Search

This paper explores how neoliberal ideologies inform both social and political agendas that influence how social workers can provide support to trans and gender diverse people attempting to access gender-affirming healthcare, using an analysis of social workers' experiences working in mental health in Nova Scotia, Canada. Qualitative semi-structured interviews provide a perspective of the experiences of social workers in Nova Scotia and how their ability to provide mental health services to trans and gender diverse people is impacted by neoliberalism. Most social workers attributed the structural context of working within a bio-medical system as contributing to social workers being disempowered, undermined, and not able to practice according to the values of their profession thus limiting their ability to provide affirming mental health supports to trans and gender diverse people in ways that align with their social work professional ethics and values. Through examining how neoliberal ideologies create notions of ideal social citizens by controlling the body, the paper explores how lived experience of neoliberal practices in mental health social work reinforce transnormativity. This paper highlights the necessity for social workers to resist dominant neoliberal and medicalized discourses which serve as mechanisms of power and control. The paper concludes with recommendations for social work practice with trans and gender diverse populations. [ABSTRACT FROM AUTHOR]

In 2019, Hurricane Dorian wreaked widespread havoc across the Province of Nova Scotia, with significant, adverse impacts affecting citizens and government services for a protracted period. This paper describes the challenges faced by the provincial emergency management and business continuity response teams. It argues that storm response requires a flexible top-down approach, with senior leadership delegating responsibility and encouraging locally-driven decision-making. Using examples from Hurricane Dorian, the paper shows that as emergency response and business continuity overlap, response teams must find a balance between the protection of life and property and safeguarding the continuity of business. This can be accomplished through strategic support from senior leadership, the adoption of evolving best practices and competency development through training and realistic exercise scenarios. [ABSTRACT FROM AUTHOR]

Epidemiology of mental disorders emerged in the post-1945 era at the intersections of different areas of knowledge. Given its ambitions, the Stirling County Study provides an instructive case study. It is also a good example of how the epidemiology applied methodological skills from social sciences. This paper aims, first, to reconstruct one of the first episodes in the development of psychiatric epidemiology. Its second purpose is to provide a detailed description of interdisciplinarity at work, and to examine its effects. After explaining some of the major features of the Stirling County Study, I emphasize the links between some of the first results, particularly regarding young people as a population at risk, and the job market after the Great Depression. [ABSTRACT FROM AUTHOR]

Background: Since March 2023, hundreds of fires have burned from coast to coast throughout the country, placing Canada on track to have the worst wildfire season ever recorded. From East to West, provinces such as Quebec, Ontario, Nova Scotia, Alberta, and British Columbia have been particularly affected by large and uncontrollable wildfires. Objectives: The objective of this study was to determine the prevalence of depression symptoms and predictors among residents living in extreme climate conditions during the Canadian wildfires of 2023 in Alberta and Nova Scotia and to update the literature with data related to those wildfires. Methods: A cross-sectional quantitative survey was conducted in this study. REDCap was used to administer an online survey between 14 May and 23 June 2023. Through the Text4Hope program, participants subscribe to receive supportive SMS messages daily. As part of the initial welcome message, participants were invited to complete an online questionnaire, containing demographic information, wildfire-related information, and responses to the Patient Health Questionnaire-9 (PHQ-9) for depression assessment. SPSS version 25 was used to analyze the data. Descriptive, univariate, and multivariate regression analyses were employed. Results: A total of 298 respondents completed the survey out of 1802 who self-subscribed to the Text4Hope program in Alberta and Nova Scotia and received a link to the online survey, producing a response rate of 16.54%. Most of the respondents were females (85.2%, 253), below 40 years of age (28.3%, 84), employed (63.6%, 189), and in a relationship (56.4%, 167). A historical depression diagnosis (OR = 3.15; 95% CI: 1.39–7.14) was a significant predictor of moderate to severe MDD in our study. The unemployed individuals were two times more likely to report moderate to severe symptoms of MDD than employed individuals (OR = 2.46; 95% CI: 1.06–5.67). Among the total sample population, the moderate to severe MDD prevalence was 50.4%, whereas it was 56.1% among those living in areas affected by wildfires. Conclusion: Based on our study findings, unemployment and a history of depression diagnosis were independently significant risk factors associated with the developing moderate to severe MDD symptoms during wildfire disasters. Further research is required to identify robust predictors of mental health disorders in disaster survivors and provide appropriate interventions to the most vulnerable communities and individuals. [ABSTRACT FROM AUTHOR]

Objectives: This paper describes the experience and evaluation of a shared care project targeted at marginalized individuals living in the North End of Halifax, Nova Scotia. This population has high rates of psychiatric disorder, often comorbid with chronic medical conditions, and people have difficulty in obtaining the help they need. This primary care liaison service covers all ages and includes outreach to emergency shelters, transitional housing and drop-in centres. Collaborative care improved access, satisfaction and outcomes for marginalized individuals in urban settings. Primary care providers with access to the service reported greater comfort in dealing with mental health problems, and satisfaction with collaborative care, as well as mental health services in general. Results were significantly better than those of control practices when such data were available. The median wait time was 6 days in comparison with 39.5 days for the comparison site. Conclusions: This model can complement other initiatives to improve the health of marginalized populations, and may be relevant to Australia. [ABSTRACT FROM AUTHOR]

Introduction: Anti-Black racism is a social determinant of health that has significantly impacted Black children and families. Limited research has examined anti-Black racism during the early years—a critical period of development. In this study, we sought to understand the manifestations of anti-Black racism in early childhood and explore its impact on Black children and families. Methods: This qualitative research project was informed by critical race theory, Black Critical Theory and interpretive description. Early childhood educators (ECEs) and parents with Black children between the ages of 18 months and 5 years (n = 15) participated in virtual, semistructured interviews. Results: Awareness of and protection against anti-Black racism was a constant in Black families’ lives. Parents felt as though they had to remain hypervigilant and overprotective of their Black children, knowing they were liable to encounter racial violence. The early learning environment was a source of heightened stress for families, given the significant amount of time young children spend in child care. Black children were often “othered” in predominately White spaces and had been objectified by White ECE staff and children. Parents worked to instill a strong sense of self-confidence in their children to counteract the negative impacts of racial discrimination. Conclusion: Results from this study suggest that children as young as 18 months are experiencing racial violence and adverse childhood experiences. Findings may contribute to antiracist policy development and a focus on more inclusive early childhood education for Black children and families. [ABSTRACT FROM AUTHOR]

Objectives: Pregnancy-Specific Perinatal Anxiety (PSPA) is an understudied mental health condition of pregnancy that may affect maternal-fetal health outcomes. The purpose of this study was to determine the prevalence of PSPA among pregnant women in the province of Nova Scotia, Canada, as well as the factors associated with it. Methods: A sample of 90 pregnant women provided data on PSPA symptomology and demographic co-variables via a self-report online survey. The prevalence of PSPA in the sample was calculated and bivariate statistics and binomial logistic regression were conducted to assess the relationship between the presence of PSPA and the independent variables. Results: The prevalence of PSPA in our sample was 17.8%. Smoking during pregnancy and a pre-pregnancy diagnosis of anxiety were significantly associated with meeting the criteria for PSPA (p = 0.008 and p = 0.013, respectively) and strongly predicted the presence of PSPA (odds ratio 8.54 and 3.44, respectively). Conclusions for Practice: A significant proportion of participants in our sample experienced symptoms consistent with a diagnosis of PSPA. This underscores the importance of further research on PSPA as a unique phenomenon in pregnant women, and the impact it may have on fetal and maternal health outcomes. A greater clinical emphasis should be placed on screening for and treating mental health conditions of pregnancy, including PSPA. Significance: Anxiety in pregnancy affects maternal, fetal, and child health outcomes. A distinction – in terms of definition and diagnostic criteria – exists between generalized anxiety disorder (GAD) affecting pregnant women and pregnancy-specific perinatal anxiety (PSPA). The latter is a condition that has been identified as affecting pregnant women uniquely and with distinct clinical impact, but few studies have made effort to distinguish it from GAD when studying its prevalence and impact on health. This study examines the prevalence of PSPA exclusively and the variables associated with it to provide insight on the importance of this distinct clinical phenomena. [ABSTRACT FROM AUTHOR]

Although recovery after birth can be promoted through bodily movement, many women do not engage in regular postpartum physical activity. While research studies have identified some of the reasons behind their decisions, including a lack of time, only a limited number of studies have been carried out to explore how postpartum physical activity is socially and institutionally constructed. Thus, the present study aimed to investigate the experiences of women regarding postpartum physical activity in Nova Scotia. Six postpartum mothers participated in semi-structured, virtual, in-depth interviews. Women's experiences of postpartum physical activity were examined through a discourse analysis guided by feminist poststructuralism. The following themes were identified: (a) socialization in different ways; (b) social support; (c) mental and emotional health; and (d) being a good role model for their children. The findings indicated that all women perceived postpartum exercise as a positive behavior that can promote mental health, although some postpartum mothers experienced social isolation and a lack of support. Furthermore, social discourses about motherhood caused the personal needs of mothers to be disregarded. The results showed that collaboration among health care providers, mothers, investigators, and community groups is necessary to promote and support mothers' engagement in postpartum physical activity. [ABSTRACT FROM AUTHOR]

Background Educators can play an important role in early identification and triage of youth with mental disorders. This paper reports findings of a program evaluation of the 'Go-To' Educator Training in a secondary school setting. Methods Pre- and posttests were administered. Results Participant mean scores on mental health competencies changed from 12 (40%) (standard deviation [ SD] = 4.3) pretraining to 21 (70%) ( SD = 3.3) posttraining, t(119) = 25.6, p < .0001, d = 2.3. Participant attitude mean scores improved from 49.9 ( SD = 4.6) pretraining, to 51.5 ( SD = 4.2), t(115) = 4.3, p < .0001, d = 0.36. Conclusions This training is a useful intervention to help educators identify youth with mental disorders and link them to appropriate services. [ABSTRACT FROM AUTHOR]

Publicly funded home care in Canada supports older adults in the community to delay institutional care, which results in complex care populations with multimorbidity that includes mental health problems. The purpose of this study is to examine prevalence of psychiatric diagnoses and other mental health symptoms among older clients in two publicly funded Home Care (HC) Programs and their psychiatry service utilization (psychiatrist visits) after being admitted to home care. This retrospective cohort study examines clients age 60 years and older in the two Canadian provinces of Manitoba (MB), specifically the Winnipeg Regional Health Authority (WRHA) (n = 5,278), and Nova Scotia (NS) (n = 5,323). Clients were admitted between 2011 and 2013 and followed up to 4 years. Linked data sources include the InterRAI Resident Assessment Instrument for Home Care (RAI-HC), physician visit/billing data and hospital admission data. Both regions had similar proportions (53%) of home care clients with one or more psychiatric diagnoses. However, we observed over 10 times the volume of psychiatry visits in the WRHA cohort (8,246 visits vs. 792 visits in NS); this translated into a 4-fold increased likelihood of receiving psychiatry visits (17.2% of WRHA clients vs. 4.2% of NS clients) and 2.5 times more visits on average per client (9.1 avg. visits in MB vs. 3.6 avg. visits in NS). The location of psychiatry services varied, with a greater number of psychiatry visits occurring while in hospital for WRHA HC clients compared to more visits in the community for NS HC clients. Younger age, psychotropic medication use, depressive symptoms, dementia, and having an unstable health condition were significantly associated with receipt of psychiatry visits in both cohorts. Access to psychiatric care differed between the cohorts despite little to no difference in need. We conclude that many home care clients who could have benefitted from psychiatrist visits did not receive them. This is particularly true for rural areas of NS. By linking the RAI-HC with other health data, our study raises important questions about differential access to psychiatry services by site of care (hospital vs. community), by geographical location (MB vs. NS and urban vs. rural) and by age. This has implications for staff training and mental health resources in home care to properly support the mental health needs of clients in care. Study results suggest the need for a mental health strategy within public home care services. [ABSTRACT FROM AUTHOR]

With the increase of South Asian immigrants in Canada, the relationship between older immigrant Punjabi women's sociocultural relationships and their mental health and well-being needs to be understood. Guided by the social determinants of health and intersectional feminist frameworks, five Punjabi women living in Nova Scotia, Canada were interviewed. Three themes were identified: (a) having freedom yet being dependent on families, (b) conflating having a happy family with having good mental health, and (c) needing ways to connect with other older Punjabi women. These findings articulate how Punjabi relationships affect women's views on mental health and well-being. [ABSTRACT FROM AUTHOR]

Given that few youth with mental health service needs actually seek help, understanding their perceptions of barriers is important. We examined principal individual, community, and systemic barriers to help-seeking, and compared barriers by population density (rural/small city), gender, age, and mental health status. Questionnaires were delivered to Cape Breton High School students. Stigma, lack of education, and awareness about resources emerged as prevalent barriers. Individual level barriers were a greater concern for rural youth; small city youth were more affected by systems level barriers. Finally, an interaction effect was found whereby rural youth with no mental health issues were least likely to report community level barriers as impediments to help-seeking. [ABSTRACT FROM AUTHOR]

This article employs appreciative inquiry to investigate factors that mediate or foster rural well-being in Tatamagouche and Advocate Harbour, Nova Scotia. Study participants identified many factors involved in bolstering well-being: community engagement, an appreciation of the natural magnificence, vibrant arts and culture, citizen efficacy, and a sense of shared responsibility. They also included environmental sustainability, healthy lifestyles, self-sufficiency, being hospitable, compassionate, and responsible citizens with playful and grateful spirits. Further study is needed to substantiate the factors that could help mediate rural well-being. [ABSTRACT FROM PUBLISHER]

Registration as a psychologist in Nova Scotia can be at the master’s or doctoral level; however, the Nova Scotia Board of Examiners in Psychology has announced a move to the doctoral degree as the entry-level to practice. Many school psychologists in Nova Scotia practice at the master’s level; therefore, this change could affect school psychology training and practice. School psychologists in Nova Scotia have indicated that they wish to expand their roles to include more intervention and consultation, and teachers have also indicated that they would like more access to psychologists in their schools. Given recent calls to increase access to mental health services for children and youth, school psychologists could play an important role in service provision in this province. The move to doctoral-level registration may provide the impetus to begin important conversations about role expansion for school psychologists. [ABSTRACT FROM AUTHOR]

Purpose: Few studies of adolescent suicidality have examined its associations with social capital. We explored associations of measures of individual level social capital with self-reported suicide ideation and suicide attempt in adolescents in Cape Breton, Nova Scotia, Canada, controlling for other factors known to be associated with adolescent suicidality. Methods: We surveyed 1,597 grade 10-12 students at three high schools in 2006 using self-completion questionnaires. Both sexes were combined for analysis. Outcome measures were suicidal ideation and attempt in the previous year. Measures of social capital included perceptions of trustworthiness and helpfulness of others at school, frequency of religious attendance and participation in extracurricular activities. Logistic regressions were carried out to determine associations of social capital with suicidality while controlling for other factors. Results: Perceived trustworthiness and helpfulness were protective for suicidal ideation and suicide attempt in the previous year. In adjusted analyses, there were interactions of gender and social capital-females reporting more social capital were more protected from suicide attempt relative to males with similar levels of social capital. Conclusions: This study provides initial evidence of protective associations of individual level social capital with adolescent suicidality. Our findings suggest that among adolescents low social capital as measured by perceptions of trust and helpfulness of others at school may be a warning sign for suicidality, particularly for females. It may be helpful to inquire of young people how they perceive the trustworthiness and helpfulness of their school environment as a measure of how supportive that environment might be to them when they are facing challenges to their mental health. [ABSTRACT FROM AUTHOR]

This mixed-methods study explored the racism-related experiences of 50 mid-life African-heritage women living in Nova Scotia, Canada, along with their use of spirituality as a coping strategy for dealing with racism-related stress. Four standardised instruments, along with qualitative in-depth interviews, were used to examine women's experiences of racism, depression, stress, and spirituality. Spirituality provided a key coping mechanism for racism-related stress, providing church community, spiritual community, faith, guidance, a personal relationship with God, and a source of meaning-making. For some women, spiritual belief provided a means of cognitive reinterpretation, allowing them to make sense of racism and other life challenges, recasting these as tests and trials which they were capable of surmounting with God's blessing and protection. Implications for mental health practitioners include working with spiritual and religious venues to help lessen stigma against mental health problems. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)