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SOCI 310 > Final > Flashcards

Final Flashcards

1
Q

Who promoted the concept of recovery

A

consumer/survivor movement

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2
Q

MHCC task

A

develop first MH strategy for Canada

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3
Q

Example of person who wrote a book on personal experience with recovery

A

Pat Deegan

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4
Q

What kind of movement is recovery (Direction)

A

Bottom-up

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5
Q

Key themes of recovery

A
  • Not the same as symptom remission
  • It’s a process not an outcome
  • recovery ‘in’ MI not ‘from’
  • as a series of short steps
  • it involves normative social roles and routines
  • emphasis on employment housing, social relationships and community integration (ROUTINE)
  • this model involves choice, empowerment and agency in the health system
  • stigma as a massive barrier to recovery
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6
Q

(recovery) Model that offers less agency is

A

paternalistic

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7
Q

Collaborative care (recovery)

A

when the model is more collaborative, shared decision-making, reaching a consensus

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8
Q

End goal in recovery?

A

Different definitions

but generally it’s seen as an ongoing process, you never stop

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9
Q

Recovery stand in contrast to notions of

A 
Chronicity
Stabilization
Paternalism
Continuing care
Segregation
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10
Q

Chronicity (recovery)

A

belief that certain illnesses will never improve

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11
Q

Stabilization (recovery)

A

focus on reducing symptoms

Goal - just to stop being from being a threat to themselves or others

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12
Q

Continuing care (recovery)

A

CC unit people would visit you to make sure you were stabilized (chronicity idea)

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13
Q

Segregation (recovery)

A 
People with severe MI separated 
"sheltered workshops"
Segregation for
1. Refuge - need refuge from society
2. containment - to stop them from being a threat to society
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14
Q

Stats about recovery/stigma

A

80% unemployment among people with severe MI
20-50% homeless people have a MI
High hate crime rate
Most budget for MI doesn’t go to recovery (containment …)

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15
Q

Clinician’s role? (recovery)

A

foster recovery

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16
Q

What do clinicians need? (recovery)

A

Retraining- adopt respectful + hopeful attitudes
support choice
encourage autonomy
fight stigma around patient’s irrationality and decisional capacity

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17
Q

Recovery oriented interventions

A
  • Supported employment (specialists help make action plan)
  • Supported housing
  • Illness self-management course (u come up with ur own strategy)
  • Psychiatric advance directive (like a will for when you have episodes)
  • Peer support
  • recovery centres (learn skills)
  • Shared decision making as 2 experts (medical + physical/personal)
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18
Q

Stigma etymology

A

Ancient greek word “mark” or “brand”

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19
Q

According to goffman stigma is perpetuated by

A

fear, myth, misconception and prejudice

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20
Q

2 types of stigma

A

External

Internal

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21
Q

External stigma

A

held by the rest of society to subgroup
becomes problem if held by people of power
Manifests itself in unemployment rate

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22
Q

Internal stigma

A

when you internalise stigma and start to question yourself

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23
Q

External stigma manifests itself in

A

Housing (high rate of homelessness)
Education (high drop-out rate, low investment in facilitating needs)
Dating and relationships
Criminal and justice issues (3 strikes you’re out policy, pb for untreated schizophrenia –> “revolving doors”)

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24
Q

in stigma -“revolving doors”

A

Police just arrest and then kick them out after a few days

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25
Q

what happens psychologically through internal stigma?

A

Self isolation
Self esteem and confidence drops
shame, guilt, self doubt

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26
Q

Result of internal stigma?

A

Embarrassed to utilize health services
Substance abuse - “self medication” to fill social/existential vacuum
Suicide and suicidality (thinking or attempting)

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27
Q

Change in stigma over time

A

Studies have shown no change
People think more and more that MI is chronic and biological
(BBB model)

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28
Q

Bottom-up ways to reduce stigma

A

Confrontation
Boycott
Media-Monitoring
Public rallies (more of emotional catharsis though)

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29
Q

Top down ways to reduce stigma

A

PSA (only short term tho, discouraged)
Legislation, courts, policy (prevent discrimination, MHCC)
Contact-based workshops (MOST EFFECTIVE)

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30
Q

Contact based workshops (stigma)

A
  • Someone with MI will go to a target group of people and make a speech
  • Collabo with an expert
  • Have long term effect
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31
Q

Best way to reduce stigma? (combo)

A

Legislation (by making things illegal), complemented by targeted contact- based workshops

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32
Q

Ödegaard (immigration)

A

compared MH - people in noarway with norwegian immigrants with native minnesotans

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33
Q

Competing theories about the high rates of MI among immigrants

A 
Social drift (people who emigrate because they're having problems)
Social causation (new country causes problems: racism, language barrier--> stress) 
Misdiagnosis or social control (stigmatization of immigrants, seen as threats)
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34
Q

3 phases of immigrant mental health

A

Pre-migration
Migration journey
Post-migration

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35
Q

Pre migration

A

odegaard attributes elevated risks to this

Many ppl came from war-struck countries, persecution, natural disasters –> risk factors for PTSD

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36
Q

Migration journey

A

Terrible journey affected mH
Vietnamese boat people
refugee camps - waiting for relocation (high rate of violence and sexual assault)

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37
Q

Post-migration

A

unemployment, underemployment, discrimination, language barriers

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38
Q

Ethnic density study

A

Faris and Dunham in the 1930s
Low ethnic density : higher racism, micro aggression
Higher ethnic density: more social support, more networks
culturally relevant community centres
places of worship –> all G for MH

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39
Q

Immigrant study - Cautor- Graae and Jelten

A

schizophrenia in immigrants 3:1
higher risk among 2nd gen
Adapting to new environment is hard (especially if it’s not a great as you expected)
Use of cannabis - predictor for psychosis (controversial though)
cultural differences interpreted as psychosis- delusions (ex. religious references, talking close to face)

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40
Q

Why higher risk of MI in 2nd gen than first gen?

A

If you’re first gen: more embedded in your own culture, but 2nd gen - foot in both camps, different norms and values (double bind)

first gen can engage in escapism not second gen

But also can have birth complications if pregnant during immigration

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41
Q

Healthy migrant effect?

A
  • selection process chooses healthier people
  • better networks among immigrants
  • rely more on alternative mental health services (traditional, religious healing and spirituality)
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42
Q

Statistics about boys and education

A

40% of undergraduate degrees
77% of dropouts
Lower performance scores

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43
Q

Suicide in men

A

second leading cause of death (15-34)

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44
Q

Why is men’s MH so bad?

A 
Technology replacing them 
Women more suited to economy 
Demasculanization of schools 
Devaluation of men 
Internet porn (addiction + loss of drive) 
Negative rep of young men in media 
Less likely to get help
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45
Q

Contributing factors to men’s MH

A

Men’s behaviour
Limitations within healthcare system
Harmful social norms/political ideologies

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46
Q

Men’s health behaviour

A
  • downplay and avoid illness
  • cowboy complex
  • stigma: contradiction with masculine ideals
  • Men’s coping : self medication + isolation
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47
Q

Cowboy complex

A
  • Idea of stoicism, self-reliance

- Not appropriate to seek help (esp. For non-physical issues)

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48
Q

Limitations within healthcare system (men’s)

A

Lack of MH programs for men
Limit of diagnostically tools
Male unfriendly places - hostile healthcare workers –> barriers to care
Lack of research on men’s MH (gender bias)

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49
Q

Limit of diagnostical tools for men’s MH

A

M and W have v different expression of emotional trouble
tool’s pick up women’s depression but not men’s
Men’s symptoms are miscategorised (alcoholism, personality disorder)

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50
Q

Media analysis - chivalry hypothesis

A

Media reflects social paradigms of gender
Women treated in chivalrous way (lighter sentences, etc)
Men with MI portrayed as villains and women with MI portrayed as victims

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51
Q

Men’s double bind

A

Because they’re advantaged in society - don’t deserve help on the micro level
7% of men get custody of their children

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52
Q

Response to terrible MHS for men

A

Men’s sheds (australia)- normalcy, integration, contribution, sense of purpose
Movember
Online support groups (sometimes are misogynistic)

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53
Q

Consequences to not addressing men’s MH

A 
Drain on health care system 
Higher suicide rates 
Higher drug/alcohol abuse
Weaker families and communities 
Weaker societies
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54
Q

Kind of support given by peer support

A

emotional, social and practical

55
Q

Why peer support (+who)

A

consumer survivor movement
Formed because of dissatisfaction with formality and distance
Experiential knowledge - know how to navigate complex system

56
Q

what do PS do

A

support and guide - don’t suggest

57
Q

How is spirituality defined

A

person’s relationship to the transcendent

more of a personal activity

58
Q

How is religiosity defined

A

The way that a person might be religious

Devotion, holiness, piousness

59
Q

What kind of factor if religiosity

A

a protective factor for onset of mental illness or disorder

60
Q

Religious variables and mental health

A

Positive correlation with well-being

Negative correlation with rates of alcohol/ substance abuse, delinquency and crime, depression and suicide, anxiety

61
Q

Religious clinical interventions

A

Respecting and supporting spiritual beliefs
Challenging beliefs –> by bringing in spiritual expert
Praying with patients
Consultation with clergy

62
Q

How does religiosity help with MI?

A

it provides meaning/structure
sense of belonging
explains hard things (ex. death)

63
Q

Different definitions of homelessness

A 
Narrow definition = strict
Sheltered homeless 
Hidden homeless (in rural areas, cars or outhouses)
64
Q

Risk factors for depression and MI (housing unit)

A

homelessness, housing instability, low quality

65
Q

Interventions to solve homelessness among people with MI

A

shelters (short term)
transitional housing
congregate housing (short term)
(BEST) housing first (str8 from street to independent appt)

66
Q

Luhrmann institutional circuit

A

–> streets –> homeless shelter –> prison –> mental hospital –> streets….

67
Q

gender and racial inequalities in homelessness

A

Aboriginal people = 30 of the homeless
75% homeless people are men
1 shelter just for men vs 600 for women (bc of lobby groups, chivalry hypo..)

68
Q

risk factors for MI in urban setting

A

Fear of crime/ actual crime
Lack of social support/social capital
Cost of living/ quality of life
Racism

69
Q

National media and MI study stats

A

40% of articles talk about MI in terms of crime and violence
only 15% talk about recovery

70
Q

Most effective way to reduce stigma in journalism

A

Contact-based educational workshops at journalism schools
Evidence-based guidelines for reporting into brochures
Online training

71
Q

Gendered representations of MI in the media

A

Articles about men are more likely to be more stigmatizing

Articles about women: quote experts, recovery, intervention + resources

72
Q

Definition of suicidal planning

A

thinking about doing it

73
Q

Definition of suicidal ideation

A

thinking about killing yourself

74
Q

Definition of deliberate self harm

A

act of intentionally trying to harm yourself

75
Q

Suicide stats in canada

A 
4000 a year 
Underestimation though 
(stigma, insurance...)
75% men 
Higher risk in homosexuals 
Lower risk in immigrants/minorities
76
Q

Slow motion suicide

A

Addictions
Continuous risky behaviour (sex, eating, driving..)
Personal neglect
Deliberate self harm

77
Q

Rate of women attempting suicide

A

3:1

interpreted more as a cry for help

78
Q

How to reduce suicide rates?

A

national anti suicide strategies

phone lines, anti suicde professional come into schools, reserved hospital beds

79
Q

Predictors of suicide/self harm

A 
Childhood experience
Mental health issues
Life transitions and consequences 
Adult employment issues 
Aboriginal people  
Men
80
Q

Childhood experience (as predictor S/SH)

A 
Physical/sexual abuse 
Separation from father 
Pbs in school/delinquency 
School drop out 
Bullying 
Childhood MD
Residential schools
81
Q

Mental health issues (as predictor S/SH)

A

Depression
Substance abuse
Not utilizing services

82
Q

Life transitions and consequences (as predictor S/SH)

A 
Divorce/break up
Unemployment 
Chronic illness and sick-leave 
Retirement 
Bereavement
83
Q

Adult employment issues (as predictor S/SH)

A

Stress in workplace
PTSD (esp. if in army)
Decline in job security, manufacturing jobs
–> feeling of defeat

84
Q

Aboriginal people (as predictor S/SH)

A 
Residential schools
poverty
racism 
lack of hope
land issue
85
Q

Men (as predictor S/SH)

A

double standard in legal system
Men misrepresented in the media
Fatherless communities
Campus culture

86
Q

Solutions to Suicide/self harm

A 
National strategy
Specified support for life transitions 
More choice in MH services 
Peer and other support in workplace 
Better training of professionals 
Work with media 
Diminish hostility towards high-risk groups
87
Q

Individualisation thesis

A

Society evolving must faster than it was before - harder to adapt.
People are lonelier
More freedom, more choice but less security
Change in 5 domains : religious, familial, economic, , demographic, culture, media

88
Q

Individualization in Religion

A

Less and less present
Much less influential in policy making
Less social support

89
Q

Individualization in Family

A 
Smaller families 
Less sibling if not any 
Have children later - don't know your grandparents 
More isolation 
High rates of divorce
90
Q

Individualization in Economy

A

Unions have more power
Less social clubs
More hours

91
Q

Individualization in Demography

A

Aging population
Married later
Isolating

92
Q

Individualization in Culture

A

Birth control
Recreational sex
Internet
Television

93
Q

Criticism of Individualization

A

People are moving away from outdated forms of groups and forming new ones - more choice

94
Q

Individualization thesis relates to

A

Epidemic of loneliness
Constant comparison with others
Self-monitoring
Insecurity and low self esteem (don’t know if you’re doing the right thing anymore bc you don’t have religion to tell you what to do)
Dialectic between conformity and difference (drive to be difference and unique but not too different)

95
Q

MI linked to Individualization

A

Suicide (social isolation and divorce)
PTSD (esp. after Vietnam war- people hated them)
Depression
Anxiety (take away social support, you’re lost)

96
Q

Individualization affects more

A

Women

they desire a lot more social contact

97
Q

Social roles and self identity in individualization

A

Much more fluid

Individuals faced with infinite choice

98
Q

Maslow on individualization

A

Solid foundation for ‘authentic self’

99
Q

Downside of individualization

A

Choice can paralyze you
Very taxing on the mind for the future to be unpredictable
Cognitive dissonance (see people with better lives on social media)
RD Laing - ‘false self syndrome’(link to internal/external validation)

100
Q

Kierkegaard quote on individualization

A

“every actual moment of despair is traceable to possibility”

101
Q

Important elements referring to appearance and behaviour in individualization thesis

A

self-presentation and self-monitoring

102
Q

Background info about the MHCC

A

Est in 2007
MH strategy for canada
Anti stigma campaign
Opening minds

103
Q

4 target groups of opening minds

A

Health care providers
Youth
News and media
Workplace

104
Q

Opening minds approach

A

Bottom up
Evidence-based (finding successful ones- identifying active ingredients)
Create toolkits

105
Q

Program evaluation (opening minds)

A

Pre-test
Post test
Focus on 2 areas (stereotypes, social acceptance)

106
Q

What learning needs to healthcare providers have in relation to stigma

A

Pessimism about recovery
Lack of skills/confidence
Lack of awareness of own prejudices
See the illness before the person

107
Q

Importance of MHCC in workplace

A

Diagnoses for MI happens much later than PI
Costs money
Absenteeism
Presenteeism/lost productivity
Help people identify MI in their coworkers

108
Q

Using colours for MH

A

Reduces stigma - no longer labels

Emphasis possibility of back and forth on this continuum

109
Q

Participatory action research (PAR)

A

Collaborative process
Constant contact

‘systematic investigation, with the collaboration of those affected by the issue being studied, for purposes of education and taking action or effecting social change’.

110
Q

Photovoice

A

group of marginalized people
Group given disposable cameras
Take pictures of barriers, challenges, triumphs..
Targeted photo-exhibits –> invite key people –> raise awareness

111
Q

Participatory video

A

Same as photovoice but with cameras
Group activity
Work with pre-existing disempowered groups
Fogo process

112
Q

Fogo process

A
  • Raise ‘critical consciousness’ through discussion groups
  • Members trained in video-scripting, filming and editing
  • Production of informative video about issues
  • Videos disseminated to chosen audience
  • Research of outcome
113
Q

Sub categories of eating disorder

A 
Disordered eating
Anorexia
Bulimia 
Binge ED 
EDNO (eating disorder not otherwise specified) 
(obesity)
114
Q

Types of ED

A

Binge - purge
Restricting
Binge

115
Q

Stats for ED

A

ED occur in 30% of the female population
10% mortality rate (highest of all MI)
2/3 of clients in ED therapy have a negative outcome

116
Q

Explanation

A

Body dissatisfaction for women has doubles since the 1970s
Society values a certain body type - reflected through media (undermines women)
40 billion dollar/year diet industry
Culture of narcissism aided by social media (external validation essential to happiness)

117
Q

ED and gender

A

10:1 ratio
Gendered response to deep psychological suffering
(men is drinking)
ED as a result of self-silencing and suppression of anger

118
Q

Internalized anger theory (ED)

A

Silencing opinions or frustrations to maintain close RS and social harmony
Expressing anger seen as unacceptable in women

119
Q

ED as symbiotic

A

ED as signal you’re sending out to the world
You feel marginalized
You feel this is the only way to express yourself
Cry for help

120
Q

Environment (and predictors of ED)

A

Family history of dieting (family systems theory)
Parenting process especially perfectionist parents
Divorce
Powerlessness and inadequacy
Perfectionism and personal standards

121
Q

Perfectionism in ED

A

Personal standards
Self-criticism (self-monitoring)
Control and lack of control (ED as a way of gaining control)

122
Q

Other side of ED

A

Women who don’t see it as an illness but as a lifestyle choice
Online communities
Social support or illness consolidation?

123
Q

Freud and civilization

A

MI as a consequence of civilization
Bourgeois form of not expressing anger, sexuality
MI doesn’t exist in colonial countries

124
Q

MI and racism

A

Drapetomania
Eugenics - frontal lobe
“happy savage”

125
Q

Psychiatry in the colonial period

A

“tropical medecine”
Centralized mental hospital operated by colonial authorities
Used to contain opponents of regime
Voyeurism

126
Q

Psychiatry in the post colonial period

A

‘international health’
Epidemiological transition
Focus on chronic diseases
International aid departments created around the world
Mental health still seen as a low priority

127
Q

Problem with global mental health

A

Treatment gap
Systems in place often scarce and unsatisfactory
Alternative healing methods used
Often condescending

128
Q

Reactions to the problems with GMH

A

Raising awareness
Creating broad alliance to take action
top down movement

129
Q

Solutions to problems with GMH

A

Finding cost effective intervention to tackle treatment gap
Scale up interventions
Task shifting to LHW

130
Q

Task shifting to LHW (GMH)

A

Lay Health workers
People with rudimentary training that have been mentored
Shifting tasks from clinicians to one of those workers

131
Q

Critiques of GMH

A

DSM and western concepts of MI are cultural construct
Top-down imposition of alien western models
Ridicule and marginalization of indigenous knowledge and local ideologies of healing
Recovery rates better in developing countries (less labeling, less segregation)
Trojan horse for mass medicalization and big pharma
Need to focus on social determinants of health
Act of cultural imperialism/neo colonialism

132
Q

Upstream factor in Aboriginal MH

A

cultural loss, impact of residential schools, colonisation, unemployment, poverty and racism

133
Q

Downstream factor in aboriginal MH

A

sense of hopelessness; as well as inadequate health care

SOCI 310 (5 decks)

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