Schizophrenia and other severe mental illnesses (SMI) often have adverse effects on work functioning. However, most research on employment in people with SMI has been conducted in developed countries and much less is known about work patterns and interest in work in people with SMI living in developing countries, including India. Moreover, treatment for SMI in developing countries is largely limited to pharmacotherapy; psychosocial interventions including vocational rehabilitation are rarely available. A comprehensive understanding of employment in people with SMI living in developing countries would inform the development of vocational services for this population. Therefore, a series of three studies were conducted as part of this dissertation with the goal of evaluating rates of employment, interest in employment, perceived benefits of work and problems related to work among employed participants, perceived barriers and desired job supports among unemployed participants, and to examine stability and change in work status and interest in work over a one-year period. In Study 1, interviews were conducted with 550 people with SMI receiving psychiatric outpatient services at two private hospitals in two different districts in the state of Maharashtra in western India. The results were that 60.9% of participants were working, with employment rates being significantly higher in men than in women (79.4% vs. 35.9%). In addition, the rates of work were higher in people who were living in rural areas compared to those living in urban areas (77.8% vs. 48.9%). The majority of employed participants living in rural areas were working in family operated businesses such as farming, while work for independent employers was more common in urban areas. Among the participants who were working for independent employers, more than 45% obtained jobs through their family or friends. Interest in work was high (77.4%) among unemployed participants and the majority indicated wanting help with their job search and with managing their mental illness. Social norms related to gender specific roles in Indian society, in which men are expected to be primary wage earners, and the involvement of families in employment may have contributed to high work rates in this study. The strong interest in work among unemployed participants suggests that the deployment of vocational services for people with SMI in India could improve employment rates. Study 2 was a one-year follow-up of participants in Study 1 to evaluate stability and change in employment status and interest in work. A total of 459 (83.5%) participants completed follow-up interviews, of whom 62.9% were employed at follow-up, compared to 60.9% at the baseline assessment. Employment status was highly stable over the one-year period, with 56.4% working at both assessments and 32.4% not working at either assessment. Among the participants who were working at both assessments, more than 80% of were employed in the same job, for an average period of 10 years. Among the participants who were unemployed at baseline, 16.9% began working at follow-up. Although interest in work among those who were unemployed was lower at follow-up than baseline (62.8% vs. 73%, respectively), 58.1% expressed a consistent interest in work across both assessments. The most commonly desired job supports for unemployed participants were assistance with finding a job and help with mental illness management. The findings suggest that the work status of people with SMI in India is stable over a period of one year. The majority of participants who wanted to work at baseline remained unemployed at follow-up but still wanted to work, suggesting that vocational rehabilitation programs for people with SMI in India could improve their employment functioning. Study 3 employed the same methods used in Study 1 to collect data from 150 participants with SMI who were receiving psychiatric outpatient services from a public hospital located in the same predominantly urban district in the state of Maharashtra as the private hospital in Study 1. This study was aimed at evaluating employment functioning in people with SMI receiving public outpatient psychiatric services as compared to those receiving private outpatient treatment in Study 1 based on the assumption that people with lower economic means would be more likely to receive treatment at a public hospital. The results of this study were that 40% of participants were working, which was slightly lower than the 48.9% employment rate in urban areas in Study 1, and much lower than rates of employment in the general population. The majority of participants were working for independent employers, similar to the employed participants urban areas in Study 1, who found their jobs with the help of family and/or friends. Over 90% of the unemployed participants expressed interest in work (compared to 79% in urban areas in Study 1), and most of them wanted help finding a job and coping with their mental illness. The slightly lower rates of work in this study compared to Study 1 may be related to the smaller proportion of participants who were working in family businesses than in Study 1 (5% vs. 13%, respectively), and greater severity of illness, as suggested by the higher proportion of participants with schizophrenia-spectrum disorders than Study 1 (90% vs. 66.2%, respectively), and a greater proportion of participants with a history of psychiatric hospitalization than Study 1 (89.3% vs. 49.5%). The findings indicate that there are significant levels of unemployment among people with SMI living in urban areas in India who are receiving publicly funded treatment, and a very high interest in work. The findings provide further support for the need for interventions designed to improve employment functioning in people with SMI living in India. Taken together these three studies indicated that while rates of work in people with SMI in India are higher than rates reported in developed countries, significant unemployment is still present, especially in urban areas. Furthermore, most unemployed persons want to work. Work status was relatively stable over time, as was the strong interest in work among unemployed participants. A high proportion of participants endorsed the need for work supports related to the job search and illness management across the three studies, suggesting the need for vocational rehabilitation services that are culturally tailored for Indian society. / 2021-09-25T00:00:00Z

Graduate school is a high stress situation due to the need of fulfilling expectations while balancing various personal, professional, and educational obligations. As a result, graduate students are especially susceptible to mental health conditions during their educational journey. Take a Stability Equilibrium Course (Take a SEC) was developed as an adaptable 11-week prevention program focused on providing support and mental health education during a graduate student’s first semester. Take a SEC can be purchased by university graduate programs. This cost includes materials and guided demonstration instructions, one-on-one problem solving with the program developer, and a team to determine short-term and long-term outcomes. This program is ideal for universities due to its affordable costs and ability to customize the program to fit the cohort’s needs with virtual or in-person methods. Although Take a SEC has several goals, ultimately this program aims to decrease negative stigmas towards mental illness and encourage peers to seek care earlier or help others struggling with their mental health to decrease the rates of dropouts, hospitalizations, and suicides in this population. This program has the opportunity and theoretical basis to reverse the growing trend of mental health conditions in graduate students. With university support, proper funding, and accessibility, Take a SEC will have the power to help individuals achieve their academic endeavors and overcome challenges during their university journey and beyond.

Emerging evidence indicates that the prevalence of child and adolescent psychiatric symptoms and disorders increased in the twenty-first century. However, few studies have focused on recent time trends in the prevalence of anxiety disorders among United States (US) children and adolescents specifically. Relatedly, an open question in the field is what factors are driving increases in reported mental health symptoms and disorders, including anxiety, among US youth. To this end, this study uses data from the National Survey on Children’s Health, a nationally representative cross-sectional survey of US parents and caregivers, to assess recent temporal trends in anxiety disorders among US children and adolescents. This study also tests associations between multiple social ecological factors (i.e., socioeconomic status, physical health, family composition, parental mental health, and neighborhood disadvantage) and youth anxiety at each survey year. Overall, results indicated that among US 6 to 17-year-olds the prevalence of parent-reported lifetime anxiety or depression increased from 5.4% to 8.3% between 2003 to 2011/12. The estimated prevalence of parent-reported lifetime anxiety rose from 10.0% to 11.5% between 2016 and 2018 among US children and adolescents aged 6 to 17. The estimated prevalence of parent-reported current anxiety increased from 8.5% to 9.5% between 2016 and 2018. Additionally, several socioecological factors at the individual- and family-level were associated with youth anxiety at each survey year. Results suggest that ongoing collaboration amongst parents/caregivers, physicians, mental health providers, and school staff might help identify at-risk youth, as well as inform the need for effective prevention and intervention strategies and guide best practices for these strategies.

The purpose of this study was to elicit how mental health care users from a mixed ancestry group, otherwise called “Coloureds” at a Mental Health Clinic in an urban South African context, understood mental illness. “Coloured” peoples perceptions about mental illness in not well documented as few studies have addressed the needs of this population group in South Africa. The purpose was addressed within a closed questionnaire schedule using the Illness Perception Questionnaire - Mental Health, which was administered over a two month period, from 3rd June 2011 to 29th July 2011, using a non experimental, prospective, descriptive research design survey method. Data were collected by means of a self administered questionnaire and analysed by means of descriptive statistics. According to the statistician no confidence level was necessary as the instrument used was already tested to be valid and reliable. Since the study was descriptive, no comparative statistics were necessary.The analysed data revealed evidence of poor identification of mental illnesses. This could be a contributory factor to the inadequate adherence to treatment strategies and high re-hospitalization rates in this community. There was also a lack of collaboration between health workers and mental health care users and inadequate imparting of mental illness information by the mental health care practitioners. The positive results that have become evident in this study of good community support, good personal control of illness, a belief in the importance of taking medication and low stress levels, may be utilized effectively to empower this community with knowledge about mental illness. This may allow this community to assume responsibility and be supportive in the efforts to destigmatise mental illness and to ensure that community mental health care services move efficiently and effectively.

People has different background of growth, living environment and work experience. Some of them can meet with the fact easily, but some have poor adaptation to the reality of the world and tends to be trapped in low tune and imbalance both physically and mentally. The results is likely to reduce the performance on the job and would have ill effect on the family mood, connection with coworkers and human relationship. The overall effect would be that the operation and performance of the whole organization will be impacted. Therefore, maintaining the physical and mental health of public servant is emerging as a key lesson for government institutions. In this Study, we tried to explore the understanding and satisfaction of public servants in Kaohsiung City Government toward the mental health measures as promoted by the City Government. ¡@¡@This Study targeted the employees and teachers of agencies and schools within the jurisdiction of Kaohsiung City Government. Method of research is basically relying on questionnaire survey, which is assisted with in-depth interview. The data obtained from the questionnaire survey are processed with SPSS for WINDOW V.10 package software and applied frequency distribution, means, standard difference, ANOVA and Scheffé Ex-Post Comparison for analysis. ¡@¡@It is understood from the conclusion of this Study that the employees of Kaohsiung City Government, female, age between 31 and 40, college graduated, married, recommended level rank, worked for 6 ¡V 10 years, non chief officer and working with administrative offices are better in the transmission of City Government¡¦s measures on mental health of employees, participation in activities and resources of consultation, or the overall understanding of the measures and satisfaction and needs are better than group of different attributes. ¡@¡@The suggestion Subsequent researcher may try with the satisfaction and factors of needs of government employees toward the mental health measures as implemented by City Government for comparison to find out their view and their attitude toward this issue.

Thesis (M.Sc.(Hons.))--University of Wollongong, 2004. / Typescript. Includes bibliographical references: leaf 135-138.

Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1993. / Source: Masters Abstracts International, Volume: 45-06, page: 2951. Abstract precedes thesis as 4 preliminary leaves. Typescript. Includes bibliographical references (leaf 75).

Thesis (MA)--University of Stellenbosch, 2006. / Bibliography.

The study developed a model for projecting potential economies from manpower substitution among the four core mental health professions and applied the model to a proposed substitution situation which would substitute psychologists for psychiatrists in the delivery of a proportion of present private practice (fee-for-service) psychiatry services in British Columbia. The model identifies three controlling variables: treatment substitutability (TS), practice privilege constraints (PPC), and relative payment rates (RR). In the model, TS and PPC are conceptualized as determining the estimated substitutable share of costs (SSC%); RR, in combination with the values derived for SSC%, is then used to estimate potential cost savings (CS%). Two conditions were defined for each of the three controlling variables in order to provide a range of possible values for SSC% and CS%. For reasons of data availability, data were obtained from the Manitoba Health Services Commission for private practice psychiatry services for FY 1984 and estimates of SSC% calculated. These estimates were then applied to B.C. Medical Services Commission data for FY 1984, and projected values of CS% calculated. Calculations were made both for all services and for the subset of psychotherapy services, which accounted for 80 percent of the larger set of services. The results of the study indicated considerable possibilities for manpower substitution, ranging from 35 to 70 percent for all services and 40 to 75 percent for psychotherapy services. However, the study also found that while salaried psychologists offered the possibility of substantial cost savings, a fee-for-service arrangement suggested virtually no potential savings. Projected values of CS% for the salaried alternative were 20 to 40 percent for all services and 15 to 30 percent for psychotherapy services but in the fee-for-service alternative, only 4 to 8 percent for all services and 4 to 7 percent for psychotherapy services. Licensure and market rigidities which might pose barriers to implementation were evaluated and a review of professional training standards (TS), licensure standards (PPC), and funding alternatives (RR) indicated that the projected economies could be achieved with no necessity for modifications in existing arrangements. PPC appear to present almost no barriers to economies from the proposed manpower substitution and those barriers which are presented by TS and RR limitations still allow considerable potential for economies. Thus, the greatest opportunities for intervention in achieving and enhancing the projected, economies appear to be in the exploration of relative payment rates and relative effectiveness of treatment methods (e.g., psychotherapy vs. pharmacotherapy). The study concludes with a discussion of factors lying outside the boundaries of the model but which impinge, nonetheless, upon the feasibility of the proposed substitution and fall, necessarily, to policy makers to address. The existing network of B.C. community mental health centres was suggested as a possible mechanism for the delivery of the substitutable share of private practice psychiatry services. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

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