Cite. Flashcards
1️⃣ Mental Health = “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community”
(WHO, 2016)
1️⃣ A study conducted with a sample of British Civil Servants; in which the findings demonstrated a social gradient in health outcomes. Specifically, an inverse association between one’s grade of employment and their resulting mortality rates for a wide range of diseases was observed. These results suggest the importance of socio-economic status with reference to health outcomes, and is one of the most pervasive and enduring observations in public health.
Whitehall Study, began in 1967
1️⃣ [X] identified a diverse range of factors influencing health outcome disparities in the broad categories of; Social and cultural factors [community social capital/social support/education], Environmental events [natural disasters/war/forced migration], Neighborhood factors [infrastructure/safety and security/housing], Economic factors [recessions/income/debt] and Demographic factors [population density/ethnicity/gender].
(Lund et al., 2018)
1️⃣ Individuals of lower socio-economic statuses exhibit a greater likelihood to report barriers to receiving mental health care
(Steele et al., 2007)
1️⃣ Highlights the four foundational pillars that are presently being integrated into the approach to mental health under the 2030 Agenda for Sustainable Development. These include; recognizing mental health as a global public good which requires interventions beyond the health sector, adopting a dimensional approach that conceptualizes mental health as a continuum and equally emphasizes prevention and treatment alongside promotion and maintenance of mental health, acknowledging that addressing challenges to global mental health require an intersectoral and interdisciplinary approach, and finally making human rights a central tenet of global mental health action with an emphasis on involving people with lived experiences; “nothing about us without us.”
(Collins, 2020)
1️⃣ This study assessed for 12 mental disorders across 204 countries between the years of 1990 and 2019: with the aim of measuring prevalence rates and assessing DALYs. Their findings showed that mental disorders are among the top 10 leading causes of burden worldwide, and that the global number of DALY’s resulting from mental health disorders increased by approximately 64% between the years 1990 and 2019.
Global Burden of Disease Study (2019)
1️⃣ 96% of research is focused on 12% of the world’s population - in WEIRD societies (Western, Educated, Industrialized, Rich, Democratic)
(Henrich et al., 2010)
2️⃣ Culture is a complex concept that touches on all the humanly constructed and transmitted dimensions of social life. Furthermore, culture should be considered the highest system level influence on mental health above all else; as it shapes and condones the existing social and political contexts.
(Kirmayer, 2018)
2️⃣ Context is the circumstances in which people are born, live, work and age, and the systems put in place to deal with illness [*and their roles, interactions and relationships]
(WHO, 2018)
2️⃣ Certain contexts can promote certain behaviors.
(Nilsen et al., 2012)
2️⃣ Syrian refugee children who were living in Lebanon were given a mental health assessment (the MINI Kid), and the results showed high rates of adolescent conduct disorder across the board. However, fighting, spending time away from home and other similar symptoms were identified as norms of their situation. Researchers posit that cultural and contextual sensitivity during the administration of structured assessments is needed, in order to better inform prevalence rates and resulting treatment plans.
(Kyrillos et al., 2023)
2️⃣ [X] ) looked at idioms of distress in Syrian Arabic and examined how those map onto more categorical symptoms of disorder. Some examples include “I feel my soul is going out” = dysphoric mood, sadness/worry, being pessimistic / “I feel the world is closing in front of my face” = hopelessness, state of despair.
(Hassan et al., 2015)
2️⃣Mental health can be experienced collectively, and not just individually (due to social changes/humanitarian disasters etc.) For example, social isolation and economic insecurity were experienced collectively during the pandemic. [*The presence of this impact impact beyond just the individual, suggests that we should also consider the impact of public MHPSS on collective suffering.]
(Chapman et al., 2020)
2️⃣PSYchiatry-led mental health services are beginning to recognize the importance of societal collective responses (such as rituals, belief systems, prayer/social gatherings, collective grief at funerals etc.) in the promotion of mental health
(Blanch, 2007)
2️⃣ Using qualitative methods to understand local expressions of emotional and behavioural distress has been increasingly used to improve cross-cultural assessment of mental health constructs (i.e., to validate subscales for use in diverse populations)
(Betancourt et al., 2011)
3️⃣ Some have called for a more ethical poverty line, which more accurately encapsulates the lived experiences of people who do not fall into the above category (X) – by this standard, around 40% of the world’s population would be considered to be living in poverty. [*Would be 648 million by official extreme poverty line standards]
(Edward, 2006)
3️⃣ Malnutrition resulting from poverty disproportionately affects children, and malnourishment early in childhood has been found to be linked with poorer neurodevelopment, impaired cognition and poorer academic achievement – although findings regarding its long-term impact on mental health remain inconclusive.
(Kirolos et al., 2022)
3️⃣ One extra year of education was linked with a lower likelihood of reporting symptoms related to depression/anxiety. [*And poverty and level of education are associated with one another]
(Kondirolli & Sunder, 2022)
3️⃣ A meta-analysis performed to examine the influence of unemployment on mental health; the results of which showed that unemployed persons showed significantly more symptoms of distress than employed persons – a finding which was moderated by sex and job type. This negative effect of unemployment was stronger in countries with unequal income distributions.
(Paul & Mosser, 2009)
3️⃣ Evidence has suggested that poverty can cause time-discounting behaviours; such that poorer households are consistently more likely to choose smaller and earlier monetary rewards over larger delayed ones. [*Such behaviours are increased by negative income shocks - making poverty difficult to ‘escape’]
(Yesuf et al., 2008)
3️⃣ Social exclusion is a social process through which individuals from certain groups are excluded from facilities, benefits, and opportunities that others enjoy.
(Morgan et al., 2007)
3️⃣ Researcher makes the distinction between absolute and relative poverty; wherein absolute poverty acts by restricting ones access to basic needs and relative poverty (in which one is living below the median income) acts primarily through psychosocial mechanisms (i.e., via low self-esteem)
(Townsend, 1979)
3️⃣ Observed across three large sample studies, a social gradient: such that psychiatric morbidity rises with decreasing socio-economic status. This gradient is also observed both with educational and occupational status.
(Marmot et al., 1997)
4️⃣ 60% of the 815 million suffering from chronic malnutrition live in areas affected by armed conflict.
(WHO, 2016)
4️⃣ Notably, children U15 who are living in conflict are 3x more likely to die from diseases linked to unsafe water and poor sanitation, than due to direct violence (20x for U5)
(UNICEF, 2019)
