bluuebunny/crossref_metadata_2025 huggingface dataset:
Between science and fiction: neuroleptic drug advertisements, stigma and schizophrenia
Authors: Thomas Philip , Phipps‐Jones Claire , Flanagan Stella
Published: August 2011

It has been suggested that the medical profession contributes to the stigmatisation of those who experience mental health problems, through ‘iatrogenic’ stigma. This study explores how pharmaceutical companies and their advertising agencies think psychiatrists view people who suffer from mental health problems, as expressed through the design and content of advertisements for neuroleptic medication intended for the psychiatric profession. All pharmaceutical company advertisements appearing in the British Journal of Psychiatry in 1999 were analysed: quantitatively as to drug type, advertisement format and demographic characteristics of subjects portrayed in advertisements, and qualitatively as to content, accompanying text and the theme of the advertisement. Although adverts for neuroleptic drugs constitute a minority of all adverts appearing in the journal in 1999, they are larger than antidepressant adverts, use more pages, and are more likely to portray people suffering from schizophrenia as inactive, socially isolated, and leading empty, meaningless lives. Some of the images resonate with the popular mythology of schizophrenia as ‘other’ and ‘split personality’. From this we conclude that pharmaceutical company advertisements for neuroleptic drugs do indeed present stigmatising images of people suffering from schizophrenia. Editors of medical journals should scrutinise advertisements for potentially stigmatising content. It is time for a debate about the position of glossy advertisements in the pages of medical journals.Declaration of interest: Philip Thomas is co‐chair of the Critical Psychiatry Network and has written extensive critiques of the biomedical model.
Betting on a different horse: a qualitative analysis of mental health in health promotion policies
Authors: Solin Pia , Lehto Juhani
Published: August 2011

The aim of this study is to analyse the position and role of mental health in health promotion policy. Policy documents from Finland, Sweden, Denmark, the Netherlands, England and Portugal indicate that, although mental health is considered a serious issue, it is problematic in policy terms. A range of arguments are put forward, making the case for the importance of mental health within the health promotion agenda, including the classification of mental illness as a public health problem, socio‐economic and individual costs of mental health problems and the view that mental well‐being is a crucial element of overall health. However problems of definition, measurement and a traditional focus on treatment and care continue to make mental health promotion problematic for policy makers.
A well‐being manifesto for a flourishing society
Authors: Marks Nic , Shah Hetan
Published: August 2011

Although economic output has nearly doubled in the last 30 years, life satisfaction levels in the UK and other developed countries have remained resolutely flat, with evidence that depression and anxiety are increasing, notably among young people. While governments in the developed world focus on economic development as the key route to well‐being, a growing body of research suggests that, once basic needs have been met, this approach is flawed. This well‐being manifesto for a flourishing society, produced by the think tank new economics foundation (nef), proposes eight alternative priorities for government action to promote well‐being. While the focus is on UK policy and the examples are largely drawn from the UK, the key themes of the manifesto will apply to many developed country contexts.
Time to extend ‘a visible helping hand’
Authors: McDaid David
Published: August 2011

Adam Smith was wrong: the new economics foundation is right: economic prosperity does not of itself bring enhanced individual and social well‐being. Indeed, it carries a significant downside. But implementing the nef manifesto would be no easy matter. In this short commentary, David McDaid outlines some of the hurdles and pitfalls that would have to be negotiated.
What do surveys of public attitudes to mental health problems really mean (and do we mean what we say)?
Authors: Smith Michael
Published: August 2011

Campaigns to improve public attitudes to people with mental health problems have yet to show significant impact, according to national surveys. But how reliable are these surveys? Michael Smith reviews recent research in the UK and in Scotland and argues that their findings are complicated by methodological bias and doubts about the public's ability to acknowledge prejudice honestly.
Mental health promotion theory: review and application
Authors: Secker Jenny
Published: August 2011

Taking the principles of health promotion as a starting point, this paper begins with a review of the ways in which mental health has been defined in the mental health promotion literature. In order to move beyond definitions that revolve only around the absence of illness or reductionist lists of individual skills and attributes, it then introduces a model derived from health promotion theory. Finally, the paper concludes with an example of the model's application to promoting the well‐being of mental health service users through the provision of evidence‐based employment support.
Public mental health in England since 1997: past, present and future
Authors: Bywaters Jenny
Published: August 2011

Although public mental health has rarely been an explicit element of national health policy in England, a range of programmes have contributed to moving it up the agenda. There is a growing movement for recognition of the potential benefits of a population‐wide approach to promoting mental health and well‐being. This paper describes work streams developed since 1997, under the current government, and outlines opportunities for the future.
The mental health needs of adult asylum seekers in Newcastle upon Tyne
Authors: Crowley Philip
Published: August 2011

Dealing with the needs of asylum seekers and refugees presents a challenge to local health services, and mental health has been identified as the main health issue for this group. This paper reports the findings of a quantitative and qualitative study of the mental health care needs of asylum seekers and refugees in Newcastle upon Tyne. Primary and mental health services were found not to be meeting the needs of this group. In some practices, attitudes to asylum seekers among both GPs and other patients were reported as stigmatising. But there is evidence that many of the mental health problems of asylum seekers are related to post‐migration stress arising from practical and economic difficulties and experience of racism and other discrimination, highlighting the need to build support and social connections and include the needs of asylum seekers in local mental health promotion strategies.
Creating a mentally healthy society: lessons from a cross‐border rural mental health project in Ireland
Authors: Barry Margaret
Published: August 2011

Public mental health can be described as the science, politics and art of creating a mentally healthy society. This paper discusses these three concepts with reference to the literature as the necessary components of any strategy or programme to create, promote and maintain mental well‐being at a community and population level. It goes on to describe how they were applied in a cross‐border rural mental health project in Ireland.
Fighting the good mental fight
Authors: Wheeler Sarah
Published: August 2011

Mental Fight is an epic poem first published five years ago to celebrate the dawn of the third millennium. Its author, Ben Okri, describes the poem as an anti‐spell for the 21st century, and prefaces it with William Blake's famous lines (Blake, 1976), subsequently immortalised in the hymn Jerusalem: ‘I will not cease from Mental Fight, nor shall the Sword sleep in my hand, ‘til we have built Jerusalem, in England's green and pleasant land.’ The poem's inspirational message has stimulated the emergence of Mental Fight Club, a user‐led group in London that describes itself as ‘a new creative force for good mental health in Southwark and beyond’.
The rise and rise of attention deficit hyperactivity disorder
Authors: Timimi Sami , Radcliffe Nick
Published: August 2011

The rise in the diagnosis of attention deficit hyperactivity disorder (ADHD) and the use of stimulant medication such as Ritalin to treat it raises important questions about how childhood is conceptualised in contemporary western society today. By focusing on within‐child explanations for behaviour, the diagnosis of ADHD divorces a child from their context; real life experiences, including traumatic ones, are marginalised or excluded from clinical consideration. This paper1 explores how ADHD manages to occupy and hold on to such a dominant position despite the lack of evidence supporting its supposed medical origins, and explores what the ADHD diagnosis reveals about cultural expectations of childhood and power hierarchies in the UK and North America.
Well‐being in Wandsworth: a public mental health audit
Authors: Gilleard Chris , Pond Claire , Scamell Amy , Lobo Ros , Simporis Katherine , Rawaf
Published: August 2011

This paper describes a survey of mental health and well‐being in the adult population served by Wandsworth Primary Care Trust. The survey was designed as a pilot to obtain benchmark data on public mental health. The findings support the argument that absence of mental ill health does not equate with mental health. More than 12% of the sample were found to have symptoms of mental illness yet reported good mental health, while just over 10% had no symptoms but reported poor mental health. Looking at predictors, the most vulnerable to mental ill health were younger, divorced or separated adults who were unemployed and had a long‐term illness or disability. Older couples in good health were among those least likely to have mental health problems. The authors conclude that more sensitive and reliable public mental health indicators are needed to demonstrate clear evidence of improved mental health and to inform future work to improve the mental health and well‐being of the local population.
Risk and resources for depression in later life
Authors: Godfrey Mary
Published: August 2011

This paper explores the evidence on risk and vulnerability to depression of older people, looking at the complex interplay between physical ill health, disability, loss of intimates and social relationships, loneliness and depression, and the resources and protective factors at individual, social and community level that either buffer risk or promote psychological well‐being. It concludes, with Blazer (2000), that effective strategies for the prevention, treatment and management of depression must ‘proceed across multiple domains simultaneously’, and address social, environmental and economic as well as medico‐biological factors if interventions are to prove effective in this greatly neglected field. Action at government level to address social inequalities throughout the life course would also have a significant protective impact on mental well‐being in old age.
The depsychiatrisation of mental illness
Authors: Dumit Joseph
Published: August 2011

Using as an example the mental health mass screening and treatment programmes instituted in some US states, Joseph Dumit describes how the western world has arrived at a state of ‘dependent normality’ in which being diagnosed and dependent on medication is rendered ordinary, largely through the marketing activities of the pharmaceutical industry, which seeks constantly to expand its market by defining at‐risk populations as broadly as possible, and through persuading the public that all risks must be combated with drugs.
In search of certainty: risk management in a biological age
Authors: Rose Nikolas
Published: August 2011

The combination of heightened emphasis on risk and its management in mental health, the precautionary principle, the idea of genetic susceptibility, advances in screening technology, and the promise of preventive pharmaceutical intervention is highly potent, especially in a world in which preventive prescription of psychiatric medication has become routine. Psychiatric professionals are given the obligation of governing, and being governed, in the name of risk, and in a political and public sphere suffused by the dread of insecurity. But there are risks in seeking to govern risk in a biological age. In this paper Nikolas Rose argues that the public, politicians and professionals alike might do better to refuse the demands of risk, and learn to live with uncertainty.
Challenging the globalisation of biomedical psychiatry
Authors: Thomas Philip , Bracken Patrick , Cutler Paul , Hayward Robert , May Rufus , Yasmeen Salma
Published: August 2011

For over 100 years biomedical psychiatry has dominated the way people throughout the western world understand their sadness and distress, despite the lack of empirical evidence that distress has a biological basis. Now, the interests of the global pharmaceutical industry and trans‐national professional elites such as the World Health Organisation and the World Psychiatric Association are extending these biomedical accounts across the globe. This paper briefly describes biomedical psychiatry and its origins before considering how this project is closely aligned to the interests of the pharmaceutical industry. It ends with a call for a new agenda in mental health, driven by the concerns and interests of ordinary people in local communities, and an outline of recent developments in Britain and elsewhere that illustrate this challenge to the biomedical hegemony.
Are better streets and parks a route to better mental health?
Authors: Thrift Julia
Published: August 2011

Public parks are good for our mental and physical health. They provide a sense of community for local people and passers‐through. They provide social role valorisation for the dispossessed. They contribute to improving urban environments and combating the stress of city life. And they are highly valued by the public, argues Julia Thrift. But recognition of their many benefits may come too late to inform the government's sustainable communities plan and its plans to construct thousands of new homes throughout the south east.
Mental health and housing: making the links in policy, research and practice
Authors: Johnson Robin
Published: August 2011

This article documents policy developments at local and national level in England that reflect a growing recognition of the role of housing and the built environment in promoting and maintaining mental health. It first considers the evidence for the housing disadvantage experienced by people with moderate and severe mental health problems and the negative impact of poor housing and neighbourhood circumstances on mental health. It goes on to explore the expansion in housing‐related support and housing‐based solutions in the 1990s, and the revived ambition to integrate housing with community care and community cohesion initiatives. It concludes by describing the work of the NIMHE housing reference group in co‐ordinating policy guidance, promoting positive practice in communication and co‐operation between housing and mental health services, and conducting research to fill gaps in current understanding.
Imagine East Greenwich: evaluating the impact of the arts on health and well‐being
Authors: Callard Felicity , Friedli Lynne
Published: August 2011

This paper describes the qualitative evaluation of Imagine East Greenwich (IEG), a series of arts/health projects developed as part of a regeneration programme on two housing estates in a London borough. The evaluation seeks to identify (through consultation with various stakeholders) indicators for measuring the impact of arts/health on communities, and to itemise some of the key factors that appeared to influence the success of IEG's arts/health projects. The paper reflects on some of the challenges that attend arts/health evaluations and, in so doing, contributes to ongoing debates about the role and value of the arts, notably in deprived and fragmented communities.
Creating healing environments: humanistic architecture and therapeutic design
Authors: Mazuch Richard , Stephen Rona
Published: August 2011

Humanistic architecture aims to place human welfare at the heart of the art and science of building design and environmental management. In this article we aim to show how humanistic architecture can contribute to public mental health and mental health promotion, using as an example our own architectural and design practice, Nightingale Associates. Nightingale Associates aims to combine psychotherapeutic methods with traditional architectural design to create healing healthcare environments that, evidence shows, can enhance and support the care and treatment process.
Mental health promotion and mental disorder prevention in Europe
Authors: Jané‐Llopis Eva
Published: August 2011

These are exciting times for prevention and promotion in mental health at the European level, writes Eva Jané‐Llopis. We have a European Commission mental health green paper; we also have WHO commitment to support member states to develop mental health policies and put them into practice. But support and engagement from practitioners and policy makers will be crucial to take forward mental health promotion on the ground, and a greater focus is needed on evidence based interventions and the evaluation of programmes and practice if the momentum is to be sustained.
Improving the mental health of the population: a strategy for Europe
Authors: Stansfield Jude
Published: August 2011

The European Commission green paper Improving the Mental Health of the Population, published in October 2005, is essentially a public mental health strategy for the European Union. In this short article Jude Stansfield outlines the main elements of the strategy and discusses its relevance and implications both for the European Union as a whole and for policy and practice in England and the other individual member states. While the green paper is in many ways welcome in that it will raise the profile of public mental health at national and international government level, it has a number of flaws ‐ not least its primary focus on mental illness and mental illness services.
Sharing spaces: school playground design and children's well‐being
Authors: Edwards Kate
Published: August 2011

The shared space of school grounds can provide a rich educational resource in addition to a safe environment for play, enjoyment and relaxation. The project described in this paper developed guidance for schools on grounds development and also provided direct support to three schools to enable them to improve their grounds and to work towards Eco Schools and Health Promoting Schools accreditation. The evaluation demonstrated a relationship between improved grounds and a reduction in negative playground incidents, improved co‐operation at break times, children having more pride in their school, children feeling happier at break time, increased sun awareness and the use of school grounds as a teaching resource. The project also achieved some influence at a more strategic level.
Mental health promotion: a perspective from Slovenia
Authors: Kamin Tanja
Published: August 2011

Slovenia regained its independence in 1991, and in 2004 became a member of the European Union. Despite some progress in public health policy and practice, mental health has so far barely featured. Mental health literacy is poor, mental health services remain firmly rooted in the medical, institutional model, and public attitudes to mental ill health are predominantly negative. But Tanja Kamin here identifies some key opportunities that may lead to a greater emphasis on prevention of mental ill health and promotion of mental well‐being across the whole population.
Mental health promotion in the workplace: a European perspective
Authors: Kuhn Karl
Published: August 2011

The links between work and mental health are gaining increasing recognition both within individual member states and at European Community level as a whole. Yet it is also well recognised that employment has significant benefits for mental health and well‐being. This paper reviews current evidence on the negative mental health impacts of employment, the key factors in work‐related stress and European policies for promoting mental health in the workplace. It ends with some examples of good practice in workplace mental health promotion drawn from a range of European countries.
Help‐seeking attitudes and behaviours among young people in Northern Ireland
Authors: Teahan Breda , McNamee Deirdre , Donnelly Lyn
Published: August 2011

Engaging young people in the planning of mental health promotion programmes and initiatives to meet their expressed needs continues to be a challenge for commissioners and providers. This paper reports a study to explore levels of self‐esteem and the main concerns of young people living with the legacy of conflict in the southern area of Northern Ireland, findings from which were used to inform good practice guidelines for service providers. The study highlighted that young people with low self‐esteem worry more, are more likely to engage in risk‐taking behaviour, feel more disillusioned and are less likely to access formal sources of help. Lack of trust, credibility and fears about confidentiality emerged as key barriers to help‐seeking.
Tackling race inequalities: community development, mental health and diversity
Authors: Thomas Philip , Seebohm Patience , Henderson Paul , Munn‐Giddings Carol , Yasmeen Salma
Published: August 2011

This paper describes some findings from an evaluation of the effectiveness of a community development project that aimed to overcome inequalities in mental health care experienced by members of the local black and minority ethnic (BME) communities. A participatory action research design was used, involving people from BME communities who had experienced mental health problems and external stakeholders. The study relied largely on qualitative methodology. Findings reported here indicate that participants in the project valued the culturally and spiritually relevant support they received, but felt that more opportunities were needed for training and employment, greater representation on the project's management committee, and greater awareness of the project in the community. External stakeholders felt that the project gained credibility from its community base and valued its ability to work across faith traditions and cultures. It was also seen as successful in acting as a bridge between the communities and statutory services, although there were concerns about the project's relationship with frontline services. The paper proposes two models of community development that primary care trusts may wish to adopt ‐ radical or consensus, or a mixture of both ‐ in order to address inequalities in mental health service provision.
Preventing suicide and self‐harm: how useful are the data currently available to those planning and providing interventions?
Authors: McElroy Helen , Chappel David
Published: August 2011

Suicide and self‐harm are major public health issues. This study aimed to assess how local and national data could be used more effectively in local suicide and self‐harm prevention strategies. Twelve semistructured interviews were carried out with a purposive sample of suicide prevention leads in one strategic health authority area and other key local and regional informants. Although suicide prevention work is supported by data, problems were identified with current processes and data and information availability. Local, regional and national health agencies all have a role in ensuring information is used in the best possible way to reduce self‐harm and suicide.
Psychiatry and the community in Slovenia: an outsider's view
Authors: Lucas Jo
Published: August 2011

This paper looks at current developments in the provision of community mental health services in the context of the history of the psychiatric system in Slovenia, based on ten years of experience working with non‐governmental organisations and the School of Social Work in Slovenia. It looks at what can be learned from both the strengths and weaknesses of what is happening in Slovenia and the implications for broader debates about the future of public mental health and the treatment of people with mental health problems.
Mental health in the Czech Republic: current problems, trends and future developments
Authors: David Ivan , Kebza Vladimír , Paclt Ivo , Raboch Jiří , Volf Jaroslav
Published: August 2011

The Czech Republic suffers many of the problems reported in other Central European and Eastern European countries with respect to the care, treatment and prevention of mental ill health. Most psychiatric care is provided in long‐stay hospitals and the transition to a community‐based service has yet to be made. Mental health services suffer from chronic under‐investment and there is a lack of mental health legislation protecting patients' rights and autonomy. The pressures of transition to a capitalist economy have brought their own problems, in the form of increased rates of addicitions, suicide, and other mental health problems related to social, policitical and economic instability, and there is a pressing need to address the position of mental health within public health services.
At work but ill: psychosocial work environment and well‐being determinants of presenteeism propensity
Authors: Biron Caroline , Brun Jean‐Pierre , Ivers Hans , Cooper Cary
Published: August 2011

Many studies have shown that an unfavourable psychosocial environment increases the risk of mental and physical illness, as well as absenteeism, or sickness absence. However, more costly than absenteeism is presenteeism, where a person is present at work even though disabled by a mental or physical illness. We sought to identify factors explaining why workers would come to work even when their health is impaired. In a cross‐sectional design data were collected from 3825 employees of a Canadian organisation. The results show a high occurrence of presenteeism: workers went to work in spite of illness 50% of the time. Presenteeism propensity (the percentage of days worked while ill over total number of sick days) was higher for workers who were ill more often. Heavier workloads, higher skill discretion, harmonious relationships with colleagues, role conflict and precarious job status increased presenteeism, but decision authority did not. Workers reporting high psychological distress and more severe psychosomatic complaints were also more likely to report higher rates of presenteeism. These results suggest that stress research should not only include absenteeism as an outcome indicator, but also consider presenteeism.
Client perceptions of the MUSCSEL project: a community‐based physical activity programme for patients with mental health problems
Authors: Butterly Ron , Adams Dan , Brown Andy , Golby Jim
Published: August 2011

The paper provides an evaluation of client perceptions of a community‐based physical activity project (MUSCSEL) in Leeds. Over a period of five months, all newcomers to the project were invited to take part in the evaluation by completing a questionnaire. All were living independently in the community. All 34 respondents were unemployed, and perceived themselves as less active and less fit than the norm for their age and gender. Incidence of smoking was higher than the national average, and the majority of respondents would have liked to be more active than they were, but perceived many barriers. Subsequent interviews (n=17) found that the project increased self‐confidence and self‐esteem, perceived fitness levels and perceived habitual physical activity levels. It also facilitated social contact and enabled the service users to manage their mental health issues better, supporting previous research findings. Further work is needed to follow subjects living independently in the community on a longitudinal basis, to determine the time course of any benefits, particularly over the period of transition from hospital to independent‐living status.
Community hospitals: a solution to the stigma and dislocation of acute inpatient hospital admission
Authors: Gwilym Hefin
Published: August 2011

This paper looks at the evolving nature of mental health services. While there has been a shift from asylums to care in the community in recent decades, what is now needed is another shift of acute inpatient psychiatric care, away from psychiatric units to community hospitals and other community settings. It is argued that this would be a further step forward in the evolution of mental health services as it would benefit the service users, their families, carers and staff working in acute psychiatric inpatient units.
Barriers to access to mental health services for migrant workers, refugees and asylum seekers
Authors: Franks Wendy , Gawn Nicola , Bowden Gillian
Published: August 2011

This paper reports findings from a qualitative study of the mental health needs of refugees, asylum seekers and migrant workers living in an East Anglian seaside town with high rates of socio‐economic deprivation. Nine key informants were recruited from people working with refugees, asylum seekers and migrant workers, and from people who were either members of, or had extensive knowledge of the issues affecting the relevant communities. Barriers were reported both at the stage of seeking services and in accessing services once sought. Barriers to seeking services included different understandings of mental health problems, lack of acknowledgement, discussion and prioritisation of mental health problems, stigma, lack of knowledge of services, fear of authority and lack of trust. Barriers to access included previous negative experiences of accessing NHS services, resource limitations, lack of interpreting and translation services, and practical barriers such as transport and hours of appointments. The findings are discussed in relation to mental health service delivery and mental health promotion.
The complex territory of well‐being: contestable evidence, contentious theories and speculative conclusions
Authors: Carlisle Sandra , Hanlon Phil
Published: August 2011

This paper brings together evidence and theories from a number of disciplines and thinkers that highlight multiple, sometimes incommensurable understandings about well‐being. We identify three broad strands or themes within the literature(s) that frame both the nature of the problem and its potential solutions in different ways. The first strand can be categorised as the ‘hard’ science of wellbeing and its stagnation or decline in modern western society. In a second strand, social and political theory suggests that conceptualisations of well‐being are shaped by aspects of western culture, often in line with the demands of a capitalist economic system. A third theme pursues the critique of consumer culture's influence on well‐being but in the context of broader human problems. This approach draws on ecology, ethics, philosophy and much else to suggest that we urgently need to reconsider what it means to be human, if we are to survive and thrive. Although no uncontroversial solutions are found within any of these themes, all play a necessary part in contributing to knowledge of this complex territory, where assumptions about the nature of the human condition come into question.
A systematic review of the evidence on the effect of the built and physical environment on mental health
Authors: Clark Charlotte , Myron Rowan , Stansfeld Stephen , Candy Bridget
Published: August 2011

This paper assesses the strength of the evidence on the impact of the physical environment on mental health and well‐being. Using a systematic review methodology, quantitative and qualitative evaluative studies of the effect of the physical environment on child and adult mental health published in English between January 1990 and September 2005 were sought from citation databases. The physical environment was defined in terms of built or natural elements of residential or neighbourhood environments; mental health was defined in terms of psychological symptoms and diagnoses. A total of 99 papers were identified. The strength of the evidence varied and was strongest for the effects of urban birth (on risk of schizophrenia), rural residence (on risk of suicide for males), neighbourhood violence, housing and neighbourhood regeneration, and neighbourhood disorder. The strength of the evidence for an effect of poor housing on mental health was weaker. There was a lack of robust research, and of longitudinal research in many areas, and some aspects of the environment have been very little studied to date. The lack of evidence of environmental effects in some domains does not necessarily mean that there are no effects: rather, that they have not yet been studied or studied meaningfully.
The health impact of policy interventions tackling the social determinants of common mental disorder: a systematic review
Authors: Candy Bridget , Cattell Vicky , Clark Charlotte , Stansfeld Stephen
Published: August 2011

Those most socially disadvantaged are at a greater risk of common mental disorder (CMD). The need to evaluate the health impact of social policy interventions that aim to reduce social inequalities between the disadvantaged and the better off is well recognised. This paper reports findings from a review to explore evidence on the health impact of UK policy interventions that aim to tackle the key social determinants of CMD. These were previously identified from the literature as cumulative socioeconomic deprivation, unemployment, psychosocial work characteristics, and poor social relationships. We identified some evidence of a positive impact on CMD of urban regeneration schemes, but evidence was sparse on interventions relating to the other determinants. The ability of research to inform policy designed to improve the lives of the disadvantaged could be assisted by a broader definition of what counts as evidence. This may include wider use of qualitative methodologies and a more deliberate focus on social processes known to be implicated in mental health.
Promoting maternal mental health: women's strategies for presenting a positive identity and the implications for mental health promotion
Authors: Franks Wendy , Henwood Karen , Bowden Gillian
Published: August 2011

There are many barriers to effective mental health promotion with mothers living in socially disadvantaged communities. These include failure to take account of local cultural knowledge, community values and identities; feelings arising from experiences of poor health and disadvantage; mistrust of health professionals, and lack of engagement with services. Qualitative methodologies were used to explore maternal mental health and service delivery to people living in poor social conditions. Individual interviews and group discussions were undertaken with nine mothers living in a disadvantaged community. Further data were obtained from fieldwork contacts with seven health professionals working in the community. The research identified four discursive strategies used by participants when they and others encountered difficulties in relation to stigma, mental health and their daily lives as mothers within the community. These strategies were othering, counteracting, blaming, and resisting. The analysis offers a resource to community initiatives seeking to examine how mothers can deal most effectively with a lack of control and power in their lives.
Containing, thinking and public health
Authors: Cohen Mark
Published: August 2011

This paper argues that the capacity of individuals and of society as a whole to ‘contain’ experience, and to use this as a basis for thought, is central to good health. The paper first defines and describes ‘containing’ and thinking, with reference to a psychoanalytic model, and compares these definitions with similar concepts. The circumstances that promote or impede the development of the capacity for thought are then outlined, and a spectrum of this capacity is described and correlated with a spectrum of vulnerability‐resilience to ill health. A review of the associated literature indicates significant links to health‐related behaviours, health outcomes and inequalities; interventions at a population level could aim to shift people at the vulnerable end of the spectrum towards resilience. However such measures are unlikely to be effective on their own: what is needed is a containing and thinking society, characterised by a wish to know about reality, and to link together information about the state of its citizens and the wider world. The paper concludes with a discussion of the political and policy‐making implications.
The potent arts
Authors: White Mike , Robson Mary
Published: August 2011

It has been argued that arts participation may be ‘more potent than anything medicine has to offer’ (Smith, 2002). Travelling further upstream from the government's initiatives to improve access to talking therapies as a solution to the mounting burden of depression, this paper describes ways in which community arts programmes involving primary schools are seeking to strengthen the mental wellbeing of children. The arts, the authors argue, deal in imagination, and imagination can be stronger than will power. Thus, by harnessing the imagination, arts interventions can influence change in children's health patterns into adulthood, and thereby help establish a healthy culture in a healthier nation.
Empowerment and arts participation for people with mental health needs
Authors: Secker Jenny , Spandler Helen , Hacking Sue , Kent Lyn , Shenton Jo
Published: August 2011

Empowerment has been described as the ‘holy grail’ of health promotion. This article describes an evaluation of arts participation for people with mental health needs that both measured empowerment outcomes and explored the processes by which positive outcomes were achieved, through six qualitative case studies. For the outcomes study, 62 arts and mental health project participants returned a questionnaire, including a measure of empowerment, soon after joining their project and again six months later. The follow‐up questionnaire asked participants to rate the impact of their arts involvement on the issues addressed in the measure. Six diverse arts and mental health projects took part in the case studies. Interviews with project participants explored what they saw as the benefits of arts involvement and how these came about. Results from the outcomes study showed significant improvements in empowerment and were suggestive of a strong causal link with arts participation. Analysis of the case study interviews revealed five processes through which benefits relating to empowerment were brought about. We argue that psychological empowerment is in itself important for people with mental health needs. In addition, our case studies indicate that some arts and mental health projects do empower participants at a social as well as individual level.
Art in Mind: implementation of a community arts initiative to promote mental health
Authors: Stickley Theodore , Duncan Kate
Published: August 2011

The arts and health agenda has experienced considerable expansion in the UK in recent years, against a backdrop of increasing social inequality and rising incidence of mental health problems. This paper explores the role of community arts in combating social and mental health inequalities as exemplified by one particular project, Art in Mind, in Nottingham, which is funded by England's New Deal for Communities programme and is designed to promote mental health. In describing Art in Mind's conceptualisation and implementation, attention is given to the importance of developing community networks that are designed to build social capital for participating groups and individuals, in order to combat health and social inequalities.
Start: a creative approach to mental health care
Authors: Teall Wendy
Published: August 2011

Start Manchester is an arts‐based, face‐to‐face mental health service within the emergent field of arts in mental health. This article describes its work and demonstrates how it uses art in a health‐focused way. While the article refers to some of the literature that explores how and why the experience of art can be beneficial to mental health, it is explicitly written from a practitioner perspective. As such, it foregrounds the thoughts/feelings of the service users (referred to throughout as students) about their engagement with the project, in order to refine our understandings of the links between creative practices and mental health.
From the 60s to their sixties. Baby boomers — challenges and choices for public mental health
Authors: Williamson Toby
Published: August 2011

This commentary considers the demographic ‘bulge’ of the so‐called ‘baby boomer’ generation and the public mental health challenge that this group will represent as they move into old age. Toby Williamson argues that now is the time to start a debate with the aim of identifying long‐term solutions to these new challenges.
Integrating the promotion of child mental health into national policies for health sector reform
Authors: Caan Woody , Jenkins Rachel
Published: August 2011

To promote stable mental well‐being during childhood (from birth to 19‐years‐old) should be a major priority for governments. This is the time within the lifespan when children will learn and develop the most, so positive influences are greatest at a young age. This paper reports recommendations suggested by a workshop held in London in 2006, organised by the World Health Organization Collaborating Centre, Institute of Psychiatry, King's College London. The workshop considered the core components of effective methods of integrating mental health within health (and other public sector) reforms, which would be relevant to future strategic planning in diverse, national settings. One of the key policy topics considered by the workshop was child mental health. Recommendations were made by the group for incorporating developmentally appropriate actions, at multiple levels: in family, school and community environments.
Work‐related distress in the 1990s ‐ a real increase in ill health?
Authors: Stansfeld Stephen , Woodley‐Jones Davina , Rasul Farhat , Head Jenny , Clarke Simon , Mackay Colin
Published: August 2011

Over recent years there have been massive changes in working life and workplaces. Across the 1990s there has been a marked increase in reports of work‐related psychological distress in the UK. This paper uses the results of the most recent Occupational Health Decennial supplement (Office for National Statistics (ONS) & Health and Safety Executive (HSE), 2007), based on nationally representative data sources on distress at work, working conditions, sickness absence and psychiatric morbidity to examine the reasons for the apparent increase in work‐related psychological distress.
CBT and the challenge of primary care: developing effective, efficient, equitable, acceptable and accessible services for common mental health problems
Authors: White Jim
Published: August 2011

Recent guidelines suggest that cognitive behavioural therapy (CBT) has a pivotal role to play in the treatment of common mental health problems (CMHPs). There is a danger that we simply ask for ‘more of the same’ instead of looking at all the current limitations preventing individuals from accessing appropriate help. Doing this leads us to aim for a more radical and innovative approach to the CMHPs. This paper suggests that progress in primary care mental health has been much more limited than mental health workers and, in particular, researchers often acknowledge. It looks at the major obstacles barring the way to the development of services that could meet the needs of the very large number of people in our communities with CMHPs.
Evaluation of SHINE — Make Every Child Count: a school‐based community intervention programme
Authors: Akrimi Sonia , Raynor Sophie , Johnson Richard , Wylie Ann
Published: August 2011

Many barriers to health and emotional well‐being for children are prevalent within inner‐city communities, and often result in negative consequences for education. Health promotion strategies have previously cited mentoring schemes as interventions through which targeted pastoral support can be effectively provided to children. This paper draws on detailed focus group interviews in order to evaluate SHINE ‐ Make Every Child Count, a student‐led charity operating five mentoring programmes across the London boroughs of Southwark and Lambeth. Following content analysis, this paper identifies six themes associated with mentor support: rapport; emotional well‐being and development; social behaviour; enabling; emerging ambition; and attitudinal development. Results show participant children have gained considerable enjoyment from mentor support. Successful friendships are built and emotional well‐being supported, with children actively including mentors as part of their support network. Children recognise the impact of a mentor on relationships with peers, behaviour within the classroom and social responsibility, in addition to direct educational support. Children also show an increased interest in learning, and evidence of considering ‐ often for the first time ‐ their own future aspirations. Findings demonstrate the impact of the mentoring programmes, as perceived by participant children. Evaluation can be used to inform future development of the programmes, as well as expansion to further schools, with the organisation working towards achieving long‐term sustainability.
Influences of lifestyle and general practice (GP) care on the symptom profile of people with panic disorder
Authors: Lambert Rodney , Caan Woody , McVicar Andrew
Published: August 2011

Current treatment guidelines for anxiety disorders, including panic disorder (PD), recommend either medication or cognitive behavioural therapy (CBT). There is currently a call through the Layard Report for significant investment to increase the availability of CBT resources. However, there are reported limitations to both medication and CBT in the treatment of anxiety, and it appears prudent to consider additional methods of treatment that may offer effective interventions. One such intervention is based around the evidence of altered sensitivity within a number of physiological body systems in anxiety patients (particularly those with PD), all of which are influenced in their function by habitual lifestyle behaviours. A randomised controlled trial compared a 16‐week occupational therapy‐led lifestyle intervention and routine general practice (GP) care for PD. At 20 weeks, 14 symptoms with ‘moderate’ to ‘very severe’ ratings were assessed in 36 GP and 31 lifestyle‐intervention patients. Composite symptom profiles, similar at baseline, were produced. The GP intervention produced modest improvements in most symptoms. The lifestyle intervention overall produced greater symptomatic relief (Wilcoxon signed ranks test, P= 0.008). The physiological and cognitive symptom profile also changed more with lifestyle intervention. Occupational therapists have developed their interventions based on their understanding of everyday occupation. Habitual lifestyle behaviours are characterised as being recurrent elements of everyday occupation and are, therefore, legitimate targets for occupational therapy interventions. They provide a vehicle through which to encourage patients to regain understanding and control of their own anxiety symptoms.