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The Development of Implementation Strategies to Reduce Mental Health Inequalities

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (30 March 2023) | Viewed by 20811

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Special Issue Editor

Dr. Victoria L. Smye

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Guest Editor

Arthur Labatt Family School of Nursing, Faculty of Health Sciences, The University of Western Ontario, London, ON N6A 3K7, Canada
Interests: inequities in access to mental health and substance use services; Indigenous health; women and violence; interpersonal and structural violence; critical theoretical perspectives; including exploration and application of the concepts of cultural safety, trauma- and violence- informed care, relational practice, and intersectionality in nursing and health care more broadly

Special Issue Information

Dear Colleagues,

The reduction of health inequalities, described as unfair and avoidable differences in health among people or society, is a key issue on the global health agenda (WHO, 2021). In terms of mental health, globally 450 million people live with mental health issues, while more than 700,000 people have a mental health ailment. COVID-19 has shone a light on pre-pandemic mental health inequalities and associated social and structural inequities. For example, during the pandemic, the meaning of physical space, place and home has taken on particular significance in the context of physical distancing and the push to create and maintain safe spaces for persons living with mental illness, poverty, homelessness and/or violence. In addition, as noted by Sukhera (2020), “structural stigma against mental illness is ‘baked in’ to our health system…” often with dire consequences for those accessing services. Around the world, many people with mental illness continue to be victimized because of their illness and become the targets of unfair discrimination. Solutions to these intersecting health and social ‘wicked problems’ is at the heart of a health equity agenda and require approaches that fit for persons with lived experience. The implementation of [mental] health policies and programs is intended to improve the health/well-being of persons living with mental illness and the mental health of society at large, i.e., there is the potential to reduce mental health inequalities.

This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) focuses on the sharing of knowledge regarding the development of implementation of strategies to reduce mental health inequalities. New research papers, reviews, case reports and conference papers are welcome for this issue. Other manuscript types accepted include methodological papers, position papers, brief reports, and commentaries.

Dr. Victoria L. Smye
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

mental health inequalities
social and structural inequities
violence, poverty and homelessness
stigma and discrimination
intersectionality
implementation strategies
persons with lived experience

Published Papers (6 papers)

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Research

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23 pages, 487 KiB

Open AccessArticle

Grounding Wellness: Coloniality, Placeism, Land, and a Critique of “Social” Determinants of Indigenous Mental Health in the Canadian Context

by Viviane Josewski, Sarah de Leeuw and Margo Greenwood

Int. J. Environ. Res. Public Health 2023, 20(5), 4319; https://doi.org/10.3390/ijerph20054319 - 28 Feb 2023

Cited by 2 | Viewed by 3970

Abstract

Authored by a small team of settler and Indigenous researchers, all of whom are deeply involved in scholarship and activism interrogating ongoing processes of coloniality in lands now known to many as Canada, this paper critically examines “social” and grounded determinants of Indigenous mental health and wellness. After placing ourselves on the grounds from which we write, we begin by providing an overview of the social determinants of health (SDOH), a conceptual framework with deep roots in colonial Canada. Though important in pushing against biomedical framings of Indigenous health and wellness, we argue that the SDOH framework nevertheless risks re-entrenching deeply colonial ways of thinking about and providing health services for Indigenous people: SDOH, we suggest, do not ultimately reckon with ecological, environmental, place-based, or geographic determinants of health in colonial states that continue to occupy stolen land. These theoretical interrogations of SDOH provide an entry point to, first, an overview of Indigenous ways of understanding mental wellness as tethered to ecology and physical geography, and second, a collection of narrative articulations from across British Columbia: these sets of knowledge offer clear and unequivocal evidence, in the form of Indigenous voices and perspectives, about the direct link between land, place, and mental wellness (or a lack thereof). We conclude with suggestions for future research, policy, and health practice actions that move beyond the current SDOH model of Indigenous health to account for and address the grounded, land-based, and ecologically self-determining nature of Indigenous mental health and wellness. Full article

(This article belongs to the Special Issue The Development of Implementation Strategies to Reduce Mental Health Inequalities)

16 pages, 407 KiB

Open AccessArticle

Social Suffering: Indigenous Peoples’ Experiences of Accessing Mental Health and Substance Use Services

by Victoria Smye, Annette J. Browne, Viviane Josewski, Barbara Keith and William Mussell

Int. J. Environ. Res. Public Health 2023, 20(4), 3288; https://doi.org/10.3390/ijerph20043288 - 13 Feb 2023

Cited by 3 | Viewed by 5839

Abstract

In this paper, we present findings from a qualitative study that explored Indigenous people’s experiences of mental health and addictions care in the context of an inner-city area in Western Canada. Using an ethnographic design, a total of 39 clients accessing 5 community-based mental health care agencies were interviewed, including 18 in-depth individual interviews and 4 focus groups. Health care providers also were interviewed (n = 24). Data analysis identified four intersecting themes: normalization of social suffering; re-creation of trauma; the challenge of reconciling constrained lives with harm reduction; and mitigating suffering through relational practice. The results highlight the complexities of experiences of accessing systems of care for Indigenous people marginalized by poverty and other forms of social inequity, and the potential harms that arise from inattention to the intersecting social context(s) of peoples’ lives. Service delivery that aims to address the mental health concerns of Indigenous people must be designed with awareness of, and responsiveness to, the impact of structural violence and social suffering on peoples’ lived realities. A relational policy and policy lens is key to alleviate patterns of social suffering and counter the harms that are unwittingly created when social suffering is normalized. Full article

(This article belongs to the Special Issue The Development of Implementation Strategies to Reduce Mental Health Inequalities)

14 pages, 1185 KiB

Open AccessArticle

Towards an Understanding of Successes of the Psychiatric Nurses in Caring for Children with Mental Health Problems: An Appreciative Inquiry

by Rorisang Mary Machailo, Daleen Koen and Molekodi Matsipane

Int. J. Environ. Res. Public Health 2023, 20(3), 1725; https://doi.org/10.3390/ijerph20031725 - 18 Jan 2023

Cited by 1 | Viewed by 2193

Abstract

Introduction: Psychiatric nurses have a specialized body of knowledge and skills in providing care to persons with mental health challenges. The literature provides scanty evidence on child psychiatric nursing practices. This paper explored the successes of psychiatric nurses in caring for children with mental health problems using appreciative inquiry (AI). Design: A qualitative exploratory and descriptive design was used to allow for new ideas that can fundamentally reshape the practice of child psychiatric nursing. Purposive sampling was used to select psychiatric nurses caring for children with mental health problems. Focus groups were used to generate data. Findings: The results indicate both positive and negative prospects for psychiatric nursing practice. The positive possibilities included commitment, passion and dedication of staff to the children. The negative aspects that need urgent attention include lack of specific, integrated child mental health within the mental health care services, shortage of resources and not-fit-for purpose infrastructure. Conclusion: Appreciative inquiry verified the commitment of psychiatric nurses in caring for children with mental health problems and the potential for dedicated child psychiatric institutions in realizing the needs of such children. The needs of children with mental health problems must be addressed through positive care in the health system. Full article

(This article belongs to the Special Issue The Development of Implementation Strategies to Reduce Mental Health Inequalities)

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13 pages, 337 KiB

Open AccessArticle

Male Farmers’ Perspectives on Psychological Wellbeing Self-Management Strategies That Work for Them and How Barriers to Seeking Professional Mental Health Assistance Could Be Overcome

by Dale D. Woolford, Matthew F. Smout, Deborah Turnbull and Kate M. Gunn

Int. J. Environ. Res. Public Health 2022, 19(19), 12247; https://doi.org/10.3390/ijerph191912247 - 27 Sep 2022

Cited by 7 | Viewed by 2239

Abstract

This research aimed to explore the self-management strategies that Australian male farmers use to improve or maintain their psychological wellbeing and their views on what would assist them to overcome barriers to seeking professional mental health assistance. Individual semi-structured telephone interviews were audio-recorded with consent. Qualitative data were analysed inductively using thematic analysis. Fifteen male farmers participated, who were an average of thirty-nine years of age (23–74 years) with twenty years of farming experience (5–57 years). Seven themes relating to self-management strategies were identified: (1) interacting with a supportive network; (2) involvement in groups and teams; (3) physical activity; (4) proactively educating themselves; (5) self-prioritising and deliberately maintaining work–life balance; (6) being grateful; and (7) focusing on the controllable aspects of farming. Five themes were identified that related to mitigating barriers to seeking mental health assistance: (1) actively welcoming mental health professionals into the community; (2) normalising help-seeking; (3) making seeking mental health assistance a priority; (4) offering services that are culturally appropriate and accessible for male farmers; and (5) tailoring mental health information delivery to farming populations. Australian male farmers already use strategies to maintain and improve their mental health that are culturally and contextually appropriate. These proactive strategies could form the basis of interventions aiming to further promote male farmers’ wellbeing. Barriers to seeking professional mental health assistance may be overcome by implementing solutions directly suggested by male farmers. Given the elevated risk of suicide in this group, investment in trialing promotion of these strategies is warranted. Full article

(This article belongs to the Special Issue The Development of Implementation Strategies to Reduce Mental Health Inequalities)

15 pages, 935 KiB

Open AccessArticle

A Kirkpatrick Model Process Evaluation of Reactions and Learning from My Strengths Training for Life™

by Mary L. Quinton, Grace Tidmarsh, Benjamin J. Parry and Jennifer Cumming

Int. J. Environ. Res. Public Health 2022, 19(18), 11320; https://doi.org/10.3390/ijerph191811320 - 08 Sep 2022

Cited by 2 | Viewed by 3744

Abstract

Underpinned by the New World Kirkpatrick model, and in the context of a community-based sport psychology programme (My Strengths Training for Life™) for young people experiencing homelessness, this process evaluation investigated (1) young peoples’ reactions (i.e., program and facilitator evaluation, enjoyment, attendance, and engagement) and learning (i.e., mental skills and transfer intention), (2) the relationship between reaction and learning variables, and (3) the mediators underpinning this relationship. A total of 301 young people living in a West Midlands housing service completed questionnaires on demographics and reaction and learning variables. Higher levels of programme engagement were positively associated with more favourable reactions to the programme. Enjoyment positively predicted learning outcomes, which was mediated by transfer intention. Recommendations are made for (1) a balance between rigor and flexibility for evaluation methods with disadvantaged youth, (2) including engagement as well as attendance as indicators of meaningful programme participation, (3) measuring programme experiences (e.g., enjoyment) to understand programme effectiveness, and (4) providing opportunities for skill transfer during and after programme participation. Our findings have implications for researchers, programme commissioners, and policymakers designing and evaluating programmes in community-based settings. Full article

(This article belongs to the Special Issue The Development of Implementation Strategies to Reduce Mental Health Inequalities)

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Other

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23 pages, 838 KiB

Open AccessSystematic Review

Experiences of Non-Pharmaceutical Primary Care Interventions for Common Mental Health Disorders in Socioeconomically Disadvantaged Groups: A Systematic Review of Qualitative Studies

by Kate Bernard, Josephine M. Wildman, Louise M. Tanner, Akvile Stoniute, Madeleine Still, Rhiannon Green, Claire Eastaugh, Sarah Sowden and Katie H. Thomson

Int. J. Environ. Res. Public Health 2023, 20(7), 5237; https://doi.org/10.3390/ijerph20075237 - 23 Mar 2023

Cited by 2 | Viewed by 2186

Abstract

Common mental health disorders (CMDs) disproportionately affect people experiencing socioeconomic disadvantage. Non-pharmaceutical interventions, such as ‘social prescribing’ and new models of care and clinical practice, are becoming increasingly prevalent in primary care. However, little is known about how these interventions work and their impact on socioeconomic inequalities in health. Focusing on people experiencing socioeconomic disadvantage, this systematic review aims to: (1) explore the mechanisms by which non-pharmaceutical primary care interventions impact CMD-related health outcomes and inequalities; (2) identify the barriers to, and facilitators of, their implementation in primary care. This study is a systematic review of qualitative studies. Six bibliographic databases were searched (Medline, ASSIA, CINAHL, Embase, PsycInfo and Scopus) and additional grey literature sources were screened. The included studies were thematically analysed. Twenty-two studies were included, and three themes were identified: (1) agency; (2) social connections; (3) socioeconomic environment. The interventions were experienced as being positive for mental health when people felt a sense of agency and social connection. The barriers to effectiveness and engagement included socioeconomic deprivation and underfunding of community sector organisations. If non-pharmaceutical primary care interventions for CMDs are to avoid widening health inequalities, key socioeconomic barriers to their accessibility and implementation must be addressed. Full article

(This article belongs to the Special Issue The Development of Implementation Strategies to Reduce Mental Health Inequalities)

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