Self-Government and the fashioning of resilient personae : legal education, criminal justice, and the government of mental health

This paper explores attempts to shape resilient personae through relations of self-government, and highlights the way that this features as part of advanced liberal forms of rule. As an example of this process, it focuses on the way that undergraduate law students are encouraged to fashion resilient personae throughout their legal studies, so as to avoid, or effectively respond to, experiences that may have a detrimental effect on their mental health. This paper argues that the production of such resilience relies on students being encouraged to take up psychologically- and biomedically-infused subject positions, becoming well-disciplined subjects, entrepreneurs of the self, and even virtuous persons. It highlights that the fashioning of resilient personae in this way involves extensions to the targets and practices of self-government and reinforces advanced liberal government. The paper then suggests how insights into fashioning resilience in this context can inform further research on resilience, particularly resilience produced within criminal justice professionals.

The impact of mental health literacy on help-seeking intentions : results of a pilot study with first year psychology students

Although mental health literacy has been proposed as a factor that may facilitate help-seeking, few studies have examined this relation. This pilot study aimed to investigate the relation between mental health literacy and help-seeking intentions, and to explore which components of mental health literacy may be best able to predict help-seeking intentions. An online questionnaire was completed by a convenience sample of 150 university students enrolled in a psychology unit, aged between 17 and 26 years. A simultaneous multiple regression indicated that higher levels of mental health literacy were able to predict greater intentions to seek help from professional sources. A number of mental health literacy components made a unique and significant contribution to the prediction of help-seeking intentions. The findings of this pilot study indicate that the role of mental health literacy in facilitating help-seeking is a promising area of research.

Diagnosed artist : what is the understanding of 'artist' held by a person with a mental illness?

What is the understanding of ‘artist’ held by a person with a mental illness? Being diagnosed with a mental illness often results in social isolation. Art programs are often used to address this isolation, and to expedite positive mental health and wellbeing. In these programs the cultural value of art can be moderated and replaced with therapeutic meanings or used for purposes of community integration. Some individuals develop artistic identities within these programs. These artists personify representative tensions within the art world. Artists with mental illness are symbolically positioned within the history of art as holding special creative providence and, yet are also viewed as having a peripheral position outside the cultural framework of the art world. This research engaged with eight artists to determine the understanding of artist held by a person with a mental illness. Through shared activities around the curatorial aspects of an exhibition entitled "Artist Citizen" the impact of illness, culture and alterity were examined. Overlapping approaches of Community Cultural Development and Participatory Action Research have been used. A perspective of alterity is given which was apparent in transformative processes of the research. This thesis shows that alterity and difference are both important social resources as well as positions of isolation and discrimination. Finally, conclusions are presented that indicated that a more nuanced understanding of alterity offers potential to discussions of the complex experiences of a person with a mental illness to negotiate subjective constructions of an identity for participation in broader political, social, health and cultural contexts.

Clinical utility of mental state screening as a predictor of intellectual outcomes 6 months after diagnosis of type 1 diabetes

Background Screening tests of basic cognitive status or ‘mental state’ have been shown to predict mortality and functional outcomes in adults. This study examined the relationship between mental state and outcomes in children with type 1 diabetes. Objective We aimed to determine whether mental state at diagnosis predicts longer term cognitive function of children with a new diagnosis of type 1 diabetes. Methods Mental state of 87 patients presenting with newly diagnosed type 1 diabetes was assessed using the School-Years Screening Test for the Evaluation of Mental Status. Cognitive abilities were assessed 1 wk and 6 months postdiagnosis using standardized tests of attention, memory, and intelligence. Results Thirty-seven children (42.5%) had reduced mental state at diagnosis. Children with impaired mental state had poorer attention and memory in the week following diagnosis, and, after controlling for possible confounding factors, significantly lower IQ at 6 months compared to those with unimpaired mental state (p < 0.05). Conclusions Cognition is impaired acutely in a significant number of children presenting with newly diagnosed type 1 diabetes. Mental state screening is an effective method of identifying children at risk of ongoing cognitive difficulties in the days and months following diagnosis. Clinicians may consider mental state screening for all newly diagnosed diabetic children to identify those at risk of cognitive sequelae.

The assessment of mental health in children with intellectual disability

Aim: Individuals with intellectual disability (ID) have higher rates of mental health problems than the general population. Assessment tends to rely heavily on self-report, but persons with ID often have difficulties in identifying and describing their own thoughts and feelings. Measures that are psychometrically sound with typically developing populations may not be as robust in samples with ID. The aim of the current study was to examine a range of self-report measures for assessing the mental health of children with ID, and to consider the appropriateness of minor modifications to those instruments. Method: The participants were 58 children with ID (mean 11.7 years) attending Year 6 in mainstream primary schools. At the first time point they completed four established measures of depression, anxiety and mood. Minor modifications were made to wording and format at re-administration six months later. Results: Internal consistency varied considerably across measures. Modifications resulted in small or no improvements, but the results were relatively consistent over time and across similar measures. Some gender differences were evident. Conclusions: The findings confirm the difficulties that children with ID may have when responding to self-report measures of mental health, and suggest that care should be taken in choice of instruments. While modifications can produce small improvements, it is clear that more robust measures of mental health are needed for persons with ID.

Educational stress among Chinese adolescents : measurement, risk factors and associations with mental health

Academic pressure among adolescents is a major risk factor for poor mental health and suicide and other harmful behaviours. While this is a worldwide phenomenon, it appears to be especially pronounced in China and other East Asian countries. Despite a growing body of research into adolescent mental health in recent years, the multiple constructs within the ‘educational stress’ phenomenon have not been clearly articulated in Chinese contexts. Further, the individual, family, school and peer influencing factors for educational stress and its associations with adolescent mental health are not well understood. An in-depth investigation may provide important information for the ongoing educational reform in Mainland China with a special focus on students’ mental health and wellbeing. The primary goal of this study was to examine the relative contribution of educational stress to poor mental health, in comparison to other well-known individual, family, school and peer factors. Another important task was to identify significant risk factors for educational stress. In addition, due to the lack of a culturally suitable instrument for educational stress in this population, a new tool – the Educational Stress Scale for Adolescents (ESSA) was initially developed in this study and tested for reliability and validity. A self-administered questionnaire was used to collect information from convenient samples of secondary school students in Shandong, China. The pilot survey was conducted with 347 students (grades 8 and 11) to test the psychometric properties of the ESSA and other scales or questions in the questionnaire. Based on factor analysis and reliability and validity testing, the 16-item scale (the ESSA) with five factors showed adequate to good internal consistency, 2-week test-retest reliability, and satisfactory concurrent and predictive validity. Its factor structure was further demonstrated in the main survey with a confirmatory factor analysis illustrating a good fit of the proposed model based on a confirmatory factor analysis. The reliabilities of other scales and questions were also adequate to be used in this study. The main survey was subsequently conducted with a sample of 1627 secondary school (grades 7-12) students to examine the influencing factors of educational stress and its associations with mental health outcomes, including depression, happiness and suicidal behaviours. A wide range of individual, family, school and peer factors were found to have a significant association with the total ESSA and subscale scores. Most of the strong factors for academic stress were school or study-related, including rural school location, low school connectedness, perceived poor academic grades and frequent emotional conflicts with teachers and peers. Unexpectedly, family and parental factors, such as parental bonding, family connectedness and conflicts with parents were found to have little or no association with educational stress. Educational stress was the most predictive variable for depression, but was not strongly associated with happiness. It had a strong association with suicide ideation but not with suicide attempts. Among five subscales of the ESSA, ‘Study despondency’ score had the strongest associations with these mental health measures. Surprising, two subscales, ‘Self-expectation’ and ‘Worry about grades’ showed a protective effect on suicidal behaviours. An additional analysis revealed that although academic pressure was the most commonly reported reason for suicidal thinking, the occurrence of problems in peer relationships such as peer teasing and bullying, and romantic problems had a much stronger relationship with actual attempts. This study provides some insights into the nature and health implications of educational stress among Chinese adolescents. Findings in this study suggest that interventions on educational stress should focus on school environment and academic factors. Intervention programs focused on educational stress may have a high impact on the prevalence of common mental disorders such as depression. Efforts to increase perceived happiness however should cover a wider range of individual, family and school factors. The importance of healthy peer relationships should be adequately emphasised in suicide prevention. In addition, the newly developed scale (the ESSA) demonstrates sound psychometric properties and is expected to be used in future research into academic-related stress among secondary school adolescents.

Mental health and well-being in resident mine workers : out of the fly-in fly-out box

Objective: To explore psychosocial issues perceived to impact the mental health and well-being of resident (non-fly-in fly-out) mine workers at a local mine in regional Queensland. Design: A descriptive qualitative study using semistructured interviews. Setting: The research was conducted on-site at an opencut coal mine in regional Queensland. Participants: Ten miners (nine men) currently employed in workshop, production or supervisory roles. Main outcome measures: Self-reported issues affecting psychological well-being. Results: Participants’ occupation and the surrounding context appeared to have both positive and negative influences on their well-being. Overall findings could be grouped into four key themes: (i) the importance of relationships; (ii) the impact of lifestyle; (iii) work characteristics; and (iv) mental health attitudes. While not without strains on mental health, in general, participants reported that their current situation was superior to their previous mining jobs. This was attributed to close relationships among locally recruited workers, respect for management practices and rosters that allowed adequate sleep recovery and family time between shifts. Conclusions: This study is the first to examine mental health and well being in non-fly-in fly-out mining populations. It suggests that while some issues appear inherent in the mining occupation, personal and organisational support can help workers have a more positive workplace experience. Further work looking at more extensive comparisons over various mining contexts will greatly assist in the development of programs and support structures for rural and regional mine workers.

Multicultural mental health awareness scale

Australia is one of the most culturally and linguistically diverse (CALD) society in the world. There are individuals from all over the globe settled in Australia. They enter Australia as migrants or refugees. Although, the process of migration differs from individual to individual, it can be an uprooting experience and can bring with it many mental health challenges which need professional attention. Mainstream allied and mental health professionals need to be prepared for this diverse population and their mental health issues and concerns. These professionals may have to offer multicultural counselling to clients from an ethnic and cultural background, which is very different from their own. It is therefore essential for them to demonstrate multicultural counselling competencies (MCC)...

Heart beats and economic decisions : Observing mental stress in the ultimatum bargaining game

One aim of experimental economics is to try to better understand human economic decision making. Early research of the ultimatum bargaining game (Gueth et al., 1982) revealed that other motives than pure monetary reward play a role. Neuroeconomic research has introduced the recording of physiological observations as signals of emotional responses. In this study, we apply heart rate variability (HRV) measuring technology to explore the behaviour and physiological reactions of proposers and responders in the ultimatum bargaining game. Since this technology is small and non-intrusive, we are able to run the experiment in a standard experimental economic setup. We show that low o�ers by a proposer cause signs of mental stress in both the proposer and the responder, as both exhibit high ratios of low to high frequency activity in the HRV spectrum.

Using critical incident interviews to identify the mental health knowledge, skills and attitudes of entry-level dietitians

Aim: This paper aims to explore new graduates experience working with clients with mental health issues using critical incident interviews. Methods: The qualitative research techniques were based on phenomenology. A purposive sample of 19 new graduate dietitians was drawn from a range of work settings and locations throughout Australia. Data was gathered using thirty minute Critical Incident Interviews. Audio-taped data was transcribed, coded to identify common themes, compared for congruence and then categorised into knowledge, skills and attitudes. Results: New graduates encountered a range of situations involving a variety of mental health, wellbeing, dietetic and clinical issues. Common themes highlighted the mental health knowledge, skills and attitudes required for entry-level dietitians which then informed the review of the National Competency Standards for Entry-Level Dietitians. Conclusion: New graduates encounter a variety of mental health and wellbeing issues in their everyday practice and therefore require training to address these situations competently.

A longitudinal study of mental health in refugees from Burma : the impact of therapeutic interventions

Objective: The present study seeks to examine the impact of therapeutic interventions for people from refugee backgrounds within a naturalistic setting. Method: Sixty-two refugees from Burma were assessed soon after arriving in Australia. All participants received standard interventions provided by a resettlement organisation which included therapeutic interventions, assessment, social assistance, and referrals where appropriate. At the completion of service provision a follow-up assessment was conducted. Results: Over the course of the intervention, participants experienced a significant decrease in symptoms of post-traumatic stress disorder, anxiety, depression and somatisation. Pre-intervention symptoms predicted symptoms post-intervention for post-traumatic stress, anxiety, and somatisation. Post-migration living difficulties, the number of traumas experienced, and the number of contacts with the service agency were unrelated to all mental health outcomes. Conclusions: In the first Australian study of its kind, reductions in mental health symptoms post-intervention were significantly linked to pre-intervention symptomatology and the number of therapy sessions predicted post-intervention symptoms of post-traumatic stress. Future studies need to include larger samples and control groups to verify findings.

Is mental health education really needed?

Dietitians play a key role in supporting and advocating for the physical health care of mental health (MH) consumers, with 68-80% seeing clients with associated depression issues in Australia. The DAA Mental Health Curricula Project found dietetic training in MH was inadequate and recommended increased MH education. A MH resource package was developed and sent to universities in 2010 for incorporation into teaching. The aim of this study was to assess dietetic students’ baseline MH knowledge, attitudes and exposure prior to dietetics coursework and package implementation. An online survey measured dietetic students’ mental health knowledge (MHK), attitudes towards mental illness (MHA) and previous exposure to mental illness. MHK was assessed by sixteen dietetics-specific questions. MHA were measured by Day’s Mental Illness Stigma Scale. Exposure was assessed using an adapted version of Eack’s Social Work Students’ Experiences with Schizophrenia questions. Fifty-nine dietetic students (30% response rate) from two universities were surveyed at the beginning of dietetic coursework. Survey responses revealed students had low MHK (mean 5.48, scale 0-16) with no significant difference between cohorts (p=0.67). Half of respondents (n=31) recorded never or rarely being in contact with people with mental illness. 82% of respondents (n=48) reported having no or little experience with mental illness. Data suggests low levels of sitgmatising attitudes about people with mental illness. Given the high prevalence of clients with MH issues in everyday dietetic practice, this study is a first step in addressing integration of MH education into dietetics training.

Review of refugee mental health interventions following resettlement : best practice and recommendations

There are increasing numbers of refugees worldwide, with approximately 16 million refugees in 2007 and over 2.5 million refugees resettled in the United States since the start of its humanitarian program. Psychologists and other health professionals who deliver mental health services for individuals from refugee backgrounds need to have confidence that the therapeutic interventions they employ are appropriate and effective for the clients with whom they work. The current review briefly surveys refugee research, examines empirical evaluations of therapeutic interventions in resettlement contexts, and provides recommendations for best practices and future directions in resettlement countries. The resettlement interventions found to be most effective typically target culturally homogeneous client samples and demonstrate moderate to large outcome effects on aspects of traumatic stress and anxiety reduction. Further evaluations of the array of psychotherapeutic, psychosocial, pharmacological, and other therapeutic approaches, including psychoeducational and community-based interventions that facilitate personal and community growth and change, are encouraged. There is a need for increased awareness, training and funding to implement longitudinal interventions that work collaboratively with clients from refugee backgrounds through the stages of resettlement.