In this article we examine the tensions between current Australian depression policy directions and lay beliefs about depression as constructed and circulated through popular media at a time when mental health education discourses are also promoting 'depression literacy' [Parslow & Jorm, 2002. Medical Journal of Australia, 177(7), 117-121]. Drawing upon research into articles on depression published in two women's magazines before and after the promulgation of the National Action Plan for Depression [Commonwealth Department of Health and Aged Care, 2000. National action plan for depression. Canberra: Commonwealth Department of Health and Aged Care-Mental Health and Special Programs Branch] we identify the cultural context of certain lay beliefs about depression as articulated through personal and celebrity stories, advice columns and resource links. The depression literacy literature privileges biomedical and psychological expertise in explaining depression and promoting help-seeking behaviour. In contrast, the magazine discourses foreground an individualising discourse of depression as a problem of self-management while also referring to biomedical expertise. They emphasise women's abilities to manage difficult life events and to build informal supportive relationships, which reinforces dominant notions of feminine identity as concerned with balancing competing gender demands. We critique the national policy on depression literacy as taking insufficient account of women's belief structures, which leads, for example, to a limited analysis of stigma. We also critique policy for not engaging sufficiently with the gendered nature of depression and its relation to social inequities, something the magazines replicate.
This paper examines emotion work within the predominantly female environment of aged-care nursing, identifying phenomena which must be accounted for in a theory of emotional labour. These phenomena include the blurring of public and private in women's experiences and maternal models of care. Initial findings demonstrate the high levels of stress experienced by staff, related to emotional labour and to conflicts around the erosion of care standards. Sixteen women, from rural Australia, participated in the first stage of the research. The oldest was in her sixties, the youngest in her thirties. Length of aged-care experience ranged from 2 to 33 years. Although most of the women expected to still be in aged care in 5 years' time, they were negative in their attitudes to personal ageing, suggesting an ambivalence in their feelings about working in aged care. Three women nurses are the particular focus of this paper. Their narratives illustrate the intersection of private and public caring in nurses' lives and the implications of this for emotional labour. Phenomena such as dual caring, conflicts in insider-outsider roles, and transference are revealed in their narratives. We argue that the welfare of the recipient of gerontic nursing is linked to the well-being of the nurse-carer but that a cultural change is needed so as to recognize and value emotion work. However, endorsing Staden, we agree that such a change is dependent on the politicization of 'caring'. There is also need for further and broader research concerning the nature of emotional labour and the ethics of care.
In this article we draw upon the work of governmentality and cultural risk theorists (Foucault 1991; Rose 1999; Dean 1999; Lupton 1999) and feminist research into women's experience of depression (Stoppard, 2000) to develop a gendered analysis of recent Australian mental health policies. We explore the power-knowledge relations that shape current policy directions, and hence the thinking that guides health professionals, in relation to women's experience of depression and emotional distress in society today. Policy discourses are a means through which neo-liberal rule is exercised in relation to women's emotional lives as a population and as individuals identified as 'at risk' of mental disorder. Yet, a sociocultural analysis of the gendered experience of depression has been largely ignored within mental health policy that draws upon biomedical and psychological discourses aimed at the prevention, identification and treatment of disorder. We ask where, in this contemporary regime of truth, is there room for women to ask critical questions about their own experiences of selfhood and emotions in contemporary culture, and importantly, to be heard?
Objective: This paper reports on the development and trial of a mental health promotion program for older people in rural north‐east Victoria entitled Healthy & Wise. The objective of the program was to increase mental health literacy among older adults referred to Aged Psychiatry who were not diagnosed with a psychiatric disorder but who were experiencing difficulties in dealing with the stresses of later life. A further objective of the program was to assist older adults develop skills in adapting to these stresses. Method: Delivery of the program was in a small‐group format. Evaluation utilised both quantitative and qualitative assessment of outcomes. In this report the focus is on assessment based on the Geriatric Depression Scale self‐administered to participants before the program began, post program, and at a 6‐month follow‐up. Results: There was a significant reduction in GDS score over time (pre/post) which was maintained at follow up. The program was successful in attracting participants experiencing a number of risk factors associated with poorer mental health (e.g. chronic illness). Conclusion: Adoption of Healthy & Wise, a trialed and evaluated community mental health program for older adults, could extend the delivery of mental health services in rural areas in an economic and effective way. At a time when smaller rural communities are ageing more rapidly than Australia as a whole, and funding constraints continue, it is recommended as a valuable addition to current programming. Because the study does not include a control group and because participants self selected for the program, generalisation to other populations and settings needs to be cautious. However, because of the success of this trial, it is recommended that the program be tested with other populations. Target groups might include hostel residents and carers of people with dementia.
Policies targeting community care of older people in Australia are predicated partly on the belief that home is a place of particular meaning to them. This research examines the meaning of home for older women living in the community in rural Australia. A life historical perspective is taken on the assumption that the significance of home is located in a network of meanings constructed over the lifetime of women interviewed. It is claimed that home and identity for these women are integrally linked. Home is a locus for experiencing power over the environment and connection with others in real and symbolic ways. The experience and expression of power and connectedness is modulated by marital status, living arrangement and physical location.
Book reviews in this article:Objective: To assess expectations about ageing of rural‐ and urban‐reared students preparing for careers in health and human services.Method: A survey of 136 students at three rural campuses was conducted using the Reactions to Ageing Questionnaire. Students were enrolled in first‐ and second‐year occupational therapy, nursing and welfare. Intimate contact with older people, defined as the number of people aged 65 and over counted as family or friends, was treated as a moderator variable.Results: There was a significant difference in attitude depending on the background of students, with rural students being more negative in attitude. Neither course of study nor intimate contact was associated with attitude score.Conclusions: Rural background may be an important factor in attitudes towards ageing and attitudes may be relatively independent of intimate contact with older people.
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