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WOS: 000469650000001, This paper explores the role positive attachment relationship plays in improving children's social and emotional development. In doing so, we are using the Attachment Theory as our principle theoretical framework. We carried out qualitative interviews with 18 teachers and school staff working in a primary school setting located in a deprived neighbourhood of Istanbul, Turkey. Significant number of children attending this school had experienced social and emotional problems. We devised an innovative psychosocial programme where 40 university student mentors and their professors provided weekly psychosocial support to 160 year-one and year-two primary schoolchildren over a period of 8 months. The objective was to create a secure proximity zone from which the university students acted the older and more knowledgeable secondary caregivers to the schoolchildren. This paper evaluates the teachers' perceptions of the effectiveness of the attachment-informed psychosocial programme on children's social and emotional wellbeing., Maltepe University, The attachment-based psychosocial programme we implemented would not have been possible without the support it received from the Maltepe University and the local municipality where the school is located. We would like to thank the psychology students, teachers, headmaster, school management and school support staff for the pivotal roles they played during the formation and delivery of the psychosocial programme.

Early School Leaving (ESL) is a complex phenomenon caused by multidimensional factors spanning personal, social and economic problems. We carried out two online surveys with 796 teachers and 900 students from Bulgaria, Italy, Malta, Romania and Turkey completed standard electronic surveys. The teachers’ survey consisted of secondary school teachers from Bulgaria (N = 147), Italy (N = 105), Malta (N = 71), Romania (n = 261), and Turkey (N = 212). For the second survey, 250 secondary school students from Bulgaria, 109 from Italy, 67 from Malta and 401 students from Turkey took part in the study. From the teachers’ findings, cultural factors, school related factors, family issues, economic reasons, peer pressures and individual life accounts were all indicated as the causes of early school leaving in all 5 partner countries We crossed-examined the data from the teachers with those of their students. From the student survey, coming from families with difficult life experiences, having family responsibilities, having difficult relationships with other students and having little interest in the learning process were linked with early school leaving. The paper brings attention to the need to revisit educational and social policies in response to the significant number of children in Europe leaving school early with low level educational attainment.

WOS: 000401802800005, Correctional officers working in detention centres have the primary responsibilities of maintaining safety and security within the walls of restrictive institutions by closely monitoring, supervising and managing inmates and prisoners with a history of violence and problematic behaviours. Particularly, the demands of providing service to detained children and adolescent groups with traumatic life events, deviance, criminality and negligence can provoke powerful and overwhelming negative emotions. These adverse emotional responses include feelings of sadness, hopelessness, helplessness, depersonalisation, frustration and guilt, which are felt by correctional officers who are involved in the care of vulnerable young people who are perceived to pose a threat to society. In the research described in this paper we used both quantitative and qualitative research methods to collect data from correctional officers. We used content analysis on the qualitative transcripts and carried out statistical analyses on a range of measures comparing the levels of burnout, depression, anxiety, job satisfaction and positive and negative affect before and after joining the Psychosocial Support Program (PSP). Our findings suggested that PSP helped to reduce burnout, depression and anxiety levels among the correctional officers who took part in the programme. At the end of programme, participants reported increased job satisfaction, decreased emotional exhaustion, decreased depersonalisation and increased personal accomplishment.

Autism (AUT) is one of the most prevalent developmental disorders emerging during childhood, and can be amongst the most incapacitating mental disorders. Some individuals with AUT require a lifetime of supervised care. Autism Speaks reported estimated costs for 2012 at £34 billion in the UK; and $3.2 million-$126 billion in the US, Australia and Canada. Ethnicity and migration experiences appear to increase risks of AUT and relate to underlying biological risk factors. Sociobiological stress factors can affect the uterine environment, or relate to stress-induced epigenetic changes during pregnancy and delivery. Epigenetic risk factors associated with AUT also include poor pregnancy conditions, low birth weight, and congenital malformation. Recent studies report that children from migrant communities are at higher risk of AUT than children born to non-migrant mothers, with the exception of Hispanic children. This paper provides the first systematic review into prevalence and predictors of AUT with a particular focus on maternal migration stressors and epigenetic risk factors. AUT rates appear higher in certain migrant communities, potentially relating to epigenetic changes after stressful experiences. Although AUT remains a rare disorder, failures to recognize its public health urgency and local community needs continue to leave certain cultural groups at a disadvantage.

Global migration is reaching record high levels and UK migrant groups comprise an increasing proportion of the total population. The migratory process causes stress that can affect mental health. There is limited consistent empirical evidence of a longitudinal nature to explain the association between migration and mental health. This review aims to examine the evidence of a relationship between migration and common mental disorder (CMD) amongst migrants over time. A comprehensive search of medical and psychiatric databases for global quantitative empirical studies investigating incidence of CMD amongst adult migrants from 1975 to July 2012 was conducted. Declines in rates of CMD amongst migrants over time were reported by two thirds of the 18 studies reviewed, less than one third of which were statistically significant. On the contrary, three studies showed an increased rate of CMD, one statistically significant. Individual psychological resources, social support, the acculturation process, cultural variations and time since relocation are identified as statistically significant protective factors against the development of CMD amongst migrants. New enlightening points include the significant impact of varying patterns of psychological distress, of which negative is the most adverse for CMD. Migration is an extremely complex process. Further clarification is needed to gain deeper understanding of the relationship between migration and CMD to address contradictions in the literature and health inequalities amongst migrants.

WOS: 000424170200002, Child laborers are typically subjected to multiple and chronic traumatic experiences. With no parents or caregivers to act as a buffer zone against stressors, they grow up in chaotic and unpredictable work environments. Child laborers are more at risk of developing a range of psychological, emotional, and behavioral problems. The authors established an 8-month psychosocial support program for child laborers and young people attending a vocational training center one day a week. The authors found that anxiety and depression moderately correlated with negative self-concept, somatization, and hostility. Toward the end of the 8-month program, participants reported improved psychological and emotional well-being. The provision of a safe and mediated psychosocial program enhanced the emotional and mental wellbeing of vulnerable children and young people., Istanbul Development Agency, The implementation of the program would have not been possible without the funding provided by the Istanbul Development Agency.

After the 7/7 bombings radicalisation became a homegrown issue in the UK with Muslims born and brought up here being responsible for the attacks. This has had a subsequent impact on wellbeing and social cohesion in the UK. It feels the Government’s strategy of tackling radicalisation is ineffective and maybe paradoxically serving to increase recruitment to radical groups. There is limited primary research from a sociological or a psychological perspective on the issue of radicalisation amongst the Muslim community in the UK. Two focus groups with six men and ten women, aged between 22 and 56, were established to determine the meaning of radicalisation to Muslims, gather experiences of the impact of the concept of radicalisation on the wellbeing of the Muslim community, understand more about the sociological and psychological processes that lead to radicalisation and gather in-group perspectives on how to tackle radicalisation as a means to promote social cohesion. Islamophobic media coverage and discrimination affected the wellbeing of the Muslim community resulting in a more orthodox religious identity. Drivers of radicalisation were perceived to include inequalities, and misrepresentation of Islamic teachings. Solutions to tackle radicalisation and promote social cohesion included authentic Islamic education, greater integration and reducing inequalities with greater acceptance by the Muslim community alongside more responsible journalism. Although further work is needed in Muslim communities, there also needs to be work done on non-Muslim communities to further understand the impact of extremism on social cohesion and wellbeing.

Within an action research framework, this investigation used a mixed-method case-study approach to investigate what impact character education has on school climate and pupil behavior within a primary school situated in an Education Action Zone of East Anglia, England. Both quantitative and qualitative data sets suggest that the implementation of a multicomponent socioculturally inspired character-education program can have positive effects on school climate, pupil behavior, and staff morale. In addition, the findings indicate that there is a positive effect on the school's ability to meet the social, emotional, and cognitive needs of pupils following the implementation of a whole-school prosocial development program rooted in empirical evidence from psychological and educational research.

Aim: To investigate the relationship between (i) khat use and (ii) traumatic events, with measures of common psychotic symptoms and symptoms of anxiety and depression. To undertake this work in a Somali population of emigrants who have sought asylum in a non-conflict zone country. Materials & Methods: A secondary analysis of data on a population sample of 180 Somali men and women. Results: Frequency of khat use was not associated with common psychotic symptoms or with symptoms of anxiety and depression, nor with traumatic events in this population. Traumatic events were related to low levels of psychotic symptoms and high levels of symptoms of anxiety and depression. Conclusions: Khat use is not inevitably linked to psychotic symptoms in population samples of Somali men and women. The contrasts between these findings and those from studies in conflict zones and studies of people with mental health problems using khat suggest further investigations are necessary. These should take account environmental and physiological interactions.

The numbers of refugees and asylum seekers shows little sign of decreasing. An increased prevalence of stress-related common mental disorders in these populations is well documented. The causes of these conditions vary according to stresses experienced and the journeys individuals take in their migration to new countries and cultural settings. The mental health practitioner must be informed of the cultural idioms by which suffering is expressed in the refugee's community, the social stigma associated with particular traumatic experiences and with mental illness. Because of their experiences of victimization, refugees may be reluctant to disclose experiences of trauma and, as is typical of common mental disorder worldwide, the presentation of mental distress in the first instance is often in the guise of somatic complaints. The specific needs of this group will include dealing with traumatic experiences without pathologizing normal human responses.

Khat has been used as a stimulant plant in many parts of Africa and the Arabian Peninsula for centuries. Its current use among particular migrant communities in Europe and elsewhere has caused alarm among policy makers and health care professionals. In the United Kingdom, the debate over the psychiatric and social implications of khat use has led to a demand for stricter legal control of this stimulant plant. This paper (a) provides a historical overview of khat use, and (b) reviews the evidence for the existence of a causal link between khat use and mental illness. To do so, we undertook a detailed search of social and medical science databases for case reports, qualitative and quantitative articles on khat use and mental illness from 1945 to 2006. The validity and reliability of the studies that met our inclusion criteria were examined. Lastly, although highlighting health concerns about khat use we suggest that the debate about this popular drug in migrant populations carries elements of a 'moral panic'. There is a need for improved research on khat use and its possible association with psychiatric disorders.

Migration is known to be associated with poor health outcomes for certain marginalised and socially disadvantaged populations. This paper reviews a number of reasons why residential mobility in the 'host' country may be associated with poor mental health for refugee populations and reports on a qualitative study of Somalis living in London, UK, and their beliefs about the relationship between residential mobility, poor health and health service use. Two discussion groups were undertaken with 13 Somali professionals and four groups with 21 lay Somalis in East and South London, UK. Lay Somalis did not wish to move accommodation but felt they were forced to move. Some Somali professionals believed that the nomadic history of Somalis made them more likely to elect to move in order to escape problems of living, but this was not supported by the lay group. Frequent geographical movements were seen as stressful and undesirable, disrupted family life and child development and were detrimental to well being. Residential mobility was also perceived to interfere with health care receipt and therefore should be more comprehensively assessed in larger quantitative studies.

This systematic review looked at the utilisation of treatment, access to treatment and referral of ethnic minorities for treatment of eating disorders in western settings. It also aimed to explore the barriers in access and utilisation of treatment including the role of acculturation.The review included both qualitative and quantitative studies. The search identified a total of 2786 articles. Out of the 2786 articles, 12 articles (1 qualitative and 11 quantitative) were selected for the purpose of the research.The review showed that ethnic minority communities in UK and USA were far less likely to seek and receive treatment for their eating disorders and also less likely to be diagnosed and referred to eating disorder services or clinics for treatment of their eating disorders. Referral bias of ethnic minority participants to specialist eating disorder services were found in three quantitative studies (Waller et al. 2009, Becker et al. 2003, Abbas et al. 2010). The review also found that more accultured ethnic minority participants were more likely to seek treatment for their eating disorders.The above study has shown that ethnic minorities are less likely to have access to treatment for Eating Disorders.

Background The discourse about mental health problems among migrants and refugees tends to focus on adverse pre-migration experiences; there is less investigation of the environmental conditions in which refugee migrants live, and the contrasts between these situations in different countries. This cross-national study of two samples of Somali refugees living in London (UK) and Minneapolis, Minnesota, (USA) helps to fill a gap in the literature, and is unusual in being able to compare information collected in the same way in two cities in different countries. Methods There were two parts to the study, focus groups to gather in-depth qualitative data and a survey of health status and quantifiable demographic and material factors. Three of the focus groups involved nineteen Somali professionals and five groups included twenty-eight lay Somalis who were living in London and Minneapolis. The quantitative survey was done with 189 Somali respondents, also living in London and Minneapolis. We used the MINI International Neuropsychiatric Interview (MINI) to assess ICD-10 and DSM-IV mental disorders. Results The overall qualitative and quantitative results suggested that challenges to masculinity, thwarted aspirations, devalued refugee identity, unemployment, legal uncertainties and longer duration of stay in the host country account for poor psychological well-being and psychiatric disorders among this group. Conclusion The use of a mixed-methods approach in this international study was essential since the quantitative and qualitative data provide different layers and depth of meaning and complement each other to provide a fuller picture of complex and multi-faceted life situations of refugees and asylum seekers. The comparison between the UK and US suggests that greater flexibility of access to labour markets for this refugee group might help to promote opportunities for better integration and mental well-being.

Aim of the study: To investigate the relationship between (i) khat use and (ii) traumatic events, with measures of common psychotic symptoms and symptoms of anxiety and depression. To undertake this work in a Somali population of emigrants who have sought asylum in a non-conflict zone country.Materials and methods: A secondary analysis of data on a population sample of 180 Somali men and women.Results: Frequency of khat use was not associated with common psychotic symptoms or with symptoms of anxiety and depression, nor with traumatic events in this population. Traumatic events were related to low levels of psychotic symptoms and high levels of symptoms of anxiety and depression.Conclusions: Khat use is not inevitably linked to psychotic symptoms in population samples of Somali men and women. The contrasts between these findings and those from studies in conflict zones and studies of people with mental health problems using khat suggest further investigations are necessary. These should take into account environmental and physiological interactions.

To investigate the relationship between (i) khat use and (ii) traumatic events, with measures of common psychotic symptoms and symptoms of anxiety and depression. To undertake this work in a Somali population of emigrants who have sought asylum in a non-conflict zone country.A secondary analysis of data on a population sample of 180 Somali men and women.Frequency of khat use was not associated with common psychotic symptoms or with symptoms of anxiety and depression, nor with traumatic events in this population. Traumatic events were related to low levels of psychotic symptoms and high levels of symptoms of anxiety and depression.Khat use is not inevitably linked to psychotic symptoms in population samples of Somali men and women. The contrasts between these findings and those from studies in conflict zones and studies of people with mental health problems using khat suggest further investigations are necessary. These should take account environmental and physiological interactions.

Within the last decade the hitherto little known psychoactive substance of khat has emerged as a regional and international issue. In the Horn of Africa khat production has spurred an economic boom, but dramatic increases in consumption have raised public health concerns. Given the complexity of the topic spanning multiple academic disciplines and fields of professional practice, the need for a systematic overview is urgent. To facilitate the exchange of information, prompt interdisciplinary research and alert international organisations and governments, the authors organised an international and interdisciplinary khat conference in 2009. This special issue of the Journal of Ethnopharmacology contains articles written by different conference speakers that present the current state of knowledge and the challenges for future research and politics.

Aim: In this article, we comment on the current international discourse on khat, we highlight pitfalls and and suggest balanced national international regulatory actions. Method: A brief an focussed review of the available literature on khat and health and examples from our own research are provided. Results: The use patterns of catha edulis (khat) have changed throughout the last decades. During this period khat has had a remarkable economic boom and developed from a niche crop to the backbone of the regional economy. Now it contributes to the livelihoods of millions of people. Today, khat use is often the proverbial “Door in the wall” for large parts of the populations in African and Arab countries beyond the traditional user groups. Its use is often excessive and not restricted by social regulation mechanisms. Under such conditions, problematic khat use patterns develop rapidly, exemplified by the growing group of binge users, and it gets even prevalent among especially vulnerable groups such as children, people with mental disorders or pregnant women. The currently existing scientific evidence suggests that problematic use patterns not the use per se can be linked to numerous health consequences. Conclusion: This paper argues that changed patterns of khat use are a burden for some of the most underdeveloped countries in the world. But the debate around khat is stuck between extreme poles arguing for prohibition or for de-regulation. Here, we call for a balanced action of governments and international organizations leaving behind the decades of debilitating debate pro vs. contra scheduling and banning khat leaves. Instead, regulation and harm-reduction measures are urgently needed. We suggest a number of steps that should be taken immediately to better understand current khat use patterns, to address noxious excesses and to relieve suffering. © 2009 Elsevier Ireland Ltd. All rights reserved.

The authors discuss the public health implications of a new study on the use of khat and other drugs by Somali combatants.

There are few mental health data for Somali people. This is due to the absence of culturally validated appropriate assessment instruments and methodological challenges. We aimed to develop a culturally appropriate instrument, and address the methodological challenges and assess some risk factors for mental disorder among Somalis in London. Following a comprehensive process of cultural adaptation of the MINI Neuropsychiatric Interview, we assessed ICD-10 mental disorders among 143 Somalis recruited from GP registers and community sites. Associations with demographic and economic characteristics, sampling venues, cultural and migration related risk factors are reported. A higher risk of mental disorders was found among Somalis who used Khat (OR = 10.5, 1.1–98.3) claimed asylum at entry to the UK (OR = 12.8, 2–81.4) and recruits from primary care rather than from community sites (OR = 5.9, 1.4–25.8). A lower risk of mental disorders was found amongst Somalis in employment (OR = 0.03, 0.01–0.61), and those receiving education in the UK and in Somalia (OR = 0.13, 0.02–0.92). Over a third of subjects had any mental disorder (36.4%, 28.4–44.4), mainly common mental disorders (CMD) (33.8%, 26–41.5) and post-traumatic stress disorder (PTSD) (14%, 8.8–20.8). CMD were found among 80% of those with PTSD. Public health interventions for Somalis should focus on CMD as well as PTSD, khat use and mental health screening for suicide risk and mental disorders on arrival.

Objective: To assess the mental health needs and service use of Somali refugees living in London. Method: Subjects (n = 143) were sampled from conventional and non-conventional sites. Needs and service use were measured using the Camberwell Assessment of Need and the Client Service Receipt Inventory, respectively. Comparisons between sites were made and cost predictors identified. Results: Basic needs occurred frequently but were often not fully addressed. The mean number of needs was around four out of a possible 22. The most used services were GPs, other clinicians and refugee services. Higher non-inpatient costs were associated with length of stay in the UK and lower costs with being at risk of suicide and having panic disorder or agoraphobia. Conclusion: Somali refugees living in London have a relatively high level of need but a low level of service use. Refugee characteristics could only account for a limited amount of cost variation.

The need for accurate information about the mental health problems of multicultural communities requires valid measures of mental health for use in a number of languages and cultural contexts. Measures of psychopathological symptoms leading to a diagnosis have been especially criticised for their universal application, without attention to their limitations across cultures. Yet, measures are crucial to assess recovery and the performance of services, and to take account of carer and user views. We summarise the main challenges in the cultural adaptation of such measures in our work with adults and adolescents of South Asian, African and Caribbean origin.

Background Ensuring Cultural Competence (CC) in health care is a mechanism to deliver culturally appropriate care and optimise recovery. In policies that promote cultural competence, the training of mental health practitioners is a key component of a culturally competent organisation. This study examines staff perceptions of CC and the integration of CC principles in a mental healthcare organisation. The purpose is to show interactions between organisational and individual processes that help or hinder recovery orientated services. Methods We carried out a case study of a large mental health provider using a cultural competence needs analysis. We used structured and semi-structured questionnaires to explore the perceptions of healthcare professionals located in one of the most ethnically and culturally diverse areas of England, its capital city London. Results There was some evidence that clinical staff were engaged in culturally competent activities. We found a growing awareness of cultural competence amongst staff in general, and many had attended training. However, strategic plans and procedures that promote cultural competence tended to not be well communicated to all frontline staff; whilst there was little understanding at corporate level of culturally competent clinical practices. The provider organisation had commenced a targeted recruitment campaign to recruit staff from under-represented ethnic groups and it developed collaborative working patterns with service users. Conclusion There is evidence to show tentative steps towards building cultural competence in the organisation. However, further work is needed to embed cultural competence principles and practices at all levels of the organisation, for example, by introducing monitoring systems that enable organisations to benchmark their performance as a culturally capable organisation.

This article has been retracted at the joint request of the publisher, the editor and the authors. Reason: The editorswould like to confirm the retraction of this paper at the request of the authors. This articlewas erroneously published n issue 131/2 (2010). The correct and full version of this article has been published in issue 132/3 (2010). The publisher would like to pologize for any inconvenience caused.

Background Cultural competency is now a core requirement for mental health professionals working with culturally diverse patient groups. Cultural competency training may improve the quality of mental health care for ethnic groups. Methods A systematic review that included evaluated models of professional education or service delivery. Results Of 109 potential papers, only 9 included an evaluation of the model to improve the cultural competency practice and service delivery. All 9 studies were located in North America. Cultural competency included modification of clinical practice and organizational performance. Few studies published their teaching and learning methods. Only three studies used quantitative outcomes. One of these showed a change in attitudes and skills of staff following training. The cultural consultation model showed evidence of significant satisfaction by clinicians using the service. No studies investigated service user experiences and outcomes. Conclusion There is limited evidence on the effectiveness of cultural competency training and service delivery. Further work is required to evaluate improvement in service users' experiences and outcomes.

Background Postnatal depression (PND) is an important health problem of global relevance for maternal health and impacts on the health and wellbeing of the child over the life-course. Multinational data is hard to locate, the economic burden of PND on health care systems have been calculated in several countries, including Canada and in the UK. In Canada, health and social care costs for a mother with PND were found to be just over twice that of mothers with no mental illness. The extra community care cost for women with PND living in the UK was found to be £35.7 million per year. Method We carried out a systematic search to the literature to investigate the associations between attachment style and PND, using meta-narrative analysis methods, reporting statistical data and life narratives. The following databases were searched: PsycInfo, PsycExtra Web of Science, The Cochrane Library and Pubmed. We focused on research papers that examined adult attachment styles and PND, and published between 1991 and 2013. We included any papers showing relationship between maternal adult attachment and PND. Out of 353 papers, 20 met the study inclusion criteria, representing a total of 2306 participants. Data from these 20 studies was extracted by means of a data extraction table. Results We found that attachment and PND share a common aetiology and that ‘insecure adult attachment style’ is an additional risk factor for PND. Of the insecure adult attachment styles, anxious styles were found to be associated with PND symptoms more frequently than avoidant or dismissing styles of attachment. Conclusion More comprehensive longitudinal research would be crucial to examine possible cause-effect associations between adult attachment style (as an intergenerational construct and risk factor) and PND (as an important maternal mental health), with new screening and interventions being essential for alleviating the suffering and consequences of PND. If more is understood about the risk profile of a new or prospective mother, more can be done to prevent the illness trajectory (PND); as well as making existing screening measures and treatment options more widely available. Electronic supplementary material The online version of this article (doi:10.1186/s40359-014-0056-x) contains supplementary material, which is available to authorized users.