Yes / During the excavation season in 2018, I experienced a depressive episode on site and struggled to maintain productivity with the rest of my team. I felt like I wasn't a "real" archaeologist, and turned to Twitter to vent about my situation using the hashtag #DiggingWhileDepressed. To my surprise, others used the hashtag to express their own feelings about mental wellness (or lack thereof) in archaeology. Now that discussion has started, this paper will propose the next steps for our discipline to tackle this pertinent issue. By challenging the toxic masculinity and ableism inherent in the way we view archaeological labour, I will posit tangible ways in which we, as archaeologists, can support each other on and off the field.

Employing an expanded meaning of the concept of sense of place within Health Geography, this thesis explores the relationship between sense of place and mental wellbeing of immigrants. The concept of sense of place demonstrates the importance of specific places for socioeconomic and health impacts on individuals and groups in their societies. While research has explored immigrants’ sense of place, few studies have attempted to explore visible minority’s perceptions of place and its influence on wellbeing. Using qualitative and quantitative techniques, this thesis explores the perceptions and experiences of place amongst Ghanaian and Somali immigrants in Hamilton, Ontario, Canada. First, we explore key informants’ revelations on immigrants’ sense of place and mental wellness in Hamilton, Ontario. Findings provide insight into the role of policies that affect determinants of health amongst immigrants. Second, we examine the effects of self-perceived mental wellness, socioeconomic and demographic variables on sense of place amongst Ghanaian and Somali immigrants living in Hamilton, based on an analysis of a survey questionnaire (n=236). Findings highlight a positive relationship between sense of place and mental wellness. Third, using descriptive and multivariate regression methods, we focus on factors that predict African immigrants’ life satisfaction in Canada. We examine sociodemographic, economic and health-related factors that predict life satisfaction amongst African immigrants, specifically Ghanaian and Somali immigrants. We find that immigrant settlement workers and agencies would be better able to meet the needs of immigrants if they are conscious of the factors that would empower immigrants to cope with life stresses. We suggest a reduction of stress by helping individuals and families identify sources of support, providing jobs, affordable housing, language interpretation and training. Lastly, we explore specific places, religious sites and their relationship to health and wellbeing for immigrants. Specifically, we explore churches and mosques where Ghanaian and Somali immigrants worship. We find that places of worship are significant for physical health, social, emotional, spiritual, mental, and general quality of life amongst immigrants. The thesis is highly relevant in the current Canadian policy context, which includes contribution to the understanding of the determinants of health and integration of immigrants, providing insights into the concepts of sense of place and mental wellbeing, and broadening our understanding of African immigrants’ integration. Overall, this thesis develops a better understanding of immigrants’ settlement and integration, and further contributes to the broader immigration literature. / Thesis / Doctor of Philosophy (PhD) / Employing an expanded meaning of the concept of sense of place within Health Geography, this thesis explores the relationship between sense of place and mental wellbeing of immigrants. The concept of sense of place demonstrates the importance of specific places for socioeconomic and health impacts on individuals and groups in their societies. While research has explored immigrants’ sense of place, few studies have attempted to explore visible minority’s perceptions of place and its influence on wellbeing. Using qualitative and quantitative techniques, this thesis explores the perceptions and experiences of place amongst Ghanaian and Somali immigrants in Hamilton, Ontario, Canada. First, we explore key informants’ revelations on immigrants’ sense of place and mental wellness in Hamilton, Ontario. Findings provide insight into the role of policies that affect determinants of health amongst immigrants. Second, we examine the effects of self-perceived mental wellness, socioeconomic and demographic variables on sense of place amongst Ghanaian and Somali immigrants living in Hamilton, based on an analysis of a survey questionnaire (n=236). Findings highlight a positive relationship between sense of place and mental wellness. Third, using descriptive and multivariate regression methods, we focus on factors that predict African immigrants’ life satisfaction in Canada. We examine sociodemographic, economic and health-related factors that predict life satisfaction amongst African immigrants, specifically Ghanaian and Somali immigrants. We find that immigrant settlement workers and agencies would be better able to meet the needs of immigrants if they are conscious of the factors that would empower immigrants to cope with life stresses. We suggest a reduction of stress by helping individuals and families identify sources of support, providing jobs, affordable housing, language interpretation and training. Lastly, we explore specific places, religious sites and their relationship to health and wellbeing for immigrants. Specifically, we explore churches and mosques where Ghanaian and Somali immigrants worship. We find that places of worship are significant for physical health, social, emotional, spiritual, mental, and general quality of life amongst immigrants. The thesis is highly relevant in the current Canadian policy context, which includes contribution to the understanding of the determinants of health and integration of immigrants, providing insights into the concepts of sense of place and mental wellbeing, and broadening our understanding of African immigrants’ integration. Overall, this thesis develops a better understanding of immigrants’ settlement and integration, and further contributes to the broader immigration literature.

No / The Anthropology of Mental Health Interest Group affirms that the state of mental health in Academic Anthropology needs serious attention and transformation. We respond to structural inequities in academia that exacerbate mental distress among graduate students and other anthropologists who experience oppression, by putting forward a policy statement with recommendations to create more equitable learning and working environments.

No

Rising rates of obesity among children have become one of the most pressing issues in modern public health. Childhood obesity threatens both the mental and physical well-being of children. Attempts to halt the rise in obesity take many forms, but one of them is the recent implementation of a programme of measurement of primary children at reception and in year 6, with results being fed back to parents. This National Child Measurement Programme (NCMP) is controversial and has been criticised in some quarters as unethical, in being a form of screening programme with no clear or effective interventions available for those detected as having a problem. Study aims and objectives The main aim of the study was to explore the relationship between weight status and children’s mental wellbeing, especially in the context of the NCMP. Within this overall aim, key specific objectives of the study were: i) to investigate the association between weight status of 10-11 year old school children and their mental well-being; ii) to assess the impact on the mental wellbeing of children, of participating in the NCMP; and iii) to collect information about parents’/guardians’ and children’s reaction to the NCMP, with particular interest in identifying whether parents/guardians and their children found the feedback useful in moving towards the adoption of a healthy lifestyle. Methods The study was undertaken in primary schools in the catchment area of Gateshead Primary Care Trust (PCT). The overall study used a mixed methods study design. The study involved administering a questionnaire prior to NCMP measurement to a total sample of 264 children, sampled using a proportionate stratified random sampling technique. One-to-one semi-structured interviews were also conducted post measurement with 21 children purposively sub-sampled from the larger group, and with 16 parents/guardians. Results Prior to measurement, most children misclassified their weight status. About 1 in 10 children who were of ideal weight perceived themselves as overweight. Over three quarters of overweight children perceived themselves to be of ideal weight. There was no significant relationship between any of the indicators of mental wellbeing and actual weight status of children. However, there was very strong evidence for a Preface xxv significant relationship between perceived weight status and mental wellbeing among children. Seven major themes emerged from the post measurement interview data, but perhaps the most intriguing was the cycle of emotional reaction of families to the NCMP and weight feedback. Discussion The reactions of parents/guardians whose children are indicated to have weight problems follow a sequence of behaviours ranging from shock, disgust with the programme, through denial and self-blame to acceptance, worry and help seeking. Reasons for these responses relate in many cases to the way the weight problem is portrayed to the parents. While health authorities are keen to portray this problem as a medical one, parents/guardians see it as social one. The roots of overeating and lack of exercise are seen as lying in the complex social and cultural milieu in which this sample of people live. Consequently, associating this problem in feedback letters with dangerous diseases like cancer, and advising parents to visit GPs to resolve child weight issues, seems inappropriate to the recipients and causes controversy and anger. Conclusion The NCMP’s routine feedback could potentially induce families into the state of readiness to change lifestyle behaviours; however, given the reactions described in this study, it seems critical to avoid placing blame on individuals but rather to acknowledge the influence of the environment surrounding families and to provide non-medical support aimed at bringing families on board to support interventions for combating child weight problems.

Background: The mental health of prisoners is of growing global health importance as prison populations increase exponentially. Though additional risks of mental disorder and poor mental wellbeing of prisoners are now better understood, women, especially those in low and middle income countries, and in regions outside North America and Europe are underrepresented in prison mental health studies. There is strong evidence of associations between religion and spirituality (RS) and mental health in the general population in North America and Europe. This thesis aims to measure and explain any associations between RS and depression and mental wellbeing among female prisoners in Chile. Methods: An explanatory sequential mixed methods approach comprised an initial quantitative study linked to a subsequent qualitative study. In the quantitative phase, 94 randomly sampled female prisoners in Chile participated in a pooled two-stage cross-sectional survey which collected data on background, mental health and RS variables. Mental wellbeing was measured using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Self-report depression data were collected and 40 prisoners were also administered the Mini International Neuropsychiatric Interview (MINI). RS variables included: affiliation, personal importance, involvement (frequency of attending services), benefits and beliefs. The design of the qualitative phase was informed by quantitative study findings. Six prisoners who had participated in the cross-sectional survey attended one of two focus groups. Individual in-depth interviews were conducted with 3 prison chaplains and 2 health professionals from the prison health centre. Topic guides for focus groups and interviews were used to facilitate discussions on the mental health and RS of female prisoners and to elicit views on selected findings from the quantitative study. Logistical regression techniques were used to statistically test the hypothesis of no association between RS and depression and mental wellbeing. Audio-recorded qualitative data were transcribed in Spanish and analysed thematically in English. Results: Of the 94 women, 11 (11.7%) reported a current professional diagnosis of depression, while major depression was confirmed in 13 (32.5%) of the 40 women assessed using the MINI. The women had a median WEMWBS score of 55 (IQR 43-61) out of 70. Religiosity was high among the sample with 86 (91.5%) women affiliated to mainstream Christianity and 69 (73.4%) who considered RS to be personally very important. In a sample of 40 women, frequency of attendance at RS services was significantly higher in prison than during the year prior to incarceration (Wilcoxon Sign Ranks Test Z=3.1; p < 0.002). No significant associations were found between depression and mental wellbeing, and the key RS variables. However, 61 (89.7%) women believed there was a connection between their mental health and spirituality. The qualitative data revealed differences within and between participant groups in understandings of mental health and RS terminology and concepts. Themes emerged around the prison determinants of mental health and the mental health effects of the female gender. Prisoners identified RS variables that influenced mental health which had not been measured in the survey. Explanations were found for the divergent survey results of the association between RS and mental health. The data showed how RS shapes prisoners' help-seeking behaviour and attitudes to mental health care. Conclusion: The association between RS and mental health among prisoners in Chile remains unclear but may differ from established patterns reported in non-prisoner populations. This a challenging area of study with an additional layer of complexity present in prison populations where there are high levels of religiosity and spirituality. Larger studies are needed to confirm the quantitative findings, while qualitative findings should lead to raised awareness of RS in the development of prison mental health strategies in accordance with the needs of a given population.

The current dissertation tested a model based on a systems perspective, where inflammation was hypothesized to mediate the influence of diet and physical condition on quality of life (base model) in a nationally representative U.S. dataset (NHANES). Three additional hypotheses, regarding social support (The Buffering Hypothesis), early microbial exposure (The Hygiene Hypothesis) and life history theory (The Tradeoff Hypothesis) were tested utilizing the base model. All analysis utilized a structural equation model. This study focused on objective measurements for dietary behavior and physical activity utilizing blood serum values of nutrients and metabolic markers and anthropometric data as well as blood serum concentrations of CRP and white blood cell count. Quality of life was assessed with the number of limitations in daily living, the number of days that were affected by mental, emotional and physical limitations and the self-reported general health condition. The hypothesized model fit well to the data and the results revealed that lower intake of healthy nutrients and reduced physical condition both predicted decreased quality of life, as mediated by inflammation and explained 31.9 % of the variation in quality of life (R² = .319, p<.001). Social support further predicted quality of life directly (β = .417, p<.001) and indirectly through dietary behavior and inflammation (β = -.106, p<.001), microbial exposure significantly moderated the relation between inflammation and quality of life (β = -.127, p<.001) and higher reproductive effort predicted lower intake of vital nutrients (β = .316, p<.001), physical condition (β = .352, p<.001) and subsequent inflammation. Reproductive effort also directly predicted reduced quality of life (β = .278, p<.001). These analyses indicated that inflammation can be considered a strong mediator between lifestyle factors and resulting quality of life and that social support, microbial exposure and reproductive effort each added unique predictive value to this model.

Psykisk ohälsa är vanligare hos personer med diabetes än befolkningen i stort. Forskning visar att det finns många olika anledningar till denna psykiska ohälsa och lyfter behov av differentiering av allmänna psykiatriska tillstånd och psykisk ohälsa kopplat till diabetesen. Ett begrepp som fångar hur personen förhåller sig till sin diabetes är diabetesrelaterad stress. Studier rapporterar att personer med diabetes upplever skam och självkritik kopplat till sin sjukdom. Självmedkänsla är ett fält inom psykologin som riktar sig specifikt mot skam och självkritik. I denna studie användes enkäter för att undersöka om det finns ett samband mellan grad av självmedkänsla och upplevd diabetesrelaterad stress samt om det finns skillnad i upplevd diabetesrelaterad stress mellan grupper med låg, medel och hög grad av självmedkänsla. Vidare undersöktes om självmedkänsla kunde förutsäga diabetesrelaterad stress, även när psykiskt välmående inkluderades. En enkät publicerades i Facebookgrupper kopplade till diabetes i Sverige och på den svarade 239 personer. Deltagarna var mellan 18 och 75 år, övervägande antalet deltagare var kvinnor. För att analysera data användes korrelationsanalys, ANOVA och Multipla linjära regressioner. Resultaten visade på ett starkt negativt samband mellan självmedkänsla och diabetesrelaterad stress. Gruppjämförelser visade att de grupper som hade högre självmedkänsla hade lägre diabetesrelaterad stress. Detta är i linje med tidigare forskning kring självmedkänsla och hantering av kroniska sjukdomar. Det starka sambandet och gruppjämförelsernas resultat motiverar att undersöka detta område ytterligare. Interventionsstudier i syfte att undersöka eventuell påverkan av självmedkänsla på diabetesrelaterad stress skulle vara relevant, för att i förlängningen utforma riktad behandlingsrekommendationer för just diabetesrelaterad stress. / Mental health problems are more common among people with diabetes than in the population in general. Research shows that there could be several reasons to this, and calls for more clarity regarding causes. Diabetes Distress is a concept that captures how a person handles the demands of living with diabetes. Studies reports that people living with diabetes experiences shame and self-blame regarding their disease. Self-Compassion is a concept which addresses shame and self-blame specifically. This study used questionnaires to investigate if there is a correlation between levels of Self-Compassion and Diabetes Distress, and if there is a difference regarding Diabetes Distress between groups with low, moderate, and high levels of Self-Compassion. The study also examined if Self-Compassion could predict Diabetes Distress, even when mental wellbeing was accounted for. Participants were recruited via Facebook groups connected to diabetes in Sweden and 239 people replied. The participants were between 18 and 75 years old, the majority were female. Correlation, ANOVA and multiple linear regression was used to analyze the collected data. The result showed a strong negative correlation between Self-Compassion and Diabetes Distress. Group comparisons showed that those with higher Self-Compassion had lower Diabetes Distress. This confirms previous research regarding Self-Compassion and coping with chronic illness. The strong correlation and the group comparisons results suggest that further research within this field should be performed. To investigate if Self-Compassion training could affect levels of Diabetes Distress studies including Self-Compassion interventions would be of interest. More research could lead to development of recommendations and care adjusted for those who are experiencing Diabetes Distress.

The purpose of this study was to examine the mental health among young elite athletes aged16-19 years old at Växjö municipality sports high schools. The focus area was anxiety anddepression disorders, which were measured using the General Health Questionnaire. Theprimary issues was to examine how common these disorders are and whether it differsbetween individual and team athletes. By actualizing the subject, there are also hopes that thesubject will be less stigmatized.A quantitative method has been used to reach out to as many people as possible. Thequestionnaire included for example questions about injury background and amount oftraining, to have a material for an analysis. Some of the conclusions are that anxiety anddepression disorders are common among students at Växjö municipality sports high schoolsand that many students consider that they don’t receive sufficient support for mental illness.

The intersection of gender and early-career stage on the mental health of physicians is emerging and evident. This qualitative, interview-based study explores the perspectives of early-career female physicians regarding their mental health in the context of their work, their experiences with taking a leave of absence from work, and promising practices and supports that can support early-career female physicians in the workplace with regards to mental health and leaves of absence. Nine interviews with female physicians in the first ten years of practice in Ontario were conducted and analyzed thematically. A conceptual framework borrowed from the Healthy Professional Worker (HPW) Partnership was employed and revised based on the findings. The findings suggest that increased awareness of the challenges faced by early-career female physicians may contribute to the destigmatization of mental health and leaves of absence and foster supports at work. Policy makers and regulatory bodies should consider developing equitable leave of absence policies for physicians and reframing how seeking mental health care is viewed to contribute to positive culture change.