No description available.

Thesis advisor: Susan Kelly-Weeder / Background: Stigma, discrimination, and victimization are common occurrences in the lives of TGGD persons (e.g. non-binary, genderqueer, agender, and other non-cisgender identities) in the U.S., including occurrences in healthcare settings. Additionally, TGGD people in the U.S. experience numerous disparities related to physical health, mental health, substance use, and health risk behaviors. Suicide prevalence data provide the strongest and most urgent indication that healthcare organizations, and mental health providers specifically, are not optimally meeting the needs of this marginalized, at-risk population. TGGD persons have experiences of stigma and discrimination in healthcare settings, and these experiences are directly associated with provider behaviors, staff cultural competence, and institutional policies/practices. Minority Stress Theory suggests that experiences of stigma are directly linked to health outcomes and health disparities. It also suggests disparities may be mitigated by one’s internal coping skills and by level of support available from affirming others. Purpose: This dissertation’s research sought to better understand the relationship between stigma/discrimination and sexual/gender minority (SGM) population health and to better understand the experiences of TGGD persons who receive mental health services in the United States. Therefore, this dissertation begins to address this critical need and fill the gap in science. Three discrete manuscripts are proposed to fully explicate three concepts: 1) How state-level policies may affect SGM mental health (a secondary data analysis); 2) A comprehensive understanding of TGGD persons’ mental healthcare experiences (an integrative review); and 3) TGGD persons’ inpatient mental healthcare experiences (a qualitative study). Methods: First, we conducted a secondary data analysis examining state-level inclusivity for SGM populations, and relationships with indicators of mental health and health risk behaviors in those states; we sought to determine whether and to what extent there is a relationship between states’ SGM policies and practices, and the mental health and health risk behaviors of those states’ SGM residents. Second, we conducted an integrative review examining the mental health treatment experiences of TGGD adults; we sought to synthesize and characterize the existing health literature regarding the mental health experiences of TGGD adults. Third, we conducted a qualitative descriptive study examining the inpatient mental health and substance disorder treatment experiences of TGGD adults; we sought to better understand the inpatient mental health and/or substance treatment experiences of TGGD persons and to identify and characterize facilitators of/barriers to gender-affirming care in inpatient mental health and/or substance treatment settings. Results: In Chapter Two of this dissertation, an ecological secondary analysis of the BRFSS data set showed statistically significant relationships between LGBTQ persons’ state of residence and self-reported mental health symptoms and risk behaviors of the LGBTQ persons who live there. Restrictive state policy environments were shown to function as a distal stress factor and inclusive state policy environments were shown to function as a resilience factor. In Chapter Three of this dissertation, integrative review results suggest that TGGD persons experience incidents of stigma and discrimination in mental health treatment settings. In Chapter Four of this dissertation, participants reported both stigmatizing aspects and welcoming/affirming aspects of inpatient mental health/substance treatment experiences. Conclusions: This dissertation explored the mental health of TGGD persons through a Minority Stress Theory conceptual framework, including potential distal stress factors, proximal stress factors, and resiliency factors. This program of research has made substantial and meaningful contributions towards an enhanced understanding of TGGD mental health experiences, sources of TGGD stigma, and sources of coping/resiliency. In each chapter, findings suggested the presence of MST concepts of distal stress factors, proximal stress factors, and resiliency factors. Nursing remains underrepresented in health literature, and dissertation results highlight ample opportunities to advance TGGD population health through nursing practice, nursing education, nursing scholarship, and nursing policy. / Thesis (PhD) — Boston College, 2021. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Includes bibliography. / This study examined the response of the Cape Mental Health Society to the mental health problems of Blacks in the Western Cape. This response has been examined against the organisational and the community contexts in which such services are provided. Environmental constraints which surround service provision were examined at macro- and micro-level. The macro-level covered the unfavourable political, social and economic aspects as experienced by both the organisation and its clientele. The micro-level covered those aspects which impinge on service delivery but are within the scope of the organisation. It is agreed that these aspects affect the nature of the response of the organisation to mental health needs of blacks negatively. The study emphasizes the need to define mental health within the South African context from a psychiatric and socio-political perspective as such a definition allows for appropriate service provision. Data was collected from primary and secondary sources. Interviewing was used as a technique for collecting primary data. Structured and unstructured interviews were carried out with people from various disciplines, community members, and present and prospective service consumers. The exploratory-descriptive approach was used. The problems and needs of clients were quantified in terms of the organisation's waiting lists and other criteria. Services rendered by the Society were quantified in terms of clients being served and the number of projects and programmes undertaken to meet different mental health needs. Ideas have been developed about mental health services amongst the black communities and their cultural perception of mental health needs. The findings emphasize inadequacy of the response of the Cape Mental Health Society to mental health needs of blacks. The present facilities are insufficient and inappropriate to mental health needs of blacks. They are characterised by inaccessibility, inefficiency and ineffectiveness where they do exist. A marked inequality in the provision of services to the two population groups, that is, Coloureds and Blacks, has been identified. A framework for developing mental health services for blacks in the Western Cape has been recommended. This framework proposed various steps which can be taken in such development.

A dissertation submitted in partial fulfillment of the requirements for the degree of Master of Arts in the Department of Psychology, University of Zululand, South Africa, 2006. / The University of Zululand Community Psychology Centre (CPC) is a joint project of the Department of Psychology, Educational Psychology and Industrial Psychology. It was established in response firstly to the University's need to provide relevant training for its post-graduate psychology students and secondly to meet the need within the Zululand community for affordable psychosocial and psycho-educational services. The Centre works in partnership with other local Zululand Mental Health centres. The Centre is accredited with the Professional Board for Psychologists of the Health Professions Council of South Africa (HPCSA). This board ensures that institutions providing psychological services observe ethical codes of conduct and good practice (HPCSA, 2002). The present research was motivated by the fact that the CPC functioning has never been evaluated in terms of service delivery and relevance. The desire to know whether the CPC serves the purposes for which it was established, and to identify areas that need improvement, is a strong motivation. This helps to identify its viability, effectiveness, and value for the University of Zululand and the community served by the University. The aims of the study were to evaluate the CPC in terms of clients' perceptions with regard to effectiveness of the centre in meeting their needs and improving their psychological well-being. An accidental or convenient sample was used. An invitation to volunteer was extended to clients who happened to come for the CPC services. Volunteers completed a questionnaire^ which included a biographical inventory needs analysis questionnaire and RyfTs Scale (1995) of psychological well-being. Participants were pre and post-tested on the variable of psychological well being. The study concluded that the CPC still serves the purpose for which it was established. It is still relevant to the demand of the community. The results revealed that pre and post testing was associated with a significant improvement in total psychological well-being as with special reference to personal growth and positive relations with others. / NRF

No description available.

Predisposition of Suicide Among Active-Duty and Transitioning Members of the US Military Nicholas Roberts, Stephen Blankenship, MD, Quillen College of Medicine, East Tennessee State University The incidence of suicide among military personnel has witnessed a concerning increase in the past two decades. Suicide has now become the primary cause of death in the military, surpassing fatalities due to training accidents and combat-related incidents. In general, the suicide cases of active-duty military personnel and veterans are commonly attributed to mental or physical trauma incurred during combat or to aged veterans who suffer from addiction and post-traumatic stress disorder. However, recent data points to a shifting trend in the demographic of individuals most susceptible to self-harm. To our knowledge, limited studies have comprehensively identified and compiled individual risk factors that increase the likelihood of suicide in active-duty and transitioning military members. Publications were collected utilizing PubMed and Web of Science, based on the association between servicemember demographics, military service characteristics, and suicidality outcomes. The studies selected were conducted explicitly on United States military personnel. The analysis of the collected data revealed a higher risk of suicide in military personnel with adverse childhood experiences and lower educational attainment. Additionally, the branch of service, military occupational specialty, and deployment history have been identified as contributing factors to an increased likelihood of suicide. Common military social habits like tobacco, alcohol and energy drink consumption have been found to correlate with higher suicide rates. Despite these findings, there is currently a lack of standardized screening tools to identify these specific risk factors in servicemembers transitioning to civilian life. Consequently, the results of this study hold tremendous potential in identifying high-risk individuals more accurately and implementing life-saving interventions at an early stage.

<p> This dissertation focuses on young people's and staffs discourses about, and participation in, day treatment mental health programs in Ontario. These experiences and perspectives are situated within broader structural contexts of power, policy and societal expectations. In doing so, I adapt and update Scheper-Hughes and Lock's (1987) Three Bodies model as an overarching structure for the thesis. I differ from their distinct division between the three bodies as my grounded theory approach to fieldwork data highlights the relational aspects of therapeutic practices, and in turn I draw attention to the interaction between and within Scheper-Hughes and Lock's individual-social-politic bodies. </p> <p> I completed fieldwork at two services, one for 13-18 and one for 5-12 year olds. These institutional settings are primarily concerned with (re)creating mental health and educational well-being. As such both they and my research are at the intersection of multiple academic disciplines, which means that my dissertation draws heavily on a variety of anthropological, sociological and childhood studies literatures and methodologies, as well as on influences from psychiatry and psychology, in addition to a broad range of post-structuralist I post-modem theorizing. </p> <p> In addition to this academic approach, my work has applicability, which was necessitated in part by the fieldwork sites' demand that they see benefits from research. My applied approach was also necessitated by my position that anthropological research can fruitfully combine both applied and academic approaches to research, known as praxis. </p> <p> Key issues addressed within my thesis are: the need for multiple qualitative methodologies, both to address questions around working with young people and questions arising from fieldwork sites primarily informed by quantitative research; the usefulness of combining aspects from the theoretical work of Bourdieu and Foucault in understanding how mental health therapies act to reenculturate young people; the importance of the role that the young people play in their own therapeutic recovery which I explore through my concept of con.fined agency; that (perhaps surprisingly) rites de passage and liminality can be useful conceptual frameworks to approach the sociality of individual bodies in the daily material activities at the fieldwork sites; and the negotiation by young people and staff of the ongoing negative impacts of stigma associated with mental illness. Within my ethnographic theorizing is the importance ofrelational interaction between individual-social-politic level bodies. </p> / Thesis / Doctor of Philosophy (PhD)

Mental health care, other than being a critical medical service, is a centrally important cultural institution, shaping individuals’ understanding of their lives and problems. This dissertation consists of a multi-method investigation examining the U.S. mental health care field from these two intersecting perspectives. To achieve this, it examines (1) how structural conditions determine different social groups’ access to different mental health care services; (2) what effects these disparities in access have on individuals’ experiences when seeking care and on the outcomes they face; (3) how the stratification of the mental health care field exposes different Americans to different sets of cultural scripts and understandings, generating correspondence between sociodemographics and intimately-held meanings and normative action scripts for mental well-being. Its four chapters thus tackle mental health care’s social significance from multiple angles, using geospatial, computational text analysis, and audit methods, seeking to provide actionable, public health policy-relevant empirical research concerning inequalities in access to care, as well as to address key theoretical problems regarding the segregation of meaning-making with which sociology has long contended.

No description available.

No description available.