Mental illness is common, and usually starts early in life. However, the majority of those affected never seek mental health care. The overall aim of this thesis was to increase knowledge about help-seeking young adults with mental illness in order to improve diagnostic procedures in clinical psychiatry. A group of young adult psychiatric out-patients (n=217) were consecutively invited to participate in the study between October 2002 and September 2003. Altogether 200 (92%) agreed to participate. Among them, there were 161 (80%) women and 39 (20%) men. Participants’ mean age was 22.4±1.9 years. All participants were carefully and comprehensively assessed with respect to axes I, II, IV and V in the DSM-IV. Psychiatric disorders and personality disorders were assessed using the Structured Clinical Interview for DSM-IV for axis I disorders and the Structured Clinical Interview for DSM-IV for axis II disorders. Psychosocial and environmental problems (axis IV) were evaluated through structured interviewing by a social worker and by self-assessment with a questionnaire. Professional and patient ratings on the Global Assessment of Functioning scale were compared before and after treatment. Patients also reported on the Swedish universities Scales of Personality, the Child and Adolescent Psychiatric Screening Inventory-Retrospect and the Coddington’s life event scale. Taken together, the young adult, psychiatric outpatients were characterized by an early onset of their mental disorders, by co-morbidity, by being female and by having mood or anxiety disorders. There were no significant differences between self-referred and those referred by medical professionals according to either number of current or lifetime diagnoses. Childhood onset of depression was associated with more severe symptoms, more psychosocial risk factors, and more childhood developmental delays. Axis IV psychosocial stress categories were related to the presence of axis I disorders, personality disorders, co-morbidity, and impaired functioning. Agreement between patients’ and professionals’ ratings on the GAF scale was good before treatment and excellent after treatment. In summary, the findings suggest that direct self-referral to specialized psychiatric care does not seem to be associated with overutilization of such care. Childhood onset of depression is associated with a more complex illness. The revised axis IV according to DSM-IV seems to have concurrent validity, but is still hampered by limited reliability. And finally, the results support the usefulness of the self-report GAF instrument for measuring outcome in psychiatric care.

This study introduces empirical data essential to our understanding of the relationship between suicidal individuals and the internet. Strong support was found for hypotheses that suicidal individuals purposely use the internet to resolve suicidal problems, whether for life or for death, and actively engage in an internal suicidal debate. A computer-administered survey (N = 64), and a multinational online survey (N = 1016), provided data on suicide-risk factors, online help-seeking, and internet use. Results from the computer-administered survey showed negative problem-solving approach, using phone helplines, and reluctance to seek professional mental health services, predicted online help-seeking for suicidal ideation. Results from the online survey demonstrated suicide-risk individuals form a unique online population. Suicide-risk participants were more likely, than nonsuicidal, to use online forums, while suicide-risk females, compared to nonsuicidal females, were more likely to create original online content (e.g., blogs, social networking), and spend time surfing/browsing. Suicide-risk participants, particularly females, were more likely to go online in search of new interpersonal relationships (as evidenced by the author-developed Online Relationship Building scale), and demonstrated some acceptance of online help sources. Suicide surfers (suicide-risk individuals who reported going online for suicide-related purposes) were compared with suicide-risk online users (who did not report such experience). Suicide surfers were found to be a higher risk group, reporting more severe suicidal and depressive symptoms, and less social support. Surfers reported higher satisfaction with unmoderated online forums, compared with helpsites and online mental health professionals. Online, they also found more support, felt less alienated, and had more satisfying communications. Results showed strong support for the internal suicidal debate hypotheses. In addition, reasons for living and dying significantly differed between highly suicidal and not suicidal participants, and most highly suicidal participants reported using the internet to look for and/or confirm their reasons for living and dying. Implications include a need for helpsites to be more user and communication oriented. Research implications include new directions for exploring the spectrum of suicidal ideation, and further examining online suicide-related behaviors.

This ethnographic study in medical anthropology is a critically interpretative analysis of fieldwork documentation I recorded during field research conducted in the mining city of Mount Isa in the far northwest of Queensland during the 1980s. Eighteen months of participant observation research was undertaken over four fieldtrips (1981-82, 1983, 1985 and 1988) at inter-connected locations: two urban reserves for Aborigines and the people I refer to as the Reserve Dwellers, as well as the local hospital and a group of hospital resident medical officers who I refer to as the Residents. During the field research I found that both Reserve Dwellers and the Residents experienced a difficult relationship during their interactions in medical consultations in the hospital clinics. Now in this dissertation I ask an overarching question of my time-lag field data. It is How can we understand the problematic relationship between indigenous reserve-dwelling help-seekers and biomedical practitioners at their local hospital clinics in the 1980s. To describe this problematic relationship I analyse time-lag data from my diaried participant observation at both the reserves and the hospital; semi-structured interviews with the hospital Residents; case studies and case histories of consenting help-seekers from the Reserves; and illustrative transcriptions of consultations between Residents and Reserve Dwellers that were tape recorded by the Residents during hospital clinics. The contemporary ethnomedical system of the Reserve Dwellers was inclusive of biomedicalized clinics and the Residents as clinicians at this remote hospital in the 1980s. I provide an ethnographic account of a changing contemporary indigenous ethnomedical system and describe the lifeways of the Reserve Dwellers in the 1980s; their pattern of help-seeking at their local hospital including grievous happenings; and their experiences in outpatients clinics and the emergency section of the local non-indigenous hospital. Their lifeways and help-seeking were in many ways defined by the collective sociality of Kalkadunga and other regional indigenous cultures as impoverished, very sick survivors of a genocidal contact history less than 100 years before. This local history is also reconstructed. The Residents view of local indigenous illness, help-seeking, and experiences of biomedicalised hospital clinics further describe the socio-cultural reality of the time. I found that the Residents had an insightful, even predictive assessment of local illness burden. At the same time, they held strong views about a pattern of help-seeking in the outpatients and emergency clinics that was considered disruptive of hospital routines. I also describe how they expressed their difficulties interacting with Aboriginal help-seekers including the taking of biomedical histories. My thesis is that a localized socio-clinical reality was shaped by a synchronic, coeval relationship between Reserve Dwellers enculturated within a changing, contemporary ethnomedical belief system that incorporated biomedicalized hospital clinics, and the Residents as clinicians enculturated within a culture of biomedical science at a remote hospital. I argue that the lifeways and pattern of help-seeking of the Reserve Dwellers, as well as the Residents’ views about sick indigenous help-seekers, formed this particular socio-clinical reality. It was then consistently replicated by problematic socio-clinical interaction and biomedicalized praxis that inhibited investigation and curative outcomes for the Reserve Dwellers and other indigenous help-seekers.

This ethnographic study in medical anthropology is a critically interpretative analysis of fieldwork documentation I recorded during field research conducted in the mining city of Mount Isa in the far northwest of Queensland during the 1980s. Eighteen months of participant observation research was undertaken over four fieldtrips (1981-82, 1983, 1985 and 1988) at inter-connected locations: two urban reserves for Aborigines and the people I refer to as the Reserve Dwellers, as well as the local hospital and a group of hospital resident medical officers who I refer to as the Residents. During the field research I found that both Reserve Dwellers and the Residents experienced a difficult relationship during their interactions in medical consultations in the hospital clinics. Now in this dissertation I ask an overarching question of my time-lag field data. It is How can we understand the problematic relationship between indigenous reserve-dwelling help-seekers and biomedical practitioners at their local hospital clinics in the 1980s. To describe this problematic relationship I analyse time-lag data from my diaried participant observation at both the reserves and the hospital; semi-structured interviews with the hospital Residents; case studies and case histories of consenting help-seekers from the Reserves; and illustrative transcriptions of consultations between Residents and Reserve Dwellers that were tape recorded by the Residents during hospital clinics. The contemporary ethnomedical system of the Reserve Dwellers was inclusive of biomedicalized clinics and the Residents as clinicians at this remote hospital in the 1980s. I provide an ethnographic account of a changing contemporary indigenous ethnomedical system and describe the lifeways of the Reserve Dwellers in the 1980s; their pattern of help-seeking at their local hospital including grievous happenings; and their experiences in outpatients clinics and the emergency section of the local non-indigenous hospital. Their lifeways and help-seeking were in many ways defined by the collective sociality of Kalkadunga and other regional indigenous cultures as impoverished, very sick survivors of a genocidal contact history less than 100 years before. This local history is also reconstructed. The Residents view of local indigenous illness, help-seeking, and experiences of biomedicalised hospital clinics further describe the socio-cultural reality of the time. I found that the Residents had an insightful, even predictive assessment of local illness burden. At the same time, they held strong views about a pattern of help-seeking in the outpatients and emergency clinics that was considered disruptive of hospital routines. I also describe how they expressed their difficulties interacting with Aboriginal help-seekers including the taking of biomedical histories. My thesis is that a localized socio-clinical reality was shaped by a synchronic, coeval relationship between Reserve Dwellers enculturated within a changing, contemporary ethnomedical belief system that incorporated biomedicalized hospital clinics, and the Residents as clinicians enculturated within a culture of biomedical science at a remote hospital. I argue that the lifeways and pattern of help-seeking of the Reserve Dwellers, as well as the Residents’ views about sick indigenous help-seekers, formed this particular socio-clinical reality. It was then consistently replicated by problematic socio-clinical interaction and biomedicalized praxis that inhibited investigation and curative outcomes for the Reserve Dwellers and other indigenous help-seekers.

This ethnographic study in medical anthropology is a critically interpretative analysis of fieldwork documentation I recorded during field research conducted in the mining city of Mount Isa in the far northwest of Queensland during the 1980s. Eighteen months of participant observation research was undertaken over four fieldtrips (1981-82, 1983, 1985 and 1988) at inter-connected locations: two urban reserves for Aborigines and the people I refer to as the Reserve Dwellers, as well as the local hospital and a group of hospital resident medical officers who I refer to as the Residents. During the field research I found that both Reserve Dwellers and the Residents experienced a difficult relationship during their interactions in medical consultations in the hospital clinics. Now in this dissertation I ask an overarching question of my time-lag field data. It is How can we understand the problematic relationship between indigenous reserve-dwelling help-seekers and biomedical practitioners at their local hospital clinics in the 1980s. To describe this problematic relationship I analyse time-lag data from my diaried participant observation at both the reserves and the hospital; semi-structured interviews with the hospital Residents; case studies and case histories of consenting help-seekers from the Reserves; and illustrative transcriptions of consultations between Residents and Reserve Dwellers that were tape recorded by the Residents during hospital clinics. The contemporary ethnomedical system of the Reserve Dwellers was inclusive of biomedicalized clinics and the Residents as clinicians at this remote hospital in the 1980s. I provide an ethnographic account of a changing contemporary indigenous ethnomedical system and describe the lifeways of the Reserve Dwellers in the 1980s; their pattern of help-seeking at their local hospital including grievous happenings; and their experiences in outpatients clinics and the emergency section of the local non-indigenous hospital. Their lifeways and help-seeking were in many ways defined by the collective sociality of Kalkadunga and other regional indigenous cultures as impoverished, very sick survivors of a genocidal contact history less than 100 years before. This local history is also reconstructed. The Residents view of local indigenous illness, help-seeking, and experiences of biomedicalised hospital clinics further describe the socio-cultural reality of the time. I found that the Residents had an insightful, even predictive assessment of local illness burden. At the same time, they held strong views about a pattern of help-seeking in the outpatients and emergency clinics that was considered disruptive of hospital routines. I also describe how they expressed their difficulties interacting with Aboriginal help-seekers including the taking of biomedical histories. My thesis is that a localized socio-clinical reality was shaped by a synchronic, coeval relationship between Reserve Dwellers enculturated within a changing, contemporary ethnomedical belief system that incorporated biomedicalized hospital clinics, and the Residents as clinicians enculturated within a culture of biomedical science at a remote hospital. I argue that the lifeways and pattern of help-seeking of the Reserve Dwellers, as well as the Residents’ views about sick indigenous help-seekers, formed this particular socio-clinical reality. It was then consistently replicated by problematic socio-clinical interaction and biomedicalized praxis that inhibited investigation and curative outcomes for the Reserve Dwellers and other indigenous help-seekers.

This ethnographic study in medical anthropology is a critically interpretative analysis of fieldwork documentation I recorded during field research conducted in the mining city of Mount Isa in the far northwest of Queensland during the 1980s. Eighteen months of participant observation research was undertaken over four fieldtrips (1981-82, 1983, 1985 and 1988) at inter-connected locations: two urban reserves for Aborigines and the people I refer to as the Reserve Dwellers, as well as the local hospital and a group of hospital resident medical officers who I refer to as the Residents. During the field research I found that both Reserve Dwellers and the Residents experienced a difficult relationship during their interactions in medical consultations in the hospital clinics. Now in this dissertation I ask an overarching question of my time-lag field data. It is How can we understand the problematic relationship between indigenous reserve-dwelling help-seekers and biomedical practitioners at their local hospital clinics in the 1980s. To describe this problematic relationship I analyse time-lag data from my diaried participant observation at both the reserves and the hospital; semi-structured interviews with the hospital Residents; case studies and case histories of consenting help-seekers from the Reserves; and illustrative transcriptions of consultations between Residents and Reserve Dwellers that were tape recorded by the Residents during hospital clinics. The contemporary ethnomedical system of the Reserve Dwellers was inclusive of biomedicalized clinics and the Residents as clinicians at this remote hospital in the 1980s. I provide an ethnographic account of a changing contemporary indigenous ethnomedical system and describe the lifeways of the Reserve Dwellers in the 1980s; their pattern of help-seeking at their local hospital including grievous happenings; and their experiences in outpatients clinics and the emergency section of the local non-indigenous hospital. Their lifeways and help-seeking were in many ways defined by the collective sociality of Kalkadunga and other regional indigenous cultures as impoverished, very sick survivors of a genocidal contact history less than 100 years before. This local history is also reconstructed. The Residents view of local indigenous illness, help-seeking, and experiences of biomedicalised hospital clinics further describe the socio-cultural reality of the time. I found that the Residents had an insightful, even predictive assessment of local illness burden. At the same time, they held strong views about a pattern of help-seeking in the outpatients and emergency clinics that was considered disruptive of hospital routines. I also describe how they expressed their difficulties interacting with Aboriginal help-seekers including the taking of biomedical histories. My thesis is that a localized socio-clinical reality was shaped by a synchronic, coeval relationship between Reserve Dwellers enculturated within a changing, contemporary ethnomedical belief system that incorporated biomedicalized hospital clinics, and the Residents as clinicians enculturated within a culture of biomedical science at a remote hospital. I argue that the lifeways and pattern of help-seeking of the Reserve Dwellers, as well as the Residents’ views about sick indigenous help-seekers, formed this particular socio-clinical reality. It was then consistently replicated by problematic socio-clinical interaction and biomedicalized praxis that inhibited investigation and curative outcomes for the Reserve Dwellers and other indigenous help-seekers.

The purpose of this study is to determine social factors that influence help seeking behaviors by mothers who are concurrently involved in two social service systems: Child Protective Services (CPS) and family violence advocacy programs. Through the application of the behavioral model (of service use) for vulnerable populations, this study seeks to determine predisposing, enabling and need characteristics that impact help seeking behaviors at a family violence agency after participation in an ADVANCE (Acknowledging Domestic Violence and Navigating Child Protection Effectively) course, a group intervention class developed specifically for women involved with CPS. The research design is a mixed-method approach with an ADVANCE course evaluation embedded within the overall analysis of help seeking behaviors. The analytic strategies include pre-test/post-test means comparisons through paired t-tests, qualitative thematic analysis through arts-based methodology, and ordinary least squares and logistic regression analysis. This study considers six outcome variables related to protective help seeking behaviors: seeking services, seeking protective actions related to children, seeking a safety plan, seeking a protective order, seeking safe housing, and seeking financial independence. Several social factors identified influenced help seeking behaviors amongst child welfare involved women experiencing violence, namely, number of children, age of children, level of interest in services, previous participation in services, level of social support, perceived victim status, perceived need for a safety plan, and perceived need for change in family. This study should serve to enhance intervention practices utilized by both family violence advocates and child welfare professionals.

Thesis (Ph.D.)--Ohio University, August, 2009. / Title from PDF t.p. Includes bibliographical references.

Thesis (Ph. D.)--University of North Texas, Dec., 2009. / Title from title page display. Includes bibliographical references.

Thesis (M.S.W.)--University of Hong Kong, 1994. / Includes bibliographical references (leaves 104-111).