relied on identifying underlying causes or symptom clusters. The purpose of this paper is to explore the value of using the patient's own reasons for sleep disturbance. Design/methodology/approach – Using secondary data analysis of a nationally representative psychiatric survey the patterning of the various reasons respondents provided for self-reported sleep problems were examined. Over two thirds (69.3 per cent) of respondents could identify a specific reason for their sleep problem with worry (37.9 per cent) and illness (20.1 per cent) representing the most commonly reported reasons. And while women reported more sleep problems for almost every reason compared with men, the patterning of reasons by age showed marked variability. Sleep problem symptoms such as difficulty getting to sleep or waking early also showed variability by different reasons, as did the association with major correlates such as worry, depression, anxiety and poor health. Findings – While prevalence surveys of “insomnia” or “poor sleep” often assume the identification of an underlying homogeneous construct, there may be grounds for recognising the existence of different sleep problem types, particularly in the context of the patient's perceived reason for the problem. Originality/value – A typology based on reasons presents a different snapshot of the landscape of insomnia. Using patient's reasons to underpin a sleep nosology is an alternative way of sub-dividing patients' symptoms which has some face validity given the “subjective” associations between reasons and symptoms.

What Works in Reducing Inequalities in Child Health?

literatinetwork@emeraldinsight.com (Woody Caan) — Fri, 15 Mar 2013 00:00:00 +0000

Editorial

literatinetwork@emeraldinsight.com (Woody Caan) — Fri, 15 Mar 2013 00:00:00 +0000