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Submitted in Partial Fulfillment of the Requirements for the Degree of PhD (Community Psychology) Faculty of Arts University of Zululand, 2008. / Research indicates that the prevalence of childhood depression is increasing, the onset of depression is occurring earlier in life, and that depression coexists with other mental health problems such as anxiety and disruptive behaviour disorders. Teachers are more responsive to behavioural manifestations such as hyperactivity, disruptive behaviour and aggression. They are less responsive to interpersonal difficulties and less disruptive behaviours such as withdrawal and social isolation. While they can correctly recognize that internalizing symptoms such as withdrawal and sadness are indicators of depression, they are unable to correctly recognize that externalizing behaviours such as disruptiveness and aggression can also be indicators of depression. Since many of these symptoms of depression manifest in the school, it is imperative that teachers are able to correctly identify the symptoms of depression. The correct management of the child prevents the depression from worsening and leading to disastrous consequences. The purpose of this study was to establish whether teachers were fully knowledgeable about the behavioural symptoms of depression. A former purpose was to determine the management strategies used at school, and to develop a guideline document for teachers. Survey methodology and interview techniques were used to collect data for the study. These methods provided quantitative and qualitative data. The participants comprised 56 primary school teachers from three randomly selected schools. Two questionnaires were specially designed to gather data for the study. The results of the study revealed that teachers were not fully knowledgeable about the behavioural symptoms of depression and that they lacked the depth of knowledge required to recognize the significance of the diagnostic criteria of depression "which manifest as behavioural symptoms in school. The results showed mat more than 57 % of participants felt that parents and home factors were responsible for depression. Results also indicated that the majority of participants were not able to recognize the multiplicity of factors that could cause and result in depression. In the perceived absence of psychological support from the Department of Education, participants indicated a need for guidelines for identification and management of symptoms of depression. There was overwhelming support for the implementation of a self-esteem programme at schools. At the conclusion of the study, a document which outlined recognition and management of the behavioural symptoms of depression, was developed by the researcher. As a result of the findings of the study, recommendations were made to teachers, the schools' management team, as well as to the Department of Education. Recommendations made to teachers included training the child in social skills and cognitive strategies, and maintaining contact with parents. One important recommendation to the schools' management was the timely referral of depressed children to mental health professionals. Recommendations made to the Department of Education included the facilitation of the formation of multidisciplinary teams which would comprise teachers, management staff, parents and school psychologists. These multidisciplinary teams would manage the successful implementation of programmes that will foster healthy social and emotional development of all children.

Master of Science / Department of Family Studies and Human Services / Sandra Stith / The Rutgers Alcohol Problem Index (RAPI) is a well-known instrument used as a primary outcome measure in intervention studies with college students. It has been used in studies assessing the developmental trajectory of high-risk drinking and also used in studies which address the predictors of alcohol-related problems among college students (Carey & Correia, 1997; Ham & Hope, 2005; Levy & Earleywine, 2003). Martens et al. (2006) found that the RAPI individual items were able to be grouped in three distinct subfactors (Abuse/Dependence, Personal Consequences, and Social Consequences). The objective of this study was to examine the relationship between various mental health problems (depression, posttraumatic stress disorder, physical abuse victimization, physical abuse perpetration, sexual coercion victimization, sexual coercion perpetration, and self-esteem) and the three subscales of the RAPI. It was anticipated that the mental health problems explain more of the variance on Abuse/Dependence than on Personal or Social Consequences. Results indicated that even though mental health problems explain more of the variance on Abuse/Dependence than on Personal or Social Consequences, the difference did not appear large enough to suggest that the subfactors represent unique domains. In conclusion, it cannot be assumed that the three subfactors measure distinct and exclusive types of consequences. A student that scores high on Abuse/Dependence also may be experiencing Personal and Social Consequences.

Mental health problems have incapacitating effects on an individual’s capacity to hold and maintain employment. Over half a million Canadians are absent from work due to mental health problems every day, which costs Canadian companies an estimated 14% of their net annual profit. Individuals who miss work for mental health reasons often experience longer periods of absence, and return to work at a much lower rate than individuals absent for other reasons (e.g., physical injury). Regrettably, empirically based return to work interventions focused on mental health problems are lacking, likely the product of a lack of consensus surrounding salient predictors of return to work. The current study sought to add to current literature aimed at identifying factors that influence the likelihood of successful re-entry into the workforce. A review of patient files from a private psychological practice yielded the sample. Clients were selected based on their satisfaction of one central criterion: having experienced a workplace absence and suffered from a mood or anxiety disorder as classified by the DSM-IV-TR. Recruitment letters and consent forms were mailed to 74 eligible participants, for a response rate of 68% (n=50). The sample was predominantly female (n=38 or 76%). Of the 50 participants, 27 successfully reintegrated to the workforce (RTW=54%), following a mean absence of 13 months (SD=7.37). Emerging from the results are higher risk categories (e.g., physically injured workers, low educational requirements, disability providers) of reduced likelihood of successful return to work. The role of symptom severity and availability of social support is also discussed along with best practice implications for stakeholder/practitioners.

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<p>It has been suggested that persons with intellectual disabilities (ID) manifest the full range of mental health problems. The main purpose of this thesis is to adapt and evaluate two clinical assessment instruments and to investigate the occurrence of mental health problems as well as psychiatric care utilisation in persons with ID. </p><p>The psychometric properties of a Swedish version of the two instruments [Reiss Screen for Maladaptive Behaviour (RSMB) and the Psychopathology Inventory for Mentally Retarded Adults (PIMRA)] were investigated in a random, institutional and clinical sample of administratively defined (ADDEF) adults with ID (n = 199). The analyses suggest that the RSMB could be used as intended by staff as a primary screening device for the identification of mental health problems in persons with ID, and that the PIMRA had a potential to identify individuals with a specific mental disorder. The psychometric evaluation reveals that the Swedish versions of the RSMB and PIMRA measure a construct related to the diagnostic categories in the DSM-III-R and DSM-IV. This construct could be conceptualised as mental health problems.</p><p>The RSMB and PIMRA results show that the overall occurrence of mental health problems in ADDEF samples of persons with ID (175 men and 148 women) ranged from 34 to 64%.</p><p>The preliminary level of ID was mild (23%), moderate (39%) and severe (38%). The most common mental health problems were aggressive and self-injurious behaviours, depression, anxiety and adjustment disorders. In registered patients receiving out- or in-patient psychiatric care the occurrence of adults with an ICD-10 diagnosis of ID was approximately 1% (70 to 90% had a mild level of ID). </p><p>In contrast to the high frequency of mental health problems reported, psychiatric care was used infrequently. This tendency is particularly evident in persons with moderate and severe ID.</p>

It has been suggested that persons with intellectual disabilities (ID) manifest the full range of mental health problems. The main purpose of this thesis is to adapt and evaluate two clinical assessment instruments and to investigate the occurrence of mental health problems as well as psychiatric care utilisation in persons with ID. The psychometric properties of a Swedish version of the two instruments [Reiss Screen for Maladaptive Behaviour (RSMB) and the Psychopathology Inventory for Mentally Retarded Adults (PIMRA)] were investigated in a random, institutional and clinical sample of administratively defined (ADDEF) adults with ID (n = 199). The analyses suggest that the RSMB could be used as intended by staff as a primary screening device for the identification of mental health problems in persons with ID, and that the PIMRA had a potential to identify individuals with a specific mental disorder. The psychometric evaluation reveals that the Swedish versions of the RSMB and PIMRA measure a construct related to the diagnostic categories in the DSM-III-R and DSM-IV. This construct could be conceptualised as mental health problems. The RSMB and PIMRA results show that the overall occurrence of mental health problems in ADDEF samples of persons with ID (175 men and 148 women) ranged from 34 to 64%. The preliminary level of ID was mild (23%), moderate (39%) and severe (38%). The most common mental health problems were aggressive and self-injurious behaviours, depression, anxiety and adjustment disorders. In registered patients receiving out- or in-patient psychiatric care the occurrence of adults with an ICD-10 diagnosis of ID was approximately 1% (70 to 90% had a mild level of ID). In contrast to the high frequency of mental health problems reported, psychiatric care was used infrequently. This tendency is particularly evident in persons with moderate and severe ID.

Purpose: The first objectives of the current study was to determine whether disparities exist in mental health and mental health service use between minority and majority Canadian Francophone and Anglophone communities both within and outside of Quebec. The second objectives was to examine if official language minority-majority status was associated with the presence of common mental health problems and mental health service utilization.<p> Methodology: The current study used data from the Canadian Community Health Survey: Mental Health and Well-being, Cycle 1.2.7 Two main comparisons were made: Quebec Francophones to Quebec Anglophones, and outside Quebec Francophones to outside Quebec Anglophones. Twelve-month and lifetime prevalences of mental disorders and mental health service use were examined through bivariate analyses. Logistic regression analyses determined whether official language minority-majority status significantly predicts mental health problems and mental health service use using the Determinants of Health Model8-10 and Andersens behavioural model.11-13<p> Results: Very few significant differences were found between official language groups both outside and within Quebec, though some notable differences were found between Quebec and outside Quebec: Anglophones and Francophones outside Quebec had a higher prevalence of poor mental health and low life satisfaction compared their respective language counterparts in Quebec. Respondents from outside Quebec had a higher prevalence of consulting with a psychiatrist than respondents from Quebec. There was no significant association between membership in an Official Language Minority Community and mental health problems, and mental health service use. Implications: Although our results indicate that very few differences exist between official language minority and majority groups, these findings remain important and can help aid key stakeholders redirect resources and develop policies and programs towards areas and geographic locations wherein health disparities exist.

Purpose: The first objectives of the current study was to determine whether disparities exist in mental health and mental health service use between minority and majority Canadian Francophone and Anglophone communities both within and outside of Quebec. The second objectives was to examine if official language minority-majority status was associated with the presence of common mental health problems and mental health service utilization.<p> Methodology: The current study used data from the Canadian Community Health Survey: Mental Health and Well-being, Cycle 1.2.7 Two main comparisons were made: Quebec Francophones to Quebec Anglophones, and outside Quebec Francophones to outside Quebec Anglophones. Twelve-month and lifetime prevalences of mental disorders and mental health service use were examined through bivariate analyses. Logistic regression analyses determined whether official language minority-majority status significantly predicts mental health problems and mental health service use using the Determinants of Health Model8-10 and Andersens behavioural model.11-13<p> Results: Very few significant differences were found between official language groups both outside and within Quebec, though some notable differences were found between Quebec and outside Quebec: Anglophones and Francophones outside Quebec had a higher prevalence of poor mental health and low life satisfaction compared their respective language counterparts in Quebec. Respondents from outside Quebec had a higher prevalence of consulting with a psychiatrist than respondents from Quebec. There was no significant association between membership in an Official Language Minority Community and mental health problems, and mental health service use. Implications: Although our results indicate that very few differences exist between official language minority and majority groups, these findings remain important and can help aid key stakeholders redirect resources and develop policies and programs towards areas and geographic locations wherein health disparities exist.

No description available.