Despite high rates of suicide and mental health concerns (Duldulao, Takeuchi, & Hong, 2009; Kisch, Leino, & Wilverman, 2005; Lee, Park, Lee, Oh, Choi, & Oh, 2018; World Health Organization, 2019), many Asian Americans including Koreans and Korean Americans do not seek mental health services (Lam & Zane, 2004; Lee, Hanner, Cho, Han, & Kim, 2008; Markus & Kitayama, 1991; Sue, Cheng, Saad, & Chu, 2012). Especially for Koreans and Korean Americans, stigma (Masuda & Latzman, 2011) as well as cultural values (e.g., Cheng, Leong, & Geist, 1993; Cheong & Snowden, 1990; Kim & Omizo, 2003; Tracey, Leong, & Glidden, 1986) can prevent them from seeking appropriate services. The current study compares Korean, Korean American, and non-Korean emerging and young adults’ mental health literacy (Jorm, Korten, Jacomb, Christensen, Rodgers, & Pollitt, 1997), specifically mental health knowledge, confidence in finding appropriate mental health services, and attitudes towards mental disorders and treatment. A pilot study was conducted to tailor the Mental Health Literacy Scale (O’Connor & Casey, 2015) to answer the main research questions and examine internal consistency and validity. Analysis of variance (ANOVA) was used to assess the differences among the sociocultural groups (i.e., Koreans, Korean Americans, and non-Asians) and investigate individual and contextual influences (e.g., age, gender, citizenship). The results demonstrated that (1) non-Asians have significantly higher mental health knowledge scores, higher self-efficacy, and less negative attitudes towards mental disorders compared to Koreans and Korean Americans and (2) there were no significant differences in the scores between Koreans and Korean Americans. The discussion section describes the importance of enhancing mental health literacy and increasing help seeking behavior for Koreans and Korean Americans and suggests cultural factors to consider in creating culturally appropriate outreach programs.

Magister Curationis - MCur / Professional nurses, with additional training in mental health, report attitudes and perceptions of mental health nursing that are more positive, whilst those with less training report more negative attitudes and perceptions to mental health nursing. The primary aim of this research study was to describe the attitudes and perceptions of professional nurses towards the mentally ill in a psychiatric hospital in the Cape Metropole. The objectives of the study were: to explore the attitudes and perceptions of professional nurses towards the mentally ill; to identify common factors that influence the professional nurses’ attitudes and perceptions towards the mentally ill; to compare the attitudes and perceptions of professional nurses who have completed the Regulation 425, Regulation 808 and Regulation 212 training in mental health nursing towards the mentally ill. A quantitative, exploratory, descriptive design was employed and cross-sectional survey was carried out. Participants comprised all permanent professional nurses (n=60) at a governmental Associated Psychiatric Hospital in the Cape Metropole. Participants completed a demographic questionnaire and two self-report questionnaires, measuring attitudes to and perceptions of mental health problems. Nurses with a diploma report significantly higher role competency than those nurses with a degree. The ethnicity of nurses played a role in the stereotyping of the mentally ill. No significant differences were evident between those professional nurses who had completed the advanced mental health course and those whom had not. However, the combined effects of learning the appropriate course and experience in the practical field of the mentally ill are necessary for the task of impacting positively on the attitudes of the nurses towards the mentally ill.

The aim of this doctoral thesis is to – from a child perspective and with children as informants – describe and analyze childhood conditions for children whose parents suffer from severe mental illness. The method used is qualitative – 28 children, 10 boys and 18 girls, 7–18 years old, were interviewed about their parents’ mental disorder; the family situation and their own personal life – in school and during free time. The analyses are based on Sociology of Childhood and Family Sociology. Previous studies have, to a great extent, focused on the risk the children run of developing mental health- and social problems and what helps them to grow up healthy. The increased risk of mental health- and social problems has been well confirmed, but also that preventive interventions can contribute to resilience in the children. Although some studies have explored children’s experiences of their parents’ mental illness and the challenges they meet, research from a childhood perspective, has so far been scarce. The results of this study reveal different degrees of emotional, physical and social exposure for the children. Their childhood conditions were related to gender, relations, communication, problem load and social situation of the family. If the parent with a mental illness was a woman, the situation for the child was often more exposed than if it was the father – most likely due to parental roles and expectations on men and women in the Swedish society at that time. Girls seemed more emotionally involved in the parents’ problems than boys, especially if the parent with a mental illness was a father. Most of the parents were divorced or had never lived together. Parental conflicts complicated the life of the children, who were expected to have maintained relationships to both parents. Lack of communication about the parent’s mental disorder in - and outside the family - was common. The children were often uninformed about the parent’s problems.  If hindered to pass information between and outside their two homes, they were left to handle difficult, sometimes dangerous, situations with the mentally ill parent, alone. The home was not always the safe place for rest and recovery, as homes are expected to be. The heavier the total problem load of the family, the more exposed was the child. Most exposed were children whose both parents had severe problems – mental illness or addiction. They were often placed in out of home care, for longer or shorter periods. The kind and degree of exposure the children experienced varied. Four kinds of childhood sceneries could be recognized: (1) the well organized childhood, where the parent’s mental health problem was mainly an emotional burden for the children; (2) the complicated childhood, where the parents conflicts and inability to protect the child made the child either too involved or too lonely in handling the problems that the parent’s mental illness caused them; (3) the problematic childhood where the parent’s mental illness was not the only problem in the family, but factors like the other parent’s drinking, siblings’ problems, social and economical difficulties added to the burden and (4) the exposed childhood where none of the parents was able to take care of the child. Knowledge and openness, about the parents’ problems, seemed to increase competence and decrease feelings of guilt and responsibility for the parent. All of the children stood forward, not as passive victims, but as competent agents in their own lives – although often more or less powerless because of their dependence of their parents and other adults around them. It was clear, though, that there is a need for professionals in adult psychiatry, social services, school and preschool, to pay attention to the children of parents with mental health problems and see to that they get the information and support they need. Keywords: Children, childhood conditions, children as agents, parental mental illness/mental disorders, mental health knowledge, exposed life situations, competence.