Magister Scientiae (Occupational Therapy) - MSc(OT) / Return to work is a recognised goal of rehabilitation by the occupational therapy discipline that is addressed through vocational rehabilitation as a key feature of work practice. Programmes that fall under the umbrella of vocational rehabilitation include work preparation and training, work hardening and supported employment. In the case of mental health care users (MHCU), meaningful employment contributes to their sense of identity and the prevention of relapse. Vocational rehabilitation is thus important in preparing MHCU for self-employment or employment in the community after they are discharged from the hospital. There is however a dearth of literature pertaining to how vocational rehabilitation programmes particularly in a rural setting, is experienced by MHCU in South Africa. Therefore, the aim of this study was to explore the experiences and perceptions of MHCU regarding the usefulness of the vocational rehabilitation programme at a rural hospital in enhancing their worker roles. A qualitative research approach and exploratory descriptive research design was utilised. Purposive sampling was used to select participants for the study. Semi-structured interviews were conducted with ten MHCU participants as well as two focus groups. Semi-structured interviews were furthermore conducted with two key informants. All interviews and the focus group discussion were audio-recorded, transcribed verbatim and analysed through thematic data analysis. Strategies implemented to ensure trustworthiness included member checking and peer review. Ethics clearance was obtained from the UWC Research Committee and permission to conduct the study at the hospital was requested from the Mpumalanga Provincial Health Ethics Committee and hospital management. Three themes originated from the findings of this study. Theme one describes the barriers experienced by people with mental illness while returning to work. Theme two describes the programme factors that influence return to work in respect of work habits, work skills, and community re-integration. Theme three captures the value of participating in the work programme as experienced by the participants. The findings of the study is related to the Model of The Ecology of Human Performance (EHP) to show how the vocational rehabilitation programme effected the MHCU’s return to work. The findings show that the context as well as the person’s skills and abilities are very important factors in reintegrating the user back to work. The study illuminated recommendations for the further development of the vocational rehabilitation programme.

Orientador: Renata Medeiros Paoliello / Banca: Ana Lúcia de Castro / Banca: Pedro Augusto Lolli / Resumo: O presente trabalho é resultado de uma pesquisa de mestrado a qual tem por objetivo analisar os impactos das atuais políticas de saúde mental no Brasil nas formas de classificação da doença mental e na subjetividade dos familiares dos usuários de um serviço de atenção psicossocial. Foi realizada etnografia no Centro de Atenção Psicossocial (CAPS) II de Araraquara - interior de São Paulo -. Com foco nos grupos de familiares e nas reuniões diárias da equipe técnica dos profissionais, procurando entender de que forma (ou se) o envolvimento com este tipo de serviço de saúde mental produz mudanças em suas práticas e discursos. Foi observado que a presença na instituição fomenta a possibilidade de pensar relações sociais em termos médicos por estes familiares, que ressignificam a conduta socialmente indesejável dos usuários como doença mental. Dessa forma, nossos resultados apontam que a participação dos assim chamados familiares no CAPS II resulta em uma tradução do projeto ético-político da instituição a seus contextos locais, de modo a modificar ou reproduzir suas práticas e discursos de acordo com suas condições de possibilidade e desejos de cuidado. / Abstract: The present work is the results of a master degree research which aims to analyze the impacts of the currents public mental health policies in Brazil upon the forms of classification of mental illness and subjectivity by the relatives of the users from a psychosocial attention service. We've made ethnography in Araraquara's Psichosocial Atention Center, especially in the families groups and in the daily reunions of the professionals, aiming to understand how (or if) the involvement in this mental health service produces any change. As results, we've observed that the attendance at the institution foment the possibility to think about social relations in medical terms by the relatives, who ressignify the users' social undesirable behaviors as mental illness, applying what is lived in the mental health service to the their local contexts. So, our result points that the participation of the so called relatives in the CAPS II translates the ethical ethical-political project of the institution to their local contexts changing or reproducting practics and discourses accordingly to their possibilities and care demands. / Mestre

A research report submitted in partial fulfilment for the degree Master of Arts in Social and Psychological Research by Coursework and Research Report (PSYC7022) in the Department of Psychology, Faculty of Humanities at the University of the Witwatersrand, February 2017 / The lifetime prevalence of Major Depressive Disorder (MDD), as reported for South Africa, is 9.7%. However, significant cultural differences occur in the clinical presentation of MDD which are connected to notions of religion, social principles and norms of relationships. With this in mind, this study explores the extent to which Hindu community members’ knowledge of MDD, their beliefs about the aetiology of MDD and their attitudes towards people with MDD impacted their perceptions on the care and management of MDD as well as their help seeking behaviours. The study also explored the extent to which Hindu religious identity mediates or moderates the relationship between aetiology, knowledge and attitudes towards MDD and the care and management of MDD and help seeking behaviour. A questionnaire consisting of a demographics section, a religious identity scale, a MDD knowledge, attitudes and practices scale and the attitudes towards seeking professional psychological help scale was completed by a convenience sample of 264 Hindus from Johannesburg and surrounding areas. Data was analysed using descriptive statistics and multiple regression analyses. Participants in this study had a moderate religious identity and generally positive attitudes towards MDD. This sample believed that stress was the main cause of MDD and that talking to their friends, family and their general practitioner would be the most beneficial in terms of care and management of MDD. Participants also had positive attitudes towards seeking professional help. Two multiple regression analyses were conducted with the attitudes towards professional help seeking as well as all the care and management factors as the dependent variables and religious identity, knowledge of MDD, attitudes towards MDD and all four aetiological factors of MDD as the independent variables. These analyses yielded varying results. Following these analyses, religious identity was explored as both a potential mediator and moderator variable between attitudes towards MDD and help seeking behaviours. These results are discussed within the broader debates on depression and its manifestation across cultures. / XL2018

Bakgrund: Psykisk ohälsa är ett växande samhällsproblem. Attityder och upplevelse av stigmatisering inom hälso- och sjukvården kan påverka relationen i vårdmötet både positivt och negativt. För personer med psykisk ohälsa kan detta vara av särskilt betydelse. Syfte: I denna studie var syftet att undersöka patienters upplevelser av attityder hos vårdpersonal samt patienters upplevelser av självstigmatisering. Metod: En litteraturstudie med en kvalitativ ansats utfördes. Artiklar söktes i databaserna PubMed, CINAHL och PsychInfo och 22 vetenskapliga originalartiklar valdes ut primärt. Efter granskning utgjordes ett definitivt urval av 13 artiklar. Hildegard Peplaus omvårdnasteori valdes som arbetets teoretiska referensram. Resultat: Negativa attityder skildrades i interaktionen mellan patient och vårdpersonal i form av brist på visat intresse och upplevelser av att bli ifrågasatt, inte bli lyssnad på eller bli tagen seriös. Maktskillnader i relationen och diskriminering beskrevs även som negativa attityder. Positiva attityder innefattade stöd och empati, erfarenheter av att bli tagen seriös, lyssnad på och sedd bortom sjukdomen. Självstigmatisering framställdes som olika aspekter av en negativ självbild präglad av rädsla och skam, vilket medförde att deltagarna tvekade på sina förmågor. Undanhållande av sin psykiska ohälsa och upplevelser av att bli märkt med etiketter var också erfarenheter av självstigmatisering. Slutsats: Verksamheter inom vården bör arbeta kontinuerligt med personalens bemötande och attityder för att skapa en god vårdande miljö för patienten. En miljö där patienten upplever goda attityder minimerar risken att denne drabbas av negativa konsekvenser, såsom en negativ självbild. För att också ge bästa möjliga omvårdnad bör patientens upplevelse tas i beaktande i omvårdnadsprocessen. / Background: Mental illness is a growing societal problem. Attitudes and experiences of stigmatization in health care services can have both positive and negative effects on the patient-staff-relationship. For people with mental illness, this can be of particular importance.  Aim: The purpose of this study was to identify patients’ experiences of attitudes among health care personnel, along with patients’ experiences of self-stigmatization. Method: A litterary study based on qualitative research was formed. PubMed, CINAHL and Psychinfo were used as databases for the literary search and 22 scientific originalarticles were chosen. After further inspection, the final selection consisted of 13 articles. Hildegard Peplau’s theory of nursing was chosen as the theoretical reference frame. Results: Negative attitudes were depicted in the patient-staff interaction in form of staff showing lack of interest and experiences of being questioned, not listened to or taken seriously. Power-imbalance and discrimination were also described as negative attitudes. Positive attitudes involved being given support and empathy, and experiences of being taken seriously, listened to and seen as beyond the disease. Self-stigma emerged in different aspects of negative self-image incused by fear and shame causing hesitancy of the participants’ abilities. The illness being withheld and feelings of being labeled also depicted experiences of self-stigma. Conclusion: In order to create a good caring environment for the patient, health care services should work continuously with attitudes of health care personnel. An environment where patients experience positive attitudes, decreases the risk of they being affected by negative consequenses, such as a negative self-image. In addition, in order to yield best possible nursing, the patients’ experiences should be considered in the nursing process.

Mental illness among children and adolescents is increasing today. Many suffer from anxiety and depression, and a group that also experiences this is university students, which also confirms previous research (Socialstyrelsen, 2017; Folkhälsomyndigheten, 2018; Storrie et al., 2009). The purpose of this questionnaire study was to investigate the occurrence of mental illness at Luleå University of Technology through a quantitative method. The questions we formulated based on the purpose were whether students at Luleå University of Technology are experiencing mental illness, the underlying causes of the perceived mental illness, and whether there are significant differences between male and female students' perceived mental illness. The results of the study show that 82.4% of the respondents have experienced mental illness during their study period, and those students state that they have mainly experienced stress, anxiety and depression / depression. The underlying causes of mental illness are said to be stress, concern for the future and high demands. The result of our study showed no significant difference between women's and men's perceived mental illness, but it showed a tendency for women to experience mental ill health to a greater extent. Mental ill-health is widespread among university students, stigmatization is still great about the subject and many choose not to seek help. The result also indicates that the Student Health Service and the help they offer may need to be made more visible to reach out to the students. The analysis also shows that there is a connection between how one feels and what control one feels to have in life, poorer attitude showed lower control. / Psykisk ohälsa bland barn och ungdomar ökar idag. Många lider av ångest och depressioner, och en grupp som också upplever detta är universitetsstudenter, vilket även tidigare forskning bekräftar (Socialstyrelsen,2017; Folkhälsomyndigheten, 2018; Storrie etal., 2009). Syftet med denna enkätstudie var att genom en kvantitativ metod undersöka förekomsten av psykisk ohälsa på Luleå tekniska universitet. De frågeställningar vi formulerat utifrån syftet var om studenter på Luleå Tekniska universitet upplever psykisk ohälsa, de bakomliggande orsakerna till den upplevda psykiska ohälsan, och om det finns signifikanta skillnader mellan manliga och kvinnliga studenters upplevda psykiska ohälsa. Resultatet från studien visar att 82.4 % av respondenterna har upplevt psykisk ohälsa under sin studietid, och det studenterna uppger sig främst ha upplevt var stressrelaterad psykisk ohälsa, ångest och nedstämdhet/depression. De faktorer som studenterna uppgav som bidragandeorsaker till den upplevda psykiska ohälsan var främststress, oro för framtiden och höga krav. Resultatet av vår studie visade ingen signifikant skillnad mellan kvinnors och mäns upplevda psykiska ohälsa, men det visade på en tendens till att kvinnor upplever psykisk ohälsa i högre grad.Psykisk ohälsa är utbrett bland universitetsstudenter, stigmatiseringen är fortfarande stor kring ämnet och många väljer att ej söka hjälp. Resultatet indikerar även på att Studenthälsan och den hjälp de erbjuder, kan behöva synliggöras mer för att nå ut till studenterna. Analysen visar även att det finns ett samband mellan hur man mår och vilken kontroll man upplever sig ha i livet, sämre mående visade på lägre kontroll.

The purpose of this study was to examine if people's knowledge about mental illness is related to their stigma against mental illness. We examined four types of knowledge a) knowledge treatment, b) knowledge of non-traditional diagnoses, c) knowledge of traditional , diagnoses, and d) personal knowledge of people with mental illness (called associations). Based on prior research, we hypothesized that the relation between high knowledge about mental health problems and treatment effectiveness would be curvilinearly related to stigma - with the higher and lower levels associated with more stigmatic cognitions, but moderate levels associated with holding fewer stigma. We also hypothesized that knowing others would be negatively related to stigma. We collected self-report survey data from 256 participants, using convenience sampling via social media forms. The results revealed that people's ability to identify traditional forms mental illness diagnoses was related to their stigmatic cognitions. In terms of associations the result revealed two subsets, including the groups we expected, but revealing more complexity. The results point to several issues that need to be addressed by future research. / Syftet med denna studie var att undersöka om människors kunskap om psykiska sjukdomar är relaterat till deras stigma mot psykisk sjukdom. Vi undersökte fyra typer av kunskaper a) kunskap om behandling, b) kunskap om icke-traditionella diagnoser, c) kunskap om traditionella diagnoser, c), och d) personlig kunskap om personer med psykisk sjukdom (kallade associationer). Baserat på tidigare forskning hypotiserade vi att förhållandet mellan hög kunskap om psykiska problem och behandlingseffektivitet skulle vara kurvlinjärt relaterad till stigma - med högre och lägre nivåer associerat med mer stigmatiserande kognitioner men måttliga nivåer associerade med mindre stigma. Vi hypotiserade också att känna andra skulle vara negativt relaterat till stigma. Vi samlade självrapporterings data från 256 deltagare, med hjälp av bekvämlighetsurval via sociala medier. Resultaten visade att människors förmåga att identifiera psykiska sjukdomsdiagnoser var signifikanta för deras stigmatiska kognitioner. Vidare visade resultatet i samband med associationer två delgrupper. De lägsta nivåerna av stigmatiska kognitioner hittades i den förväntade gruppen, men det fanns andra grupper som inte var signifikant olika.

"The purpose of this study was to determine whether or not 82 adults who continued treatment and 42 adults who discontinued treatment at the Leon County Mental Health Clinic differed significantly when cross-tabulated with seven baseline characteristics, six agency-client descriptive items, and eight items designed to reveal 'perception of the client's problem.' It was hoped that additional knowledge of and insight into the problem of discontinuance by a study of closed adult treatment records during a period of one year would help the Clinic serve, more effectively, adult clients in Leon County"--Introduction. / Typescript. / "June, 1961." / "Submitted to the Graduate School of Florida State University in partial fulfillment of the requirements for the degree of Master of Social Work." / Advisor: Dorothy D. Hayes, Professor Directing Study. / Includes bibliographical references (leaves 63-65).

"The purpose of the study was to indicate differences of significance in the incidences of professional action between patients diagnosed as organic brain syndromes and patients diagnosed as functional psychoses. The incidences of professional action were results of expediting the recommendations of the Neuropsychiatric Therapeutic Review Committee Veterans Administration Hospital, Lenwood Division, Augusta, Georgia, for the seventy-five patients of the study sample. The two groups of patients derived from the dichotomy of the study sample on the basis of psychiatric diagnosis: twenty-four patients had established psychiatric diagnoses of organic brain syndromes, and fifty-one patients had established psychiatric diagnoses within the range of functional psychoses. Difference of significance in the incidences of professional action between the two subsamples have been studied"--Introduction. / Typescript. / "August, 1960." / "Submitted to the Graduate School of Florida State University in partial fulfillment of the requirements for the degree of Master of Social Work." / Advisor: James H. Williams, Professor Directing Study. / Includes bibliographical references (leaves 38-39).

Bakgrund: Psykisk ohälsa är ett samlingsord som täcker både psykiska besvär och psykiatriska diagnoser. Hälso- och sjukvården består av en vårdkedja där primärvård, länssjukvård, regionsjukvård, nationell högspecialiserad vård och hemsjukvård ingår. Sjuksköterskan skall värna socialt utsatta och sårbara grupper i samhället, hen ska ansvara för att patienter och anhöriga får korrekt information på ett för dem förståeligt sätt. Patienter med psykisk ohälsa kan uppleva att deras fysiska hälsoproblem inte tas på allvar vid sjukvårdskontakt. Syfte: Att belysa hur patienter med psykisk ohälsa upplever mötet med hälso- och sjukvården. Metod: Studien är en analys av bloggar utifrån en kvalitativ innehållsanalys. Elva bloggar har utgjort källan för data. Resultat: Det är en vanlig uppfattning från patienter som lider av psykisk ohälsa, att uppleva att de får en stämpel på sig. Väntetiden för att få adekvat psykiatrisk vård är lång. Patienterna upplever att vårdpersonal tagit den enkla vägen ut och skickat hem dem med en burk piller som ska lösa deras problem. Men det finns hopp om en bättre psykiatrisk vård. Konklusion:  Det är sjuksköterskans ansvar att ta dessa patienter på allvar och ge dem den vård de förtjänar, med eller utan psykisk ohälsa. / Background: Mental illness is a collective term that covers both mental disorders and psychiatric diagnoses. The healthcare system consists of a care chain where primary care, county healthcare, regional healthcare, national highly specialized care and homecare are included. The nurse should defend socially vulnerable individuals and groups at risk in society, and is responsible for ensuring that patients and relatives receive correct information in a manner that is comprehensible. Patients with mental illness experience that their physical health problems are not taken seriously by healthcare providers. Purpose: To illuminate how patients with mental illness experience the interaction with healthcare providers. Method: The study is an analysis of blogs based on a qualitative content analysis. Eleven blogs have been used as data source. Result: It is common that patients suffering from mental illness experience being labeled. The waiting time for adequate psychiatric care is long. Patients find that healthcare professionals often take the easy way out and send them home with a pillbox that is expected to solve their problems. However there is hope for a better psychiatric care. Conclusion: It is the nurse's responsibility to take these patients seriously and give them the care they deserve, regardless of mental illness.

Thesis advisor: Ramsay Liem / Underutilization of mental health services among Asian Americans is a pressing concern. It is possible that knowledge and beliefs about mental illness (a.k.a. “mental health literacy”) serve as barriers to seeking appropriate help, and that Asian cultural values plays a role in determining such attitudes. This study investigated the relationships among mental health literacy, attitudes towards mental health services, and adherence to Asian cultural values. A sample of 17 Caucasian and 22 Asian American college students completed a questionnaire including the Asian Values Scale, the Attitudes Toward Seeking Professional Psychological Help Scale – Shortened Version, and four vignettes portraying depression, schizophrenia, alcohol dependency, and anorexia. Results indicated that Caucasians were slightly more likely to correctly recognize and identify mental illnesses than were Asian Americans. Causal attributions varied greatly across different mental disorders, and Asian Americans showed less positive attitudes towards seeking professional psychological help, and preferred to solve problems on their own or seek help from family or friends. The greatest barriers to treatment for Asian Americans were a fear of showing personal weakness and concern about stigma. Adherence to Asian cultural values was inversely associated with willingness to seek professional help, and with willingness to take medication for psychological problems. / Thesis (BA) — Boston College, 2005. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Psychology. / Discipline: College Honors Program.