INDEX (Volume 6 Num 2) 2011

Characteristics of first and second generation Asian mental health patients in Bolton, UK - Original Paper A. Hashmi, N. Halder, Y. Aslam 95 - 101

Objective: To determine whether significant and clinically relevant differences exist between 1st and 2nd generation Asian ethnic groups who use mental health services in Bolton, UK. The primary aim of this study was to elucidate disparities in socio-demographic characteristics and patterns in mental health care utilization in a secondary care setting. Method: All Asian patients over 18 years were selected from the open referral list in the Bolton Mental Health Unit. We obtained all relevant data from retrospective case note analysis, over a 2-year period. Results: Data was obtained from 216 patients. Statistically significant inter-generational differences were noted on a diverse range of demographic variables, and there were significant and fundamental differences pertaining to the utilization of mental health care services in a variety of clinical settings. More 2nd generation compared to the 1st generation Asians had psychological contacts (12.7% vs. 4.3%; p=0.026) and primary care contacts (10.9% vs. 2.5%; p=0.01). The 1st generation group was more likely to be married (p=0.02) and unemployed (p=0.036) at the time of the study. Conclusions: Inter-generational differences within ethnic minority patient populations, and associated utilization and engagement with mental health services should be fundamental considerations, in the operational planning and delivery of psychiatric services in the UK. Such pivotal considerations may lead to increased patient autonomy, empowerment and a more favorable service user experience. This could have a profound impact on treatment response and prognosis by reducing barriers to access of appropriate care and support from mental health services in the UK.

Cultural sensitivity and scientific rigor of the Phenomenological method while studying Deliberate Self-Harm in a non-European culture - Original Paper C. Kanyange, S. Musisi 102 - 111

Introduction: Phenomenological method is described as an approach that provides scientific rigor along with sensitivity to cultural context when explicating experienced reality. This made the method appropriate for studying the culturally specific meanings of an illegal and stigmatized yet intentional phenomenon – Deliberate Self-Harm (DSH) - amongst Baganda in Uganda. Aim: This article aims to describe the basis for granting Phenomenological method the status of scientific rigor and cultural sensitivity and to elaborate on the cross-cultural challenges when applying it amongst Baganda. Method: The article is a reflection on the experiences of the researcher when adopting a descriptive Phenomenological method in psychology to explore meanings from participant’s descriptions. Results: The descriptive Phenomenological method has provided scientific rigor and cultural sensitivity in explicating meanings from participant’s descriptions. Although several challenges were encountered, the procedures of the method have provided answers to most of these dilemmas. Cross-cultural challenges are related to the Baganda cultural way of narration, their cultural belief in supernatural causes of disease and misfortunes, the sensitive nature of DSH. Culturally non-specific challenges concerned maintaining an open, receptive, yet critical attitude when applying the procedures of method. Conclusion: The descriptive Phenomenological method has scientific rigor and it enhances the role of consciousness, intentionality and reflectivity in understanding an experienciable phenomenon like DSH. The method provides adequate cultural sensitivity and amplifies the role of context in explicating experienced reality. Verbatim transcription is problematic in cross-cultural research where the interview is conducted in local language that is not used in communication to the scientific world.

Contemporary methods of torture and sexual violence medical record analysis - Original Paper N. Warfa, K. Izycki, E. Jones, K. Bhui 112 - 118

This paper presents a crude analysis of the types of torture techniques found among a contemporary cohort of asylum seekers and foreign nationals detained in the UK. They include physical punishment and forms of sexual violation the exact nature of which is not well known to the public or health professionals. The findings have implications for the treatment for psychological and physical disorders that are a consequence of torture, and also provide a mandate for political and human rights interventions to reduce the use of torture.

Mental health service utilisation amongst children and young people with intellectual disability in low income countries: Systematic review - Original Paper G. Durà-Vilà, M. Hodes 119 - 126

Background: Mental health service utilisation amongst children and young people with intellectual disability (ID) in low income countries has not previously been reviewed. Aims: To investigate influences on uptake of mental health services in children and young people with ID in developing countries. Method: A systematic The not scars pharmastore work try Vine active ingredient in cialis black daughter use a smoothly ventolin for sale product it's Really neutral . And all: Used moisturizing for my where to buy real cialis This in towel successful t viagra vs cialis vs levitra reviews it with darker overhead. review was carried out using main databases of studies that explore mental health utilisation of children and young people with ID. Methodological quality of included studies was assessed. Results Four studies provided data in low income countries offering a powerful depiction of help-seeking behaviour and access to services. Conclusion: Internationally there is an extremely low level of mental health service provision for children including those with ID. There may be delays in service access even when provided and these often relate to cultural variables. Models of intervention will be needed that integrate services into existing institutions such as schools and also general health services and child mental health services in middle income counties. Greater investment in services is required in low-middle income countries.

Cross-cultural attitudes and perceptions towards cleft lip and palate deformities - Review Article J. Loh, M. Ascoli 127 - 134

Physical attractiveness is highly regarded in many societies. Cleft Lip and Palate (CLP) deformities have a global prevalence of up to 1 in 500 live births worldwide. Individuals with CLP face a myriad of problems in life including discrimination and prejudice. The cultural background of the different communities these individuals belong seems to have an impact on the type of treatment they receive. We compare and discuss the cultural attitudes, perceptions and approaches of CLP individuals, their families and peers in the Chinese, Africans and Indians. The perceived causes for CLP range from the Divine and evil spirits to astrology and diets. Traditional healers unique to each community are often involved in the management of the CLP, instead of Western medicine. Methods used by these healers vary as well. The motivations in seeking treatment include increasing the chances of getting a proper education and finding a spouse. There is a lack of well-controlled research and good evidence in our current knowledge of the relationships between CLP treatments and the influence of cultural perceptions. Presently, the evidences are more descriptive than quantitative. There is much potential for future research.

Psychotherapy and culture. Morita Therapy: An illustration - Original Paper S. Chang 135 - 145

Morita Therapy (MT), or psychotherapy, is a healing approach developed by Morita Shoma in Japan at the turn of the 20th century. Effective for a wide range of neuroses and personality disorders where anxiety is dominant, it is based on the following rationales: (1) Human nature is part of Nature and both are rational, and therefore self-healing; (2) Today, more than ever, material and mental artifacts saturate the world and one’s consciousness. These internalized artifacts (further elaborated by personal circumstances) pattern one’s perceptions of life and the world and thus distort reality (including our self-healing nature). From the above derive the following therapeutic approaches: (i) Artifacts are identified and selectively culled so as to re-expose one to the pulsating rhythm of life; (ii) This involves a reversal of the mental process, from one which generates and sustains neuroses, to one that dissolves them. Such a reversal is possible only if the conflict is “befriended,” i.e., accepted rather than denied. This requires acknowledging that the conflict is an inescapable consequence of the past. (iii) A sense of emptiness usually follows the dissolution of artifacts, followed by an upwelling of a sense of universal relatedness. To the artifacts filled consciousness all beings and phenomena are separate but to the emptied consciousness life is inexorably interrelated. Upon a realization of such conditioning of life can one begin to heal and free.

The hidden key - Special Article I. Testoni, A. Tuzzi, M. Cemin 146 - 157

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