An engaged approach to exploring issues around poverty and mental health: A reflective evaluation of the research process from researchers and community partners involved in the DeStress study

Thomas, Felicity; Hansford, Lorraine; Wyatt, Katrina; Byng, Richard; Coombes, Karen; Finch, Jenna; Finnerty, Kirsty; Ford, Joe; Guppy, Keith; Guppy, Rachel; Hughes, Susanne; Richardson, Hilary; Roche, Debbie; Stuteley, Hazel

doi:10.1111/hex.13065

Cited by 13 publications

(23 citation statements)

References 28 publications

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“…We need to make absolutely clear in this paper our support for the development of specialist services and responses to mental health and psychological harm. While mental health issues affect people at the level of individual experience, however, there is gathering evidence that the root causes and manifestation of the majority of mental health-related problems are affected by circumstances that lie beyond both the individual and the arena of medical or clinical health (Friedli, 2009;Cromby et al, 2013;Read & Dillon, 2013;Pinderhughes et al, 2015;WHO, 2016;Thomas et al, 2020).…”

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confidence: 99%

Conditions for mental health in education: Towards relational practice

Billington

Gibson

Fogg

et al. 2021

British Educational Res J

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There are concerns globally about the emotional wellbeing and mental health of young people and in this paper a critical orientation comprises both theoretical and empirical data sources. The case is made that (1) the medical model of mental healththat of problem identification, diagnosis and medical treatment at the level of the individualis not appropriate for the vast majority of children and young people in schools and (2) relational approaches would be more sensitive in responding to the complexity of the 'conditions' in the schools, homes and communities in which young people live. Articulations of these conditions in the literature are explored while we also draw on empirical data from part of an evaluation of a school-based teacher-training programme in which interviewees and respondents mapped out their own conditions for emotional wellbeing and mental health. We conclude with proposals for relational approaches which (1) acknowledge the links between affect, cognition and school climate and culture, (2) foreground mental health and poverty as impacting on young people's emotional wellbeing in their communities, families and schools and (3) attend to voiceproviding spaces in which young people can develop their own 'preferred narratives' concerning emotional wellbeing and mental health.

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confidence: 99%

Conditions for mental health in education: Towards relational practice

Billington

Gibson

Fogg

et al. 2021

British Educational Res J

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“…This study was developed as part of the DeStress Project on mental health in low-income communities ( Thomas et al, 2019 ). The consultations analyzed are part of a wider corpus of 52 video- and audio-recorded GP–patient mental health consultations taken from the One in a Million archive.…”

Section: Methodsmentioning

confidence: 99%

Use of the Patient Health Questionnaire (PHQ-9) in Practice: Interactions between patients and physicians

2020

Self Cite

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We analyze the use of nine-item Patient Health Questionnaire (PHQ-9), an instrument that is widely used in diagnosing and determining the severity of depression. Using conversation analysis, we show how the doctor deploys the PHQ-9 in response to the patient’s doubts about whether she is depressed. Rather than relaying the PHQ-9 verbatim, the doctor deviates from the wording so that the response options are selectively offered to upgrade the severity of the patient’s symptoms. This works in favor of a positive diagnosis and is used to justify a treatment recommendation that the patient previously resisted. This contrasted with the rest of the data set, where diagnosis was either not delivered (as patients are presenting with ongoing problems) or delivered without using the PHQ-9. When clinician-administered, the PHQ-9 can be influenced by how response items are presented. This can lead to either downgrading or upgrading the severity of depression.

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“…Some of them have much higher relevance than any known biological or genetic correlates [51]. To mention just a few examples, financial and social status [52,53], belonging to an ethnic minority [54], or being a victim of child abuse and other adversities [55] have been shown to influence the frequency of particular diagnoses and prescription of psychiatric drugs. A longitudinal study revealed that financial problems of British students precede depression and alcohol abuse [56], and difficulty paying back debts precede common mental disorders in the adult population in the Netherlands [57], pointing to economic factors as causal.…”

Section: Etiology-problems In Livingmentioning

confidence: 99%

From Mental Health Industry to Humane Care. Suggestions for an Alternative Systemic Approach to Distress

Stupak

Dobroczyński

2021

IJERPH

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The article proposes a rough outline of an alternative systemic approach to mental health issues and of a more humane mental health care system. It suggests focusing on understanding mental distress as stemming from problems in living, using medications as agents facilitating psychotherapy, or as a last resort and short-term help, according to the principles of harm reduction. It argues that understanding drugs as psychoactive substances and studying the subjective effects they produce could lead to better utilization of medications and improvements in terms of conceptualizing and assessing treatment effects. Qualitative research could be particularly useful in that regard. It also advocates a radical departure from current diagnostic systems and proposes a synthesis of already existing alternatives to be used for both research and clinical purposes. Accordingly, a general idea for an alternative mental health care system, based on a combination of Open Dialogue Approach, Soteria houses, individual and group psychotherapy, cautious prescribing, services helping with drug discontinuation, peer-led services and social support is presented. The proposition could be seen as a first step towards developing a systemic alternative that could replace the currently dominating approach instead of focusing on implementing partial solutions that can be co-opted by the current one.

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An engaged approach to exploring issues around poverty and mental health: A reflective evaluation of the research process from researchers and community partners involved in the DeStress study

Cited by 13 publications

References 28 publications

Conditions for mental health in education: Towards relational practice

Conditions for mental health in education: Towards relational practice

Use of the Patient Health Questionnaire (PHQ-9) in Practice: Interactions between patients and physicians

From Mental Health Industry to Humane Care. Suggestions for an Alternative Systemic Approach to Distress

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