Bakgrund: Psykisk ohälsa är ett samlingsnamn för psykiska tillstånd som orsakar lidande och innebär vissa svårigheter att fungera i vardagslivet. Tonåren är en tid av såväl psykiska som fysiska förändringar och gör därför tonåren till en sårbar period för psykisk ohälsa. Cirka tio procent av tonåringarna har så omfattande psykiska problem att det påverkar den dagliga livsföringen. Skolsköterskan är en av de första att träffa tonåringar med psykisk ohälsa och utgör därför en viktig del av tonåringens välbefinnande.  Syfte: Syftet var att undersöka skolsköterskors erfarenheter av att arbeta med tonåringar med psykisk ohälsa.  Metod: En litteraturöversikt med integrerad analys. Litteratursökning utfördes i tre databaser; Cinahl, PubMed och PsycINFO. Totalt tolv kvalitativa artiklar analyserades och inkluderades i litteraturöversikten. Alla inkluderade artiklar kvalitetsgranskades med hjälp av en kvalitetsgranskningsmall.  Resultat: Fyra kategorier framkom i analysen; Saknar verktyg och kunskap om psykisk ohälsa, Tidsbrist och arbetsbelastning, Vikten av teamarbete och Meningsfullt arbete men känslomässigt tärande. Resultatet visade att skolsköterskorna efterfrågade verktyg och mer kunskap om tonåringars psykiska ohälsa. Vidare upplevde skolsköterskorna tidsbrist och att de inte alltid kunde vara så tillgängliga för tonåringarna som de önskade. Teamarbetet med övriga professioner och externa aktörer kunde bli bättre då skolsköterskorna inte alltid kände sig accepterade i sin yrkesroll. Även om skolsköterskorna upplevde arbetet som känslomässigt tärande så kände de ändå att deras arbete var meningsfullt för den enskilde tonåringen.  Slutsats: Skolsköterskorna saknade kunskap, verktyg och resurser i arbetet med tonåringar med psykisk ohälsa. De upplevde att tidsbristen försvårar det förebyggande arbetet för psykisk ohälsa och att de inte alltid kände sig accepterade av andra professioner. Det är av stor vikt att skolsköterskan i klinisk praxis kan erbjudas mer kunskap, tid och resurser för att jobba förebyggande mot psykisk ohälsa. / Background: Mental illness is an overall term for mental conditions that cause suffering and involve certain difficulties in functioning in everyday life. Adolescence is a time of both mental and physical change and therefore makes adolescence a vulnerable period for mental illness. About ten percent of teenagers have such extensive mental health problems that it affects their daily life. The school nurse is one of the first to meet teenagers with mental illness and therefore forms an important part of the teenager's well-being.  Aim: The aim was to investigate school nurses' experiences of working with adolescents with mental illness.  Design: A literature review with integrated analysis. Literature search was performed in three databases; Cinahl, PubMed and PsycINFO. A total of twelve qualitative articles were analyzed and included in the literature review. All included items were quality reviewed using a quality review template.    Results: Four categories emerged in the analysis; Lacks tools and knowledge about mental illness, Lack of time and workload, The importance of teamwork and Meaningful work but emotionally consuming. The results indicated that school nurses need tools and more knowledge about teenagers' mental illness. Furthermore, school nurses experienced a lack of time and that they could not always be as accessible to the teenagers as they wanted. The teamwork with other professions and external actors could be better as the school nurses did not always feel accepted in their professional role. Even though the school nurses experienced the work as emotionally consuming, they still felt that their work was meaningful to the individual teenager.  Conclusion: School nurses lack knowledge, tools and resources in working with adolescents with mental illness. They experience that the lack of time complicates the preventive work for mental illness and that they do not always feel accepted by other professions. It is of great importance that the school nurse in clinical practice can be offered more knowledge, time and resources to work preventively against mental illness.

Bakgrund: Under graviditet genomgår kvinnan fysiologiska, psykologiska och hormonella förändringar. Att drabbas av psykisk ohälsa i samband med graviditet och tiden efter barnets födelse är inte annorlunda än att drabbas av psykisk ohälsa under andra perioder i livet men psykisk ohälsa under den perinatala perioden kan påverka bindningen till barnet och barnets anknytning till sin mamma. Psykisk ohälsa kan leda till att kvinnor ifrågasätter sin modersroll och barn till mödrar med psykisk ohälsa kan påverkas negativt genom emotionella-, kognitiva- och beteendemässiga svårigheter som kan bli långvariga. Barnmorskan har i uppgift att upptäcka och identifiera kvinnor med risk för psykisk ohälsa, tidiga insatser är av vikt. Barnmorskan kan remittera kvinnan till adekvat vård inom och utanför professionen. Det är av vikt att barnmorskan skapar förtroendefulla relationer, vården ska ges med värdighet och vara personcentrerad samt möjliggöra kontinuitet. Dock visar forskning att kvinnor upplevt att bemötande och vård inte tillgodoses vilket leder till att den psykiska ohälsan inte uppmärksammas. Syfte: Att, utifrån barnmorskors erfarenheter och upplevelser, belysa vad som påverkar bemötandet och vården gentemot kvinnor i relation till psykisk ohälsa i samband med graviditet och tiden närmast efter barnets födelse, så kallad perinatal psykisk ohälsa. Metod: Litteraturöversikt med kvalitativa och kvantitativa artiklar som analyserades med integrativ metod. Resultat: Barnmorskor ansåg att relationsskapandet var viktigt i avseendet att främja den psykiska hälsan och för att identifiera psykisk ohälsa. Barnmorskorna upplevde inte att stödet alltid räckte till, varken för att skapa förtroendefull relation eller för att erbjuda lämplig vård till kvinnor som drabbats av psykisk ohälsa. Helhetsperspektivet var bristande, en del barnmorskor ansåg att perinatal psykisk ohälsa var deras ansvar, medan ansvarsrollen upplevdes som otydlig av andra barnmorskor. Barnmorskor tillfrågade inte kvinnor om den psykisk hälsan under graviditeten och de kände sig mer bekväma att prata om fysiska besvär och frågor specifikt riktade mot graviditeten och dess fortskridande. Det framkom också negativa attityder och stigma kopplade till psykisk ohälsa, och att vården och bemötandet påverkades av tidsbrist. Barnmorskor upplevde kompetensbrist och otydlighet gällande remittering, vilket bidrog till osäkerhet och oro. Det visade sig att flertalet barnmorskor hade kunskapsbrister angående perinatal psykisk ohälsa. Slutsats: Bemötande och vård påverkas av förtroendefulla relationer, kontinuitet och kunskapsbrist. Genom att synliggöra betydelsen av förtroendefulla relationer skulle det möjliggöra att barnmorskor skulle kunna förebygga perinatal psykisk ohälsa och därmed kunna skydda, kanske den viktigaste relationen i livet, mammans bindning till sitt barn och barnets anknytning till sin mamma. / Background: During pregnancy, the woman undergoes physiological, psychological, and hormonal changes. Suffering from mental illness in context to pregnancy; before, during and the time after child’s birth, is no different than suffering from mental illness during other periods in life. But mental illness during the perinatal period can have a negative impact on the attachment to the child and the child´s attachment to the mother. Mental illness can lead to women´s questioning their role as mothers and children of mothers with mental illness can be negatively affected by emotional, cognitive, and behavioral difficulties that can be long-lasting. The midwife has the task of discovering and identifying women at risk of mental illness and early intervention is important. The midwife can refer the woman to adequate care within and outside the profession. It is important that the midwife creates trusting relationships, enable continuity and the care must be given with dignity and be person-centered. However, research shows that women have experienced that treatment and care are not provided, which leads to perinatal mental illness not being noticed.  Purpose: To, based on midwife’s view´s and experience, shed light on what affect the treatment and care towards women in relation to mental illness in connection with pregnancy and the time immediately after the child´s birth, so-called perinatal mental illness. Method: Literature review with qualitative and quantitative articles that were analyzed with an integrative method. Results: Midwives considered that building a relationship was important in promoting mental health and in identifying mental illness. The midwives did not feel that their support was always sufficient, neither to create a trusting relationship nor to offer appropriate care to women who have suffered from mental illness. The holistic perspective was lacking, some midwives considered that perinatal mental illness was their responsibility, while the role of responsibility was perceived as unclear by other midwives. Midwives did not ask women about their mental health during pregnancy, and midwives felt more comfortable talking about physical ailment and issues specifically related to pregnancy and its progression. There were also negative attitudes and stigmas associated with perinatal mental illness, and that care and treatment were affected negatively by lack of time. Midwives experienced a lack of skills and uncertainty regarding referral, which contributed to doubt and concern. It turned out that most midwives had a lack of knowledge regarding perinatal mental illness. Conclusion: Treatment and care are affected by trusting relationships, continuity, and lack of knowledge. By highlighting the importance of trusting relationships, it would enable midwives to prevent perinatal mental illness and thus protect, perhaps the most important relationship in life, the mother´s attachment to her child and the child´s attachment to the mother.

Bakgrund: Personer som lider av psykisk ohälsa upplever stigmatisering i olikasammanhang. Det finns varierande faktorer som påverkas av stigmatisering hospersoner som lider av psykisk ohälsa vilket leder även till upplevelser avdiskriminering hos dem. Stigmatisering är ett vanligt förekommande problem isamhället vilket medför konsekvenser hos dem.Syfte: Syftet med denna studie är att beskriva faktorer relaterade till stigmatiseringav samt dessa konsekvenser för personer som lider av psykisk ohälsa utanförpsykiatrin.Metod: Examensarbetet genomfördes som en litteraturöversikt där 15 vetenskapligaartiklar söktes fram utifrån syftet som sedan analyserades och sammanställdes tillresultatet. Artiklarna var av både kvalitativ, kvantitativ design samt en mixad metod.Databaserna CINAHL och PsycINFO användes som sökmotorer.Resultat: Resultatet består av fyra huvudkategorier. “Livskvalitet” där beskrivskonsekvenser av stigmatisering på livskvalitet. “kulturella och sociodemografiskafaktorer” där diskuteras kulturella perspektivens påverkan på stigmatisering samtsambandet mellan stigmatisering och utbildningsnivå beskrivs. “Socialdistansering” där påpekas faktorer som förorsakar att personer som lider av psykiskohälsa dra sig ur sociala situationer. “Familjen” där beskrivs familjen som en källatill stigmatisering.Slutsats: Stigmatisering påverkar livskvaliteten hos personer som lider av psykiskohälsa. Vidare kan bristande tillgång och nivå på utbildning öka risken förstigmatisering. Stigmatisering leder även till social distansering hos personer somlider av psykisk ohälsa. Dessutom räknas familjen till personer som lider av psykiskohälsa som en viktig källa till stigmatisering vilket gör att de undviker prata ompsykisk ohälsa i familjen. / Background: People suffering from mental illness experience stigma in differentcontexts. There are various factors that affected by stigma in people suffering frommental illness, which also leads to experiences of discrimination in them. Stigma isa common problem in today's society, which has consequences in people sufferingfrom mental illness.Aim: The purpose of this study is to describe factors related to the stigma of as wellas these consequences for people suffering from mental illness outside psychiatry.Method: The thesis carried out as a literature review where 15 scientific articlessearched based on the purpose, which then analyzed and compiled into the results.The articles were of both qualitative, quantitative design and a mixed method. TheCINAHL and PsycINFO databases used as search engines.Result: The result consists of four main categories. “Quality of life” describes theconsequences of stigma on quality of life. “Cultural and socio-demographic factors”which discuss the impact of cultural perspectives on stigma and the link betweenstigma and educational attainment are described. “Social distancing,” points outfactors that cause people suffering from mental illness to withdraw from socialsituations. "Family" there describes the family as a source of stigma.Conclusion: Stigma affects the quality of life of people suffering from mentalillness. Furthermore, lack of access and level of education can increase the risk ofstigma. Stigma also leads to social distancing in people suffering from mentalillness. In addition, the family of people suffering from mental illness considered animportant source of stigma, which means that they avoid talking about mental illnessin the family.

No description available.

Bakgrund: Stress relaterat till psykisk ohälsa är den vanligaste orsaken till sjukskrivning i Sverige. Sjuksköterskors arbete innebär nära kontakt med människor och kan vara komplext och oförutsägbart. Sjuksköterskor är en yrkesgrupp som upplever stress relaterat till arbetsmiljön. En stressreaktion ska normalt vara under en kort tid men när det sker under längre perioder riskerar kroppens hälsa att påverkas negativt. Vid stress tvingas människan prestera över sin normala förmåga och resulterar i hög påfrestning på kroppen vilket i slutändan kan leda till psykisk ohälsa. Syfte: Var att belysa sjuksköterskors upplevelser om stressorer i arbetsmiljön som kan leda till psykisk ohälsa. Metod: En kvalitativ litteraturöversikt användes till studien där elva stycken vetenskapliga artiklar analyserades enligt Fribergs metod. Resultat: Studien belyser sju identifierade stressorer som sjuksköterskor upplever i arbetsmiljön som kan leda till psykisk ohälsa. Slutsats: Stressorer som sjuksköterskor upplever skapas av både verksamheten och arbetsgruppen. / Background: The most common cause of sick leave in Sweden is stress related to mental illness. Nurses work involves close contact with people and can be complex and unpredictable. Nurses are a professional group that experiences stress related to the work environment. A stress reaction should normally be for a short period of time, but when it occurs for longer periods, the body's health risks being adversely affected. Stress force people to perform above their normal ability and overperforming adversely affects the body and can lead to mental illness. Purpose: To elucidate nurses' experiences about stressors in the work environment can lead to mental illness. Method: A qualitative litteratured based study was used where eleven scientific articles were analyzed according to Friberg's method. Results: The study highlights seven identified stressors that nurses experience in the work environment that can lead to mental illness. Conclusion: Various stressors that nurses experience are created by the organisation and the working group.

Socialarbetares bemötande av personer de möter är av yttersta vikt i förändringsprocessen. Syftet med denna studie var att belysa de olika faktorer som ligger till grund för ett bra bemötande med ungdomar som har psykisk ohälsa utifrån de professionellas perspektiv samt undersöka vilka utmaningar som kan upplevas i sådana möten. Datainsamlingen skedde genom kvalitativa intervjuer med sex socialarbetare. Materialet analyserades genom tematisk-analys. De teoretiska utgångspunkterna som tillämpades i denna studie var lösningsfokuserad teori och Goffmans teori om stigma. Resultatet visar att ett bra bemötande grundar sig i ömsesidig respekt, förståelse och trygghet mellan socialarbetaren och ungdomen. Dessutom bör socialarbetaren inneha kunskap, erfarenhet, lyhördhet, empati, tålamod och accepterande för att ha ett bra bemötande. Det framkom även att socialarbetare kan uppleva utmaningar i möten med ungdomar, såsom att ungdomarna är motstridiga inför att söka hjälp, brister i deras motivation eller att ungdomarna mår så dåligt att de inte orkar söka hjälp. / Social workers encounter with individuals is important to support individuals to reach a positive change in their lives. The purpose of this study was to elucidate the various factors that form the basis for a good encounter with young people who have mental illness from the perspective of the professionals, as well as what challenges can be experienced in such meetings. Data collection was done through qualitative interviews with six social workers. The material was analyzed by a thematic analysis. The theoretical starting points used in this study were solution focused theory and Goffman's theory of stigma. The result of the study shows that a good encounter is based on mutual respect, understanding and security between the social worker and the youth. In addition, the social worker should possess knowledge and experience, be responsive, empathetic, patient and show acceptance in order to have a good approach. It also emerged that social workers may experience challenges in encounters with young people, such as that young people are contradictory to seek help, lack of motivation, or that young people’s mental illness is so bad that they are unable to seek help.

abstract: Adolescents experience a lot of stress from changes and difficulties in their physical appearance and their relationships—affecting their mental and emotional well-being as well as their family's relationships and functioning. Research has shown that family music therapy has been fairly successful in helping both children and adolescents and their families improve their communication and mutual attunement while encouraging self-expression in the child and teenager. However, the literature focuses mainly on families with children ages 10 and under, at-risk families, and non-clinical families. Little focus in the research literature is given to adolescents and their mental and emotional health concerns. The purpose of this thesis was two-fold: 1) to perform a systematic review and collect information from articles that used music interventions or music programs to address the mental health needs of families and adolescents, and 2) to develop a family music therapy program for teenagers with mental health concerns based on the research literature used for the systematic review. Fourteen articles were included in the study. The main interventions and programs were improvisation (n = 6), songwriting (n = 3), lyric analysis or song discussions on client-selected music for introspective and expressive purposes (n = 3), therapeutic singing (n =1) and structured group music making (n = 1). Common outcomes included improvement in the adolescents' self-expression and communication, restoration of family relationships, increased awareness of covert family issues, and improved family communication and interactions. The proposed six-week music therapy program is improvisation-based, considering the amount of improvisational interventions that were found in research. Session plans include interventions such as musical “icebreakers” and warm-ups, improvisation, lyric analysis, and a culminating songwriting experience. Keywords: family therapy, music therapy, adolescents, mental illness / Dissertation/Thesis / Masters Thesis Music Therapy 2019

Patienter med somatisk och psykiatrisk samsjuklighet är en sårbar och vårdmässigt komplex grupp som löper större risk, jämfört med normalpopulationen, att avlida i förtid till följd av sjukdomar som kunde ha förebyggts. Bristande socioekonomiska resurser tycks vara en förklaring men forskning visar också på sämre bemötande av patientgruppen samt att fler diagnostiska misstag görs vid samsjuklighet. Syftet med denna studie var att undersöka hur läkare inom somatiken upplever svårigheter i diagnostik och behandling gällande samsjukliga patienter. Semistrukturerade intervjuer genomfördes med tio läkare verksamma inom somatisk vård. Induktiv tematisk analys visade att läkarnas upplevelser kunde delas in i fyra teman; Osäkerhet, Relationen, Kapacitet och Integration. Resultaten visar att läkare upplever svårigheter kopplat till individen, patient-läkar-relationen och vården i stort. Kärnkategorin Otillräcklighet är beskrivande för samt genomsyrar samtliga teman och handlar om en otillräcklighet i hela vården, hos såväl patient som vårdpersonal och organisation. Dessa fynd bekräftar dels tidigare forskning och tillför fördjupade perspektiv i en svensk kontext. Behov finns av vidare kvantitativ forskning inom ämnet för ett mer generaliserbart resultat. / Patients with somatic and psychiatric comorbidity constitute a vulnerable and care-wise complex group at higher risk, compared to the general population, of premature death due to preventable diseases. A lack of socio-economic resources seems to be one explanation, but research also shows that these patients are subjected to worse interpersonal treatment and that more diagnostic mistakes are made in relation to comorbid patients. The purpose of this study was to investigate how physicians in the somatic care experience difficulties in diagnosis and treatment of comorbid patients. Semi-structured interviews were conducted with ten physicians in the somatic care. Inductive thematic analysis showed that the experiences could be categorized into four themes; Uncertainty, The relationship, Capacity and Integration. The results show that physicians experience difficulties relating to the individual, the patient-physician-relationship, and the care system as a whole. The core category Insufficiency is descriptive of all themes and refers to an insufficiency regarding the patient herself as well as the staff and the organization. The findings confirm previous research and adds an in-depth perspective in a Swedish context. There is a need for future quantitative research on this topic in order to generate more generalizable results.

abstract: Users of psychedelic drugs frequently report various types of healing effects after the experience has completed. How these substances actually do the healing work is still being understood. I argue that the phenomenology of the psychedelic experience is relevant to and doing at least some of the healing work. This occurs in part via the phenomenon of transformative experiences. Psychedelic experiences provide insight into first and second order desires of an individual. They alter an individual’s self-narrative and provide an ideal to aim for in addition to the motivation to achieve that ideal. Additionally, psychedelic experiences foster feelings of connection to other people and nature. This heals through altering an individual’s in-group/out-group perceptions and provide a sense of oneness which increases accurate perspective taking. The experience of ego-dissolution had under psychedelics can be compared to the ultimate transformative experience—death—which facilitates the healing process. These experiences promote social healing and serve as a reopening of previously closed possibilities due to trauma or mental illness. / Dissertation/Thesis / Masters Thesis Philosophy 2020

The research reviews that the majority of Black South Africans will frequent a traditional African healer as a primary means of health care. This may be partly due to the fact that traditional African healer is accredited as offering more affordable means of health care. Traditional African healing has been esteemed in treating the physical, mental and spiritual health of the population. This paradigm is also respected for its holistic approach which stretches beyond sole biological assumptions in the pursuit of optimum health. Depression is also confirmed as being an illness which is rife in contemporary living. South Africans may also be at an increased risk with regards to this mood disorder, due to harsh psychosocial circumstances including poverty, unemployment and crime. The research offers that the social worker and mental health care professional alike are under increased pressure to obtain ‘cultural competence’ in understanding how traditional African discourse constructs common mental illnesses like depression. Therefore in light the above, the research attempted to explore an understanding of depression amongst a sample of traditional healers in Johannesburg. There is little research done on this subject. Therefore a qualitative research approach was adopted. Qualitative research may offer a more reflective space as a point of entry into a subject which has not been explored. The case study research design, specifically a collective case study was used and semi-structured interviews were conducted, using an interview schedule. The researcher interviewed 10 traditional healers. The interview aimed to explore how traditional healers understand depression. iii The research used a content analysis to draw common themes from the transcribed interviews with the participants who formed part of the sample, selected by means of purposive sampling. The themes derived from the interviews offer some reflections on the traditional healers’ understanding of depression. These themes included: relevancy of depression; distinctions between depression and sadness; intuitive assessments of depression; external circumstances and psychosocial circumstances; relevance of biomedical interventions; treatment by the African traditional healer; counselling; supernatural and spiritual influences; punishment; depression experienced as a collective vs. individualistic cultural experience; somatisation and specific emotional difficulties related to the vocation of traditional African medicine. The research concluded that the traditional healers’ conception of depression was in a state of flux and was very much dependent on the individual interpretations by the traditional healer. This appeared to be influenced by the level of the traditional healers’ acculturation into westernized culture and exposure to biomedical interventions. The relevancy of the concept of depression was viewed as being both redundant and ripe in relevance by the sample. Depression and sadness could not always be distinguished between. However, there was a conceptualization of depression as being a more intense and severe form of sadness. Intuitive assessments of depression were generally adopted as opposed to exploring specific diagnostic criteria. Cognitive distortions such as ‘thinking too much’ and external circumstances were recognized as significant contributors. Depression was mostly indirectly recognized as an illness. Allopathic medicine was both rejected and held in high regard. Counselling was viewed as being necessary. This was not always adopted by the traditional healers. The spiritual significance was graded on a subjective spectrum of making meaning of depressive experiences. However the ancestors were still revered in all assessments and interventions. Depression was viewed on a continuum between individualistic and collective cultures. There were no significant somatic reports. In a nutshell the research concludes that there is no unified perception of depression, but highlights some common cultural variables. The research specifically highlighted the psychosocial and spiritual qualifying factors which may differentiate and qualify this paradigm from other biological and allopathic interventions. iv The research paves the way for further research to be done in this area. Recommendations are made for social workers and mental health care professionals alike to become more fluent in traditional African healing discourse in the area of mental health and depression in order to understand their clients from the African culture. / Dissertation (MSW)--University of Pretoria, 2013. / Social work and Criminology / unrestricted