Mental Health

The toolkit on mental health is available here: http://www.newhealth.govt.nz/toolkits/mentalhealth.htm

Here are links to resources on mental health:

• New Zealand
• Maori and Pacific
• International
• NZ Links and other resources

New Zealand

• Depressed about abortion - WHW June 2006
• Aropax and pregnancy - WHU January 2006
• Lesbians in New Zealand: their mental health and satisfaction with mental health services Sarah Welch, Sunny C.D. Collings, Phillippa Howden-Chapman, Australian and New Zealand Journal of Psychiatry Volume 34 Issue 2 Page 256 - April 2000 doi:10.1046/j.1440-1614.2000.00710.
  Objectives: To describe the mental health of lesbians in New Zealand, and to document their accounts of their experience of mental health services.
  Method: This is a descriptive cross-sectional study. A postal questionnaire, the Lesbian Mental Health Survey, was distributed via lesbian newsletters to 1222 women throughout New Zealand. Mental health measures included the General Health Questionnaire (GHQ-28), Interview Schedule for Social Interaction (ISSI), and respondents' histories of sexual abuse and psychiatric histories. Experiences of mental health services were sought. Results: The estimated response rate was 50.8%. The respondent group were predominantly New Zealand European, highly educated, urban women between 25 and 50 years of age. Three-quarters had identified as lesbian for more than 5 years. Recent self-identification as lesbian was associated with higher GHQ score, as was being younger than 35, having a history of sexual abuse, and not living with a partner. Eighty percent of respondents had used mental health services sometime in their lives and nearly 30 percent of users had received 'lesbian-unfriendly' treatment at some point. One-sixth of respondents had experienced discrimination from service providers in the previous 5 years.
  Conclusion: While the mental health of lesbians is influenced by factors similar to those influencing women's mental health in general, because of social factors, such as stigma and isolation, lesbians may be more vulnerable to common mental illnesses. Health professionals, mental health professionals in particular, need to raise their awareness of the issues lesbians face in dealing with their sexuality, therapeutic relationships and mental health services. Increased training about sexuality for health professionals, as well as further research into areas such as stress and stigma, sexual abuse and attempted suicide among lesbian women, is recommended. Available for purchase here
• O'Brien, A. P.//Hardy, D. J.//Boddy, J. M. (2002). Field study of mental health nursing practice at Site K District Health Board Mental Health Service September 2001: Report to the Mental Health Service Manager. District Health Boards New Zealand
• Coverdale, J., Nairn, R., and Claasen, D. ‘A legal opinion’s consequences for the stigmatisation of the mentally ill: case analysis’. Psychiatry, Psychology and Law 7,192-197, 2000.
• Raeburn, J.M. ‘Community approaches to mental health promotion’. International Journal of Mental Health Promotion, 2, 4, 13-19, 2000.
• Sullivn, S.1, Arroll, B.2, Coster, G.2, Abbott, M.3, Adams, P. ‘Problem gamblers: do GPs want to intervene?’ NZ Medical Journal, 113, 204-7, 2000.
• Towns, A.2, and Adams, P. ‘"If I really loved him enough he would be okay": Women’s accounts of male partner violence’ . Violence Against Women, 6(6), 558-585, 2000.
• Wilson, C., Nairn, R., Coverdale, J., Panapa, A. ‘How mental illness is portrayed in children’s television: a prospective study’. British Journal of Psychiatry 176, 2000, 440-443.
• Raeburn, J.M. ‘Community approaches to mental health promotion’. International Journal of Mental Health Promotion 2(4), 13-19, 2000.
• Nelson, K., The relationship of public health and mental health, PHA News, 10, (5), p 2.
• Barnett P and Newberry S. Reshaping community mental health services in a restructured state: New Zealand 1984-97. Public Management Review 4(2):187-208, 2002.
• Making Women Sick? Gender and Psychosocial Determinants of Occupational Health
  This is the paper which Celia Briar gave at the 2001 Women's Studies Association conference. It can be downloaded here
• IPRC No: RP127 Title: Association between bullying and mental health status among a sample of 3,265 New Zealand adolescents. International Journal of Mental Health Promotion 2003; 5 (1): 16-22. Authors: Coggan C, Bennett S, Hooper R, Dickinson P Topics: Youth Suicide, Date: 2003
• IPRC No: RP125 Title: Problematising depression: young people mental health and suicidal behaviours. Social Science and Medicine 2003; 57 (2): 289-299. Authors: Bennett S, Coggan C, Adams P Topics: Youth Suicide, Date: 2003

Maori and Pacific

• IPRC No: TD18 Title: Reasons to live: Samoan young people's responses to suicidal behaviour. PhD thesis. University of Auckland Authors: Tiatia J Topics: Youth Suicide, Youth Suicide Prevention, Pacific peoples and injury prevention, Date: 2003
• A model for understanding "cultural" performance standards in Maori mental health
  In October 2000 Amohia Boulton began her three year Health Research Council Training Fellowship in Mäori Health. As part of the Training Fellowship Amohia is enrolled in a PhD through Massey Unversity. The PhD is investigating the tensions Mäori providers face in trying to deliver services which are effective both from a Crown perspective and from a Mäori perspective. The similarities and differences in expectations of Crown and providers will be identified. The research aims ultimately to develop a framework for assessing the perfomance of Mäori health service providers which meets both public sector and Mäori standards. Amohia will be based at Te Pumanawa Hauora in Palmerston North while receiving co-supervision from the Health Services Research Centre. Researcher: Amohia Boulton (Vic Uni)
• Kingi, K.R.//Durie, M.H. (2000). "Hua oranga" A Maori measure of mental health outcome. (TPH/01) 1-92//1-29. Massey University: Te Pumanawa Hauora, School of Maori Studies.
• Durie, M.H. (1997). Maori cultural identity and its implications for mental health services. International Journal of Mental Health Nursing, 26(3) 23-35.0
• RR No 1 Barriers to Mental Health Care in the Community: Towards an Economic Model. Bushnell, J., Carter, H., Collings, S., Cumming, J., Howden-Chapman, P., Salmond, G., Collings, S., MacMillan, M., Sutton, F., November 1994, 81 pp.
• RR No 1 Barriers to Mental Health Care in the Community: Towards an Economic Model. Bushnell, J., Carter, H., Collings, S., Cumming, J., Howden-Chapman, P., Salmond, G., Collings, S., MacMillan, M., Sutton, F., November 1994, 81 pp.

International

• Women’s Unpaid Caregiving and Stress
  Cyndi Brannen, Healthy Balance Research Program
  If the title of this article makes you wonder if your daughter has enough medication to last until payday or whether your father-in-law’s new home-care worker will actually follow your instructions, then you are like many women in Canada today. It’s no secret that women provide the vast majority of care for family and friends,[1] but the health effects of women’s unpaid caregiving have not been well researched.
  Available online at: http://www.cewh-cesf.ca/en/publications/RB/v5n1/page5.shtml
• Social Determinants of Mental Health Disparities among New Mothers
  Cecilia Benoit, Rachel Westfall, Adrienne Bonfonti and Kim Nuernberger, Department of Sociology, University of Victoria
  Research into the social determinants of health has shone new light upon disparities in health outcomes and their relation to a broad range of social factors including, but certainly not limited to, social support in early childhood, economic stability, educational achievement, housing and food security, and access to affordable and adequate health and social care.[1] Although many studies have explored the clinical causes of maternal morbidity and in particular postpartum depression, there has been little research on the social determinants of mental health disparities among new mothers, with the exception of a few studies on the relationship between type of delivery - vaginal birth versus caesarean section[2] - and critical life stresses and postpartum depression.[3] Although popular celebrity biographies have recently brought postpartum depression to public attention,[4] far less attention has been paid to the fundamental causes of mental health disparities among different groups of new mothers.
  Available online: http://www.cewh-cesf.ca/en/publications/RB/v5n1/page4.shtml
• Fostering Social Support for Women Living with Serious Mental Illness
  Wanda M. Chernomas, University of Manitoba and Diana E. Clarke, University of Manitoba and Health Sciences Centre, Winnipeg
  The people in a social support network can help someone find solutions to problems, validate an individual’s identity, direct the individual to helpful information, and provide comfort when that is all that can be done. Because connections to others contribute to a sense of well-being and give meaning to life, social support has been identified as one of the determinants of health. For people living with schizophrenia, it is a painful irony that a vital support system is placed at risk by the very illness that needs the support of relationships. Available online: http://www.cewh-cesf.ca/en/publications/RB/v5n1/page7.shtml
• Changing Diets, Changing Minds
  The report from Sustain's Food and Mental Health Project (UK) pulls together the evidence linking what we eat to how we feel--from foetal brain development to adolescent behaviour through to Alzheimer's disease. PDF of report available from Sustain website.
  http://www.sustainweb.org/news_detail.asp?iEve=135&iType=1082
• Two New Publications Available From Women and Health Protection
  The Marketing of Depression: The prescribing of SSRI antidepressants to women by Janet Currie and Marching to Different Drummers: Health advocacy groups in Canada and funding from the pharmaceutical industry by Sharon Batt. http://www.cwhn.ca/hot/resources/default.html#whpPubs
• Perinatal Depression: Prevalence, Screening Accuracy, and Screening Outcomes: Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, Brody S, Miller WC. A new evidence report by the U.S. Department of Health and Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ) states that depression is as common in women during pregnancy as it is after giving birth. Health care providers and patients may fail to recognize depression during pregnancy because signs of depression like tiredness, trouble sleeping, emotional changes, and weight gain may also occur with pregnancy.
  Visit: http://www.ahrq.gov/clinic/epcsums/peridepsum.htm
• A Guide to Post-partum Depression - Canadian resource
  A Guide to Post-partum DepressionPost-Partum Depression: A Guide For Frontline Care Providers is a comprehensive new guide published by the Centre for Addiction and Mental Health. Developed specifically to meet the information needs of the front-line health and social service providers who work with women during and after pregnancy, the guide reviews the latest research in the area of postpartum depression and offers clear and practical advice from the field. Co-authors of the guide include Dr. Cindy-Lee Dennis, Dr. Emma Robertson Blackmore, Dr. Donna Stewart and CRWH member researcher Dr. Lori Ross. One unique aspect of the guide is its consideration of diversity issues and the needs of specific populations of women. The guide can be ordered by calling 1-800-661-1111 or by email at marketing@camh.net. For details of this and other CAMH publications, visit http://www.camh.net/publications.
• Association between lifestyle factors and mental health measures among community-dwelling older women: Kellie Cassidy; Ria Kotynia-English; John Acres; Leon Flicker; Nicola T. Lautenschlager; Osvaldo P. Almeida; Australian and New Zealand Journal of Psychiatry, November 2004, vol. 38, no. 11-12, pp. 940-947(8)
  Objective: To investigate the association between potentially modifiable lifestyle factors and cognitive abilities/depressive symptoms in community-dwelling women aged 70 years and over.
  Method: Cross-sectional study of community-dwelling women aged 70 years and over (n = 278; mean age = 74.6 years). Lifestyle variables assessed included smoking, alcohol consumption, physical activity, nutrition and education. The mental health measures of interest were depression, anxiety, quality of life and cognitive function, as assessed by the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), SF-36, and the Cambridge Cognitive Examination for Mental Disorders of the Elderly (CAMCOG), respectively.
  Results: Physically active women were half as likely to be depressed (BDI score ge10) and anxious (BAI score ge 8) when compared to their physically inactive counterparts (OR = 0.5, 95% CI = 0.3-0.8 for both, adjusted for marital status and smoking in the case of depression). Having ever smoked more than 20 cigarettes per day was associated with increased risk of depression (OR = 2.8, 95% CI = 1.4-5.5, adjusted for marital status and physical activity). Moderate alcohol use was associated with increased likelihood of having a CAMCOG score within the highest 50 percentile (OR = 2.0, 95% CI = 1.1-3.5, adjusted for age and education), as was more than minimum statutory education (OR = 2.0, 95% CI = 1.1-3.5, adjusted for age and alcohol consumption). There was no obvious association between vitamin B12/folate deficiency or obesity with any of the measures of interest.
  Conclusions: The results of this study are consistent with the hypothesis that depression is directly associated with heavy smoking and inversely associated with physical activity. They also support the idea that non-harmful alcohol consumption is associated with better cognitive performance. Randomised clinical trials should be now designed to clarify whether management of lifestyle factors reduces the incidence of mood disorders and cognitive impairment in later life.
• Violence and Trauma in the Lives of Women with Serious Mental Illness Often Overlooked
  From Marina Morrow with the British Columbia Centre of Excellence for Women’s Health
• Depression Hits 1 in 10 Teen Girls Each Year, Teen Girls Twice as Likely to Suffer Depression as Boys February 4, 2004 (WebMD Medical News)
  About one in 10 teen girls suffer a major depression each year, a Canadian study shows.
  Visit http://my.webmd.com/content/article/81/96998.htm to read more.
• Fergusson DM, Woodward LJ. Mental health, educational and social role outcomes of depressed adolescents. Archives of General Psychiatry, 2002; 59: 225-231.
• Fergusson DM, Horwood LJ, Beautrais AL. Is sexual orientation related to mental health problems and suicidality in young people? Archives of General Psychiatry, 1999; 56 (October): 876-880.
• Assessing the impact of SSRI antidepressants on popular notions of women's depressive illness J.M. Metzl, J. Angel Social Science and Medicine, Feb-2004 pp 577-584 re via http://www.cwhn.ca/hot/research/archive.html
  Abstract only: This study examines how Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants have played a contributing role in expanding categories of women's "mental illness" in relation to categories of "normal" behavior. We hypothesized that between 1985 and 2000, as Premenopausal Dysphoric Disorder (PMDD), postpartum depression, and perimenopausal depression were increasingly treated with SSRIs, popular categories of depressive illness expanded to encompass what were previously considered normative women's life events such as motherhood, menstruation, or child birth. We quantified and qualified this expansion through an in-depth analysis of popular representations of depressive illness during the time period when SSRIs were introduced. Using established coding methods, we analyzed popular articles about depression from a mix of American magazines and newspapers spanning the years 1985-2000. Through this approach, we uncovered a widening set of gender-specific criteria outside of the Diagnostic and Statistical Manual criteria for dysthymic or depressive disorders that have, over time, been conceived as indicative of treatment with SSRIs. Our results suggest that SSRI discourse may have helped shift popular categories of "normal/acceptable" and "pathological/treatable" womanhood, in much the same way that the popularity of Ritalin has shifted these categories for childhood.
• Mainstreaming Women's Mental Health: Building a Canadian strategy (PDF: 74k/14p) Marina Morrow 2003
  Briefly reviews the evidence with respect to sex and gender differences in mental health as they pertain to women. Urges governments to use the evidence base and strategies necessary to improve the mental health system's responsiveness to women and their unique mental health needs. Provides recommendations for a national women's mental health strategy. Includes bibliographical references.
• There's a very good discussion of the terms race, ethnicity, and culture in "Mental Health: Culture, Race, and Ethnicity: A Supplement to 'Mental Health: A Report of the Surgeon General'" [available on-line at http://mentalhealth.samhsa.gov/cre/toc.asp]
• Women and Post Traumatic Stress Disorder: Moving Research to Policy http://www.pwhce.ca/ptsdResearchPolicy.htm
• I Couldn't Say Anything So My Body Tried To Speak For Me: The Cost of Providing Health Care Services to Women Survivors of Childhood Sexual Abuse http://www.pwhce.ca/iCouldntSay.htm
• The importance of low control at work and home on depression and anxiety: Do these effects vary by gender and social class?, Joan M Griffin, Rebecca Fuhrer, Stephen A Stansfeld, Michael Marmot (2002)
  This paper uses a gender model of stress and examines social roles at home and at work to investigate patterns of gender difference in psychological morbidity across different social positions. It aimed to explore factors that relate to higher rates of depression and anxiety among women, and the higher mortality rate at the lower end of the social hierarchy. Link: to summary of study here. email: joan@public-health.ucl.ac.uk
• Socio-economic gradients in psychological distress: A focus on women, social roles and work-home characteristics, Sharon Matthews, Chris Power (2002)
  This study found that the combined effect of work and home factors did not account for a class gradient in distress. The results did not support the hypothesis that multiple roles create strain . Some roles increase risk of distress while others appeared to decrease risk. A summary of this study is in the References and Resources section of the website. Link to summary of study here. email: c.power@ich.ucl.ac.uk
• Chronic Stress and Social Patterning in Canada, Peggy McDonough, Vivienne Walters, Lisa Strohschein, Department of Sociology, York University, Social Science & Medicine 54 (2002) 767-782
• This study looked at the links between women's self-rated ill health, distress and reports of long standing health conditions by education, housing tenure, income level, marital, parental and employment status. It then related these to a series of chronic stressors. Email: peggymcd@yorku.ca, Link to the Chronic Stress Summary Paper here
• Influence of work, household structure and social, material resources on health in Canada. Data from the 1994 Canadian National Population Survey
  Data from the 1994 Canadian National Population Suvey do not confirm the assumption that women experience more ill health than men with only minor differences by gender in distress, migraines, arthritis/rheumatism which are problems more commonly associated with women. Link to summary of this study here.
• Gender, patterns of social relations and health: Support from 'close persons' R Fuhrer, SA Stansfeld, (2002)
  This study looked at the health effects of social support which was defined as the actual or perceived type of support received, provided or exchanged in social relations and networks. There appears to be a consistent association between inadequate levels of social relations and poor physical and mental health. Link to summary of this study here. email: Rebecca.fuhrer@mcgill.ca

NZ Links and other resources

• Consumer involvement in mental health research
  This Health Research Council funded training fellowship explores mental health orientated social science research as it is relates to mental health consumer. It also focuses on ethical issues, consumers’ experiences as research participants and researchers, and researchers' experiences of research with consumers. The research commenced in mid-1999 and is due for completion in 2003. Researcher: Debbie Peterson
• An extension to the evaluation of the Hawkes Bay shared care pilot
  An earlier study evaluated arrangements whereby the care of people with ongoing needs for mental health services is shared between general practitioners and hospital-based community mental health services. the evaluation found that it took almost two years for shared care to become established. During this time there were several achievements such as the development of a consumer focussed care plan. There was not statistically significant improvement in health status, nor were there any changes in secondary service utilisation. Most consumers, GPs and the mental health considered shared care provides an improved service. This extension project continued the evaluation of the Hawkes Bay shared care pilot project service. It provided for a two-year follow-up of those who joined the pilot in the first year. This provided an opportunity to evaluate the pilot in its established stage. Researchers: Katherine Nelson, Jackie Cumming, Debbie Peterson, Evan Roberts, Peter Ellis (Wellington School of Medicine and Health Sciences) (Vic Uni)
• Notions of danger and risk in mental health
  A barrier to dealing with discrimination against people with mental illness is the contradictions and paradoxes surrounding notions of 'danger' in the mental health sector. The belief that people with mental illness are by definition dangerous, and that mental health services are primarily about providing safety to the community, is common in discourse in many parts of our society. This study focused on the mental health literature looking at 'danger', 'risk' and 'violence' in mental health, and deconstructed some of the tensions underlying these concepts. Interaction between the media and the mental health sector was also explored. Researchers: Debbie Peterson, Tessa Thompson (Mental Health Commission) (Vic Uni)
• Consumer involvement in mental health research
  This Health Research Council funded training fellowship explores mental health orientated social science research as it is relates to mental health consumer. It also focuses on ethical issues, consumers’ experiences as research participants and researchers, and researchers' experiences of research with consumers. The research commenced in mid-1999 and is due for completion in 2003. Researcher: Debbie Peterson (Vic Uni)
• NZHTA Report   - Effectiveness of early interventions for preventing mental illness in young people: A critical appraisal of the literature (August 1999 Volume 2 Number 3). [html] [word7 (216 KB)] [PDF> 605 KB)
• Academics in the department have been part of the MaGPie research group since 1998. The MaGPie study has regional, national and international significance. It describes the prevalence, form, course and outcome of common mental disorders, including alcohol disorders, in New Zealand general practices and determines the factors influencing recognition and management of these disorders by general practitioners. MaGPIe Study - pilot paper (PDF 255 KB)
  • The nature and prevalence of psychological problems in New Zealand primary healthcare: A report on Mental Health and General Practice Investigation (MaGPIe). NZMJ 2003;116(1171) Contact John Bushnell, Tony Dowell, Deborah McLeod, Marjan Kljakovic or Lynn McBain for more information. Additional funding from a University of Otago Research Grant has been used to support an in depth-exploration of factors affecting consultation with a general practitioner for mental illness. General practitioners and patients who have participated in the MaGPIe study will be interviewed. The information will be used to: help understand the present pattern of detection and "missed diagnosis" of psychological disorder in New Zealand general practice; complement and consolidate the findings of the MaGPIe study; and improve ways for patients to discuss psychological problems with their doctor. Contact Kevin Dew, Deborah McLeod, Tony Dowell or Sonya White
  • Informal Carers of People with Schizophrenia (PhD project)
  • Supervision in Psychiatry (PhD project)
  • Schizophrenia in Primary Care
  • MaGPIe Study: Mental Health and General Practice Investigation
  • Treatment Outcome Measures for New Zealad General Adult Mental Health Services
  • Psychological Adjustment to Cancer: The comparative effectiveness of Interpersonal Psychotherapy and Cognitive-Behavioural Therapy (PhD project)
  • Treatment of Cognitive Impairment in Early Phase Schizophrenia (PhD project)
  • Heavy cannabis use linked to mental health problems is available here as a pdf. file
• Christchurch Health & Development Study Overview
  The Christchurch Health and Development Study is a longitudinal study of a birth cohort of 1265 children born in Christchurch in mid 1977. These children have been studied at birth, four months, 1 year, annual intervals to age 16 and again at 18 and 21. Recent research has focussed on issues relating to the mental health and personal adjustment of cohort members as young adults. The study has published over 200 articles in peer reviewed journals. Further information Professor David M Fergusson, Executive Director, Christchurch Health and Development Study. Department of Psychological Medicine, Christchurch School of Medicine, PO Box 4345, Christchurch, Tel 64 3 372 0406, Fax 64 3 372 0405, Email david.fergusson@chmeds.ac.nz
• http://www.otago.ac.nz/CIC/downloads/publication3.pdf articles from children’s issues center
• Guidelines for the Treatment and Management of Depression by Primary Healthcare Professionals is available from the NZ Guidelines Group. Go to website: http://www.nzgg.org.nz/index.cfm, enter title in search and guideline will pop up.
• http://www.mhc.govt.nz/pages/publications.htm for articles on mental health 1998-200

From Women's Health Action publications

• Tangled web: skinny sisters in cyberspace - WHW Dec 2002
• Eating Disorders - a report from a WHA seminar held in 1999
• Dementia - a women's health issue - WHU July 1997
• Services for people with dementia and their carers in the Auckland and Northern regions - WHU July 1997