Thesis (M. A. (Clinical Psychology)) -- University of Limpopo, 2015 / Culture affects the way people conceptualise and make meaning in their daily experiences, and in turn influence their decisions to seek solutions to their predicaments. Therefore the definition, causes and treatment of illnesses appear to be perceived in a socio-cultural context. A qualitative study was conducted among the indigenous healers of Moletjie (Capricorn District), Limpopo Province, (South Africa) to explore the treatment of mental illness. Indigenous healers were selected using the purposive sampling after the African Religion/ Culture & Health Forum was consulted and the names of indigenous healers who are members were obtained. 5 males and 5 females were interviewed. Data were collected using semi-structured interviews and analyzed using the content analysis method. The following psychological themes emerged from the study: indigenous healers’ notions of mental illness; perceived causes of mental illness; the process of assessment using the divination bones (ditaola); general treatment practices; treatment approaches to psychotic patients; continuous assessment during the treatment process; constant observation of patients during the treatment process; and, treatment procedures that are executed on discharge of the patient. The findings revealed that there are multiple causalities of mental illness and were accounted for by African traditional beliefs. The study revealed that 90% of the indigenous healers admit patients in their homestead during the healing process but the duration differs. The results further revealed that there are two major treatment modalities employed: namely, the use of herbs and ritual performance. The findings emphasize that treatment of mental illness is mainly determined by the perceived causes which emanate from cultural ideologies.

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A Thesis submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements of the Degree of Doctor of Philosophy. Johannesburg, 2015 / Sensemaking is the process through which people construct meaning around issues or events that are novel, ambiguous, confusing, or in some regard run contrary to expectations. Drawing on key insights from the work of Karl Weick on sensemaking, the aim of this study was to explore how staff members and volunteers at a non-profit human service organisation make sense of and enact the idea of quality in their environments. The study employed an interpretive approach and took the form of a single-case holistic case study. Using thematic analysis, several themes emerged from the data, which suggest that in order to deconstruct the idea of quality, as it exists in the minds and behaviours of organisational members, it is critical to obtain insight into the social and context driven processes that influence sensemaking. The findings also suggest that existing models and approaches to quality in the literature are incomplete in terms of their lack of a sensemaking focus. Practical recommendations are made for human services organisation administrators and managers to improve and monitor quality in their respective environments. The study concludes with a discussion of limitations as well as possible avenues for future research in light of the findings

Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / The American Psychiatric Association criteria for differential psychiatric diagnoses (DSM III-R) do not exhaust the list of socially problematic behaviors displayed by the mentally ill. The extent to which such behaviors influence a person's "career" as a deinstitutionalized patient is the major topic of this study. Fiscal crises and changing public commitments have reduced support to those with severe mental illness who are deinstitutionalized, increasing the importance of understanding how degrees of competence at activities of daily living and the extent of socially problematic behaviors affect their participation in the community. The concept Interactive Competence was developed on the basis of the writer's clinical experience and a review of the literature on community adjustment of persons with severe mental illness. The concept characterizes the social functioning of persons diagnosed as mentally ill, and includes demonstration of self-care (ADL) skills and self-management skills (trouble in relationships). Secondary analysis was performed on data from a 1984 probability sample of clients in Community Support Programs for seriously mentally ill adults. Factor analysis reduced items in the original instrument, The Uniform Client Data Instrument, to scales measuring Interactive Competence. Only persons with the diagnosis of Schizophrenia or Affective Disorders were studied (n=824 of 1053), excluding diagnoses which were diverse in nature and infrequent in occurrence. Bivariate correlation and regression techniques were used to test the major hypotheses: 1) Schizophrenics demonstrate less Interactive Competence than those with the diagnosis of Affective Disorder; 2) the greater the chronicity (length of time in the social role as a patient from point of first diagnosis) the less Interactive Competence; 3) lower level of Interactive Competence is associated with a lower level of mental health service utilization. Monitoring Interactive Competence self-care (ADL) skills and selfmanagement skills (trouble in relationships) provides new insights about the service utilization of the severely mentally ill and their families. Schizophrenics had less the Interactive Competence than those with Affective Disorders; those with lower scores on Interactive Competence used more services; family involvement influenced clients' use of crisis assistance services and urgent care services. / 2031-01-01

The proliferation of social media-based research on mental health offers exciting possibilities to complement traditional methods in mental health care. As ascertained by psychology experts, the online platform should get priority over offline as it offers considerably reliable diagnosis than granted in person. Early detection does not only alleviate the effects of depression on the patient but also benefits the whole community. In this thesis, we explore computational methods in tackling some of the research challenges in depression analysis and make four contributions to the body of knowledge. First, we develop a binary classification model for classifying depression-indicative text from social media. We propose three feature engineering strategies and assess the effectiveness of supervised model to enhance the classification performance in predicting posts indicate depression. To tackle the short and sparse social media data, we particularly integrate the coherent sentiment-topic extracted from the topic model. Additionally, we propose strategies to investigate the effectiveness of affective lexicon in the task of depression classification. Second, we propose a computational method for analysing potential causes of depression from text. With this study, we demonstrate the ability to employ the topic model to discover the potential factors that might lead to depression. We show the most prominent causes and how it evolved over time. Furthermore, we highlight some differences in causes triggered between two different groups, i.e. high-risk of depression and low-risk. Hence, this study significantly expands the ability to discover the potential factors that trigger depression, making it possible to increase the efficiency of depression treatment. Third, we develop a computational method for monitoring the psychotherapy outcome from the individual psychotherapy counselling. Third, we develop a computational method for monitoring the psychotherapy outcome from the individual psychotherapy counselling. By doing this, we show the possibilities of utilising the topic model to track the treatment progress of each patient by assessing the sentiment and topic discussed throughout the course of psychotherapy treatment. Fourth, we propose an unsupervised method called split over-training for identifying user's intention expressed in social media text. We develop a binary classification model for classifying intentions in texts. With this study, we want to show the possibility of applying the intention analysis in mental health domain. Overall, we demonstrate how computational analysis can be fully utilised to benefit clinical settings in mental health analysis. We suggest that more future work could be further explored to complement the traditional settings in mental health care.

Si bien la prevención es una disposición prioritaria en la salud pública, específicamente en el ámbito de la salud mental comunitaria su desarrollo es menos visible y más heterogéneo en cuanto a enfoques, metodologías y resultados. En el presente trabajo se exploran los posibles aportes del psicoanálisis a la noción de prevención comunitaria, dimensión fundamental dentro del campo más vasto de la salud mental comunitaria. A lo largo de estas páginas, se realiza un recorrido teórico a través de la literatura psicoanalítica con el fin de mostrar la relación de tensión entre esta disciplina y el campo de la salud mental. Se hace esto con el objetivo de identificar y discutir estas tensiones para luego resaltar los puntos de encuentro en los que el psicoanálisis puede generar aportes para la prevención en salud mental comunitaria. Entre los motivos de las tensiones que fomentan la mutua exclusión entre el psicoanálisis y el campo de la prevención en salud comunitaria se identifica la visión medicalista y positivista que suele marcar al campo de la salud mental y, respecto de la perspectiva psicoanalítica, se advierte del riesgo de adoptar una mirada de superioridad, tanto como una perspectiva autosuficiente y hegemónica, poco permeable a la escucha o a la interpelación por parte del campo de la salud comunitaria. Por otro lado, la prevención comunitaria, que supone la participación del sujeto en la comunidad y la facilitación de recursos o agencias psicosociales para la población, emerge en este estudio como un ámbito de potencial encuentro fructífero con el psicoanálisis especialmente en nuestro medio peruano, en el que la violencia y la inequidad afectan de modo significativo la salud mental de los sectores más vulnerables y marginados. En este sentido, se invita a complejizar la noción de prevención y plantear las contribuciones del psicoanálisis desde la teoría y la clínica en una perspectiva de prevención comunitaria que incluya fundamentalmente la dimensión inconsciente de la vida y la centralidad del vínculo interpersonal, articulando así la palabra, la reflexión y los afectos con la acción. Estos son algunos de los principales aportes que se relevan en el presente trabajo. / Tesis

Global studies investigating scaling-up of mental health services have highlighted mental health policy development and implementation as a priority area, especially in low- and middle-income countries. This research aimed to investigate Malaysia's National Mental Health Policy (NMHP) development and implementation and explore the barriers and facilitators to mental health care from multi-stakeholder point of view. This study, consisting of two main parts, adopted the situation analysis model from the Global Mental Health Lancet 2011 Series. Part One details the current mental health plans and development of the NMHP with data obtained via semi-structured interview, consultation observation, and government documents analysis. Part Two investigates key stakeholder perceptions and/or experiences gained through semi-structured interviews with 54 participants across five main stakeholder groups: policymakers, service providers, NGOs, service users, and caregivers. These were analysed using content analysis and the Framework Method respectively. Six categories of types of mental health plans emerged: (1) 'action plans', (2) 'education and training', (3) 'operational', (4) 'community psychiatry', (5) 'promotion', and (6) 'NGO'. Further, stakeholders identified seven key areas in relation to mental health care: (1) 'barriers to mental health care', (2) 'suggestions for improvement', (3) 'awareness and knowledge on mental health', (4) 'facilitators to mental health care', (5) 'impact of mental illness', (6) 'duty of care', and (7) 'cultural spiritual or ethnic influence'. Findings indicate the extent to which the NMHP objectives and goals were achieved between 2009 and 2016. Issues around attitude, resources, and awareness are most pressing to address. Facilitating factors, as well as suggestions for improvements, were uncovered too. Further important considerations in providing care in Malaysia revolve around raising awareness and knowledge, cultural appropriateness, and the roles of family, friends and even NGOs. This study concludes with proposed needs- and asset-based recommendations for future national mental health policy development.

Mestrado em Psiquiatria e Saúde Mental / Master Degree Course in Psychiatry and Mental Health