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Special Issue "Mental Health and Social Care and Social Interventions"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 April 2018).

Special Issue Editor

Guest Editor
Dr. Jed Boardman

Institute of Psychiatry, Psychology & Neuroscience King’s College London, London, UK
Website | E-Mail
Phone: 07969587288
Interests: epidemiology of mental disorders; psychological disorders in primary care; evaluation of mental health services; recovery and employment

Special Issue Information

Dear Colleagues,

Mental ill-health is recognised as a major contributor to the Global Disease Burden. The organisation and quality of mental health services varies considerably throughout the world, and many countries have shifted the focus of their services from a hospital-based model to a community-based one. This presents a wide range of challenges to social policy and the provision of high quality mental health services to the population. Biomedical and other health service interventions have a clear role to play in the management of mental disorders, but alone they are not sufficient to support the recovery of many people with mental health conditions. Factors, such as poverty, debt, lack of employment, poor housing, violence and trauma, stigma and discrimination, all play a role in causing mental ill-health and impeding recovery. These factors play a role across the life-span.

Many countries recognise the important role that social services and independent sector providers play in contributing to the provision of comprehensive mental health services. Social security provision, services for housing, employment, education and training, leisure and day facilities, debt and financial advice, community development, all can play a role in the prevention of and recovery from mental health conditions.

This Special Issue is open to any subject area relating to public mental health, the provision of social-related services and interventions for people with mental health conditions, and interventions that are focused on increasing their social inclusion.

Dr. Jed Boardman
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 papers will be 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 semimonthly 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 1800 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 disorders
  • mental health
  • public mental health
  • social services
  • community services
  • community development
  • social interventions
  • poverty
  • debt
  • social exclusion
  • employment
  • leisure services
  • education and training
  • economic and social costs
  • prevention

Published Papers (14 papers)

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Editorial

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Open AccessEditorial
Mental Health and Social Care and Social Interventions
Int. J. Environ. Res. Public Health 2018, 15(11), 2328; https://doi.org/10.3390/ijerph15112328
Received: 15 October 2018 / Accepted: 17 October 2018 / Published: 23 October 2018
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Abstract
In common parlance, the term ‘social’ is used in many senses ranging from the way society is organised to the rank or status someone has in society; to activities that involve meeting with other people; to the experience, behaviour and interaction of persons [...] Read more.
In common parlance, the term ‘social’ is used in many senses ranging from the way society is organised to the rank or status someone has in society; to activities that involve meeting with other people; to the experience, behaviour and interaction of persons forming groups; and to promoting companionship and communal activities. [...] Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)

Research

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Open AccessArticle
Implementing Supported Employment. Lessons from the Making IPS Work Project
Int. J. Environ. Res. Public Health 2018, 15(7), 1545; https://doi.org/10.3390/ijerph15071545
Received: 2 June 2018 / Revised: 13 July 2018 / Accepted: 13 July 2018 / Published: 21 July 2018
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Abstract
Individual Placement and Support (IPS) is an internationally accepted and effective form of supported employment for people with severe mental health conditions. Despite its strong evidence base, the implementation of IPS has been slow and inconsistent. In England, a demonstration project, Making IPS [...] Read more.
Individual Placement and Support (IPS) is an internationally accepted and effective form of supported employment for people with severe mental health conditions. Despite its strong evidence base, the implementation of IPS has been slow and inconsistent. In England, a demonstration project, Making IPS Work, was developed to offer support for the implementation of IPS in six local sites National Health Service Mental Health trusts. The project aimed to: Establish Individual Placement and Support services within clinical teams; develop high fidelity practice and leave a sustainable IPS service beyond the project. The number of people gaining open employment in each site was monitored. Fidelity checks were carried out at three sites by independent assessors. Stakeholders were interviewed over the 18-month lifetime of the implementation period to examine the experience of developing the services in the six sites. A total of 421 jobs were found for people with mental health conditions over 18 months with a large variation between the highest and lowest performing sites. The sites assessed for fidelity all attained the threshold for a ‘Good Fidelity’ service. The new services were readily accepted by mental health service users, clinical staff and managers across the trust sites. Maintaining the funding for the Individual Placement and Support services beyond the project period proved to be problematic for many sites. Placing the services within a broader strategy of improving psychosocial services and bringing together decision making at the corporate, commissioning and clinical management level were helpful in achieving success. The growth and maintenance of these services is difficult to achieve whilst the current cost pressures on the NHS continue. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
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Open AccessArticle
Integrating Qualitative and Quantitative Data in the Development of Outcome Measures: The Case of the Recovering Quality of Life (ReQoL) Measures in Mental Health Populations
Int. J. Environ. Res. Public Health 2018, 15(7), 1342; https://doi.org/10.3390/ijerph15071342
Received: 31 May 2018 / Revised: 19 June 2018 / Accepted: 19 June 2018 / Published: 26 June 2018
Cited by 3 | PDF Full-text (553 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
While it is important to treat symptoms, there is growing recognition that in order to help people with mental health problems lead meaningful and fulfilling lives, it is crucial to capture the impact of their conditions on wider aspects of their social lives. [...] Read more.
While it is important to treat symptoms, there is growing recognition that in order to help people with mental health problems lead meaningful and fulfilling lives, it is crucial to capture the impact of their conditions on wider aspects of their social lives. We constructed two versions of the Recovering Quality of Life (ReQoL) measure—ReQoL-10 and ReQoL-20—for use in routine settings and clinical trials from a larger pool of items by combining qualitative and quantitative evidence covering six domains. Qualitative evidence was gathered through interviews and focus groups with over 76 service users, clinicians, and a translatability assessment. Psychometric evidence generated from data from over 6200 service users was obtained from confirmatory factor models and item response theory analyses. In this paper we present an approach based on a traffic light pictorial format that was developed to present qualitative and quantitative evidence to a group of service users, clinicians, and researchers to help to make the final selection. This work provides a pragmatic yet rigorous approach to combining qualitative and quantitative evidence to ensure that ReQoL is psychometrically robust and has high relevance to service users and clinicians. This approach can be extended to the development of patient reported outcome measures in general. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
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Open AccessArticle
Evaluation of Arts based Courses within a UK Recovery College for People with Mental Health Challenges
Int. J. Environ. Res. Public Health 2018, 15(6), 1170; https://doi.org/10.3390/ijerph15061170
Received: 29 April 2018 / Revised: 28 May 2018 / Accepted: 30 May 2018 / Published: 4 June 2018
Cited by 2 | PDF Full-text (397 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
No previous studies have evaluated arts based recovery college courses. Yet arts may assist in personal recovery, as often defined by service users, through social connection and personal meaning. This interdisciplinary study evaluated (i) whether self-reported wellbeing and arts activities increased following arts [...] Read more.
No previous studies have evaluated arts based recovery college courses. Yet arts may assist in personal recovery, as often defined by service users, through social connection and personal meaning. This interdisciplinary study evaluated (i) whether self-reported wellbeing and arts activities increased following arts based recovery college courses, and (ii) how students, peer trainers and artist-trainers understood courses’ impact. The design was mixed-methods. Of 42 service user students enrolling, 39 completed a course and 37 consented to provide data. Of these, 14 completed pre and post course questionnaires on mental wellbeing and 28 on arts participation. Post course focus groups were held with six of eight peer trainers and five of seven artist-trainers, and 28 students gave written feedback. Twenty-four students were interviewed up to three times in the subsequent nine months. There were statistically significant increases in self-reported mental wellbeing and range of arts activities following course attendance. At follow-up 17 of 24 students reported improved mental wellbeing, while seven reported little or no change. Some spoke of increased social inclusion and continuing to use skills learned in the course to maintain wellbeing. Initial in-course experience of ‘artistic growth’ predicted follow-up reports of improvement. Future controlled studies should employ standardized measures of social inclusion and arts participation. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
Open AccessArticle
The Importance of Nidotherapy and Environmental Change in the Management of People with Complex Mental Disorders
Int. J. Environ. Res. Public Health 2018, 15(5), 972; https://doi.org/10.3390/ijerph15050972
Received: 12 April 2018 / Revised: 10 May 2018 / Accepted: 10 May 2018 / Published: 13 May 2018
Cited by 1 | PDF Full-text (1151 KB) | HTML Full-text | XML Full-text
Abstract
Much has been done in the last 50 years to achieve a better understanding of the psychosocial causes and other factors influencing the manifestation of mental illness, but there has been a conspicuous omission. Although gross environmental deficiencies were exposed in old mental [...] Read more.
Much has been done in the last 50 years to achieve a better understanding of the psychosocial causes and other factors influencing the manifestation of mental illness, but there has been a conspicuous omission. Although gross environmental deficiencies were exposed in old mental institutions, 70 years ago the more subtle maladaptive settings that reinforce chronicity in mental illness have often been forgotten. In this review, the potential of systematic environmental manipulation as a treatment (nidotherapy) and other similar forms of management, used many times in the past but now mainly in forensic settings, is examined. There is now accumulating evidence, reinforced by controlled trials, that planned environmental change, preferably carried out with the full cooperation of the patient, can be a major contributor to therapeutic benefit. It is also very cost-effective. All forms of the environment, physical, social and personal, can be addressed in making assessments, and once a planned way forward has been chosen, progress can be monitored by personnel with limited mental health experience. These interventions have applications in general mental health and occupational health services and deserve much wider use. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
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Open AccessArticle
Taking a Gamble for High Rewards? Management Perspectives on the Value of Mental Health Peer Workers
Int. J. Environ. Res. Public Health 2018, 15(4), 746; https://doi.org/10.3390/ijerph15040746
Received: 14 March 2018 / Revised: 5 April 2018 / Accepted: 11 April 2018 / Published: 13 April 2018
Cited by 2 | PDF Full-text (319 KB) | HTML Full-text | XML Full-text
Abstract
Mental health peer work is attracting growing interest and provides a potentially impactful method of service user involvement in mental health design and delivery, contributing to mental health reform. The need to effectively support this emerging workforce is consequently increasing. This study aimed [...] Read more.
Mental health peer work is attracting growing interest and provides a potentially impactful method of service user involvement in mental health design and delivery, contributing to mental health reform. The need to effectively support this emerging workforce is consequently increasing. This study aimed to better understand the views of management in relation to peer work and specifically explores the value of peer work from the perspective of management. This qualitative research employed grounded theory methods. There were 29 participants in total, employed in both peer designated and non-peer designated management roles, in not for profit and public health organisations in Queensland, Australia. The value of peer work as described by participants is found to be partially dependent on practical supports and strategies from the organisation. There were high benefits for all facets of the organisation when effective recruitment and ongoing support for peer workers was prioritised and a higher perception of limitations when they were not. Due to some parallels, it may be useful to explore the potential for peer work to be conceptually and/or practically considered as a form of diversity and inclusion employment. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
Open AccessFeature PaperArticle
What Works? Toward a New Classification System for Mental Health Supported Accommodation Services: The Simple Taxonomy for Supported Accommodation (STAX-SA)
Int. J. Environ. Res. Public Health 2018, 15(2), 190; https://doi.org/10.3390/ijerph15020190
Received: 5 December 2017 / Revised: 15 January 2018 / Accepted: 19 January 2018 / Published: 24 January 2018
Cited by 10 | PDF Full-text (711 KB) | HTML Full-text | XML Full-text
Abstract
Inconsistent terminology and variation in service models have made synthesis of the supported accommodation literature challenging. To overcome this, we developed a brief, categorical taxonomy that aimed to capture the defining features of different supported accommodation models: the simple taxonomy for supported accommodation [...] Read more.
Inconsistent terminology and variation in service models have made synthesis of the supported accommodation literature challenging. To overcome this, we developed a brief, categorical taxonomy that aimed to capture the defining features of different supported accommodation models: the simple taxonomy for supported accommodation (STAX-SA). Data from a previous review of existing classification systems were used to develop the taxonomy structure. After initial testing and amendments, the STAX-SA and an existing taxonomy were applied to 132 supported accommodation service descriptions drawn from two systematic reviews and their performance compared. To assess external validity, the STAX-SA was distributed to a sample of supported accommodation managers in England and they were asked to use it to classify their services. The final version of the STAX-SA comprised of five supported accommodation ‘types’, based on four domains; Staffing location; Level of support; Emphasis on move-on; and Physical setting. The STAX-SA accurately categorized 71.1% (n = 94) of service descriptions, outperforming the comparison tool, and was not affected by publication date or research design. The STAX-SA effectively discriminated between ‘real world’ service models in England and 53.2% (n = 17) of service managers indicated that the taxonomy was ‘Very effective’ or ‘Extremely effective’ in capturing key characteristics of their service. The STAX-SA is an effective tool for classifying supported accommodation models and represents a promising approach to synthesizing the extant effectiveness literature. The authors recommend the development of reporting guidelines for future supported accommodation publications to facilitate comparison between models. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
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Review

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Open AccessReview
The Role of Communities in Mental Health Care in Low- and Middle-Income Countries: A Meta-Review of Components and Competencies
Int. J. Environ. Res. Public Health 2018, 15(6), 1279; https://doi.org/10.3390/ijerph15061279
Received: 9 May 2018 / Revised: 13 June 2018 / Accepted: 14 June 2018 / Published: 16 June 2018
Cited by 10 | PDF Full-text (1404 KB) | HTML Full-text | XML Full-text
Abstract
Community-based mental health services are emphasized in the World Health Organization’s Mental Health Action Plan, the World Bank’s Disease Control Priorities, and the Action Plan of the World Psychiatric Association. There is increasing evidence for effectiveness of mental health interventions delivered [...] Read more.
Community-based mental health services are emphasized in the World Health Organization’s Mental Health Action Plan, the World Bank’s Disease Control Priorities, and the Action Plan of the World Psychiatric Association. There is increasing evidence for effectiveness of mental health interventions delivered by non-specialists in community platforms in low- and middle-income countries (LMIC). However, the role of community components has yet to be summarized. Our objective was to map community interventions in LMIC, identify competencies for community-based providers, and highlight research gaps. Using a review-of-reviews strategy, we identified 23 reviews for the narrative synthesis. Motivations to employ community components included greater accessibility and acceptability compared to healthcare facilities, greater clinical effectiveness through ongoing contact and use of trusted local providers, family involvement, and economic benefits. Locations included homes, schools, and refugee camps, as well as technology-aided delivery. Activities included awareness raising, psychoeducation, skills training, rehabilitation, and psychological treatments. There was substantial variation in the degree to which community components were integrated with primary care services. Addressing gaps in current practice will require assuring collaboration with service users, utilizing implementation science methods, creating tools to facilitate community services and evaluate competencies of providers, and developing standardized reporting for community-based programs. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
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Open AccessReview
The Arts as a Medium for Care and Self-Care in Dementia: Arguments and Evidence
Int. J. Environ. Res. Public Health 2018, 15(6), 1151; https://doi.org/10.3390/ijerph15061151
Received: 2 April 2018 / Revised: 14 May 2018 / Accepted: 30 May 2018 / Published: 1 June 2018
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Abstract
The growing prevalence of dementia, combined with an absence of effective pharmacological treatments, highlights the potential of psychosocial interventions to alleviate the effects of dementia and enhance quality of life. With reference to a manifesto from the researcher network Interdem, this paper shows [...] Read more.
The growing prevalence of dementia, combined with an absence of effective pharmacological treatments, highlights the potential of psychosocial interventions to alleviate the effects of dementia and enhance quality of life. With reference to a manifesto from the researcher network Interdem, this paper shows how arts activities correspond to its definition of psycho-social care. It presents key dimensions that help to define different arts activities in this context, and illustrates the arts with reference to three major approaches that can be viewed online; visual art, music and dance. It goes on to discuss the features of each of these arts activities, and to present relevant evidence from systematic reviews on the arts in dementia in general. Developing the analysis into a template for differentiating arts interventions in dementia, the paper goes on to discuss implications for future research and for the uptake of the arts by people with dementia as a means to self-care. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
Open AccessFeature PaperReview
The Place of Social Recovery in Mental Health and Related Services
Int. J. Environ. Res. Public Health 2018, 15(6), 1052; https://doi.org/10.3390/ijerph15061052
Received: 18 April 2018 / Revised: 15 May 2018 / Accepted: 16 May 2018 / Published: 23 May 2018
Cited by 1 | PDF Full-text (295 KB) | HTML Full-text | XML Full-text
Abstract
This article looks at the place of social recovery in mental health and social care services, alongside personal recovery. Despite its conceptual and practice centrality to the new meaning of recovery, social recovery has remained a relatively neglected dimension. This article attempts to [...] Read more.
This article looks at the place of social recovery in mental health and social care services, alongside personal recovery. Despite its conceptual and practice centrality to the new meaning of recovery, social recovery has remained a relatively neglected dimension. This article attempts to provide an updated critical commentary based on findings from fifty nine studies, including a variety of research methodologies and methods. Definitions of social recovery within the new meaning of recovery are looked at. This is followed by outlining the development and significance of this dimension as reflected in the key areas of shared decision making, co-production and active citizenship, re-entering employment after experiencing mental ill health, being in employment, poverty and coping with poverty, the economic and the scientific cases for social recovery. The article highlights the connections between service users’ experiencing mental health and social care systems, and the implications of ideologies and policies reflecting positions on social recovery. The complexity of social recovery is indicated in each of these areas; the related conceptual and methodological frameworks developed to research this dimension, and key achievements and barriers concerning everyday practice application of social recovery. The summary indicates potential future development perspectives of this dimension. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
Open AccessFeature PaperReview
From Community to Meta-Community Mental Health Care
Int. J. Environ. Res. Public Health 2018, 15(4), 806; https://doi.org/10.3390/ijerph15040806
Received: 13 February 2018 / Revised: 17 April 2018 / Accepted: 17 April 2018 / Published: 20 April 2018
Cited by 1 | PDF Full-text (310 KB) | HTML Full-text | XML Full-text
Abstract
Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income [...] Read more.
Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although community mental health care has been positive for many service users, it has also had severe shortcomings. Expectations that it would lead to fuller social integration have not been fulfilled and many service users remain secluded in sheltered or custodial environments with limited social contacts and no prospect of work. Others receive little or no service at all. In today’s complex landscape of increasingly specialised services for people with mental health problems, the number of possible interfaces between services is increasing. Together with existing uneven financing systems and a context of constant change, these interfaces are challenging us to develop effective care pathways adjusted to the needs of service users and their carers. This discussion paper reviews the developments in community mental health care over the recent years and puts forward the concept of “Meta-Community Mental Health Care”. “Meta-Community Mental Health Care” embraces pluralism in understanding and treating psychiatric disorders, acknowledges the complexities of community provision, and reflects the realities and needs of the current era of care. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
Open AccessReview
The Weakening of Kin Ties: Exploring the Need for Life-World Led Interventions
Int. J. Environ. Res. Public Health 2018, 15(2), 203; https://doi.org/10.3390/ijerph15020203
Received: 1 November 2017 / Revised: 18 January 2018 / Accepted: 19 January 2018 / Published: 25 January 2018
Cited by 2 | PDF Full-text (285 KB) | HTML Full-text | XML Full-text
Abstract
The protective features that families and wider social relationships can have are required to meet the demands of life in contemporary Western societies. Choice and detraditionalization, however; impede this source of solidarity. Family Group Conferencing (FGC) and other life-world led interventions have the [...] Read more.
The protective features that families and wider social relationships can have are required to meet the demands of life in contemporary Western societies. Choice and detraditionalization, however; impede this source of solidarity. Family Group Conferencing (FGC) and other life-world led interventions have the potential to strengthen primary groups. This paper explores the need for such a social intervention, using insights from sociological and philosophical theories and empirical findings from a case study of the research project ‘FGC in mental health’. This need is understandable considering the weakening of kin ties, the poor qualities of state agencies to mobilise self-care and informal care, its capacity to produce a shift of power from public to private spheres and its capacity to mitigate the co-isolation of individuals, families and communities. A life-world led intervention like FGC with a specific and modest ambition contributes to small-scale solidarity. This ambition is not inclined to establish a broad social cohesion within society but to restore; in terms of the German philosopher Peter Sloterdijk; immunity (protection) and solidarity in primary groups, and consequently, resolve issues with those (family, neighbours, colleagues) who share a sphere (a situation, a process, a fate). Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)

Other

Open AccessFeature PaperPerspective
Mental Health Related Stigma as a ‘Wicked Problem’: The Need to Address Stigma and Consider the Consequences
Int. J. Environ. Res. Public Health 2018, 15(6), 1158; https://doi.org/10.3390/ijerph15061158
Received: 11 April 2018 / Revised: 17 May 2018 / Accepted: 30 May 2018 / Published: 2 June 2018
Cited by 2 | PDF Full-text (321 KB) | HTML Full-text | XML Full-text
Abstract
Recent reviews on the evidence base for mental health related stigma reduction show that under certain conditions interpersonal contact is effective in promoting more positive attitudes, reduced desire for social distance, and increased stigma related knowledge (knowledge which disconfirms beliefs based on stereotypes). [...] Read more.
Recent reviews on the evidence base for mental health related stigma reduction show that under certain conditions interpersonal contact is effective in promoting more positive attitudes, reduced desire for social distance, and increased stigma related knowledge (knowledge which disconfirms beliefs based on stereotypes). Short-term interventions may have effects that are attenuated over time; longer term programmes may support sustained improvements, but research following up long-term interventions is scarce. However, the effectiveness of these interventions should not obscure the nature of stigma as a social problem. In this article we describe stigma as a ‘wicked problem’ to highlight some implications for intervening against stigma and evaluating these efforts. These include the risks of unintended consequences and the need to continually reformulate the concept of stigma, to ensure that tackling stigma at the structural, interpersonal, and intrapersonal levels become part of the core business of stakeholder organisations. We compare the main targets of anti-stigma programmes with what is known about the sources of stigma and discrimination and their impacts to identify targets for future intervention. In some cases, interventions have been directed at the interpersonal level when structural level intervention is also needed; in others, systematic reviews have not so far identified any interventions. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
Open AccessDiscussion
The Impact of Austerity on Mental Health Service Provision: A UK Perspective
Int. J. Environ. Res. Public Health 2018, 15(6), 1145; https://doi.org/10.3390/ijerph15061145
Received: 7 April 2018 / Revised: 28 May 2018 / Accepted: 30 May 2018 / Published: 1 June 2018
Cited by 2 | PDF Full-text (269 KB) | HTML Full-text | XML Full-text
Abstract
This is a discussion paper which examines the impact of austerity policies on the provision of mental health services in the United Kingdom. Austerity is a shorthand for a series of policies introduced by the Conservative and Liberal Democrat Coalition government in the [...] Read more.
This is a discussion paper which examines the impact of austerity policies on the provision of mental health services in the United Kingdom. Austerity is a shorthand for a series of policies introduced by the Conservative and Liberal Democrat Coalition government in the UK from 2010 onwards. In response to the fiscal crisis following the bail out of the banks in 2008, it was argued that significant reductions in public spending were required. The background to these policies is examined before a consideration of their impact on mental health services. These policies had a disproportionate impact on people living in poverty. People with health problems including mental problems are overrepresented in this group. At the same time, welfare and community services are under increasing financial pressures having to respond to increased demand within a context of reduced budgets. There is increasing recognition of the role that social factors and adverse childhood experiences have in the development and trajectory of mental health problems. Mental health social workers, alongside other professionals, seek to explain mental distress by the use of some variant of a biopsychosocial model. The extent of mental health problems as a one of their measures of the impact of inequality. More unequal societies create greater levels of distress. There is a social gradient in the extent of mental health problems—the impact of severe mental illness means that many individuals are unable to work or, if they can return to work, they find it difficult to gain employment because of discrimination. The paper concludes that austerity and associated policies have combined to increase the overall burden of mental distress and marginalisation within the UK. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
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