There is emerging evidence of the significance of paternal mental health problems as well as its influence on spouses and children. However, current research attention mainly focuses on paternal postpartum depression. The present study aims at determining the prevalence of paternal mental health problems, identifying risk factors and the relationship among various risk factors across different stages of pregnancy and the postpartum period. In particular, it attempts to examine the significance of gender role and traditionalism-modernity as personality traits for paternal mental health problems in the perinatal period as well as fill the current gap in knowledge on the impact of paternal mental health problems on paternal-fetal attachment. Given the relative lack of data in the existing literature, the present study involved two phases of investigation combining qualitative and quantitative approaches to provide a more systematic understanding on the nature of paternal mental health problems. In phase 1, a qualitative study was conducted on 31 expectant fathers as the hypothesis-generating ground work. Subsequently, a total of 622 expectant couples were recruited and followed up in a large-scale survey in Phase 2. Expectant couples were recruited from regional antenatal clinics in Tsan Yuk Hospital and Queen Mary Hospital. In the quantitative component, the expectant couples were assessed using standardized and validated psychological instruments on 3 time points including early pregnancy, late pregnancy and six week postpartum. The results showed that a significant proportion of expectant fathers manifested anxiety, and depressive symptoms, high level of perceived stress, psychosomatic symptoms, fatigue and tobacco consumption during the perinatal period. Different demographic risk factors for the outcome variables varied across different time points. Psychosocial risk factors were consistently associated with outcome variables in different time points. Maternal depression and anxiety were not only predictors of paternal psychological distress but also the predictor of higher level of paternal psychosomatic symptoms and fatigue severity. Gender role and Traditionalism-modernity were found to be significant moderators for paternal mental health problems. Undifferentiated, masculine fathers and fathers who adhere to traditional values were at higher risk of mental health problems during the transition of fatherhood. A mixed effect model analysis showed that paternal anxiety, depression and psychosomatic symptoms changes over time and was higher during the antenatal period. The relationships between paternal and maternal anxiety and depressive symptoms were significant across different time points even after controlling for confounding factors and the correlations were found to be strongest at six weeks postpartum. Findings also showed that paternal mental health problems had a detrimental effect on paternal-fetal bonding from antenatal to postpartum period. The present study points to the need for greater research and clinical attention to paternal mental health problems given that paternal mental health problems is a highly prevalent problem with changing course and is related to maternal well-being and paternal-fetal attachment. The present findings contributes to theoretical basis of the relationships of personality traits, risk factors and mental health problems and have implications for the design of effective identification, prevention, and interventions of these clinical problems. / published_or_final_version / Psychiatry / Doctoral / Doctor of Philosophy

Background: As military women enter roles directly related to combat, they will have greater risk of injury. The present study examined the prevalence of mental health conditions among female service members one year postinjury, and analyzed factors which may place women at risk for mental health concerns and lower quality of life (QOL). Methods: A total of 1,012 U.S. servicewomen who sustained combat-related injury in Iraq and Afghanistan were identified from the Expeditionary Medical Encounter Database (EMED). Injury severity was calculated and QOL scores were collected from a subset of the women. Injury severity, military occupation, branch of service, age, rank, marital status, number of deployments, initial treatment facility, and environment of care were collected as predictor variables. The Military Health System Data Repository was queried for mental health International Classification of Diseases, 9th and 10th Revision codes occurring within one year postinjury. Results: Within the first year postinjury, 404 women (40%) were diagnosed with mental health conditions. The most common were posttraumatic stress disorder (PTSD), (n = 203, 20%), depressive disorders (n = 123, 12.1%), adjustment disorders (n = 92, 9.0%), and anxiety disorders (n = 81, 8.0%). Logistic regression identified that women with minor or moderate injuries had lower odds of mental health diagnoses. Occupation categories of combat support and communications predicted fewer mental health issues. Enlisted women had increased risk of mental health issues. Linear regression showed that officers had higher QOL compared with enlisted women 0.055 (95% CI, 0.005-0.183), p<.05. Women serving in the Air Force had higher QOL postinjury 0.119 (95% CI, .055-.183), p<.000. An independent samples t-test showed that women with mental health diagnoses postinjury (M = 0.46, SD = 0.12) had significantly lower QOL scores (range 0-1) compared to those without mental health diagnoses (M = 0.52, SD = 0.13), t(3.46), p <.05. Conclusions: These findings showed that PTSD, depression, adjustment disorder, and anxiety comprise the most prevalent mental health diagnoses in this population. QOL is significantly lower in injured women with mental health issues after injury. Further research is needed to discover strategies for maintaining optimum health in this population.

The purpose of this study ­is to identify social workers’ perspectives on the barriers and motivating factors impacting Latino men in seeking mental health services, and to seek ways to overcome the barriers. Research has established that Latino men suffer from mental health problems at a similar rate compared to other populations, yet they underutilize mental health services. Given the rapid growth of the Latino population that continues to need mental health services, the findings of this study may influence the social work field to develop programs and interventions that are geared towards encouraging Latino men to seek services. They may also assist in preparing clinicians entering the field. This qualitative study used individual interviews as a tool to find themes from social workers’ point of views on the subject. The results from interviews were transcribed to written document. Major themes identified include barriers, motivating factors, and recommendations for change.

The mental health (MH) of health workers during the 2019 pandemic has been severely affected by the disruptive coping and heavy workload management of the Covid crisis. Critical emergency contexts trigger many MH issues and disorders in many health workers who do not have adequate tools and strategies to respond to MH threats when traditional medical methods cannot be provided. Given the successful recovery outcomes obtained against physical illness disorders through physical illness representations, this project was carried out to search for effective discursive strategies within visual representations applied to MH issues. Exploring improved MH representation techniques could lead to finding strategies for informing about the stigma and triggering self-therapy, self-recovery and self-regulation coping mechanisms in health workers against MH threats. This study used discourse analysis to explore four representative YouTube videos portraying health workers and MH issues. The findings show that visual representations, including audiovisual and prosodic elements, rhetoric and storytelling techniques, impact people's psychological and behavioural processes. Once medically tested, these resources could support health professionals and institutions as an extension of the existing scientific methods, treatment and tools dealing with MH issues. E-mental health and digital technologies, which use media representation, could represent the first step to trigger a much more extensive study and scientific debate on the complementary strategy of media representation for MH acknowledgement, therapy and recovery. Nevertheless, additional and more quantitative interlinked medical and media studies on MH issues and representation have to be carried out. Therefore, the need to investigate highlights the need for interdisciplinary collaboration between media and communication, traditional medical therapy research and the participation of all the actors involved.

O objeto de estudo desta pesquisa qualitativa são as práticas dos trabalhadores de um Centro de Atenção Picossocial III - CAPS III. A finalidade é contribuir para a compreensão das práticas em saúde mental produzidas no CAPS III, por meio da perspectiva crítica e colaborar com a consolidação da Reforma Psiquiátrica brasileira. Tem como objetivos: descrever as práticas de saúde mental dos trabalhadores do CAPS III; verificar se as práticas se articulam às diretrizes da Reforma Psiquiátrica brasileira e analisar os processos de trabalho desenvolvidos pelos trabalhadores nos seus elementos constitutivos, da perspectiva do campo psicossocial. O cenário de estudo é Núcleo de Atenção Psicossocial I da Secretaria Municipal de Saúde de Santo André. Participaram deste estudo 11 (onze) trabalhadores, um de cada categoria profissional, de nível médio e superior. Os dados empíricos foram obtidos por meio de entrevista individual semi-estruturada e para a caracterização do cenário de estudo, o Instrumento de Captação da Realidade Objetiva, método proposto pela Teoria de Intervenção Práxica em Enfermagem em Saúde Coletiva. O material empírico foi analisado de acordo com a orientação de Minayo, baseada na hermenêutica-dialética. A análise dos dados deu origem às categorias: a) o CAPS III e a rede de atenção à saúde mental; b) Organização interna do CAPS III; c) as práticas em saúde mental no CAPS III e as diretrizes da Reforma Psiquiátrica brasileira; d) os processos de trabalho no CAPS III. Os resultados indicam que, no plano descritivo, as práticas de saúde mental dos trabalhadores do CAPS III articulam-se às diretrizes da Reforma Psiquiátrica. A análise dos elementos constitutivos dos processos de trabalho evidencia contradições. Pode-se constatar atitudes coerentes com o quadro teórico de referência adotado, o campo psicossocial, embora estas não se articulem a um projeto coletivo institucional, revelando práxis espontâneas e reiterativas. A consolidação da Reforma Psiquiátrica requer processos de trabalho que se traduzam em práxis criativas, capazes de produzir transformações concretas na vida dos usuários dos serviços. Identifica-se a necessidade de formação dos trabalhadores com relação ao projeto coletivo institucional, visando qualificar a força de trabalho dos Centros de Atenção Psicossocial, dada a função social destes equipamentos, considerados estratégicos na reorientação do modelo de atenção à saúde mental. O material empírico evidencia uma crise na organização do serviço, revelando o sofrimento dos trabalhadores e a precarização da assistência prestada aos usuários do serviço. É necessário que o serviço possa colocar-se em crise para que esta necessidade possa ser tomada pelo poder local, visando transformar essa realidade / The object of study of this qualitative research are practices of the workers of a Pshychosocial Attention Center III (CAPS III). The purpose of this study is to contribute to the understanding of the mental heath practices produced in the Pshychosocial Attention Center III, through a critical perspective, to cooperate with the consolidation of the Brazilian Psychiatric Reform. Objectives are: describe the mental heath practices of the workers of a CAPS III; verify if the mental health practices are related to the references of the Brazilian Psychiatric Reform and; analyze the processes of work developed by the workers of the CAPS III, in its constitutive elements, form a the perspective of the Pshychosocial Field. The scenery of this study is the Núcleo de Atenção Psicossocial I of the Health Department of Santo André. 11 (eleven) workers participated in the study; one form each professional category, medium level and higher education level workers. The empirical data were gathered through individual interviews with the workers and the characterization of the scenery of the study, according to the Method of Praxis Intervention of Nursing in Collective Heath. The empirical data are analyzed according to Minayo´s propose, based in dialectical-hermeneutic. The data provided the categories: a) CAPS III and the mental health care net; b) Internal organization of CAPS III; c) mental heath practices in CAPS III and the references of the Brazilian Psychiatric Reform; d) processes of work in CAPS III. The results indicate that, in a descriptive view, the mental health practices of the workers of CAPS III, correspond to the Brazilian Psychiatric Reform´s references. The analyzes of processes of work demonstrate contradictions. It is possible to recognize attitudes according to the theoretical references, the Pshychosocial Field, even though these attitudes are not related to a collective project, revealing spontaneous and reiterative praxis. The consolidation of the Brazilian Psychiatric Reform requires processes of work that constitutes creative praxis, capable to produce concrete transformation in user’s life. It is identified the need to develop the formation of the workers related to the collective project, aiming to qualify the work strength of the Pshychosocial Attention Center, considering the social function of this equipment, considered strategic in reorientation of the Mental Heath care model. The empirical data indicate crises in the internal organization of the service, revealing workers\' suffer and the loss on the quality of the assistance, which makes it necessary to the service to put its self in crises to be assumed by the local government instances

Made available in DSpace on 2016-04-29T13:31:09Z (GMT). No. of bitstreams: 1 Julia Hatakeyama Joia.pdf: 2173399 bytes, checksum: c450bdeaa534aaeaccb25dc46237ca81 (MD5) Previous issue date: 2014-03-18 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / The following research is based on the relations between the fields of mental health, rights of children and adolescents, and the judicial system. Throughout this work psychiatry internment of children and adolescents in situation of vulnerability were examined, particularly those who attend the specialized services on treatment of people who use drugs . At first, the study contextualizes governmental measures aimed at people in street situation in the center of Sao Paulo during the period of 2012-2013, by highlighting the Sufoco operation, the implementation of a judicial addendum at the CRATOD (Reference Center for Alcohol, Tabaco, and other drugs) and the enforcement of the services to drug addicts at the CAISM (Center of Integrated Support for Mental Health) Philippe Pinel. Secondly, the study seeks to analyze the psychiatry internment of a specialized service, which was created to attend initially people who live on the streets - SAID (Service of Integral Support to Addicts), later referred to as UNAD (Unit of Services to Addicts). In order to do so, a consultation was carried out among the institutional services and data of the clinic prompt-books, which sought to evidence the institutional path of the service users. The patterns of internment were identified, underscoring the flux and characteristics of the users, as well as identifying the major situations of compulsory internment which occur under the health and the judiciary systems. The study follows with the problematization of the systems put in action by the psychiatry internment, which is characterized by isolation and punitive functions, many times going beyond its therapeutical function, which should instead build up care networks and methods to reduce vulnerabilities of children and adolescents. Even if the psychiatric reform had the non-institucionalization as a motto of its mental health policy, which was based on the disconnection between unsound mind, dangerousness, and segregation, under the perspective of guaranteeing the rights of users, some step backs were identified. In the fields of childhood and youth it has been present a trend of psyquiatrization of social conflicts, which evidence the renewal of strategies of dangerousness policy . The thematic of drug consumption, reduced to the diagnosis of chemical dependency has been lately an important factor that drives the psyquiatric internment, particularly compulsory ones, reaffirming the systems of isolation and tutorship / A presente pesquisa localiza-se na interface dos campos da saúde mental, dos direitos da infância e juventude e do sistema de justiça. Investigaram-se as internações psiquiátricas de crianças e adolescentes em situação de vulnerabilidade social, em um serviço especializado no tratamento de dependentes químicos . Em um primeiro momento, contextualizam-se as ações do poder público para pessoas em situação de rua no centro de São Paulo, no período 2012-2013, dando especial destaque à Operação Sufoco, à implantação de um anexo judiciário no CRATOD (Centro de Referência de Álcool, Tabaco e Outras Drogas) e à imposição do atendimento de dependentes químicos no CAISM (Centro de Atenção Integrada em Saúde Mental) Philippe Pinel. O segundo momento é reservado à análise das internações psiquiátricas de um serviço especializado, criado para atender, inicialmente, a população de rua - SAID (Serviço de Atenção Integral ao Dependente), depois chamado UNAD (Unidade de Atendimento ao Dependente). Para isso, foi realizada consulta a censos institucionais no serviço e a dados de prontuários, a fim de evidenciar as trajetórias institucionais dos usuários. Traça-se um perfil das internações, destacando fluxos e características dos usuários, e identificam-se as principais compulsoriedades nas relações da rede de saúde com o Poder Judiciário. Posteriormente, problematizam-se os circuitos acionados pela internação psiquiátrica, em que funções asilares e punitivas aparecem muitas vezes sobrepondo-se à função terapêutica, à articulação de redes territoriais de cuidados e à busca de diminuição das vulnerabilidades das crianças e adolescentes. Ainda que a Reforma Psiquiátrica tenha a desinstitucionalização como norteadora das políticas de saúde mental, fundamentada na desvinculação entre loucura, periculosidade e segregação, e na perspectiva da garantia dos direitos aos usuários, identificam-se também retrocessos. O campo da infância e juventude apresenta uma tendência crescente à psiquiatrização dos conflitos sociais, que evidenciam a renovação de estratégias de gestão da periculosidade . A temática do consumo de drogas, reduzida ao diagnóstico dependência química , vem sendo, atualmente, um importante vetor que aciona a internação psiquiátrica, em especial nas suas compulsoriedades, reafirmando circuitos asilares e tutelares

O objeto de estudo desta pesquisa qualitativa são as práticas dos trabalhadores de um Centro de Atenção Picossocial III - CAPS III. A finalidade é contribuir para a compreensão das práticas em saúde mental produzidas no CAPS III, por meio da perspectiva crítica e colaborar com a consolidação da Reforma Psiquiátrica brasileira. Tem como objetivos: descrever as práticas de saúde mental dos trabalhadores do CAPS III; verificar se as práticas se articulam às diretrizes da Reforma Psiquiátrica brasileira e analisar os processos de trabalho desenvolvidos pelos trabalhadores nos seus elementos constitutivos, da perspectiva do campo psicossocial. O cenário de estudo é Núcleo de Atenção Psicossocial I da Secretaria Municipal de Saúde de Santo André. Participaram deste estudo 11 (onze) trabalhadores, um de cada categoria profissional, de nível médio e superior. Os dados empíricos foram obtidos por meio de entrevista individual semi-estruturada e para a caracterização do cenário de estudo, o Instrumento de Captação da Realidade Objetiva, método proposto pela Teoria de Intervenção Práxica em Enfermagem em Saúde Coletiva. O material empírico foi analisado de acordo com a orientação de Minayo, baseada na hermenêutica-dialética. A análise dos dados deu origem às categorias: a) o CAPS III e a rede de atenção à saúde mental; b) Organização interna do CAPS III; c) as práticas em saúde mental no CAPS III e as diretrizes da Reforma Psiquiátrica brasileira; d) os processos de trabalho no CAPS III. Os resultados indicam que, no plano descritivo, as práticas de saúde mental dos trabalhadores do CAPS III articulam-se às diretrizes da Reforma Psiquiátrica. A análise dos elementos constitutivos dos processos de trabalho evidencia contradições. Pode-se constatar atitudes coerentes com o quadro teórico de referência adotado, o campo psicossocial, embora estas não se articulem a um projeto coletivo institucional, revelando práxis espontâneas e reiterativas. A consolidação da Reforma Psiquiátrica requer processos de trabalho que se traduzam em práxis criativas, capazes de produzir transformações concretas na vida dos usuários dos serviços. Identifica-se a necessidade de formação dos trabalhadores com relação ao projeto coletivo institucional, visando qualificar a força de trabalho dos Centros de Atenção Psicossocial, dada a função social destes equipamentos, considerados estratégicos na reorientação do modelo de atenção à saúde mental. O material empírico evidencia uma crise na organização do serviço, revelando o sofrimento dos trabalhadores e a precarização da assistência prestada aos usuários do serviço. É necessário que o serviço possa colocar-se em crise para que esta necessidade possa ser tomada pelo poder local, visando transformar essa realidade / The object of study of this qualitative research are practices of the workers of a Pshychosocial Attention Center III (CAPS III). The purpose of this study is to contribute to the understanding of the mental heath practices produced in the Pshychosocial Attention Center III, through a critical perspective, to cooperate with the consolidation of the Brazilian Psychiatric Reform. Objectives are: describe the mental heath practices of the workers of a CAPS III; verify if the mental health practices are related to the references of the Brazilian Psychiatric Reform and; analyze the processes of work developed by the workers of the CAPS III, in its constitutive elements, form a the perspective of the Pshychosocial Field. The scenery of this study is the Núcleo de Atenção Psicossocial I of the Health Department of Santo André. 11 (eleven) workers participated in the study; one form each professional category, medium level and higher education level workers. The empirical data were gathered through individual interviews with the workers and the characterization of the scenery of the study, according to the Method of Praxis Intervention of Nursing in Collective Heath. The empirical data are analyzed according to Minayo´s propose, based in dialectical-hermeneutic. The data provided the categories: a) CAPS III and the mental health care net; b) Internal organization of CAPS III; c) mental heath practices in CAPS III and the references of the Brazilian Psychiatric Reform; d) processes of work in CAPS III. The results indicate that, in a descriptive view, the mental health practices of the workers of CAPS III, correspond to the Brazilian Psychiatric Reform´s references. The analyzes of processes of work demonstrate contradictions. It is possible to recognize attitudes according to the theoretical references, the Pshychosocial Field, even though these attitudes are not related to a collective project, revealing spontaneous and reiterative praxis. The consolidation of the Brazilian Psychiatric Reform requires processes of work that constitutes creative praxis, capable to produce concrete transformation in user’s life. It is identified the need to develop the formation of the workers related to the collective project, aiming to qualify the work strength of the Pshychosocial Attention Center, considering the social function of this equipment, considered strategic in reorientation of the Mental Heath care model. The empirical data indicate crises in the internal organization of the service, revealing workers\' suffer and the loss on the quality of the assistance, which makes it necessary to the service to put its self in crises to be assumed by the local government instances