Interventions To Improve Mental Health & Wellbeing - Diversity, Positive Psychology And Transdiagnostic Approach

Front 1

Characteristics Protected Under Equality Act

Back 1

1) Age
2) Disability
3) Gender reassignment
4) Marriage/civil partnership
5) Pregnancy/maternity
6) Race
7) Religion/belief
8) Sex
9) Sexual orientation

Front 2

Why Does Diversity Matter?

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1) Legislative Framework: Human Rights Act, Equality Act
2) Healthcare Policy Context: NHS ethos
3) Practice Context: epidemiology (disease prevalence) useful for designing support services

Front 3

LGBT Mental Health

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- 1.5 times higher risk: depression, anxiety, substance use
- 2-4 times higher risk of suicide in gay men
- Self-harm rates twice general population
- Discrimination, social stress, concealment, stigma internalised homophobia

Front 4

Minority Differences in Mental Health

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- African/Black Caribbean: lower common mental disorders, higher sever mental illness (schizophrenia)
- Asian: low suicide/depression in men, high in women, high alcohol in Indian men
- White Irish: high depression, alcohol use, suicide - especially men

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Women's Mental Health

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- Overall no difference between men and women
- Women more likely to suffer depression, OCD, PTSD
- Less likely suicide

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Downside of Choice

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- Regret: anticipation and post-decision
- Opportunity costs
- High expectations
- Social comparisons
- Learned helplessness and self-blame

Front 7

Self-Determination Theory

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- When basic psychological needs of relatedness, competence and autonomy are satisfied: well-being is enhanced
- Ryan & Deci (2000)

Front 8

3 Routes to Happiness

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- Seligman (2003)
1) The Pleasant Life: positive emotion, gratification
2) The Good Life: Absorption, engagement, 'going with the flow'
3) The Meaningful Life: Using your strengths in service of something greater than yourself (i.e. religion/charity)

Front 9

Subjective Well-Being

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= Life Satisfaction + High Positive Affect + Low Negative Affect
- Life Satisfaction: discrepancy between present situation and what is thought to be ideal/deserved standard

Front 10

WHOQOL-BREF

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- WHO Quality of Life questionnaire
- Measures Domains: physical health, psychological health, social relationships, environment
- Used by Dept. of Mental Health & Addiction Services (DMHAS) study
- Used for developing policies/procedures
- Measures weather QoL improvements work
- Shows where support needed

Front 11

Gillison et al. (2009)

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- Meta-analysis 56 studies on exercise interventions effect on QoL
- 3 subgroups: healthy, rehabilitation, disease management
- Moderate positive effect of exercise on QoL for rehabilitation
- Healthy: significantly higher physical/psychological QoL than controls
- Disease management: significantly lower psych QoL than controls
- Light intensity (group) exercise improves overall QoL, moderate intensity improves physical QoL

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Limitations of Disorder-Based Therapies

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- Many different disorders: train therapist in models for treating all?
- Average number of sessions attended around 5
- Greatest treatment gains in first session
- 30-80% patients have comorbid disorders
- Standardised diagnosis not conducted

Front 13

Key Factors Shared Across Disorders

Back 13

- Pivotal papers
- Biology (e.g. COMT gene)
- Social factors (e.g. expressed emotion)
- Transdiagnostic CBT for Eating Disorders

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Harvey, Watkins, Mansell & Shafran (2004)

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- Systematic review of cognitive and behavioural processes in Adult Axis 1 Disorders
- Criteria for transdiagnostic process: strong methodology, present in ALL disorders (more than 4)
- 12 definite transdiagnostic processes found (+ 3 possible)
- Helps understand comorbidity and inform new treatment